158 research outputs found
Multivariable model to predict an ACTH stimulation test to diagnose adrenal insufficiency using previous test results
Context
The adrenocorticotropin hormone stimulation test (AST) is used to diagnose adrenal insufficiency, and is often repeated in patients when monitoring recovery of the hypothalamo–pituitary–adrenal axis.
Objective
To develop and validate a prediction model that uses previous AST results with new baseline cortisol to predict the result of a new AST.
Methods
This was a retrospective, longitudinal cohort study in patients who had undergone at least 2 ASTs, using polynomial regression with backwards variable selection, at a Tertiary UK adult endocrinology center. Model was developed from 258 paired ASTs over 5 years in 175 adults (mean age 52.4 years, SD 16.4), then validated on data from 111 patients over 1 year (51.8, 17.5) from the same center, data collected after model development. Candidate prediction variables included previous test baseline adrenocorticotropin hormone (ACTH), previous test baseline and 30-minute cortisol, days between tests, and new baseline ACTH and cortisol used with calculated cortisol/ACTH ratios to assess 8 candidate predictors. The main outcome measure was a new test cortisol measured 30 minutes after Synacthen administration.
Results
Using 258 sequential ASTs from 175 patients for model development and 111 patient tests for model validation, previous baseline cortisol, previous 30-minute cortisol and new baseline cortisol were superior at predicting new 30-minute cortisol (R2 = 0.71 [0.49-0.93], area under the curve [AUC] = 0.97 [0.94-1.0]) than new baseline cortisol alone (R2 = 0.53 [0.22-0.84], AUC = 0.88 [0.81-0.95]).
Conclusion
Results of a previous AST can be objectively combined with new early-morning cortisol to predict the results of a new AST better than new early-morning cortisol alone. An online calculator is available at https://endocrinology.shinyapps.io/sheffield_sst_calculator/ for external validation
Anti-Search for the Glueball Candidate f_J(2220) in Two-Photon Interactions
Using 13.3 fb^{-1} of e^+e^- data recorded with the CLEO II and CLEO II.V
detector configurations at CESR, we have searched for f_J(2220) decays to
K^0_{S} K^0_{S} in untagged two-photon interactions. We report an upper limit
on the product of the two-photon partial width and the branching fraction,
Gamma_gamma gamma cdot B (f_J(2220) to K^0_{S} K^0_{S}) of less than 1.1 eV at
the 95% C.L: systematic uncertainties are included. This dataset is four times
larger than that used in the previous CLEO publication.Comment: 10 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLNS, Submitted to PRD (R
Observation of a Narrow Resonance of Mass 2.46 GeV/c^2 Decaying to D_s^*+ pi^0 and Confirmation of the D_sJ^* (2317) State
Using 13.5 inverse fb of e+e- annihilation data collected with the CLEO II
detector we have observed a narrow resonance in the Ds*+pi0 final state, with a
mass near 2.46 GeV. The search for such a state was motivated by the recent
discovery by the BaBar Collaboration of a narrow state at 2.32 GeV, the
DsJ*(2317)+ that decays to Ds+pi0. Reconstructing the Ds+pi0 and Ds*+pi0 final
states in CLEO data, we observe peaks in both of the corresponding
reconstructed mass difference distributions, dM(Dspi0)=M(Dspi0)-M(Ds) and
dM(Ds*pi0)=M(Ds*pi0)-M(Ds*), both of them at values near 350 MeV. We interpret
these peaks as signatures of two distinct states, the DsJ*(2317)+ plus a new
state, designated as the DsJ(2463)+. Because of the similar dM values, each of
these states represents a source of background for the other if photons are
lost, ignored or added. A quantitative accounting of these reflections confirms
that both states exist. We have measured the mean mass differences
= 350.0 +/- 1.2 [stat] +/- 1.0 [syst] MeV for the DsJ*(2317) state, and
= 351.2 +/- 1.7 [stat] +/- 1.0 [syst] MeV for the new DsJ(2463)+
state. We have also searched, but find no evidence, for decays of the two
states via the channels Ds*+gamma, Ds+gamma, and Ds+pi+pi-. The observations of
the two states at 2.32 and 2.46 GeV, in the Ds+pi0 and Ds*+pi0 decay channels
respectively, are consistent with their interpretations as (c anti-strange)
mesons with orbital angular momentum L=1, and spin-parities of 0+ and 1+.Comment: 16 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLNS, version to be published in Physical
Review D; minor modifications and fixes to typographical errors, plus an
added section on production properties. The main results are unchanged; they
supersede those reported in hep-ex/030501
Measurement of the Charge Asymmetry in
We report on a search for a CP-violating asymmetry in the charmless hadronic
decay B -> K*(892)+- pi-+, using 9.12 fb^-1 of integrated luminosity produced
at \sqrt{s}=10.58 GeV and collected with the CLEO detector. We find A_{CP}(B ->
K*(892)+- pi-+) = 0.26+0.33-0.34(stat.)+0.10-0.08(syst.), giving an allowed
interval of [-0.31,0.78] at the 90% confidence level.Comment: 7 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLNS, submitted to PR
Study of the q^2-Dependence of B --> pi ell nu and B --> rho(omega)ell nu Decay and Extraction of |V_ub|
We report on determinations of |Vub| resulting from studies of the branching
fraction and q^2 distributions in exclusive semileptonic B decays that proceed
via the b->u transition. Our data set consists of the 9.7x10^6 BBbar meson
pairs collected at the Y(4S) resonance with the CLEO II detector. We measure
B(B0 -> pi- l+ nu) = (1.33 +- 0.18 +- 0.11 +- 0.01 +- 0.07)x10^{-4} and B(B0 ->
rho- l+ nu) = (2.17 +- 0.34 +0.47/-0.54 +- 0.41 +- 0.01)x10^{-4}, where the
errors are statistical, experimental systematic, systematic due to residual
form-factor uncertainties in the signal, and systematic due to residual
form-factor uncertainties in the cross-feed modes, respectively. We also find
B(B+ -> eta l+ nu) = (0.84 +- 0.31 +- 0.16 +- 0.09)x10^{-4}, consistent with
what is expected from the B -> pi l nu mode and quark model symmetries. We
extract |Vub| using Light-Cone Sum Rules (LCSR) for 0<= q^2<16 GeV^2 and
Lattice QCD (LQCD) for 16 GeV^2 <= q^2 < q^2_max. Combining both intervals
yields |Vub| = (3.24 +- 0.22 +- 0.13 +0.55/-0.39 +- 0.09)x10^{-3}$ for pi l nu,
and |Vub| = (3.00 +- 0.21 +0.29/-0.35 +0.49/-0.38 +-0.28)x10^{-3} for rho l nu,
where the errors are statistical, experimental systematic, theoretical, and
signal form-factor shape, respectively. Our combined value from both decay
modes is |Vub| = (3.17 +- 0.17 +0.16/-0.17 +0.53/-0.39 +-0.03)x10^{-3}.Comment: 45 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLNS, submitted to PR
Search for CP Violation in D^0--> K_S^0 pi^+pi^-
We report on a search for CP violation in the decay of D0 and D0B to Kshort
pi+pi-. The data come from an integrated luminosity of 9.0 1/fb of e+e-
collisions at sqrt(s) ~ 10 GeV recorded with the CLEO II.V detector. The
resonance substructure of this decay is well described by ten quasi-two-body
decay channels (K*-pi+, K*0(1430)-pi+, K*2(1430)-pi+, K*(1680)-pi+, Kshort rho,
Kshort omega, Kshort f0(980), Kshort f2(1270), Kshort f0(1370), and the ``wrong
sign'' K*+ pi-) plus a small non-resonant component. We observe no evidence for
CP violation in the amplitudes and phases that describe the decay D0 to K_S^0
pi+pi-.Comment: 10 pages, 3 figures, also available at
http://w4.lns.cornell.edu/public/CLNS/, submitted to PR
Measurement of Lepton Momentum Moments in the Decay bar{B} \to X \ell \bar{\nu} and Determination of Heavy Quark Expansion Parameters and |V_cb|
We measure the primary lepton momentum spectrum in B-bar to X l nu decays,
