Dysthyroid optic neuropathy: update on pathogenesis, diagnosis, and management

INTRODUCTION: Dysthyroid optic neuropathy (DON) is a severe manifestation of thyroid eye disease (TED) that can result in permanent vision loss. Management is complex, multidisciplinary, and involves medical and/or surgical therapies. This review describes current concepts in the epidemiology, pathophysiology, diagnosis, and treatment of DON. AREAS COVERED: An extensive review of the literature was performed to detail current concepts on the diagnosis and management of DON. This includes utilization of various medical and surgical modalities for disease management. EXPERT COMMENTARY: DON can result in permanent blindness and often requires the use of corticosteroids and surgical decompression. We favor the use of intravenous corticosteroids and a transcaruncular approach when surgical decompression is indicated. The use of orbital radiation for DON is often reserved for patients that are poor surgical candidates and/or patients with refractory disease

Rotating "Black Holes" with Holes in the Horizon

Kerr-Schild solutions of the Einstein-Maxwell field equations, containing semi-infinite axial singular lines, are investigated. It is shown that axial singularities break up the black hole, forming holes in the horizon. As a result, a tube-like region appears which allows matter to escape from the interior without crossing the horizon. It is argued that axial singularities of this kind, leading to very narrow beams, can be created in black holes by external electromagnetic or gravitational excitations and may be at the origin of astrophysically observable effects such as jet formation.Comment: Revtex, 6 pages, 3 figures. Corrected version. To appear in Phys Rev D, Rapid Communication

Effects of neutrino-driven kicks on the supernova explosion mechanism

We show that neutrino-driven pulsar kicks can increase the energy of the supernova shock. The observed large velocities of pulsars are believed to originate in the supernova explosion, either from asymmetries in the ejecta or from an anisotropic emission of neutrinos (or other light particles) from the cooling neutron star. In this paper we assume the velocities are caused by anisotropic neutrino emission and study the effects of these neutrino-driven kicks on the supernova explosion. We find that if the collapsed star is marginally unable to produce an explosion, the neutrino-driven mechanisms can drive the convection to make a successful explosion. The resultant explosion is asymmetric, with the strongest ejecta motion roughly in the direction of the neutron star kick. This is in sharp contrast with the ejecta-driven mechanisms, which predict the motion of the ejecta in the opposite direction. This difference can be used to distinguish between the two mechanisms based on the observations of the supernova remnants.Comment: 22 pages including 8 figures, submitted to ApJ, version with high resolution figures can be found at http://qso.lanl.gov/~cl

Opportunities and barriers for adoption of a decision-support tool for Alzheimer's Disease

Clinical decision-support tools (DSTs) represent a valuable resource in healthcare. However, lack of Human Factors considerations and early design research has often limited their successful adoption. To complement previous technically focused work, we studied adoption opportunities of a future DST built on a predictive model of Alzheimer’s Disease (AD) progression. Our aim is two-fold: exploring adoption opportunities for DSTs in AD clinical care, and testing a novel combination of methods to support this process. We focused on understanding current clinical needs and practices, and the potential for such a tool to be integrated into the setting, prior to its development. Our user-centred approach was based on field observations and semi-structured interviews, analysed through workflow analysis, user profiles, and a design-reality gap model. The first two are common practice, whilst the latter provided added value in highlighting specific adoption needs. We identified the likely early adopters of the tool as being both psychiatrists and neurologists based in research-oriented clinical settings. We defined ten key requirements for the translation and adoption of DSTs for AD around IT, user, and contextual factors. Future works can use and build on these requirements to stand a greater chance to get adopted in the clinical setting

