Magnetic Fields in Massive Star-forming Regions (MagMaR). II. Tomography through Dust and Molecular Line Polarization in NGC 6334I(N)

Here, we report ALMA detections of polarized emission from dust, CS(J = 5 → 4), and C33S(J = 5 → 4) toward the high-mass star-forming region NGC 6334I(N). A clear “hourglass” magnetic field morphology was inferred from the polarized dust emission, which is also directly seen from the polarized CS emission across velocity, where the polarization appears to be parallel to the field. By considering previous findings, the field retains a pinched shape that can be traced to clump length scales from the envelope scales traced by ALMA, suggesting that the field is dynamically important across multiple length scales in this region. The CS total intensity emission is found to be optically thick (τ CS = 32 ± 12) while the C33S emission appears to be optically thin (). This suggests that sources of anisotropy other than large velocity gradients, i.e., anisotropies in the radiation field, are required to explain the polarized emission from CS seen by ALMA. By using four variants of the Davis–Chandrasekhar–Fermi technique and the angle dispersion function methods (ADF), we obtain an average of the estimates for the magnetic field strength on the plane of the sky of mG from the dust and mG from the CS emission, where each emission traces different molecular hydrogen number densities. This effectively enables a tomographic view of the magnetic field within a single ALMA observation.Fil: Cortés, Paulo C.. National Radio Astronomy Observatory; Estados UnidosFil: Sanhueza, Patricio. No especifíca;Fil: Houde, Martin. Western University; CanadáFil: Martín, Sergio. No especifíca;Fil: Hull, Charles L. H.. No especifíca;Fil: Girart, Josep M.. Consejo Superior de Investigaciones Científicas; EspañaFil: Zhang, Qizhou. Harvard-Smithsonian Center for Astrophysics; Estados UnidosFil: Fernandez Lopez, Manuel. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Instituto Argentino de Radioastronomía. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto Argentino de Radioastronomía; ArgentinaFil: Zapata, Luis A.. Universidad Nacional Autónoma de México; MéxicoFil: Stephens, Ian W.. No especifíca;Fil: Li, Hua Bai. No especifíca;Fil: Wu, Benjamin. No especifíca;Fil: Olguin, Fernando. No especifíca;Fil: Lu, Xing. No especifíca;Fil: Guzmán, Andres E.. No especifíca;Fil: Nakamura, Fumitaka. No especifíca

Gravity-driven Magnetic Field at ∼1000 au Scales in High-mass Star Formation

A full understanding of high-mass star formation requires the study of one of the most elusive components of the energy balance in the interstellar medium: magnetic fields. We report Atacama Large Millimeter/submillimeter Array (ALMA) 1.2 mm, high-resolution (700 au) dust polarization and molecular line observations of the rotating hot molecular core embedded in the high-mass star-forming region IRAS 18089-1732. The dust continuum emission and magnetic field morphology present spiral-like features resembling a whirlpool. The velocity field traced by the H13CO+ (J = 3-2) transition line reveals a complex structure with spiral filaments that are likely infalling and rotating, dragging the field with them. We have modeled the magnetic field and find that the best model corresponds to a weakly magnetized core with a mass-to-magnetic-flux ratio (λ) of 8.38. The modeled magnetic field is dominated by a poloidal component, but with an important contribution from the toroidal component that has a magnitude of 30% of the poloidal component. Using the Davis-Chandrasekhar-Fermi method, we estimate a magnetic field strength of 3.5 mG. At the spatial scales accessible to ALMA, an analysis of the energy balance of the system indicates that gravity overwhelms turbulence, rotation, and the magnetic field. We show that high-mass star formation can occur in weakly magnetized environments, with gravity taking the dominant role.Fil: Sanhueza, Patricio. National Astronomical Observatory Of Japan; JapónFil: Girart, Josep Miquel. Instituto de Estudios Espaciales de Cataluña; EspañaFil: Padovani, Marco. Osservatorio Astrofisico Di Arcetri; ItaliaFil: Galli, Daniele. Osservatorio Astrofisico Di Arcetri; ItaliaFil: Hull, Charles L. H.. Atacama Large Millimeter-submillimeter Array; ChileFil: Zhang, Qizhou. Harvard-Smithsonian Center for Astrophysics; Estados UnidosFil: Cortes, Paulo. National Radio Astronomy Observatory; Estados UnidosFil: Stephens, Ian. Worcester State University; Estados UnidosFil: Fernandez Lopez, Manuel. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Instituto Argentino de Radioastronomía. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto Argentino de Radioastronomía; ArgentinaFil: Jackson, James M.. NASA Ames Research Center; Estados UnidosFil: Frau, Pau. Csic. Instituto de Ciencias del Espacio; EspañaFil: Kock, Patrick M.. Academia Sinica; ChinaFil: Wu, Benjamin. National Astronomical Observatory Of Japan; JapónFil: Zapata, Luis A.. Instituto de Radioastronomía y Astrofísica; MéxicoFil: Olguin, Fernando. National Tsing Hua University; ChinaFil: Lu, Xing. National Astronomical Observatory Of Japan; JapónFil: Silva, Andrea. National Astronomical Observatory Of Japan; JapónFil: Tang, Ya Wen. Academia Sinica; ChinaFil: Sakai, Takeshi. The University Of Electro-communications; JapónFil: Guzmán, Andrés E.. National Astronomical Observatory Of Japan; JapónFil: Tatematsu, Ken'Ichi. National Astronomical Observatory Of Japan; JapónFil: Nakamura, Fumitaka. National Astronomical Observatory Of Japan; JapónFil: Chen, Huei Ru Vivien. National Tsing Hua University; Chin

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

On the effects of the fuel injection phase on heat release and soot formation in counterflow flames

Total rates of heat release, , and soot emission, , are studied in ethanol-N2/air and n-butanol-N2/air counterflow flames. A gas flame is first established as a base case and fractions of the gaseous fuel are then replaced by droplets and nitrogen, keeping the total fuel mass flux constant. Several values of the liquid to total fuel mass ratio, φl, are employed, covering the entire range from a gas flame to a spray flame (0 ≤ φl ≤ 1). Different initial droplet radii, R0, are considered, as well as both low and close to extinction strain rates. Results show qualitative similarities for both fuels, even though quantitative differences are observed. In general, ethanol flames release more heat and less soot than n-butanol flames. For low strain rates, φl = 1 leads to lower soot emissions than for the reference gas flame, independently of R0. Also, is higher for R0 = 25 and 40 μm. Close to extinction, increasing φl notoriously improved without considerably raising for R0 = 25 μm. Also, for R0 = 40 μm, there are some particular values of φl for which similar situations occur. These results show that the fuel injection phase plays an important role in optimizing combustion processes