Background Few data are available regarding the long-term mortality rate for patients receiving nocturnal home hemodialysis. Study Design Posttrial observational study. Setting & Participants ...Frequent Hemodialysis Network (FHN) Nocturnal Trial participants who consented to extended follow-up. Intervention The FHN Nocturnal Trial randomly assigned 87 individuals to 6-times-weekly home nocturnal hemodialysis or 3-times-weekly hemodialysis for 1 year. Patients were enrolled starting in March 2006 and follow-up was completed by May 2010. After the 1-year trial concluded, FHN Nocturnal participants were free to modify their hemodialysis prescription. Outcomes & Measurements We obtained dates of death and kidney transplantation through July 2011 using linkage to the US Renal Data System and queries of study centers. We used log-rank tests and Cox regression to relate mortality to the initial randomization assignment. Results Median follow-up for the trial and posttrial observational period was 3.7 years. In the nocturnal arm, there were 2 deaths during the 12-month trial period and an additional 12 deaths during the extended follow-up. In the conventional arm, the numbers of deaths were 1 and 4, respectively. In the nocturnal dialysis group, the overall mortality HR was 3.88 (95% CI, 1.27-11.79; P = 0.01). Using as-treated analysis with a 12-month running treatment average, the HR for mortality was 3.06 (95% CI, 1.11-8.43; P = 0.03). Six-month running treatment data analysis showed an HR of 1.12 (95% CI, 0.44-3.22; P = 0.7). Limitations These results should be interpreted cautiously due to a surprisingly low (0.03 deaths/patient-year) mortality rate for individuals randomly assigned to conventional home hemodialysis, low statistical power for the mortality comparison due to the small sample size, and the high rate of hemodialysis prescription changes. Conclusions Patients randomly assigned to nocturnal hemodialysis had a higher mortality rate than those randomly assigned to conventional dialysis. The implications of this result require further investigation.
Abstract
We examine the production of energetic neutral atoms (ENAs) in solar flares and coronal mass ejection (CME)-driven shocks and their subsequent propagation to 1 au. Time profiles and fluence ...spectra of solar ENAs at 1 au are computed for two scenarios: (1) ENAs are produced downstream at CME-driven shocks, and (2) ENAs are produced at large-scale post-flare loops in solar flares. Both the time profiles and fluence spectra for these two scenarios are vastly different. Our calculations indicate that we can use solar ENAs as a new probe to examine the underlying acceleration process of solar energetic particles (SEPs) and to differentiate the two acceleration sites: large loops in solar flares and downstream of CME-driven shocks, in large SEP events.
To determine the baseline predictors of visual acuity (VA) outcomes 1 year after treatment with ranibizumab or bevacizumab for neovascular age-related macular degeneration (AMD).
Cohort study within ...the Comparison of Age-related Macular Degeneration Treatments Trials (CATT).
A total of 1105 participants with neovascular AMD, baseline VA 20/25 to 20/320, and VA measured at 1 year.
Participants were randomly assigned to ranibizumab or bevacizumab on a monthly or as-needed schedule. Masked readers evaluated fundus morphology and features on optical coherence tomography (OCT). Visual acuity was measured using electronic VA testing. Independent predictors were identified using regression techniques.
The VA score, VA score change from baseline, and ≥3-line gain at 1 year.
At 1 year, the mean VA score was 68 letters, mean improvement from baseline was 7 letters, and 28% of participants gained ≥3 lines. Older age, larger area of choroidal neovascularization (CNV), and elevation of retinal pigment epithelium (RPE) were associated with worse VA (all P<0.005), less gain in VA (all P<0.02), and a lower proportion gaining ≥3 lines (all P<0.04). Better baseline VA was associated with better VA at 1 year, less gain in VA, and a lower proportion gaining ≥3 lines (all P<0.0001). Predominantly or minimally classic lesions were associated with worse VA than occult lesions (66 vs. 69 letters; P=0.0003). Retinal angiomatous proliferans (RAP) lesions were associated with more gain in VA (10 vs. 7 letters; P=0.03) and a higher proportion gaining ≥3 lines (odds ratio, 1.9; 95% confidence interval, 1.2-3.1). Geographic atrophy (GA) was associated with worse VA (64 vs. 68 letters; P=0.02). Eyes with total foveal thickness in the second quartile (325-425 μm) had the best VA (P=0.01) and were most likely to gain ≥3 lines (P=0.004). Predictors did not vary by treatment group.
For all treatment groups, older age, better baseline VA, larger CNV area, predominantly or minimally classic lesion, absence of RAP lesion, presence of GA, greater total fovea thickness, and RPE elevation on optical coherence tomography were independently associated with less improvement in VA at 1 year.
