Change in Physiological Variables in the Last Two Weeks of Life: An Observational Study of Hospitalized Adults With Heart Failure

Context Recognition of dying is a difficult task in end-stage heart failure, yet it remains an important clinical skill in providing good palliative care to these patients. Objectives To use routinely collected data to explore evidence for physiological change in the final two weeks of life in end-stage heart failure. Methods This was a retrospective cohort study of routinely collected data from hospital inpatients dying as a result of heart failure during a one-year period in a U.K. hospital. Data were analyzed using descriptive techniques and multilevel modeling. Results Results were obtained on 81 patients. Respiratory function (evidenced by falling oxygen saturation and rising respiratory rate) deteriorated by a clinically significant amount in the final two weeks of life (P < 0.001). Renal function (evidenced by rising serum urea and creatinine) also demonstrated a clinically significant deterioration over the same period (P < 0.001 and P = 0.005, respectively). Serum albumin fell over a period of months (P < 0.001). Heart rate and blood pressure did not demonstrate clinically significant change over the same period. Conclusions Deteriorating respiratory and renal function may indicate imminent dying in heart failure. A fall in serum albumin may signify poor prognosis over a timescale of weeks to months. Conversely, hemodynamic parameters may remain relatively stable in the final days of life and should not be reassuring in end-stage heart failure patients

Velocity Fluctuations in Electrostatically Driven Granular Media

We study experimentally the particle velocity fluctuations in an electrostatically driven dilute granular gas. The experimentally obtained velocity distribution functions have strong deviations from Maxwellian form in a wide range of parameters. We have found that the tails of the distribution functions are consistent with a stretched exponential law with typical exponents of the order 3/2. Molecular dynamic simulations shows qualitative agreement with experimental data. Our results suggest that this non-Gaussian behavior is typical for most inelastic gases with both short and long range interactions.Comment: 4 pages, 4 figure

Ab initio calculation of the neutron-proton mass difference

The existence and stability of atoms rely on the fact that neutrons are more massive than protons. The measured mass difference is only 0.14\% of the average of the two masses. A slightly smaller or larger value would have led to a dramatically different universe. Here, we show that this difference results from the competition between electromagnetic and mass isospin breaking effects. We performed lattice quantum-chromodynamics and quantum-electrodynamics computations with four nondegenerate Wilson fermion flavors and computed the neutron-proton mass-splitting with an accuracy of $300$ kilo-electron volts, which is greater than $0$ by $5$ standard deviations. We also determine the splittings in the $\Sigma$, $\Xi$, $D$ and $\Xi_{cc}$ isospin multiplets, exceeding in some cases the precision of experimental measurements.Comment: 57 pages, 15 figures, 6 tables, revised versio

Dielectric and conductivity relaxation in mixtures of glycerol with LiCl

We report a thorough dielectric characterization of the alpha relaxation of glass forming glycerol with varying additions of LiCl. Nine salt concentrations from 0.1 - 20 mol% are investigated in a frequency range of 20 Hz - 3 GHz and analyzed in the dielectric loss and modulus representation. Information on the dc conductivity, the dielectric relaxation time (from the loss) and the conductivity relaxation time (from the modulus) is provided. Overall, with increasing ion concentration, a transition from reorientationally to translationally dominated behavior is observed and the translational ion dynamics and the dipolar reorientational dynamics become successively coupled. This gives rise to the prospect that by adding ions to dipolar glass formers, dielectric spectroscopy may directly couple to the translational degrees of freedom determining the glass transition, even in frequency regimes where usually strong decoupling is observed.Comment: 8 pages, 7 figure

Kepler-22b: A 2.4 Earth-radius Planet in the Habitable Zone of a Sun-like Star

A search of the time-series photometry from NASA's Kepler spacecraft reveals a transiting planet candidate orbiting the 11th magnitude G5 dwarf KIC 10593626 with a period of 290 days. The characteristics of the host star are well constrained by high-resolution spectroscopy combined with an asteroseismic analysis of the Kepler photometry, leading to an estimated mass and radius of 0.970 +/- 0.060 MSun and 0.979 +/- 0.020 RSun. The depth of 492 +/- 10ppm for the three observed transits yields a radius of 2.38 +/- 0.13 REarth for the planet. The system passes a battery of tests for false positives, including reconnaissance spectroscopy, high-resolution imaging, and centroid motion. A full BLENDER analysis provides further validation of the planet interpretation by showing that contamination of the target by an eclipsing system would rarely mimic the observed shape of the transits. The final validation of the planet is provided by 16 radial velocities obtained with HIRES on Keck 1 over a one year span. Although the velocities do not lead to a reliable orbit and mass determination, they are able to constrain the mass to a 3{\sigma} upper limit of 124 MEarth, safely in the regime of planetary masses, thus earning the designation Kepler-22b. The radiative equilibrium temperature is 262K for a planet in Kepler-22b's orbit. Although there is no evidence that Kepler-22b is a rocky planet, it is the first confirmed planet with a measured radius to orbit in the Habitable Zone of any star other than the Sun.Comment: Accepted to Ap

Coarsening of granular clusters: two types of scaling behaviors

We report on an experimental study of small cluster dynamics during the coarsening process in driven granular submonolayers of 120mkm bronze particles. The techniques of electrostatic and vertical mechanical vibration were employed to excite the granular gas. We measure the scaling exponent for the evaporation of small clusters during coarsening. It was found that the surface area of small clusters S vs time t behaves as S ~ (t_0-t)^(2/3) for lower frequencies and S ~ (t_0-t) for higher frequencies. We argue that the change in the scaling exponent is related to the transition from three dimensional to two dimensional character of motion in the granular gas.Comment: 4 pages,5 figures, submitted to Phys.Rev.

Asteroseismology of Eclipsing Binary Stars in the Kepler Era

Eclipsing binary stars have long served as benchmark systems to measure fundamental stellar properties. In the past few decades, asteroseismology - the study of stellar pulsations - has emerged as a new powerful tool to study the structure and evolution of stars across the HR diagram. Pulsating stars in eclipsing binary systems are particularly valuable since fundamental properties (such as radii and masses) can determined using two independent techniques. Furthermore, independently measured properties from binary orbits can be used to improve asteroseismic modeling for pulsating stars in which mode identifications are not straightforward. This contribution provides a review of asteroseismic detections in eclipsing binary stars, with a focus on space-based missions such as CoRoT and Kepler, and empirical tests of asteroseismic scaling relations for stochastic ("solar-like") oscillations.Comment: 28 pages, 12 figures, 2 tables; Proceedings of the AAS topical conference "Giants of Eclipse" (AASTCS-3), July 28 - August 2 2013, Monterey, C

Identifying patient-important outcomes in polycystic kidney disease: An international nominal group technique study

AIM: Patients with autosomal dominant polycystic kidney disease (ADPKD) are at increased risk of premature mortality, morbidities and complications, which severely impair quality of life. However, patient-centered outcomes are not consistently reported in trials in ADPKD, which can limit shared decision-making. We aimed to identify outcomes important to patients and caregivers and the reasons for their priorities. METHODS: Nominal group technique was adopted involving patients with ADPKD and caregivers who were purposively selected from eight centres across Australia, France and the Republic of Korea. Participants identified, ranked and discussed outcomes for trials in ADPKD. We calculated an importance score (0-1) for each outcome and conducted thematic analyses. RESULTS: Across 17 groups, 154 participants (121 patients, 33 caregivers) aged 19 to 78 (mean 54.5 years) identified 55 outcomes. The 10 highest ranked outcomes were: kidney function (importance score 0.36), end-stage kidney disease (0.32), survival (0.21), cyst size/growth (0.20), cyst pain/bleeding (0.18), blood pressure (0.17), ability to work (0.16), cerebral aneurysm/stroke (0.14), mobility/physical function (0.12), and fatigue (0.12). Three themes were identified: threatening semblance of normality, inability to control and making sense of diverse risks. CONCLUSION: For patients with ADPKD and their caregivers, kidney function, delayed progression to end-stage kidney disease and survival were the highest priorities, and were focused on achieving normality, and maintaining control over health and lifestyle. Implementing these patient-important outcomes may improve the meaning and relevance of trials to inform clinical care in ADPKD

Zodiacal Exoplanets in Time (ZEIT). VII. A Temperate Candidate Super-Earth in the Hyades Cluster

Transiting exoplanets in young open clusters present opportunities to study how exoplanets evolve over their lifetimes. Recently, significant progress detecting transiting planets in young open clusters has been made with the K2 mission, but so far all of these transiting cluster planets orbit close to their host stars, so planet evolution can only be studied in a high-irradiation regime. Here, we report the discovery of a long-period planet candidate, called HD 283869 b, orbiting a member of the Hyades cluster. Using data from the K2 mission, we detected a single transit of a super-Earth-sized (1.96 0.12 R ⊕) planet candidate orbiting the K-dwarf HD 283869 with a period longer than 72 days. As we only detected a single-transit event, we cannot validate HD 283869 b with high confidence, but our analysis of the K2 images, archival data, and follow-up observations suggests that the source of the event is indeed a transiting planet. We estimated the candidate's orbital parameters and find that if real, it has a period P ≈ 100 days and receives approximately Earth-like incident flux, giving the candidate a 71% chance of falling within the circumstellar habitable zone. If confirmed, HD 283869 b would have the longest orbital period, lowest incident flux, and brightest host star of any known transiting planet in an open cluster, making it uniquely important to future studies of how stellar irradiation affects planetary evolution

Measurement of the polarisation of W bosons produced with large transverse momentum in pp collisions at sqrt(s) = 7 TeV with the ATLAS experiment

This paper describes an analysis of the angular distribution of W->enu and W->munu decays, using data from pp collisions at sqrt(s) = 7 TeV recorded with the ATLAS detector at the LHC in 2010, corresponding to an integrated luminosity of about 35 pb^-1. Using the decay lepton transverse momentum and the missing transverse energy, the W decay angular distribution projected onto the transverse plane is obtained and analysed in terms of helicity fractions f0, fL and fR over two ranges of W transverse momentum (ptw): 35 < ptw < 50 GeV and ptw > 50 GeV. Good agreement is found with theoretical predictions. For ptw > 50 GeV, the values of f0 and fL-fR, averaged over charge and lepton flavour, are measured to be : f0 = 0.127 +/- 0.030 +/- 0.108 and fL-fR = 0.252 +/- 0.017 +/- 0.030, where the first uncertainties are statistical, and the second include all systematic effects.Comment: 19 pages plus author list (34 pages total), 9 figures, 11 tables, revised author list, matches European Journal of Physics C versio