Survival of branching random walks in random environment

We study survival of nearest-neighbour branching random walks in random environment (BRWRE) on ${\mathbb Z}$. A priori there are three different regimes of survival: global survival, local survival, and strong local survival. We show that local and strong local survival regimes coincide for BRWRE and that they can be characterized with the spectral radius of the first moment matrix of the process. These results are generalizations of the classification of BRWRE in recurrent and transient regimes. Our main result is a characterization of global survival that is given in terms of Lyapunov exponents of an infinite product of i.i.d. $2\times 2$ random matrices.Comment: 17 pages; to appear in Journal of Theoretical Probabilit

Association of admission cortisol levels with outcomes and treatment response in patients at nutritional risk : A secondary analysis of a randomized clinical trial.

INTRODUCTION Cortisol is a metabolically active stress hormone that may play a role in the pathogenesis of malnutrition. We studied the association between admission cortisol levels and nutritional parameters, disease severity, and response to nutritional support among medical inpatients at nutritional risk. METHODS Admission cortisol was measured in a subset of 764 patients participating in the Effect of Early Nutritional Support on Frailty, Functional Outcomes, and Recovery of Malnourished Medical Inpatients Trial (EFFORT), a multicentre, randomized-controlled trial that compared individualized nutritional support with usual nutritional care. RESULTS Overall, mean cortisol levels were 570 (± 293) nmol/L and significantly higher in patients with high nutritional risk (NRS ≥ 5) and in patients reporting loss of appetite. Cortisol levels in the highest quartile (> 723 nmol/l) were associated with adverse outcomes including mortality at 30 days and 5 years (adjusted HR 2.31, [95%CI 1.47 to 3.62], p = 0.001 and 1.51, [95%CI 1.23 to 1.87], p < 0.001). Nutritional treatment tended to be more effective regarding mortality reduction in patients with high vs. low cortisol levels (adjusted OR of nutritional support 0.54, [95%CI 0.24 to 1.24] vs. OR 1.11, [95%CI 0.6 to 2.04], p for interaction = 0.134). This effect was most pronounced in the subgroup of patients with severe malnutrition (NRS 2002 ≥ 5, p for interaction = 0.047). CONCLUSION This secondary analysis of a randomized nutritional trial suggests that cortisol levels are linked to nutritional and clinical outcome among multimorbid medical patients at nutritional risk and may help to improve risk assessment, as well as response to nutritional treatment. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02517476

Assessing the length of the mandibular ramus and the condylar process: a comparison of OPG, CBCT, CT, MRI, and lateral cephalometric measurements

SummaryBackground/Objectives: To compare different imaging procedures [cone beam computed tomography (CBCT), computed tomography (CT), magnetic resonance imaging (MRI), orthopantomography (OPG), and lateral cephalometry (LC)] for assessing the mandibular height [ramus height (RH)] and condylar process (CondProc) length as they reflect mandibular growth. Materials/Methods: The RH and CondProc of eight cadaver heads (each side separately) were measured using CBCT, CT, MRI, OPG, and LC. They were measured twice by two independent observers parallel to the posterior border of the mandibular ramus. An intraclass correlation coefficient (ICC) was used to assess the inter- and intraobserver reliability. The coefficient of variation was used to elucidate precision. Bland-Altman (BA) plots were used to assess the agreement between the procedures and the intra- and interobserver measurements. Results: All procedures, with the exception of LC, showed good intra- and interobserver agreement (maximum range of agreement: 5.3mm) and excellent reliability (ICC > 0.9). The BA plot analysis for the CondProc and RH showed similar ranges of agreement between MRI, CT, and CBCT (maximum 6.4mm) but higher ranges for OPG and LC. The MRI and OPG values were generally smaller. Conclusions/Implications: All 3D imaging procedures yielded nearly equal results when used to measure the CondProc and RH. MRI is recommended because it avoids ionizing radiation and has higher sensitivity in the detection of inflammation. A 2-year threshold for detecting growth in the follow-up period should be taken into account for all 3D imaging methods. Measuring the RH is recommended for the follow-up of condylar growth because reference values for annual increments are publishe

