Are Delayed Radio Flares Common in Tidal Disruption Events? The Case of the TDE iPTF 16fnl

Radio emission from tidal disruption events (TDEs) originates from an interaction of an outflow with the super-massive black hole (SMBH) circum nuclear material (CNM). In turn, this radio emission can be used to probe properties of both the outflow launched at the event and the CNM. Until recently, radio emission was detected only for a relatively small number of events. While the observed radio emission pointed to either relativistic or sub-relativistic outflows of different nature, it also indicated that the outflow has been launched shortly after the stellar disruption. Recently, however, delayed radio flares, several months and years after stellar disruption, were reported in the case of the TDE ASASSN-15oi. These delayed flares suggest a delay in the launching of outflows and thus may provide new insights into SMBH accretion physics. Here, we present a new radio dataset of another TDE, iPTF16fnl, and discuss the possibility that a delayed radio flare has been observed also in this case, ~ 5 months after optical discovery, suggesting that this phenomenon may be common in TDEs. Unlike ASASSN-15oi, the data for iPTF16fnl is sparse and the delayed radio flare can be explained by several alternative models: among them are a complex varying CNM density structure and a delayed outflow ejection

A detailed radio study of the energetic, nearby, and puzzling GRB 171010A

We present the results of an intensive multi-epoch radio frequency campaign on the energetic and nearby GRB 171010A with the Karl G. Janksy Very Large Array and Arcminute Microkelvin Imager Large Array. We began observing GRB 171010A a day after its initial detection, and were able to monitor the temporal and spectral evolution of the source over the following weeks. The spectra and their evolution are compared to the canonical theories for broadband GRB afterglows, with which we find a general agreement. There are, however, a number of features that are challenging to explain with a simple forward shock model, and we discuss possible reasons for these discrepancies. This includes the consideration of the existence of a reverse shock component, potential microphysical parameter evolution and the effect of scintillation

Risk of Cerebrovascular Events in 178 962 Five-Year Survivors of Cancer Diagnosed at 15 to 39 Years of Age: The TYACSS (Teenage and Young Adult Cancer Survivor Study)

Background: Survivors of teenage and young adult (TYA) cancer are at risk of cerebrovascular events, but the magnitude of and extent to which this risk varies by cancer type, decade of diagnosis, age at diagnosis and attained age remains uncertain. This is the largest ever cohort study to evaluate the risks of hospitalisation for a cerebrovascular event among long-term survivors of TYA cancer. Methods:The population-based Teenage and Young Adult Cancer Survivor Study (N=178,962) was linked to Hospital Episode Statistics data for England to investigate the risks of hospitalisation for a cerebrovascular event among 5-year survivors of cancer diagnosed when aged 15-39 years. Observed numbers of first hospitalisations for cerebrovascular events were compared to that expected from the general population using standardised hospitalisation ratios (SHR) and absolute excess risks (AER) per 10,000 person-years. Cumulative incidence was calculated with death considered a competing risk. Results: Overall, 2,782 cancer survivors were hospitalised for a cerebrovascular event—40% higher than expected (SHR=1.4, 95% confidence interval [CI]=1.3-1.4). Survivors of central nervous system (CNS) tumours (SHR=4.6, CI=4.3-5.0), head & neck tumours (SHR=2.6, CI=2.2-3.1) and leukaemia (SHR=2.5, CI=1.9-3.1) were at greatest risk. Males had a significantly higher AER than females (AER=7 versus 3), especially among head & neck tumour survivors (AER=30 versus 11). By age 60, 9%, 6% and 5% of CNS tumour, head & neck tumour, and leukaemia survivors, respectively, had been hospitalised for a cerebrovascular event. Beyond age 60, every year 0.4% of CNS tumour survivors were hospitalised for a cerebral infarction (versus 0.1% expected. Whereas at any age, every year 0.2% of head & neck tumour survivors were hospitalised for a cerebral infarction 7 (versus 0.06% expected). Conclusions: Survivors of a CNS tumour, head & neck tumour, and leukaemia are particularly at risk of hospitalisation for a cerebrovascular event. The excess risk of cerebral infarction among CNS tumour survivors increases with attained age. For head & neck tumour survivors this excess risk remains high across all ages. These groups of survivors, and in particular males, should be considered for surveillance of cerebrovascular risk factors and potential pharmacological interventions for cerebral infarction prevention

Primary vs. Secondary Antibody Deficiency: Clinical Features and Infection Outcomes of Immunoglobulin Replacement

