G11.92-0.61 MM1: A Keplerian disc around a massive young proto-O star

The formation process of massive stars is not well understood, and advancement in our understanding benefits from high resolution observations and modelling of the gas and dust surrounding individual high-mass (proto)stars. Here we report sub-arcsecond (<1550 au) resolution observations of the young massive star G11.92-0.61 MM1 with the SMA and VLA. Our 1.3 mm SMA observations reveal consistent velocity gradients in compact molecular line emission from species such as CH$_3$CN, CH$_3$OH, OCS, HNCO, H$_2$CO, DCN and CH$_3$CH$_2$CN, oriented perpendicular to the previously reported bipolar molecular outflow from MM1. Modelling of the compact gas kinematics suggests a structure undergoing rotation around the peak of the dust continuum emission. The rotational profile can be well fit by a model of a Keplerian disc, including infall, surrounding an enclosed mass of 30-60M$_{\odot}$, of which 2-3M$_{\odot}$ is attributed to the disc. From modelling the CH$_3$CN emission, we determine that two temperature components, of 150 K and 230 K, are required to adequately reproduce the spectra. Our 0.9 and 3.0cm VLA continuum data exhibit an excess above the level expected from dust emission; the full centimetre-submillimetre wavelength spectral energy distribution of MM1 is well reproduced by a model including dust emission, an unresolved hypercompact H{\i}{\i} region, and a compact ionised jet. In combination, our results suggest that MM1 is an example of a massive proto-O star forming via disc accretion, in a similar way to that of lower mass stars.European Research Council (ERC-2013-ADG DISCSIM project (Grant ID: 341137), ERC-2011-ADG ECOGAL project (Grant ID: 291227)), Science and Technology Facilities Council (Grant ID: ST/M001296/1), Royal Astronomical Society (Undergraduate Research Bursary)This is the final version of the article. It first appeared from Oxford University Press via http://dx.doi.org/10.1093/mnras/stw191

ALMA observations of the Extended Green Object G19.01−0.03 – I. A Keplerian disc in a massive protostellar system

Using the Atacama Large Millimetre/submillimeter Array (ALMA) and the Karl G. Jansky Very Large Array (VLA), we observed the Extended Green Object (EGO) G19.01-0.03 with sub-arcsec resolution from 1.05 mm to 5.01 cm wavelengths. Our 0.4 arcsec 1600 au angular resolution ALMA observations reveal a velocity gradient across the millimetre core MM1, oriented perpendicular to the previously known bipolar molecular outflow, which is consistently traced by 20 lines of 8 molecular species with a range of excitation temperatures, including complex organic molecules (COMs). Kinematic modelling shows the data are well described by models that include a disc in Keplerian rotation and infall, with an enclosed mass of 40-70 M (within a 2000 au outer radius) for a disc inclination angle of i = 40, of which 5.4-7.2 M is attributed to the disc. Our new VLA observations show that the 6.7 GHz Class II methanol masers associated with MM1 fo a partial ellipse, consistent with an inclined ring, with a velocity gradient consistent with that of the theal gas. The disc-to-star mass ratio suggests the disc is likely to be unstable and may be fragmenting into as-yet-undetected low-mass stellar companions. Modelling the centimetre-millimetre spectral energy distribution of MM1 shows the ALMA 1.05 mm continuum emission is dominated by dust, whilst a free-free component, interpreted as a hypercompact H ii region, is required to explain the VLA 5 cm emission. The high enclosed mass derived for a source with a moderate bolometric luminosity (104L) suggests that the MM1 disc may feed an unresolved high-mass binary system

Radio emission from Supernova Remnants

The explosion of a supernova releases almost instantaneously about 10^51 ergs of mechanic energy, changing irreversibly the physical and chemical properties of large regions in the galaxies. The stellar ejecta, the nebula resulting from the powerful shock waves, and sometimes a compact stellar remnant, constitute a supernova remnant (SNR). They can radiate their energy across the whole electromagnetic spectrum, but the great majority are radio sources. Almost 70 years after the first detection of radio emission coming from a SNR, great progress has been achieved in the comprehension of their physical characteristics and evolution. We review the present knowledge of different aspects of radio remnants, focusing on sources of the Milky Way and the Magellanic Clouds, where the SNRs can be spatially resolved. We present a brief overview of theoretical background, analyze morphology and polarization properties, and review and critical discuss different methods applied to determine the radio spectrum and distances. The consequences of the interaction between the SNR shocks and the surrounding medium are examined, including the question of whether SNRs can trigger the formation of new stars. Cases of multispectral comparison are presented. A section is devoted to reviewing recent results of radio SNRs in the Magellanic Clouds, with particular emphasis on the radio properties of SN 1987A, an ideal laboratory to investigate dynamical evolution of an SNR in near real time. The review concludes with a summary of issues on radio SNRs that deserve further study, and analyzing the prospects for future research with the latest generation radio telescopes.Comment: Revised version. 48 pages, 15 figure

