Gamma-ray astronomy

Abstract:

Background

Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART).

Methods/design

ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH2O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure ≤30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle.

Discussion

If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.

Trial registration

ClinicalTrials.gov Identifier: NCT01374022.

Abstract:

The LOw FRequency ARray - LOFAR is a new radio telescope that is moving the science of radio pulsars and transients into a new phase. Its design places emphasis on digital hardware and flexible software instead of mechanical solutions. LOFAR observes at radio frequencies between 10 and 240 MHz where radio pulsars and many transients are expected to be brightest. Radio frequency signals emitted from these objects allow us to study the intrinsic pulsar emission and phenomena such as propagation effects through the interstellar medium. The design of LOFAR allows independent use of its stations to conduct observations of known bright objects, or wide field monitoring of transient events. One such combined software/hardware solution is called the Advanced Radio Transient Event Monitor and Identification System (ARTEMIS). It is a backend for both targeted observations and real-time searches for millisecond radio transients which uses Graphical Processing Unit (GPU) technology to remove interstellar dispersion and detect millisecond radio bursts from astronomical sources in real-time using a single LOFAR station.

Abstract:

Dispersion in the interstellar medium is a well known phenomenon that follows a simple relationship, which has been used to predict the time delay of dispersed radio pulses since the late 1960s. We performed wide-band simultaneous observations of four pulsars with LOFAR (at 40-190 MHz), the 76-m Lovell Telescope (at 1400 MHz) and the Effelsberg 100-m Telescope (at 8000 MHz) to test the accuracy of the dispersion law over a broad frequency range. In this paper we present the results of these observations which show that the dispersion law is accurate to better than 1 part in 105 across our observing band. We use this fact to constrain some of the properties of the interstellar medium along the line-of-sight and use the lack of any aberration or retardation effects to determine upper limits on emission heights in the pulsar magnetosphere. We also discuss the effect of pulse profile evolution on our observations, and the implications that it could have for precision pulsar timing projects such as the detection of gravitational waves with pulsar timing arrays. © 2012 ESO.

Abstract:

Abell 2256 is one of the best known examples of a galaxy cluster hosting large-scale diffuse radio emission that is unrelated to individual galaxies. It contains both a giant radio halo and a relic, as well as a number of head-tail sources and smaller diffuse steep-spectrum radio sources. The origin of radio halos and relics is still being debated, but over the last years it has become clear that the presence of these radio sources is closely related to galaxy cluster merger events. Here we present the results from the first LOFAR low band antenna (LBA) observations of Abell 2256 between 18 and 67 MHz. To our knowledge, the image presented in this paper at 63 MHz is the deepest ever obtained at frequencies below 100 MHz in general. Both the radio halo and the giant relic are detected in the image at 63 MHz, and the diffuse radio emission remains visible at frequencies as low as 20 MHz. The observations confirm the presence of a previously claimed ultra-steep spectrum source to the west of the cluster center with a spectral index of-2.3 ± 0.4 between 63 and 153 MHz. The steep spectrum suggests that this source is an old part of a head-tail radio source in the cluster. For the radio relic we find an integrated spectral index of-0.81 ± 0.03, after removing the flux contribution from the other sources. This is relatively flat which could indicate that the efficiency of particle acceleration at the shock substantially changed in the last ~0.1 Gyr due to an increase of the shock Mach number. In an alternative scenario, particles are re-accelerated by some mechanism in the downstream region of the shock, resulting in the relatively flat integrated radio spectrum. In the radio halo region we find indications of low-frequency spectral steepening which may suggest that relativistic particles are accelerated in a rather inhomogeneous turbulent region. © 2012 ESO.