Protoplanetary disks often appear as multiple concentric rings in dust continuum emission maps and scattered light images. These features are often associated with possible young planets in these ...disks. Many non-planetary explanations have also been suggested, including snow lines, dead zones and secular gravitational instabilities in the dust. In this paper we suggest another potential origin. The presence of copious amounts of dust tends to strongly reduce the conductivity of the gas, thereby inhibiting the magneto-rotational instability, and thus reducing the turbulence in the disk. From viscous disk theory it is known that a disk tends to increase its surface density in regions where the viscosity (i.e. turbulence) is low. Local maxima in the gas pressure tend to attract dust through radial drift, increasing the dust content even more. We have investigated mathematically if this could potentially lead to a feedback loop in which a perturbation in the dust surface density could perturb the gas surface density, leading to increased dust drift and thus amplification of the dust perturbation and, as a consequence, the gas perturbation. We find that this is indeed possible, even for moderately small dust grain sizes, which drift less efficiently, but which are more likely to affect the gas ionization degree. We speculate that this instability could be triggered by the small dust population initially, and when the local pressure maxima are strong enough, the larger dust grains get trapped and lead to the familiar ring-like shapes. We also discuss the many uncertainties and limitations of this model.
Context.
A large portion of stars is found to be part of binary or higher-order multiple systems. The ubiquity of planets found around single stars raises the question of whether and how planets in ...binary systems form. Protoplanetary disks are the birthplaces of planets, and characterizing them is crucial in order to understand the planet formation process.
Aims.
Our goal is to characterize the morphology of the GG Tau A disk, one of the largest and most massive circumbinary disks. We also aim to trace evidence for binary-disk interactions.
Methods.
We obtained observations in polarized scattered light of GG Tau A using the SPHERE/IRDIS instrument in the
H
-band filter. We analyzed the observed disk morphology and substructures. We ran 2D hydrodynamical models to simulate the evolution of the circumbinary ring over the lifetime of the disk.
Results.
The disk and also the cavity and the inner region are highly structured, with several shadowed regions, spiral structures, and streamer-like filaments. Some of these are detected here for the first time. The streamer-like filaments appear to connect the outer ring with the northern arc. Their azimuthal spacing suggests that they may be generated through periodic perturbations by the binary, which tear off material from the inner edge of the outer disk once during each orbit. By comparing observations to hydrodynamical simulations, we find that the main features, in particular, the gap size, but also the spiral and streamer filaments, can be qualitatively explained by the gravitational interactions of a binary with a semimajor axis of ~35 au on an orbit coplanar with the circumbinary ring.
Among the few well-established techniques to diagnose autonomic dysfunction are head-up-tilt table testing, heart rate variability measurement and axon-reflex based sudomotor testing. Recent research ...focused on the development of novel techniques to assess autonomic function based on axon-reflex testing in both vasomotor and pilomotor nerve fibers. However, these techniques are clinically not widely used due to technical limitations and the lack of data on their utility to detect autonomic dysfunction in patients with neuropathy. The treatment of autonomic neuropathies should focus on the management of the underlying disease. In addition, symptomatic treatment of autonomic dysfunction should be provided in an individual patient-centered multimodal regimen that may incorporate both pharmacological and non-pharmacological strategies. The use of medication in autonomic dysfunction requires a careful risk-benefit assessment and should be individually adjusted based on both therapeutic success and occurrence of adverse effects.
The Kepler space mission discovered about a dozen planets orbiting around binary stars systems. Most of these circumbinary planets lie near their instability boundaries at about 3 to 5 binary ...separations. Past attempts to match these final locations through an inward migration process were only successful for the Kepler-16 system. Here, we study 10 circumbinary systems and try to match the final parking locations and orbital parameters of the planets with a disc driven migration scenario. We performed 2D locally isothermal hydrodynamical simulations of circumbinary discs with embedded planets and followed their migration evolution using different values for the disc viscosity and aspect ratio. We found that for the six systems with intermediate binary eccentricities (\(0.1 \le e_{bin}\le 0.21\)) the final planetary orbits matched the observations closely for a single set of disc parameters, specifically a disc viscosity of \(\alpha = 10^{-4}\), and an aspect ratio of \(H/r \sim 0.04\). For these systems the planet masses were large enough to open at least a partial gap in their discs as they approach the binary, forcing the discs to become circularized and allowing for further migration towards the binary, leading to good agreement with the observed planetary orbital parameters. For systems with very small or large binary eccentricities the match was not as good because the very eccentric discs and large inner cavities in these cases prevented close-in planet migration. In test simulations with higher than observed planet masses better agreement could be found for those systems. The good agreement for 6 out of the 10 modelled systems, where the relative difference between observed and simulated final planet orbit is \(\leq 10\%\), strongly supports the idea that planet migration in the disc brought the planets to their present locations.
