943 research outputs found

    Medication-overuse headache: causes, consequences and management

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    Huntington's disease: A clinical primer for acute and general physicians

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    Huntington's disease (HD) usually manifests in adulthood and is characterised by progressive neurodegeneration in the brain that causes worsening involuntary movements, mental health and cognition over many years. Depression, anxiety and apathy are common. HD is autosomal dominant and affects about 1 in 8,000 people in the UK. There are currently no disease-modifying treatments and so patient care centres on multidisciplinary therapy support and medical treatments to relieve distressing symptoms. Progression of HD is usually slow, and so acute deteriorations often indicate another problem, such as intercurrent infections, constipation, urinary retention, gastro-oesophageal reflux disease or poor dentition. In this review we outline common presentations in HD patients, both acute and chronic, consider therapeutic options and discuss specific considerations in advanced HD

    Genetic modifiers of Mendelian disease: Huntington's disease and the trinucleotide repeat disorders

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    In the decades since the genes and mutations associated with the commoner Mendelian disorders were first discovered, technological advances in genetic analysis have made finding genomic variation a much less onerous task. Recently, the global efforts to collect subjects with Mendelian disorders, to better define the disorders and to empower appropriate clinical trials, along with improved genetic technologies, have allowed the identification of genetic variation that does not cause disease, but substantially modifies disease presentation. The advantage of this is it identifies biological pathways and molecules, that, if modified in people, might alter disease presentation. In Huntington’s disease (HD), caused by an expanded CAG repeat tract in HTT, genetic variation has been uncovered that is associated with change in the onset or progression of disease. Some of this variation lies in genes that are part of the DNA damage response, previously suggested to be important in modulating expansion of the repeat tract in germline and somatic cells. The genetic evidence implicates a DNA damage response-related pathway in modulating the pathogenicity of the repeat tracts in HD, and possibly, in other trinucleotide repeat disorders. These findings offer new targets for drug development in these currently intractable disorders

    Computational Analysis of a Chevron Nozzle Uniquely Tailored for Propulsion Airframe Aeroacoustics

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    A computational flow field and predicted jet noise source analysis is presented for asymmetrical fan chevrons on a modern separate flow nozzle at take off conditions. The propulsion airframe aeroacoustic asymmetric fan nozzle is designed with an azimuthally varying chevron pattern with longer chevrons close to the pylon. A baseline round nozzle without chevrons and a reference nozzle with azimuthally uniform chevrons are also studied. The intent of the asymmetric fan chevron nozzle was to improve the noise reduction potential by creating a favorable propulsion airframe aeroacoustic interaction effect between the pylon and chevron nozzle. This favorable interaction and improved noise reduction was observed in model scale tests and flight test data and has been reported in other studies. The goal of this study was to identify the fundamental flow and noise source mechanisms. The flow simulation uses the asymptotically steady, compressible Reynolds averaged Navier-Stokes equations on a structured grid. Flow computations are performed using the parallel, multi-block, structured grid code PAB3D. Local noise sources were mapped and integrated computationally using the Jet3D code based upon the Lighthill Acoustic Analogy with anisotropic Reynolds stress modeling. In this study, trends of noise reduction were correctly predicted. Jet3D was also utilized to produce noise source maps that were then correlated to local flow features. The flow studies show that asymmetry of the longer fan chevrons near the pylon work to reduce the strength of the secondary flow induced by the pylon itself, such that the asymmetric merging of the fan and core shear layers is significantly delayed. The effect is to reduce the peak turbulence kinetic energy and shift it downstream, reducing overall noise production. This combined flow and noise prediction approach has yielded considerable understanding of the physics of a fan chevron nozzle designed to include propulsion airframe aeroacoustic interaction effects

    Measurements of the Complex Conductivity of NbxSi1-x Alloys on the Insulating Side of the Metal-Insulator Transition

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    We have conducted temperature and frequency dependent transport measurements in amorphous Nb_x Si_{1-x} samples in the insulating regime. We find a temperature dependent dc conductivity consistent with variable range hopping in a Coulomb glass. The frequency dependent response in the millimeter-wave frequency range can be described by the expression sigma(omega)(ıomega)alphasigma(omega) \propto (-\imath omega)^alpha with the exponent somewhat smaller than one. Our ac results are not consistent with extant theories for the hopping transport.Comment: 4 pages with 3 figures; published version has a different title from original (was: "Electrodynamics in a Coulomb glass"

    Computational Analysis of the Flow and Acoustic Effects of Jet-Pylon Interaction

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    Computational simulation and prediction tools were used to understand the jet-pylon interaction effect in a set of bypass-ratio five core/fan nozzles. Results suggest that the pylon acts as a large scale mixing vane that perturbs the jet flow and jump starts the jet mixing process. The enhanced mixing and associated secondary flows from the pylon result in a net increase of noise in the first 10 diameters of the jet s development, but there is a sustained reduction in noise from that point downstream. This is likely the reason the pylon nozzle is quieter overall than the baseline round nozzle in this case. The present work suggests that focused pylon design could lead to advanced pylon shapes and nozzle configurations that take advantage of propulsion-airframe integration to provide additional noise reduction capabilities

    Reconceptualizing Context: A Multilevel Model of the Context of Reception and Second-Generation Educational Attainment

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    This paper seeks to return scholarly attention to a core intellectual divide between segmented and conventional (or neo-)assimilation approaches, doing so through a theoretical and empirical reconsideration of contextual effects on second-generation outcomes. We evaluate multiple approaches to measuring receiving country contextual effects and measuring their impact on the educational attainment of the children of immigrants. We demonstrate that our proposed measures better predict second-generation educational attainment than prevailing approaches, enabling a multilevel modeling strategy that accounts for the structure of immigrant families nested within different receiving contexts
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