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John Soper,1 Islam Sadek,2 Alyson Urniasz-Lippel,2 Deborah Norton,2 Marina Ness,3 Ruben Mesa4 1Bioaeronautical Research Laboratory, Civil Aerospace Medical Research Institute, Oklahoma City, OK, USA; 2Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA; 3Inspire, Arlington, VA, USA; 4Mays Cancer Center at UT Health San Antonio MD Anderson, San Antonio, TX, USACorrespondence: Ruben MesaMays Cancer Center at UT Health San Antonio MD Anderson, 7979 Wurzbach Road, San Antonio, TX, 78229, USA, Tel +1 210-450-1724, Fax +1 210-450-1100, Email mesar@uthscsa.eduAbstract: A diagnosis of myelodysplastic syndrome (MDS) is typically unexpected and can be difficult for patients to grasp. Not only is MDS a complicated disease to understand, which can contribute to stress and anxiety, but it also has an uncertain prognosis, which can be emotionally paralyzing. Not surprisingly, emotional distress and the symptom burden of MDS, including extreme fatigue due to cytopenias, negatively impact a patient’s quality of life (QOL). Studies have shown that patient-centered care—including greater physician understanding of the disease burden their patients experience, discussing and establishing agreed-on treatment goals, and including patients in the decision-making process about their care—may help improve patient QOL. To better understand patient and caregiver experiences with MDS and how the disease impacts QOL, a small survey was conducted of patients with MDS or leukemia and their caregivers on an online health network. Among the 30 respondents who completed the survey, four had MDS and one was a caregiver for a patient with MDS. Here we focus on the five MDS respondents and contextualize the findings with personal experiences from a patient and physician perspective. The patient perspective was provided by John Soper, PhD, DABCC, who was diagnosed with MDS in 2019. Dr Soper is a retired board-certified clinical chemist and a member of the MDS Foundation. The physician perspective was provided by Dr Ruben Mesa, Executive Director of the Mays Cancer Center at UT Health San Antonio MD Anderson. The survey responses and the accompanying patient and physician perspectives highlight the importance of open communication between patients and their healthcare provider to better serve those with MDS and improve their QOL.Keywords: quality of life, survey, online health network, personal experiences

We introduce the 4-metre Multi-Object Spectroscopic Telescope (4MOST), a new high-multiplex, wide-field spectroscopic survey facility under development for the four-metre-class Visible and Infrared Survey Telescope for Astronomy (VISTA) at Paranal. Its key specifications are: a large field of view (FoV) of 4.2 square degrees and a high multiplex capability, with 1624 fibres feeding two low-resolution spectrographs ($R = \lambda/\Delta\lambda \sim 6500$), and 812 fibres transferring light to the high-resolution spectrograph ($R \sim 20\,000$). After a description of the instrument and its expected performance, a short overview is given of its operational scheme and planned 4MOST Consortium science; these aspects are covered in more detail in other articles in this edition of The Messenger. Finally, the processes, schedules, and policies concerning the selection of ESO Community Surveys are presented, commencing with a singular opportunity to submit Letters of Intent for Public Surveys during the first five years of 4MOST operations., Comment: Part of the 4MOST issue of The Messenger, published in preparation of 4MOST Community Workshop, see http://www.eso.org/sci/meetings/2019/4MOST.html

This white paper is meant to capture many different elements of stellar astrophysics and galactic archaeology that highlight the important role this science will play in the 2020s era of precision astronomy.

The next decade affords tremendous opportunity to achieve the goals of Galactic archaeology. That is, to reconstruct the evolutionary narrative of the Milky Way, based on the empirical data that describes its current morphological, dynamical, temporal and chemical structures. Here, we describe the path to achieving this goal.

It is well established that the chemical structure of the Milky Way exhibits a bimodality with respect to the α-enhancement of stars at a given [Fe/H]. This has been studied largely based on a bulk α abundance, computed as a summary of several individual α-elements. Inspired by the expected subtle differences in their nucleosynthetic origins, here we probe the higher level of granularity encoded in the inter-family [Mg/Si] abundance ratio. Using a large sample of stars with APOGEE abundance measurements, we first demonstrate that there is additional information in this ratio beyond what is already apparent in [α/Fe] and [Fe/H] alone. We then consider Gaia astrometry and stellar age estimates to empirically characterize the relationships between [Mg/Si] and various stellar properties. We find small but significant trends between this ratio and α-enhancement, age, [Fe/H], location in the Galaxy, and orbital actions. To connect these observed [Mg/Si] variations to a physical origin, we attempt to predict the Mg and Si abundances of stars with the galactic chemical evolution model Chempy. We find that we are unable to reproduce abundances for the stars that we fit, which highlights tensions between the yield tables, the chemical evolution model, and the data. We conclude that a more data-driven approach to nucleosynthetic yield tables and chemical evolution modeling is necessary to maximize insights from large spectroscopic surveys.

