1. |
- Glasbey, JC, et al.
(author)
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- 2021
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swepub:Mat__t
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2. |
- Tabiri, S, et al.
(author)
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- 2021
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swepub:Mat__t
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- Bravo, L, et al.
(author)
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- 2021
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swepub:Mat__t
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6. |
- Khatri, C, et al.
(author)
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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
- 2021
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In: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
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Journal article (peer-reviewed)abstract
- Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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9. |
- Amati, L., et al.
(author)
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The THESEUS space mission concept : science case, design and expected performances
- 2018
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In: Advances in Space Research. - : ELSEVIER SCI LTD. - 0273-1177 .- 1879-1948. ; 62:1, s. 191-244
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Journal article (peer-reviewed)abstract
- THESEUS is a space mission concept aimed at exploiting Gamma-Ray Bursts for investigating the early Universe and at providing a substantial advancement of multi-messenger and time-domain astrophysics. These goals will be achieved through a unique combination of instruments allowing GRB and X-ray transient detection over a broad field of view (more than 1 sr) with 0.5-1 arcmin localization, an energy band extending from several MeV down to 0.3 keV and high sensitivity to transient sources in the soft X-ray domain, as well as on-board prompt (few minutes) follow-up with a 0.7 m class IR telescope with both imaging and spectroscopic capabilities. THESEUS will be perfectly suited for addressing the main open issues in cosmology such as, e.g., star formation rate and metallicity evolution of the inter-stellar and intra-galactic medium up to redshift similar to 10, signatures of Pop III stars, sources and physics of re-ionization, and the faint end of the galaxy luminosity function. In addition, it will provide unprecedented capability to monitor the X-ray variable sky, thus detecting, localizing, and identifying the electromagnetic counterparts to sources of gravitational radiation, which may be routinely detected in the late '20s/early '30s by next generation facilities like aLIGO/ aVirgo, eLISA, KAGRA, and Einstein Telescope. THESEUS will also provide powerful synergies with the next generation of multi-wavelength observatories (e.g., LSST, ELT, SKA, CTA, ATHENA).
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11. |
- Van Haute, L., et al.
(author)
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TEFM variants impair mitochondrial transcription causing childhood-onset neurological disease
- 2023
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In: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 14:1
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Journal article (peer-reviewed)abstract
- Mutations in the mitochondrial or nuclear genomes are associated with a diverse group of human disorders characterized by impaired mitochondrial respiration. Within this group, an increasing number of mutations have been identified in nuclear genes involved in mitochondrial RNA biology. The TEFM gene encodes the mitochondrial transcription elongation factor responsible for enhancing the processivity of mitochondrial RNA polymerase, POLRMT. We report for the first time that TEFM variants are associated with mitochondrial respiratory chain deficiency and a wide range of clinical presentations including mitochondrial myopathy with a treatable neuromuscular transmission defect. Mechanistically, we show muscle and primary fibroblasts from the affected individuals have reduced levels of promoter distal mitochondrial RNA transcripts. Finally, tefm knockdown in zebrafish embryos resulted in neuromuscular junction abnormalities and abnormal mitochondrial function, strengthening the genotype-phenotype correlation. Our study highlights that TEFM regulates mitochondrial transcription elongation and its defect results in variable, tissue-specific neurological and neuromuscular symptoms.
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12. |
- Lu, C. W., et al.
(author)
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Heart Failure and Patient-Reported Outcomes in Adults With Congenital Heart Disease from 15 Countries
- 2022
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In: Journal of the American Heart Association. - : Ovid Technologies (Wolters Kluwer Health). - 2047-9980. ; 11:9
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Journal article (peer-reviewed)abstract
- BACKGROUND: Heart failure (HF) is the leading cause of mortality and associated with significant morbidity in adults with congenital heart disease. We sought to assess the association between HF and patient-report outcomes in adults with congenital heart disease. METHODS AND RESULTS: As part of the APPROACH-IS (Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease-International Study), we collected data on HF status and patient-reported outcomes in 3959 patients from 15 countries across 5 continents. Patient-report outcomes were: perceived health status (12-item Short Form Health Survey), quality of life (Linear Analogue Scale and Satisfaction with Life Scale), sense of coherence-13, psychological distress (Hospital Anxiety and Depression Scale), and illness perception (Brief Illness Perception Questionnaire). In this sample, 137 (3.5%) had HF at the time of investigation, 298 (7.5%) had a history of HF, and 3524 (89.0%) had no current or past episode of HF. Patients with current or past HF were older and had a higher prevalence of complex congenital heart disease, arrhythmias, implantable cardioverter-defibrillators, other clinical comorbidities, and mood disorders than those who never had HF. Patients with HF had worse physical functioning, mental functioning, quality of life, satisfaction with life, sense of coherence, depressive symptoms, and illness perception scores. Magnitudes of differences were large for physical functioning and illness perception and moderate for mental functioning, quality of life, and depressive symptoms. CONCLUSIONS: HF in adults with congenital heart disease is associated with poorer patient-reported outcomes, with large effect sizes for physical functioning and illness perception.
