Humanism in the Age of COVID-19: Renewing Focus on Communication and Compassion

The global COVID-19 pandemic has become one of the largest clinical and operational challenges faced by emergency medicine, and our EDs continue to see increased volumes of infected patients, many of whom are not only ill, but acutely aware and fearful of their circumstances and potential mortality. Given this, there may be no more important time to focus on staff-patient communication and expression of compassion.However, many of the techniques usually employed by emergency clinicians to provide comfort to patients and their families are made more challenging or impossible by the current circumstances. Geriatric ED patients, who are at increased risk of severe disease, are particularly vulnerable to the effects of isolation.Despite many challenges, emergency clinicians have at their disposal a myriad of tools that can still be used to express compassion and empathy to their patients. Placing emphasis on using these techniques to maximize humanism in the care of COVID-19 patients during this crisis has the potential to bring improvements to ED patient care well after this pandemic has passed

The Projected Three-point Correlation Function: Theory and Observations

We report results for the angular three-point galaxy correlation function in the APM survey and compare them with theoretical expectations. For the first time, these measurements extend to sufficiently large scales to probe the weakly non-linear regime. On large scales, the results are in good agreement with the predictions of non-linear cosmological perturbation theory, for a model with initially Gaussian fluctuations and linear power spectrum $P(k)$ consistent with that inferred from the APM survey. These results reinforce the conclusion that large-scale structure is driven by non-linear gravitational instability and that APM galaxies are relatively unbiased tracers of the mass on large scales; they also provide stringent constraints upon models with non-Gaussian initial conditions and strongly exclude the standard cold dark matter model.Comment: 10 pages, latex, 2 figures, submited to ApJ Le

The Formation of High Redshift Submillimeter Galaxies

We describe a model for the formation of \zsim 2 Submillimeter Galaxies (SMGs) which simultaneously accounts for both average and bright SMGs while providing a reasonable match to their mean observed spectral energy distributions (SEDs). By coupling hydrodynamic simulations of galaxy mergers with the high resolution 3D polychromatic radiative transfer code Sunrise, we find that a mass sequence of merger models which use observational constraints as physical input naturally yield objects which exhibit black hole, bulge, and H2 gas masses similar to those observed in SMGs. The dominant drivers behind the 850 micron flux are the masses of the merging galaxies and the stellar birthcloud covering fraction. The most luminous (S850 ~ 15 mJy) sources are recovered by ~10^13 Msun 1:1 major mergers with a birthcloud covering fraction close to unity, whereas more average SMGs ~5-7 mJy) may be formed in lower mass halos ~5x10^12 Msun. These models demonstrate the need for high spatial resolution hydrodynamic and radiative transfer simulations in matching both the most luminous sources as well as the full SEDs of SMGs. While these models suggest a natural formation mechanism for SMGs, they do not attempt to match cosmological statistics of galaxy populations; future efforts along this line will help ascertain the robustness of these models.Comment: MNRAS Accepted; Revised version includes expanded discussion of simulated radio properties of SMG

Galaxy-Quasar correlations between APM galaxies and Hamburg-ESO QSOs

We detect angular galaxy-QSO cross-correlations between the APM Galaxy Catalogue and a preliminary release (consisting of roughly half of the anticipated final catalogue) of the Hamburg-ESO Catalogue of Bright QSOs as a function of source QSO redshift using multiple cross-correlation estimators. Each of the estimators yield very similar results, implying that the APM catalogue and the Hamburg-ESO survey are both fair samples of the respective true galaxy and QSO populations. Though the signal matches the expectations of gravitational lensing qualitatively, the strength of the measured cross-correlation signal is significantly greater than the CDM models of lensing by large scale structure would suggest. This same disagreement between models and observation has been found in several earlier studies. We estimate our confidence in the correlation detections versus redshift by generating 1000 random realizations of the Hamburg-ESO QSO survey: We detect physical associations between galaxies and low-redshift QSOs at 99% confidence and detect lensing associations at roughly 95% confidence for QSOs with redshifts between 0.6 and 1. Control cross-correlations between Galactic stars and QSOs show no signal. Finally, the overdensities (underdensities) of galaxies near QSO positions relative to those lying roughly 135 - 150 arcmin away are uncorrelated with differences in Galactic extinction between the two regions, implying that Galactic dust is not significantly affecting the QSO sample.Comment: 35 pages total, including 9 figures. Accepted by the Astrophysical Journa

Succinylated Octopamine Ascarosides and a New Pathway of Biogenic Amine Metabolism in Caenorhabditis elegans

