Effect of audible and visual reminders on adherence in glaucoma patients using a commercially available dosing aid

We studied the effects of audible and visual alarms on adherence with a recommended dosing regimen in the management of glaucoma. Forty-two patients were begun on therapy with the Travatan® Dosing Aid (TDA) and randomly divided into two observation groups – one with visual and audible alarm functions turned on and the other with alarms off. Dosing information was analyzed for mean rates of adherence, missed days, and dosing at the wrong time. Twenty patients were randomized to the TDA alarm on group and 22 to the alarm off group. The rates of adherence were 87.9% and 79.7% (p = 0.02), rates of missed dosing were 7.6% and 14.4% (p = 0.03), and rates of dosing at the incorrect times were 7.1% and 9.8% (p = 0.19), respectively for alarm on versus alarm off groups. In the alarm on group, the adherence rate was significantly higher and proportion of missed dosing was significantly lower. It is still yet to be determined whether there is a relationship between adherence and progression of glaucoma

A ROSAT HRI survey of bright nearby galaxies

We use the extensive public archive of ROSAT High Resolution Imager (HRI) observations to carry out a statistical investigation of the X-ray properties of nearby galaxies. Specifically we focus on the sample of 486 bright (B_T < 12.5) northern galaxies studied by Ho, Filippenko and Sargent (HFS) in the context of their exploration of the optical spectroscopic properties of nearby galactic nuclei. Over 20% of HFS galaxies are encompassed in ROSAT HRI fields of reasonable (> 10ks) exposure. The X-ray sources detected within the optical extent of each galaxy are categorised as either nuclear or non-nuclear depending on whether the source is positioned within or outside of a 25 arcsecond radius circle centred on the optical nucleus. A nuclear X-ray source is detected in over 70% of the galaxies harbouring either a Seyfert or LINER nucleus compared to a detection rate of only ~40% in less active systems. The correlation of the H alpha luminosity with nuclear X-ray luminosity previously observed in QSOs and bright Seyfert 1 galaxies appears to extend down into the regime of ultra-low luminosity (L(x)~10^38 - 10^40 erg/s) active galactic nuclei (AGN). The inferred accretion rates for this sample of low-luminosity AGN are significantly sub-Eddington. In total 142 non-nuclear sources were detected. In combination with published data for M31 this leads to a luminosity distribution (normalised to an optical blue luminosity of L(B) = 10^10 L(solar)) for the discrete X-ray source population in spiral galaxies of the form dN/dL38 = 1.0 +/- 0.2 L38^-1.8, where L38 is the X-ray luminosity in units of 10^38 erg/s. The implied L(x)/L(B) ratio is ~1.1 x 10^39 erg/s/(10^10 L(solar)). The nature of the substantial number of ``super-luminous'' non-nuclear objects detected in the survey is discussed.Comment: 20 pages, 7 figures, accepted for publication in MNRAS. Also available from http://www.star.le.ac.uk/~tro/papers/xhfs.p

Effective descriptions of branes on non-geometric tori

We investigate the low-energy effective description of non-geometric compactifications constructed by T-dualizing two or three of the directions of a T^3 with non-vanishing H-flux. Our approach is to introduce a D3-brane in these geometries and to take an appropriate decoupling limit. In the case of two T-dualities, we find at low energies a non-commutative T^2 fibered non-trivially over an S^1. In the UV this theory is still decoupled from gravity, but is dual to a little string theory with flavor. For the case of three T-dualities, we do not find a sensible decoupling limit, casting doubt on this geometry as a low-energy effective notion in critical string theory. However, by studying a topological toy model in this background, we find a non-associative geometry similar to one found by Bouwknegt, Hannabuss, and Mathai.Comment: 22 pages, 4 figures, references adde

Mid-Infrared Spectroscopic Properties of Ultra-Luminous Infrared Quasars

We analyse mid-infrared (MIR) spectroscopic properties for 19 ultra-luminous infrared quasars (IR QSOs) in the local universe based on the spectra from the Infrared Spectrograph on board the Spitzer Space Telescope. The MIR properties of IR QSOs are compared with those of optically-selected Palomar-Green QSOs (PG QSOs) and ultra-luminous infrared galaxies (ULIRGs). The average MIR spectral features from ~ 5 to 30um, including the spectral slopes, 6.2um PAH emission strengths and [NeII] 12.81um luminosities of IR QSOs, differ from those of PG QSOs. In contrast, IR QSOs and ULIRGs have comparable PAH and [NeII] luminosities. These results are consistent with IR QSOs being at a transitional stage from ULIRGs to classical QSOs. We also find that the colour index alpha(30, 15) is a good indicator of the relative contribution of starbursts to AGNs for all QSOs. Correlations between the [NeII] 12.81um and PAH 6.2um luminosities and those between the [NeII], PAH with 60um luminosities for ULIRGs and IR QSOs indicate that both [NeII] and PAH luminosities are approximate star formation rate indicators for IR QSOs and starburst-dominated galaxies; the scatters are, however, quite large (~ 0.7 to 0.8 dex). Finally the correlation between the EW(PAH 6.2um) and outflow velocities suggests that star formation activities are suppressed by feedback from AGNs and/or supernovae.Comment: 19 pages, 8 figures, 6 tables, accepted for publication in MNRA

Disorder and size effects on Kondo interactions and magnetic correlations in CePt2 nanoscrystals

