Search

We present a two-epoch Hubble Space Telescope (HST) study of NGC 2071 IR highlighting HOPS 361-C, a protostar producing an arced 0.2 parsec-scale jet. Proper motions for the brightest knots decrease from 350 to 100 km/s with increasing distance from the source. The [Fe II] and Pa$\beta$ emission line intensity ratio gives a velocity jump through each knot of 40--50 km/s. A new [O I] 63 \mic\ spectrum, taken with the German REciever for Astronomy at Terahertz frequencies (GREAT) instrument aboard Stratospheric Observatory for Infrared Astronomy (SOFIA), shows a low line-of-sight velocity indicative of high jet inclination. Proper motions and jump velocities then estimate 3D flow speed for knots. Subsequently, we model knot positions and speeds with a precessing jet that decelerates. Measurements are matched with a precession period of 1,000--3,000 years and half opening angle of $15^\circ$. The [Fe II] 1.26-to-1.64 \mic\ line intensity ratio determines visual extinction to each knot from 5--30 mag. Relative to $\sim$14 mag of extinction through the cloud from $\rm{C}^{18}$O emission maps, the jet is embedded at a 1/5 to 4/5 fractional cloud depth. Our model suggests the jet is dissipated over a 0.2 pc arc. This short distance may result from the jet sweeping through a wide angle, allowing the cloud time to fill cavities opened by the jet. Precessing jets contrast with nearly unidirectional protostellar jets that puncture host clouds and can propagate significantly further., Comment: 25 pages, 10 figures, submitted to ApJ on 22-11-2022, revised until 8-3-2023, accepted 9-3-2023

From imaging observations of [Fe ii] emission in Herbig–Haro objects, I find a lower limit to the zero-extinction [Fe ii] 1.26 μm/1.64 μm intensity ratio of 2.6 and argue that this lower limit must be close to the true zero-extinction intensity ratio. My extinction determinations using this zero-extinction value yields results on well-studied HH objects consistent with results from other ionic-line spectra, whereas using nearly all theoretical values of [Fe ii] 1.26 μm/1.64 μm in the literature gives rise to unphysical results.

The physical processes occurring within the inner few astronomical units of proto-planetary disks surrounding Herbig Ae stars are crucial to setting the environment in which the outer planet-forming disk evolves and put critical constraints on the processes of accretion and planet migration. We present the most complete published sample of high angular resolution H- and K-band observations of the stars HD 163296 and HD 190073, including 30 previously unpublished nights of observations of the former and 45 nights of the latter with the CHARA long-baseline interferometer, in addition to archival VLTI data. We confirm previous observations suggesting significant near-infrared emission originates within the putative dust evaporation front of HD 163296 and show this is the case for HD 190073 as well. The H- and K-band sizes are the same within $(3 \pm 3)\%$ for HD 163296 and within $(6 \pm 10)\%$ for HD 190073. The radial surface brightness profiles for both disks are remarkably Gaussian-like with little or no sign of the sharp edge expected for a dust evaporation front. Coupled with spectral energy distribution analysis, our direct measurements of the stellar flux component at H and K bands suggest that HD 190073 is much younger (, 19 pages, 6 figures

Background: Morphology may provide the basis for the understanding of wrist mechanics. Methods: We used classification systems based on cadaver dissection of lunate and capitate types to evaluate a normal database of 70 wrist radiographs in 35 subjects looking for associations between bone shapes. Kappa statistics and a log-linear mixed -effects model with a random intercept were used. Results: There were 39 type-1, 31 type- 2 lunates, 50 spherical, 10 flat and 10 V-shaped capitates. There was a significant difference in lunate and capitate shape between the hands of the same individual p Conclusion: Further study to better understand the development of radiographic parameters of the midcarpal joint may aid in our understanding of the morphology and mechanics of the wrist.

Herbig Ae/Be (HAeBe) stars have been classified into Group I or Group II, which were initially thought to be flared and flat disks, respectively. Several Group I sources have been shown to have large gaps, suggesting ongoing planet formation, while no large gaps have been found in the disks of Group II sources. We analyzed the disk around the Group II source, HD 142666, using irradiated accretion disk modeling of the broad-band spectral energy distribution along with the 1.3 millimeter spatial brightness distribution traced by Atacama Large Millimeter and Submillimeter Array (ALMA) observations. Our model reproduces the available data, predicting a high degree of dust settling in the disk, which is consistent with the Group II classification of HD 142666. In addition, the observed visibilities and synthesized image could only be reproduced when including a depletion of large grains out to ~16 au in our disk model, although the ALMA observations did not have enough angular resolution to fully resolve the inner parts of the disk. These results may suggest that some disks around Group II HAeBe stars have cavities of large grains as well. Further ALMA observations of Group II sources are needed to discern how commonly cavities occur in this class of objects, as well as to reveal their possible origins., 11 pages, 3 figures, accepted for publication by The Astrophysical Journal

Herbig Ae/Be stars are young, pre-main-sequence stars that sample the transition in structure and evolution between low- and high-mass stars, providing a key test of accretion processes in higher-mass stars. Few Herbig Ae/Be stars have detected magnetic fields, calling into question whether the magnetospheric accretion paradigm developed for low-mass stars can be scaled to higher masses. We present He I 10830 \AA\ line profiles for 64 Herbig Ae/Be stars with a magnetic field measurement in order to test magnetospheric accretion in the physical regime where its efficacy remains uncertain. Of the 5 stars with a magnetic field detection, 1 shows redshifted absorption, indicative of infall, and 2 show blueshifted absorption, tracing mass outflow. The fraction of redshifted and blueshifted absorption profiles in the non-magnetic Herbig Ae/Be stars is remarkably similar, suggesting that the stellar magnetic field does not affect gas kinematics traced by He I 10830 \AA. Line profile morphology does not correlate with the luminosity, rotation rate, mass accretion rate, or disk inclination. Only the detection of a magnetic field and a nearly face-on disk inclination show a correlation (albeit for few sources). This provides further evidence for weaker dipoles and more complex field topologies as stars develop a radiative envelope. The small number of magnetic Herbig Ae/Be stars has already called into question whether magnetospheric accretion can be scaled to higher masses; accretion signatures are not substantially different in magnetic Herbig Ae/Be stars, casting further doubt that they accrete in the same manner as classical T Tauri stars., Comment: accepted to ApJ; 17 pages, 4 figures, 3 tables

Objective We evaluated a combined technique designed for procedures requiring intraoperative language mapping. We planned to induce general anesthesia with endotracheal intubation and hyperventilation and then to awaken and extubate the patient for speech testing. After the latter, endotracheal reintubation and general anesthesia were planned. Methods With the patient under intravenously induced sedation, we topically anesthetized the airway with lidocaine that was delivered through a spraying catheter. Fiberoptic endotracheal intubation was then performed on the awake patient, using a modified endotracheal tube. General anesthesia with intravenous propofol or sodium thiopental was induced, the patient's head was attached to a Mayfield holder, and the pin and operative sites were infiltrated with 0.5% bupivacaine with epinephrine. In anticipation of speech mapping, general anesthesia was discontinued and lidocaine was injected into the catheter that was spirally attached to the endotracheal tube. After speech mapping, the awake patients were endotracheally intubated, guided with the fiberoptic laryngoscope or tube changer, and general anesthesia was induced and maintained until termination of the surgery. Results We did not observe any complications, such as coughing or head movements, during the preparation for general anesthesia, awakening and endotracheal extubation for speech mapping, and post-testing reintubation or induction of general anesthesia. Conclusion The combined technique that we describe abolished the potential discomfort of surgical stimulation on a sedated patient, reduced the duration of wakefulness, and provided a secure airway and the means to hyperventilate our patients before dural opening.

Traditional folktales, so easily dismissed as "charming little stories told by common people long ago," contain much of what we find lack ing today in our lives and our schools. Perhaps if we viewed these tales with more respect, understanding, and acceptance, we might see the way to some much-needed change.

Aims: To evaluate vancomycin penetration into human corneal stromal tissue in patients treated with topical vancomycin eyedrops before penetrating keratoplasty (PKP). Methods: Twenty four patients who underwent PKP, seven patients with keratoconus (group 1) and 17 patients with corneal scar or corneal decompensation (group 2). All patients received topical application of vancomycin eyedrops (concentration: 33 mg/ml) 10, 3, 2, 1 hour, and 15 minutes before the operation. Corneal cumulative vancomycin levels were assessed by bioassay. Results: Mean vancomycin corneal stromal tissue concentration was 46.7 (SE 4.11) µg/g tissue. This value was four to 20-fold in excess of the MIC90 of vancomycin in Staphylococcus aureus (2–10 µg/ml). Conclusions: Vancomycin reached high corneal tissue concentrations that significantly exceeded the MIC90 (2–10 µg/ml) for most key Gram positive corneal pathogens. The ratio of vancomycin stromal concentration to protein concentration was statistically higher in group 2 (non-keratoconus).

