1,166 research outputs found

    Cerebral Small Vessel Disease burden is increased in Systemic Lupus Erythematosus

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    BACKGROUND AND PURPOSE—: Systemic lupus erythematosus (SLE) increases stroke risk, but the mechanism is uncertain. This study aimed to determine the association between SLE and features on neuroimaging of cerebral small vessel disease (SVD), a risk factor for stroke. METHODS—: Consecutive patients attending a clinic for SLE were recruited. All patients underwent brain magnetic resonance imaging; had blood samples taken for markers of inflammation, endothelial dysfunction, cholesterol, and autoantibodies; and underwent cognitive and psychiatric testing. The data were compared with sex- and age-matched healthy controls and patients with minor stroke. Features of SVD were measured, a total SVD score calculated, and associations sought with vascular risk factors, cognition, SLE activity, and disease duration. RESULTS—: Fifty-one SLE patients (age: 48.8 years; SD: 14.3 years) had a greater total SVD score compared with healthy controls (1 versus 0; P<0.0001) and stroke patients (1 versus 0; P=0.02). There were higher perivascular spaces and deep white matter hyperintensity scores and more superficial brain atrophy in SLE patients versus healthy controls. Despite fewer vascular risk factors than similarly aged stroke patients, SLE patients had similar or more of some SVD features. The total SVD score was not associated with SLE activity, cognition, disease duration, or any blood measure. CONCLUSIONS—: In this data set, SLE patients had a high burden of SVD features on magnetic resonance imaging, particularly perivascular spaces. A larger longitudinal study is warranted to determine the causes of SVD features in SLE and clinical implications

    Ozone and PM(2.5) Exposure and Acute Pulmonary Health Effects: A Study of Hikers in the Great Smoky Mountains National Park

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    To address the lack of research on the pulmonary health effects of ozone and fine particulate matter (≤ 2.5 μm in aerodynamic diameter; PM(2.5)) on individuals who recreate in the Great Smoky Mountains National Park (USA) and to replicate a study performed at Mt. Washington, New Hampshire (USA), we conducted an observational study of adult (18–82 years of age) day hikers of the Charlies Bunion trail during 71 days of fall 2002 and summer 2003. Volunteer hikers performed pre- and posthike pulmonary function tests (spirometry), and we continuously monitored ambient O(3), PM(2.5), temperature, and relative humidity at the trailhead. Of the 817 hikers who participated, 354 (43%) met inclusion criteria (nonsmokers and no use of bronchodilators within 48 hr) and gave acceptable and reproducible spirometry. For these 354 hikers, we calculated the posthike percentage change in forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV(1)), FVC/FEV(1), peak expiratory flow, and mean flow rate between 25 and 75% of the FVC and regressed each separately against pollutant (O(3) or PM(2.5)) concentration, adjusting for age, sex, hours hiked, smoking status (former vs. never), history of asthma or wheeze symptoms, hike load, reaching the summit, and mean daily temperature. O(3) and PM(2.5) concentrations measured during the study were below the current federal standards, and we found no significant associations of acute changes in pulmonary function with either pollutant. These findings are contrasted with those in the Mt. Washington study to examine the hypothesis that pulmonary health effects are associated with exposure to O(3) and PM(2.5) in healthy adults engaged in moderate exercise

    A clinical prediction model for long-term functional outcome after traumatic spinal cord injury based on acute clinical and imaging factors.

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    To improve clinicians\u27 ability to predict outcome after spinal cord injury (SCI) and to help classify patients within clinical trials, we have created a novel prediction model relating acute clinical and imaging information to functional outcome at 1 year. Data were obtained from two large prospective SCI datasets. Functional independence measure (FIM) motor score at 1 year follow-up was the primary outcome, and functional independence (score ≥ 6 for each FIM motor item) was the secondary outcome. A linear regression model was created with the primary outcome modeled relative to clinical and imaging predictors obtained within 3 days of injury. A logistic model was then created using the dichotomized secondary outcome and the same predictor variables. Model validation was performed using a bootstrap resampling procedure. Of 729 patients, 376 met the inclusion criteria. The mean FIM motor score at 1 year was 62.9 (±28.6). Better functional status was predicted by less severe initial American Spinal Injury Association (ASIA) Impairment Scale grade, and by an ASIA motor score \u3e50 at admission. In contrast, older age and magnetic resonance imaging (MRI) signal characteristics consistent with spinal cord edema or hemorrhage predicted worse functional outcome. The linear model predicting FIM motor score demonstrated an R-square of 0.52 in the original dataset, and 0.52 (95% CI 0.52,0.53) across the 200 bootstraps. Functional independence was achieved by 148 patients (39.4%). For the logistic model, the area under the curve was 0.93 in the original dataset, and 0.92 (95% CI 0.92,0.93) across the bootstraps, indicating excellent predictive discrimination. These models will have important clinical impact to guide decision making and to counsel patients and families

