877 research outputs found
Alpha, Betti and the Megaparsec Universe: on the Topology of the Cosmic Web
We study the topology of the Megaparsec Cosmic Web in terms of the
scale-dependent Betti numbers, which formalize the topological information
content of the cosmic mass distribution. While the Betti numbers do not fully
quantify topology, they extend the information beyond conventional cosmological
studies of topology in terms of genus and Euler characteristic. The richer
information content of Betti numbers goes along the availability of fast
algorithms to compute them.
For continuous density fields, we determine the scale-dependence of Betti
numbers by invoking the cosmologically familiar filtration of sublevel or
superlevel sets defined by density thresholds. For the discrete galaxy
distribution, however, the analysis is based on the alpha shapes of the
particles. These simplicial complexes constitute an ordered sequence of nested
subsets of the Delaunay tessellation, a filtration defined by the scale
parameter, . As they are homotopy equivalent to the sublevel sets of
the distance field, they are an excellent tool for assessing the topological
structure of a discrete point distribution. In order to develop an intuitive
understanding for the behavior of Betti numbers as a function of , and
their relation to the morphological patterns in the Cosmic Web, we first study
them within the context of simple heuristic Voronoi clustering models.
Subsequently, we address the topology of structures emerging in the standard
LCDM scenario and in cosmological scenarios with alternative dark energy
content. The evolution and scale-dependence of the Betti numbers is shown to
reflect the hierarchical evolution of the Cosmic Web and yields a promising
measure of cosmological parameters. We also discuss the expected Betti numbers
as a function of the density threshold for superlevel sets of a Gaussian random
field.Comment: 42 pages, 14 figure
Social media posts and online search behaviour as early-warning system for MRSA outbreaks
Background: Despite many preventive measures, outbreaks with multi-drug resistant micro-organisms (MDROs) still
occur. Moreover, current alert systems from healthcare organizations have shortcomings due to delayed or
incomplete notifications, which may amplify the spread of MDROs by introducing infected patients into a new
healthcare setting and institutions. Additional sources of information about upcoming and current outbreaks, may
help to prevent further spread of MDROs.
The study objective was to evaluate whether methicillin-resistant Staphylococcus aureus (MRSA) outbreaks could be
detected via social media posts or online search behaviour; if so, this might allow earlier detection than the official
notifications by healthcare organizations.
Methods: We conducted an exploratory study in which we compared information about MRSA outbreaks in the
Netherlands derived from two online sources, Coosto for Social Media, and Google Trends for search behaviour, to
the mandatory Dutch outbreak notification system (SO-ZI/AMR). The latter provides information on MDRO
outbreaks including the date of the outbreak, micro-organism involved, the region/location, and the type of health
care organization.
Results: During the research period of 15 months (455 days), 49 notifications of outbreaks were recorded in SO-ZI/
AMR. For Coosto, the number of unique potential outbreaks was 37 and for Google Trends 24. The use of social
media and online search behaviour missed many of the hospital outbreaks that were reported to SO-ZI/AMR, but
detected additional outbreaks in long-term care facilities.
Conclusions: Despite several limitations, using information from social media and online search behaviour allows
rapid identification of potential MRSA outbreaks, especially in healthcare settings with a low notification
compliance. When combined in an automated system with real-time updates, this approach might increase early
discovery and subsequent implementation of preventive measures.EPI-Net COMBACTE-MAGNET project 115737Unión Europea FP7/2007–201
Respiratory function in LAMA2-related muscular dystrophy and SELENON-related congenital myopathy, a 1.5-year natural history study
INTRODUCTION: LAMA2-related muscular dystrophy (LAMA2-MD) and SELENON(SEPN1)-related congenital myopathy (SELENON-RM) are rare neuromuscular diseases with respiratory impairment from a young age. Prospective natural history studies are needed for prevalence estimations, respiratory characterization, optimizing clinical care and selecting outcome measures for trial readiness.METHODS: Our prospective 1.5-year natural history study included spirometry (forced vital capacity (FVC); difference between upright and supine vital capacity (dVC)), respiratory muscle strength tests (sniff nasal inspiratory pressure (SNIP)) (age≥5 years), and diaphragm ultrasound (thickness; thickening; echogenicity; all ages).RESULTS: Twenty-six LAMA2-MD patients (M = 8, median 21 [9; 31] years) and 11 SELENON-RM patients (M = 8, 20 [10; 33] years) were included. At baseline, 17 (85 %) LAMA2-MD (FVC%: 59 % [33; 68]) and all SELENON-RM patients (FVC%: 34 % [31; 46]) had an impaired respiratory function (FVC%<80 %). Nine (35 %) LAMA2-MD and eight (73 %) SELENON-RM patients received mechanical ventilation at baseline, and