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- Auchus, RJ, et al.
(författare)
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Treatment patterns and unmet needs in adults with classic congenital adrenal hyperplasia: A modified Delphi consensus study
- 2022
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Ingår i: Frontiers in endocrinology. - : Frontiers Media SA. - 1664-2392. ; 13, s. 1005963-
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Tidskriftsartikel (refereegranskat)abstract
- Classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is a rare autosomal recessive condition characterized by cortisol deficiency and excess androgen production. The current standard of care is glucocorticoid (GC) therapy, and sometimes mineralocorticoids, to replace endogenous cortisol deficiency; however, supraphysiologic GC doses are usually needed to reduce excess androgen production. Monitoring/titrating GC treatment remains a major challenge, and there is no agreement on assessment of treatment adequacy. This study surveyed expert opinions on current treatment practices and unmet needs in adults with classic CAH.MethodsA modified two-round Delphi process with adult endocrinologists was conducted via online questionnaire. Survey questions were organized into three categories: practice characteristics/CAH experience, GC management, and unmet needs/complications. Anonymized aggregate data from Round 1 were provided as feedback for Round 2. Responses from both rounds were analyzed using descriptive statistics. Consensus was defined a priori as: full consensus (100%, n=9/9); near consensus (78% to <100%, n=7/9 or 8/9); no consensus (<78%, n<7/9).ResultsThe same nine panelists participated in both survey rounds; five (56%) were based in North America and four (44%) in Europe. Most panelists (78%) used hydrocortisone in the majority of patients, but two (22%) preferred prednisone/prednisolone. Panelists agreed (89%) that adequate control is best evaluated using a balance of clinical presentation and androgen/precursor laboratory values; no consensus was reached on optimal timing of collecting samples for androgen testing or laboratory values indicating good control. Despite lack of consensus on many aspects of CAH management, panelists agreed on the importance of many disease- and GC-related complications, and that there is a large unmet need for new treatments. With currently available treatments, panelists reported that 46% of classic CAH patients did not have optimized androgen levels, regardless of GC dose.ConclusionsThe limited areas of consensus obtained in this study reflect the variability in treatment practices for adults with classic CAH, even among clinicians with expertise in treating this population. However, all panelists agreed on the need for new treatments for classic CAH and the importance of many disease- and GC-related complications, which are difficult to manage with currently available treatments.
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- Irani, Ido, et al.
(författare)
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SN 2022oqm-A Ca-rich Explosion of a Compact Progenitor Embedded in C/O Circumstellar Material
- 2024
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Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 962:2
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Tidskriftsartikel (refereegranskat)abstract
- We present the discovery and analysis of SN 2022oqm, a Type Ic supernova (SN) detected <1 day after the explosion. The SN rises to a blue and short-lived (2 days) initial peak. Early-time spectral observations of SN 2022oqm show a hot (40,000 K) continuum with high ionization C and O absorption features at velocities of 4000 km s−1, while its photospheric radius expands at 20,000 km s−1, indicating a pre-existing distribution of expanding C/O material. After ∼2.5 days, both the spectrum and light curves evolve into those of a typical SN Ic, with line velocities of ∼10,000 km s−1, in agreement with the evolution of the photospheric radius. The optical light curves reach a second peak at t ≈ 15 days. By t = 60 days, the spectrum of SN 2022oqm becomes nearly nebular, displaying strong Ca ii and [Ca ii] emission with no detectable [O i], marking this event as Ca-rich. The early behavior can be explained by 10−3M⊙ of optically thin circumstellar material (CSM) surrounding either (1) a massive compact progenitor such as a Wolf–Rayet star, (2) a massive stripped progenitor with an extended envelope, or (3) a binary system with a white dwarf. We propose that the early-time light curve is powered by both the interaction of the ejecta with the optically thin CSM and shock cooling (in the massive star scenario). The observations can be explained by CSM that is optically thick to X-ray photons, is optically thick in the lines as seen in the spectra, and is optically thin to visible-light continuum photons that come either from downscattered X-rays or from the shock-heated ejecta. Calculations show that this scenario is self-consistent.
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- Maguire, Kate, et al.
(författare)
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SN 2020udy : an SN Iax with strict limits on interaction consistent with a helium-star companion
- 2023
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Ingår i: Monthly notices of the Royal Astronomical Society. - 0035-8711 .- 1365-2966. ; 525:1, s. 1210-1228
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Tidskriftsartikel (refereegranskat)abstract
- Early observations of transient explosions can provide vital clues to their progenitor origins. In this paper, we present the nearby Type Iax (02cx-like) supernova (SN), SN 2020udy, that was discovered within hours (∼7 h) of estimated first light. An extensive data set of ultra-violet, optical, and near-infrared observations was obtained, covering out to ∼150 d after explosion. SN 2020udy peaked at −17.86 ± 0.43 mag in the r band and evolved similarly to other ‘luminous’ SNe Iax, such as SNe 2005hk and 2012Z. Its well-sampled early light curve allows strict limits on companion interaction to be placed. Main-sequence companion stars with masses of 2 and 6 M⊙ are ruled out at all viewing angles, while a helium-star companion is allowed from a narrow range of angles (140–180° away from the companion). The spectra and light curves of SN 2020udy are in good agreement with those of the ‘N5def’ deflagration model of a near Chandrasekhar-mass carbon–oxygen white dwarf. However, as has been seen in previous studies of similar luminosity events, SN 2020udy evolves slower than the model. Broad-band linear polarization measurements taken at and after peak are consistent with no polarization, in agreement with the predictions of the companion-star configuration from the early light-curve measurements. The host galaxy environment is low metallicity and is consistent with a young stellar population. Overall, we find the most plausible explosion scenario to be the incomplete disruption of a CO white dwarf near the Chandrasekhar-mass limit, with a helium-star companion.
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- Bender, Michael, et al.
(författare)
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Future of nuclear fission theory
- 2020
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Ingår i: Journal of Physics G: Nuclear and Particle Physics. - : IOP Publishing. - 0954-3899 .- 1361-6471. ; 47:11
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Forskningsöversikt (refereegranskat)abstract
- There has been much recent interest in nuclear fission, due in part to a new appreciation of its relevance to astrophysics, stability of superheavy elements, and fundamental theory of neutrino interactions. At the same time, there have been important developments on a conceptual and computational level for the theory. The promising new theoretical avenues were the subject of a workshop held at the University of York in October 2019; this report summarises its findings and recommendations.
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