Preoperative Cognitive Impairment and Postoperative Delirium Predict Decline in Activities of Daily Living after Cardiac Surgery-A Prospective, Observational Cohort Study.

Cardiac surgery and subsequent treatment in the intensive care unit (ICU) has been shown to be associated with functional decline, especially in elderly patients. Due to the different assessment tools and assessment periods, it remains yet unclear what parameters determine unfavorable outcomes. This study sought to identify risk factors during the entire perioperative period and focused on the decline in activity of daily living (ADL) half a year after cardiac surgery. Follow-ups of 125 patients were available. It was found that in the majority of patients (60%), the mean ADL declined by 4.9 points (95% CI, -6.4 to -3.5; p < 0.000). In the "No decline" -group, the ADL rose by 3.3 points (2.0 to 4.6; p < 0.001). A multiple regression analysis revealed that preoperative cognitive impairment (MMSE ≤ 26; Exp(B) 2.862 (95%CI, 1.192-6.872); p = 0.019) and duration of postoperative delirium ≥ 2 days (Exp(B) 3.534 (1.094-11.411); p = 0.035) was independently associated with ADL decline half a year after the operation and ICU. Of note, preoperative ADL per se was neither associated with baseline cognitive function nor a risk factor for functional decline. We conclude that the preoperative assessment of cognitive function, rather than functional assessments, should be part of risk stratification when planning complex cardiosurgical procedures

Evolution of low-mass metal-free stars including effects of diffusion and external pollution

We investigate the evolution of low-mass metal-free Population III stars. Emphasis is laid upon the question of internal and external sources for CNO-elements, which - if present in sufficient amounts in the hydrogen-burning regions - lead to a strong modification of the stars' evolutionary behavior. For the production of carbon due to nuclear processes inside the stars, we use an extended nuclear network, demonstrating that hot pp-chains do not suffice to produce enough carbon or are less effective than the triple3-alpha-process. As an external source of CNO-elements we test the efficiency of pollution by a nearby massive star combined with particle diffusion. For all cases investigated, the additional metals fail to reach nuclear burning regions before deep convection on the Red Giant Branch obliterates the previous evolution. The surface abundance history of the polluted Pop III stars is presented. The possibilities to discriminate between a Pop II and a polluted Pop III field star are also discussed.Comment: Accepted for publication in Ap

The Magnetic Fields of Classical T Tauri Stars

We report new magnetic field measurements for 14 classical T Tauri stars (CTTSs). We combine these data with one previous field determination in order to compare our observed field strengths with the field strengths predicted by magnetospheric accretion models. We use literature data on the stellar mass, radius, rotation period, and disk accretion rate to predict the field strength that should be present on each of our stars according to these magnetospheric accretion models. We show that our measured field values do not correlate with the field strengths predicted by simple magnetospheric accretion theory. We also use our field strength measurements and literature X-ray luminosity data to test a recent relationship expressing X-ray luminosity as a function of surface magnetic flux derived from various solar feature and main sequence star measurements. We find that the T Tauri stars we have observed have weaker than expected X-ray emission by over an order of magnitude on average using this relationship. We suggest the cause for this is actually a result of the very strong fields on these stars which decreases the efficiency with which gas motions in the photosphere can tangle magnetic flux tubes in the corona.Comment: 25 pages, 5 figure

Can a “state of the art” chemistry transport model simulate Amazonian tropospheric chemistry?

