200 research outputs found
Shifting the Universe: Early Dark Energy and Standard Rulers
The presence of dark energy at high redshift influences both the cosmic sound
horizon and the distance to last scattering of the cosmic microwave background.
We demonstrate that through the degeneracy in their ratio, early dark energy
can lie hidden in the CMB temperature and polarization spectra, leading to an
unrecognized shift in the sound horizon. If the sound horizon is then used as a
standard ruler, as in baryon acoustic oscillations, then the derived
cosmological parameters can be nontrivially biased. Fitting for the absolute
ruler scale (just as supernovae must be fit for the absolute candle magnitude)
removes the bias but decreases the leverage of the BAO technique by a factor 2.Comment: 6 pages, 3 figure
Early Dark Energy Cosmologies
We propose a novel parameterization of the dark energy density. It is
particularly well suited to describe a non-negligible contribution of dark
energy at early times and contains only three parameters, which are all
physically meaningful: the fractional dark energy density today, the equation
of state today and the fractional dark energy density at early times. As we
parameterize Omega_d(a) directly instead of the equation of state, we can give
analytic expressions for the Hubble parameter, the conformal horizon today and
at last scattering, the sound horizon at last scattering, the acoustic scale as
well as the luminosity distance. For an equation of state today w_0 < -1, our
model crosses the cosmological constant boundary. We perform numerical studies
to constrain the parameters of our model by using Cosmic Microwave Background,
Large Scale Structure and Supernovae Ia data. At 95% confidence, we find that
the fractional dark energy density at early times Omega_early < 0.06. This
bound tightens considerably to Omega_early < 0.04 when the latest Boomerang
data is included. We find that both the gold sample of Riess et. al. and the
SNLS data by Astier et. al. when combined with CMB and LSS data mildly prefer
w_0 < -1, but are well compatible with a cosmological constant.Comment: 6 pages, 3 figures; references added, matches published versio
Cosmological Backreaction from Perturbations
We reformulate the averaged Einstein equations in a form suitable for use
with Newtonian gauge linear perturbation theory and track the size of the
modifications to standard Robertson-Walker evolution on the largest scales as a
function of redshift for both Einstein de-Sitter and Lambda CDM cosmologies. In
both cases the effective energy density arising from linear perturbations is of
the order of 10^-5 the matter density, as would be expected, with an effective
equation of state w ~ -1/19. Employing a modified Halofit code to extend our
results to quasilinear scales, we find that, while larger, the deviations from
Robertson-Walker behaviour remain of the order of 10^-5.Comment: 15 pages, 8 figures; replaced by version accepted by JCA
Intra-observer and interobserver variability of biventricular function, volumes and mass in patients with congenital heart disease measured by CMR imaging
Cardiovascular magnetic resonance (CMR) imaging provides highly accurate measurements of biventricular volumes and mass and is frequently used in the follow-up of patients with acquired and congenital heart disease (CHD). Data on reproducibility are limited in patients with CHD, while measurements should be reproducible, since CMR imaging has a main contribution to decision making and timing of (re)interventions. The aim of this study was to assess intra-observer and interobserver variability of biventricular function, volumes and mass in a heterogeneous group of patients with CHD using CMR imaging. Thirty-five patients with CHD (7–62 years) were included in this study. A short axis set was acquired using a steady-state free precession pulse sequence. Intra-observer and interobserver variability was assessed for left ventricular (LV) and right ventricular (RV) volumes, function and mass by calculating the coefficient of variability. Intra-observer variability was between 2.9 and 6.8% and interobserver variability was between 3.9 and 10.2%. Overall, variations were smallest for biventricular end-diastolic volume and highest for biventricular end-systolic volume. Intra-observer and interobserver variability of biventricular parameters assessed by CMR imaging is good for a heterogeneous group of patients with CHD. CMR imaging is an accurate and reproducible method and should allow adequate assessment of changes in ventricular size and global ventricular function
Averaging Robertson-Walker Cosmologies
The cosmological backreaction arises when one directly averages the Einstein
equations to recover an effective Robertson-Walker cosmology, rather than
assuming a background a priori. While usually discussed in the context of dark
energy, strictly speaking any cosmological model should be recovered from such
a procedure. We apply the Buchert averaging formalism to linear
Robertson-Walker universes containing matter, radiation and dark energy and
evaluate numerically the discrepancies between the assumed and the averaged
behaviour, finding the largest deviations for an Einstein-de Sitter universe,
increasing rapidly with Hubble rate to a 0.01% effect for h=0.701. For the LCDM
concordance model, the backreaction is of the order of Omega_eff~4x10^-6, with
those for dark energy models being within a factor of two or three. The impacts
at recombination are of the order of 10^-8 and those in deep radiation
domination asymptote to a constant value. While the effective equations of
state of the backreactions in Einstein-de Sitter, concordance and quintessence
models are generally dust-like, a backreaction with an equation of state
w_eff<-1/3 can be found for strongly phantom models.Comment: 18 pages, 11 figures, ReVTeX. Updated to version accepted by JCA
Elevated monocyte-specific type I interferon signalling correlates positively with cardiac healing in myocardial infarct patients but interferon alpha application deteriorates myocardial healing in rats
Patient information portal for congenital aortic and pulmonary valve disease:A stepped-wedge cluster randomised trial