We measure the circular velocity curve v c(R) of the Milky Way with the highest precision to date across Galactocentric distances of 5 ≤ R ≤ 25 kpc. Our analysis draws on the six-dimensional phase-space coordinates of ≳23,000 luminous red giant stars, for which we previously determined precise parallaxes using a data-driven model that combines spectral data from APOGEE with photometric information from WISE, 2MASS, and Gaia. We derive the circular velocity curve with the Jeans equation assuming an axisymmetric gravitational potential. At the location of the Sun we determine the circular velocity with its formal uncertainty to be vc(R☉ ) = (229.0+/- 0.2) km s-1 with systematic uncertainties at the ~2%-5% level. We find that the velocity curve is gently but significantly declining at (-1.7 ± 0.1) km s-1 kpc-1, with a systematic uncertainty of 0.46 km s-1 kpc-1, beyond the inner 5 kpc. We exclude the inner 5 kpc from our analysis due to the presence of the Galactic bar, which strongly influences the kinematic structure and requires modeling in a nonaxisymmetric potential. Combining our results with external measurements of the mass distribution for the baryonic components of the Milky Way from other studies, we estimate the Galaxy’s dark halo mass within the virial radius to be Mvir = (7.25+/- 0.26)\cdot 1011 M☉ and a local dark matter density of ρ dm(R☉ ) = 0.30+/- 0.03 GeV cm-3.

We develop and apply a model to quantify the global efficiency of radial orbit migration among stars in the Milky Way disk. This model parameterizes the possible star formation and enrichment histories and radial birth profiles, and combines them with a migration model that relates present-day orbital radii to birth radii through a Gaussian probability, broadening with age τ as {σ }RM8}\sqrt{τ /8 {Gyr}}. Guided by observations, we assume that stars are born with an initially tight age-metallicity relation at given radius, which becomes subsequently scrambled by radial orbit migration, thereby providing a direct observational constraint on radial orbit migration strength {σ }RM8}. We fit this model with Markov Chain Monte Carlo sampling of the observed age-metallicity distribution of low-α red clump stars with Galactocentric radii between 5 and 14 kpc from APOGEE DR12, sidestepping the complex spatial selection function and accounting for the considerable age uncertainties. This simple model reproduces the observed data well, and we find a global (in radius and time) radial orbit migration efficiency in the Milky Way of {σ }RM8} = 3.6 ± 0.1 kpc when marginalizing over all other aspects of the model. This shows that radial orbit migration in the Milky Way’s main disk is indeed rather strong, in line with theoretical expectations: stars migrate by about a half-mass radius over the age of the disk. The model finds the Sun’s birth radius at ̃5.2 kpc. If such strong radial orbit migration is typical, this mechanism indeed plays an important role in setting the structural regularity of disk galaxies.

Analyses the relationship between satisfaction with mail-order speciality food attributes, overall satisfaction, and likelihood of future purchase using a structural equation model. The results indicate that customer satisfaction is associated with both service and product features of mail order speciality food.

International audience

It has been assumed that the general public is unable to conceptualizeinformation about risk uncertainties, and so communication about food riskhas tended to avoid this type of information. However, recent societal andpolitical pressure to increase transparency in risk management practices willresult in the uncertainties inherent in risk analysis becoming subject to publicscrutiny. Best practice regarding risk communication must address how tocommunicate risk uncertainty. A questionnaire was developed that aimed toassess how the general public characterized uncertainty associated with foodrisks. The results indicated that people wanted to be provided with informationabout food risk uncertainty as soon as the uncertainty was identified. Peoplewere more accepting of uncertainty associated with the scientific process ofrisk management than they were of uncertainty due to lack of action or lack ofinterest on the part of the government. The findings indicate that the focus of riskcommunication should be on “what is being done to reduce the uncertainty.”Recommendations are made regarding best practice for communicating riskuncertainty

This paper draws upon a consumer survey carried out in Bucharest (Romania) to explore determinants of food choice in a transition economy. An adapted version of the Theory of Reasoned Action was developed. This included attitude toward intention, habit and preference as independent variables. The structural equations modelling carried out in 'Analysis of MOment Structures' AMOS showed a significant positive influence of all variables. Similar to other studies conducted in European Union (EU) countries (Saba, Di Natale, 1998) habit outweighed the other variables. The study emphasises the heterogeneity of consumer beliefs about food. Furthermore it was suggested that there is scope for noneconomic variables in explaining food choices and consumer behaviour in these emerging economies, though the influence of these variables may be still limited relative the economic factors. Further research on special groups is required to quantify the influence of non-economic factors and compare the results estimated in Romania with other countries which are candidates to EU accession.

