On the Optical -- X-ray correlation from outburst to quiescence in Low Mass X-ray Binaries: the representative cases of V404 Cyg and Cen X-4

Low mass X-ray binaries (LMXBs) show evidence of a global correlation of debated origin between X-ray and optical luminosity. We study for the first time this correlation in two transient LMXBs, the black hole V404 Cyg and the neutron star Cen X-4, over 6 orders of magnitude in X-ray luminosity, from outburst to quiescence. After subtracting the contribution from the companion star, the Cen X-4 data can be described by a single power law correlation of the form $L_{opt}\propto\,L_{X}^{0.44}$, consistent with disk reprocessing. We find a similar correlation slope for V404 Cyg in quiescence (0.46) and a steeper one (0.56) in the outburst hard state of 1989. However, V404 Cyg is about $160-280$ times optically brighter, at a given $3-9$ keV X-ray luminosity, compared to Cen X-4. This ratio is a factor of 10 smaller in quiescence, where the normalization of the V404 Cyg correlation also changes. We show that once the bolometric X-ray emission is considered and the known main differences between V404 Cyg and Cen X-4 are taken into account (a larger compact object mass, accretion disk size, and the presence of a strong jet contribution in the hard state for the black hole system) the two systems lie on the same correlation. In V404 Cyg, the jet dominates spectrally at optical-infrared frequencies during the hard state, but makes a negligible contribution in quiescence, which may account for the change in its correlation slope and normalization. These results provide a benchmark to compare with data from the 2015 outburst of V404 Cyg and, potentially, other transient LMXBs as well.Comment: Accepted on ApJ, 12 pages, 4 figures, 4 table

The origin of optical emission lines in the soft state of X-ray binary outbursts: the case of MAXI J1820+070

The optical emission line spectra of X-ray binaries (XRBs) are thought to be produced in an irradiated atmosphere, possibly the base of a wind, located above the outer accretion disc. However, the physical nature of - and physical conditions in - the line-forming region remain poorly understood. Here, we test the idea that the optical spectrum is formed in the transition region between the cool, geometrically thin part of the disc near the mid-plane and a hot, vertically extended atmosphere or outflow produced by X-ray irradiation. We first present a VLT X-Shooter spectrum of XRB MAXI J1820+070 in the soft state associated with its 2018 outburst, which displays a rich set of double-peaked hydrogen and helium recombination lines. Aided by ancillary X-ray spectra and reddening estimates, we then model this spectrum with the Monte Carlo radiative transfer code Python, using a simple biconical disc wind model inspired by radiation-hydrodynamic simulations of irradiation-driven outflows from XRB discs. Such a model can qualitatively reproduce the observed features; nearly all of the optical emission arising from the transonic 'transition region' near the base of the wind. In this region, characteristic electron densities are on the order of 10$^{12-13}$ cm$^{-3}$, in line with the observed flat Balmer decrement (H$\alpha$/H$\beta \approx 1.3$). We conclude that strong irradiation can naturally give rise to both the optical line-forming layer in XRB discs and an overlying outflow/atmosphere that produces X-ray absorption lines.Comment: 17 pages, 11 figures. This article has been accepted for publication in MNRAS published by Oxford University Press on behalf of the Royal Astronomical Societ

Aberrant expression of ALK and EZH2 in Merkel cell carcinoma

BACKGROUND: Distinct characteristic features categorize Merkel cell carcinoma (MCC) into two subgroups according to the Merkel cell polyomavirus infection. Many mutational studies on MCC have been carried out in recent years without identifying a prominent driver mutation. However, there is paucity reporting the expression of cancer genes at the RNA level in MCC tumors. In this study, we studied the RNA expression profiles of 26 MCC tumors, with a goal to identify prospective molecular targets that could improve the treatment strategies of MCC. METHODS: RNA expression of 50 cancer-related genes in 26 MCC tumors was analyzed by targeted amplicon based next-generation sequencing using the Ion Torrent technology and the expression compared with that of normal, non-cancerous skin samples. Sequencing data were processed using Torrent Suite Software. Expression profiles of MCV-negative and MCV-positive tumors were compared. Fluorescence in situ hybridization was performed to study ALK rearrangements and immunohistochemistry to study ALK expression in tumor tissue. RESULTS: ALK, CDKN2A, EZH2 and ERBB4 were overexpressed, and EGFR, ERBB2, PDGFRA and FGFR1 were underexpressed in MCC tumors compared to normal skin. In the MCV-negative tumors, MET, NOTCH1, FGFR3, and SMO were overexpressed and JAK3 and NPM1 were under-expressed compared to the MCV-positive tumors. CONCLUSIONS: High expression of ALK, CDKN2A and EZH2 was recorded in MCC tumors. No ALK fusion was seen by FISH analysis. Overexpression of EZH2 suggests its potential as a drug target in MCC.Peer reviewe

