The AGASA/SUGAR Anisotropies and TeV Gamma Rays from the Galactic Center: A Possible Signature of Extremely High-energy Neutrons

Recent analysis of data sets from two extensive air shower cosmic ray detectors shows tantalizing evidence of an anisotropic overabundance of cosmic rays towards the Galactic Center (GC) that ``turns on'' around $10^{18}$ eV. We demonstrate that the anisotropy could be due to neutrons created at the Galactic Center through charge-exchange in proton-proton collisions, where the incident, high energy protons obey an $\sim E^{-2}$ power law associated with acceleration at a strong shock. We show that the normalization supplied by the gamma-ray signal from EGRET GC source 3EG J1746-2851 -- ascribed to pp induced neutral pion decay at GeV energies -- together with a very reasonable spectral index of 2.2, predicts a neutron flux at $\sim 10^{18}$ eV fully consistent with the extremely high energy cosmic ray data. Likewise, the normalization supplied by the very recent GC data from the HESS air-Cerenkov telescope at \~TeV energies is almost equally-well compatible with the $\sim 10^{18}$ eV cosmic ray data. Interestingly, however, the EGRET and HESS data appear to be themselves incompatible. We consider the implications of this discrepancy. We discuss why the Galactic Center environment can allow diffusive shock acceleration at strong shocks up to energies approaching the ankle in the cosmic ray spectrum. Finally, we argue that the shock acceleration may be occuring in the shell of Sagittarius A East, an unusual supernova remnant located very close to the Galactic Center. If this connection between the anisotropy and Sagittarius A East could be firmly established it would be the first direct evidence for a particular Galactic source of cosmic rays up to energies near the ankle.Comment: 57 pages, 2 figure

Source Dimensions in Ultrarelativistic Heavy Ion Collisions

Recent experiments on pion correlations, interpreted as interferometric measurements of the collision zone, are compared with models that distinguish a prehadronic phase and a hadronic phase. The models include prehadronic longitudinal expansion, conversion to hadrons in local kinetic equilibrium, and rescattering of the produced hadrons. We find that the longitudinal and outward radii are surprisingly sensitive to the algorithm used for two-body collisions. The longitudinal radius measured in collisions of 200 GeV/u sulfur nuclei on a heavy target requires the existence of a prehadronic phase which converts to the hadronic phase at densities around 0.8-1.0 GeV/fm$^3$. The transverse radii cannot be reproduced without introducing more complex dynamics into the transverse expansion.Comment: RevTeX 3.0, 28 pages, 6 figures, not included, revised version, major change is an additional discussion of the classical two-body collision algorithm, a (compressed) postscript file of the complete paper including figures can be obtained from Authors or via anonymous ftp at ftp://ftp_int.phys.washington.edu/pub/herrmann/pisource.ps.

Independent external validation of a stroke recurrence score in patients with embolic stroke of undetermined source

Abstract Background Embolic stroke of undetermined source (ESUS) accounts for a substantial proportion of ischaemic strokes. A stroke recurrence score has been shown to predict the risk of recurrent stroke in patients with ESUS based on a combination of clinical and imaging features. This study aimed to externally validate the performance of the ESUS recurrence score using data from a randomized controlled trial. Methods The validation dataset consisted of eligible stroke patients with available magnetic resonance imaging (MRI) data enrolled in the PreDAFIS sub-study of the MonDAFIS study. The score was calculated using three variables: age (1 point per decade after 35 years), presence of white matter hyperintensities (2 points), and multiterritorial ischaemic stroke (3 points). Patients were assigned to risk groups as described in the original publication. The model was evaluated using standard discrimination and calibration methods. Results Of the 1054 patients, 241 (22.9%) were classified as ESUS. Owing to insufficient MRI quality, three patients were excluded, leaving 238 patients (median age 65.5 years [IQR 20.75], 39% female) for analysis. Of these, 30 (13%) patients experienced recurrent ischaemic stroke or transient ischemic attack (TIA) during a follow-up period of 383 patient-years, corresponding to an incidence rate of 7.8 per 100 patient-years (95% CI 5.3–11.2). Patients with an ESUS recurrence score value of ≥ 7 had a 2.46 (hazard ratio (HR), 95% CI 1.02–5.93) times higher risk of stroke recurrence than patients with a score of 0–4. The cumulative probability of stroke recurrence in the low-(0–4), intermediate-(5–6), and high-risk group (≥ 7) was 9%, 13%, and 23%, respectively (log-rank test, χ2 = 4.2, p = 0.1). Conclusions This external validation of a published scoring system supports a threshold of ≥ 7 for identifying ESUS patients at high-risk of stroke recurrence. However, further adjustments may be required to improve the model’s performance in independent cohorts. The use of risk scores may be helpful in guiding extended diagnostics and further trials on secondary prevention in patients with ESUS. Trial registration: Clinical Trials, NCT02204267. Registered 30 July 2014, https://clinicaltrials.gov/ct2/show/NCT02204267