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13. |
- Urrutia, T., et al.
(author)
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The MUSE-Wide Survey : survey description and first data release
- 2019
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In: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 624
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Journal article (peer-reviewed)abstract
- We present the MUSE-Wide survey, a blind, 3D spectroscopic survey in the CANDELS/GOODS-S and CANDELS/COSMOS regions. The final survey will cover 100 x 1 arcmin(2) MUSE fields. Each MUSE-Wide pointing has a depth of one hour and hence targets more extreme and more luminous objects over ten times the area of the MUSE-Deep fields. The legacy value of MUSE-Wide lies in providing spectroscopy of everything without photometric pre-selection. We describe the data reduction, post-processing and PSF characterization of the first 44 CANDELS /GOODS-S MUSE-Wide pointings released with this publication. Using a 3D matched filtering approach we detect 1602 emission line sources, including 479 Lyman-alpha (Ly alpha) emitting galaxies with redshifts 2.9 less than or similar to z less than or similar to 6.3. We cross-matched the emission line sources to existing photometric catalogs, finding almost complete agreement in redshifts (photometric and spectroscopic) and stellar masses for our low redshift (z < 1.5) emitters. At high redshift, we only find similar to 55% matches to photometric catalogs. We encounter a higher outlier rate and a systematic offset of Delta z similar or equal to 0.2 when comparing our MUSE redshifts with photometric redshifts from the literature. Cross-matching the emission line sources with X-ray catalogs from the Chandra Deep Field South, we find 127 matches, mostly in agreement with the literature redshifts, including ten objects with no prior spectroscopic identification. Stacking X-ray images centered on our Ly alpha emitters yields no signal; the Ly alpha population is not dominated by even low luminosity AGN. Other cross-matches of our emission-line catalog to radio and submillimeter data, yielded far lower numbers of matches, most of which already were covered by the X-ray catalog. A total of 9205 photometrically selected objects from the CANDELS survey lie in the MUSE-Wide footprint, of which we provide optimally extracted 1D spectra. We are able to determine the spectroscopic redshift of 98% of 772 photometrically selected galaxies brighter than 24th F775W magnitude. All the data in the first data release - datacubes, catalogs, extracted spectra, maps - are available on the MUSE-Wide data release webpage.
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15. |
- Ko, Jong Mi, et al.
(author)
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Differential impact of physical activity type on depression in adults with congenital heart disease : A multi-center international study
- 2019
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In: Journal of Psychosomatic Research. - : Elsevier BV. - 0022-3999 .- 1879-1360. ; 124
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Journal article (peer-reviewed)abstract
- OBJECTIVE: This study aimed to examine the association between physical activity (PA) and depression in a large international cohort of adults with congenital heart disease (ACHD) as data about the differential impact of PA type on depression in this population are lacking.METHODS: In 2018, we conducted a cross-sectional assessment of 3908 ACHD recruited from 24 ACHD-specialized centers in 15 countries between April 2013 to March 2015. The Hospital Anxiety and Depression Scale was used to assess self-reported depressive symptoms and the Health-Behavior Scale-Congenital Heart Disease was used to collect PA information. Cochran-Armitage tests were performed to assess trends between depressive symptom levels and PA participation. Chi-Square and Wilcoxon Rank Sum tests were utilized to examine relations between depressive symptom levels and patient characteristics. Stepwise multivariable models were then constructed to understand the independent impact of PA on depressive symptoms.RESULTS: The overall prevalence of elevated depressive symptoms in this sample was 12% with significant differences in rates between countries (p < .001). Physically active individuals were less likely to be depressed than those who were sedentary. Of the 2 PA domains examined, sport participation rather than active commute was significantly associated with reduced symptoms of depression. After adjustment in multivariable analysis, sport participation was still significantly associated with 38% decreased probability of depressive symptoms (p < .001).CONCLUSIONS: Sport participation is independently associated with reduced depressive symptoms. The development and promotion of sport-related exercise prescriptions uniquely designed for ACHD may improve depression status in this unique population.
