15,391 research outputs found

    Maternal glucose and fatty acid kinetics and infant birth weight in obese women with type 2 diabetes

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    The objectives of this study were 1) to describe maternal glucose and lipid kinetics and 2) to examine the relationships with infant birth weight in obese women with pregestational type 2 diabetes during late pregnancy. Using stable isotope tracer methodology and mass spectrometry, maternal glucose and lipid kinetic rates during the basal condition were compared in three groups: lean women without diabetes (Lean, n = 25), obese women without diabetes (OB, n = 26), and obese women with pregestational type 2 diabetes (OB+DM, n = 28; total n = 79). Glucose and lipid kinetics during hyperinsulinemia were also measured in a subset of participants (n = 56). Relationships between maternal glucose and lipid kinetics during both conditions and infant birth weight were examined. Maternal endogenous glucose production (EGP) rate was higher in OB+DM than OB and Lean during hyperinsulinemia. Maternal insulin value at 50% palmitate R(a) suppression (IC50) for palmitate suppression with insulinemia was higher in OB+DM than OB and Lean. Maternal EGP per unit insulin and plasma free fatty acid concentration during hyperinsulinemia most strongly predicted infant birth weight. Our findings suggest maternal fatty acid and glucose kinetics are altered during late pregnancy and might suggest a mechanism for higher birth weight in obese women with pregestational diabetes

    Detection of Trace Amounts of Toxic Metals in Environmental Samples by Laser-excited Atomic Fluorescence Spectrometry

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    Results for the direct determination of trace amounts of Pb and Cd in Antarctic and Greenland ancient ice and recent snow by laser-excited atomic fluorescence spectrometry (LEAFS) are presented. The whole procedure starting from field sampling, mechanical decontamination of the samples in an ultra-clean laboratory and final analysis of the decontaminated samples is described. The measured concentrations varied in the ranges 0.1–3 pg ml^(–1) for Cd and 0.3–30 pg ml^(–1) for Pb. The results for direct analysis by LEAFS agree favourable with those obtained by isotope dilution mass spectrometry and electrothermal atomic absorption spectrometry, which require time-consuming pre-treatment and pre-concentration stages

    Search for the electric dipole moment of the electron with thorium monoxide

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    The electric dipole moment of the electron (eEDM) is a signature of CP-violating physics beyond the Standard Model. We describe an ongoing experiment to measure or set improved limits to the eEDM, using a cold beam of thorium monoxide (ThO) molecules. The metastable H3Δ1H {}^3\Delta_1 state in ThO has important advantages for such an experiment. We argue that the statistical uncertainty of an eEDM measurement could be improved by as much as 3 orders of magnitude compared to the current experimental limit, in a first-generation apparatus using a cold ThO beam. We describe our measurements of the HH state lifetime and the production of ThO molecules in a beam, which provide crucial data for the eEDM sensitivity estimate. ThO also has ideal properties for the rejection of a number of known systematic errors; these properties and their implications are described.Comment: v2: Equation (11) correcte

    Ancient human genomes suggest three ancestral populations for present-day Europeans

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    We sequenced the genomes of a 7,000-year-old farmer from Germany and eight 8,000-year-old hunter-gatherers from Luxembourg and Sweden. We analysed these and other ancient genomes¹-₄ with 2,345 contemporary humans to show that most present-day Europeans derive from at least three highly differentiated populations:west European hunter-gatherers, who contributed ancestry to all Europeans but not to Near Easterners; ancient north Eurasians related to Upper Palaeolithic Siberians³, who contributed to both Europeans and Near Easterners; and early European farmers, who were mainly of Near Eastern origin but also harboured west European hunter-gatherer related ancestry.We model these populations’ deep relationships and show that early European farmers had 44% ancestry from a ‘basal Eurasian’ population that split before the diversification of other non-African lineage

    On the circularly polarized optical emission from AE Aquarii

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    The reported nightly mean value of the circular polarization of optical emission observed from the close binary system AE Aqr is 0.06% (+-) 0.01%. We discuss a possibility that the observed polarized radiation is emitted mainly by the white dwarf or its vicinity. We demonstrate that this hypothesis is rather unlikely since the contribution of the white dwarf to the optical radiation of the system is too small. This indicates that the polarimetric data on AE Aqr cannot be used for the evaluation of the surface magnetic field strength of the white dwarf in this system.Comment: 4 pages, 3 figures, accepted for publication in Astron. & Astrophy

    Surgical results of the Lung Cancer Mutation Consortium 3 trial: A phase II multicenter single-arm study to investigate the efficacy and safety of atezolizumab as neoadjuvant therapy in patients with stages IB-select IIIB resectable non-small cell lung cancer

