| 151. |
- Sepanlou, Sadaf G., et al.
(författare)
-
The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017 : a systematic analysis for the Global Burden of Disease Study 2017
- 2020
-
Ingår i: The Lancet Gastroenterology & Hepatology. - 2468-1253. ; 5:3, s. 245-266
-
Tidskriftsartikel (refereegranskat)abstract
- Background Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. Methods We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100 000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries. Findings In 2017, cirrhosis caused more than 1.32 million (95% UI 1.27-1.45) deaths (440000 [416 000-518 000; 33.3%] in females and 883 000 [838 000-967 000; 66.7%] in males) globally, compared with less than 899 000 (829 000-948 000) deaths in 1990. Deaths due to cirrhosis constituted 2.4% (2.3-2.6) of total deaths globally in 2017 compared with 1.9% (1.8-2.0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21.0 (19.2-22.3) per 100 000 population in 1990 to 16.5 (15.8-18-1) per 100 000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32.2 [25.8-38.6] deaths per 100 000 population in 2017), and the high-income super-region had the lowest (10.1 [9.8-10-5] deaths per 100 000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3.7 [3.3-4.0] per 100 000 in 2017) and highest in Egypt in all years since 1990 (103.3 [64.4-133.4] per 100 000 in 2017). There were 10.6 million (10.3-10.9) prevalent cases of decompensated cirrhosis and 112 million (107-119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the other four causes showed declines in age-standardised death rate. The age-standardised prevalence of compensated and decompensated cirrhosis due to NASH increased more than for any other cause of cirrhosis (by 33.2% for compensated cirrhosis and 54.8% for decompensated cirrhosis) over the study period. From 1990 to 2017, the number of prevalent cases snore than doubled for compensated cirrhosis due to NASH and more than tripled for decompensated cirrhosis due to NASH. In 2017, age-standardised death and DALY rates were lower among countries and territories with higher SDI. Interpretation Cirrhosis imposes a substantial health burden on many countries and this burden has increased at the global level since 1990, partly due to population growth and ageing. Although the age-standardised death and DALY rates of cirrhosis decreased from 1990 to 2017, numbers of deaths and DALYs and the proportion of all global deaths due to cirrhosis increased. Despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, they were still the main causes of cirrhosis burden worldwide, particularly in low-income countries. The impact of hepatitis B and C is expected to be attenuated and overtaken by that of NASH in the near future. Cost-effective interventions are required to continue the prevention and treatment of viral hepatitis, and to achieve early diagnosis and prevention of cirrhosis due to alcohol-related liver disease and NASH.
|
|
| 152. |
- Stein, Robert, et al.
(författare)
-
A tidal disruption event coincident with a high-energy neutrino
- 2021
-
Ingår i: Nature Astronomy. - : Springer Science and Business Media LLC. - 2397-3366. ; :5, s. 510-518
-
Tidskriftsartikel (refereegranskat)abstract
- Cosmic neutrinos provide a unique window into the otherwise hidden mechanism of particle acceleration in astrophysical objects. The IceCube Collaboration recently reported the likely association of one high-energy neutrino with a flare from the relativistic jet of an active galaxy pointed towards the Earth. However a combined analysis of many similar active galaxies revealed no excess from the broader population, leaving the vast majority of the cosmic neutrino flux unexplained. Here we present the likely association of a radio-emitting tidal disruption event, AT2019dsg, with a second high-energy neutrino. AT2019dsg was identified as part of our systematic search for optical counterparts to high-energy neutrinos with the Zwicky Transient Facility. The probability of finding any coincident radio-emitting tidal disruption event by chance is 0.5%, while the probability of finding one as bright in bolometric energy flux as AT2019dsg is 0.2%. Our electromagnetic observations can be explained through a multizone model, with radio analysis revealing a central engine, embedded in a UV photosphere, that powers an extended synchrotron-emitting outflow. This provides an ideal site for petaelectronvolt neutrino production. Assuming that the association is genuine, our observations suggest that tidal disruption events with mildly relativistic outflows contribute to the cosmic neutrino flux. The tidal disruption event AT2019dsg is probably associated with a high-energy neutrino, suggesting that such events can contribute to the cosmic neutrino flux. The electromagnetic emission is explained in terms of a central engine, a photosphere and an extended synchrotron-emitting outflow.
|
|
| 153. |
- Stephens, Elizabeth H., et al.
