2,747 research outputs found
Recommended from our members
SEYFERT\u27S SEXTET: A SLOWLY DISSOLVING STEPHAN\u27S QUINTET?
We present a multiwavelength study of the highly evolved compact galaxy group known as Seyfert\u27s Sextet (HCG79: SS). We interpret SS as a 2-3 Gyr more evolved analog of Stephan\u27s Quintet (HCG92: SQ). We postulate that SS formed by sequential acquisition of 4-5 primarily late-type field galaxies. Four of the five galaxies show an early-type morphology which is likely the result of secular evolution driven by gas stripping. Stellar stripping has produced a massive/luminous halo and embedded galaxies that are overluminous for their size. These are interpreted as remnant bulges of the accreted spirals. H79d could be interpreted as the most recent intruder, being the only galaxy with an intact interstellar medium (ISM) and uncertain evidence for tidal perturbation. In addition to stripping activity we find evidence for past accretion events. H79b (NGC6027) shows a strong counter-rotating emission line component interpreted as an accreted dwarf spiral. H79a shows evidence for an infalling component of gas representing feedback or possible cross-fueling by H79d. The biggest challenge to this scenario involves the low gas fraction in the group. If SS formed from normal field spirals then much of the gas is missing. Finally, despite its advanced stage of evolution, we find no evidence for major mergers and infer that SS (and SQ) are telling us that such groups coalesce via slow dissolution
Kinetic roughening of ion-sputtered Pd(001) surface: Beyond the Kuramoto-Sivashinsky model
The kinetic roughening of Ar+ ion-sputtered Pd(001) surface was investigated. The facet formation on the sputtered surface was studied by tracing the extradiffraction peaks or satellites around the diffraction peaks corresponding to the sample surface. The morphological evolution of the sputtered Pd(001) surface was also investigated by an scanning tunneling microscopy (STM). It was shown that the nanoscale adatom islands form and grow with increasing sputter time.open313
Field-induced polarisation of Dirac valleys in bismuth
Electrons are offered a valley degree of freedom in presence of particular
lattice structures. Manipulating valley degeneracy is the subject matter of an
emerging field of investigation, mostly focused on charge transport in
graphene. In bulk bismuth, electrons are known to present a threefold valley
degeneracy and a Dirac dispersion in each valley. Here we show that because of
their huge in-plane mass anisotropy, a flow of Dirac electrons along the
trigonal axis is extremely sensitive to the orientation of in-plane magnetic
field. Thus, a rotatable magnetic field can be used as a valley valve to tune
the contribution of each valley to the total conductivity. According to our
measurements, charge conductivity by carriers of a single valley can exceed
four-fifth of the total conductivity in a wide range of temperature and
magnetic field. At high temperature and low magnetic field, the three valleys
are interchangeable and the three-fold symmetry of the underlying lattice is
respected. As the temperature lowers and/or the magnetic field increases, this
symmetry is spontaneously lost. The latter may be an experimental manifestation
of the recently proposed valley-nematic Fermi liquid state.Comment: 14 pages + 5 pages of supplementary information; a slightly modified
version will appear as an article in Nature physic
Prognostic Value of Stress Myocardial Perfusion Positron Emission Tomography: Results From A Multicenter Observational Registry
ObjectivesThe primary objective of this multicenter registry was to study the prognostic value of positron emission tomography (PET) myocardial perfusion imaging (MPI) and the improved classification of risk in a large cohort of patients with suspected or known coronary artery disease (CAD).BackgroundLimited prognostic data are available for MPI with PET.MethodsA total of 7,061 patients from 4 centers underwent a clinically indicated rest/stress rubidium-82 PET MPI, with a median follow-up of 2.2 years. The primary outcome of this study was cardiac death (n = 169), and the secondary outcome was all-cause death (n = 570). Net reclassification improvement (NRI) and integrated discrimination analyses were performed.ResultsRisk-adjusted hazard of cardiac death increased with each 10% myocardium abnormal with mildly, moderately, or severely abnormal stress PET (hazard ratio [HR]: 2.3 [95% CI: 1.4 to 3.8; p = 0.001], HR: 4.2 [95% CI: 2.3 to 7.5; p < 0.001], and HR: 4.9 [95% CI: 2.5 to 9.6; p < 0.0001], respectively [normal MPI: referent]). Addition of percent myocardium ischemic and percent myocardium scarred to clinical information (age, female sex, body mass index, history of hypertension, diabetes, dyslipidemia, smoking, angina, beta-blocker use, prior revascularization, and resting heart rate) improved the model performance (C-statistic 0.805 [95% CI: 0.772 to 0.838] to 0.839 [95% CI: 0.809 to 0.869]) and risk reclassification for cardiac death (NRI 0.116 [95% CI: 0.021 to 0.210]), with smaller improvements in risk assessment for all-cause death.ConclusionsIn patients with known or suspected CAD, the extent and severity of ischemia and scar on PET MPI provided powerful and incremental risk estimates of cardiac death and all-cause death compared with traditional coronary risk factors
Clinical risk factors and atherosclerotic plaque extent to define risk for major events in patients without obstructive coronary artery disease: the long-term coronary computed tomography angiography CONFIRM registry.