The ascarosides, small-molecule signals derived from combinatorial assembly of primary metabolism-derived building blocks, play a central role in Caenorhabditis elegans biology and regulate many aspects of development and behavior in this model organism as well as in other nematodes. Using HPLCMS/ MS-based targeted metabolomics, we identified novel ascarosides incorporating a side chain derived from succinylation of the neurotransmitter octopamine. These compounds, named osas#2, osas#9, and osas#10, are produced predominantly by L1 larvae, where they serve as part of a dispersal signal, whereas these ascarosides are largely absent from the metabolomes of other life stages. Investigating the biogenesis of these octopamine- derived ascarosides, we found that succinylation represents a previously unrecognized pathway of biogenic amine metabolism. At physiological concentrations, the neurotransmitters serotonin, dopamine, and octopamine are converted to a large extent into the corresponding succinates, in addition to the previously described acetates. Chemically, bimodal deactivation of biogenic amines via acetylation and succinylation parallels posttranslational modification of proteins via acetylation and succinylation of L-lysine. Our results reveal a small-molecule connection between neurotransmitter signaling and interorganismal regulation of behavior and suggest that ascaroside biosynthesis is based in part on co-option of degradative biochemical pathways

Clinical, radiologic, pathologic, and molecular characteristics of long-term survivors of diffuse intrinsic pontine glioma (DIPG): a collaborative report from the International and European Society for Pediatric Oncology DIPG registries

Purpose Diffuse intrinsic pontine glioma (DIPG) is a brainstem malignancy with a median survival of < 1 year. The International and European Society for Pediatric Oncology DIPG Registries collaborated to compare clinical, radiologic, and histomolecular characteristics between short-term survivors (STSs) and long-term survivors (LTSs). Materials and Methods Data abstracted from registry databases included patients from North America, Australia, Germany, Austria, Switzerland, the Netherlands, Italy, France, the United Kingdom, and Croatia. Results Among 1,130 pediatric and young adults with radiographically confirmed DIPG, 122 (11%) were excluded. Of the 1,008 remaining patients, 101 (10%) were LTSs (survival ≥ 2 years). Median survival time was 11 months (interquartile range, 7.5 to 16 months), and 1-, 2-, 3-, 4-, and 5-year survival rates were 42.3% (95% CI, 38.1% to 44.1%), 9.6% (95% CI, 7.8% to 11.3%), 4.3% (95% CI, 3.2% to 5.8%), 3.2% (95% CI, 2.4% to 4.6%), and 2.2% (95% CI, 1.4% to 3.4%), respectively. LTSs, compared with STSs, more commonly presented at age < 3 or > 10 years (11% v 3% and 33% v 23%, respectively; P < .001) and with longer symptom duration ( P < .001). STSs, compared with LTSs, more commonly presented with cranial nerve palsy (83% v 73%, respectively; P = .008), ring enhancement (38% v 23%, respectively; P = .007), necrosis (42% v 26%, respectively; P = .009), and extrapontine extension (92% v 86%, respectively; P = .04). LTSs more commonly received systemic therapy at diagnosis (88% v 75% for STSs; P = .005). Biopsies and autopsies were performed in 299 patients (30%) and 77 patients (10%), respectively; 181 tumors (48%) were molecularly characterized. LTSs were more likely to harbor a HIST1H3B mutation (odds ratio, 1.28; 95% CI, 1.1 to 1.5; P = .002). Conclusion We report clinical, radiologic, and molecular factors that correlate with survival in children and young adults with DIPG, which are important for risk stratification in future clinical trials

A Physical Model for z~2 Dust Obscured Galaxies

We present a physical model for the origin of z~2 Dust-Obscured Galaxies (DOGs), a class of high-redshift ULIRGs selected at 24 micron which are particularly optically faint (24/R>1000). By combining N-body/SPH simulations of high redshift galaxy evolution with 3D polychromatic dust radiative transfer models, we find that luminous DOGs (with F24 > 0.3 mJy at z~2 are well-modeled as extreme gas-rich mergers in massive (~5x10^12-10^13 Msun) halos, with elevated star formation rates (~500-1000 Msun/yr) and/or significant AGN growth (Mdot > 0.5 Msun/yr), whereas less luminous DOGs are more diverse in nature. At final coalescence, merger-driven DOGs transition from being starburst dominated to AGN dominated, evolving from a "bump" to a power-law shaped mid-IR (IRAC) spectral energy distribution (SED). After the DOG phase, the galaxy settles back to exhibiting a "bump" SED with bluer colors and lower star formation rates. While canonically power-law galaxies are associated with being AGN-dominated, we find that the power-law mid-IR SED can owe both to direct AGN contribution, as well as to a heavily dust obscured stellar bump at times that the galaxy is starburst dominated. Thus power-law galaxies can be either starburst or AGN dominated. Less luminous DOGs can be well-represented either by mergers, or by massive ($M_{\rm baryon} ~5x10^11 Msun) secularly evolving gas-rich disc galaxies (with SFR > 50 Msun/yr). By utilising similar models as those employed in the SMG formation study of Narayanan et al. (2010), we investigate the connection between DOGs and SMGs. We find that the most heavily star-forming merger driven DOGs can be selected as Submillimetre Galaxies (SMGs), while both merger-driven and secularly evolving DOGs typically satisfy the BzK selection criteria.Comment: Accepted by MNRAS; major changes include better description of dependency on ISM specification and updated models allowing dust to evolve with metallicity

