Biological sex has a diverse impact on the cardiovascular system. Its influence on dilated cardiomyopathy (DCM) remains unresolved.
This study aims to investigate sex-specific differences in DCM ...presentation, natural history, and prognostic factors.
The authors conducted a prospective observational cohort study of DCM patients assessing baseline characteristics, cardiac magnetic resonance imaging, biomarkers, and genotype. The composite outcome was cardiovascular mortality or major heart failure (HF) events.
Overall, 206 females and 398 males with DCM were followed for a median of 3.9 years. At baseline, female patients had higher left ventricular ejection fraction, smaller left ventricular volumes, less prevalent mid-wall myocardial fibrosis (23% vs 42%), and lower high-sensitivity cardiac troponin I than males (all P < 0.05) with no difference in time from diagnosis, age at enrollment, N-terminal pro–B-type natriuretic peptide levels, pathogenic DCM genetic variants, myocardial fibrosis extent, or medications used for HF. Despite a more favorable profile, the risk of the primary outcome at 2 years was higher in females than males (8.6% vs 4.4%, adjusted HR: 3.14; 95% CI: 1.55-6.35; P = 0.001). Between 2 and 5 years, the effect of sex as a prognostic modifier attenuated. Age, mid-wall myocardial fibrosis, left ventricular ejection fraction, left atrial volume, N-terminal pro–B-type natriuretic peptide, high-sensitivity cardiac troponin I, left bundle branch block, and NYHA functional class were not sex-specific prognostic factors.
The authors identified a novel paradox in prognosis for females with DCM. Female DCM patients have a paradoxical early increase in major HF events despite less prevalent myocardial fibrosis and a milder phenotype at presentation. Future studies should interrogate the mechanistic basis for these sex differences.
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A numerical study of soliton spectral tunnelling in an index-guiding photonic crystal fibre with a sub-wavelength central air core defect is presented. Specifically, for a fibre design where two ...regions of anomalous dispersion bracket a 90nm wide region of normal dispersion, simulations show tunnelling from 1300 to 1475nm across the forbidden normal dispersion regime, with near unity efficiency. In addition, this effect can be exploited to obtain over a factor of two nonlinear pulse compression by interrupting propagation at the distance at which soliton tunnelling occurs.
OBJECTIVES To report on a 10 year follow up of patients with idiopathic Parkinson’s disease, particularly with respect to mortality and the effect of early treatment with bromocriptine. METHODS The ...patients are from the 149 new patients recruited for a double blind, randomised study of low dose levodopa-carbidopa versus low dose bromocriptine. Patients were examined neurologically at least yearly. Neuropsychological examinations were performed at 0, 3, 5, and 10 years. Mortality and cause of death in these patients were compared with the Australian population using standardised mortality ratios (SMRs). Mortality and disease progression were compared by sex and treatment group. Predictors of death within 10 years, nursing home admission, and progression in Columbia score of ⩾20 points were examined by logistic regression analysis. RESULTS Thirteen patients were excluded as having atypical Parkinsonism and six were lost to follow up. All available patients have been followed up for 10 years. Fifty patients (38%) were dead by 10 years and 63 by the last follow up. The SMR was 1.58 for all patients (p<0.001). There was no significant difference in SMRs between the sexes. The mean duration of disease until death was 9.1 years. Parkinson’s disease was thought to have contributed substantially to the death of 30 patients. The most common cause of death was pneumonia. Women progressed at a similar rate to men until 8 years, when the severity of their disease as measured by Hoehn and Yahr stage became greater (p<0.05). Older age of onset correlated with increased risk of death but the SMR was increased even in those aged <70 years (SMR 1.80, p=0.03). Early use of bromocriptine did not reduce mortality or slow progression of disease. One quarter of all patients had been admitted to nursing homes by 10 years. Only four patients were still employed. CONCLUSIONS Mortality in Parkinson’s disease remains increased despite low dose levodopa-carbidopa therapy and no additional benefit was gained from early use of bromocriptine. Duration of disease was similar to that in the era before levodopa.
OBJECTIVE: Misdiagnosis of maturity-onset diabetes of the young (MODY) remains widespread, despite the benefits of optimized management. This cross-sectional study examined diagnostic ...misclassification of MODY in subjects with clinically labeled young adult-onset type 1 and type 2 diabetes by extending genetic testing beyond current guidelines. RESEARCH DESIGN AND METHODS: Individuals were selected for diagnostic sequencing if they displayed features atypical for their diagnostic label. From 247 case subjects with clinically labeled type 1 diabetes, we sequenced hepatocyte nuclear factor 1 α (HNF1A) and hepatocyte nuclear factor 4 α (HNF4A) in 20 with residual β-cell function ≥3 years from diagnosis (random or glucagon-stimulated C-peptide ≥0.2 nmol/L). From 322 with clinically labeled type 2 diabetes, we sequenced HNF1A and HNF4A in 80 with diabetes diagnosed ≤30 years and/or diabetes diagnosed ≤45 years without metabolic syndrome. We also sequenced the glucokinase (GCK) in 40 subjects with mild fasting hyperglycemia. RESULTS: In the type 1 diabetic group, two HNF1A mutations were found (0.8% prevalence). In type 2 diabetic subjects, 10 HNF1A, two HNF4A, and one GCK mutation were identified (4.0%). Only 47% of MODY case subjects identified met current guidelines for diagnostic sequencing. Follow-up revealed a further 12 mutation carriers among relatives. Twenty-seven percent of newly identified MODY subjects changed treatment, all with improved glycemic control (HbA1c 8.8 vs. 7.3% at 3 months; P = 0.02). CONCLUSIONS: The systematic use of widened diagnostic testing criteria doubled the numbers of MODY case subjects identified compared with current clinical practice. The yield was greatest in young adult-onset type 2 diabetes. We recommend that all patients diagnosed before age 30 and with presence of C-peptide at 3 years' duration are considered for molecular diagnostic analysis.
