742 research outputs found

    Asteroid Belt Meteoroid Hazard Study

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    Mathematical models for probability of successful traverse of asteroid belt or zero penetration of spacecraft shiel

    ADULT PATIENTS WITH UNDIAGNOSED CONDITIONS AND THEIR RESPONSES TO CLINICALLY UNCERTAIN RESULTS FROM EXOME SEQUENCING

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    Patients pursuing exome sequencing in their quest for diagnosis will most often receive a clinically uncertain result. A clinically uncertain result has some level of objective uncertainty as viewed by clinicians regarding a patient’s diagnosis. A clinically uncertain result can be a result that is negative, with no reportable genetic variants, or that includes one or more genetic variants deemed uncertain with regard to the cause of a patient’s condition. Clinically uncertain results present challenges to both providers and patients in disclosing and processing ambiguous health information. This exploratory study sought insight into the psychological and behavioral impact of receiving clinically uncertain results from exome sequencing. Semi-structured phone interviews were conducted with 23 adult patients with undiagnosed conditions who have received two of the more common types of clinically uncertain results from exome sequencing: either a negative result or a result with one or more variants of uncertain significance. Interviews focused on the experience of receiving the clinically uncertain result, with emphasis on conceptualization of uncertainty and coping. Interviews were transcribed and subjected to thematic analysis, and results were analyzed within the context of participants’ diagnostic odysseys. No thematic differences were found between the experiences of those who received negative results versus those who received one or more variants of uncertain significance. Participants demonstrated a variety of conceptualizations of the uncertainty related to their exome sequencing result and undiagnosed condition. They were generally acclimated to illness uncertainty due to their lengthy and ongoing diagnostic journey, which resulted in realistic expectations about and acceptance of their clinically uncertain results. However, participants still hoped that exome sequencing would end their diagnostic odyssey, and many remain hopeful that future technological advances will provide them with a diagnosis. This residual hope, as well as optimism, were used as coping strategies to deal with continued uncertainty. Understanding how patients with undiagnosed conditions respond to clinically uncertain results from exome sequencing can inform providers’ practices around informed consent and the disclosure of clinically uncertain results through a greater consideration of patients’ reactions, concerns, and challenges with adaptation to uncertainty

    Discovery and Early Evolution of ASASSN-19bt, the First TDE Detected by TESS

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    We present the discovery and early evolution of ASASSN-19bt, a tidal disruption event (TDE) discovered by the All-Sky Automated Survey for Supernovae (ASAS-SN) at a distance of d115d\simeq115 Mpc and the first TDE to be detected by TESS. As the TDE is located in the TESS Continuous Viewing Zone, our dataset includes 30-minute cadence observations starting on 2018 July 25, and we precisely measure that the TDE begins to brighten 8.3\sim8.3 days before its discovery. Our dataset also includes 18 epochs of Swift UVOT and XRT observations, 2 epochs of XMM-Newton observations, 13 spectroscopic observations, and ground data from the Las Cumbres Observatory telescope network, spanning from 32 days before peak through 37 days after peak. ASASSN-19bt thus has the most detailed pre-peak dataset for any TDE. The TESS light curve indicates that the transient began to brighten on 2019 January 21.6 and that for the first 15 days its rise was consistent with a flux t2\propto t^2 power-law model. The optical/UV emission is well-fit by a blackbody SED, and ASASSN-19bt exhibits an early spike in its luminosity and temperature roughly 32 rest-frame days before peak and spanning up to 14 days that has not been seen in other TDEs, possibly because UV observations were not triggered early enough to detect it. It peaked on 2019 March 04.9 at a luminosity of L1.3×1044L\simeq1.3\times10^{44} ergs s1^{-1} and radiated E3.2×1050E\simeq3.2\times10^{50} ergs during the 41-day rise to peak. X-ray observations after peak indicate a softening of the hard X-ray emission prior to peak, reminiscent of the hard/soft states in X-ray binaries.Comment: 23 pages, 14 figures, 5 tables. A machine-readable table containing the host-subtracted photometry presented in this manuscript is included as an ancillary fil

    An Amusing Look at the Host of the Periodic Nuclear Transient ASASSN-14ko Reveals a Second AGN

