Characteristics and Prognostic Importance of Myocardial Fibrosis in Patients with Dilated Cardiomyopathy Assessed by Contrast-Enhanced Cardiac Magnetic Resonance Imaging

Introduction Dilated cardiomyopathy (DCM) is associated with significant morbidity and mortality. Contrast-enhanced cardiac MRI (CE-CMR) can detect potentially prognostic myocardial fibrosis in DCM. We investigated the role of CE-CMR in New Zealand patients with DCM, both Maori and non-Maori, including the characteristics and prognostic importance of fibrosis. Methods One hundred and three patients (mean age 58 ± 13, 78 male) referred for CMR assessment of DCM were followed for 660 ± 346 days. Major adverse cardiac events (MACE) were defined as death, infarction, ventricular arrhythmias or rehospitalisation. CE-CMR used cines for functional analysis, and delayed enhancement to assess fibrosis. Results Myocardial fibrosis was present in 30% of patients, the majority of which was mid-myocardial (63%). Volumetric parameters were similar in patients with or without fibrosis. At 2 years patients with fibrosis had an increased rate of MACE (HR = 0.77, 95% CI 0.3-2.0). Patients with full thickness or subendocardial fibrosis had the highest MACE, even in the absence of CAD). More Maori had fibrosis on CE-CMR (40% vs. 28% for non-Maori), and the majority (75%) was mid-myocardial. Maori and non-Maori had similar outcomes (25% vs. 24% with events during follow-up). Conclusions DCM patients frequently have myocardial fibrosis detected on CE-CMR, the majority of which is mid-myocardial. Fibrosis is associated with worse outcome in the medium term. The information obtained using CE-CMR in DCM may be of incremental clinical benefit

The EVIL-MC Model for Ellipsoidal Variations of Planet-Hosting Stars and Applications to the HAT-P-7 System

We present a new model for Ellipsoidal Variations Induced by a Low-Mass Companion, the EVIL-MC model. We employ several approximations appropriate for planetary systems to substantially increase the computational efficiency of our model relative to more general ellipsoidal variation models and improve upon the accuracy of simpler models. This new approach gives us a unique ability to rapidly and accurately determine planetary system parameters. We use the EVIL-MC model to analyze Kepler Quarter 0-2 (Q0-2) observations of the HAT-P-7 system, an F-type star orbited by a nearly Jupiter-mass companion. Our analysis corroborates previous estimates of the planet-star mass ratio q = (1.10 +/- 0.06) x 10^(-3), and we have revised the planet's dayside brightness temperature to 2680 +10/-20 K. We also find a large difference between the day- and nightside planetary flux, with little nightside emission. Preliminary dynamical+radiative modeling of the atmosphere indicates this result is qualitatively consistent with high altitude absorption of stellar heating. Similar analyses of Kepler and CoRoT photometry of other planets using EVIL-MC will play a key role in providing constraints on the properties of many extrasolar systems, especially given the limited resources for follow-up and characterization of these systems. However, as we highlight, there are important degeneracies between the contributions from ellipsoidal variations and planetary emission and reflection. Consequently, for many of the hottest and brightest Kepler and CoRoT planets, accurate estimates of the planetary emission and reflection, diagnostic of atmospheric heat budgets, will require accurate modeling of the photometric contribution from the stellar ellipsoidal variation.Comment: Accepted to ApJ; minor revisions to original submission; An IDL version of the EVIL-MC model is publicly available at http://www.lpl.arizona.edu/~bjackson/idl_code/index.htm

Planetary Candidates Observed by Kepler, III: Analysis of the First 16 Months of Data

