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1.
J Cardiovasc Electrophysiol ; 35(4): 654-663, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38288888

RESUMO

INTRODUCTION: In hypertrophic cardiomyopathy (HCM), atrial fibrillation (AF) has historically been regarded to have a deleterious impact on clinical course, strongly associated with progressive heart failure (HF) symptoms. However, there is a paucity of information regarding the impact of AF on HCM employing validated quality of life (QoL) surveys. Therefore, we evaluated the impact of AF on QoL utilizing patient reported outcome measures (PROMs). METHODS: 218 consecutive HCM patients with or without AF at the Lahey HCM center in 2022 completed PROMs at their most recent visit evaluating HF (Kansas City Cardiomyopathy Questionnaire [KCCQ]) and AF symptoms (AF Effect on QoL [AFEQT]). RESULTS: Among the 218 patients, 50 (23%) had a history of AF and comprise the primary study cohort. AF was diagnosed at 55 ± 10 years of age, median of 5.5 years before PROM, with 66% of patients treated with a rhythm control strategy with antiarrhythmic drug and/or AF ablation. AFEQT indicated that 52% of patients experienced no or minimal AF-related disability, mild to moderate in 22%, and severe in 26%. There was no substantial difference in HCM phenotype in patients with no or minimal AF disability compared to those with severe disability. HF symptoms for most HCM patients with prior AF history was consistent with no or minimal (59%) or only mild (27%) disability as measured by KCCQ overall summary scores. In addition, with multivariate analysis, AF history was associated with less HF symptoms and improved QoL (OR 0.4, p = 0.02). CONCLUSION: In contrast to prior perceptions, HCM patients with prior AF history were less likely to incur HF symptoms impairing QoL compared to HCM patients without AF. After treatment, prior history of AF did not substantially impact current QoL. These data provide a realistic appraisal for the impact that AF has on HCM patients and also offers a measure of reassurance for this patient subgroup.


Assuntos
Fibrilação Atrial , Cardiomiopatia Hipertrófica , Doenças Vasculares , Humanos , Qualidade de Vida , Antiarrítmicos/uso terapêutico , Cardiomiopatia Hipertrófica/complicações , Cardiomiopatia Hipertrófica/diagnóstico , Cardiomiopatia Hipertrófica/terapia , Doenças Vasculares/complicações
2.
Neuroimage Clin ; 37: 103325, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36724732