Medical futility regarding cardiopulmonary resuscitation in in-hospital cardiac arrests of adult patients: A Systematic Review and Meta-analysis

For some patients, survival with good neurologic function after cardiopulmonary resuscitation (CPR) is highly unlikely, thus CPR would be considered medically futile. Yet, in clinical practice, there are no well-established criteria, guidelines or measures to determine futility. We aimed to investigate how medical futility for CPR in adult patients is defined, measured, and associated with do-not-resuscitate (DNR) code status as well as to evaluate through meta-analysis the predictive value of clinical risk scores.; We searched Embase, PubMed, CINAHL, and PsycINFO from the inception of each database up to January 22, 2021. Data were pooled using a fixed-effects model. Data collection and reporting followed the PRISMA guidelines.; Thirty-one studies were included in the systematic review and 11 in the meta-analysis. Medical futility defined by risk scores was associated with a significantly higher risk of in-hospital mortality (5 studies, 3102 participants with Pre-Arrest Morbidity (PAM) and Prognosis After Resuscitation (PAR) score; overall RR 3.38 [95% CI 1.92-5.97]) and poor neurologic outcome/in-hospital mortality (6 studies, 115213 participants with Good Outcome Following Attempted Resuscitation (GO-FAR) and Prediction of Outcome for In-Hospital Cardiac Arrest (PIHCA) score; RR 6.93 [95% CI 6.43-7.47]). All showed high specificity (>90%) for identifying patients with poor outcome.; There is no international consensus and a lack of specific definitions of CPR futility in adult patients. Clinical risk scores might aid decision-making when CPR is assumed to be futile. Future studies are needed to assess their clinical value and reliability as a measure of futility regarding CPR

Subtype-specific differentiation of cardiac pacemaker cell clusters from human induced pluripotent stem cells

Background: Human induced pluripotent stem cells (hiPSC) harbor the potential to differentiate into diverse cardiac cell types. Previous experimental efforts were primarily directed at the generation of hiPSC-derived cells with ventricular cardiomyocyte characteristics. Aiming at a straightforward approach for pacemaker cell modeling and replacement, we sought to selectively differentiate cells with nodal-type properties. Methods: hiPSC were differentiated into spontaneously beating clusters by co-culturing with visceral endoderm-like cells in a serum-free medium. Subsequent culturing in a specified fetal bovine serum (FBS)-enriched cell medium produced a pacemaker-type phenotype that was studied in detail using quantitative real-time polymerase chain reaction (qRT-PCR), immunocytochemistry, and patch-clamp electrophysiology. Further investigations comprised pharmacological stimulations and co-culturing with neonatal cardiomyocytes. Results: hiPSC co-cultured in a serum-free medium with the visceral endoderm-like cell line END-2 produced spontaneously beating clusters after 10–12 days of culture. The pacemaker-specific genes HCN4, TBX3, and TBX18 were abundantly expressed at this early developmental stage, while levels of sarcomeric gene products remained low. We observed that working-type cardiomyogenic differentiation can be suppressed by transfer of early clusters into a FBS-enriched cell medium immediately after beating onset. After 6 weeks under these conditions, sinoatrial node (SAN) hallmark genes remained at high levels, while working-type myocardial transcripts (NKX2.5, TBX5) were low. Clusters were characterized by regular activity and robust beating rates (70–90 beats/min) and were triggered by spontaneous Ca2+ transients recapitulating calcium clock properties of genuine pacemaker cells. They were responsive to adrenergic/cholinergic stimulation and able to pace neonatal rat ventricular myocytes in co-culture experiments. Action potential (AP) measurements of cells individualized from clusters exhibited nodal-type (63.4%) and atrial-type (36.6%) AP morphologies, while ventricular AP configurations were not observed. Conclusion: We provide a novel culture media-based, transgene-free approach for targeted generation of hiPSC-derived pacemaker-type cells that grow in clusters and offer the potential for disease modeling, drug testing, and individualized cell-based replacement therapy of the SAN

