| 1. |
- Witjes, J. Alfred, et al.
(författare)
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EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer – An International Collaborative Multistakeholder Effort : Under the Auspices of the EAU-ESMO Guidelines Committees
- 2020
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Ingår i: European Urology. - : Elsevier. - 0302-2838 .- 1873-7560. ; 77:2, s. 223-250
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial.OBJECTIVE: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management.DESIGN: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts prior to voting during a consensus conference.SETTING: Online Delphi survey and consensus conference.PARTICIPANTS: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), and 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus).RESULTS AND LIMITATIONS: Overall, 116 statements were included in the Delphi survey. Of these statements, 33 (28%) achieved level 1 consensus and 49 (42%) achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease, and the evolving role of checkpoint inhibitor therapy in metastatic disease.CONCLUSIONS: These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time when further evidence is available to guide our approach.PATIENT SUMMARY: This report summarises findings from an international, multistakeholder project organised by the EAU and ESMO. In this project, a steering committee identified areas of bladder cancer management where there is currently no good-quality evidence to guide treatment decisions. From this, they developed a series of proposed statements, 71 of which achieved consensus by a large group of experts in the field of bladder cancer. It is anticipated that these statements will provide further guidance to health care professionals and could help improve patient outcomes until a time when good-quality evidence is available.
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| 2. |
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| 3. |
- Lundin, Susanne, et al.
(författare)
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Introduction : Medicine across borders
- 2023
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Ingår i: Medicine across borders : Exploration of grey zones - Exploration of grey zones. - 9781991260307 - 9781991260314 ; 17, s. 1-12
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Bokkapitel (refereegranskat)
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| 4. |
- Delva, Pacôme, et al.
(författare)
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GENESIS: co-location of geodetic techniques in space
- 2023
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Ingår i: Earth, Planets and Space. - : Springer Science and Business Media LLC. - 1880-5981 .- 1343-8832. ; 75:1
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Tidskriftsartikel (refereegranskat)abstract
- Improving and homogenizing time and space reference systems on Earth and, more specifically, realizing the Terrestrial Reference Frame (TRF) with an accuracy of 1 mm and a long-term stability of 0.1 mm/year are relevant for many scientific and societal endeavors. The knowledge of the TRF is fundamental for Earth and navigation sciences. For instance, quantifying sea level change strongly depends on an accurate determination of the geocenter motion but also of the positions of continental and island reference stations, such as those located at tide gauges, as well as the ground stations of tracking networks. Also, numerous applications in geophysics require absolute millimeter precision from the reference frame, as for example monitoring tectonic motion or crustal deformation, contributing to a better understanding of natural hazards. The TRF accuracy to be achieved represents the consensus of various authorities, including the International Association of Geodesy (IAG), which has enunciated geodesy requirements for Earth sciences. Moreover, the United Nations Resolution 69/266 states that the full societal benefits in developing satellite missions for positioning and Remote Sensing of the Earth are realized only if they are referenced to a common global geodetic reference frame at the national, regional and global levels. Today we are still far from these ambitious accuracy and stability goals for the realization of the TRF. However, a combination and co-location of all four space geodetic techniques on one satellite platform can significantly contribute to achieving these goals. This is the purpose of the GENESIS mission, a component of the FutureNAV program of the European Space Agency. The GENESIS platform will be a dynamic space geodetic observatory carrying all the geodetic instruments referenced to one another through carefully calibrated space ties. The co-location of the techniques in space will solve the inconsistencies and biases between the different geodetic techniques in order to reach the TRF accuracy and stability goals endorsed by the various international authorities and the scientific community. The purpose of this paper is to review the state-of-the-art and explain the benefits of the GENESIS mission in Earth sciences, navigation sciences and metrology. This paper has been written and supported by a large community of scientists from many countries and working in several different fields of science, ranging from geophysics and geodesy to time and frequency metrology, navigation and positioning. As it is explained throughout this paper, there is a very high scientific consensus that the GENESIS mission would deliver exemplary science and societal benefits across a multidisciplinary range of Navigation and Earth sciences applications, constituting a global infrastructure that is internationally agreed to be strongly desirable. Graphical Abstract: [Figure not available: see fulltext.]
