Curved jet motion. I. Orbiting and precessing jets

Astrophysical jets are often observed as bent or curved structures. We also know that the different jet sources may be binary in nature, which may lead to a regular, periodic motion of the jet nozzle, an orbital motion or precession. Here, we present the results of 2D (M)HD simulations in order to investigate how a precessing or orbiting jet nozzle affects the propagation of a high-speed jet. We have performed a parameter study of systems with different precession angles, orbital periods or separations, and different magnetic field strengths. We find that these kinds of nozzles lead to curved jet propagation which is determined by the main parameters that define the jet nozzle. We find C-shaped jets from orbiting nozzles and S-shaped jets from precessing nozzles. Over long time and long distances, the initially curved jet motion bores a broad channel into the ambient gas that is filled with high-speed jet material which lateral motion is damped, however. A strong (longitudinal) magnetic field can damp the jet curvature that is enforced by either precession of orbital motion of the jet sources. We have investigated the force balance across the jet and ambient medium and found that the lateral magnetic pressure and gas pressure gradients are almost balanced, but that a lack of gas pressure on the concave side of the curvature is leading to the lateral motion. Magnetic tension does not play a significant role. Our results are obtained in code units, but we provide scaling relations such that our results may be applied to young stars, micro-quasars, symbiotic stars or AGN.Comment: 20 pp, 14 figs; accepted by Ap

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified