On an apparent dearth of recurrent nova super-remnants in the Local Group

The Andromeda Galaxy is home to the annually erupting recurrent nova (RN) M31N 2008-12a (12a); the first nova found to host a nova super-remnant (NSR). A NSR is an immense structure surrounding a RN, created from many millions of eruptions sweeping up material in the local environment to form a shell tens of parsecs across. Theory has demonstrated that NSRs should be found around all RNe, even those systems with long periods between eruptions. Befittingly, the second NSR was found around the Galactic classical (and long suspected recurrent) nova, KT Eridani. In this Paper, we aim to find more of these phenomena through conducting the first ever survey for NSRs in M31 and the Large Magellanic Cloud (LMC). We find that the surroundings of fourteen RNe in M31 as well as the surroundings of the four RNe in the LMC do not show any evidence of vast parsec-scale structures in narrowband (Hα and [S II]) images, unlike the one clearly seen around 12a, and therefore conclude that observable NSRs are either rare structures, or they are too faint (or small) to be detected in our existing datasets. Yet, the NSR surrounding 12a would also likely to have been overlooked in our study if it were approximately one magnitude fainter. Searches for NSRs around other RNe 'masquerading' as classical novae may prove to be fruitful as would whole surveys of other Local Group galaxies

Discovery of a nova super-remnant cavity surrounding RS Ophiuchi

The prototypical nova super-remnant (NSR) was uncovered around the most rapidly recurring nova (RN), M31N 2008-12a. Simulations of the growth of NSRs revealed that these large structures should exist around all novae, whether classical or recurrent. NSRs consist of large shell-like structures surrounding excavated cavities. Predictions, informed by these simulations, led to the discovery of an extended cavity coincident with the Galactic RN, RS Ophiuchi, in far-infrared archival IRAS images. We propose that this cavity is associated with RS Oph and is therefore evidence of another NSR to be uncovered

Hydrodynamic simulations of the KT Eridani nova super-remnant

A nova super-remnant (NSR) is an immense structure associated with a nova that forms when frequent and recurrent nova eruptions sweep up surrounding interstellar material (ISM) into a high density and distant shell. The prototypical NSR, measuring over 100 pc across, was discovered in 2014 around the annually erupting nova M31N 2008-12a. Hydrodynamical simulations demonstrated that the creation of a dynamic NSR by repeated eruptions transporting large quantities of ISM is not only feasible but that these structures should exist around all novae, whether the white dwarf (WD) is increasing or decreasing in mass. But it is only the recurrent nova (RNe) with the highest WD masses and accretion rates that should host observable NSRs. KT Eridani is, potentially, the eleventh RNe recorded in the Galaxy and is also surrounded by a recently unveiled H{\alpha} shell tens of parsecs across, consistent with a NSR. Through modelling the nova ejecta from KT Eri, we demonstrate that such an observable NSR could form in approximately 50,000 years, which fits with the proper motion history of the nova. We compute the expected H{\alpha} emission from the KT Eri NSR and predict that the structure might be accessible to wide-field X-ray facilities

On the Observability of Recurrent Nova Super-Remnants

The nova super-remnant (NSR) surrounding M 31N 2008-12a (12a), the annually erupting recurrent nova (RN), is the only known example of this phenomenon. As this structure has grown as a result of frequent eruptions from 12a, we might expect to see NSRs around other RNe; this would confirm the RN–NSR association and strengthen the connection between novae and type Ia supernovae (SN Ia) as NSRs centered on SN Ia provide a lasting, unequivocal signpost to the single degenerate progenitor type of that explosion. The only previous NSR simulation used identical eruptions from a static white dwarf (WD). In this Paper, we simulate the growth of NSRs alongside the natural growth/erosion of the central WD, within a range of environments, accretion rates, WD temperatures, and initial WD masses. The subsequent evolving eruptions create dynamic NSRs tens of parsecs in radius comprising a low-density cavity, bordered by a hot ejecta pile-up region, and surrounded by a cool high-density, thin, shell. Higher density environments restrict NSR size, as do higher accretion rates, whereas the WD temperature and initial mass have less impact. NSRs form around growing or eroding WDs, indicating that NSRs also exist around old novae with low-mass WDs. Observables such as X-ray and

