Abstract Glaucoma is an ocular disorder characterized by the progressive loss of retinal ganglion cells (RGC) and their axons. There are various hypotheses concerning the cause of RGC death. ...Previously, glaucoma was defined by high intraocular pressure (IOP); during the past decade, however, glaucoma specialists have acknowledged that elevated IOP is the most important risk factor for glaucoma, but does not define the disease. Other factors such as genetics, blood flow, and excitotoxicity are suggested as potential causal factors for progressive RGC death observed in glaucoma. We review recent studies elucidating a possible role of low-grade inflammation as a causal factor in the pathogenesis of glaucoma.
It is known that GPS time series contain a seasonal variation that is not due to tectonic motions, and it has recently been shown that crustal seismic velocities may also vary seasonally. In order to ...explain these changes, a number of hypotheses have been given, among which thermoelastic and hydrology‐induced stresses and strains are leading candidates. Unfortunately, though, since a general framework does not exist for understanding such seasonal variations, it is currently not possible to quickly evaluate the plausibility of these hypotheses. To fill this gap in the literature, I generalize a two‐dimensional thermoelastic strain model to provide an analytic solution for the displacements and wave speed changes due to either thermoelastic stresses or hydrologic loading, which consists of poroelastic stresses and purely elastic stresses. The thermoelastic model assumes a periodic surface temperature, and the hydrologic models similarly assume a periodic near‐surface water load. Since all three models are two‐dimensional and periodic, they are expected to only approximate any realistic scenario; but the models nonetheless provide a quantitative framework for estimating the effects of thermoelastic and hydrologic variations. Quantitative comparison between the models and observations is further complicated by the large uncertainty in some of the relevant parameters. Despite this uncertainty, though, I find that maximum realistic thermoelastic effects are unlikely to explain a large fraction of the observed annual variation in a typical GPS displacement time series or of the observed annual variations in seismic wave speeds in southern California. Hydrologic loading, on the other hand, may be able to explain a larger fraction of both the annual variations in displacements and seismic wave speeds. Neither model is likely to explain all of the seismic wave speed variations inferred from observations. However, more definitive conclusions cannot be made until the model parameters are better constrained.
Key Points
To model seasonal variability in GPS displacements and seismic wave speeds
To model this variability with a thermoelastic model and a hydrologic model
To tentatively compare the model results with observations
Stroke thrombolysis with alteplase is currently recommended 0–4·5 h after stroke onset. We aimed to determine whether perfusion imaging can identify patients with salvageable brain tissue with ...symptoms 4·5 h or more from stroke onset or with symptoms on waking who might benefit from thrombolysis.
In this systematic review and meta-analysis of individual patient data, we searched PubMed for randomised trials published in English between Jan 1, 2006, and March 1, 2019. We also reviewed the reference list of a previous systematic review of thrombolysis and searched ClinicalTrials.gov for interventional studies of ischaemic stroke. Studies of alteplase versus placebo in patients (aged ≥18 years) with ischaemic stroke treated more than 4·5 h after onset, or with wake-up stroke, who were imaged with perfusion-diffusion MRI or CT perfusion were eligible for inclusion. The primary outcome was excellent functional outcome (modified Rankin Scale mRS score 0–1) at 3 months, adjusted for baseline age and clinical severity. Safety outcomes were death and symptomatic intracerebral haemorrhage. We calculated odds ratios, adjusted for baseline age and National Institutes of Health Stroke Scale score, using mixed-effects logistic regression models. This study is registered with PROSPERO, number CRD42019128036.
We identified three trials that met eligibility criteria: EXTEND, ECASS4-EXTEND, and EPITHET. Of the 414 patients included in the three trials, 213 (51%) were assigned to receive alteplase and 201 (49%) were assigned to receive placebo. Overall, 211 patients in the alteplase group and 199 patients in the placebo group had mRS assessment data at 3 months and thus were included in the analysis of the primary outcome. 76 (36%) of 211 patients in the alteplase group and 58 (29%) of 199 patients in the placebo group had achieved excellent functional outcome at 3 months (adjusted odds ratio OR 1·86, 95% CI 1·15–2·99, p=0·011). Symptomatic intracerebral haemorrhage was more common in the alteplase group than the placebo group (ten 5% of 213 patients vs one <1% of 201 patients in the placebo group; adjusted OR 9·7, 95% CI 1·23–76·55, p=0·031). 29 (14%) of 213 patients in the alteplase group and 18 (9%) of 201 patients in the placebo group died (adjusted OR 1·55, 0·81–2·96, p=0·66).
