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| 2. |
- Thoma, B, et al.
(författare)
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An international, interprofessional investigation of the self-reported podcast listening habits of emergency clinicians: A METRIQ Study
- 2020
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Ingår i: CJEM. - : Springer Science and Business Media LLC. - 1481-8043 .- 1481-8035. ; 22:1, s. 112-117
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesPodcasts are increasingly being used for medical education. A deeper understanding of usage patterns would inform both producers and researchers of medical podcasts. We aimed to determine how and why podcasts are used by emergency medicine and critical care clinicians.MethodsAn international interprofessional sample (medical students, residents, physicians, nurses, physician assistants, and paramedics) was recruited through direct contact and a multimodal social media (Twitter and Facebook) campaign. Each participant completed a survey outlining how and why they utilize medical podcasts. Recruitment materials included an infographic and study website.Results390 participants from 33 countries and 4 professions (medicine, nursing, paramedicine, physician assistant) completed the survey. Participants most frequently listened to medical podcasts to review new literature (75.8%), learn core material (75.1%), and refresh memory (71.8%). The majority (62.6%) were aware of the ability to listen at increased speeds, but most (76.9%) listened at 1.0 x (normal) speed. All but 25 (6.4%) participants concurrently performed other tasks while listening. Driving (72.3%), exercising (39.7%), and completing chores (39.2%) were the most common. A minority of participants used active learning techniques such as pausing, rewinding, and replaying segments of the podcast. Very few listened to podcasts multiple times.ConclusionsAn international cohort of emergency clinicians use medical podcasts predominantly for learning. Their listening habits (rarely employing active learning strategies and frequently performing concurrent tasks) may not support this goal. Further exploration of the impact of these activities on learning from podcasts is warranted.
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| 3. |
- Eijsbouts, C., et al.
(författare)
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Genome-wide analysis of 53,400 people with irritable bowel syndrome highlights shared genetic pathways with mood and anxiety disorders
- 2021
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 53:11, s. 1543-1552
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Tidskriftsartikel (refereegranskat)abstract
- Irritable bowel syndrome (IBS) results from disordered brain–gut interactions. Identifying susceptibility genes could highlight the underlying pathophysiological mechanisms. We designed a digestive health questionnaire for UK Biobank and combined identified cases with IBS with independent cohorts. We conducted a genome-wide association study with 53,400 cases and 433,201 controls and replicated significant associations in a 23andMe panel (205,252 cases and 1,384,055 controls). Our study identified and confirmed six genetic susceptibility loci for IBS. Implicated genes included NCAM1, CADM2, PHF2/FAM120A, DOCK9, CKAP2/TPTE2P3 and BAG6. The first four are associated with mood and anxiety disorders, expressed in the nervous system, or both. Mirroring this, we also found strong genome-wide correlation between the risk of IBS and anxiety, neuroticism and depression (rg > 0.5). Additional analyses suggested this arises due to shared pathogenic pathways rather than, for example, anxiety causing abdominal symptoms. Implicated mechanisms require further exploration to help understand the altered brain–gut interactions underlying IBS. © 2021, The Author(s).
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| 4. |
- Freissinet, C., et al.
