New horizons in the role of digital data in the healthcare of older people

There are national and global moves to improve effective digital data design and application in healthcare. This New Horizons commentary describes the role of digital data in healthcare of the ageing population. We outline how health and social care professionals can engage in the proactive design of digital systems that appropriately serve people as they age, carers and the workforce that supports them.// Key Points: //Healthcare improvements have resulted in increased population longevity and hence multimorbidity.// //Shared care records to improve communication and information continuity across care settings hold potential for older people.// Data structure and coding are key considerations.// A workforce with expertise in caring for older people with relevant knowledge and skills in digital healthcare is important./

Detailed multiwavelength modelling of the dark GRB 140713A and its host galaxy

We investigate the afterglow of GRB 140713A, a gamma-ray burst (GRB) that was detected and relatively well sampled at X-ray and radio wavelengths, but was not present at optical and near-infrared wavelengths, despite searches to deep limits. We present the emission spectrum of the likely host galaxy at z = 0.935 ruling out a high-redshift explanation for the absence of the optical flux detection. Modelling the GRB multiwavelength afterglow using the radiative transfer hydrodynamics code boxfit provides constraints on physical parameters of the GRB jet and its environment, for instance a relatively wide jet opening angle and an electron energy distribution slope p below 2. Most importantly, the model predicts an optical flux about two orders of magnitude above the observed limits. We calculated that the required host extinction to explain the observed limits in the r, i, and z bands was A rm host-V gt 3.2 mag, equivalent to E(B ' V) host > 1.0 mag. From the X-ray absorption we derive that the GRB host extinction is A rm host-V = 11.6 +7.5-5.3 mag, equivalent to E(B-V) rm host = 3.7 +2.4-1.7 mag, which is consistent with the extinction required from our boxfit derived fluxes. We conclude that the origin of the optical darkness is a high level of extinction in the line of sight to the GRB, most likely within the GRB host galaxy. © 2019 The Author(s) Published by Oxford University Press on behalf of the Royal Astronomical Society

Short GRB 160821B: A Reverse Shock, a Refreshed Shock, and a Well-sampled Kilonova

We report our identification of the optical afterglow and host galaxy of the short-duration gamma-ray burst sGRB 160821B. The spectroscopic redshift of the host is z = 0.162, making it one of the lowest redshift short-duration gamma-ray bursts (sGRBs) identified by Swift. Our intensive follow-up campaign using a range of ground-based facilities as well as Hubble Space Telescope, XMM-Newton, and Swift, shows evidence for a late-time excess of optical and near-infrared emission in addition to a complex afterglow. The afterglow light curve at X-ray frequencies reveals a narrow jet, ${\theta }_{j}\sim {1.9}_{-0.03}^{+0.10}$ deg, that is refreshed at >1 day post-burst by a slower outflow with significantly more energy than the initial outflow that produced the main GRB. Observations of the 5 GHz radio afterglow shows a reverse shock into a mildly magnetized shell. The optical and near-infrared excess is fainter than AT2017gfo associated with GW170817, and is well explained by a kilonova with dynamic ejecta mass M dyn = (1.0 ± 0.6) × 10−3 M ⊙ and a secular (post-merger) ejecta mass with M pm = (1.0 ± 0.6) × 10−2 M ⊙, consistent with a binary neutron star merger resulting in a short-lived massive neutron star. This optical and near-infrared data set provides the best-sampled kilonova light curve without a gravitational wave trigger to date

Detailed afterglow modelling and host galaxy properties of the dark GRB 111215A

Gamma-ray burst (GRB) 111215A was bright at X-ray and radio frequencies, but not detected in the optical or near-infrared (nIR) down to deep limits. We have observed the GRB afterglow with the Westerbork Synthesis Radio Telescope and Arcminute Microkelvin Imager at radio frequencies, with the William Herschel Telescope and Nordic Optical Telescope in the nIR/optical, and with the Chandra X-ray Observatory. We have combined our data with the Swift X-Ray Telescope monitoring, and radio and millimetre observations from the literature to perform broad-band modelling, and determined the macro- and microphysical parameters of the GRB blast wave. By combining the broad-band modelling results with our nIR upper limits we have put constraints on the extinction in the host galaxy. This is consistent with the optical extinction we have derived from the excess X-ray absorption, and higher than in other dark bursts for which similar modelling work has been performed.We also present deep imaging of the host galaxy with the Keck I telescope, Spitzer Space Telescope, and Hubble Space Telescope (HST), which resulted in a well-constrained photometric redshift, giving credence to the tentative spectroscopic redshift we obtained with the Keck II telescope, and estimates for the stellar mass and star formation rate of the host. Finally, our high-resolution HST images of the host galaxy show that the GRB afterglow position is offset from the brightest regions of the host galaxy, in contrast to studies of optically bright GRBs. © 2014 The Authors