We report the spectroscopic confirmation of SPT-CL J0546-5345 at = 1.067. To date this is the most distant cluster to be spectroscopically confirmed from the 2008 South Pole Telescope (SPT) catalog, ...and indeed the first z > 1 cluster discovered by the Sunyaev-Zel'dovich Effect (SZE). We identify 21 secure spectroscopic members within 0.9 Mpc of the SPT cluster position, 18 of which are quiescent, early-type galaxies. From these quiescent galaxies we obtain a velocity dispersion of 1179^{+232}_{-167} km/s, ranking SPT-CL J0546-5345 as the most dynamically massive cluster yet discovered at z > 1. Assuming that SPT-CL J0546-5345 is virialized, this implies a dynamical mass of M_200 = 1.0^{+0.6}_{-0.4} x 10^{15} Msun, in agreement with the X-ray and SZE mass measurements. Combining masses from several independent measures leads to a best-estimate mass of M_200 = (7.95 +/- 0.92) x 10^{14} Msun. The spectroscopic confirmation of SPT-CL J0546-5345, discovered in the wide-angle, mass-selected SPT cluster survey, marks the onset of the high redshift SZE-selected galaxy cluster era.
Genetically-altered mice, lacking functional NK1 receptors (NK1R-/-), express abnormal behaviours that are prominent in Attention Deficit Hyperactivity Disorder: namely, inattentiveness and ...impulsivity (indicated by their greater % omissions and premature responses in the 5-Choice Serial Reaction-Time Task (5-CSRTT) and locomotor hyperactivity. We investigated how behaviour in the 5-CSRTT is affected by repeated testing and whether the abnormalities expressed by NK1R-/- mice are mimicked by treating wild type mice with a NK1R antagonist (L 733060 or RP 67580; 5 or 10 mg/kg). Repeated testing with a variable (VITI) or fixed, prolonged (LITI) intertrial interval reduced % omissions. Premature responses also declined, but only in NK1R-/- mice, in the VITI test. By contrast, perseveration increased in both genotypes. RP 67580 (10 mg/kg) increased the % omissions in both genotypes in the VITI, an action which cannot be attributed to NK1R antagonism. Neither drug affected perseveration. However, for premature responses, the response profile suggested that the low and high doses of RP 67580 (VITI) and L 733060 (LITI) had opposing effects on this behaviour. We infer that the effect of NK1R antagonists in the 5-CSRTT is confounded by animals’ test experience and non-specific drug effects at sites other than NK1R, possibly L-type Ca2+v channels.
The phase coherence of supercontinuum generation in microstructure fiber is quantified by performing a Young's type interference experiment between independently generated supercontinua from two ...separate fiber segments. Analysis of the resulting interferogram yields the wavelength dependence of the magnitude of the mutual degree of coherence, and a comparison of experimental results with numerical simulations suggests that the primary source of coherence degradation is the technical noise-induced fluctuations in the injected peak power.
Few studies have evaluated the effects of large wildfires on downstream non-salmonid fish assemblages. Using multi-year (2009–2015) data from fish assemblage surveys and high-frequency water quality ...monitoring, we analyzed within-site responses of a cypriniform-dominated fish assemblage at two sites located > 20 km downstream of a 633 km
2
wildfire in 2011 in the Rio Grande watershed in New Mexico, USA. Season had a weak influence on fish assemblage (fish) catch rate, richness, and evenness at the upstream site, but it had a strong negative influence (during spring/winter) on fish catch rate and richness at the downstream site. Fish species richness and evenness at both sites were not strongly affected by the wildfire, despite numerous post-fire sags in dissolved oxygen (including short-lived hypoxia < 2 mg L
−1
and anoxia—0 mg L
−1
) during subsequent monsoon seasons. Although fish catch rate was negatively impacted by the wildfire at the upstream site, it was unaffected at the downstream site. Fish catch rate, richness, and evenness at the upstream site were suppressed following a major flood event that occurred 26 months post-fire, but the downstream fish assemblage was resistant to the flood disturbance. Our study provided a rare opportunity to evaluate how aridland riverine fishes respond to disturbance from wildfire and subsequent flooding. Larger and more severe wildfires are occurring due to climate warming, and responses of water quality and fish community assemblages require study and assessment.
Although theoretical work on optimal migration has been largely restricted to birds, relevant free-flight data are now becoming available for migratory insects. Here we report, for the first time in ...passion-vine butterflies, that
migrates directionally. To test optimal migration models for insects, we quantified the aerodynamic power curve for free-flying
as they migrated across the Panama Canal. Using synchronized stereo-images from high-speed video cameras, we reconstructed three-dimensional flight kinematics of
migrating naturally across the Panama Canal. We also reconstructed flight kinematics from a single-camera view of butterflies flying through a flight tunnel. We calculated the power requirements for flight for
over a range of flight velocities. The relationship between aerodynamic power and velocity was "J"-shaped across the measured velocities with a minimum power velocity of 0.9 m/s and a maximum range velocity of 2.25 m/s. Migrating
did not compensate for crosswind drift. Changes in airspeed with tailwind drift were consistent with the null hypothesis that
did not compensate for tailwind drift, but they were also not significantly different from those predicted to maximize the migratory range of the insects.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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