Exercise-induced hypoxemia in heart transplant recipient

AbstractObjectives. The purpose of this study was to determine whether heart transplantation has an adverse effect on pulmonary diffusion and to investigate the potentially deleterious effects of impaired pulmonary diffusion on arterial blood gas dynamics during exercise in heart transplant reciplents.Background. Abnormal pulmonary diffusing capacity is reported in patients after orthotopic heart transplantation. Abnormal diffusion may be caused by cyclosporlne or by the persistence of preexisting conditions known to adversely affect diffusion, such as congestive heart failure and chronic obstructive pulmonary disease.Methods. Eleven patients (mean age 50 ± 14 years) performed pulmonary function tests 3 ± 1 months before and 18 ± 12 (mean ± SD) months after heart transplantation. Transplant patients were assigned to groups with diffusion > 70% (n = 5) or diffusion < 70% of predicted values (n = 5). The control group and both subsets of patients performed 10 min of cycle exercise at 40% and 70% of peak power output. Arterial blood gases were drawn every 30 s during the 1st 5 min and at 6, 8 and 10 min.Results. Significant improvements in forced vital capacity (17,4%), forced expiratory volume in 1 s (11.7%) and diffusion capacity (6.6%) occurred in the patients; however, posttransplantation vital capacity, forced expiratory volume and diffusion were lower (p ≤ 0.05) compared with values in 11 control subjects. Changes in blood gases were similar among groups at 40% of peak power output. At 76% of peak power output, arterial blood gases and pH were significantly (p ≤ 0.05) lower in transplant patients with low diffusion (arterial oxygen pressure 15 to 38 mm Hg below baseline) than in patients with normal diffusion and control subjects. Cardiac index did not differ (p ≥0.05) between transplant patients with noramal and low diffusion at rest or during exercise. Posttransplantation mean pulmonary artery pressure was significantly related to exercise-induced hypoxemia (r = 0.71; p = 0.03).Conclusions. Abnormal pulmonary diffusion observed in patients before heart transplantation persists after transplantation with or without restrictive or obstructive ventilatory defects. Heart transplant recipients exprience exercise-induced hypoxemia when diffusion at rest is < 70% of predicted. Our data also suggest that abnormal pulmonary gas exchange possibly contributes to diminished peak oxygen consumption in some heart transplant recipients; however, direct testing of this hypothesis was beyond the scope of the present study. This possibility needs to be investigated further

Ultracool Field Brown Dwarf Candidates Selected at 4.5 microns

We have identified a sample of cool field brown dwarf candidates using IRAC data from the Spitzer Deep, Wide-Field Survey (SDWFS). The candidates were selected from 400,000 SDWFS sources with [4.5] <= 18.5 mag and required to have [3.6]-[4.5] >= 1.5 and [4.5] - [8.0] <= 2.0 on the Vega system. The first color requirement selects objects redder than all but a handful of presently known brown dwarfs with spectral classes later than T7, while the second eliminates 14 probable reddened AGN. Optical detection of 4 of the remaining 18 sources implies they are likely also AGN, leaving 14 brown dwarf candidates. For two of the brightest candidates (SDWFS J143524.44+335334.6 and SDWFS J143222.82+323746.5), the spectral energy distributions including near-infrared detections suggest a spectral class of ~ T8. The proper motion is < 0.25 "/yr, consistent with expectations for a luminosity inferred distance of >70 pc. The reddest brown dwarf candidate (SDWFS J143356.62+351849.2) has [3.6] - [4.5]=2.24 and H - [4.5] > 5.7, redder than any published brown dwarf in these colors, and may be the first example of the elusive Y-dwarf spectral class. Models from Burrows et al. (2003) predict larger numbers of cool brown dwarfs should be found for a Chabrier (2003) mass function. Suppressing the model [4.5] flux by a factor of two, as indicated by previous work, brings the Burrows models and observations into reasonable agreement. The recently launched Wide-field Infrared Survey Explorer (WISE) will probe a volume ~40x larger and should find hundreds of brown dwarfs cooler than T7.Comment: 13 pages, 6 figures, accepted for publication in the June 2010 issue of The Astronomical Journa

Scaling Ecosystem Services to Reef Development : Effects of oyster density on nitrogen removal and reef community structure