(författare)
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Organic molecules in the Sheepbed Mudstone, Gale Crater, Mars
- 2015
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Ingår i: Journal of Geophysical Research - Planets. - 2169-9097 .- 2169-9100. ; 120:3, s. 495-514
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Tidskriftsartikel (refereegranskat)abstract
- The Sample Analysis at Mars (SAM) instrument [Mahaffy et al., 2012] onboard the Mars Science Laboratory (MSL) Curiosity rover is designed to conduct inorganic and organic chemical analyses of the atmosphere and the surface regolith and rocks to help evaluate the past and present habitability potential of Mars at Gale Crater [Grotzinger et al., 2012]. Central to this task is the development of an inventory of any organic molecules present to elucidate processes associated with their origin, diagenesis, concentration and long-term preservation. This will guide the future search for biosignatures [Summons et al., 2011]. Here we report the definitive identification of chlorobenzene (150–300 parts per billion by weight (ppbw)) and C2 to C4 dichloroalkanes (up to 70 ppbw) with the SAM gas chromatograph mass spectrometer (GCMS), and detection of chlorobenzene in the direct evolved gas analysis (EGA) mode, in multiple portions of the fines from the Cumberland drill hole in the Sheepbed mudstone at Yellowknife Bay. When combined with GCMS and EGA data from multiple scooped and drilled samples, blank runs and supporting laboratory analog studies, the elevated levels of chlorobenzene and the dichloroalkanes cannot be solely explained by instrument background sources known to be present in SAM. We conclude that these chlorinated hydrocarbons are the reaction products of martian chlorine and organic carbon derived from martian sources (e.g. igneous, hydrothermal, atmospheric, or biological) or exogenous sources such as meteorites, comets or interplanetary dust particles.
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| 6. |
- Tobias, Deirdre K, et al.
(författare)
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Second international consensus report on gaps and opportunities for the clinical translation of precision diabetes medicine
- 2023
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Ingår i: Nature Medicine. - 1546-170X. ; 29:10, s. 2438-2457
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Forskningsöversikt (refereegranskat)abstract
- Precision medicine is part of the logical evolution of contemporary evidence-based medicine that seeks to reduce errors and optimize outcomes when making medical decisions and health recommendations. Diabetes affects hundreds of millions of people worldwide, many of whom will develop life-threatening complications and die prematurely. Precision medicine can potentially address this enormous problem by accounting for heterogeneity in the etiology, clinical presentation and pathogenesis of common forms of diabetes and risks of complications. This second international consensus report on precision diabetes medicine summarizes the findings from a systematic evidence review across the key pillars of precision medicine (prevention, diagnosis, treatment, prognosis) in four recognized forms of diabetes (monogenic, gestational, type 1, type 2). These reviews address key questions about the translation of precision medicine research into practice. Although not complete, owing to the vast literature on this topic, they revealed opportunities for the immediate or near-term clinical implementation of precision diabetes medicine; furthermore, we expose important gaps in knowledge, focusing on the need to obtain new clinically relevant evidence. Gaps include the need for common standards for clinical readiness, including consideration of cost-effectiveness, health equity, predictive accuracy, liability and accessibility. Key milestones are outlined for the broad clinical implementation of precision diabetes medicine.
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| 7. |
- Ali, S., et al.
(författare)
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Influence of the water–sediment interaction on the major ions chemistry and fluoride pollution in groundwater of the Older Alluvial Plains of Delhi, India
- 2021
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Ingår i: Journal of Earth System Science. - : Springer Nature. - 2347-4327 .- 0973-774X. ; 130:2
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Tidskriftsartikel (refereegranskat)abstract
- Fluoride (F–) pollution in groundwater of the Older Alluvial Plain (OAP) of Delhi has been reported as a major problem. About 34% of the groundwater samples collected for this study had F– level beyond the permissible limit; with F– concentration in the range of 0.14–3.15 mg/L (average 1.20 mg/L). In this context, this article for the first time attempts on the genesis of major ions chemistry and F– pollution in groundwater of OAP Delhi by going beyond the statistical analysis to sediment geochemistry, chemical weathering processes and understanding of the processes using stable environmental isotopes (2H and 18O). The XRD of the OAP sediments revealed the dominance of fluor-biotite, albite, calcite, quartz, and chlorite. Whereas, the separated clay revealed the dominance of chlorite, kaolinite, and illite minerals. The saturation index (SI) values indicated that the groundwater chemistry is in the process of further F– enrichment by way of sediment groundwater interaction. With the given mineralogy of the sediments, the dominance of major ions like Na+, K+, Mg2+, Ca2+, Cl– and F– has been attributed to chemical weathering of biotites, phlogopites, albite, and calcite during sediment–water interaction. While the dominance of SO42– has been attributed to anthropogenic sources and confirmed by its association with heavier stable isotopes of hydrogen (δ2H: −50.44 to −40.02‰) and oxygen (δ18O: −7.19 to −5.62‰) indicating evaporative enrichment during isotopic fractionation.
