Correlated X-ray Spectral and Timing Behavior of the Black Hole Candidate XTE J1550-564: A New Interpretation of Black Hole States

We present an analysis of RXTE data of the X-ray transient XTE J1550-564. The source went through several states, which were divided into spectrally soft and hard states. These states showed up as distinct branches in the color-color diagram, forming a structure with a comb-like topology; the soft state branch forming the spine and the hard state branches forming the teeth. Variability was strongly correlated with the position on the branches. The broad band noise became stronger, and changed from power law like to band limited, as the spectrum became harder. Three types of QPOs were found: 1-18 Hz and 102-284 Hz QPOs on the hard branches, and 16-18 Hz QPOs on and near the soft branch. The frequencies of the high and low frequency QPOs on the hard branches were correlated with each other, and anti-correlated with spectral hardness. The changes in QPO frequency suggest that the inner disc radius only increases by a factor of 3-4 as the source changes from a soft to a hard state. Our results on XTE J1550-564 strongly favor a 2-dimensional description of black hole behavior, where the regions near the spine of the comb in the color-color diagram can be identified with the high state, and the teeth with transitions from the high state, via the intermediate state (which includes the very high state) to the low state, and back. The two physical parameters underlying this behavior vary to a large extent independently and could for example be the mass accretion rate through the disk and the size of a Comptonizing region.Comment: 49 pages (inlcuding 26 figures and 4 tables), accepted for publication in ApJ Supplement

Correlated X-ray spectral and timing behavior of the black hole candidate XTE J1550-564: A new interpretation of black hole states

We present an analysis of data of the black hole candidate and X-ray transient XTE J1550-564, taken with the Rossi X-Ray Timing Explorer between 1998 November 22 and 1999 May 20. During this period the source went through several different states, which could be divided into soft and hard states based on the relative strength of the high-energy spectral component. These states showed up as distinct branches in the color-color and hardness-intensity diagrams, connecting to form a structure with a comblike topology, the branch corresponding to the soft state forming the spine and the branches corresponding to the various hard states forming the teeth of the comb. The power spectral properties of the source were strongly correlated with its position on the branches. The broadband noise became stronger and changed from power law-like to band-limited, as the spectrum became harder. Three types of quasi-periodic oscillations (QPOs) were found: 1-18 Hz and 102-284 Hz QPOs on the hard branches, and 16-18 Hz QPOs on and near the soft branch. The 1-18 Hz QPOs on the hard branches could be divided into three subtypes. The frequencies of the high- and low-frequency QPOs on the hard branches were correlated with each other and were anticorrelated with spectral hardness. The changes in QPO frequency suggest that the inner disk radius only increases by a factor of 3-4 as the source changes from a soft to a hard state. Our results on XTE J1550-564 strongly favor a two-dimensional description of black hole behavior, where the regions near the spine of the comb in the color-color diagram can be identified with the high state, and the teeth with transitions from the high state, via the intermediate state (which includes the very high state) to the low state, and back. The two physical parameters under-lying this two-dimensional behavior vary to a large extent independently and could for example be the accretion rate through the disk and the size of the Comptonizing region causing the hard tail. The difference between the various teeth is then associated with the mass accretion rate through the disk, suggesting that high state ↔ low state transitions can occur at any disk mass accretion rate and that these transitions are primarily caused by another, independent parameter. We discuss how this picture could tie in with the canonical, one-dimensional behavior of black hole candidates that has usually been observed.Facultad de Ciencias Astronómicas y Geofísica

Fine-specificity of cytotoxic T lymphocytes which recognize conserved epitopes of the Gag protein of human immunodeficiency virus type 1

