Out-of-hospital cardiac arrest and survival in a patient with Noonan syndrome and multiple lentigines: a case report

BACKGROUND: A 9-year-old Arabic boy attending middle school presented with an out-of-hospital cardiac arrest due to ventricular fibrillation recorded by Holter electrocardiographic monitoring. He had a background history of Noonan syndrome with multiple lentigines (also known as LEOPARD syndrome), a rare condition of autosomal dominant inheritance with approximately 200 cases reported worldwide. CASE PRESENTATION: Apart from characteristic features, the boy was known to have asymmetric septal hypertrophy with a maximum wall thickness of 24 mm measured by cardiovascular magnetic resonance imaging. A day prior to the event, he attended cardiology follow-up at our institution, and Holter monitoring was commenced. Following cardiopulmonary resuscitation by bystanders and paramedics, he reverted back into sinus rhythm after a total downtime of 24 min. He was initially treated in the intensive care unit and underwent implantable cardioverter defibrillator implantation. He has made a full recovery and remains at the top of his class. CONCLUSION: This case demonstrates that sudden cardiac arrest in patients with secondary forms of hypertrophic cardiomyopathy is not necessarily protected by apparently favorable phenotypes and that events may be preceded by non-sustained ventricular tachycardia observed by Holter monitoring. Implantable cardioverter defibrillator implantation plays a critical role in both primary and secondary prevention in patients at high risk of out-of-hospital cardiac arrest

Cluster Evolution in the ROSAT North Ecliptic Pole Survey

The deepest region of the ROSAT All-Sky Survey, at the North Ecliptic Pole, has been studied to produce a complete and unbiased X-ray selected sample of clusters of galaxies. This sample is used to investigate the nature of cluster evolution and explore potential implications for large-scale structure models. The survey is 99.6% optically identified. Spectroscopic redshifts have been measured for all the extragalactic identifications. In this Letter, first results on cluster evolution are presented based on a comparison between the number of the observed clusters in the North Ecliptic Pole survey and the number of expected clusters assuming no-evolution models. At z>0.3 there is a deficit of clusters with respect to the local universe which is significant at > 4.7sigma. The evolution appears to commence at L_{0.5-2.0} > 1.8x10^{44} erg s^{-1} in our data. The negative evolution goes in the same direction as the original EMSS result, the results from the 160 deg^{2} survey by Vikhlinin et al. (1998) and the recent results from the RDCS (Rosati et al. 2000). At lower redshifts there is no evidence for evolution, a result in agreement with these and other cluster surveys.Comment: 17 pages, 3 figures. Accepted for publication in ApJ Letter

Discovery of a new cataclysmic variable through optical variability and X-ray emission

Aims: We present discovery observations of the new cataclysmic variable star (CV) 1RXS J092737.4-191529, as well as spectra and photometry of SY Vol. The selection technique that turned up these two CVs is described; it should be efficient for finding dwarf novae with high outburst duty cycles. Methods: Two very common observational features of CVs, namely optical variability and X-ray emission, are combined to select targets for follow-up observations. Long-slit spectra were taken to identify CVs in the sample. Results: Two out of three objects selected in this way are CVs. One of these is the known dwarf nova SY Vol, while the second system, 1RXS J092737.4-191529, is a new discovery. We present medium resolution spectra, $UBVRI$ magnitudes, and high-speed photometry for both these CVs. Rapid flickering in the light curve of 1RXS J092737.4-191529 confirms the mass transferring binary nature of this object; it is probably a dwarf nova that was in quiescence during our observations.Comment: 4 pages, 5 figures, accepted to A&

The Effect of Hot Gas in WMAP's First Year Data

By cross-correlating templates constructed from the 2 Micron All Sky Survey (2MASS) Extended Source (XSC) catalogue with WMAP's first year data, we search for the thermal Sunyaev-Zel'dovich signature induced by hot gas in the local Universe. Assuming that galaxies trace the distribution of hot gas, we select regions on the sky with the largest projected density of galaxies. Under conservative assumptions on the amplitude of foreground residuals, we find a temperature decrement of -35 $\pm$ 7 $\mu$K ($\sim 5\sigma$ detection level, the highest reported so far) in the $\sim$ 26 square degrees of the sky containing the largest number of galaxies per solid angle. We show that most of the reported signal is caused by known galaxy clusters which, when convolved with the average beam of the WMAP W band channel, subtend a typical angular size of 20--30 arcmins. Finally, after removing from our analyses all pixels associated with known optical and X-ray galaxy clusters, we still find a tSZ decrement of -96 $\pm$ 37 $\mu$K in pixels subtending about $\sim$ 0.8 square degrees on the sky. Most of this signal is coming from five different cluster candidates in the Zone of Avoidance (ZoA), present in the Clusters In the ZoA (CIZA) catalogue. We found no evidence that structures less bound than clusters contribute to the tSZ signal present in the WMAP data.Comment: 10 pages, 4 figures, matches accepted version in ApJ Letter