RESUMO

PURPOSE: Proton magnetic resonance spectroscopy (1H MRS) offers biomarkers of metabolic damage after mild traumatic brain injury (mTBI), but a lack of replicability studies hampers clinical translation. In a conceptual replication study design, the results reported in four previous publications were used as the hypotheses (H1-H7), specifically: abnormalities in patients are diffuse (H1), confined to white matter (WM) (H2), comprise low N-acetyl-aspartate (NAA) levels and normal choline (Cho), creatine (Cr) and myo-inositol (mI) (H3), and correlate with clinical outcome (H4); additionally, a lack of findings in regional subcortical WM (H5) and deep gray matter (GM) structures (H6), except for higher mI in patients' putamen (H7). METHODS: 26 mTBI patients (20 female, age 36.5 ± 12.5 [mean ± standard deviation] years), within two months from injury and 21 age-, sex-, and education-matched healthy controls were scanned at 3 Tesla with 3D echo-planar spectroscopic imaging. To test H1-H3, global analysis using linear regression was used to obtain metabolite levels of GM and WM in each brain lobe. For H4, patients were stratified into non-recovered and recovered subgroups using the Glasgow Outcome Scale Extended. To test H5-H7, regional analysis using spectral averaging estimated metabolite levels in four GM and six WM structures segmented from T1-weighted MRI. The Mann-Whitney U test and weighted least squares analysis of covariance were used to examine mean group differences in metabolite levels between all patients and all controls (H1-H3, H5-H7), and between recovered and non-recovered patients and their respectively matched controls (H4). Replicability was defined as the support or failure to support the null hypotheses in accordance with the content of H1-H7, and was further evaluated using percent differences, coefficients of variation, and effect size (Cohen's d). RESULTS: Patients' occipital lobe WM Cho and Cr levels were 6.0% and 4.6% higher than controls', respectively (Cho, d = 0.37, p = 0.04; Cr, d = 0.63, p = 0.03). The same findings, i.e., higher patients' occipital lobe WM Cho and Cr (both p = 0.01), but with larger percent differences (Cho, 8.6%; Cr, 6.3%) and effect sizes (Cho, d = 0.52; Cr, d = 0.88) were found in the comparison of non-recovered patients to their matched controls. For the lobar WM Cho and Cr comparisons without statistical significance (frontal, parietal, temporal), unidirectional effect sizes were observed (Cho, d = 0.07 - 0.37; Cr, d = 0.27 - 0.63). No differences were found in any metabolite in any lobe in the comparison between recovered patients and their matched controls. In the regional analyses, no differences in metabolite levels were found in any GM or WM region, but all WM regions (posterior, frontal, corona radiata, and the genu, body, and splenium of the corpus callosum) exhibited unidirectional effect sizes for Cho and Cr (Cho, d = 0.03 - 0.34; Cr, d = 0.16 - 0.51). CONCLUSIONS: We replicated findings of diffuse WM injury, which correlated with clinical outcome (supporting H1-H2, H4). These findings, however, were among the glial markers Cho and Cr, not the neuronal marker NAA (not supporting H3). No differences were found in regional GM and WM metabolite levels (supporting H5-H6), nor in putaminal mI (not supporting H7). Unidirectional effect sizes of higher patients' Cho and Cr within all WM analyses suggest widespread injury, and are in line with the conclusion from the previous publications, i.e., that detection of WM injury may be more dependent upon sensitivity of the 1H MRS technique than on the selection of specific regions. The findings lend further support to the corollary that clinic-ready 1H MRS biomarkers for mTBI may best be achieved by using high signal-to-noise-ratio single-voxels placed anywhere within WM. The biochemical signature of the injury, however, may differ and therefore absolute levels, rather than ratios may be preferred. Future replication efforts should further test the generalizability of these findings.


Assuntos
Concussão Encefálica , Lesões Encefálicas , Humanos , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Espectroscopia de Prótons por Ressonância Magnética , Concussão Encefálica/patologia , Espectroscopia de Ressonância Magnética/métodos , Prótons , Lesões Encefálicas/patologia , Encéfalo/patologia , Ácido Aspártico , Creatina/metabolismo , Colina/metabolismo
3.
Proc Natl Acad Sci U S A ; 120(3): e2212507120, 2023 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-36626558

RESUMO

Intracellular cargos are often membrane-enclosed and transported by microtubule-based motors in the presence of microtubule-associated proteins (MAPs). Whereas increasing evidence reveals how MAPs impact the interactions between motors and microtubules, critical questions remain about the impact of the cargo membrane on transport. Here we combined in vitro optical trapping with theoretical approaches to determine the effect of a lipid cargo membrane on kinesin-based transport in the presence of MAP tau. Our results demonstrate that attaching kinesin to a fluid lipid membrane reduces the inhibitory effect of tau on kinesin. Moreover, adding cholesterol, which reduces kinesin diffusion in the cargo membrane, amplifies the inhibitory effect of tau on kinesin binding in a dosage-dependent manner. We propose that reduction of kinesin diffusion in the cargo membrane underlies the effect of cholesterol on kinesin binding in the presence of tau, and we provide a simple model for this proposed mechanism. Our study establishes a direct link between cargo membrane cholesterol and MAP-based regulation of kinesin-1. The cholesterol effects uncovered here may more broadly extend to other lipid alterations that impact motor diffusion in the cargo membrane, including those associated with aging and neurological diseases.


