Status Update and Interim Results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2)

Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362. © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved

The Geometry and Ionization Structure of the Wind in the Eclipsing Nova-like Variables RW Tri and UX UMa

The UV spectra of nova-like variables are dominated by emission from the accretion disk, modified by scattering in a wind emanating from the disk. Here we model the spectra of RW Tri and UX UMa, the only two eclipsing nova-likes which have been observed with the Hubble Space Telescope in the far-ultraviolet, in an attempt to constrain the geometry and the ionization structure of their winds. Using our Monte Carlo radiative transfer code we computed spectra for simply-parameterized axisymmetric biconical outflow models and were able to find plausible models for both systems. These reproduce the primary UV resonance lines - N V, Si IV, and C IV - in the observed spectra in and out of eclipse. The distribution of these ions in the wind models is similar in both cases as is the extent of the primary scattering regions in which these lines are formed. The inferred mass loss rates are 6% to 8% of the mass accretion rates for the systems. We discuss the implication of our point models for our understanding of accretion disk winds in cataclysmic variables.Comment: 13 pages, 15 figures and 4 tables. Published in Ap

First record of Maro sublestus FALCONER, 1915 for Saxony (Araneae, Linyphiidae)

Die Gattung Maro ist nach PLATEN et al. (1995) in Deutschland mit vier Arten vertreten, die alle sehr selten und deshalb in der Roten Liste Deutschlands (PLATEN et al. 1996) aufgeführt sind. Die jetzt erstmals für Sachsen nachgewiesene Art M. sublestus FALCON ER, 1915 wird dort als stark gefährdet (2) aufgeführt. Der einzige bislang publizierte Nachweis der Art für Deutschland stammt aus Sachsen-Anhalt (MORITZ 1973). Für dieses Bundesland wird M. sublestus von SACHER (1993) ebenfalls als stark gefährdet eingestuft. In Artenlisten anderer Bundesländer, insbesondere in der für Sachsen (TOLKE & HIEBSCH 1995), wird die Art nicht erwähnt

Systematic Errors in the Estimation of Black Hole Masses by Reverberation Mapping

The mass of the central black hole in many active galactic nuclei has been estimated on the basis of the assumption that the dynamics of the broad emission line gas are dominated by the gravity of the black hole. The most commonly-employed method is to estimate a characteristic size-scale $r_*$ from reverberation mapping experiments and combine it with a characteristic velocity $v_*$ taken from the line profiles; the inferred mass is then estimated by $r_* v_*^2/G$. We critically discuss the evidence supporting the assumption of gravitational dynamics and find that the arguments are still inconclusive. We then explore the range of possible systematic error if the assumption of gravitational dynamics is granted. Inclination relative to a flattened system may cause a systematic underestimate of the central mass by a factor $\sim (h/r)^2$, where $h/r$ is the aspect ratio of the flattening. The coupled effects of a broad radial emissivity distribution, an unknown angular radiation pattern of line emission, and sub-optimal sampling in the reverberation experiment can cause additional systematic errors as large as a factor of 3 or more in either direction.Comment: 19 pages, 4 figures, AASLaTeX, accepted by Ap

Blockchain in EU e-health - blocked by the barrier of data protection?

Compliance with data protection requirements is always a tricky business and even more intricate when it comes to cutting-edge technologies such as distributed ledger technology (DLT), better known as Block Chain Technology (BCT). These difficulties increase even more when the personal data concerned is accorded a special level of protection, as is the case with health data. The following article aims to describe and analyze the legal issues associated with this scenario. The focus here is on the European Union's (EU) General Data Protection Regulation (GDPR) 1, which took effect on May 25, 2018. Furthermore, the functionality of BCT and its possible fields of application in healthcare will be outlined