255 research outputs found
Perceptions of patients with rheumatic diseases on the impact on daily life and satisfaction with their medications: RHEU-LIFE, a survey to patients treated with subcutaneous biological products
[Abstract] Objective: The aim of this study was to explore perceptions of patients with rheumatic diseases treated with subcutaneous (SC) biological drugs on the impact on daily life and satisfaction with current therapy, including preferred attributes.
Methods: A survey was developed ad hoc by four rheumatologists and three patients, including Likert questions on the impact of disease and treatment on daily life and preferred attributes of treatment. Rheumatologists from 50 participating centers were instructed to handout the survey to 20 consecutive patients with rheumatoid arthritis (RA), axial spondyloarthritis (ax-SpA), or psoriatic arthritis (PsA) receiving SC biological drugs. Patients responded to the survey at home and sent it to a central facility by prepaid mail.
Results: A total of 592 patients returned the survey (response rate: 59.2%), 51.4% of whom had RA, 23.8% had ax-SpA, and 19.6% had PsA. Patients reported moderate-to-severe impact of their disease on their quality of life (QoL) (51.9%), work/daily activities (49.2%), emotional well-being (41.0%), personal relationships (26.0%), and close relatives’ life (32.3%); 30%–50% patients reported seldom/never being inquired about these aspects by their rheumatologists. Treatment attributes ranked as most important were the normalization of QoL (43.6%) and the relief from symptoms (35.2%). The satisfaction with their current antirheumatic therapy was high (>80% were “satisfied” or “very satisfied”), despite moderate/severe impact of disease.
Conclusion: Patients with rheumatic diseases on SC biological therapy perceive a high disease impact on different aspects of daily life, despite being highly satisfied with their treatment; the perception is that physicians do not frequently address personal problems. Normalization of QoL is the most important attribute of therapies to patients
Proctitis in patients with monkeypox infection: a single‑center analysis of 42 consecutive cases from a multidisciplinary observational study on monkeypox proctitis
Background: The current monkeypox (MP) virus outbreak was declared an international emergency in July 2022. The aim of this report is to describe our initial experience with patients with MP, focusing on proctitis. Methods: We conducted an observational study between 20 May and 31 July 2022, on patients with MP at a reference tertiary center in Madrid, Spain. A descriptive analysis on MP was performed, focusing on its characteristics, symptoms, diagnosis, and outcomes. Results: A total of 143 positive MP cases were diagnosed in our center; 42 of them [all male, median age 39 years (range: 22–57 years)] had proctitis (29.37%), and 3 patients (2.09%/MP total cases and 7.14%/MP proctitis) required surgical drainage of a perianal abscess. Conclusions: General and digestive surgeons must be aware of the presence of proctological impairment and complications due to MP viru
Observation of the Crab Nebula with the HAWC Gamma-Ray Observatory
The Crab Nebula is the brightest TeV gamma-ray source in the sky and has been
used for the past 25 years as a reference source in TeV astronomy, for
calibration and verification of new TeV instruments. The High Altitude Water
Cherenkov Observatory (HAWC), completed in early 2015, has been used to observe
the Crab Nebula at high significance across nearly the full spectrum of
energies to which HAWC is sensitive. HAWC is unique for its wide field-of-view,
nearly 2 sr at any instant, and its high-energy reach, up to 100 TeV. HAWC's
sensitivity improves with the gamma-ray energy. Above 1 TeV the
sensitivity is driven by the best background rejection and angular resolution
ever achieved for a wide-field ground array.
We present a time-integrated analysis of the Crab using 507 live days of HAWC
data from 2014 November to 2016 June. The spectrum of the Crab is fit to a
function of the form . The data is well-fit with values of
, , and
log when
is fixed at 7 TeV and the fit applies between 1 and 37 TeV. Study of the
systematic errors in this HAWC measurement is discussed and estimated to be
50\% in the photon flux between 1 and 37 TeV.