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16. |
- Ko, Jong Mi, et al.
(author)
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Physical Activity-Related Drivers of Perceived Health Status in Adults With Congenital Heart Disease
- 2018
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In: American Journal of Cardiology. - : Elsevier BV. - 0002-9149 .- 1879-1913. ; 122:8, s. 1437-1442
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Journal article (peer-reviewed)abstract
- Data on the differential impact of physical activity on perceived health status (PHS) in a large adult congenital heart disease (ACHD) patient population are lacking. We conducted a cross-sectional assessment of 4,028 ACHD patients recruited from 24 ACHD-specialized centers in 15 countries across 5 continents to examine the association between physical activity and PHS in a large international cohort of ACHD patients. A linear analog scale of the EuroQol-5D 3 level version and the 12-item Short Form Health Survey-version 2 were used to assess self-reported health status and the Health-Behavior Scale-Congenital Heart Disease was used as a subjective measurement of physical activity type, participation, and level. Correlation analyses and Wilcoxon Rank Sum tests examined bivariate relations between sample characteristics and PHS scores. Then, multivariable models were constructed to understand the impact of physical activity on PHS. Only 30% of our sample achieved recommended physical activity levels. Physically active patients reported better PHS than sedentary patients; however, the amount of physical activity was not associated with PHS. Further statistical analyses demonstrated that specifically sport participation regardless of physical activity level was a predictor of PHS. In conclusion, the majority of ACHD patients across the world are physically inactive. Sport participation appears to be the primary physical activity-related driver of PHS. By promoting sport-related exercise ACHD specialists thus may improve PHS in ACHD patients.
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17. |
- Sluman, Maayke A., et al.
(author)
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Education as important predictor for successful employment in adults with congenital heart disease worldwide
- 2019
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In: Congenital Heart Disease. - : Computers, Materials and Continua (Tech Science Press). - 1747-079X .- 1747-0803. ; 14:3, s. 362-371
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Journal article (peer-reviewed)abstract
- BackgroundConflicting results have been reported regarding employment status and work ability in adults with congenital heart disease (CHD). Since this is an important determinant for quality of life, we assessed this in a large international adult CHD cohort.MethodsData from 4028 adults with CHD (53% women) from 15 different countries were collected by a uniform survey in the cross-sectional APPROACH International Study. Predictors for employment and work limitations were studied using general linear mixed models.ResultsMedian age was 32 years (IQR 25-42) and 94% of patients had at least a high school degree. Overall employment rate was 69%, but varied substantially among countries. Higher education (OR 1.99-3.69) and having a partner (OR 1.72) were associated with more employment; female sex (OR 0.66, worse NYHA functional class (OR 0.67-0.13), and a history of congestive heart failure (OR 0.74) were associated with less employment. Limitations at work were reported in 34% and were associated with female sex (OR 1.36), increasing age (OR 1.03 per year), more severe CHD (OR 1.31-2.10), and a history of congestive heart failure (OR 1.57) or mental disorders (OR 2.26). Only a university degree was associated with fewer limitations at work (OR 0.62).ConclusionsThere are genuine differences in the impact of CHD on employment status in different countries. Although the majority of adult CHD patients are employed, limitations at work are common. Education appears to be the main predictor for successful employment and should therefore be encouraged in patients with CHD.
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18. |
- Spiers, H, et al.
(author)
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Self propagating high temperature synthesis of magnesium zinc ferrites (MgxZn1-xFe2O3): thermal imaging and time resolved X-ray diffraction experiments
- 2004
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In: Journal of Materials Chemistry. - : Royal Society of Chemistry (RSC). - 1364-5501. ; 14:7, s. 1104-1111
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Journal article (peer-reviewed)abstract
- Spinel ferrites of the form MgxZn1-xFe2O4 ( x = 0. 0.25, 0.50, 0.75, 1.00) were prepared by self-propagating high-temperature synthesis (SHS) from reactions of iron(III), zinc and magnesium oxides, iron powder and sodium perchlorate. The driving force for the reactions is the oxidation of iron powder. Reactions were carried out in the presence of an external magnetic field of 0.2 or 1.1 T. Reaction velocity and temperatures were obtained by thermal imaging camera. The transformation of reactants to products was studied by time resolved X-ray diffraction using Rietveld refinement for determination of phase percentages. Reactions typically reached temperatures in excess of 1150 degreesC with a timescale of complete conversion of reactant to products of 20 s. All materials were characterised by X-ray powder diffraction (XRD), energy dispersive X-ray analysis (EDXA), scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), Mossbauer spectroscopy and vibrating sample magnetometry (VSM).