Obscured AGN: the hidden side of the X-ray Universe

Most Active Galactic Nuclei (AGN) are `obscured', i.e. the nucleus is hiding behind a screen of absorbing material. The advantage of having the nucleus obscured is to make easier the observations of those emission components which originate in circumnuclear matter outside the absorbing regions, because in this case they are not outshined by the nuclear emission. This is particularly important in X-rays, where spatial resolution is (with the notable exception of Chandra) poorer than in the optical, and the study of circumnuclear regions is often based on spectral analysis only. The properties of circumnuclear matter, in the light of recent high spectral and/or angular resolution $Chandra$ and XMM--Newton observations, will be reviewed in Sec.2. In Sec.3 we will discuss obscured AGN in the framework of the Unification Model. Recent discoveries of X-ray obscured Seyfert 1, and of X-ray loud but optically normal galaxies, are calling for a revision of the Unification Model. Obscured AGN have also a cosmological relevance. Not only are they a fundamental ingredient of synthesis models of the Cosmic X-ray Background (XRB), but provide a link between the XRB and the Cosmic Infrared Background, as briefly discussed in Sec.4.Comment: 12 pages; to appear in Philosophical Transactions of the Royal Society (Series A: Mathematical, Physical, and Engineering Sciences

A method of estimation of the dynamical age of FR II-type radio sources from multifrequency data

We propose a new approach in determining ages of FR II type radio sources. We apply the assumed dynamical model of Kaiser et al. (1997) to a number of FR II type radio galaxies observed at different radio frequencies, and fit - for each frequency separately - the model free parameters to the observed sources' quantities. Such a procedure, using enlarged in fact a number of observables, enables us to determine relatively precise ages and other crucial characteristics of the analyzed sources. The resulting age estimates agree very well with those obtained by means of `classical' spectral ageing method for objects not older than 10 Myr, for which good-quality spectral data are available. The presented method is however also applicable in the case of the sources older than this, and/or the ones for which the only available low-resolution radio data do not allow for detailed spectral ageing studies. Our analysis indicates that the main factor precluding precise age determination for FR II type radio galaxies regards the poorly known shape of the initial electron energy distribution injected by the jet terminal shocks to the expanding lobes/cocoons. We briefly consider this issue, and conclude that the broad-band single power-law form assumed here may be accurate enough for the presented estimates, although most likely it does not strictly correspond to some well-defined realistic particle acceleration process. Instead, it should be considered as a simplest model approximation of the initial electron continuum, averaged over a very broad energy range and over the age of the source, with the effective spectral index which may be different for different sources.Comment: 15 pages, 9 figures included. Accepted for publication in A&

A blind test of photometric redshift prediction

Results of a blind test of photometric redshift predictions against spectroscopic galaxy redshifts obtained in the Hubble Deep Field with the Keck Telescope are presented. The best photometric redshift schemes predict spectroscopic redshifts with a redshift accuracy of |Delta-z|<0.1 for more than 68 percent of sources and with |Delta-z|<0.3 for 100 percent, when single-feature spectroscopic redshifts are removed from consideration. This test shows that photometric redshift schemes work well at least when the photometric data are of high quality and when the sources are at moderate redshifts.Comment: 14 pp., accepted for publication in A

Warped discs and the directional stability of jets in Active Galactic Nuclei

Warped accretion discs in Active Galactic Nuclei (AGN) exert a torque on the black hole that tends to align the rotation axis with the angular momentum of the outer disc. We compute the magnitude of this torque by solving numerically for the steady state shape of the warped disc, and verify that the analytic solution of Scheuer and Feiler (1996) provides an excellent approximation. We generalise these results for discs with strong warps and arbitrary surface density profiles, and calculate the timescale on which the black hole becomes aligned with the angular momentum in the outer disc. For massive holes and accretion rates of the order of the Eddington limit the alignment timescale is always short (less than a Myr), so that jets accelerated from the inner disc region provide a prompt tracer of the angular momentum of gas at large radii in the disc. Longer timescales are predicted for low luminosity systems, depending on the degree of anisotropy in the disc's hydrodynamic response to shear and warp, and for the final decay of modest warps at large radii in the disc that are potentially observable via VLBI. We discuss the implications of this for the inferred accretion history of those Active Galactic Nuclei whose jet directions appear to be stable over long timescales. The large energy deposition rate at modest disc radii during rapid realignment episodes should make such objects transiently bright at optical and infrared wavelengths.Comment: MNRAS, in press. Revised to match accepted version, with one new figure showing alignment timescale as a function of black hole mas