Several dozen optical echelle spectra demonstrate that
HR 6819
is a hierarchical triple. A classical Be star is in a wide orbit with an unconstrained period around an inner 40 d binary consisting of ...a B3 III star and an unseen companion in a circular orbit. The radial-velocity semi-amplitude of 61.3 km s
−1
of the inner star and its minimum (probable) mass of 5.0
M
⊙
(6.3 ± 0.7
M
⊙
) imply a mass of the unseen object of ≥4.2
M
⊙
(≥5.0 ± 0.4
M
⊙
), that is, a black hole (BH). The spectroscopic time series is stunningly similar to observations of LB-1. A similar triple-star architecture of LB-1 would reduce the mass of the BH in LB-1 from ∼70
M
⊙
to a level more typical of Galactic stellar remnant BHs. The BH in HR 6819 probably is the closest known BH to the Sun, and together with LB-1, suggests a population of quiet BHs. Its embedment in a hierarchical triple structure may be of interest for models of merging double BHs or BH + neutron star binaries. Other triple stars with an outer Be star but without BH are identified; through stripping, such systems may become a source of single Be stars.
The intent of this pooled analysis as part of the German society for radiation oncology (DEGRO) stereotactic body radiotherapy (SBRT) initiative was to analyze the patterns of care of SBRT for liver ...oligometastases and to derive factors influencing treated metastases control and overall survival in a large patient cohort.
From 17 German and Swiss centers, data on all patients treated for liver oligometastases with SBRT since its introduction in 1997 has been collected and entered into a centralized database. In addition to patient and tumor characteristics, data on immobilization, image guidance and motion management as well as dose prescription and fractionation has been gathered. Besides dose response and survival statistics, time trends of the aforementioned variables have been investigated.
In total, 474 patients with 623 liver oligometastases (median 1 lesion/patient; range 1–4) have been collected from 1997 until 2015. Predominant histologies were colorectal cancer (n = 213 pts.; 300 lesions) and breast cancer (n = 57; 81 lesions). All centers employed an SBRT specific setup. Initially, stereotactic coordinates and CT simulation were used for treatment set-up (55%), but eventually were replaced by CBCT guidance (28%) or more recently robotic tracking (17%). High variance in fraction (fx) number (median 1 fx; range 1–13) and dose per fraction (median: 18.5 Gy; range 3–37.5 Gy) was observed, although median BED remained consistently high after an initial learning curve. Median follow-up time was 15 months; median overall survival after SBRT was 24 months. One- and 2-year treated metastases control rate of treated lesions was 77% and 64%; if maximum isocenter biological equivalent dose (BED) was greater than 150 Gy EQD2Gy, it increased to 83% and 70%, respectively. Besides radiation dose colorectal and breast histology and motion management methods were associated with improved treated metastases control.
After an initial learning curve with regards to total cumulative doses, consistently high biologically effective doses have been employed translating into high local tumor control at 1 and 2 years. The true impact of histology and motion management method on treated metastases control deserve deeper analysis. Overall survival is mainly influenced by histology and metastatic tumor burden.
Perhaps unexpectedly, English travel writing during the long eighteenth century reveals a discourse of global civility. By bringing together representations of the then already familiar Ottoman ...Empire and the largely unknown South Pacific, Sascha Klement adopts a uniquely global perspective and demonstrates how cross-cultural encounters were framed by Enlightenment philosophy, global interconnections, and even-handed exchanges across cultural divides. In so doing, this book shows that both travel and travel-writing from the seventeenth to the nineteenth centuries were much more complex and multi-layered than reductive Eurocentric histories often suggest.
