The dense gas in the largest molecular complexes of the antennae: HCN and HCO+ observations of NGC 4038/39 using ALMA

We present observations of the dense molecular gas tracers $\mathrm{HCN}$, $\mathrm{HNC}$, and ${\mathrm{HCO}}^{+}$ in the $J=1-0$ transition using the Atacama Large Millimeter/submillimeter Array. We supplement our data sets with previous observations of $\mathrm{CO}$ $J=1-0$, which trace the total molecular gas content. We separate the Antennae into seven bright regions in which we detect emission from all three molecules, including the nuclei of NGC 4038 and NGC 4039, five super giant molecular complexes in the overlap region, and two additional bright clouds. We find that the ratio of ${L}_{\mathrm{HCN}}/{L}_{\mathrm{CO}}$, which traces the dense molecular gas fraction, is greater in the two nuclei (${L}_{\mathrm{HCN}}/{L}_{\mathrm{CO}}$ $\sim \quad 0.07-0.08$) than in the overlap region (${L}_{\mathrm{HCN}}/{L}_{\mathrm{CO}}$ $\lt 0.05$). We attribute this to an increase in pressure due to the stellar potential within the nuclei; a similar effect to what has been seen previously in the Milky Way and nearby spiral galaxies. Furthermore, the ratio of ${L}_{\mathrm{HNC}}/{L}_{\mathrm{HCN}}$ $\sim \quad 0.3-0.4$ does not vary by more than a factor of 1.5 between regions. By comparing our measured ratios to photon dominated region (PDR) models including mechanical heating, we find that the ratio of ${L}_{\mathrm{HNC}}/{L}_{\mathrm{HCN}}$ is consistent with mechanical heating contributing gsim5%–10% of the PDR surface heating to the total heating budget. Finally, the ratio of ${L}_{\mathrm{HCN}}/{L}_{\mathrm{HCO}+}$ varies from ~1 in the nucleus of NGC 4038 down to ~0.5 in the overlap region. The lower ratio in the overlap region may be due to an increase in the cosmic ray rate from the increased supernova rate within this region

The first maps of κd - the dust mass absorption coefficient - in nearby galaxies, with DustPedia

The dust mass absorption coefficient, κd is the conversion function used to infer physical dust masses from observations of dust emission. However, it is notoriously poorly constrained, and it is highly uncertain how it varies, either between or within galaxies. Here we present the results of a proof-of-concept study, using the DustPedia data for two nearby face-on spiral galaxies M 74 (NGC 628) and M 83 (NGC 5236), to create the first ever maps of κd in galaxies. We determine κd using an empirical method that exploits the fact that the dust-to-metals ratio of the interstellar medium is constrained by direct measurements of the depletion of gas-phase metals. We apply this method pixel-by-pixel within M 74 and M 83, to create maps of κd. We also demonstrate a novel method of producing metallicity maps for galaxies with irregularly sampled measurements, using the machine learning technique of Gaussian process regression. We find strong evidence for significant variation in κd. We find values of κd at 500 μm spanning the range 0.11-0.25 m^{2 kg^{-1}} in M 74, and 0.15-0.80 m^{2 kg^{-1}} in M 83. Surprisingly, we find that κd shows a distinct inverse correlation with the local density of the interstellar medium. This inverse correlation is the opposite of what is predicted by standard dust models. However, we find this relationship to be robust against a large range of changes to our method - only the adoption of unphysical or highly unusual assumptions would be able to suppress it

The interstellar medium in Andromeda's dwarf spheroidal galaxies - I. Content and origin of the interstellar dust