for p_l > 1.5 GeV/c in the B rest frame. From this, we calculate various
moments of the spectrum. In particular, we find R_0 = [int(E_l>1.7)
(dGam/dE_sl)*dE_l] / [int(E_l>1.5) (dGam/dE_sl)*dE_l] = 0.6187 +/- 0.0014_stat
+/- 0.0016_sys and R_1 = [int(E_l>1.5) E_l(dGam/dE_sl)*dE_l] / [int(E_l>1.5)
(dGam/dE_sl)*dE_l] = (1.7810 +/- 0.0007_stat +/- 0.0009_sys) GeV. We use these
moments to determine non-perturbative parameters governing the semileptonic
width. In particular, we extract the Heavy Quark Expansion parameters
Lambda-bar = (0.39 +/- 0.03_stat +/- 0.06_sys +/- 0.12_th) GeV and lambda_1 =
(-0.25 +/- 0.02_stat +/- 0.05_sys +/- 0.14_th) GeV^2. The theoretical
constraints used are evaluated through order 1/M_B^3 in the non-perturbative
expansion and beta_0*alpha__s^2 in the perturbative expansion. We use these
parameters to extract |V_cb| from the world average of the semileptonic width
and find |V_cb| = (40.8 +/- 0.5_Gam-sl +/- 0.4_(lambda_1,Lambda-bar)-exp +/-
0.9_th) x 10^-3. In addition, we extract the short range b-quark mass m_b^1S =
(4.82 +/- 0.07_exp +/- 0.11_th) GeV/c^2. Finally, we discuss the implications
of our measurements for the theoretical understanding of inclusive semileptonic
processes.Comment: 21 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLNS, submitted to PR
Horizontal Branch Stars: The Interplay between Observations and Theory, and Insights into the Formation of the Galaxy
We review HB stars in a broad astrophysical context, including both variable
and non-variable stars. A reassessment of the Oosterhoff dichotomy is
presented, which provides unprecedented detail regarding its origin and
systematics. We show that the Oosterhoff dichotomy and the distribution of
globular clusters (GCs) in the HB morphology-metallicity plane both exclude,
with high statistical significance, the possibility that the Galactic halo may
have formed from the accretion of dwarf galaxies resembling present-day Milky
Way satellites such as Fornax, Sagittarius, and the LMC. A rediscussion of the
second-parameter problem is presented. A technique is proposed to estimate the
HB types of extragalactic GCs on the basis of integrated far-UV photometry. The
relationship between the absolute V magnitude of the HB at the RR Lyrae level
and metallicity, as obtained on the basis of trigonometric parallax
measurements for the star RR Lyrae, is also revisited, giving a distance
modulus to the LMC of (m-M)_0 = 18.44+/-0.11. RR Lyrae period change rates are
studied. Finally, the conductive opacities used in evolutionary calculations of
low-mass stars are investigated. [ABRIDGED]Comment: 56 pages, 22 figures. Invited review, to appear in Astrophysics and
Space Scienc
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Energetic particle influence on the Earth's atmosphere
This manuscript gives an up-to-date and comprehensive overview of the effects of energetic particle precipitation (EPP) onto the whole atmosphere, from the lower thermosphere/mesosphere through the stratosphere and troposphere, to the surface. The paper summarizes the different sources and energies of particles, principally
galactic cosmic rays (GCRs), solar energetic particles (SEPs) and energetic electron precipitation (EEP). All the proposed mechanisms by which EPP can affect the atmosphere
are discussed, including chemical changes in the upper atmosphere and lower thermosphere, chemistry-dynamics feedbacks, the global electric circuit and cloud formation. The role of energetic particles in Earth’s atmosphere is a multi-disciplinary problem that requires expertise from a range of scientific backgrounds. To assist with this synergy, summary tables are provided, which are intended to evaluate the level of current knowledge of the effects of energetic particles on processes in the entire atmosphere
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