Confirmation of the Crab flux serves to establish the HAWC instrument's
sensitivity for surveys of the sky. The HAWC survey will exceed sensitivity of
current-generation observatories and open a new view of 2/3 of the sky above 10
TeV.Comment: Submitted 2017/01/06 to the Astrophysical Journa
All-particle cosmic ray energy spectrum measured by the HAWC experiment from 10 to 500 TeV
We report on the measurement of the all-particle cosmic ray energy spectrum
with the High Altitude Water Cherenkov (HAWC) Observatory in the energy range
10 to 500 TeV. HAWC is a ground based air-shower array deployed on the slopes
of Volcan Sierra Negra in the state of Puebla, Mexico, and is sensitive to
gamma rays and cosmic rays at TeV energies. The data used in this work were
taken from 234 days between June 2016 to February 2017. The primary cosmic-ray
energy is determined with a maximum likelihood approach using the particle
density as a function of distance to the shower core. Introducing quality cuts
to isolate events with shower cores landing on the array, the reconstructed
energy distribution is unfolded iteratively. The measured all-particle spectrum
is consistent with a broken power law with an index of prior to
a break at ) TeV, followed by an index of . The
spectrum also respresents a single measurement that spans the energy range
between direct detection and ground based experiments. As a verification of the
detector response, the energy scale and angular resolution are validated by
observation of the cosmic ray Moon shadow's dependence on energy.Comment: 16 pages, 11 figures, 4 tables, submission to Physical Review
Daily monitoring of TeV gamma-ray emission from Mrk 421, Mrk 501, and the Crab Nebula with HAWC
We present results from daily monitoring of gamma rays in the energy range
to TeV with the first 17 months of data from the High
Altitude Water Cherenkov (HAWC) Observatory. Its wide field of view of 2
steradians and duty cycle of % are unique features compared to other TeV
observatories that allow us to observe every source that transits over HAWC for
up to hours each sidereal day. This regular sampling yields
unprecedented light curves from unbiased measurements that are independent of
seasons or weather conditions. For the Crab Nebula as a reference source we
find no variability in the TeV band. Our main focus is the study of the TeV
blazars Markarian (Mrk) 421 and Mrk 501. A spectral fit for Mrk 421 yields a
power law index and
an exponential cut-off
TeV. For Mrk 501, we find an index and exponential cut-off TeV. The light curves for both sources show clear
variability and a Bayesian analysis is applied to identify changes between flux
states. The highest per-transit fluxes observed from Mrk 421 exceed the Crab
Nebula flux by a factor of approximately five. For Mrk 501, several transits
show fluxes in excess of three times the Crab Nebula flux. In a comparison to
lower energy gamma-ray and X-ray monitoring data with comparable sampling we
cannot identify clear counterparts for the most significant flaring features
observed by HAWC.Comment: 18 pages, 10 figures, accepted for publication in The Astrophysical
Journa
Constraining the Ratio in TeV Cosmic Rays with Observations of the Moon Shadow by HAWC
An indirect measurement of the antiproton flux in cosmic rays is possible as
the particles undergo deflection by the geomagnetic field. This effect can be
measured by studying the deficit in the flux, or shadow, created by the Moon as
it absorbs cosmic rays that are headed towards the Earth. The shadow is
displaced from the actual position of the Moon due to geomagnetic deflection,
which is a function of the energy and charge of the cosmic rays. The
displacement provides a natural tool for momentum/charge discrimination that
can be used to study the composition of cosmic rays. Using 33 months of data
comprising more than 80 billion cosmic rays measured by the High Altitude Water
Cherenkov (HAWC) observatory, we have analyzed the Moon shadow to search for
TeV antiprotons in cosmic rays. We present our first upper limits on the
fraction, which in the absence of any direct measurements, provide
the tightest available constraints of on the antiproton fraction for
energies between 1 and 10 TeV.Comment: 10 pages, 5 figures. Accepted by Physical Review
Very high energy particle acceleration powered by the jets of the microquasar SS 433
SS 433 is a binary system containing a supergiant star that is overflowing
its Roche lobe with matter accreting onto a compact object (either a black hole
or neutron star). Two jets of ionized matter with a bulk velocity of
extend from the binary, perpendicular to the line of sight, and
terminate inside W50, a supernova remnant that is being distorted by the jets.
SS 433 differs from other microquasars in that the accretion is believed to be
super-Eddington, and the luminosity of the system is erg
s. The lobes of W50 in which the jets terminate, about 40 pc from the
central source, are expected to accelerate charged particles, and indeed radio
and X-ray emission consistent with electron synchrotron emission in a magnetic
field have been observed. At higher energies (>100 GeV), the particle fluxes of
rays from X-ray hotspots around SS 433 have been reported as flux
upper limits. In this energy regime, it has been unclear whether the emission
is dominated by electrons that are interacting with photons from the cosmic
microwave background through inverse-Compton scattering or by protons
interacting with the ambient gas. Here we report TeV -ray observations
of the SS 433/W50 system where the lobes are spatially resolved. The TeV
emission is localized to structures in the lobes, far from the center of the
system where the jets are formed. We have measured photon energies of at least
25 TeV, and these are certainly not Doppler boosted, because of the viewing
geometry. We conclude that the emission from radio to TeV energies is
consistent with a single population of electrons with energies extending to at
least hundreds of TeV in a magnetic field of ~micro-Gauss.Comment: Preprint version of Nature paper. Contacts: S. BenZvi, B. Dingus, K.
Fang, C.D. Rho , H. Zhang, H. Zho
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