AT 2017fvz: a nova in the dwarf irregular galaxy NGC 6822

A transient in the Local Group dwarf irregular galaxy NGC 6822 (Barnard's Galaxy) was discovered on 2017 August 2 and is only the second classical nova discovered in that galaxy. We conducted optical, near-ultraviolet, and X-ray follow-up observations of the eruption, the results of which we present here. This 'very fast' nova had a peak $V$-band magnitude in the range $-7.41>M_V>-8.33$ mag, with decline times of $t_{2,V} = 8.1 \pm 0.2$ d and $t_{3,V} = 15.2 \pm 0.3$ d. The early- and late-time spectra are consistent with an Fe II spectral class. The H$\alpha$ emission line initially has a full width at half-maximum intensity of $\sim 2400$ km s$^{-1}$ - a moderately fast ejecta velocity for the class. The H$\alpha$ line then narrows monotonically to $\sim1800$ km s$^{-1}$ by 70 d post-eruption. The lack of a pre-eruption coincident source in archival Hubble Space Telescope imaging implies that the donor is a main sequence, or possibly subgiant, star. The relatively low peak luminosity and rapid decline hint that AT 2017fvz may be a 'faint and fast' nova

Mycolactone-dependent depletion of endothelial cell thrombomodulin is strongly associated with fibrin deposition in Buruli ulcer lesions

A well-known histopathological feature of diseased skin in Buruli ulcer (BU) is coagulative necrosis caused by the Mycobacterium ulcerans macrolide exotoxin mycolactone. Since the underlying mechanism is not known, we have investigated the effect of mycolactone on endothelial cells, focussing on the expression of surface anticoagulant molecules involved in the protein C anticoagulant pathway. Congenital deficiencies in this natural anticoagulant pathway are known to induce thrombotic complications such as purpura fulimans and spontaneous necrosis. Mycolactone profoundly decreased thrombomodulin (TM) expression on the surface of human dermal microvascular endothelial cells (HDMVEC) at doses as low as 2ng/ml and as early as 8hrs after exposure. TM activates protein C by altering thrombin's substrate specificity, and exposure of HDMVEC to mycolactone for 24 hours resulted in an almost complete loss of the cells' ability to produce activated protein C. Loss of TM was shown to be due to a previously described mechanism involving mycolactone-dependent blockade of Sec61 translocation that results in proteasome-dependent degradation of newly synthesised ER-transiting proteins. Indeed, depletion from cells determined by live-cell imaging of cells stably expressing a recombinant TM-GFP fusion protein occurred at the known turnover rate. In order to determine the relevance of these findings to BU disease, immunohistochemistry of punch biopsies from 40 BU lesions (31 ulcers, nine plaques) was performed. TM abundance was profoundly reduced in the subcutis of 78% of biopsies. Furthermore, it was confirmed that fibrin deposition is a common feature of BU lesions, particularly in the necrotic areas. These findings indicate that there is decreased ability to control thrombin generation in BU skin. Mycolactone's effects on normal endothelial cell function, including its ability to activate the protein C anticoagulant pathway are strongly associated with this. Fibrin-driven tisischemia could contribute to the development of the tissue necrosis seen in BU lesions

Three little pieces for computer and relativity

Numerical relativity has made big strides over the last decade. A number of problems that have plagued the field for years have now been mostly solved. This progress has transformed numerical relativity into a powerful tool to explore fundamental problems in physics and astrophysics, and I present here three representative examples. These "three little pieces" reflect a personal choice and describe work that I am particularly familiar with. However, many more examples could be made.Comment: 42 pages, 11 figures. Plenary talk at "Relativity and Gravitation: 100 Years after Einstein in Prague", June 25 - 29, 2012, Prague, Czech Republic. To appear in the Proceedings (Edition Open Access). Collects results appeared in journal articles [72,73, 122-124

Effectiveness of an online curriculum for medical students on genetics, genetic testing and counseling

Background: It is increasingly important that physicians have a thorough understanding of the basic science of human genetics and the ethical, legal and social implications (ELSI) associated with genetic testing and counseling. Methods: The authors developed a series of web-based courses for medical students on these topics. The course modules are interactive, emphasize clinical case studies, and can easily be incorporated into existing medical school curricula. Results: Results of a ‘real world’ effectiveness trial indicate that the courses have a statistically significant effect on knowledge, attitude, intended behavior and self-efficacy related to genetic testing (p<0.001; N varies between 163 and 596 for each course). Conclusions: The results indicate that this curriculum is an effective tool for educating medical students on the ELSI associated with genetic testing and for promoting positive changes in students' confidence, counseling attitudes and behaviors

