ABSTRACT New insights on stellar evolution and stellar interior physics are being made possible by asteroseismology. Throughout the course of the Kepler mission, asteroseismology has also played an ...important role in the characterization of exoplanet-host stars and their planetary systems. The upcoming NASA Transiting Exoplanet Survey Satellite (TESS) will be performing a near all-sky survey for planets that transit bright nearby stars. In addition, its excellent photometric precision, combined with its fine time sampling and long intervals of uninterrupted observations, will enable asteroseismology of solar-type and red-giant stars. Here we develop a simple test to estimate the detectability of solar-like oscillations in TESS photometry of any given star. Based on an all-sky stellar and planetary synthetic population, we go on to predict the asteroseismic yield of the TESS mission, placing emphasis on the yield of exoplanet-host stars for which we expect to detect solar-like oscillations. This is done for both the target stars (observed at a 2-minute cadence) and the full-frame-image stars (observed at a 30-minute cadence). A similar exercise is also conducted based on a compilation of known host stars. We predict that TESS will detect solar-like oscillations in a few dozen target hosts (mainly subgiant stars but also in a smaller number of F dwarfs), in up to 200 low-luminosity red-giant hosts, and in over 100 solar-type and red-giant known hosts, thereby leading to a threefold improvement in the asteroseismic yield of exoplanet-host stars when compared to Kepler's.
BackgroundMore US adolescents use e-cigarettes than smoke cigarettes. Research suggests flavoured e-cigarettes appeal to youth, but little is known about perceptions of and reasons for attraction to ...specific flavours.MethodsA national sample of adolescents (n=1125) ages 13–17 participated in a phone survey from November 2014 to June 2015. We randomly assigned adolescents to respond to survey items about 1 of 5 e-cigarette flavours (tobacco, alcohol, menthol, candy or fruit) and used regression analysis to examine the impact of flavour on interest in trying e-cigarettes and harm beliefs.ResultsAdolescents were more likely to report interest in trying an e-cigarette offered by a friend if it were flavoured like menthol (OR=4.00, 95% CI 1.46 to 10.97), candy (OR=4.53, 95% CI 1.67 to 12.31) or fruit (OR=6.49, 95% CI 2.48 to 17.01) compared with tobacco. Adolescents believed that fruit-flavoured e-cigarettes were less harmful to health than tobacco-flavoured e-cigarettes (p<0.05). Perceived harm mediated the relationship between some flavours and interest in trying e-cigarettes. A minority of adolescents believed that e-cigarettes did not have nicotine (14.6%) or did not know whether they had nicotine (3.6%); these beliefs did not vary by flavour.DiscussionCandy-flavoured, fruit-flavoured and menthol-flavoured e-cigarettes appeal to adolescents more than tobacco-flavoured or alcohol-flavoured e-cigarettes. This appeal is only partially explained by beliefs about reduced harm. Given adolescents' interest in trying e-cigarettes with certain flavours, policymakers should consider restricting advertisements promoting flavoured products in media that reach large numbers of young people. Future research should examine other reasons for the appeal of individual flavours, such as novelty and perceived luxury.
Paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is a frequent complication of antiretroviral therapy in resource-limited countries. We aimed to assess ...whether a 4-week course of prednisone would reduce morbidity in patients with paradoxical TB-IRIS without excess adverse events.
A randomized, double-blind, placebo-controlled trial of prednisone (1.5 mg/kg per day for 2 weeks then 0.75 mg/kg per day for 2 weeks). Patients with immediately life-threatening TB-IRIS manifestations were excluded.
The primary combined endpoint was days of hospitalization and outpatient therapeutic procedures, which were counted as one hospital day.
One hundred and ten participants were enrolled (55 to each arm). The primary combined endpoint was more frequent in the placebo than the prednisone arm {median hospital days 3 interquartile range (IQR) 0-9 and 0 (IQR 0-3), respectively; P = 0.04}. There were significantly greater improvements in symptoms, Karnofsky score, and quality of life (MOS-HIV) in the prednisone vs. the placebo arm at 2 and 4 weeks, but not at later time points. Chest radiographs improved significantly more in the prednisone arm at weeks 2 (P = 0.002) and 4 (P = 0.02). Infections on study medication occurred in more participants in prednisone than in placebo arm (27 vs. 17, respectively; P = 0.05), but there was no difference in severe infections (2 vs. 4, respectively; P = 0.40). Isolates from 10 participants were found to be resistant to rifampicin after enrolment.
Prednisone reduced the need for hospitalization and therapeutic procedures and hastened improvements in symptoms, performance, and quality of life. It is important to investigate for drug-resistant tuberculosis and other causes for deterioration before administering glucocorticoids.