<div><p>Secondary antibody deficiency can occur as a result of haematological malignancies or certain medications, but not much is known about the clinical and immunological features of this group of patients as a whole. Here we describe a cohort of 167 patients with primary or secondary antibody deficiencies on immunoglobulin (Ig)-replacement treatment. The demographics, causes of immunodeficiency, diagnostic delay, clinical and laboratory features, and infection frequency were analysed retrospectively. Chemotherapy for B cell lymphoma and the use of Rituximab, corticosteroids or immunosuppressive medications were the most common causes of secondary antibody deficiency in this cohort. There was no difference in diagnostic delay or bronchiectasis between primary and secondary antibody deficiency patients, and both groups experienced disorders associated with immune dysregulation. Secondary antibody deficiency patients had similar baseline levels of serum IgG, but higher IgM and IgA, and a higher frequency of switched memory B cells than primary antibody deficiency patients. Serious and non-serious infections before and after Ig-replacement were also compared in both groups. Although secondary antibody deficiency patients had more serious infections before initiation of Ig-replacement, treatment resulted in a significant reduction of serious and non-serious infections in both primary and secondary antibody deficiency patients. Patients with secondary antibody deficiency experience similar delays in diagnosis as primary antibody deficiency patients and can also benefit from immunoglobulin-replacement treatment.</p></div

Managerial Work in a Practice-Embodying Institution - The role of calling, the virtue of constancy

What can be learned from a small scale study of managerial work in a highly marginal and under-researched working community? This paper uses the ‘goods-virtues-practices-institutions’ framework to examine the managerial work of owner-directors of traditional circuses. Inspired by MacIntyre’s arguments for the necessity of a narrative understanding of the virtues, interviews explored how British and Irish circus directors accounted for their working lives. A purposive sample was used to select subjects who had owned and managed traditional touring circuses for at least 15 years, a period in which the economic and reputational fortunes of traditional circuses have suffered badly. This sample enabled the research to examine the self-understanding of people who had, at least on the face of it, exhibited the virtue of constancy. The research contributes to our understanding of the role of the virtues in organizations by presenting evidence of an intimate relationship between the virtue of constancy and a ‘calling’ work orientation. This enhances our understanding of the virtues that are required if management is exercised as a domain-related practice

Diagnostic accuracy of non-specialist versus specialist health workers in diagnosing hearing loss and ear disease in Malawi.

OBJECTIVE: To determine whether a non-specialist health worker can accurately undertake audiometry and otoscopy, the essential clinical examinations in a survey of hearing loss, instead of a highly skilled specialist (i.e. ENT or audiologist). METHODS: A clinic-based diagnostic accuracy study was conducted in Malawi. Consecutively sampled participants ≥ 18 years had their hearing tested using a validated tablet-based audiometer (hearTest) by an audiologist (gold standard), an audiology officer, a nurse and a community health worker (CHW). Otoscopy for diagnosis of ear pathologies was conducted by an ENT specialist (gold standard), an ENT clinical officer, a CHW, an ENT nurse and a general nurse. Sensitivity, specificity and kappa (κ) were calculated. 80% sensitivity, 70% specificity and kappa of 0.6 were considered adequate. RESULTS: Six hundred and seventeen participants were included. High sensitivity (>90%) and specificity (>85%) in detecting bilateral hearing loss was obtained by all non-specialists. For otoscopy, sensitivity and specificity were >80% for all non-specialists in diagnosing any pathology except for the ENT nurse. Agreement in diagnoses for the ENT clinical officer was good (κ = 0.7) in both ears. For other assessors, moderate agreement was found (κ = 0.5). CONCLUSION: A non-specialist can be trained to accurately assess hearing using mobile-based audiometry. However, accurate diagnosis of ear conditions requires at least an ENT clinical officer (or equivalent). Conducting surveys of hearing loss with non-specialists could lower costs and increase data collection, particularly in low- and middle-income countries, where ENT specialists are scarce

Rapid Detection and Subtyping of Human Influenza A Viruses and Reassortants by Pyrosequencing