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| 8. |
- Janko, Matthew R., et al.
(författare)
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In-situ bypass is associated with superior infection-free survival compared with extra-anatomic bypass for the management of secondary aortic graft infections without enteric involvement
- 2022
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Ingår i: Journal of Vascular Surgery. - : Elsevier. - 0741-5214 .- 1097-6809. ; 76:2, s. 546-
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The optimal revascularization modality following complete resection of aortic graft infection (AGI) without enteric involvement remains unclear. The purpose of this investigation is to determine the revascularization approach associated with the lowest morbidity and mortality using real-world data in patients undergoing complete excision of AGI. Methods: A retrospective, multi-institutional study of AGI from 2002 to 2014 was performed using a standardized database. Baseline demographics, comorbidities, and perioperative variables were recorded. The primary outcome was infection-free survival. Descriptive statistics, Kaplan-Meier survival analysis, and univariate and multivariable analyses were performed. Results: A total of 241 patients at 34 institutions from seven countries presented with AGI during the study period (median age, 68 years; 75% male). The initial aortic procedures that resulted in AGI were 172 surgical grafts (71%), 66 endografts (27%), and three unknown (2%). Of the patients, 172 (71%) underwent complete excision of infected aortic graft material followed by in situ (in-line) bypass (ISB), including antibiotic-treated prosthetic graft (35%), autogenous femoral vein (neo-aortoiliac surgery) (24%), and cryopreserved allograft (41%). Sixty-nine patients (29%) underwent extra-anatomic bypass (EAB). Overall median Kaplan-Meier estimated survival was 5.8 years. Perioperative mortality was 16%. When stratified by ISB vs EAB, there was a significant difference in Kaplan-Meier estimated infection-free survival (2910 days; interquartile range, 391-3771 days vs 180 days; interquartile range, 27-3750 days; P <.001). There were otherwise no significant differences in presentation, comorbidities, or perioperative variables. Multivariable Cox regression showed lower infection-free survival among patients with EAB (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.6-3.6; P <.001), polymicrobial infection (HR, 2.2; 95% CI, 1.4-3.5; P = .001), methicillin-resistant Staphylococcus aureus infection (HR, 1.7; 95% CI, 1.1-2.7; P = .02), as well as the protective effect of omental/muscle flap coverage (HR, 0.59; 95% CI, 0.37-0.92; P = .02). Conclusions: After complete resection of AGI, perioperative mortality is 16% and median overall survival is 5.8 years. EAB is associated with nearly a two and one-half-fold higher reinfection/mortality compared with ISB. Omental and/or muscle flap coverage of the repair appear protective.
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| 11. |
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| 12. |
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| 13. |
- Janko, Matthew, et al.