(författare)
-
Greater asymmetric wall shear stress in Sievers type 1/LR compared with 0/LAT bicuspid aortic valves after valve-sparing aortic root replacement
- 2015
-
Ingår i: Journal of Thoracic and Cardiovascular Surgery. - : Elsevier. - 0022-5223 .- 1097-685X. ; 150:1, s. 59-68
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the role of commissure orientation on downstream blood flow patterns and ascending aortic wall shear stress (WSS) in patients with bicuspid aortic valves (BAV) after valve-sparing aortic root replacement (V-SARR). Methods: Nineteen BAV patients after V-SARR (9 Sievers type 1/LR [type 1 valve with fusion of the left and right cusps] and 10 Sievers type 0/LAT ["naturally perfect; type 0 valve without the presence of a raphe, and with the 2 commissures oriented right-anterior-to-left-posterior]) were imaged using time-resolved 3-D phase contrast magnetic resonance imaging. A control group of 5 unoperated tricuspid aortic valve patients were used for comparison purposes. Wall shear stress and eccentricity of flow normalized to aortic diameter were measured in planes placed perpendicular to the axis of the ascending aorta at the level of the sinotubular junction (proximal ascending), main pulmonary artery (mid-ascending), and origin of the brachiocephalic (distal ascending). Results: The ratio of WSS along the outer curvature to that along the inner curvature was greater in Sievers type 1/LR patients compared with Sievers type 0/LAT patients in the proximal (3.8 +/- 1.6 vs 2.1 +/- 0.9, P = .009) and mid-ascending aorta (4.5 +/- 2.4 vs 2.4 +/- 1.3, P = .027). Relative to control normal tricuspid patients, Sievers type 1/LR BAV patients had a higher WSS ratio in the mid-ascending aorta (4.5 +/- 2.4 vs 1.2 +/- 1.2, P = .007). Conversely, WSS in Sievers type 0/LAT patients was not different than in normal tricuspid patients. Conclusions: After V-SARR, BAV cusp morphology has a major impact on the pattern of blood flow and WSS in the ascending aorta.
|
|
| 154. |
- Sun, Yi, et al.
(författare)
-
Blockade of the CD93 pathway normalizes tumor vasculature to facilitate drug delivery and immunotherapy
- 2021
-
Ingår i: Science Translational Medicine. - : American Association for the Advancement of Science (AAAS). - 1946-6234 .- 1946-6242. ; 13:604
-
Tidskriftsartikel (refereegranskat)abstract
- The immature and dysfunctional vascular network within solid tumors poses a substantial obstacle to immunotherapy because it creates a hypoxic tumor microenvironment that actively limits immune cell infiltration. The molecular basis underpinning this vascular dysfunction is not fully understood. Using genome-scale receptor array technology, we showed here that insulin-like growth factor binding protein 7 (IGFBP7) interacts with its receptor CD93, and we subsequently demonstrated that this interaction contributes to abnormal tumor vasculature. Both CD93 and IGFBP7 were up-regulated in tumor-associated endothelial cells. IGFBP7 interacted with CD93 via a domain different from multimerin-2, the known ligand for CD93. In two mouse tumor models, blockade of the CD93/IGFBP7 interaction by monoclonal antibodies promoted vascular maturation to reduce leakage, leading to reduced tumor hypoxia and increased tumor perfusion. CD93 blockade in mice increased drug delivery, resulting in an improved antitumor response to gemcitabine or fluorouracil. Blockade of the CD93 pathway triggered a substantial increase in intratumoral effector T cells, thereby sensitizing mouse tumors to immune checkpoint therapy. Last, analysis of samples from patients with cancer under anti-programmed death 1/programmed death-ligand 1 treatment revealed that overexpression of the IGFBP7/CD93 pathway was associated with poor response to therapy. Thus, our study identified a molecular interaction involved in tumor vascular dysfunction and revealed an approach to promote a favorable tumor microenvironment for therapeutic intervention.
|
|
| 155. |
- van Velzen, Sjoert, et al.
