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To define optimal thromboprophylaxis strategy after stent implantation in superior or total cavopulmonary connections.
Stent thrombosis is a rare complication of intravascular stenting, with a perceived higher risk in single-ventricle patients.
All patients who underwent stent implantation within superior or total cavopulmonary connections (caval vein, innominate vein, Fontan, or branch pulmonary arteries) were included. Cohort was divided into aspirin therapy alone versus advanced anticoagulation, including warfarin, enoxaparin, heparin, or clopidogrel. Primary endpoint was in-stent or downstream thrombus, and secondary endpoints included bleeding complications.
A total of 58 patients with single-ventricle circulation underwent 72 stent implantations. Of them 14 stents (19%) were implanted post-superior cavopulmonary connection and 58 (81%) post-total cavopulmonary connection. Indications for stenting included vessel/conduit stenosis (67%), external compression (18%), and thrombotic occlusion (15%). Advanced anticoagulation was prescribed for 32 (44%) patients and aspirin for 40 (56%) patients. Median follow up was 1.1 (25th–75th percentile, 0.5–2.6) years. Echocardiograms were available in 71 patients (99%), and advanced imaging in 44 patients (61%). Thrombosis was present in two patients on advanced anticoagulation (6.3%) and none noted in patients on aspirin (p = 0.187). Both patients with in-stent thrombus underwent initial stenting due to occlusive left pulmonary artery thrombus acutely post-superior cavopulmonary connection. There were seven (22%) significant bleeding complications for advanced anticoagulation and none for aspirin (p < 0.001).
Antithrombotic strategy does not appear to affect rates of in-stent thrombus in single-ventricle circulations. Aspirin alone may be sufficient for most patients undergoing stent implantation, while pre-existing thrombus may warrant advanced anticoagulation.
Transcatheter right ventricle decompression in neonates with pulmonary atresia and intact ventricular septum is technically challenging, with risk of cardiac perforation and death. Further, despite successful right ventricle decompression, re-intervention on the pulmonary valve is common. The association between technical factors during right ventricle decompression and the risks of complications and re-intervention are not well described.
This is a multicentre retrospective study among the participating centres of the Congenital Catheterization Research Collaborative. Between 2005 and 2015, all neonates with pulmonary atresia and intact ventricular septum and attempted transcatheter right ventricle decompression were included. Technical factors evaluated included the use and characteristics of radiofrequency energy, maximal balloon-to-pulmonary valve annulus ratio, infundibular diameter, and right ventricle systolic pressure pre- and post-valvuloplasty (BPV). The primary end point was cardiac perforation or death; the secondary end point was re-intervention.
A total of 99 neonates underwent transcatheter right ventricle decompression at a median of 3 days (IQR 2–5) of age, including 63 patients by radiofrequency and 32 by wire perforation of the pulmonary valve. There were 32 complications including 10 (10.5%) cardiac perforations, of which two resulted in death. Cardiac perforation was associated with the use of radiofrequency (p=0.047), longer radiofrequency duration (3.5 versus 2.0 seconds, p=0.02), and higher maximal radiofrequency energy (7.5 versus 5.0 J, p<0.01) but not with patient weight (p=0.09), pulmonary valve diameter (p=0.23), or infundibular diameter (p=0.57). Re-intervention was performed in 36 patients and was associated with higher post-intervention right ventricle pressure (median 60 versus 50 mmHg, p=0.041) and residual valve gradient (median 15 versus 10 mmHg, p=0.046), but not with balloon-to-pulmonary valve annulus ratio, atmospheric pressure used during BPV, or the presence of a residual balloon waist during BPV. Re-intervention was not associated with any right ventricle anatomic characteristics, including pulmonary valve diameter.
Technical factors surrounding transcatheter right ventricle decompression in pulmonary atresia and intact ventricular septum influence the risk of procedural complications but not the risk of future re-intervention. Cardiac perforation is associated with the use of radiofrequency energy, as well as radiofrequency application characteristics. Re-intervention after right ventricle decompression for pulmonary atresia and intact ventricular septum is common and relates to haemodynamic measures surrounding initial BPV.
The Total Solar Irradiance (TSI), which is the total radiation arriving at Earth's atmosphere from the Sun, is one of the most important forcing of the Earths climate. Measurements of the TSI have been made employing instruments on board several space-based platforms during the last four solar cycles. However, combining these measurements is still challenging due to the degradation of the sensor elements and the long-term stability of the electronics. Here we describe the preliminary efforts to design an absolute radiometer based on the principle of electrical substitution that is under development at Brazilian's National Institute for Space Research (INPE).
