[Treatment of hypertension in type 2 diabetes mellitus--2002 update]

Arterial hypertension and diabetes are potent independent risk factors for cardiovascular, cerebral, renal and peripheral (atherosclerotic) vascular disease. The prevalence of hypertension in diabetic individuals is approximately twice that in the non-diabetic population. Diabetic individuals with hypertension have a greater risk of macrovascular and microvascular disease than normotensive diabetic individuals. Hypertension is a major contributor to morbidity and mortality in diabetes, and should be recognized and treated early. Type 2 diabetes and hypertension share certain risk factors such as overweight, visceral obesity, and possibly insulin resistance. Life-style modifications (weight reduction, exercise, limitation of daily alcohol intake, stop smoking) are the foundation of hypertension and diabetes management as the definitive treatment or adjunctive to pharmacological therapy. Additional pharmacological therapy should be initiated when life-style modifications are unsuccessful or hypertension is too severe at the time of diagnosis. All classes of antihypertensive drugs are effective in controlling blood pressure in diabetic patients. For single-agent therapy, ACE-inhibitors, angiotensin receptor blocker, beta-blockers, and diuretics can be recommended. Because of concerns about the lower effectiveness of calcium channel blockers in decreasing coronary events and heart failure and in reducing progression of renal disease in diabetes, it is recommended to use these agents as second-line drugs for patients who cannot tolerate the other preferred classes or who require additional agents to achieve the target blood pressure. The choice depends on the patients specific treatment indications since each of these drugs have potential advantages and disadvantages. In patients with microalbuminuria or clinical nephropathy, both ACE-inhibitors and angiotensin receptor blockers are considered first line therapy for the prevention of and progression of nephropathy. Since treatment is usually life-long, cost effectiveness should be included in treatment evaluation.

Esthetic outcomes following immediate and early implant placement in the anterior maxilla: a systematic review.

PURPOSE The objectives of this systematic review are (1) to quantitatively estimate the esthetic outcomes of implants placed in postextraction sites, and (2) to evaluate the influence of simultaneous bone augmentation procedures on these outcomes. MATERIALS AND METHODS Electronic and manual searches of the dental literature were performed to collect information on esthetic outcomes based on objective criteria with implants placed after extraction of maxillary anterior and premolar teeth. All levels of evidence were accepted (case series studies required a minimum of 5 cases). RESULTS From 1,686 titles, 114 full-text articles were evaluated and 50 records included for data extraction. The included studies reported on single-tooth implants adjacent to natural teeth, with no studies on multiple missing teeth identified (6 randomized controlled trials, 6 cohort studies, 5 cross-sectional studies, and 33 case series studies). Considerable heterogeneity in study design was found. A meta-analysis of controlled studies was not possible. The available evidence suggests that esthetic outcomes, determined by esthetic indices (predominantly the pink esthetic score) and positional changes of the peri-implant mucosa, may be achieved for single-tooth implants placed after tooth extraction. Immediate (type 1) implant placement, however, is associated with a greater variability in outcomes and a higher frequency of recession of > 1 mm of the midfacial mucosa (eight studies; range 9% to 41% and median 26% of sites, 1 to 3 years after placement) compared to early (type 2 and type 3) implant placement (2 studies; no sites with recession > 1 mm). In two retrospective studies of immediate (type 1) implant placement with bone graft, the facial bone wall was not detectable on cone beam CT in 36% and 57% of sites. These sites had more recession of the midfacial mucosa compared to sites with detectable facial bone. Two studies of early implant placement (types 2 and 3) combined with simultaneous bone augmentation with GBR (contour augmentation) demonstrated a high frequency (above 90%) of facial bone wall visible on CBCT. Recent studies of immediate (type 1) placement imposed specific selection criteria, including thick tissue biotype and an intact facial socket wall, to reduce esthetic risk. There were no specific selection criteria for early (type 2 and type 3) implant placement. CONCLUSIONS Acceptable esthetic outcomes may be achieved with implants placed after extraction of teeth in the maxillary anterior and premolar areas of the dentition. Recession of the midfacial mucosa is a risk with immediate (type 1) placement. Further research is needed to investigate the most suitable biomaterials to reconstruct the facial bone and the relationship between long-term mucosal stability and presence/absence of the facial bone, the thickness of the facial bone, and the position of the facial bone crest.

