Context. Ultra-low frequency observations (< 100 MHz) are particularly challenging because they are usually performed in a low signal-to-noise ratio regime due to the high sky temperature and... Show moreContext. Ultra-low frequency observations (< 100 MHz) are particularly challenging because they are usually performed in a low signal-to-noise ratio regime due to the high sky temperature and because of ionospheric disturbances whose effects are inversely proportional to the observing frequency. Nonetheless, these observations are crucial for studying the emission from low-energy populations of cosmic rays.Aims. We aim to obtain the first thermal-noise limited (similar to 1.5 mJy beam(-1)) deep continuum radio map using the Low Frequency Array's Low Band Antenna (LOFAR LBA) system. Our demonstration observation targeted the galaxy cluster RX J0603.3+4214 (known as the Toothbrush cluster). We used the resulting ultra-low frequency (39-78 MHz) image to study cosmic-ray acceleration and evolution in the post shock region considering the presence of a radio halo.Methods. We describe the data reduction we used to calibrate LOFAR LBA observations. The resulting image was combined with observations at higher frequencies (LOFAR 150 MHz and VLA 1500 MHz) to extract spectral information.Results. We obtained the first thermal-noise limited image from an observation carried out with the LOFAR LBA system using all Dutch stations at a central frequency of 58 MHz. With eight hours of data, we reached an rms noise of 1.3 mJy beam(-1) at a resolution of 18 '' x11 ''.Conclusions. The procedure we developed is an important step towards routine high-fidelity imaging with the LOFAR LBA. The analysis of the radio spectra shows that the radio relic extends to distances of 800 kpc downstream from the shock front, larger than what is allowed by electron cooling time. Furthermore, the shock wave started accelerating electrons already at a projected distance of < 300 kpc from the crossing point of the two clusters. These results may be explained by electrons being re-accelerated downstream by background turbulence, possibly combined with projection effects with respect to the radio halo. Show less
Gasperin, F. de; Brunetti, G.; Brüggen, M.; Weeren, R.J. van; Williams, W.L.; Botteon, A.; ... ; Shimwell, T. 2020
ImportanceLocoregionally advanced head and neck squamous cell cancer (HNSCC) is treated curatively; however, risk of recurrence remains high among some patients. The ERBB family blocker afatinib... Show moreImportanceLocoregionally advanced head and neck squamous cell cancer (HNSCC) is treated curatively; however, risk of recurrence remains high among some patients. The ERBB family blocker afatinib has shown efficacy in recurrent or metastatic HNSCC. ObjectiveTo assess whether afatinib therapy after definitive chemoradiotherapy (CRT) improves disease-free survival (DFS) in patients with HNSCC. Design, Setting, and ParticipantsThis multicenter, phase 3, double-blind randomized clinical trial (LUX-Head & Neck 2) studied 617 patients from November 2, 2011, to July 4, 2016. Patients who had complete response after CRT, comprising radiotherapy with cisplatin or carboplatin, with or without resection of residual disease, for locoregionally advanced high- or intermediate-risk HNSCC of the oral cavity, hypopharynx, larynx, or oropharynx were included in the study. Data analysis was of the intention-to-treat population. InterventionsPatients were randomized (2:1) to treatment with afatinib (40 mg/d) or placebo, stratified by nodal status (N0-2a or N2b-3) and Eastern Cooperative Oncology Group performance status (0 or 1). Treatment continued for 18 months or until disease recurrence, unacceptable adverse events, or patient withdrawal. Main Outcomes and MeasuresThe primary end point was DFS, defined as time from the date of randomization to the date of tumor recurrence or secondary primary tumor or death from any cause. Secondary end points were DFS at 2 years, overall survival (defined as time from the date of randomization to death), and health-related quality of life. ResultsA total of 617 patients were studied (mean [SD] age, 58 [8.4] years; 528 male [85.6%]). Recruitment was stopped after a preplanned interim futility analysis on July 4, 2016, on recommendation from an independent data monitoring committee. Treatment was discontinued. Median DFS was 43.4 months (95% CI, 37.4 months to not estimable) in the afatinib group and not estimable (95% CI, 40.1 months to not estimable) in the placebo group (hazard ratio, 1.13; 95% CI, 0.81-1.57; stratified log-rank test P=.48). The most common grade 3 and 4 drug-related adverse effects were acneiform rash (61 [14.8%] of 411 patients in the afatinib group vs 1 [0.5%] of 206 patients in the placebo group), stomatitis (55 [13.4%] in the afatinib group vs 1 [0.5%] in the placebo group), and diarrhea (32 [7.8%] in the afatinib group vs 1 [0.5%] in the placebo group). Conclusions and RelevanceThis study's findings indicate that treatment with afatinib after CRT did not improve DFS and was associated with more adverse events than placebo in patients with primary, unresected, clinically high- to intermediate-risk HNSCC. The use of adjuvant afatinib after CRT is not recommended. Trial RegistrationClinicalTrials.gov identifier: NCT01345669 Show less
Weeren, R.J. van; Gasperin, F. de; Akamatsu, H.; Brüggen, M.; Feretti, L.; Kang, H.; ... ; Zandanel, F. 2019
On the largest scales, the Universe consists of voids and filaments making up the cosmic web. Galaxy clusters are located at the knots in this web, at the intersection of filaments. Clusters grow... Show moreOn the largest scales, the Universe consists of voids and filaments making up the cosmic web. Galaxy clusters are located at the knots in this web, at the intersection of filaments. Clusters grow through accretion from these large-scale filaments and by mergers with other clusters and groups. In a growing number of galaxy clusters, elongated Mpc-sized radio sources have been found1,2 . Also known as radio relics, these regions of diffuse radio emission are thought to trace relativistic electrons in the intracluster plasma accelerated by low-Mach-number shocks generated by cluster–cluster merger events 3 . A long-standing problem is how low-Mach-number shocks can accelerate electrons so efficiently to explain the observed radio relics. Here, we report the discovery of a direct connection between a radio relic and a radio galaxy in the merging galaxy cluster Abell 3411–3412 by combining radio, X-ray and optical observations. This discovery indicates that fossil relativistic electrons from active galactic nuclei are re-accelerated at cluster shocks. It also implies that radio galaxies play an important role in governing the non-thermal component of the intracluster medium in merging clusters. Show less