(författare)
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Contemporary Outcomes After Partial Resection of Infected Aortic Grafts
- 2021
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Ingår i: Annals of Vascular Surgery. - : Elsevier. - 0890-5096 .- 1615-5947. ; 76, s. 202-210
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Aortic graft infection remains a considerable clinical challenge, and it is unclear which variables are associated with adverse outcomes among patients undergoing partial resection.METHODS: A retrospective, multi-institutional study of patients who underwent partial resection of infected aortic grafts from 2002 to 2014 was performed using a standard database. Baseline demographics, comorbidities, operative, and postoperative variables were recorded. The primary outcome was mortality. Descriptive statistics, Kaplan-Meier (KM) survival analysis, and Cox regression analysis were performed.RESULTS: One hundred fourteen patients at 22 medical centers in 6 countries underwent partial resection of an infected aortic graft. Seventy percent were men with median age 70 years. Ninety-seven percent had a history of open aortic bypass graft: 88 (77%) patients had infected aortobifemoral bypass, 18 (16%) had infected aortobiiliac bypass, and 1 (0.8%) had an infected thoracic graft. Infection was diagnosed at a median 4.3 years post-implant. All patients underwent partial resection followed by either extra-anatomic (47%) or in situ (53%) vascular reconstruction. Median follow-up period was 17 months (IQR 1, 50 months). Thirty-day mortality was 17.5%. The KM-estimated median survival from time of partial resection was 3.6 years. There was no significant survival difference between those undergoing in situ reconstruction or extra-anatomic bypass (P = 0.6). During follow up, 72% of repairs remained patent and 11% of patients underwent major amputation. On univariate Cox regression analysis, Candida infection was associated with increased risk of mortality (HR 2.4; P = 0.01) as well as aortoenteric fistula (HR 1.9, P = 0.03). Resection of a single graft limb only to resection of abdominal (graft main body) infection was associated with decreased risk of mortality (HR 0.57, P = 0.04), as well as those with American Society of Anesthesiologists classification less than 3 (HR 0.35, P = 0.04). Multivariate analysis did not reveal any factors significantly associated with mortality. Persistent early infection was noted in 26% of patients within 30 days postoperatively, and 39% of patients were found to have any post-repair infection during the follow-up period. Two patients (1.8%) were found to have a late reinfection without early persistent postoperative infection. Patients with any post-repair infection were older (67 vs. 60 years, P = 0.01) and less likely to have patent repairs during follow up (59% vs. 32%, P = 0.01). Patients with aortoenteric fistula had a higher rate of any post-repair infection (63% vs. 29%, P < 0.01)CONCLUSION: This large multi-center study suggests that patients who have undergone partial resection of infected aortic grafts may be at high risk of death or post-repair infection, especially older patients with abdominal infection not isolated to a single graft limb, or with Candida infection or aortoenteric fistula. Late reinfection correlated strongly with early persistent postoperative infection, raising concern for occult retained infected graft material.
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| 14. |
- Janko, Matthew R., et al.
(författare)
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In situ bypass and extra-anatomic bypass procedures result in similar survival in patients with secondary aortoenteric fistulas
- 2021
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Ingår i: Journal of Vascular Surgery. - : Elsevier. - 0741-5214 .- 1097-6809. ; 73:1, s. 210-221.e1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The optimal revascularization modality in secondary aortoenteric fistula (SAEF) remains unclear in the literature. The purpose of this investigation was to determine the revascularization approach associated with the lowest morbidity and mortality using real-world data in patients with SAEF. Methods: A retrospective, multi-institutional study of SAEF from 2002 to 2014 was performed using a standardized database. Baseline demographics, comorbidities, and operative and postoperative variables were recorded. The primary outcome was long-term mortality. Descriptive statistics, Kaplan-Meier survival analysis, and univariate and multivariate analyses were performed. Results: During the study period, 182 patients at 34 institutions from 11 countries presented with SAEF (median age, 72 years; 79% male). The initial aortic procedures that resulted in SAEF were 138 surgical grafts (76%) and 42 endografts (23%), with 2 unknown; 102 of the SAEFs (56%) underwent complete excision of infected aortic graft material, followed by in situ (in-line) bypass (ISB), including antibiotic-soaked prosthetic graft (53), autogenous femoral vein (neoaortoiliac surgery; 17), cryopreserved allograft (28), and untreated prosthetic grafts (4). There were 80 patients (44%) who underwent extra-anatomic bypass (EAB) with infected graft excision. Overall median Kaplan-Meier estimated survival was 319 days (interquartile range, 20-2410 days). Stratified by EAB vs ISB, there was no significant difference in Kaplan-Meier estimated survival (P = .82). In comparing EAB vs ISB, EAB patients were older (74 vs 70 years; P = .01), had less operative hemorrhage (1200 mL vs 2000 mL; P = .04), were more likely to initiate dialysis within 30 days postoperatively (15% vs 5%; P = .02), and were less likely to experience aorta-related hemorrhage within 30 days postoperatively (3% aortic stump dehiscence vs 11% anastomotic rupture; P = .03). There were otherwise no significant differences in presentation, comorbidities, and intraoperative or postoperative variables. Multivariable Cox regression showed that the duration of antibiotic use (hazard ratio, 0.92; 95% confidence interval, 0.86-0.98; P = .01) and rifampin use at time of discharge (hazard ratio, 0.20; 95% confidence interval, 0.05-0.86; P = .03) independently decreased mortality. Conclusions: These data suggest that ISB does not offer a survival advantage compared with EAB and does not decrease the risk of postoperative aorta-related hemorrhage. After repair, <50% of SAEF patients survive 10-months. Each week of antibiotic use decreases mortality by 8%. Further study with risk modeling is imperative for this population. (J Vasc Surg 2021;73:210-21.)