Assuntos
Cinesinas , Proteínas Associadas aos Microtúbulos , Cinesinas/metabolismo , Proteínas Associadas aos Microtúbulos/metabolismo , Microtúbulos/metabolismo , Transporte Biológico/fisiologia , Lipídeos
4.
J Interv Card Electrophysiol ; 64(2): 519-530, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35043250

RESUMO

INTRODUCTION: Cardiac resynchronization therapy (CRT) improves outcomes in sinus rhythm, but the data in atrial fibrillation (AF) is limited. Atrio-ventricular junctional ablation (AVJA) has been proposed as a remedy. The objective was to test if AVJA results in LV end-systolic volume (ESV) reduction ≥ 15% from baseline to 6 months. METHODS: The trial was a prospective multicenter randomized trial in 26 patients with permanent AF who were randomized 1:1 to CRT-D with or without AVJA. RESULTS: LVESV improved similarly by at least 15% in 5/10 (50%) in the CRT-D-only arm and in 6/12 (50%) in the AVJA + CRT-D arm (OR = 1.00 [0.14, 7.21], p = 1.00). In the CRT-D-only arm, the median 6-month improvement in LVEF was 9.2%, not different from the AVJA + CRT-D arm, 8.2%. When both groups were combined, a significant increase in LVEF was observed (25.4% at baseline vs 36.2% at 6 months, p = 0.002). NYHA class from baseline to 6 months for all patients combined improved 1 class in 15 of 24 (62.5%), whereas 9 remained in the same class and 0 degraded to a worse class. CONCLUSION: In patients with permanent AF, reduced LVEF, and broad QRS who were eligible for CRT, there was insufficient evidence that AVJA improved echocardiographic or clinical outcomes; the results should be interpreted in light of a smaller than planned sample size. CRT, however, seemed to be effective in the combined study cohort overall, suggesting that CRT can be reasonably deployed in patients with AF. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02946853.


Assuntos
Fibrilação Atrial , Terapia de Ressincronização Cardíaca , Insuficiência Cardíaca , Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/cirurgia , Terapia de Ressincronização Cardíaca/métodos , Insuficiência Cardíaca/terapia , Humanos , Projetos Piloto , Estudos Prospectivos , Resultado do Tratamento
5.
Eur Radiol ; 32(2): 1308-1319, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34410458

RESUMO

OBJECTIVES: To assess whether MR fingerprinting (MRF)-based relaxation properties exhibit cross-sectional and prospective correlations with patient outcome and compare the results with those from DTI. METHODS: Clinical imaging, MRF, and DTI were acquired in patients (24 ± 10 days after injury (timepoint 1) and 90 ± 17 days after injury (timepoint 2)) and once in controls. Patient outcome was assessed with global functioning, symptom profile, and neuropsychological testing. ADC and fractional anisotropy (FA) from DTI and T1 and T2 from MRF were compared in 12 gray and white matter regions with Mann-Whitney tests. Bivariate associations between MR measures and outcome were assessed using the Spearman correlation and logistic regression. RESULTS: Data from 22 patients (38 ± 12 years; 17 women) and 18 controls (32 ± 8 years; 12 women) were analyzed. Fourteen patients (37 ± 12 years; 11 women) returned for timepoint 2, while two patients provided only timepoint 2 clinical outcome data. At timepoint 1, there were no differences between patients and controls in T1, T2, and ADC, while FA was lower in mTBI frontal white matter. T1 at timepoint 1 and the change in T1 exhibited more (n = 18) moderate to strong correlations (|r|= 0.6-0.85) with clinical outcome at timepoint 2 than T2 (n = 3), FA (n = 7), and ADC (n = 2). High T1 at timepoint 1, and serially increasing T1, accounted for five of the six MR measures with the highest utility for identification of non-recovered patients at timepoint 2 (AUC > 0.80). CONCLUSION: T1 derived from MRF was found to have higher utility than T2, FA, and ADC for predicting 3-month outcome after mTBI. KEY POINTS: • In a region-of-interest approach, FA, ADC, and T1 and T2 all showed limited utility in differentiating patients from controls at an average of 24 and 90 days post-mild traumatic brain injury. • T1 at 24 days, and the serial change in T1, revealed more and stronger predictive correlations with clinical outcome at 90 days than did T2, ADC, or FA. • T1 showed better prospective identification of non-recovered patients at 90 days than ADC, T2, and FA.


