Reports of ChAdOx1 vaccine-associated thrombocytopenia and vascular adverse events have led to some countries restricting its use. Using a national prospective cohort, we estimated associations ...between exposure to first-dose ChAdOx1 or BNT162b2 vaccination and hematological and vascular adverse events using a nested incident-matched case-control study and a confirmatory self-controlled case series (SCCS) analysis. An association was found between ChAdOx1 vaccination and idiopathic thrombocytopenic purpura (ITP) (0-27 d after vaccination; adjusted rate ratio (aRR) = 5.77, 95% confidence interval (CI), 2.41-13.83), with an estimated incidence of 1.13 (0.62-1.63) cases per 100,000 doses. An SCCS analysis confirmed that this was unlikely due to bias (RR = 1.98 (1.29-3.02)). There was also an increased risk for arterial thromboembolic events (aRR = 1.22, 1.12-1.34) 0-27 d after vaccination, with an SCCS RR of 0.97 (0.93-1.02). For hemorrhagic events 0-27 d after vaccination, the aRR was 1.48 (1.12-1.96), with an SCCS RR of 0.95 (0.82-1.11). A first dose of ChAdOx1 was found to be associated with small increased risks of ITP, with suggestive evidence of an increased risk of arterial thromboembolic and hemorrhagic events. The attenuation of effect found in the SCCS analysis means that there is the potential for overestimation of the reported results, which might indicate the presence of some residual confounding or confounding by indication. Public health authorities should inform their jurisdictions of these relatively small increased risks associated with ChAdOx1. No positive associations were seen between BNT162b2 and thrombocytopenic, thromboembolic and hemorrhagic events.
The broadening of atomic emission lines by high-velocity motion of gas near accreting supermassive black holes is an observational hallmark of quasars
. Observations of broad emission lines could ...potentially constrain the mechanism for transporting gas inwards through accretion disks or outwards through winds
. The size of regions for which broad emission lines are observed (broad-line regions) has been estimated by measuring the delay in light travel time between the variable brightness of the accretion disk continuum and the emission lines
-a method known as reverberation mapping. In some models the emission lines arise from a continuous outflow
, whereas in others they arise from orbiting gas clouds
. Directly imaging such regions has not hitherto been possible because of their small angular size (less than 10
arcseconds
). Here we report a spatial offset (with a spatial resolution of 10
arcseconds, or about 0.03 parsecs for a distance of 550 million parsecs) between the red and blue photo-centres of the broad Paschen-α line of the quasar 3C 273 perpendicular to the direction of its radio jet. This spatial offset corresponds to a gradient in the velocity of the gas and thus implies that the gas is orbiting the central supermassive black hole. The data are well fitted by a broad-line-region model of a thick disk of gravitationally bound material orbiting a black hole of 3 × 10
solar masses. We infer a disk radius of 150 light days; a radius of 100-400 light days was found previously using reverberation mapping
. The rotation axis of the disk aligns in inclination and position angle with the radio jet. Our results support the methods that are often used to estimate the masses of accreting supermassive black holes and to study their evolution over cosmic time.
Dynamical histories of planetary systems, as well as the atmospheric evolution of highly irradiated planets, can be studied by characterizing the ultra-short-period planet population, which the TESS ...mission is particularly well suited to discover. Here, we report on the follow-up of a transit signal detected in the TESS sector 19 photometric time series of the M3.0 V star TOI-1685 (2MASS J04342248+4302148). We confirm the planetary nature of the transit signal, which has a period of
P
b
= 0.6691403
−0.0000021
+0.0000023
d, using precise radial velocity measurements taken with the CARMENES spectrograph. From the joint photometry and radial velocity analysis, we estimate the following parameters for TOI-1685 b: a mass of
M
b
= 3.78
−0.63
+0.63
M
⊕
, a radius of
R
b
= 1.70
−0.07
+0.07
R
⊕
, which together result in a bulk density of
ρ
b
= 4.21
−0.82
+0.95
g cm
−3
, and an equilibrium temperature of
T
eq
= 1069
−16
+16
K. TOI-1685 b is the least dense ultra-short-period planet around an M dwarf known to date. TOI-1685 b is also one of the hottest transiting super-Earth planets with accurate dynamical mass measurements, which makes it a particularly attractive target for thermal emission spectroscopy. Additionally, we report with moderate evidence an additional non-transiting planet candidate in the system, TOI-1685 c, which has an orbital period of
P
c
= 9.02
−0.12
+0.10
d.
