Astrometric Microlensing by Local Dark Matter Subhalos

High-resolution N-body simulations of dark matter halos indicate that the Milky Way contains numerous subhalos. When a dark matter subhalo passes in front of a star, the light from that star will be deflected by gravitational lensing, leading to a small change in the star's apparent position. This astrometric microlensing signal depends on the inner density profile of the subhalo and can be greater than a few microarcseconds for an intermediate-mass subhalo (Mvir > 10000 solar masses) passing within arcseconds of a star. Current and near-future instruments could detect this signal, and we evaluate SIM's, Gaia's, and ground-based telescopes' potential as subhalo detectors. We develop a general formalism to calculate a subhalo's astrometric lensing cross section over a wide range of masses and density profiles, and we calculate the lensing event rate by extrapolating the subhalo mass function predicted by simulations down to the subhalo masses potentially detectable with this technique. We find that, although the detectable event rates are predicted to be low on the basis of current simulations, lensing events may be observed if the central regions of dark matter subhalos are more dense than current models predict (>1 solar mass within 0.1 pc of the subhalo center). Furthermore, targeted astrometric observations can be used to confirm the presence of a nearby subhalo detected by gamma-ray emission. We show that, for sufficiently steep density profiles, ground-based adaptive optics astrometric techniques could be capable of detecting intermediate-mass subhalos at distances of hundreds of parsecs, while SIM could detect smaller and more distant subhalos.Comment: 18 pages, 8 figures, minor revisions made to match version to appear in Ap

All-graphene-based open fluidics for pumpless, small-scale fluid transport via laser-controlled wettability patterning

Open microfluidics have emerged as a low-cost, pumpless alternative strategy to conventional microfluidics for delivery of fluid for a wide variety of applications including rapid biochemical analysis and medical diagnosis. However, creating open microfluidics by tuning the wettability of surfaces typically requires sophisticated cleanroom processes that are unamenable to scalable manufacturing. Herein, we present a simple approach to develop open microfluidic platforms by manipulating the surface wettability of spin-coated graphene ink films on flexible polyethylene terephthalate via laser-controlled patterning. Wedge-shaped hydrophilic tracks surrounded by superhydrophobic walls are created within the graphene films by scribing micron-sized grooves into the graphene with a CO2 laser. This scribing process is used to make superhydrophobic walls (water contact angle ∼160°) that delineate hydrophilic tracks (created through an oxygen plasma pretreatment) on the graphene for fluid transport. These all-graphene open microfluidic tracks are capable of transporting liquid droplets with a velocity of 20 mm s−1 on a level surface and uphill at elevation angles of 7° as well as transporting fluid in bifurcating cross and tree branches. The all-graphene open microfluidic manufacturing technique is rapid and amenable to scalable manufacturing, and consequently offers an alternative pumpless strategy to conventional microfluidics and creates possibilities for diverse applications in fluid transport

Outcome of Colorectal Cancer Patients Treated with Combination Bevacizumab Therapy: A Pooled Retrospective Analysis of Three European Cohorts from the Angiopredict Initiative

Background/Aims: This study is aimed at analyzing the survival rates and prognostic factors of stage IV colorectal cancer patients from 3 European cohorts undergoing combination chemotherapy with bevacizumab. Methods: Progression free-survival (PFS) and overall survival (OS) were analyzed in 172 patients using the Kaplan–Meier method and uni- and multivariable Cox proportional hazards regression models. Results: The median PFS was 9.7 and the median OS 27.4 months. Patients treated at centers in Germany (n = 97), Ireland (n = 32), and The Netherlands (n = 43) showed a median PFS of 9.9, 9.2, and 9.7 months, OS of 34.0, 20.5, and 25.1 months, respectively. Patients >65 years had a significantly shorter PFS (9.5 vs. 9.8 months) but not OS (27.4 vs. 27.5 months) than younger patients. High tumor grade (G3/4) was associated with a shorter PFS, T4 classification with both shorter PFS and OS. Fluoropyrimidine (FP) chemotherapy backbones (doublets and single) had comparable outcomes, while patients not receiving FP backbones had a shorter PFS. In multivariable analysis, age and non-FP backbone were associated with inferior PFS, T4 classification and therapy line >2nd were significantly associated with poor PFS and OS. Conclusion: The observed survival rates confirm previous studies and demonstrate reproducible benefits of combination bevacizumab regimens. Classification T4, non-FP chemotherapy backbone, and age >65 were associated with inferior outcome

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

All-graphene-based open fluidics for pumpless, small-scale fluid transport via laser-controlled wettability patterning

Open microfluidics have emerged as a low-cost, pumpless alternative strategy to conventional microfluidics for delivery of fluid for a wide variety of applications including rapid biochemical analysis and medical diagnosis. However, creating open microfluidics by tuning the wettability of surfaces typically requires sophisticated cleanroom processes that are unamenable to scalable manufacturing. Herein, we present a simple approach to develop open microfluidic platforms by manipulating the surface wettability of spin-coated graphene ink films on flexible polyethylene terephthalate via laser-controlled patterning. Wedge-shaped hydrophilic tracks surrounded by superhydrophobic walls are created within the graphene films by scribing micron-sized grooves into the graphene with a CO2 laser. This scribing process is used to make superhydrophobic walls (water contact angle ∼160°) that delineate hydrophilic tracks (created through an oxygen plasma pretreatment) on the graphene for fluid transport. These all-graphene open microfluidic tracks are capable of transporting liquid droplets with a velocity of 20 mm s−1 on a level surface and uphill at elevation angles of 7° as well as transporting fluid in bifurcating cross and tree branches. The all-graphene open microfluidic manufacturing technique is rapid and amenable to scalable manufacturing, and consequently offers an alternative pumpless strategy to conventional microfluidics and creates possibilities for diverse applications in fluid transport.This article is published as Hall, Lucas S., Dohgyu Hwang, Bolin Chen, Bryan Van Belle, Zachary T. Johnson, John A. Hondred, Carmen L. Gomes, Michael D. Bartlett, and Jonathan C. Claussen. "All-graphene-based open fluidics for pumpless, small-scale fluid transport via laser-controlled wettability patterning." Nanoscale Horizons 6, no. 1 (2021): 24-32. DOI: 10.1039/D0NH00376J. Posted with permission.</p