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  • Ederle, Joerg, et al. (författare)
  • Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial
  • 2010
  • Ingår i: The Lancet. - Elsevier. - 1474-547X. ; 375:9719, s. 985-997
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were randomly assigned in a 1:1 ratio to receive carotid artery stenting or carotid endarterectomy. Randomisation was by telephone call or fax to a central computerised service and was stratified by centre with minimisation for sex, age, contralateral occlusion, and side of the randomised artery. Patients and investigators were not masked to treatment assignment. Patients were followed up by independent clinicians not directly involved in delivering the randomised treatment. The primary outcome measure of the trial is the 3-year rate of fatal or disabling stroke in any territory, which has not been analysed yet. The main outcome measure for the interim safety analysis was the 120-day rate of stroke, death, or procedural myocardial infarction. Analysis was by intention to treat (ITT). This study is registered, number ISRCTN25337470. Findings The trial enrolled 1713 patients (stenting group, n=855; endarterectomy group, n=858). Two patients in the stenting group and one in the endarterectomy group withdrew immediately after randomisation, and were not included in the ITT analysis. Between randomisation and 120 days, there were 34 (Kaplan-Meier estimate 4.0%) events of disabling stroke or death in the stenting group compared with 27 (3.2%) events in the endarterectomy group (hazard ratio [HR] 1.28, 95% CI 0.77-2.11). The incidence of stroke, death, or procedural myocardial infarction was 8.5% in the stenting group compared with 5.2% in the endarterectomy group (72 vs 44 events; HR 1.69, 1.16-2.45, p=0.006), Risks of any stroke (65 vs 35 events; HR 1.92, 1.27-2.89) and all-cause death (19 vs seven events; HR 2.76, 1.16-6.56) were higher in the stenting group than in the endarterectomy group. Three procedural myocardial infarctions were recorded in the stenting group, all of which were fatal, compared with four, all non-fatal, in the endarterectomy group. There was one event of cranial nerve palsy in the stenting group compared with 45 in the endarterectomy group. There were also fewer haematomas of any severity in the stenting group than in the endarterectomy group (31 vs 50 events; p=0.0197). Interpretation Completion of long-term follow-up is needed to establish the efficacy of carotid artery stenting compared with endarterectomy. In the meantime, carotid endarterectomy should remain the treatment of choice for patients suitable for surgery.
  • Romanelli, F., et al. (författare)
  • Overview of the JET results
  • 2015
  • Ingår i: Nuclear Fusion. - 0029-5515 .- 1741-4326. ; 55:10
  • Tidskriftsartikel (refereegranskat)abstract
    • Since the installation of an ITER-like wall, the JET programme has focused on the consolidation of ITER design choices and the preparation for ITER operation, with a specific emphasis given to the bulk tungsten melt experiment, which has been crucial for the final decision on the material choice for the day-one tungsten divertor in ITER. Integrated scenarios have been progressed with the re-establishment of long-pulse, high-confinement H-modes by optimizing the magnetic configuration and the use of ICRH to avoid tungsten impurity accumulation. Stationary discharges with detached divertor conditions and small edge localized modes have been demonstrated by nitrogen seeding. The differences in confinement and pedestal behaviour before and after the ITER-like wall installation have been better characterized towards the development of high fusion yield scenarios in DT. Post-mortem analyses of the plasma-facing components have confirmed the previously reported low fuel retention obtained by gas balance and shown that the pattern of deposition within the divertor has changed significantly with respect to the JET carbon wall campaigns due to the absence of thermally activated chemical erosion of beryllium in contrast to carbon. Transport to remote areas is almost absent and two orders of magnitude less material is found in the divertor.
