Search

Albuminuria is a key biomarker for cardiovascular disease and chronic kidney disease. Our study aimed to describe the prevalence of albuminuria amongst people who inject drugs in London and to test any potential associations with demographic characteristics, past diagnoses, and drug preparation and administration practices. We carried out a cross-sectional survey amongst people who use drugs in London. The main outcome measure was any albuminuria including both microalbuminuria and macroalbuminuria. Three-hundred and sixteen samples were tested by local laboratory services. Our study initially employed point-of-care testing methods but this resulted in a high number of false positives. Our findings suggest the prevalence of albuminuria amongst PWID is twice that of the general population at 19% (95%CI 15.3-24.0%). Risk factors associated with albuminuria were HIV (aOR 4.11 [95% CI 1.37-12.38]); followed by overuse of acidifier for dissolving brown heroin prior to injection (aOR 2.10 [95% CI 1.04-4.22]). Albuminuria is high amongst people who inject drugs compared to the general population suggesting the presence of increased cardiovascular and renal pathologies. This is the first study to demonstrate an association with acidifier overuse. Dehydration may be common amongst this population and may affect the diagnostic accuracy of point-of-care testing for albuminuria.

Albuminuria is a key biomarker for cardiovascular disease and chronic kidney disease. Our study aimed to describe the prevalence of albuminuria amongst people who inject drugs in London and to test any potential associations with demographic characteristics, past diagnoses, and drug preparation and administration practices. We carried out a cross-sectional survey amongst people who use drugs in London. The main outcome measure was any albuminuria including both microalbuminuria and macroalbuminuria. Three-hundred and sixteen samples were tested by local laboratory services. Our study initially employed point-of-care testing methods but this resulted in a high number of false positives. Our findings suggest the prevalence of albuminuria amongst PWID is twice that of the general population at 19% (95%CI 15.3-24.0%). Risk factors associated with albuminuria were HIV (aOR 4.11 [95% CI 1.37-12.38]); followed by overuse of acidifier for dissolving brown heroin prior to injection (aOR 2.10 [95% CI 1.04-4.22]). Albuminuria is high amongst people who inject drugs compared to the general population suggesting the presence of increased cardiovascular and renal pathologies. This is the first study to demonstrate an association with acidifier overuse. Dehydration may be common amongst this population and may affect the diagnostic accuracy of point-of-care testing for albuminuria.

BackgroundSkin and soft tissue infections (SSTIs) are a leading cause of morbidity and mortality among people who inject drugs (PWID). International data indicate up to one third of PWID have experienced an SSTI within the past month. Complications include sepsis, endocarditis and amyloid A (AA) amyloidosis. AA amyloidosis is a serious sequela of chronic SSTI among PWID. Though there is a paucity of literature reporting on AA amyloidosis among PWID, what has been published suggests there is likely a causal relationship between AA amyloidosis and injecting-related SSTI. If left untreated, AA amyloidosis can lead to renal failure; premature mortality among diagnosed PWID is high. Early intervention may reverse disease. Despite the high societal and individual burden of SSTI among PWID, empirical evidence on the barriers and facilitators to injecting-related SSTI prevention and care or the feasibility and acceptability of AA amyloidosis screening and treatment referral are limited. This study aims to fill these gaps and assess the prevalence of AA amyloidosis among PWID.MethodsCare and Prevent is a UK National Institute for Health Research-funded mixed-methods study. In five phases (P1-P5), we aim to assess the evidence for AA amyloidosis among PWID (P1); assess the feasibility of AA amyloidosis screening, diagnostic and treatment referral among PWID in London (P2); investigate the barriers and facilitators to AA amyloidosis care (P3); explore SSTI protection and risk (P4); and co-create harm reduction resources with the affected community (P5). This paper describes the conceptual framework, methodological design and proposed analysis for the mixed-methods multi-phase study.ResultsWe are implementing the Care and Prevent protocol in London. The systematic review component of the study has been completed and published. Care and Prevent will generate an estimate of AA amyloidosis prevalence among community recruited PWID in London, with implications for the development of screening recommendations and intervention implementation. We aim to recruit 400 PWID from drug treatment services in London, UK.ConclusionsCare and Prevent is the first study to assess screening feasibility and the prevalence of positive proteinuria, as a marker for AA amyloidosis, among PWID accessing drug treatment services. AA amyloidosis is a serious, yet under-recognised condition for which early intervention is available but not employed.

