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Open Access Publications from the University of California

Scholarly Works (12 results)

  • Article
  • Peer Reviewed
Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, Volume 11, Issue 4 (2010)

Background: Cardiac stress tests for diagnosis of coronary artery disease (CAD) are incompletely sensitive and specific.

Objective: We examined the frequency of significant CAD in patients presenting to the emergency department (ED) with chest pain who have had a recent negative or inconclusive (<85% of predicted maximum heart rate) cardiac stress test.

Methods: This was a retrospective chart review of patients identified from ED and cardiology registries at the study hospital. We included patients presenting to the ED with a chief complaint of chest pain, with a negative cardiac stress test in the past three years as the last cardiac test, and hospital admission. One-hundred sixty-four patients met the inclusion criteria. Their admission was reviewed for diagnosis of CAD by positive serum troponin, percutaneous coronary intervention, or positive stress test while an inpatient.

Results: Of 164 patients, 122 (74.4%, 95% CI 67.7, 81.1) had a negative stress test prior to the index admission, while 42 (25.6%, 95% CI 18.9, 32.3) had otherwise normal but inconclusive stress tests. Thirty-four (20.7%, 95% CI 14.4,27.0) of the included patients were determined to have CAD. Twenty-five of the 122 patients (20.5%, 95% CI 13.3, 27.7) had negative pre-admission stress tests and nine of 42 patients (21.4%, 95% CI 9.0, 33.8) had inclusive stress tests of CAD. A statistical comparison between these two proportions showed no significant difference (p = .973).

Conclusion: Due to inadequate sensitivity, negative non-invasive cardiac stress tests should not be used to rule out CAD. Patients with negative stress tests are just as likely to have CAD as patients with inconclusive stress tests. [West J Emerg Med 2010; 11(4):384-388.]

    Cover page: Coronary Disease in Emergency Department Chest Pain Patients with Recent Negative Stress TestingCreative Commons 'BY-NC' version 4.0 license
    • Article
    • Peer Reviewed
    Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, Volume 19, Issue 6 (2018)

    Background: Cardiac stress tests for diagnosis of coronary artery disease (CAD) are incompletely sensitive and specific.

    Objective: We examined the frequency of significant CAD in patients presenting to the emergency department (ED) with chest pain who have had a recent negative or inconclusive (<85% of predicted maximum heart rate) cardiac stress test.

    Methods: This was a retrospective chart review of patients identified from ED and cardiology registries at the study hospital. We included patients presenting to the ED with a chief complaint of chest pain, with a negative cardiac stress test in the past three years as the last cardiac test, and hospital admission. One-hundred sixty-four patients met the inclusion criteria. Their admission was reviewed for diagnosis of CAD by positive serum troponin, percutaneous coronary intervention, or positive stress test while an inpatient.

    Results: Of 164 patients, 122 (74.4%, 95% CI 67.7, 81.1) had a negative stress test prior to the index admission, while 42 (25.6%, 95% CI 18.9, 32.3) had otherwise normal but inconclusive stress tests. Thirty-four (20.7%, 95% CI 14.4,27.0) of the included patients were determined to have CAD. Twenty-five of the 122 patients (20.5%, 95% CI 13.3, 27.7) had negative pre-admission stress tests and nine of 42 patients (21.4%, 95% CI 9.0, 33.8) had inclusive stress tests of CAD. A statistical comparison between these two proportions showed no significant difference (p = .973).

    Conclusion: Due to inadequate sensitivity, negative non-invasive cardiac stress tests should not be used to rule out CAD. Patients with negative stress tests are just as likely to have CAD as patients with inconclusive stress tests.