Patients with ischaemic stroke 4·5–9 h from stroke onset or wake-up stroke with salvageable brain tissue who were treated with alteplase achieved better functional outcomes than did patients given placebo. The rate of symptomatic intracerebral haemorrhage was higher with alteplase, but this increase did not negate the overall net benefit of thrombolysis.
None.
A number of patient-specific and leukemia-associated factors are related to the poor outcome in older patients with acute myeloid leukemia (AML). However, comprehensive studies regarding the impact ...of genetic alterations in this group of patients are limited. In this study, we compared relevant mutations in 21 genes between AML patients aged 60 years or older and those younger and exposed their prognostic implications. Compared with the younger patients, the elderly had significantly higher incidences of PTPN11, NPM1, RUNX1, ASXL1, TET2, DNMT3A and TP53 mutations but a lower frequency of WT1 mutations. The older patients more frequently harbored one or more adverse genetic alterations. Multivariate analysis showed that DNMT3A and TP53 mutations were independent poor prognostic factors among the elderly, while NPM1 mutation in the absence of FLT3/ITD was an independent favorable prognostic factor. Furthermore, the status of mutations could well stratify older patients with intermediate-risk cytogenetics into three risk groups. In conclusion, older AML patients showed distinct genetic alterations from the younger group. Integration of cytogenetics and molecular mutations can better risk-stratify older AML patients. Development of novel therapies is needed to improve the outcome of older patients with poor prognosis under current treatment modalities.
Surface waves from earthquakes are known to cause strong damage, especially for larger structures such as skyscrapers and bridges. However, common practice in characterizing seismic hazard at a ...specific site considers the effect of near‐surface geology on only vertically propagating body waves. Here we show that surface waves have a unique and different frequency‐dependent response to known geologic structure and that this amplification can be analytically calculated in a manner similar to current hazard practices. Applying this framework to amplification in the Los Angeles Basin, we find that peak ground accelerations for certain large regional earthquakes are underpredicted if surface waves are not properly accounted for and that the frequency of strongest ground motion amplification can be significantly different. Including surface‐wave amplification in hazards calculations is therefore essential for accurate predictions of strong ground motion for future San Andreas Fault ruptures.
Key Points
Site amplification term is different between surface waves and vertically‐incident shear waves
Amplification maps for Southern California, based on 1‐D profiles, can be very different
Waveforms from the El Mayor Cucapah earthquake support a different site term definition between wave types
Social distancing measures to address the US coronavirus disease 2019 (COVID-19) epidemic may have notable health and social impacts.
We conducted a longitudinal pretest-posttest comparison group ...study to estimate the change in COVID-19 case growth before versus after implementation of statewide social distancing measures in the US. The primary exposure was time before (14 days prior to, and through 3 days after) versus after (beginning 4 days after, to up to 21 days after) implementation of the first statewide social distancing measures. Statewide restrictions on internal movement were examined as a secondary exposure. The primary outcome was the COVID-19 case growth rate. The secondary outcome was the COVID-19-attributed mortality growth rate. All states initiated social distancing measures between March 10 and March 25, 2020. The mean daily COVID-19 case growth rate decreased beginning 4 days after implementation of the first statewide social distancing measures, by 0.9% per day (95% CI -1.4% to -0.4%; P < 0.001). We did not observe a statistically significant difference in the mean daily case growth rate before versus after implementation of statewide restrictions on internal movement (0.1% per day; 95% CI -0.04% to 0.3%; P = 0.14), but there is substantial difficulty in disentangling the unique associations with statewide restrictions on internal movement from the unique associations with the first social distancing measures. Beginning 7 days after social distancing, the COVID-19-attributed mortality growth rate decreased by 2.0% per day (95% CI -3.0% to -0.9%; P < 0.001). Our analysis is susceptible to potential bias resulting from the aggregate nature of the ecological data, potential confounding by contemporaneous changes (e.g., increases in testing), and potential underestimation of social distancing due to spillover effects from neighboring states.
Statewide social distancing measures were associated with a decrease in the COVID-19 case growth rate that was statistically significant. Statewide social distancing measures were also associated with a decrease in the COVID-19-attributed mortality growth rate beginning 7 days after implementation, although this decrease was no longer statistically significant by 10 days.