Dwarf spheroidal galaxies are among the most numerous galaxy population in the Universe, but their main formation and evolution channels are still not well understood. The three dwarf spheroidal satellites (NGC147, NGC185, and NGC205) of the Andromeda galaxy are characterised by very different interstellar medium (ISM) properties, which might suggest them being at different galaxy evolutionary stages. While the dust content of NGC205 has been studied in detail by De Looze et al. (2012), we present new Herschel dust continuum observations of NGC147 and NGC185. The non-detection of NGC147 in Herschel SPIRE maps puts a strong constraint on its dust mass (< 128 Msun). For NGC185, we derive a total dust mass M_d = 5.1 x 10^3 Msun, which is a factor of ~2-3 higher than that derived from ISO and Spitzer observations and confirms the need for longer wavelength observations to trace more massive cold dust reservoirs. We, furthermore, estimate the dust production by asymptotic giant branch (AGB) stars and supernovae (SNe). For NGC147, the upper limit on the dust mass is consistent with expectations of the material injected by the evolved stellar population. In NGC185 and NGC205, the observed dust content is one order of magnitude higher compared to the estimated dust production by AGBs and SNe. Efficient grain growth, and potentially longer dust survival times (3-6 Gyr) are required to account for their current dust content. Our study confirms the importance of grain growth in the gas phase to account for the current dust reservoir in galaxies.DL gratefully acknowledge the support of the Science and Technology Facilities Council (STFC) and the Flemish Fund for Scientific Research (FWO-Vlaanderen). PACS has been developed by a consortium of institutes led by MPE (Germany) and including UVIE (Austria); KU Leuven, CSL, IMEC (Belgium); CEA, LAM (France); MPIA (Germany); INAFIFSI/OAA/OAP/OAT, LENS, SISSA (Italy); IAC (Spain). This development has been supported by the funding agencies BMVIT (Austria), ESA-PRODEX (Belgium), CEA/CNES (France), DLR (Germany), ASI/INAF (Italy), and CICYT/MCYT (Spain). SPIRE has been developed by a consortium of institutes led by Cardiff University (UK) and including Univ. Lethbridge (Canada); NAOC (China); CEA, LAM (France); IFSI, Univ. Padua (Italy); IAC (Spain); Stockholm Observatory (Sweden); Imperial College London, RAL, UCL-MSSL, UKATC, Univ. Sussex (UK); and Caltech, JPL, NHSC, Univ. Colorado (USA). This development has been supported by national funding agencies: CSA (Canada); NAOC (China); CEA, CNES, CNRS (France); ASI (Italy); MCINN (Spain); SNSB (Sweden); STFC and UKSA (UK); and NASA (USA). This research has made use of the NASA/IPAC Extragalactic Database (NED) which is operated by the Jet Propulsion Laboratory, California Institute of Technology, under contract with the National Aeronautics and Space Administration.This is the author accepted manuscript. The final version is available from Oxford University Press via http://dx.doi.org/10.1093/mnras/stw86

Pregnancy in women with pulmonary hypertension

Women with pulmonary hypertension have a high risk of morbidity and mortality during pregnancy. The inability to increase cardiac output leads to heart failure while further risks are introduced with hypercoagulability and decrease in systemic vascular resistance. There is no proof that new advanced therapies for pulmonary hypertension decrease the risk, though some promising results have been reported. However, pregnancy should still be regarded as contraindicated in women with pulmonary hypertension. When pregnancy occurs and termination is declined, pregnancy and delivery should be managed by multidisciplinary services with experience in the management of both pulmonary hypertension and high-risk pregnancies

Modeling the molecular gas content and CO-to-H2 conversion factors in low-metallicity star-forming dwarf galaxies

Context. Low-metallicity dwarf galaxies often show no or little CO emission, despite the intense star formation observed in local samples. Both simulations and resolved observations indicate that molecular gas in low-metallicity galaxies may reside in small dense clumps, surrounded by a substantial amount of more diffuse gas that is not traced by CO. Constraining the relative importance of CO-bright versus CO-dark H2 star-forming reservoirs is crucial to understanding how star formation proceeds at low metallicity. // Aims. We test classically used single component radiative transfer models and compare their results to those obtained on the assumption of an increasingly complex structure of the interstellar gas, mimicking an inhomogeneous distribution of clouds with various physical properties. // Methods. Using the Bayesian code MULTIGRIS, we computed representative models of the interstellar medium as combinations of several gas components, each with a specific set of physical parameters. We introduced physically motivated models assuming power-law distributions for the density, ionization parameter, and the depth of molecular clouds. // Results. This new modeling framework allows for the simultaneous reproduction of the spectral constraints from the ionized gas, neutral atomic gas, and molecular gas in 18 galaxies from the Dwarf Galaxy Survey. We confirm the presence of a predominantly CO-dark molecular reservoir in low-metallicity galaxies. The predicted total H2 mass is best traced by [C II]158 μm and, to a lesser extent, by [C I] 609 μm, rather than by CO(1–0). We examine the CO-to-H2 conversion factor (αCO) versus metallicity relation and find that its dispersion increases significantly when different geometries of the gas are considered. We define a “clumpiness” parameter that is anti-correlated with [C II]/CO and explains the dispersion of the αCO versus metallicity relation. We find that low-metallicity galaxies with high clumpiness parameters may have αCO values as low as the Galactic value, even at low metallicity. // Conclusions. We identify the clumpiness of molecular gas as a key parameter for understanding variations of geometry-sensitive quantities, such as αCO. This new modeling framework enables the derivation of constraints on the internal cloud distribution of unresolved galaxies, based solely on their integrated spectra