Assuntos
Concussão Encefálica , Encéfalo , Concussão Encefálica/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Estudos Prospectivos
6.
Brain Commun ; 3(2): fcab051, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33928248

RESUMO

The pathological cascade of tissue damage in mild traumatic brain injury is set forth by a perturbation in ionic homeostasis. However, whether this class of injury can be detected in vivo and serve as a surrogate marker of clinical outcome is unknown. We employ sodium MRI to test the hypotheses that regional and global total sodium concentrations: (i) are higher in patients than in controls and (ii) correlate with clinical presentation and neuropsychological function. Given the novelty of sodium imaging in traumatic brain injury, effect sizes from (i), and correlation types and strength from (ii), were compared to those obtained using standard diffusion imaging metrics. Twenty-seven patients (20 female, age 35.9 ± 12.2 years) within 2 months after injury and 19 controls were scanned with proton and sodium MRI at 3 Tesla. Total sodium concentration, fractional anisotropy and apparent diffusion coefficient were obtained with voxel averaging across 12 grey and white matter regions. Linear regression was used to obtain global grey and white matter total sodium concentrations. Patient outcome was assessed with global functioning, symptom profiles and neuropsychological function assessments. In the regional analysis, there were no statistically significant differences between patients and controls in apparent diffusion coefficient, while differences in sodium concentration and fractional anisotropy were found only in single regions. However, for each of the 12 regions, sodium concentration effect sizes were uni-directional, due to lower mean sodium concentration in patients compared to controls. Consequently, linear regression analysis found statistically significant lower global grey and white matter sodium concentrations in patients compared to controls. The strongest correlation with outcome was between global grey matter sodium concentration and the composite z-score from the neuropsychological testing. In conclusion, both sodium concentration and diffusion showed poor utility in differentiating patients from controls, and weak correlations with clinical presentation, when using a region-based approach. In contrast, sodium linear regression, capitalizing on partial volume correction and high sensitivity to global changes, revealed high effect sizes and associations with patient outcome. This suggests that well-recognized sodium imbalances in traumatic brain injury are (i) detectable non-invasively; (ii) non-focal; (iii) occur even when the antecedent injury is clinically mild. Finally, in contrast to our principle hypothesis, patients' sodium concentrations were lower than controls, indicating that the biological effect of traumatic brain injury on the sodium homeostasis may differ from that in other neurological disorders. Note: This figure has been annotated.

7.
Elife ; 102021 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-33929319

RESUMO

IL-33 is an alarmin required for resistance to the parasite Toxoplasma gondii, but its role in innate resistance to this organism is unclear. Infection with T. gondii promotes increased stromal cell expression of IL-33, and levels of parasite replication correlate with release of IL-33 in affected tissues. In response to infection, a subset of innate lymphoid cells (ILC) emerges composed of IL-33R+ NK cells and ILC1s. In Rag1-/-mice, where NK cells and ILC1 production of IFN-γ mediate innate resistance to T. gondii, the loss of the IL-33R resulted in reduced ILC responses and increased parasite replication. Furthermore, administration of IL-33 to Rag1-/- mice resulted in a marked decrease in parasite burden, increased production of IFN-γ, and the recruitment and expansion of inflammatory monocytes associated with parasite control. These protective effects of exogenous IL-33 were dependent on endogenous IL-12p40 and the ability of IL-33 to enhance ILC production of IFN-γ. These results highlight that IL-33 synergizes with IL-12 to promote ILC-mediated resistance to T. gondii.