We present the discovery of a transiting mini-Neptune around TOI-1201, a relatively bright and moderately young early M dwarf (
J
≈ 9.5 mag, ~600–800 Myr) in an equal-mass ~8 arcsecond-wide binary ...system, using data from the Transiting Exoplanet Survey Satellite, along with follow-up transit observations. With an orbital period of 2.49 d, TOI-1201 b is a warm mini-Neptune with a radius of
R
b
= 2.415 ± 0.090
R
⊕
. This signal is also present in the precise radial velocity measurements from CARMENES, confirming the existence of the planet and providing a planetary mass of
M
b
= 6.28 ± 0.88
M
⊕
and, thus, an estimated bulk density of 2.45
−0.42
+0.48
g cm
−3
. The spectroscopic observations additionally show evidence of a signal with a period of 19 d and a long periodic variation of undetermined origin. In combination with ground-based photometric monitoring from WASP-South and ASAS-SN, we attribute the 19 d signal to the stellar rotation period (
P
rot
= 19–23 d), although we cannot rule out that the variation seen in photometry belongs to the visually close binary companion. We calculate precise stellar parameters for both TOI-1201 and its companion. The transiting planet is anexcellent target for atmosphere characterization (the transmission spectroscopy metric is 97
−16
+21
) with the upcoming
James Webb
Space Telescope. It is also feasible to measure its spin-orbit alignment via the Rossiter-McLaughlin effect using current state-of-the-art spectrographs with submeter per second radial velocity precision.
Allogeneic hematopoietic cell transplantation is increasingly utilized in older adults. This study prospectively evaluated the prognostic utility of geriatric assessment domains prior to allogeneic ...transplantation in recipients aged 50 years and over. Geriatric assessment was performed prior to transplant, and included validated measures across domains of function and disability, comorbidity, frailty, mental health, nutritional status, and systemic inflammation. A total of 203 patients completed geriatric assessment and underwent transplant. Median age was 58 years (range 50-73). After adjusting for established prognostic factors, limitations in instrumental activities of daily living (HR 2.38, 95%CI: 1.59-3.56; P<0.001), slow walk speed (HR 1.80, 95%CI: 1.14-2.83; P=0.01), high comorbidity by hematopoietic cell transplantation-specific comorbidity index (HR 1.56, 95%CI: 1.07-2.28; P=0.02), low mental health by short-form-36 mental component summary (HR 1.67, 95%CI: 1.13-2.48; P=0.01), and elevated serum C-reactive protein (HR 2.51, 95%CI: 1.54-4.09; P<0.001) were significantly associated with inferior overall survival. These associations were more pronounced in the cohort 60 years and over. Geriatric assessment measures confer independent prognostic utility in older allogeneic transplant recipients. Implementation of geriatric assessment prior to allogeneic transplantation may aid appropriate selection of older adults.
In this prospective phase 2 clinical trial conducted by Cancer and Leukemia Group B (CALGB, now the Alliance), we studied decitabine as maintenance therapy for younger adults with acute myeloid ...leukemia (AML) who remained in first complete remission (CR1) following intensive induction and consolidation. Given that decitabine is clinically active in AML and with hypomethylating activity distinct from cytotoxic chemotherapy, we hypothesized that 1 year of maintenance therapy would improve disease-free survival (DFS) for AML patients <60 years, who did not receive allogeneic stem cell transplantation in CR1. After blood count recovery from final consolidation, patients received decitabine at 20 mg/m
intravenously daily for 4-5 days, every 6 weeks for eight cycles. One hundred and thirty-four patients received decitabine and 85 (63%) had favorable risk AML. The median number of cycles received was 7 (range: 1-8) and the primary reason for discontinuation was relapse. DFS at 1 year and 3 years was 79% and 54%, respectively. These results are similar to the outcomes in the historical control comprising similar patients treated on recent CALGB trials. Thus, maintenance with decitabine provided no benefit overall. Standard use of decitabine maintenance in younger AML patients in CR1 is not warranted. This trial was registered at www.clinicaltrials.gov as NCT00416598.
Vital sign monitoring systems are essential in the care of hospitalized neonates. Due to the immaturity of their organs and immune system, premature infants require continuous monitoring of their ...vital parameters and sensors need to be directly attached to their fragile skin. Besides mobility restrictions and stress, these sensors often cause skin irritation and may lead to pressure necrosis. In this work, we show that a contactless radar-based approach is viable for breathing monitoring in the Neonatal intensive care unit (NICU). For the first time, different scenarios common to the NICU daily routine are investigated, and the challenges of monitoring in a real clinical setup are addressed through different contributions in the signal processing framework. Rather than just discarding measurements under strong interference, we present a novel random body movement mitigation technique based on the time-frequency decomposition of the recovered signal. In addition, we propose a simple and accurate frequency estimator which explores the harmonic structure of the breathing signal. As a result, the proposed radar-based solution is able to provide reliable breathing frequency estimation, which is close to the reference cabled device values most of the time. Our findings shed light on the strengths and limitations of this technology and lay the foundation for future studies toward a completely contactless solution for vital signs monitoring.
