Glucocorticoid therapy for adrenal insufficiency: nonadherence, concerns and dissatisfaction with information

Objective: Appropriate self‐management of glucocorticoid therapy (GC) is crucial for patients with adrenal insufficiency (AI). We aimed to describe patients’ self‐reported nonadherence to GC, evaluate perceived doubts about need for GC, concerns about adverse effects, and dissatisfaction with information received about GC. Design: Cross‐sectional survey. Patients: Patients prescribed GC for AI (n = 81) from five European countries. Measurements: Online survey including the Medication Adherence Report Scale (MARS), Beliefs about Medicines Questionnaire© (BMQ Specific, adapted for AI) and Satisfaction with Information about Medicines Scale© (Prof Rob Horne; SIMS). Results: Most patients (85·2%) reported a degree of nonadherence to GC. The most frequent types of nonadherence concerned changing the timing of GC doses, for example taking a dose later in the day than advised (37·0%). Few patients doubted their personal need for daily GC, but most reported high concerns about GC including potential weight gain (50·6%), osteoporosis (53·6%) and the continuing risk of adrenal crisis (50·6%). Dissatisfaction with information about GC was frequent, with participants particularly dissatisfied with the amount of information they had received about potential problems with GC. People who expressed dissatisfaction with information about GC, and concerns about its adverse effects were also more likely to report nonadherence (P < 0·05). Conclusions: Nonadherence to treatment, concerns about potential adverse effects and dissatisfaction with the information provided about treatment were frequently reported by this European sample of AI patients. Many AI patients may need additional information about their GC and support to address concerns about GC and facilitate adherence

Realistic Expanding Source Model for Invariant One-Particle Multiplicity Distributions and Two-Particle Correlations in Relativistic Heavy-Ion Collisions

We present a realistic expanding source model with nine parameters that are necessary and sufficient to describe the main physics occuring during hydrodynamical freezeout of the excited hadronic matter produced in relativistic heavy-ion collisions. As a first test of the model, we compare it to data from central Si + Au collisions at p_lab/A = 14.6 GeV/c measured in experiment E-802 at the AGS. An overall chi-square per degree of freedom of 1.055 is achieved for a fit to 1416 data points involving invariant pi^+, pi^-, K^+, and K^- one-particle multiplicity distributions and pi^+ and K^+ two-particle correlations. The 99-percent-confidence region of parameter space is identified, leading to one-dimensional error estimates on the nine fitted parameters and other calculated physical quantities. Three of the most important results are the freezeout temperature, longitudinal proper time, and baryon density along the symmetry axis. For these we find values of 92.9 +/- 4.4 MeV, 8.2 +/- 2.2 fm/c, and 0.0222 + 0.0096 / - 0.0069 fm^-3, respectively.Comment: 37 pages and 12 figures. RevTeX 3.0. Submitted to Physical Review C. Complete preprint, including device-independent (dvi), PostScript, and LaTeX versions of the text, plus PostScript files of all figures, are available at http://t2.lanl.gov/publications/publications.html or at ftp://t2.lanl.gov/publications/res

Estimating plasma volume in neonatal Holstein calves fed one or two feedings of a lacteal-based colostrum replacer using Evans blue dye and hematocrit values at various time points.

Twenty-eight Holstein calves were blocked by birth date and randomly assigned to one of two treatments to investigate the effect of colostrum replacer (CR) feeding regimen on plasma volume (PV). Treatments were: 1) one feeding of CR (C1; 3L of reconstituted CR 675 g of powder providing 184.5 g of IgG at birth) or 2) two feedings of CR (C2; 2L of reconstituted CR at birth and 1 L of reconstituted CR at six h). By 6 h of age, all calves had received 3L of CR providing 184.5 g of IgG. Plasma volume was estimated at six, 12, 18, and 24 h after birth using Evans blue dye (EBD). No treatment effects were noted at any time points (P \u3e 0.05). Mean PV for all calves regardless of treatment at six, 12, 18, and 24 h were 78.6, 89.2, 83.9, and 90.7 mL kg-1 of BW, respectively. Plasma volume was correlated with hematocrit (HCT), initial HCT, and treatment. Hematocrit was correlated with PV, initial HCT, and body weight. Hematocrit for six, 12, 18 and 24 h after birth can be predicted with an initial precolostral HCT determination

Observations of cosmic ray induced phosphenes

Phosphene observations by astronauts on flights near and far from earth atmosphere are discussed. It was concluded that phosphenes could be observed by the naked eye. Further investigation is proposed to determine realistic human tolerance levels for extended missions and to evaluate the need to provide special spacecraft shielding

Oxygen diffusion and reactivity at low temperature on bare amorphous olivine-type silicate

