Transthoracic Bioimpedance Monitoring Predicts Heart Failure Decompensation and Early Readmission after Heart Failure Hospitalization: Preliminary Data from SENTINEL-HF

Background: Patients, providers, and health systems are focused on reducing readmissions for patients with acute decompensated heart failure (ADHF). Readmission after hospitalization is common and often secondary to HF decompensation, but it remains challenging to identify patients at-risk. Bioimpedance is a validated marker of thoracic fluid accumulation. We examined whether transthoracic bioimpedance, measured using a Fluid Accumulation Vest (FAV), predicted HF decompensation in advance of a clinical event in patients discharged after ADHF. Methods: Participants included 42 patients hospitalized for ADHF. Participants were trained on the use of a FAV-smartphone dyad to obtain and transmit a 5-minute bioimpedance measurement once daily for 45-days after discharge. Readmission and diuretic dosing adjustments were identified using participant report and causes adjudicated using medical records. Receiver operating characteristic (ROC) curves and C-statistics were calculated to describe the characteristics of a bioimpedance based algorithm as a predictor of HF decompensation 3 or 7-days in advance of the clinical event. Results: Participants (mean age 69 ± 12 years, 43% female, 88% white, 11% cognitively impaired, 12% depressed) had a mean ejection fraction of 50 ± 18%. HF-related rehospitalization occurred in 10% (n=4) and 10% (n=4) reported diuretic up-titration during the 45-day follow-up. An algorithm analyzing bioimpedance up to 3 or 7 days prior to an event was related to HF readmission (C statistics for 3 and 7 days = 0.83, 0.94, respectively) and the combined outcome of HF hospitalization or diuretic up-titration (C statistics for 3 and 7 days = 0.76, 0.80, respectively). Conclusions: Early readmission after hospitalization for ADHF was common and predicted up to 7 days in advance by an algorithm analyzing transthoracic bioimpedance. Despite their advanced age and high burden of comorbid diseases, study participants with ADHF were able to make daily bioimpedance measurements using a FAV and transmit them using a smartphone. Transthoracic bioimpedance monitoring may offer possibilities for reducing HF readmissions by enabling identification and treatment of outpatients with early HF decompensation

Computer simulations of hard pear-shaped particles

We report results obtained from Monte Carlo simulations investi- gating mesophase formation in two model systems of hard pear-shaped particles. The first model considered is a hard variant of the trun- cated Stone-Expansion model previously shown to form nematic and smectic mesophases when embedded within a 12-6 Gay-Berne-like po- tential [1]. When stripped of its attractive interactions, however, this system is found to lose its liquid crystalline phases. For particles of length to breadth ratio k = 3, glassy behaviour is seen at high pressures, whereas for k = 5 several bi-layer-like domains are seen, with high intradomain order but little interdomain orientational correlation. For the second model, which uses a parametric shape parameter based on the generalised Gay-Berne formalism, results are presented for particles with elongation k = 3; 4 and 5. Here, the systems with k = 3 and 4 fail to display orientationally ordered phases, but that with k = 5 shows isotropic, nematic and, unusually for a hard-particle model, interdigitated smectic A2 phases.</p

The Pomeron and Gauge/String Duality

The traditional description of high-energy small-angle scattering in QCD has two components -- a soft Pomeron Regge pole for the tensor glueball, and a hard BFKL Pomeron in leading order at weak coupling. On the basis of gauge/string duality, we present a coherent treatment of the Pomeron. In large-N QCD-like theories, we use curved-space string-theory to describe simultaneously both the BFKL regime and the classic Regge regime. The problem reduces to finding the spectrum of a single j-plane Schrodinger operator. For ultraviolet-conformal theories, the spectrum exhibits a set of Regge trajectories at positive t, and a leading j-plane cut for negative t, the cross-over point being model-dependent. For theories with logarithmically-running couplings, one instead finds a discrete spectrum of poles at all t, where the Regge trajectories at positive t continuously become a set of slowly-varying and closely-spaced poles at negative t. Our results agree with expectations for the BFKL Pomeron at negative t, and with the expected glueball spectrum at positive t, but provide a framework in which they are unified. Effects beyond the single Pomeron exchange are briefly discussed.Comment: 68 pages, uses JHEP3.cls, utphys.bst; references added, typos corrected, and clarifying remarks adde

The Basics of Water Waves Theory for Analogue Gravity

This chapter gives an introduction to the connection between the physics of water waves and analogue gravity. Only a basic knowledge of fluid mechanics is assumed as a prerequisite.Comment: 36 pages. Lecture Notes for the IX SIGRAV School on "Analogue Gravity", Como (Italy), May 201

Solar Magnetic Carpet I: Simulation of Synthetic Magnetograms

This paper describes a new 2D model for the photospheric evolution of the magnetic carpet. It is the first in a series of papers working towards constructing a realistic 3D non-potential model for the interaction of small-scale solar magnetic fields. In the model, the basic evolution of the magnetic elements is governed by a supergranular flow profile. In addition, magnetic elements may evolve through the processes of emergence, cancellation, coalescence and fragmentation. Model parameters for the emergence of bipoles are based upon the results of observational studies. Using this model, several simulations are considered, where the range of flux with which bipoles may emerge is varied. In all cases the model quickly reaches a steady state where the rates of emergence and cancellation balance. Analysis of the resulting magnetic field shows that we reproduce observed quantities such as the flux distribution, mean field, cancellation rates, photospheric recycle time and a magnetic network. As expected, the simulation matches observations more closely when a larger, and consequently more realistic, range of emerging flux values is allowed (4e16 - 1e19 Mx). The model best reproduces the current observed properties of the magnetic carpet when we take the minimum absolute flux for emerging bipoles to be 4e16 Mx. In future, this 2D model will be used as an evolving photospheric boundary condition for 3D non-potential modeling.Comment: 33 pages, 16 figures, 5 gif movies included: movies may be viewed at http://www-solar.mcs.st-and.ac.uk/~karen/movies_paper1

Time-variability in the Interstellar Boundary Conditions of the Heliosphere: Effect of the Solar Journey on the Galactic Cosmic Ray Flux at Earth

During the solar journey through galactic space, variations in the physical properties of the surrounding interstellar medium (ISM) modify the heliosphere and modulate the flux of galactic cosmic rays (GCR) at the surface of the Earth, with consequences for the terrestrial record of cosmogenic radionuclides. One phenomenon that needs studying is the effect on cosmogenic isotope production of changing anomalous cosmic ray fluxes at Earth due to variable interstellar ionizations. The possible range of interstellar ram pressures and ionization levels in the low density solar environment generate dramatically different possible heliosphere configurations, with a wide range of particle fluxes of interstellar neutrals, their secondary products, and GCRs arriving at Earth. Simple models of the distribution and densities of ISM in the downwind direction give cloud transition timescales that can be directly compared with cosmogenic radionuclide geologic records. Both the interstellar data and cosmogenic radionuclide data are consistent with cloud transitions during the Holocene, with large and assumption-dependent uncertainties. The geomagnetic timeline derived from cosmic ray fluxes at Earth may require adjustment to account for the disappearance of anomalous cosmic rays when the Sun is immersed in ionized gas.Comment: Submitted to Space Sciences Review

Local covariance estimation using costationarity

In this paper we propose a novel estimator for the time-varying covariance of locally stationary time series. This new approach is based on costationary combinations, that is, time-varying deterministic combinations of locally stationary time series that are second-order stationary. We show with a simulation example that the new estimator has smaller variance than other approaches exclusively based on the evolutionary cross-periodogram, and can therefore be appealing in a large number of applications

Next-to-next-to-leading order prediction for the photon-to-pion transition form factor

We evaluate the next-to-next-to-leading order corrections to the hard-scattering amplitude of the photon-to-pion transition form factor. Our approach is based on the predictive power of the conformal operator product expansion, which is valid for a vanishing $\beta$-function in the so-called conformal scheme. The Wilson--coefficients appearing in the non-forward kinematics are then entirely determined from those of the polarized deep-inelastic scattering known to next-to-next-to-leading accuracy. We propose different schemes to include explicitly also the conformal symmetry breaking term proportional to the $\beta$-function, and discuss numerical predictions calculated in different kinematical regions. It is demonstrated that the photon-to-pion transition form factor can provide a fundamental testing ground for our QCD understanding of exclusive reactions.Comment: 62 pages LaTeX, 2 figures, 9 tables; typos corrected, some references added, to appear in Phys. Rev.

Physics Opportunities with the 12 GeV Upgrade at Jefferson Lab

This white paper summarizes the scientific opportunities for utilization of the upgraded 12 GeV Continuous Electron Beam Accelerator Facility (CEBAF) and associated experimental equipment at Jefferson Lab. It is based on the 52 proposals recommended for approval by the Jefferson Lab Program Advisory Committee.The upgraded facility will enable a new experimental program with substantial discovery potential to address important topics in nuclear, hadronic, and electroweak physics.Comment: 64 page