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19. |
- Apers, Silke, et al.
(author)
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Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study (APPROACH-IS) : Rationale, design, and methods
- 2015
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In: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 179, s. 334-342
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Journal article (peer-reviewed)abstract
- Background: Data on patient-reported outcomes (PROs) in adults with congenital heart disease (CHD) are inconsistent and vary across the world. Better understanding of PROs and their differences across cultural and geographic barriers can best be accomplished via international studies using uniform research methods. The APPROACH-IS consortium (Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study) was created for this purpose and investigates PROs in adults with CHD worldwide. This paper outlines the project rationale, design, and methods. Methods/design: APPROACH-IS is a cross-sectional study. The goal is to recruit 3500-4000 adults with CHD from 15 countries in five major regions of the world (Asia, Australia, Europe, North and South America). Self-report questionnaires are administered to capture information on PRO domains: (i) perceived health status (12-item Short-form Health Survey & EuroQOL-5D); (ii) psychological functioning (Hospital Anxiety and Depression Scale); (iii) health behaviors (Health-Behavior Scale-Congenital Heart Disease); and (iv) quality of life (Linear Analog Scale & Satisfaction With Life Scale). Additionally, potential explanatory variables are assessed: (i) socio-demographic variables; (ii) medical history (chart review); (iii) sense of coherence (Orientation to Life Questionnaire); and (iv) illness perceptions (Brief Illness Perception Questionnaire). Descriptive analyses and multilevel models will examine differences in PROs and investigate potential explanatory variables. Discussion: APPROACH-IS represents a global effort to increase research understanding and capacity in the field of CHD, and will have major implications for patient care. Results will generate valuable information for developing interventions to optimize patients' health and well-being.
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20. |
- Callus, Edward, et al.
(author)
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Phenotypes of adults with congenital heart disease around the globe : a cluster analysis.
- 2021
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In: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 19:1
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To derive cluster analysis-based groupings for adults with congenital heart disease (ACHD) when it comes to perceived health, psychological functioning, health behaviours and quality of life (QoL).METHODS: This study was part of a larger worldwide multicentre study called APPROACH-IS; a cross sectional study which recruited 4028 patients (2013-2015) from 15 participating countries. A hierarchical cluster analysis was performed using Ward's method in order to group patients with similar psychological characteristics, which were defined by taking into consideration the scores of the following tests: Sense Of Coherence, Health Behavior Scale (physical exercise score), Hospital Anxiety Depression Scale, Illness Perception Questionnaire, Satisfaction with Life Scale and the Visual Analogue Scale scores of the EQ-5D perceived health scale and a linear analogue scale (0-100) measuring QoL.RESULTS: 3768 patients with complete data were divided into 3 clusters. The first and second clusters represented 89.6% of patients in the analysis who reported a good health perception, QoL, psychological functioning and the greatest amount of exercise. Patients in the third cluster reported substantially lower scores in all PROs. This cluster was characterised by a significantly higher proportion of females, a higher average age the lowest education level, more complex forms of congenital heart disease and more medical comorbidities.CONCLUSIONS: This study suggests that certain demographic and clinical characteristics may be linked to less favourable health perception, quality of life, psychological functioning, and health behaviours in ACHD. This information may be used to improve psychosocial screening and the timely provision of psychosocial care.
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21. |
- Casteigt, Benjamin, et al.
(author)
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Atrial arrhythmias and patient-reported outcomes in adults with congenital heart disease : An international study
- 2021
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In: Heart Rhythm. - : Elsevier BV. - 1547-5271 .- 1556-3871. ; 18:5, s. 793-800
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Journal article (peer-reviewed)abstract
- Background Atrial arrhythmias (ie, intra-atrial reentrant tachycardia and atrial fibrillation) are a leading cause of morbidity and hospitalization in adults with congenital heart disease (CHD). Little is known about their effect on quality of life and other patient-reported outcomes (PROs) in adults with CHD. Objective The purpose of this study was to assess the impact of atrial arrhythmias on PROs in adults with CHD and explore geographic variations. Methods Associations between atrial arrhythmias and PROs were assessed in a cross-sectional study of adults with CHD from 15 countries spanning 5 continents. A propensity-based matching weight analysis was performed to compare quality of life, perceived health status, psychological distress, sense of coherence, and illness perception in patients with and those without atrial arrhythmias. Results A total of 4028 adults with CHD were enrolled, 707 (17.6%) of whom had atrial arrhythmias. After applying matching weights, patients with and those without atrial arrhythmias were comparable with regard to age (mean 40.1 vs 40.2 years), demographic variables (52.5% vs 52.2% women), and complexity of CHD (15.9% simple, 44.8% moderate, and 39.2% complex in both groups). Patients with atrial arrhythmias had significantly worse PRO scores with respect to quality of life, perceived health status, psychological distress (ie, depression), and illness perception. A summary score that combines all PRO measures was significantly lower in patients with atrial arrhythmias (-3.3%; P = .0006). Differences in PROs were consistent across geographic regions. Conclusion Atrial arrhythmias in adults with CHD are associated with an adverse impact on a broad range of PROs consistently across various geographic regions.
