Signatures of particle collisions near extreme black holes

Finite-energy particles in free fall can collide with diverging center-of-mass energy near rapidly rotating black holes. What are the most salient observational signatures of this remarkable geometric effect? Here we revisit the problem from the standpoint of the near-horizon extreme Kerr geometry, where these collisions naturally take place. It is shown that the ingoing particle kinematics admits a simple, universal form. Given a scattering cross section, determination of emission properties is reduced to evaluation of particular integrals on the sky of a near-horizon orbiting particle. We subsequently apply this scheme to the example of single-photon bremsstrahlung, substantiating past results which indicate that ejected particles are observable, but their energies are bounded by the rest masses of the colliding particles. Our framework is readily applicable for any scattering process.Comment: 11 pages, 4 figure

Post-ISCO Ringdown Amplitudes in Extreme Mass Ratio Inspiral

An extreme mass ratio inspiral consists of two parts: adiabatic inspiral and plunge. The plunge trajectory from the innermost stable circular orbit (ISCO) is special (somewhat independent of initial conditions). We write an expression for its solution in closed-form and for the emitted waveform. In particular we extract an expression for the associated black-hole ringdown amplitudes, and evaluate them numerically.Comment: 21 pages, 5 figures. v4: added section with numerical evaluation of the ringdown amplitude

Exploring the Interplay Between Colorectal Cancer Subtypes Genomic Variants and Cellular Morphology: A Deep-Learning Approach

Molecular subtypes of colorectal cancer (CRC) significantly influence treatment decisions. While convolutional neural networks (CNNs) have recently been introduced for automated CRC subtype identification using H&E stained histopathological images, the correlation between CRC subtype genomic variants and their corresponding cellular morphology expressed by their imaging phenotypes is yet to be fully explored. The goal of this study was to determine such correlations by incorporating genomic variants in CNN models for CRC subtype classification from H&E images. We utilized the publicly available TCGA-CRC-DX dataset, which comprises whole slide images from 360 CRC-diagnosed patients (260 for training and 100 for testing). This dataset also provides information on CRC subtype classifications and genomic variations. We trained CNN models for CRC subtype classification that account for potential correlation between genomic variations within CRC subtypes and their corresponding cellular morphology patterns. We assessed the interplay between CRC subtypes' genomic variations and cellular morphology patterns by evaluating the CRC subtype classification accuracy of the different models in a stratified 5-fold cross-validation experimental setup using the area under the ROC curve (AUROC) and average precision (AP) as the performance metrics. Combining the CNN models account for variations in CIMP and SNP further improved classification accuracy (AUROC: 0.847$\pm$0.01 vs. 0.787$\pm$0.03, p$=$0.01, AP: 0.68$\pm$0.02 vs. 0.64$\pm$0.05)

Seeing an exercise as a single mathematical object: using variation to structure sense-making

In this theoretical paper we take an exercise to be a collection of procedural questions or tasks. It can be useful to treat such an exercise as a single object, with individual questions seen as elements in a mathematically and pedagogically structured set. We use the notions of 'dimensions of possible variation' and 'range of permissible change', derived from Ference Marton, to discuss affordances and constraints of some sample exercises. This gives insight into the potential pedagogical role of exercises, and shows how exercise analysis and design might contribute to hypotheses about learning trajectories. We argue that learners' response to an exercise has something in common with modeling that we might call 'micro-modeling', but we resort to a more inclusive description of mathematical thinking to describe learners' possible responses to a well-planned exercise. Finally we indicate how dimensions of possible variation inform the design and use of an exercise

Brain death in low-income countries: a report from Malawi

Most low-income nations have no practice guidelines for brain death; data describing brain death in these regions is absent. Our retrospective study describes the prevalence of brain death among patients treated in an intensive care unit (ICU) at a referral hospital in Malawi. The primary outcome was designation of brain death in the medical chart. Of 449 ICU patients included for analysis between September 2016 and May 2018, 43 (9.6%) were diagnosed with brain death during the ICU admission. The most common diagnostic reasons for admission among these patients were trauma (49%), malaria (16%) and postoperative monitoring after general abdominal surgery (19%). All patients diagnosed with brain death were declared dead in the hospital, after cardiac death. In conclusion, the incidence of brain death in a Malawi ICU is substantially higher than that seen in high-income ICU settings. Brain death is not treated as clinical death in Malawi

Paradoxical augmented relapse in alcohol-dependent rats during deep-brain stimulation in the nucleus accumbens

Case reports indicate that deep-brain stimulation in the nucleus accumbens may be beneficial to alcohol-dependent patients. The lack of clinical trials and our limited knowledge of deep-brain stimulation call for translational experiments to validate these reports. To mimic the human situation, we used a chronic-continuous brain-stimulation paradigm targeting the nucleus accumbens and other brain sites in alcohol-dependent rats. To determine the network effects of deep-brain stimulation in alcohol-dependent rats, we combined electrical stimulation of the nucleus accumbens with functional magnetic resonance imaging (fMRI), and studied neurotransmitter levels in nucleus accumbens-stimulated versus sham-stimulated rats. Surprisingly, we report here that electrical stimulation of the nucleus accumbens led to augmented relapse behavior in alcohol-dependent rats. Our associated fMRI data revealed some activated areas, including the medial prefrontal cortex and caudate putamen. However, when we applied stimulation to these areas, relapse behavior was not affected, confirming that the nucleus accumbens is critical for generating this paradoxical effect. Neurochemical analysis of the major activated brain sites of the network revealed that the effect of stimulation may depend on accumbal dopamine levels. This was supported by the finding that brain- stimulation-treated rats exhibited augmented alcohol-induced dopamine release compared with sham-stimulated animals. Our data suggest that deep-brain stimulation in the nucleus accumbens enhances alcohol-liking probably via augmented dopamine release and can thereby promote relapse

