A hemispherical power asymmetry from inflation

Measurements of cosmic microwave background temperature fluctuations by the Wilkinson Microwave Anisotropy Probe indicate that the fluctuation amplitude in one half of the sky differs from the amplitude in the other half. We show that such an asymmetry cannot be generated during single-field slow-roll inflation without violating constraints to the homogeneity of the Universe. In contrast, a multifield inflationary theory, the curvaton model, can produce this power asymmetry without violating the homogeneity constraint. The mechanism requires the introduction of a large-amplitude superhorizon perturbation to the curvaton field, possibly a preinflationary remnant or a superhorizon curvaton-web structure. The model makes several predictions, including non-Gaussianity and modifications to the inflationary consistency relation, that will be tested with forthcoming cosmic microwave background experiments

Superhorizon perturbations and the cosmic microwave background

Superhorizon perturbations induce large-scale temperature anisotropies in the cosmic microwave background (CMB) via the Grishchuk-Zel'dovich effect. We analyze the CMB temperature anisotropies generated by a single-mode adiabatic superhorizon perturbation. We show that an adiabatic superhorizon perturbation in a ΛCDM universe does not generate a CMB temperature dipole, and we derive constraints to the amplitude and wavelength of a superhorizon potential perturbation from measurements of the CMB quadrupole and octupole. We also consider constraints to a superhorizon fluctuation in the curvaton field, which was recently proposed as a source of the hemispherical power asymmetry in the CMB

Are metabolic equivalents (METS) an accurate method for estimating change in peak oxygen consumption after cardiac rehabilitation?

Background: Maximal cardiopulmonary exercise testing (CPET) is the “gold standard” method of determining Vo2peak. When CPET is unavailable, VO2peak and metabolic equivalents (METs) are estimated from treadmill or cycle ergometer workloads. UK cardiac rehabilitation programmes (CR) use estimated METs to report changes in cardiorespiratory fitness (CRF). However, the accuracy of determining changes in VO2peak based on changes in estimated METs is not known. Methods: 27 patients with coronary heart disease (88.9% male; age 59.5 ± 10.0 years, body mass index 29.6 ± 3.8 kg.m-2) performed maximal CPET before and after an exercise based CR intervention. VO2peak was directly determined using ventilatory gas exchange data and was also estimated using the American College of Sports Medicine (ACSM) leg cycling equation for METs. Agreement between changes in directly determined VO2peak and VO2peak estimated from METs was tested using Bland-Altman limits of agreement (LoA), and intraclass correlation coefficients. Results: Directly determined VO2peak did not increase significantly following CR (0.5 ml.kg-1.min-1 (2.7%); p=0.332). In contrast, estimated VO2peak increased significantly (0.4 METs; 1.4 ml.kg-1.min-1; 6.7%; p=0.006). The mean bias for estimated VO2peak versus directly-determined VO2peak was 0.7 ml.kg-1.min-1 (LoA -4.7 to 5.9 ml.kg-1.min-1). Aerobic efficiency, (ΔVO2/ΔWR slope) was significantly associated with estimated VO2peak measurement error. Conclusion: Changes in estimated VO2peak determined using the ACSM equation for leg cycling are not accurate surrogates for directly determined changes in VO2peak. Reporting mean CRF changes using estimated METs may over-estimate the efficacy of CR and lead to a different interpretation of study findings compared to directly determined VO2peak

Gauged Dimension Bubbles

Some of the peculiar electrodynamical effects associated with gauged ``dimension bubbles'' are presented. Such bubbles, which effectively enclose a region of 5d spacetime, can arise from a 5d theory with a compact extra dimension. Bubbles with thin domain walls can be stabilized against total collapse by the entrapment of light charged scalar bosons inside the bubble, extending the idea of a neutral dimension bubble to accommodate the case of a gauged U(1) symmetry. Using a dielectric approach to the 4d dilaton-Maxwell theory, it is seen that the bubble wall is almost totally opaque to photons, leading to a new stabilization mechanism due to trapped photons. Photon dominated bubbles very slowly shrink, resulting in a temperature increase inside the bubble. At some critical temperature, however, these bubbles explode, with a release of radiation.Comment: 14 pages, no figures; to appear in Phys.Rev.

