PEXO : a global modeling framework for nanosecond timing, microsecond astrometry, and μm/s radial velocities

54 pages, 2 tables, 19 figures, accepted for publication in ApJS, PEXO is available at https://github.com/phillippro/pexoThe ability to make independent detections of the signatures of exoplanets with complementary telescopes and instruments brings a new potential for robust identification of exoplanets and precision characterization. We introduce PEXO, a package for Precise EXOplanetology to facilitate the efficient modeling of timing, astrometry, and radial velocity data, which will benefit not only exoplanet science but also various astrophysical studies in general. PEXO is general enough to account for binary motion and stellar reflex motions induced by planetary companions and is precise enough to treat various relativistic effects both in the solar system and in the target system. We also model the post-Newtonian barycentric motion for future tests of general relativity in extrasolar systems. We benchmark PEXO with the pulsar timing package TEMPO2 and find that PEXO produces numerically similar results with timing precision of about 1 ns, space-based astrometry to a precision of 1{\mu}as, and radial velocity of 1 {\mu}m/s and improves on TEMPO2 for decade-long timing data of nearby targets, due to its consideration of third-order terms of Roemer delay. PEXO is able to avoid the bias introduced by decoupling the target system and the solar system and to account for the atmospheric effects which set a practical limit for ground-based radial velocities close to 1 cm/s. Considering the various caveats in barycentric correction and ancillary data required to realize cm/s modeling, we recommend the preservation of original observational data. The PEXO modeling package is available at GitHub (https://github.com/phillippro/pexo).Peer reviewe

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline