4,308 research outputs found
Psoriasis and comorbid diseases: Implications for management.
: As summarized in the first article in this continuing medical education series, the currently available epidemiologic data suggest that psoriasis may be a risk factor for cardiometabolic disease. Emerging data also suggest associations between psoriasis and other comorbidities beyond psoriatic arthritis, including chronic kidney disease, inflammatory bowel disease, hepatic disease, certain malignancies, infections, and mood disorders. Recognizing the comorbid disease burden of psoriasis is essential for ensuring comprehensive care of patients with psoriasis. The clinical implications of the comorbid diseases that are associated with psoriasis and recommendations for clinical management are reviewed in this article.<br/
Psoriasis and comorbid diseases: Epidemiology.
Psoriasis is a common chronic inflammatory disease of the skin that is increasingly being recognized as a systemic inflammatory disorder. Psoriatic arthritis is a well-known comorbidity of psoriasis. A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic diseases, gastrointestinal diseases, kidney disease, malignancy, infection, and mood disorders. The pathogenesis of comorbid disease in patients with psoriasis remains unknown; however, shared inflammatory pathways, cellular mediators, genetic susceptibility, and common risk factors are hypothesized to be contributing elements. As additional psoriasis comorbidities continue to emerge, education of health care providers is essential to ensuring comprehensive medical care for patients with psoriasis
Dopaminergic organization of striatum is linked to cortical activity and brain expression of genes associated with psychiatric illness
Dopamine signaling is constrained to discrete tracts yet has brain-wide effects on neural activity. The nature of this relationship between local dopamine signaling and brain-wide neuronal activity is not clearly defined and has relevance for neuropsychiatric illnesses where abnormalities of cortical activity and dopamine signaling coexist. Using simultaneous PET-MRI in healthy volunteers, we find strong evidence that patterns of striatal dopamine signaling and cortical blood flow (an index of local neural activity) contain shared information. This shared information links amphetamine-induced changes in gradients of striatal dopamine receptor availability to changes in brain-wide blood flow and is informed by spatial patterns of gene expression enriched for genes implicated in schizophrenia, bipolar disorder, and autism spectrum disorder. These results advance our knowledge of the relationship between cortical function and striatal dopamine, with relevance for understanding pathophysiology and treatment of diseases in which simultaneous aberrations of these systems exist
Influence of shear stress magnitude and direction on atherosclerotic plaque composition
British Heart Foundation (BHF) grants (no. RG/11/13/29055 and PG/15/49/31595), awarded to R.K. and E.P. who are employed by Bioengineering and the MRC Clinical Sciences
Centre at Imperial College London. The grants also supported R.M.P. and S.M.B. V.V.M. was supported by a BHF. PhD studentship
Chronic Lung Function Decline in Cotton Textile Workers: Roles of Historical and Recent Exposures to Endotoxin
BackgroundLong-term occupational exposure to cotton dust that contains endotoxin is associated with chronic respiratory symptoms and excessive decline in forced expiratory volume in 1 sec (FEV1), but the mechanisms of endotoxin-related chronic airflow obstruction remain unclear.ObjectiveIn the current study, we examined temporal aspects of the exposure-response relationship between airborne endotoxin exposure, longitudinal change in FEV1, and respiratory symptoms in a cohort of Chinese cotton textile workers.MethodsThis prospective cohort study followed 447 cotton textile workers from 1981 to 2006. at approximately 5-year intervals. We used a generalized estimating equations approach to model FEV1 level and respiratory symptoms as a function of past exposure (cumulative exposure up to the start of the most recent 5-year survey interval) and cumulative exposure (within the most recent interval) to endotoxins, after adjusting for other covariates. Models were stratified by active versus retired work status and by years employed before the baseline survey (< 5 and > or = 5 years).Results and conclusionsPast exposure to endotoxin was associated with reduced FEV1 level among retired cotton workers. Among all cotton workers, past exposure was more strongly associated with reduced FEV1 for those hired < 5 years before baseline than for those who were hired > or = 5 years after baseline. Recent endotoxin exposure was significantly associated with byssinosis, chronic bronchitis, and chronic cough
Evidence for the classical integrability of the complete AdS(4) x CP(3) superstring
We construct a zero-curvature Lax connection in a sub-sector of the
superstring theory on AdS(4) x CP(3) which is not described by the
OSp(6|4)/U(3) x SO(1,3) supercoset sigma-model. In this sub-sector worldsheet
