Longitudinal Intra- and Inter-individual variation in T-cell subsets of HIV-infected and uninfected men participating in the LA Multi-Center AIDS Cohort Study.

To assess the intra-individual and inter-individuals biological variation and the effect of aging on lymphocyte T-cells subsets.We assessed lymphocyte phenotypes (CD3, CD4, and CD8 T-cells) in 89 HIV-1-infected and 88 uninfected white non-Hispanic men every 6 months, to examine the biological variation for those measurements, and the average change in lymphocyte phenotype over 34 years.The markers showed significant intra-individuality in HIV-infected and uninfected individuals with index of individuality of <1.4. No mean changes were seen over the 34 years, with the exception of percentage CD4T-cells in HIV-uninfected individuals.In the pre-HAART era, HIV-infected individuals experienced an increase in mean absolute CD3 T-cell numbers (11.21 cells/μL, P = 0.02) and absolute CD8 T-cell numbers (34.57 cell/μl, P < .001), and in the percentage of CD8 T-cells (1.45%, P < .001) per year and a significant decrease in mean absolute CD4 T-cell numbers (23.68 cells/μl, P < .001) and in the percentage of CD4 T-cells (1.49%, P < .001) per year.In the post-HAART era, no changes in mean levels were observed in absolute CD3 T-cell count (P = .15) or percentage (P = .99). Significant decreases were seen in mean count (8.56 cells/μl, P < .001) and percentage (0.59%, P < .001) of CD8 T-cells, and increases in mean absolute count (10.72 cells/μl, P < .001) and percentage (0.47%, P < .001) of CD4 T-cells.With the exception of CD4 (%), no average changes per year were seen in lymphocyte phenotype of HIV-uninfected men. The results of coefficients of variation of intra and inter-individuals of this study can be useful for HIV-1 infection monitoring and in addition the observation could be a useful guide for intra- and inter-individual coefficient variations, and establishing quality goal studies of different blood biomarkers in healthy and other diseases

SAMplus: adaptive optics at optical wavelengths for SOAR

Adaptive Optics (AO) is an innovative technique that substantially improves the optical performance of ground-based telescopes. The SOAR Adaptive Module (SAM) is a laser-assisted AO instrument, designed to compensate ground-layer atmospheric turbulence in near-IR and visible wavelengths over a large Field of View. Here we detail our proposal to upgrade SAM, dubbed SAMplus, that is focused on enhancing its performance in visible wavelengths and increasing the instrument reliability. As an illustration, for a seeing of 0.62 arcsec at 500 nm and a typical turbulence profile, current SAM improves the PSF FWHM to 0.40 arcsec, and with the upgrade we expect to deliver images with a FWHM of $\approx0.34$ arcsec -- up to 0.23 arcsec FWHM PSF under good seeing conditions. Such capabilities will be fully integrated with the latest SAM instruments, putting SOAR in an unique position as observatory facility.Comment: To appear in Proc. SPIE 10703 (Ground-based and Airborne Instrumentation for Astronomy VII; SPIEastro18

Mortality in non-exacerbating COPD: a longitudinal analysis of UK primary care data

Introduction: Non-exacerbating patients with chronic obstructive pulmonary disease (COPD) are a less studied phenotype. We investigated clinical characteristics, mortality rates and causes of death among non-exacerbating compared with exacerbating patients with COPD. Methods: We used data from the Clinical Practice Research Datalink, Hospital Episode Statistics and Office for National Statistics between 1 January 2004 and 31 December 2018. Ever smokers with a COPD diagnosis with minimum 3 years of baseline information were included. We compared overall using Cox regression and cause-specific mortality rates using competing risk analysis, adjusted for age, sex, deprivation, smoking status, body mass index, GOLD stage and comorbidities. Causes of death were identified using International Classification of Diseases-10 codes. Results: Among 67 516 patients, 17.3% did not exacerbate during the 3-year baseline period. Mean follow-up was 4 years. Non-exacerbators were more likely to be male (63.3% vs 52.4%, p<0.001) and less often had a history of asthma (33.9% vs 43.6%, p<0.001) or FEV1<50% predicted (23.7 vs 31.8%) compared with exacerbators. Adjusted HR for overall mortality in non-exacerbators compared with exacerbators was 0.62 (95% CI 0.56 to 0.70) in the first year of follow-up and 0.87 (95% CI 0.83 to 0.91) thereafter. Non-exacerbating patients with COPD died less of respiratory causes than exacerbators (29.2% vs 40.3%) and more of malignancies (29.4% vs 23.4%) and cardiovascular diseases (26.2% vs 22.9%). HRs for malignant and circulatory causes of death were increased after the first year of follow-up. Discussion: In this primary care cohort, non-exacerbators showed distinct clinical characteristics and lower mortality rates. Non-exacerbators were equally likely to die of respiratory, malignant or cardiovascular diseases

External validation of ADO, DOSE, COTE and CODEX at predicting death in primary care patients with COPD using standard and machine learning approaches

