Thermal Studies on Rubidium Dinitramide

The present study has been carried out to investigate conflicting reports in the literature on the nature of the thermal decomposition of the energetic oxidant rubidium dinitramide in the liquid state. The techniques employed included DSC, simultaneous TG-DTA, simultaneous TG-mass spectrometry and thermomicroscopy. The measurements were supplemented by quantitative chemical analysis of the reaction products. The results showed that, following fusion at 106 °C, the overall decomposition proceeded in a single exothermic reaction stage forming a mixture of rubidium nitrate and rubidium nitrite in the molar ratio 1.2 : 1

Phenomenology of the Gowdy Universe on T3×RT^3 \times R

Numerical studies of the plane symmetric, vacuum Gowdy universe on $T^3 \times R$ yield strong support for the conjectured asymptotically velocity term dominated (AVTD) behavior of its evolution toward the singularity except, perhaps, at isolated spatial points. A generic solution is characterized by spiky features and apparent ``discontinuities'' in the wave amplitudes. It is shown that the nonlinear terms in the wave equations drive the system generically to the ``small velocity'' AVTD regime and that the spiky features are caused by the absence of these terms at isolated spatial points.Comment: 19 pages, 21 figures, uses Revtex, psfi

Longitudinal analysis of safety and medication adherence of patients in the Fingolimod patient support program: a real-world observational study.

The Fingolimod Patient Support Program (F-PSP) is an interprofessional specialty pharmacy service designed to ensure responsible use of fingolimod by promoting patient safety and medication adherence. This study aims to evaluate the safety and medication adherence of patients who joined the F-PSP between 2013 and 2016. Sociodemographic and medical characteristics, patient safety data (patient-reported symptoms, discontinuations due to adverse events (AEs), repeated first-dose monitoring), and medication adherence (implementation, persistence, reasons for discontinuation, influence of covariates, barriers and facilitators) were described. Sixty-seven patients joined the F-PSP. Patients reported a high frequency of symptoms. Due to AEs, 7 patients discontinued fingolimod, 3 took therapeutic breaks, and 1 reduced the regimen temporarily. Three patients repeated the first-dose monitoring. Patients had a high medication adherence over the 18-month analysis period: implementation decreased from 98.8 to 93.7%, and fingolimod persistence was 83.2% at 18 months. The patients' level of education, professional situation, and living with child(ren) influenced implementation. Patients reported more facilitators of medication adherence than barriers. The F-PSP seems valuable for supporting individual patients (ensuring responsible use of fingolimod and inviting patients for shared-decision making) and public health (indirectly gathering real-world evidence)

Practical application and clinical impact of the WHO histopathological criteria on bone marrow biopsy for the diagnosis of essential thrombocythemia versus prefibrotic primary myelofibrosis

Aims: To evaluate the feasibility of the histopathological diagnosis of prefibrotic–early primary myelofibrosis (PM) as described in the World Health Organization (WHO) classification and to evaluate the clinical implications of prefibrotic–early PM in a series of patients previously diagnosed as having essential thrombocythemia (ET) according to the Polycythemia Vera Study Group criteria. Methods and results: WHO criteria were applied to bone marrow biopsy specimens by two pathologists who then reclassified 127 cases as 102 ET (80.3%), 18 prefibrotic–early PM (14.2%) and seven fibrotic PM (5.5%). In 45 cases (35%), the final diagnosis was only reached by consensus. The megakaryocytic criteria that best discriminated between ET and prefibrotic–early PM were an increased nucleo–cytoplasmic ratio, presence of cloudlike nuclei, hyperchromatic-dysplastic nuclei, paratrabecular megakaryocytes and tight clusters. A histological score discriminated between ET (score ≤3) and PM (score ≥6), but 21 cases showed an intermediate ambiguous score. No significant differences were observed at diagnosis and at follow-up (median time 93 months) for thrombosis, major haemorrhage, laboratory data, transformation into overt myeloid metaplasia and survival. Conclusions: The distinction between ET and prefibrotic–early PM is impaired by subjectivity in pathological practice and is of questionable clinical relevance, at least when considering individual patients

How much energy do closed timelike curves in 2+1 spacetimes need?

