The Effect of Porosity on X-ray Emission Line Profiles from Hot-Star Winds

We investigate the degree to which the nearly symmetric form of X-ray emission lines seen in Chandra spectra of early-type supergiant stars could be explained by a possibly porous nature of their spatially structured stellar winds. Such porosity could effectively reduce the bound-free absorption of X-rays emitted by embedded wind shocks, and thus allow a more similar transmission of red- vs. blue-shifted emission from the back vs. front hemispheres. For a medium consisting of clumps of size l and volume filling factor f, in which the `porosity length' h=l/f increases with local radius as h = h' r, we find that a substantial reduction in wind absorption requires a quite large porosity scale factor h' > 1, implying large porosity lengths h > r. The associated wind structure must thus have either a relatively large scale l~ r, or a small volume filling factor f ~ l/r << 1, or some combination of these. The relatively small-scale, moderate compressions generated by intrinsic instabilities in line-driving seem unlikely to give such large porosity lengths, leaving again the prospect of instead having to invoke a substantial (ca. factor 5) downward revision in assumed mass-loss rates.Comment: 6 pages in apj-emulate; 3 figures; submitted to Ap

Deposing the Cool Corona of KPD 0005+5106

The ROSAT PSPC pulse height spectrum of the peculiar He-rich hot white dwarf KPD 0005+5106 provided a great surprise when first analysed by Fleming, Werner & Barstow (1993). It defied the best non-LTE modelling attempts in terms of photospheric emission from He-dominated atmospheres including C, N and O and was instead interpreted as the first evidence for a coronal plasma around a white dwarf. We show here that a recent high resolution Chandra LETGS spectrum has more structure than expected from a thermal bremsstrahlung continuum and lacks the narrow lines of H-like and He-like C expected from a coronal plasma. Moreover, a coronal model requires a total luminosity more than two orders of magnitude larger than that of the star itself. Instead, the observed 20-80 AA flux is consistent with photospheric models containing trace amounts of heavier elements such as Fe. The soft X-ray flux is highly sensitive to the adopted metal abundance and provides a metal abundance diagnostic. The weak X-ray emission at 1 keV announced by O'Dwyer et al (2003) instead cannot arise from the photosphere and requires alternative explanations. We echo earlier speculation that such emission arises in a shocked wind. Despite the presence of UV-optical O VIII lines from transitions between levels n=7-10, no X-ray O VIII Ly alpha flux is detected. We show that O VIII Lyman photons can be trapped by resonant scattering within the emitting plasma and destroyed by photoelectric absorption.Comment: 15 Pages, 4 figures. Accepted for the Astrophysical Journa

To what extent are psychiatrists aware of the comorbid somatic illnesses of their patients with serious mental illnesses? – a cross-sectional secondary data analysis

Background Somatic comorbidities are a serious problem in patients with severe mental illnesses. These comorbidities often remain undiagnosed for a long time. In Germany, physicians are not allowed to access patients’ health insurance data and do not have routine access to documentation from other providers of health care. Against this background, the objective of this article was to investigate psychiatrists’ knowledge of relevant somatic comorbidities in their patients with severe mental illnesses. Methods Cross- sectional secondary data analysis was performed using primary data from a prospective study evaluating a model of integrated care of patients with serious mental illnesses. The primary data were linked with claims data from health insurers. Patients’ diagnoses were derived on the basis of the ICD-10 and the Anatomical Therapeutic Chemical (ATC) classification system. Diabetes, hypertension, coronary artery disease (CAD), hyperlipidaemia, glaucoma, osteoporosis, polyarthritis and chronic obstructive pulmonary disease (COPD) were selected for evaluation. We compared the number of diagnoses reported in the psychiatrists’ clinical report forms with those in the health insurance data. Results The study evaluated records from 1,195 patients with severe mental illnesses. The frequency of documentation of hypertension ranged from 21% in claims data to 4% in psychiatrists’ documentation, for COPD from 12 to 0%, respectively, and for diabetes from 7 to 2%, respectively. The percentage of diagnoses deduced from claims data but not documented by psychiatrists ranged from 68% for diabetes and 83% for hypertension, to 90% for CAD to 98% for COPD. Conclusions The majority of psychiatrists participating in the integrated care programme were insufficiently aware of the somatic comorbidities of their patients. We support allowing physicians to access patients’ entire medical records to increase their knowledge of patients’ medical histories and, consequently, to increase the safety and quality of care

Frequency and clinical relevance of potential cytochrome P450 drug interactions in a psychiatric patient population – an analysis based on German insurance claims data

Background Numerous drugs used in the treatment of psychiatric disorders are substrates of cytochrome P450 enzymes and are potential candidates for drug- drug interactions (DDIs). Methods Claims data of a German statutory health insurance company from severely mentally ill patients who registered in an integrated care contract from August 2004 to December 2009 were analysed. We measured time periods of concomitant prescription of drugs that have been reported to interact via cytochrome P450, with a focus on drugs acting as strong inhibitors. Such drug-drug exposure (DDE) is an incontrovertible precursor of DDIs. We assessed whether potential DDIs were considered clinically relevant based on the prescribing information of the respective drugs. Results Among all 1221 patients, 186 patients (15.2 %; Clopper-Pearson 95 % confidence interval (CI): 13.3–17.4 %) had at least one DDE prescription, and 58 patients (4.8 %; 95 % CI 3.6–6.1) had at least one DDE prescription involving a strong cytochrome P450 inhibitor. In 59 patients, (4.8 %; 95 % CI: 3.7–6.2 %) five or more DDEs were identified, and five or more DDEs with a strong inhibitor were identified in 18 patients (1.5 %; 95 % CI: 0.9–2.3). The rates of DDEs were 0.27 (Garwood 95%CI: 0.25–0.28) per person-year and 0.07 (95 % CI: 0.07–0.08) for strong-inhibitor DDEs. Four of the ten most frequent DDEs were identified as clinically relevant, and seven of the eight most frequent DDEs involving a strong inhibitor were clinically relevant. Conclusions The number of patients with DDEs was not alarmingly high in our sample. Nevertheless, prescription information showed that some prescribed drug combinations could result in serious adverse consequences that are known to weaken or strengthen the effect of the drugs and should therefore be avoided

A detailed X-ray investigation of zeta Puppis I. The dataset and some preliminary results

Aims: zeta Puppis, one of the closest and brightest massive stars, was the first early-type object observed by the current generation of X-ray observatories. These data provided some surprising results, confirming partly the theoretical predictions while simultaneously unveiling some problematic mismatches with expectations. In this series of papers, we perform a thorough study of zeta Puppis in X-rays, using a decade of XMM observations. Methods: zeta Puppis was observed 18 times by XMM, totaling 1Ms in exposure. This provides the highest-quality high-resolution X-ray spectrum of a massive star to date, as well as a perfect dataset for studying X-ray variability in an "archetype" object. Results: This first paper reports on the data reduction of this unique dataset and provides a few preliminary results. On the one hand, the analysis of EPIC low-resolution spectra shows the star to have a remarkably stable X-ray emission from one observation to the next. On the other hand, the fitting by a wind model of individual line profiles recorded by RGS confirms the wavelength dependence of the line morphology.Comment: 9 pages, 3 figures, accepted for publication by A&