Human immunodeficiency virus type 1 (HIV-1) Gag-specific cytotoxic T lymphocyte (CTL) responses were studied in seven seropositive long-term asymptomatic individuals (CDC A1)with stable CD4 counts for more than 8 years. Using a set of partially overlapping peptides covering the whole Gag, five 15-20-mer peptides were found to contain CTL epitopes. Further characterization of these epitopes revealed a new HLA-A25-restricted CTL epitope in p24, p24203-212 ETINEEAAEW. This region of Gag highly conserved in clades B and D of HIV-1. Naturally occurring amino acid sequences, containing p24203D (consensus HIV-1 clades A, C, F, G and H) or p24204I(HIV-2(ROD)) were not recognized by CTL recognizing the index peptide. No virus variants with mutations in this sequence were found in peripheral blood mononuclear cells from the HIV-1-infected individual concerned during the 8 year observation period, indicating that the virus had not escaped from the observed CTL response.</p

RXTE observations of the first transient Z source XTE J1701-462: shedding new light on mass accretion in luminous neutron star LMXBs

(Abridged) We report on ten weeks of RXTE observations of the X-ray transient XTE J1701-462. Comparisons with other sources suggest it had all the characteristics of the neutron star Z sources (the brightest persistent neutron star LMXBs). These include Z tracks in X-ray color diagrams and typical variability components detected in the power spectra. XTE J1701-462 is the first transient Z source and provides unique insights into mass accretion rate (Mdot) and luminosity dependencies in neutron star LMXBs. As its overall luminosity decreased, we observed a switch between two types of Z-source behavior, with most of the branches of the Z-track changing their shape and/or orientation. We interpret this switch as an extreme case of the longterm changes seen in the persistent Z sources and suggest that these result from changes in Mdot. We also suggest that the Cyg-like Z sources (Cyg X-2, GX 5-1, and GX 340+0) might be more luminous (> 50%) than the Sco-like Z sources (Sco X-1, GX 17+2, and GX 349+2). Adopting a possible explanation for the behavior of kHz QPOs, which involves a prompt as well as a filtered response to changes in Mdot, we propose that changes in Mdot can explain both movement along the Z track and changes in the shape of the Z track. We discuss some consequences of this and consider the possibility that the branches of the Z will evolve into the branches observed in the X-ray color diagrams of the less luminous atoll sources, but not in a way that was previously suggested.Comment: Accepted for publication in ApJ, 11 page

Effects of diet versus gastric bypass on metabolic function in diabetes

BackgroundSome studies have suggested that in people with type 2 diabetes, Roux-en-Y gastric bypass has therapeutic effects on metabolic function that are independent of weight loss.MethodsWe evaluated metabolic regulators of glucose homeostasis before and after matched (approximately 18%) weight loss induced by gastric bypass (surgery group) or diet alone (diet group) in 22 patients with obesity and diabetes. The primary outcome was the change in hepatic insulin sensitivity, assessed by infusion of insulin at low rates (stages 1 and 2 of a 3-stage hyperinsulinemic euglycemic pancreatic clamp). Secondary outcomes were changes in muscle insulin sensitivity, beta-cell function, and 24-hour plasma glucose and insulin profiles.ResultsWeight loss was associated with increases in mean suppression of glucose production from baseline, by 7.04 μmol per kilogram of fat-free mass per minute (95% confidence interval [CI], 4.74 to 9.33) in the diet group and by 7.02 μmol per kilogram of fat-free mass per minute (95% CI, 3.21 to 10.84) in the surgery group during clamp stage 1, and by 5.39 (95% CI, 2.44 to 8.34) and 5.37 (95% CI, 2.41 to 8.33) μmol per kilogram of fat-free mass per minute in the two groups, respectively, during clamp stage 2; there were no significant differences between the groups. Weight loss was associated with increased insulin-stimulated glucose disposal, from 30.5±15.9 to 61.6±13.0 μmol per kilogram of fat-free mass per minute in the diet group and from 29.4±12.6 to 54.5±10.4 μmol per kilogram of fat-free mass per minute in the surgery group; there was no significant difference between the groups. Weight loss increased beta-cell function (insulin secretion relative to insulin sensitivity) by 1.83 units (95% CI, 1.22 to 2.44) in the diet group and by 1.11 units (95% CI, 0.08 to 2.15) in the surgery group, with no significant difference between the groups, and it decreased the areas under the curve for 24-hour plasma glucose and insulin levels in both groups, with no significant difference between the groups. No major complications occurred in either group.ConclusionsIn this study involving patients with obesity and type 2 diabetes, the metabolic benefits of gastric bypass surgery and diet were similar and were apparently related to weight loss itself, with no evident clinically important effects independent of weight loss. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT02207777.)