The evolution of the Kondo effect and magnetic correlations with size reduction in CePt{sub 2} nanoparticles (3.1-26 nm) is studied by analysis of the temperature-dependent specific heat and magnetic susceptibility. The antiferromagnetic correlations diminish with size reduction. The Kondo effect predominates at small particle size with trivalent, small Kondo temperature (T{sub K}) magnetic regions coexisting with strongly mixed valent, large T{sub K} nonmagnetic regions. We discuss the role of structural disorder, background density of states and the electronic quantum size effect on the results

Observing Supermassive Black Holes across cosmic time: from phenomenology to physics

In the last decade, a combination of high sensitivity, high spatial resolution observations and of coordinated multi-wavelength surveys has revolutionized our view of extra-galactic black hole (BH) astrophysics. We now know that supermassive black holes reside in the nuclei of almost every galaxy, grow over cosmological times by accreting matter, interact and merge with each other, and in the process liberate enormous amounts of energy that influence dramatically the evolution of the surrounding gas and stars, providing a powerful self-regulatory mechanism for galaxy formation. The different energetic phenomena associated to growing black holes and Active Galactic Nuclei (AGN), their cosmological evolution and the observational techniques used to unveil them, are the subject of this chapter. In particular, I will focus my attention on the connection between the theory of high-energy astrophysical processes giving rise to the observed emission in AGN, the observable imprints they leave at different wavelengths, and the methods used to uncover them in a statistically robust way. I will show how such a combined effort of theorists and observers have led us to unveil most of the SMBH growth over a large fraction of the age of the Universe, but that nagging uncertainties remain, preventing us from fully understating the exact role of black holes in the complex process of galaxy and large-scale structure formation, assembly and evolution.Comment: 46 pages, 21 figures. This review article appears as a chapter in the book: "Astrophysical Black Holes", Haardt, F., Gorini, V., Moschella, U and Treves A. (Eds), 2015, Springer International Publishing AG, Cha

Highly malignant soft tissue sarcoma of the extremity with a delayed diagnosis

<p>Abstract</p> <p>Purpose</p> <p>To evaluate the characteristics of highly malignant soft tissue sarcoma of the extremity with a delayed diagnosis.</p> <p>Materials and methods</p> <p>The clinical and radiological characteristics of 18 cases of highly malignant soft tissue sarcomas of the extremity with a delayed diagnosis were determined.</p> <p>Results</p> <p>Ten men and eight women of mean age 44.8 years (range, 15-79 years) were included in this study. Seven cases of synovial sarcoma, three cases each of alveolar soft part sarcoma and malignant fibrous histiocytoma, two cases each of highly malignant leiomyosarcoma and myxofibrosarcoma, and one case of clear cell sarcoma were enrolled. Times from tumor detection to diagnosis ranged from 1 to 3 years in most cases; three of the seven synovial sarcoma cases took more than 10 years to diagnose. Of the seven cases of synovial sarcoma, five cases of small, superficial located masses were simply excised without a pre-surgical biopsy. Three cases of alveolar soft part sarcoma showed characteristic T1- and T2-weighted high signal intensities with signal voids in MR images. In addition, one synovial sarcoma patient and one alveolar soft part sarcoma patient showed evidence of calcification on plain radiographs. However, no general characteristic clinical findings were found to be common to the 18 cases.</p> <p>Conclusions</p> <p>Contrary to general expectations, some soft tissue tumors that grow slowly are painless, and those that occur in superficial limbs may be highly malignant. Thus, even when a slow growing, painless superficial mass is encountered in a limb, physicians should keep the possibility of highly malignant soft tissue sarcoma in mind.</p

Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: An update 2018

Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the 'gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages. These include pre-endoscopy risk stratification scores, blood and platelet transfusion, use of proton pump inhibitors; during endoscopy new haemostasis techniques (haemostatic powder spray and over-the-scope clips); and post-endoscopy management by second-look endoscopy and medication strategies. Emerging techniques, including capsule endoscopy and Doppler endoscopic probe in assessing adequacy of endoscopic therapy, and the pre-emptive use of angiographic embolisation, are attracting new attention. An emerging problem is the increasing use of dual antiplatelet agents and direct oral anticoagulants in patients with cardiac and cerebrovascular diseases. Guidelines on the discontinuation and then resumption of these agents in patients presenting with NVUGIB are very much needed. The Asia-Pacific Working Group examined recent evidence and recommends practical management guidelines in this updated consensus statement

Familial Mediterranean fever, Inflammation and Nephrotic Syndrome: Fibrillary Glomerulopathy and the M680I Missense Mutation

BACKGROUND: Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by inflammatory serositis (fever, peritonitis, synovitis and pleuritis). The gene locus responsible for FMF was identified in 1992 and localized to the short arm of chromosome 16. In 1997, a specific FMF gene locus, MEFV, was discovered to encode for a protein, pyrin that mediates inflammation. To date, more than forty missense mutations are known to exist. The diversity of mutations identified has provided insight into the variability of clinical presentation and disease progression. CASE REPORT: We report an individual heterozygous for the M680I gene mutation with a clinical diagnosis of FMF using the Tel-Hashomer criteria. Subsequently, the patient developed nephrotic syndrome with biopsy-confirmed fibrillary glomerulonephritis (FGN). Further diagnostic studies were unremarkable with clinical workup negative for amyloidosis or other secondary causes of nephrotic syndrome. DISCUSSION: Individuals with FMF are at greater risk for developing nephrotic syndrome. The most serious etiology is amyloidosis (AA variant) with renal involvement, ultimately progressing to end-stage renal disease. Other known renal diseases in the FMF population include IgA nephropathy, IgM nephropathy, Henoch-Schönlein purpura as well as polyarteritis nodosa. CONCLUSION: To our knowledge, this is the first association between FMF and the M680I mutation later complicated by nephrotic syndrome and fibrillary glomerulonephritis