We present an evaluation of a nested high-resolution Goddard Earth Observing System (GEOS)-Chem chemistry transport model simulation of tropospheric chemistry over tropical South America. The model has been constrained with two isoprene emission inventories: (1) the canopy-scale Model of Emissions of Gases and Aerosols from Nature (MEGAN) and (2) a leaf-scale algorithm coupled to the Lund-Potsdam-Jena General Ecosystem Simulator (LPJ-GUESS) dynamic vegetation model, and the model has been run using two different chemical mechanisms that contain alternative treatments of isoprene photo-oxidation. Large differences of up to 100 Tg C yr^(−1) exist between the isoprene emissions predicted by each inventory, with MEGAN emissions generally higher. Based on our simulations we estimate that tropical South America (30–85°W, 14°N–25°S) contributes about 15–35% of total global isoprene emissions. We have quantified the model sensitivity to changes in isoprene emissions, chemistry, boundary layer mixing, and soil NO_x emissions using ground-based and airborne observations. We find GEOS-Chem has difficulty reproducing several observed chemical species; typically hydroxyl concentrations are underestimated, whilst mixing ratios of isoprene and its oxidation products are overestimated. The magnitude of model formaldehyde (HCHO) columns are most sensitive to the choice of chemical mechanism and isoprene emission inventory. We find GEOS-Chem exhibits a significant positive bias (10–100%) when compared with HCHO columns from the Scanning Imaging Absorption Spectrometer for Atmospheric Chartography (SCIAMACHY) and Ozone Monitoring Instrument (OMI) for the study year 2006. Simulations that use the more detailed chemical mechanism and/or lowest isoprene emissions provide the best agreement to the satellite data, since they result in lower-HCHO columns

K2-106, a system containing a metal-rich planet and a planet of lower density

Aims: Planets in the mass range from 2 to 15 M? are very diverse. Some of them have low densities, while others are very dense. By measuring the masses and radii, the mean densities, structure, and composition of the planets are constrained. These parameters also give us important information about their formation and evolution, and about possible processes for atmospheric loss. Methods: We determined the masses, radii, and mean densities for the two transiting planets orbiting K2-106

Evolution of Low-Mass Population III Stars

We present the evolutionary models of metal-free stars in the mass range from 0.8 to 1.2 Msun with up-to-date input physics. The evolution is followed to the onset of hydrogen mixing into a convection, driven by the helium flash at red giant or asymptotic giant branch phase. The models of mass M >= 0.9 Msun undergo the central hydrogen flash, triggered by the carbon production due to the 3-alpha reactions. We find that the border of the off-center and central ignition of helium core flash falls between 1.1 and 1.2 Msun; the models of mass M <= 1.1 Msun experience the hydrogen mixing at the tip of red giant branch while the models of M = 1.2 Msun during the helium shell flashes on the asymptotic giant branch. The equation of state for the Coulomb liquid region, where electron conduction and radiation compete, is shown to be important since it affects the thermal state in the helium core and influences the red giant branch evolution. It is also found that the non-resonant term of 3-alpha reactios plays an important role, although it has negligible effect in the evolution of stars of younger populations. We compare our models with the computations by several other sets of authors, to confirm the good agreement except for one study which finds the helium ignition much closer to the center with consequences important for subsequent evolution.Comment: 23 pages, 6 figures, 2 tables, accepted for Ap

Systems biologists seek fuller integration of systems biology approaches in new cancer research programs

Systems biology takes an interdisciplinary approach to the systematic study of complex interactions in biological systems. This approach seeks to decipher the emergent behaviors of complex systems rather than focusing only on their constituent properties. As an increasing number of examples illustrate the value of systems biology approaches to understand the initiation, progression, and treatment of cancer, systems biologists from across Europe and the United States hope for changes in the way their field is currently perceived among cancer researchers. In a recent EU-US workshop, supported by the European Commission, the German Federal Ministry for Education and Research, and the National Cancer Institute of the NIH, the participants discussed the strengths, weaknesses, hurdles, and opportunities in cancer systems biology

Modeling Efforts to Aid in the Prediction of Process Enrichment Levels with the Intent of Identifying Potential Material Diversion

As part of an ongoing effort at Lawrence Livermore National Laboratory (LLNL) to enhance analytical models that simulate enrichment and conversion facilities, efforts are underway to develop routines to estimate the total gamma-ray flux and that of specific lines around process piping containing UF{sub 6}. The intent of the simulation modeling effort is to aid in the identification of possible areas where material diversion could occur, as input to an overall safeguards strategy. The operation of an enrichment facility for the production of low enriched uranium (LEU) presents certain proliferation concerns, including both the possibility of diversion of LEU and the potential for producing material enriched to higher-than-declared, weapons-usable levels. Safeguards applied by the International Atomic Energy Agency (IAEA) are designed to provide assurance against diversion or misuse. Among the measures being considered for use is the measurement of radiation fields at various locations in the cascade hall. Our prior efforts in this area have focused on developing a model to predict neutron fields and how they would change during diversion of misuse. The neutron models indicated that while neutron detection useful in monitoring feed and product containers, it was not useful for monitoring process lines. Our current effort is aimed at developing algorithms that provide estimates of the gamma radiation field outside any process line for the purpose of determining the most effective locations for placing in-plant gamma-monitoring equipment. These algorithms could also be modified to provide both dose and spectral information and, ultimately, detector responses that could be physically measured at various points on the process line. Such information could be used to optimize detector locations in support of real-time on-site monitoring to determine the enrichment levels within a process stream. The results of parametric analyses to establish expected variations for several different process streams and configurations are presented. The benefits and issues associated with both passive and active interrogation measurement techniques are also being explored

MOST discovers a multimode delta Scuti star in a triple system: HD 61199

A field star, HD 61199 (V ~ 8), simultaneously observed with Procyon by the MOST (Microvariability & Oscillations of STars) satellite in continuous runs of 34, 17, and 34 days in 2004, 2005, and 2007, was found to pulsate in 11 frequencies in the delta Scuti range with amplitudes from 1.7 down to 0.09 mmag. The photometry also showed variations with a period of about four days. To investigate the nature of the longer period, 45 days of time-resolved spectroscopy was obtained at the Thueringer Landessternwarte Tautenburg in 2004. The radial velocity measurements indicate that HD 61199 is a triple system. A delta Scuti pulsator with a rich eigenspectrum in a multiple system is promising for asteroseismology. Our objectives were to identify which of the stars in the system is the delta Scuti variable and to obtain the orbital elements of the system and the fundamental parameters of the individual components, which are constrained by the pulsation frequencies of the delta Scuti star. Classical Fourier techniques and least-squares multi-sinusoidal fits were applied to the MOST photometry to identify the pulsation frequencies. The groundbased spectroscopy was analysed with least-squares-deconvolution (LSD) techniques, and the orbital elements derived with the KOREL and ORBITX routines. Asteroseismic models were also generated. The photometric and spectroscopic data are compatible with a triple system consisting of a close binary with an orbital period of 3.57 days and a delta Scuti companion (HD 61199,A) as the most luminous component. The delta Scuti star is a rapid rotator with about vsin i = 130 km/s and an upper mass limit of about 2.1 Msun. For the close binary components, we find they are of nearly equal mass, with lower mass limits of about 0.7 Msun.Comment: 11 pages, 14 figures, accepted by A&

The effects of sprifermin on symptoms and structure in a subgroup at risk of progression in the FORWARD knee osteoarthritis trial

Objective To assess pain outcomes and cartilage thickness change in a subgroup at risk (SAR) of further progression in the FORWARD trial of knee osteoarthritis patients treated with sprifermin. Methods Patients were randomised 1:1:1:1:1 to: sprifermin 100 µg every 6 months (q6mo), 100 µg q12mo, 30 µg q6mo, 30 µg q12mo, or placebo for 18 months. SAR was defined as baseline medial or lateral minimum joint-space width (mJSW) 1.5–3.5 mm and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score 40–90 units. Follow-up to 3 years was included in the analysis. Treatment benefit was explored by repeated measures, linear dose-effect trends by timepoint. Results The SAR comprised 161 (29%) of 549 patients. Mean difference (95% CI) in WOMAC pain at year 3 for sprifermin 100 µg q6mo vs placebo SAR was -8.75 (-22.42, 4.92) for SAR vs 0.97 (-6.22, 8.16) for the intent-to-treat population. SAR placebo patients lost more cartilage over 2 years than the modified ITT (mITT) placebo arm (mean change from baseline, mm [SD]: -0.05 [0.10] vs -0.02 [0.07]). Net total femorotibial joint thickness gain with sprifermin 100 µg q6mo (adjusted mean difference from placebo [95% CI] was similar in the SAR and in the mITT group: 0.06 [0.01, 0.11] vs 0.05 [0.03, 0.07]). Conclusions Selection for low mJSW and moderate-to-high pain at baseline resulted in more rapid disease progression and demonstrated translation of structure modification (with maintained net benefit on total cartilage thickness) into symptomatic benefit. This subgroup may represent a target population for future trials. Clinical trial registration : NCT01919164