Assuntos
Interferon gama/imunologia , Interleucina-33/imunologia , Linfócitos/imunologia , Toxoplasma/imunologia , Toxoplasmose/imunologia , Animais , Feminino , Humanos , Imunidade Inata , Interferon gama/genética , Interleucina-33/genética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Toxoplasma/genética , Toxoplasmose/genética , Toxoplasmose/parasitologia
8.
Light Sci Appl ; 9(1): 204, 2020 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-33353941

RESUMO

As light propagates along a waveguide, a fraction of the field can be reflected by Rayleigh scatterers. In high-quality-factor whispering-gallery-mode microresonators, this intrinsic backscattering is primarily caused by either surface or bulk material imperfections. For several types of microresonator-based experiments and applications, minimal backscattering in the cavity is of critical importance, and thus, the ability to suppress backscattering is essential. We demonstrate that the introduction of an additional scatterer into the near field of a high-quality-factor microresonator can coherently suppress the amount of backscattering in the microresonator by more than 30 dB. The method relies on controlling the scatterer position such that the intrinsic and scatterer-induced backpropagating fields destructively interfere. This technique is useful in microresonator applications where backscattering is currently limiting the performance of devices, such as ring-laser gyroscopes and dual frequency combs, which both suffer from injection locking. Moreover, these findings are of interest for integrated photonic circuits in which back reflections could negatively impact the stability of laser sources or other components.

9.
Nat Commun ; 11(1): 6384, 2020 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-33318482

RESUMO

Broadband optical frequency combs are extremely versatile tools for precision spectroscopy, ultrafast ranging, as channel generators for telecom networks, and for many other metrology applications. Here, we demonstrate that the optical spectrum of a soliton microcomb generated in a microresonator can be extended by bichromatic pumping: one laser with a wavelength in the anomalous dispersion regime of the microresonator generates a bright soliton microcomb while another laser in the normal dispersion regime both compensates the thermal effect of the microresonator and generates a repetition-rate-synchronized second frequency comb. Numerical simulations agree well with experimental results and reveal that a bright optical pulse from the second pump is passively formed in the normal dispersion regime and trapped by the primary soliton. In addition, we demonstrate that a dispersive wave can be generated and influenced by cross-phase-modulation-mediated repetition-rate synchronization of the two combs. The demonstrated technique provides an alternative way to generate broadband microcombs and enables the selective enhancement of optical power in specific parts of a comb spectrum.

10.
Circ Arrhythm Electrophysiol ; 13(12): e009288, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33185144

RESUMO

BACKGROUND: The limited effectiveness of endocardial catheter ablation (CA) for persistent and long-standing persistent atrial fibrillation (AF) treatment led to the development of a minimally invasive epicardial/endocardial ablation approach (Hybrid Convergent) to achieve a more comprehensive lesion set with durable transmural lesions. The multicenter randomized controlled CONVERGE trial (Convergence of Epicardial and Endocardial Ablation for the Treatment of Symptomatic Persistent AF) evaluated the safety of Hybrid Convergent and compared its effectiveness to CA for persistent and long-standing persistent AF treatment. METHODS: One-hundred fifty-three patients were randomized 2:1 to Hybrid Convergent versus CA. Primary effectiveness was freedom from AF/atrial flutter/atrial tachycardia absent new/increased dosage of previously failed/intolerant class I/III antiarrhythmic drugs through 12 months. Primary safety was major adverse events through 30 days. CONVERGE permitted left atrium size up to 6 cm and imposed no limits on AF duration, making it the only ablation trial to substantially include long-standing persistent-AF, that is, 42% patients with long-standing persistent-AF. RESULTS: Of 149 evaluable patients at 12 months, primary effectiveness was achieved in 67.7% (67/99) patients with Hybrid Convergent and 50.0% (25/50) with CA (P=0.036) on/off previously failed antiarrhythmic drugs and in 53.5% (53/99) versus 32.0% (16/50; P=0.0128) respectively off antiarrhythmic drugs. At 18 months using 7-day Holter, 74.0% (53/72) Hybrid Convergent and 55% (23/42) CA patients experienced ≥90% AF burden reduction. A total of 2.9% (3/102) patients had primary safety events within 7 days, and 4.9% (5/102) between 8 and 30 days postprocedure. No deaths, cardiac perforations, or atrioesophageal fistulas occurred. All but one primary safety event resolved. CONCLUSIONS: The Hybrid Convergent procedure has superior effectiveness compared to the CA for the treatment of persistent and long-standing persistent atrial fibrillation. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01984346.