Correlated X-ray spectral and timing behavior of the black hole candidate XTE J1550-564: A new interpretation of black hole states

We present an analysis of data of the black hole candidate and X-ray transient XTE J1550-564, taken with the Rossi X-Ray Timing Explorer between 1998 November 22 and 1999 May 20. During this period the source went through several different states, which could be divided into soft and hard states based on the relative strength of the high-energy spectral component. These states showed up as distinct branches in the color-color and hardness-intensity diagrams, connecting to form a structure with a comblike topology, the branch corresponding to the soft state forming the spine and the branches corresponding to the various hard states forming the teeth of the comb. The power spectral properties of the source were strongly correlated with its position on the branches. The broadband noise became stronger and changed from power law-like to band-limited, as the spectrum became harder. Three types of quasi-periodic oscillations (QPOs) were found: 1-18 Hz and 102-284 Hz QPOs on the hard branches, and 16-18 Hz QPOs on and near the soft branch. The 1-18 Hz QPOs on the hard branches could be divided into three subtypes. The frequencies of the high- and low-frequency QPOs on the hard branches were correlated with each other and were anticorrelated with spectral hardness. The changes in QPO frequency suggest that the inner disk radius only increases by a factor of 3-4 as the source changes from a soft to a hard state. Our results on XTE J1550-564 strongly favor a two-dimensional description of black hole behavior, where the regions near the spine of the comb in the color-color diagram can be identified with the high state, and the teeth with transitions from the high state, via the intermediate state (which includes the very high state) to the low state, and back. The two physical parameters under-lying this two-dimensional behavior vary to a large extent independently and could for example be the accretion rate through the disk and the size of the Comptonizing region causing the hard tail. The difference between the various teeth is then associated with the mass accretion rate through the disk, suggesting that high state ↔ low state transitions can occur at any disk mass accretion rate and that these transitions are primarily caused by another, independent parameter. We discuss how this picture could tie in with the canonical, one-dimensional behavior of black hole candidates that has usually been observed.Facultad de Ciencias Astronómicas y Geofísica

A family history of breast cancer will not predict female early onset breast cancer in a population-based setting

ABSTRACT: BACKGROUND: An increased risk of breast cancer for relatives of breast cancer patients has been demonstrated in many studies, and having a relative diagnosed with breast cancer at an early age is an indication for breast cancer screening. This indication has been derived from estimates based on data from cancer-prone families or from BRCA1/2 mutation families, and might be biased because BRCA1/2 mutations explain only a small proportion of the familial clustering of breast cancer. The aim of the current study was to determine the predictive value of a family history of cancer with regard to early onset of female breast cancer in a population based setting. METHODS: An unselected sample of 1,987 women with and without breast cancer was studied with regard to the age of diagnosis of breast cancer. RESULTS: The risk of early-onset breast cancer was increased when there were: (1) at least 2 cases of female breast cancer in first-degree relatives (yes/no; HR at age 30: 3.09; 95% CI: 128-7.44), (2) at least 2 cases of female breast cancer in first or second-degree relatives under the age of 50 (yes/no; HR at age 30: 3.36; 95% CI: 1.12-10.08), (3) at least 1 case of female breast cancer under the age of 40 in a first- or second-degree relative (yes/no; HR at age 30: 2.06; 95% CI: 0.83-5.12) and (4) any case of bilateral breast cancer (yes/no; HR at age 30: 3.47; 95%: 1.33-9.05). The positive predictive value of having 2 or more of these characteristics was 13% for breast cancer before the age of 70, 11% for breast cancer before the age of 50, and 1% for breast cancer before the age of 30. CONCLUSION: Applying family history related criteria in an unselected population could result in the screening of many women who will not develop breast cancer at an early age