Properties of Accretion Flows Around Coalescing Supermassive Black Holes

What are the properties of accretion flows in the vicinity of coalescing supermassive black holes (SBHs)? The answer to this question has direct implications for the feasibility of coincident detections of electromagnetic (EM) and gravitational wave (GW) signals from coalescences. Such detections are considered to be the next observational grand challenge that will enable testing general relativity in the strong, nonlinear regime and improve our understanding of evolution and growth of these massive compact objects. In this paper we review the properties of the environment of coalescing binaries in the context of the circumbinary disk and hot, radiatively inefficient accretion flow models and use them to mark the extent of the parameter space spanned by this problem. We report the results from an ongoing, general relativistic, hydrodynamical study of the inspiral and merger of black holes, motivated by the latter scenario. We find that correlated EM+GW oscillations can arise during the inspiral phase followed by the gradual rise and subsequent drop-off in the light curve at the time of coalescence. While there are indications that the latter EM signature is a more robust one, a detection of either signal coincidentally with GWs would be a convincing evidence for an impending SBH binary coalescence. The observability of an EM counterpart in the hot accretion flow scenario depends on the details of a model. In the case of the most massive binaries observable by the Laser Interferometer Space Antenna, upper limits on luminosity imply that they may be identified by EM searches out to z~0.1-1. However, given the radiatively inefficient nature of the gas flow, we speculate that a majority of massive binaries may appear as low luminosity AGN in the local universe.Comment: Revised version accepted to Class. Quantum Grav. for proceedings of 8th LISA Symposium. 15 pages, 3 figures, includes changes suggested in referee report

The (Surprising) Efficacy of Academic and Behavioral Intervention with Disadvantaged Youth : Results from a Randomized Experiment in Chicago

There is growing concern that improving the academic skills of disadvantaged youth is too difficult and costly, so policymakers should instead focus either on vocationally oriented instruction for teens or else on early childhood education. Yet this conclusion may be premature given that so few previous interventions have targeted a potential fundamental barrier to school success: "mismatch" between what schools deliver and the needs of disadvantaged youth who have fallen behind in their academic or non-academic development. This paper reports on a randomized controlled trial of a two-pronged intervention that provides disadvantaged youth with non-academic supports that try to teach youth social-cognitive skills based on the principles of cognitive behavioral therapy (CBT), and intensive individualized academic remediation. The study sample consists of 106 male 9th and 10th graders in a public high school on the south side of Chicago, of whom 95% are black and 99% are free or reduced price lunch eligible. Participation increased math test scores by 0.65 of a control group standard deviation (SD) and 0.48 SD in the national distribution, increased math grades by 0.67 SD, and seems to have increased expected graduation rates by 14 percentage points (46%). While some questions remain about the intervention, given these effects and a cost per participant of around $4,400 (with a range of$3,000 to $6,000), this intervention seems to yield larger gains in adolescent outcomes per dollar spent than many other intervention strategies

Comparison of patient comprehension of rapid HIV pre-test fundamentals by information delivery format in an emergency department setting