Nanocomposite Bienzymatic Sensor for Monitoring Xanthine in Wound Diagnostics

This work reports a biosensor for monitoring xanthine for potential wound healing assessment. Active substrate of the biosensor has xanthine oxidase (XO) and horseradish peroxidase (HRP) physisorbed on a nanocomposite of multiwalled carbon nanotubes (MWCNT) decorated with gold nanoparticles (AuNP). The presence of HRP provided a two-fold increase in response to xanthine, and a three-fold increase in response to the nanocomposite. With a sensitivity of 155.71 nA μM−1 cm−2 the biosensor offers a detection limit of 1.3 μM, with linear response between 22 μM and 0.4 mM. Clinical sample analyses showed the feasibility of xanthine detection from biofluids in a lesion site due to diffusion of the analyte into surrounding biofluids. Higher concentrations by three-fold were observed from wound proximity, than away from injury, with an average recovery of 110%. Results show the feasibility of monitoring wound severity through longitudinal measurements of xanthine from injured vicinity

Randomized Trials of Retosiban Versus Placebo or Atosiban in Spontaneous Preterm Labor.

OBJECTIVE:  The aim of this study is to assess the efficacy and safety of retosiban in spontaneous preterm labor (sPTL). STUDY DESIGN:  Two multicenter, randomized, and double-blind trials compared retosiban with placebo and retosiban with atosiban in women with a singleton pregnancy and intact membranes in sPTL at 24 to 336/7 weeks' gestation. Coprimary endpoints in the placebo-controlled trial were time to delivery (TTD) or treatment failure (whichever occurred first) and neonatal composite morbidity and mortality. The primary endpoint of the atosiban comparator trial was TTD. RESULTS:  The trials were terminated early because of slow recruitment. The placebo-controlled trial enrolled 23 participants (February 2016-July 2017; 2.6% of target);the atosiban-comparator trial enrolled 97 (March 2015-August 2017; 29% of target). Baseline participant characteristics were similar between treatments. In the placebo-controlled trial, mean gestational ages at randomization were 30.8 (retosiban, n = 10) and 30.5 weeks (placebo, n = 13), and mean times to delivery/treatment failure were 18.9 days (retosiban) and 11.1 days (placebo). Two and four neonates in the retosiban and placebo groups, respectively, had ≥1 component of the neonatal composite endpoint. In the atosiban-comparator trial, mean gestational age at randomization was 31.5 weeks (for both retosiban, n = 47, and atosiban, n = 50), and adjusted mean TTDs were 32.51 days (retosiban) and 33.71 days (atosiban; p > 0.05). Adverse events were no more common with retosiban than placebo or atosiban. CONCLUSION:  Despite considerable efforts to conduct two adequate and well-controlled studies in patients with sPTL, both studies were unable to recruit effectively and consequently terminated prematurely. Key factors negatively affecting participation were patient and physician resistance to use of a placebo comparator, lack of investigator consensus on diagnostic criteria and acceptance of protocol procedures, and ethics committee decisions. Meaningful cooperation between pharmaceutical companies, regulatory authorities, and the obstetric community is essential for future development of drugs to treat sPTL

The effect of anatomic location of injury on mortality risk in a resource-poor setting

Introduction Injury is a significant cause of death, with approximately 4.7 million people mortalities each year. By 2030, injury is predicted to be among the top 20 causes of death worldwide. We sought to characterize and compare the mortality probability in trauma patients in a resource-poor setting based on anatomic location of injury. Methods We performed a retrospective analysis of prospectively collected data using the trauma database at Kamuzu Central Hospital (KCH) in Lilongwe, Malawi. We included all adult trauma patients (≥16years) admitted between 2011 and 2015. We stratified patients according to anatomic location of injury, and used descriptive statistics to compare characteristics and management of each group. Bivariate analysis by mortality was done to determine covariates for our adjusted model. A Cox proportional hazard model was performed, using upper extremity injury as the baseline comparator. Descriptive statistics were used to describe the trend in incidence and mortality of head and spine injuries over five years. Results Of the 76,984 trauma patients who presented to KCH from 2011 to 2015, 49,126 (63.8%) were adults, and 8569 (17.4%) were admitted. The most common injury was to the head or spine, seen in 3712 patients (43.6%). The highest unadjusted hazard ratio for mortality was in head and spine injury patients, at 3.685 (95% CI = 2.50–5.44), which increased to 4.501 (95% CI = 2.78–7.30) when adjusted for age, sex, injury severity, transfer status, injury mechanism, and surgical intervention. Abdominal trauma had the second highest adjusted hazard of mortality, at 3.62 (95% CI = 1.92–6.84) followed by thoracic trauma (HR = 1.3621, 95% CI = 0.49–3.56). Conclusion In our setting, head or spine injury significantly increases the hazard of mortality significantly compared to all other anatomic injury locations. The prioritization of timely operative and non-operative head injury management is imperative. The development of head injury units may help attenuate trauma- related mortality in resource poor settings