  • Lituadon, Xavier, et al. (författare)
  • Overview of the JET results in support to ITER
  • 2017
  • Ingår i: Nuclear Fusion. - IOP PUBLISHING LTD. - 0029-5515 .- 1741-4326. ; 57:10
  • Tidskriftsartikel (refereegranskat)abstract
    • The 2014-2016 JET results are reviewed in the light of their significance for optimising the ITER research plan for the active and non-active operation. More than 60 h of plasma operation with ITER first wall materials successfully took place since its installation in 2011. New multi-machine scaling of the type I-ELM divertor energy flux density to ITER is supported by first principle modelling. ITER relevant disruption experiments and first principle modelling are reported with a set of three disruption mitigation valves mimicking the ITER setup. Insights of the L-H power threshold in Deuterium and Hydrogen are given, stressing the importance of the magnetic configurations and the recent measurements of fine-scale structures in the edge radial electric. Dimensionless scans of the core and pedestal confinement provide new information to elucidate the importance of the first wall material on the fusion performance. H-mode plasmas at ITER triangularity (H = 1 at beta(N) similar to 1.8 and n/n(GW) similar to 0.6) have been sustained at 2 MA during 5 s. The ITER neutronics codes have been validated on high performance experiments. Prospects for the coming D-T campaign and 14 MeV neutron calibration strategy are reviewed.
  • Weiner, D. J., et al. (författare)
  • Polygenic transmission disequilibrium confirms that common and rare variation act additively to create risk for autism spectrum disorders
  • 2017
  • Ingår i: Nature Genetics. - 1061-4036. ; 49:7, s. 978-
  • Tidskriftsartikel (refereegranskat)abstract
    • Autism spectrum disorder (ASD) risk is influenced by common polygenic and de novo variation. We aimed to clarify the influence of polygenic risk for ASD and to identify subgroups of ASD cases, including those with strongly acting de novo variants, in which polygenic risk is relevant. Using a novel approach called the polygenic transmission disequilibrium test and data from 6,454 families with a child with ASD, we show that polygenic risk for ASD, schizophrenia, and greater educational attainment is over-transmitted to children with ASD. These findings hold independent of proband IQ. We find that polygenic variation contributes additively to risk in ASD cases who carry a strongly acting de novo variant. Lastly, we show that elements of polygenic risk are independent and differ in their relationship with phenotype. These results confirm that the genetic influences on ASD are additive and suggest that they create risk through at least partially distinct etiologic pathways.
  • Abdalla, H., et al. (författare)
  • The gamma-ray spectrum of the core of Centaurus A as observed with HESS and Fermi-LAT
  • 2018
  • Ingår i: Astronomy and Astrophysics. - EDP Sciences. - 0004-6361 .- 1432-0746. ; 619
  • Tidskriftsartikel (refereegranskat)abstract
    • Centaurus A (Cen A) is the nearest radio galaxy discovered as a very-high-energy (VHE; 100 GeV-100 TeV) gamma-ray source by the High Energy Stereoscopic System (H.E.S.S.). It is a faint VHE gamma-ray emitter, though its VHE flux exceeds both the extrapolation from early Fermi-LAT observations as well as expectations from a (misaligned) single-zone synchrotron-self Compton (SSC) description. The latter satisfactorily reproduces the emission from Cen A at lower energies up to a few GeV. New observations with H.E.S.S., comparable in exposure time to those previously reported, were performed and eight years of Fermi-LAT data were accumulated to clarify the spectral characteristics of the gamma-ray emission from the core of Cen A. The results allow us for the first time to achieve the goal of constructing a representative, contemporaneous gamma-ray core spectrum of Cen A over almost five orders of magnitude in energy. Advanced analysis methods, including the template fitting method, allow detection in the VHE range of the core with a statistical significance of 12 sigma on the basis of 213 hours of total exposure time. The spectrum in the energy range of 250 GeV-6 TeV is compatible with a power-law function with a photon index Gamma = 2.52 +/- 0.13(stat) +/- 0.20(sys). An updated Fermi-LAT analysis provides evidence for spectral hardening by Delta Gamma similar or equal to 0.4 +/- 0.1 at gamma-ray energies above 2.8(-0.6)(+1.0) GeV at a level of 4.0 sigma. The fact that the spectrum hardens at GeV energies and extends into the VHE regime disfavour a single-zone SSC interpretation for the overall spectral energy distribution (SED) of the core and is suggestive of a new gamma-ray emitting component connecting the high-energy emission above the break energy to the one observed at VHE energies. The absence of significant variability at both GeV and TeV energies does not yet allow disentanglement of the physical nature of this component, though a jet-related origin is possible and a simple two-zone SED model fit is provided to this end.
