The Santa Fe Light Cone Simulation Project: I. Confusion and the WHIM in Upcoming Sunyaev-Zel'dovich Effect Surveys

We present the first results from a new generation of simulated large sky coverage (~100 square degrees) Sunyaev-Zeldovich effect (SZE) cluster surveys using the cosmological adaptive mesh refinement N-body/hydro code Enzo. We have simulated a very large (512^3h^{-3}Mpc^3) volume with unprecedented dynamic range. We have generated simulated light cones to match the resolution and sensitivity of current and future SZE instruments. Unlike many previous studies of this type, our simulation includes unbound gas, where an appreciable fraction of the baryons in the universe reside. We have found that cluster line-of-sight overlap may be a significant issue in upcoming single-dish SZE surveys. Smaller beam surveys (~1 arcmin) have more than one massive cluster within a beam diameter 5-10% of the time, and a larger beam experiment like Planck has multiple clusters per beam 60% of the time. We explore the contribution of unresolved halos and unbound gas to the SZE signature at the maximum decrement. We find that there is a contribution from gas outside clusters of ~16% per object on average for upcoming surveys. This adds both bias and scatter to the deduced value of the integrated SZE, adding difficulty in accurately calibrating a cluster Y-M relationship. Finally, we find that in images where objects with M > 5x10^{13} M_{\odot} have had their SZE signatures removed, roughly a third of the total SZE flux still remains. This gas exists at least partially in the Warm Hot Intergalactic Medium (WHIM), and will possibly be detectable with the upcoming generation of SZE surveys.Comment: 14 pages, 13 figures, version accepted to ApJ. Major revisions mad

AAPM/SNMMI Joint Task Force: report on the current state of nuclear medicine physics training

The American Association of Physicists in Medicine (AAPM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) recognized the need for a review of the current state of nuclear medicine physics training and the need to explore pathways for improving nuclear medicine physics training opportunities. For these reasons, the two organizations formed a joint AAPM/SNMMI Ad Hoc Task Force on Nuclear Medicine Physics Training. The mission of this task force was to assemble a representative group of stakeholders to:• Estimate the demand for board-certified nuclear medicine physicists in the next 5-10 years,• Identify the critical issues related to supplying an adequate number of physicists who have received the appropriate level of training in nuclear medicine physics, and• Identify approaches that may be considered to facilitate the training of nuclear medicine physicists.As a result, a task force was appointed and chaired by an active member of both organizations that included representation from the AAPM, SNMMI, the American Board of Radiology (ABR), the American Board of Science in Nuclear Medicine (ABSNM), and the Commission for the Accreditation of Medical Physics Educational Programs (CAMPEP). The Task Force first met at the AAPM Annual Meeting in Charlotte in July 2012 and has met regularly face-to-face, online, and by conference calls. This manuscript reports the findings of the Task Force, as well as recommendations to achieve the stated mission

Stabilization of i-motif structures by 2'-β-fluorination of DNA

i-Motifs are four-stranded DNA structures consisting of two parallel DNA duplexes held together by hemi-protonated and intercalated cytosine base pairs (C:CH(+)). They have attracted considerable research interest for their potential role in gene regulation and their use as pH responsive switches and building blocks in macromolecular assemblies. At neutral and basic pH values, the cytosine bases deprotonate and the structure unfolds into single strands. To avoid this limitation and expand the range of environmental conditions supporting i-motif folding, we replaced the sugar in DNA by 2-deoxy-2-fluoroarabinose. We demonstrate that such a modification significantly stabilizes i-motif formation over a wide pH range, including pH 7. Nuclear magnetic resonance experiments reveal that 2-deoxy-2-fluoroarabinose adopts a C2'-endo conformation, instead of the C3'-endo conformation usually found in unmodified i-motifs. Nevertheless, this substitution does not alter the overall i-motif structure. This conformational change, together with the changes in charge distribution in the sugar caused by the electronegative fluorine atoms, leads to a number of favorable sequential and inter-strand electrostatic interactions. The availability of folded i-motifs at neutral pH will aid investigations into the biological function of i-motifs in vitro, and will expand i-motif applications in nanotechnology.This work is dedicated to the Memory of Alfredo Villasante, valuable collaborator and friend. FUNDING Funding for open access charge: NSERC Discovery grant (to M.J.D., A.K.M.); CIHR DDTP Training Grant (to H.A., R.H.V.); MINECO [BFU2014-52864-R to C.G.]; CSIC-JAE contract (to N.M.P.). Conflict of interest statement. None declaredS

'Magic coins' and 'magic squares': the discovery of astrological sigils in the Oldenburg Letters