We describe a case of propylene glycol toxicity due to intravenous administration of etomidate for cerebral protection. A continuous etomidate infusion was titrated to burst suppression of the electroencephalogram during surgical resection of a large intracranial arteriovenous malformation. The etomidate formulation used (Amidate, Abbot) contains etomidate 2 mg/ml in a 35% propylene glycol vehicle. A total of 5 g/kg of the solvent was given during 12 h. Adverse effects of propylene glycol were observed including hyperosmolality with an increased osmolal gap, hemolysis, hemoglobinuria, and metabolic acidosis. Normalization of these metabolic and ionic alterations occurred after 12 h of discontinuation of the infusion. The potential toxicity of the solvent should be considered during long-term administration of etomidate.

Hospital-acquired infections (HAI) are infections that originate during or shortly after hospitalization. Such infections play a major part in malpractice litigation. The cause for the popularity of such litigation is due to the fact that the public considers HA1 to be an avoidable complication of hospitalization and medical procedures. If HA1 occur in one institution but not in another, the public view the institution at which these avoidable HA1 occur as negligent. Similarly, if the rate of HA1 at a particular institution is higher than the national or international levels, then that institution would be regarded as negligent. This negligence may be particularly evident if the on-going rate of HA1 in an institution is higher than the national average for a prolonged period of time and no demonstrable attempts have been made to reduce this rate. Some authorities view health as a commodity produced by physicians and hospitals and sold to the public. Suffering, impairment or death are therefore perceived as an avoidable malfunction. In a commercial market such a malfunction would fall under product liability, and, in the health system, as medical malpractice.

The effects of D1 and D2 dopamine receptor agonists on phosphoinositide hydrolysis were studied by measuring the accumulation of radioactive inositol phosphates in slices of rat corpus striatum prelabelled with [3H]inositol. All assays were performed in the presence of lithium. Neither the D1 receptor agonist SKF 38393 nor the D2 receptor agonist quinpirole, alone or in combination, had an effect on basal accumulation of inositol phosphates. The muscarinic receptor agonist carbachol produced a robust increase in the accumulation of inositol monophosphate and a smaller increase in the accumulation of inositol bisphosphate. These effects were not altered by the presence of quinpirole. Additionally, quinpirole also had no effect when assays were conducted in the presence of the muscarinic receptor antagonist scopolamine, the glutamic acid receptor antagonist kynurenic acid, and the antioxidant glutathione. These results are discussed in relation to recent contradictory reports and lend support to the position that D2 dopamine receptors are not coupled to phosphoinositide hydrolysis in rat striatum.

Contains fulltext : 48229.pdf (Publisher’s version ) (Closed access) BACKGROUND: Voriconazole has proven efficacy against invasive aspergillosis and oesophageal candidiasis. This multicentre, randomised, non-inferiority study compared voriconazole with a regimen of amphotericin B followed by fluconazole for the treatment of candidaemia in non-neutropenic patients. METHODS: Non-neutropenic patients with a positive blood culture for a species of candida and clinical evidence of infection were enrolled. Patients were randomly assigned, in a 2:1 ratio, either voriconazole (n=283) or amphotericin B followed by fluconazole (n=139). The primary efficacy analysis was based on clinical and mycological response 12 weeks after the end of treatment, assessed by an independent data-review committee unaware of treatment assignment. FINDINGS: Of 422 patients randomised, 370 were included in the modified intention-to-treat population. Voriconazole was non-inferior to amphotericin B/fluconazole in the primary efficacy analysis, with successful outcomes in 41% of patients in both treatment groups (95% CI for difference -10.6% to 10.6%). At the last evaluable assessment, outcome was successful in 162 (65%) patients assigned voriconazole and 87 (71%) assigned amphotericin B/fluconazole (p=0.25). Voriconazole cleared blood cultures as quickly as amphotericin B/fluconazole (median time to negative blood culture, 2.0 days). Treatment discontinuations due to all-cause adverse events were more frequent in the voriconazole group, although most discontinuations were due to non-drug-related events and there were significantly fewer serious adverse events and cases of renal toxicity than in the amphotericin B/fluconazole group. INTERPRETATION: Voriconazole was as effective as the regimen of amphotericin B followed by fluconazole in the treatment of candidaemia in non-neutropenic patients, and with fewer toxic effects. RELEVANCE TO PRACTICE: There are several options for treatment of candidaemia in non-neutropenic patients, including amphotericin B, fluconazole, voriconazole, and echinocandins. Voriconazole can be given both as initial intravenous treatment and as an oral stepdown agent.