Renal function, revascularization and risk

Peer reviewedAuthor versio

Utility of B-type natriuretic peptide in predicting medium-term mortality in patients undergoing major non-cardiac surgery

We assessed the ability of pre-operative B-type natriuretic peptide (BNP) levels to predict medium-term mortality in patients undergoing major noncardiac surgery. During a median 654 days follow-up 33 patients from a total cohort of 204 patients (16%) died. The optimal cut-off in this cohort, determined using a receiver operating characteristic curve, was >35pg.mL-1. This was associated with a 3.47-fold increase in the hazard of death (p=0.001) and had a sensitivity of 70% and a specificity of 68% for this outcome. These findings extend recent work demonstrating that BNP levels obtained before major noncardiac surgery can be used to predict peri-operative morbidity, and indicate that they also forecast medium-term mortality.This work was supported by a grant from TENOVUS Scotland. The Health Services Research Unit is core-funded by the Chief Scientists Office of the Scottish Executive Health Department.Peer reviewedAuthor versio

Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting

Background: An elevated preoperative white blood cell count has been associated with a worse outcome after coronary artery bypass grafting (CABG). Leukocyte subtypes, and particularly the neutrophil-lymphocyte (N/L) ratio, may however, convey superior prognostic information. We hypothesized that the N/L ratio would predict the outcome of patients undergoing surgical revascularization. Methods: Baseline clinical details were obtained prospectively in 1938 patients undergoing CABG. The differential leukocyte was measured before surgery, and patients were followed-up 3.6 years later. The primary end point was all-cause mortality. Results: The preoperative N/L ratio was a powerful univariable predictor of mortality (hazard ratio [HR] 1.13 per unit, P 3.36). Conclusion: An elevated N/L ratio is associated with a poorer survival after CABG. This prognostic utility is independent of other recognized risk factors.Peer reviewedAuthor versio

Contemporary stress orientations in the Faroe-Shetland region

The Faroe-Shetland Region (FSR) of the NE Atlantic continental margin contains a number of complexly structured Mesozoic-Palaeogene-age rift basins, but in comparison to the contiguous British Isles and North Sea Basin, the state of crustal stress in the FSR is poorly understood. The orientation of maximum horizontal compressional stress (σHmax) across most of NW Europe is ~NW-SE, which is considered to be controlled by forces acting at the plate boundaries. We have determined 16 B-D quality σHmax orientations based on borehole breakouts interpreted in petroleum wells, and define three distinct stress provinces within the FSR. Stress orientations in the NE are ~NW-SE, consistent with the regional pattern of stresses in NW Europe and local neotectonic structural trends. However, contemporary stress orientations in the central and SW of the FSR exhibit short-wavelength (distances <10-50 km) variation, with NE-SW, N-S and E-W orientations that are parallel or sub-parallel to underlying structural trends. This variation is interpreted in terms of stress deflections towards weak faults that downthrow the Mesozoic-Cenozoic sedimentary successions against basement highs. These local-scale sources are superposed on a background ~WNW-ESE σHmax orientation that is controlled by both plate boundary forces and regional-scale sources of stresses

Adaptive walks on time-dependent fitness landscapes

The idea of adaptive walks on fitness landscapes as a means of studying evolutionary processes on large time scales is extended to fitness landscapes that are slowly changing over time. The influence of ruggedness and of the amount of static fitness contributions are investigated for model landscapes derived from Kauffman's $NK$ landscapes. Depending on the amount of static fitness contributions in the landscape, the evolutionary dynamics can be divided into a percolating and a non-percolating phase. In the percolating phase, the walker performs a random walk over the regions of the landscape with high fitness.Comment: 7 pages, 6 eps-figures, RevTeX, submitted to Phys. Rev.