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    OBJECTIVE: Multimodality treatment for resectable non-small cell lung cancer has long remained at a therapeutic plateau. Immune checkpoint inhibitors are highly effective in advanced non-small cell lung cancer and promising preoperatively in small clinical trials for resectable non-small cell lung cancer. This large multicenter trial tested the safety and efficacy of neoadjuvant atezolizumab and surgery. METHODS: Patients with stage IB to select IIIB resectable non-small cell lung cancer and Eastern Cooperative Oncology Group performance status 0/1 were eligible. Patients received atezolizumab 1200 mg intravenously every 3 weeks for 2 cycles or less followed by resection. The primary end point was major pathological response in patients without EGFR/ALK+ alterations. Pre- and post-treatment computed tomography, positron emission tomography, pulmonary function tests, and biospecimens were obtained. Adverse events were recorded by Common Terminology Criteria for Adverse Events v.4.0. RESULTS: From April 2017 to February 2020, 181 patients were entered in the study. Baseline characteristics were mean age, 65.1 years; female, 93 of 181 (51%); nonsquamous histology, 112 of 181 (62%); and clinical stages IIB to IIIB, 147 of 181 (81%). In patients without EGFR/ALK alterations who underwent surgery, the major pathological response rate was 20% (29/143; 95% confidence interval, 14-28) and the pathological complete response rate was 6% (8/143; 95% confidence interval, 2-11). There were no grade 4/5 treatment-related adverse events preoperatively. Of 159 patients (87.8%) undergoing surgery, 145 (91%) had pathologic complete resection. There were 5 (3%) intraoperative complications, no intraoperative deaths, and 2 postoperative deaths within 90 days, 1 treatment related. Median disease-free and overall survival have not been reached. CONCLUSIONS: Neoadjuvant atezolizumab in resectable stage IB to IIIB non-small cell lung cancer was well tolerated, yielded a 20% major pathological response rate, and allowed safe, complete surgical resection. These results strongly support the further development of immune checkpoint inhibitors as preoperative therapy in locally advanced non-small cell lung cancer

    Neoadjuvant atezolizumab for resectable non-small cell lung cancer: An open-label, single-arm phase II trial

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    In an ongoing, open-label, single-arm phase II study ( NCT02927301 ), 181 patients with untreated, resectable, stage IB-IIIB non-small cell lung cancer received two doses of neoadjuvant atezolizumab monotherapy. The primary end point was major pathological response (MPR; ≤10% viable malignant cells) in resected tumors without EGFR or ALK alterations. Of the 143 patients in the primary end point analysis, the MPR was 20% (95% confidence interval, 14-28%). With a minimum duration of follow-up of 3 years, the 3-year survival rate of 80% was encouraging. The most common adverse events during the neoadjuvant phase were fatigue (39%, 71 of 181) and procedural pain (29%, 53 of 181), along with expected immune-related toxicities; there were no unexpected safety signals. In exploratory analyses, MPR was predicted using the pre-treatment peripheral blood immunophenotype based on 14 immune cell subsets. Immune cell subsets predictive of MPR in the peripheral blood were also identified in the tumor microenvironment and were associated with MPR. This study of neoadjuvant atezolizumab in a large cohort of patients with resectable non-small cell lung cancer was safe and met its primary end point of MPR ≥ 15%. Data from this single-arm, non-randomized trial suggest that profiles of innate immune cells in pre-treatment peripheral blood may predict pathological response after neoadjuvant atezolizumab, but additional studies are needed to determine whether these profiles can inform patient selection and new therapeutic approaches

    Development and validation of a pragmatic natural language processing approach to identifying falls in older adults in the emergency department

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    BACKGROUND: Falls among older adults are both a common reason for presentation to the emergency department, and a major source of morbidity and mortality. It is critical to identify fall patients quickly and reliably during, and immediately after, emergency department encounters in order to deliver appropriate care and referrals. Unfortunately, falls are difficult to identify without manual chart review, a time intensive process infeasible for many applications including surveillance and quality reporting. Here we describe a pragmatic NLP approach to automating fall identification. METHODS: In this single center retrospective review, 500 emergency department provider notes from older adult patients (age 65 and older) were randomly selected for analysis. A simple, rules-based NLP algorithm for fall identification was developed and evaluated on a development set of 1084 notes, then compared with identification by consensus of trained abstractors blinded to NLP results. RESULTS: The NLP pipeline demonstrated a recall (sensitivity) of 95.8%, specificity of 97.4%, precision of 92.0%, and F1 score of 0.939 for identifying fall events within emergency physician visit notes, as compared to gold standard manual abstraction by human coders. CONCLUSIONS: Our pragmatic NLP algorithm was able to identify falls in ED notes with excellent precision and recall, comparable to that of more labor-intensive manual abstraction. This finding offers promise not just for improving research methods, but as a potential for identifying patients for targeted interventions, quality measure development and epidemiologic surveillance

    Human Time-Frequency Acuity Beats the Fourier Uncertainty Principle

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    The time-frequency uncertainty principle states that the product of the temporal and frequency extents of a signal cannot be smaller than 1/(4π)1/(4\pi). We study human ability to simultaneously judge the frequency and the timing of a sound. Our subjects often exceeded the uncertainty limit, sometimes by more than tenfold, mostly through remarkable timing acuity. Our results establish a lower bound for the nonlinearity and complexity of the algorithms employed by our brains in parsing transient sounds, rule out simple "linear filter" models of early auditory processing, and highlight timing acuity as a central feature in auditory object processing.Comment: 4 pages, 2 figures; Accepted at PR
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