As more and more links between cancer and metabolism are discovered, new approaches to treat cancer using these mechanisms are considered. Dietary restriction of either calories or macronutrients has ...shown great potential in animal studies to both reduce the incidence and growth of cancer, and to act synergistically with other treatment strategies. These studies have also shown that dietary restriction simultaneously targets many of the molecular pathways that are targeted individually by anticancer drugs. The insulin/insulin-like growth factor-1 (IGF-1) system has thereby emerged as a key regulator of cancer growth pathways. Although lowering of insulin levels with diet or drugs such as metformin and diazoxide seems generally beneficial, some practitioners also utilize strategic elevations of insulin levels in combination with chemotherapeutic drugs. This indicates a broad spectrum of possibilities for modulating the insulin/IGF-1 system in cancer treatment. With a specific focus on dietary restriction, insulin administration and the insulin-lowering drug diazoxide, such modifications of the insulin/IGF-1 system are the topic of this review. Although preclinical data are promising, we point out that insulin regulation and the metabolic response to a certain diet often differ between mice and humans. Thus, the need for collecting more human data has to be emphasized.
Abstract Introduction Stereotactic body radiation therapy (SBRT) is applied in the oligometastatic setting to treat liver metastases. However, factors influencing tumor control probability (TCP) ...other than radiation dose have not been thoroughly investigated. Here we set out to investigate such factors with a focus on the influence of histology and chemotherapy prior to SBRT using a large multi-center database from the German Society of Radiation Oncology. Methods 452 SBRT treatments in 363 patients were analyzed after collection of patient, tumor and treatment data in a multi-center database. Histology was considered through random effects in semi-parametric and parametric frailty models. Dose prescriptions were parametrized by conversion to the maximum biologically effective dose using alpha/beta of 10 Gy (BEDmax ). Results After adjusting for histology, BEDmax was the strongest predictor of TCP. Larger PTV volumes, chemotherapy prior to SBRT and simple motion management techniques predicted significantly lower TCP. The model predicted a BED of 209 ± 67 Gy10 necessary for 90% TCP at 2 years with no prior chemotherapy, but 286 ± 78 Gy10 when chemotherapy had been given. Breast cancer metastases were significantly more responsive to SBRT compared to other histologies with 90% TCP at 2 years achievable with BEDmax of 157 ± 80 Gy10 or 80 ± 62 Gy10 with and without prior chemotherapy, respectively. Conclusions Besides dose, histology and pretreatment chemotherapy were important factors influencing local TCP in this large cohort of liver metastases. After adjusting for prior chemotherapy, our data add to the emerging evidence that breast cancer metastases do respond better to hypofractionated SBRT compared to other histologies.
Context. The structure of the inner parts of Be star disks (≲ 20 stellar radii) is well explained by the viscous decretion disk (VDD) model, which is able to reproduce the observable properties of ...most of the objects studied so far. The outer parts, on the other hand, are not observationally well-explored, as they are observable only at radio wavelengths. A steepening of the spectral slope somewhere between infrared and radio wavelengths was reported for several Be stars that were previously detected in the radio, but a convincing physical explanation for this trend has not yet been provided. Aims. We test the VDD model predictions for the extended parts of a sample of six Be disks that have been observed in the radio to address the question of whether the observed turndown in the spectral energy distribution (SED) can be explained in the framework of the VDD model, including recent theoretical development for truncated Be disks in binary systems. Methods. We combine new multi-wavelength radio observations from the Karl. G. Jansky Very Large Array (JVLA) and Atacama Pathfinder Experiment (APEX) with previously published radio data and archival SED measurements at ultraviolet, visual, and infrared wavelengths. The density structure of the disks, including their outer parts, is constrained by radiative transfer modeling of the observed spectrum using VDD model predictions. In the VDD model we include the presumed effects of possible tidal influence from faint binary companions. Results. For 5 out of 6 studied stars, the observed SED shows strong signs of SED turndown between far-IR and radio wavelengths. A VDD model that extends to large distances closely reproduces the observed SEDs up to far IR wavelengths, but fails to reproduce the radio SED. Using a truncated VDD model improves the fit, leading to a successful explanation of the SED turndown observed for the stars in our sample. The slope of the observed SEDs in the radio is however not well reproduced by disks that are simply cut off at a certain distance. Rather, some matter seems to extend beyond the truncation radius, where it still contributes to the observed SEDs, making the spectral slope in the radio shallower. This finding is in agreement with our current understanding of binary truncation from hydrodynamical simulations, in which the disk does extend past the truncation radius. Therefore, the most probable cause for the SED turndown is the presence of binary companions that remain undetected for most of our sources.