Forest resampling for distributed sequential Monte Carlo

This paper brings explicit considerations of distributed computing architectures and data structures into the rigorous design of Sequential Monte Carlo (SMC) methods. A theoretical result established recently by the authors shows that adapting interaction between particles to suitably control the Effective Sample Size (ESS) is sufficient to guarantee stability of SMC algorithms. Our objective is to leverage this result and devise algorithms which are thus guaranteed to work well in a distributed setting. We make three main contributions to achieve this. Firstly, we study mathematical properties of the ESS as a function of matrices and graphs that parameterize the interaction amongst particles. Secondly, we show how these graphs can be induced by tree data structures which model the logical network topology of an abstract distributed computing environment. Thirdly, we present efficient distributed algorithms that achieve the desired ESS control, perform resampling and operate on forests associated with these trees

From quantum cellular automata to quantum lattice gases

A natural architecture for nanoscale quantum computation is that of a quantum cellular automaton. Motivated by this observation, in this paper we begin an investigation of exactly unitary cellular automata. After proving that there can be no nontrivial, homogeneous, local, unitary, scalar cellular automaton in one dimension, we weaken the homogeneity condition and show that there are nontrivial, exactly unitary, partitioning cellular automata. We find a one parameter family of evolution rules which are best interpreted as those for a one particle quantum automaton. This model is naturally reformulated as a two component cellular automaton which we demonstrate to limit to the Dirac equation. We describe two generalizations of this automaton, the second of which, to multiple interacting particles, is the correct definition of a quantum lattice gas.Comment: 22 pages, plain TeX, 9 PostScript figures included with epsf.tex (ignore the under/overfull \vbox error messages); minor typographical corrections and journal reference adde

Direct visualisation of collateral ventilation in COPD with hyperpolarised gas MRI

Abstract Background Collateral ventilation has been proposed as a mechanism of compensation of respiratory function in obstructive lung diseases but observations of it in vivo are limited. The assessment of collateral ventilation with an imaging technique might help to gain insight into lung physiology and assist the planning of new bronchoscopic techniques for treating emphysema. Objective To obtain images of delayed ventilation that might be related to collateral ventilation over the period of a single breath-hold in patients with chronic obstructive pulmonary disease (COPD). Methods Time-resolved breath-hold hyperpolarised 3He MRI was used to obtain images of the progressive influx of polarised gas into initially non-ventilated defects. Results A time-series of images showed that 3He moves into lung regions which were initially non-ventilated. Ventilation defects with delayed filling were observed in 8 of the 10 patients scanned. Conclusions A method for direct imaging of delayed ventilation within a single breath-hold has been demonstrated in patients with COPD. Images of what is believed to be collateral ventilation and slow filling of peripheral airspaces due to increased flow resistance are presented. The technique provides 3D whole-lung coverage with sensitivity to regional information, and is non-invasive and non-ionising

Data incongruence and the problem of avian louse phylogeny

Recent studies based on different types of data (i.e. morphological and molecular) have supported conflicting phylogenies for the genera of avian feather lice (Ischnocera: Phthiraptera). We analyse new and published data from morphology and from mitochondrial (12S rRNA and COI) and nuclear (EF1-) genes to explore the sources of this incongruence and explain these conflicts. Character convergence, multiple substitutions at high divergences, and ancient radiation over a short period of time have contributed to the problem of resolving louse phylogeny with the data currently available. We show that apparent incongruence between the molecular datasets is largely attributable to rate variation and nonstationarity of base composition. In contrast, highly significant character incongruence leads to topological incongruence between the molecular and morphological data. We consider ways in which biases in the sequence data could be misleading, using several maximum likelihood models and LogDet corrections. The hierarchical structure of the data is explored using likelihood mapping and SplitsTree methods. Ultimately, we concede there is strong discordance between the molecular and morphological data and apply the conditional combination approach in this case. We conclude that higher level phylogenetic relationships within avian Ischnocera remain extremely problematic. However, consensus between datasets is beginning to converge on a stable phylogeny for avian lice, at and below the familial rank