ABSTRACT
PSR J2032+4127 is only the second known gamma-ray binary where it is confirmed that a young radio pulsar is in orbit around a Be-star. The interaction of the pulsar wind with the mass ...outflow from the companion leads to broad-band emission from radio up to TeV energies. In this paper we present results of optical monitoring of the 2017 periastron passage with the Nordic Optical Telescope. These observations are complemented by X-ray (Swift/XRT, NuSTAR) and GeV (Fermi/LAT) monitoring. Joint analysis of the evolution of the parameters of the H α line and the broad-band (X-ray to TeV) spectral shape allows us to propose a model linking the observed emission to the interaction of the pulsar and Be-star winds under the assumption of the inclined disc geometry. Our model allows the observed flux and spectral evolution of the system to be explained in a self-consistent way.
Purpose
GANEA2 study was designed to assess accuracy and safety of sentinel lymph node (SLN) after neo-adjuvant chemotherapy (NAC) in breast cancer patients.
Methods
Early breast cancer patients ...treated with NAC were included. Before NAC, patients with cytologically proven node involvement were allocated into the pN1 group, other patient were allocated into the cN0 group. After NAC, pN1 group patients underwent SLN and axillary lymph node dissection (ALND); cN0 group patients underwent SLN and ALND only in case of mapping failure or SLN involvement. The main endpoint was SLN false negative rate (FNR). Secondary endpoints were predictive factors for remaining positive ALND and survival of patients treated with SLN alone.
Results
From 2010 to 2014, 957 patients were included. Among the 419 patients from the cN0 group treated with SLN alone, one axillary relapse occurred during the follow-up. Among pN1 group patients, with successful mapping, 103 had a negative SLN. The FNR was 11.9% (95% CI 7.3–17.9%). Multivariate analysis showed that residual breast tumor size after NAC ≥ 5 mm and lympho-vascular invasion remained independent predictors for involved ALND. For patients with initially involved node, with negative SLN after NAC, no lympho-vascular invasion and a remaining breast tumor size 5 mm, the risk of a positive ALND is 3.7% regardless the number of SLN removed.
Conclusion
In patients with no initial node involvement, negative SLN after NAC allows to safely avoid an ALND. Residual breast tumor and lympho-vascular invasion after NAC allow identifying patients with initially involved node with a low risk of ALND involvement.
Abstract
The discovery of very slow pulsations (P
spin =5560 s) has solved the long-standing question of the nature of the compact object in the high-mass X-ray binary 4U 2206+54 but has posed new ...ones. According to spin evolutionary models in close binary systems, such slow pulsations require a neutron star magnetic field strength larger than the quantum critical value of 4.4 × 1013 G, suggesting the presence of a magnetar. We present the first XMM-Newton observations of 4U 2206+54 and investigate its spin evolution. We find that the observed spin-down rate agrees with the magnetar scenario. We analyse Integral Spacecraft Gamma-Ray Imager (ISGRI)/INTErnational Gamma-RAy Laboratory (INTEGRAL) observations of 4U 2206+54 to search for the previously suggested cyclotron resonance scattering feature at ∼30 keV. We do not find a clear indication of the presence of the line, although certain spectra display shallow dips, not always at 30 keV. The association of these dips with a cyclotron line is very dubious because of its apparent transient nature. We also investigate the energy spectrum of 4U 2206+54 in the energy range 0.3-10 keV with unprecedented detail and report for the first time the detection of very weak 6.5 keV fluorescence iron lines. The photoelectric absorption is consistent with the interstellar value, indicating very small amount of local matter, which would explain the weakness of the florescence lines. The lack of matter locally to the source may be the consequence of the relatively large orbital separation of the two components of the binary. The wind would be too tenuous in the vicinity of the neutron star.
