Abstract A number of stellar astrophysical phenomena, such as tidal novae and planetary engulfment, involve sudden injection of subbinding energy in a thin layer within the star, leading to mass ...ejection of the stellar envelope. We use a 1D hydrodynamical model to survey the stellar response and mass loss for various amounts ( E dep ) and locations of the energy deposition. We find that the total mass ejection has a nontrivial dependence on E dep due to the varying strengths of mass ejection events, which are associated with density/pressure waves breaking out from the stellar surface. The rapid occurrence of multiple breakouts may present a unique observational signature for sudden envelope heating events in stars.
Abstract
GeV and TeV emission from the forward shocks of supernova remnants (SNRs) indicates that they are capable particle accelerators, making them promising sources of Galactic cosmic rays (CRs). ...However, it remains uncertain whether this
γ
-ray emission arises primarily from the decay of neutral pions produced by very-high-energy hadrons, or from inverse-Compton and/or bremsstrahlung emission from relativistic leptons. By applying a semi-analytic approach to non-linear diffusive shock acceleration, and calculating the particle and photon spectra produced in different environments, we parameterize the relative strength of hadronic and leptonic emission. We show that even if CR acceleration is likely to occur in all SNRs, the observed photon spectra may primarily reflect the environment surrounding the SNR: the emission is expected to look hadronic unless the ambient density is particularly low (with proton number density ≲0.1 cm
−3
) or the photon background is enhanced with respect to average Galactic values (with radiation energy density
u
rad
≳ 10 eV cm
−3
). We introduce a hadronicity parameter to characterize how hadronic or leptonic we expect a source to look based on its environment, which can be used to guide the interpretation of current
γ
-ray observations and the detection of high-energy neutrinos from SNRs.
In this paper we report the set-up and results of the Multimodal Brain Tumor Image Segmentation Benchmark (BRATS) organized in conjunction with the MICCAI 2012 and 2013 conferences. Twenty ...state-of-the-art tumor segmentation algorithms were applied to a set of 65 multi-contrast MR scans of low- and high-grade glioma patients - manually annotated by up to four raters - and to 65 comparable scans generated using tumor image simulation software. Quantitative evaluations revealed considerable disagreement between the human raters in segmenting various tumor sub-regions (Dice scores in the range 74%-85%), illustrating the difficulty of this task. We found that different algorithms worked best for different sub-regions (reaching performance comparable to human inter-rater variability), but that no single algorithm ranked in the top for all sub-regions simultaneously. Fusing several good algorithms using a hierarchical majority vote yielded segmentations that consistently ranked above all individual algorithms, indicating remaining opportunities for further methodological improvements. The BRATS image data and manual annotations continue to be publicly available through an online evaluation system as an ongoing benchmarking resource.
Batting in baseball or softball represents a physically and perceptually challenging task. Changes in flight of a high-speed pitched ball require quick and accurate predictions of future location. To ...be successful, an individual must be able to rapidly gather and process visual information, suggesting an emphasis on spatial working memory. The current experiment assessed if individuals of variant expertise levels (novices and varsity softball players) differed in ability to determine future locations of a pitched ball based on different pitch types and durations. Data suggest an impressive base capability for visual motion prediction including a time appropriate ability to predict motion timing. Additionally, while not central to this capability, data suggest a relevance for spatial working memory in predicting speed. These results demonstrate a need to further investigate a base ability in motion prediction as well as the impact of working memory in high performance skills.
The DAMIC-M (DArk Matter In CCDs at Modane) experiment employs thick, fully depleted silicon charged-coupled devices (CCDs) to search for dark matter particles with a target exposure of 1 kg-year. A ...novel skipper readout implemented in the CCDs provides single electron resolution through multiple non-destructive measurements of the individual pixel charge, pushing the detection threshold to the eV-scale. DAMIC-M will advance by several orders of magnitude the exploration of the dark matter particle hypothesis, in particular of candidates pertaining to the so-called “hidden sector.” A prototype, the Low Background Chamber (LBC), with 20g of low background Skipper CCDs, has been recently installed at Laboratoire Souterrain de Modane and is currently taking data. We will report the status of the DAMIC-M experiment and first results obtained with LBC commissioning data.