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Using observations from the FourStar Galaxy Evolution Survey (ZFOURGE), we obtain the deepest measurements to date of the galaxy stellar mass function (SMF) at 0.2 < z < 3. We combine this with ...Hubble Space Telescope imaging from the Cosmic Assembly Near-IR Deep Extragalactic Legacy Survey, allowing for the efficient selection of both blue and red galaxies down to stellar masses of ~10 super(9.5) M sub(middot in circle) at z ~ 2.5. The total surveyed area is 316 arcmin super(2) distributed over three independent fields. We supplement these data with the wider and shallower NEWFIRM Medium-Band Survey to provide stronger constraints at high masses. Our data allow us, for the first time, to observe a rapid buildup at the low-mass end of the quiescent SMF. Since z = 2.5, the total stellar mass density of quiescent galaxies (down to 10 super(9) M sub(middot in circle)) has increased by a factor of ~12, whereas the mass density of star-forming galaxies only increases by a factor of ~2.2.
For the first time, we present the size evolution of a mass-complete (log(M*/M ) > 10) sample of star-forming galaxies over redshifts z = 1-7, selected from the FourStar Galaxy Evolution Survey. ...Observed H-band sizes are measured from the Cosmic Assembly Near-infrared Deep Extragalactic Legacy Survey (CANDELS) Hubble Space Telescope (HST)/F160W imaging. Distributions of individual galaxy masses and sizes illustrate that a clear mass−size relation exists up to z ∼ 7. At z ∼ 7, we find that the average galaxy size from the mass−size relation is more compact at a fixed mass of log(M*/M ) = 10.1, with kpc, than at lower redshifts. This is consistent with our results from stacking the same CANDELS HST/F160W imaging, when we correct for galaxy position angle alignment. We find that the size evolution of star-forming galaxies is well fit by a power law of the form kpc, which is consistent with previous works for normal star-formers at 1 < z < 4. In order to compare our slope with those derived Lyman break galaxy studies, we correct for different IMFs and methodology and find a slope of −0.97 0.02, which is shallower than that reported for the evolution of Lyman break galaxies (LBGs) at z > 4 ( ). Therefore, we conclude the LBGs likely represent a subset of highly star-forming galaxies that exhibit rapid size growth at z > 4.
ABSTRACT
The
FourStar
galaxy evolution survey (ZFOURGE) is a 45 night legacy program with the
FourStar
near-infrared camera on Magellan and one of the most sensitive surveys to date. ZFOURGE covers a ...total of 400 arcmin
2
in cosmic fields CDFS, COSMOS and UDS, overlapping CANDELS. We present photometric catalogs comprising >70,000 galaxies, selected from ultradeep
K
s
-band detection images (25.5–26.5 AB mag, 5
σ
, total), and >80% complete to
K
s
< 25.3–25.9 AB. We use 5 near-IR medium-bandwidth filters (
J
1
,
J
2
,
J
3
,
H
s
,
H
l
) as well as broad-band
K
s
at 1.05–2.16
μ
m to 25–26 AB at a seeing of ∼0.″5. Each field has ancillary imaging in 26–40 filters at 0.3–8
μ
m. We derive photometric redshifts and stellar population properties. Comparing with spectroscopic redshifts indicates a photometric redshift uncertainty
σ
z
= 0.010, 0.009, and 0.011 in CDFS, COSMOS, and UDS. As spectroscopic samples are often biased toward bright and blue sources, we also inspect the photometric redshift differences between close pairs of galaxies, finding
σ
z
,pairs
= 0.01–0.02 at 1 <
z
< 2.5. We quantify how
σ
z
,pairs
depends on redshift, magnitude, spectral energy distribution type, and the inclusion of
FourStar
medium bands.
σ
z
,pairs
is smallest for bright, blue star-forming samples, while red star-forming galaxies have the worst
σ
z
,pairs
. Including
FourStar
medium bands reduces
σ
z
,pairs
by 50% at 1.5 <
z
< 2.5. We calculate star formation rates (SFRs) based on ultraviolet and ultradeep far-IR
Spitzer
/MIPS and
Herschel
/PACS data. We derive rest-frame
U
−
V
and
V
−
J
colors, and illustrate how these correlate with specific SFR and dust emission to
z
= 3.5. We confirm the existence of quiescent galaxies at
z
∼ 3, demonstrating their SFRs are suppressed by > ×15.
About 60% of patients with type 2 diabetes achieve remission after Roux-en-Y gastric bypass (RYGB) surgery. No accurate method is available to preoperatively predict the probability of remission. Our ...goal was to develop a way to predict probability of diabetes remission after RYGB surgery on the basis of preoperative clinical criteria.
In a retrospective cohort study, we identified individuals with type 2 diabetes for whom electronic medical records were available from a primary cohort of 2300 patients who underwent RYGB surgery at the Geisinger Health System (Danville, PA, USA) between Jan 1, 2004, and Feb 15, 2011. Partial and complete remission were defined according to the American Diabetes Association criteria. We examined 259 clinical variables for our algorithm and used multiple logistic regression models to identify independent predictors of early remission (beginning within first 2 months after surgery and lasting at least 12 months) or late remission (beginning more than 2 months after surgery and lasting at least 12 months). We assessed a final Cox regression model with a consistent subset of variables that predicted remission, and used the resulting hazard ratios (HRs) to guide creation of a weighting system to produce a score (DiaRem) to predict probability of diabetes remission within 5 years. We assessed the validity of the DiaRem score with data from two additional cohorts.
