Relação entre a Razão Nitrogênio Ureico/Creatinina e Prognóstico de Insuficiência Cardíaca em Todo o Espectro da Fração de Ejeção

Resumo Fundamento Em pacientes com insuficiência cardíaca (IC), devido à relativa deficiência do volume sanguíneo, a ativação do sistema neuro-hormonal leva à vasoconstrição renal, que afeta o teor de nitrogênio ureico (NU) e creatinina (C) no organismo, sendo que NU e C são facilmente afetados por outros fatores. Portanto, a razão NU/C pode ser utilizada como mais um marcador para o prognóstico da IC. Objetivo Explorar o prognóstico do desfecho adverso da IC no grupo NU/C alta em comparação com o grupo NU/C baixa em todo o espectro da fração de ejeção. Métodos De 2014 a 2016, pacientes sintomáticos hospitalizados com IC foram recrutados e acompanhados para observar desfechos cardiovasculares adversos. Foram realizadas análise logística e a análise COX para determinar a significância. Valores de p<0,05 foram considerados estatisticamente significativos. Resultados Na análise de regressão logística univariada, o grupo NU/C alta apresentou maior risco de desfecho adverso na insuficiência cardíaca com fração de ejeção reduzida (ICFEr) e insuficiência cardíaca com fração de ejeção preservada (ICFEp). A análise de regressão logística multivariada mostrou que o risco de morte cardíaca no grupo ICFEr foi maior do que no grupo NU/C baixa, enquanto o risco de morte por todas as causas foi significativo apenas em 3 meses (p<0,05) (Ilustração Central). O risco de morte por todas as causas no grupo NU/C alta no grupo ICFEP foi significativamente maior do que no grupo NU/C baixa em dois anos. Conclusão O grupo NU/C alta está relacionado ao risco de mau prognóstico da ICFEP, não sendo inferior ao valor preditivo da fração de ejeção do ventrículo esquerdo (FEVE)

Observing Dynamical Phases of a Bardeen-Cooper-Schrieffer Superconductor in a Cavity QED Simulator

In conventional Bardeen-Cooper-Schrieffer (BCS) superconductors, electrons with opposite momenta bind into Cooper pairs due to an attractive interaction mediated by phonons in the material. While superconductivity naturally emerges at thermal equilibrium, it can also emerge out of equilibrium when the system's parameters are abruptly changed. The resulting out-of-equilibrium phases are predicted to occur in real materials and ultracold fermionic atoms but have not yet been directly observed. This work realizes an alternate way to generate the proposed dynamical phases using cavity quantum electrodynamics (cavity QED). Our system encodes the presence or absence of a Cooper pair in a long-lived electronic transition in $^{88}$Sr atoms coupled to an optical cavity and represents interactions between electrons as photon-mediated interactions through the cavity. To fully explore the phase diagram, we manipulate the ratio between the single-particle dispersion and the interactions after a quench and perform real-time tracking of subsequent dynamics of the superconducting order parameter using non-destructive measurements. We observe regimes where the order parameter decays to zero ("phase I"), assumes a non-equilibrium steady-state value ("phase II"), or exhibits persistent oscillations ("phase III") in the form of a self-generated Floquet phase. The capability to emulate these dynamical phases in optical cavities without real Cooper pairs demonstrates that programmable simulators can overcome many challenges faced by traditional approaches. This opens up exciting prospects for quantum simulation, including the potential to engineer unconventional superconductors and to probe beyond mean-field effects like the spectral form factor, and for increasing coherence time for quantum sensing.Comment: Main Text with Supporting Material, 18 pages, 10 figure

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Data for: Observing dynamical phases of BCS superconductors in a cavity QED simulator

