A Cross-Sectional Survey of the Association between Bilateral Topical Prostaglandin Analogue Use and Ocular Adnexal Features

We studied the relation between prostaglandin analogue use and ocular adnexal features. We used a prospective, cross-sectional study involving 157 current, 15 past, and 171 never users of prostaglandin analogues. Patients 50 years of age or older and without conditions affecting ocular adnexal anatomy underwent glaucoma medication use history, external digital photography and systematic external adnexal exam. Two masked readers assessed the digital photos for upper lid dermatochalasis and lower lid steatoblepharon using a validated grading scheme. Another masked clinical examiner also assessed upper lid ptosis, levator muscle function, and inferior scleral show. We performed ordinal logistic regression analysis accounting for multiple covariates to assess the relation between prostaglandin analogue use and adnexal features. Multivariable analyses indicated there was a 230-fold increased risk of incremental involution of dermatochalasis (odds ratio (OR) = 2.30; 95% confidence interval (CI) 1.43–3.69; p = 5.44E-04) and a 249-fold increased risk of incremental loss of lower lid steatoblepharon (OR = 2.49; 95% CI, 1.54–4.03; p = 1.98E-04) associated with current prostaglandin analogue use (bimatoprost 0.03%, travoprost 0.005%, or latanoprost 0.004%) versus prostaglandin analogue never or past users. Upper lid ptosis (OR = 4.04; 95% CI, 2.43–6.72; p = 7.37E-08), levator dysfunction (OR = 7.51; 95% CI, 3.39–16.65; p = 6.74E-07) and lower lid retraction (OR = 2.60; 95% CI, 1.58–4.28; p = 1.72E-04) were highly associated with current prostaglandin analogue use versus prostaglandin analogue never or past users. The associations between prostaglandin analogue use and deepening of the upper lid sulci and between prostaglandin analogue use and loss of inferior periorbital fat are confirmed in this multivariable analysis. The associations between prostaglandin analogue use and levator muscle dysfunction and between prostaglandin analogue use and upper lid ptosis represent significant side effects that could impact visual function in glaucoma patients

Parker/buoyancy instabilities with anisotropic thermal conduction, cosmic rays, and arbitrary magnetic field strength

We report the results of a local stability analysis for a magnetized, gravitationally stratified plasma containing cosmic rays. We account for cosmic-ray diffusion and thermal conduction parallel to the magnetic field and allow beta to take any value, where p is the plasma pressure and B is the magnetic field strength. We take the gravitational acceleration to be in the -z-direction and the equilibrium magnetic field to be in the y-direction, and we derive the dispersion relation for small-amplitude instabilities and waves in the large-|k_x| limit. We use the Routh-Hurwitz criterion to show analytically that the necessary and sufficient criterion for stability in this limit is n k_B dT/dz + dp_cr/dz + (1/8pi)dB^2/dz > 0, where T is the temperature, n is the number density of thermal particles, and p_cr is the cosmic-ray pressure. We present approximate analytical solutions for the normal modes in the low- and high-diffusivity limits, show that they are consistent with the derived stability criterion, and compare them to numerical results obtained from the full, unapproximated, dispersion relation. Our results extend earlier analyses of buoyancy instabilities in galaxy-cluster plasmas to the beta <= 1 regime. Our results also extend earlier analyses of the Parker instability to account for anisotropic thermal conduction, and show that the interstellar medium is more unstable to the Parker instability than was predicted by previous studies in which the thermal plasma was treated as adiabatic.Comment: 36 pages, 2 figures, Accepted for publication in Ap

Continuum Halos in Nearby Galaxies -- an EVLA Survey (CHANG-ES) -- I: Introduction to the Survey

We introduce a new survey to map the radio continuum halos of a sample of 35 edge-on spiral galaxies at 1.5 GHz and 6 GHz in all polarization products. The survey is exploiting the new wide bandwidth capabilities of the Karl G. Jansky Very Large Array (i.e. the Expanded Very Large Array, or EVLA) in a variety of array configurations (B, C, and D) in order to compile the most comprehensive data set yet obtained for the study of radio halo properties. This is the first survey of radio halos to include all polarization products. In this first paper, we outline the scientific motivation of the survey, the specific science goals, and the expected improvements in noise levels and spatial coverage from the survey. Our goals include investigating the physical conditions and origin of halos, characterizing cosmic ray transport and wind speed, measuring Faraday rotation and mapping the magnetic field, probing the in-disk and extraplanar far-infrared - radio continuum relation, and reconciling non-thermal radio emission with high-energy gamma-ray models. The sample size allows us to search for correlations between radio halos and other properties, including environment, star formation rate, and the presence of AGNs. In a companion paper (Paper II) we outline the data reduction steps and present the first results of the survey for the galaxy, NGC 4631.Comment: 17 pages, 1 figure, accepted to the Astronomical Journal, Version 2 changes: added acknowledgement to NRA

Large-scale cis- and trans-eQTL analyses identify thousands of genetic loci and polygenic scores that regulate blood gene expression

