The High Energy Telescope on EXIST

The Energetic X-ray Imaging Survey Telescope (EXIST) is a proposed next generation multi-wavelength survey mission. The primary instrument is a High Energy telescope (HET) that conducts the deepest survey for Gamma-ray Bursts (GRBs), obscured-accreting and dormant Supermassive Black Holes and Transients of all varieties for immediate followup studies by the two secondary instruments: a Soft X-ray Imager (SXI) and an Optical/Infrared Telescope (IRT). EXIST will explore the early Universe using high redshift GRBs as cosmic probes and survey black holes on all scales. The HET is a coded aperture telescope employing a large array of imaging CZT detectors (4.5 m^2, 0.6 mm pixel) and a hybrid Tungsten mask. We review the current HET concept which follows an intensive design revision by the HET imaging working group and the recent engineering studies in the Instrument and Mission Design Lab at the Goddard Space Flight Center. The HET will locate GRBs and transients quickly (<10-30 sec) and accurately (< 20") for rapid (< 1-3 min) onboard followup soft X-ray and optical/IR (0.3-2.2 micron) imaging and spectroscopy. The broad energy band (5-600 keV) and the wide field of view (~90 deg x 70 deg at 10% coding fraction) are optimal for capturing GRBs, obscured AGNs and rare transients. The continuous scan of the entire sky every 3 hours will establish a finely-sampled long-term history of many X-ray sources, opening up new possibilities for variability studies.Comment: 10 pages, 6 figures, 3 tables, SPIE conference proceedings (UV, X-ray, and Gamma-Ray Space Instrumentation for Astronomy XVI, 7435-9

Non-functional immunoglobulin G transcripts in a case of hyper-immunoglobulin M syndrome similar to type 4

86% of immunoglobulin G (IgG) heavy-chain gene transcripts were found to be non-functional in the peripheral blood B cells of a patient initially diagnosed with common variable immunodeficiency, who later developed raised IgM, whereas no non-functionally rearranged transcripts were found in the cells of seven healthy control subjects. All the patient's IgM heavy-chain and κ light-chain transcripts were functional, suggesting that either non-functional rearrangements were being selectively class-switched to IgG, or that receptor editing was rendering genes non-functional after class-switching. The functional γ-chain sequences showed a normal rate of somatic hypermutation while non-functional sequences contained few somatic mutations, suggesting that most came from cells that had no functional gene and therefore were not receiving signals for hypermutation. However, apoptosis of peripheral blood lymphocytes was not impaired. No defects have been found in any of the genes currently known to be responsible for hyper-IgM syndrome but the phenotype fits best to type 4

The 6-minute walk test and other endpoints in Duchenne muscular dystrophy: longitudinal natural history observations over 48 weeks from a multicenter study.

IntroductionDuchenne muscular dystrophy (DMD) subjects ≥5 years with nonsense mutations were followed for 48 weeks in a multicenter, randomized, double-blind, placebo-controlled trial of ataluren. Placebo arm data (N = 57) provided insight into the natural history of the 6-minute walk test (6MWT) and other endpoints.MethodsEvaluations performed every 6 weeks included the 6-minute walk distance (6MWD), timed function tests (TFTs), and quantitative strength using hand-held myometry.ResultsBaseline age (≥7 years), 6MWD, and selected TFT performance are strong predictors of decline in ambulation (Δ6MWD) and time to 10% worsening in 6MWD. A baseline 6MWD of &lt;350 meters was associated with greater functional decline, and loss of ambulation was only seen in those with baseline 6MWD &lt;325 meters. Only 1 of 42 (2.3%) subjects able to stand from supine lost ambulation.ConclusionFindings confirm the clinical meaningfulness of the 6MWD as the most accepted primary clinical endpoint in ambulatory DMD trials

Effects of traumatic brain injury on cognitive functioning and cerebral metabolites in HIV-infected individuals.

We explored the possible augmenting effect of traumatic brain injury (TBI) history on HIV (human immunodeficiency virus) associated neurocognitive complications. HIV-infected participants with self-reported history of definite TBI were compared to HIV patients without TBI history. Groups were equated for relevant demographic and HIV-associated characteristics. The TBI group evidenced significantly greater deficits in executive functioning and working memory. N-acetylaspartate, a putative marker of neuronal integrity, was significantly lower in the frontal gray matter and basal ganglia brain regions of the TBI group. Together, these results suggest an additional brain impact of TBI over that from HIV alone. One clinical implication is that HIV patients with TBI history may need to be monitored more closely for increased risk of HIV-associated neurocognitive disorder signs or symptoms

