Total Pancreatectomy with Islet Autologous Transplantation: The Cure for Chronic Pancreatitis?

Chronic pancreatitis (CP) is a debilitating disease that leads to varying degrees of pancreatic endocrine and exocrine dysfunction. One of the most difficult symptoms of CP is severe abdominal pain, which is often challenging to control with available analgesics and therapies. In the last decade, total pancreatectomy with autologous islet cell transplantation has emerged as a promising treatment for the refractory pain of CP and is currently performed at approximately a dozen centers in the United States. While total pancreatectomy is not a new procedure, the endocrine function-preserving autologous islet cell isolation and re-implantation have made the prospect of total pancreatectomy more acceptable to patients and clinicians. This review will focus on the current status of total pancreatectomy with autologous islet cell transplant including patient selection, technical considerations, and outcomes. As the procedure is performed at an increasing number of centers, this review will highlight opportunities for quality improvement and outcome optimization

Harmonic Analysis of Boolean Networks: Determinative Power and Perturbations

Consider a large Boolean network with a feed forward structure. Given a probability distribution on the inputs, can one find, possibly small, collections of input nodes that determine the states of most other nodes in the network? To answer this question, a notion that quantifies the determinative power of an input over the states of the nodes in the network is needed. We argue that the mutual information (MI) between a given subset of the inputs X = {X_1, ..., X_n} of some node i and its associated function f_i(X) quantifies the determinative power of this set of inputs over node i. We compare the determinative power of a set of inputs to the sensitivity to perturbations to these inputs, and find that, maybe surprisingly, an input that has large sensitivity to perturbations does not necessarily have large determinative power. However, for unate functions, which play an important role in genetic regulatory networks, we find a direct relation between MI and sensitivity to perturbations. As an application of our results, we analyze the large-scale regulatory network of Escherichia coli. We identify the most determinative nodes and show that a small subset of those reduces the overall uncertainty of the network state significantly. Furthermore, the network is found to be tolerant to perturbations of its inputs

A Search for FeH in Hot-Jupiter Atmospheres with High-Dispersion Spectroscopy

Most of the molecules detected thus far in exoplanet atmospheres, such as water and CO, are present for a large range of pressures and temperatures. In contrast, metal hydrides exist in much more specific regimes of parameter space, and so can be used as probes of atmospheric conditions. Iron hydride (FeH) is a dominant source of opacity in low-mass stars and brown dwarfs, and evidence for its existence in exoplanets has recently been observed at low resolution. We performed a systematic search of archival CARMENES near-infrared data for signatures of FeH during transits of 12 exoplanets. These planets span a large range of equilibrium temperatures (600 $\lesssim T_{eq} \lesssim$ 4000K) and surface gravities (2.5 $\lesssim \mathrm{log} g \lesssim$ 3.5). We did not find a statistically significant FeH signal in any of the atmospheres, but obtained potential low-confidence signals (SNR$\sim$3) in two planets, WASP-33b and MASCARA-2b. Previous modeling of exoplanet atmospheres indicate that the highest volume mixing ratios (VMRs) of 10$^{-7}$ to 10$^{-9}$ are expected for temperatures between 1800 and 3000K and log $g \gtrsim3$. The two planets for which we find low-confidence signals are in the regime where strong FeH absorption is expected. We performed injection and recovery tests for each planet and determined that FeH would be detected in every planet for VMRs $\geq 10^{-6}$, and could be detected in some planets for VMRs as low as 10$^{-9.5}$. Additional observations are necessary to conclusively detect FeH and assess its role in the temperature structures of hot Jupiter atmospheres.Comment: Accepted to AAS journal

Radii of 88 M subdwarfs and updated radius relations for low-metallicity M-dwarf stars

M subdwarfs are low-metallicity M dwarfs that typically inhabit the halo population of the Galaxy. Metallicity controls the opacity of stellar atmospheres; in metal-poor stars, hydrostatic equilibrium is reached at a smaller radius, leading to smaller radii for a given effective temperature. We compile a sample of 88 stars that span spectral classes K7 to M6 and include stars with metallicity classes from solar-metallicity dwarf stars to the lowest metallicity ultra subdwarfs to test how metallicity changes the stellar radius. We fit models to Palomar Double Spectrograph (DBSP) optical spectra to derive effective temperatures (T_ eff) and we measure bolometric luminosities (L_ bol) by combining broad wavelength-coverage photometry with Gaia parallaxes. Radii are then computed by combining the T_ eff and L_ bol using the Stefan–Boltzman law. We find that for a given temperature, ultra subdwarfs can be as much as five times smaller than their solar-metallicity counterparts. We present color-radius and color-surface brightness relations that extend down to [Fe/H] of −2.0 dex, in order to aid the radius determination of M subdwarfs, which will be especially important for the WFIRST exoplanetary microlensing survey.Published versio

Spatially-resolved high-resolution retrievals of Ultra-hot Jupiters

Stars and planetary system

Magnetic inflation and Stellar Mass. II. On the radii of wingle, rapidly rotating, fully convective M-dwarf stars