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22. |
- Daelman, Bo, et al.
(author)
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Frailty and cognitive function in middle-aged and older adults with congenital heart disease
- 2024
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In: Journal of the American College of Cardiology. - : Elsevier. - 0735-1097 .- 1558-3597. ; 83:12, s. 1149-1159
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Journal article (peer-reviewed)abstract
- Background: Life expectancy of patients with congenital heart disease (CHD) has increased rapidly, resulting in a growing and aging population. Recent studies have shown that older people with CHD have higher morbidity, health care use, and mortality. To maintain longevity and quality of life, understanding their evolving medical and psychosocial challenges is essential.Objectives: The authors describe the frailty and cognitive profile of middle-aged and older adults with CHD to identify predictor variables and to explore the relationship with hospital admissions and outpatient visits.Methods: Using a cross-sectional, multicentric design, we included 814 patients aged ≥40 years from 11 countries. Frailty phenotype was determined using the Fried method. Cognitive function was assessed by the Montreal Cognitive Assessment.Results: In this sample, 52.3% of patients were assessed as robust, 41.9% as prefrail, and 5.8% as frail; 38.8% had cognitive dysfunction. Multinomial regression showed that frailty was associated with older age, female sex, higher physiologic class, and comorbidities. Counterintuitively, patients with mild heart defects were more likely than those with complex lesions to be prefrail. Patients from middle-income countries displayed more prefrailty than those from higher-income countries. Logistic regression demonstrated that cognitive dysfunction was related to older age, comorbidities, and lower country-level income.Conclusions: Approximately one-half of included patients were (pre-)frail, and more than one-third experienced cognitive impairment. Frailty and cognitive dysfunction were identified in patients with mild CHD, indicating that these concerns extend beyond severe CHD. Assessing frailty and cognition routinely could offer valuable insights into this aging population.
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23. |
- Drake, A. B., et al.
(author)
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The MUSE Hubble Ultra Deep Field Survey VI. The faint-end of the Lyα luminosity function at 2.91
- 2017
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In: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 608
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Journal article (peer-reviewed)abstract
- We present the deepest study to date of the Ly alpha luminosity function in a blank field using blind integral field spectroscopy from MUSE. We constructed a sample of 604 Ly alpha emitters (LAEs) across the redshift range 2.91 < z < 6.64 using automatic detection software in the Hubble Ultra Deep Lield. The deep data cubes allowed us to calculate accurate total Ly alpha fluxes capturing low surface-brightness extended Ly alpha emission now known to be a generic property of high-redshift star-forming galaxies. We simulated realistic extended LAEs to fully characterise the selection function of our samples, and performed flux-recovery experiments to test and correct for bias in our determination of total Ly alpha fluxes. We find that an accurate completeness correction accounting for extended emission reveals a very steep faint-end slope of the luminosity function, alpha, down to luminosities of log(10) L erg s(-1) < 41.5, applying both the 1/V-max and maximum likelihood estimators. Splitting the sample into three broad redshift bins, we see the faint-end slope increasing from -2.03(-0.07)(+1.42) at z approximate to 3.44 to -2.86(-infinity)(+0.76) Z approximate to 76 at z approximate to 5.48, however no strong evolution is seen between the 68% confidence regions in L*-alpha parameter space. Using the Ly alpha line flux as a proxy for star formation activity, and integrating the observed luminosity functions, we find that LAEs' contribution to the cosmic star formation rate density rises with redshift until it is comparable to that from continuum-selected samples by z approximate to 6. This implies that LAEs may contribute more to the star-formation activity of the early Universe than previously thought, as any additional intergalactic medium (IGM) correction would act to further boost the Ly alpha luminosities. Linally, assuming fiducial values for the escape of Ly alpha and LyC radiation, and the dumpiness of the IGM, we integrated the maximum likelihood luminosity function at 5.00 < z < 6.64 and find we require only a small extrapolation beyond the data (<1 dex in luminosity) for LAEs alone to maintain an ionised IGM at z approximate to 6.
