Supervised Physical Therapy and Polymyositis/Dermatomyositis—A Systematic Review of the Literature

Objective: to find the most up-to-date evidence of the effectiveness and safety of supervised physical therapy in polymyositis/dermatomyositis patients. Methods: a systematic review of the literature in the main scientific databases was carried out. We searched for randomized controlled trials concerning supervised physical therapy and polymyositis/dermatomyositis. The PICOS method was used for the formulation of the clinical query. Methodological quality and the level of evidence of the included studies were assessed using the modified Jadad scale and the Oxford Centre for Evidence-Based Medicine Levels of Evidence guide, respectively. Results: a total of 2591 articles were found. By applying the inclusion/exclusion criteria, six randomized controlled clinical trials were admitted to the final phase of the review. The compared approaches concerned supervised exercise programs based on strategies of muscle strengthening or aerobic work. Following these exercises, an increase in the maximum rate of oxygen consumption, a decrease in creatine phosphokinase levels, an enhancement in the patient’s aerobic performance and an improvement in the quality of life indexes were registered. The methodological quality of the included studies ranged from 3 to 4.5. All the studies were classified as presenting an evidence level of 2b. Conclusions: supervised physical therapy in polymyositis/dermatomyositis is an effective, safe and free-of-contraindications tool to be used both in the acute and in the established phases of the pathology. However, further and higher-quality studies are necessary to confirm those findings, to clarify the timing of exercise delivery and to guide the choice towards different types of muscle contraction exercises

Arterial Hypertension, Metabolic Syndrome and Subclinical Cardiovascular Organ Damage in Patients with Asymptomatic Primary Hyperparathyroidism before and after Parathyroidectomy: Preliminary Results

Background. Primary hyperparathyroidism (PHPT) is associated with high cardiovascular morbidity, and the role of calcium and parathyroid hormone is still controversial. Objective. To evaluate the prevalence and outcomes of metabolic syndrome, hypertension, and some cardiovascular alterations in asymptomatic PHPT, and specific changes after successful parathyroidectomy. Material and Methods. We examined 30 newly diagnosed PHPT patients (8 males, 22 females; mean age 56 ± 6 yrs), 30 patients with essential hypertension (EH) (9 males, 21 females; mean age 55 ± 4), and 30 normal subjects (NS) (9 males, 21 females: mean age 55 ± 6). All groups underwent evaluation with ambulatory monitoring blood pressure, echocardiography, and color-Doppler artery ultrasonography and were successively revaluated after one year from parathyroidectomy. Results. PHPT patients presented a higher prevalence of metabolic syndrome (38%) with respect to EH (28%). Prevalence of hypertension in PHPT was 81%, and 57% presented altered circadian rhythm of blood pressure, with respect to EH (35%) and NS (15%). PHPT showed an important myocardial and vascular remodelling. During follow-up in PHPT patients, we found significant reduction of prevalence of metabolic syndrome, blood pressure, and “non-dipping phenomenon.” Conclusions. Cardiovascular and metabolic alterations should be considered as added parameters in evaluation of patients with asymptomatic PHPT

Engaging Citizen Scientists to Keep Transit Times Fresh and Ensure the Efficient Use of Transiting Exoplanet Characterization Missions

This white paper advocates for the creation of a community-wide program to maintain precise mid-transit times of exoplanets that would likely be targeted by future platforms. Given the sheer number of targets that will require careful monitoring between now and the launch of the next generation of exoplanet characterization missions, this network will initially be devised as a citizen science project -- focused on the numerous amateur astronomers, small universities and community colleges and high schools that have access to modest sized telescopes and off-the-shelf CCDs.Comment: White Paper submitted to Astro2020 Science Call, 5 pages, 3 figures, community comments and involvement are welcome