Eighteen native oyster experimental reefs (16-m2 each) were restored using six oyster densities (0, 10, 25, 50, 100 and 250 adult oysters m-2) with three replicates of each density at each of two sites: one subtidal site in Onancock Creek, Virginia and one intertidal site in Hillcrest Oyster Sanctuary within The Nature Conservancy’s Virginia Coast Reserve. A science-based monitoring program explored quantitative relationships between structural and functional characteristics of these restored reefs. Structural parameters examined included oyster abundance, oyster size/biomass, surface shell volume, reef topographic complexity and sediment characteristics. Functional parameters included denitrification rates and macrofaunal abundance and biomass. Data were collected from the intertidal site during six sampling periods between April 2012 and July 2013 and from the subtidal site in April and June 2012. Relationships between reef structural parameters and functional parameters were complex and variable. As of July 2014, the intertidal reefs continue to serve as a platform for continued studies of the relationships between reef structural and functional characteristics

Absolute properties of the low-mass eclipsing binary CM Draconis

Spectroscopic and eclipsing binary systems offer the best means for determining accurate physical properties of stars, including their masses and radii. The data available for low-mass stars have yielded firm evidence that stellar structure models predict smaller radii and higher effective temperatures than observed, but the number of systems with detailed analyses is still small. In this paper we present a complete reanalysis of one of such eclipsing systems, CM Dra, composed of two dM4.5 stars. New and existing light curves as well as a radial velocity curve are modeled to measure the physical properties of both components. The masses and radii determined for the components of CM Dra are M1=0.2310+/-0.0009 Msun, M2=0.2141+/-0.0010 Msun, R1=0.2534+/-0.0019 Rsun, and R2=0.2396+/-0.0015 Rsun. With relative uncertainties well below the 1% level, these values constitute the most accurate properties to date for fully convective stars. This makes CM Dra a valuable benchmark for testing theoretical models. In comparing our measurements with theory, we confirm the discrepancies reported previously for other low-mass eclipsing binaries. These discrepancies seem likely to be due to the effects of magnetic activity. We find that the orbit of this system is slightly eccentric, and we have made use of eclipse timings spanning three decades to infer the apsidal motion and other related properties.Comment: 19 pages, 9 figures. Accepted for publication in Ap

The Josephson relation for the superfluid density in the BCS-BEC crossover

The Josephson relation for the superfluid density is derived for a Fermi superfluid in the BCS-BEC crossover. This identity extends the original Josephson relation for Bose superfluids. It gives a simple exact relation between the superfluid density $\rho_s$ and the broken-symmetry Cooper pair order parameter $\Delta_0$ in terms of the infrared limit of the pair fluctuation propagator. The same expression holds through the entire BCS-BEC crossover, describing the superfluid density of a weak-coupling BCS superfluid as well as the superfluid density of a Bose condensate of dimer molecules.Comment: Published versio

Is type II diabetes mellitus (NIDDM) a surgical disease?

Since February 1, 1980, 515 morbidly obese patients have undergone the Greenville gastric bypass (GGB) operation. Of these, 212 (41.2%) were euglycemic, 288 (55.9%) were either diabetic or had glucose intolerance, and 15 (2.9%) were unable to complete the evaluation. After the operation, only 30 (5.8%) patients remained diabetic (and 20 of these improved), 457 (88.7%) became and have remained euglycemic, and inadequate data prevented classification of the other 28 (5.4%). The patients who failed to return to normal glucose values were older and their diabetes was of longer duration than those who did. The effect of the GGB was not only limited to the correction of abnormal glucose levels. The GGB also corrected the abnormal levels of fasting insulin and glycosylated hemoglobin in a cohort of 52 consecutive severely obese patients with non-insulin-dependent diabetes. The GGB effectively controls weight. If morbid obesity is defined as 100 pounds over ideal body weight, 89% of the patients are no longer "morbidly" obese within 2 years. In most patients, the control of the weight has been well maintained during the 11 years of follow-up; most of the upward creep in weight of 20.8% between 24 and 132 months was from the 49 (9.5%) patients who had staple line breakdowns between the large and small gastric pouches. Non-insulin-dependent diabetes, previously considered a chronic unrelenting disease, can be controlled in the severely obese by the gastric bypass. Whether the correction of glucose metabolism affects the complications of diabetes is unknown. Whether the gastric bypass should be considered for patients with advanced non-insulin-dependent diabetes but who are not severely obese deserves consideration. The GGB has an unacceptably high rate of staple line failure. Accordingly, the authors have recently changed their procedure to one that divides the stomach rather than partitions it with staples. Originally published Annals of Surgery, Vol. 215, No. 6, June 199