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24. |
- Fogleman, Nicholas D., et al.
(author)
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Regional variation in quality of life in patients with a Fontan circulation: A multinational perspective
- 2017
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In: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 193, s. 55-62
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Journal article (peer-reviewed)abstract
- © 2017 Elsevier Inc. Background Impaired quality of life (QOL) is associated with congenital heart disease (CHD) and country of residence; however, few studies have compared QOL in patients with differing complexities of CHD across regional populations. The current study examined regional variation in QOL outcomes in a large multinational sample of patients with a Fontan relative to patients with atrial septal defects (ASDs) and ventricular septal defects (VSDs). Methods From the Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease—International Study (APPROACH-IS), 405 patients (163 Fontan and 242 ASD/VSD) across Asia, Europe, and North America provided consent for access to their medical records and completed a survey evaluating QOL (0 to 100 linear analog scale). Primary CHD diagnosis, disease complexity, surgical history, and documented history of mood and anxiety disorders were recorded. Differences in QOL, medical complications, and mood and anxiety disorders between Fontan and ASD/VSD patients, and across geographic regions, were examined using analysis of covariance. Hierarchical regression analyses were conducted to identify variables associated with the QOL ratings. Results Patients with a Fontan reported significantly lower QOL, and greater medical complications and mood and anxiety disorders relative to patients with ASD/VSD. Inpatient cardiac admissions, mood disorders, and anxiety disorders were associated with lower QOL among patients with a Fontan, and mood disorders were associated with lower QOL among patients with ASD/VSD. Regional differences for QOL were not observed in patients with a Fontan; however, significant differences were identified in patients with ASD/VSD. Conclusions Regional variation of QOL is commonplace in adults with CHD; however, it appears affected by greater disease burden. Among patients with a Fontan, regional variation of QOL is lost. Specific attempts to screen for QOL and mood and anxiety disorders among CHD patients may improve the care of patients with the greatest disease burden.
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25. |
- Hashimoto, T., et al.
(author)
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The MUSE Hubble Ultra Deep Field Survey X. Ly alpha equivalent widths at 2.9 < z < 6.6
- 2017
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In: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 608
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Journal article (peer-reviewed)abstract
- We present rest-frame Ly alpha equivalent widths (EW0) of 417 Ly alpha emitters (LAEs) detected with Multi Unit Spectroscopic Explorer (MUSE) on the Very Large Telescope (VLT) at 2.9 < z < 6.6 in the Hubble Ultra Deep Field. Based on the deep MUSE spectroscopy and ancillary Hubble Space Telescope (HST) photometry data, we carefully measured EW0 values taking into account extended Ly alpha emission and UV continuum slopes (beta). Our LAEs reach unprecedented depths, both in Ly alpha luminosities and UV absolute magnitudes, from log (L-Ly alpha/erg s(-1)) similar to 41.0 to 43.0 and from M-UV similar to -16 to -21 (0.01-1.0 L-z=3(*)). The EW0 values span the range of similar to 5 to 240 angstrom or larger, and their distribution can be well fitted by an exponential law N = N-0 exp(-EW0/w(0)). Owing to the high dynamic range in M-UV, we find that the scale factor, w(0), depends on M-UV in the sense that including fainter M-UV objects increases w(0), i.e., the Ando effect. The results indicate that selection functions affect the EW0 scale factor. Taking these effects into account, we find that our w(0) values are consistent with those in the literature within 1 sigma uncertainties at 2.9 < z < 6.6 at a given threshold of M-UV and LLy alpha. Interestingly, we find 12 objects with EW0> 200 angstrom above 1 sigma uncertainties. Two of these 12 LAEs show signatures of merger or AGN activity: the weak Civ lambda 1549 emission line. For the remaining 10 very large EW0 LAEs, we find that the EW0 values can be reproduced by young stellar ages (< 100 Myr) and low metallicities (less than or similar to 0.02 Z(circle dot)). Otherwise, at least part of the Ly alpha emission in these LAEs needs to arise from anisotropic radiative transfer effects, fluorescence by hidden AGN or quasi-stellar object activity, or gravitational cooling.
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