Trait-associated genetic variants affect complex phenotypes primarily via regulatory mechanisms on the transcriptome. To investigate the genetics of gene expression, we performed cis- and trans-expression quantitative trait locus (eQTL) analyses using blood-derived expression from 31,684 individuals through the eQTLGen Consortium. We detected cis-eQTL for 88% of genes, and these were replicable in numerous tissues. Distal trans-eQTL (detected for 37% of 10,317 trait-associated variants tested) showed lower replication rates, partially due to low replication power and confounding by cell type composition. However, replication analyses in single-cell RNA-seq data prioritized intracellular trans-eQTL. Trans-eQTL exerted their effects via several mechanisms, primarily through regulation by transcription factors. Expression of 13% of the genes correlated with polygenic scores for 1,263 phenotypes, pinpointing potential drivers for those traits. In summary, this work represents a large eQTL resource, and its results serve as a starting point for in-depth interpretation of complex phenotypes

Proof of concept of an accelerometer as a trigger for unilateral diaphragmatic pacing: a porcine model

Abstract Background Unilateral diaphragmatic paralysis in patients with univentricular heart is a known complication after pediatric cardiac surgery. Because diaphragmatic excursion has a significant influence on perfusion of the pulmonary arteries and hemodynamics in these patients, unilateral loss of function leads to multiple complications. The current treatment of choice, diaphragmatic plication, does not lead to a full return of function. A unilateral diaphragmatic pacemaker has shown potential as a new treatment option. In this study, we investigated an accelerometer as a trigger for a unilateral diaphragm pacemaker (closed-loop system). Methods Seven pigs (mean weight 20.7 ± 2.25 kg) each were implanted with a customized accelerometer on the right diaphragmatic dome. Accelerometer recordings (mV) of the diaphragmatic excursion of the right diaphragm were compared with findings using established methods (fluoroscopy [mm]; ultrasound, M-mode [cm]). For detection of the amplitude of diaphragmatic excursions, the diaphragm was stimulated with increasing amperage by a cuff electrode implanted around the right phrenic nerve. Results Results with the different techniques for measuring diaphragmatic excursions showed correlations between accelerometer and fluoroscopy values (correlation coefficient 0.800, P < 0.001), accelerometer and ultrasound values (0.883, P < 0.001), and fluoroscopy and ultrasound values (0.816, P < 0.001). Conclusion The accelerometer is a valid method for detecting diaphragmatic excursion and can be used as a trigger for a unilateral diaphragmatic pacemaker

Multivariable odds ratio (95% confidence interval; p-value) for duration of current prostaglandin analogue (PGA) use in months associated with selected ocular adnexal features.

<p>The reported odds ratios (ORs) reflect likelihood of increasing scores. Increasing digital D score reflects loss of upper lid dermatochalasis judged from digital photos. Increasing digital S score reflects loss of lower lid steatoblepharon judged from digital photos. Increasing clinical P score reflects increasing upper lid ptosis as judged by a masked clinical observer. Increasing clinical L score reflects worsening levator function as judged by a masked clinical observer. Increasing clinical I score reflects increasing inferior scleral show as judged by a masked clinical observer.</p><p>• Data is for right eye. Digital scores reflect mean of 2 readers.</p><p>• Bonferroni correction calculation: 0.05/9 exposures×5 outcomes =  1.11E-03. p-values that are significant after Bonferroni correction are in bold.</p><p>• ORs are corrected for age, ethnicity, sex, use of other glaucoma medications, ocular disease such as age-related macular degeneration and glaucoma, systemic disease such as hypertension and diabetes, and history of ocular laser surgery using ordinal logistic regression.</p>*<p>Patients who were current travoprost users and current latanoprost users were excluded from this analysis. ** Patients who were current bimatoprost users and current latanoprost users were excluded from this analysis. *** Patients who were current bimatoprost users and current travoprost users were excluded from this analysis.</p

Multivariable odds ratio (95% confidence interval; p-value) for current prostaglandin analogue (PGA) use associated with selected ocular adnexal features.

<p>The reported odds ratios (ORs) reflect likelihood of increasing scores. Increasing digital D score reflects loss of upper lid dermatochalasis judged from digital photos. Increasing digital S score reflects loss of lower lid steatoblepharon judged from digital photos. Increasing clinical P score reflects increasing upper lid ptosis as judged by a masked clinical observer. Increasing clinical L score reflects worsening levator function as judged by a masked clinical observer. Increasing clinical I score reflects increasing inferior scleral show as judged by a masked clinical observer.</p><p>• Data is for the right eye. Digital scores reflect mean of 2 readers.</p><p>• Bonferroni correction calculation: 0.05/9 exposures x 5 outcomes =  1.11E-03. p-values that are significant after Bonferroni correction are in bold.</p><p>• ORs are corrected for age, ethnicity, sex, use of other glaucoma medications, ocular disease such as age-related macular degeneration and glaucoma, systemic disease such as hypertension and diabetes, and history of ocular laser surgery using ordinal logistic regression.</p>*<p>Patients who were current travoprost users and current latanoprost users were excluded from this analysis. ** Patients who were current bimatoprost users and current latanoprost users were excluded from this analysis. *** Patients who were current bimatoprost users and current travoprost users were excluded from this analysis.</p