Use of a Noninvasive Continuous Monitoring Device in the Management of Atrial Fibrillation: A Pilot Study

Background: Outpatient ambulatory cardiac rhythm monitoring is a routine part of the management of patients with paroxysmal atrial fibrillation (AF). Current systems are limited by patient convenience and practicality. Methods: We compared the Zio® Patch, a single-use, noninvasive waterproof long-term continuous monitoring patch, with a 24-hour Holter monitor in 74 consecutive patients with paroxysmal AF referred for Holter monitoring for detection of arrhythmias. Results: The Zio® Patch was well tolerated, with a mean monitoring period of 10.8 ± 2.8 days (range 4–14 days). Over a 24-hour period, there was excellent agreement between the Zio® Patch and Holter for identifying AF events and estimating AF burden. Although there was no difference in AF burden estimated by the Zio® Patch and the Holter monitor, AF events were identified in 18 additional individuals, and the documented pattern of AF (persistent or paroxysmal) changed in 21 patients after Zio® Patch monitoring. Other clinically relevant cardiac events recorded on the Zio® Patch after the first 24 hours of monitoring, including symptomatic ventricular pauses, prompted referrals for pacemaker placement or changes in medications. As a result of the findings from the Zio® Patch, 28.4% of patients had a change in their clinical management. Conclusions: The Zio® Patch was well tolerated, and allowed significantly longer continuous monitoring than a Holter, resulting in an improvement in clinical accuracy, the detection of potentially malignant arrhythmias, and a meaningful change in clinical management. Further studies are necessary to examine the long-term impact of the use of the Zio® Patch in AF management

The ACS Survey of Galactic Globular Clusters: M54 and Young Populations in the Sagittarius Dwarf Spheroidal Galaxy

We present new Hubble Space Telescope photometry of the massive globular cluster M54 (NGC 6715) and the superposed core of the tidally disrupted Sagittarius (Sgr) dSph galaxy as part of the ACS Survey of Galactic Globular Clusters. Our deep (F606W~26.5), high-precision photometry yields an unprecedentedly detailed color-magnitude diagram showing the extended blue horizontal branch and multiple main sequences of the M54+Sgr system. The distance and reddening to M54 are revised usingboth isochrone and main-sequence fitting to (m-M)_0=17.27 and E(B-V)=0.15. Preliminary assessment finds the M54+Sgr field to be dominated by the old metal-poor populations of Sgr and the globular cluster. Multiple turnoffs indicate the presence of at least two intermediate-aged star formation epochs with 4 and 6 Gyr ages and [Fe/H]=-0.4 to -0.6. We also clearly show, for the first time, a prominent, 2.3 Gyr old Sgr population of near-solar abundance. A trace population of even younger (0.1-0.8 Gyr old), more metal-rich ([Fe/H]\sim0.6) stars is also indicated. The Sgr age-metallicity relation is consistent with a closed-box model and multiple (4-5) star formation bursts over the entire life of the satellite, including the time since Sgr began disrupting.Comment: Accepted to ApJ Letter; 11 pages, 2 figures; figure 1 uploaded as jpg; paper in ApJ format with full-resolution figures available at: http://www.astro.ufl.edu/~ata/public_hstgc/paperIV/paperIV.p

The ACS Survey Of Galactic Globular Clusters. VI. NGC 6366: A Heavily Stripped Galactic Globular Cluster

We have used observations obtained as part of the Hubble Space Telescope/ACS Survey of Galactic globular clusters (GCs) to construct a color-magnitude diagram for the bulge cluster, NGC 6366. The luminosity function derived from those data extends to M(F606W) similar to 9, or masses of similar to 0.3 M(circle dot). Unlike most GCs, the mass function peaks near the main-sequence turnoff with significantly fewer low-mass stars even after correction for completeness and mass segregation. Using a multimass King model, we extrapolate the global cluster behavior and find the global mass function to be poorly matched by a power law, with a particular deficit of stars with masses between 0.5 and 0.7 M(circle dot). We briefly discuss this interesting anomaly within the context of tidal stripping.NASA GO-10775, 5-26555Space Telescope Science InstituteInstituto de Astrofisica de Canarias P3-94Ministry of Education and Science of the Kingdom of Spain AYA-2008-67913Astronom

The Stride program: Feasibility and pre-to-post program change of an exercise service for university students experiencing mental distress