  • Conrad, Jan M., et al. (författare)
  • Search for gamma-Ray Line Signals from Dark Matter Annihilations in the Inner Galactic Halo from 10 Years of Observations with HESS
  • 2018
  • Ingår i: Physical Review Letters. - American Physical Society. - 0031-9007. ; 120:20
  • Tidskriftsartikel (refereegranskat)abstract
    • Spectral lines are among the most powerful signatures for dark matter (DM) annihilation searches in very-high-energy gamma rays. The central region of the Milky Way halo is one of the most promising targets given its large amount of DM and proximity to Earth. We report on a search for a monoenergetic spectral line from self-annihilations of DM particles in the energy range from 300 GeV to 70 TeV using a two-dimensional maximum likelihood method taking advantage of both the spectral and spatial features of the signal versus background. The analysis makes use of Galactic center observations accumulated over ten years (2004-2014) with the H.E.S.S. array of ground-based Cherenkov telescopes. No significant gamma-ray excess above the background is found. We derive upper limits on the annihilation cross section (sigma v) for monoenergetic DM lines at the level of 4 x 10(-28) cm(3) s(-1) at 1 TeV, assuming an Einasto DM profile for the Milky Way halo. For a DM mass of 1 TeV, they improve over the previous ones by a factor of 6. The present constraints are the strongest obtained so far for DM particles in the mass range 300 GeV-70 TeV. Ground-based gamma-ray observations have reached sufficient sensitivity to explore relevant velocity-averaged cross sections for DM annihilation into two gamma-ray photons at the level expected from the thermal relic density for TeV DM particles.
  • Abdalla, H., et al. (författare)
  • Detection of variable VHE gamma-ray emission from the extra-galactic gamma-ray binary LMC P3
  • 2018
  • Ingår i: Astronomy and Astrophysics. - EDP Sciences. - 0004-6361. ; 610
  • Tidskriftsartikel (refereegranskat)abstract
    • Context. Recently, the high-energy (HE, 0.1-100 GeV) gamma-ray emission from the object LMC P3 in the Large Magellanic Cloud (LMC) has been discovered to be modulated with a 10.3-day period, making it the first extra-galactic gamma-ray binary. Aims. This work aims at the detection of very-high-energy (VHE, >100 GeV) gamma-ray emission and the search for modulation of the VHE signal with the orbital period of the binary system. Methods. LMC P3 has been observed with the High Energy Stereoscopic System (H.E.S.S.); the acceptance-corrected exposure time is 100 h. The data set has been folded with the known orbital period of the system in order to test for variability of the emission. Results. VHE gamma-ray emission is detected with a statistical significance of 6.4 sigma. The data clearly show variability which is phase-locked to the orbital period of the system. Periodicity cannot be deduced from the H.E.S.S. data set alone. The orbit-averaged luminosity in the 1-10 TeV energy range is (1.4 +/- 0.2) x 10(35) erg s(-1). A luminosity of (5 +/- 1) x 10(35) erg s(-1) is reached during 20% of the orbit. HE and VHE gamma-ray emissions are anti-correlated. LMC P3 is the most luminous gamma-ray binary known so far.
  • Conrad, Jan M., et al. (författare)
  • Population study of Galactic supernova remnants at very high gamma-ray energies with HESS
  • 2018
  • Ingår i: Astronomy and Astrophysics. - EDP Sciences. - 0004-6361. ; 612
  • Tidskriftsartikel (refereegranskat)abstract
    • Shell-type supernova remnants (SNRs) are considered prime candidates for the acceleration of Galactic cosmic rays (CRs) up to the knee of the CR spectrum at E approximate to 3 x 10(15) eV. Our MilkyWay galaxy hosts more than 350 SNRs discovered at radio wavelengths and at high energies, of which 220 fall into the H.E.S.S. Galactic Plane Survey (HGPS) region. Of those, only 50 SNRs are coincident with a H.E.S.S source and in 8 cases the very high-energy (VHE) emission is firmly identified as an SNR. The H.E.S.S. GPS provides us with a legacy for SNR population study in VHE gamma-rays and we use this rich data set to extract VHE flux upper limits from all undetected SNRs. Overall, the derived flux upper limits are not in contradiction with the canonical CR paradigm. Assuming this paradigm holds true, we can constrain typical ambient density values around shell-type SNRs to n <= 7 cm(-3) and electron-to-proton energy fractions above 10 TeV to epsilon(ep) <= 5 x 10(-3). Furthermore, comparisons of VHE with radio luminosities in non-interacting SNRs reveal a behaviour that is in agreement with the theory of magnetic field amplification at shell-type SNRs.