Enclosed in a 1673 letter to Henry Oldenburg were two drawings of a series of astrological sigils, coins and amulets from the collection of Strasbourg mathematician Julius Reichelt (1637–1719). As portrayals of particular medieval and early modern sigils are relatively rare, this paper will analyse the role of these medals in medieval and early modern medicine, the logic behind their perceived efficacy, and their significance in early modern astrological and cabalistic practice. I shall also demonstrate their change in status in the late seventeenth century from potent magical healing amulets tied to the mysteries of the heavens to objects kept in a cabinet for curiosos. The evolving perception of the purpose of sigils mirrored changing early modern beliefs in the occult influences of the heavens upon the body and the natural world, as well as the growing interests among virtuosi in collecting, numismatics and antiquities

CT and ultrasound in abscess detection at specific anatomic sites: A study of 198 patients

Records of 902 patients with possible abdominal abscess were reviewed and of these 198 had abscesses on at least one occasion imaged either with ultrasound (US) or computed tomography (CT). There were 235 episodes of either one or simultaneous multiple abscesses. Sensitivities of CT and US were analyzed according to anatomic site. The nature of errors made was tabulated. CT was significantly more sensitive than US for the detection of abdominal abscess. Causes of CT and US error in abscess detection are discussed, and recommendations regarding choice of exam and means of improving performance are made.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26859/1/0000424.pd

Cost effectiveness of epidural steroid injections to manage chronic lower back pain

Background The efficacy of epidural steroid injections in the management of chronic low back pain is disputed, yet the technique remains popular amongst physicians and patients alike. This study assesses the cost effectiveness of injections administered in a routine outpatient setting in England. Methods Patients attending the Nottingham University Hospitals’ Pain Clinic received two injections of methylprednisolone plus levobupivacaine at different dosages, separated by at least 12 weeks. Prior to each injection, and every week thereafter for 12 weeks, participants completed the EQ-5D health-related quality of life instrument. For each patient for each injection, total health state utility gain relative to baseline was calculated. The cost of the procedure was modelled from observed clinical practice. Cost effectiveness was calculated as procedure cost relative to utility gain. Results 39 patients provided records. Over a 13-week period commencing with injection, mean quality adjusted life year (QALY) gains per patient for the two dosages were 0.028 (SD 0.063) and 0.021 (SD 0.057). The difference in QALYs gained by dosage was insignificant (paired t-test, CIs -0.019 – 0.033). Based on modelled resource use and data from other studies, the mean cost of an injection was estimated at £219 (SD 83). The cost utility ratio of the two injections amounted to £8,975 per QALY gained (CIs 5,480 – 22,915). However, at costs equivalent to the tariff price typically paid to providers by health care purchasers, the ratio increased to £27,459 (CIs 16,779 – 70,091). Conclusions When provided in an outpatient setting, epidural steroid injections are a short term, but nevertheless cost effective, means of managing chronic low back pain. However, designation of the procedure as a day case requires the National Health Service to reimburse providers at a price which pushes the procedure to the margin of cost effectiveness

Chronic pain in primary care. German figures from 1991 and 2006

<p>Abstract</p> <p>Background</p> <p>Until now only limited research has been done on the prevalence of chronic pain in primary care. The aim of this investigation was to study the health care utilisation of patients suffering from pain. How many patients visit an outpatient clinic because of the symptom of pain? These data were compared with data from a similar study in 1991, to investigate whether improvements had been achieved.</p> <p>Methods</p> <p>A total of 1201 consecutive patients visiting outpatient clinics were surveyed in six practices in the western part of Germany on randomly selected days by means of questionnaires. Topics were the point prevalence of pain and the period prevalence of chronic pain, its characteristics and its impact on daily life, as well as data on previous therapies for pain. A retrospective comparison was made with the data from a similar study with same design surveying 900 patients that took place in five practices during 1991.</p> <p>Results</p> <p>In 2006, pain was the main reason for consulting a doctor in 42.5% of all patients (1991: 50.3%). Of all respondents, 62% suffered from pain on the particular day of the consultation, and 40% reported that they had been suffering from pain for more than six months (1991: 36.4%). As many as 88.3% of patients with chronic pain reported a negative impact on their daily life due to this pain (1991: 68%), and 88.1% reported impairment of their working life because of chronic pain (1991: 59.1%).</p> <p>Conclusion</p> <p>Pain, and chronic pain in particular, is a central problem in primary care. Over the last 15 years, the number of patients suffering from chronic pain has not decreased. In nearly half of all cases, pain is still the reason for health care utilisation in outpatient clinics. Pain represents a major primary health care problem with enormous impact on public health. Improvements can only be achieved by improving the quality of health care at the primary care level.</p