Effect of coping strategies on patient and physician perceptions of disease severity and disability in systemic sclerosis

Objective. Systemic sclerosis (SSc) results in impaired function, disability, and reduced health-related quality of life. We investigated the effect of coping strategies on the patient global assessment of health (PtGA) and Health Assessment Questionnaire–Disability Index (HAQ-DI), after controlling for clinical characteristics and disease activity. We also explored the relationship between coping strategies and the correlation between the PtGA and physician global assessment (PGA) in SSc. Methods. We undertook posthoc analyses using baseline data obtained from the Raynaud Symptom Study (RSS). The PtGA, Coping Strategies Questionnaire, Pain Catastrophizing Scale, and Scleroderma Health Assessment Questionnaire were collected alongside the PGA, clinical characteristics, and patient demographics. Multivariable linear regression models and correlations were used to evaluate the relationship between coping strategies with the PtGA, HAQ-DI, and PGA. Results. Of the 107 patients with SSc enrolled in the RSS, there were sufficient data available for the analysis of 91 participants. The mean PtGA was 40/100 (SD 27) and the mean HAQ-DI was 0.87/3.0 (SD 0.73). After controlling for clinical and patient demographics, pain catastrophizing and maladaptive coping skills were significantly associated with the PtGA and HAQ-DI scores (P &lt; 0.05 for both), but not the PGA. Conclusion. The effect of coping strategies on PtGA and HAQ-DI (but not PGA in SSc) could influence the result of composite measures incorporating these outcome measures. Interventions to improve patient coping skills may support increased resilience and improve patient-perceived functional status and PtGA in SSc.</p

Spectropolarimetry of SN 2011dh in M51: geometric insights on a Type IIb supernova progenitor and explosion

We present seven epochs of spectropolarimetry of the Type IIb supernova (SN) 2011dh in M51, spanning 86 days of its evolution. The first epoch was obtained 9 days after the explosion, when the photosphere was still in the depleted hydrogen layer of the stripped-envelope progenitor. Continuum polarization is securely detected at the level of P~0.5% through day 14 and appears to diminish by day 30, which is different from the prevailing trends suggested by studies of other core-collapse SNe. Time-variable modulations in P and position angle are detected across P-Cygni line features. H-alpha and HeI polarization peak after 30 days and exhibit position angles roughly aligned with the earlier continuum, while OI and CaII appear to be geometrically distinct. We discuss several possibilities to explain the evolution of the continuum and line polarization, including the potential effects of a tidally deformed progenitor star, aspherical radioactive heating by fast-rising plumes of Ni-56 from the core, oblique shock breakout, or scattering by circumstellar material. While these possibilities are plausible and guided by theoretical expectations, they are not unique solutions to the data. The construction of more detailed hydrodynamic and radiative-transfer models that incorporate complex aspherical geometries will be required to further elucidate the nature of the polarized radiation from SN 2011dh and other Type IIb supernovae.Comment: Post-proof edit. Accepted to MNRAS 2015 Aug 1

A missing dimension in measures of vaccination impacts

Immunological protection, acquired from either natural infection or vaccination, varies among hosts, reflecting underlying biological variation and affecting population-level protection. Owing to the nature of resistance mechanisms, distributions of susceptibility and protection entangle with pathogen dose in a way that can be decoupled by adequately representing the dose dimension. Any infectious processes must depend in some fashion on dose, and empirical evidence exists for an effect of exposure dose on the probability of transmission to mumps-vaccinated hosts [1], the case-fatality ratio of measles [2], and the probability of infection and, given infection, of symptoms in cholera [3]. Extreme distributions of vaccine protection have been termed leaky (partially protects all hosts) and all-or-nothing (totally protects a proportion of hosts) [4]. These distributions can be distinguished in vaccine field trials from the time dependence of infections [5]. Frailty mixing models have also been proposed to estimate the distribution of protection from time to event data [6], [7], although the results are not comparable across regions unless there is explicit control for baseline transmission [8]. Distributions of host susceptibility and acquired protection can be estimated from dose-response data generated under controlled experimental conditions [9]–[11] and natural settings [12], [13]. These distributions can guide research on mechanisms of protection, as well as enable model validity across the entire range of transmission intensities. We argue for a shift to a dose-dimension paradigm in infectious disease science and community health