New transiting planet candidates are identified in sixteen months (May 2009 - September 2010) of data from the Kepler spacecraft. Nearly five thousand periodic transit-like signals are vetted against astrophysical and instrumental false positives yielding 1,091 viable new planet candidates, bringing the total count up to over 2,300. Improved vetting metrics are employed, contributing to higher catalog reliability. Most notable is the noise-weighted robust averaging of multi-quarter photo-center offsets derived from difference image analysis which identifies likely background eclipsing binaries. Twenty-two months of photometry are used for the purpose of characterizing each of the new candidates. Ephemerides (transit epoch, T_0, and orbital period, P) are tabulated as well as the products of light curve modeling: reduced radius (Rp/R*), reduced semi-major axis (d/R*), and impact parameter (b). The largest fractional increases are seen for the smallest planet candidates (197% for candidates smaller than 2Re compared to 52% for candidates larger than 2Re) and those at longer orbital periods (123% for candidates outside of 50-day orbits versus 85% for candidates inside of 50-day orbits). The gains are larger than expected from increasing the observing window from thirteen months (Quarter 1-- Quarter 5) to sixteen months (Quarter 1 -- Quarter 6). This demonstrates the benefit of continued development of pipeline analysis software. The fraction of all host stars with multiple candidates has grown from 17% to 20%, and the paucity of short-period giant planets in multiple systems is still evident. The progression toward smaller planets at longer orbital periods with each new catalog release suggests that Earth-size planets in the Habitable Zone are forthcoming if, indeed, such planets are abundant.Comment: Submitted to ApJS. Machine-readable tables are available at http://kepler.nasa.gov, http://archive.stsci.edu/kepler/results.html, and the NASA Exoplanet Archiv

Spatio-temporal Models of Lymphangiogenesis in Wound Healing

Several studies suggest that one possible cause of impaired wound healing is failed or insufficient lymphangiogenesis, that is the formation of new lymphatic capillaries. Although many mathematical models have been developed to describe the formation of blood capillaries (angiogenesis), very few have been proposed for the regeneration of the lymphatic network. Lymphangiogenesis is a markedly different process from angiogenesis, occurring at different times and in response to different chemical stimuli. Two main hypotheses have been proposed: 1) lymphatic capillaries sprout from existing interrupted ones at the edge of the wound in analogy to the blood angiogenesis case; 2) lymphatic endothelial cells first pool in the wound region following the lymph flow and then, once sufficiently populated, start to form a network. Here we present two PDE models describing lymphangiogenesis according to these two different hypotheses. Further, we include the effect of advection due to interstitial flow and lymph flow coming from open capillaries. The variables represent different cell densities and growth factor concentrations, and where possible the parameters are estimated from biological data. The models are then solved numerically and the results are compared with the available biological literature.Comment: 29 pages, 9 Figures, 6 Tables (39 figure files in total

Planet Populations as a Function of Stellar Properties

Exoplanets around different types of stars provide a window into the diverse environments in which planets form. This chapter describes the observed relations between exoplanet populations and stellar properties and how they connect to planet formation in protoplanetary disks. Giant planets occur more frequently around more metal-rich and more massive stars. These findings support the core accretion theory of planet formation, in which the cores of giant planets form more rapidly in more metal-rich and more massive protoplanetary disks. Smaller planets, those with sizes roughly between Earth and Neptune, exhibit different scaling relations with stellar properties. These planets are found around stars with a wide range of metallicities and occur more frequently around lower mass stars. This indicates that planet formation takes place in a wide range of environments, yet it is not clear why planets form more efficiently around low mass stars. Going forward, exoplanet surveys targeting M dwarfs will characterize the exoplanet population around the lowest mass stars. In combination with ongoing stellar characterization, this will help us understand the formation of planets in a large range of environments.Comment: Accepted for Publication in the Handbook of Exoplanet

Safety of bazedoxifene in a randomized, double-blind, placebo- and active-controlled phase 3 study of postmenopausal women with osteoporosis

