Warfarin prevalence, indications for use and haemorrhagic events

Warfarin, the standard oral anticoagulant drug used in Ireland, is a widely prescribed medication, particularly in the elderly. A HSE Mid-Western Area wide audit was undertaken over a 12-month period to examine the prevalence and indications for warfarin use and haemorrhagic complications associated with the drug. Every patient receiving warfarin therapy over a 13-week period was included (2564). The age standardised rate varied from 0.09% of 35-39 year olds to 6.1% of 80-84 year olds. Atrial fibrillation was the most common indication (54%) in patients attending the Mid-Western Regional Hospital anticoagulation clinic. The annual cumulative incidence of adverse haemorrhagic events in patients with a recorded INR > or = 5.0 episode was 16.6%. The incidence of major and minor haemorrhagic events per INR > or = 5.0 episode was 1.3% and 15.3% respectively. The most common sites of haemorrhage were genitourinary (39%) and gastrointestinal (27%). No fatal or intracranial haemorrhage relating to episodes of over-anticoagulation were reported during the audit period. The most frequent reason for over-anticoagulation was drug interaction (43%). In 74% of patients, the elevated INR was reversed by omitting or reducing warfarin dose. In 17% of cases, vitamin K was administered. Only 3% of incidents were treated with fresh frozen plasma or prothrombin complex concentrates.Warfarin, the standard oral anticoagulant drug used in Ireland, is a widely prescribed medication, particularly in the elderly. A HSE Mid-Western Area wide audit was undertaken over a 12-month period to examine the prevalence and indications for warfarin use and haemorrhagic complications associated with the drug. Every patient receiving warfarin therapy over a 13-week period was included (2564). The age standardised rate varied from 0.09% of 35-39 year olds to 6.1% of 80-84 year olds. Atrial fibrillation was the most common indication (54%) in patients attending the Mid-Western Regional Hospital anticoagulation clinic. The annual cumulative incidence of adverse haemorrhagic events in patients with a recorded INR > or = 5.0 episode was 16.6%. The incidence of major and minor haemorrhagic events per INR > or = 5.0 episode was 1.3% and 15.3% respectively. The most common sites of haemorrhage were genitourinary (39%) and gastrointestinal (27%). No fatal or intracranial haemorrhage relating to episodes of over-anticoagulation were reported during the audit period. The most frequent reason for over-anticoagulation was drug interaction (43%). In 74% of patients, the elevated INR was reversed by omitting or reducing warfarin dose. In 17% of cases, vitamin K was administered. Only 3% of incidents were treated with fresh frozen plasma or prothrombin complex concentrates

OnRamp: a Galaxy-based platform for collaborative annotation of eukaryotic genomes

G-OnRamp provides a user-friendly, web-based platform for collaborative, end-to-end annotation of eukaryotic genomes using UCSC Assembly Hubs and JBrowse/Apollo genome browsers with evidence tracks derived from sequence alignments, ab initio gene predictors, RNA-Seq data and repeat finders. G-OnRamp can be used to visualize large genomics datasets and to perform collaborative genome annotation projects in both research and educational settings

Generating genome browsers to facilitate undergraduate-driven collaborative genome annotation

Scientists are sequencing new genomes at an increasing rate with the goal of associating genome contents with phenotypic traits. After a new genome is sequenced and assembled, structural gene annotation is often the first step in analysis. Despite advances in computational gene prediction algorithms, most eukaryotic genomes still benefit from manual gene annotation. Undergraduates can become skilled annotators, and in the process learn both about genes/genomes and about how to utilize large datasets. Data visualizations provided by a genome browser are essential for manual gene annotation, enabling annotators to quickly evaluate multiple lines of evidence (e.g., sequence similarity, RNA-Seq, gene predictions, repeats). However, creating genome browsers requires extensive computational skills; lack of the expertise required remains a major barrier for many biomedical researchers and educators.To address these challenges, the Genomics Education Partnership (GEP; https://gep.wustl.edu/) has partnered with the Galaxy Project (https://galaxyproject.org) to develop G-OnRamp (http://g-onramp.org), a web-based platform for creating UCSC Assembly Hubs and JBrowse genome browsers. G-OnRamp can also convert a JBrowse instance into an Apollo instance for collaborative genome annotations in research and educational settings. G-OnRamp enables researchers to easily visualize their experimental results, educators to create Course-based Undergraduate Research Experiences (CUREs) centered on genome annotation, and students to participate in genomics research.Development of G-OnRamp was guided by extensive user feedback from in-person workshops. Sixty-five researchers and educators from over 40 institutions participated in these workshops, which produced over 20 genome browsers now available for research and education. For example, genome browsers for four parasitoid wasp species were used in a CURE engaging 142 students taught by 13 faculty members —producing a total of 192 gene models. G-OnRamp can be deployed on a personal computer or on cloud computing platforms, and the genome browsers produced can be transferred to the CyVerse Data Store for long-term access

