We present timing models for 20 millisecond pulsars in the Parkes Pulsar Timing Array. The precision of the parameter measurements in these models has been improved over earlier results by using ...longer data sets and modelling the non-stationary noise. We describe a new noise modelling procedure and demonstrate its effectiveness using simulated data. Our methodology includes the addition of annual dispersion measure (DM) variations to the timing models of some pulsars. We present the first significant parallax measurements for PSRs J1024−0719, J1045−4509, J1600−3053, J1603−7202, and J1730−2304, as well as the first significant measurements of some post-Keplerian orbital parameters in six binary pulsars, caused by kinematic effects. Improved Shapiro delay measurements have resulted in much improved pulsar mass measurements, particularly for PSRs J0437−4715 and J1909−3744 with M
p = 1.44 ± 0.07 and 1.47 ± 0.03 M⊙, respectively. The improved orbital period-derivative measurement for PSR J0437−4715 results in a derived distance measurement at the 0.16 per cent level of precision, D = 156.79 ± 0.25 pc, one of the most fractionally precise distance measurements of any star to date.
Gravitational waves are expected to be radiated by supermassive black hole binaries formed during galaxy mergers. A stochastic superposition of gravitational waves from all such binary systems would ...modulate the arrival times of pulses from radio pulsars. Using observations of millisecond pulsars obtained with the Parkes radio telescope, we constrained the characteristic amplitude of this background, Ac,yr, to be <1.0 × 10–15 with 95% confidence. This limit excludes predicted ranges for Ac,yr from current models with 91 to 99.7% probability. We conclude that binary evolution is either stalled or dramatically accelerated by galactic-center environments and that higher-cadence and shorter-wavelength observations would be more sensitive to gravitational waves.
Abstract Background In patients with severe aortic stenosis at increased risk for surgery, self-expanding transcatheter aortic valve replacement (TAVR) is associated with improved 2-year survival ...compared with surgery. Objectives This study sought to determine whether this clinical benefit was sustained over time. Methods Patients with severe aortic stenosis deemed at increased risk for surgery by a multidisciplinary heart team were randomized 1:1 to TAVR or open surgical valve replacement (SAVR). Three-year clinical and echocardiographic outcomes were obtained in those patients with an attempted procedure. Results A total of 797 patients underwent randomization at 45 U.S. centers; 750 patients underwent an attempted procedure. Three-year all-cause mortality or stroke was significantly lower in TAVR patients (37.3% vs. 46.7% in SAVR; p = 0.006). Adverse clinical outcome components were also reduced in TAVR patients compared with SAVR patients, including all-cause mortality (32.9% vs. 39.1%, respectively; p = 0.068), all stroke (12.6% vs. 19.0%, respectively; p = 0.034), and major adverse cardiovascular or cerebrovascular events (40.2% vs. 47.9%, respectively; p = 0.025). At 3 years aortic valve hemodynamics were better with TAVR patients (mean aortic valve gradient 7.62 ± 3.57 mm Hg vs. 11.40 ± 6.81 mm Hg in SAVR; p < 0.001), although moderate or severe residual aortic regurgitation was higher in TAVR patients (6.8% vs. 0.0% in SAVR; p < 0.001). There was no clinical evidence of valve thrombosis in either group. Conclusions Patients with severe aortic stenosis at increased risk for surgery had improved 3-year clinical outcomes after TAVR compared with surgery. Aortic valve hemodynamics were more favorable in TAVR patients without differences in structural valve deterioration. (Safety and Efficacy Study of the Medtronic CoreValve® System in the Treatment of Symptomatic Severe Aortic Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve Replacement; NCT01240902 )
ABSTRACT
Pulsar timing array projects measure the pulse arrival times of millisecond pulsars for the primary purpose of detecting nanohertz-frequency gravitational waves. The measurements include ...contributions from a number of astrophysical and instrumental processes, which can either be deterministic or stochastic. It is necessary to develop robust statistical and physical models for these noise processes because incorrect models diminish sensitivity and may cause a spurious gravitational wave detection. Here we characterize noise processes for the 26 pulsars in the second data release of the Parkes Pulsar Timing Array using Bayesian inference. In addition to well-studied noise sources found previously in pulsar timing array data sets such as achromatic timing noise and dispersion measure variations, we identify new noise sources including time-correlated chromatic noise that we attribute to variations in pulse scattering. We also identify ‘exponential dip’ events in four pulsars, which we attribute to magnetospheric effects as evidenced by pulse profile shape changes observed for three of the pulsars. This includes an event in PSR J1713+0747, which had previously been attributed to interstellar propagation. We present noise models to be used in searches for gravitational waves. We outline a robust methodology to evaluate the performance of noise models and identify unknown signals in the data. The detection of variations in pulse profiles highlights the need to develop efficient profile domain timing methods.
