Abstract The superb image quality, stability, and sensitivity of JWST permit deconvolution techniques to be pursued with a fidelity unavailable to ground-based observations. We present an assessment ...of several deconvolution approaches to improve image quality and mitigate the effects of the complex JWST point-spread function (PSF). The optimal deconvolution method is determined by using WebbPSF to simulate JWST’s complex PSF and MIRISim to simulate multiband JWST/Mid-Infrared Imager Module (MIRIM) observations of a toy model of an active galactic nucleus (AGN). Five different deconvolution algorithms are tested: (1) Kraken deconvolution, (2) Richardson–Lucy, (3) the adaptive imaging deconvolution algorithm, (4) sparse regularization with the Condat–Vũ algorithm, and (5) iterative Wiener filtering and thresholding. We find that Kraken affords the greatest FWHM reduction of the nuclear source of our MIRISim observations for the toy AGN model while retaining good photometric integrity across all simulated wave bands. Applying Kraken to Galactic Activity, Torus, and Outflow Survey (GATOS) multiband JWST/MIRIM observations of the Seyfert 2 galaxy NGC 5728, we find that the algorithm reduces the FWHM of the nuclear source by a factor of 1.6–2.2 across all five filters. Kraken images facilitate detection of extended nuclear emission ∼2.″5 (∼470 pc, position angle ≃ 115°) in the SE–NW direction, especially at the longest wavelengths. We demonstrate that Kraken is a powerful tool to enhance faint features otherwise hidden in the complex JWST PSF.
Objectives This study sought to determine the incidence and predictors of recovery of normal echocardiographic function among children with idiopathic dilated cardiomyopathy (DCM). Background Most ...children with idiopathic DCM have poor outcomes; however, some improve. Methods We studied children <18 years of age from the Pediatric Cardiomyopathy Registry who had both depressed left ventricular (LV) function (fractional shortening or ejection fraction z- score <–2) and LV dilation (end-diastolic dimension LVEDD z- score >2) at diagnosis and who had at least 1 follow-up echocardiogram 30 days to 2 years from the initial echocardiogram. We estimated the cumulative incidence and predictors of normalization. Results Among 868 children who met the inclusion criteria, 741 (85%) had both echocardiograms. At 2 years, 22% had recovered normal LV function and size; 51% had died or undergone heart transplantation (median, 3.2 months), and 27% had persistently abnormal echocardiograms. Younger age (hazard ratio HR: 0.92; 95% confidence interval CI: 0.88 to 0.97) and lower LVEDD z- score (HR: 0.78; 95% CI: 0.70 to 0.87) independently predicted normalization. Nine children (9%) with normal LV function and size within 2 years of diagnosis later underwent heart transplantation or died. Conclusions Despite marked LV dilation and depressed function initially, children with idiopathic DCM can recover normal LV size and function, particularly those younger and with less LV dilation at diagnosis. Investigations related to predictors of recovery, such as genetic associations, serum markers, and the impact of medical therapy or ventricular unloading with assist devices are important next steps. Longer follow-up after normalization is warranted as cardiac failure can recur. (Pediatric Cardiomyopathy Registry; NCT00005391 )
The umbral regions of sunspots and pores in the solar photosphere are generally dominated by 3 mHz oscillations, which are due to
p
-modes penetrating the magnetic region. In these locations, wave ...power is also significantly reduced with respect to the quiet Sun. However, here we study a pore where not only is the power of the oscillations in the umbra comparable to, or even larger than, that of the quiet Sun, but the main dominant frequency is not 3 mHz as expected, but instead 5 mHz. By combining Doppler velocities and spectropolarimetry and analysing the relationship between magnetic field strength and frequency, the resultant
B
−
ω
diagram reveals distinct ridges that are remarkably clear signatures of resonant magneto-hydrodynamic (MHD) oscillations confined within the pore umbra. We demonstrate that these modes, in addition to velocity oscillations, are also accompanied by magnetic oscillations, as predicted from MHD theory. The novel technique of
B
−
ω
analysis proposed in this article opens up an exciting new avenue for identifying MHD wave modes in the umbral regions of both pores and sunspots.
Magnetohydrodynamics (MHD) wave propagation inside the Sun’s atmosphere is closely related to the magnetic field topology. For example, magnetic fields are able to lower the cutoff frequency for ...acoustic waves, thus allowing the propagation of waves that would otherwise be trapped below the photosphere into the upper atmosphere. In addition, MHD waves can be either transmitted or converted into other forms of waves at altitudes where the sound speed equals the Alfvén speed. We take advantage of the large field-of-view provided by the IBIS experiment to study the wave propagation at two heights in the solar atmosphere, which is probed using the photospheric Fe 617.3 nm spectral line and the chromospheric Ca 854.2 nm spectral line, and its relationship to the local magnetic field. Among other things, we find substantial leakage of waves with five-minute periods in the chromosphere at the edges of a pore and in the diffuse magnetic field surrounding it. By using spectropolarimetric inversions of Hinode SOT/SP data, we also find a relationship between the photospheric power spectrum and the magnetic field inclination angle. In particular, we identify well-defined transmission peaks around 25° for five-minute waves and around 15° for three-minute waves. We propose a very simple model based on wave transmission theory to explain this behavior. Finally, our analysis of both the power spectra and chromospheric amplification spectra suggests the presence of longitudinal acoustic waves along the magnetic field lines.
