Transcranial Doppler ultrasound (TCD) and magnetic resonance angiography (MRA) can identify intracranial atherosclerosis but have not been rigorously validated against the gold standard, catheter ...angiography. The WASID trial (Warfarin Aspirin Symptomatic Intracranial Disease) required performance of angiography to verify the presence of intracranial stenosis, allowing for prospective evaluation of TCD and MRA. The aims of Stroke Outcomes and Neuroimaging of Intracranial Atherosclerosis (SONIA) trial were to define abnormalities on TCD/MRA to see how well they identify 50 to 99% intracranial stenosis of large proximal arteries on catheter angiography.
SONIA standardized the performance and interpretation of TCD, MRA, and angiography. Study-wide cutpoints defining positive TCD/MRA were used. Hard copy TCD/MRA were centrally read, blind to the results of angiography.
SONIA enrolled 407 patients at 46 sites in the United States. For prospectively tested noninvasive test cutpoints, positive predictive values (PPVs) and negative predictive values (NPVs) were TCD, PPV 36% (95% CI: 27 to 46); NPV, 86% (95% CI: 81 to 89); MRA, PPV 59% (95% CI: 54 to 65); NPV, 91% (95% CI: 89 to 93). For cutpoints modified to maximize PPV, they were TCD, PPV 50% (95% CI: 36 to 64), NPV 85% (95% CI: 81 to 88); MRA PPV 66% (95% CI: 58 to 73), NPV 87% (95% CI: 85 to 89). For each test, a characteristic performance curve showing how the predictive values vary with a changing test cutpoint was obtained.
Both transcranial Doppler ultrasound and magnetic resonance angiography noninvasively identify 50 to 99% intracranial large vessel stenoses with substantial negative predictive value. The Stroke Outcomes and Neuroimaging of Intracranial Atherosclerosis trial methods allow transcranial Doppler ultrasound and magnetic resonance angiography to reliably exclude the presence of intracranial stenosis. Abnormal findings on transcranial Doppler ultrasound or magnetic resonance angiography require a confirmatory test such as angiography to reliably identify stenosis.
Declarative memory is usually described as consisting of two systems: semantic and episodic memory. Between these two poles, however, may lie a third entity: personal semantics (PS). PS concerns ...knowledge of one's past. Although typically assumed to be an aspect of semantic memory, it is essentially absent from existing models of knowledge. Furthermore, like episodic memory (EM), PS is idiosyncratically personal (i.e., not culturally-shared). We show that, depending on how it is operationalized, the neural correlates of PS can look more similar to semantic memory, more similar to EM, or dissimilar to both. We consider three different perspectives to better integrate PS into existing models of declarative memory and suggest experimental strategies for disentangling PS from semantic and episodic memory.
Immune‐mediated hemolytic anemia (IMHA) is an important cause of morbidity and mortality in dogs. IMHA also occurs in cats, although less commonly. IMHA is considered secondary when it can be ...attributed to an underlying disease, and as primary (idiopathic) if no cause is found. Eliminating diseases that cause IMHA may attenuate or stop immune‐mediated erythrocyte destruction, and adverse consequences of long‐term immunosuppressive treatment can be avoided. Infections, cancer, drugs, vaccines, and inflammatory processes may be underlying causes of IMHA. Evidence for these comorbidities has not been systematically evaluated, rendering evidence‐based decisions difficult. We identified and extracted data from studies published in the veterinary literature and developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria for IMHA, comorbidities, and causality. Succinct evidence summary statements were written, along with screening recommendations. Statements were refined by conducting 3 iterations of Delphi review with panel and task force members. Commentary was solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted. The resulting document is intended to provide clinical guidelines for diagnosis of, and underlying disease screening for, IMHA in dogs and cats. These should be implemented with consideration of animal, owner, and geographical factors.
The global rise of obesity, both adult and childhood, has been paralleled by a rise in type 2 diabetes, a trend predicted to continue for at least the next two decades. The combined effect will ...create a burden of direct and co-morbidities that will strain the physical and financial resources of all countries. While it is accepted that both type 1 and type 2 diabetes are major risk factors for the development and progression of periodontal disease, there is growing evidence that obesity is both an indirect risk factor because it affects glycaemic control and a direct risk factor because secretion of pro-inflammatory agents by adipose tissue modifies the periodontal reaction to the plaque biofilm. Recent research suggests that periodontitis may adversely affect glycaemic control, which can be improved by periodontal treatment with reduced risk of diabetic co-morbidity, thereby creating a two-way relationship. Furthermore it appears possible that periodontitis may stimulate inflammatory change in adipose tissue, creating a triangular self-generating cycle of morbidity linking obesity, diabetes and periodontal disease. Dentists should recognise these interlinked risk factors and consider including an assessment of glycaemic control and adiposity, possibly by waist-to-hip ratio, when periodontitis is diagnosed and in collaboration with medical practitioners provide treatment to help reduce the development of systemic disease.