Randomized controlled trials - a matter of design Spieth, Peter Markus; Kubasch, Anne Sophie; Penzlin, Ana Isabel ...
Neuropsychiatric disease and treatment,
01/2016, Letnik:
12, Številka:
Issue 1
Journal Article
Recenzirano
Odprti dostop
Randomized controlled trials (RCTs) are the hallmark of evidence-based medicine and form the basis for translating research data into clinical practice. This review summarizes commonly applied ...designs and quality indicators of RCTs to provide guidance in interpreting and critically evaluating clinical research data. It further reflects on the principle of equipoise and its practical applicability to clinical science with an emphasis on critical care and neurological research. We performed a review of educational material, review articles, methodological studies, and published clinical trials using the databases MEDLINE, PubMed, and ClinicalTrials.gov. The most relevant recommendations regarding design, conduction, and reporting of RCTs may include the following: 1) clinically relevant end points should be defined a priori, and an unbiased analysis and report of the study results should be warranted, 2) both significant and nonsignificant results should be objectively reported and published, 3) structured study design and performance as indicated in the Consolidated Standards of Reporting Trials statement should be employed as well as registration in a public trial database, 4) potential conflicts of interest and funding sources should be disclaimed in study report or publication, and 5) in the comparison of experimental treatment with standard care, preplanned interim analyses during an ongoing RCT can aid in maintaining clinical equipoise by assessing benefit, harm, or futility, thus allowing decision on continuation or termination of the trial.
Protoplanetary disks often appear as multiple concentric rings in dust continuum emission maps and scattered light images. These features are often associated with possible young planets in these ...disks. Many non-planetary explanations have also been suggested, including snow lines, dead zones and secular gravitational instabilities in the dust. In this paper we suggest another potential origin. The presence of copious amounts of dust tends to strongly reduce the conductivity of the gas, thereby inhibiting the magneto-rotational instability, and thus reducing the turbulence in the disk. From viscous disk theory it is known that a disk tends to increase its surface density in regions where the viscosity (i.e. turbulence) is low. Local maxima in the gas pressure tend to attract dust through radial drift, increasing the dust content even more. We investigate mathematically if this could potentially lead to a feedback loop in which a perturbation in the dust surface density could perturb the gas surface density, leading to increased dust drift and thus amplification of the dust perturbation and, as a consequence, the gas perturbation. We find that this is indeed possible, even for moderately small dust grain sizes, which drift less efficiently, but which are more likely to affect the gas ionization degree. We speculate that this instability could be triggered by the small dust population initially, and when the local pressure maxima are strong enough, the larger dust grains get trapped and lead to the familiar ring-like shapes. We also discuss the many uncertainties and limitations of this model.
Depressive disorders are among the most important health problems and are predicted to constitute the leading cause of disease burden by the year 2030. Aside significant impact on quality of life, ...psychosocial well-being and socioeconomic status of affected patients, depression is associated with impaired cardiovascular health and increased mortality. The link between affective and cardiovascular disease has largely been attributed to dysregulation of the autonomic nervous system resulting in a chronic shift toward increased sympathetic and decreased parasympathetic activity and, consecutively, cardiac dysautonomia. Among proposed surrogate parameters to capture and quantitatively analyze this shift, heart rate variability (HRV) and baroreflex sensitivity have emerged as reliable tools. Attenuation of these parameters is frequently seen in patients suffering from depression and is closely linked to cardiovascular morbidity and mortality. Therefore, diagnostic and therapeutic strategies were designed to assess and counteract cardiac dysautonomia. While psychopharmacological treatment can effectively improve affective symptoms of depression, its effect on cardiac dysautonomia is limited. HRV biofeedback is a non-invasive technique which is based on a metronomic breathing technique to increase parasympathetic tone. While some small studies observed beneficial effects of HRV biofeedback on dysautonomia in patients with depressive disorders, larger confirmatory trials are lacking. We reviewed the current literature on cardiac dysautonomia in patients suffering from depression with a focus on the underlying pathophysiology as well as diagnostic workup and treatment.