Routine exercise-based cardiac rehabilitation does not increase aerobic fitness: A CARE CR study

Background Recent evidence suggests that routine exercise-based cardiac rehabilitation (CR) may not lead to a substantial increase in estimated peak oxygen uptake (V̇O2peak). This could reduce the potential benefits of CR and explain why CR no longer improves patient survival in recent studies. We aimed to determine whether routine exercise-based CR increases V̇O2peak using gold-standard maximal cardiopulmonary exercise testing (CPET), and to quantify the exercise training stimulus which might be insufficient in patients undertaking CR. Methods We studied the effects of a routine, twice weekly, exercise-based CR programme for eight weeks (intervention group) compared with abstention from supervised exercise training (control group) in patients with coronary heart disease. The primary outcome was V̇O2peak measured using CPET. We also measured changes in body composition using dual X-ray absorptiometry, carotid intima-media thickness, hs-CRP and N-terminal pro B-type natriuretic peptide at baseline, 10 weeks and one year. We also calculated the Calibre 5-year all-cause mortality risk score. Results Seventy patients (age 63.1 SD10.0 years; BMI 29.2 SD4.0 kg·m−2; 86% male) were recruited (n = 48 intervention; n = 22 controls). The mean aerobic exercise training duration was 23 min per training session, and the mean exercise training intensity was 45.9% of heart rate reserve. V̇O2peak was 23·3 ml·kg-1·min−1 at baseline, and there were no changes in V̇O2peak between groups at any time point. The intervention had no effect on any of the secondary endpoints. Conclusion Routine CR does not lead to an increase in V̇O2peak and is unlikely to improve long-term outcomes

Shapes, contact angles, and line tensions of droplets on cylinders

Using an interface displacement model we calculate the shapes of nanometer-size liquid droplets on homogeneous cylindrical surfaces. We determine effective contact angles and line tensions, the latter defined as excess free energies per unit length associated with the two contact lines at the ends of the droplet. The dependences of these quantities on the cylinder radius and on the volume of the droplets are analyzed.Comment: 26 pages, RevTeX, 10 Figure

In-canopy gas-phase chemistry during CABINEX 2009: Sensitivity of a 1-D canopy model to vertical mixing and isoprene chemistry

Vegetation emits large quantities of biogenic volatile organic compounds (BVOC). At remote sites, these compounds are the dominant precursors to ozone and secondary organic aerosol (SOA) production, yet current field studies show that atmospheric models have difficulty in capturing the observed HOx cycle and concentrations of BVOC oxidation products. In this manuscript, we simulate BVOC chemistry within a forest canopy using a one-dimensional canopy-chemistry model (Canopy Atmospheric CHemistry Emission model; CACHE) for a mixed deciduous forest in northern Michigan during the CABINEX 2009 campaign. We find that the base-case model, using fully-parameterized mixing and the simplified biogenic chemistry of the Regional Atmospheric Chemistry Model (RACM), underestimates daytime in-canopy vertical mixing by 50–70% and by an order of magnitude at night, leading to discrepancies in the diurnal evolution of HOx, BVOC, and BVOC oxidation products. Implementing observed micrometeorological data from above and within the canopy substantially improves the diurnal cycle of modeled BVOC, particularly at the end of the day, and also improves the observation-model agreement for some BVOC oxidation products and OH reactivity. We compare the RACM mechanism to a version that includes the Mainz isoprene mechanism (RACM-MIM) to test the model sensitivity to enhanced isoprene degradation. RACM-MIM simulates higher concentrations of both primary BVOC (isoprene and monoterpenes) and oxidation products (HCHO, MACR+MVK) compared with RACM simulations. Additionally, the revised mechanism alters the OH concentrations and increases HO2. These changes generally improve agreement with HOx observations yet overestimate BVOC oxidation products, indicating that this isoprene mechanism does not improve the representation of local chemistry at the site. Overall, the revised mechanism yields smaller changes in BVOC and BVOC oxidation product concentrations and gradients than improving the parameterization of vertical mixing with observations, suggesting that uncertainties in vertical mixing parameterizations are an important component in understanding observed BVOC chemistry

