102 research outputs found

    The cardiac complications of COVID-19; many publications, multiple uncertainties

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    Since the first description of COVID-19 in December 2019, more than 63,000 publications have described its virology, clinical course, management, treatment and prevention. Most physicians are now encountering, or will soon encounter, patients with COVID-19 and must attempt to simultaneously assimilate this avalanche of information while managing an entirely novel disease with few guiding precedents. It is increasingly clear that, although primarily a respiratory illness, COVID-19 is associated with cardiovascular complications. However, the true incidence of direct cardiac complications remains unclear, as all complications thus far reported can also occur in patients without COVID19. In this review, we briefly summarise and critically appraise the data on cardiac complications associated with COVID-19 and describe some cases from our own experience. We identify unresolved questions and highlight the many uncertainties in this developing field

    Fertility, Living Arrangements, Care and Mobility

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    There are four main interconnecting themes around which the contributions in this book are based. This introductory chapter aims to establish the broad context for the chapters that follow by discussing each of the themes. It does so by setting these themes within the overarching demographic challenge of the twenty-first century – demographic ageing. Each chapter is introduced in the context of the specific theme to which it primarily relates and there is a summary of the data sets used by the contributors to illustrate the wide range of cross-sectional and longitudinal data analysed

    A qualitative study of behavioral and social drivers of COVID-19 vaccine confidence and uptake among unvaccinated Americans in the US April-May 2021

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    Introduction Around one-third of Americans reported they were unwilling to get a COVID-19 vaccine in April 2021. This focus group study aimed to provide insights on the factors contributing to unvaccinated adults’ hesitancy or refusal to get vaccinated with COVID-19 vaccines. Method Ipsos recruited 59 unvaccinated US adults who were vaccine hesitant (i.e., conflicted about or opposed to receiving a COVID-19 vaccination) using the Ipsos KnowledgePanel. Trained facilitators led a total of 10 focus groups via video-conference in March and April 2021. Two coders manually coded the data from each group using a coding frame based on the focus group discussion guide. The coding team collaborated in analyzing the data for key themes. Results Data analysis of transcripts from the focus groups illuminated four main themes associated with COVID-19 vaccine hesitancy: lack of trust in experts and institutions; concern about the safety of COVID-19 vaccines; resistance towards prescriptive guidance and restrictions; and, despite personal reluctance or unwillingness to get vaccinated, acceptance of others getting vaccinated. Discussion Vaccine confidence communication strategies should address individual concerns, describe the benefits of COVID-19 vaccination, and highlight evolving science using factural and neutral presentations of information to foster trust

    Brane inflation revisited after WMAP five-year results

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    In this paper, we revisit brane inflation models with the WMAP five-year results. The WMAP five-year data favor a red-tilted power spectrum of primordial fluctuations at the level of two standard deviations, which is the same as the WMAP three-year result qualitatively, but quantitatively the spectral index is slightly greater than the three-year value. This result can bring impacts on brane inflation models. According to the WMAP five-year data, we find that the KKLMMT model can survive at the level of one standard deviation, and the fine-tuning of the parameter ÎČ\beta can be alleviated to a certain extent at the level of two standard deviations.Comment: 23 pages, 11 figure

    Dynamic control of a single-server system with abandonments

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    In this paper, we discuss the dynamic server control in a two-class service system with abandonments. Two models are considered. In the first case, rewards are received upon service completion, and there are no abandonment costs (other than the lost opportunity to gain rewards). In the second, holding costs per customer per unit time are accrued, and each abandonment involves a fixed cost. Both cases are considered under the discounted or average reward/cost criterion. These are extensions of the classic scheduling question (without abandonments) where it is well known that simple priority rules hold. The contributions in this paper are twofold. First, we show that the classic c-Ό rule does not hold in general. An added condition on the ordering of the abandonment rates is sufficient to recover the priority rule. Counterexamples show that this condition is not necessary, but when it is violated, significant loss can occur. In the reward case, we show that the decision involves an intuitive tradeoff between getting more rewards and avoiding idling. Secondly, we note that traditional solution techniques are not directly applicable. Since customers may leave in between services, an interchange argument cannot be applied. Since the abandonment rates are unbounded we cannot apply uniformization-and thus cannot use the usual discrete-time Markov decision process techniques. After formulating the problem as a continuous-time Markov decision process (CTMDP), we use sample path arguments in the reward case and a savvy use of truncation in the holding cost case to yield the results. As far as we know, this is the first time that either have been used in conjunction with the CTMDP to show structure in a queueing control problem. The insights made in each model are supported by a detailed numerical study. © 2010 Springer Science+Business Media, LLC