The practice of ‘vancomycin wrapping’ of harvested hamstring autografts during Anterior Cruciate Ligament Reconstruction (ACLR) surgery has gathered recent interest.
This practice involves the ...wrapping of harvested grafts in a vancomycin-soaked swab during the preparatory phase. Different techniques are observed, and a small number of studies have shown that pre-soaking hamstring ACLR grafts in this manner dramatically reduces the post-surgical infection rate compared with standard intravenous antibiotic prophylaxis alone. However, the literature surrounding this practice is surprisingly limited and thus the basis and rationale of the ‘vancomycin wrap’ has established itself largely without question. The exact popularity of this practice is difficult to establish but there has been increasing disclosure of its efficacy in reducing post-operative infection in ACLR since 2012.
We provide a synopsis of the current literature surrounding vancomycin and its use in ‘wraps’ in ACLR to help apprise the surgeon of the nature of infection in ACLR, the rationale for vancomycin, whilst considering evidence to support alternatives and discussing potential ramifications for future practice.
Low birth weight increases adult metabolic disease risk in both the first (F1) and second (F2) generation. Physiological stress during pregnancy in F1 females that were born small induces F2 fetal ...growth restriction, but the long-term metabolic health of these F2 offspring is unknown. Uteroplacental insufficiency (restricted) or sham (control) surgery was performed in F0 rats. F1 females (control, restricted) were allocated to unstressed or stressed pregnancies. F2 offspring exposed to maternal stress in utero had reduced birth weight. At 6 months, F2 stressed males had elevated fasting glucose. In contrast, F2 restricted males had reduced pancreatic β-cell mass. Interestingly, these metabolic deficits were not present at 12 month. F2 males had increased adrenal mRNA expression of steroidogenic acute regulatory protein and IGF-1 receptor when their mothers were born small or exposed to stress during pregnancy. Stressed control F2 males had increased expression of adrenal genes that regulate androgen signaling at 6 months, whereas expression increased in restricted male and female offspring at 12 months. F2 females from stressed mothers had lower area under the glucose curve during glucose tolerance testing at 12 months compared with unstressed females but were otherwise unaffected. If F1 mothers were either born small or exposed to stress during her pregnancy, F2 offspring had impaired physiological outcomes in a sex- and age-specific manner. Importantly, stress during pregnancy did not exacerbate disease risk in F2 offspring of mothers born small, suggesting that they independently program disease in offspring through different mechanisms.
Duchenne and Becker muscular dystrophies are caused by mutations in dystrophin. Cardiac manifestations vary broadly, making prognosis difficult. Current dystrophin genotype–cardiac phenotype ...correlations are limited. For skeletal muscle, the reading-frame rule suggests in-frame mutations tend to yield milder phenotypes. We performed dystrophin genotype–cardiac phenotype correlations using a protein-effect model and cardiac magnetic resonance imaging. A translational model was applied to patient-specific deletion, indel, and nonsense mutations to predict exons and protein domains present within truncated dystrophin protein. Patients were dichotomized into predicted present and predicted absent groups for exons and protein domains of interest. Development of myocardial fibrosis (represented by late gadolinium enhancement LGE) and depressed left ventricular ejection fraction (LVEF) were compared. Patients (n = 274) with predicted present cysteine-rich domain (CRD), C -terminal domain (CTD), and both the N -terminal actin-binding and cysteine-rich domains (ABD1 + CRD) had a decreased risk of LGE and trended toward greater freedom from LGE. Patients with predicted present CTD (exactly the same as those with in-frame mutations) and ABD1 + CRD trended toward decreased risk of and greater freedom from depressed LVEF. In conclusion, genotypes previously implicated in altering the dystrophinopathic cardiac phenotype were not significantly related to LGE and depressed LVEF. Patients with predicted present CRD, CTD/in-frame mutations, and ABD1 + CRD trended toward milder cardiac phenotypes, suggesting that the reading-frame rule may be applicable to the cardiac phenotype. Genotype–phenotype correlations may help predict the cardiac phenotype for dystrophinopathic patients and guide future therapies.
Key points
Women born small are at an increased risk of developing pregnancy complications. Stress may further increase a woman's likelihood for an adverse pregnancy.
Adverse pregnancy adaptations ...can lead to long‐term diseases even after her pregnancy.
The current study investigated the effects of stress during pregnancy on the long‐term adrenal, metabolic and cardio‐renal health of female rats that were born small.
Stress programmed increased adrenal Mc2r gene expression, a higher insulin secretory response to glucose during intraperitoneal glucose tolerance test (+36%) and elevated renal creatinine clearance after pregnancy.