ABSTRACT
Transit observations have found the majority of exoplanets to date. Also spectroscopic observations of transits and eclipses are the most commonly used tool to characterize exoplanet ...atmospheres and will be used in the search for life. However, an exoplanet’s orbit must be aligned with our line of sight to observe a transit. Here, we ask, from which stellar vantage points would a distant observer be able to search for life on Earth in the same way? We use the TESS Input Catalog and data from Gaia DR2 to identify the closest stars that could see Earth as a transiting exoplanet: We identify 1004 main-sequence stars within 100 parsecs, of which 508 guarantee a minimum 10-h long observation of Earth’s transit. Our star list consists of about 77 percent M-type, 12 percent K-type, 6 percent G-type, 4 percent F-type stars, and 1 percent A-type stars close to the ecliptic. SETI searches like the Breakthrough Listen Initiative are already focusing on this part of the sky. Our catalogue now provides a target list for this search. As part of the extended mission, NASA’s TESS will also search for transiting planets in the ecliptic to find planets that could already have found life on our transiting Earth .
In this multicenter trial, higher-risk adults undergoing on-pump CABG (with or without valve surgery) were randomly assigned to preconditioning with transient arm ischemia and reperfusion or sham ...conditioning. Remote ischemic preconditioning did not improve clinical outcomes.
Coronary heart disease is the leading cause of death and disability worldwide. For patients with multivessel coronary artery disease, the treatment of choice for many is revascularization by means of coronary-artery bypass grafting (CABG) surgery. As a result of the aging of the population, an increased prevalence of coexisting conditions (e.g., diabetes, obesity, and hypertension), and a growing need for concomitant valve surgery, higher-risk patients are undergoing CABG surgery (with or without valve surgery); the clinical outcomes in such patients have been worse than the outcomes in patients without so many problems.
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Thus, novel cardioprotective interventions are indicated to . . .
OBJECTIVES:Observational studies suggest obesity is associated with sepsis survival, but these studies are small, fail to adjust for key confounders, measure body mass index at inconsistent time ...points, and/or use administrative data to define sepsis. To estimate the relationship between body mass index and sepsis mortality using detailed clinical data for case detection and risk adjustment.
DESIGN:Retrospective cohort analysis of a large clinical data repository.
SETTING:One-hundred thirty-nine hospitals in the United States.
PATIENTS:Adult inpatients with sepsis meeting Sepsis-3 criteria.
EXPOSURE:Body mass index in six categoriesunderweight (body mass index < 18.5 kg/m), normal weight (body mass index = 18.5–24.9 kg/m), overweight (body mass index = 25.0–29.9 kg/m), obese class I (body mass index = 30.0–34.9 kg/m), obese class II (body mass index = 35.0–39.9 kg/m), and obese class III (body mass index ≥ 40 kg/m).
MEASUREMENTS:Multivariate logistic regression with generalized estimating equations to estimate the effect of body mass index category on short-term mortality (in-hospital death or discharge to hospice) adjusting for patient, infection, and hospital-level factors. Sensitivity analyses were conducted in subgroups of age, gender, Elixhauser comorbidity index, Sequential Organ Failure Assessment quartiles, bacteremic sepsis, and ICU admission.
MAIN RESULTS:From 2009 to 2015, we identified 55,038 adults with sepsis and assessable body mass index measurements6% underweight, 33% normal weight, 28% overweight, and 33% obese. Crude mortality was inversely proportional to body mass index categoryunderweight (31%), normal weight (24%), overweight (19%), obese class I (16%), obese class II (16%), and obese class III (14%). Compared with normal weight, the adjusted odds ratio (95% CI) of mortality was 1.62 (1.50–1.74) for underweight, 0.73 (0.70–0.77) for overweight, 0.61 (0.57–0.66) for obese class I, 0.61 (0.55–0.67) for obese class II, and 0.65 (0.59–0.71) for obese class III. Results were consistent in sensitivity analyses.
CONCLUSIONS:In adults with clinically defined sepsis, we demonstrate lower short-term mortality in patients with higher body mass indices compared with those with normal body mass indices (both unadjusted and adjusted analyses) and higher short-term mortality in those with low body mass indices. Understanding how obesity improves survival in sepsis would inform prognostic and therapeutic strategies.