Brown Fat Expresses Adiponectin in Humans

The presence of brown adipose tissue (BAT) in humans is unclear. Pheochromocytomas (PHEO) are rare tumors of neuroectodermal origin which occur in 0.1-0.2% of patients with hypertension. We sought to evaluate the presence and activity of BAT surrounding adrenal PHEO in a well-studied sample of 11 patients who were diagnosed with PHEO and then underwent adrenalectomy. Areas of white fat (WAT) and BAT surrounding PHEO were obtained by Laser Capture Microdissection for analysis of uncoupling protein (UCP)-1 and adiponectin mRNA expression. Adiponectin and UCP-1 mRNA levels were significantly higher in BAT than in WAT (0.62 versus 0.15 and 362.4 versus 22.1, resp., for both). Adiponectin mRNA levels significantly correlated with urinary metanephrines (, ), vanilly mandelic acid (VMA) (, ), and serum adiponectin levels (, ). Serum adiponectin levels significantly decreased ( μg/mL versus  μg/mL, ) after adrenalectomy in PHEO subjects. This study provides the following findings: (1) BAT surrounding PHEO expresses adiponectin and UCP-1 mRNA, (2) expression of adiponectin mRNA is significantly higher in BAT than in WAT surrounding PHEO, and (3) catecholamines and serum adiponectin levels significantly correlate with BAT UCP-1 and adiponectin mRNA

The Science Case for an Extended Spitzer Mission

Although the final observations of the Spitzer Warm Mission are currently scheduled for March 2019, it can continue operations through the end of the decade with no loss of photometric precision. As we will show, there is a strong science case for extending the current Warm Mission to December 2020. Spitzer has already made major impacts in the fields of exoplanets (including microlensing events), characterizing near Earth objects, enhancing our knowledge of nearby stars and brown dwarfs, understanding the properties and structure of our Milky Way galaxy, and deep wide-field extragalactic surveys to study galaxy birth and evolution. By extending Spitzer through 2020, it can continue to make ground-breaking discoveries in those fields, and provide crucial support to the NASA flagship missions JWST and WFIRST, as well as the upcoming TESS mission, and it will complement ground-based observations by LSST and the new large telescopes of the next decade. This scientific program addresses NASA's Science Mission Directive's objectives in astrophysics, which include discovering how the universe works, exploring how it began and evolved, and searching for life on planets around other stars.Comment: 75 pages. See page 3 for Table of Contents and page 4 for Executive Summar

Optimizing laser coupling, matter heating, and particle acceleration from solids using multiplexed ultraintense lasers

Realizing the full potential of ultrahigh-intensity lasers for particle and radiation generation will require multi-beam arrangements due to technology limitations. Here, we investigate how to optimize their coupling with solid targets. Experimentally, we show that overlapping two intense lasers in a mirror-like configuration onto a solid with a large preplasma can greatly improve the generation of hot electrons at the target front and ion acceleration at the target backside. The underlying mechanisms are analyzed through multidimensional particle-in-cell simulations, revealing that the self-induced magnetic fields driven by the two laser beams at the target front are susceptible to reconnection, which is one possible mechanism to boost electron energization. In addition, the resistive magnetic field generated during the transport of the hot electrons in the target bulk tends to improve their collimation. Our simulations also indicate that such effects can be further enhanced by overlapping more than two laser beams

WASP-107b’s Density Is Even Lower: A Case Study for the Physics of Planetary Gas Envelope Accretion and Orbital Migration

With a mass in the Neptune regime and a radius of Jupiter, WASP-107b presents a challenge to planet formation theories. Meanwhile, the planet's low surface gravity and the star's brightness also make it one of the most favorable targets for atmospheric characterization. Here, we present the results of an extensive 4 yr Keck/HIRES radial-velocity (RV) follow-up program of the WASP-107 system and provide a detailed study of the physics governing the accretion of the gas envelope of WASP-107b. We reveal that WASP-107b's mass is only 1.8 Neptune masses (M_b = 30.5 ± 1.7 M_⊕). The resulting extraordinarily low density suggests that WASP-107b has a H/He envelope mass fraction of >85% unless it is substantially inflated. The corresponding core mass of <4.6 M_⊕ at 3σ is significantly lower than what is traditionally assumed to be necessary to trigger massive gas envelope accretion. We demonstrate that this large gas-to-core mass ratio most plausibly results from the onset of accretion at gsim1 au onto a low-opacity, dust-free atmosphere and subsequent migration to the present-day a_b = 0.0566 ± 0.0017 au. Beyond WASP-107b, we also detect a second, more massive planet (M_c sin i = 0.36 ± 0.04MJ ) on a wide eccentric orbit (e _c = 0.28 ± 0.07) that may have influenced the orbital migration and spin–orbit misalignment of WASP-107b. Overall, our new RV observations and envelope accretion modeling provide crucial insights into the intriguing nature of WASP-107b and the system's formation history. Looking ahead, WASP-107b will be a keystone planet to understand the physics of gas envelope accretion