Review Article : Feudalism or Absolute Monarchism?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68809/2/10.1177_009770049001600304.pd

Antenatal antiarrhythmic treatment for fetal tachyarrhythmias: a study protocol for a prospective multicentre trial

Introduction Several retrospective or single-centrestudies demonstrated the efficacy of transplacentaltreatment of fetal tachyarrhythmias. Our retrospectivenationwide survey showed that the fetal therapy willbe successful at an overall rate of 90%. For fetuseswith hydrops, the treatment success rate will be 80%.However, standard protocol has not been established.The objective of this study is to evaluate the efficacy andsafety of the protocol-defined transplacental treatment offetal tachyarrhythmias. Participant recruitment began inOctober 2010.Methods and analysis The current study is a multicentre,single-arm interventional study. A total of 50 fetuseswill be enrolled from 15 Japanese institutions. Theprotocol-defined transplacental treatment is performed forsingletons with sustained fetal tachyarrhythmia ≥180 bpm,with a diagnosis of supraventricular tachycardia or atrialflutter. Digoxin, sotalol, flecainide or a combination is usedfor transplacental treatment. The primary endpoint isdisappearance of fetal tachyarrhythmias. The secondaryendpoints are fetal death related to tachyarrhythmia,proportion of preterm birth, rate of caesarean sectionattributable to fetal arrhythmia, improvement in fetalhydrops, neonatal arrhythmia, neonatal central nervoussystem disorders and neonatal survival. Maternal, fetal andneonatal adverse events are evaluated at 1 month afterbirth. Growth and development are also evaluated at 18and 36 months of corrected age.Ethics and dissemination The Institutional Review Boardof the National Cerebral and Cardiovascular Center ofJapan has approved this study. Our findings will be widelydisseminated through conference presentations and peerreviewedpublications

AGN number fraction in galaxy groups and clusters at z < 1.4 from the Subaru Hyper Suprime-Cam survey

One of the key questions on active galactic nuclei (AGN) in galaxy clusters is how AGN could affect the formation and evolution of member galaxies and galaxy clusters in the history of the Universe. To address this issue, we investigate the dependence of AGN number fraction ($f_{\rm AGN}$) on cluster redshift ($z_{\rm cl}$) and distance from the cluster center ($R/R_{\rm 200}$). We focus on more than 27,000 galaxy groups and clusters at $0.1 < z_{\rm cl} < 1.4$ with more than 1 million member galaxies selected from the Subaru Hyper Suprime-Cam. By combining various AGN selection methods based on infrared (IR), radio, and X-ray data, we identify 2,688 AGN. We find that (i) $f_{\rm AGN}$ increases with $z_{\rm cl}$ and (ii) $f_{\rm AGN}$ decreases with $R/R_{\rm 200}$. The main contributors to the rapid increase of $f_{\rm AGN}$ towards high-$z$ and cluster center are IR- and radio-selected AGN, respectively. Those results indicate that the emergence of the AGN population depends on the environment and redshift, and galaxy groups and clusters at high-$z$ play an important role in AGN evolution. We also find that cluster-cluster mergers may not drive AGN activity in at least the cluster center, while we have tentative evidence that cluster-cluster mergers would enhance AGN activity in the outskirts of (particularly massive) galaxy clusters.Comment: 16 pages, 21 figures, and 2 tables, accepted for publication in PAS