Essentials
Risk stratification for venous thromboembolism (VTE) in patients with brain tumors is challenging.
Patients with IDH1 wildtype and high podoplanin expression have a 6‐month VTE risk of ...18.2%.
Patients with IDH1 mutation and no podoplanin expression have a 6‐month VTE risk of 0%.
IDH1 mutation and podoplanin overexpression in primary brain tumors appear to be exclusive.
Summary
Background
Venous thromboembolism (VTE) is a frequent complication in primary brain tumor patients. Independent studies revealed that podoplanin expression in brain tumors is associated with increased VTE risk, whereas the isocitrate dehydrogenase 1 (IDH1) mutation is associated with very low VTE risk.
Objectives
To investigate the interrelation between intratumoral podoplanin expression and IDH1 mutation, and their mutual impact on VTE development.
Patients/Methods
In a prospective cohort study, intratumoral IDH1 R132H mutation and podoplanin were determined in brain tumor specimens (mainly glioma) by immunohistochemistry. The primary endpoint of the study was symptomatic VTE during a 2‐year follow‐up.
Results
All brain tumors that expressed podoplanin to a medium‐high extent showed also an IDH1 wild‐type status. A score based on IDH1 status and podoplanin expression levels allowed prediction of the risk of VTE. Patients with wild‐type IDH1 brain tumors and high podoplanin expression had a significantly increased VTE risk compared with those with mutant IDH1 tumors and no podoplanin expression (6‐month risk 18.2% vs. 0%).
Conclusions
IDH1 mutation and podoplanin overexpression seem to be exclusive. Although brain tumor patients with IDH1 mutation are at very low risk of VTE, the risk of VTE in patients with IDH1 wild‐type tumors is strongly linked to podoplanin expression levels.
ABSTRACT
Using the Atacama Large Millimetre/submillimeter Array (ALMA) and the Karl G. Jansky Very Large Array (VLA), we observed the Extended Green Object (EGO) G19.01−0.03 with sub-arcsec ...resolution from 1.05 mm to 5.01 cm wavelengths. Our ∼0.4 arcsec ∼ 1600 au angular resolution ALMA observations reveal a velocity gradient across the millimetre core MM1, oriented perpendicular to the previously known bipolar molecular outflow, which is consistently traced by 20 lines of 8 molecular species with a range of excitation temperatures, including complex organic molecules (COMs). Kinematic modelling shows the data are well described by models that include a disc in Keplerian rotation and infall, with an enclosed mass of 40–70 M⊙ (within a 2000 au outer radius) for a disc inclination angle of i = 40○, of which 5.4–7.2 M⊙ is attributed to the disc. Our new VLA observations show that the 6.7 GHz Class II methanol masers associated with MM1 form a partial ellipse, consistent with an inclined ring, with a velocity gradient consistent with that of the thermal gas. The disc-to-star mass ratio suggests the disc is likely to be unstable and may be fragmenting into as-yet-undetected low-mass stellar companions. Modelling the centimetre–millimetre spectral energy distribution of MM1 shows the ALMA 1.05 mm continuum emission is dominated by dust, whilst a free–free component, interpreted as a hypercompact H ii region, is required to explain the VLA ∼5 cm emission. The high enclosed mass derived for a source with a moderate bolometric luminosity (∼104 L⊙) suggests that the MM1 disc may feed an unresolved high-mass binary system.
