BONNSAI: a Bayesian tool for comparing stars with stellar evolution models

Powerful telescopes equipped with multi-fibre or integral field spectrographs combined with detailed models of stellar atmospheres and automated fitting techniques allow for the analysis of large number of stars. These datasets contain a wealth of information that require new analysis techniques to bridge the gap between observations and stellar evolution models. To that end, we develop BONNSAI (BONN Stellar Astrophysics Interface), a Bayesian statistical method, that is capable of comparing all available observables simultaneously to stellar models while taking observed uncertainties and prior knowledge such as initial mass functions and distributions of stellar rotational velocities into account. BONNSAI can be used to (1) determine probability distributions of fundamental stellar parameters such as initial masses and stellar ages from complex datasets, (2) predict stellar parameters that were not yet observationally determined and (3) test stellar models to further advance our understanding of stellar evolution. An important aspect of BONNSAI is that it singles out stars that cannot be reproduced by stellar models through $\chi^{2}$ hypothesis tests and posterior predictive checks. BONNSAI can be used with any set of stellar models and currently supports massive main-sequence single star models of Milky Way and Large and Small Magellanic Cloud composition. We apply our new method to mock stars to demonstrate its functionality and capabilities. In a first application, we use BONNSAI to test the stellar models of Brott et al. (2011a) by comparing the stellar ages inferred for the primary and secondary stars of eclipsing Milky Way binaries. Ages are determined from dynamical masses and radii that are known to better than 3%. We find that the stellar models reproduce the Milky Way binaries well. BONNSAI is available through a web-interface at http://www.astro.uni-bonn.de/stars/bonnsai.Comment: Accepted for publication in A&A; 15 pages, 10 figures, 4 tables; BONNSAI is available through a web-interface at http://www.astro.uni-bonn.de/stars/bonnsa

Oral antiplatelet therapy in diabetes mellitus and the role of prasugrel: an overview

Diabetics have a prothrombotic state that includes increased platelet reactivity. This contributes to the less favorable clinical outcomes observed in diabetics experiencing acute coronary syndromes as well as stable coronary artery disease. Many diabetics are relatively resistant to or have insufficient response to several antithrombotic agents. In the setting of percutaneous coronary intervention, hyporesponsiveness to clopidogrel is particularly common among diabetics. Several strategies have been examined to further enhance the benefits of oral antiplatelet therapy in diabetics. These include increasing the dose of clopidogrel, triple antiplatelet therapy with cilostazol, and new agents such as prasugrel. The large TRITON TIMI 38 randomized trial compared clopidogrel to prasugrel in the setting of percutaneous coronary intervention for acute coronary syndromes. The diabetic subgroup (n = 3146) experienced considerable incremental benefit with a 4.8% reduction in cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke at 15-month follow-up with prasugrel treatment. Among diabetics on insulin this combined endpoint was reduced by 7.9% at 15 months. Major bleeding was not increased in the diabetic subgroup. This confirms the general hypothesis that more potent oral antiplatelet therapy can partially overcome the prothrombotic milieu and safely improve important clinical outcomes in diabetics

Repetitive arm functional tasks after stroke (RAFTAS): a pilot randomised controlled trial

Background Repetitive functional task practise (RFTP) is a promising treatment to improve upper limb recovery following stroke. We report the findings of a study to determine the feasibility of a multi-centre randomised controlled trial to evaluate this intervention. Methods A pilot randomised controlled trial was conducted. Patients with new reduced upper limb function were recruited within 14 days of acute stroke from three stroke units in North East England. Participants were randomised to receive a four week upper limb RFTP therapy programme consisting of goal setting, independent activity practise, and twice weekly therapy reviews in addition to usual post stroke rehabilitation, or usual post stroke rehabilitation. The recruitment rate; adherence to the RFTP therapy programme; usual post stroke rehabilitation received; attrition rate; data quality; success of outcome assessor blinding; adverse events; and the views of study participants and therapists about the intervention were recorded. Results Fifty five eligible patients were identified, 4-6% of patients screened at each site. Twenty four patients participated in the pilot study. Two of the three study sites met the recruitment target of 1-2 participants per month. The median number of face to face therapy sessions received was 6 [IQR 3-8]. The median number of daily repetitions of activities recorded was 80 [IQR 39-80]. Data about usual post stroke rehabilitation were available for 18/24 (75%). Outcome data were available for 22/24 (92%) at one month and 20/24 (83%) at three months. Outcome assessors were unblinded to participant group allocation for 11/22 (50%) at one month and 6/20 (30%) at three months. Four adverse events were considered serious as they resulted in hospitalisation. None were related to study treatment. Feedback from patients and local NHS therapists about the RFTP programme was mainly positive. Conclusions A multi-centre randomised controlled trial to evaluate an upper limb RFTP therapy programme provided early after stroke is feasible and acceptable to patients and therapists, but there are issues which needed to be addressed when designing a Phase III study. A Phase III study will need to monitor and report not only recruitment and attrition but also adherence to the intervention, usual post stroke rehabilitation received, and outcome assessor blinding

