Statin Therapy Associated With Improved Thrombus Resolution In Patients With Deep Vein Thrombosis

Objectives: Statin therapy has been associated with a decreased incidence of venous thromboembolism (VTE) in clinical trials and enhanced thrombus resolution in animal models. The effect of statins on thrombus resolution has not been reported clinically. This study investigates the association of statins with thrombus resolution or improvement in patients with deep vein thrombosis (DVT). Methods: A retrospective study of the electronic medical records of consecutive adult patients presenting with lower extremity DVT was performed. Patients were divided into two groups based on statin therapy (statin group) or lack thereof (non-statin group). The two groups were compared with respect to demographics, comorbidities, and risk factors for VTE. Initial as well as all subsequent ultrasound reports were reviewed for each patient to determine extent of DVT and subsequent change in thrombus characteristics. Long-term outcomes examined were thrombus improvement or resolution on follow up ultrasound, VTE recurrence, mortality. Multivariable analysis was used to determine independent predictors of thrombus resolution or improvement, VTE recurrence, and mortality. Results: A total of 818 patients with DVT were identified [statin group: n = 279 (34%), non-statin group: n = 539 (66%)]. The patients in the statin group were significantly older (P \u3c .001). Patients on statin were more likely to have risk factors for and manifestations of atherosclerosis and to be on antiplatelet therapy (P \u3c .001) while those in the non-statin group were more likely to have a hypercoagulable disorder (P = .009) or prior DVT (P = .033). There was no significant difference in provoked DVT, extent of DVT, or association with PE (pulmonary embolus), but patients on statin were more likely to have high-risk PE (P = .046). There was no difference in patients receiving anticoagulation, type and duration of anticoagulation, inferior vena cava filter placement, or treatment with lytic therapy. There was no difference in thrombus resolution, mortality, or recurrence of DVT, PE, or VTE between the groups. On multivariable analysis, age, proximal DVT, CAD, and cancer were associated with higher mortality while anticoagulation with warfarin and DOACs and antiplatelet therapy were associated with lower mortality. Statin therapy, antiplatelet therapy and younger age were associated with thrombus resolution or improvement. Conclusions: Statin therapy is associated with greater thrombus resolution or improvement in patients with DVT. However, statin therapy in this study was not associated with different clinical outcomes of VTE recurrence or mortality

Structural Break or Asymmetry? An Empirical Study of the Stock Wealth Effect on Consumption

The purpose of this paper is to examine whether the stock wealth effect of consumption exhibits structural change(s) or behaves asymmetrically over business cycles. We first perform a general test of linearity for the behavior of aggregate consumption in response to changes in stock wealth based on Hamilton's (2001) approach. When a nonlinear relation is discovered, we move on to investigate the source(s) of this nonlinearity. We consider two types of nonlinearity: structural break and asymmetry. It is of interest to policy makers whether the sensitivity of consumption to changes in households' financial wealth shows a significant shift over time due to institutional and policy changes, and whether consumption is likely to decline more due to stock wealth shrinkage when the economy is in a downturn, as has been found in investmeconsumption, stock wealth, asymmetric effect, structural change

Coordination of Mathematics and Physical Resources by Physics Graduate Students

We investigate the dynamics of how graduate students coordinate their mathematics and physics knowledge within the context of solving a homework problem for a plasma physics survey course. Students were asked to obtain the complex dielectric function for a plasma with a specified distribution function and find the roots of that expression. While all the 16 participating students obtained the dielectric function correctly in one of two equivalent expressions, roughly half of them (7 of 16) failed to compute the roots correctly. All seven took the same initial step that led them to the incorrect answer. We note a perfect correlation between the specific expression of dielectric function obtained and the student's success in solving for the roots. We analyze student responses in terms of a resources framework and suggest routes for future research.Comment: 4 page

Quantum measurements of spatial conjugate variables: Displacement and tilt of a Gaussian beam

We consider the problem of measurement of optical transverse profile parameters and their conjugate variable. Using multi-mode analysis, we introduce the concept of detection noise-modes. For Gaussian beams, displacement and tilt are a pair of transverse profile conjugate variables. We experimentally demonstrate their optimal encoding and detection with a spatial homodyning scheme. Using higher order spatial mode squeezing, we show the sub-shot noise measurements for the displacement and tilt of a Gaussian beam.Comment: 3 page

Tubular secretion of creatinine and kidney function: an observational study.

