The wonderful complexity of the Mira AB system

We have mapped the CO(3-2) line emission around the Mira AB system at 0.5 resolution using the Atacama Large Millimeter/submillimeter Array (ALMA). The CO map shows amazing complexity. The circumstellar gas has been shaped by different dynamical actors during the evolution of the system and several morphological components can be identified. The companion is marginally resolved in continuum emission and is currently at 0.487$\pm$0.006 separation. In the main line component, centered on the stellar velocity, spiral arcs around Mira A are found. The spiral appears to be relatively flat and oriented in the orbital plane. An accretion wake behind the companion is clearly visible and the projected arc separation is of order 5''. In the blue wing of the line emission, offset from the main line, several large ($\sim$5-10''), opposing arcs are found. We tentatively suggest that this structure is created by the wind of Mira B blowing a bubble in the expanding envelope of Mira A.Comment: Letter accepted in A&

Impact of diagnosis of diabetes on health-related quality of life among high risk individuals: the Diabetes Prevention Program outcomes study

Purpose The purpose of this study is to assess if diagnosis of type 2 diabetes affected health-related quality of life (HRQoL) among participants in the Diabetes Prevention Program/Diabetes Prevention Program Outcome Study and changes with treatment or diabetes duration. Methods 3,210 participants with pre-diabetes were randomized to metformin (MET), intensive lifestyle intervention (ILS), or placebo (PLB). HRQoL was assessed using the SF-36 including: (1) 8 SF-36 subscales; (2) the physical component (PCS) and mental component summary (MCS) scores; and (3) the SF-6D. The sample was categorized by diabetes free versus diagnosed. For diagnosed subgroup, mean scores in the diabetes-free period, at 6 months, 2, 4 and 6 years post-diagnosis, were compared. Results PCS and SF-6D scores declined in all participants in all treatment arms (P <.001). MCS scores did not change significantly in any treatment arm regardless of diagnosis. ILS participants reported a greater decrease in PCS scores at 6 months post-diagnosis (P <.001) and a more rapid decline immediately post-diagnosis in SF-6D scores (P = .003) than the MET or PLB arms. ILS participants reported a significant decrease in the social functioning subscale at 6 months (P <.001) and two years (P <.001) post-diagnosis. Conclusions Participants reported a decline in measures of overall health state (SF-6D) and overall physical HRQoL, whether or not they were diagnosed with diabetes during the study. There was no change in overall mental HRQoL. Participants in the ILS arm with diabetes reported a more significant decline in some HRQoL measures than those in the MET and PLB arms that developed diabetes

Powered bone marrow biopsy procedures produce larger core specimens, with less pain, in less time than with standard manual devices

Bone marrow sampling remains essential in the evaluation of hematopoietic and many non-hematopoietic disorders. One common limitation to these procedures is the discomfort experienced by patients. To address whether a Powered biopsy system could reduce discomfort while providing equivalent or better results, we performed a randomized trial in adult volunteers. Twenty-six subjects underwent bilateral biopsies with each device. Core samples were obtained in 66.7% of Manual insertions; 100% of Powered insertions (P=0.002). Initial mean biopsy core lengths were 11.1±4.5 mm for the Manual device; 17.0±6.8 mm for the Powered device (P<0.005). Pathology assessment for the Manual device showed a mean length of 6.1±5.6 mm, width of 1.0±0.7 mm, and volume of 11.0±10.8 mm3. Powered device measurements were mean length of 15.3±6.1 mm, width of 2.0±0.3 mm, and volume of 49.1±21.5 mm3 (P<0.001). The mean time to core ejection was 86 seconds for Manual device; 47 seconds for the Powered device (P<0.001). The mean second look overall pain score was 33.3 for the Manual device; 20.9 for the Powered (P=0.039). We conclude that the Powered biopsy device produces superior sized specimens, with less overall pain, in less time

The Chandra X-ray Survey of Planetary Nebulae (ChanPlaNS): Probing Binarity, Magnetic Fields, and Wind Collisions

We present an overview of the initial results from the Chandra Planetary Nebula Survey (ChanPlaNS), the first systematic (volume-limited) Chandra X-ray Observatory survey of planetary nebulae (PNe) in the solar neighborhood. The first phase of ChanPlaNS targeted 21 mostly high-excitation PNe within ~1.5 kpc of Earth, yielding 4 detections of diffuse X-ray emission and 9 detections of X-ray-luminous point sources at the central stars (CSPNe) of these objects. Combining these results with those obtained from Chandra archival data for all (14) other PNe within ~1.5 kpc that have been observed to date, we find an overall X-ray detection rate of ~70%. Roughly 50% of the PNe observed by Chandra harbor X-ray-luminous CSPNe, while soft, diffuse X-ray emission tracing shocks formed by energetic wind collisions is detected in ~30%; five objects display both diffuse and point-like emission components. The presence of X-ray sources appears correlated with PN density structure, in that molecule-poor, elliptical nebulae are more likely to display X-ray emission (either point-like or diffuse) than molecule-rich, bipolar or Ring-like nebulae. All but one of the X-ray point sources detected at CSPNe display X-ray spectra that are harder than expected from hot (~100 kK) central star photospheres, possibly indicating a high frequency of binary companions to CSPNe. Other potential explanations include self-shocking winds or PN mass fallback. Most PNe detected as diffuse X-ray sources are elliptical nebulae that display a nested shell/halo structure and bright ansae; the diffuse X-ray emission regions are confined within inner, sharp-rimmed shells. All sample PNe that display diffuse X-ray emission have inner shell dynamical ages <~5x10^3 yr, placing firm constraints on the timescale for strong shocks due to wind interactions in PNe.Comment: 41 pages, 6 figures; submitted to the Astronomical Journa

Sleep disordered breathing and cardiovascular risk in older patients initiating dialysis in the United States: a retrospective observational study using medicare data

Background: Sleep disordered breathing (SDB) such as sleep apnea is associated with cardiovascular disease in the general population. However, little is known about the cardiovascular risks of SDB in patients with end-stage renal disease (ESRD). Methods: We identified Medicare fee-for-service beneficiaries aged ≥67 years initiating dialysis between 2004 and 2009. Outcomes of interest included all-cause mortality, incident myocardial infarction, ischemic stroke, and atrial fibrillation. We compared patients with and without diagnosed SDB using Cox proportional hazards regression. Results: Between 2004 and 2009, 184,217 older patients developed ESRD, of whom 15,121 (8.2 %) were previously diagnosed with SDB. Patients diagnosed with SDB were younger, more likely to be male and Caucasian, less Medicaid eligible, had more non-Nephrology clinic visits, higher body mass index, and more comorbidity. In analyses adjusting for demographics and BMI, diagnosed SDB was associated with higher risk of death and atrial fibrillation, but not associated with myocardial infarction or ischemic stroke risk. After further adjustment for all baseline characteristics, diagnosed SDB was associated with slightly lower risks of death (hazard ratio [HR]: 0.93, 95 % confidence interval [CI]: 0.91–0.96), myocardial infarction (HR: 0.92, CI: 0.87–0.98), and ischemic stroke (HR: 0.90, 95 % CI: 0.82–0.98), and not associated with atrial fibrillation (HR: 1.02, CI: 0.98–1.07). Conclusions: In older patients initiating dialysis in the U.S., diagnosed SDB was weakly associated with lower risks of death and important cardiovascular outcomes, thus adding to the list of established risk factors that are paradoxically associated with cardiovascular outcomes in the ESRD population

The Herschel Planetary Nebula Survey (HerPlaNS) I. Data Overview and Analysis Demonstration with NGC 6781

This is the first of a series of investigations into far-IR characteristics of 11 planetary nebulae (PNs) under the Herschel Space Observatory Open Time 1 program, Herschel Planetary Nebula Survey (HerPlaNS). Using the HerPlaNS data set, we look into the PN energetics and variations of the physical conditions within the target nebulae. In the present work, we provide an overview of the survey, data acquisition and processing, and resulting data products. We perform (1) PACS/SPIRE broadband imaging to determine the spatial distribution of the cold dust component in the target PNs and (2) PACS/SPIRE spectral-energy-distribution (SED) and line spectroscopy to determine the spatial distribution of the gas component in the target PNs. For the case of NGC 6781, the broadband maps confirm the nearly pole-on barrel structure of the amorphous carbon-richdust shell and the surrounding halo having temperatures of 26-40 K. The PACS/SPIRE multi-position spectra show spatial variations of far-IR lines that reflect the physical stratification of the nebula. We demonstrate that spatially-resolved far-IR line diagnostics yield the (T_e, n_e) profiles, from which distributions of ionized, atomic, and molecular gases can be determined. Direct comparison of the dust and gas column mass maps constrained by the HerPlaNS data allows to construct an empirical gas-to-dust mass ratio map, which shows a range of ratios with the median of 195+-110. The present analysis yields estimates of the total mass of the shell to be 0.86 M_sun, consisting of 0.54 M_sun of ionized gas, 0.12 M_sun of atomic gas, 0.2 M_sun of molecular gas, and 4 x 10^-3 M_sun of dust grains. These estimates also suggest that the central star of about 1.5 M_sun initial mass is terminating its PN evolution onto the white dwarf cooling track.Comment: 27 pages, 16 figures, accepted for publication in A&

X-ray Imaging of Planetary Nebulae with Wolf-Rayet-type Central Stars: Detection of the Hot Bubble in NGC 40

We present the results of Chandra X-ray Observatory (CXO) observations of the planetary nebulae (PNs) NGC 40 and Hen 2-99. Both PNs feature late-type Wolf-Rayet central stars that are presently driving fast ~1000 km/s, massive winds into denser, slow-moving (~10 km/s) material ejected during recently terminated asymptotic giant branch (AGB) evolutionary phases. Hence, these observations provide key tests of models of wind-wind interactions in PNs. In NGC 40, we detect faint, diffuse X-ray emission distributed within a partial annulus that lies nested within a ~40'' diameter ring of nebulosity observed in optical and near-infrared images. Hen 2-99 is undetected. The inferred X-ray temperature (T_X ~10^6 K) and luminosity (L_X ~ 2 X 10^30 ergs/s) of NGC 40 are the lowest measured thus far for any PN displaying diffuse X-ray emission. These results, combined with the ring-like morphology of the X-ray emission from NGC 40, suggest that its X-ray emission arises from a ``hot bubble'' that is highly evolved and is generated by a shocked, quasi-spherical fast wind from the central star, as opposed to AGB or post-AGB jet activity. In constrast, the lack of detectable X-ray emission from Hen 2-99 suggests that this PN has yet to enter a phase of strong wind-wind shocks.Comment: 15 pages, 5 figures to appear in The Astrophysical Journa

Early results from ChanPLaNS: mystery of hard X-ray emitting CSPNe

We are presently using the Chandra X-ray Observatory to conduct the first systematic X-ray survey of planetary nebulae (PNe) in the solar neighborhood. The Chandra Planetary Nebula Survey (ChanPlaNS) is a 570 ks Chandra Cycle 12 Large Program targeting 21 high-excitation PNe within ∼1.5 kpc of Earth. When complete, this survey will provide a suite of new X-ray diagnostics that will inform the study of late stellar evolution, binary star astrophysics, and wind interactions. Among the early results of ChanPlaNS (when combined with archival Chandra data) is a surprisingly high detection rate of relatively hard X-ray emission from CSPNe. Specifically, X-ray point sources are clearly detected in roughly half of the ∼30 high-excitation PNe observed thus far by Chandra, and all but one of these X-ray-emitting CSPNe display evidence for a hard (few MK) component in their Chandra spectra. Only the central star of the Dumbbell appears to display 'pure' hot blackbody emission from a ∼200 kK hot white dwarf photosphere in the X-ray band. Potential explanations for the'excess' hard X-ray emission detected from the other CSPNe include late-type companions (heretofore undetected, in most cases) whose coronae have been rejuvenated by recent interactions with the mass-losing WD progenitor, non-LTE effects in hot white dwarf photospheres, self-shocking variable winds from the central star, and slow (re-)accretion of previously ejected red giant envelope mass. © 2012 International Astronomical Union.published_or_final_versio

MEG resting state functional connectivity in Parkinson's disease related dementia

Parkinson's disease (PD) related dementia (PDD) develops in up to 60% of patients, but the pathophysiology is far from being elucidated. Abnormalities of resting state functional connectivity have been reported in Alzheimer's disease (AD). The present study was performed to determine whether PDD is likewise characterized by changes in resting state functional connectivity. MEG recordings were obtained in 13 demented and 13 non-demented PD patients. The synchronization likelihood (SL) was calculated within and between cortical areas in six frequency bands. Compared to non-demented PD, PDD was characterized by lower fronto-temporal SL in the alpha range, lower intertemporal SL in delta, theta and alpha1 bands as well as decreased centro-parietal gamma band synchronization. In addition, higher parieto-occipital synchronization in the alpha2 and beta bands was found in PDD. The observed changes in functional connectivity are reminiscent of changes in AD, and may reflect reduced cholinergic activity and/or loss of cortico-cortical anatomical connections in PDD. © 2008 The Author(s)