fermions associated to eight broken supersymmetries of the type IIA background
are physical fields. As such, the prescription for the construction of the Lax
connection based on the Z_4-automorphism of the isometry superalgebra OSp(6|4)
does not do the job. So, to construct the Lax connection we have used an
alternative method which nevertheless relies on the isometry of the target
superspace and kappa-symmetry of the Green-Schwarz superstring.Comment: 1+26 pages; v2: minor typos corrected, acknowledgements adde
Photon statistics of a random laser
A general relationship is presented between the statistics of thermal
radiation from a random medium and its scattering matrix S. Familiar results
for black-body radiation are recovered in the limit S to 0. The mean photocount
is proportional to the trace of 1-SS^dagger, in accordance with Kirchhoff's law
relating emissivity and absorptivity. Higher moments of the photocount
distribution are related to traces of powers of 1-SS^dagger, a generalization
of Kirchhoff's law. The theory can be applied to a random amplifying medium (or
"random laser") below the laser threshold, by evaluating the Bose-Einstein
function at a negative temperature. Anomalously large fluctuations are
predicted in the photocount upon approaching the laser threshold, as a
consequence of overlapping cavity modes with a broad distribution of spectral
widths.Comment: 26 pages, including 9 figure
Random Matrix Theory for the Hermitian Wilson Dirac Operator and the chGUE-GUE Transition
We introduce a random two-matrix model interpolating between a chiral
Hermitian (2n+nu)x(2n+nu) matrix and a second Hermitian matrix without
symmetries. These are taken from the chiral Gaussian Unitary Ensemble (chGUE)
and Gaussian Unitary Ensemble (GUE), respectively. In the microscopic large-n
limit in the vicinity of the chGUE (which we denote by weakly non-chiral limit)
this theory is in one to one correspondence to the partition function of Wilson
chiral perturbation theory in the epsilon regime, such as the related two
matrix-model previously introduced in refs. [20,21]. For a generic number of
flavours and rectangular block matrices in the chGUE part we derive an
eigenvalue representation for the partition function displaying a Pfaffian
structure. In the quenched case with nu=0,1 we derive all spectral correlations
functions in our model for finite-n, given in terms of skew-orthogonal
polynomials. The latter are expressed as Gaussian integrals over standard
Laguerre polynomials. In the weakly non-chiral microscopic limit this yields
all corresponding quenched eigenvalue correlation functions of the Hermitian
Wilson operator.Comment: 27 pages, 4 figures; v2 typos corrected, published versio
Predicting Atrial Fibrillation Recurrence by Combining Population Data and Virtual Cohorts of Patient-Specific Left Atrial Models.
BACKGROUND: Current ablation therapy for atrial fibrillation is suboptimal, and long-term response is challenging to predict. Clinical trials identify bedside properties that provide only modest prediction of long-term response in populations, while patient-specific models in small cohorts primarily explain acute response to ablation. We aimed to predict long-term atrial fibrillation recurrence after ablation in large cohorts, by using machine learning to complement biophysical simulations by encoding more interindividual variability. METHODS: Patient-specific models were constructed for 100 atrial fibrillation patients (43 paroxysmal, 41 persistent, and 16 long-standing persistent), undergoing first ablation. Patients were followed for 1 year using ambulatory ECG monitoring. Each patient-specific biophysical model combined differing fibrosis patterns, fiber orientation maps, electrical properties, and ablation patterns to capture uncertainty in atrial properties and to test the ability of the tissue to sustain fibrillation. These simulation stress tests of different model variants were postprocessed to calculate atrial fibrillation simulation metrics. Machine learning classifiers were trained to predict atrial fibrillation recurrence using features from the patient history, imaging, and atrial fibrillation simulation metrics. RESULTS: We performed 1100 atrial fibrillation ablation simulations across 100 patient-specific models. Models based on simulation stress tests alone showed a maximum accuracy of 0.63 for predicting long-term fibrillation recurrence. Classifiers trained to history, imaging, and simulation stress tests (average 10-fold cross-validation area under the curve, 0.85±0.09; recall, 0.80±0.13; precision, 0.74±0.13) outperformed those trained to history and imaging (area under the curve, 0.66±0.17) or history alone (area under the curve, 0.61±0.14). CONCLUSION: A novel computational pipeline accurately predicted long-term atrial fibrillation recurrence in individual patients by combining outcome data with patient-specific acute simulation response. This technique could help to personalize selection for atrial fibrillation ablation
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