Main-sequence, fully convective M dwarfs in eclipsing binaries are observed to be larger than stellar evolutionary models predict by as much as 10%–15%. A proposed explanation for this discrepancy involves effects from strong magnetic fields, induced by rapid rotation via the dynamo process. Although, a handful of single, slowly rotating M dwarfs with radius measurements from interferometry also appear to be larger than models predict, suggesting that rotation or binarity specifically may not be the sole cause of the discrepancy. We test whether single, rapidly rotating, fully convective stars are also larger than expected by measuring their $R\sin i$ distribution. We combine photometric rotation periods from the literature with rotational broadening ($v\sin i$) measurements reported in this work for a sample of 88 rapidly rotating M dwarf stars. Using a Bayesian framework, we find that stellar evolutionary models underestimate the radii by 10 \% \mbox{--}15{ \% }_{-2.5}^{+3}, but that at higher masses (0.18 < M < 0.4 M Sun), the discrepancy is only about 6% and comparable to results from interferometry and eclipsing binaries. At the lowest masses (0.08 < M < 0.18 M Sun), we find that the discrepancy between observations and theory is 13%–18%, and we argue that the discrepancy is unlikely to be due to effects from age. Furthermore, we find no statistically significant radius discrepancy between our sample and the handful of M dwarfs with interferometric radii. We conclude that neither rotation nor binarity are responsible for the inflated radii of fully convective M dwarfs, and that all fully convective M dwarfs are larger than models predict.The authors would like to thank the referee for the thoughtful report, which greatly improved the manuscript. The authors would also like to thank Lisa Prato and Larissa Nofi for IGRINS training, and Heidi Larson, Jason Sanborn, and Andrew Hayslip for operating the DCT during our observations. We would also like to thank Jen Winters, Jonathan Irwin, Paul Dalba, Mark Veyette, Eunkyu Han, and Andrew Vanderburg for useful discussions and helpful comments on this work. Some of this work was supported by the NASA Exoplanet Research Program (XRP) under grant No. NNX15AG08G issued through the Science Mission Directorate.These results made use of the Lowell Observatory's Discovery Channel Telescope, supported by Discovery Communications, Inc., Boston University, the University of Maryland, the University of Toledo and Northern Arizona University; the Immersion Grating Infrared Spectrograph (IGRINS) that was developed under a collaboration between the University of Texas at Austin and the Korea Astronomy and Space Science Institute (KASI) with the financial support of the US National Science Foundation under grant AST-1229522, of the University of Texas at Austin, and of the Korean GMT Project of KASI; data taken at The McDonald Observatory of The University of Texas at Austin; and data products from the Two Micron All Sky Survey, which is a joint project of the University of Massachusetts and the Infrared Processing and Analysis Center/California Institute of Technology, funded by NASA and the NSF. (NNX15AG08G - NASA Exoplanet Research Program (XRP); Discovery Communications, Inc.; Boston University; University of Maryland; University of Toledo; Northern Arizona University; AST-1229522 - US National Science Foundation; University of Texas at Austin; Korean GMT Project of KASI; NASA; NSF

Titanium cold-trapping, near-solar abundance ratios for tens of species, and the first unambiguous detection of VO revealed on the ultra-hot Jupiter WASP-76b using MAROON-X

Stars and planetary system

iPTF Archival Search for Fast Optical Transients

There has been speculation about a class of relativistic explosions with an initial Lorentz factor Γ_init smaller than that of classical gamma-ray bursts (GRBs). These “dirty fireballs” would lack prompt GRB emission but could be pursued via their optical afterglow, appearing as transients that fade overnight. Here we report a search for such transients (that fade by 5-σ in magnitude overnight) in four years of archival photometric data from the intermediate Palomar Transient Factory (iPTF). Our search criteria yielded 50 candidates. Of these, two were afterglows to GRBs that had been found in dedicated follow-up observations to triggers from the Fermi GRB Monitor. Another (iPTF14yb) was a GRB afterglow discovered serendipitously. Eight were spurious artifacts of reference image subtraction, and one was an asteroid. The remaining 38 candidates have red stellar counterparts in external catalogs. The photometric and spectroscopic properties of the counterparts identify these transients as strong flares from M dwarfs of spectral type M3–M7 at distances of d ≈ 0.15–2.1 kpc; three counterparts were already spectroscopically classified as late-type M stars. With iPTF14yb as the only confirmed relativistic outflow discovered independently of a high-energy trigger, we constrain the all-sky rate of transients that peak at m = 18 and fade by Δm = 2 mag in Δt = 3 hr to be 680 yr-1, with a 68% confidence interval of 119-2236 {{yr}}-1. This implies that the rate of visible dirty fireballs is at most comparable to that of the known population of long-duration GRBs

Inequalities in health and health service utilisation among reproductive age women in St. Petersburg, Russia: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Russian society has faced dramatic changes in terms of social stratification since the collapse of the Soviet Union. During this time, extensive reforms have taken place in the organisation of health services, including the development of the private sector. Previous studies in Russia have shown a wide gap in mortality between socioeconomic groups. There are just a few studies on health service utilisation in post-Soviet Russia and data on inequality of health service use are limited. The aim of the present study was to analyse health (self-rated health and self-reported chronic diseases) and health care utilisation patterns by socioeconomic status (SES) among reproductive age women in St. Petersburg.</p> <p>Methods</p> <p>The questionnaire survey was conducted in 2004 (n = 1147), with a response rate of 67%. Education and income were used as dimensions of SES. The association between SES and health and use of health services was assessed by logistic regression, adjusting for age.</p> <p>Results</p> <p>As expected low SES was associated with poor self-rated health (education: OR = 1.48; personal income: OR = 1.42: family income: OR = 2.31). University education was associated with use of a wider range of outpatient medical services and increased use of the following examinations: Pap smear (age-adjusted OR = 2.06), gynaecological examinations (age-adjusted OR = 1.62) and mammography among older (more than 40 years) women (age-adjusted OR = 1.98). Personal income had similar correlations, but family income was related only to the use of mammography among older women.</p> <p>Conclusions</p> <p>Our study suggests a considerable inequality in health and utilisation of preventive health service among reproductive age women. Therefore, further studies are needed to identify barriers to health promotion resources.</p