Outflows From Evolved Stars: The Rapidly Changing Fingers Of CRL 618

Our ultimate goal is to probe the nature of the collimator of the outflows in the pre-planetary nebula CRL 618. CRL 618 is uniquely suited for this purpose owing to its multiple, bright, and carefully studied finger-shaped outflows east and west of its nucleus. We compare new Hubble Space Telescope images to images in the same filters observed as much as 11 yr ago to uncover large proper motions and surface brightness changes in its multiple finger-shaped outflows. The expansion age of the ensemble of fingers is close to 100 yr. We find strong brightness variations at the fingertips during the past decade. Deep IR images reveal a multiple ring-like structure of the surrounding medium into which the outflows propagate and interact. Tightly constrained three-dimensional hydrodynamic models link the properties of the fingers to their possible formation histories. We incorporate previously published complementary information to discern whether each of the fingers of CRL 618 are the results of steady, collimated outflows or a brief ejection event that launched a set of bullets about a century ago. Finally, we argue on various physical grounds that fingers of CRL 618 are likely to be the result of a spray of clumps ejected at the nucleus of CRL 618 since any mechanism that form a sustained set of unaligned jets is unprecedented.HST GO 11580NASA through Space Telescope Science Institute GO11580NASA NAS5-26555Boeing ScholarshipOffice of Undergraduate Academic Affairs at the University of WashingtonSpanish MICINN CSD2009-00038NASA Office of Space Science NAG5-7584Astronom

Clinical subgroups in bilateral meniere disease

Meniere disease (MD) is a heterogeneous clinical condition characterized by sensorineural hearing loss, episodic vestibular symptoms, and tinnitus associated with several comorbidities, such as migraine or autoimmune disorders (AD). The frequency of bilateral involvement may range from 5 to 50%, and it depends on the duration of the disease. We have performed a two-step cluster analysis in 398 patients with bilateral MD (BMD) to identify the best predictors to define clinical subgroups with a potential different etiology to improve the phenotyping of BMD and to develop new treatments. We have defined five clinical variants in BMD. Group 1 is the most frequently found, includes 46% of patients, and is defined by metachronic hearing loss without migraine and without AD. Group 2 is found in 17% of patients, and it is defined by synchronic hearing loss without migraine or AD. Group 3, with 13% of patients, is characterized by familial MD, while group 4, that includes 12% of patients, is associated by the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by AD. This approach can be helpful in selecting patients for genetic and clinical research. However, further studies will be required to improve the phenotyping in these clinical variants for a better understanding of the diverse etiological factors contributing to BMD