ABSTRACT
We present a study of the physical and chemical properties of the Extended Green Object (EGO) G19.01−0.03 using sub-arcsecond angular resolution Atacama Large Millimetre/submillimetre Array ...(ALMA) 1.05 mm and Karl G. Jansky Very Large Array (VLA) 1.21 cm data. G19.01−0.03 MM1, the millimetre source associated with the central massive young stellar object (MYSO), appeared isolated and potentially chemically young in previous Submillimetre Array observations. In our ∼0.4 arcsec-resolution ALMA data, MM1 has four low-mass millimetre companions within 0.12 pc, all lacking maser or outflow emission, indicating they may be pre-stellar cores. With a rich ALMA spectrum full of complex organic molecules, MM1 does not appear chemically young, but has molecular abundances typical of high-mass hot cores in the literature. At the 1.05 mm continuum peak of MM1, N(CH3OH) = (2.22 ± 0.01) × 1018 cm−2 and $T_{\mathrm{ex}} = 162.7\substack{+0.3 \\
-0.5}$ K based on pixel-by-pixel Bayesian analysis of LTE synthetic methanol spectra across MM1. Intriguingly, the peak CH3OH Tex = 165.5 ± 0.6 K is offset from MM1’s millimetre continuum peak by 0.22 arcsec ∼ 880 au, and a region of elevated CH3OH Tex coincides with free–free VLA 5.01 cm continuum, adding to the tentative evidence for a possible unresolved high-mass binary in MM1. In our VLA 1.21 cm data, we report the first NH3(3,3) maser detections towards G19.01−0.03, along with candidate 25 GHz CH3OH 5(2, 3) − 5(1, 4) maser emission; both are spatially and kinematically coincident with 44 GHz Class I CH3OH masers in the MM1 outflow. We also report the ALMA detection of candidate 278.3 GHz Class I CH3OH maser emission towards this outflow, strengthening the connection of these three maser types to MYSO outflows.
Protostellar disks are known to accrete; however, the exact mechanism that extracts the angular momentum and drives accretion in the low-ionization “dead” region of the disk is under debate. In ...recent years, magnetohydrodynamic (MHD) disk winds have become a popular solution. Even so, observations of these winds require both high spatial resolution (~10 s au) and high sensitivity, which has resulted in only a handful of MHD disk wind candidates to date. In this work we present high angular resolution (~30 au) ALMA observations of the emblematic L1448-mm protostellar system and find suggestive evidence for an MHD disk wind. The disk seen in dust continuum (~0.9 mm) has a radius of ~23 au. Rotating infall signatures in H13CO+ indicate a central mass of 0.4 ± 0.1 M⊙ and a centrifugal radius similar to the dust disk radius. Above the disk, we identify rotation signatures in the outflow traced by H13CN, CH3OH, and SO lines and find a kinematical structure consistent with theoretical predictions for MHD disk winds. This is the first detection of an MHD disk wind candidate in H13CN and CH3OH. The wind launching region estimated from cold MHD wind theory extends out to the disk edge. The magnetic lever arm parameter would be λϕ ≃ 1.7, in line with recent non-ideal MHD disk models. The estimated mass-loss rate is approximately four times the protostellar accretion rate (Ṁacc ≃ 2 × 10−6M⊙ yr−1) and suggests that the rotating wind could carry enough angular momentum to drive disk accretion.
BACKGROUND AND PURPOSEPublished data regarding embolic protection device efficacy is mixed, and its use during carotid artery stent placement remains variable. We, therefore, examined the frequency ...of embolic protection device use and its association with outcomes after carotid artery stent placement using a national quality improvement data base. MATERIALS AND METHODSPatients undergoing carotid artery stent placement with or without embolic protection devices were identified in the American College of Surgeons National Surgical Quality Improvement Program data base. The primary outcome was the incidence of major adverse cardiovascular events (defined as death, stroke, or myocardial infarction/arrhythmia) within 30 days. Propensity scoring was used to create 2 matching cohorts of patients using demographic and baseline variables. RESULTSBetween 2011 and 2018, among 1200 adult patients undergoing carotid artery stent placement, 23.8% did not have embolic protection devices. There was no trend toward increased embolic protection device use with time. Patients without embolic protection device use received preoperative antiplatelets less frequently (90.6% versus 94.6%, P = .02), underwent more emergent carotid artery stent placement (7.2% versus 3.6%, P = .01), and had a higher incidence of major adverse cardiovascular events (OR = 1.81; 95% CI, 1.11-2.94) and stroke (OR = 3.31; 95% CI, 1.71-6.39). After compensating for baseline imbalances using propensity-matched cohorts (n = 261 for both), carotid artery stent placement without an embolic protection device remained associated with increased major adverse cardiovascular events (9.2% versus 4.2%; OR = 2.30; 95% CI, 1.10-4.80) and stroke (6.5% versus 1.5%; OR = 4.48; 95% CI, 1.49-13.49). CONCLUSIONSLack of embolic protection device use during carotid artery stent placement is associated with a 4-fold increase in the likelihood of perioperative stroke. Nevertheless, nearly one-quarter of patients in the American College of Surgeons National Surgical Quality Improvement Program underwent unprotected carotid artery stent placement. Efforts targeting improved embolic protection device use during carotid artery stent placement are warranted.