(författare)
-
Seventeen Tidal Disruption Events from the First Half of ZTF Survey Observations : Entering a New Era of Population Studies
- 2021
-
Ingår i: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 908:1
-
Tidskriftsartikel (refereegranskat)abstract
- While tidal disruption events (TDEs) have long been heralded as laboratories for the study of quiescent black holes, the small number of known TDEs and uncertainties in their emission mechanism have hindered progress toward this promise. Here we present 17 new TDEs that have been detected recently by the Zwicky Transient Facility along with Swift UV and X-ray follow-up observations. Our homogeneous analysis of the optical/UV light curves, including 22 previously known TDEs from the literature, reveals a clean separation of light-curve properties with spectroscopic class. The TDEs with Bowen fluorescence features in their optical spectra have smaller blackbody radii, lower optical luminosities, and higher disruption rates compared to the rest of the sample. The small subset of TDEs that show only helium emission lines in their spectra have the longest rise times, the highest luminosities, and the lowest rates. A high detection rate of Bowen lines in TDEs with small photometric radii could be explained by the high density that is required for this fluorescence mechanism. The stellar debris can provide a source for this dense material. Diffusion of photons through this debris may explain why the rise and fade timescale of the TDEs in our sample are not correlated. We also report, for the first time, the detection of soft X-ray flares from a TDE on similar to day timescales. Based on the fact that the X-ray flares peak at a luminosity similar to the optical/UV blackbody luminosity, we attribute them to brief glimpses through a reprocessing layer that otherwise obscures the inner accretion flow.
|
|
| 156. |
- Watts, Anna L., et al.
(författare)
-
Dense matter with eXTP
- 2019
-
Ingår i: Science China Physics, Mechanics & Astronomy. - : Science Press. - 1674-7348 .- 1869-1927. ; 62:2
-
Forskningsöversikt (refereegranskat)abstract
- In this White Paper we present the potential of the Enhanced X-ray Timing and Polarimetry (eXTP) mission for determining the nature of dense matter; neutron star cores host an extreme density regime which cannot be replicated in a terrestrial laboratory. The tightest statistical constraints on the dense matter equation of state will come from pulse profile modelling of accretion-powered pulsars, burst oscillation sources, and rotation-powered pulsars. Additional constraints will derive from spin measurements, burst spectra, and properties of the accretion flows in the vicinity of the neutron star. Under development by an international Consortium led by the Institute of High Energy Physics of the Chinese Academy of Sciences, the eXTP mission is expected to be launched in the mid 2020s.
|
|
| 157. |
- Wheaton, Benjamin J., et al.
(författare)
-
Identification of regenerative processes in neonatal spinal cord injury in the opossum (Monodelphis domestica) : A transcriptomic study
- 2021
-
Ingår i: Journal of Comparative Neurology. - : John Wiley & Sons. - 0021-9967 .- 1096-9861. ; 529:5, s. 969-986
-
Tidskriftsartikel (refereegranskat)abstract
- This study investigates the response to spinal cord injury in the gray short‐tailed opossum (Monodelphis domestica). In opossums spinal injury early in development results in spontaneous axon growth through the injury, but this regenerative potential diminishes with maturity until it is lost entirely. The mechanisms underlying this regeneration remain unknown. RNA sequencing was used to identify differential gene expression in regenerating (SCI at postnatal Day 7, P7SCI) and nonregenerating (SCI at Day 28, P28SCI) cords +1d, +3d, and +7d after complete spinal transection, compared to age‐matched controls. Genes showing significant differential expression (log2FC ≥ 1, Padj ≤ 0.05) were used for downstream analysis. Across all time‐points 233 genes altered expression after P7SCI, and 472 genes altered expression after P28SCI. One hundred and forty‐seven genes altered expression in both injury ages (63% of P7SCI data set). The majority of changes were gene upregulations. Gene ontology overrepresentation analysis in P7SCI gene‐sets showed significant overrepresentations only in immune‐associated categories, while P28SCI gene‐sets showed overrepresentations in these same immune categories, along with other categories such as “cell proliferation,” “cell adhesion,” and “apoptosis.” Cell‐type–association analysis suggested that, regardless of injury age, injury‐associated gene transcripts were most strongly associated with microglia and endothelial cells, with strikingly fewer astrocyte, oligodendrocyte and neuron‐related genes, the notable exception being a cluster of mostly downregulated oligodendrocyte‐associated genes in the P7SCI + 7d gene‐set. Our findings demonstrate a more complex transcriptomic response in nonregenerating cords, suggesting a strong influence of non‐neuronal cells in the outcome after injury and providing the largest survey yet of the transcriptomic changes occurring after SCI in this model.
|
|