AimsIn patients without obstructive coronary artery disease (CAD), we examined the prognostic value of risk factors and atherosclerotic extent.Methods and resultsPatients from the long-term CONFIRM registry without prior CAD and without obstructive (≥50%) stenosis were included. Within the groups of normal coronary computed tomography angiography (CCTA) (N = 1849) and non-obstructive CAD (N = 1698), the prognostic value of traditional clinical risk factors and atherosclerotic extent (segment involvement score, SIS) was assessed with Cox models. Major adverse cardiac events (MACE) were defined as all-cause mortality, non-fatal myocardial infarction, or late revascularization. In total, 3547 patients were included (age 57.9 ± 12.1 years, 57.8% male), experiencing 460 MACE during 5.4 years of follow-up. Age, body mass index, hypertension, and diabetes were the clinical variables associated with increased MACE risk, but the magnitude of risk was higher for CCTA defined atherosclerotic extent; adjusted hazard ratio (HR) for SIS >5 was 3.4 (95% confidence interval [CI] 2.3-4.9) while HR for diabetes and hypertension were 1.7 (95% CI 1.3-2.2) and 1.4 (95% CI 1.1-1.7), respectively. Exclusion of revascularization as endpoint did not modify the results. In normal CCTA, presence of ≥1 traditional risk factors did not worsen prognosis (log-rank P = 0.248), while it did in non-obstructive CAD (log-rank P = 0.025). Adjusted for SIS, hypertension and diabetes predicted MACE risk in non-obstructive CAD, while diabetes did not increase risk in absence of CAD (P-interaction = 0.004).ConclusionAmong patients without obstructive CAD, the extent of CAD provides more prognostic information for MACE than traditional cardiovascular risk factors. An interaction was observed between risk factors and CAD burden, suggesting synergistic effects of both
Recommended from our members
Coronary atherosclerosis scoring with semiquantitative CCTA risk scores for prediction of major adverse cardiac events: Propensity score-based analysis of diabetic and non-diabetic patients.
AIMS:We aimed to compare semiquantitative coronary computed tomography angiography (CCTA) risk scores - which score presence, extent, composition, stenosis and/or location of coronary artery disease (CAD) - and their prognostic value between patients with and without diabetes mellitus (DM). Risk scores derived from general chest-pain populations are often challenging to apply in DM patients, because of numerous confounders. METHODS:Out of a combined cohort from the Leiden University Medical Center and the CONFIRM registry with 5-year follow-up data, we performed a secondary analysis in diabetic patients with suspected CAD who were clinically referred for CCTA. A total of 732 DM patients was 1:1 propensity-matched with 732 non-DM patients by age, sex and cardiovascular risk factors. A subset of 7 semiquantitative CCTA risk scores was compared between groups: 1) any stenosis ≥50%, 2) any stenosis ≥70%, 3) stenosis-severity component of the coronary artery disease-reporting and data system (CAD-RADS), 4) segment involvement score (SIS), 5) segment stenosis score (SSS), 6) CT-adapted Leaman score (CT-LeSc), and 7) Leiden CCTA risk score. Cox-regression analysis was performed to assess the association between the scores and the primary endpoint of all-cause death and non-fatal myocardial infarction. Also, area under the receiver-operating characteristics curves were compared to evaluate discriminatory ability. RESULTS:A total of 1,464 DM and non-DM patients (mean age 58 ± 12 years, 40% women) underwent CCTA and 155 (11%) events were documented after median follow-up of 5.1 years. In DM patients, the 7 semiquantitative CCTA risk scores were significantly more prevalent or higher as compared to non-DM patients (p ≤ 0.022). All scores were independently associated with the primary endpoint in both patients with and without DM (p ≤ 0.020), with non-significant interaction between the scores and diabetes (interaction p ≥ 0.109). Discriminatory ability of the Leiden CCTA risk score in DM patients was significantly better than any stenosis ≥50% and ≥70% (p = 0.003 and p = 0.007, respectively), but comparable to the CAD-RADS, SIS, SSS and CT-LeSc that also focus on the extent of CAD (p ≥ 0.265). CONCLUSION:Coronary atherosclerosis scoring with semiquantitative CCTA risk scores incorporating the total extent of CAD discriminate major adverse cardiac events well, and might be useful for risk stratification of patients with DM beyond the binary evaluation of obstructive stenosis alone