SN2010jp (PTF10aaxi): A Jet-Driven Type II Supernova

We present photometry and spectroscopy of the peculiar TypeII supernova (SN) 2010jp, also named PTF10aaxi. The light curve exhibits a linear decline with a relatively low peak absolute magnitude of only -15.9, and a low radioactive decay luminosity at late times that suggests a nickel mass below 0.003 $M_{\odot}$. Spectra of SN2010jp display an unprecedented triple-peaked H$\alpha$ line profile, showing: (1) a narrow (800 km/s) central component that suggests shock interaction with dense CSM; (2) high-velocity blue and red emission features centered at -12600 and +15400 km/s; and (3) broad wings extending from -22000 to +25000 km/s. These features persist during 100 days after explosion. We propose that this line profile indicates a bipolar jet-driven explosion, with the central component produced by normal SN ejecta and CSM interaction at mid latitudes, while the high-velocity bumps and broad line wings arise in a nonrelativistic bipolar jet. Two variations of the jet interpretation seem plausible: (1) A fast jet mixes 56Ni to high velocities in polar zones of the H-rich envelope, or (2) the reverse shock in the jet produces blue and red bumps in Balmer lines when a jet interacts with dense CSM. Jet-driven SNeII are predicted for collapsars resulting from a wide range of initial masses above 25 $M_{\odot}$ at sub-solar metallicity. This seems consistent with the SN host environment, which is either an extremely low-luminosity dwarf galaxy or very remote parts of an interacting pair of star-forming galaxies. It also seems consistent with the low 56Ni mass that may accompany black hole formation. We speculate that the jet survives to produce observable signatures because the star's H envelope was mostly stripped away by previous eruptive mass loss.Comment: 11 pages, 9 figures, submitted to MNRA

PTF11iqb: Cool supergiant mass loss that bridges the gap between Type IIn and normal supernovae

PTF11iqb was initially classified as a TypeIIn event caught very early after explosion. It showed narrow Wolf-Rayet (WR) spectral features on day 2, but the narrow emission weakened quickly and the spectrum morphed to resemble those of Types II-L and II-P. At late times, Halpha emission exhibited a complex, multipeaked profile reminiscent of SN1998S. In terms of spectroscopic evolution, we find that PTF11iqb was a near twin of SN~1998S, although with weaker interaction with circumstellar material (CSM) at early times, and stronger CSM interaction at late times. We interpret the spectral changes as caused by early interaction with asymmetric CSM that is quickly (by day 20) enveloped by the expanding SN ejecta photosphere, but then revealed again after the end of the plateau when the photosphere recedes. The light curve can be matched with a simple model for weak CSM interaction added to the light curve of a normal SN~II-P. This plateau requires that the progenitor had an extended H envelope like a red supergiant, consistent with the slow progenitor wind speed indicated by narrow emission. The cool supergiant progenitor is significant because PTF11iqb showed WR features in its early spectrum --- meaning that the presence of such WR features in an early SN spectrum does not necessarily indicate a WR-like progenitor. [abridged] Overall, PTF11iqb bridges SNe~IIn with weaker pre-SN mass loss seen in SNe II-L and II-P, implying a continuum between these types.Comment: 21 pages, 12 figures, submitted to MNRA

ULTRAVIOLET SPECTROSCOPY OF TYPE IIB SUPERNOVAE: DIVERSITY AND THE IMPACT OF CIRCUMSTELLAR MATERIAL

We present new Hubble Space Telescope (HST) multi-epoch ultraviolet (UV) spectra of the bright Type IIb SN 2013df, and undertake a comprehensive analysis of the set of four SNe IIb for which HST UV spectra are available (SN 1993J, SN 2001ig, SN 2011dh, and SN 2013df). We find strong diversity in both continuum levels and line features among these objects. We use radiative-transfer models that fit the optical part of the spectrum well, and find that in three of these four events we see a UV continuum flux excess, apparently unaffected by line absorption. We hypothesize that this emission originates above the photosphere, and is related to interaction with circumstellar material (CSM) located in close proximity to the SN progenitor. In contrast, the spectra of SN 2001ig are well fit by single-temperature models, display weak continuum and strong reverse-fluorescence features, and are similar to spectra of radioactive 56Ni-dominated SNe Ia. A comparison of the early shock-cooling components in the observed light curves with the UV continuum levels which we assume trace the strength of CSM interaction suggests that events with slower cooling have stronger CSM emission. The radio emission from events having a prominent UV excess is perhaps consistent with slower blast-wave velocities, as expected if the explosion shock was slowed down by the CSM that is also responsible for the strong UV, but this connection is currently speculative as it is based on only a few events

Observational and Physical Classification of Supernovae

This chapter describes the current classification scheme of supernovae (SNe). This scheme has evolved over many decades and now includes numerous SN Types and sub-types. Many of these are universally recognized, while there are controversies regarding the definitions, membership and even the names of some sub-classes; we will try to review here the commonly-used nomenclature, noting the main variants when possible. SN Types are defined according to observational properties; mostly visible-light spectra near maximum light, as well as according to their photometric properties. However, a long-term goal of SN classification is to associate observationally-defined classes with specific physical explosive phenomena. We show here that this aspiration is now finally coming to fruition, and we establish the SN classification scheme upon direct observational evidence connecting SN groups with specific progenitor stars. Observationally, the broad class of Type II SNe contains objects showing strong spectroscopic signatures of hydrogen, while objects lacking such signatures are of Type I, which is further divided to numerous subclasses. Recently a class of super-luminous SNe (SLSNe, typically 10 times more luminous than standard events) has been identified, and it is discussed. We end this chapter by briefly describing a proposed alternative classification scheme that is inspired by the stellar classification system. This system presents our emerging physical understanding of SN explosions, while clearly separating robust observational properties from physical inferences that can be debated. This new system is quantitative, and naturally deals with events distributed along a continuum, rather than being strictly divided into discrete classes. Thus, it may be more suitable to the coming era where SN numbers will quickly expand from a few thousands to millions of events.Comment: Extended final draft of a chapter in the "SN Handbook". Comments most welcom