Much can be learned from terrestrial planets that appear to have had the potential to be habitable, but failed to realize that potential. Mars shows evidence of a once hospitable surface environment. The reasons for its current state, and in particular its thin atmosphere and dry surface, are of great interest for what they can tell us about habitable zone planet outcomes. A main goal of the MAVEN mission is to observe Mars’ atmosphere responses to solar and space weather influences, and in particular atmosphere escape related to space weather ‘storms’ caused by interplanetary coronal mass ejections (ICMEs). Numerical experiments with a data-validated MHD model suggest how the effects of an observed moderately strong ICME compare to what happens during a more extreme event. The results suggest the kinds of solar and space weather conditions that can have evolutionary importance at a planet like Mars.
It is well known that the cosmic ray intensity observed at the Earth's surface presents an 11 and 22-yr variations associated with the solar activity cycle. However, the observation and analysis of this modulation through ground muon detectors datahave been difficult due to the temperature effect. Furthermore, instrumental changes or temporary problems may difficult the analysis of these variations. In this work, we analyze the cosmic ray intensity observed since October 1970 until December 2012 by the Nagoya muon detector. We show the results obtained after analyzing all discontinuities and gaps present in this data and removing changes not related to natural phenomena. We also show the results found using the mass weighted method for eliminate the influence of atmospheric temperature changes on muon intensity observed at ground. As a preliminary result of our analyses, we show the solar cycle modulation in the muon intensity observed for more than 40 years.
An extremely weak circularly-polarized signature was recently detected in the spectral lines of the Am star Sirius A. With a prominent positive lobe, the shape of the phase-averaged Stokes V line profile is atypical of stellar Zeeman signatures, casting doubts on its magnetic origin. We report here on ultra-deep spectropolarimetric observations of two more bright Am stars: β Uma and θ Leo. Stokes V line signatures are detected in both objects, with a shape and amplitude similar to the one observed on Sirius A. We demonstrate that the amplitude of the Stokes V line profiles depend on various line parameters (Landé factor, wavelength, depth) as expected from a Zeeman signature, confirming that extremely weak magnetic fields are likely present in a large fraction of Am stars. We suggest that the strong asymmetry of the polarized signatures, systematically observed so far in Am stars and never reported in strongly magnetic Ap stars, bears unique information about the structure and dynamics of the thin surface convective shell of Am stars.
The UVMag consortium proposed the space mission project Arago to ESA at its M4 call. Arago is dedicated to the study of the dynamic 3D environment of stars and planets. This space mission will be equipped with a high-resolution spectropolarimeter working from 119 to 888 nm. A preliminary optical design of the whole instrument has been prepared and is presented here. The design consists of the telescope, the instrument itself, and the focusing optics. Considering not only the scientific requirements, but also the cost and size constraints to fit an M-size mission, the telescope has a 1.3 m diameter primary mirror and is a classical Cassegrain-type telescope that allows a polarization-free focus. The polarimeter is placed at this Cassegrain focus. This is the key element of the mission and the most challenging one to be designed. The main challenge lies in the huge spectral range offered by the instrument; the polarimeter has to deliver the full Stokes vector with a high precision from the FUV (119 nm) to the NIR (888 nm). The polarimeter module is then followed by a high-resolution echelle-spectrometer achieving a resolution of 35000 in the visible range and 25000 in the UV. The two channels are separated after the echelle grating, allowing specific cross-dispersion and focusing optics for the UV and the visible ranges. Considering the large field of view and the high numerical aperture, the focusing optics for both the UV and the visible channels is a Three-Mirror-Anastigmatic (TMA) telescope, needed to focus the various wavelengths and many orders onto the detectors.
Red supergiant stars (RSGs) are not only a key evolutionary stage of massive stars participating in the chemical evolution of galaxies, they also represent a fantastic and challenging laboratory of (magneto-)hydrodynamics. We present recent results and on-going research on mass loss, atmospheres, and polarimetric studies of RSGs that reveal a magnetic field of unknown origin. We discuss the potential interplay between these different processes.