The current study aims at investigating and identifying the ionospheric effects of the geomagnetic storm that occurred during 17–19 March 2015. Incidentally, with SYM‐H hitting a minimum of −232 nT, ...this was the strongest storm of the current solar cycle 24. The study investigates how the storm has affected the equatorial, low‐latitude, and midlatitude ionosphere in the American and the European sectors using available ground‐based ionosonde and GPS TEC (total electron content) data. The possible effects of prompt electric field penetration is observed in both sectors during the main phase of the storm. In the American sector, the coexistence of both positive and negative ionospheric storm phases are observed at low latitudes and midlatitudes to high latitudes, respectively. The positive storm phase is mainly due to the prompt penetration electric fields. The negative storm phase in the midlatitude region is a combined effect of disturbance dynamo electric fields, the equatorward shift of the midlatitude density trough, and the equatorward compression of the plasmapause in combination with chemical compositional changes. Strong negative ionospheric storm phase is observed in both ionosonde and TEC observations during the recovery phase which also shows a strong hemispherical asymmetry. Additionally, the variation of equatorial ionization anomaly as seen through the SWARM constellation plasma measurements across different longitudes has been discussed. We, also, take a look at the performance of the IRI Real‐Time Assimilative Mapping during this storm as an ionospheric space weather tool.
Key Points
Simultaneous presence of positive and negative storms in American sector
Equatorward shift and enhancement of the midlatitude density trough in the American longitude sector
Strong hemispheric asymmetry in the negative storm phase during recovery phase
We present mid-infrared photometry and measured global properties of the 100 largest galaxies in the sky, including the well-studied Magellanic Clouds, Local Group galaxies M31 and M33, the Fornax ...and Virgo galaxy cluster giants, and many of the most spectacular Messier objects (e.g., M51 and M83). This is the first release of a larger catalog of extended sources as imaged in the mid-infrared, called the Wide-field Infrared Survey Explorer (WISE) Extended Source Catalog (WXSC). In this study, we measure their global attributes, including integrated flux, surface brightness, and radial distribution. The largest of the large are the LMC, SMC, and Andromeda galaxy, which are also the brightest mid-infrared galaxies in the sky. We interrogate the large galaxies using WISE colors, which serve as proxies for four general types of galaxies: bulge-dominated spheroidals, intermediate semi-quiescent disks, star-forming (SF) spirals, and AGN-dominated. The colors reveal a tight "sequence" that spans 5 mag in W2-W3 color, ranging from early to late types and low to high SF activity; we fit the functional form given by . Departures from this sequence may reveal nuclear, starburst, and merging events. Physical properties and luminosity attributes are computed, notably the diameter, aggregate stellar mass, and dust-obscured star formation activity. To effectively study and compare these galaxy characteristics, we introduce the "pinwheel" diagram, which depicts physical properties with respect to the median value observed for WISE galaxies in the local universe. Utilized with the WXSC, this diagram will delineate between different kinds of galaxies, identifying those with similar star formation and structural properties. Finally, we present the mid-infrared photometry of the 25 brightest globular clusters in the sky, of which many are also the largest and brightest objects orbiting the Milky Way, including Omega Centauri, 47 Tucanae, and a number of famed night-sky targets (e.g., M13).
Background
Obesity accelerates and exacerbates the age-related changes on muscle function and exercise capacity. In addition, the middle-aged population is often overlooked when talking about the ...prevention of sarcopenia. This study investigated the effects of exercise alone or in combination with a high-protein diet on muscle function and physical fitness in middle-aged obese adults.
Materials and methods
Sixty-nine middle-aged (501–64 years old) obese adults were randomly assigned to one of the following groups: control group (C; n=23), exercise group (E; n=23) or exercise plus high-protein group (EP; n=23). Individuals within the E and EP groups received 12 weeks of exercise training; whereas, the individuals in the EP group also received a highprotein diet intervention (1.6g/kg/day). Individuals within the C group were asked to maintain their lifestyle for 12 weeks. Participants were evaluated before and after the intervention. Outcome measures included maximal exercise capacity, muscle function and functional physical performance. Analysis of covariance was used to determine the effects of the intervention.
Results
After the intervention, the E and EP groups had greater maximal work rate, peak oxygen consumption, and muscle power during muscle contractions at 180°/sec than that in the C group (P<0.05). The EP group, but not the E group, showed significant improvement in the sit-to-stand test and climbing stairs test than the C group after the intervention (P<0.05). Within group comparisons showed that the anaerobic threshold only increased in the EP group (+12% from pre-test).
Conclusions
For middle-aged obese adults, exercise with a high-protein diet not only improved muscle power and exercise capacity but also enhanced their functional physical performance.
PDF