PTF11eon/SN2011dh: Discovery of a Type IIb Supernova From a Compact Progenitor in the Nearby Galaxy M51

On May 31, 2011 UT a supernova (SN) exploded in the nearby galaxy M51 (the Whirlpool Galaxy). We discovered this event using small telescopes equipped with CCD cameras, as well as by the Palomar Transient Factory (PTF) survey, and rapidly confirmed it to be a Type II supernova. Our early light curve and spectroscopy indicates that PTF11eon resulted from the explosion of a relatively compact progenitor star as evidenced by the rapid shock-breakout cooling seen in the light curve, the relatively low temperature in early-time spectra and the prompt appearance of low-ionization spectral features. The spectra of PTF11eon are dominated by H lines out to day 10 after explosion, but initial signs of He appear to be present. Assuming that He lines continue to develop in the near future, this SN is likely a member of the cIIb (compact IIb; Chevalier and Soderberg 2010) class, with progenitor radius larger than that of SN 2008ax and smaller than the eIIb (extended IIb) SN 1993J progenitor. Our data imply that the object identified in pre-explosion Hubble Space Telescope images at the SN location is possibly a companion to the progenitor or a blended source, and not the progenitor star itself, as its radius (~10^13 cm) would be highly inconsistent with constraints from our post-explosion photometric and spectroscopic data

PTF11iqb: cool supergiant mass-loss that bridges the gap between Type IIn and normal supernovae

The supernova (SN) PTF11iqb was initially classified as a Type IIn event caught very early after explosion. It showed narrow Wolf–Rayet (WR) spectral features on day 2 (as in SN 1998S and SN 2013cu), but the narrow emission weakened quickly and the spectrum morphed to resemble Types II-L and II-P. At late times, H? exhibited a complex, multipeaked profile reminiscent of SN 1998S. In terms of spectroscopic evolution, we find that PTF11iqb was a near twin of SN 1998S, although with somewhat weaker interaction with circumstellar material (CSM) at early times, and stronger interaction at late times. We interpret the spectral changes as caused by early interaction with asymmetric CSM that is quickly (by day 20) enveloped by the expanding SN ejecta photosphere, but then revealed again after the end of the plateau when the photosphere recedes. The light curve can be matched with a simple model for CSM interaction (with a mass-loss rate of roughly 10?4 M? yr?1) added to the light curve of a normal SN II-P. The underlying plateau requires a progenitor with an extended hydrogen envelope like a red supergiant at the moment of explosion, consistent with the slow wind speed (&lt;80?km?s?1) inferred from narrow H? emission. The cool supergiant progenitor is significant because PTF11iqb showed WR features in its early spectrum – meaning that the presence of such WR features does not necessarily indicate a WR-like progenitor. Overall, PTF11iqb bridges SNe IIn with weaker pre-SN mass-loss seen in SNe II-L and II-P, implying a continuum between these types

PTF11iqb: cool supergiant mass-loss that bridges the gap between Type IIn and normal supernovae

The supernova (SN) PTF11iqb was initially classified as a Type IIn event caught very early after explosion. It showed narrow Wolf–Rayet (WR) spectral features on day 2 (as in SN 1998S and SN 2013cu), but the narrow emission weakened quickly and the spectrum morphed to resemble Types II-L and II-P. At late times, H? exhibited a complex, multipeaked profile reminiscent of SN 1998S. In terms of spectroscopic evolution, we find that PTF11iqb was a near twin of SN 1998S, although with somewhat weaker interaction with circumstellar material (CSM) at early times, and stronger interaction at late times. We interpret the spectral changes as caused by early interaction with asymmetric CSM that is quickly (by day 20) enveloped by the expanding SN ejecta photosphere, but then revealed again after the end of the plateau when the photosphere recedes. The light curve can be matched with a simple model for CSM interaction (with a mass-loss rate of roughly 10?4 M? yr?1) added to the light curve of a normal SN II-P. The underlying plateau requires a progenitor with an extended hydrogen envelope like a red supergiant at the moment of explosion, consistent with the slow wind speed (&lt;80?km?s?1) inferred from narrow H? emission. The cool supergiant progenitor is significant because PTF11iqb showed WR features in its early spectrum – meaning that the presence of such WR features does not necessarily indicate a WR-like progenitor. Overall, PTF11iqb bridges SNe IIn with weaker pre-SN mass-loss seen in SNe II-L and II-P, implying a continuum between these types