Health-related quality of life in relation to shark symptomatic and radiographic definitions of knee osteoarthritis : data from Osteoarthritis Initiative (OAI) 4-year follow- up study

Background: The purpose was to quantify the decrement in health utility (referred as disutility) associated with knee osteoarthritis (OA) and different symptomatic and radiographic uni- and bilateral definitions of knee OA in a repeated measures design of persons with knee OA or at increased risk of developing knee OA. Methods: Data were obtained from the Osteoarthritis Initiative database. SF-12 health-related quality of life was converted into SF-6D utilities, and were then handled as the health utility loss by subtracting 1.000 from the utility score, yielding a negative value (disutility). Symptomatic OA was defined by radiographic findings (Kellgren-Lawrence, K-L, grade >= 2) and frequent knee pain in the same knee. Radiographic OA was defined by five different definitions (K-L >= 2 unilaterally / bilaterally, or the highest / mean / combination of K-L grades of both knees). Repeated measures generalized estimating equation (GEE) models were used to investigate disutility in relation to these different definitions. Results: Utility decreased with worsening of symptomatic or radiographic status of knee OA. The participants with bilateral and unilateral symptomatic knee OA had 0.03 (p <0.001) and 0.02 (p <0.001) points lower utility scores, respectively, compared with the reference group. The radiographic K-L grade 4 defined as the mean or the highest grade of both knees was related to a decrease of 0.04 (p <0.001) and 0.03 (p <0.001) points in utility scores, respectively, compared to the reference group. Conclusions: Knee OA is associated with diminished health-related quality of life. Health utility can be quantified in relation to both symptomatic and radiographic uni- and bilateral definitions of knee OA, and these definitions are associated with differing disutilities. The performance of symptomatic definition was better, indicating that pain experience is an important factor in knee OA related quality of life.Peer reviewe

X-raying the Beating Heart of a Newborn Star: Rotational Modulation of High-energy Radiation from V1647 Ori

We report a periodicity of ~1 day in the highly elevated X-ray emission from the protostar V1647 Ori during its two recent multiple-year outbursts of mass accretion. This periodicity is indicative of protostellar rotation at near-breakup speed. Modeling of the phased X-ray light curve indicates the high-temperature (~50 MK), X-ray-emitting plasma, which is most likely heated by accretion-induced magnetic reconnection, resides in dense (>~5e10 cm-3), pancake-shaped magnetic footprints where the accretion stream feeds the newborn star. The sustained X-ray periodicity of V1647 Ori demonstrates that such protostellar magnetospheric accretion configurations can be stable over timescales of years.Comment: 26 pages, 10 figure

Charged Scalar Particles and τ\tau Leptonic Decay

Charged scalar particles introduced in some extensions of the standard model can induce $\tau$ leptonic decay at tree level. We find that with some charged SU(2)-singlet scalar particles, like ones introduced in Zee-type models, $\tau$ leptonic decay width is always smaller than what is predicted by the standard model, therefore they may offer a natural solution to $\tau$ decay puzzle. To be more specific, we examine some Zee-type models in detail to see if at the same time they are acceptable in particle physics, cosmology and astrophysics. It is shown that $\tau$ decay data do put some constrains on these models.Comment: ICTP Report No. IC/93/31, 12 pages, Latex, one figure is not included, it is available upon deman

Solar Flares and Coronal Mass Ejections: A Statistically Determined Flare Flux-CME Mass Correlation

