Extrasolar planetary dynamics with a generalized planar Laplace-Lagrange secular theory

The dynamical evolution of nearly half of the known extrasolar planets in multiple-planet systems may be dominated by secular perturbations. The commonly high eccentricities of the planetary orbits calls into question the utility of the traditional Laplace-Lagrange (LL) secular theory in analyses of the motion. We analytically generalize this theory to fourth-order in the eccentricities, compare the result with the second-order theory and octupole-level theory, and apply these theories to the likely secularly-dominated HD 12661, HD 168443, HD 38529 and Ups And multi-planet systems. The fourth-order scheme yields a multiply-branched criterion for maintaining apsidal libration, and implies that the apsidal rate of a small body is a function of its initial eccentricity, dependencies which are absent from the traditional theory. Numerical results indicate that the primary difference the second and fourth-order theories reveal is an alteration in secular periodicities, and to a smaller extent amplitudes of the planetary eccentricity variation. Comparison with numerical integrations indicates that the improvement afforded by the fourth-order theory over the second-order theory sometimes dwarfs the improvement needed to reproduce the actual dynamical evolution. We conclude that LL secular theory, to any order, generally represents a poor barometer for predicting secular dynamics in extrasolar planetary systems, but does embody a useful tool for extracting an accurate long-term dynamical description of systems with small bodies and/or near-circular orbits.Comment: 14 pages, 12 figures, 1 table, accepted for publication in Ap

Multi-Spectral Imaging from LEO: High-Resolution Images and Data from the NAPA-2 Turn-Key Mission

Napa-2 is a 6U Earth observation satellite flying the Simera Sense MultiScape 100CIS: a 7-band multi-spectral line-scan imager. Together with an on-ground calibration and processing chain from Pinkmatter Solutions, the Napa-2 system can deliver high-quality multi-spectral line scan images at an impressive ground sampling distance of 5m. After its launch and deployment in July 2021, hundreds of line scan images have been taken and valuable (and critical) data was obtained from the spacecraft platform related to attitude and control and timing. Imperative to the success of obtaining high-quality images, was the implementation of the newly developed ISISPACE Attitude Determination and Control System (ADCS). Line scan images were acquired under different conditions, such as simple flyovers, target pointing, and while executing forward-motion compensation maneuvers. The latter included imaging while the ground speed was reduced up to 50 times! In addition, time-delayed integration was applied in various levels to find the optimal signal-to-noise ratio. With the demand for hyper-spectral imaging from CubeSats, ISISPACE believes that the operational experience gained with multi-spectral imaging in combination with the attitude and orbital control system is vital to be able to educate future customers on the optical performance they can expect

Safety of nifedipine GITS in stable angina: The ACTION trial

Aim: We describe the safety profile of nifedipine GITS as assessed from adverse events reported in the ACTION trial in which 7,665 patients with stable, symptomatic coronary artery disease were randomly assigned nifedipine GITS or placebo and followed for a mean of 4.9 years. Methods: All adverse events were coded using the COSTART coding dictionary. The incidence rate for each event was calculated as the number of patients with the event concerned divided by the total time 'at risk'. Hazard ratios comparing nifedipine with placebo and their 95% confidence intervals were obtained by Cox proportional-hazards analysis. Results: As reported previously, nifedipine significantly reduced the incidence of cardiovascular events and procedures [hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.83-0.95]. Apart from the known side effects of nifedipine, which include peripheral oedema, vasodilatation, hypotension, asthenia, constipation, leg cramps, non-specific respiratory complaints, impotence and polyuria, and which were reported more frequently in patients assigned nifedipine, the incidence rates of most other adverse events were similar. There were no differences in the occurrence of gastrointestinal haemorrhage, myocardial infarction and suicide. The rate of occurrence of death or new cancer excluding non-melanoma skin cancer for patients with no history of cancer at baseline was 2.53/100 patient years for patients assigned nifedipine and 2.37/100 patient years for patients assigned placebo (HR 1.06, 95% CI 0.93-1.22). Conclusion: Overall nifedipine GITS was well tolerated by patients with stable symptomatic angina

Dr. Conway et al reply

We thank Sauret et al for their interest in our systematic literature review that explored potential diagnostic confusion between giant cell arteritis (GCA) and the coronavirus disease 2019 (COVID-19). This was a particularly important consideration during the early months of the COVID-19 pandemic, when community testing for SARS-CoV-2 was limited and diagnostic tests for GCA were restricted or unavailable due to redeployment of staff.</p