    Anomalous accelerations in spacecraft flybys of the Earth

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    [EN] The flyby anomaly is a persistent riddle in astrodynamics. Orbital analysis in several flybys of the Earth since the Galileo spacecraft flyby of the Earth in 1990 have shown that the asymptotic post-encounter velocity exhibits a difference with the initial velocity that cannot be attributed to conventional effects. To elucidate its origin, we have developed an orbital program for analyzing the trajectory of the spacecraft in the vicinity of the perigee, including both the Sun and the MoonÂżs tidal perturbations and the geopotential zonal, tesseral and sectorial harmonics provided by the EGM96 model. The magnitude and direction of the anomalous acceleration acting upon the spacecraft can be estimated from the orbital determination program by comparing with the trajectories fitted to telemetry data as provided by the mission teams. This acceleration amounts to a fraction of a mm/s2 and decays very fast with altitude. 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    The L 98-59 System: Three Transiting, Terrestrial-Size Planets Orbiting A Nearby M Dwarf

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    We report the Transiting Exoplanet Survey Satellite (TESS) discovery of three terrestrial-size planets transiting L 98-59 (TOI-175, TIC 307210830)—a bright M dwarf at a distance of 10.6 pc. Using the Gaia-measured distance and broadband photometry, we find that the host star is an M3 dwarf. Combined with the TESS transits from three sectors, the corresponding stellar parameters yield planet radii ranging from 0.8 R⊕ to 1.6 R⊕. All three planets have short orbital periods, ranging from 2.25 to 7.45 days with the outer pair just wide of a 2:1 period resonance. Diagnostic tests produced by the TESS Data Validation Report and the vetting package DAVE rule out common false-positive sources. These analyses, along with dedicated follow-up and the multiplicity of the system, lend confidence that the observed signals are caused by planets transiting L 98-59 and are not associated with other sources in the field. The L 98-59 system is interesting for a number of reasons: the host star is bright (V = 11.7 mag, K = 7.1 mag) and the planets are prime targets for further follow-up observations including precision radial-velocity mass measurements and future transit spectroscopy with the James Webb Space Telescope; the near-resonant configuration makes the system a laboratory to study planetary system dynamical evolution; and three planets of relatively similar size in the same system present an opportunity to study terrestrial planets where other variables (age, metallicity, etc.) can be held constant. L 98-59 will be observed in four more TESS sectors, which will provide a wealth of information on the three currently known planets and have the potential to reveal additional planets in the system

    The genetic architecture of the human cerebral cortex

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    INTRODUCTION The cerebral cortex underlies our complex cognitive capabilities. Variations in human cortical surface area and thickness are associated with neurological, psychological, and behavioral traits and can be measured in vivo by magnetic resonance imaging (MRI). Studies in model organisms have identified genes that influence cortical structure, but little is known about common genetic variants that affect human cortical structure. RATIONALE To identify genetic variants associated with human cortical structure at both global and regional levels, we conducted a genome-wide association meta-analysis of brain MRI data from 51,665 individuals across 60 cohorts. We analyzed the surface area and average thickness of the whole cortex and 34 cortical regions with known functional specializations. RESULTS We identified 306 nominally genome-wide significant loci (P < 5 × 10−8) associated with cortical structure in a discovery sample of 33,992 participants of European ancestry. Of the 299 loci for which replication data were available, 241 loci influencing surface area and 14 influencing thickness remained significant after replication, with 199 loci passing multiple testing correction (P < 8.3 × 10−10; 187 influencing surface area and 12 influencing thickness). Common genetic variants explained 34% (SE = 3%) of the variation in total surface area and 26% (SE = 2%) in average thickness; surface area and thickness showed a negative genetic correlation (rG = −0.32, SE = 0.05, P = 6.5 × 10−12), which suggests that genetic influences have opposing effects on surface area and thickness. Bioinformatic analyses showed that total surface area is influenced by genetic variants that alter gene regulatory activity in neural progenitor cells during fetal development. By contrast, average thickness is influenced by active regulatory elements in adult brain samples, which may reflect processes that occur after mid-fetal development, such as myelination, branching, or pruning. When considered together, these results support the radial unit hypothesis that different developmental mechanisms promote surface area expansion and increases in thickness. To identify specific genetic influences on individual cortical regions, we controlled for global measures (total surface area or average thickness) in the regional analyses. After multiple testing correction, we identified 175 loci that influence regional surface area and 10 that influence regional thickness. Loci that affect regional surface area cluster near genes involved in the Wnt signaling pathway, which is known to influence areal identity. We observed significant positive genetic correlations and evidence of bidirectional causation of total surface area with both general cognitive functioning and educational attainment. We found additional positive genetic correlations between total surface area and Parkinson’s disease but did not find evidence of causation. Negative genetic correlations were evident between total surface area and insomnia, attention deficit hyperactivity disorder, depressive symptoms, major depressive disorder, and neuroticism. CONCLUSION This large-scale collaborative work enhances our understanding of the genetic architecture of the human cerebral cortex and its regional patterning. The highly polygenic architecture of the cortex suggests that distinct genes are involved in the development of specific cortical areas. Moreover, we find evidence that brain structure is a key phenotype along the causal pathway that leads from genetic variation to differences in general cognitive function
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