<p>Abstract</p> <p>Background</p> <p>Two trials were conducted to compare emergency department patient comprehension of rapid HIV pre-test information using different methods to deliver this information.</p> <p>Methods</p> <p>Patients were enrolled for these two trials at a US emergency department between February 2005 and January 2006. In Trial One, patients were randomized to a no pre-test information or an in-person discussion arm. In Trial Two, a separate group of patients were randomized to an in-person discussion arm or a Tablet PC-based video arm. The video, "Do you know about rapid HIV testing?", and the in-person discussion contained identical Centers for Disease Control and Prevention-suggested pre-test information components as well as information on rapid HIV testing with OraQuick^®. Participants were compared by information arm on their comprehension of the pre-test information by their score on a 26-item questionnaire using the Wilcoxon rank-sum test.</p> <p>Results</p> <p>In Trial One, 38 patients completed the no-information arm and 31 completed the in-person discussion arm. Of these 69 patients, 63.8% had twelve years or fewer of formal education and 66.7% had previously been tested for HIV. The mean score on the questionnaire for the in-person discussion arm was higher than for the no information arm (18.7 vs. 13.3, p ≤ 0.0001). In Trial Two, 59 patients completed the in-person discussion and 55 completed the video arms. Of these 114 patients, 50.9% had twelve years or fewer of formal education and 68.4% had previously been tested for HIV. The mean score on the questionnaire for the video arm was similar to the in-person discussion arm (20.0 vs. 19.2; p ≤ 0.33).</p> <p>Conclusion</p> <p>The video "Do you know about rapid HIV testing?" appears to be an acceptable substitute for an in-person pre-test discussion on rapid HIV testing with OraQuick^®. In terms of adequately informing ED patients about rapid HIV testing, either form of pre-test information is preferable than for patients to receive no pre-test information.</p

A Pair of Dopamine Neurons Target the D1-Like Dopamine Receptor DopR in the Central Complex to Promote Ethanol-Stimulated Locomotion in Drosophila

Dopamine is a mediator of the stimulant properties of drugs of abuse, including ethanol, in mammals and in the fruit fly Drosophila. The neural substrates for the stimulant actions of ethanol in flies are not known. We show that a subset of dopamine neurons and their targets, through the action of the D1-like dopamine receptor DopR, promote locomotor activation in response to acute ethanol exposure. A bilateral pair of dopaminergic neurons in the fly brain mediates the enhanced locomotor activity induced by ethanol exposure, and promotes locomotion when directly activated. These neurons project to the central complex ellipsoid body, a structure implicated in regulating motor behaviors. Ellipsoid body neurons are required for ethanol-induced locomotor activity and they express DopR. Elimination of DopR blunts the locomotor activating effects of ethanol, and this behavior can be restored by selective expression of DopR in the ellipsoid body. These data tie the activity of defined dopamine neurons to D1-like DopR-expressing neurons to form a neural circuit that governs acute responding to ethanol

Evaluation of the third- and fourth-generation GOCE Earth gravity field models with Australian terrestrial gravity data in spherical harmonics

In March 2013 the fourth generation of ESA’s (European Space Agency) global gravity field models, DIR4 (Bruinsma et al, 2010b) and TIM4 (Pail et al, 2010), generated from the GOCE (Gravity field and steady-state Ocean Circulation Explorer) gravity observation satellite were released. We evaluate the models using an independent ground truth data set of gravity anomalies over Australia. Combined with GRACE (Gravity Recovery and Climate Experiment) satellite gravity, a new gravity model is obtained that is used to perform comparisons with GOCE models in spherical harmonics. Over Australia, the new gravity model proves to have significantly higher accuracy in the degrees below 120 as compared to EGM2008 and seems to be at least comparable to the accuracy of this model between degree 150 and degree 260. Comparisons in terms of residual quasi-geoid heights, gravity disturbances, and radial gravity gradients evaluated on the ellipsoid and at approximate GOCE mean satellite altitude (h=250 km) show both fourth generation models to improve significantly w.r.t. their predecessors.Relatively, we find a root-mean-square improvement of 39 % for the DIR4 and 23 % for TIM4 over the respective third release models at a spatial scale of 100 km (degree 200). In terms of absolute errors TIM4 is found to perform slightly better in the bands from degree 120 up to degree 160 and DIR4 is found to perform slightly better than TIM4 from degree 170 up to degree 250. Our analyses cannot confirm the DIR4 formal error of 1 cm geoid height (0.35 mGal in terms of gravity) at degree 200. The formal errors of TIM4, with 3.2 cm geoid height (0.9 mGal in terms of gravity) at degree 200, seem to be realistic. Due to combination with GRACE and SLR data, the DIR models, at satellite altitude, clearly show lower RMS values compared to TIM models in the long wavelength part of the spectrum (below degree and order 120). Our study shows different spectral sensitivity of different functionals at ground level and at GOCE satellite altitude and establishes the link among these findings and the Meissl scheme (Rummel and van Gelderen in Manuscripta Geodaetica 20:379–385, 1995)