An obscured cluster associated with the H II region RCW173

Context. The discovery of several clusters of red supergiants towards l = 24°−30° has triggered interest in this area of the Galactic plane, where lines of sight are very complex and previous explorations of the stellar content were very preliminary. Aims. We attempt to characterise the stellar population associated with the H ii region RCW 173 (=Sh2-60), located at, as previous studies have suggested that this population could be beyond the Sagittarius arm. Methods. We obtained UBV photometry of a stellar field to the south of the brightest part of RCW 173, as well as spectroscopy of about twenty stars in the area. We combined our new data with archival 2MASS near-infrared photometry and Spitzer/GLIMPSE imaging and photometry, to achieve a more accurate characterisation of the stellar sources and the associated cloud. Results. We find a significant population of early-type stars located at d = 3.0 kpc, in good agreement with the “near” dynamical distance to the H ii region. This population should be located at the near intersection of the Scutum-Crux arm. A luminous O7 II star is likely to be the main source of ionisation. Many stars are concentrated around the bright nebulosity, where GLIMPSE images in the mid infrared show the presence of a bubble of excited material surrounding a cavity that coincides spatially with a number of B0-1 V stars. We interpret this as an emerging cluster, perhaps triggered by the nearby O7 II star. We also find a number of B-type giants. Some of them are located at approximately the same distance, and may be part of an older population in the same area, characterised by much lower reddening. A few have shorter distance moduli and are likely to be located in the Sagittarius arm. Conclusions. The line of sight in this direction is very complex. Optically visible tracers delineate two spiral arms, but seem to be absent beyond d ≈ 3 kpc. Several H ii regions in this area suggest that the Scutum-Crux arm contains thick clouds actively forming stars. All these populations are projected on top of the major stellar complex signposted by the clusters of red supergiants.

Efficacy and safety of dapagliflozin monotherapy in people with Type 2 diabetes:a randomized double-blind placebo-controlled 102-week trial

Aims: To assess initial pharmacotherapy of Type 2 diabetes with the sodium-glucose cotransporter-2 inhibitor dapagliflozin. Methods: This double-blind, placebo-controlled trial, randomly allocated people with Type 2 diabetes aged 18-77 years and inadequate glycaemic control on diet and exercise [HbA1c 53-86 mmol/mol (7.0-10.0%)] to receive placebo (n = 75) or dapagliflozin monotherapy 2.5 mg (n = 65), 5 mg (n = 64) or 10 mg (n = 70) once daily in the morning. After 24 weeks, low-dose double-blind metformin 500 mg/day was added to the placebo group regimen (placebo+low-dose metformin group). Changes in HbA1c level, fasting plasma glucose and body weight, as well as adverse events, were assessed over 102 weeks. Results: Of the 274 participants randomized, 167 completed the study (60.9%). At 102 weeks, significant differences vs placebo+low-dose metformin with dapagliflozin 5 and 10 mg were observed for HbA1c (-5.8 mmol/mol [-0.53%], P = 0.018; and -4.8 mmol/mol [-0.44%], P = 0.048), respectively); and for FPG (-0.69 mmol/L, P = 0.044; and -1.12 mmol/l, P = 0.001, respectively). For body weight, the difference between the dapagliflozin 10-mg group and the placebo+low-dose metformin group was significant (-2.60 kg; P = 0.016). Hypoglycaemic events were uncommon, with rates of 5.3% for placebo+low-dose metformin group and 0-4.6% for the dapagliflozin groups. Genital infections and urinary tract infections were more common in the dapagliflozin groups than in the placebo+low-dose metformin group. Conclusions: Dapagliflozin as monotherapy in treatment-naïve people with early Type 2 diabetes improved glycaemic control and reduced weight without increasing hypoglycaemia over 102 weeks. Dapagliflozin may provide an alternative initial pharmacotherapy in such people.