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| 5. |
- Aalto, Susanne, 1964, et al.
(författare)
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ALMA resolves the remarkable molecular jet and rotating wind in the extremely radio-quiet galaxy NGC 1377
- 2020
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 640
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Tidskriftsartikel (refereegranskat)abstract
- Submillimetre and millimetre line and continuum observations are important in probing the morphology, column density, and dynamics of the molecular gas and dust around obscured active galactic nuclei (AGNs) and their mechanical feedback. With very high-resolution (0.'' 02x0.'' 03 (2x3 pc)) ALMA 345 GHz observations of CO 3-2, HCO+ 4-3, vibrationally excited HCN 4-3 nu (2)=1f, and continuum we have studied the remarkable, extremely radio-quiet, molecular jet and wind of the lenticular galaxy NGC 1377. The outflow structure is resolved, revealing a 150 pc long, clumpy, high-velocity (similar to 600 km s(-1)), collimated molecular jet where the molecular emission is emerging from the spine of the jet with an average diameter of 3-7 pc. The jet widens to 10-15 pc about 25 pc from the centre, which is possibly due to jet-wind interactions. A narrow-angle (50 degrees -70 degrees), misaligned and rotating molecular wind surrounds the jet, and both are enveloped by a larger-scale CO-emitting structure at near-systemic velocity. The jet and narrow wind have steep radial gas excitation gradients and appear turbulent with high gas dispersion (sigma> 40 km s(-1)). The jet shows velocity reversals that we propose are caused by precession, or more episodic directional changes. We discuss the mechanisms powering the outflow, and we find that an important process for the molecular jet and narrow wind is likely magneto-centrifugal driving. In contrast, the large-scale CO-envelope may be a slow wind, or cocoon that stems from jet-wind interactions. An asymmetric, nuclear r similar to 2 pc dust structure with a high inferred molecular column density N(H-2) similar or equal to 1.8x10(24) cm(-2) is detected in continuum and also shows compact emission from vibrationally excited HCN. The nuclear dust emission is hot (T-d> 180 K) and its luminosity is likely powered by a buried AGN. The lopsided structure appears to be a warped disk, which is responsible for a significant part of the nuclear obscuration and possibly formed as a result of uneven gas inflows. The dynamical mass inside r=1.4 pc is estimated to 9(-3)(+2) x 10(6)M(circle dot) 9 - 3 + 2 x 10 6 M circle dot , implying that the supermassive black hole (SMBH) has a high mass with respect to the stellar velocity dispersion of NGC 1377. We suggest that the SMBH of NGC 1377 is currently in a state of moderate growth, at the end of a more intense phase of accretion and also evolving from a state of more extreme nuclear obscuration. The nuclear growth may be fuelled by low-angular momentum gas inflowing from the gas ejected in the molecular jet and wind. Such a feedback-loop of cyclic outflows and central accretion could explain why there is still a significant reservoir of molecular gas in this ageing, lenticular galaxy. A feedback-loop would be an effective process in growing the nuclear SMBH and thus would constitute an important phase in the evolution of NGC 1377. This also invites new questions as to SMBH growth processes in obscured, dusty galaxies.
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| 6. |
- Armus, Lee, et al.
