Stellar Properties of z ~ 8 Galaxies in the Reionization Lensing Cluster Survey

Measurements of stellar properties of galaxies when the universe was less than one billion years old yield some of the only observational constraints of the onset of star formation. We present here the inclusion of \textit{Spitzer}/IRAC imaging in the spectral energy distribution fitting of the seven highest-redshift galaxy candidates selected from the \emph{Hubble Space Telescope} imaging of the Reionization Lensing Cluster Survey (RELICS). We find that for 6/8 \textit{HST}-selected $z\gtrsim8$ sources, the $z\gtrsim8$ solutions are still strongly preferred over $z\sim$1-2 solutions after the inclusion of \textit{Spitzer} fluxes, and two prefer a $z\sim 7$ solution, which we defer to a later analysis. We find a wide range of intrinsic stellar masses ($5\times10^6 M_{\odot}$ -- $4\times10^9$ $M_{\odot}$), star formation rates (0.2-14 $M_{\odot}\rm yr^{-1}$), and ages (30-600 Myr) among our sample. Of particular interest is Abell1763-1434, which shows evidence of an evolved stellar population at $z\sim8$, implying its first generation of star formation occurred just $< 100$ Myr after the Big Bang. SPT0615-JD, a spatially resolved $z\sim10$ candidate, remains at its high redshift, supported by deep \textit{Spitzer}/IRAC data, and also shows some evidence for an evolved stellar population. Even with the lensed, bright apparent magnitudes of these $z \gtrsim 8$ candidates (H = 26.1-27.8 AB mag), only the \textit{James Webb Space Telescope} will be able further confirm the presence of evolved stellar populations early in the universe.Comment: 8 pages, 3 figures, 2 table

RELICS: A Very Large (θE∼40"\theta_{E}\sim40") Cluster Lens -- RXC J0032.1+1808

Extensive surveys with the \textit{Hubble Space Telescope} (HST) over the past decade, targeting some of the most massive clusters in the sky, have uncovered dozens of galaxy-cluster strong lenses. The massive cluster strong-lens scale is typically \theta_{E}\sim10\arcsec to \sim30-35\arcsec, with only a handful of clusters known with Einstein radii \theta_{E}\sim40\arcsec or above (for $z_{source}=2$, nominally). Here we report another very large cluster lens, RXC J0032.1+1808 ($z=0.3956$), the second richest cluster in the redMapper cluster catalog and the 85th most massive cluster in the Planck Sunyaev-Zel'dovich catalog. With our Light-Traces-Mass and fully parametric (dPIEeNFW) approaches, we construct strong lensing models based on 18 multiple images of 5 background galaxies newly identified in the \textit{Hubble} data mainly from the \textit{Reionization Lensing Cluster Survey} (RELICS), in addition to a known sextuply imaged system in this cluster. Furthermore, we compare these models to Lenstool and GLAFIC models that were produced independently as part of the RELICS program. All models reveal a large effective Einstein radius of \theta_{E}\simeq40\arcsec ($z_{source}=2$), owing to the obvious concentration of substructures near the cluster center. Although RXC J0032.1+1808 has a very large critical area and high lensing strength, only three magnified high-redshift candidates are found within the field targeted by RELICS. Nevertheless, we expect many more high-redshift candidates will be seen in wider and deeper observations with \textit{Hubble} or \emph{JWST}. Finally, the comparison between several algorithms demonstrates that the total error budget is largely dominated by systematic uncertainties.Comment: 23 pages, accepted for publication in Ap

RELICS: Reionization Lensing Cluster Survey

Large surveys of galaxy clusters with the Hubble and Spitzer Space Telescopes, including CLASH and the Frontier Fields, have demonstrated the power of strong gravitational lensing to efficiently deliver large samples of high-redshift galaxies. We extend this strategy through a wider, shallower survey named RELICS, the Reionization Lensing Cluster Survey. This survey, described here, was designed primarily to deliver the best and brightest high-redshift candidates from the first billion years after the Big Bang. RELICS observed 41 massive galaxy clusters with Hubble and Spitzer at 0.4-1.7um and 3.0-5.0um, respectively. We selected 21 clusters based on Planck PSZ2 mass estimates and the other 20 based on observed or inferred lensing strength. Our 188-orbit Hubble Treasury Program obtained the first high-resolution near-infrared images of these clusters to efficiently search for lensed high-redshift galaxies. We observed 46 WFC3/IR pointings (~200 arcmin^2) with two orbits divided among four filters (F105W, F125W, F140W, and F160W) and ACS imaging as needed to achieve single-orbit depth in each of three filters (F435W, F606W, and F814W). As previously reported by Salmon et al., we discovered 322 z ~ 6 - 10 candidates, including the brightest known at z ~ 6, and the most distant spatially-resolved lensed arc known at z ~ 10. Spitzer IRAC imaging (945 hours awarded, plus 100 archival) has crucially enabled us to distinguish z ~ 10 candidates from z ~ 2 interlopers. For each cluster, two HST observing epochs were staggered by about a month, enabling us to discover 11 supernovae, including 3 lensed supernovae, which we followed up with 20 orbits from our program. We delivered reduced HST images and catalogs of all clusters to the public via MAST and reduced Spitzer images via IRSA. We have also begun delivering lens models of all clusters, to be completed before the JWST GO call for proposals.Comment: 29 pages, 6 figures, submitted to ApJ. For reduced images, catalogs, lens models, and more, see relics.stsci.ed

Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial

Aims The objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM). Methods and results ASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction). Conclusion This pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without D

Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients from 29 Countries

Importance: Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events. Objective: To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients. Design, Setting, and Participants: The International Observational Study to Understand the Impact and Best Practices of Airway Management in Critically Ill Patients (INTUBE) study was an international, multicenter, prospective cohort study involving consecutive critically ill patients undergoing tracheal intubation in the intensive care units (ICUs), emergency departments, and wards, from October 1, 2018, to July 31, 2019 (August 28, 2019, was the final follow-up) in a convenience sample of 197 sites from 29 countries across 5 continents. Exposures: Tracheal intubation. Main Outcomes and Measures: The primary outcome was the incidence of major adverse peri-intubation events defined as at least 1 of the following events occurring within 30 minutes from the start of the intubation procedure: cardiovascular instability (either: systolic pressure &lt;65 mm Hg at least once, &lt;90 mm Hg for &gt;30 minutes, new or increase need of vasopressors or fluid bolus &gt;15 mL/kg), severe hypoxemia (peripheral oxygen saturation &lt;80%) or cardiac arrest. The secondary outcomes included intensive care unit mortality. Results: Of 3659 patients screened, 2964 (median age, 63 years; interquartile range [IQR], 49-74 years; 62.6% men) from 197 sites across 5 continents were included. The main reason for intubation was respiratory failure in 52.3% of patients, followed by neurological impairment in 30.5%, and cardiovascular instability in 9.4%. Primary outcome data were available for all patients. Among the study patients, 45.2% experienced at least 1 major adverse peri-intubation event. The predominant event was cardiovascular instability, observed in 42.6% of all patients undergoing emergency intubation, followed by severe hypoxemia (9.3%) and cardiac arrest (3.1%). Overall ICU mortality was 32.8%. Conclusions and Relevance: In this observational study of intubation practices in critically ill patients from a convenience sample of 197 sites across 29 countries, major adverse peri-intubation events - in particular cardiovascular instability - were observed frequently