MID-IR luminosities and UV/optical star formation rates at z < 1.4

Ultraviolet (UV) nonionizing continuum and mid-infrared (IR) emission constitute the basis of two widely used star formation (SF) indicators at intermediate and high redshifts. We study 2430 galaxies with z < 1.4 in the Extended Groth Strip with deep MIPS 24 μm observations from FIDEL, spectroscopy from DEEP2, and UV, optical, and near-IR photometry from the AEGIS. The data are coupled with dust-reddened stellar population models and Bayesian spectral energy distribution (SED) fitting to estimate dust-corrected star formation rates (SFRs). In order to probe the dust heating from stellar populations of various ages, the derived SFRs were averaged over various timescales—from 100 Myr for "current" SFR (corresponding to young stars) to 1-3 Gyr for long-timescale SFRs (corresponding to the light-weighted age of the dominant stellar populations). These SED-based UV/optical SFRs are compared to total IR luminosities extrapolated from 24 μm observations, corresponding to 10-18 μm rest frame. The total IR luminosities are in the range of normal star-forming galaxies and luminous IR galaxies (10^10-10^12 L_☉). We show that the IR luminosity can be estimated from the UV and optical photometry to within a factor of 2, implying that most z < 1.4 galaxies are not optically thick. We find that for the blue, actively star-forming galaxies the correlation between the IR luminosity and the UV/optical SFR shows a decrease in scatter when going from shorter to longer SFR-averaging timescales. We interpret this as the greater role of intermediate age stellar populations in heating the dust than what is typically assumed. Equivalently, we observe that the IR luminosity is better correlated with dust-corrected optical luminosity than with dust-corrected UV light. We find that this holds over the entire redshift range. Many so-called green valley galaxies are simply dust-obscured actively star-forming galaxies. However, there exist 24 μm detected galaxies, some with L_IR>10^11 L_☉, yet with little current SF. For them a reasonable amount of dust absorption of stellar light (but presumably higher than in nearby early-type galaxies) is sufficient to produce the observed levels of IR, which includes a large contribution from intermediate and old stellar populations. In our sample, which contains very few ultraluminous IR galaxies, optical and X-ray active galactic nuclei do not contribute on average more than ~50% to the mid-IR luminosity, and we see no evidence for a large population of "IR excess" galaxies.

Approximate Bayesian Computation for astronomical model analysis : a case study in galaxy demographics and morphological transformation at high redshift

Approximate Bayesian Computation’ (ABC) represents a powerful methodology for the analysis of complex stochastic systems for which the likelihood of the observed data under an arbitrary set of input parameters may be entirely intractable – the latter condition rendering useless the standard machinery of tractable likelihood-based, Bayesian statistical inference [e.g. conventional Markov chain Monte Carlo (MCMC) simulation]. In this paper, we demonstrate the potential of ABC for astronomical model analysis by application to a case study in the morphological transformation of high-redshift galaxies. To this end, we develop, first, a stochastic model for the competing processes of merging and secular evolution in the early Universe, and secondly, through an ABC-based comparison against the observed demographics of massive (Mgal > 1011 M⊙) galaxies (at 1.5 < z < 3) in the Cosmic Assembly Near-IR Deep Extragalatic Legacy Survey (CANDELS)/Extended Groth Strip (EGS) data set we derive posterior probability densities for the key parameters of this model. The ‘Sequential Monte Carlo’ implementation of ABC exhibited herein, featuring both a self-generating target sequence and self-refining MCMC kernel, is amongst the most efficient of contemporary approaches to this important statistical algorithm. We highlight as well through our chosen case study the value of careful summary statistic selection, and demonstrate two modern strategies for assessment and optimization in this regard. Ultimately, our ABC analysis of the high-redshift morphological mix returns tight constraints on the evolving merger rate in the early Universe and favours major merging (with disc survival or rapid reformation) over secular evolution as the mechanism most responsible for building up the first generation of bulges in early-type discs.

