Dark energy and dark matter from an inhomogeneous dilaton

A cosmological scenario is proposed where the dark matter (DM) and dark energy (DE) of the universe are two simultaneous manifestations of an inhomogenous dilaton. The equation of state of the field is scale-dependent and pressureless at galactic and larger scales and it has negative pressure as a DE at very large scales. The dilaton drives an inflationary phase followed by a kinetic energy-dominated one, as in the "quintessential inflation" model introduced by Peebles & Vilenkin, and soon after the end of inflation particle production seeds the first inhomogeneities that lead to galaxy formation. The dilaton is trapped near the minimum of the potential where it oscillates like a massive field, and the excess of kinetic energy is dissipated via the mechanism of "gravitational cooling" first introduced by Seidel & Suen. The inhomogeneities therefore behave like solitonic oscillations around the minimum of the potential, known as "oscillatons", that we propose account for most DM in galaxies. Those regions where the dilaton does not transform enough kinetic energy into reheating or carry an excess of it from regions that have cooled, evolve to the tail of the potential as DE, driving the acceleration of the universe.Comment: 9 pages, 8 figures, uses revtex, submitted PR

ALPK1 missense pathogenic variant in five families leads to ROSAH syndrome, an ocular multisystem autosomal dominant disorder

Purpose: To identify the molecular cause in five unrelated families with a distinct autosomal dominant ocular systemic disorder we called ROSAH syndrome due to clinical features of retinal dystrophy, optic nerve edema, splenomegaly, anhidrosis, and migraine headache. Methods: Independent discovery exome and genome sequencing in families 1, 2, and 3, and confirmation in families 4 and 5. Expression of wild-type messenger RNA and protein in human and mouse tissues and cell lines. Ciliary assays in fibroblasts from affected and unaffected family members. Results: We found the heterozygous missense variant in the ɑkinase gene, ALPK1, (c.710C>T, [p.Thr237Met]), segregated with disease in all five families. All patients shared the ROSAH phenotype with additional low-grade ocular inflammation, pancytopenia, recurrent infections, and mild renal impairment in some. ALPK1 was notably expressed in retina, retinal pigment epithelium, and optic nerve, with immunofluorescence indicating localization to the basal body of the connecting cilium of the photoreceptors, and presence in the sweat glands. Immunocytofluorescence revealed expression at the centrioles and spindle poles during metaphase, and at the base of the primary cilium. Affected family member fibroblasts demonstrated defective ciliogenesis. Conclusion: Heterozygosity for ALPK1, p.Thr237Met leads to ROSAH syndrome, an autosomal dominant ocular systemic disorder

Central Venous Catheters: A Survey of ICU Practices

Aim. This paper describes the current infection control practices for CVC care and compares these to evidence-based practice guidelines. Background. Intensive care patients with central venous catheters (CVCs) are at risk of catheter-related infection, which increases morbidity, mortality and health care costs. Infection control practices, including care of intravenous administration sets and catheter sites, are undertaken by nurses in an attempt to avoid infection. Although practice guidelines are available, infection control practices may vary between practitioners and institutions; however, current practice has not been formally surveyed. Method. A prospective, cross-sectional descriptive survey was carried out. Intensive care units (n = 14) in Australia were surveyed about their infection control policies for CVC care. Results were tabulated and compared with evidence-based practice guidelines. Results. A wide variety of responses was received about duration of administration set use for standard, parenteral nutrition and propofol (lipid-based anaesthetic) infusions; ad hoc administration set connection technique; dressing frequency, materials and solutions; and barrier precautions used during procedures. There was inconsistent adherence to the guidelines. Conclusion. There is variation in the infection control approach to CVC care. Greater adherence to existing Centers for Disease Control Guidelines would assist in the standardization of best practice and facilitate evidence-based care. What is already known about this topic Patients with central venous catheters are at risk of catheter-related infection, which increases morbidity, mortality and health care costs. Many nursing practices attempt to minimize infective risk, although not all are supported by evidence. The Centers for Disease Control provide evidence-based practice guidelines for the prevention of infection and care of central venous catheters. What this paper adds The state of current nursing practice with regards to infection control with central venous catheters. The level of adherence by nurses to the Centers for Disease Control practice guidelines. Recommendations for nursing practice, education and future research

Randomized controlled trial of intravitreal ranibizumab versus standard grid laser for macular edema following branch retinal vein occlusion

10.1016/j.ajo.2013.08.013American Journal of Ophthalmology1571237-247.e1AJOP