In an effort to examine the relationship between flare flux and corresponding CME mass, we temporally and spatially correlate all X-ray flares and CMEs in the LASCO and GOES archives from 1996 to 2006. We cross-reference 6,733 CMEs having well-measured masses against 12,050 X-ray flares having position information as determined from their optical counterparts. For a given flare, we search in time for CMEs which occur 10-80 minutes afterward, and we further require the flare and CME to occur within +/-45 degrees in position angle on the solar disk. There are 826 CME/flare pairs which fit these criteria. Comparing the flare fluxes with CME masses of these paired events, we find CME mass increases with flare flux, following an approximately log-linear, broken relationship: in the limit of lower flare fluxes, log(CME mass)~0.68*log(flare flux), and in the limit of higher flare fluxes, log(CME mass)~0.33*log(flare flux). We show that this broken power-law, and in particular the flatter slope at higher flare fluxes, may be due to an observational bias against CMEs associated with the most energetic flares: halo CMEs. Correcting for this bias yields a single power-law relationship of the form log(CME mass)~0.70*log(flare flux). This function describes the relationship between CME mass and flare flux over at least 3 dex in flare flux, from ~10^-7 to 10^-4 W m^-2.Comment: 28 pages, 16 figures, accepted to Solar Physic

Physicians' views on patient participation in choice of oral anticoagulants in atrial fibrillation-a qualitative study

Direct oral anticoagulants provide an alternative to vitamin K antagonists for the anticoagulation therapy in atrial fibrillation (AF). The availability of several treatment options with different attributes makes shared decision-making appropriate for the choice of anticoagulation therapy. The aim of this study was to understand how physicians choose an oral anticoagulant (OAC) for patients with AF and how physicians view patients' participation in this decision. Semi-structured interviews with 17 Finnish physicians (eight general practitioners and nine specialists) working in the public sector were conducted. An interview guide on experience, prescribing and opinions about oral anticoagulants was developed based on previous literature. The data were thematically analysed using deductive and inductive approaches. Based on the interviews, patient's opinion was the most influential factor in decision-making when there were no clinical factors limiting the choice between OACs. Of patient's preferences, the most important was the attitude towards co-payments of OACs. Patients' opinions on monitoring of treatment, dosing and antidote availability were also mentioned by the interviewees. The choice of an OAC in AF was patient-centred as all interviewees expressed that patient's opinion affects the choice.</p

Rationality as the Rule of Reason

The demands of rationality are linked both to our subjective normative perspective (given that rationality is a person-level concept) and to objective reasons or favoring relations (given that rationality is non-contingently authoritative for us). In this paper, I propose a new way of reconciling the tension between these two aspects: roughly, what rationality requires of us is having the attitudes that correspond to our take on reasons in the light of our evidence, but only if it is competent. I show how this view can account for structural rationality on the assumption that intentions and beliefs as such involve competent perceptions of downstream reasons, and explore various implications of the account

FU Orionis disk outburst: evidence for a gravitational instability scenario triggered in a magnetically dead zone

Context: FUors outbursts are a crucial stage of accretion in young stars. However a complete mechanism at the origin of the outburst still remains missing. Aims: We aim at constraining the instability mechanism in FU Orionis star itself, by directly probing the size and the evolution in time of the outburst region with near-infrared interferometry, and to confront it to physical models of this region. Methods: FU Orionis has been a regular target of near-infrared interferometry. In this paper, we analyze more than 20 years of interferometric observations to perform a temporal monitoring of the region of the outburst, and compare it to the spatial structure deduced from 1D MHD simulations. Results: We measure from the interferometric observations that the size variation of the outburst region is compatible with a constant or slightly decreasing size over time in the H and K band. The temporal variation and the mean sizes are consistently reproduced by our 1D MHD simulations. We find that the most compatible scenario is a model of an outburst occurring in a magnetically layered disk, where a Magneto-Rotational Instability (MRI) is triggered by a Gravitational Instability (GI) at the outer edge of a dead-zone. The scenario of a pure Thermal Instability (TI) fails to reproduce our interferometric sizes since it can only be sustained in a very compact zone of the disk <0.1 AU. The scenario of MRI-GI could be compatible with an external perturbation enhancing the GI, such as tidal interactions with a stellar companion, or a planet at the outer edge of the dead-zone. Conclusions: The layered disk model driven by MRI turbulence is favored to interpret the spatial structure and temporal evolution of FU Orionis outburst region. Understanding this phase gives a crucial link between the early phase of disk evolution and the process of planet formation in the first inner AUs.Comment: Accepted for publication in A&