The Serotonin Transporter Promoter Polymorphism and Childhood Positive and Negative Emotionality

Association studies of the serotonin transporter promoter polymorphism (5-HTTLPR) and negative emotionality (NE) are inconclusive. However, emerging evidence suggests that the association between this polymorphism and NE may be influenced by levels of another temperament trait, positive emotionality (PE). Therefore, this study examined whether the association between the 5-HTTLPR and NE was moderated by PE. A community sample of 413 three-year-old children completed a standardized battery of laboratory tasks designed to tap temperamental emotionality. Children were also genotyped for the 5-HTTLPR. No direct association between 5-HTTLPR genotype and NE was found. However, the interaction of child PE and NE predicted 5-HTTLPR genotype. Furthermore, children with a short allele who were also low in PE had significantly greater NE than children without a short allele or children with high PE. Our findings suggest that the short allele of the 5-HTTLPR is associated with NE only in the context of low PE. Inconsistent links between NE and this gene in previous research may stem from the failure to consider other temperament traits that moderate associations. © 2010 American Psychological Association

Predicting mortality in patients with suspected sepsis at the Emergency Department; A retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score

Objective In hospitalized patients, the risk of sepsis-related mortality can be assessed using the quick Sepsis-related Organ Failure Assessment (qSOFA). Currently, different tools that predict deterioration such as the National Early Warning Score (NEWS) have been introduced in clinical practice in Emergency Departments (ED) worldwide. It remains ambiguous which screening tool for mortality at the ED is best. The objective of this study was to evaluate the predictive performance for mortality of two sepsis-based scores (i.e. qSOFA and Systemic Inflammatory Response Syndrome (SIRS)-criteria) compared to the more general NEWS score, in patients with suspected infection directly at presentation to the ED. Methods We performed a retrospective cohort study. Patients who presented to the ED between June 2012 and May 2016 with suspected sepsis in a large tertiary care center were included. Suspected sepsis was defined as initiation of intravenous antibiotics and/or collection of any culture in the ED. Outcome was defined as 10-day and 30-day mortality after ED presentation. Predictive performance was expressed as discrimination (AUC) and calibration using Hosmer-Lemeshow goodness-of-fit test. Subsequently, sensitivity, and specificity were calculated. Results In total 8,204 patients were included of whom 286 (3.5%) died within ten days and 490 (6.0%) within 30 days after presentation. NEWS had the best performance, followed by qSOFA and SIRS (10-day AUC: 0.837, 0.744, 0.646, 30-day AUC: 0.779, 0.697, 0.631). qSOFA (�2) lacked a high sensitivity versus SIRS (�2) and NEWS (�7) (28.5%, 77.2%, 68.0%), whilst entailing highest specificity versus NEWS and SIRS (93.7%, 66.5%, 37.6%). Conclusions NEWS is more accurate in predicting 10- and 30-day mortality than qSOFA and SIRS in patients presenting to the ED with suspected sepsis

Optimally Repeatable Kinetic Model Variant for Myocardial Blood Flow Measurements with 82Rb PET

Purpose. Myocardial blood flow (MBF) quantification with R b 82 positron emission tomography (PET) is gaining clinical adoption, but improvements in precision are desired. This study aims to identify analysis variants producing the most repeatable MBF measures. Methods. 12 volunteers underwent same-day test-retest rest and dipyridamole stress imaging with dynamic R b 82 PET, from which MBF was quantified usin