Generation of rotationally dominated galaxies by mergers of pressure-supported progenitors

Through the analysis of a set of numerical simulations of major mergers between initially non-rotating, pressure-supported progenitor galaxies with a range of central mass concentrations, we have shown that: (1) it is possible to generate elliptical-like galaxies, with outside one effective radius, as a result of the conversion of orbital- into internal-angular momentum; (2) the outer regions acquire part of the angular momentum first; (3) both the baryonic and the dark matter components of the remnant galaxy acquire part of the angular momentum, the relative fractions depending on the initial concentration of the merging galaxies. For this conversion to occur the initial baryonic component must be sufficiently dense and/or the encounter should take place on an orbit with high angular momentum. Systems with these hybrid properties have recently been observed through a combination of stellar absorption lines and planetary nebulae for kinematic studies of early-type galaxies. Our results are in qualitative agreement with these observations and demonstrate that even mergers composed of non rotating, pressure-supported progenitor galaxies can produce early-type galaxies with significant rotation at large radii.

Asymmetric Warps in Disk Galaxies: Dependence on Dark Matter Halo

Recent observations have shown that most of the warps in the disk galaxies are asymmetric. However there exists no generic mechanism to generate these asymmetries in warps. We have shown that a rich variety of possible asymmetries in the z-distribution of the spiral galaxies can naturally arise due to a dynamical wave interference between the first two bending modes i.e. bowl-shaped mode(m=0) and S-shaped warping mode(m = 1) in the galactic disk embedded in a dark matter halo. We show that the asymmetric warps are more pronounced when the dark matter content within the optical disk is lower as in early-type galaxies.

Origin of Disk Lopsidedness in Spiral Galaxies

In our work we have used the atomic hydrogen [HΙ] gas distribution in the HΙ 21-cm line emission to study the dark matter halo perturbations. For tHΙs analysis, the 2-D HΙ surface density and velocity maps (arcHΙval) of the galaxies in the Eridanus group (obtained using the GMRT) and in the Ursa Major group (obtained from WSRT) were used. In addition a few HΙckson Compact Groups of galaxies were also studied using the GMRT. The HΙ maps of these galaxies were Fourier analysed to estimate the asymmetry in the distribution and motion of gas. The average asymmetry parameter in the 1.5 to 2.5 K′-band scale lengths was found to be ~ 0.27 for the Eridanus group of galaxies wHΙle it was ~ 0.14 for the Ursa Major group of galaxies. The asymmetries in the distribution of HΙ as a function of Hubble type of galaxies were also studied and was found to be directly correlated with the compactness of the groups. In addition, the trend in the asymmetry as a function of the Hubble type of galaxies was opposite to that seen in the field galaxies, i.e., in the group galaxies, the early type galaxies showed more asymmetry than late type. These two aspects indicated that tidal interactions between the galaxies in a group environment to be the major cause of asymmetries. The observed asymmetry parameters were consistent with recent numerical simulations of asymmetries of gas disk caused by fly-by interactions. We have also estimated the perturbation of dark matter halo using the asymmetry parameter obtained from the Fourier series analysis of the surface density maps.

