An HI absorption distance to the black hole candidate X-ray binary MAXI J1535-571

With the Australian Square Kilometre Array Pathfinder (ASKAP) we monitored the black hole candidate X-ray binary MAXI J1535--571 over seven epochs from 21 September to 2 October 2017. Using ASKAP observations, we studied the HI absorption spectrum from gas clouds along the line-of-sight and thereby constrained the distance to the source. The maximum negative radial velocities measured from the HI absorption spectra for MAXI J1535--571 and an extragalactic source in the same field of view are $-69\pm4$ km s$^{-1}$ and $-89\pm4$ km s$^{-1}$, respectively. This rules out the far kinematic distance ($9.3^{+0.5}_{-0.6}$ kpc), giving a most likely distance of $4.1^{+0.6}_{-0.5}$ kpc, with a strong upper limit of the tangent point at $6.7^{+0.1}_{-0.2}$ kpc. At our preferred distance, the peak unabsorbed luminosity of MAXI J1535--571 was $>78$ per cent of the Eddington luminosity, and shows that the soft-to-hard spectral state transition occurred at the very low luminosity of 1.2 -- 3.4 $\times$ 10$^{-5}$ times the Eddington luminosity. Finally, this study highlights the capabilities of new wide-field radio telescopes to probe Galactic transient outbursts, by allowing us to observe both a target source and a background comparison source in a single telescope pointing.Comment: Revised after favorable referee report from MNRAS Letter

Real-time gauge/gravity duality: Prescription, Renormalization and Examples

We present a comprehensive analysis of the prescription we recently put forward for the computation of real-time correlation functions using gauge/gravity duality. The prescription is valid for any holographic supergravity background and it naturally maps initial and final data in the bulk to initial and final states or density matrices in the field theory. We show in detail how the technique of holographic renormalization can be applied in this setting and we provide numerous illustrative examples, including the computation of time-ordered, Wightman and retarded 2-point functions in Poincare and global coordinates, thermal correlators and higher-point functions.Comment: 85 pages, 13 figures; v2: added comments and reference

Studying the impact of ocean eddies on the ecosystem of the Prince Edward Islands: DEIMEC ll

The Dynamics of Eddy Impacts on Marion’s Ecosystem Study (DEIMEC) programme was begun in 2002 with the aim of understanding the importance of the oceanic, upstream environment to the ecosystem of the Prince Edward Islands. This island group consists of two small volcanic islands and provides many opportunities for studying ecological and evolutionary processes, for monitoring ecological changes in relation to global climate change and for conserving a unique component of the planet’s biological diversity

Topologically Massive Gravity and the AdS/CFT Correspondence

We set up the AdS/CFT correspondence for topologically massive gravity (TMG) in three dimensions. The first step in this procedure is to determine the appropriate fall off conditions at infinity. These cannot be fixed a priori as they depend on the bulk theory under consideration and are derived by solving asymptotically the non-linear field equations. We discuss in detail the asymptotic structure of the field equations for TMG, showing that it contains leading and subleading logarithms, determine the map between bulk fields and CFT operators, obtain the appropriate counterterms needed for holographic renormalization and compute holographically one- and two-point functions at and away from the 'chiral point' (mu = 1). The 2-point functions at the chiral point are those of a logarithmic CFT (LCFT) with c_L = 0, c_R = 3l/G_N and b = -3l/G_N, where b is a parameter characterizing different c = 0 LCFTs. The bulk correlators away from the chiral point (mu \neq 1) smoothly limit to the LCFT ones as mu \to 1. Away from the chiral point, the CFT contains a state of negative norm and the expectation value of the energy momentum tensor in that state is also negative, reflecting a corresponding bulk instability due to negative energy modes.Comment: 54 pages, v2: added comments and reference

Designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain

Abstract Background Opioid prescribing for chronic pain is common and controversial, but recommended clinical practices are followed inconsistently in many clinical settings. Strategies for increasing adherence to clinical practice guideline recommendations are needed to increase effectiveness and reduce negative consequences of opioid prescribing in chronic pain patients. Methods Here we describe the process and outcomes of a project to operationalize the 2003 VA/DOD Clinical Practice Guideline for Opioid Therapy for Chronic Non-Cancer Pain into a computerized decision support system (DSS) to encourage good opioid prescribing practices during primary care visits. We based the DSS on the existing ATHENA-DSS. We used an iterative process of design, testing, and revision of the DSS by a diverse team including guideline authors, medical informatics experts, clinical content experts, and end-users to convert the written clinical practice guideline into a computable algorithm to generate patient-specific recommendations for care based upon existing information in the electronic medical record (EMR), and a set of clinical tools. Results The iterative revision process identified numerous and varied problems with the initially designed system despite diverse expert participation in the design process. The process of operationalizing the guideline identified areas in which the guideline was vague, left decisions to clinical judgment, or required clarification of detail to insure safe clinical implementation. The revisions led to workable solutions to problems, defined the limits of the DSS and its utility in clinical practice, improved integration into clinical workflow, and improved the clarity and accuracy of system recommendations and tools. Conclusions Use of this iterative process led to development of a multifunctional DSS that met the approval of the clinical practice guideline authors, content experts, and clinicians involved in testing. The process and experiences described provide a model for development of other DSSs that translate written guidelines into actionable, real-time clinical recommendations.http://deepblue.lib.umich.edu/bitstream/2027.42/78267/1/1748-5908-5-26.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/2/1748-5908-5-26.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/3/1748-5908-5-26-S3.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/4/1748-5908-5-26-S2.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/5/1748-5908-5-26-S1.TIFFPeer Reviewe