Casimir scaling, glueballs and hybrid gluelumps

Assuming that the Casimir scaling hypothesis is well verified in QCD, masses of glueballs and hybrid gluelumps (gluon with a point-like $c\bar c$ pair) are computed within the rotating string formalism. In our model, two gluons are attached by an adjoint string in a glueball while the gluon and the colour octet $c\bar c$ pair are attached by two fundamental strings in a hybrid gluelump. Masses for such exotic hadrons are computed with very few free parameters. These predictions can serve as a guide for experimental searches. In particular, the ground state glueballs lie on a Regge trajectory and the lightest $2^{++}$ state has a mass compatible with some experimental candidates.Comment: 3 figure

Regulating financial conglomerates

We investigate the optimal regulation of financial conglomerates which combine a bank and a non-bank financial institution. The conglomerate’s risk-taking incentives depend upon the level of market discipline it faces, which in turn is determined by the conglomerate’s liability structure. We examine optimal capital requirements for stand-alone institutions, for integrated financial conglomerates, and for financial conglomerates that are structured as holding companies. For a given risk profile, integrated conglomerates have a lower probability of failure than either their stand-alone or decentralized equivalent. However, when risk profiles are endogenously selected, conglomeration may extend the reach of the deposit insurance safety net and hence provide incentives for increased risk-taking. As a result, integrated conglomerates may optimally attract higher capital requirements. In contrast, decentralised conglomerates are able to hold assets in the socially most efficient place. Their optimal capital requirements encourage this. Hence, the practice of “regulatory arbitrage”, or of transferring assets from one balance sheet to another, is welfare-increasing. We discuss the policy implications of our finding in the context not only of the present debate on the regulation of financial conglomerates but also in the light of existing US bank holding company regulation

Assessing the prevalence of sensory and motor impairments in childhood in Bangladesh using key informants.

OBJECTIVES: The study was conducted to determine whether trained key informants (KI) could identify children with impairments. DESIGN: Trained KI identified children with defined impairments/epilepsy who were then examined by a medical team at a nearby assessment centre (Key Informant Methodology: KIM). A population-based household randomised sample survey was also conducted for comparing the prevalence estimates. SETTING: Three districts in North Bangladesh. PARTICIPANTS: Study population of approximately 258 000 children aged 0-<18 years, within which 3910 children were identified by KI, 94.8% of whom attended assessment camps. In the household survey, 8120 children were examined, of whom 119 were identified with an impairment/epilepsy. MAIN OUTCOME MEASURES: Prevalence estimates of severe visual impairment (SVI), moderate/severe hearing impairment (HI), substantial physical impairment (PI) and epilepsy. RESULTS: Overall prevalence estimates of impairments, including presumed HI, showed significant differences comparing KIM (9.0/1000 (95% CI 8.7 to 9.4)) with the household survey (14.7/1000 (95% CI 12.0 to 17.3)). Good agreement was observed for SVI (KIM 0.7/1000 children: survey 0.5/1000), PI (KIM 6.2/1000 children: survey 8.0/1000) and epilepsy (KIM 1.5/1000 children: survey 2.2/1000). Prevalence estimates for HI were much lower using KIM (2/1000) compared to the survey (6.4/1000). Excluding HI, overall prevalence estimates were similar (KIM: 7.5/1000 children (95% CI 7.2 to 7.8) survey: 8.4/1000 (95% CI 6.4 to 10.4)). CONCLUSIONS: KIM offers a low cost and relatively rapid way to identify children with SVI, PI and epilepsy in Bangladesh. HI is underestimated using KIM, requiring further research

Bone mineral density and fracture risk with long-term use of inhaled corticosteroids in patients with asthma: systematic review and meta-analysis

Objectives: We aimed to assess the association between long-term use of inhaled corticosteroids (ICS) and bone adverse effects in patients with asthma. Design: Systematic review and meta-analysis of fracture risk and changes in bone mineral density with long-term ICS use in asthma. Methods: We initially searched MEDLINE and EMBASE in July 2013, and performed an updated PubMed search in December 2014. We selected randomised controlled trials (RCTs) and controlled observational studies of any ICS (duration at least 12 months) compared to non-ICS use in patients with asthma. We conducted meta-analysis of ORs for fractures, and mean differences in bone mineral density. Heterogeneity was assessed using the I2 statistic. Results: We included 18 studies (7 RCTs and 11 observational studies) in the systematic review. Meta-analysis of observational studies did not demonstrate any significant association between ICS and fractures in children (pooled OR 1.02, 95% CI 0.94 to 1.10, two studies), or adults (pooled OR 1.09, 95% CI 0.45 to 2.62, four studies). Three RCTs and three observational studies in children reported on bone mineral density at the lumbar spine, and our meta-analysis did not show significant reductions with ICS use. Three RCTs and four observational studies in adults reported on ICS use and bone mineral density at the lumbar spine and femur, with no significant reductions found in the meta-analysis compared to control. Conclusions ICS use for ≥12 months in adults or children with asthma was not significantly associated with harmful effects on fractures or bone mineral density