Rates of mental illness are disproportionately high for young adult and higher education (e.g., university student) populations. As such, universities and tertiary institutions often devote significant efforts to services and programs that support and treat mental illness and/or mental distress. However, within that portfolio of treatment approaches, structured exercise has been relatively underutilised and greater research attention is needed to develop this evidence base. The Stride program is a structured 12-week exercise service for students experiencing mental distress. We aimed to explore the feasibility of the program and assess pre- and post-program change, through assessments of student health, lifestyle, and wellbeing outcomes. Drawing from feasibility and effectiveness-implementation hybrid design literatures, we conducted a non-randomised feasibility trial of the Stride program. Participants were recruited from the Stride program (N = 114, Mage = 24.21 years). Feasibility results indicated the program was perceived as acceptable and that participants reported positive perceptions of program components, personnel, and sessions. Participants’ pre-to-post program change in depressive symptomatology, physical activity levels, mental health-related quality of life, and various behavioural outcomes were found to be desirable. Our results provide support for the feasibility of the Stride program, and more broadly for the delivery and potential effectiveness of structured exercise programs to support university students experiencing mental distress

The ACS Survey of Galactic Globular Clusters. II. Stellar Evolution Tracks, Isochrones, Luminosity Functions, and Synthetic Horizontal-Branch Models

The ACS Survey of Galactic Globular Clusters, an HST Treasury Project, will deliver high quality, homogeneous photometry of 65 globular clusters. This paper introduces a new collection of stellar evolution tracks and isochrones suitable for analyzing the ACS Survey data. Stellar evolution models were computed at [Fe/H]= -2.5, -2.0, -1.5, -1.0, -0.5, and 0; [alpha/Fe]= -0.2, 0, 0.2, 0.4, 0.6, and 0.8; and three initial He abundances for masses from 0.1 to 1.8 Msun and ages from 2 to 15 Gyr. Each isochrone spans a wide range in luminosity from Mv~14 up to the tip of the red giant branch. These are complemented by a set of He-burning tracks that extend from the zero age horizontal branch to the onset of thermal pulsations on the asymptotic giant branch. In addition, a set of computer programs are provided that make it possible to interpolate the isochrones in [Fe/H], generate luminosity functions from the isochrones, and create synthetic horizontal branch models. The tracks and isochrones have been converted to the observational plane with two different color-Teff transformations, one synthetic and one semi-empirical, in ground-based B, V, and I, and F606W and F814W for both ACS-WFC and WFPC2 systems. All models and programs presented in this paper are available from http://stellar.dartmouth.edu/~models/Comment: 46 pages, 12 figures, AJ in press; figures 11 and 12 are reduced in siz

Phylotastic! Making Tree-of-Life Knowledge Accessible, Reusable and Convenient

Scientists rarely reuse expert knowledge of phylogeny, in spite of years of effort to assemble a great "Tree of Life" (ToL). A notable exception involves the use of Phylomatic, which provides tools to generate custom phylogenies from a large, pre-computed, expert phylogeny of plant taxa. This suggests great potential for a more generalized system that, starting with a query consisting of a list of any known species, would rectify non-standard names, identify expert phylogenies containing the implicated taxa, prune away unneeded parts, and supply branch lengths and annotations, resulting in a custom phylogeny suited to the user's needs. Such a system could become a sustainable community resource if implemented as a distributed system of loosely coupled parts that interact through clearly defined interfaces. Results: With the aim of building such a "phylotastic" system, the NESCent Hackathons, Interoperability, Phylogenies (HIP) working group recruited 2 dozen scientist-programmers to a weeklong programming hackathon in June 2012. During the hackathon (and a three-month follow-up period), 5 teams produced designs, implementations, documentation, presentations, and tests including: (1) a generalized scheme for integrating components; (2) proof-of-concept pruners and controllers; (3) a meta-API for taxonomic name resolution services; (4) a system for storing, finding, and retrieving phylogenies using semantic web technologies for data exchange, storage, and querying; (5) an innovative new service, DateLife.org, which synthesizes pre-computed, time-calibrated phylogenies to assign ages to nodes; and (6) demonstration projects. These outcomes are accessible via a public code repository (GitHub.com), a website (www.phylotastic.org), and a server image. Conclusions: Approximately 9 person-months of effort (centered on a software development hackathon) resulted in the design and implementation of proof-of-concept software for 4 core phylotastic components, 3 controllers, and 3 end-user demonstration tools. While these products have substantial limitations, they suggest considerable potential for a distributed system that makes phylogenetic knowledge readily accessible in computable form. Widespread use of phylotastic systems will create an electronic marketplace for sharing phylogenetic knowledge that will spur innovation in other areas of the ToL enterprise, such as annotation of sources and methods and third-party methods of quality assessment.NESCent (the National Evolutionary Synthesis Center)NSF EF-0905606iPlant Collaborative (NSF) DBI-0735191Biodiversity Synthesis Center (BioSync) of the Encyclopedia of LifeComputer Science

The ACS Survey of Galactic Globular Clusters. IX. Horizontal Branch Morphology and the Second Parameter Phenomenon

