Nitrogen Enrichment in Atmospheres of A- and F- Type Supergiants

Using new accurate fundamental parameters of 30 Galactic A and F supergiants, namely their effective temperatures Teff and surface gravities log g, we implemented a non-LTE analysis of the nitrogen abundance in their atmospheres. It is shown that the non-LTE corrections to the N abundances increase with Teff. The nitrogen overabundance as a general feature of this type of stars is confirmed. A majority of the stars has a nitrogen excess [N/Fe] between 0.2 and 0.9 dex with the maximum position of the star's distribution on [N/Fe] between 0.4 and 0.7 dex. The N excesses are discussed in light of predictions for B-type main sequence (MS) stars with rotationally induced mixing and for their next evolutionary phase, i.e. A- and F-type supergiants that have experienced the first dredge-up. Rotationally induced mixing in the MS progenitors of the supergiants may be a significant cause of the nitrogen excesses. When comparing our results with predictions of the theory developed for stars with the mixing, we find that the bulk of the supergiants (28 of 30) show the N enrichment that can be expected (i) either after the MS phase for stars with the initial rotational velocities v0 = 200-400 km s-1, (ii) or after the first dredge-up for stars with v0 = 50-400 km s-1. The latter possibility is preferred on account of the longer lifetime for stars on red-blue loops following the first dredge-up. Two supergiants without a discernible N enrichment, namely HR 825 and HR 7876, may be post-MS objects with the relatively low initial rotational velocity of about 100 km s-1. The suggested range for v0 is approximately consistent with inferences from the observed projected rotational velocities of B-type MS stars, progenitors of A and F supergiants.Comment: 14 pages, 13 figure

Mixing of CNO-cycled matter in massive stars

Aims: We test predictions of evolution models on mixing of CNO-cycled products in massive stars from a fundamental perspective. Relative changes within the theoretical C:N:O abundance ratios and the buildup of helium are compared with observational results. Methods: A sample of well-studied Galactic massive stars is presented. High-quality optical spectra are carefully analysed using improved NLTE line-formation and comprehensive analysis strategies. The results are put in the context of the existing literature data. Results: A tight trend in the observed N/C vs. N/O ratios and the buildup of helium is found from the self-consistent analysis of main-sequence to supergiant stars for the first time. The catalytic nature of the CNO-cycles is confirmed quantitatively, though further investigations are required to derive a fully consistent picture. Our observational results support the case of strong mixing, as predicted e.g. by evolution models that consider magnetic fields or by models that have gone through the first dredge-up in the case of many supergiants.Comment: 6 pages, 6 figures. A&A, in pres

Development and evaluation of an internet- and mobile-based intervention for individualized return to work planning after inpatient rehabilitation : study protocol for a randomized-controlled-trial

Background: Following discharge, it is crucial for patients to transfer intentions and action plans from inpatient rehabilitation into everyday life. This ensures their reintegration into social and working life and prevents economic costs due to sick leave or reduced earning capacity pension. However, most established aftercare programs do not specifically address occupational problems or challenges during occupational measures such as graded return to work. The aim of this study is to evaluate the efficacy of the low-threshold online self-help intervention marena (Meine Arbeitsbezogene Reha-Nachsorge - My Work-related Rehabilitation Aftercare) to support return to work. Methods: A two-arm randomized-controlled-trial (RCT) will be conducted. A total of N = 400 rehabilitation inpatients across different indication areas (psychosomatic, orthopedic, or cardiologic) aged 18 to 65 years with a planned return to work after medical rehabilitation, have a heightened social-medical risk and private internet access and are insured with the German Pension insurance or statutory health insurance, will be recruited in four medical and psychosomatic clinics in Germany. Participants will be allocated to either the intervention (IG) or the control group (CG). In a stepped-care model, participants of the IG will receive access to the non-guided internet- and mobile-based intervention marena (IG subgroup 1) or marena in combination with GSA-Online plus (IG subgroup 2), a guided psychodynamic internet-based intervention that has proven effective in two trials regarding occupational and health objectives. Based on a priori defined indication criteria, clinic staff will recommend either IG subgroup 1 or IG subgroup 2. The CG will receive optimized treatment as usual with access to a survey feature within marena. The primary outcome will be work status after 6 months (T2) and 12 months (T4). The endpoint at 12 months (T4) after discharge from inpatient rehabilitation will be considered as secondary endpoint. Work status is defined as positive if the participant is working and has ≤ 6 weeks of sick leave at T2 and ≤ 12 weeks of sick leave at T4. Secondary outcomes include successful completion of graded return to work, successful application for benefits for participation in working life, current work ability, social-medical risk, subjective prognosis of future employment, quality of life, somatic symptoms, coping, social support, depression, anxiety, and psychosocial stress. Discussion: This study will contribute to the evidence concerning efficacy of online aftercare interventions. If proven efficacious, marena could provide an individualized and adaptable self-help approach to promote return to work following inpatient rehabilitation