&lt;p&gt;In conventional Bardeen-Cooper-Schrieffer (BCS) superconductors, electrons with opposite momenta bind into Cooper pairs due to an attractive interaction mediated by phonons in the material. While superconductivity naturally emerges at thermal equilibrium, it can also emerge out of equilibrium when the system's parameters are abruptly changed. The resulting out-of-equilibrium phases are predicted to occur in real materials and ultracold fermionic atoms but have not yet all been directly observed. Here we realise an alternate way to generate the proposed dynamical phases using cavity quantum electrodynamics (cavity QED). Our system encodes the presence or absence of a Cooper pair in a long-lived electronic transition in &lt;sup&gt;88&lt;/sup&gt;Sr atoms coupled to an optical cavity and represents interactions between electrons as photon-mediated interactions through the cavity. To fully explore the phase diagram, we manipulate the ratio between the single-particle dispersion and the interactions after a quench and perform real-time tracking of subsequent dynamics of the superconducting order parameter using non-destructive measurements. We observe regimes where the order parameter decays to zero (phase I), assumes a non-equilibrium steady-state value (phase II), or exhibits persistent oscillations (phase III). This opens up exciting prospects for quantum simulation, including the potential to engineer unconventional superconductors and to probe beyond mean-field effects like the spectral form factor, and for increasing coherence time for quantum sensing.&lt;/p&gt;&lt;p&gt;Funding provided by: United States Department of Energy&lt;br&gt;Crossref Funder Registry ID: https://ror.org/01bj3aw27&lt;br&gt;Award Number: &lt;/p&gt;&lt;p&gt;Funding provided by: National Science Foundation&lt;br&gt;Crossref Funder Registry ID: https://ror.org/021nxhr62&lt;br&gt;Award Number: 1734006&lt;/p&gt;&lt;p&gt;Funding provided by: National Science Foundation&lt;br&gt;Crossref Funder Registry ID: https://ror.org/021nxhr62&lt;br&gt;Award Number: 2016244&lt;/p&gt;&lt;p&gt;Funding provided by: Defense Advanced Research Projects Agency&lt;br&gt;Crossref Funder Registry ID: https://ror.org/02caytj08&lt;br&gt;Award Number: W911NF-16-1-0576&lt;/p&gt;&lt;p&gt;Funding provided by: National Institute of Standards and Technology&lt;br&gt;Crossref Funder Registry ID: https://ror.org/05xpvk416&lt;br&gt;Award Number: &lt;/p&gt;&lt;p&gt;Funding provided by: Defense Advanced Research Projects Agency&lt;br&gt;Crossref Funder Registry ID: https://ror.org/02caytj08&lt;br&gt;Award Number: W911NF-19-1-0210&lt;/p&gt;&lt;p&gt;Funding provided by: United States Air Force Office of Scientific Research&lt;br&gt;Crossref Funder Registry ID: https://ror.org/011e9bt93&lt;br&gt;Award Number: FA9550-18-1-0319&lt;/p&gt;&lt;p&gt;Funding provided by: United States Air Force Office of Scientific Research&lt;br&gt;Crossref Funder Registry ID: https://ror.org/011e9bt93&lt;br&gt;Award Number: FA9550-19-1-0275&lt;/p&gt

Ambient carbon monoxide and cardiovascular mortality: a nationwide time-series analysis in 272 cities in China

Background: Evidence of the acute health effects of ambient carbon monoxide air pollution in developing countries is scarce and mixed. We aimed to evaluate short-term associations between carbon monoxide and daily cardiovascular disease mortality in China. Methods: We did a nationwide time-series analysis in 272 major cities in China from January, 2013, to December, 2015. We extracted daily cardiovascular disease mortality data from China's Disease Surveillance Points system. Data on daily carbon monoxide concentrations for each city were obtained from the National Urban Air Quality Real-time Publishing Platform. City-specific associations between carbon monoxide concentrations and daily mortality from cardiovascular disease, coronary heart disease, and stroke were estimated with over-dispersed generalised linear models. Bayesian hierarchical models were used to obtain national and regional average associations. Exposure–response association curves and potential effect modifiers were evaluated. Two-pollutant models were fit to evaluate the robustness of the effects of carbon monoxide on cardiovascular mortality. Findings: The average annual mean carbon monoxide concentration in these cities from 2013 to 2015 was 1·20 mg/m3, ranging from 0·43 mg/m3 to 2·45 mg/m3. For a 1 mg/m3 increase in average carbon monoxide concentrations on the present day and previous day (lag 0–1), we observed significant increments in mortality of 1·12% (95% posterior interval [PI] 0·42–1·83) from cardiovascular disease, 1·75% (0·85–2·66) from coronary heart disease, and 0·88% (0·07–1·69) from stroke. These associations did not vary substantially by city, region, and demographic characteristics (age, sex, and level of education), and the associations for cardiovascular disease and coronary heart disease were robust to the adjustment of criteria co-pollutants. We did not find a threshold below which carbon monoxide exposure had no effect on cardiovascular disease mortality. Interpretation: This analysis is, to our knowledge, the largest study done in a developing country, and provides robust evidence of the association between short-term exposure to ambient carbon monoxide and increased cardiovascular disease mortality, especially coronary heart disease mortality. Funding: Public Welfare Research Program

Personal Ozone Exposure and Respiratory Inflammatory Response: The Role of DNA Methylation in the Arginase–Nitric Oxide Synthase Pathway

Little is known regarding the molecular mechanisms behind respiratory inflammatory response induced by ozone. We performed a longitudinal panel study with four repeated measurements among 43 young adults in Shanghai, China from May to October in 2016. We collected buccal samples and measured the fractional exhaled nitric oxide (FeNO) after 3-day personal ozone monitoring. In buccal samples, we measured concentrations of inducible nitric oxide synthase (iNOS) and arginase (ARG), and DNA methylation of <i>NOS2A</i> and <i>ARG2</i>. We used linear mixed-effect models to analyze the effects of ozone on FeNO, two enzymes and their DNA methylation. A 10 ppb increase in ozone (lag 0–8 h) was significantly associated with a 3.89% increase in FeNO, a 36.33% increase in iNOS, and a decrease of 0.36 in the average methylation (%5mC) of <i>NOS2A</i>. Ozone was associated with decreased ARG and elevated <i>ARG2</i> methylation, but the associations were not significant. These effects were more pronounced among allergic subjects than healthy subjects. The effects were much stronger when using personal exposure monitoring than fixed-site measurements. Our study demonstrated that personal short-term exposure to ozone may result in acute respiratory inflammation, which may be mainly modulated by <i>NOS2A</i> hypomethylation in the arginase–nitric oxide synthase pathway