Autonomic neuropathies Siepmann, T; Penzlin, A I; Illigens, B M W
Deutsche medizinische Wochenschrift (1946)
138, Številka:
28-29
Journal Article
Recenzirano
Autonomic neuropathies are a heterogeneous group of diseases that involve damage of small peripheral autonomic Aδ- and C-fibers. Causes of autonomic nerve fiber damage are disorders such as diabetes ...mellitus and HIV-infection. Predominant symptoms of autonomic neuropathy are orthostatic hypotension, gastro-intestinal problems, urogenital dysfunction, and cardiac arrhythmia, which can severely impair the quality of life in affected patients. Furthermore, autonomic neuropathies can be induced by autoimmune diseases such as acute inflammatory demyelinating polyneuropathy, hereditary disorders such as the lysosomal storage disorder Fabry disease and hereditary sensory and autonomic neuropathies, as well as certain toxins and drugs.
Ana Isabel Penzlin,1 Timo Siepmann,2 Ben Min-Woo Illigens,3 Kerstin Weidner,4 Martin Siepmann4 1Institute of Clinical Pharmacology, 2Department of Neurology, University Hospital Carl Gustav Carus, ...Technische Universität Dresden, Dresden, Saxony, Germany; 3Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 4Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Saxony, Germany Background and objective: In patients with alcohol dependence, ethyl-toxic damage of vasomotor and cardiac autonomic nerve fibers leads to autonomic imbalance with neurovascular and cardiac dysfunction, the latter resulting in reduced heart rate variability (HRV). Autonomic imbalance is linked to increased craving and cardiovascular mortality. In this study, we sought to assess the effects of HRV biofeedback training on HRV, vasomotor function, craving, and anxiety. Methods: We conducted a randomized controlled study in 48 patients (14 females, ages 25-59 years) undergoing inpatient rehabilitation treatment. In the treatment group, patients (n=24) attended six sessions of HRV biofeedback over 2 weeks in addition to standard rehabilitative care, whereas, in the control group, subjects received standard care only. Psychometric testing for craving (Obsessive Compulsive Drinking Scale), anxiety (Symptom Checklist-90-Revised), HRV assessment using coefficient of variation of R-R intervals (CVNN) analysis, and vasomotor function assessment using laser Doppler flowmetry were performed at baseline, immediately after completion of treatment or control period, and 3 and 6 weeks afterward (follow-ups 1 and 2). Results: Psychometric testing showed decreased craving in the biofeedback group immediately postintervention (OCDS scores: 8.6±7.9 post-biofeedback versus 13.7±11.0 baseline mean ± standard deviation, P<0.05), whereas craving was unchanged at this time point in the control group. Anxiety was reduced at follow-ups 1 and 2 post-biofeedback, but was unchanged in the control group (P<0.05). Following biofeedback, CVNN tended to be increased (10.3%±2.8% post-biofeedback, 10.1%±3.5% follow-up 1, 10.1%±2.9% follow-up 2 versus 9.7%±3.6% baseline; P=not significant). There was no such trend in the control group. Vasomotor function assessed using the mean duration to 50% vasoconstriction of cutaneous vessels after deep inspiration was improved following biofeedback immediately postintervention and was unchanged in the control group (P<0.05). Conclusion: Our data indicate that HRV biofeedback might be useful to decrease anxiety, increase HRV, and improve vasomotor function in patients with alcohol dependence when complementing standard rehabilitative inpatient care. Keywords: HRV, CVNN, alcohol addiction, rehabilitation, craving, laser Doppler flowmetry
A large fraction of stars is found to be part of binary or higher-order multiple systems. The ubiquity of planets found around single stars raises the question if and how planets in binary systems ...may form. Protoplanetary disks are the birthplaces of planets, and their characterization is crucial in order to understand the planet formation process. Our aim is to characterize the morphology of the GG Tau A disk, one of the largest and most massive circumbinary disks, and trace evidence for binary-disk interactions. We obtained observations in polarized scattered light of GG Tau A using the SPHERE/IRDIS instrument in the H-band filter. We analyze the observed disk morphology and substructures. We run 2D hydrodynamical models simulating the evolution of the circumbinary ring over the lifetime of the disk. The disk, as well as the cavity and the inner region are highly structured with several shadowed regions, spiral structures, and streamer-like filaments, some of them detected for the first time. The streamer-like filaments appear to connect the outer ring with the northern arc. Their azimuthal spacing suggests that they may be generated by periodic perturbations by the binary, tearing off material from the inner edge of the outer disk once during each orbit. By comparing observations to hydrodynamical simulations we find that the main features, in particular the gap size, as well as the spiral and streamer filaments, can be qualitatively explained by the gravitational interactions of a binary with semi-major axis of \(\sim\)35 au on an orbit coplanar with the circumbinary ring.
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