On the evolutionary and pulsation mass of Classical Cepheids: III. the case of the eclipsing binary Cepheid CEP0227 in the Large Magellanic Cloud

We present a new Bayesian approach to constrain the intrinsic parameters (stellar mass, age) of the eclipsing binary system CEP0227 in the LMC. We computed evolutionary models covering a broad range in chemical compositions and in stellar mass. Independent sets of models were constructed either by neglecting or by including a moderate convective core overshooting (beta=0.2) during central H-burning phases. Models were also constructed either by neglecting or by assuming a canonical (eta=0.4,0.8) or an enhanced (eta=4) mass loss rate. The solutions were computed in three different planes: luminosity-temperature, mass-radius and gravity-temperature. By using the Bayes Factor, we found that the most probable solutions were obtained in the gravity-temperature plane with a Gaussian mass prior distribution. The evolutionary models constructed by assuming a moderate convective core overshooting (beta=0.2) and a canonical mass loss rate (eta=0.4) give stellar masses for the primary Cepheid M=4.14^{+0.04}_{-0.05} M_sun and for the secondary M=4.15^{+0.04}_{-0.05} M_sun that agree at the 1% level with dynamical measurements. Moreover, we found ages for the two components and for the combined system t=151^{+4}_{-3} Myr that agree at the 5% level. The solutions based on evolutionary models that neglect the mass loss attain similar parameters, while those ones based on models that either account for an enhanced mass loss or neglect convective core overshooting have lower Bayes Factors and larger confidence intervals. The dependence on the mass loss rate might be the consequence of the crude approximation we use to mimic this phenomenon. By using the isochrone of the most probable solution and a Gaussian prior on the LMC distance, we found a distance modulus 18.53^{+0.02}_{-0.02} mag and a reddening value E(B-V)= 0.142^{+0.005}_{-0.010} mag that agree well with literature estimates.Comment: Accepted for publication in ApJ. 17 pages, 9 figure

On the distance and reddening of the starburst galaxy IC10

We present deep and accurate optical photometry of the Local Group starburst galaxy IC10. The photometry is based on two sets of images collected with the Advanced Camera for Surveys and with the Wide Field Planetary Camera 2 on board the Hubble Space Telescope. We provide new estimates of the Red Giant Branch tip (TRGB) magnitude, m_{F814W}^{TRGB}=21.90+-0.03, and of the reddening, E(B-V)=0.78+-0.06, using field stars in the Small Magellanic Cloud (SMC) as a reference. Adopting the SMC and two globulars, Omega Centauri and 47 Tucanae, as references we estimate the distance modulus to IC10: independent calibrations give weighted average distances of mu=24.51+-0.08 (TRGB) and mu=24.56+-0.08 (RR Lyrae). We also provide a new theoretical calibration for the TRGB luminosity, and using these predictions we find a very similar distance to IC10 (mu~24.60+-0.15). These results suggest that IC10 is a likely member of the M31 subgroup.Comment: 4 pages, 4 figures, ApJ Letters accepte

The stroke oxygen pilot study: a randomized control trial of the effects of routine oxygen supplementation early after acute stroke--effect on key outcomes at six months

Introduction: Post-stroke hypoxia is common, and may adversely affect outcome. We have recently shown that oxygen supplementation may improve early neurological recovery. Here, we report the six-month outcomes of this pilot study. Methods: Patients with a clinical diagnosis of acute stroke were randomized within 24 h of admission to oxygen supplementation at 2 or 3 L/min for 72 h or to control treatment (room air). Outcomes (see below) were assessed by postal questionnaire at 6 months. Analysis was by intention-to-treat, and statistical significance was set at p#0.05. Results: Out of 301 patients randomized two refused/withdrew consent and 289 (148 in the oxygen and 141 in the control group) were included in the analysis: males 44%, 51%; mean (SD) age 73 (12), 71 (12); median (IQR) National Institutes of Health Stroke Scale score 6 (3, 10), 5 (3, 10) for the two groups respectively. At six months 22 (15%) patients in the oxygen group and 20 (14%) in the control group had died; mean survival in both groups was 162 days (p= 0.99). Median (IQR) scores for the primary outcome, the modified Rankin Scale, were 3 (1, 5) and 3 (1, 4) for the oxygen and control groups respectively. The covariate-adjusted odds ratio was 1.04 (95% CI 0.67, 1.60), indicating that the odds of a lower (i.e. better) score were non-significantly higher in the oxygen group (p= 0.86). The mean differences in the ability to perform basic (Barthel Index) and extended activities of daily living (NEADL), and quality of life (EuroQol) were also non-significant. Conclusions: None of the key outcomes differed at 6 months between the groups. Although not statistically significant and generally of small magnitude, the effects were predominantly in favour of the oxygen group; a larger trial, powered to show differences in longer-term functional outcomes, is now on-going. Trial Registration: Controlled-Trials.com ISRCTN12362720; Eudract.ema.europa.eu 2004-001866-4