Complications in pulmonary vein isolation in the Netherlands Heart Registration differ with sex and ablation technique

Aims Pulmonary vein isolation (PVI) has become a cornerstone of the invasive treatment of atrial fibrillation. Severe complications are reported in 1-3% of patients. This study aims to compare complications and follow-up outcome of PVI in patients with atrial fibrillation. Methods and results The data were extracted from the Netherlands Heart Registration. Procedural and follow-up outcomes in patients treated with conventional radiofrequency (C-RF), multielectrode phased RF (Ph-RF), or cryoballoon (CB) ablation from 2012 to 2017 were compared. Subgroup analysis was performed to identify variables associated with complications and repeat ablations. In total, 13 823 patients (69% male) were included. The reported complication incidence was 3.6%. Patients treated with C-RF developed more cardiac tamponades (C-RF 0.8% vs. Ph-RF 0.3% vs. CB 0.3%, P Conclusion The reported complication rate during PVI was low. Patients treated with C-RF ablation were more likely to develop cardiac tamponades and vascular complications. Female sex was associated with more cardiac tamponade and bleeding complications

Sub-Optimal Vitamin B-12 Levels among ART-Naïve HIV-Positive Individuals in an Urban Cohort in Uganda

Malnutrition is common among HIV-infected individuals and is often accompanied by low serum levels of micronutrients. Vitamin B-12 deficiency has been associated with various factors including faster HIV disease progression and CD4 depletion in resource-rich settings. To describe prevalence and factors associated with sub-optimal vitamin B-12 levels among HIV-infected antiretroviral therapy (ART) naïve adults in a resource-poor setting, we performed a cross-sectional study with a retrospective chart review among individuals attending either the Mulago-Mbarara teaching hospitals’ Joint AIDS Program (MJAP) or the Infectious Diseases Institute (IDI) clinics, in Kampala, Uganda. Logistic regression was used to determine factors associated with sub-optimal vitamin B-12. The mean vitamin B-12 level was 384 pg/ml, normal range (200–900). Sub-optimal vitamin B-12 levels (<300 pg/ml) were found in 75/204 (36.8%). Twenty-one of 204 (10.3%) had vitamin B-12 deficiency (<200 pg/ml) while 54/204 (26.5%) had marginal depletion (200–300 pg/ml). Irritable mood was observed more among individuals with sub-optimal vitamin B-12 levels (OR 2.5, 95% CI; 1.1–5.6, P = 0.03). Increasing MCV was associated with decreasing serum B-12 category; 86.9 fl (±5.1) vs. 83 fl (±8.4) vs. 82 fl (±8.4) for B-12 deficiency, marginal and normal B-12 categories respectively (test for trend, P = 0.017). Compared to normal B-12, individuals with vitamin B-12 deficiency had a longer known duration of HIV infection: 42.2 months (±27.1) vs. 29.4 months (±23.8; P = 0.02). Participants eligible for ART (CD4<350 cells/µl) with sub-optimal B-12 had a higher mean rate of CD4 decline compared to counterparts with normal B-12; 118 (±145) vs. 22 (±115) cells/µl/year, P = 0.01 respectively. The prevalence of a sub-optimal vitamin B-12 was high in this HIV-infected, ART-naïve adult clinic population in urban Uganda. We recommend prospective studies to further clarify the causal relationships of sub-optimal vitamin B-12, and explore the role of vitamin B-12 supplementation in immune recovery

Irrelevant deformations and the holographic Callan-Symanzik equation

We discuss the systematics of obtaining the Callan-Symanzik equation within the framework of the gauge/gravity dualities. We present a completely general formula which in particular takes into account the new holographic renormalization results of arXiv:1102.2239. Non-trivial beta functions are obtained from new logarithmic terms in the radial expansion of the fields. The appearance of multi-trace counterterms is also discussed in detail and we show that mixing between single- and multi-trace operators leads to very specific non-linearities in the Callan-Symanzik equation. Additionally, we compute the conformal anomaly for a scalar three-point function in a CFT.Comment: 40 page