The Be X-ray binary EXO 2030+375was in an extended low-luminosity state during most of 2016. We observed this state with NuSTARand Swift, supported by INTEGRALobservations and optical spectroscopy ...with the Nordic Optical Telescope (NOT). We present a comprehensive spectral and timing analysis of these data here to study the accretion geometry and investigate a possible onset of the propeller effect. The Hα data show that the circumstellar disk of the Be-star is still present. We measure equivalent widths similar to values found during more active phases in the past, indicating that the low-luminosity state is not simply triggered by a smaller Be disk. The NuSTARdata, taken at a 3–78 keV luminosity of ~ 6.8 × 1035 erg s-1 (for a distance of 7.1 kpc), are nicely described by standard accreting pulsar models such as an absorbed power law with a high-energy cutoff. We find that pulsations are still clearly visible at these luminosities, indicating that accretion is continuing despite the very low mass transfer rate. In phase-resolved spectroscopy we find a peculiar variation of the photon index from ~1.5 to ~2.5 over only about 3% of the rotational period. This variation is similar to that observed with XMM-Newtonat much higher luminosities. It may be connected to the accretion column passing through our line of sight. With Swift/XRT we observe luminosities as low as 1034 erg s-1 where the data quality did not allow us to search for pulsations, but the spectrum is much softer and well described by either a blackbody or soft power-law continuum. This softer spectrum might be due to the accretion being stopped by the propeller effect and we only observe the neutron star surface cooling.
We report a new subdwarf B pulsator, PG 1142-037, discovered during the first full-length campaign of K2, the two-gyro mission of the Kepler space telescope. 14 periodicities have been detected ...between 0.9 and 2.5 hr with amplitudes below 0.35 parts-per-thousand. We have been able to associate all of the pulsations with low-degree, ℓ ≤ 2 modes. Follow-up spectroscopy of PG 1142 has revealed it to be in a binary with a period of 0.54 d. Phase-folding the K2 photometry reveals a two-component variation including both Doppler boosting and ellipsoidal deformation. Perhaps the most surprising and interesting result is the detection of an ellipsoidal, tidally distorted variable with no indication of rotationally induced pulsation multiplets. This indicates that the rotation period is longer than 45 d, even though the binary period is near 13 h.
Objective
The ENVOL study was designed to assess the psychosocial impact of disease and therapy in a French cohort of cryopyrin‐associated periodic syndromes (CAPS) patients (and caregivers) treated ...with canakinumab.
Methods
The ENVOL study was a multicenter, observational study of CAPS patients given ≥1 canakinumab dose. Data were collected before treatment, at 6 and 12 months afterward, and at the last visit. Patients and caregivers completed questionnaires assessing changes from the 12 months of pretreatment to 12 months prior to interview. Data were analyzed retrospectively.
Results
The study included 10 physicians and 68 patients (53 adults, 15 children). Sixty‐five patients (95.6%) were still receiving canakinumab at the last visit (median 5 years after starting therapy). The mean ± SD score for patient‐reported general health increased from 7 ± 2.9 before canakinumab to 2.7 ± 2.7 after treatment (P < 0.001). Physical and emotional symptoms resolved or improved in a substantial proportion of patients, including bodily pain (38 of 46 patients), fever (32 of 39), skin disease (35 of 41), fatigue (31 of 47), self‐confidence (29 of 46), and energy (34 of 47). Social activity, relationships, sexuality, and energy measures improved in >40% of respondents. Caregivers spent a median of 3 versus 0.5 hours/week on care in the 12 months of pretreatment versus 12 months prior to interview (P < 0.001). Following treatment, patients required fewer consultations with general practitioners (mean ± SD per patient per year: 5.2 ± 7.4 versus 8.5 ± 7.2 pretreatment), internists/rheumatologists/dermatologists (2.0 ± 2.1 versus 3.7 ± 3.9), and pediatricians (1.8 ± 1.5 versus 4.4 ± 4.2).
Conclusion
Long‐term treatment with canakinumab achieves a highly relevant improvement in the physical, emotional, and social lives of patients with CAPS, accompanied by a marked reduction in support required from caregivers and in health care consultations.