Analyzing Korean Public Health Centers’ Infectious Disease Disaster Response Experiences with a Focus on Business Continuity
Eun Kyoung Yun, Jeong-Won Han, Jung Ok Kim, Sungmo Jung, Jeongeun Cha, Keunhee Yoo, Soyoon Min, Boeun Yang College of nursing science, Kyung Hee University, Seoul, Republic of KoreaCorrespondence: Jeong-Won Han, College of Nursing Science, Kyung Hee University, 26, Kyunghee-daero, Dongdaemun-gu, Seoul, 02447, Republic of Korea, Tel/Fax +82-2-961-2123, Email [email protected]: This study aims to provide basic data for establishing strategies to maintain the core functions of health centers, and enable an effective response to emergency tasks in the event of future infectious disease disasters.Methods: The participants were 41 workers from two public health centers in Seoul. They all had prior experience in responding to the early and middle stages of the COVID-19 pandemic. Data were collected through Focus Group Discussions, and then analyzed using the deductive method of content analysis.Results: The participants’ experiences during the infectious disease disaster crisis were examined through ten categories: governance and coordination, information management, human resources, essential medical supplies and equipment, infrastructure, administration, finance and logistics, community engagement and risk communication, delivery of essential services, security, and additional considerations for vulnerable populations. The analysis of the results made it apparent that new systems and policies were imperative for responding appropriately to the concerns and experiences of the public healthcare center staff, and for improving the response to future epidemics.Conclusion: We found that to prepare for infectious disaster situations in the future, it is necessary for health centers to establish a mid- to long-term business continuity plan to ensure the continuation and stability of their operations. Additionally, it was found that health professionals in public health centers also believe in the necessity of education and training programs on disaster preparedness, based on Business Continuity Planning proposed by the World Health Organization. They deem these essential to sustain routine tasks for the management of the health of local community residents during outbreaks of novel infectious diseases in the future.Keywords: public health, disaster crisis, qualitative researc
The validity of using ICD-9 codes and pharmacy records to identify patients with chronic obstructive pulmonary disease
Background: Administrative data is often used to identify patients with chronic obstructive pulmonary disease (COPD), yet the validity of this approach is unclear. We sought to develop a predictive model utilizing administrative data to accurately identify patients with COPD.
Methods: Sequential logistic regression models were constructed using 9573 patients with postbronchodilator spirometry at two Veterans Affairs medical centers (2003-2007). COPD was defined as: 1) FEV1/FVC <0.70, and 2) FEV1/FVC < lower limits of normal. Model inputs included age, outpatient or inpatient COPD-related ICD-9 codes, and the number of metered does inhalers (MDI) prescribed over the one year prior to and one year post spirometry. Model performance was assessed using standard criteria.
Results: 4564 of 9573 patients (47.7%) had an FEV1/FVC < 0.70. The presence of ≥1 outpatient COPD visit had a sensitivity of 76% and specificity of 67%; the AUC was 0.75 (95% CI 0.74-0.76). Adding the use of albuterol MDI increased the AUC of this model to 0.76 (95% CI 0.75-0.77) while the addition of ipratropium bromide MDI increased the AUC to 0.77 (95% CI 0.76-0.78). The best performing model included: ≥6 albuterol MDI, ≥3 ipratropium MDI, ≥1 outpatient ICD-9 code, ≥1 inpatient ICD-9 code, and age, achieving an AUC of 0.79 (95% CI 0.78-0.80).
Conclusion: Commonly used definitions of COPD in observational studies misclassify the majority of patients as having COPD. Using multiple diagnostic codes in combination with pharmacy data improves the ability to accurately identify patients with COPD.Department of Veterans Affairs, Health Services Research and Development (DHA), American Lung Association (CI- 51755-N) awarded to DHA, the American Thoracic Society Fellow Career Development AwardPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/84155/1/Cooke - ICD9 validity in COPD.pd
- …