Background: Given the continuing co-circulation of the 2009 H1N1 pandemic influenza A viruses with seasonal H3N2 viruses, rapid and reliable detection of newly emerging influenza reassortant viruses is important to enhance our influenza surveillance. Methodology/Principal Findings: A novel pyrosequencing assay was developed for the rapid identification and subtyping of potential human influenza A virus reassortants based on all eight gene segments of the virus. Except for HA and NA genes, one universal set of primers was used to amplify and subtype each of the six internal genes. With this method, all eight gene segments of 57 laboratory isolates and 17 original specimens of seasonal H1N1, H3N2 and 2009 H1N1 pandemic viruses were correctly matched with their corresponding subtypes. In addition, this method was shown to be capable of detecting reassortant viruses by correctly identifying the source of all 8 gene segments from three vaccine production reassortant viruses and three H1N2 viruses. Conclusions/Significance: In summary, this pyrosequencing assay is a sensitive and specific procedure for screening large numbers of viruses for reassortment events amongst the commonly circulating human influenza A viruses, which is mor

An extremely powerful long-lived superluminal ejection from the black hole MAXI J1820+070

Black holes in binary systems execute patterns of outburst activity where two characteristic X-ray states are associated with different behaviours observed at radio wavelengths. The hard state is associated with radio emission indicative of a continuously replenished, collimated, relativistic jet, whereas the soft state is rarely associated with radio emission, and never continuously, implying the absence of a quasi-steady jet. Here we report radio observations of the black hole transient MAXI J1820$+$070 during its 2018 outburst. As the black hole transitioned from the hard to soft state we observed an isolated radio flare, which, using high angular resolution radio observations, we connect with the launch of bi-polar relativistic ejecta. This flare occurs as the radio emission of the core jet is suppressed by a factor of over 800. We monitor the evolution of the ejecta over 200 days and to a maximum separation of 10$''$, during which period it remains detectable due to in-situ particle acceleration. Using simultaneous radio observations sensitive to different angular scales we calculate an accurate estimate of energy content of the approaching ejection. This energy estimate is far larger than that derived from state transition radio flare, suggesting a systematic underestimate of jet energetics

Strong low-frequency radio flaring from Cygnus X-3 observed with LOFAR

We present Low-Frequency Array (LOFAR) 143.5-MHz radio observations of flaring activity during 2019 May from the X-ray binary Cygnus X-3. Similar to radio observations of previous outbursts from Cygnus X-3, we find that this source was significantly variable at low frequencies, reaching a maximum flux density of about 5.8 Jy. We compare our LOFAR light curve with contemporaneous observations taken at 1.25 and 2.3 GHz with the RATAN-600 telescope, and at 15 GHz with the Arcminute Microkelvin Imager (AMI) Large Array. The initial 143.5-MHz flux density level, $\sim$2 Jy, is suggested to be the delayed and possibly blended emission from at least some of the flaring activity that had been detected at higher frequencies before our LOFAR observations had begun. There is also evidence of a delay of more than four days between a bright flare that initially peaked on May 6 at 2.3 and 15 GHz, and the corresponding peak ($\gtrsim$ 5.8 Jy) at 143.5 MHz. From the multi-frequency light curves, we estimate the minimum energy and magnetic field required to produce this flare to be roughly 10$^{44}$ erg and 40 mG, respectively, corresponding to a minimum mean power of $\sim$10$^{38}$ erg s$^{-1}$. Additionally, we show that the broadband radio spectrum evolved over the course of our observing campaign; in particular, the two-point spectral index between 143.5 MHz and 1.25 GHz transitioned from being optically thick to optically thin as the flare simultaneously brightened at 143.5 MHz and faded at GHz frequencies

The Dynamical Mechanism of Auto-Inhibition of AMP-Activated Protein Kinase

We use a novel normal mode analysis of an elastic network model drawn from configurations generated during microsecond all-atom molecular dynamics simulations to analyze the mechanism of auto-inhibition of AMP-activated protein kinase (AMPK). A recent X-ray and mutagenesis experiment (Chen, et al Nature 2009, 459, 1146) of the AMPK homolog S. Pombe sucrose non-fermenting 1 (SNF1) has proposed a new conformational switch model involving the movement of the kinase domain (KD) between an inactive unphosphorylated open state and an active or semi-active phosphorylated closed state, mediated by the autoinhibitory domain (AID), and a similar mutagenesis study showed that rat AMPK has the same auto-inhibition mechanism. However, there is no direct dynamical evidence to support this model and it is not clear whether other functionally important local structural components are equally inhibited. By using the same SNF1 KD-AID fragment as that used in experiment, we show that AID inhibits the catalytic function by restraining the KD into an unproductive open conformation, thereby limiting local structural rearrangements, while mutations that disrupt the interactions between the KD and AID allow for both the local structural rearrangement and global interlobe conformational transition. Our calculations further show that the AID also greatly impacts the structuring and mobility of the activation loop