BackgroundPrior papers have been inconsistent regarding how much creatinine clearance (CrCl) overestimates glomerular filtration rate (GFR). A recent cross-sectional study suggested that measurement error alone could entirely account for the longstanding observation that CrCl/GFR ratio is larger when GFR is lower among patients with chronic kidney disease (CKD); but there have been no validation of this in other cohorts.MethodsTo fill these gaps in knowledge regarding the relation between CrCl and GFR, we conducted cross-sectional and longitudinal analysis of the Modification of Diet in Renal Disease study (MDRD) and African American Study of Kidney Disease and Hypertension (AASK); and cross-sectional analysis of a clinical dataset from the Mayo Clinic of four different patient populations (CKD patients, kidney transplant recipients, post kidney donation subgroup and potential kidney donors). In the cross-sectional analyses (MDRD, AASK and Mayo Clinic cohort), we examined the relation between the CrCl/iothalamate GFR (iGFR) ratio at different categories of iGFR or different levels of CrCl. In the MDRD and AASK longitudinal analyses, we studied how the CrCl/iGFR ratio changed with those who had improvement in iGFR (CrCl) over time versus those who had worsening of iGFR (CrCl) over time.ResultsObserved CrCl/iGFR ratios were generally on the lower end of the range reported in the literature for CKD (median 1.24 in MDRD, 1.13 in AASK and 1.25 in Mayo Clinic cohort). Among CKD patients in whom CrCl and iGFR were measured using different timed urine collections, CrCl/iGFR ratio were higher with lower iGFR categories but lower with lower CrCl categories. However, among CKD patients in whom CrCl and iGFR were measured using the same timed urine collections (which reduces dis-concordant measurement error), CrCl/iGFR ratio were higher with both lower iGFR categories and lower CrCl categories.ConclusionsThese data refute the recent suggestion that measurement error alone could entirely account for the longstanding observation that CrCl/GFR ratio increases as GFR decreases in CKD patients. They also highlight the lack of certainty in our knowledge with regard to how much CrCl actually overestimates GFR

Draft Genome Sequence of Mycobacterium arupense Strain GUC1.

We report the draft genome sequence of Mycobacterium arupense strain GUC1 from a sputum sample of a patient with bronchiectasis. This is the first draft genome sequence of Mycobacterium arupense, a rapidly growing nonchromogenic mycobacteria

Draft Genome Sequence of Mycobacterium elephantis Strain Lipa.

We report the draft genome sequence of Mycobacterium elephantis strain Lipa from a sputum sample of a patient with pulmonary disease. This is the first draft genome sequence of M. elephantis, a rapidly growing mycobacterium

Draft Genome Sequence of Mycobacterium obuense Strain UC1, Isolated from Patient Sputum.

We report the draft genome sequence of Mycobacterium obuense strain UC1 from a patient sputum sample. This is the first draft genome sequence of Mycobacterium obuense, a rapidly growing scotochromogenic mycobacterium

The Dynamics of Students' Behaviors and Reasoning during Collaborative Physics Tutorial Sessions

We investigate the dynamics of student behaviors (posture, gesture, vocal register, visual focus) and the substance of their reasoning during collaborative work on inquiry-based physics tutorials. Scherr has characterized student activity during tutorials as observable clusters of behaviors separated by sharp transitions, and has argued that these behavioral modes reflect students' epistemological framing of what they are doing, i.e., their sense of what is taking place with respect to knowledge. We analyze students' verbal reasoning during several tutorial sessions using the framework of Russ, and find a strong correlation between certain behavioral modes and the scientific quality of students' explanations. We suggest that this is due to a dynamic coupling of how students behave, how they frame an activity, and how they reason during that activity. This analysis supports the earlier claims of a dynamic between behavior and epistemology. We discuss implications for research and instruction.Comment: 4 pages, PERC 200