CH abundance gradient in TMC-1

Aims. The aim of this study is to examine if the well-known chemical gradient in TMC-1 is reflected in the amount of rudimentary forms of carbon available in the gas-phase. As a tracer we use the CH radical which is supposed to be well correlated with carbon atoms and simple hydrocarbon ions. Methods. We observed the 9-cm ?-doubling lines of CH along the dense filament of TMC-1. The CH column densities were compared with the total H2 column densities derived using the 2MASS NIR data and previously published SCUBA maps and with OH column densities derived using previous observations with Effelsberg. We also modelled the chemical evolution of TMC-1 adopting physical conditions typical of dark clouds using the UMIST Database for Astrochemistry gas-phase reaction network to aid the interpretation of the observed OH/CH abundance ratios. Results. The CH column density has a clear peak in the vicinity of the cyanopolyyne maximum of TMC-1. The fractional CH abundance relative to H2 increases steadily from the northwestern end of the filament where it lies around 1.0 × 10-8 , to the southeast where it reaches a value of 2.0 × 10-8. The OH and CH column densities are well correlated, and we obtained OH/CH abundance ratios of ~16–20. These values are clearly larger than what has been measured recently in diffuse interstellar gas and is likely to be related to C to CO conversion at higher densities. The good correlation between CH and OH can be explained by similar production and destruction pathways. We suggest that the observed CH and OH abundance gradients are mainly due to enhanced abundances in a low-density envelope which becomes more prominent in the southeastern part and seems to continue beyond the dense filament. Conclusions. An extensive envelope probably signifies an early stage of dynamical evolution, and conforms with the detection of a large CH abundance in the southeastern part of the cloud. The implied presence of other simple forms of carbon in the gas phase provides a natural explanation for the observation of “early-type” molecules in this region.

The Ultraviolet-Bright, Slowly Declining Transient PS1-11af as a Partial Tidal Disruption Event

We present the Pan-STARRS1 discovery of the long-lived and blue transient PS1-11af, which was also detected by Galaxy Evolution Explorer with coordinated observations in the near-ultraviolet (NUV) band. PS1-11af is associated with the nucleus of an early type galaxy at redshift z = 0.4046 that exhibits no evidence for star formation or active galactic nucleus activity. Four epochs of spectroscopy reveal a pair of transient broad absorption features in the UV on otherwise featureless spectra. Despite the superficial similarity of these features to P-Cygni absorptions of supernovae (SNe), we conclude that PS1-11af is not consistent with the properties of known types of SNe. Blackbody fits to the spectral energy distribution are inconsistent with the cooling, expanding ejecta of a SN, and the velocities of the absorption features are too high to represent material in homologous expansion near a SN photosphere. However, the constant blue colors and slow evolution of the luminosity are similar to previous optically selected tidal disruption events (TDEs). The shape of the optical light curve is consistent with models for TDEs, but the minimum accreted mass necessary to power the observed luminosity is only 0.002 M, which points to a partial disruption model. A full disruption model predicts higher bolometric luminosities, which would require most of the radiation to be emitted in a separate component at high energies where we lack observations. In addition, the observed temperature is lower than that predicted by pure accretion disk models for TDEs and requires reprocessing to a constant, lower temperature. Three deep non-detections in the radio with the Very Large Array over the first two years after the event set strict limits on the production of any relativistic outflow comparable to Swift J1644+57, even if off-axis.

Multi-wavelength observations of Proxima Centauri

Aims: We report simultaneous observations of the nearby flare star Proxima Centauri with VLT/UVES and XMM-Newton over three nights in March 2009. Our optical and X-ray observations cover the star's quiescent state, as well as its flaring activity and allow us to probe the stellar atmospheric conditions from the photosphere into the chromosphere, and then the corona during its different activity stages. Methods: Using the X-ray data, we investigate variations in coronal densities and abundances and infer loop properties for an intermediate-sized flare. The optical data are used to investigate the magnetic field and its possible variability, to construct an emission line list for the chromosphere, and use certain emission lines to construct physical models of Proxima Centauri's chromosphere. Results: We report the discovery of a weak optical forbidden Fe xiii line at 3388 Å during the more active states of Proxima Centauri. For the intermediate flare, we find two secondary flare events that may originate in neighbouring loops, and discuss the line asymmetries observed during this flare in H i, He i, and Ca ii lines. The high time-resolution in the Hα line highlights strong temporal variations in the observed line asymmetries, which re-appear during a secondary flare event. We also present theoretical modelling with the stellar atmosphere code PHOENIX to construct flaring chromospheric models. Based on observations collected at the European Southern Observatory, Paranal, Chile, 082.D-0953A and on observations obtained with XMM-Newton, an ESA science mission with instruments and contributions directly funded by ESA Member states and NASA.Full Table 6 is only available at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/534/A133