By noticing that, in open 2+1 gravity, polarized surfaces cannot converge in the presence of timelike total energy momentum (except for a rotation of 2 pi), we give a simple argument which shows that, quite generally, closed timelike curves cannot exist in the presence of such energy condition.Comment: 3 pages, with no figures. Accepted in PRD as Rapid Communicatio

Immunology of multiple sclerosis

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) leading to demyelination, axonal damage, and progressive neurologic disability. The development of MS is influenced by environmental factors, particularly the Epstein-Barr virus (EBV), and genetic factors, which include specific HLA types, particularly DRB1*1501-DQA1*0102-DQB1*0602, and a predisposition to autoimmunity in general. MS patients have increased circulating T-cell and antibody reactivity to myelin proteins and gangliosides. It is proposed that the role of EBV is to infect autoreactive B cells that then seed the CNS and promote the survival of autoreactive T cells there. It is also proposed that the clinical attacks of relapsing-remitting MS are orchestrated by myelin-reactive T cells entering the white matter of the CNS from the blood, and that the progressive disability in primary and secondary progressive MS is caused by the action of autoantibodies produced in the CNS by ­meningeal lymphoid follicles with germinal centers

LLL 44-4 : Micronutrients in acute disease and critical illness.

Micronutrients (MN), i.e. trace elements and vitamins, are essential components of the diet in relatively small amounts in any form of nutrition, with special needs in critically ill patients. Critical illness is characterised by the presence of inflammation and oxidative stress. MNs are tightly involved in antioxidant and immune defences. In addition, some conditions, and treatments result in large losses of biological fluids containing MNs: therefore, acute renal injury requiring renal replacement therapy, acute intestinal failure, and major burns and trauma are at high risk of acute depletion of body stores, and of deficiency. MN requirements are increased above standard DRI. Blood level interpretation is complicated by inflammation: some biomarkers assist the status determination. Due to the acute challenges of critical illness, it of utmost importance to cover the needs to maintain the organism's endogenous immune and antioxidant defences, and capacity to repair tissues. Practical strategies are proposed

LLL 44 - 2 - Micronutrients in clinical nutrition: Vitamins.

Vitamins are essential organic molecules, which are required in the diet in relatively small amounts in any form of nutrition (oral, enteral, parenteral). Despite the small amounts that are required, the vitamins are essential both for maintenance of health, growth, and treatment of disease. After reminding about the principal function of all the vitamins, their needs and the clinical consequences of their deficit, the text present some common clinical problems: the impact of inflammation on the assessment of status. The reasons and diseases which cause increased requirements are presented, with the indications to monitoring of blood levels which remain the classical way to assess status in clinical settings. The text summarises the most relevant clinical manifestations of vitamins depletion and deficiency, the difficulties in assessing status, and makes recommendations for provision for medical nutrition therapy

Running into New Territory in SUSY Parameter Space

The LEP-II bound on the light Higgs mass rules out the vast majority of parameter space left to the Minimal Supersymmetric Standard Model (MSSM) with weak-scale soft-masses. This suggests the importance of exploring extensions of the MSSM with non-minimal Higgs physics. In this article, we explore a theory with an additional singlet superfield and an extended gauge sector. The theory has a number of novel features compared to both the MSSM and Next-to-MSSM, including easily realizing a light CP-even Higgs mass consistent with LEP-II limits, tan(beta) < 1, and a lightest Higgs which is charged. These features are achieved while remaining consistent with perturbative unification and without large stop-masses. Discovery modes at the Tevatron and LHC are discussed.Comment: 15 pages, 5 figures; Typo in equation (4.5) corrected; submitted to JHE