Distribution of immune cells in head and neck cancer: CD8+ T-cells and CD20+ B-cells in metastatic lymph nodes are associated with favourable outcome in patients with oro- and hypopharyngeal carcinoma

<p>Abstract</p> <p>Background</p> <p>Tumour infiltrating lymphocytes (TIL) are generally considered to represent a host immune response directed against tumour antigens. TIL are also increasingly recognised as possible prognostic parameters. However, the effects observed are variable indicating that results cannot be extrapolated from type of tumour to another. Moreover, it has been suggested that primary solid tumours may be ignored by the immune system and that a meaningful immune response is only mounted in regional lymph nodes.</p> <p>Methods</p> <p>We have examined the local distribution of immune cells in tumour-related compartments in head and neck squamous cell carcinomas (HNSCC). In a second step, the prognostic impact of these cells on disease-free survival (DFS) was analysed. A total of 198 tissue cores from 33 patients were evaluated using tissue mircroarray technique and immunohistochemistry. Tumour-infiltrating immune cells were identified using antibodies specific for CD3, CD8, GranzymeB, FoxP3, CD20 and CD68 and quantified using an image analysis system.</p> <p>Results</p> <p>We demonstrate a relative expansion of FoxP3⁺regulatory T-cells (Treg) and of cytotoxic T-cells among tumour infitrating T-cells. We also show that intratumoural CD20⁺B-cells are significantly more frequent in metastatic deposits than in primary tumours. Furthermore, we observed a reduced number of peritumoural CD8⁺T-cells in metastatic lymph nodes as compared to univolved regional nodes suggesting a local down-modulation of cellular immunity. All other immune cells did not show significant alterations in distribution. We did not observe an association of tumour infiltrating immune cells at the primary site with outcome. However, increased numbers of intraepithelial CD8⁺TIL in metastatic tumours as well as large numbers of peritumoural B-cells in lymph node metastases were associated with favourable outcome. Unexpectedly, no effect on patient outcome was observed for Treg in any compartment.</p> <p>Conclusion</p> <p>Our results suggest that alterations in lymphocyte distribution in regional lymph nodes rather than at the primary tumour site may be relevant for patient prognosis. Moreover, we demonstrate that in addition to cellular immunity humoral immune responses may be clinically relevant in anti-tumour immunity.</p

Lensing without borders. I. A blind comparison of the amplitude of galaxy-galaxy lensing between independent imaging surveys

Lensing Without Borders is a cross-survey collaboration created to assess the consistency of galaxy-galaxy lensing signals (ΔΣ) across different data-sets and to carry out end-to-end tests of systematic errors. We perform a blind comparison of the amplitude of ΔΣ using lens samples from BOSS and six independent lensing surveys. We find good agreement between empirically estimated and reported systematic errors which agree to better than 2.3σ in four lens bins and three radial ranges. For lenses with zL &amp;gt; 0.43 and considering statistical errors, we detect a 3-4σ correlation between lensing amplitude and survey depth. This correlation could arise from the increasing impact at higher redshift of unrecognised galaxy blends on shear calibration and imperfections in photometric redshift calibration. At zL &amp;gt; 0.54 amplitudes may additionally correlate with foreground stellar density. The amplitude of these trends is within survey-defined systematic error budgets which are designed to include known shear and redshift calibration uncertainty. Using a fully empirical and conservative method, we do not find evidence for large unknown systematics. Systematic errors greater than 15 per cent (25 per cent) ruled out in three lens bins at 68 per cent (95 per cent) confidence at z &amp;lt; 0.54. Differences with respect to predictions based on clustering are observed to be at the 20-30 per cent level. Our results therefore suggest that lensing systematics alone are unlikely to fully explain the ‘lensing is low’ effect at z &amp;lt; 0.54. This analysis demonstrates the power of cross-survey comparisons and provides a promising path for identifying and reducing systematics in future lensing analyses

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Design concepts for the Cherenkov Telescope Array CTA: an advanced facility for ground-based high-energy gamma-ray astronomy

Ground-based gamma-ray astronomy has had a major breakthrough with the impressive results obtained using systems of imaging atmospheric Cherenkov telescopes. Ground-based gamma-ray astronomy has a huge potential in astrophysics, particle physics and cosmology. CTA is an international initiative to build the next generation instrument, with a factor of 5-10 improvement in sensitivity in the 100 GeV-10 TeV range and the extension to energies well below 100 GeV and above 100 TeV. CTA will consist of two arrays (one in the north, one in the south) for full sky coverage and will be operated as open observatory. The design of CTA is based on currently available technology. This document reports on the status and presents the major design concepts of CTA