Extreme rituals (body-piercing, fire-walking, etc.) are anecdotally associated with altered states of consciousness-subjective alterations of ordinary mental functioning (Ward, 1984)-but empirical ...evidence of altered states using both direct and indirect measures during extreme rituals in naturalistic settings is limited. Participants in the "Dance of Souls", a 3.5-hour event during which participants received temporary piercings with hooks or weights attached to the piercings and danced to music provided by drummers, responded to measures of two altered states of consciousness. Participants also completed measures of positive and negative affect, salivary cortisol (a hormone associated with stress), self-reported stress, sexual arousal, and intimacy. Both pierced participants (pierced dancers) and non-pierced participants (piercers, piercing assistants, observers, drummers, and event leaders) showed evidence of altered states aligned with transient hypofrontality (Dietrich, 2003; measured with a Stroop test) and flow (Csikszentmihalyi, 1990; Csikszentmihalyi & Csikszentmihalyi, 1990; measured with the Flow State Scale). Both pierced and non-pierced participants also reported decreases in negative affect and psychological stress and increases in intimacy from before to after the ritual. Pierced and non-pierced participants showed different physiological reactions, however, with pierced participants showing increases in cortisol and non-pierced participants showing decreases from before to during the ritual. Overall, the ritual appeared to induce different physiological effects but similar psychological effects in focal ritual participants (i.e., pierced dancers) and in participants adopting other roles.
ABSTRACT
Classical B emission (Be) stars are fast rotating, near-main-sequence B-type stars. The rotation and the presence of circumstellar discs profoundly modify the observables of active Be stars. ...Our goal is to infer stellar and disc parameters, as well as distance and interstellar extinction, using the currently most favoured physical models for these objects. We present BeAtlas, a grid of $61\, 600$ non-local thermodynamic equilibrium radiative transfer models for Be stars, calculated with the hdust code. The grid was coupled with a Monte Carlo Markov chain (MCMC) code to sample the posterior distribution. We test our method on two well-studied Be stars, α Eri and β CMi, using photometric, polarimetric, and spectroscopic data as input to the code. We recover literature determinations for most of the parameters of the targets, in particular the mass and age of α Eri, the disc parameters of β CMi, and their distances and inclinations. The main discrepancy is that we estimate lower rotational rates than previous works. We confirm previously detected signs of disc truncation in β CMi and note that its inner disc seems to have a flatter density slope than its outer disc. The correlations between the parameters are complex, further indicating that exploring the entire parameter space simultaneously is a more robust approach, statistically. The combination of BeAtlas and Bayesian-MCMC techniques proves successful, and a powerful new tool for the field: The fundamental parameters of any Be star can now be estimated in a matter of hours or days.
Stereotactic body radiotherapy (SBRT) for oligometastatic disease is characterized by an excellent safety profile; however, experiences are mostly based on treatment of one single metastasis. It was ...the aim of this study to evaluate safety and efficacy of SBRT for multiple pulmonary metastases.
This study is based on a retrospective database of the DEGRO stereotactic working group, consisting of 637 patients with 858 treatments. Cox regression and logistic regression were used to analyze the association between the number of SBRT treatments or the number and the timing of repeat SBRT courses with overall survival (OS) and the risk of early death.
Out of 637 patients, 145 patients were treated for multiple pulmonary metastases; 88 patients received all SBRT treatments within one month whereas 57 patients were treated with repeat SBRT separated by at least one month. Median OS for the total patient population was 23.5 months and OS was not significantly influenced by the overall number of SBRT treatments or the number and timing of repeat SBRT courses. The risk of early death within 3 and 6 months was not increased in patients treated with multiple SBRT treatments, and no grade 4 or grade 5 toxicity was observed in these patients.
In appropriately selected patients, synchronous SBRT for multiple pulmonary oligometastases and repeat SBRT may have a comparable safety and efficacy profile compared to SBRT for one single oligometastasis.
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