    Viewpoints of pedestrians with and without cognitive impairment on shared zones and zebra crossings

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    Background: Shared zones are characterised by an absence of traditional markers that segregate the road and footpath. Negotiation of a shared zone relies on an individual’s ability to perceive, assess and respond to environmental cues. This ability may be impacted by impairments in cognitive processing, which may lead to individuals experiencing increased anxiety when negotiating a shared zone. Method: Q method was used in order to identify and explore the viewpoints of pedestrians, with and without cognitive impairments as they pertain to shared zones. Results: Two viewpoints were revealed. Viewpoint one was defined by “confident users” while viewpoint two was defined by users who “know what [they] are doing but drivers might not”. Discussion: Overall, participants in the study would not avoid shared zones. Pedestrians with intellectual disability were, however, not well represented by either viewpoint, suggesting that shared zones may pose a potential barrier to participation for this group

    A statistical review of light curves and the prevalence of contact binaries in the Kuiper Belt

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    We investigate what can be learned about a population of distant Kuiper Belt Objects (KBOs) by studying the statistical properties of their light curves. Whereas others have successfully inferred the properties of individual, highly variable KBOs, we show that the fraction of KBOs with low amplitudes also provides fundamental information about a population. Each light curve is primarily the result of two factors: shape and orientation. We consider contact binaries and ellipsoidal shapes, with and without flattening. After developing the mathematical framework, we apply it to the existing body of KBO light curve data. Principal conclusions are as follows. (1) When using absolute magnitude H as a proxy for the sizes of KBOs, it is more accurate to use the maximum of the light curve (minimum H) rather than the mean. (2) Previous investigators have noted that smaller KBOs tend to have higher-amplitude light curves, and have interpreted this as evidence that they are systematically more irregular in shape than larger KBOs; we show that a population of flattened bodies with uniform proportions, independent of size, could also explain this result. (3) Our method of analysis indicates that prior assessments of the fraction of contact binaries in the Kuiper Belt may be artificially low. (4) The pole orientations of some KBOs can be inferred from observed changes in their light curves over time scales of decades; however, we show that these KBOs constitute a biased sample, whose pole orientations are not representative of the population overall. (5) Although surface topography, albedo patterns, limb darkening, and other surface properties can affect individual light curves, they do not have a strong influence on the statistics overall. (6) Photometry from the Outer Solar System Origins Survey (OSSOS) survey is incompatible with previous results and its statistical properties defy easy interpretation. We also discuss the promise of this approach for the analysis of future, much larger data sets such as the one anticipated from the upcoming Vera C. Rubin Observatory

    A statistical review of light curves and the prevalence of contact binaries in the Kuiper Belt

    Get PDF
    We investigate what can be learned about a population of distant Kuiper Belt Objects (KBOs) by studying the statistical properties of their light curves. Whereas others have successfully inferred the properties of individual, highly variable KBOs, we show that the fraction of KBOs with low amplitudes also provides fundamental information about a population. Each light curve is primarily the result of two factors: shape and orientation. We consider contact binaries and ellipsoidal shapes, with and without flattening. After developing the mathematical framework, we apply it to the existing body of KBO light curve data. Principal conclusions are as follows. (1) When using absolute magnitude H as a proxy for the sizes of KBOs, it is more accurate to use the maximum of the light curve (minimum H) rather than the mean. (2) Previous investigators have noted that smaller KBOs tend to have higher-amplitude light curves, and have interpreted this as evidence that they are systematically more irregular in shape than larger KBOs; we show that a population of flattened bodies with uniform proportions, independent of size, could also explain this result. (3) Our method of analysis indicates that prior assessments of the fraction of contact binaries in the Kuiper Belt may be artificially low. (4) The pole orientations of some KBOs can be inferred from observed changes in their light curves over time scales of decades; however, we show that these KBOs constitute a biased sample, whose pole orientations are not representative of the population overall. (5) Although surface topography, albedo patterns, limb darkening, and other surface properties can affect individual light curves, they do not have a strong influence on the statistics overall. (6) Photometry from the Outer Solar System Origins Survey (OSSOS) survey is incompatible with previous results and its statistical properties defy easy interpretation. We also discuss the promise of this approach for the analysis of future, much larger data sets such as the one anticipated from the upcoming Vera C. Rubin Observatory

    Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization.

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    The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using a genome-wide association and replication study in up to 100,000 individuals, we identified 35 common variant loci associated with QT interval that collectively explain ∼8-10% of QT-interval variation and highlight the importance of calcium regulation in myocardial repolarization. Rare variant analysis of 6 new QT interval-associated loci in 298 unrelated probands with LQTS identified coding variants not found in controls but of uncertain causality and therefore requiring validation. Several newly identified loci encode proteins that physically interact with other recognized repolarization proteins. Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies new candidate genes for ventricular arrhythmias, LQTS and SCD
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