Objectives This study sought to evaluate the safety and efficacy of the CoreValve transcatheter heart valve (THV) for the treatment of severe aortic stenosis in patients at extreme risk for surgery. ...Background Untreated severe aortic stenosis is a progressive disease with a poor prognosis. Transcatheter aortic valve replacement (TAVR) with a self-expanding bioprosthesis is a potentially effective therapy. Methods We performed a prospective, multicenter, nonrandomized investigation evaluating the safety and efficacy of self-expanding TAVR in patients with symptomatic severe aortic stenosis with prohibitive risks for surgery. The primary endpoint was a composite of all-cause mortality or major stroke at 12 months, which was compared with a pre-specified objective performance goal (OPG). Results A total of 41 sites in the United States recruited 506 patients, of whom 489 underwent attempted treatment with the CoreValve THV. The rate of all-cause mortality or major stroke at 12 months was 26.0% (upper 2-sided 95% confidence bound: 29.9%) versus 43.0% with the OPG (p < 0.0001). Individual 30-day and 12-month events included all-cause mortality (8.4% and 24.3%, respectively) and major stroke (2.3% and 4.3%, respectively). Procedural events at 30 days included life-threatening/disabling bleeding (12.7%), major vascular complications (8.2%), and need for permanent pacemaker placement (21.6%). The frequency of moderate or severe paravalvular aortic regurgitation was lower 12 months after self-expanding TAVR (4.2%) than at discharge (10.7%; p = 0.004 for paired analysis). Conclusions TAVR with a self-expanding bioprosthesis was safe and effective in patients with symptomatic severe aortic stenosis at prohibitive risk for surgical valve replacement. (Safety and Efficacy Study of the Medtronic CoreValve System in the Treatment of Symptomatic Severe Aortic Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve Replacement; NCT01240902 )
ABSTRACT
The main goal of pulsar timing array experiments is to detect correlated signals such as nanohertz-frequency gravitational waves. Pulsar timing data collected in dense monitoring campaigns ...can also be used to study the stars themselves, their binary companions, and the intervening ionized interstellar medium. Timing observations are extraordinarily sensitive to changes in path-length between the pulsar and the Earth, enabling precise measurements of the pulsar positions, distances and velocities, and the shapes of their orbits. Here we present a timing analysis of 25 pulsars observed as part of the Parkes Pulsar Timing Array (PPTA) project over time spans of up to 24 yr. The data are from the second data release of the PPTA, which we have extended by including legacy data. We make the first detection of Shapiro delay in four Southern pulsars (PSRs J1017−7156, J1125−6014, J1545−4550, and J1732−5049), and of parallax in six pulsars. The prominent Shapiro delay of PSR J1125−6014 implies a neutron star mass of Mp = 1.5 ± 0.2 M⊙ (68 per cent credibility interval). Measurements of both Shapiro delay and relativistic periastron advance in PSR J1600−3053 yield a large but uncertain pulsar mass of $M_p = 2.06^{+0.44}_{-0.41}$ M⊙ (68 per cent credibility interval). We measure the distance to PSR J1909−3744 to a precision of 10 lyr, indicating that for gravitational wave periods over a decade, the pulsar provides a coherent baseline for pulsar timing array experiments.
Abstract Background A series of models have been developed to identify patients at high risk for poor outcomes after transcatheter aortic valve replacement (TAVR) to help guide treatment choices, ...offer patients realistic expectations of long-term outcomes, and support decision making. Objectives This study examined the performance of the previously developed TAVR Poor Outcome risk models in an external dataset and explored the incremental contribution of geriatric domains to model performance. Methods Poor outcome after TAVR was defined as death, poor quality of life (QOL), or decline in QOL, as assessed using the Kansas City Cardiomyopathy Questionnaire. We tested 4 TAVR Poor Outcome risk models: 6-month and 1-year full and clinical (reduced) models. We examined each model’s discrimination and calibration in the CoreValve trial dataset, and then tested the incremental contribution of frailty and disability markers to the model’s discrimination using the incremental discrimination index. Results Among 2,830 patients who underwent TAVR in the CoreValve US Pivotal Extreme and High Risk trials and associated continued access registries, 31.2% experienced a poor outcome at 6 months following TAVR (death, 17.6%; very poor QOL, 11.6%; QOL decline, 2.0%) and 50.8% experienced a poor outcome at 1 year (death, 30.2%; poor QOL, 19.6%; QOL, decline 1.0%). The models demonstrated similar discrimination as in the Placement of Aortic Transcatheter Valves Trial cohorts (c-indexes, 0.637 to 0.665) and excellent calibration. Adding frailty as a syndrome increased the c-indexes by 0.000 to 0.004 (incremental discrimination index, p < 0.01 for all except the 1-year clinical model), with the most important individual components being disability and unintentional weight loss. Conclusions Although discrimination of the TAVR Poor Outcome risk models was generally moderate, calibration was excellent among patients with different risk profiles and treated with a different TAVR device. These findings demonstrated the value of these models for individualizing outcome predictions in high-risk patients undergoing TAVR.