      Cover page: This Article Corrects: "Coronary Disease in Emergency Department Chest Pain Patients with Recent Negative Stress Testing"Creative Commons 'BY' version 4.0 license
      • Article
      • Peer Reviewed
      UCLA Previously Published Works (2016)
      The HD 61005 debris disk ("The Moth") stands out from the growing collection of spatially resolved circumstellar disks by virtue of its unusual swept-back morphology, brightness asymmetries, and dust ring offset. Despite several suggestions for the physical mechanisms creating these features, no definitive answer has been found. In this work, we demonstrate the plausibility of a scenario in which the disk material is shaped dynamically by an eccentric, inclined planet. We present new Keck NIRC2 scattered-light angular differential imaging of the disk at 1.2-2.3 μm that further constrains its outer morphology (projected separations of 27-135 au). We also present complementary Gemini Planet Imager 1.6 μm total intensity and polarized light detections that probe down to projected separations less than 10 au. To test our planet-sculpting hypothesis, we employed secular perturbation theory to construct parent body and dust distributions that informed scattered-light models. We found that this method produced models with morphological and photometric features similar to those seen in the data, supporting the premise of a planet-perturbed disk. Briefly, our results indicate a disk parent body population with a semimajor axis of 40-52 au and an interior planet with an eccentricity of at least 0.2. Many permutations of planet mass and semimajor axis are allowed, ranging from an Earth mass at 35 au to a Jupiter mass at 5 au.
        Cover page: BRINGING “THE MOTH” TO LIGHT: A PLANET-SCULPTING SCENARIO FOR THE HD 61005 DEBRIS DISK
        • Article
        • Peer Reviewed
        UCLA Previously Published Works (2016)
        Using the Gemini Planet Imager, we have resolved the circumstellar debris disk around HD 111520 at a projected range of ∼30-100 AU in both total and polarized H-band intensity. The disk is seen edge-on at a position angle of 165° along the spine of emission. A slight inclination and asymmetric warp are covariant and alter the interpretation of the observed disk emission. We employ three point-spread function subtraction methods to reduce the stellar glare and instrumental artifacts to confirm that there is a roughly 2:1 brightness asymmetry between the NW and SE extension. This specific feature makes HD 111520 the most extreme example of asymmetric debris disks observed in scattered light among similar highly inclined systems, such as HD 15115 and HD 106906. We further identify a tentative localized brightness enhancement and scale height enhancement associated with the disk at ∼40 AU away from the star on the SE extension. We also find that the fractional polarization rises from 10% to 40% from 0.″5 to 0.″8 from the star. The combination of large brightness asymmetry and symmetric polarization fraction leads us to believe that an azimuthal dust density variation is causing the observed asymmetry.
          Cover page: THE PECULIAR DEBRIS DISK OF HD 111520 AS RESOLVED BY THE GEMINI PLANET IMAGER
          • Article
          • Peer Reviewed
          UCLA Previously Published Works (2017)
          We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager (GPI) as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J (1.12-1.3 μm) and H (1.50-1.80 μm) bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au (70-year) orbit with a 68% confidence interval between 14 and 28 au, an eccentricity of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log(Lbol/L⊙)=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object.
            Cover page: Integral Field Spectroscopy of the Low-mass Companion HD 984 B with the Gemini Planet Imager
            • Article
            • Peer Reviewed
            UCLA Previously Published Works (2017)
            We present optical and near-infrared high-contrast images of the transitional disk HD 100546 taken with the Magellan Adaptive Optics system (MagAO) and the Gemini Planet Imager (GPI). GPI data include both polarized intensity and total intensity imagery, and MagAO data are taken in Simultaneous Differential Imaging mode at Hα. The new GPI H-band total intensity data represent a significant enhancement in sensitivity and field rotation compared to previous data sets and enable a detailed exploration of substructure in the disk. The data are processed with a variety of differential imaging techniques (polarized, angular, reference, and simultaneous differential imaging) in an attempt to identify the disk structures that are most consistent across wavelengths, processing techniques, and algorithmic parameters. The inner disk cavity at 15 au is clearly resolved in multiple data sets, as are a variety of spiral features. While the cavity and spiral structures are identified at levels significantly distinct from the neighboring regions of the disk under several algorithms and with a range of algorithmic parameters, emission at the location of HD 100546 "c" varies from point-like under aggressive algorithmic parameters to a smooth continuous structure with conservative parameters, and is consistent with disk emission. Features identified in the HD 100546 disk bear qualitative similarity to computational models of a moderately inclined two-armed spiral disk, where projection effects and wrapping of the spiral arms around the star result in a number of truncated spiral features in forward-modeled images.
              Cover page: Complex Spiral Structure in the HD 100546 Transitional Disk as Revealed by GPI and MagAO
              • Article
              • Peer Reviewed
              UCLA Previously Published Works (2015)
              We present H-band observations of β Pic with the Gemini Planet Imager's (GPI's) polarimetry mode that reveal the debris disk between ∼0.″3 (6 AU) and ∼1.″7 (33 AU), while simultaneously detecting β Pic b. The polarized disk image was fit with a dust density model combined with a Henyey-Greenstein scattering phase function. The best-fit model indicates a disk inclined to the line of sight () with a position angle (PA) (slightly offset from the main outer disk, ), that extends from an inner disk radius of to well outside GPI's field of view. In addition, we present an updated orbit for β Pic b based on new astrometric measurements taken in GPI's spectroscopic mode spanning 14 months. The planet has a semimajor axis of , with an eccentricity The PA of the ascending node is offset from both the outer main disk and the inner disk seen in the GPI image. The orbital fit constrains the stellar mass of β Pic to Dynamical sculpting by β Pic b cannot easily account for the following three aspects of the inferred disk properties: (1) the modeled inner radius of the disk is farther out than expected if caused by β Pic b; (2) the mutual inclination of the inner disk and β Pic b is when it is expected to be closer to zero; and (3) the aspect ratio of the disk () is larger than expected from interactions with β Pic b or self-stirring by the disk's parent bodies.
                Cover page: β PICTORIS’ INNER DISK IN POLARIZED LIGHT AND NEW ORBITAL PARAMETERS FOR β PICTORIS b
                • Article
                • Peer Reviewed
                UCLA Previously Published Works (2016)
                We present H-band near-infrared polarimetric imaging observations of the F5V star HD 157587 obtained with the Gemini Planet Imager (GPI) that reveal the debris disk as a bright ring structure at a separation of ∼80-100 au. The new GPI data complement recent Hubble Space Telescope/STIS observations that show the disk extending out to over 500 au. The GPI image displays a strong asymmetry along the projected minor axis as well as a fainter asymmetry along the projected major axis. We associate the minor and major axis asymmetries with polarized forward scattering and a possible stellocentric offset, respectively. To constrain the disk geometry, we fit two separate disk models to the polarized image, each using a different scattering phase function. Both models favor a disk inclination of ∼70° and a 1.5 ± 0.6 au stellar offset in the plane of the sky along the projected major axis of the disk. We find that the stellar offset in the disk plane, perpendicular to the projected major axis is degenerate with the form of the scattering phase function and remains poorly constrained. The disk is not recovered in total intensity due in part to strong adaptive optics residuals, but we recover three point sources. Considering the system's proximity to the galactic plane and the point sources' positions relative to the disk, we consider it likely that they are background objects and unrelated to the disk's offset from the star.
                  Cover page: IMAGING AN 80 au RADIUS DUST RING AROUND THE F5V STAR HD 157587
                  • Article
                  • Peer Reviewed
                  UCLA Previously Published Works (2017)
                    Cover page: Integral Field Spectroscopy of the Low-mass Companion HD 984 B with the Gemini Planet Imager
                    • Article
                    • Peer Reviewed
                    UCLA Previously Published Works (2017)
                    We present H band spectroscopic and Hμ photometric observations of HD 100546 obtained with the Gemini Planet Imager and the Magellan Visible AO camera. We detect H band emission at the location of the protoplanet HD 100546 b, but show that the choice of data processing parameters strongly affects the morphology of this source. It appears point-like in some aggressive reductions, but rejoins an extended disk structure in the majority of the others. Furthermore, we demonstrate that this emission appears stationary on a timescale of 4.6 years, inconsistent at the 2σ level with a Keplerian clockwise orbit at 59 au in the disk plane. The H band spectrum of the emission is inconsistent with any type of low effective temperature object or accreting protoplanetary disk. It strongly suggests a scattered-light origin, as this is consistent with the spectrum of the star and the spectra extracted at other locations in the disk. A non-detection at the 5σ level of HD 100546 b in differential Hμ imaging places an upper limit, assuming the protoplanet lies in a gap free of extinction, on the accretion luminosity of 1.7 ? 10-4 L o and for 1 R Jup. These limits are comparable to the accretion luminosity and accretion rate of T-Tauri stars or LkCa 15 b. Taken together, these lines of evidence suggest that the H band source at the location of HD 100546 b is not emitted by a planetary photosphere or an accreting circumplanetary disk but is a disk feature enhanced by the point-spread function subtraction process. This non-detection is consistent with the non-detection in the K band reported in an earlier study but does not exclude the possibility that HD 100546 b is deeply embedded.
                      Cover page: An Optical/Near-infrared Investigation of HD 100546 b with the Gemini Planet Imager and MagAO
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