Background Several models for predicting the risk of death in people with chronic obstructive pulmonary disease (COPD) exist but have not undergone large scale validation in primary care. The objective of this study was to externally validate these models using statistical and machine learning approaches. Methods We used a primary care COPD cohort identified using data from the UK Clinical Practice Research Datalink. Age-standardised mortality rates were calculated for the population by gender and discrimination of ADO (age, dyspnoea, airflow obstruction), COTE (COPD-specific comorbidity test), DOSE (dyspnoea, airflow obstruction, smoking, exacerbations) and CODEX (comorbidity, dyspnoea, airflow obstruction, exacerbations) at predicting death over 1–3 years measured using logistic regression and a support vector machine learning (SVM) method of analysis. Results The age-standardised mortality rate was 32.8 (95%CI 32.5–33.1) and 25.2 (95%CI 25.4–25.7) per 1000 person years for men and women respectively. Complete data were available for 54879 patients to predict 1-year mortality. ADO performed the best (c-statistic of 0.730) compared with DOSE (c-statistic 0.645), COTE (c-statistic 0.655) and CODEX (c-statistic 0.649) at predicting 1-year mortality. Discrimination of ADO and DOSE improved at predicting 1-year mortality when combined with COTE comorbidities (c-statistic 0.780 ADO + COTE; c-statistic 0.727 DOSE + COTE). Discrimination did not change significantly over 1–3 years. Comparable results were observed using SVM. Conclusion In primary care, ADO appears superior at predicting death in COPD. Performance of ADO and DOSE improved when combined with COTE comorbidities suggesting better models may be generated with additional data facilitated using novel approaches

Calculation of electrostatic fields using quasi-Green's functions: application to the hybrid Penning trap.

Penning traps offer unique possibilities for storing, manipulating and investigating charged particles with high sensitivity and accuracy. The widespread applications of Penning traps in physics and chemistry comprise e.g. mass spectrometry, laser spectroscopy, measurements of electronic and nuclear magnetic moments, chemical sample analysis and reaction studies. We have developed a method, based on the Green's function approach, which allows for the analytical calculation of the electrostatic properties of a Penning trap with arbitrary electrodes. The ansatz features an extension of Dirichlet's problem to nontrivial geometries and leads to an analytical solution of the Laplace equation. As an example we discuss the toroidal hybrid Penning trap designed for our planned measurements of the magnetic moment of the (anti)proton. As in the case of cylindrical Penning traps, it is possible to optimize the properties of the electric trapping fields, which is mandatory for high-precision experiments with single charged particles. Of particular interest are the anharmonicity compensation, orthogonality and optimum adjustment of frequency shifts by the continuous SternGerlach effect in a quantum jump spectrometer. The mathematical formalism developed goes beyond the mere design of novel Penning traps and has potential applications in other fields of physics and engineering

Proposal for the determination of nuclear masses by high-precision spectroscopy of Rydberg states

The theoretical treatment of Rydberg states in one-electron ions is facilitated by the virtual absence of the nuclear-size correction, and fundamental constants like the Rydberg constant may be in the reach of planned high-precision spectroscopic experiments. The dominant nuclear effect that shifts transition energies among Rydberg states therefore is due to the nuclear mass. As a consequence, spectroscopic measurements of Rydberg transitions can be used in order to precisely deduce nuclear masses. A possible application of this approach to the hydrogen and deuterium, and hydrogen-like lithium and carbon is explored in detail. In order to complete the analysis, numerical and analytic calculations of the quantum electrodynamic (QED) self-energy remainder function for states with principal quantum number n=5,...,8 and with angular momentum L=n-1 and L=n-2 are described (j = L +/- 1/2).Comment: 21 pages; LaTe

Temporal trends in the incidence, treatment patterns, and outcomes of coronary artery disease and peripheral artery disease in the UK, 2006–2015

Aims Most reports estimating national incidence rates of coronary (CAD) and peripheral arterial disease (PAD) have focused on stable outpatients or acute or elective hospital admissions, but not on the overall burden of disease. In this study, we report the changing trends in the population-level incidence of CAD and PAD, respectively from 2006 to 2015, statin utilization for secondary prevention and survival outcomes using multiple nationally representative data sources from the UK (primary care encounters, hospital admissions, and procedure-level data). Methods and results A nationally representative study of linked primary and secondary care electronic health records of 4.6 million individuals from the UK. We calculated crude and standardized annual incidence rates separately for CAD and PAD. Statin use for secondary prevention, trends in annual major vascular event rates, and mortality between 2006 and 2015, were estimated for CAD and PAD, respectively. We identified 160 376 and 70 753 patients with incident CAD and PAD, respectively. The age- and sex-standardized incidence of CAD was similar in 2006 (443 per 100 000 person-years) and 2015 [436 per 100 000 person-years; adjusted incidence rate ratio (IRR) 0.98, 95% confidence interval (CI) 0.96–1.00]. In contrast, there was a 15% decline in the standardized incidence of PAD (236 per 100 000 person-years in 2006 to 202 per 100 000 person-years in 2015; adjusted IRR 0.85, 95% CI 0.82–0.88). The proportion of incident CAD and PAD patients prescribed long-term statins, was only 66% and 55%, respectively and was less common amongst women, patients aged >70 years, with heart failure, chronic lung disease, or depression. Cardiovascular mortality declined by 43% for incident CAD (adjusted IRR 0.57, 95% CI 0.50–0.64) between 2006 and 2015 but did not decline for incident PAD (adjusted IRR 0.84, 95% CI 0.70–1.00). Conclusion and relevance In the UK, the standardized incidence of CAD appears stable but mortality rates are falling, whereas the standardized incidence of PAD is falling but mortality rates are not