Females that were born small had increased homeostatic model assessment‐insulin resistance and elevated systolic blood pressure after pregnancy, regardless of stress exposure.
These findings suggest that being born small or being stressed during pregnancy programs long‐term adverse health outcomes after pregnancy. However, stress in pregnancy does not exacerbate the long‐term adverse health outcomes for females that were born small.
Females born small are more likely to experience complications during their pregnancy, including pregnancy‐induced hypertension, pre‐eclampsia and gestational diabetes. The risk of developing complications is increased by stress exposure during pregnancy. In addition, pregnancy complications may predispose the mother to diseases after pregnancy. We determined whether stress during pregnancy would exacerbate the adrenal, metabolic and cardio‐renal dysfunction of growth‐restricted females in later life. Late gestation bilateral uterine vessel ligation was performed in Wistar Kyoto rats to induce growth restriction. At 4 months, growth‐restricted and control female offspring were mated with normal males. Those allocated to the stressed group had physiological measurements metabolic cage, tail cuff blood pressure, intraperitoneal glucose tolerance test (IPGTT) conducted during pregnancy whilst the unstressed groups were unhandled. After the completion of pregnancy, dams were aged to 12 months and blood pressure, and metabolic and renal function were assessed. At 13 months, adrenal glands, pancreases and plasma were collected at post‐mortem. Females stressed during pregnancy had increased adrenal Mc2r gene expression (+22%), higher insulin secretory response to glucose during IPGTT (+36%) and higher creatinine clearance (+29%, indicating increased estimated glomerular filtration rate). In contrast, females that were born small had increased homeostatic model assessment‐insulin resistance (+54%), increased water intake (+23%), urine output (+44%) and elevated systolic blood pressure (+7%) regardless of exposure to stress. Our findings suggest that low maternal birth weight and maternal stress exposure during pregnancy are both independently detrimental for long‐term adrenal, metabolic and cardio‐renal health of the mother, although their effects were not exacerbated.
Key points
Women born small are at an increased risk of developing pregnancy complications. Stress may further increase a woman's likelihood for an adverse pregnancy.
Adverse pregnancy adaptations can lead to long‐term diseases even after her pregnancy.
The current study investigated the effects of stress during pregnancy on the long‐term adrenal, metabolic and cardio‐renal health of female rats that were born small.
Stress programmed increased adrenal Mc2r gene expression, a higher insulin secretory response to glucose during intraperitoneal glucose tolerance test (+36%) and elevated renal creatinine clearance after pregnancy.
Females that were born small had increased homeostatic model assessment‐insulin resistance and elevated systolic blood pressure after pregnancy, regardless of stress exposure.
These findings suggest that being born small or being stressed during pregnancy programs long‐term adverse health outcomes after pregnancy. However, stress in pregnancy does not exacerbate the long‐term adverse health outcomes for females that were born small.
Recent evidence suggests that acute emergency management of mandible fractures does not improve surgical outcomes yet is associated with increased financial burden. Current NHS policy advocating for ...increased adoption of day-case and semi-elective surgical procedures to reduce bed strain must be balanced with providing timely, effective treatment. Our research aims to determine patient groups currently managed via semi-elective admission and whether this can be extended to other groups to provide safe and effective management of mandible fractures.
A multi-national trainee-led audit of mandibular fractures across 49 units was completed by the Maxillofacial Trainee Research Collaborative (MTReC). Each unit prospectively collected data on fractures on admission and at follow-up. Data collected included patient demographics, behaviour, health, injury, timing to intervention and surgical complications.
Data were collected on 947 mandibular fractures. Of the surgically managed patients, 649 (90%) were managed via acute emergency admission at the time of presentation, while 68 (10%) were managed semi-electively. Patient demographics, injury pattern and mechanism appeared to significantly affect timing of management, whereas patient behaviour, health status, timing of injury and presentation did not. Semi-elective management was associated with a significantly shorter inpatient duration (0.9 versus 1.9 days,
=0.000) with no differences in readmission, antibiotic usage or surgical complications (
=1.000, RR 1.030).
Our study demonstrates the efficacy of planned admissions and semi-elective management of mandibular fractures. Simple mandibular fractures in compliant patients are suitable for semi-elective treatment. Holistic patient assessment and tailored surgical planning is crucial in determining admission modality to effectively manage mandibular trauma.
In this work we explore the possibility of using recurrence quantification analysis (RQA) in astronomical high-contrast imaging to statistically discriminate the signal of faint objects from speckle ...noise. To this end, we tested RQA on a sequence of high frame rate (1 kHz) images acquired with the SHARK-VIS forerunner at the Large Binocular Telescope. Our tests show promising results in terms of detection contrasts at angular separations as small as 50 mas, especially when RQA is applied to a very short sequence of data (2 s). These results are discussed in light of possible science applications and with respect to other techniques such as, for example, angular differential imaging and speckle-free imaging.
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