two additional SELENON-RM patients started during follow-up. Contrarily to LAMA2-MD, SELENON-RM patients had severe diaphragm atrophy (diaphragm thickness z-score: 2.5 [-3.1; -2.1]) and dysfunction (diaphragm thickness ratio: 1.2 [1.0; 1.7]; dVC: 30 % [7.7; 41]). SNIP was low in both neuromuscular diseases and correlated with motor function. In SELENON-RM, respiratory function decreased during follow-up.CONCLUSION: The majority of LAMA2-MD and all SELENON-RM patients had respiratory impairment. SELENON-RM patients showed lower respiratory function which was progressive, more prevalent mechanical ventilation, and more severe diaphragm atrophy and dysfunction than LAMA2-MD patients. Spirometry (FVC%, dVC) and respiratory muscle strength tests (SNIP) are useful in clinical care and as outcome measure in clinical trials.CLINICAL TRIAL NUMBER: NCT04478981.</p
Respiratory function in LAMA2-related muscular dystrophy and SELENON-related congenital myopathy, a 1.5-year natural history study
INTRODUCTION: LAMA2-related muscular dystrophy (LAMA2-MD) and SELENON(SEPN1)-related congenital myopathy (SELENON-RM) are rare neuromuscular diseases with respiratory impairment from a young age. Prospective natural history studies are needed for prevalence estimations, respiratory characterization, optimizing clinical care and selecting outcome measures for trial readiness.METHODS: Our prospective 1.5-year natural history study included spirometry (forced vital capacity (FVC); difference between upright and supine vital capacity (dVC)), respiratory muscle strength tests (sniff nasal inspiratory pressure (SNIP)) (age≥5 years), and diaphragm ultrasound (thickness; thickening; echogenicity; all ages).RESULTS: Twenty-six LAMA2-MD patients (M = 8, median 21 [9; 31] years) and 11 SELENON-RM patients (M = 8, 20 [10; 33] years) were included. At baseline, 17 (85 %) LAMA2-MD (FVC%: 59 % [33; 68]) and all SELENON-RM patients (FVC%: 34 % [31; 46]) had an impaired respiratory function (FVC%<80 %). Nine (35 %) LAMA2-MD and eight (73 %) SELENON-RM patients received mechanical ventilation at baseline, and two additional SELENON-RM patients started during follow-up. Contrarily to LAMA2-MD, SELENON-RM patients had severe diaphragm atrophy (diaphragm thickness z-score: 2.5 [-3.1; -2.1]) and dysfunction (diaphragm thickness ratio: 1.2 [1.0; 1.7]; dVC: 30 % [7.7; 41]). SNIP was low in both neuromuscular diseases and correlated with motor function. In SELENON-RM, respiratory function decreased during follow-up.CONCLUSION: The majority of LAMA2-MD and all SELENON-RM patients had respiratory impairment. SELENON-RM patients showed lower respiratory function which was progressive, more prevalent mechanical ventilation, and more severe diaphragm atrophy and dysfunction than LAMA2-MD patients. Spirometry (FVC%, dVC) and respiratory muscle strength tests (SNIP) are useful in clinical care and as outcome measure in clinical trials.CLINICAL TRIAL NUMBER: NCT04478981.</p
Long-term follow-up of respiratory function in facioscapulohumeral muscular dystrophy
OBJECTIVE: To evaluate the 5-year change in respiratory function in patients with facioscapulohumeral muscular dystrophy (FSHD). METHODS: Genetically confirmed patients with FSHD aged ≥ 18 years were examined twice over five years. Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were measured using hand-held spirometry with a face mask. Several clinical outcome measures were correlated to respiratory function. RESULTS: Ninety-two patients were included (57% male, age 18–75 years). At baseline, the spirometry outcomes of 41 patients showed a restrictive ventilatory pattern (FVC  10% predicted. The subgroup of 15 patients was more severely affected at baseline (p = 0.002 for FSHD clinical score and 0.007 for Ricci score). They developed more frequently spinal and thorax deformities (p < 0.001 for kyphoscoliosis and 0.012 for pectus excavatum) and had a larger decline in axial muscle function (p = 0.020). Only weak correlations were found between the change in FVC% predicted and the change in clinical scores between baseline and follow-up. INTERPRETATION: Respiratory function remained stable in most patients with FSHD, but a subgroup of patients showed a pronounced deterioration. They showed more severe muscle weakness including the leg muscles at baseline (Ricci score ≥ 6), had spinal and thorax deformities and a relatively fast decline in axial muscle function at follow-up
Social media posts and online search behaviour as early-warning system for MRSA outbreaks
Despite many preventive measures, outbreaks with multi-drug resistant micro-organisms (MDROs) still occur. Moreover, current alert systems from healthcare organizations have shortcomings due to delayed or incomplete notifications, which may amplify the spread of MDROs by introducing infected patients into a new healthcare setting and institutions. Additional sources of information about upcoming and current outbreaks, may help to prevent further spread of MDROs.The study objective was to evaluate whether methicillin-resistant Staphylococcus aureus (MRSA) outbreaks could be detected via social media posts or online search behaviour; if so, this might allow earlier detection than the official notifications by healthcare organizations
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