GW190521 formation scenarios via relativistic accretion

The recent gravitational wave transient GW190521 has been interpreted by the LIGO-Virgo collaboration (LVC) as sourced by a binary black hole (BH) merger. According to the LVC parameter estimation, at least one of these progenitors falls into the so-called pair-instability supernova mass gap. This raises the important question of how and when these progenitors formed. In this paper we use an accretion model with super-Eddington mass accretion rate obtained from General Relativity hydrodynamics simulations to analyse the scenario wherein the GW190521 original progenitors (OPs) formed at lower masses (and spins) and grew to their estimated LVC parameters by relativistic accretion. We consider that the environment wherein the binary is immersed has density gradients as well as a dependence on the Mach number of the gas. Taking the LVC parameter estimation at $z=0.82$ as the endpoint of the accretion evolution, we estimate the initial masses and spins of the OPs at three different red-shifts $z=100, \ 50$, and$20$. We found three distinct possible types of OPs:$(i)$$10^{-4} M_{\odot} - 3 M_{\odot}$almost non-rotating (with Kerr spin parameter$a_{\star}< 10^{-2}$) primordial BHs;$(ii)$$3 M_{\odot} - 40M_{\odot}$slowly rotating ($ 10^{-2} < a_{\star} < 0.5$) stellar mass BHs;$(iii)$$40M_{\odot} - 70M_{\odot}$BHs with a moderate spin parameter$a_{\star}\sim 0.5$, which could originate from the collapse of high mass Pop III stars. The mass spread is due to varying the density gradient and the relativistic Mach number of the cosmic plasma; the variation of the masses due to the origin at different red-shifts, on the other hand, is negligible,$\sim 2\%$ ...Comment: 16 pages, 5 figures, 1 tabl

An Exact Homogeneous Stiff Cosmology that Reduces to the Kasner Solution

A family of exact simple solutions of Einstein field equations for homogeneous stiff cosmologies is presented. The method to obtain the solution is based on the introduction of auxiliary functions in order to cast the Einstein equations in such a way that can be explicitly integrated. The obtained solution is expressed in terms of simple functions of the used coordinates. The geometrical and kinematical properties of the solution are analyzed and the parameters are restricted in order to have a physically acceptable behavior. The solution is of the Petrov type I and presents a big-bang singularity. Now, for a particular value of one of the parameters, the solution is a vacuum solution of the Bianchi I type that reduces to the Kasner solution.&nbsp; &nbsp;Se presenta una familia de soluciones exactas sencillas de las ecua­ciones de Einstein homogéneas sobre el plano para las cosmologías rígidas. El método para obtener la solución se basa en la introducción de funciones auxiliares, a fin de emitir las ecuaciones de Einstein de tal manera que puedan ser integradas explícitamente. La solución obtenida se expresa en términos de funciones simples de las coordenadas utilizadas. Se analizan las propiedades geométricas y cinemáticas de la solución; los parámetros están restringidas a fin de tener un comportamiento aceptable físicamente. Las soluciones son del tipo Petrov I, y presentan una singularidad de big-bang. Ahora bien, para un cierto valor de uno de los parámetros la solución es una solución de vacío de tipo Bianchi I, que se reduce a la solución de Kasner.&nbsp; &nbsp; &nbsp

Two Simple Families of Exact Inhomogeneous Stiff Cosmologies

Two families of exact simple solutions of Einstein field equations for inhomogeneous stiff cosmologies are presented. The method to obtain the solutions is based on the introduction of auxiliary functions in order to cast the Einstein equations in such a way that can be explicitly integrated. Although the equations are mathematically equivalent to the equations obtained when the source of matter is a scalar field, it is worth to mention that the source that we consider is not a scalar field but a perfect fluid with a stiff equation of state. The obtained solutions are expressed in terms of simple functions of the used coordinates and two families of particular solutions are considered. The geometrical and kinematical properties of the solutions are then analyzed and the parameters are restricted in order to have a physically acceptable behavior. The two particular solutions are of the Petrov type I, the first one being regular everywhere whereas the second one presents a big-bang singularity. Now, for a particular value of one of the parameters, the second particular solution is a vacuum solution of the Bianchi I type that reduces to the Kasner solution

Magnetised tori with magnetic polarisation around Kerr black holes: variable angular momentum discs

Analytical models of magnetised, geometrically thick discs are relevant to understand the physical conditions of plasma around compact objects and to explore its emitting properties. This has become increasingly important in recent years in the light of the Event Horizon Telescope observations of Sgr A* and M87. Models of thick discs around black holes usually consider constant angular momentum distributions and do not take into account the magnetic response of the fluid to applied magnetic fields. We present a generalisation of our previous work on stationary models of magnetised accretion discs with magnetic polarisation (Pimentel et al. 2018). This extension is achieved by accounting for non-constant specific angular momentum profiles, done through a two-parameter ansatz for those distributions. We build a large number of new equilibrium solutions of thick discs with magnetic polarisation around Kerr black holes, selecting suitable parameter values within the intrinsically substantial parameter space of the models. We study the morphology and the physical properties of those solutions, finding qualitative changes with respect to the constant angular momentum tori of (Pimentel et al. 2018). However, the dependences found on the angular momentum distribution or on the black hole spin do not seem to be strong. Some of the new solutions, however, exhibit a local maximum of the magnetisation function, absent in standard magnetised tori. Due to the enhanced development of the magneto-rotational instability as a result of magnetic susceptibility, those models might be particularly well-suited to investigate jet formation through general-relativistic MHD simulations. The new equilibrium solutions reported here can be used as initial data in numerical codes to assess the impact of magnetic susceptibility in the dynamics and observational properties of thick disc-black hole systems.Comment: 15 pages, 8 figures. Comments welcom

Scalar Field Dark Matter: behavior around black holes

We present the numerical evolution of a massive test scalar fields around a Schwarzschild space-time. We proceed by using hyperboloidal slices that approach future null infinity, which is the boundary of scalar fields, and also demand the slices to penetrate the event horizon of the black hole. This approach allows the scalar field to be accreted by the black hole and to escape toward future null infinity. We track the evolution of the energy density of the scalar field, which determines the rate at which the scalar field is being diluted. We find polynomial decay of the energy density of the scalar field, and use it to estimate the rate of dilution of the field in time. Our findings imply that the energy density of the scalar field decreases even five orders of magnitude in time scales smaller than a year. This implies that if a supermassive black hole is the Schwarzschild solution, then scalar field dark matter would be diluted extremely fastComment: 15 pages, 21 eps figures. Appendix added, accepted for publication in JCA

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR &lt; 60 mL/min/1.73 m2) or eGFR reduction &gt; 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR &lt; 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR &gt; 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6&nbsp;years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P &lt; 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100&nbsp;years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception