1,049 research outputs found
Multi-modal Biomarkers Quantify Recovery in Autoimmune Autonomic Ganglionopathy
Objective:
To evaluate patients with ganglionic acetylcholine receptor antibody (gAChRâAb) positive autoimmune autonomic ganglionopathy using a multiâmodal testing protocol to characterise their full clinical phenotype and explore biomarkers to quantify immunotherapy response.
Methods:
Cohort study of thirteen individuals (seven female; 21â69âyears) with autonomic failure and gAChRâAb>100pM identified between 2005â2019. From 2018, all patients were longitudinally assessed with cardiovascular, pupillary, urinary, sudomotor, lacrimal and salivary testing, and COMPASSâ31 autonomic symptom questionnaires. The orthostatic intolerance ratio was calculated by dividing change in systolic blood pressure over time tolerated on headâup tilt. Eleven patients received immunotherapy.
Results:
At first assessment, all 13 patients had cardiovascular and pupillary impairments, 7/8 had postâganglionic sudomotor dysfunction, 9/11 had urinary retention and xeropthalmia, and 6/8 had xerostomia. After immunotherapy, there were significant improvements in orthostatic intolerance ratio (33.3[17.8â61.3] to 5.2[1.4â8.2], P = .007), heart rate response to deep breathing (1.5[0.0â3.3] to 4.5[3.0â6.3], P = .02), pupillary constriction to light (12.0[5.5â18.0] to 19.0[10.6â23.8]%, P = .02), saliva production (0.01[0.01â0.05] to 0.08[0.02â0.20]g/min, P = .03) and COMPASSâ31 scores (52 to 17, P = .03). Orthostatic intolerance ratio correlated with autonomic symptoms at baseline (r = 0.841, P = .01) and following immunotherapy (r = 0.889, P = .02). Immunofluorescence analyses of skin samples from a patient 32âyears after disease onset showed loss of nerve fibres supplying the dermal autonomic adnexa and epidermis, with clear improvements following immunotherapy.
Interpretation:
Patients with autoimmune autonomic ganglionopathy demonstrated objective evidence of widespread sympathetic and parasympathetic autonomic failure, with significant improvements after immunotherapy. Quantitative autonomic biomarkers should be used to define initial deficits, guide therapeutic decisions, and document treatment response
Gender Differences in Mortality and CD4 Count Response Among Virally Suppressed HIV-Positive Patients
Treatment outcomes for antiretroviral therapy (ART) patients may vary by gender, but estimates from current evidence may be confounded by disease stage and adherence. We investigated the gender differences in treatment response among HIV-positive patients virally suppressed within 6 months of treatment initiation
Cold gas accretion in galaxies
Evidence for the accretion of cold gas in galaxies has been rapidly
accumulating in the past years. HI observations of galaxies and their
environment have brought to light new facts and phenomena which are evidence of
ongoing or recent accretion:
1) A large number of galaxies are accompanied by gas-rich dwarfs or are
surrounded by HI cloud complexes, tails and filaments. It may be regarded as
direct evidence of cold gas accretion in the local universe. It is probably the
same kind of phenomenon of material infall as the stellar streams observed in
the halos of our galaxy and M31. 2) Considerable amounts of extra-planar HI
have been found in nearby spiral galaxies. While a large fraction of this gas
is produced by galactic fountains, it is likely that a part of it is of
extragalactic origin. 3) Spirals are known to have extended and warped outer
layers of HI. It is not clear how these have formed, and how and for how long
the warps can be sustained. Gas infall has been proposed as the origin. 4) The
majority of galactic disks are lopsided in their morphology as well as in their
kinematics. Also here recent accretion has been advocated as a possible cause.
In our view, accretion takes place both through the arrival and merging of
gas-rich satellites and through gas infall from the intergalactic medium (IGM).
The infall may have observable effects on the disk such as bursts of star
formation and lopsidedness. We infer a mean ``visible'' accretion rate of cold
gas in galaxies of at least 0.2 Msol/yr. In order to reach the accretion rates
needed to sustain the observed star formation (~1 Msol/yr), additional infall
of large amounts of gas from the IGM seems to be required.Comment: To appear in Astronomy & Astrophysics Reviews. 34 pages.