Background In response to an increased need for patient information in congenital heart disease, we previously developed an online, evidence-based information portal for patients with congenital aortic and pulmonary valve disease. To assess its effectiveness, a stepped-wedge cluster randomised trial was conducted. Methods Adult patients and caregivers of paediatric patients with congenital aortic and/or pulmonary valve disease and/or tetralogy of Fallot who visited the outpatient clinic at any of the four participating centres in the Netherlands between 1 March 2016-1 July 2017 were prospectively included. The intervention (information portal) was introduced in the outpatient clinic according to a stepped-wedge randomised design. One month after outpatient clinic visit, each participant completed a questionnaire on disease-specific knowledge, anxiety, depression, mental quality of life, involvement and opinion/attitude concerning patient information and involvement. Results 343 participants were included (221 control, 122 intervention). Cardiac diagnosis (p=0.873), educational level (p=0.153) and sex (p=0.603) were comparable between the two groups. All outcomes were comparable between groups in the intention-to-treat analyses. However, only 51.6% of subjects in the intervention group (n=63) reported actually visiting the portal. Among these subjects (as-treated), disease-specific knowledge (p=0.041) and mental health (p=0.039) were significantly better than in control subjects, while other baseline and outcome variables were comparable. Conclusion Even after being invited by their cardiologists, only half of the participants actually visited the information portal. Only in those participants that actually visited the portal, knowledge of disease and mental health were significantly better. This underlines the importance of effective implementation of online evidence-based patient information portals in clinical practice.Cardiolog
Patient information portal for congenital aortic and pulmonary valve disease:A stepped-wedge cluster randomised trial
Validity of the self-administered comorbidity questionnaire in patients with inflammatory bowel disease
Background: The International Consortium for Health Outcomes Measurement has selected the self-administered comorbidity questionnaire (SCQ) to adjust case-mix when comparing outcomes of inflammatory bowel disease (IBD) treatment between healthcare providers. However, the SCQ has not been validated for use in IBD patients. Objectives: We assessed the validity of the SCQ for measuring comorbidities in IBD patients. Design: Cohort study. Methods: We assessed the criterion validity of the SCQ for IBD patients by comparing patient-reported and clinician-reported comorbidities (as noted in the electronic health record) of the 13 diseases of the SCQ using Cohen’s kappa. Construct validity was assessed using the Spearman correlation coefficient between the SCQ and the Charlson Comorbidity Index (CCI), clinician-reported SCQ, quality of life, IBD-related healthcare and productivity costs, prevalence of disability, and IBD disease activity. We assessed responsiveness by correlating changes in the SCQ with changes in healthcare costs, productivity costs, quality of life, and disease activity after 15 months. Results: We included 613 patients. At least fair agreement (κ > 0.20) was found for most comorbidities, but the agreement was slight (κ < 0.20) for stomach disease [κ = 0.19, 95% CI (−0.03; 0.41)], blood disease [κ = 0.02, 95% CI (−0.06; 0.11)], and back pain [κ = 0.18, 95% CI (0.11; 0.25)]. Correlations were found between the SCQ and the clinician-reported SCQ [ρ = 0.60, 95% CI (0.55; 0.66)], CCI [ρ = 0.39, 95% CI (0.31; 0.45)], the prevalence of disability [ρ = 0.23, 95% CI (0.15; 0.32)], and quality of life [ρ = −0.30, 95% CI (−0.37; −0.22)], but not between the SCQ and healthcare or productivity costs or disease activity (|ρ| ⩽ 0.2). A change in the SCQ after 15 months was not correlated with a change in any of the outcomes.Conclusion: The SCQ is a valid tool for measuring comorbidity in IBD patients, but face and content validity should be improved before being used to correct case-mix differences.</p
The rs1990760 polymorphism within the IFIH1 locus is not associated with Graves' disease, Hashimoto's thyroiditis and Addison's disease
Background: Three genes have been confirmed as major joint susceptibility genes for endocrine autoimmune disease:human leukocyte antigen class II, cytotoxic T-lymphocyte antigen 4 and protein tyrosine phosphatase non-receptor type 22. Recent studies showed that a genetic variation within the interferon induced helicase domain 1 (IFIH1) locus (rs1990760 polymorphism) is an additional risk factor in type 1 diabetes and Graves' disease (GD). Methods: The aim of the present study was to investigate the role of the rs1990760 polymorphism within the IFIH1 gene in German patients with GD (n=258), Hashimoto's thyroiditis (HT,n=106), Addison's disease (AD,n=195) and healthy controls (HC,n=227) as well as in 55 GD families (165 individuals, German) and 100 HT families (300 individuals, Italian). Furthermore, the interaction between rs1990760 polymorphism with human leukocyte antigen (HLA) risk haplotype DQ2(DQA*0501-DQB*0201), the risk haplotypes DQ2/DQ8 (DQA*0301-DQB*0302) and the status of thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb) and TSH receptor antibody (TRAb) in patients and families were analysed. Results:No significant differences were found between the allele and genotype frequencies for rs1990760 IFIH1 polymorphism in patients with GD, HT, AD and HC. Also no differences were observed when stratifying the IFIH1 rs1990760 polymorphism for gender, presence or absence of thyroid antibodies (GD:TRAb and HT:TPOAb/TgAb) and HLA risk haplotypes (DQ2:for GD and HT, DQ2/DQ8:for AD). Furthermore the transmission analysis in GD and HT families revealed no differences in alleles transmission for rs1990760 IFIH1 from parents with or without HLA risk haplotype DQ2 to the affected offspring. In contrast, by dividing the HT parents according to the presence or absence of thyroid Ab titers, mothers and fathers both positive for TPOAb/TgAb overtransmitted the allele A of IFIH1 rs1990760 to their HT affected offspring (61.8% vs 38.2%;p=0.05;corrected p [pc]=0.1). However, these associations did not remain statistically significant after correction of the p-values. Conclusion: In conclusion, our data suggest, no contribution from IFIH1 rs1990760 polymorphism to the pathogenesis of either Graves' disease, Hashimoto's thyroiditis or Addison's disease in our study populations. However, in order to exclude a possible influence of the studied polymorphism in specified subgroups within patients with autoimmune thyroid disease, further investigations in larger populations are needed
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