ABSTRACT
We present the results of a 4-month, spectroscopic campaign of the Wolf–Rayet dust-making binary, WR137. We detect only small-amplitude random variability in the C iii λ5696 emission line ...and its integrated quantities (radial velocity, equivalent width, skewness, and kurtosis) that can be explained by stochastic clumps in the wind of the WC star. We find no evidence of large-scale periodic variations often associated with Corotating Interaction Regions that could have explained the observed intrinsic continuum polarization of this star. Our moderately high-resolution and high signal-to-noise average Keck spectrum shows narrow double-peak emission profiles in the H α, H β, H γ, He ii λ6678, and He ii λ5876 lines. These peaks have a stable blue-to-red intensity ratio with a mean of 0.997 and a root mean square of 0.004 commensurate with the noise level; no variability is found during the entire observing period. We suggest that these profiles arise in a decretion disc around the O9 companion, which is thus an O9e star. The characteristics of the profiles are compatible with those of other Be/Oe stars. The presence of this disc can explain the constant component of the continuum polarization of this system, for which the angle is perpendicular to the plane of the orbit, implying that the rotation axis of the O9e star is aligned with that of the orbit. It remains to be explained why the disc is so stable within the strong ultraviolet radiation field of the O star. We present a binary evolutionary scenario that is compatible with the current stellar and system parameters.
During the summer of 2013, a 4-month spectroscopic campaign took place to observe the variabilities in three Wolf–Rayet stars. The spectroscopic data have been analysed for WR 134 (WN6b), to better ...understand its behaviour and long-term periodicity, which we interpret as arising from corotating interaction regions (CIRs) in the wind. By analysing the variability of the He ii λ5411 emission line, the previously identified period was refined to P = 2.255 ± 0.008 (s.d.) d. The coherency time of the variability, which we associate with the lifetime of the CIRs in the wind, was deduced to be 40 ± 6 d, or ∼18 cycles, by cross-correlating the variability patterns as a function of time. When comparing the phased observational grey-scale difference images with theoretical grey-scales previously calculated from models including CIRs in an optically thin stellar wind, we find that two CIRs were likely present. A separation in longitude of Δϕ ≃ 90° was determined between the two CIRs and we suggest that the different maximum velocities that they reach indicate that they emerge from different latitudes. We have also been able to detect observational signatures of the CIRs in other spectral lines (C iv λλ5802,5812 and He i λ5876). Furthermore, a DAC was found to be present simultaneously with the CIR signatures detected in the He i λ5876 emission line which is consistent with the proposed geometry of the large-scale structures in the wind. Small-scale structures also show a presence in the wind, simultaneously with the larger scale structures, showing that they do in fact co-exist.
We present the results of a four-month, spectroscopic campaign of the Wolf-Rayet dust-making binary, WR137. We detect only small-amplitude, random variability in the CIII5696 emission line and its ...integrated quantities (radial velocity, equivalent width, skewness, kurtosis) that can be explained by stochastic clumps in the wind of the WC star. We find no evidence of large-scale, periodic variations often associated with Corotating Interaction Regions that could have explained the observed intrinsic continuum polarization of this star. Our moderately high-resolution and high signal-to-noise average Keck spectrum shows narrow double-peak emission profiles in the Halpha, Hbeta, Hgamma, HeII6678 and HeII5876 lines. These peaks have a stable blue-to-red intensity ratio with a mean of 0.997 and a root-mean-square of 0.004, commensurate with the noise level; no variability is found during the entire observing period. We suggest that these profiles arise in a decretion disk around the O9 companion, which is thus an O9e star. The characteristics of the profiles are compatible with those of other Be/Oe stars. The presence of this disk can explain the constant component of the continuum polarization of this system, for which the angle is perpendicular to the plane of the orbit, implying that the rotation axis of the O9e star is aligned with that of the orbit. It remains to be explained why the disk is so stable within the strong ultraviolet radiation field of the O star. We present a binary evolutionary scenario that is compatible with the current stellar and system parameters.
During the summer of 2013, a 4-month spectroscopic campaign took place to observe the variabilities in three Wolf-Rayet stars. The spectroscopic data have been analyzed for WR 134 (WN6b), to better ...understand its behaviour and long-term periodicity, which we interpret as arising from corotating interaction regions (CIRs) in the wind. By analyzing the variability of the He II \(\lambda\)5411 emission line, the previously identified period was refined to P = 2.255 \(\pm\) 0.008 (s.d.) days. The coherency time of the variability, which we associate with the lifetime of the CIRs in the wind, was deduced to be 40 \(\pm\) 6 days, or \(\sim\) 18 cycles, by cross-correlating the variability patterns as a function of time. When comparing the phased observational grayscale difference images with theoretical grayscales previously calculated from models including CIRs in an optically thin stellar wind, we find that two CIRs were likely present. A separation in longitude of \(\Delta \phi \simeq\) 90\(^{\circ}\) was determined between the two CIRs and we suggest that the different maximum velocities that they reach indicate that they emerge from different latitudes. We have also been able to detect observational signatures of the CIRs in other spectral lines (C IV \(\lambda\lambda\)5802,5812 and He I \(\lambda\)5876). Furthermore, a DAC was found to be present simultaneously with the CIR signatures detected in the He I \(\lambda\)5876 emission line which is consistent with the proposed geometry of the large-scale structures in the wind. Small-scale structures also show a presence in the wind, simultaneously with the larger scale structures, showing that they do in fact co-exist.
