The arrival directions of the most energetic cosmic rays

In this Letter we examine the arrival directions of the most energetic cosmic rays (E > 2 * 10^19 eV) detected by several air shower experiments. We find that data taken by different air shower arrays show positive correlations, indicating a non--uniform arrival direction distribution. We also find that the events with energy $ > 4 * 10^19 eV exhibit a correlation with the general direction of the supergalactic plane, where a large number of potential sources is located. If confirmed by data from other experiments our results would support models for the extragalactic origin of the highest energy cosmic rays.Comment: 7 pages; 1 figure included; uuencoded, compressed PostScript file; final version, corrected in some points, accepted for publication in Phys.Rev.Let

Muscle oxygenation as an indicator of shock severity in patients with suspected severe sepsis or septic shock.

The aim of this pilot study was to evaluate the potential of a new noninvasive optical measurement of muscle oxygenation (MOx) to identify shock severity in patients with suspected sepsis.We enrolled 51 adult patients in the emergency department (ED) who presented with possible sepsis using traditional Systematic Inflammatory Response Syndrome criteria or who triggered a "Code Sepsis." Noninvasive MOx measurements were made from the first dorsal interosseous muscles of the hand once potential sepsis/septic shock was identified, as soon as possible after admission to the ED. Shock severity was defined by concurrent systolic blood pressure, heart rate, and serum lactate levels. MOx was also measured in a control group of 17 healthy adults.Mean (± SD) MOx in the healthy control group was 91.0 ± 5.5% (n = 17). Patients with mild, moderate, and severe shock had mean MOx values of 79.4 ± 21.2%, 48.6 ± 28.6%, and 42.2 ± 4.7%, respectively. Mean MOx for the mild and moderate shock severity categories were statistically different from healthy controls and from each other based on two-sample t-tests (p < 0.05).We demonstrate that noninvasive measurement of MOx was associated with clinical assessment of shock severity in suspected severe sepsis or septic shock. The ability of MOx to detect even mild septic shock has meaningful implications for emergency care, where decisions about triage and therapy must be made quickly and accurately. Future longitudinal studies may validate these findings and the value of MOx in monitoring patient status as treatment is administered

Identification of a population of X-ray-emitting massive stars in the galactic plane

We present X-ray, infrared, optical, and radio observations of four previously unidentified Galactic plane X-ray sources: AX J163252-4746, AX J184738-0156, AX J144701-5919, and AX J144547-5931. Detection of each source with the Chandra X-ray Observatory has provided sub-arcsecond localizations, which we use to identify bright infrared counterparts to all four objects. Infrared and optical spectroscopy of these counterparts demonstrate that all four X-ray sources are extremely massive stars, with spectral classifications: Ofpe/WN9 (AX J163252-4746), WN7 (AX J184738-0156 = WR121a), WN7-8h (AX J144701-5919), and OIf(+) (AX J144547-5931). AX J163252-4746 and AX J184738-0156 are both luminous, hard, X-ray emitters with strong Fe XXV emission lines in their X-ray spectra at similar to 6.7 keV. The multi-wavelength properties of AX J163252-4746 and AX J184738-0156 are not consistent with isolated massive stars or accretion onto a compact companion; we conclude that their X-ray emission is most likely generated in a colliding-wind binary (CWB) system. For both AX J144701-5919 and AX J144547-5931, the X-ray emission is an order of magnitude less luminous and with a softer spectrum. These properties are consistent with a CWB interpretation for these two sources also, but other mechanisms for the generation of X-rays cannot be excluded. There are many other as yet unidentified X-ray sources in the Galactic plane, with X-ray properties similar to those seen for AX J163252-4746, AX J184738-0156, AX J144701-5919, and AX J144547-5931. This may indicate a substantial population of X-ray-emitting massive stars and CWBs in the Milky Way

Patient enrollment.

<p>Muscle oxygenation (MOx) was measured from spectra acquired from patients. Q-residuals measure the similarity between patient spectra and the spectra that were used to train the algorithm that measures MOx. High Q-residuals (> 95% confidence interval) indicate a level of dissimilarity that renders MOx measurements invalid. MOx from 51 subjects was included in the final data set analyzed.</p

Muscle oxygenation (MOx) (mean ± SD) as a function of shock severity based on clinical scoring.

<p>Patients in mild and moderate shock categories were statistically significantly lower than healthy controls (*), and the mean MOx decrease between mild and moderate groups was also significant, p < 0.05. Statistical hypothesis testing was not performed on the severe group due to the small number of patients in that group.</p

Schematic diagram of the optical spectral acquisition system configuration.

<p>A fiber-optic probe brings the incident light to the subject and returns reflected light to a spectrometer for computer processing.</p

Clinical shock severity stratification scoring system.

<p>Clinical shock severity stratification scoring system.</p

Photograph of the optical probe placed on a subject’s hand.

<p>The spectrometer and associated equipment is on a mobile cart at the bedside.</p