Nitrogen-bearing complex organic molecules have been commonly detected in the gas phase but not yet in interstellar ices. This has led to the long-standing question of whether these molecules form in ...the gas phase or in ices. The James Webb Space Telescope (JWST) offers the sensitivity, spectral resolution, and wavelength coverage needed to detect them in ices and investigate whether their abundance ratios are similar in gas and ice. We report the first tentative detection of CH3CN, C2H5CN and the simple molecule, N2O, based on the CN-stretch band in interstellar ices toward three (HOPS 153, HOPS 370, and IRAS 20126+4104) out of the five protostellar systems observed as part of the Investigating Protostellar Accretion (IPA) GO program with JWST-NIRSpec. We also provide upper limits for the two other sources with smaller luminosities in the sample. We detect OCN− in the ices of all sources with typical CH3CN/OCN− ratios of around 1. Ice and gas column density ratios of the nitrogen-bearing species with respect to each other are better matched than those with respect to methanol, which are a factor of ~5 larger in the ices than the gas. We attribute the elevated ice column densities with respect to methanol to the difference in snowline locations of nitrogen-bearing molecules and of methanol, biasing the gas-phase observations toward fewer nitrogen-bearing molecules. Moreover, we find tentative evidence of the enhancement of OCN−, CH3CN, and C2H5CN in warmer ices; although, the formation of these molecules likely starts along with methanol in the cold prestellar phase. Future surveys combining NIRSpec and MIRI, and additional laboratory spectroscopic measurements of C2H5CN ice, are necessary for robust detection and conclusions on the formation history of complex cyanides.
Context. Thanks to the Mid-InfraRed Instrument (MIRI) on the James Webb Space Telescope (JWST), our ability to observe the star formation process in the infrared has greatly improved. Due to its ...unprecedented spatial and spectral resolution and sensitivity in the mid-infrared, JWST/MIRI can see through highly extincted protostellar envelopes and probe the warm inner regions. An abundant molecule in these warm inner regions is SO2, which is a common tracer of both outflow and accretion shocks as well as hot core chemistry. Aims. This paper presents the first mid-infrared detection of gaseous SO2 emission in an embedded low-mass protostellar system rich in complex molecules and aims to determine the physical origin of the SO2 emission. Methods. JWST/MIRI observations taken with the Medium Resolution Spectrometer (MRS) of the low-mass protostellar binary NGC 1333 IRAS 2A in the JWST Observations of Young protoStars (JOYS+) program are presented. The observations reveal emission from the SO2 v3 asymmetric stretching mode at 7.35 µm. Using simple slab models and assuming local thermodynamic equilibrium (LTE), we derived the rotational temperature and total number of SO2 molecules. We then compared the results to those derived from high-angular-resolution SO2 data on the same scales (~50–100 au) obtained with the Atacama Large Millimeter/submillimeter Array (ALMA). Results. The SO2 emission from the v3 band is predominantly located on ~50–100 au scales around the mid-infrared continuum peak of the main component of the binary, IRAS 2A1. A rotational temperature of 92 ± 8 K is derived from the v3 lines. This is in good agreement with the rotational temperature derived from pure rotational lines in the vibrational ground state (i.e., v = 0) with ALMA (104 ± 5 K), which are extended over similar scales. However, the emission of the v3 lines in the MIRI-MRS spectrum is not in LTE given that the total number of molecules predicted by a LTE model is found to be a factor of 2 × 104 higher than what is derived for the v = 0 state from the ALMA data. This difference can be explained by a vibrational temperature that is ~100 K higher than the derived rotational temperature of the v = 0 state: Tvib ~ 200 K versus Trot = 104 ± 5 K. The brightness