(författare)
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GOALS-JWST: Mid-infrared Spectroscopy of the Nucleus of NGC 7469
- 2023
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Ingår i: Astrophysical Journal Letters. - : American Astronomical Society. - 2041-8213 .- 2041-8205. ; 942:2
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Tidskriftsartikel (refereegranskat)abstract
- We present mid-infrared spectroscopic observations of the nucleus of the nearby Seyfert galaxy NGC 7469 taken with the MIRI instrument on the James Webb Space Telescope (JWST) as part of Directors Discretionary Time Early Release Science program 1328. The high-resolution nuclear spectrum contains 19 emission lines covering a wide range of ionization. The high-ionization lines show broad, blueshifted emission reaching velocities up to 1700 km s−1 and FWHM ranging from ∼500 to 1100 km s−1. The width of the broad emission and the broad-to-narrow line flux ratios correlate with ionization potential. The results suggest a decelerating, stratified, AGN-driven outflow emerging from the nucleus. The estimated mass outflow rate is 1-2 orders of magnitude larger than the current black hole accretion rate needed to power the AGN. Eight pure rotational H2 emission lines are detected with intrinsic widths ranging from FWHM ∼125 to 330 km s−1. We estimate a total mass of warm H2 gas of ∼1.2 × 107 M ⊙ in the central 100 pc. The PAH features are extremely weak in the nuclear spectrum, but a 6.2 μm PAH feature with an equivalent width of ∼0.07 μm and a flux of 2.7 × 10−17 W m−2 is detected. The spectrum is steeply rising in the mid-infrared, with a silicate strength of ∼0.02, significantly smaller than seen in most PG QSOs but comparable to other Seyfert 1s. These early MIRI mid-infrared IFU data highlight the power of JWST to probe the multiphase interstellar media surrounding actively accreting supermassive black holes.
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| 7. |
- Audibert, A., et al.
(författare)
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Black hole feeding and star formation in NGC 1808
- 2021
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 656
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Tidskriftsartikel (refereegranskat)abstract
- We report on Atacama Large Millimeter Array (ALMA) observations of CO(3-2) emission in the Seyfert2/starburst galaxy NGC1808, at a spatial resolution of 4 pc. Our aim is to investigate the morphology and dynamics of the gas inside the central 0.5 kpc and to probe the nuclear feeding and feedback phenomena. We discovered a nuclear spiral of radius 100 = 45 pc. Within it, we found a decoupled circumnuclear disk or molecular torus of a radius of 0:1300 = 6 pc. The HCN(4-3) and HCO+(4-3) and CS(7-6) dense gas line tracers were simultaneously mapped and detected in the nuclear spiral and they present the same misalignment in the molecular torus. At the nucleus, the HCN/HCO+ and HCN/CS ratios indicate the presence of an active galactic nucleus (AGN). The molecular gas shows regular rotation, within a radius of 400 pc, except for the misaligned disk inside the nuclear spiral arms. The computations of the torques exerted on the gas by the barred stellar potential reveal that the gas within a radius of 100 pc is feeding the nucleus on a timescale of five rotations or on an average timescale of 60 Myr. Some non-circular motions are observed towards the center, corresponding to the nuclear spiral arms. We cannot rule out that small extra kinematic perturbations could be interpreted as a weak outflow attributed to AGN feedback. The molecular outflow detected at 250 pc in the NE direction is likely due to supernovae feedback and it is connected to the kpc-scale superwind.
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| 8. |
- Barrientos, Alejandro, et al.
(författare)
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Towards the prediction of molecular parameters from astronomical emission lines using Neural Networks
- 2021
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Ingår i: Experimental Astronomy. - : Springer Science and Business Media LLC. - 0922-6435 .- 1572-9508. ; 52:1-2, s. 157-182
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Tidskriftsartikel (refereegranskat)abstract
- Molecular astronomy is a field that is blooming in the era of large observatories such as the Atacama Large Millimeter/Submillimeter Array (ALMA). With modern, sensitive, and high spectral resolution radio telescopes like ALMA and the Square Kilometer Array, the size of the data cubes is rapidly escalating, generating a need for powerful automatic analysis tools. This work introduces MolPred, a pilot study to perform predictions of molecular parameters such as excitation temperature (Tex) and column density (log(N)) from input spectra by the use of neural networks. We used as test cases the spectra of CO, HCO+, SiO and CH3CN between 80 and 400 GHz. Training spectra were generated with MADCUBA, a state-of-the-art spectral analysis tool. Our algorithm was designed to allow the generation of predictions for multiple molecules in parallel. Using neural networks, we can predict the column density and excitation temperature of these molecules with a mean absolute error of 8.5% for CO, 4.1% for HCO+, 1.5% for SiO and 1.6% for CH3CN. The prediction accuracy depends on the noise level, line saturation, and number of transitions. We performed predictions upon real ALMA data. The values predicted by our neural network for this real data differ by 13% from the MADCUBA values on average. Current limitations of our tool include not considering linewidth, source size, multiple velocity components, and line blending.
