On the modulation of low frequency Quasi-Periodic Oscillations in black-hole transients

We studied the properties of the low-frequency quasi-periodic oscillations detected in a sample of six black hole candidates (XTE J1550-564, H 1743-322, XTE J1859+226, 4U 1630-47,GX 339-4, XTE J1650-500) observed by the Rossi XTE satellite. We analyzed the relation between the full width half maximum and the frequency of all the narrow peaks detected in power density spectra where a type-C QPO is observed. Our goal was to understand the nature of the modulation of the signal by comparing the properties of different harmonic peaks in the power density spectrum. We find that for the sources in our sample the width of the fundamental and of the first harmonic are compatible with a frequency modulation, while that of the sub-harmonic is independent of frequency, possibly indicating the presence of an additional modulation in amplitude. We compare our results with those obtained earlier from GRS 1915+105 and XTE J1550-564.Comment: 8 pages, 3 figures, accepted for publication in Monthly Notices of the Royal Astronomical Society Main Journa

‘It would help people to help me’: Acceptability of digital phenotyping among young people with visual impairment and their families

Objectives: To explore the acceptability of an eHealth App for vision-related monitoring and symptom reporting among young people with a visual impairment and their parents. Methods: Qualitative investigation using virtual semi-structured focus groups (via Zoom software) of seven young participants with a genetic eye disorder including inherited retinal disease and structural eye abnormalities (e.g. microphthalmia), and 7 parents; all recruited from ocular genetic clinics at Moorfields Eye Hospital. Audio transcripts were analysed using thematic analysis. Results: Data were coded into six key themes: (1) increased involvement in care, (2) opportunity for less hospital-centric care, (3) better representation of visual impairment in a real-world setting, (4) trust in a reputable service provider, (5) harnessing data for health purposes and (6) intended purpose of the app. Both young people and their families were accepting of an eHealth app and felt they would be empowered by greater involvement in their care plan, if privacy of the data was retained, and information was managed correctly. While parents endorsed the opportunity for mental health tracking, young people were hesitant towards its inclusion. Conclusion: In summary, there was overall acceptability of an eHealth app among young people with a visual impairment and their parents. These findings will help to maximise the effective integration of digital phenotyping when monitoring and supporting young people experiencing sight loss

Tonsillectomy and its effect on ASO titre

Background: Acute tonsillitis is one of the most common manifestations of the upper respiratory tract infections. It is common in children and accounts for an incidence of about 32 per 1000 patients per year. The objective of this study was to determine the effect of tonsillectomy on ASO titre and to evaluate the sensitivity and specificity of throat swab culture.Methods: Present study performed a prospective study, a total number of 50 children were screened, out which 25 patients under the age of 15 years (16 male and 9 female), were included in the study, who were having chronic tonsillitis with raised anti-streptolysin O titre (>200IU/ml). All the patient underwent tonsillectomy and serological estimation of ASO titre was done at the end of first, second and third month post-surgery. Throat swab culture was performed prior to tonsillectomy and at the third month of follow up.Results: Twelve children (48%), twenty children (80%) and twenty-two children (88%) became serologically negative for ASO antibody at the end of first, second and third month respectively, with a statistically significant p value of 0.0001. The sensitivity and specificity of throat swab culture was 16% and 100% respectively.Conclusions: Tonsillectomy has a significant role in reducing the serological levels of anti-streptolysin O antibody and its reactivation, thereby decreasing the rate of complications associated with Group A-beta haemolytic streptococci

Severe androgenetic alopecia as a maker of metabolic syndrome in male patients of androgenetic alopecia: a hospital based case control study

Background: Several previous studies have investigated the association between androgenetic alopecia (AGA) and metabolic syndrome (MS), with inconsistent results. Objectives of the study were to study the prevalence of metabolic syndrome in male patients of androgenetic alopecia and compare with control population and study the relationship of metabolic syndrome with different grades of AGA.Methods: This prospective hospital based case control study included 100 new clinically diagnosed males of androgenetic alopecia, and age and sex matched control group. Assessment for presence of various components of metabolic syndrome was done following a uniform protocol in cases and controls. AGA was classified as per Hamilton –Narwood classification, grade I to III was classified as mild –moderate and grade IV and higher as severe AGA.Results: Of the 100 male AGA patients (age range 21-50, mean 34.49), 36 had grade II AGA, 24 had grade III AGA, 20 had grade IV AGA, 15 had grade V AGA and 5 had grade VI AGA. Among AGA patients, 60 of patients had mild-moderate AGA and 40 patients had severe AGA. Metabolic syndrome was statistically significantly more common in patients with AGA compared to controls. Among patients of AGA, metabolic syndrome was statistically significantly present in severe AGA compared to mild-moderate AGA. Among the evaluated parameters, like blood pressure, fasting blood sugar, dyslipedemia, abdominal obesity, all were significantly more common in AGA patients compared to controls except abdominal obesity.Conclusions: In the present study, metabolic syndrome was found to be 4.6 times more common in patients of androgenetic alopecia as compared to controls, being statistically significant, and more common in those with severe grades. This suggests that androgenetic alopecia patients especially with severe grades are at risk of metabolic syndrome and other cardiovascular diseases