Opening the random forest black box by the analysis of the mutual impact of features

Random forest is a popular machine learning approach for the analysis of high-dimensional data because it is flexible and provides variable importance measures for the selection of relevant features. However, the complex relationships between the features are usually not considered for the selection and thus also neglected for the characterization of the analysed samples. Here we propose two novel approaches that focus on the mutual impact of features in random forests. Mutual forest impact (MFI) is a relation parameter that evaluates the mutual association of the featurs to the outcome and, hence, goes beyond the analysis of correlation coefficients. Mutual impurity reduction (MIR) is an importance measure that combines this relation parameter with the importance of the individual features. MIR and MFI are implemented together with testing procedures that generate p-values for the selection of related and important features. Applications to various simulated data sets and the comparison to other methods for feature selection and relation analysis show that MFI and MIR are very promising to shed light on the complex relationships between features and outcome. In addition, they are not affected by common biases, e.g. that features with many possible splits or high minor allele frequencies are prefered

A Sample of X-Ray active extragalactic Sources suitable for NIR Adaptive Optics Observations

Recent X-ray surveys have now resolved most of the X-ray background (XRB) into discrete sources. While this represents a break- through in the understanding of the XRB, the astrophysical nature of these sources still remains mysterious. In this article we present a sample of X-ray/optically selected extragalactic objects which are suitable for adaptive optics observations in the near infrared (NIR) at highest angu- lar resolution. The sample is based on a cross-correlation of the Sloan Digital Sky Survey and the ROSAT All Sky Survey. The NIR properties can help to disentangle the nature of the X-ray bright, partially absorbed and spectroscopically passive background objects and their hosts.Comment: 4 pages with 1 figure, LateX, uses newpasp.sty, to appear in "AGN Physics with the Sloan Digital Sky Survey", ed. G. T. Richards and P. B. Hall (San Francisco: ASP), 200

The ROSAT North Ecliptic Pole Survey: The Optical Identifications

The X-ray data around the North Ecliptic Pole (NEP) of the ROSAT All Sky Survey have been used to construct a contiguous area survey consisting of a sample of 445 individual X-ray sources above a flux of ~2x10^-14 erg cm^-2 s^-1 in the 0.5-2.0 keV energy band. The NEP survey is centered at RA (2000) = 18h 00m, DEC(2000) = +66deg 33arcmin and covers a region of 80.7 sq. deg at a moderate Galactic latitude of b = 29.8deg. Hence, the NEP survey is as deep and covers a comparable solid angle to the ROSAT serendipitous surveys, but is also contiguous. We have identified 99.6% of the sources and determined redshifts for the extragalactic objects. In this paper we present the optical identifications of the NEP catalog of X-ray sources including basic X-ray data and properties of the sources. We also describe with some detail the optical identification procedure. The classification of the optical counterparts to the NEP sources is very similar to that of previous surveys, in particular the Einstein Extended Medium Sensitivity Survey (EMSS). The main constituents of the catalog are active galactic nuclei (~49%), either type 1 or type 2 according to the broadness of their permitted emission lines. Stellar counterparts are the second most common identification class (~34%). Clusters and groups of galaxies comprise 14%, and BL Lacertae objects 2%. One non-AGN galaxy, and one planetary nebula have also been found. The NEP catalog of X-ray sources is a homogeneous sample of astronomical objects featuring complete optical identification.Comment: Accepted for publication in the ApJS; 33 pages including 12 postscript figures and 3 tables; uses emulateapj.sty. On-line source catalog at http://www.eso.org/~cmullis/research/nep-catalog.htm

The North Ecliptic Pole Supercluster

We have used the ROSAT All-Sky Survey to detect a known supercluster at z=0.087 in the North Ecliptic Pole region. The X-ray data greatly improve our understanding of this supercluster's characteristics, approximately doubling our knowledge of the structure's spatial extent and tripling the cluster/group membership compared to the optical discovery data. The supercluster is a rich structure consisting of at least 21 galaxy clusters and groups, 12 AGN, 61 IRAS galaxies, and various other objects. A majority of these components were discovered with the X-ray data, but the supercluster is also robustly detected in optical, IR, and UV wavebands. Extending 129 x 102 x 67 (1/h50 Mpc)^3, the North Ecliptic Pole Supercluster has a flattened shape oriented nearly edge-on to our line-of-sight. Owing to the softness of the ROSAT X-ray passband and the deep exposure over a large solid angle, we have detected for the first time a significant population of X-ray emitting galaxy groups in a supercluster. These results demonstrate the effectiveness of X-ray observations with contiguous coverage for studying structure in the Universe.Comment: Accepted for publication in The Astrophysical Journal; 5 pages with 2 embedded figures; uses emulateapj.sty; For associated animations, see http://www.ifa.hawaii.edu/~mullis/nep3d.html; A high-resolution color postscript version of the full paper is available at http://www.ifa.hawaii.edu/~mullis/papers/nepsc.ps.g