Actualized lower body contouring surgery after bariatric surgery - a nationwide register-based study

Massive weight loss might lead to excess skin folds causing functional, physical, and psychosocial discomfort. Following bariatric procedures, an increasing number of patients are seeking lower body contouring surgery (LBCS). The proportion of bariatric patients who undergo LBCS is largely unknown. The aim of this current study was to analyse the incidence and realization of LBCS in bariatric patients in Finland. National retrospective register linkage study including all adult patients who received bariatric surgery in Finland during 1998-2016. The data were obtained from the Finnish national health registers maintained by the Finnish Institute for Health and Welfare. Altogether 1089 (14.1%) of 7703 bariatric patients underwent LBCS during the study period. The majority of the LBCS procedures were abdominoplasty (89%). Median latency between bariatric surgery and LBCS was 31 months. The patients with LBCS were younger (p < 0.001) and received sleeve gastrectomy (p < 0.001). We revealed an annual correlation between LBCS and bariatric procedures (r = 0.683). With a two-year latency between the bariatric and post-bariatric operations, the correlation co-efficiency was strong (r = 0.927). LBCS operations ranged from 5 to 215 per hospital district. Most LBCSs (97.3%) were performed in public hospitals, and some (41%) were performed in university hospitals. This study shows that only 14.1% of bariatric patients undergo LBCS. There is a correlation between bariatric procedures and succeeding plastic surgical reconstructive procedures

Sensitization and desensitization of burn patients as potential candidates for vascularized composite allotransplantation

Sensitization describes the acquired ability of the immune system to react to foreign human leukocyte antigens (HLA) by producing antibodies and developing memory cells. In the field of transplantation, recipient preformed HLA antibodies due to previous sensitization have been identified - beneath ABO incompatibility - as a major factor for acute graft rejection. Several reasons for sensitization have largely been studied, such as previous blood transfusions, pregnancies or former transplants. Recent studies indicate that the use of assist devices (e.g. ECMO) or cadaveric skin allotransplantation providing temporary coverage in burn patients may lead to additional sensitization. As vascularized composite allotransplantation (VCA) has become a rapidly advancing therapeutic option for reconstruction of complex tissue defects in burns, it seems even more important to become familiar with immunological principles and to be cautiously aware of both sources of sensitization and therapeutic concepts in burns avoiding sensitization. This may also include emergency VCAs in burn patients as potential strategy for early definitive reconstruction avoiding procedures triggering HLA antibody formation. We hereby provide an overview on current evidence in the field of pre- and peritrans-plant sensitization, followed by posttransplant strategies of desensitization and their potential impact on future treatments of burn patients. (C) 2015 Elsevier Ltd and ISBI. All rights reserved.Peer reviewe

The Hardness-Intensity Diagram of Cygnus X-3: Revisiting the Radio/X-Ray States

Cygnus X-3 is one of the brightest X-ray and radio sources in the Galaxy, and is well known for its erratic behaviour in X-rays as well as in the radio, occasionally producing major radio flares associated with relativistic ejections. However, even after many years of observations in various wavelength bands Cyg X-3 still eludes clear physical understanding. Studying different emission bands simultaneously in microquasars has proved to be a fruitful approach towards understanding these systems, especially by shedding light on the accretion disc/jet connection. We continue this legacy by constructing a hardness-intensity diagram (HID) from archival Rossi X-ray Timing Explorer data and linking simultaneous radio observations to it. We find that surprisingly Cyg X-3 sketches a similar shape in the HID to that seen in other transient black hole X-ray binaries during outburst but with distinct differences. Together with the results of this analysis and previous studies of Cyg X-3 we conclude that the X-ray states can be assigned to six distinct states. This categorization relies heavily on the simultaneous radio observations and we identify one new X-ray state, the hypersoft state, similar to the ultrasoft state, which is associated to the quenched radio state during which there is no or very faint radio emission. Recent observations of GeV flux observed from Cyg X-3 (Tavani et al. 2009; Fermi LAT Collaboration et al. 2009) during a soft X-ray and/or radio quenched state at the onset of a major radio flare hint that a very energetic process is at work during this time, which is also when the hypersoft X-ray state is observed. In addition, Cyg X-3 shows flaring with a wide range of hardness.Comment: 17 pages, 9 figures, accepted for publication in MNRA