The impact of psoriasis on wellbeing and clinical outcomes in juvenile psoriatic arthritis

Objectives: Juvenile psoriatic arthritis (JPsA) has varied clinical features that are distinctive to other juvenile idiopathic arthritis (JIA) categories. This study investigates whether such features impact patient-reported and clinical outcomes. // Methods: Children and young people (CYP) were selected if recruited to the Childhood Arthritis Prospective Study, a UK multicentre JIA inception cohort, between January 2001 and March 2018. At diagnosis, patient/parent-reported outcomes (as age-appropriate) included the parental global assessment (10 cm VAS), functional ability (CHAQ), pain (10 cm VAS), health-related quality of life (CHQ psychosocial score), mood/depressive symptoms (MFQ) and parent psychosocial health (GHQ). Three-year outcome trajectories have previously been defined using active joint counts, physician and parent global assessments (PGA, PaGA respectively). Patient-reported outcomes and outcome trajectories were compared in i) CYP with JPsA versus other JIA categories, ii) CYP within JPsA, with and without psoriasis via multivariable linear regression. // Results: There were no significant differences in patient-reported outcomes at diagnosis between CYP with JPsA and non-JPsA. Within JPsA, those with psoriasis had more depressive symptoms (coefficient = 9.8, 95% CI = 0.5–19.0) than those without psoriasis at diagnosis. CYP with JPsA had 2.3 times the odds of persistent high PaGA than other ILAR categories, despite improving joint counts and PGA (95% CI 1.2, 4.6). // Conclusion: CYP with psoriasis at JPsA diagnosis report worse mood, supporting a greater disease impact in those with both skin and joint involvement. Multidisciplinary care with added focus to support wellbeing in children with JPsA plus psoriasis may help improve these outcomes

Large-scale analyses of common and rare variants identify 12 new loci associated with atrial fibrillation

Atrial fibrillation affects more than 33 million people worldwide and increases the risk of stroke, heart failure, and death. Fourteen genetic loci have been associated with atrial fibrillation in European and Asian ancestry groups. To further define the genetic basis of atrial fibrillation, we performed large-scale, trans-ancestry meta-analyses of common and rare variant association studies. The genome-wide association studies (GWAS) included 17,931 individuals with atrial fibrillation and 115,142 referents; the exome-wide association studies (ExWAS) and rare variant association studies (RVAS) involved 22,346 cases and 132,086 referents. We identified 12 new genetic loci that exceeded genome-wide significance, implicating genes involved in cardiac electrical and structural remodeling. Our results nearly double the number of known genetic loci for atrial fibrillation, provide insights into the molecular basis of atrial fibrillation, and may facilitate the identification of new potential targets for drug discovery

Multi-ethnic genome-wide association study for atrial fibrillation

Atrial fibrillation (AF) affects more than 33 million individuals worldwide and has a complex heritability. We conducted the largest meta-analysis of genome-wide association studies (GWAS) for AF to date, consisting of more than half a million individuals, including 65,446 with AF. In total, we identified 97 loci significantly associated with AF, including 67 that were novel in a combined-ancestry analysis, and 3 that were novel in a European-specific analysis. We sought to identify AF-associated genes at the GWAS loci by performing RNA-sequencing and expression quantitative trait locus analyses in 101 left atrial samples, the most relevant tissue for AF. We also performed transcriptome-wide analyses that identified 57 AF-associated genes, 42 of which overlap with GWAS loci. The identified loci implicate genes enriched within cardiac developmental, electrophysiological, contractile and structural pathways. These results extend our understanding of the biological pathways underlying AF and may facilitate the development of therapeutics for AF

Atrial fibrillation genetic risk differentiates cardioembolic stroke from other stroke subtypes

AbstractObjectiveWe sought to assess whether genetic risk factors for atrial fibrillation can explain cardioembolic stroke risk.MethodsWe evaluated genetic correlations between a prior genetic study of AF and AF in the presence of cardioembolic stroke using genome-wide genotypes from the Stroke Genetics Network (N = 3,190 AF cases, 3,000 cardioembolic stroke cases, and 28,026 referents). We tested whether a previously-validated AF polygenic risk score (PRS) associated with cardioembolic and other stroke subtypes after accounting for AF clinical risk factors.ResultsWe observed strong correlation between previously reported genetic risk for AF, AF in the presence of stroke, and cardioembolic stroke (Pearson’s r=0.77 and 0.76, respectively, across SNPs with p &lt; 4.4 × 10−4 in the prior AF meta-analysis). An AF PRS, adjusted for clinical AF risk factors, was associated with cardioembolic stroke (odds ratio (OR) per standard deviation (sd) = 1.40, p = 1.45×10−48), explaining ∼20% of the heritable component of cardioembolic stroke risk. The AF PRS was also associated with stroke of undetermined cause (OR per sd = 1.07, p = 0.004), but no other primary stroke subtypes (all p &gt; 0.1).ConclusionsGenetic risk for AF is associated with cardioembolic stroke, independent of clinical risk factors. Studies are warranted to determine whether AF genetic risk can serve as a biomarker for strokes caused by AF.</jats:sec

Preliminary environmental risk consideration for small UAV ground risk mapping

Small unmanned aerial vehicles (sUAV) or 'drones' are projected to rapidly develop in the future and be employed for a multitude of applications such as parcel delivery, search and rescue, surveillance monitoring, and farming. Consequently, an increase in sUAV traffic may lead to a higher likelihood of failure, and crash occur primarily due to environmental factors. Hence, the objective of this study was to investigate the influence of environmental factors on sUAV operations.The study identifies three environmental risk categories relevant to Singapore’s context, namely weather, obstacle, and signal. Subsequently, Python code was developed to perform data analysis on environmental risk data gathered from open source, relevant agencies, and literature surveys. Three environmental risk factors were considered for proof of concept, namely rainfall, windspeed, bird population, and cell tower signal strength.From the data analysis, the average daily rainfall across weather stations in Singapore was observed to be 8.58 mm. In August, weather stations in West of Singapore, such as Choa Chu Kang and Tengah, reported the highest rainfall, approximately 22.65 mm. In contrast, weather stations in the East such as Changi and Pasir Ris reported the lowest rainfall near 0.036 mm in February. Data of the three most invasive bird species in Singapore was examined. The site of Chinese Garden in West Singapore reported the highest bird population of 432 birds per site. The study of bird population data potentially provides an insight into the possibility of sUAV bird strike events. Similarly, signal strength data from cell towers in Singapore was studied.Overall environmental risk-tiering can be visualized using all the analyzed environmental factors data on a risk map. The regions with high rainfall, increased bird population per site and strong signal interference can be extracted.These high-risk locations can be expected to be more hazardous for sUAVs to fly in. Findings for environmental risk-tiering and risk-mapping are preliminary and based on the available environmental data as identified in this study. Further research will be done to include other environmental risk factors and to generate better accuracy of the environmental risk-tier map. Insights from this study will facilitate the demarcation of low, medium, and high-risk areas for risk assessment of sUAVs operation in Singapore.Civil Aviation Authority of Singapore (CAAS)National Research Foundation (NRF)Submitted/Accepted versionThis research is supported by the National Research Foundation, Singapore, and the Civil Aviation Authority of Singapore, under the Aviation Transformation Programme

Pillars of salt

This project book is a documentation of the process taken to create "Pillars of Salt".Bachelor of Fine Arts in Media Ar