The mobility of O atoms at very low temperatures is not generally taken into account, despite O diffusion would add to a series of processes leading to the observed rich molecular diversity in space. We present a study of the mobility and reactivity of O atoms on an amorphous silicate surface. Our results are in the form of RAIRS and temperature-programmed desorption spectra of O2 and O3 produced via two pathways: O + O and O2 + O, investigated in a submonolayer regime and in the range of temperature between 6.5 and 30 K. All the experiments show that ozone is formed efficiently on silicate at any surface temperature between 6.5 and 30 K. The derived upper limit for the activation barriers of O + O and O2 + O reactions is 150 K/kb. Ozone formation at low temperatures indicates that fast diffusion of O atoms is at play even at 6.5 K. Through a series of rate equations included in our model, we also address the reaction mechanisms and show that neither the Eley Rideal nor the Hot atom mechanisms alone can explain the experimental values. The rate of diffusion of O atoms, based on modeling results, is much higher than the one generally expected, and the diffusive process proceeds via the Langmuir-Hinshelwood mechanism enhanced by tunnelling. In fact, quantum effects turn out to be a key factor that cannot be neglected in our simulations. Astrophysically, efficient O3 formation on interstellar dust grains would imply the presence of huge reservoirs of oxygen atoms. Since O3 is a reservoir of elementary oxygen, and also of OH via its hydrogenation, it could explain the observed concomitance of CO2 and H2O in the ices.Comment: 28 pages, 14 figure

Regional heat-flow variations across the sedimented Juan de Fuca Ridge eastern flank: constraints on lithospheric cooling and lateral hydrothermal heat transport

Journal ArticleSeafloor heat flow has been estimated continuously along a transect on the sedimented eastern flank of the Juan de Fuca Ridge to provide constraints on the scale and rate of lateral heat and fluid transport in the upper igneous crust, and on the total flux from the young lithosphere beneath. The profile extends from 20 km east of the ridge axis, where turbidite sediments lap onto the oceanic crust at an age of less than 1 Ma, and ends 110 km east of the axis over 3.6 Ma crust

Resonance contributions to HBT correlation radii

We study the effect of resonance decays on intensity interferometry for heavy ion collisions. Collective expansion of the source leads to a dependence of the two-particle correlation function on the pair momentum K. This opens the possibility to reconstruct the dynamics of the source from the K-dependence of the measured HBT radii. Here we address the question to what extent resonance decays can fake such a flow signal. Within a simple parametrization for the emission function we present a comprehensive analysis of the interplay of flow and resonance decays on the one- and two-particle spectra. We discuss in detail the non-Gaussian features of the correlation function introduced by long-lived resonances and the resulting problems in extracting meaningful HBT radii. We propose to define them in terms of the second order q-moments of the correlator C(q, K). We show that this yields a more reliable characterisation of the correlator in terms of its width and the correlation strength `lambda' than other commonly used fit procedures. The normalized fourth-order q-moments (kurtosis) provide a quantitative measure for the non-Gaussian features of the correlator. At least for the class of models studied here, the kurtosis helps separating effects from expansion flow and resonance decays, and provides the cleanest signal to distinguish between scenarios with and without transverse flow.Comment: 23 pages, twocolumn RevTeX, 12 eps-figures included, minor changes following referee comment

Monitoring aquifer recharge using repeated high-precision gravity measurements: a pilot study in South Weber, Utah

Journal ArticleRepeated high-precision gravity surveys were conducted over two infiltration cycles on an alluvial-fan aquifer system at the mouth of Weber Canyon in northern Utah as part of the Weber River Basin Aquifer Storage and Recovery Pilot Project (WRBASR). Gravity measurements collected before, during, and after infiltration events indicate that a perched groundwater mound formed during infiltration events and decayed smoothly following infiltration. Data also suggest the groundwater mound migrated gradually south-southwest from the surface infiltration site

Homogeneous Relaxation at Strong Coupling from Gravity

Homogeneous relaxation is a ubiquitous phenomenon in semiclassical kinetic theories where the quasiparticles are distributed uniformly in space, and the equilibration involves only their velocity distribution. For such solutions, the hydrodynamic variables remain constant. We construct asymptotically AdS solutions of Einstein's gravity dual to such processes at strong coupling, perturbatively in the amplitude expansion, where the expansion parameter is the ratio of the amplitude of the non-hydrodynamic shear-stress tensor to the pressure. At each order, we sum over all time derivatives through exact recursion relations. We argue that the metric has a regular future horizon, order by order in the amplitude expansion, provided the shear-stress tensor follows an equation of motion. At the linear order, this equation of motion implies that the metric perturbations are composed of zero wavelength quasinormal modes. Our method allows us to calculate the non-linear corrections to this equation perturbatively in the amplitude expansion. We thus derive a special case of our previous conjecture on the regularity condition on the boundary stress tensor that endows the bulk metric with a regular future horizon, and also refine it further. We also propose a new outlook for heavy-ion phenomenology at RHIC and ALICE.Comment: 60 pages, a section titled "Outlook for RHIC and ALICE" has been added, accepted for publication in Physical Review