Early Endarterectomy Carries a Lower Procedural Risk Than Early Stenting in Patients With Symptomatic Stenosis of the Internal Carotid Artery: Results From 4 Randomized Controlled Trials.

Patients undergoing carotid endarterectomy (CEA) for symptomatic stenosis of the internal carotid artery benefit from early intervention. Heterogeneous data are available on the influence of timing of carotid artery stenting (CAS) on procedural risk. We investigated the association between timing of treatment (0-7 days and >7 days after the qualifying neurological event) and the 30-day risk of stroke or death after CAS or CEA in a pooled analysis of individual patient data from 4 randomized trials by the Carotid Stenosis Trialists' Collaboration. Analyses were done per protocol. To obtain combined estimates, logistic mixed models were applied. Among a total of 4138 patients, a minority received their allocated treatment within 7 days after symptom onset (14% CAS versus 11% CEA). Among patients treated within 1 week of symptoms, those treated by CAS had a higher risk of stroke or death compared with those treated with CEA: 8.3% versus 1.3%, risk ratio, 6.7; 95% confidence interval, 2.1 to 21.9 (adjusted for age at treatment, sex, and type of qualifying event). For interventions after 1 week, CAS was also more hazardous than CEA: 7.1% versus 3.6%, adjusted risk ratio, 2.0; 95% confidence interval, 1.5 to 2.7 (P value for interaction with time interval 0.06). In randomized trials comparing stenting with CEA for symptomatic carotid artery stenosis, CAS was associated with a substantially higher periprocedural risk during the first 7 days after the onset of symptoms. Early surgery is safer than stenting for preventing future stroke. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00190398; URL: http://www.controlled-trials.com. Unique identifier: ISRCTN57874028; URL: http://www.controlled-trials.com. Unique identifier: ISRCTN25337470; URL: http://www.clinicaltrials.gov. Unique identifier: NCT00004732

The SOS Pilot Study: a RCT of routine oxygen supplementation early after acute stroke—effect on recovery of neurological function at one week

Mild hypoxia is common after stroke and associated with poor long-term outcome. Oxygen supplementation could prevent hypoxia and improve recovery. A previous study of routine oxygen supplementation showed no significant benefit at 7 and 12 months. This pilot study reports the effects of routine oxygen supplementation for 72 hours on oxygen saturation and neurological outcomes at 1 week after a stroke

Wind modelling of very massive stars up to 300 solar masses

Some studies have claimed a universal stellar upper-mass limit of 150 Msun. A factor that is often overlooked is that there might be a difference between the current and initial masses of the most massive stars, as a result of mass loss. We present Monte Carlo mass-loss predictions for very massive stars in the range 40-300 Msun, with large luminosities and Eddington factors Gamma. Using our new dynamical approach, we find an upturn in the mass-loss vs. Gamma dependence, at the point where the winds become optically thick. This coincides with the location where wind efficiency numbers surpass the single-scattering limit of Eta = 1, reaching values up to Eta = 2.5. Our modelling suggests a transition from common O-type winds to Wolf-Rayet characteristics at the point where the winds become optically thick. This transitional behaviour is also revealed with respect to the wind acceleration parameter beta, which starts at values below 1 for the optically thin O-stars, and naturally reaches values as high as 1.5-2 for the optically thick Wolf-Rayet models. An additional finding concerns the transition in spectral morphology of the Of and WN characteristic He II line at 4686 Angstrom. When we express our mass-loss predictions as a function of the electron scattering Gamma_e (=L/M) only, we obtain a mass-loss Gamma dependence that is consistent with a previously reported power-law Mdot propto Gamma^5 (Vink 2006) that was based on our semi-empirical modelling approach. When we express Mdot in terms of both Gamma and stellar mass, we find Mdot propto M^0.8 Gamma^4.8 for our high Gamma models. Finally, we confirm that the Gamma-effect on the mass-loss predictions is much stronger than that of an increased helium abundance, calling for a fundamental revision in the way mass loss is incorporated in evolutionary models of the most massive stars.Comment: minor language changes (Astronomy & Astrophysics in press - 11 pages, 10 figures