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| 15. |
- Kashyap, Rahul, et al.
(författare)
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Numerical relativity simulations of prompt collapse mergers : Threshold mass and phenomenological constraints on neutron star properties after GW170817
- 2022
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Ingår i: Physical Review D. - 2470-0010 .- 2470-0029. ; 105:10
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Tidskriftsartikel (refereegranskat)abstract
- We determine the threshold mass for prompt (no bounce) black hole formation in equal-mass neutron star (NS) mergers using a new set of 227 numerical relativity simulations. We consider 23 phenomenological and microphysical finite-temperature equations of state (EOS), including models with hyperons and first-order phase transitions to deconfined quarks. We confirm the existence of EOS-insensitive relations between the threshold mass, binary tidal parameter at the threshold (Λth), maximum mass of nonrotating NSs, and radii of reference mass NSs. We combine the EOS-insensitive relations, phenomenological constraints on NS properties, and observational data from GW170817 to derive an improved lower limit on radii of maximum mass and a 1.6 M⊙ NS of 9.81 and 10.90 km, respectively. We also constrain the radius and quadrupolar tidal deformability (Λ) of a 1.4 M⊙ NS to be larger than 10.74 km and 172, respectively. We consider uncertainties in all independent parameters—fitting coefficients as well as GW170817 masses while reporting the range of radii constraints. We discuss an approach to constrain the upper as well as lower limit of NS maximum mass using future binary NS detections and their identification as prompt or delayed collapse. With future observations, it will be possible to derive even tighter constraints on the properties of matter at and above nuclear density using the method proposed in this work.
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| 16. |
- Patel, Kashyap A., et al.
(författare)
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Heterozygous RFX6 protein truncating variants are associated with MODY with reduced penetrance
- 2017
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Finding new causes of monogenic diabetes helps understand glycaemic regulation in humans. To find novel genetic causes of maturity-onset diabetes of the young (MODY), we sequenced MODY cases with unknown aetiology and compared variant frequencies to large public databases. From 36 European patients, we identify two probands with novel RFX6 heterozygous nonsense variants. RFX6 protein truncating variants are enriched in the MODY discovery cohort compared to the European control population within ExAC (odds ratio = 131, P = 1 × 10-4). We find similar results in non-Finnish European (n = 348, odds ratio = 43, P = 5 × 10-5) and Finnish (n = 80, odds ratio = 22, P = 1 × 10-6) replication cohorts. RFX6 heterozygotes have reduced penetrance of diabetes compared to common HNF1A and HNF4A-MODY mutations (27, 70 and 55% at 25 years of age, respectively). The hyperglycaemia results from beta-cell dysfunction and is associated with lower fasting and stimulated gastric inhibitory polypeptide (GIP) levels. Our study demonstrates that heterozygous RFX6 protein truncating variants are associated with MODY with reduced penetrance.
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| 17. |
- Provino, Alessia, et al.