The Pneumonia Etiology Research for Child Health (PERCH) project is a 7-country, standardized, comprehensive evaluation of the etiologic agents causing severe pneumonia in children from developing ...countries. During previous etiology studies, between one-quarter and one-third of patients failed to yield an obvious etiology; PERCH will employ and evaluate previously unavailable innovative, more sensitive diagnostic techniques. Innovative and rigorous epidemiologic and analytic methods will be used to establish the causal association between presence of potential pathogens and pneumonia. By strategic selection of study sites that are broadly representative of regions with the greatest burden of childhood pneumonia, PERCH aims to provide data that reflect the epidemiologic situation in developing countries in 2015, using pneumococcal and Haemophilus influenzae type b vaccines. PERCH will also address differences in host, environmental, and/or geographic factors that might determine pneumonia etiology and, by preserving specimens, will generate a resource for future research and pathogen discovery.
Abstract Background In 1940s, it was proposed that frozen shoulder progresses through a self-limiting natural history of painful, stiff and recovery phases, leading to full recovery without ...treatment. However, clinical evidence of persistent limitations lasting for years contradicts this assumption. Objectives To assess evidence for the natural history theory of frozen shoulder by examining: (1) progression through recovery phases, and (2) full resolution without treatment. Data sources MEDLINE, PubMed, EBSCO CINAHL and PEDro database searches augmented by hand searching. Study selection Cohort or randomised controlled trials with no-treatment comparison groups including adults with frozen shoulder who received no treatment and reporting range of motion, pain or function for ≥6 months. Data extraction Reviewers assessed study eligibility and quality, and extracted data before reaching consensus. Limited early range-of-motion improvements and greater late improvements defined progression through recovery phases. Restoration of normal range of motion and previous function defined full resolution. Results Of 508 citations, 13 articles were reviewed and seven were included in this review. Low-quality evidence suggested that no treatment yielded some, but not complete, improvement in range of motion after 1 to 4 years of follow-up. No evidence supported the theory of progression through recovery phases to full resolution without treatment. On the contrary, moderate-quality evidence from three randomised controlled trials with longitudinal data demonstrated that most improvement occurred early, not late. Limitations Low-quality evidence revealed the weakness of longstanding assumptions about frozen shoulder. Conclusion Contradictory evidence and a lack of supporting evidence shows that the theory of recovery phases leading to complete resolution without treatment for frozen shoulder is unfounded.
Abstract
Gamma-ray bursts (GRBs) are fascinating events due to their panchromatic nature. We study optical plateaus in GRB afterglows via an extended search into archival data. We comprehensively ...analyze all published GRBs with known redshifts and optical plateaus observed by many ground-based telescopes (e.g., Subaru Telescope, RATIR) around the world and several space-based observatories such as the Neil Gehrels Swift Observatory. We fit 500 optical light curves, showing the existence of the plateau in 179 cases. This sample is 75% larger than the previous one, and it is the largest compilation so far of optical plateaus. We discover the 3D fundamental plane relation at optical wavelengths using this sample. This correlation is between the rest-frame time at the end of the plateau emission,
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, its optical luminosity,
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, and the peak in the optical prompt emission,
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, thus resembling the three-dimensional (3D) X-ray fundamental plane (the so-called 3D Dainotti relation). We correct our sample for redshift evolution and selection effects, discovering that this correlation is indeed intrinsic to GRB physics. We investigate the rest-frame end-time distributions in X-rays and optical (
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,
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), and conclude that the plateau is achromatic only when selection biases are not considered. We also investigate if the 3D optical correlation may be a new discriminant between optical GRB classes and find that there is no significant separation between the classes compared to the Gold sample plane after correcting for evolution.
The WASID trial showed no advantage of warfarin over aspirin for preventing the primary endpoint of ischemic stroke, brain hemorrhage, or vascular death. In analyses of selected subgroups, there was ...no definite benefit from warfarin. Warfarin reduced the risk of the primary endpoint among patients with basilar artery stenosis, but there was no reduction in stroke in the basilar artery territory or benefit for vertebral artery stenosis or posterior circulation disease in general.