temperature derived from the continuum around the v3 band (~7.35 µm) of SO2 is ~180 K, which confirms that the v3 = 1 level is not collisionally populated but rather infrared-pumped by scattered radiation. This is also consistent with the non-detection of the v2 bending mode at 18–20 µm. The similar rotational temperature derived from the MIRI-MRS and ALMA data implies that they are in fact tracing the same molecular gas. The inferred abundance of SO2 , determined using the LTE fit to the lines of the vibrational ground state in the ALMA data, is 1.0 ± 0.3 × 10−8 with respect to H2, which is on the lower side compared to interstellar and cometary ices (10−8−10−7). Conclusions. Given the rotational temperature, the extent of the emission (~100 au in radius), and the narrow line widths in the ALMA data (~3.5 km s−1), the SO2 in IRAS 2A likely originates from ice sublimation in the central hot core around the protostar rather than from an accretion shock at the disk–envelope boundary. Furthermore, this paper shows the importance of radiative pumping and of combining JWST observations with those from millimeter interferometers such as ALMA to probe the physics on disk scales and to infer molecular abundances.
Context. Complex organic molecules (COMs) have been detected ubiquitously in protostellar systems. However, at shorter wavelengths (~0.8 mm), it is generally more difficult to detect larger molecules ...than at longer wavelengths (~3 mm) because of the increase in millimeter dust opacity, line confusion, and unfavorable partition function. Aims. We aim to search for large molecules (more than eight atoms) in the Atacama Large Millimeter/submillimeter Array (ALMA) Band 3 spectrum of IRAS 16293-2422 B. In particular, the goal is to quantify the usability of ALMA Band 3 for molecular line surveys in comparison to similar studies at shorter wavelengths. Methods. We used deep ALMA Band 3 observations of IRAS 16293-2422 B to search for more than 70 molecules and identified as many lines as possible in the spectrum. The spectral settings were set to specifically target three-carbon species such as i- and n-propanol and glycerol, the next step after glycolaldehyde and ethylene glycol in the hydrogenation of CO. We then derived the column densities and excitation temperatures of the detected species and compared the ratios with respect to methanol between Band 3 (~3 mm) and Band 7 (~1 mm, Protostellar Interferometric Line Survey) observations of this source to examine the effect of the dust optical depth. Results. We identified lines of 31 molecules including many oxygen-bearing COMs such as CH 3 OH, CH 2 OHCHO, CH 3 CH 2 OH, and c-C 2 H 4 O and a few nitrogen- and sulfur-bearing ones such as HOCH 2 CN and CH 3 SH. The largest detected molecules are gGg-(CH 2 OH) 2 and CH 3 COCH 3 . We did not detect glycerol or i- and n-propanol, but we do provide upper limits for them which are in line with previous laboratory and observational studies. The line density in Band 3 is only ~2.5 times lower in frequency space than in Band 7. From the detected lines in Band 3 at a ≳ 6σ level, ~25–30% of them could not be identified indicating the need for more laboratory data of rotational spectra. We find similar column densities and column density ratios of COMs (within a factor ~2) between Band 3 and Band 7. Conclusions. The effect of the dust optical depth for IRAS 16293-2422 B at an off-source location on column densities and column density ratios is minimal. Moreover, for warm protostars, long wavelength spectra (~3 mm) are not only crowded and complex, but they also take significantly longer integration times than shorter wavelength observations (~0.8 mm) to reach the same sensitivity limit. The 3 mm search has not yet resulted in the detection of larger and more complex molecules in warm sources. A full deep ALMA Band 2–3 (i.e., ~3–4 mm wavelengths) survey is needed to assess whether low frequency data have the potential to reveal more complex molecules in warm sources.
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