SN 2019ehk: A Double-peaked Ca-rich Transient with Luminous X-Ray Emission and Shock-ionized Spectral Features

We present panchromatic observations and modeling of the Calcium-rich supernova (SN) 2019ehk in the star-forming galaxy M100 (d ≈ 16.2 Mpc) starting 10 hr after explosion and continuing for ~300 days. SN 2019ehk shows a double-peaked optical light curve peaking at t = 3 and 15 days. The first peak is coincident with luminous, rapidly decaying Swift-XRT–discovered X-ray emission (L_x ≈ 10⁴¹ erg s⁻¹ at 3 days; L_x ∝ t⁻³), and a Shane/Kast spectral detection of narrow Hα and He II emission lines (v ≈ 500 km s⁻¹) originating from pre-existent circumstellar material (CSM). We attribute this phenomenology to radiation from shock interaction with extended, dense material surrounding the progenitor star at r (0.1–1) × 10¹⁷ cm. The photometric and spectroscopic properties during the second light-curve peak are consistent with those of Ca-rich transients (rise-time of t_r = 13.4 ± 0.210 days and a peak B-band magnitude of M_B = −15.1 ± 0.200 mag). We find that SN 2019ehk synthesized (3.1 ± 0.11) × 10⁻² M_⊙ of ⁵⁶Ni and ejected M_(ej) = (0.72 ± 0.040) M⊙ total with a kinetic energy E_k = (1.8 ± 0.10) × 10⁵⁰ erg. Finally, deep HST pre-explosion imaging at the SN site constrains the parameter space of viable stellar progenitors to massive stars in the lowest mass bin (~10 M_⊙) in binaries that lost most of their He envelope or white dwarfs (WDs). The explosion and environment properties of SN 2019ehk further restrict the potential WD progenitor systems to low-mass hybrid HeCO WD+CO WD binaries

Integral Medicine: Treating the Whole—Patient, Provider, Healthcare System

Purpose: Integral Medicine is an approach to health, disease and healing that invites multiple perspectives and modes of inquiry to synergistically support healing for patients, providers and health care systems.Approach: Integral Theory is a framework for organizing information that considers four perspectives essential to view the whole patient simultaneously – any or all of which may illuminate health or illness in a patient, population or system: “Interior-Individual” (mind, psycho-spiritual development, etc.), “Exterior-Individual” (molecules, cells, organs, bodies, etc.), “Interior-Collective” (cultural, ethical practices or norms, etc.), and “Exterior-Collective” (socioeconomic, environmental system, etc.).Major Points: In practice, the application of Integral Theory to patient care can lead to four quadrant diagnosis and therapy for everything from status asthmaticus to chronic fatigue syndrome. When applied to the personal and professional development of providers an Integral Theory framework may improve critical thinking, ethical reasoning, mindfulness and empathy. At the healthcare system design level, patients have better outcomes when cared for by organizations ranked as having better work environments (where nurses report low rates of burnout, adequate time with patients, good relationships with colleagues, and opportunities for advanced training and continuing education).Conclusions: Treating the whole person becomes more than simply including body, mind and spirit. The whole person includes multiple epistemological ways of knowing. Building on Integrative, Alternative, Complementary, Evidence-based Medicine, and Values-based care, Integral Medicine offers a methodology for integrating the “best” of each of these medical methodologies. Integral Theory, in this respect, can act as a meta-theory weaving together many of the converging concepts emerging in the service of whole patient care. Integral methodology also provides a common map/language for knowledge integration/translation and a shared inter-professional approach to whole patient care at the patient, population and health system levels

SN 2019ehk: A Double-peaked Ca-rich Transient with Luminous X-Ray Emission and Shock-ionized Spectral Features

We present panchromatic observations and modeling of the Calcium-rich supernova 2019ehk in the star-forming galaxy M100 (d$\approx$16.2 Mpc) starting 10 hours after explosion and continuing for ~300 days. SN 2019ehk shows a double-peaked optical light curve peaking at $t = 3$ and $15$ days. The first peak is coincident with luminous, rapidly decaying $\textit{Swift}$-XRT discovered X-ray emission ($L_x\approx10^{41}~\rm{erg~s^{-1}}$ at 3 days; $L_x \propto t^{-3}$), and a Shane/Kast spectral detection of narrow H$\alpha$ and He II emission lines ($v \approx 500$ km/s) originating from pre-existent circumstellar material. We attribute this phenomenology to radiation from shock interaction with extended, dense material surrounding the progenitor star at $r<10^{15}$ cm and the resulting cooling emission. We calculate a total CSM mass of $\sim$ $7\times10^{-3}$ $\rm{M_{\odot}}$ with particle density $n\approx10^{9}\,\rm{cm^{-3}}$. Radio observations indicate a significantly lower density $n < 10^{4}\,\rm{cm^{-3}}$ at larger radii. The photometric and spectroscopic properties during the second light curve peak are consistent with those of Ca-rich transients (rise-time of $t_r =13.4\pm0.210$ days and a peak B-band magnitude of $M_B =-15.1\pm0.200$ mag). We find that SN 2019ehk synthesized $(3.1\pm0.11)\times10^{-2} ~ \rm{M_{\odot}}$ of ${}^{56}\textrm{Ni}$ and ejected $M_{\rm ej} = (0.72\pm 0.040)~\rm{M_{\odot}}$ total with a kinetic energy $E_{\rm k}=(1.8\pm0.10)\times10^{50}~\rm{erg}$. Finally, deep $\textit{HST}$ pre-explosion imaging at the SN site constrains the parameter space of viable stellar progenitors to massive stars in the lowest mass bin (~10 $\rm{M_{\odot}}$) in binaries that lost most of their He envelope or white dwarfs. The explosion and environment properties of SN 2019ehk further restrict the potential WD progenitor systems to low-mass hybrid HeCO WD + CO WD binaries.Comment: 51 pages, 27 figures. Accepted for publication in Ap