Context. The NASA mission TESS is currently doing an all-sky survey from space to detect transiting planets around bright stars. As part of the validation process, the most promising planet ...candidates need to be confirmed and characterized using follow-up observations.
Aims. In this article, our aim is to confirm the planetary nature of the transiting planet candidate TOI-674b using spectroscopic and photometric observations.
Methods. We use TESS, Spitzer, ground-based light curves, and HARPS spectrograph radial velocity measurements to establish the physical properties of the transiting exoplanet candidate TOI-674b. We perform a joint fit of the light curves and radial velocity time series to measure the mass, radius, and orbital parameters of the candidate.
Results. We confirm and characterize TOI-674b, a low-density super-Neptune transiting a nearby M dwarf. The host star (TIC 158588995, V = 14.2 mag, J = 10.3 mag) is characterized by its M2V spectral type with M⋆ = 0.420 ± 0.010 Mꙩ, R⋆ = 0.420 ± 0.013 Rꙩ, and T(eff) = 3514 ± 57 K; it is located at a distance d = 46.16 ± 0.03 pc. Combining the available transit light curves plus radial velocity measurements and jointly fitting a circular orbit model, we find an orbital period of 1.977143 ± 3 × 10^(−6) days, a planetary radius of 5.25 ± 0.17 Rꚛ, and a mass of 23.6 ± 3.3 Mꚛ implying a mean density of ρp =0.91 ± 0.15 g/cu. cm. A non-circular orbit model fit delivers similar planetary mass and radius values within the uncertainties. Given the measured planetary radius and mass, TOI-674b is one of the largest and most massive super-Neptune class planets discovered around an M-type star to date. It is found in the Neptunian desert, and is a promising candidate for atmospheric characterization using the James Webb Space Telescope.
Please cite this paper as: Lynch A, Murphy J, Gibbs R, Levine R, Giclas P, Salmon J, Holers V. The interrelationship of complement‐activation fragments and angiogenesis‐related factors in early ...pregnancy and their association with pre‐eclampsia. BJOG 2010; 117:456–462.
Objective To determine the interrelationships during early pregnancy of complement‐activation fragments Bb, C3a and sC5b‐9, and angiogenesis‐related factors placental growth factor (PiGF), soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and soluble endoglin (sEng), and their associations with pre‐eclampsia.
Design Prospective cohort study.
Setting Denver complement study (June 2005–June 2008).
Population A total of 668 pregnant women with singleton gestations, recruited between 10 and 15 weeks of gestation.
Methods Using univariable and multivariable logistic regression analysis, concentrations of complement‐activation fragments and angiogenesis‐related factors were compared between 10 and 15 weeks of gestation in women who subsequently did or did not develop pre‐eclampsia. Interrelationships between these variables were tested using the non‐parametric Spearman rank correlation coefficient.
Main outcome measure Pre‐eclampsia. The association of complement‐activation fragments and angiogenesis‐related factors with obesity was also examined.
Results The mean (±SD) levels of complement Bb in early pregnancy among women who did and did not develop pre‐eclampsia were 0.84 (±0.26) μg/ml and 0.69 (±0.2) μg/ml, respectively (P = 0.001). Concentrations of PiGF were significantly (P = 0.01) lower (31 ± 12 pg/ml) in early pregnancy in the pre‐eclamptic group of women, as compared with the normotensive group (39 ± 32 pg/ml). The adjusted odds ratio (AOR) of Bb and PiGF were 2.1 (CI = 1.4–3.1, P < 0.0003) and 0.2 (CI = 0.07–0.7, P = 0.01), respectively. There was no significant difference in the levels of C3a, sC5b‐9, sFlt‐1 and sEng in early pregnancy among women who developed pre‐eclampsia, compared with women who remained normotensive during pregnancy. Higher levels of Bb (P = 0.0001) and C3a (P = 0.03), and lower levels of sFlt‐1 (P = 0.0002) and sEng (P = 0.0001) were found among women with obesity, compared with non‐obese controls. No meaningful relationships were found between the complement‐activation fragments and the angiogenesis‐related factors.
Conclusions In this cohort during early pregnancy, increased concentrations of complement‐activation factor Bb and lower concentrations of PiGF were associated with the development of pre‐eclampsia later in pregnancy.
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