Active rehabilitation for chronic low back pain: Cognitive-behavioral, physical, or both? First direct post-treatment results from a randomized controlled trial [ISRCTN22714229]

BACKGROUND: The treatment of non-specific chronic low back pain is often based on three different models regarding the development and maintenance of pain and especially functional limitations: the deconditioning model, the cognitive behavioral model and the biopsychosocial model. There is evidence that rehabilitation of patients with chronic low back pain is more effective than no treatment, but information is lacking about the differential effectiveness of different kinds of rehabilitation. A direct comparison of a physical, a cognitive-behavioral treatment and a combination of both has never been carried out so far. METHODS: The effectiveness of active physical, cognitive-behavioral and combined treatment for chronic non-specific low back pain compared with a waiting list control group was determined by performing a randomized controlled trial in three rehabilitation centers. Two hundred and twenty three patients were randomized, using concealed block randomization to one of the following treatments, which they attended three times a week for 10 weeks: Active Physical Treatment (APT), Cognitive-Behavioral Treatment (CBT), Combined Treatment of APT and CBT (CT), or Waiting List (WL). The outcome variables were self-reported functional limitations, patient's main complaints, pain, mood, self-rated treatment effectiveness, treatment satisfaction and physical performance including walking, standing up, reaching forward, stair climbing and lifting. Assessments were carried out by blinded research assistants at baseline and immediately post-treatment. The data were analyzed using the intention-to-treat principle. RESULTS: For 212 patients, data were available for analysis. After treatment, significant reductions were observed in functional limitations, patient's main complaints and pain intensity for all three active treatments compared to the WL. Also, the self-rated treatment effectiveness and satisfaction appeared to be higher in the three active treatments. Several physical performance tasks improved in APT and CT but not in CBT. No clinically relevant differences were found between the CT and APT, or between CT and CBT. CONCLUSION: All three active treatments were effective in comparison to no treatment, but no clinically relevant differences between the combined and the single component treatments were found

Lumbar segmental mobility disorders: comparison of two methods of defining abnormal displacement kinematics in a cohort of patients with non-specific mechanical low back pain

BACKGROUND: Lumbar segmental rigidity (LSR) and lumbar segmental instability (LSI) are believed to be associated with low back pain (LBP), and identification of these disorders is believed to be useful for directing intervention choices. Previous studies have focussed on lumbar segmental rotation and translation, but have used widely varying methodologies. Cut-off points for the diagnosis of LSR & LSI are largely arbitrary. Prevalence of these lumbar segmental mobility disorders (LSMDs) in a non-surgical, primary care LBP population has not been established. METHODS: A cohort of 138 consecutive patients with recurrent or chronic low back pain (RCLBP) were recruited in this prospective, pragmatic, multi-centre study. Consenting patients completed pain and disability rating instruments, and were referred for flexion-extension radiographs. Sagittal angular rotation and sagittal translation of each lumbar spinal motion segment was measured from the radiographs, and compared to a reference range derived from a study of 30 asymptomatic volunteers. In order to define reference intervals for normal motion, and define LSR and LSI, we approached the kinematic data using two different models. The first model used a conventional Gaussian definition, with motion beyond two standard deviations (2sd) from the reference mean at each segment considered diagnostic of rotational LSMD and translational LSMD. The second model used a novel normalised within-subjects approach, based on mean normalised contribution-to-total-lumbar-motion. An LSMD was then defined as present in any segment that contributed motion beyond 2sd from the reference mean contribution-to-normalised-total-lumbar-motion. We described reference intervals for normal segmental mobility, prevalence of LSMDs under each model, and the association of LSMDs with pain and disability. RESULTS: With the exception of the conventional Gaussian definition of rotational LSI, LSMDs were found in statistically significant prevalences in patients with RCLBP. Prevalences at both the segmental and patient level were generally higher using the normalised within-subjects model (2.8 to 16.8% of segments; 23.3 to 35.5% of individuals) compared to the conventional Gaussian model (0 to 15.8%; 4.7 to 19.6%). LSMDs are associated with presence of LBP, however LSMDs do not appear to be strongly associated with higher levels of pain or disability compared to other forms of non-specific LBP. CONCLUSION: LSMDs are a valid means of defining sub-groups within non-specific LBP, in a conservative care population of patients with RCLBP. Prevalence was higher using the normalised within-subjects contribution-to-total-lumbar-motion approach