  • Conrad, Jan M., et al. (författare)
  • The HESS Galactic plane survey
  • 2018
  • Ingår i: Astronomy and Astrophysics. - EDP Sciences. - 0004-6361. ; 612
  • Tidskriftsartikel (refereegranskat)abstract
    • We present the results of the most comprehensive survey of the Galactic plane in very high-energy (VHE) gamma-rays, including a public release of Galactic sky maps, a catalog of VHE sources, and the discovery of 16 new sources of VHE gamma-rays. The High Energy Spectroscopic System (H.E.S.S.) Galactic plane survey (HGPS) was a decade-long observation program carried out by the H.E.S.S. I array of Cherenkov telescopes in Namibia from 2004 to 2013. The observations amount to nearly 2700 h of quality-selected data, covering the Galactic plane at longitudes from l = 250 degrees to 65 degrees and latitudes vertical bar b vertical bar <= 3 degrees. In addition to the unprecedented spatial coverage, the HGPS also features a relatively high angular resolution (0.08 degrees approximate to 5 arcmin mean point spread function 68% containment radius), sensitivity (less than or similar to 1.5% Crab flux for point-like sources), and energy range (0.2-100 TeV). We constructed a catalog of VHE gamma-ray sources from the HGPS data set with a systematic procedure for both source detection and characterization of morphology and spectrum. We present this likelihood-based method in detail, including the introduction of a model component to account for unresolved, large-scale emission along the Galactic plane. In total, the resulting HGPS catalog contains 78 VHE sources, of which 14 are not reanalyzed here, for example, due to their complex morphology, namely shell-like sources and the Galactic center region. Where possible, we provide a firm identification of the VHE source or plausible associations with sources in other astronomical catalogs. We also studied the characteristics of the VHE sources with source parameter distributions. 16 new sources were previously unknown or unpublished, and we individually discuss their identifications or possible associations. We firmly identified 31 sources as pulsar wind nebulae (PWNe), supernova remnants (SNRs), composite SNRs, or gamma-ray binaries. Among the 47 sources not yet identified, most of them (36) have possible associations with cataloged objects, notably PWNe and energetic pulsars that could power VHE PWNe.
  • Conrad, Jan, et al. (författare)
  • TeV Gamma-Ray Observations of the Binary Neutron Star Merger GW170817 with HESS
  • 2017
  • Ingår i: Astrophysical Journal Letters. - Institute of Physics Publishing (IOPP). - 2041-8205. ; 850:2
  • Tidskriftsartikel (refereegranskat)abstract
    • We search for high-energy gamma-ray emission from the binary neutron star merger GW170817 with the H.E.S.S. Imaging Air Cherenkov Telescopes. The observations presented here have been obtained starting only 5.3 hr after GW170817. The H.E.S.S. target selection identified regions of high probability to find a counterpart of the gravitational-wave event. The first of these regions contained the counterpart SSS17a that has been identified in the optical range several hours after our observations. We can therefore present the first data obtained by a ground-based pointing instrument on this object. A subsequent monitoring campaign with the H.E.S.S. telescopes extended over several days, covering timescales from 0.22 to 5.2 days and energy ranges between 270 GeV to 8.55 TeV. No significant gamma-ray emission has been found. The derived upper limits on the very-high-energy gamma-ray flux for the first time constrain non-thermal, high-energy emission following the merger of a confirmed binary neutron star system.
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