291 research outputs found

    Markers of focal and diffuse nonischemic myocardial fibrosis are associated with adverse cardiac remodeling and prognosis in patients with hypertension: the REMODEL study

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    Background: The prognostic significance of focal and diffuse myocardial fibrosis in patients with cardiovascular risk factors is unclear. Methods: REMODEL (Response of the Myocardium to Hypertrophic Conditions in the Adult Population) is an observational cohort of asymptomatic patients with essential hypertension. All participants underwent cardiovascular magnetic resonance to assess for myocardial fibrosis: nonischemic late gadolinium enhancement (LGE), native myocardial T1, postcontrast myocardial T1, extracellular volume fraction including/excluding LGE regions, interstitial volume (extracellular volume×myocardial volume), and interstitial/myocyte ratio. Primary outcome was a composite of first occurrence acute coronary syndrome, heart failure hospitalization, strokes, and cardiovascular mortality. Patients were recruited from February 2016 and followed until June 2021. Results: Of the 786 patients with hypertension (58±11 years; 39% women; systolic blood pressure, 130±14 mm Hg), 145 (18%) had nonischemic LGE. Patients with nonischemic LGE were more likely to be men, have diabetes, be current smokers, and have higher blood pressure (P<0.05 for all). Compared with those without LGE, patients with nonischemic LGE had greater left ventricular mass (66±22 versus 49±9 g/m2; P<0.001), worse multidirectional strain (P<0.001 for all measures), and elevated circulating markers of myocardial wall stress and myocardial injury, adjusted for potential confounders. Twenty-four patients had primary outcome over 39 (30–50) months of follow-up. Of all the cardiovascular magnetic resonance markers of myocardial fibrosis assessed, only nonischemic LGE (hazard ratio, 6.69 [95% CI, 2.54–17.60]; P<0.001) and indexed interstitial volume (hazard ratio, 1.11 [95% CI, 1.04–1.19]; P=0.002) demonstrated independent association with primary outcome. Conclusions: In patients with hypertension, myocardial fibrosis on cardiovascular magnetic resonance is associated with adverse cardiac remodeling and outcomes

    Vertical accuracy comparison of multi-source Digital Elevation Model (DEM) with Airborne Light Detection and Ranging (LiDAR)

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    Digital Elevation Model (DEM) is a digital representation of ground surface topography or terrain. There are many freely available DEM data with a spatial resolution of 30 m to 90 m. Nevertheless, their vertical accuracy may vary, depending on the vegetation cover and terrain characteristics. This study examined the vertical accuracy of open-access global DEMs (ALOS PALSAR, ASTER GDEM3, SRTM, TanDEM-X) and fused DEM (EarthEnvDEM90, MERIT DEM). Their performances were assessed using a Digital Terrain Model (DTM) generated using airborne LiDAR data that had an outstanding absolute vertical accuracy (mean error (ME) = 0.24 m; root mean square error (RMSEz) = 1.20 m). Height differences between the global DEMs and the LiDAR DTM were calculated and examined their performances by forested vs. non-forested, slope, and elevation classes. The results showed the MERIT DEM was superior to other DEMs in most of the testing methods. It outperformed other DEMs with an RMSEz value of 3.02 m in the forested areas, followed by ALOS PALSAR (9.29 m), EarthEnv-DEM90 (9.40 m), SRTM (9.80 m), TanDEM-X (10.41 m), and ASTER GDEM3 (12.57 m). The MERIT DEM also had the best accuracy in the higher elevation areas. Overall, the ASTER GDEM3 had the worst accuracies, with relatively large over-estimations compared to other DEMs. Despite its low spatial resolution, the MERIT DEM was the best for representing terrain elevation for applications over a large area

    Quantum Physics and Human Language

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    Human languages employ constructions that tacitly assume specific properties of the limited range of phenomena they evolved to describe. These assumed properties are true features of that limited context, but may not be general or precise properties of all the physical situations allowed by fundamental physics. In brief, human languages contain `excess baggage' that must be qualified, discarded, or otherwise reformed to give a clear account in the context of fundamental physics of even the everyday phenomena that the languages evolved to describe. The surest route to clarity is to express the constructions of human languages in the language of fundamental physical theory, not the other way around. These ideas are illustrated by an analysis of the verb `to happen' and the word `reality' in special relativity and the modern quantum mechanics of closed systems.Comment: Contribution to the festschrift for G.C. Ghirardi on his 70th Birthday, minor correction

    Gelsolin dysfunction causes photoreceptor loss in induced pluripotent cell and animal retinitis pigmentosa models

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    Mutations in the Retinitis Pigmentosa GTPase Regulator (RPGR) cause X-linked RP (XLRP), an untreatable, inherited retinal dystrophy that leads to premature blindness. RPGR localises to the photoreceptor connecting cilium where its function remains unknown. Here we show, using murine and human induced pluripotent stem cell models, that RPGR interacts with and activates the actin-severing protein gelsolin, and that gelsolin regulates actin disassembly in the connecting cilium, thus facilitating rhodopsin transport to photoreceptor outer segments. Disease-causing RPGR mutations perturb this RPGR-gelsolin interaction, compromising gelsolin activation. Both RPGR and Gelsolin knockout mice show abnormalities of actin polymerisation and mislocalisation of rhodopsin in photoreceptors. These findings reveal a clinically-significant role for RPGR in the activation of gelsolin, without which abnormalities in actin polymerisation in the photoreceptor connecting cilia cause rhodopsin mislocalisation and eventual retinal degeneration in XLRP.Mutations in the Retinitis Pigmentosa GTPase Regulator (RPGR) cause retinal dystrophy, but how this arises at a molecular level is unclear. Here, the authors show in induced pluripotent stem cells and mouse knockouts that RPGR mediates actin dynamics in photoreceptors via the actin-severing protein, gelsolin
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