Context. The source 4U 2206+54 is one of the most enigmatic high-mass X-ray binaries. In spite of intensive searches, X-ray pulsations have not been detected in the time range 10-3–103 s. A cyclotron ...line at ~30 keV has been suggested by various authors but never detected with significance. The stellar wind of the optical companion is abnormally slow. The orbital period, initially reported to be 9.6 days, disappeared and a new periodicity of 19.25 days emerged. Aims. The main objective of our RXTE monitoring of 4U 2206+54 is to study the X-ray orbital variability of the spectral and timing parameters. The new long and uninterrupted RXTE observations allow us to search for long (~1 h) pulsations for the first time. Methods. We divided the ~7-day observation into five intervals and obtained time-averaged energy spectra and power spectral density for each observation interval. We also searched for pulsations using various algorithms. Results. We have discovered 5560-s pulsations in the light curve of 4U 2206+54. Initially detected in RXTE data, these pulsations are also present in INTEGRAL and EXOSAT observations. The average X-ray luminosity in the energy range 2–10 keV is $1.5 \times 10^{35}$ erg s-1 with a ratio $F_{\rm max}/F_{\rm min} \approx 5$. This ratio implies an eccentricity of ~0.4, somewhat higher than previously suggested. The power spectrum is dominated by red noise that can be fitted with a single power law whose index and strength decrease with X-ray flux. The source also shows a soft excess at low energies. If the soft excess is modelled with a blackbody component, then the size and temperature of the emitting region agrees with its interpretation in terms of a hot spot on the neutron star surface. Conclusions. The discovery of X-ray pulsations in 4U 2206+54 confirms the neutron star nature of the compact companion and definitively rules out the presence of a black hole. The source displays variability on time scales of days, presumably due to changes in the mass accretion rate as the neutron star moves around the optical companion in a moderately eccentric orbit. If current models for the spin evolution in X-ray pulsars are correct, then the magnetic field of 4U 2206+54 at birth must have been $B \gtrsim 10^{14}$ G.
To assess the risk of malignancy in patients with rheumatoid arthritis (RA) receiving tumour necrosis factor (TNF) antagonists through a meta-analysis of data from registry studies and systematic ...review of long-term extension (LTE) studies.
We systematically reviewed the literature up to January 2010 in the Embase and Medline databases, as well as abstracts from the 2008 and 2009 annual meetings of the EULAR and the ACR. The Mantel-Haenszel method was used to provide a common odds ratio (OR). Statistical heterogeneity was assessed by the chi-square Q test (χ²). Standardised incidence ratio (SIR) was extracted for post-marketing studies and registries.
The literature search identified 634 articles and 110 abstracts, of which 12 and 5, respectively, were selected for analysis. We could perform a meta-analysis of data from 4 and 3 registries for risk of total malignancy and non-melanoma skin cancers (NMSC), respectively. The pooled OR for total malignancy and for NMSC was 0.81 95% confidence interval (CI) 0.71-0.94 and 0.79 0.62-1.02 in TNF antagonist group versus DMARD group, respectively. There was no significant heterogeneity. Among 4 LTE studies and 4 registries, no significant increase in the incidence of total malignancy was noted versus the general population. The only signal may be an increased risk of non-melanoma skin cancers.
Our meta-analysis of data from registries and systematic review of LTE studies did not reveal an increased risk of total malignancy in RA patients receiving anti-TNF therapy.
SAX J2103.5+4545 is the Be/X-ray binary (BeX) with the shortest orbital period. It shows extended bright and faint X-ray states that last for a few hundred days. The main objective of this work is to ...investigate the relationship between the X-ray and optical variability and to characterize the spectral and timing properties of the bright and faint states. We have found a correlation between the spectral and temporal parameters that fit the energy and power spectra. Softer energy spectra correspond to softer power spectra. That is to say, when the energy spectrum is soft, the power at high frequencies is suppressed. We also present the results of our monitoring of the Hα line of the optical counterpart since its discovery in 2003. There is a correlation between the strength and shape of the Hα line, originated in the circumstellar envelope of the massive companion and the X-ray emission from the vicinity of the neutron star. Hα emission, indicative of an equatorial disc around the B-type star, is detected whenever the source is bright in X-rays. When the disc is absent, the X-ray emission decreases significantly. The long-term variability of SAX J2103.5+4545 is characterized by fast episodes of disc loss and subsequent reformation. The time-scales for the loss and reformation of the disc (about 2 yr) are the fastest among BeXs.
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