(författare)
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Stability, Crystal Chemistry, and Magnetism of U2+xN21-xB6 and Nb3-yNi20+yB6 and the Role of Uranium in the Formation of the Quaternary U2-zNbzNi21B6 and U delta Nb3-delta Ni20B6 Systems
- 2019
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Ingår i: Inorganic Chemistry. - : American Chemical Society (ACS). - 0020-1669 .- 1520-510X. ; 58:22, s. 15045-15059
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Tidskriftsartikel (refereegranskat)abstract
- We investigated the U-Ni-B and Nb-Ni-B systems to search for possible new heavy fermion compounds and superconducting materials. The formation, crystal chemistry, and physical properties of U2Ni21B6 and Nb3-yNi20+yB6 [ternary derivatives of the cubic Cr23C6-type (cF116, Fm3m)] have been studied; the formation of the hypothetical U3Ni20B6 and Nb2Ni21B6 has been disproved. U2Ni21B6 [a = 10.6701(2) angstrom] crystallizes in the ordered W2Cr21C6-type, whereas Nb3-yNi20+yB6 [a = 10.5842(1) angstrom] adopts the Mg3Ni20B6-type. Ni in U2Ni21B6 can be substituted by U, leading to the solid solution U2-xNi21+yB6 (0 <= x <= 0.3); oppositely, Nb in Nb3Ni20B6 is partially replaced by Ni, forming the solution Nb3-yNi20+yB6 (0 <= y <= 0.5), none of them reaching the limit corresponding to the hypothetically ordered U3Ni20B6 and Nb2Ni21B6. These results prompted us to investigate quaternary compounds U2-zNbzNi21B6 and U6Nb3-delta Ni20B6: strong competition in the occupancy of the 4a and 8c sites by U, Nb, and Ni atoms has been observed, with the 4a site occupied by U/Ni atoms only and the 8c site filled by U/Nb atoms only. U2Ni21B6, U2.3Ni20.7B6, and Nb3Ni20B6 are Pauli paramagnets. Interestingly, Nb2.5Ni20.5B6 shows ferromagnetism with T-c approximate to 11 K; the Curie-Weiss fit gives an effective magnetic moment of 2.78 mu(B)/Ni, suggesting that all Ni atoms in the formula unit contribute to the total magnetic moment. The M(H) data at 2 K further corroborate the ferromagnetic behavior with a saturation moment of 10 mu(B)/fu (approximate to 0.49 mu(B)/Ni). The magnetic moment of Ni at the 4a site induces a moment in all of the Ni atoms of the whole unit cell (32f and 48h sites), with all atoms ordering ferromagnetically at 11 K. Density functional theory (DFT) shows that the formation of U2Ni21B6 and Nb3Ni20B6 is energetically preferred. The various electronic states generating ferromagnetism on Nb2.5Ni20.5B6 and Pauli paramagnetism on U2Ni21B6 and Nb3Ni20B6 have been identified.
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| 18. |
- Sit, Tawny, et al.
(författare)
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Long-rising Type II Supernovae in the Zwicky Transient Facility Census of the Local Universe
- 2023
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Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 959:2
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Tidskriftsartikel (refereegranskat)abstract
- SN 1987A was an unusual hydrogen-rich core-collapse supernova originating from a blue supergiant star. Similar blue supergiant explosions remain a small family of events, and are broadly characterized by their long rises to peak. The Zwicky Transient Facility Census of the Local Universe (CLU) experiment aims to construct a spectroscopically complete sample of transients occurring in galaxies from the CLU galaxy catalog. We identify 13 long-rising (>40 days) Type II supernovae from the volume-limited CLU experiment during a 3.5 yr period from 2018 June to 2021 December, approximately doubling the previously known number of these events. We present photometric and spectroscopic data of these 13 events, finding peak r-band absolute magnitudes ranging from −15.6 to −17.5 mag and the tentative detection of Ba ii lines in nine events. Using our CLU sample of events, we derive a long-rising Type II supernova rate of Mpc−3 yr−1, ≈1.4% of the total core-collapse supernova rate. This is the first volumetric rate of these events estimated from a large, systematic, volume-limited experiment.
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