Stellar Black Holes and Compact Stellar Remnants

The recent observations of gravitational waves (GWs) by the LIGO-Virgo-KAGRA collaboration (LVK) have provided a new opportunity for studying our Universe. By detecting several merging events of black holes (BHs), LVK has spurred the astronomical community to improve theoretical models of single, binary, and multiple star evolution in order to better understand the formation of binary black hole (BBH) systems and interpret their observed properties. The final BBH system configuration before the merger depends on several processes, including those related to the evolution of the inner stellar structure and those due to the interaction with the companion and the environment (such as in stellar clusters). This chapter provides a summary of the formation scenarios of stellar BHs in single, binary, and multiple systems. We review all the important physical processes that affect the formation of BHs and discuss the methodologies used to detect these elusive objects and constrain their properties.Comment: To appear in Chapter 1 in the book Black Holes in the Era of Gravitational Wave Astronomy, ed. Arca Sedda, Bortolas, Spera, pub. Elsevier. All authors equally contributed to the chapter. Figures from other publications have been reproduced with permissio

A Variable Black Hole X-Ray Source in a NGC 1399 Globular Cluster

We have discovered an accreting black hole (BH) in a spectroscopically confirmed globular cluster (GC) in NGC 1399 through monitoring of its X-ray activity. The source, with a peak luminosity of L_x=2x10^39 ergs/s, reveals an order of magnitude change in the count rate within ~10 ks in a Chandra observation. The BH resides in a metal-rich [Fe/H]~0.2 globular cluster. After RZ2109 in NGC 4472 this is only the second black-hole X-ray source in a GC confirmed via rapid X-ray variability. Unlike RZ2109, the X-ray spectrum of this BH source did not change during the period of rapid variability. In addition to the short-term variability the source also exhibits long-term variability. After being bright for at least a decade since 1993 within a span of 2 years it became progressively fainter, and eventually undetectable, or marginally detectable, in deep Chandra and XMM observations. The source also became harder as it faded. The characteristics of the long term variability in itself provide sufficient evidence to identify the source as a BH. The long term decline in the luminosity of this object was likely not recognized in previous studies because the rapid variability within the bright epoch suppressed the average luminosity in that integration. The hardening of the spectrum accompanying the fading would also make this black hole source indistinguishable from an accreting neutron star in some epochs. Therefore some low mass X-ray binaries identified as NS accretors in snapshot studies of nearby galaxies may also be BHs. Thus the discovery of the second confirmed BH in an extragalactic GC through rapid variability at the very least suggests that accreting BHs in GCs are not exceedingly rare occurences.Comment: 8 pages, 2 figs. Accepted for publication in Ap

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

Discovering exotic AGN behind the Magellanic Clouds

The nearby Magellanic Clouds system covers more than 200 square degrees on the sky. Much of it has been mapped across the electromagnetic spectrum at high angular resolution and sensitivity –X-ray (XMM-Newton), UV (UVIT), optical (SMASH), IR (VISTA, WISE, Spitzer, Herschel), radio (ATCA, ASKAP, MeerKAT). This provides us with an excellent dataset to explore the galaxy populations behind the stellar-rich Magellanic Clouds. We seek to identify and characterise AGN via machine learning algorithms on this exquisite data set. Our project focuses not on establishing sequences and distributions of common types of galaxies and active galactic nuclei (AGN), but seeks to identify extreme examples, building on the recent accidental discoveries of unique AGN behind the Magellanic Clouds

Tropical tree hydraulic responses to the 2015-2016 ENSO: A cross-site analysis and insights from a model

International audienceBackground/Question/Methods Tropical forest responses to moisture remain poorly understood, in part because of the large diversity of plant hydraulic traits found therein. Changing moisture regimes, such as more frequent drought events, are expected to interact with these diverse hydraulic traits and other requirements of tropical trees in complex ways, making prediction of ecosystem-scale responses and community compositional trajectories difficult. A first step towards discerning such responses is in the analysis of how plant hydraulic and edaphic conditions control trajectories of individual trees’ water use over pre-drought, drought, and recovery periods. We took advantage of the 2015-2016 ENSO event, which induced drought over much of the tropics, to collect sap flow data on 47 canopy and numerous sub-canopy trees across nine sites in Latin America varying in annual precipitation from 1700 mm to > 3000 mm. This enabled us to determine a range of responses to changes in moisture, both atmospheric (VPD) and in soil. Where available, via measurements on conspecific individuals or species-mean values in trait databases, plant hydraulic traits were associated with individual sap flux trajectories, in addition to site-specific soil properties and climate. Results/Conclusions We found a large heterogeneity of sap flow responses during the ENSO within and among study regions. The diversity of strategies to deal with drought stress was partially explained by species functional traits, background climate and intensity of soil water depletion during the ENSO. Preliminary simulations of drought responses using the Community Land Model coupled to the hydraulically-enabled Functionally Assembled Terrestrial Ecosystem Simulator (CLM-FATES-Hydro) were used to demonstrate multiple mechanisms, both edaphic- and plant trait-related, responsible for the divergence in observed sap flow responses, as well as highlight critical field measurements needed to discern among these mechanisms