A163: Alternative Mechanisms of Care Delivery in Pediatric Rheumatology: To What Extent Do They Expand the Reach of Pediatric Rheumatologists?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106674/1/art38589.pd

Mapping out the thermodynamic stability of a QCD equation of state with a critical point using active learning

The Beam Energy Scan Theory (BEST) collaboration's equation of state (EoS) incorporates a 3D Ising model critical point into the Quantum Chromodynamics (QCD) equation of state from lattice simulations. However, it contains 4 free parameters related to the size and location of the critical region in the QCD phase diagram. Certain combinations of the free parameters lead to acausal or unstable realizations of the EoS that should not be considered. In this work, we use an active learning framework to rule out pathological EoS efficiently. We find that checking stability and causality for a small portion of the parameters' range is sufficient to construct algorithms that perform with $>$96% accuracy across the entire parameter space. Though in this work we focus on a specific case, our approach can be generalized to any EoS containing a parameter space-class correspondence.Comment: 14 pages, 9 figure

Lattice-QCD-based equations of state at finite temperature and density

The equation of state (EoS) of QCD is a crucial input for the modeling of heavy-ion-collision (HIC) and neutron-star-merger systems. Calculations of the fundamental theory of QCD, which could yield the true EoS, are hindered by the infamous Fermi sign problem which only allows direct simulations at zero or imaginary baryonic chemical potential. As a direct consequence, the current coverage of the QCD phase diagram by lattice simulations is limited. In these proceedings, two different equations of state based on first-principle lattice QCD (LQCD) calculations are discussed. The first is solely informed by the fundamental theory by utilizing all available diagonal and non-diagonal susceptibilities up to $\mathcal{O}(\mu_B^4)$ in order to reconstruct a full EoS at finite baryon number, electric charge and strangeness chemical potentials. For the second, we go beyond information from the lattice in order to explore the conjectured phase structure, not yet determined by LQCD methods, to assist the experimental HIC community in their search for the critical point. We incorporate critical behavior into this EoS by relying on the principle of universality classes, of which QCD belongs to the 3D Ising Model. This allows one to study the effects of a singularity on the thermodynamical quantities that make up the equation of state used for hydrodynamical simulations of HICs. Additionally, we ensure that these EoSs are valid for applications to HICs by enforcing conditions of strangeness neutrality and fixed charge-to-baryon-number ratio.Comment: Contribution to the 37th Winter Workshop on Nuclear Dynamics. arXiv admin note: text overlap with arXiv:2103.0814

A left circumflex aorta with a displaced thoracic duct in a 94-year-old male cadaver: a case report with discussion on embryology

A left circumflex aorta (LCA) is an extremely rare variation of the thoracic aorta. It is distinguished by a retroesophageal descending aorta that subsequently travels down the right side of the thoracic vertebrae towards the aortic hiatus. Nonetheless, its embryological origin ought not to be overly generalized, but each case should be considered individually due to its unique vascular patterns. This study presents a description of a LCA in a 94-year-old male cadaver. The dissection revealed the descending aorta posteriorly from the trachea and esophagus and then laterally on the right from the thoracic vertebral bodies. The branching pattern of the aortic arch was typical, so was the course of the left and right recurrent laryngeal nerves. However, the thoracic duct was placed on the right, and drained into the right internal carotid vein. Due to the normal appearance of the ascending part and the arch of the aorta, it is safe to presume that the variation originated from the persistent right dorsal aorta, with the retroesophageal part from the persistent left dorsal aorta. Detailed understanding of the variations of the thoracic aorta, and the anomalies associated with the LCA, can help to improve management of these conditions, and with that, improve patients’ overall outcomes. Patients with a LCA, or another vascular ring, can either be asymptomatic or present with esophageal and / or tracheal compression symptoms. Management of this anomaly consists namely of ligation of the patent ductus arteriosus / ligamentum arteriosum and aortic uncrossing

Pathologic RFC1 repeat expansions do not contribute to the development of inflammatory neuropathies

Biallelic expansions of the AAGGG repeat in the replication factor C subunit 1 (RFC1) have recently been described to be responsible for cerebellar ataxia, peripheral neuropathy and vestibular areflexia syndrome. This genetic alteration has also allowed genetic classification in up to one-third of cases with idiopathic sensory neuropathy. Here, we screened a well-characterized cohort of inflammatory neuropathy patients for RFC1 repeat expansions to explore whether RFC1 was increased from background rates and possibly involved in the pathogenesis of inflammatory neuropathy. A total of 259 individuals with inflammatory neuropathy and 243 healthy controls were screened for the AAGGG repeat expansion using short-range flanking PCR and repeat-primed PCR. Cases without amplifiable PCR product on flanking PCR and positive repeat-primed PCR were also tested for the mostly non-pathogenic expansions of the AAAGG and AAAAG repeat units. None of the patients showed biallelic AAGGG expansion of RFC1, and their carrier frequency for AAGGG was comparable with controls [n = 27 (5.2%) and n = 23 (4.7%), respectively; P > 0.5]. Data suggest that the pathologic expansions of AAGGG repeats do not contribute to the development of inflammatory neuropathies nor lead to misdiagnosed cases. Accordingly, routine genetic screening for RFC1 repeat expansion is not indicated in this patient population