Past research suggests there are systematic associations between oral health and chronic illness among older adults. Although causality has not yet been credibly established, periodontitis has been ...found to be associated with higher risk of both heart disease and stroke. We advance this literature by estimating the direct association between dental care use and systemic health using multiple waves of the 1992 to 2016 Health and Retirement Study. Through the inclusion of individual fixed effects in our regression models, we account for unobservable time-invariant characteristics of individuals that might otherwise bias estimates of the association between dental care use and health. We find statistically significant negative associations between dental care use and the number of health conditions, self-reported overall health, the incidence of heart disease, and the incidence of stroke. In particular, the use of dental care within the past 2 y is associated with a 2.7% reduction in the likelihood of being diagnosed with a heart condition and a reduction in the likelihood of a stroke diagnosis of between 5.3% and 11.6%. We also find large positive correlations between edentulism and the measures of chronic illness. Associations from models estimated separately for men and women are qualitatively similar to one another. These findings provide additional motivation for the consideration of a Medicare dental benefit.
ABSTRACT
We present the first asteroseismic results for δ Scuti and γ Doradus stars observed in Sectors 1 and 2 of the TESS mission. We utilize the 2-min cadence TESS data for a sample of 117 stars ...to classify their behaviour regarding variability and place them in the Hertzsprung–Russell diagram using Gaia DR2 data. Included within our sample are the eponymous members of two pulsator classes, γ Doradus and SX Phoenicis. Our sample of pulsating intermediate-mass stars observed by TESS also allows us to confront theoretical models of pulsation driving in the classical instability strip for the first time and show that mixing processes in the outer envelope play an important role. We derive an empirical estimate of 74 per cent for the relative amplitude suppression factor as a result of the redder TESS passband compared to the Kepler mission using a pulsating eclipsing binary system. Furthermore, our sample contains many high-frequency pulsators, allowing us to probe the frequency variability of hot young δ Scuti stars, which were lacking in the Kepler mission data set, and identify promising targets for future asteroseismic modelling. The TESS data also allow us to refine the stellar parameters of SX Phoenicis, which is believed to be a blue straggler.
Background. Paradoxical neurologic tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is a potentially life-threatening condition that occurs within 3 months after starting ...combination antiretroviral therapy (ART). The reports in the published literature are anecdotal, and the prevalence and outcomes of neurologic TB-IRIS are unknown. Methods. We prospectively assessed patients with suspected TB-IRIS from June 2005 through October 2007 at our hospital in Cape Town, South Africa. We defined paradoxical TB-IRIS and paradoxical neurologic TB-IRIS with use of consensus clinical case definitions. We collected data on tuberculosis diagnosis, ART, details of TB-IRIS diagnosis, other opportunistic infections, corticosteroid use, and outcome. Results. We reviewed 279 patients with suspected TB-IRIS, 54 (19%) of whom had suspected neurologic TB-IRIS, and 225 (81%) of whom had suspected non-neurologic TB-IRIS. Paradoxical TB-IRIS was diagnosed in 190 patients; 23 (12%) of these 190 patients had neurologic TB-IRIS (95% confidence interval, 7%–17%). Eight had meningitis, 7 had tuberculoma, 5 had both tuberculoma and meningitis, and 3 had radiculomyelopathy. Twenty (87%) of the 23 patients with neurologic TB-IRIS required hospital admission (median duration, 12 days; interquartile range, 6–24 days), and 21 (91%) received corticosteroids (median duration, 58 days; interquartile range, 29–86 days). Outcomes 6 months after the initial assessment for neurologic deterioration were as follows: 16 (70%) of the patients were alive (10 of these patients had documented full physical and mental recovery), 3 (13%) were dead, and 4 (17%) were lost to follow-up. Conclusions. Paradoxical neurologic TB-IRIS accounts for 12% of paradoxical TB-IRIS cases. Neurologic TB-IRIS causes considerable short-term morbidity but has reasonable long-term outcomes. Further research is needed to devise optimal diagnostic and management strategies for patients with tuberculosis who experience neurologic deterioration after starting ART.
Abstract Boundary conditions (BCs) are an essential part in computational fluid dynamics (CFD) simulations of blood flow in large arteries. Although several studies have investigated the influence of ...BCs on predicted flow patterns and hemodynamic wall parameters in various arterial models, there is a lack of comprehensive assessment of outlet BCs for patient-specific analysis of aortic flow. In this study, five different sets of outlet BCs were tested and compared using a subject-specific model of a normal aorta. Phase-contrast magnetic resonance imaging (PC-MRI) was performed on the same subject and velocity profiles extracted from the in vivo measurements were used as the inlet boundary condition. Computational results obtained with different outlet BCs were assessed in terms of their agreement with the PC-MRI velocity data and key hemodynamic parameters, such as pressure and flow waveforms and wall shear stress related indices. Our results showed that the best overall performance was achieved by using a well-tuned three-element Windkessel model at all model outlets, which not only gave a good agreement with in vivo flow data, but also produced physiological pressure waveforms and values. On the other hand, opening outlet BCs with zero pressure at multiple outlets failed to reproduce any physiologically relevant flow and pressure features.
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