This paper draws upon a consumer survey carried out in Bucharest (Romania) to explore determinants of food choice in a transition economy. An adapted version of the Theory of Reasoned Action was developed. This included attitude toward intention, habit and preference as independent variables. The structural equations modelling carried out in 'Analysis of MOment Structures' AMOS showed a significant positive influence of all variables. Similar to other studies conducted in European Union (EU) countries (Saba, Di Natale, 1998) habit outweighed the other variables. The study emphasises the heterogeneity of consumer beliefs about food. Furthermore it was suggested that there is scope for noneconomic variables in explaining food choices and consumer behaviour in these emerging economies, though the influence of these variables may be still limited relative the economic factors. Further research on special groups is required to quantify the influence of non-economic factors and compare the results estimated in Romania with other countries which are candidates to EU accession.

Theoretical models of stellar evolution predict that most of the lithium inside a star is destroyed as the star becomes a red giant. However, observations reveal that about 1% of red giants are peculiarly rich in lithium, often exceeding the amount in the interstellar medium or predicted from the Big Bang. With only about 150 lithium-rich giants discovered in the past four decades, and no distinguishing properties other than lithium enhancement, the origin of lithium-rich giant stars is one of the oldest problems in stellar astrophysics. Here we report the discovery of 2,330 low-mass (1 to 3$\,M_\odot$) lithium-rich giant stars, which we argue are consistent with internal lithium production that is driven by tidal spin-up by a binary companion. Our sample reveals that most lithium-rich giants have helium-burning cores ($80^{+7}_{-6}\%$), and that the frequency of lithium-rich giants rises with increasing stellar metallicity. We find that while planet accretion may explain some lithium-rich giants, it cannot account for the majority that have helium-burning cores. We rule out most other proposed explanations as the primary mechanism for lithium-rich giants, including all stages related to single star evolution. Our analysis shows that giants remain lithium-rich for only about two million years. A prediction from this lithium depletion timescale is that most lithium-rich giants with a helium-burning core have a binary companion.

Stars with unusual elemental abundances offer clues about rare astrophysical events or nucleosynthetic pathways. Stars with significantly depleted magnesium and enhanced potassium ([Mg/Fe] < -0.5; [K/Fe] > 1) have to date only been found in the massive globular cluster NGC 2419 and, to a lesser extent, NGC 2808. The origin of this abundance signature remains unknown, as does the reason for its apparent exclusivity to these two globular clusters. Here we present 112 field stars, identified from 454,180 LAMOST giants, that show significantly enhanced [K/Fe] and possibly depleted [Mg/Fe] abundance ratios. Our sample spans a wide range of metallicities (-1.5 < [Fe/H] < 0.3), yet none show abundance ratios of [K/Fe] or [Mg/Fe] that are as extreme as those observed in NGC 2419. If confirmed, the identified sample of stars represents evidence that the nucleosynthetic process producing the anomalous abundances ratios of [K/Fe] and [Mg/Fe] probably occurs at a wide range of metallicities. This would suggest that pollution scenarios that are limited to early epochs (such as Population III supernovae) are an unlikely explanation, although they cannot be ruled out entirely. This sample is expected to help guide modelling attempts to explain the origin of the Mg-K abundance signature.

We quantify the inside-out growth of the Milky Way's low-alpha stellar disk, modelling the ages, metallicities and Galactocentric radii of APOGEE red clump stars with 6 < R < 13 kpc. The current stellar distribution differs significantly from that expected from the star formation history due to the redistribution of stars through radial orbit mixing. We propose and fit a global model for the Milky Way disk, specified by an inside-out star formation history, radial orbit mixing, and an empirical, parametric model for its chemical evolution. We account for the spatially complex survey selection function, and find that the model fits all data well. We find distinct inside-out growth of the Milky Way disk; the best fit model implies that the half-mass radius of the Milky Way disk has grown by 43\% over the last 7 Gyr. Yet, such inside-out growth still results in present-day age gradient weaker than 0.1 Gyr/kpc. Our model predicts the half-mass and half-light sizes of the Galactic disk at earlier epochs, which can be compared to the observed redshift -size relations of disk galaxies. We show that radial orbit migration can reconcile the distinct disk-size evolution with redshift, also expected from cosmological simulations, with the modest present-day age gradients seen in the Milky Way and other galaxies., Accepted in ApJ

Liver transplantation is recognized as having a risk of excessive bleeding due to surgical factors and multifactorial coagulopathy pre-existing as well as those occured during surgery itself. This paper addresses transfusion requirements from primary orthotopic liver transplantation (OLT) focused on the relevance of perioperative parameters to blood transfusion.