Profiles of physical, emotional and psychosocial wellbeing in the Lothian birth cohort 1936

<p>Abstract</p> <p>Background</p> <p>Physical, emotional, and psychosocial wellbeing are important domains of function. The aims of this study were to explore the existence of separable groups among 70-year olds with scores representing physical function, perceived quality of life, and emotional wellbeing, and to characterise any resulting groups using demographic, personality, cognition, health and lifestyle variables.</p> <p>Methods</p> <p>We used latent class analysis (LCA) to identify possible groups.</p> <p>Results</p> <p>Results suggested there were 5 groups. These included High (n = 515, 47.2% of the sample), Average (n = 417, 38.3%), and Poor Wellbeing (n = 37, 3.4%) groups. The two other groups had contrasting patterns of wellbeing: one group scored relatively well on physical function, but low on emotional wellbeing (Good Fitness/ Low Spirits,n = 60, 5.5%), whereas the other group showed low physical function but relatively well emotional wellbeing (Low Fitness/Good Spirits, n = 62, 5.7%). Salient characteristics that distinguished all the groups included smoking and drinking behaviours, personality, and illness.</p> <p>Conclusions</p> <p>Despite there being some evidence of these groups, the results also support a largely one-dimensional construct of wellbeing in old age—for the domains assessed here—though with some evidence that some individuals have uneven profiles.</p

Background Independent Quantum Gravity: A Status Report

The goal of this article is to present an introduction to loop quantum gravity -a background independent, non-perturbative approach to the problem of unification of general relativity and quantum physics, based on a quantum theory of geometry. Our presentation is pedagogical. Thus, in addition to providing a bird's eye view of the present status of the subject, the article should also serve as a vehicle to enter the field and explore it in detail. To aid non-experts, very little is assumed beyond elements of general relativity, gauge theories and quantum field theory. While the article is essentially self-contained, the emphasis is on communicating the underlying ideas and the significance of results rather than on presenting systematic derivations and detailed proofs. (These can be found in the listed references.) The subject can be approached in different ways. We have chosen one which is deeply rooted in well established physics and also has sufficient mathematical precision to ensure that there are no hidden infinities. In order to keep the article to a reasonable size, and to avoid overwhelming non-experts, we have had to leave out several interesting topics, results and viewpoints; this is meant to be an introduction to the subject rather than an exhaustive review of it.Comment: 125 pages, 5 figures (eps format), the final version published in CQ

Profile of Lipid and Protein Autacoids in Diabetic Vitreous Correlates With the Progression of Diabetic Retinopathy

OBJECTIVE: This study was aimed at obtaining a profile of lipids and proteins with a paracrine function in normal and diabetic vitreous and exploring whether the profile correlates with retinal pathology. RESEARCH DESIGN AND METHODS: Vitreous was recovered from 47 individuals undergoing vitreoretinal surgery: 16 had nonproliferative diabetic retinopathy (NPDR), 15 had proliferative diabetic retinopathy, 7 had retinal detachments, and 9 had epiretinal membranes. Protein and lipid autacoid profiles were determined by protein arrays and mass spectrometry-based lipidomics. RESULTS: Vitreous lipids included lipoxygenase (LO)- and cytochrome P450 epoxygenase (CYP)-derived eicosanoids. The most prominent LO-derived eicosanoid was 5-hydroxyeicosate traenoic acid (HETE), which demonstrated a diabetes-specific increase (P = 0.027) with the highest increase in NPDR vitreous. Vitreous also contained CYP-derived epoxyeicosatrienoic acids; their levels were higher in nondiabetic than diabetic vitreous (P < 0.05). Among inflammatory, angiogenic, and angiostatic cytokines and chemokines, only vascular endothelial growth factor (VEGF) showed a significant diabetes-specific profile (P < 0.05), although a similar trend was noted for tumor necrosis factor (TNF)-alpha. Soluble VEGF receptors R1 and R2 were detected in all samples with lowest VEGF-R2 levels (P < 0.05) and higher ratio of VEGF to its receptors in NPDR and PDR vitreous. CONCLUSIONS: This study is the first to demonstrate diabetes-specific changes in vitreous lipid autacoids including arachidonate and docosahexanoate-derived metabolites indicating an increase in inflammatory versus anti-inflammatory lipid mediators that correlated with increased levels of inflammatory and angiogenic proteins, further supporting the notion that inflammation plays a role the pathogenesis of this disease