Working with Gravitational-Wave sky localizations: new methods and implementations

International audience; The era of multi-messenger astrophysics with Gravitational Waves (GW) requires the exploration and development of suitable methods and tools for real-time analysis as well as post-processing activities. The irregular and complex shapes of the GW sky localizations represent a new challenge for observational astronomers, who need to work with fast tiling, catalog queries, transient localizations, visibility and sky map comparisons. Here we show how gravitational-wave sky maps can be easily and efficiently visualized and processed using Multi-Order Coverage (MOC) maps. These maps are based on HEALPix sky tessellation which uses both Python language and the recent implementation in Aladin Desktop/Lite. In addition to this, we describe a specific interactive script, named GWsky, that we developed to effectively tile the sky localization of a gravitational-wave event providing accurate telescope pointings. We also show applications of these methods and tools for educational purposes in Virtual Reality Apps, high resolution images, and basic sonification of the GW sky maps.Finally, we describe possible evolutions of such implementations when three or more ground-based interferometers will be involved in a gravitational-wave source localization (i.e. Virgo,LIGO–Hanford, LIGO–Livingston, KAGRA, LIGO–India) with a corresponding increase of the sky map resolution

Genetic modifiers of CHEK2*1100delC-associated breast cancer risk

Purpose: CHEK2*1100delC is a founder variant in European populations that confers a two-to threefold increased risk of breast cancer (BC). Epidemiologic and family studies have suggested that the risk associated with CHEK2*1100delC is modified by other genetic factors in a multiplicative fashion. We have investigated this empirically using data from the Breast Cancer Association Consortium (BCAC). Methods: Using genotype data from 39,139 (624 1100delC carriers) BC patients and 40,063 (224) healthy controls from 32 BCAC studies, we analyzed the combined risk effects of CHEK2*1100delC and 77 common variants in terms of a polygenic risk score (PRS) and pairwise interaction. Results: The PRS conferred odds ratios (OR) of 1.59 (95% CI: 1.212.09) per standard deviation for BC for CHEK2*1100delC carriers and 1.58 (1.55-1.62) for noncarriers. No evidence of deviation from the multiplicative model was found. The OR for the highest quintile of the PRS was 2.03 (0.86-4.78) for CHEK2*1100delC carriers, placing them in the high risk category according to UK NICE guidelines. The OR for the lowest quintile was 0.52 (0.16-1.74), indicating a lifetime risk close to the population average. Conclusion: Our results confirm the multiplicative nature of risk effects conferred by CHEK2*1100delC and the common susceptibility variants. Furthermore, the PRS could identify carriers at a high lifetime risk for clinical actions.Peer reviewe

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Algues et dermatologie (dermatoses induites et ressources thérapeutiques)

BREST-BU Médecine-Odontologie (290192102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Pancytopaenia secondary to bone marrow dissemination of Merkel cell carcinoma in a patient with Waldenström macroglobulinaemia

International audienc

Multi Order Coverage data structure to plan multi-messenger observations

International audienceWe describe the use of Multi Order Coverage (MOC) maps as a practical way to manage complex regions of the sky for the planning of multi-messenger observations. MOC maps are a data structure that provides a multi-resolution representation of irregularly shaped and fragmentary regions over the sky based on the HEALPix (Hierarchical Equal Area isoLatitude Pixelization) tessellation. We present a new application of MOC, in combination with the astroplan observation planning package, to enable the efficient computation of sky regions and the visibility of these regions from a specific location on the Earth at a particular time. Using the example of the low-latency gravitational-wave alerts, and a simulated observational campaign with three observatories, we show that the use of MOC maps allows a high level of interoperability to support observing schedule plans. Gravitational-wave detections have an associated credible region localisation on the sky. We demonstrate that these localisations can be encoded as MOC maps, and how they can be used in visualisation tools, and processed (filtered, combined) and also their utility for access to Virtual Observatory services which can be queried ‘by MOC’ for data within the region of interest. The ease of generating the MOC maps and the fast access to data means that the whole system can be very efficient, so that any updates on the gravitational-wave sky localisation can be quickly taken into account and the corresponding adjustments to observing schedule plans can be rapidly implemented. We provide example Python code as a practical example of these methods. In addition, a video demonstration of the entire workflow is available

Capability for Encoding Gravitational-wave Sky Localizations with the Multi Order Coverage Data Structure: Present and Future Developments

International audienceThe IVOA standard Multi-Order Coverage map (MOC) is a data structure based on the HEALPix tessellation of the sky, and it can be used to encode the area within a given probability level contour of a gravitational-wave (credible region) sky localization. MOC encoded credible regions can be created, visualised and manipulated using Aladin Desktop. The Aladin Desktop enables the users to compare the MOC regions with existing electromagnetic surveys and to query the VizieR database. These tasks can also be performed via Python using the astropy affiliated package, mocpy, which are efficiently displayed in javascript applications with Aladin Lite, and integrated within Jupyter notebooks through the ipyaladin widgets. The paper also describes an enhanced MOC structure which allows us to include temporal information about gravitational-wave events. This data structure, the Space and Time MOC (ST–MOC), provides us with an effective way to develop new multi-messenger data analysis tools which will be necessary when the third-generation interferometric gravitational wave observatories, such as the Einstein Telescope (ET), will begin operation

Search for Spatial and Temporal Coincidence Between Fermi-LAT Exposure Maps and Gravitational Wave Sky Localizations

International audienceWe describe a practical method for searching for spatial and temporal coincidence of the Fermi-LAT exposure maps over a gravitational-wave sky localization. The method provides in output the overlap region between multi-frequency sky areas within a proper time window selected by the user. This approach offers a prompt setting of the observational strategies for searching for potential electromagnetic candidates as well as for a fast cross-matching between the LAT and the LIGO, Virgo and KAGRA databases for dedicated post-processing analysis. The tasks are performed using the encoded standard method named Multi Order Coverage Map and visualized in the Aladin Desktop

Oxybutynin as a treatment for generalized hyperhidrosis: a randomized, placebo-controlled trial.

International audienceHyperhidrosis is a disorder that can impair quality of life. Localized treatments may be cumbersome and ineffective, and no systemic treatments have proven to be significantly beneficial. To evaluate the effectiveness and tolerance of low-dose oxybutynin for hyperhidrosis. We conducted a prospective, randomized, placebo-controlled trial. From June 2013 to January 2014, 62 patients with localized or generalized hyperhidrosis were enrolled. Oxybutynin was started at a dose of 2·5 mg per day and increased gradually to 7·5 mg per day. The primary outcome was defined as improvement of at least one point on the Hyperhidrosis Disease Severity Scale (HDSS). Dermatology Life Quality Index (DLQI) and tolerance were also reported. Most patients (83%) in our study had generalized hyperhidrosis. Oxybutynin was superior to placebo in improving the HDSS: 60% of patients treated with oxybutynin, compared with 27% of patients treated with placebo, improved at least one point on the HDSS (P = 0·009). The mean improvement in quality of life measured by DLQI was significantly better in the oxybutynin arm (6·9) than in the placebo arm (2·3). The most frequent side-effect was dry mouth, which was observed in 43% of the patients in the oxybutynin arm, compared with 11% in the placebo arm. Treatment with low-dose oxybutynin is effective in reducing symptoms of hyperhidrosis in generalized or localized forms. Side-effects were frequent but minor and mainly involved dry mouth