Hypertension is a heritable and major contributor to the global burden of disease. The sum of rare and common genetic variants robustly identified so far explain only 1%-2% of the population ...variation in BP and hypertension. This suggests the existence of more undiscovered common variants. We conducted a genome-wide association study in 1,621 hypertensive cases and 1,699 controls and follow-up validation analyses in 19,845 cases and 16,541 controls using an extreme case-control design. We identified a locus on chromosome 16 in the 5' region of Uromodulin (UMOD; rs13333226, combined P value of 3.6×10-11). The minor G allele is associated with a lower risk of hypertension (OR 95%CI: 0.87 0.84-0.91), reduced urinary uromodulin excretion, better renal function; and each copy of the G allele is associated with a 7.7% reduction in risk of CVD events after adjusting for age, sex, BMI, and smoking status (H.R. = 0.923, 95% CI 0.860-0.991; p = 0.027). In a subset of 13,446 individuals with estimated glomerular filtration rate (eGFR) measurements, we show that rs13333226 is independently associated with hypertension (unadjusted for eGFR: 0.89 0.83-0.96, p = 0.004; after eGFR adjustment: 0.89 0.83-0.96, p = 0.003). In clinical functional studies, we also consistently show the minor G allele is associated with lower urinary uromodulin excretion. The exclusive expression of uromodulin in the thick portion of the ascending limb of Henle suggests a putative role of this variant in hypertension through an effect on sodium homeostasis. The newly discovered UMOD locus for hypertension has the potential to give new insights into the role of uromodulin in BP regulation and to identify novel drugable targets for reducing cardiovascular risk.
We present a discontinuous Galerkin-finite difference hybrid scheme that allows high-order shock capturing with the discontinuous Galerkin method for general relativistic magnetohydrodynamics in ...dynamical spacetimes. We present several optimizations and stability improvements to our algorithm that allow the hybrid method to successfully simulate single, rotating, and binary neutron stars. The hybrid method achieves the efficiency of discontinuous Galerkin methods throughout almost the entire spacetime during the inspiral phase, while being able to robustly capture shocks and resolve the stellar surfaces. We also use Cauchy-Characteristic evolution to compute the first gravitational waveforms at future null infinity from binary neutron star mergers. The simulations presented here are the first successful binary neutron star inspiral and merger simulations using discontinuous Galerkin methods.
Transcatheter aortic valve replacement (TAVR) is now the standard of care for patients with symptomatic severe aortic stenosis who are extreme, high, or intermediate risk for surgical aortic valve ...replacement (SAVR).
The authors sought to evaluate TAVR in a prospective multicenter trial involving low-risk patients.
The Low Risk TAVR (Feasibility of Transcatheter Aortic Valve Replacement in Low-Risk Patients With Symptomatic, Severe Aortic Stenosis) trial was the first U.S. Food and Drug Administration–approved Investigational Device Exemption trial to enroll in the United States. This investigator-led trial was a prospective, multicenter, unblinded, comparison to historical controls from the Society of Thoracic Surgeons (STS) database. The primary endpoint was all-cause mortality at 30 days.
The authors enrolled 200 low-risk patients with symptomatic severe aortic stenosis at 11 centers to undergo TAVR. The authors compared outcomes with an inverse probability weighting–adjusted control cohort of 719 patients who underwent SAVR at the same institutions using the STS database. At 30 days, there was zero all-cause mortality in the TAVR group versus 1.7% mortality in the SAVR group. There was zero in-hospital stroke rate in the TAVR group versus 0.6% stroke in the SAVR group. Permanent pacemaker implantation rates were similar between TAVR and SAVR (5.0% vs. 4.5%). The rates of new-onset atrial fibrillation (3.0%) and length of stay (2.0 ± 1.1 days) were low in the TAVR group. One patient (0.5%) in the TAVR group had >mild paravalvular leak at 30 days. Fourteen percent of TAVR patients had evidence of subclinical leaflet thrombosis at 30 days.
TAVR is safe in low-risk patients with symptomatic severe aortic stenosis, with low procedural complication rates, short hospital length of stay, zero mortality, and zero disabling stroke at 30 days. Subclinical leaflet thrombosis was observed in a minority of TAVR patients at 30 days. (Feasibility of Transcatheter Aortic Valve Replacement in Low-Risk Patients With Symptomatic, Severe Aortic Stenosis Low Risk TAVR; NCT02628899)
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This study sought to evaluate clinical outcomes and transcatheter heart valve hemodynamics at 1 year after transcatheter aortic valve replacement (TAVR) in low-risk patients.
Early results from the ...LRT (Low Risk TAVR) trial demonstrated that TAVR is safe in patients with symptomatic severe aortic stenosis who are at low risk for surgical valve replacement.
The LRT trial was an investigator-initiated, prospective, multicenter study and was the first Food and Drug Administration-approved Investigational Device Exemption trial to evaluate feasibility of TAVR in low-risk patients. The primary endpoint was all-cause mortality at 30 days. Secondary endpoints included clinical outcomes and valve hemodynamics at 1 year.
The LRT trial enrolled 200 low-risk patients with symptomatic severe AS to undergo TAVR at 11 centers. Mean age was 73.6 years and 61.5% were men. At 30 days, there was zero mortality, zero disabling stroke, and low permanent pacemaker implantation rate (5.0%). At 1-year follow-up, mortality was 3.0%, stroke rate was 2.1%, and permanent pacemaker implantation rate was 7.3%. Two (1.0%) subjects underwent surgical reintervention for endocarditis. Of the 14% of TAVR subjects who had evidence of hypoattenuated leaflet thickening at 30 days, there was no impact on valve hemodynamics at 1 year, but the stroke rate was numerically higher (3.8% vs. 1.9%; p = 0.53).
TAVR in low-risk patients with symptomatic severe aortic stenosis appears to be safe at 1 year. Hypoattenuated leaflet thickening, observed in a minority of TAVR patients at 30 days, did not have an impact on valve hemodynamics in the longer term.
Stereotactic radiosurgery (SRS) without whole brain radiotherapy (WBRT) for brain metastases can avoid WBRT toxicities, but with risk of subsequent distant brain failure (DBF). Sole use of number of ...metastases to triage patients may be an unrefined method. Data on 1354 patients treated with SRS monotherapy from 2000 to 2013 for new brain metastases was collected across eight academic centers. The cohort was divided into training and validation datasets and a prognostic model was developed for time to DBF. We then evaluated the discrimination and calibration of the model within the validation dataset, and confirmed its performance with an independent contemporary cohort. Number of metastases (≥8, HR 3.53 p = 0.0001), minimum margin dose (HR 1.07 p = 0.0033), and melanoma histology (HR 1.45, p = 0.0187) were associated with DBF. A prognostic index derived from the training dataset exhibited ability to discriminate patients’ DBF risk within the validation dataset (c-index = 0.631) and Heller’s explained relative risk (HERR) = 0.173 (SE = 0.048). Absolute number of metastases was evaluated for its ability to predict DBF in the derivation and validation datasets, and was inferior to the nomogram. A nomogram high-risk threshold yielding a 2.1-fold increased need for early WBRT was identified. Nomogram values also correlated to number of brain metastases at time of failure (r = 0.38, p < 0.0001). We present a multi-institutionally validated prognostic model and nomogram to predict risk of DBF and guide risk-stratification of patients who are appropriate candidates for radiosurgery versus upfront WBRT.
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