Dr. Conway et al reply

We thank Sauret et al for their interest in our systematic literature review that explored potential diagnostic confusion between giant cell arteritis (GCA) and the coronavirus disease 2019 (COVID-19). This was a particularly important consideration during the early months of the COVID-19 pandemic, when community testing for SARS-CoV-2 was limited and diagnostic tests for GCA were restricted or unavailable due to redeployment of staff.</p

Clinical aspects of incorporating cord clamping into stabilisation of preterm infants

Fetal to neonatal transition is characterised by major pulmonary and haemodynamic changes occurring in a short period of time. In the international neonatal resuscitation guidelines, comprehensive recommendations are available on supporting pulmonary transition and delaying clamping of the cord in preterm infants. Recent experimental studies demonstrated that the pulmonary and haemodynamic transition are intimately linked, could influence each other and that the timing of umbilical cord clamping should be incorporated into the respiratory stabilisation. We reviewed the current knowledge on how to incorporate cord clamping into stabilisation of preterm infants and the physiological-based cord clamping (PBCC) approach, with the infant's transitional status as key determinant of timing of cord clamping. This approach could result in optimal timing of cord clamping and has the potential to reduce major morbidities and mortality in preterm infants

Giant Cell Arteritis and COVID-19:Similarities and Discriminators. A Systematic Literature Review

OBJECTIVE: To identify shared and distinct features of giant cell arteritis (GCA) and coronavirus disease 2019(COVID-19) to reduce diagnostic errors that could cause delays in correct treatment. METHODS: Two systematic literature reviews determined the frequency of clinical features of GCA and COVID-19 in published reports. Frequencies in each disease were summarized using medians and ranges. RESULTS: Headache was common in GCA but was also observed in COVID-19 (GCA 66%, COVID-19 10%). Jaw claudication or visual loss (43% and 26% in GCA, respectively) generally were not reported in COVID-19. Both diseases featured fatigue (GCA 38%, COVID-19 43%) and elevated inflammatory markers (C-reactive protein [CRP] elevated in 100% of GCA, 66% of COVID-19), but platelet count was elevated in 47% of GCA but only 4% of COVID-19 cases. Cough and fever were commonly reported in COVID-19 and less frequently in GCA (cough, 63% for COVID-19 vs 12% for GCA; fever, 83% for COVID-19 vs 27% for GCA). Gastrointestinal upset was occasionally reported in COVID-19 (8%), rarely in GCA (4%). Lymphopenia was more common in COVID-19 than GCA (53% in COVID-19, 2% in GCA). Alteration of smell and taste have been described in GCA but their frequency is unclear. CONCLUSION: Overlapping features of GCA and COVID-19 include headache, fever, elevated CRP and cough. Jaw claudication, visual loss, platelet count and lymphocyte count may be more discriminatory. Physicians should be aware of the possibility of diagnostic confusion. We have designed a simple checklist to aid evidence-based evaluation of patients with suspected GCA

Metabolic features and glucocorticoid-induced comorbidities in patients with giant cell arteritis and polymyalgia rheumatica in a Dutch and Danish cohort

OBJECTIVES: Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are age-associated inflammatory diseases that frequently overlap. Both diseases require long-term treatment with glucocorticoids (GCs), often associated with comorbidities. Previous population-based cohort studies reported that an unhealthier metabolic profile might prevent the development of GCA. Here, we report metabolic features before start of treatment and during treatment in patients with GCA and PMR. METHODS: In the Dutch GCA/PMR/SENEX (GPS) cohort, we analysed metabolic features and prevalence of comorbidities (type 2 diabetes, hypercholesterolaemia, hypertension, obesity and cataract) in treatment-naïve patients with GCA (n=50) and PMR (n=42), and compared those with the population-based Lifelines cohort (n=91). To compare our findings in the GPS cohort, we included data from patients with GCA (n=52) and PMR (n=25) from the Aarhus cohort. Laboratory measurements, comorbidities and GC use were recorded for up to 5 years in the GPS cohort. RESULTS: Glycated haemoglobin levels tended to be higher in treatment-naïve patients with GCA, whereas high-density lipoprotein, low-density lipoprotein and cholesterol levels were lower compared with the Lifelines population. Data from the Aarhus cohort were aligned with the findings obtained in the GPS cohort. Presence of comorbidities at baseline did not predict long-term GC requirement. The incidence of diabetes, obesity and cataract among patients with GCA increased upon initiation of GC treatment. CONCLUSION: Data from the GCA and PMR cohorts imply a metabolic dysregulation in treatment-naïve patients with GCA, but not in patients with PMR. Treatment with GCs led to the rise of comorbidities and an unhealthier metabolic profile, stressing the need for prednisone-sparing targeted treatment in these vulnerable patients