Assuntos
Fibrilação Atrial/cirurgia , Ablação por Cateter/métodos , Veias Pulmonares/cirurgia , Idoso , Antiarrítmicos/uso terapêutico , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/fisiopatologia , Ablação por Cateter/efeitos adversos , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Veias Pulmonares/fisiopatologia , Recidiva , Fatores de Tempo , Resultado do Tratamento , Reino Unido , Estados Unidos
11.
Phys Rev Lett ; 124(22): 223901, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32567919

RESUMO

The Kerr effect in optical microresonators plays an important role for integrated photonic devices and enables third harmonic generation, four-wave mixing, and the generation of microresonator-based frequency combs. Here we experimentally demonstrate that the Kerr nonlinearity can split ultra-high-Q microresonator resonances for two continuous-wave lasers. The resonance splitting is induced by self- and cross-phase modulation and counterintuitively enables two lasers at different wavelengths to be simultaneously resonant in the same microresonator mode. We develop a pump-probe spectroscopy scheme that allows us to measure power dependent resonance splittings of up to 35 cavity linewidths (corresponding to 52 MHz) at 10 mW of pump power. The required power to split the resonance by one cavity linewidth is only 286 µW. In addition, we demonstrate threefold resonance splitting when taking into account four-wave mixing and two counterpropagating probe lasers. These Kerr splittings are of interest for applications that require two resonances at optically controlled offsets, e.g., for optomechanical coupling to phonon modes, optical memories, and precisely adjustable spectral filters.

12.
Respir Res ; 21(1): 77, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228581

RESUMO

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease characterized by frequent exacerbation phenotypes independent of disease stage. Increasing evidence shows that the microbiota plays a role in disease progression and severity, but long-term and international multicenter assessment of the variations in viral and bacterial communities as drivers of exacerbations are lacking. METHODS: Two-hundred severe COPD patients from Europe and North America were followed longitudinally for 3 years. We performed nucleic acid detection for 20 respiratory viruses and 16S ribosomal RNA gene sequencing to evaluate the bacterial microbiota in 1179 sputum samples collected at stable, acute exacerbation and follow-up visits. RESULTS: Similar viral and bacterial taxa were found in patients from the USA compared to Bulgaria and Czech Republic but their microbiome diversity was significantly different (P < 0.001) and did not impact exacerbation rates. Virus infection was strongly associated with exacerbation events (P < 5E-20). Human rhinovirus (13.1%), coronavirus (5.1%) and influenza virus (3.6%) constitute the top viral pathogens in triggering exacerbation. Moraxella and Haemophilus were 5-fold and 1.6-fold more likely to be the dominating microbiota during an exacerbation event. Presence of Proteobacteria such as Pseudomonas or Staphylococcus amongst others, were associated with exacerbation events (OR > 0.17; P < 0.02) but more strongly associated with exacerbation frequency (OR > 0.39; P < 4E-10), as confirmed by longitudinal variations and biotyping of the bacterial microbiota, and suggesting a role of the microbiota in sensitizing the lung. CONCLUSIONS: This study highlights bacterial taxa in lung sensitization and viral triggers in COPD exacerbations. It provides a global overview of the diverse targets for drug development and explores new microbiome analysis methods to guide future patient management applications.