Metacognition and lifelong e-learning: a contextual and cyclical process

Metacognition is arguably an important conceptualisation within the area of lifelong e- learning, with many theorists and practitioners claiming that it enhances the learning process. However, the lifelong, cyclical and flexible aspects of 'before', 'during' and 'after' metacognitions within lifelong e-learning (inclusive of whether an 'input' necessarily leads to a completed 'output') seem marginal within current areas of practical and theoretical debate. This article analyses Reeves's (1997) model of web-based learning in the context of the ADAPT project; a study of lifelong learners based in small and medium sized enterprises. The article focuses upon an analysis of this model's view of metacognition, and in the light of the project findings and literature review, aims to put forward an extended and expanded version of the model with reference to lifelong e-learnin

Identification of potential non-invasive biomarkers in diastrophic dysplasia.

Diastrophic dysplasia (DTD) is a recessive chondrodysplasia caused by pathogenic variants in the SLC26A2 gene encoding for a cell membrane sulfate/chloride antiporter crucial for sulfate uptake and glycosaminoglycan (GAG) sulfation. Research on a DTD animal model has suggested possible pharmacological treatment approaches. In view of future clinical trials, the identification of non-invasive biomarkers is crucial to assess the efficacy of treatments. Urinary GAG composition has been analyzed in several metabolic disorders including mucopolysaccharidoses. Moreover, the N-terminal fragment of collagen X, known as collagen X marker (CXM), is considered a real-time marker of endochondral ossification and growth velocity and was studied in individuals with achondroplasia and osteogenesis imperfecta. In this work, urinary GAG sulfation and blood CXM levels were investigated as potential biomarkers for individuals affected by DTD. Chondroitin sulfate disaccharide analysis was performed on GAGs isolated from urine by HPLC after GAG digestion with chondroitinase ABC and ACII, while CXM was assessed in dried blood spots. Results from DTD patients were compared with an age-matched control population. Undersulfation of urinary GAGs was observed in DTD patients with some relationship to the clinical severity and underlying SLC26A2 variants. Lower than normal CXM levels were observed in most patients, even if the marker did not show a clear pattern in our small patient cohort because CXM values are highly dependent on age, gender and growth velocity. In summary, both non-invasive biomarkers are promising assays targeting various aspects of the disorder including overall metabolism of sulfated GAGs and endochondral ossification

The management of diabetic ketoacidosis in children

The object of this review is to provide the definitions, frequency, risk factors, pathophysiology, diagnostic considerations, and management recommendations for diabetic ketoacidosis (DKA) in children and adolescents, and to convey current knowledge of the causes of permanent disability or mortality from complications of DKA or its management, particularly the most common complication, cerebral edema (CE). DKA frequency at the time of diagnosis of pediatric diabetes is 10%–70%, varying with the availability of healthcare and the incidence of type 1 diabetes (T1D) in the community. Recurrent DKA rates are also dependent on medical services and socioeconomic circumstances. Management should be in centers with experience and where vital signs, neurologic status, and biochemistry can be monitored with sufficient frequency to prevent complications or, in the case of CE, to intervene rapidly with mannitol or hypertonic saline infusion. Fluid infusion should precede insulin administration (0.1 U/kg/h) by 1–2 hours; an initial bolus of 10–20 mL/kg 0.9% saline is followed by 0.45% saline calculated to supply maintenance and replace 5%–10% dehydration. Potassium (K) must be replaced early and sufficiently. Bicarbonate administration is contraindicated. The prevention of DKA at onset of diabetes requires an informed community and high index of suspicion; prevention of recurrent DKA, which is almost always due to insulin omission, necessitates a committed team effort