Treatment of insomnia in myasthenia gravis-A prospective study on non-benzodiazepine hypnotics in the treatment of myasthenia gravis patients with insomnia

Objectives: This study aimed to evaluate the efficacy and safety of non-benzodiazepine hypnotics in the treatment of myasthenia gravis (MG) patients with insomnia. Methods: This is a prospective longitudinal study. Outpatients who met the criteria for stable MG and insomnia diagnosis according to the International Classification of Sleep Disorders (third edition) were included in the study. They took a regular dose of non-benzodiazepine hypnotics (zolpidem 10 mg per night or zopiclone 7.5 mg per night) based on their own preferences. Patients received psychotherapy (including sleep health education) and were followed up for 4–5 weeks. Cases with lung diseases, respiratory disorders, or inappropriate use of hypnotic medications were excluded. The primary outcome is the difference in total Pittsburgh Sleep Quality Index (PSQI) score between baseline and the end of follow-up period. Secondary outcomes include the difference in Myasthenia Gravis Activities of Daily Living (MG-ADL) score, 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9) between baseline and the end of follow-up period and the safety of medication. Results: A total of 75 MG patients with insomnia were included in this study. After 4–5 weeks of treatment, the total PSQI score and MG-ADL score were lower than baseline (p < 0.01). No patients had an increased MG-ADL score. The incidence rate of adverse events was 16.0% (12 cases), including dizziness (6 cases, 8.0%), drowsiness (3 cases, 4.0%), fatigue (2 cases, 2.7%), and nausea (1 case, 1.3%), all of which were mild. No patients had new onset breathing disorders. Conclusion: Non-benzodiazepine hypnotics are safe and effective for stable MG patients who need insomnia treatment

Observation of CR Anisotropy with ARGO-YBJ

The measurement of the anisotropies of cosmic ray arrival direction provides important informations on the propagation mechanisms and on the identification of their sources. In this paper we report the observation of anisotropy regions at different angular scales. In particular, the observation of a possible anisotropy on scales between $\sim$ 10 $^{\circ}$ and $\sim$ 30 $^{\circ}$ suggests the presence of unknown features of the magnetic fields the charged cosmic rays propagate through, as well as potential contributions of nearby sources to the total flux of cosmic rays. Evidence of new weaker few-degree excesses throughout the sky region $195^{\circ}\leq$ R.A. $\leq 315^{\circ}$ is reported for the first time.Comment: Talk given at 12th TAUP Conference 2011, 5-9 September 2011, Munich, German

Observation of the cosmic ray moon shadowing effect with the ARGO-YBJ experiment

Cosmic rays are hampered by the Moon and a deficit in its direction is expected (the so-called Moon shadow). The Moon shadow is an important tool to determine the performance of an air shower array. Indeed, the westward displacement of the shadow center, due to the bending effect of the geomagnetic field on the propagation of cosmic rays, allows the setting of the absolute rigidity scale of the primary particles inducing the showers recorded by the detector. In addition, the shape of the shadow permits to determine the detector point spread function, while the position of the deficit at high energies allows the evaluation of its absolute pointing accuracy. In this paper we present the observation of the cosmic ray Moon shadowing effect carried out by the ARGO-YBJ experiment in the multi-TeV energy region with high statistical significance (55 standard deviations). By means of an accurate Monte Carlo simulation of the cosmic rays propagation in the Earth-Moon system, we have studied separately the effect of the geomagnetic field and of the detector point spread function on the observed shadow. The angular resolution as a function of the particle multiplicity and the pointing accuracy have been obtained. The primary energy of detected showers has been estimated by measuring the westward displacement as a function of the particle multiplicity, thus calibrating the relation between shower size and cosmic ray energy. The stability of the detector on a monthly basis has been checked by monitoring the position and the deficit of the Moon shadow. Finally, we have studied with high statistical accuracy the shadowing effect in the ''day/night’’ time looking for possible effect induced by the solar wind

Highlights from the ARGO-YBJ experiment

The ARGO-YBJ experiment at YangBaJing in Tibet (4300 m a.s.l.) has been taking data with its full layout since October 2007. Here we present a few significant results obtained in gamma-ray astronomy and cosmic-ray physics. Emphasis is placed on the analysis of gamma-ray emission from point-like sources (Crab Nebula, MRK 421), on the preliminary limit on the antiproton/proton flux ratio, on the large-scale cosmic-ray anisotropy and on the proton–air cross-section. The performance of the detector is also discussed, and the perspectives of the experiment are outlined

Measurement of the antiproton/proton ratio in the few-TeV energy range with ARGO-YBJ

Cosmic ray antiprotons provide an important probe for the study of cosmic ray propagation in the interstellar space and to investigate the existence of Galactic dark matter. The ARGO-YBJ experiment is observing the Moon shadow with high statistical significance at an energy threshold of a few hundred GeV. Using all the data collected until November 2009, we set two upper limits on the antip/p flux ratio: 5% at an energy of 1.4 TeV and 6% at 5 TeV with a confidence level of 90%. In the few-TeV range the ARGO-YBJ results are the lowest available, useful to constrain models for antiproton production in antimatter domains.Comment: Talk given at the CRIS 2010 Conference, September 2010, Catania - Italy, 6 page

Switches between accretion structures during flares in 4U 1901+03

We report on our analysis of the 2019 outburst of the X-ray accreting pulsar 4U 1901+03 observed with Insight-HXMT and NICER. Both spectra and pulse profiles evolve significantly in the decaying phase of the outburst. Dozens of flares are observed throughout the outburst. They are more frequent and brighter at the outburst peak. We find that the flares, which have a duration from tens to hundreds of seconds, are generally brighter than the persistent emission by a factor of similar to 1.5. The pulse-profile shape during the flares can be significantly different from that of the persistent emission. In particular, a phase shift is clearly observed in many cases. We interpret these findings as direct evidence of changes of the pulsed beam pattern, due to transitions between the sub- and supercritical accretion regimes on a short time-scale. We also observe that at comparable luminosities the flares' pulse profiles are rather similar to those of the persistent emission. This indicates that the accretion on the polar cap of the neutron star is mainly determined by the luminosity, i.e. the mass accretion rate