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| 9. |
- Bianchin, Marina, et al.
(författare)
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GOALS-JWST: Gas Dynamics and Excitation in NGC 7469 Revealed by NIRSpec
- 2024
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Ingår i: Astrophysical Journal. - 1538-4357 .- 0004-637X. ; 965:2
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Tidskriftsartikel (refereegranskat)abstract
- We present new JWST NIRSpec integral field spectroscopy (IFS) data for the luminous infrared galaxy NGC 7469, a nearby (70.6 Mpc) active galaxy with a Seyfert 1.5 nucleus that drives a highly ionized gas outflow and a prominent nuclear star-forming ring. Using the superb sensitivity and high spatial resolution of the JWST instrument NIRSpec IFS, we investigate the role of the Seyfert nucleus in the excitation and dynamics of the circumnuclear gas. Our analysis focuses on the [Fe ii], H2, and hydrogen recombination lines that trace the radiation/shocked-excited molecular and ionized interstellar medium around the active galactic nucleus (AGN). We investigate gas excitation through H2/Brγ and [Fe ii]/Paβ emission line ratios and find that photoionization by the AGN dominates within the central 300 pc of the galaxy except in a small region that shows signatures of shock-heated gas; these shock-heated regions are likely associated with a compact radio jet. In addition, the velocity field and velocity dispersion maps reveal complex gas kinematics. Rotation is the dominant feature, but we also identify noncircular motions consistent with gas inflows as traced by the velocity residuals and the spiral pattern in the Paα velocity dispersion map. The inflow is 2 orders of magnitude higher than the AGN accretion rate. The compact nuclear radio jet has enough power to drive the highly ionized outflow. This scenario suggests that the inflow and outflow are in a self-regulating feeding-feedback process, with a contribution from the radio jet helping to drive the outflow.
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| 10. |
- Cicone, Claudia, et al.
(författare)
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Enhanced UV radiation and dense clumps in the molecular outflow of Mrk 231
- 2020
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 633
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Tidskriftsartikel (refereegranskat)abstract
- We present interferometric observations of the CN(1-0) line emission in Mrk 231 and combine them with previous observations of CO and other H-2 gas tracers to study the physical properties of the massive molecular outflow. We find a strong boost of the CN/CO(1-0) line luminosity ratio in the outflow of Mrk 231, which is unprecedented compared to any other known Galactic or extragalactic astronomical source. For the dense gas phase in the outflow traced by the HCN and CN emissions, we infer X-CN equivalent to [CN]/[H-2]> X-HCN by at least a factor of three, with H-2 gas densities of n(H2) similar to 10(5-6)& x2006;cm(-3). In addition, we resolve for the first time narrow spectral features in the HCN(1-0) and HCO+(1-0) high-velocity line wings tracing the dense phase of the outflow. The velocity dispersions of these spectral features, sigma(v) similar to 7-20 km s(-1), are consistent with those of massive extragalactic giant molecular clouds detected in nearby starburst nuclei. The H-2 gas masses inferred from the HCN data are quite high, M-mol similar to 0.3-5 x 10(8) M-circle dot. Our results suggest that massive complexes of denser molecular gas survive embedded into the more diffuse H-2 phase of the outflow, and that the chemistry of these outflowing dense clouds is strongly affected by UV radiation.
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