BackgroundSkin and soft tissue infections (SSTIs) are a leading cause of morbidity and mortality among people who inject drugs (PWID). International data indicate up to one third of PWID have experienced an SSTI within the past month. Complications include sepsis, endocarditis and amyloid A (AA) amyloidosis. AA amyloidosis is a serious sequela of chronic SSTI among PWID. Though there is a paucity of literature reporting on AA amyloidosis among PWID, what has been published suggests there is likely a causal relationship between AA amyloidosis and injecting-related SSTI. If left untreated, AA amyloidosis can lead to renal failure; premature mortality among diagnosed PWID is high. Early intervention may reverse disease. Despite the high societal and individual burden of SSTI among PWID, empirical evidence on the barriers and facilitators to injecting-related SSTI prevention and care or the feasibility and acceptability of AA amyloidosis screening and treatment referral are limited. This study aims to fill these gaps and assess the prevalence of AA amyloidosis among PWID.MethodsCare and Prevent is a UK National Institute for Health Research-funded mixed-methods study. In five phases (P1-P5), we aim to assess the evidence for AA amyloidosis among PWID (P1); assess the feasibility of AA amyloidosis screening, diagnostic and treatment referral among PWID in London (P2); investigate the barriers and facilitators to AA amyloidosis care (P3); explore SSTI protection and risk (P4); and co-create harm reduction resources with the affected community (P5). This paper describes the conceptual framework, methodological design and proposed analysis for the mixed-methods multi-phase study.ResultsWe are implementing the Care and Prevent protocol in London. The systematic review component of the study has been completed and published. Care and Prevent will generate an estimate of AA amyloidosis prevalence among community recruited PWID in London, with implications for the development of screening recommendations and intervention implementation. We aim to recruit 400 PWID from drug treatment services in London, UK.ConclusionsCare and Prevent is the first study to assess screening feasibility and the prevalence of positive proteinuria, as a marker for AA amyloidosis, among PWID accessing drug treatment services. AA amyloidosis is a serious, yet under-recognised condition for which early intervention is available but not employed.

Using the Gemini Planet Imager located at Gemini South, we measured the near-infrared (1.0-2.4 μm) spectrum of the planetary companion to the nearby, young star β Pictoris. We compare the spectrum obtained with currently published model grids and with known substellar objects and present the best matching models as well as the best matching observed objects. Comparing the empirical measurement of the bolometric luminosity to evolutionary models, we find a mass of 12.9 ±0.2 , an effective temperature of 1724 ±15 K, a radius of 1.46 ±0.01 , and a surface gravity of [dex] (cgs). The stated uncertainties are statistical errors only, and do not incorporate any uncertainty on the evolutionary models. Using atmospheric models, we find an effective temperature of 1700-1800 K and a surface gravity of -4.0 [dex] depending upon the model. These values agree well with other publications and with "hot-start" predictions from planetary evolution models. Further, we find that the spectrum of β Pic b best matches a low surface gravity L2 ±1 brown dwarf. Finally, comparing the spectrum to field brown dwarfs, we find the the spectrum best matches 2MASS J04062677-381210 and 2MASS J03552337+1133437.

We present H-band observations of β Pic with the Gemini Planet Imager's (GPI's) polarimetry mode that reveal the debris disk between ∼0.″3 (6 AU) and ∼1.″7 (33 AU), while simultaneously detecting β Pic b. The polarized disk image was fit with a dust density model combined with a Henyey-Greenstein scattering phase function. The best-fit model indicates a disk inclined to the line of sight () with a position angle (PA) (slightly offset from the main outer disk, ), that extends from an inner disk radius of to well outside GPI's field of view. In addition, we present an updated orbit for β Pic b based on new astrometric measurements taken in GPI's spectroscopic mode spanning 14 months. The planet has a semimajor axis of , with an eccentricity The PA of the ascending node is offset from both the outer main disk and the inner disk seen in the GPI image. The orbital fit constrains the stellar mass of β Pic to Dynamical sculpting by β Pic b cannot easily account for the following three aspects of the inferred disk properties: (1) the modeled inner radius of the disk is farther out than expected if caused by β Pic b; (2) the mutual inclination of the inner disk and β Pic b is when it is expected to be closer to zero; and (3) the aspect ratio of the disk () is larger than expected from interactions with β Pic b or self-stirring by the disk's parent bodies.