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    We present Multi-Unit Spectroscopic Explorer (MUSE) integral-field spectroscopy of ESO 253-G003, which hosts a known Active Galactic Nucleus (AGN) and the periodic nuclear transient ASASSN-14ko, observed as part of the All-weather MUse Supernova Integral-field of Nearby Galaxies (AMUSING) survey. The MUSE observations reveal that the inner region hosts two AGN separated by 1.4±0.1 kpc1.4\pm0.1~\rm{kpc} (\approx 1.\!\!^{\prime\prime}7). The brighter nucleus has asymmetric broad, permitted emission-line profiles and is associated with the archival AGN designation. The fainter nucleus does not have a broad emission-line component but exhibits other AGN characteristics, including vFWHM700 km s1v_{\rm{FWHM}}\approx 700~\rm{km}~\rm{s}^{-1} forbidden line emission, log10([OIII]/Hβ)1.1\log_{10}(\rm{[OIII]}/\rm{H}\beta) \approx 1.1, and high excitation potential emission lines such as [Fe ~VII] λ6086~\lambda6086 and He ~II λ4686~\lambda4686. The host galaxy exhibits a disturbed morphology with large kpc-scale tidal features, potential outflows from both nuclei, and a likely superbubble. A circular relativistic disk model cannot reproduce the asymmetric broad emission-line profiles in the brighter nucleus, but two non-axisymmetric disk models provide good fits to the broad emission-line profiles: an elliptical disk model and a circular disk + spiral arm model. Implications for the periodic nuclear transient ASASSN-14ko are discussed.Comment: 20 pages, 16 figures, and 2 tables. Accepted by MNRA

    Once is an Instance, Twice is a Hobby: Multiple Optical and Near-Infrared Changing-Look Events in NGC 5273

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    NGC 5273 is a known optical and X-ray variable AGN. We analyze new and archival IR, optical, UV, and X-ray data in order to characterize its long-term variability from 2000 to 2022. At least one changing-look event occurred between 2011 and 2014, when the AGN changed from a Type 1.8/1.9 Seyfert to a Type 1. It then faded considerably at all wavelengths, followed by a dramatic but slow increase in UV/optical brightness between 2021 and 2022. We propose that NGC 5273 underwent multiple changing-look events between 2000 and 2022 -- starting as a Type 1.8/1.9, NGC 5273 changes-look to a Type 1 only temporarily in 2002 and again in 2014, reverting back to a Type 1.8/1.9 by 2005 and 2017, respectively. In 2022, it is again a Type 1 Seyfert with optical and NIR broad emission lines. We characterize the changing-look events and their connection to the dynamic accretion and radiative processes in NGC 5273.Comment: 18 pages, 13 figures, 4 tables, submitting to MNRA

    What Qualities Are Most Important to Making a Point of Care Test Desirable for Clinicians and Others Offering Sexually Transmitted Infection Testing?

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    To investigate the possible effects of different levels of attributes of a point-of-care test (POCT) on sexually transmitted infection (STI) professionals' decisions regarding an ideal POCT for STI(s).An online survey was designed based on a large-scale in-depth focus discussion study among STI experts and professionals. The last section of the survey "build your own POCT" was designed by employing the discrete choice experiment approach. Practicing clinicians from two venues, STI-related international conference attendees and U.S. STD clinic clinicians were invited to participate in the survey. Conditional logistical regression modeling was used for data analysis.Overall, 256 subjects took the online survey with 218 (85%) completing it. Most of the participants were STD clinic clinicians who already used some POCTs in their practice. "The time frame required" was identified as a major barrier that currently made it difficult to use STI POCTs. Chlamydia trachomatis was the organism chosen as the top priority for a new POCT, followed by a test that would diagnose early seroconversion for HIV, and a syphilis POCT. Without regard to organism type selected, sensitivity of 90-99% was always the most important attribute to be considered, followed by a cost of $20. However, when the test platform was prioritized for early HIV seroconversion or syphilis, sensitivity was still ranked as most important, but specificity was rated second most important.STI professionals preferred C. trachomatis as the top priority for a new POCT with sensitivity over 90%, low cost, and a very short completion time
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