We present the discovery and characterisation of two transiting planets observed by the Transiting Exoplanet Survey Satellite (TESS) orbiting the nearby (d⋆ ≈ 22 pc), bright (J ≈ 9 mag) M3.5 dwarf ...LTT 3780 (TOI–732). We confirm both planets and their association with LTT 3780 via ground-based photometry and determine their masses using precise radial velocities measured with the CARMENES spectrograph. Precise stellar parameters determined from CARMENES high-resolution spectra confirm that LTT 3780 is a mid-M dwarf with an effective temperature of T(eff) = 3360 ± 51 K, a surface gravity of log g⋆ = 4.81 ± 0.04 (cgs), and an iron abundance of Fe/H = 0.09 ± 0.16 dex, with an inferred mass of M⋆ = 0.379 ± 0.016M⊙ and a radius of R⋆ = 0.382 ± 0.012R⊙. The ultra-short-period planet LTT 3780 b (P(b) = 0.77 d) with a radius of 1.35(−0.06,+0.06) R⊕, a mass of 2.34(−0.23,+0.24) M⊕, and a bulk density of 5.24(−0.81,+0.94) g/cu.cm joins the population of Earth-size planets with rocky, terrestrial composition. The outer planet, LTT 3780 c, with an orbital period of 12.25 d, radius of 2.42(−0.10,+0.10) R⊕, mass of 6.29(−0.61,+0.63) M⊕, and mean density of 2.45(−0.37,+0.44) g/cu.cm belongs to the population of dense sub-Neptunes. With the two planets located on opposite sides of the radius gap, this planetary system is an excellent target for testing planetary formation, evolution, and atmospheric models. In particular, LTT 3780 c is an ideal object for atmospheric studies with the James Webb Space Telescope (JWST).
Peripheral neuropathy is a major toxicity of vincristine, yet no strategies exist for identifying adult patients at high‐risk. We used a case–control design of 48 adults receiving protocol therapy ...for acute lymphoblastic leukemia (ALL) who developed vincristine‐induced neuropathy (NCI grade 2–4) during treatment, and 48 matched controls who did not develop grade 2–4 neuropathy. Peripheral neuropathy was prospectively graded by National Cancer Institute (NCI) criteria. CEP72 promoter genotype (rs924607) was determined using polymerase chain reaction (PCR)‐based single nucleotide polymorphism (SNP) genotyping. Frequency of the CEP72 T/T genotype was higher in cases (31% vs. 10%, P = 0.0221) and the incidence of vincristine‐induced neuropathy (grades 2–4) was significantly higher in patients homozygous for the CEP72 T/T genotype. 75% of the 20 patients homozygous for the CEP72 T allele developed grade 2–4 neuropathy, compared to 44% of patients with CEP72 CC or CT genotype (P = 0.0221). The CEP72 polymorphism can identify adults at increased risk of vincristine‐induced peripheral neuropathy.
Consideration of both low- and high-resolution transmission spectroscopy is key for obtaining a comprehensive picture of exoplanet atmospheres. In studies of transmission spectra, the continuum ...information is well established with low-resolution spectra, while the shapes of individual lines are best constrained with high-resolution observations. In this work, we aim to merge high- with low-resolution transmission spectroscopy to place tighter constraints on physical parameters of the atmospheres. We present the analysis of three primary transits of WASP-69 b in the visible (VIS) channel of the CARMENES instrument and perform a combined low- and high-resolution analysis using additional data from HARPS-N, OSIRIS/GTC, and WFC3/HST already available in the literature. We investigate the Na
I
D
1
and D
2
doublet, H
α
, the Ca
II
infra-red triplet (IRT), and K
I
λ
7699 Å lines, and we monitor the stellar photometric variability by performing long-term photometric observations with the STELLA telescope. During the first CARMENES observing night, we detected the planet Na
I
D
2
and D
1
lines at ~7 and ~3
σ
significance levels, respectively. We measured a D
2
/D
1
intensity ratio of 2.5 ± 0.7, which is in agreement with previous HARPS-N observations. Our modelling of WFC3 and OSIRIS data suggests strong Rayleigh scattering, solar to super-solar water abundance, and a highly muted Na feature in the atmosphere of this planet, in agreement with previous investigations of this target. We use the continuum information retrieved from the low-resolution spectroscopy as a prior to break the degeneracy between the Na abundance, reference pressure, and thermosphere temperature for the high-resolution spectroscopic analysis. We fit the Na
I
D
1
and D
2
lines individually and find that the posterior distributions of the model parameters agree with each other within 1
σ
. Our results suggest that local thermodynamic equilibrium processes can explain the observed D
2
/D
1
ratio because the presence of haze opacity mutes the absorption features.
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