Biblical Theology of Life in the New Testament

This publication deals with A Biblical Theology of Life based on the New Testament. It forms the second of a two volume publication on A Biblical Theology of Life. These two volumes trace the concept of life throughout Protestant canon, working with the final form of the biblical books in Hebrew (vol. 5) and Greek (vol. 6) Scripture. This is done by providing the reader with a book-by-book overview of this concept. This book concludes with a final chapter synthesising the findings of the respective investigations of the Old and New Testament corpora in order to provide a summative theological perspective of the development of the concept through Scripture. It is clear that life forms a central and continuous theme throughout the Biblical text. The theme begins with the living God that creates life, but is shortly followed by death that threatens life. Despite this threat, God sustains life and awakens life from death. The text concludes with the consummation depicting eternal life in the new heaven and earth. The biblical theological approach that has been taken entails a thematic approach as it investigates the concept of life, with contextual foci on what individual books of Scripture teach about life, joined diachronically with an investigation of the progressive use of the concept of life in Scripture, while providing a theology of Scripture as a whole investigating the concept of life in all sixty-six books of the Protestant canon

Expression of microRNAs in cerebrospinal fluid of dogs with central nervous system disease

Abstract In this pilot study we investigated the expression of 14 microRNAs in the cerebrospinal fluid (CSF) of dogs with neoplastic, inflammatory and degenerative disorders affecting the central nervous system (CNS). CSF microRNA (miRNA) expression profiles were compared to those from dogs with neurological signs but no evidence of structural or inflammatory CNS disease. Seven miRNAs were easily detected in all samples: miR-10b-5p, miR-19b, miR-21-5p, miR-30b-5p, miR-103a-3p, miR-124, and miR-128-3p. Expression of miR-10b-5p was significantly higher in the neoplastic group compared to other groups. There was no relation between miRNA expression and either CSF nucleated cell count or CSF protein content. Higher expression of miR-10b-5p in the neoplastic group is consistent with previous reports in human medicine where aberrant expression of miR-10b is associated with various neoplastic diseases of the CNS

Quantifying the Detrimental Impacts of Land-Use and Management Change on European Forest Bird Populations

The ecological impacts of changing forest management practices in Europe are poorly understood despite European forests being highly managed. Furthermore, the effects of potential drivers of forest biodiversity decline are rarely considered in concert, thus limiting effective conservation or sustainable forest management. We present a trait-based framework that we use to assess the detrimental impact of multiple land-use and management changes in forests on bird populations across Europe. Major changes to forest habitats occurring in recent decades, and their impact on resource availability for birds were identified. Risk associated with these changes for 52 species of forest birds, defined as the proportion of each species' key resources detrimentally affected through changes in abundance and/or availability, was quantified and compared to their pan-European population growth rates between 1980 and 2009. Relationships between risk and population growth were found to be significantly negative, indicating that resource loss in European forests is an important driver of decline for both resident and migrant birds. Our results demonstrate that coarse quantification of resource use and ecological change can be valuable in understanding causes of biodiversity decline, and thus in informing conservation strategy and policy. Such an approach has good potential to be extended for predictive use in assessing the impact of possible future changes to forest management and to develop more precise indicators of forest health

Biblical Theology of Life in the New Testament

This publication deals with A Biblical Theology of Life based on the New Testament. It forms the second of a two volume publication on A Biblical Theology of Life. These two volumes trace the concept of life throughout Protestant canon, working with the final form of the biblical books in Hebrew (vol. 5) and Greek (vol. 6) Scripture. This is done by providing the reader with a book-by-book overview of this concept. This book concludes with a final chapter synthesising the findings of the respective investigations of the Old and New Testament corpora in order to provide a summative theological perspective of the development of the concept through Scripture. It is clear that life forms a central and continuous theme throughout the Biblical text. The theme begins with the living God that creates life, but is shortly followed by death that threatens life. Despite this threat, God sustains life and awakens life from death. The text concludes with the consummation depicting eternal life in the new heaven and earth. The biblical theological approach that has been taken entails a thematic approach as it investigates the concept of life, with contextual foci on what individual books of Scripture teach about life, joined diachronically with an investigation of the progressive use of the concept of life in Scripture, while providing a theology of Scripture as a whole investigating the concept of life in all sixty-six books of the Protestant canon