Dose-escalated chemoradiation (CRT) for locally advanced rectal cancer did not result in higher complete response rates but initiated more tumor regression in the randomized RECTAL-BOOST trial ...(Clinicaltrials.gov NCT01951521). This study compared patient reported outcomes between patients who received dose-escalated CRT (5 × 3 gray boost + CRT) or standard CRT for 2 years after randomization.
Patients with locally advanced rectal cancer who were participating in the RECTAL-BOOST trial filled out European Organisation for Research and Treatment of Cancer QLQ-C30 and CR29 questionnaires on quality of life (QoL) and symptoms at baseline, 3, 6, 12, 18, and 24 months after start of treatment. Between-group differences in functional QoL domains were estimated using a linear mixed-effects model and expressed as effect size (ES). Symptom scores were compared using Mann-Whitney U test.
Patients treated with dose-escalated CRT (boost group, n = 51) experienced a significantly stronger decline in global health at 3 and 6 months (ES -0.4 and ES -0.4), physical functioning at 6 months (ES -1.1), role functioning at 3 and 6 months (ES -0.8 and ES -0.6), and social functioning at 6 months (ES -0.6), compared with patients treated with standard CRT (control group, n = 64). The boost group reported significantly more fatigue at 3 and 6 months (83% vs 66% respectively 89% vs 76%), pain at 3 and 6 months (67% vs 36% respectively 80% vs 44%), and diarrhea at 3 months (45% vs 29%) compared with the control group. From 12 months onwards, QoL and symptoms were similar between groups, apart from more blood/mucus in stool in the boost group.
In patients with locally advanced rectal cancer, dose-escalated CRT resulted in a transient deterioration in global health, physical, role, and social functioning and more pain, fatigue and diarrhea at 3 and 6 months after start of treatment compared with standard CRT. From 12 months onwards, the effect of dose-escalated CRT on QoL largely resolved.
Aim
A prolonged interval (>4 weeks) between short‐course radiotherapy (25 Gy in five fractions) (SCRT‐delay) and total mesorectal excision for rectal cancer has been associated with a decreased ...postoperative complication rate and offers the possibility of organ preservation in the case of a complete tumour response. This prospective cohort study systematically evaluated patient‐reported bowel dysfunction and physician‐reported radiation‐induced toxicity for 8 weeks following SCRT‐delay.
Method
Patients who were referred for SCRT‐delay for intermediate risk, oligometastatic or locally advanced rectal cancer were included. Repeated measurements were done for patient‐reported bowel dysfunction (measured by the low anterior resection syndrome LARS questionnaire and categorized as no, minor or major LARS) and physician‐reported radiation‐induced toxicity (according to Common Terminology Criteria for Adverse Events version 4.0) before start of treatment (baseline), at completion of SCRT and 1, 2, 3, 4, 6 and 8 weeks thereafter.
Results
Fifty‐one patients were included; 31 (61%) were men and the median age was 67 years (range 44–91). Patient‐reported bowel dysfunction and physician‐reported radiation‐induced toxicity peaked at weeks 1–2 after completion of SCRT and gradually declined thereafter. Major LARS was reported by 44 patients (92%) at some time during SCRT‐delay. Grade 3 radiation‐induced toxicity was reported in 17 patients (33%) and concerned predominantly diarrhoea. No Grade 4–5 radiation‐induced toxicity occurred.
Conclusion
During SCRT‐delay, almost every patient experiences temporary mild–moderate radiation‐induced toxicity and major LARS, but life‐threatening toxicity is rare. SCRT‐delay is a safe alternative to SCRT‐direct surgery that should be proposed when counselling rectal cancer patients on neoadjuvant strategies.
The epidermis is innervated by fine nerve endings that are important in mediating nociceptive stimuli. However, their precise role in neuropathic pain is still controversial. Here, we have studied ...the role of epidermal peptidergic nociceptive fibers that are located adjacent to injured fibers in a rat model of neuropathic pain. Using the Spared Nerve Injury (SNI) model, which involves complete transections of the tibial and common peroneal nerve while sparing the sural and saphenous branches, mechanical hypersensitivity was induced of the uninjured lateral (sural) and medial (saphenous) area of the foot sole. At different time points, a complete foot sole biopsy was taken from the injured paw and processed for Calcitonin Gene-Related Peptide (CGRP) immunohistochemistry. Subsequently, a novel 2D-reconstruction model depicting the density of CGRP fibers was made to evaluate the course of denervation and re-innervation by uninjured CGRP fibers. The results show an increased density of uninjured CGRP-IR epidermal fibers on the lateral and medial side after a SNI procedure at 5 and 10 weeks. Furthermore, although in control animals the density of epidermal CGRP-IR fibers in the footpads was lower compared to the surrounding skin of the foot, 10 weeks after the SNI procedure, the initially denervated footpads displayed a hyper-innervation. These data support the idea that uninjured fibers may play a considerable role in development and maintenance of neuropathic pain and that it is important to take larger biopsies to test the relationship between innervation of injured and uninjured nerve areas.
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