Full-resolution version available at
http://www.astron.nl/~oosterlo/accretionRevie
Lattice Boltzmann simulations of soft matter systems
This article concerns numerical simulations of the dynamics of particles
immersed in a continuum solvent. As prototypical systems, we consider colloidal
dispersions of spherical particles and solutions of uncharged polymers. After a
brief explanation of the concept of hydrodynamic interactions, we give a
general overview over the various simulation methods that have been developed
to cope with the resulting computational problems. We then focus on the
approach we have developed, which couples a system of particles to a lattice
Boltzmann model representing the solvent degrees of freedom. The standard D3Q19
lattice Boltzmann model is derived and explained in depth, followed by a
detailed discussion of complementary methods for the coupling of solvent and
solute. Colloidal dispersions are best described in terms of extended particles
with appropriate boundary conditions at the surfaces, while particles with
internal degrees of freedom are easier to simulate as an arrangement of mass
points with frictional coupling to the solvent. In both cases, particular care
has been taken to simulate thermal fluctuations in a consistent way. The
usefulness of this methodology is illustrated by studies from our own research,
where the dynamics of colloidal and polymeric systems has been investigated in
both equilibrium and nonequilibrium situations.Comment: Review article, submitted to Advances in Polymer Science. 16 figures,
76 page
Centrifuge modelling of the effects of root geometry on transpiration-induced suction and stability of vegetated slopes
Interventional radiology virtual simulator for liver biopsy
Purpose
Training in Interventional Radiology currently uses the apprenticeship model, where clinical and technical skills of invasive procedures are learnt during practice in patients. This apprenticeship training method is increasingly limited by regulatory restrictions on working hours, concerns over patient risk through traineesâ inexperience and the variable exposure to case mix and emergencies during training. To address this, we have developed a computer-based simulation of visceral needle puncture procedures.
Methods
A real-time framework has been built that includes: segmentation, physically based modelling, haptics rendering, pseudo-ultrasound generation and the concept of a physical mannequin. It is the result of a close collaboration between different universities, involving computer scientists, clinicians, clinical engineers and occupational psychologists.
Results
The technical implementation of the framework is a robust and real-time simulation environment combining a physical platform and an immersive computerized virtual environment. The face, content and construct validation have been previously assessed, showing the reliability and effectiveness of this framework, as well as its potential for teaching visceral needle puncture.
Conclusion
A simulator for ultrasound-guided liver biopsy has been developed. It includes functionalities and metrics extracted from cognitive task analysis. This framework can be useful during training, particularly given the known difficulties in gaining significant practice of core skills in patients
Cephalometric effects of the Jones Jig appliance followed by fixed appliances in Class II malocclusion treatment
The effects of electrical hippocampal kindling of seizures on amino acids and kynurenic acid concentrations in brain structures
Our study demonstrated that the development of seizures during the electrically induced kindling of seizures is associated with significant changes in the concentration of kynurenic acid (KYNA) and its precursor, tryptophan (TRP). The primary finding of our study was an increase in KYNA levels and the KYNA/TRP ratio (a theoretical index of activity of the kynurenine pathway) in the amygdala and hippocampus of kindled animals. We also found decreases in the concentration of tryptophan in the hippocampus and prefrontal cortex. Changes in the concentration of KYNA and TRP in the amygdala were accompanied by a significant decrease in Îł-Aminobutryic Acid (GABA) levels and an increase in the glutamate/GABA ratio. Moreover, we found a significant negative correlation between the local concentrations of KYNA and glutamate in the amygdala of kindled rats. However, there were no changes in the local concentrations of the following amino acids: glutamate, aspartate, glutamine, glycine, taurine and alanine. In conclusion, these new results suggest a modulatory influence of KYNA on the process of epileptogenesis, characterized by a negative relationship between the KYNA and glutamate systems in the amygdala
Measurement of the Dipion Mass Spectrum in X(3872) -> J/Psi Pi+ Pi- Decays
We measure the dipion mass spectrum in X(3872)--> J/Psi Pi+ Pi- decays using
360 pb-1 of pbar-p collisions at 1.96 TeV collected with the CDF II detector.
The spectrum is fit with predictions for odd C-parity (3S1, 1P1, and 3DJ)
charmonia decaying to J/Psi Pi+ Pi-, as well as even C-parity states in which
the pions are from Rho0 decay. The latter case also encompasses exotic
interpretations, such as a D0-D*0Bar molecule. Only the 3S1 and J/Psi Rho
hypotheses are compatible with our data. Since 3S1 is untenable on other
grounds, decay via J/Psi Rho is favored, which implies C=+1 for the X(3872).
Models for different J/Psi-Rho angular momenta L are considered. Flexibility in
the models, especially the introduction of Rho-Omega interference, enable good
descriptions of our data for both L=0 and 1.Comment: 7 pages, 4 figures -- Submitted to Phys. Rev. Let
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