Abstract Background The U.S. pivotal trial for the self-expanding valve found that among patients with severe aortic stenosis at increased risk for surgery, the 1-year survival rate was 4.9 ...percentage points higher in patients treated with a self-expanding transcatheter aortic valve bioprosthesis than in those treated with a surgical bioprosthesis. Objectives Longer-term clinical outcomes were examined to confirm if this mortality benefit is sustained. Methods Patients with severe aortic stenosis who were at increased surgical risk were recruited. Eligible patients were randomly assigned in a 1:1 ratio to transcatheter aortic valve replacement with the self-expanding transcatheter valve (transcatheter aortic valve replacement TAVR group) or to aortic valve replacement with a surgical bioprosthesis (surgical group). The 2-year clinical and echocardiographic outcomes were evaluated in these patients. Results A total of 797 patients underwent randomization at 45 centers in the United States. The rate of 2-year all-cause mortality was significantly lower in the TAVR group (22.2%) than in the surgical group (28.6%; log-rank test p < 0.05) in the as-treated cohort, with an absolute reduction in risk of 6.5 percentage points. Similar results were found in the intention-to-treat cohort (log-rank test p < 0.05). The rate of 2-year death or major stroke was significantly lower in the TAVR group (24.2%) than in the surgical group (32.5%; log-rank test p = 0.01). Conclusions In patients with severe aortic stenosis who are at increased surgical risk, the higher rate of survival with a self-expanding TAVR compared with surgery was sustained at 2 years. (Safety and Efficacy Study of the Medtronic CoreValve System in the Treatment of Symptomatic Severe Aortic Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve Replacement; NCT01240902 )
Abstract
A nanohertz-frequency stochastic gravitational-wave background can potentially be detected through the precise timing of an array of millisecond pulsars. This background produces ...low-frequency noise in the pulse arrival times that would have a characteristic spectrum common to all pulsars and a well-defined spatial correlation. Recently the North American Nanohertz Observatory for Gravitational Waves collaboration (NANOGrav) found evidence for the common-spectrum component in their 12.5 yr data set. Here we report on a search for the background using the second data release of the Parkes Pulsar Timing Array. If we are forced to choose between the two NANOGrav models—one with a common-spectrum process and one without—we find strong support for the common-spectrum process. However, in this paper, we consider the possibility that the analysis suffers from model misspecification. In particular, we present simulated data sets that contain noise with distinctive spectra but show strong evidence for a common-spectrum process under the standard assumptions. The Parkes data show no significant evidence for, or against, the spatially correlated Hellings–Downs signature of the gravitational-wave background. Assuming we did observe the process underlying the spatially uncorrelated component of the background, we infer its amplitude to be
A
=
2.2
−
0.3
+
0.4
×
10
−
15
in units of gravitational-wave strain at a frequency of 1 yr
−1
. Extensions and combinations of existing and new data sets will improve the prospects of identifying spatial correlations that are necessary to claim a detection of the gravitational-wave background.
ABSTRACT
Long-term studies of binary millisecond pulsars (MSPs) provide precise tests of strong-field gravity, and can be used to measure neutron-star masses. PSR J1909-3744, a binary MSP has been ...the subject of several pulsar timing analyses. The edge-on orbit enables measurement of its mass using the Shapiro delay; however, there is degeneracy in the sense of the inclination angle, i, and multiple solutions for the longitude of ascending node, Ω. Radio pulsars scintillate due to inhomogeneities in the ionized interstellar medium (IISM). This can result in scintillation arcs in the power spectrum of the dynamic spectrum that can use these to study the interstellar medium and constrain binary pulsar orbits. Here, we study the scintillation of PSR J1909-3744 using observations from the 64-m Parkes Radio Telescope (Murriyang) over ≈13 yr, using techniques to study scintillation in a lower signal-to-noise regime. By monitoring annual and orbital variations of the arc-curvature measurements, we are able to characterize the velocity of the IISM. We find that the statistics of the IISM remained stationary over this time and a slightly anisotropic model (axial ratio ≳1.2) is preferred. We measure the relative distance to a single dominant thin scattering screen at s = 0.49 ± 0.04, or Ds = 590 ± 50 pc, with an angle of anisotropy ζ = 85 ± 6° (East of North) and velocity in the direction of anisotropy VIISM,ζ = 14 ± 10 km s−1. By combining a physical model of the IISM and current pulsar timing results, we also constrain Ω = 225 ± 3° and i = 86.46 ± 0.05°.