The shape of the SDSS DR5 galaxy power spectrum

We present a Fourier analysis of the clustering of galaxies in the combined Main galaxy and Luminous Red Galaxy (LRG) Sloan Digital Sky Survey (SDSS) Data Release 5 (DR5) sample. The aim of our analysis is to consider how well we can measure the cosmological matter density using the signature of the horizon at matter-radiation equality embedded in the large-scale power spectrum. The new data constrains the power spectrum on scales 100--600h^-1Mpc with significantly higher precision than previous analyses of just the SDSS Main galaxies, due to our larger sample and the inclusion of the LRGs. This improvement means that we can now reveal a discrepancy between the shape of the measured power and linear CDM models on scales 0.01<k<0.15hMpc^-1, with linear model fits favouring a lower matter density (Omega_m=0.22+/-0.04) on scales 0.01<k<0.06hMpc^-1 and a higher matter density (Omega_m=0.32+/-0.01) when smaller scales are included, assuming a flat LCDM model with h=0.73 and n_s=0.96. This discrepancy could be explained by scale-dependent bias and, by analysing subsamples of galaxies, we find that the ratio of small-scale to large-scale power increases with galaxy luminosity, so all of the SDSS galaxies cannot trace the same power spectrum shape over 0.01<k<0.2hMpc^-1. However, the data are insufficient to clearly show a luminosity-dependent change in the largest scale at which a significant increase in clustering is observed, although they do not rule out such an effect. Significant scale-dependent galaxy bias on large-scales, which changes with the r-band luminosity of the galaxies, could potentially explain differences in our Omega_m estimates and differences previously observed between 2dFGRS and SDSS power spectra and the resulting parameter constraints.Comment: 21 pages, 19 figures, minor corrections to match version accepted by Ap

The physical scale of the far-infrared emission in the most luminous submillimetre galaxies II: evidence for merger-driven star formation

We present high-resolution 345 GHz interferometric observations of two extreme luminous (L_{IR}>10^{13} L_sun), submillimetre-selected galaxies (SMGs) in the COSMOS field with the Submillimeter Array (SMA). Both targets were previously detected as unresolved point-sources by the SMA in its compact configuration, also at 345 GHz. These new data, which provide a factor of ~3 improvement in resolution, allow us to measure the physical scale of the far-infrared in the submillimetre directly. The visibility functions of both targets show significant evidence for structure on 0.5-1 arcsec scales, which at z=1.5 translates into a physical scale of 5-8 kpc. Our results are consistent with the angular and physical scales of two comparably luminous objects with high-resolution SMA followup, as well as radio continuum and CO sizes. These relatively compact sizes (<5-10 kpc) argue strongly for merger-driven starbursts, rather than extended gas-rich disks, as the preferred channel for forming SMGs. For the most luminous objects, the derived sizes may also have important physical consequences; under a series of simplifying assumptions, we find that these two objects in particular are forming stars close to or at the Eddington limit for a starburst.Comment: 9 pages, 3 Figures, submitted to MNRA

A physical model for the origin of the diffuse cosmic infrared background

We present a physical model for origin of the cosmic diffuse infrared background (CDIRB). By utilizing the observed stellar mass function and its evolution as input to a semi-empirical model of galaxy formation, we isolate the physics driving diffuse IR emission. The model includes contributions from three primary sources of IR emission: steady-state star formation owing to isolated disk galaxies, interaction-driven bursts of star formation owing to close encounters and mergers, and obscured active galactic nuclei (AGN). We find that most of the CDIRB is produced by equal contributions from objects at z=0.5-1 and z>1, as suggested by recent observations. Of those sources, the vast majority of the emission originates in systems with low to moderate IR luminosities (L_{IR}<10^{12} $L_sun); the most luminous objects contribute significant flux only at high-redshifts (z>2). All star formation in ongoing mergers accounts for <10% of the total at all wavelengths and redshifts, while emission directly attributable to the interaction-driven burst itself accounts for <5%. We furthermore find that obscured AGN contribute <1-2% of the CDIRB at all wavelengths and redshifts, with a strong upper limit of less than 4% of the total emission. Finally, since electron-positron pair production interactions with the CDIRB represent the primary source of opacity to very high energy (VHE: E_\gamma > 1 TeV) \gamma-rays, the model provides predictions for the optical depth of the Universe to the most energetic photons. We find that these predictions agree with observations of high-energy cutoffs at TeV energies in nearby blazars, and suggest that while the Universe is extremely optically thick at >10 TeV, the next generation of VHE \gamma-ray telescopes can reasonably expect detections from out to 50-150 Mpc.Comment: 14 pages, 13 figures, submitted to MNRA