Incidence of Insect Pests on Vegetable Crops in Trans-Himalayan Ladakh India A Survey

Insect pests are among the most critical constraints limiting vegetable production in trans-Himalayan Ladakh. However, there is limited information about the extent of crop damage, which hinders the development of effective pest management approaches for vegetable growers. The present study, therefore, aimed to identify farmers’ perceptions of the most damaging insect pests of vegetable crops and the extent of crop damage in the Ladakh region. A standard questionnaire was used to interview individual vegetable growers (n=586) about their perception regarding insect pests in four major vegetable-producing valleys in the region. Most farmers (87.9 %) perceived insect pest attacks on vegetable crops have increased in the past ten years. Among the insect pests reported by the growers, onion maggot was ranked the most damaging by 58.4 % of the respondents, followed by aphids (22.7 %), the caterpillar of cabbage butterfly (16.0 %), and cutworms (2.9 % of the respondents). Of the farmers surveyed, 35.5 % of vegetable growers reported that the onion maggot caused over 70 % damage to onion crops. The result of the study will enable the researchers, extension personnel, administrators, and policymakers to prioritize developing strategies for managing these key insect pests in the region. To our knowledge, no such data for the region is available

Hard and soft multilayered SiCN nanocoatings with high hardness and toughness

Alternate hard and soft layers increase deformation accommodation as thin hard layers slide relative to each other due to shear deformation of low modulus layers. However, the processing of such multilayers is challenging. In the present paper the alternating soft and hard multilayered SiCN coating deposited by magnetron sputtering has been studied and presented. A hardness and modulus of 37 GPa and 317 GPa with elastic recovery of 62% are achieved by alternate hard and soft layer of Si-C-N by magnetron sputtering. The trilayer films sustained even 2000 gf under indentation without failure though substrate plastically deformed. The fracture toughness value K-IC was measured to be 9.5-10 MPa m(1/2), significantly higher than many reported hard coatings

Tracking Cardiac Rehabilitation Utilization in Medicare Beneficiaries: 2017 UPDATE

PURPOSE: This study updates cardiac rehabilitation (CR) utilization data in a cohort of Medicare beneficiaries hospitalized for CR-eligible events in 2017, including stratification by select patient demographics and state of residence. METHODS: We identified Medicare fee-for-service beneficiaries who experienced a CR-eligible event and assessed their CR participation (≥1 CR sessions in 365 d), engagement, and completion (≥36 sessions) rates through September 7, 2019. Measures were assessed overall, by beneficiary characteristics and state of residence, and by primary (myocardial infarction; coronary artery bypass surgery; heart valve repair/replacement; percutaneous coronary intervention; or heart/heart-lung transplant) and secondary (angina; heart failure) qualifying event type. RESULTS: In 2017, 412 080 Medicare beneficiaries had a primary CR-eligible event and 28.6% completed ≥1 session of CR within 365 d after discharge from a qualifying event. Among beneficiaries who completed ≥1 CR session, the mean total number of sessions was 25 ± 12 and 27.6% completed ≥36 sessions. Nebraska had the highest enrollment rate (56.1%), with four other states also achieving an enrollment rate \u3e50% and 23 states falling below the overall rate for the United States. CONCLUSIONS: The absolute enrollment, engagement, and program completion rates remain low among Medicare beneficiaries, indicating that many patients did not benefit or fully benefit from a class I guideline-recommended therapy. Additional research and continued widespread adoption of successful enrollment and engagement initiatives are needed, especially among identified populations

Progressive pulmonary fibrosis: an expert group consensus statement

This expert group consensus statement emphasises the need for standardising the definition of progressive fibrosing interstitial lung diseases (F-ILDs), with an accurate initial diagnosis being of paramount importance in ensuring appropriate initial management. Equally, case-by-case decisions on monitoring and management are essential, given the varying presentations of F-ILDs and the varying rates of progression. The value of diagnostic tests in risk stratification at presentation and, separately, the importance of a logical monitoring strategy, tailored to manage the risk of progression, are also stressed. The term “progressive pulmonary fibrosis” (PPF) exactly describes the entity that clinicians often face in practice. The importance of using antifibrotic therapy early in PPF (once initial management has failed to prevent progression) is increasingly supported by evidence. Artificial intelligence software for high-resolution computed tomography analysis, although an exciting tool for the future, awaits validation. Guidance is provided on pulmonary rehabilitation, oxygen and the use of non-invasive ventilation focused specifically on the needs of ILD patients with progressive disease. PPF should be differentiated from acute deterioration due to drug-induced lung toxicity or other forms of acute exacerbations. Referral criteria for a lung transplant are discussed and applied to patient needs in severe diseases where transplantation is not realistic, either due to access limitations or transplantation contraindications. In conclusion, expert group consensus guidance is provided on the diagnosis, treatment and monitoring of F-ILDs with specific focus on the recognition of PPF and the management of pulmonary fibrosis progressing despite initial management