Assuntos
Bactérias/isolamento & purificação , Pulmão/microbiologia , Pulmão/virologia , Doença Pulmonar Obstrutiva Crônica/microbiologia , Doença Pulmonar Obstrutiva Crônica/virologia , Vírus/isolamento & purificação , Idoso , Idoso de 80 Anos ou mais , Bactérias/genética , Carga Bacteriana , Progressão da Doença , Europa (Continente)/epidemiologia , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Escarro/microbiologia , Escarro/virologia , Fatores de Tempo , Estados Unidos/epidemiologia , Carga Viral , Vírus/genética
13.
Methods Mol Biol ; 2121: 115-127, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32147791

RESUMO

Innate lymphoid cells (ILCs) are lymphocytes with critical roles in homeostasis, inflammation, and immunity to pathogens. ILCs are rare relative to other immune cell populations and are primarily defined by lack of expression of markers associated with other immune cell lineages and are predominantly found in mucosal tissues like the gut, lung and skin. They are classified into distinct subsets, ILC1, ILC2, and ILC3, which mirror subsets of CD4+ helper T cells. ILC subsets have distinct cytokine and transcription factor profiles which align with their biological functions, although recently it has emerged that ILC subsets are not phenotypically fixed and exhibit considerable heterogeneity and plasticity in different contexts. Here, we describe protocols for the maintenance, expansion, and induction of plasticity in mouse and human ILC2s. The resulting cells can be used for molecular interrogation of ILC function and biology, both in vivo and in vitro.


Assuntos
Plasticidade Celular/imunologia , Citocinas/administração & dosagem , Citocinas/farmacologia , Imunidade Inata , Leucócitos Mononucleares/citologia , Pulmão/citologia , Subpopulações de Linfócitos/citologia , Animais , Contagem de Células , Linhagem da Célula , Plasticidade Celular/efeitos dos fármacos , Células Cultivadas , Regulação da Expressão Gênica/efeitos dos fármacos , Regulação da Expressão Gênica/imunologia , Humanos , Interleucina-12/administração & dosagem , Interleucina-12/farmacologia , Interleucina-18/administração & dosagem , Interleucina-1beta/farmacologia , Interleucina-2/farmacologia , Interleucina-33/administração & dosagem , Células Matadoras Naturais/citologia , Células Matadoras Naturais/imunologia , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/imunologia , Pulmão/efeitos dos fármacos , Pulmão/imunologia , Subpopulações de Linfócitos/imunologia , Subpopulações de Linfócitos/metabolismo , Camundongos
14.
JACC Case Rep ; 2(5): 796-801, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-34317350

RESUMO

We present the case of a 57-year-old man with a primary prevention internal cardioverter-defibrillator for severe nonischemic cardiomyopathy. At the time of elective replacement indicator, systolic function had fully recovered, and his generator was not changed. Nearly 5 years post-elective replacement indicator he received appropriate internal cardioverter-defibrillator therapies during a myocardial infarction. (Level of Difficulty: Intermediate.).

15.
Opt Express ; 27(24): 35257-35266, 2019 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-31878698

RESUMO

The Terahertz or millimeter wave frequency band (300 GHz - 3 THz) is spectrally located between microwaves and infrared light and has attracted significant interest for applications in broadband wireless communications, space-borne radiometers for Earth remote sensing, astrophysics, and imaging. In particular optically generated THz waves are of high interest for low-noise signal generation. Here, we propose and demonstrate stabilized terahertz wave generation using a microresonator-based frequency comb (microcomb). A unitravelling-carrier photodiode (UTC-PD) converts low-noise optical soliton pulses from the microcomb to a terahertz wave at the soliton's repetition rate (331 GHz). With a free-running microcomb, the Allan deviation of the Terahertz signal is 4.5×10-9 at 1 s measurement time with a phase noise of -72 dBc/Hz (-118 dBc/Hz) at 10 kHz (10 MHz) offset frequency. By locking the repetition rate to an in-house hydrogen maser, in-loop fractional frequency stabilities of 9.6×10-15 and 1.9×10-17 are obtained at averaging times of 1 s and 2000 s respectively, indicating that the stability of the generated THz wave is limited by the maser reference signal. Moreover, the terahertz signal is successfully used to perform a proof-of-principle demonstration of terahertz imaging of peanuts. Combining the monolithically integrated UTC-PD with an on-chip microcomb, the demonstrated technique could provide a route towards highly stable continuous terahertz wave generation in chip-scale packages for out-of-the-lab applications. In particular, such systems would be useful as compact tools for high-capacity wireless communication, spectroscopy, imaging, remote sensing, and astrophysical applications.