We present the first results from the polarimetry mode of the Gemini Planet Imager (GPI), which uses anew integral field polarimetry architecture to provide high contrast linear polarimetry with minimal systematic biases between the orthogonal polarizations. We describe the design, data reduction methods, and performance of polarimetry with GPI. Point-spread function (PSF) subtraction via differential polarimetry suppresses unpolarized starlight by a factor of over 100, and provides sensitivity to circumstellar dust reaching the photon noise limit for these observations. in the case of the circumstellar disk around HR 4796A,GPI's advanced adaptive optics system reveals the disk clearly even prior to PSF subtraction. In polarized light, the disk is seen all the way in to its semi-minor axis for the first time. The disk exhibits surprisingly strong asymmetry in polarized intensity, with the west side ≳9 times brighter than the east side despite the fact that the east side is slightly brighter in total intensity. Based on a synthesis of the total and polarized intensities, we now believe that the west side is closer to us, contrary to most prior interpretations. Forward scattering by relatively large silicate dust particles leads to the strong polarized intensity on thewest side, and the ring must be slightly optically thick in order to explain the lower brightness in total intensity there. These findings suggest that the ring is geometrically narrow and dynamically cold, perhaps shepherded by larger bodies in the same manner as Saturn's Fring.

Using the recently installed Gemini Planet Imager (GPI), we have obtained the first H-band spectrum of the planetary companion to the nearby young star β Pictoris. GPI is designed to image and provide low-resolution spectra of Jupiter-sized, self-luminous planetary companions around young nearby stars. These observations were taken covering the H band (1.65 μm). The spectrum has a resolving power of ∼45 and demonstrates the distinctive triangular shape of a cool substellar object with low surface gravity. Using atmospheric models, we find an effective temperature of 1600-1700K and a surface gravity of log(g) = 3.5-4.5 (cgs units). These values agree well with "hot-start" predictions from planetary evolution models for a gas giant with mass between 10 and 12 MJup and age between 10 and 20 Myr.

During the first-light run of the Gemini Planet Imager we obtained K-band spectra of exoplanets HR 8799 c and d. Analysis of the spectra indicates that planet d may be warmer than planet c. Comparisons to recent patchy cloud models and previously obtained observations over multiple wavelengths confirm that thick clouds combined with horizontal variation in the cloud cover generally reproduce the planets' spectral energy distributions. When combined with the 3 to 4 μm photometric data points, the observations provide strong constraints on the atmospheric methane content for both planets. The data also provide further evidence that future modeling efforts must include cloud opacity, possibly including cloud holes, disequilibrium chemistry, and super-solar metallicity.

Using coherent x-ray speckle metrology, we have measured the influence of disorder on major loop return point memory (RPM) and complementary point memory (CPM) for a series of perpendicular anisotropy Co/Pt multilayer films. In the low disorder limit, the domain structures show no memory with field cycling--no RPM and no CPM. With increasing disorder, we observe the onset and the saturation of both the RPM and the CPM. These results provide the first direct ensemble-sensitive experimental study of the effects of varying disorder on microscopic magnetic memory and are compared against the predictions of existing theories.

Two-particle correlation functions of negative hadrons over wide phase space, and transverse mass spectra of negative hadrons and deuterons near mid-rapidity have been measured in central Pb+Pb collisions at 158 GeV per nucleon by the NA49 experiment at the CERN SPS. A novel Coulomb correction procedure for the negative two-particle correlations is employed making use of the measured oppositely charged particle correlation. Within an expanding source scenario these results are used to extract the dynamic characteristics of the hadronic source, resolving the ambiguities between the temperature and transverse expansion velocity of the source, that are unavoidable when single and two particle spectra are analysed separately. The source shape, the total duration of the source expansion, the duration of particle emission, the freeze-out temperature and the longitudinal and transverse expansion velocities are deduced.