Full Stokes spectropolarimetric observations of a Mira star (χ Cyg) and a RV Tauri star (R Sct) are presented and analyzed comparatively. From their Stokes V data (circular polarization), we report the detection of a weak magnetic field at the surface of these cool and evolved radially pulsating stars. For both stars, we analyse this detection in the framework of their complex atmospheric dynamics, with the possibility that shock waves may imprint an efficient compressive effect on the surface magnetic field. We also report strong Stokes U and Stokes Q signatures associated to metallic lines (as a global trend), those linear polarimetric features appear to be time variable along the pulsating phase. More surprising, in the Stokes U and Stokes Q data, we also detect signatures associated to individual metallic lines (such as Sr i 460.7 nm, Na D2588.9 nm), that are known (from the solar case) to be easily polarizable in case of a global asymmetry at the photospheric level.
The bacterium Francisella tularensis causes the vector-borne zoonotic disease tularemia, and may infect a wide range of hosts including invertebrates, mammals and birds. Transmission to humans occurs through contact with infected animals or contaminated environments, or through arthropod vectors. Tularemia has a broad geographical distribution, and there is evidence which suggests local emergence or re-emergence of this disease in Europe. This review was developed to provide an update on the geographical distribution of F. tularensis in humans, wildlife, domestic animals and vector species, to identify potential public health hazards, and to characterize the epidemiology of tularemia in Europe. Information was collated on cases in humans, domestic animals and wildlife, and on reports of detection of the bacterium in arthropod vectors, from 38 European countries for the period 1992–2012. Multiple international databases on human and animal health were consulted, as well as published reports in the literature. Tularemia is a disease of complex epidemiology that is challenging to understand and therefore to control. Many aspects of this disease remain poorly understood. Better understanding is needed of the epidemiological role of animal hosts, potential vectors, mechanisms of maintenance in the different ecosystems, and routes of transmission of the disease.
The structure and dynamics of young stellar object (YSO) accretion shocks depend strongly on the local magnetic field strength and configuration, as well as on the radiative transfer effects responsible for the energy losses. We present the first 3D YSO shock simulations of the interior of the stream, assuming a uniform background magnetic field, a clumpy infalling gas, and an acoustic energy flux flowing at the base of the chromosphere. We study the dynamical evolution and the post-shock structure as a function of the plasma-beta (thermal pressure over magnetic pressure). We find that a strong magnetic field (~hundreds of Gauss) leads to the formation of fibrils in the shocked gas due to the plasma confinement within flux tubes. The corresponding emission is smooth and fully distinguishable from the case of a weak magnetic field (~tenths of Gauss) where the hot slab demonstrates chaotic motion and oscillates periodically.
The dynamo process is believed to drive the magnetic activity of stars like the Sun that have an outer convection zone. Large spectroscopic surveys showed that there is a relation between the rotation periods and the cycle periods: the longer the rotation period is, the longer the magnetic activity cycle period will be. We present the analysis of F stars observed by Kepler for which individual p modes have been measure and with surface rotation periods shorter than 12 days. We defined magnetic indicators and proxies based on photometric observations to help characterise the activity levels of the stars. With the Kepler data, we investigate the existence of stars with cycles (regular or not), stars with a modulation that could be related to magnetic activity, and stars that seem to show a flat behaviour.
A subpopulation (~10%) of hot, luminous, massive stars have been revealed through spectropolarimetry to harbor strong (hundreds to tens of thousand Gauss), steady, large-scale (often significantly dipolar) magnetic fields. This review focuses on the role of such fields in channeling and trapping the radiatively driven wind of massive stars, including both in the strongly perturbed outflow from open field regions, and the wind-fed “magnetospheres” that develop from closed magnetic loops. For B-type stars with weak winds and moderately fast rotation, one finds “centrifugal magnetospheres”, in which rotational support allows magnetically trapped wind to accumulate to a large density, with quite distinctive observational signatures, e.g. in Balmer line emission. In contrast, more luminous O-type stars have generally been spun down by magnetic braking from angular momentum loss in their much stronger winds. The lack of centrifugal support means their closed loops form a “dynamical magnetosphere”, with trapped material falling back to the star on a dynamical timescale; nonetheless, the much stronger wind feeding leads to a circumstellar density that is still high enough to give substantial Balmer emission. Overall, this review describes MHD simulations and semi-analytic dynamical methods for modeling the magnetospheres, the magnetically channeled wind outflows, and the associated spin-down of these magnetic massive stars.