Photodissociation and the Morphology of HI in Galaxies

Young massive stars produce Far-UV photons which dissociate the molecular gas on the surfaces of their parent molecular clouds. Of the many dissociation products which result from this ``back-reaction'', atomic hydrogen \HI is one of the easiest to observe through its radio 21-cm hyperfine line emission. In this paper I first review the physics of this process and describe a simplified model which has been developed to permit an approximate computation of the column density of photodissociated \HI which appears on the surfaces of molecular clouds. I then review several features of the \HI morphology of galaxies on a variety of length scales and describe how photodissociation might account for some of these observations. Finally, I discuss several consequences which follow if this view of the origin of HI in galaxies continues to be successful.Comment: 18 pages, 7 figures in 8 files, invited review paper for the conference "Penetrating Bars Through Masks of Cosmic Dust: The Hubble Tuning Fork Strikes a New Note", South Africa, June 2004. Proceedings to be published by Kluwer, eds. D.L. Block, K.C. Freeman, I. Puerari, R. Groess, & E.K. Bloc

Time reclaimed: temporality and the experience of meaningful work

The importance of meaningful work has been identified in scholarly writings across a range of disciplines. However, empirical studies remain sparse and the potential relevance of the concept of temporality, hitherto somewhat neglected even in wider sociological studies of organizations, has not been considered in terms of the light that it can shed on the experience of work as meaningful. These two disparate bodies of thought are brought together to generate new accounts of work meaningfulness through the lens of temporality. Findings from a qualitative study of workers in three occupations with ostensibly distinct temporal landscapes are reported. All jobs had the potential to be both meaningful and meaningless; meaningfulness arose episodically through work experiences that were shared, autonomous and temporally complex. Schutz’s notion of the ‘vivid present’ emerged as relevant to understanding how work is rendered meaningful within an individual’s personal and social system of relevances

Nutritional supplementation for nonalcohol-related fatty liver disease: a network meta-analysis.