X-Ray Emission from the Super-Earth Host GJ 1214

Stellar activity can produce large amounts of high-energy radiation, which is absorbed by the planetary atmosphere leading to irradiation-driven mass loss. We present the detection and an investigation of high-energy emission in a transiting super-Earth host system, GJ 1214, based on XMM-Newton observations. We derive an X-ray luminosity of LX = 7.4 × 1025 erg s-1 and a corresponding activity level of log (LX /L bol) ~ -5.3. Further, we determine a coronal temperature of about ~3.5 MK, which is typical for coronal emission of moderately active low-mass stars. We estimate that GJ 1214 b evaporates at a rate of 1.3× 1010 g s-1 and has lost a total of ≈2-5.6 M ⊕.

Ultraviolet emission lines of Si II in cool star and solar spectra

Recent atomic physics calculations for Si II are employed within the CLOUDY modelling code to analyse Hubble Space Telescope (HST) STIS ultraviolet spectra of three cool stars, β Geminorum, α Centauri A and B, as well as previously published HST/GHRS observations of α Tau, plus solar quiet Sun data from the High Resolution Telescope and Spectrograph. Discrepancies found previously between theory and observation for line intensity ratios involving the 3s²3p ²PJ-3s3p^{2 4}P^J' intercombination multiplet of Si II at ~ 2335 Å are significantly reduced, as are those for ratios containing the 3s²3p ²PJ-3s3p^{2 2}DJ ~ transitions at ~1816 Å. This is primarily due to the effect of the new Si II transition probabilities. However, these atomic data are not only very different from previous calculations, but also show large disagreements with measurements, specifically those of Calamai et al. for the intercombination lines. New measurements of transition probabilities for Si II are hence urgently required to confirm (or otherwise) the accuracy of the recently calculated values. If the new calculations are confirmed, then a long-standing discrepancy between theory and observation will have finally been resolved. However, if the older measurements are found to be correct, then the agreement between theory and observation is simply a coincidence and the existing discrepancies remain.

GHASP: an H alpha kinematic survey of spiral and irregular galaxies - IX. The near-infrared, stellar and baryonic Tully-Fisher relations

We studied, for the first time, the near-infrared, stellar and baryonic Tully-Fisher relations for a sample of field galaxies taken from a homogeneous Fabry-Perot sample of galaxies [the Gassendi HAlpha survey of SPirals (GHASP) survey]. The main advantage of GHASP over other samples is that the maximum rotational velocities were estimated from 2D velocity fields, avoiding assumptions about the inclination and position angle of the galaxies. By combining these data with 2MASS photometry, optical colours, HI masses and different mass-to-light ratio estimators, we found a slope of 4.48 +/- 0.38 and 3.64 +/- 0.28 for the stellar and baryonic Tully-Fisher relation, respectively. We found that these values do not change significantly when different mass-to-light ratio recipes were used. We also point out, for the first time, that the rising rotation curves as well as asymmetric rotation curves show a larger dispersion in the Tully-Fisher relation than the flat ones or the symmetric ones. Using the baryonic mass and the optical radius of galaxies, we found that the surface baryonic mass density is almost constant for all the galaxies of this sample. In this study we also emphasize the presence of a break in the NIR Tully-Fisher relation at M(H,K) similar to -20 and we confirm that late-type galaxies present higher total-to-baryonic mass ratios than early-type spirals, suggesting that supernova feedback is actually an important issue in late-type spirals. Due to the well-defined sample selection criteria and the homogeneity of the data analysis, the Tully-Fisher relation for GHASP galaxies can be used as a reference for the study of this relation in other environments and at higher redshifts.