Growing Ohio's Green Energy Economy

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Shear velocity model for the Kyrgyz Tien Shan from joint inversion of receiver function and surface wave data

The Tien Shan is the largest active intracontinental orogenic belt on Earth. To better understand the processes causing mountains to form at great distances from a plate boundary, we analyse passive source seismic data collected on 40 broad band stations of the MANAS project (2005-2007) and 12 stations of the permanent KRNET seismic network to determine variations in crustal thickness and shear wavespeed across the range. We jointly invert P- and S-wave receiver functions with surface wave observations from both earthquakes and ambient noise to reduce the ambiguity inherent in the images obtained from the techniques applied individually. Inclusion of ambient noise data improves constraints on the upper crust by allowing dispersion measurements to be made at shorter periods. Joint inversion can also reduce the ambiguity in interpretation by revealing the extent to which various features in the receiver functions are amplified or eliminated by interference from multiples. The resulting wavespeed model shows a variation in crustal thickness across the range. We find that crustal velocities extend to ∼ 75 km beneath the Kokshaal Range, which we attribute to underthrusting of the Tarim Basin beneath the southern Tien Shan. This result supports the plate model of intracontinental convergence. Crustal thickness elsewhere beneath the range is about 50 km, including beneath the Naryn Valley in the central Tien Shan where previous studies reported a shallow Moho. This difference apparently is the result of wavespeed variations in the upper crust that were not previously taken into account. Finally, a high velocity lid appears in the upper mantle of the Central and Northern part of the Tien Shan, which we interpret as a remnant of material that may have delaminated elsewhere under the range.km, including beneath the Naryn Valley in the central Tien Shan where previous studies reported a shallow Moho. This difference apparently is the result of wavespeed variations in the upper crust that were not previously taken into account. Finally, a high velocity lid appears in the upper mantle of the Central and Northern part of the Tien Shan, which we interpret as a remnant of material that may have delaminated elsewhere under the range.This is the final published version. It's also available from Oxford Journals at http://gji.oxfordjournals.org/content/199/1/480.full

Long-term results of the DelIVery for Pulmonary Arterial Hypertension trial

Background: The DelIVery for Pulmonary Arterial Hypertension clinical trial was a multi-center, prospective, single arm, Investigational Device Exemption study utilizing a fully implantable, programmable intravascular delivery system consisting of a pump and a catheter for intravenous treprostinil. The study met its primary endpoint and demonstrated that the intravascular delivery system significantly reduced catheter related complications at 22,000 subject-days of follow-up compared with a predefined objective performance criterion. Here we summarize the results obtained during a 6.4-year follow-up period. Methods: Throughout study follow-up, participants had clinic visits and medication refills at least every 12 weeks (dependent on the subjects\u27 dose). All adverse events and intravascular delivery system complications were evaluated and recorded. Results: Sixty pulmonary arterial hypertension subjects were followed post device implantation for approximately 282 patient-years (range 87 days to 6.4 years). Of the 60 subjects, 14 died (1 related to intravascular delivery system pump failure), 2 withdrew after lung transplants, and 2 withdrew due to pump pocket infection. No catheter-related bloodstream infections, catheter thrombosis or occlusions, or catheter kinks occurred through 282 patient-years. Two participants had adverse events of abdominal pain, rash, due to subcutaneous treprostinil leaks after one catheter puncture and one catheter laceration during pump refill and replacement, respectively. Eight pump failure events occurred: seven pump motor stalls and one early replacement (faulty battery). Conclusion: Delivery of treprostinil with an intravascular delivery system is a safe alternative to an external delivery system, while providing enhanced life experiences. To preserve the risk-benefit ratio, treatment at specialized pulmonary arterial hypertension centers is recommended until training is disseminated at other sites

Long-term results of the DelIVery for Pulmonary Arterial Hypertension trial.

Background: The DelIVery for Pulmonary Arterial Hypertension clinical trial was a multi-center, prospective, single arm, Investigational Device Exemption study utilizing a fully implantable, programmable intravascular delivery system consisting of a pump and a catheter for intravenous treprostinil. The study met its primary endpoint and demonstrated that the intravascular delivery system significantly reduced catheter related complications at 22,000 subject-days of follow-up compared with a predefined objective performance criterion. Here we summarize the results obtained during a 6.4-year follow-up period. Methods: Throughout study follow-up, participants had clinic visits and medication refills at least every 12 weeks (dependent on the subjects\u27 dose). All adverse events and intravascular delivery system complications were evaluated and recorded. Results: Sixty pulmonary arterial hypertension subjects were followed post device implantation for approximately 282 patient-years (range 87 days to 6.4 years). Of the 60 subjects, 14 died (1 related to intravascular delivery system pump failure), 2 withdrew after lung transplants, and 2 withdrew due to pump pocket infection. No catheter-related bloodstream infections, catheter thrombosis or occlusions, or catheter kinks occurred through 282 patient-years. Two participants had adverse events of abdominal pain, rash, due to subcutaneous treprostinil leaks after one catheter puncture and one catheter laceration during pump refill and replacement, respectively. Eight pump failure events occurred: seven pump motor stalls and one early replacement (faulty battery). Conclusion: Delivery of treprostinil with an intravascular delivery system is a safe alternative to an external delivery system, while providing enhanced life experiences. To preserve the risk-benefit ratio, treatment at specialized pulmonary arterial hypertension centers is recommended until training is disseminated at other sites

Effects of sotatercept on haemodynamics and right heart function : analysis of the STELLAR trial

BACKGROUND: In the phase 3 STELLAR trial, sotatercept, an investigational first-in-class activin signalling inhibitor, demonstrated beneficial effects on 6-min walk distance and additional efficacy endpoints in pre-treated participants with pulmonary arterial hypertension (PAH). METHODS: This analysis evaluated data from right heart catheterisation (RHC) and echocardiography (ECHO) obtained from the STELLAR trial. Changes from baseline in RHC and ECHO parameters were assessed at 24 weeks. An analysis of covariance (ANCOVA) model was used to estimate differences in least squares means with treatment and randomisation stratification (mono/double triple therapy; World Health Organization functional class II III) as fixed factors, and baseline value as covariate. RESULTS: Relative to placebo, treatment with sotatercept led to significant (all p\u3c0.0001 except where noted) improvements from baseline in mean pulmonary artery (PA) pressure (-13.9 mmHg), pulmonary vascular resistance (-254.8 dyn·s·cm), mean right atrial pressure (-2.7 mmHg), mixed venous oxygen saturation (3.84%), PA elastance (-0.42 mmHg·mL·beat), PA compliance (0.58 mL·mmHg), cardiac efficiency (0.48 mL·beat·mmHg), right ventricular (RV) work (-0.85 g·m) and RV power (-32.70 mmHg·L·min). ECHO showed improvements in tricuspid annular plane systolic excursion (TAPSE) to systolic pulmonary artery pressure ratio (0.12 mm·mmHg), end-systolic and end-diastolic RV areas (-4.39 cm and -5.31 cm, respectively), tricuspid regurgitation and RV fractional area change (2.04% p\u3c0.050). No significant between-group changes from baseline were seen for TAPSE, heart rate, cardiac output, stroke volume or their indices. CONCLUSION: In pre-treated patients with PAH, sotatercept demonstrated substantial improvements in PA pressures, PA compliance, PA-RV coupling and right heart function