Probing the Inner Regions of Protoplanetary Disks with CO Absorption Line Spectroscopy

Carbon monoxide (CO) is the most commonly used tracer of molecular gas in the inner regions of protoplanetary disks. CO can be used to constrain the excitation and structure of the circumstellar environment. Absorption line spectroscopy provides an accurate assessment of a single line-of-sight through the protoplanetary disk system, giving more straightforward estimates of column densities and temperatures than CO and molecular hydrogen emission line studies. We analyze new observations of ultraviolet CO absorption from the Hubble Space Telescope along the sightlines to six classical T Tauri stars. Gas velocities consistent with the stellar velocities, combined with the moderate-to-high disk inclinations, argue against the absorbing CO gas originating in a fast-moving disk wind. We conclude that the far-ultraviolet observations provide a direct measure of the disk atmosphere or possibly a slow disk wind. The CO absorption lines are reproduced by model spectra with column densities in the range N(^{12}CO) ~ 10^{16} - 10^{18} cm^{-2} and N(^{13}CO) ~ 10^{15} - 10^{17} cm^{-2}, rotational temperatures T_{rot}(CO) ~ 300 - 700 K, and Doppler b-values, b ~ 0.5 - 1.5 km s^{-1}. We use these results to constrain the line-of-sight density of the warm molecular gas (n_{CO} ~ 70 - 4000 cm^{-3}) and put these observations in context with protoplanetary disk models.Comment: 12 pages, 14 figures, ApJ - accepte

Increased hazard of myocardial infarction with insulin‐provision therapy in actively smoking patients with diabetes mellitus and stable ischemic heart disease: The BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial

Background In the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial, randomization of diabetic patients with stable ischemic heart disease to insulin provision ( IP ) therapy, as opposed to insulin sensitization ( IS ) therapy, resulted in biochemical evidence of impaired fibrinolysis but no increase in adverse clinical outcomes. We hypothesized that the prothrombotic effect of IP therapy in combination with the hypercoagulable state induced by active smoking would result in an increased risk of myocardial infarction ( MI ). Methods and Results We analyzed BARI 2D patients who were active smokers randomized to IP or IS therapy. The primary end point was fatal or nonfatal MI . PAI ‐1 (plasminogen activator inhibitor 1) activity was analyzed at 1, 3, and 5 years. Of 295 active smokers, MI occurred in 15.4% randomized to IP and in 6.8% randomized to IS over the 5.3 years ( P =0.023). IP therapy was associated with a 3.2‐fold increase in the hazard of MI compared with IS therapy (hazard ratio: 3.23; 95% confidence interval, 1.43–7.28; P =0.005). Baseline PAI ‐1 activity (19.0 versus 17.5 Au/mL, P =0.70) was similar in actively smoking patients randomized to IP or IS therapy. However, IP therapy resulted in significantly increased PAI ‐1 activity at 1 year (23.0 versus 16.0 Au/mL, P =0.001), 3 years (24.0 versus 18.0 Au/mL, P =0.049), and 5 years (29.0 versus 15.0 Au/mL, P =0.004) compared with IS therapy. Conclusions Among diabetic patients with stable ischemic heart disease who were actively smoking, IP therapy was independently associated with a significantly increased hazard of MI . This finding may be explained by higher PAI ‐1 activity in active smokers treated with IP therapy. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 00006305. </jats:sec

Association of inferior vena cava filter placement for venous thromboembolic disease and a contraindication to anticoagulation with 30-day mortality

Importance: Despite the absence of data from randomized clinical trials, professional societies recommend inferior vena cava (IVC) filters for patients with venous thromboembolic disease (VTE) and a contraindication to anticoagulation therapy. Prior observational studies of IVC filters have suggested a mortality benefit associated with IVC filter insertion but have often failed to adjust for immortal time bias, which is the time before IVC filter insertion, during which death can only occur in the control group. Objective: To determine the association of IVC filter placement with 30-day mortality after adjustment for immortal time bias. Design, Setting, and Participants: This comparative effectiveness, retrospective cohort study used a population-based sample of hospitalized patients with VTE and a contraindication to anticoagulation using the State Inpatient Database and the State Emergency Department Database, part of the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, from hospitals in California (January 1, 2005, to December 31, 2011), Florida (January 1, 2005, to December 31, 2013), and New York (January 1, 2005, to December 31, 2012). Data analysis was conducted from September 15, 2015, to March 14, 2018. Exposure: Inferior vena cava filter placement. Main Outcomes and Measures: Multivariable Cox proportional hazard models were constructed with IVC filters as a time-dependent variable that adjusts for immortal time bias. The Cox model was further adjusted using the propensity score as an adjustment variable. Results: Of 126 030 patients with VTE, 61 281 (48.6%) were male and the mean (SD) age was 66.9 (16.6) years. In this cohort, 45 771 (36.3%) were treated with an IVC filter, whereas 80 259 (63.7%) did not receive a filter. In the Cox model with IVC filter status analyzed as a time-dependent variable to account for immortal time bias, IVC filter placement was associated with a significantly increased hazard ratio of 30-day mortality (1.18; 95% CI, 1.13-1.22; P \u3c .001). When the propensity score was included in the Cox model, IVC filter placement remained associated with an increased hazard ratio of 30-day mortality (1.18; 95% CI, 1.13-1.22; P \u3c .001). Conclusions and Relevance: After adjustment for immortal time bias, IVC filter placement was associated with increased 30-day mortality in patients with VTE and a contraindication to anticoagulation. Randomized clinical trials are needed to determine the efficacy of IVC filter placement in patients with VTE and a contraindication to anticoagulation

Investigation of mixed element hybrid grid-based CFD methods for rotorcraft flow analysis

Accurate first-principles flow prediction is essential to the design and development of rotorcraft, and while current numerical analysis tools can, in theory, model the complete flow field, in practice the accuracy of these tools is limited by various inherent numerical deficiencies. An approach that combines the first-principles physical modeling capability of CFD schemes with the vortex preservation capabilities of Lagrangian vortex methods has been developed recently that controls the numerical diffusion of the rotor wake in a grid-based solver by employing a vorticity-velocity, rather than primitive variable, formulation. Coupling strategies, including variable exchange protocols are evaluated using several unstructured, structured, and Cartesian-grid Reynolds Averaged Navier-Stokes (RANS)/Euler CFD solvers. Results obtained with the hybrid grid-based solvers illustrate the capability of this hybrid method to resolve vortex-dominated flow fields with lower cell counts than pure RANS/Euler methods