16.
Opt Express ; 27(14): 19242-19254, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31503687

RESUMO

We report on 'slow' pulsing dynamics in a silica resonator-based laser system: by nesting a high-Q rod-resonator inside an amplifying fiber cavity, we demonstrate that trains of microsecond pulses can be generated with repetition rates in the hundreds of kilohertz. We show that such pulses are produced with a period equivalent to several hundreds of laser cavity roundtrips via the interaction between the gain dynamics in the fiber cavity and the thermo-optical effects in the high-Q resonator. Experiments reveal that the pulsing properties can be controlled by adjusting the amplifying fiber cavity parameters. Our results, confirmed by numerical simulations, provide useful insights on the dynamical onset of complex self-organization phenomena in resonator-based laser systems where thermo-optical effects play an active role. In addition, we show how the thermal state of the resonator can be probed and even modified by an external, counter-propagating optical field, thus hinting towards novel approaches for all-optical control and sensing applications.

17.
Phys Rev Lett ; 122(1): 013905, 2019 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-31012656

RESUMO

Optically induced breaking of symmetries plays an important role in nonlinear photonics, with applications ranging from optical switching in integrated photonic circuits to soliton generation in ring lasers. In this work we study for the first time the interplay of two types of spontaneous symmetry breaking that can occur simultaneously in optical ring resonators. Specifically we investigate a ring resonator that is synchronously pumped with short pulses of light. In this system we numerically study the interplay and transition between regimes of temporal symmetry breaking (in which pulses in the resonator either run ahead or behind the seed pulses) and polarization symmetry breaking (in which the resonator spontaneously generates elliptically polarized light out of linearly polarized seed pulses). We find ranges of pump parameters for which each symmetry breaking can be independently observed, but also a regime in which a dynamical interplay takes place. Besides the fundamentally interesting physics of the interplay of different types of symmetry breaking, our work contributes to a better understanding of the nonlinear dynamics of optical ring cavities which are of interest for future applications including all-optical logic gates, synchronously pumped optical frequency comb generation, and resonator-based sensor technologies.

18.
J Phys Chem B ; 122(49): 11561-11570, 2018 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-30346755

RESUMO

In magnetic tweezers experiments, we observe that torsional DNA buckling rates and transition state distances are insensitive to base-pairing defects. This is surprising because defects are expected to kink DNA and lower the energy of a localized loop. Nonetheless, base-pairing defects lead to pinning of buckled structures at the defects, which may be important for DNA repair in vivo. We find that the decrease in entropy from pinning roughly balances the decrease in bending energy, explaining why defects have little effect on buckling rates. Our data are generally consistent with elastic rod theory, which predicts that the transition state structure for torsional buckling is a localized wave with a specific shape ("soliton"). The transition state soliton decays to a metastable looped intermediate ("curl") that is separated from the final, fully buckled state by a second, low energy barrier. DNAs with base mismatch defects buckle at lower torque, where elastic rod theory predicts the loop structure is more stable, and manifest an intermediate buckling structure consistent with such a loop. We estimate that, under our high force, high salt experimental conditions, the soliton barrier is approximately 10 kB T and, to reach this transition state from the unbuckled state, the system torque instantaneously decreases by approximately 1 pN·nm for DNA with or without a small defect.


Assuntos
DNA/química , Pinças Ópticas , Termodinâmica , Cinética
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