The horizontal branch (HB) morphology of globular clusters (GCs) is most strongly influenced by metallicity. The second parameter phenomenon acknowledges that metallicity alone is not enough to describe the HB morphology of all GCs. In particular, the outer Galactic halo contains GCs with redder HBs at a given metallicity than are found inside the Solar circle. Thus, at least a second parameter is required to characterize HB morphology. Here we analyze the median color difference between the HB and the red giant branch (RGB), d(V-I), measured from HST ACS photometry of 60 GCs within ~20 kpc of the Galactic Center. Analysis of this homogeneous data set reveals that, after the influence of metallicity has been removed, the correlation between d(V-I) and age is stronger than that of any other parameter considered. Expanding the sample to include HST photometry of the 6 most distant Galactic GCs lends additional support to the correlation between d(V-I) and age. This result is robust with respect to the adopted metallicity scale and the method of age determination, but must bear the caveat that high quality, detailed abundance information is not available for a significant fraction of the sample. When a subset of GCs with similar metallicities and ages are considered, a correlation between d(V-I) and central luminosity density is exposed. With respect to the existence of GCs with anomalously red HBs at a given metallicity, we conclude that age is the second parameter and central density is most likely the third. Important problems related to HB morphology in GCs, notably multi-modal distributions and faint blue tails, remain to be explained. (Abridged)Comment: Accepted for publication in ApJ; 49 pages, 19 figure

The ACS Survey of Galactic Globular Clusters. I. Overview and Clusters without PreviousHubble Space Telescope Photometry

We present the first results of a large Advanced Camera for Surveys (ACS) survey of Galactic globular clusters. This Hubble Space Telescope (HST) Treasury project is designed to obtain photometry with S/N (signal-to-noise ratio) 10 for main-sequence stars with masses 0.2 M⊙ in a sample of globulars using the ACS Wide Field Channel. Here we focus on clusters without previous HST imaging data. These include NGC 5466, NGC 6779, NGC 5053, NGC 6144, Palomar 2, E3, Lyngå 7, Palomar 1, and NGC 6366. Our color-magnitude diagrams (CMDs) extend reliably from the horizontal branch to as much as 7 mag fainter than the main-sequence turnoff and represent the deepest CMDs published to date for these clusters. Using fiducial sequences for three standard clusters (M92, NGC 6752, and 47 Tuc) with well-known metallicities and distances, we perform main-sequence fitting on the target clusters in order to obtain estimates of their distances and reddenings. These comparisons, along with fitting the cluster main sequences to theoretical isochrones, yield ages for the target clusters. We find that the majority of the clusters have ages that are consistent with the standard clusters at their metallicities. The exceptions are E3, which appears ~2 Gyr younger than 47 Tuc, and Pal 1, which could be as much as 8 Gyr younger than 47 Tuc

The ACS Survey of Galactic Globular Clusters XI: The Three-Dimensional Orientation of the Sagittarius Dwarf Spheroidal Galaxy and its Globular Clusters

We use observations from the ACS study of Galactic globular clusters to investigate the spatial distribution of the inner regions of the disrupting Sagittarius dwarf spheroidal galaxy (Sgr). We combine previously published analyses of four Sgr member clusters located near or in the Sgr core (M54, Arp 2, Terzan 7 and Terzan 8) with a new analysis of diffuse Sgr material identified in the background of five low-latitude Galactic bulge clusters (NGC 6624, 6637, 6652, 6681 and 6809) observed as part of the ACS survey. By comparing the bulge cluster CMDs to our previous analysis of the M54/Sgr core, we estimate distances to these background features. The combined data from four Sgr member clusters and five Sgr background features provides nine independent measures of the Sgr distance and, as a group, provide uniformly measured and calibrated probes of different parts of the inner regions of Sgr spanning twenty degrees over the face of the disrupting dwarf. This allows us, for the first time, to constrain the three dimensional orientation of Sgr's disrupting core and globular cluster system and compare that orientation to the predictions of an N-body model of tidal disruption. The density and distance of Sgr debris is consistent with models that favor a relatively high Sgr core mass and a slightly greater distance (28-30 kpc, with a mean of 29.4 kpc). Our analysis also suggests that M54 is in the foreground of Sgr by ~2 kpc, projected on the center of the Sgr dSph. While this would imply a remarkable alignment of the cluster and the Sgr nucleus along the line of sight, we can not identify any systematic effect in our analysis that would falsely create the measured 2 kpc separation. Finally, we find that the cluster Terzan 7 has the most discrepant distance (25 kpc) among the four Sgr core clusters, which may suggest a different dynamical history than the other Sgr core clusters.Comment: 41 pages, 16 figures, accepted to Ap