Electronic medical records were available for 690 patients in the primary cohort, of whom 463 (63%) had achieved partial or complete remission. Four preoperative clinical variables were included in the final Cox regression model: insulin use, age, HbA1c concentration, and type of antidiabetic drugs. We developed a DiaRem score that ranges from 0 to 22, with the greatest weight given to insulin use before surgery (adding ten to the score; HR 5·90, 95% CI 4·41–7·90; p<0·0001). Kaplan-Meier analysis showed that 88% (95% CI 83–92%) of patients who scored 0–2, 64% (58–71%) of those who scored 3–7, 23% (13–33%) of those who scored 8–12, 11% (6–16%) of those who scored 13–17, and 2% (0–5%) of those who scored 18–22 achieved early remission (partial or complete). As in the primary cohort, the proportion of patients achieving remission in the replication cohorts was highest for the lowest scores, and lowest for the highest scores.
The DiaRem score is a novel preoperative method to predict the probability of remission of type 2 diabetes after RYGB surgery.
Geisinger Health System and the US National Institutes of Health.
Background Preterm delivery remains the leading cause of perinatal mortality. Risk factors and biomarkers have traditionally failed to identify the majority of preterm deliveries. Objective To ...develop and validate a mass spectrometry–based serum test to predict spontaneous preterm delivery in asymptomatic pregnant women. Study Design A total of 5501 pregnant women were enrolled between 170/7 and 286/7 weeks gestational age in the prospective Proteomic Assessment of Preterm Risk study at 11 sites in the United States between 2011 and 2013. Maternal blood was collected at enrollment and outcomes collected following delivery. Maternal serum was processed by a proteomic workflow, and proteins were quantified by multiple reaction monitoring mass spectrometry. The discovery and verification process identified 2 serum proteins, insulin-like growth factor–binding protein 4 (IBP4) and sex hormone–binding globulin (SHBG), as predictors of spontaneous preterm delivery. We evaluated a predictor using the log ratio of the measures of IBP4 and SHBG (IBP4/SHBG) in a clinical validation study to classify spontaneous preterm delivery cases (<370/7 weeks gestational age) in a nested case-control cohort different from subjects used in discovery and verification. Strict blinding and independent statistical analyses were employed. Results The predictor had an area under the receiver operating characteristic curve value of 0.75 and sensitivity and specificity of 0.75 and 0.74, respectively. The IBP4/SHBG predictor at this sensitivity and specificity had an odds ratio of 5.04 for spontaneous preterm delivery. Accuracy of the IBP4/SHBG predictor increased using earlier case-vs-control gestational age cutoffs (eg, <350/7 vs ≥350/7 weeks gestational age). Importantly, higher-risk subjects defined by the IBP4/SHBG predictor score generally gave birth earlier than lower-risk subjects. Conclusion A serum-based molecular predictor identifies asymptomatic pregnant women at risk of spontaneous preterm delivery, which may provide utility in identifying women at risk at an early stage of pregnancy to allow for clinical intervention. This early detection would guide enhanced levels of care and accelerate development of clinical strategies to prevent preterm delivery.
Abstract
We investigate the properties of galaxies as they shut off star formation over the 4 billion years surrounding peak cosmic star formation. To do this, we categorize ∼7000 galaxies from 1 <
...z
< 4 into 90 groups based on the shape of their spectral energy distributions (SEDs) and build composite SEDs with
R
∼ 50 resolution. These composite SEDs show a variety of spectral shapes and also show trends in parameters such as color, mass, star formation rate, and emission-line equivalent width. Using emission-line equivalent widths and strength of the 4000 Å break,
, we categorize the composite SEDs into five classes: extreme emission line, star-forming, transitioning, post-starburst, and quiescent galaxies. The transitioning population of galaxies shows modest H
α
emission (EW
REST
∼ 40 Å) compared to more typical star-forming composite SEDs at log
10
(
M
/
M
⊙
) ∼ 10.5 (EW
REST
∼ 80 Å). Together with their smaller sizes (3 kpc vs. 4 kpc) and higher Sérsic indices (2.7 vs. 1.5), this indicates that morphological changes initiate before the cessation of star formation. The transitional group shows a strong increase of over 1 dex in number density from
z
∼ 3 to
z
∼ 1, similar to the growth in the quiescent population, while post-starburst galaxies become rarer at
z
≲ 1.5. We calculate average quenching timescales of 1.6 Gyr at
z
∼ 1.5 and 0.9 Gyr at
z
∼ 2.5 and conclude that a fast-quenching mechanism producing post-starbursts dominated the quenching of galaxies at early times, while a slower process has become more common since
z
∼ 2.
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