Background. We report the safety findings from a 3-year phase 3 study (NCT00205777) of bazedoxifene, a novel selective estrogen receptor modulator under development for the prevention and treatment of postmenopausal osteoporosis. Methods. Healthy postmenopausal osteoporotic women (N = 7,492; mean age, 66.4 years) were randomized to daily doses of bazedoxifene 20 or 40 mg, raloxifene 60 mg, or placebo for 3 years. Safety and tolerability were assessed by adverse event (AE) reporting and routine physical, gynecologic, and breast examination. Results. Overall, the incidence of AEs, serious AEs, and discontinuations due to AEs in the bazedoxifene groups was not different from that seen in the placebo group. The incidence of hot flushes and leg cramps was higher with bazedoxifene or raloxifene compared with placebo. The rates of cardiac disorders and cerebrovascular events were low and evenly distributed among groups. Venous thromboembolic events, primarily deep vein thromboses, were more frequently reported in the active treatment groups compared with the placebo group; rates were similar with bazedoxifene and raloxifene. Bazedoxifene showed a neutral effect on the breast and an excellent endometrial safety profile. The incidence of fibrocystic breast disease was lower with bazedoxifene 20 and 40 mg versus raloxifene or placebo. Reductions in total and low-density lipoprotein levels and increases in high-density lipoprotein levels were seen with bazedoxifene versus placebo; similar results were seen with raloxifene. Triglyceride levels were similar among groups. Conclusion. Bazedoxifene showed a favorable safety and tolerability profile in women with postmenopausal osteoporosis. © 2010 Christiansen et al; licensee BioMed Central Ltd.link_to_subscribed_fulltex

Tentative Evidence for Water Vapor in the Atmosphere of the Neptune-Size Exoplanet HD 106315 c

We present a transmission spectrum for the Neptune-size exoplanet HD 106315 c from optical to infrared wavelengths based on transit observations from the Hubble Space Telescope/Wide Field Camera 3, K2, and Spitzer. The spectrum shows tentative evidence for a water absorption feature in the 1.1−1.7μm wavelength range with a small amplitude of 30 ppm (corresponding to just 0.8±0.04 atmospheric scale heights). Based on an atmospheric retrieval analysis, the presence of water vapor is tentatively favored with a Bayes factor of 1.7 - 2.6 (depending on prior assumptions). The spectrum is most consistent with either enhanced metallicity, high altitude condensates, or both. Cloud-free solar composition atmospheres are ruled out at >5σ confidence. We compare the spectrum to grids of cloudy and hazy forward models and find that the spectrum is fit well by models with moderate cloud lofting or haze formation efficiency, over a wide range of metallicities (1−100× solar). We combine the constraints on the envelope composition with an interior structure model and estimate that the core mass fraction is ≳0.3. With a bulk composition reminiscent of that of Neptune and an orbital distance of 0.15 AU, HD 106315 c hints that planets may form out of broadly similar material and arrive at vastly different orbits later in their evolution

Tentative Evidence for Water Vapor in the Atmosphere of the Neptune-Size Exoplanet HD 106315 c

We present a transmission spectrum for the Neptune-size exoplanet HD 106315 c from optical to infrared wavelengths based on transit observations from the Hubble Space Telescope/Wide Field Camera 3, K2, and Spitzer. The spectrum shows tentative evidence for a water absorption feature in the $1.1 - 1.7\mu$m wavelength range with a small amplitude of 30 ppm (corresponding to just $0.8 \pm 0.04$ atmospheric scale heights). Based on an atmospheric retrieval analysis, the presence of water vapor is tentatively favored with a Bayes factor of 1.7 - 2.6 (depending on prior assumptions). The spectrum is most consistent with either enhanced metallicity, high altitude condensates, or both. Cloud-free solar composition atmospheres are ruled out at $>5\sigma$ confidence. We compare the spectrum to grids of cloudy and hazy forward models and find that the spectrum is fit well by models with moderate cloud lofting or haze formation efficiency, over a wide range of metallicities ($1 - 100\times$ solar). We combine the constraints on the envelope composition with an interior structure model and estimate that the core mass fraction is $\gtrsim0.3$. With a bulk composition reminiscent of that of Neptune and an orbital distance of 0.15 AU, HD 106315 c hints that planets may form out of broadly similar material and arrive at vastly different orbits later in their evolution.Comment: Submitted to AAS journals; 19 pages, 12 figure