Evaluation of sit-stand workstations in an office setting: A randomised controlled trial

Background: Excessive sitting time is a risk factor for cardiovascular disease mortality and morbidity independent of physical activity. This aim of this study was to evaluate the impact of a sit-stand workstation on sitting time, and vascular, metabolic and musculoskeletal outcomes in office workers, and to investigate workstation acceptability and feasibility. Methods: A two-arm, parallel-group, individually randomised controlled trial was conducted in one organisation. Participants were asymptomatic full-time office workers aged ≥18 years. Each participant in the intervention arm had a sit-stand workstation installed on their workplace desk for 8 weeks. Participants in the control arm received no intervention. The primary outcome was workplace sitting time, assessed at 0, 4 and 8 weeks by an ecological momentary assessment diary. Secondary behavioural, cardiometabolic and musculoskeletal outcomes were assessed. Acceptability and feasibility were assessed via questionnaire and interview. ANCOVA and magnitude-based inferences examined intervention effects relative to controls at 4 and 8 weeks. Participants and researchers were not blind to group allocation. Results: Forty-seven participants were randomised (intervention n = 26; control n = 21). Relative to the control group at 8 weeks, the intervention group had a beneficial decrease in sitting time (-80.2 min/8-h workday (95 % CI = -129.0, -31.4); p = 0.002), increase in standing time (72.9 min/8-h workday (21.2, 124.6); p = 0.007) and decrease in total cholesterol (-0.40 mmol/L (-0.79, -0.003); p = 0.049). No harmful changes in musculoskeletal discomfort/pain were observed relative to controls, and beneficial changes in flow-mediated dilation and diastolic blood pressure were observed. Most participants self-reported that the workstation was easy to use and their work-related productivity did not decrease when using the device. Factors that negatively influenced workstation use were workstation design, the social environment, work tasks and habits. Conclusion: Short-term use of a feasible sit-stand workstation reduced daily sitting time and led to beneficial improvements in cardiometabolic risk parameters in asymptomatic office workers. These findings imply that if the observed use of the sit-stand workstations continued over a longer duration, sit-stand workstations may have important ramifications for the prevention and reduction of cardiometabolic risk in a large proportion of the working population. Trial registration: ClinicalTrials.gov NCT02496507

Association between mortality from suicide in England and antidepressant prescribing: an ecological study

BACKGROUND: Antidepressant prescribing has been increasing in England. Studies in other countries suggest that while this may be associated with reduced suicide rates, it may also be associated with increased fatal poisoning from antidepressant drugs. We therefore conducted an ecological study to assess the association between prescription rates for antidepressants and suicide or fatal antidepressant-related poisoning in England. METHODS: The Office for National Statistics provided information on the number of suicides, antidepressant-related poisoning deaths and populations for England between 1993 and 2002. The Department of Health supplied data on prescriptions for all antidepressants dispensed in England. Associations between prescriptions and deaths were assessed using Spearman's rank correlation coefficient. RESULTS: There were 46,747 suicides, 3,987 deaths involving tricyclic antidepressants and 430 involving selective serotonin re-uptake inhibitors and other antidepressants. Increased antidepressant prescribing was statistically associated with a fall in suicide rates (Spearman's r(s )= -0.73, p = 0.02) and fatal poisoning involving tricyclic antidepressants (r(s )= -0.64, p = 0.05). In contrast, increased prescribing of selective serotonin re-uptake inhibitors and other antidepressants was statistically associated with an increase in fatal poisoning involving these drugs (r(s )= 0.99, p < 0.001). CONCLUSION: Increased prescribing of antidepressants may indicate improved diagnosis and treatment of depression in primary care. Our analysis suggests that this was accompanied by lower suicide rates. A decrease in poisoning deaths involving tricyclic antidepressants may suggest a change in preference for using serotonin reuptake inhibitors and other antidepressant drugs for high-risk patients. This may also partially explain the increase in deaths involving these drugs. Due to the ecological nature of the design, we cannot say conclusively whether reduced suicide rates are a direct consequence of increased antidepressant prescribing rates. To confirm these associations, individual level data on prescribing and suicide is needed