The maximum standardized uptake value in patients with recurrent or persistent prostate cancer after radical prostatectomy and PSMA-PET-guided salvage radiotherapy-a multicenter retrospective analysis

Purpose This study aims to evaluate the association of the maximum standardized uptake value (SUVmax) in positron-emission tomography targeting prostate-specific membrane antigen (PSMA-PET) prior to salvage radiotherapy (sRT) on biochemical recurrence free survival (BRFS) in a large multicenter cohort.Methods Patients who underwent (68) Ga-PSMA11-PET prior to sRT were enrolled in four high-volume centers in this retrospective multicenter study. Only patients with PET-positive local recurrence (LR) and/or nodal recurrence (NR) within the pelvis were included. Patients were treated with intensity-modulated-sRT to the prostatic fossa and elective lymphatics in case of nodal disease. Dose escalation was delivered to PET-positive LR and NR. Androgen deprivation therapy was administered at the discretion of the treating physician. LR and NR were manually delineated and SUVmax was extracted for LR and NR. Cox-regression was performed to analyze the impact of clinical parameters and the SUVmax-derived values on BRFS.Results Two hundred thirty-five patients with a median follow-up (FU) of 24 months were included in the final cohort. Two-year and 4-year BRFS for all patients were 68% and 56%. The presence of LR was associated with favorable BRFS (p = 0.016). Presence of NR was associated with unfavorable BRFS (p = 0.007). While there was a trend for SUVmax values >= median (p = 0.071), SUVmax values >= 75% quartile in LR were significantly associated with unfavorable BRFS (p = 0.022, HR: 2.1, 95%CI 1.1-4.6). SUVmax value in NR was not significantly associated with BRFS. SUVmax in LR stayed significant in multivariate analysis (p = 0.030). Sensitivity analysis with patients for who had a FU of > 12 months (n = 197) confirmed these results.Conclusion The non-invasive biomarker SUVmax can prognosticate outcome in patients undergoing sRT and recurrence confined to the prostatic fossa in PSMA-PET. Its addition might contribute to improve risk stratification of patients with recurrent PCa and to guide personalized treatment decisions in terms of treatment intensification or de-intensification. This article is part of the Topical Collection on Oncology-Genitourinary

Eclipsing binaries in open clusters. I. V615 Per and V618 Per in h Per

We derive absolute dimensions for two early-type main sequence detached eclipsing binaries in the young open cluster h Persei (NGC 869). V615 Persei has a spectral type of B7V and a period of 13.7d. V618 Persei is A2V and has a period of 6.4d. New ephemerides are calculated for both systems. The masses of the component stars have been derived using high-resolution spectroscopy and are 4.08+/-0.06 Msun and 3.18+/-0.05 Msun for V615 Per and 2.33+/-0.03 Msun and 1.56+/-0.02 Msun for V618 Per. The radii have been measured by fitting the available light curves using EBOP and are 2.29+/-0.14 Rsun and 1.90+/-0.09 Rsun for V615 Per and 1.64+/-0.07 Rsun and 1.32+/-0.07 Rsun for V618 Per. By comparing the observed spectra of V615 Per to synthetic spectra from model atmospheres we find that the effective temperatures of the two stars are 15000+/-500 K and 11000+/-500 K. The equatorial rotational velocities of the primary and secondary components of V615 Per are 28+/-5 km/s and 8+/-5 km/s, respectively. Both components of V618 Per rotate at 10+/-5 km/s. The equatorial rotational velocities for synchronous rotation are about 10 km/s for all four stars. The timescales for orbital circularisation for both systems, and the timescale for rotational synchronisation of V615 Per, are much greater than the age of h Per. Their negligible eccentricities and equatorial rotational velocities therefore support the hypothesis that they were formed by 'delayed breakup'. We have compared the radii of these stars to models by the Granada and the Padova groups for stars of the same masses but different compositions. We conclude that the metallicity of the stars is about Z=0.01. This appears to be the first estimate of the bulk metallicity of h Per. Recent photometric studies have assumed a solar metallicity so their results should be reviewed.Comment: Accepted for publication in MNRAS (15 pages, 9 figures

Application of bone growth factors—the potential of different carrier systems

Aim The aim of the present review was to characterize the potential of different biomaterials as carriers for bone growth factors. Introduction Beyond mechanical and structural characteristics, one of the features that account for a potential carrier is the possibility to couple growth factor molecules to it. As simple adsorption of the growth factor to the carrier surface by soak loading produces a burst release of growth factors with rapid decrease of biological activity, the ability to accomplish controlled release of functional growth factor molecules is one of the crucial characteristics for an appropriate carrier material. Conclusion The variety of carrier materials requires different strategies to either couple growth factors to the material surface or to incorporate them into the carrier matrix. The present review outlines current technical approaches and discusses future trends in the use of carrier materials for bone growth factors

Single-cell RNA sequencing reveals ex vivo signatures of SARS-CoV-2-reactive T cells through ‘reverse phenotyping’

Abstract The in vivo phenotypic profile of T cells reactive to severe acute respiratory syndrome (SARS)-CoV-2 antigens remains poorly understood. Conventional methods to detect antigen-reactive T cells require in vitro antigenic re-stimulation or highly individualized peptide-human leukocyte antigen (pHLA) multimers. Here, we use single-cell RNA sequencing to identify and profile SARS-CoV-2-reactive T cells from Coronavirus Disease 2019 (COVID-19) patients. To do so, we induce transcriptional shifts by antigenic stimulation in vitro and take advantage of natural T cell receptor (TCR) sequences of clonally expanded T cells as barcodes for ‘reverse phenotyping’. This allows identification of SARS-CoV-2-reactive TCRs and reveals phenotypic effects introduced by antigen-specific stimulation. We characterize transcriptional signatures of currently and previously activated SARS-CoV-2-reactive T cells, and show correspondence with phenotypes of T cells from the respiratory tract of patients with severe disease in the presence or absence of virus in independent cohorts. Reverse phenotyping is a powerful tool to provide an integrated insight into cellular states of SARS-CoV-2-reactive T cells across tissues and activation states

Protons, Photons & the Prostate – is there emerging evidence in the ongoing discussion on particle therapy for the treatment of prostate cancer?

Proton therapy is actively and repeatedly discussed within the framework of particle therapy for the treatment of prostate cancer. The argument in favor of treating the prostate with protons is partly financial: given that small volumes are treated, treat-ment times are low, resulting in a hypothetical high patient throughput. However, such considerations should not form the basis of medical decision-making. There are also physical and biological arguments which further support the use of particle therapy for prostate cancer.The only relevant randomized data currently available is the study by Zietman and colleagues, comparing a high to a low proton boost, resulting in a significant increase in PSA-free survival in the experimental (high-dose) arm. 1 With modern photon treatments and image guided radiotherapy (IGRT) equally high doses can be applied with photons, and thus a randomized trial comparing high-end photons to protons is warranted.For high-linear energy transfer (LET) particles, such as carbon ions, the increase in relative biological effectiveness (RBE) could potentially convert into an improvement in outcome. Additionally, through the physical differences of protons and carbon ions, the steeper dose gradient with carbon ions and the lack of beam broadening in the proton beam lead to a superior dos

Definitive, intensity modulated tomotherapy with a simultaneous integrated boost for prostate cancer patients – Long term data on toxicity and biochemical control

AimTo report long-term data regarding biochemical control and late toxicity of simultaneous integrated boost intensity modulated radiotherapy (SIB-IMRT) with tomotherapy in patients with localized prostate cancer.BackgroundDose escalation improves cancer control after curative intended radiation therapy (RT) to patients with localized prostate cancer, without increasing toxicity, if IMRT is used.Materials and methodsIn this retrospective analysis, we evaluated long-term toxicity and biochemical control of the first 40 patients with intermediate risk prostate cancer receiving SIB-IMRT. Primary target volume (PTV) 1 including the prostate and proximal third of the seminal vesicles with safety margins was treated with 70Gy in 35 fractions. PTV 2 containing the prostate with smaller safety margins was treated as SIB to a total dose of 76Gy with 2.17Gy per fraction. Toxicity was evaluated using an adapted CTCAE-Score (Version 3).ResultsMedian follow-up of living patients was 66 (20–78) months. No late genitourinary toxicity higher than grade 2 has been reported. Grade 2 genitourinary toxicity rates decreased from 58% at the end of the treatment to 10% at 60 months. Late gastrointestinal (GI) toxicity was also moderate, though the prescribed PTV Dose of 76Gy was accepted at the anterior rectal wall. 74% of patients reported any GI toxicity during follow up and no toxicity rates higher than grade 2 were observed. Grade 2 side effects were reported by 13% of the patients at 60 months. 5-year freedom from biochemical failure was 95% at our last follow up.ConclusionSIB-IMRT using daily MV-CT guidance showed excellent long-term biochemical control and low toxicity rates