Parental effects on early life history traits of haddock Melanogrammus aeglefinus

Gametes from five male and three female haddock ( Melanogrammus aeglefinus ) were crossed to produce 15 half-sibling families that were used to evaluate potential parental contributions to early life history variability. Larval morphology at 0 and 5 days post-hatch (dph) and time to starvation in the absence of food were examined. Maternal influences on larval standard length and yolk area were significant at 0 and 5 dph. Paternal effects on larval standard length were significant at 0 and 5 dph, whereas paternal effects on yolk area were only significant at 5 dph. Larval eye diameter was influenced by maternity at day 0 post-hatch and by both maternity and paternity at 5 dph. Myotome height of larvae was subject to maternal and paternal influences at 0 and 5 dph. Growth rate was significantly influenced by both paternity and maternity. Yolk utilization efficiency was significantly influenced by parental interaction, while the time taken for larvae to die in the absence of food was affected only by maternity. Results of this study not only confirm the importance of female contributions to larval development but also indicate a paternal influence on the development and the early life history success of marine fish

Kepler-21b: A 1.6REarth Planet Transiting the Bright Oscillating F Subgiant Star HD 179070

We present Kepler observations of the bright (V=8.3), oscillating star HD 179070. The observations show transit-like events which reveal that the star is orbited every 2.8 days by a small, 1.6 R_Earth object. Seismic studies of HD 179070 using short cadence Kepler observations show that HD 179070 has a frequencypower spectrum consistent with solar-like oscillations that are acoustic p-modes. Asteroseismic analysis provides robust values for the mass and radius of HD 179070, 1.34{\pm}0.06 M{\circ} and 1.86{\pm}0.04 R{\circ} respectively, as well as yielding an age of 2.84{\pm}0.34 Gyr for this F5 subgiant. Together with ground-based follow-up observations, analysis of the Kepler light curves and image data, and blend scenario models, we conservatively show at the >99.7% confidence level (3{\sigma}) that the transit event is caused by a 1.64{\pm}0.04 R_Earth exoplanet in a 2.785755{\pm}0.000032 day orbit. The exoplanet is only 0.04 AU away from the star and our spectroscopic observations provide an upper limit to its mass of ~10 M_Earth (2-{\sigma}). HD 179070 is the brightest exoplanet host star yet discovered by Kepler.Comment: Accepted to Ap

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Further Defining Spectral Type "Y" and Exploring the Low-mass End of the Field Brown Dwarf Mass Function

We present the discovery of another seven Y dwarfs from the Wide-field Infrared Survey Explorer (WISE). Using these objects, as well as the first six WISE Y dwarf discoveries from Cushing et al., we further explore the transition between spectral types T and Y. We find that the T/Y boundary roughly coincides with the spot where the J-H colors of brown dwarfs, as predicted by models, turn back to the red. Moreover, we use preliminary trigonometric parallax measurements to show that the T/Y boundary may also correspond to the point at which the absolute H (1.6 um) and W2 (4.6 um) magnitudes plummet. We use these discoveries and their preliminary distances to place them in the larger context of the Solar Neighborhood. We present a table that updates the entire stellar and substellar constituency within 8 parsecs of the Sun, and we show that the current census has hydrogen-burning stars outnumbering brown dwarfs by roughly a factor of six. This factor will decrease with time as more brown dwarfs are identified within this volume, but unless there is a vast reservoir of cold brown dwarfs invisible to WISE, the final space density of brown dwarfs is still expected to fall well below that of stars. We also use these new Y dwarf discoveries, along with newly discovered T dwarfs from WISE, to investigate the field substellar mass function. We find that the overall space density of late-T and early-Y dwarfs matches that from simulations describing the mass function as a power law with slope -0.5 < alpha < 0.0; however, a power-law may provide a poor fit to the observed object counts as a function of spectral type because there are tantalizing hints that the number of brown dwarfs continues to rise from late-T to early-Y. More detailed monitoring and characterization of these Y dwarfs, along with dedicated searches aimed at identifying more examples, are certainly required.Comment: 91 pages, 15 figures, accepted for publication in The Astrophysical Journa