We present a preliminary 3D potential field extrapolation model of the joint magnetosphere of the close accreting PMS binary V4046 Sgr. The model is derived from magnetic maps obtained as part of a coordinated optical and X-ray observing program.
Asymmetries in exoplanet transits are a useful tool for developing our understanding of magnetic activity on both stars and planets outside our Solar System. Near-UV observations of the WASP-12 system have revealed asymmetries in the timing of the transit when compared with the optical light curve. In this proceedings we review a number of reported asymmetries and present work simulating near-UV transits for the hot-Jupiter hosting star HD 189733.
We report on a long-term monitoring of the cool supergiant Betelgeuse, using the NARVAL and ESPaDOnS high-resolution spectropolarimeters, respectively installed at Telescope Bernard Lyot (Pic du Midi Observatory, France) and at the Canada-France-Hawaii Telescope (Mauna Kea Observatory, Hawaii). The data set, constituted of circularly polarized (Stokes V) and intensity (Stokes I) spectra, was collected between 2010 and 2012. We investigate here the temporal evolution of magnetic field, convection and temperature at photospheric level, using simultaneous measurements of the longitudinal magnetic field component, the core emission of the Ca II infrared triplet, the line-depth ratio of selected photospheric lines and the radial velocity of the star.
We study flows and interface deformations produced by the scattering of a laser beam propagating through non-absorbing turbid fluids. Light scattering produces a force density resulting from the transfer of linear momentum from the laser to the scatterers. The flow induced in the direction of the beam propagation, called ‘optical streaming’, is also able to deform the interface separating the two liquid phases and to produce wide humps. The viscous flow taking place in these two liquid layers is solved analytically, in one of the two liquid layers with a stream function formulation, as well as numerically in both fluids using a boundary integral element method. Quantitative comparisons are shown between the numerical and analytical flow patterns. Moreover, we present predictive simulations regarding the effects of the geometry, of the scattering strength and of the viscosities, on both the flow pattern and the deformation of the interface. Finally, theoretical arguments are put forth to explain the robustness of the emergence of secondary flows in a two-layer fluid system.
Within the Herschel key project “The Warm And Dense ISM” (WADI) we systematically observe
a number of prominent photon-dominated regions (PDRs) to measure the impact of varying UV
fields on the energy balance, the chemical and dynamical structure of heated molecular
In this work our purposes are (1) geochemical characterization of loess (‘primary loess’ or ‘true loess’ and ‘secondary loess’ or ‘loess-like deposits’) located in the centre of the Iberian Peninsula, (2) systematic study of element behaviour during pedogenesis and (3) evaluation of the suitability of using the geochemistry of loess to establish the average composition of these discontinuous aeolian sedimentary covers in central Spain. Several analyses were carried out on the bulk sample and on the sandy and clay fractions (mineralogical composition by X-ray diffraction, mineralogical studies of heavy minerals by petrographical microscopy and chemical composition by flame atomic absorption spectrometry). Loess from the Spanish central region has a local origin. The presence of gypsum in the ‘loess-like’ deposits reaches values two times higher than in ‘true loess’, and ‘true loess’ has a higher concentration of quartz, calcite and kaolinite. Regarding chemical composition, similar concentrations of Ca, K, Mg and Na were found, although it is important to note the higher concentration of Na in some of the samples.
Magnetic fields of cool stars can be directly investigated through the study of the Zeeman effect on photospheric spectral lines using several approaches. With spectroscopic measurement in unpolarised light, the total magnetic flux averaged over the stellar disc can be derived but very little information on the field geometry is available. Spectropolarimetry provides a complementary information on the large-scale magnetic topology. With Zeeman-Doppler Imaging (ZDI), this information can be retrieved to produce a map of the vector magnetic field at the surface of the star, and in particular to assess the relative importance of the poloidal and toroidal components as well as the degree of axisymmetry of the field distribution.
The development of high-performance spectropolarimeters associated with multi-lines techniques and ZDI allows us to explore magnetic topologies throughout the Hertzsprung-Russel diagram, on stars spanning a wide range of mass, age and rotation period. These observations bring novel constraints on magnetic field generation by dynamo effect in cool stars. In particular, the study of solar twins brings new insight on the impact of rotation on the solar dynamo, whereas the detection of strong and stable dipolar magnetic fields on fully convective stars questions the precise role of the tachocline in this process.