Understanding the inclusion and participation of adults from Black African Diaspora Communities (BAFDC) in health and care research in the UK:a realist review protocol

Introduction: People from Black African Diaspora Communities (BAFDC) experience poorer health outcomes, have many long-term conditions and are persistently under-represented in health and care research. There is limited focus on programmes, or interventions that support inclusion and participation of people from BAFDC in research. Through coproduction, this realist review seeks to provide a programme theory explaining what context and mechanisms may be required, to produce outcomes that facilitate inclusion and participation for people from BAFDC in health and care research, in the UK.Methods and analysis: A group of people from BAFDC with lived and professional experience, representing all levels of the health and care research system, will coproduce a realist review with a team of African-Caribbean, white British and white British of Polish origin health and care researchers. They will follow Pawson’s five steps: (1) shaping the scope of the review; (2) searching for evidence; (3) document selection and appraisal; (4) data extraction and (5) data synthesis. The coproduction group will help to map the current landscape, identifying key issues that may inhibit or facilitate inclusion. Data will be extracted, analysed and synthesised following realist logic analysis, identifying and explaining how context and mechanisms are conceptualised in the literature and the types of contextual factors that exist and impact on inclusion and participation. Findings will be reported in accordance with Realist and Meta-narrative Evidence Synthesis Evolving Standards .Ethics and dissemination: The coproduction group will agree an ethical approach considering accountability, responsibility and power dynamics, by establishing a terms of reference, taking a reflexive approach and coproducing an ethical framework. Findings will be disseminated to BAFDC and the research community through arts-based methods, peer-reviewed publications and conference presentations, agreeing a coproduced strategy for dissemination. Ethical review is not required.PROSPERO registration number: CRD42024517124

Wandering Black Hole Candidates in Dwarf Galaxies at VLBI Resolution

Thirteen dwarf galaxies have recently been found to host radio-selected accreting massive black hole (MBH) candidates, some of which are ``wandering" in the outskirts of their hosts. We present 9 GHz Very Long Baseline Array (VLBA) observations of these sources at milliarcsecond resolution. Our observations have beam solid angles ${\sim}10^4$ times smaller than the previous Very Large Array (VLA) observations at 9 GHz, with comparable point source sensitivities. We detect milliarcsecond-scale radio sources at the positions of the four VLA sources most distant from the photo-centers of their associated dwarf galaxies. These sources have brightness temperatures of ${>}10^6~\mathrm{K}$, consistent with active galactic nuclei (AGNs), but the significance of their preferential location at large distances ($p$-value~$=0.0014$) favors a background AGN interpretation. The VLBA non-detections toward the other 9 galaxies indicate that the VLA sources are resolved out on scales of tens of milliarcseconds, requiring extended radio emission and lower brightness temperatures consistent with either star formation or radio lobes associated with AGN activity. We explore the star formation explanation by calculating the expected radio emission for these nine VLBA non-detections, finding that about 5 have VLA luminosities that are inconsistent with this scenario. Of the remaining four, two are associated with spectroscopically confirmed AGNs that are consistent with being located at their galaxy photo-centers. There are therefore between 5 and 7 wandering MBH candidates out of the 13 galaxies we observed, although we cannot rule out background AGNs for five of them with the data in hand.Comment: 13 pages, 3 figures, Accepted in Ap

The evolution of the cosmic molecular gas density

One of the last missing pieces in the puzzle of galaxy formation and evolution through cosmic history is a detailed picture of the role of the cold gas supply in the star-formation process. Cold gas is the fuel for star formation, and thus regulates the buildup of stellar mass, both through the amount of material present through a galaxy's gas mass fraction, and through the efficiency at which it is converted to stars. Over the last decade, important progress has been made in understanding the relative importance of these two factors along with the role of feedback, and the first measurements of the volume density of cold gas out to redshift 4, (the "cold gas history of the Universe") has been obtained. To match the precision of measurements of the star formation and black-hole accretion histories over the coming decades, a two orders of magnitude improvement in molecular line survey speeds is required compared to what is possible with current facilities. Possible pathways towards such large gains include significant upgrades to current facilities like ALMA by 2030 (and beyond), and eventually the construction of a new generation of radio-to-millimeter wavelength facilities, such as the next generation Very Large Array (ngVLA) concept.Comment: 7 pages, 2 figures, Science White paper submitted to Astro2020 Decadal Surve

The Morphology of Galaxies in the Baryon Oscillation Spectroscopic Survey

We study the morphology of luminous and massive galaxies at 0.3<z<0.7 targeted in the Baryon Oscillation Spectroscopic Survey (BOSS) using publicly available Hubble Space Telescope imaging from COSMOS. Our sample (240 objects) provides a unique opportunity to check the visual morphology of these galaxies which were targeted based solely on stellar population modelling. We find that the majority (74+/-6%) possess an early-type morphology (elliptical or S0), while the remainder have a late-type morphology. This is as expected from the goals of the BOSS target selection which aimed to predominantly select slowly evolving galaxies, for use as cosmological probes, while still obtaining a fair fraction of actively star forming galaxies for galaxy evolution studies. We show that a colour cut of (g-i)>2.35 selects a sub-sample of BOSS galaxies with 90% early-type morphology - more comparable to the earlier Luminous Red Galaxy (LRG) samples of SDSS-I/II. The remaining 10% of galaxies above this cut have a late-type morphology and may be analogous to the "passive spirals" found at lower redshift. We find that 23+/-4% of the early-type galaxies are unresolved multiple systems in the SDSS imaging. We estimate that at least 50% of these are real associations (not projection effects) and may represent a significant "dry merger" fraction. We study the SDSS pipeline sizes of BOSS galaxies which we find to be systematically larger (by 40%) than those measured from HST images, and provide a statistical correction for the difference. These details of the BOSS galaxies will help users of the data fine-tune their selection criteria, dependent on their science applications. For example, the main goal of BOSS is to measure the cosmic distance scale and expansion rate of the Universe to percent-level precision - a point where systematic effects due to the details of target selection may become important.Comment: 18 pages, 11 figures; v2 as accepted by MNRA

CO Luminosity Density at High-z (COLDz) Survey: A Sensitive, Large-area Blind Search for Low-J CO Emission from Cold Gas in the Early Universe with the Karl G. Jansky Very Large Array

We describe the CO Luminosity Density at High-z (COLDz) survey, the first spectral line deep field targeting CO(1–0) emission from galaxies at z = 1.95–2.85 and CO(2–1) at z = 4.91–6.70. The main goal of COLDz is to constrain the cosmic density of molecular gas at the peak epoch of cosmic star formation. By targeting both a wide (~51 arcmin2) and a deep (~9 arcmin^2) area, the survey is designed to robustly constrain the bright end and the characteristic luminosity of the CO(1–0) luminosity function. An extensive analysis of the reliability of our line candidates and new techniques provide detailed completeness and statistical corrections as necessary to determine the best constraints to date on the CO luminosity function. Our blind search for CO(1–0) uniformly selects starbursts and massive main-sequence galaxies based on their cold molecular gas masses. Our search also detects CO(2–1) line emission from optically dark, dusty star-forming galaxies at z > 5. We find a range of spatial sizes for the CO-traced gas reservoirs up to ~40 kpc, suggesting that spatially extended cold molecular gas reservoirs may be common in massive, gas-rich galaxies at z ~ 2. Through CO line stacking, we constrain the gas mass fraction in previously known typical star-forming galaxies at z = 2–3. The stacked CO detection suggests lower molecular gas mass fractions than expected for massive main-sequence galaxies by a factor of ~3–6. We find total CO line brightness at ~34 GHz of 0.45 ± 0.2 μK, which constrains future line intensity mapping and CMB experiments