Medium-size-vessel vasculitis

Medium-size-artery vasculitides do occur in childhood and manifest, in the main, as polyarteritis nodosa (PAN), cutaneous PAN and Kawasaki disease. Of these, PAN is the most serious, with high morbidity and not inconsequential mortality rates. New classification criteria for PAN have been validated that will have value in epidemiological studies and clinical trials. Renal involvement is common and recent therapeutic advances may result in improved treatment options. Cutaneous PAN is a milder disease characterised by periodic exacerbations and often associated with streptococcal infection. There is controversy as to whether this is a separate entity or part of the systemic PAN spectrum. Kawasaki disease is an acute self-limiting systemic vasculitis, the second commonest vasculitis in childhood and the commonest cause of childhood-acquired heart disease. Renal manifestations occur and include tubulointerstitial nephritis and renal failure. An infectious trigger and a genetic predisposition seem likely. Intravenous immunoglobulin (IV-Ig) and aspirin are effective therapeutically, but in resistant cases, either steroid or infliximab have a role. Greater understanding of the pathogenetic mechanisms involved in these three types of vasculitis and better long-term follow-up data will lead to improved therapy and prediction of prognosis

Extracorporeal Membrane Oxygenation for Acute Pediatric Respiratory Failure

This article is made available for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.The use of extracorporeal membrane oxygenation (ECMO) to support children with acute respiratory failure has steadily increased over the past several decades, with major advancements having been made in the care of these children. There are, however, many controversies regarding indications for initiating ECMO in this setting and the appropriate management strategies thereafter. Broad indications for ECMO include hypoxia, hypercarbia, and severe air leak syndrome, with hypoxia being the most common. There are many disease-specific considerations when evaluating children for ECMO, but there are currently very few, if any, absolute contraindications. Venovenous rather than veno-arterial ECMO cannulation is the preferred configuration for ECMO support of acute respiratory failure due to its superior side-effect profile. The approach to lung management on ECMO is variable and should be individualized to the patient, with the main goal of reducing the risk of VILI. ECMO is a relatively rare intervention, and there are likely a minimum number of cases per year at a given center to maintain competency. Patients who have prolonged ECMO runs (i.e., greater than 21 days) are less likely to survive, though no absolute duration of ECMO that would mandate withdrawal of ECMO support can be currently recommended

Health state utilities associated with attributes of treatments for hepatitis C

BACKGROUND: Cost-utility analyses are frequently conducted to compare treatments for hepatitis C, which are often associated with complex regimens and serious adverse events. Thus, the purpose of this study was to estimate the utility associated with treatment administration and adverse events of hepatitis C treatments. DESIGN: Health states were drafted based on literature review and clinician interviews. General population participants in the UK valued the health states in time trade-off (TTO) interviews with 10- and 1-year time horizons. The 14 health states described hepatitis C with variations in treatment regimen and adverse events. RESULTS: A total of 182 participants completed interviews (50 % female; mean age = 39.3 years). Utilities for health states describing treatment regimens without injections ranged from 0.80 (1 tablet) to 0.79 (7 tablets). Utilities for health states describing oral plus injectable regimens were 0.77 (7 tablets), 0.75 (12 tablets), and 0.71 (18 tablets). Addition of a weekly injection had a disutility of −0.02. A requirement to take medication with fatty food had a disutility of −0.04. Adverse events were associated with substantial disutilities: mild anemia, −0.12; severe anemia, −0.32; flu-like symptoms, −0.21; mild rash, −0.13; severe rash, −0.48; depression, −0.47. One-year TTO scores were similar to these 10-year values. CONCLUSIONS: Adverse events and greater treatment regimen complexity were associated with lower utility scores, suggesting a perceived decrease in quality of life beyond the impact of hepatitis C. The resulting utilities may be used in models estimating and comparing the value of treatments for hepatitis C. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10198-014-0649-6) contains supplementary material, which is available to authorized users

The 2014 ALMA Long Baseline Campaign: An Overview

A major goal of the Atacama Large Millimeter/submillimeter Array (ALMA) is to make accurate images with resolutions of tens of milliarcseconds, which at submillimeter (submm) wavelengths requires baselines up to ~15 km. To develop and test this capability, a Long Baseline Campaign (LBC) was carried out from September to late November 2014, culminating in end-to-end observations, calibrations, and imaging of selected Science Verification (SV) targets. This paper presents an overview of the campaign and its main results, including an investigation of the short-term coherence properties and systematic phase errors over the long baselines at the ALMA site, a summary of the SV targets and observations, and recommendations for science observing strategies at long baselines. Deep ALMA images of the quasar 3C138 at 97 and 241 GHz are also compared to VLA 43 GHz results, demonstrating an agreement at a level of a few percent. As a result of the extensive program of LBC testing, the highly successful SV imaging at long baselines achieved angular resolutions as fine as 19 mas at ~350 GHz. Observing with ALMA on baselines of up to 15 km is now possible, and opens up new parameter space for submm astronomy