BACKGROUND: The prevalence of non-alcohol-related fatty liver disease (NAFLD) varies between 19% and 33% in different populations. NAFLD decreases life expectancy and increases risks of liver cirrhosis, hepatocellular carcinoma, and the requirement for liver transplantation. Uncertainty surrounds relative benefits and harms of various nutritional supplements in NAFLD. Currently no nutritional supplement is recommended for people with NAFLD. OBJECTIVES: • To assess the benefits and harms of different nutritional supplements for treatment of NAFLD through a network meta-analysis • To generate rankings of different nutritional supplements according to their safety and efficacy SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Science Citation Index Expanded, Conference Proceedings Citation Index-Science, the World Health Organization International Clinical Trials Registry Platform, and trials registers until February 2021 to identify randomised clinical trials in people with NAFLD. SELECTION CRITERIA: We included only randomised clinical trials (irrespective of language, blinding, or status) for people with NAFLD, irrespective of method of diagnosis, age and diabetic status of participants, or presence of non-alcoholic steatohepatitis (NASH). We excluded randomised clinical trials in which participants had previously undergone liver transplantation. DATA COLLECTION AND ANALYSIS: We performed a network meta-analysis with OpenBUGS using Bayesian methods whenever possible and calculated differences in treatments using hazard ratios (HRs), odds ratios (ORs), and rate ratios with 95% credible intervals (CrIs) based on an available-case analysis, according to National Institute of Health and Care Excellence Decision Support Unit guidance. MAIN RESULTS: We included in the review a total of 202 randomised clinical trials (14,200 participants). Nineteen trials were at low risk of bias. A total of 32 different interventions were compared in these trials. A total of 115 trials (7732 participants) were included in one or more comparisons. The remaining trials did not report any of the outcomes of interest for this review. Follow-up ranged from 1 month to 28 months. The follow-up period in trials that reported clinical outcomes was 2 months to 28 months. During this follow-up period, clinical events related to NAFLD such as mortality, liver cirrhosis, liver decompensation, liver transplantation, hepatocellular carcinoma, and liver-related mortality were sparse. We did not calculate effect estimates for mortality because of sparse data (zero events for at least one of the groups in the trial). None of the trials reported that they measured overall health-related quality of life using a validated scale. The evidence is very uncertain about effects of interventions on serious adverse events (number of people or number of events). We are very uncertain about effects on adverse events of most of the supplements that we investigated, as the evidence is of very low certainty. However, people taking PUFA (polyunsaturated fatty acid) may be more likely to experience an adverse event than those not receiving an active intervention (network meta-analysis results: OR 4.44, 95% CrI 2.40 to 8.48; low-certainty evidence; 4 trials, 203 participants; direct evidence: OR 4.43, 95% CrI 2.43 to 8.42). People who take other supplements (a category that includes nutritional supplements other than vitamins, fatty acids, phospholipids, and antioxidants) had higher numbers of adverse events than those not receiving an active intervention (network meta-analysis: rate ratio 1.73, 95% CrI 1.26 to 2.41; 6 trials, 291 participants; direct evidence: rate ratio 1.72, 95% CrI 1.25 to 2.40; low-certainty evidence). Data were sparse (zero events in all groups in the trial) for liver transplantation, liver decompensation, and hepatocellular carcinoma. So, we did not perform formal analysis for these outcomes. The evidence is very uncertain about effects of other antioxidants (antioxidants other than vitamins) compared to no active intervention on liver cirrhosis (HR 1.68, 95% CrI 0.23 to 15.10; 1 trial, 99 participants; very low-certainty evidence). The evidence is very uncertain about effects of interventions in any of the remaining comparisons, or data were sparse (with zero events in at least one of the groups), precluding formal calculations of effect estimates. Data were probably because of the very short follow-up period (2 months to 28 months). It takes follow-up of 8 to 28 years to detect differences in mortality between people with NAFLD and the general population. Therefore, it is unlikely that differences in clinical outcomes are noted in trials providing less than 5 to 10 years of follow-up. AUTHORS' CONCLUSIONS: The evidence indicates considerable uncertainty about effects of nutritional supplementation compared to no additional intervention on all clinical outcomes for people with non-alcohol-related fatty liver disease. Accordingly, high-quality randomised comparative clinical trials with adequate follow-up are needed. We propose registry-based randomised clinical trials or cohort multiple randomised clinical trials (study design in which multiple interventions are trialed within large longitudinal cohorts of patients to gain efficiencies and align trials more closely to standard clinical practice) comparing interventions such as vitamin E, prebiotics/probiotics/synbiotics, PUFAs, and no nutritional supplementation. The reason for the choice of interventions is the impact of these interventions on indirect outcomes, which may translate to clinical benefit. Outcomes in such trials should be mortality, health-related quality of life, decompensated liver cirrhosis, liver transplantation, and resource utilisation measures including costs of intervention and decreased healthcare utilisation after minimum follow-up of 8 years (to find meaningful differences in clinically important outcomes)

Lifestyle modifications for nonalcohol-related fatty liver disease: a network meta-analysis

BACKGROUND: The prevalence of nonalcohol-related fatty liver disease (NAFLD) varies between 19% and 33% in different populations. NAFLD decreases life expectancy and increases the risks of liver cirrhosis, hepatocellular carcinoma, and requirement for liver transplantation. There is uncertainty surrounding the relative benefits and harms of various lifestyle interventions for people with NAFLD. OBJECTIVES: To assess the comparative benefits and harms of different lifestyle interventions in the treatment of NAFLD through a network meta-analysis, and to generate rankings of the different lifestyle interventions according to their safety and efficacy. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, Science Citation Index Expanded, Conference Proceedings Citation Index - Science, World Health Organization International Clinical Trials Registry Platform, and trials registers until February 2021 to identify randomised clinical trials in people with NAFLD. SELECTION CRITERIA: We included only randomised clinical trials (irrespective of language, blinding, or status) in people with NAFLD, whatever the method of diagnosis, age, and diabetic status of participants, or presence of non-alcoholic steatohepatitis (NASH). We excluded randomised clinical trials in which participants had previously undergone liver transplantation. DATA COLLECTION AND ANALYSIS: We planned to perform a network meta-analysis with OpenBUGS using Bayesian methods and to calculate the differences in treatments using hazard ratios (HRs), odds ratios (ORs), and rate ratios (RaRs) with 95% credible intervals (CrIs) based on an available-participant analysis, according to National Institute of Health and Care Excellence Decision Support Unit guidance. However, the data were too sparse for the clinical outcomes. We therefore performed only direct comparisons (head-to-head comparisons) with OpenBUGS using Bayesian methods. MAIN RESULTS: We included a total of 59 randomised clinical trials (3631 participants) in the review. All but two trials were at high risk of bias. A total of 33 different interventions, ranging from advice to supervised exercise and special diets, or a combination of these and no additional intervention were compared in these trials. The reference treatment was no active intervention. Twenty-eight trials (1942 participants) were included in one or more comparisons. The follow-up ranged from 1 month to 24 months. The remaining trials did not report any of the outcomes of interest for this review. The follow-up period in the trials that reported clinical outcomes was 2 months to 24 months. During this short follow-up period, clinical events related to NAFLD such as mortality, liver cirrhosis, liver decompensation, liver transplantation, hepatocellular carcinoma, and liver-related mortality were sparse. This is probably because of the very short follow-up periods. It takes a follow-up of 8 years to 28 years to detect differences in mortality between people with NAFLD and the general population. It is therefore unlikely that differences by clinical outcomes will be noted in trials with less than 5 years to 10 years of follow-up. In one trial, one participant developed an adverse event. There were no adverse events in any of the remaining participants in this trial, or in any of the remaining trials, which seemed to be directly related to the intervention. AUTHORS' CONCLUSIONS: The evidence indicates considerable uncertainty about the effects of the lifestyle interventions compared with no additional intervention (to general public health advice) on any of the clinical outcomes after a short follow-up period of 2 months to 24 months in people with nonalcohol-related fatty liver disease. Accordingly, high-quality randomised clinical trials with adequate follow-up are needed. We propose registry-based randomised clinical trials or cohort multiple randomised clinical trials (a study design in which multiple interventions are trialed within large longitudinal cohorts of participants to gain efficiencies and align trials more closely to standard clinical practice), comparing aerobic exercise and dietary advice versus standard of care (exercise and dietary advice received as part of national health promotion). The reason for the choice of aerobic exercise and dietary advice is the impact of these interventions on indirect outcomes which may translate to clinical benefit. The outcomes in such trials should be mortality, health-related quality of life, decompensated liver cirrhosis, liver transplantation, and resource use measures including costs of intervention and decreased healthcare use after a minimum follow-up of eight years, to find meaningful differences in the clinically important outcomes

Interventional bronchoscopy for benign tracheobronchial diseases under cardiopulmonary bypass support: case reports and literature review

The use of cardiopulmonary bypass as an adjunct to airway surgery for non-malignant diseases in adults is not well established in the UK. We are reporting two cases which demonstrate the additional benefits of using cardiopulmonary bypass during difficult bronchoscopy and complex airway stenting. The first case presents an emergency indication for cardiopulmonary bypass in a life-threatening but benign condition. The second case presented, utilises cardiopulmonary bypass standby as adjunct to a potentially life threatening procedure. A review of the literature is also provided