Choroidal Changes in Blood Flow in Patients with Intermediate AMD after Oral Dietary Supplement Based on Astaxanthin, Bromelain, Vitamin D3, Folic Acid, Lutein, and Antioxidants

Background and Objectives: The aim of this study was to investigate the impact of oral administration of the combination of astaxanthin (AXT), lutein, folic acid, vitamin D3, and bromelain with antioxidants on choroidal blood flow in patients with age-related intermediate macular degeneration (AMD). Materials and Methods: Patients affected by intermediate AMD and treated with daily oral nutritional supplement with AXT, bromelain, vitamin D3, folic acid, lutein, and antioxidants for a period of at least 6 months were included in this retrospective study. A control group homogenous for age and sex was also included in the analysis. All participants underwent a complete ophthalmologic examination, spectral domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (OCTA) evaluation. Outcome measures were choroidal thickness (CHT) and choriocapillary vessel density (CCVD) after six months of AXT assumption. Results: CCVD values showed statistically significant difference between cases and controls at baseline (p < 0.001) and in the cases during follow-up (p < 0.001). The CHT measurements showed statistically significant difference between cases and controls (p = 0.002) and in the cases during follow-up (p < 0.001). Conclusions: The combined use of structural OCT and OCTA allows for a detailed analysis in vivo of perfusion parameters of the choriocapillaris and choroid and evaluation of changes of choroidal blood flow after oral nutritional supplements that affect blood flow velocity

An Eddington ratio-driven origin for the LX- M∗relation in quiescent and star-forming active galaxies

A mild correlation exists in active galaxies between the mean black hole accretion, as traced by the mean X-ray luminosity and the host galaxy stellar mass M∗, characterised by a normalization steadily decreasing with cosmic time and lower in more quiescent galaxies. We create comprehensive semi-empirical mock catalogues of active black holes to pin down which parameters control the shape and evolution of the - M∗ relation of X-ray-detected active galaxies. We find that the normalization of the - M∗ relation is largely independent of the fraction of active galaxies (the duty cycle), but strongly dependent on the mean Eddington ratio, when adopting a constant underlying MBH - M∗ relation as suggested by observational studies. The data point to a decreasing mean Eddington ratio with cosmic time and with galaxy stellar mass at fixed redshift. Our data can be reproduced by black holes and galaxies evolving on similar MBH - M∗ relations but progressively decreasing their average Eddington ratios, mean X-ray luminosities, and specific star formation rates, when moving from the starburst to the quiescent phase. Models consistent with the observed - M∗ relation and independent measurements of the mean Eddington ratios are characterised by MBH - M∗ relations lower than those derived from dynamically measured local black holes. Our results point to the - M∗ relation as a powerful diagnostic to: (1) probe black hole-galaxy scaling relations and the level of accretion on to black holes; (2) efficiently break the degeneracies between duty cycles and accretion rates in cosmological models of black holes

HST grism spectroscopy of z ∼3 massive quiescent galaxies: Approaching the metamorphosis

Tracing the emergence of the massive quiescent galaxy (QG) population requires the build-up of reliable quenched samples by distinguishing these systems from red, dusty star-forming sources. We present Hubble Space Telescope WFC3/G141 grism spectra of ten quiescent galaxy candidates selected at 2.5 < z < 3.5 in the COSMOS field. Spectroscopic confirmation for the whole sample is obtained within one to three orbits through the detection of strong spectral breaks and Balmer absorption lines. When their spectra are combined with optical to near-infrared photometry, star-forming solutions are formally rejected for the entire sample. Broad spectral indices are consistent with the presence of young A-type stars, which indicates that the last major episode of star formation has taken place no earlier than ∼300-800 Myr prior to observation. This confirms clues from their post-starburst UVJ colors. Marginalising over three different slopes of the dust attenuation curve, we obtain young mass-weighted ages and an average peak star formation rate (SFR) of ∼103 M yr-1 at zformation ∼ 3.5. Although mid- and far-IR data are too shallow to determine the obscured SFR on a galaxy-by-galaxy basis, the mean stacked emission from 3 GHz data constrains the level of residual-obscured SFR to be globally below 50 M yr-1, three times below the scatter of the coeval main sequence. Alternatively, the very same radio detection suggests a widespread radio-mode feedback by active galactic nuclei (AGN) four times stronger than in z ∼ 1.8 massive QGs. This is accompanied by a 30% fraction of X-ray luminous AGN with a black hole accretion rate per unit SFR enhanced by a factor of ∼30 with respect to similarly massive QGs at lower redshift. The average compact, high Sérsic index morphologies of the galaxies in this sample, coupled with their young mass-weighted ages, suggest that the mechanisms responsible for the development of a spheroidal component might be concomitant with (or preceding) those causing their quenching

Antibiotic susceptibility of isolates of Bacillus anthracis, a bacterial pathogen with the potential to be used in biowarfare

Bacillus anthracis is a bacterial species that could be used in a bioterrorist attack. We tested a collection of isolates with a range of relevant antimicrobial compounds. All isolates tested were susceptible to ciprofloxacin and doxycycline. Penicillin and amoxicillin, with or without clavulanate, showed in vitro activity against all B. anthracis isolates. Ceftriaxone demonstrated lower-level in vitro activity compared to penicillin-related compounds against B. anthracis. In vitro data from this study are in keeping with available guidelines

Laparoscopic vs. open mesorectal excision for rectal cancer: Are these approaches still comparable? A systematic review and metaanalysis

Background To analyze pathologic and perioperative outcomes of laparoscopic vs. open resections for rectal cancer performed over the last 10 years. Methods A systematic literature search of the following databases was conducted: Cochrane Central Register of Controlled Trials, MEDLINE (through PubMed), EMBASE, and Scopus. Only articles published in English from January 1, 2008 to December 31, 2018 (i.e. the last 10 years), which met inclusion criteria were considered. The review only included articles which compared Laparoscopic rectal resection (LRR) and Open Rectal Resection (ORR) for rectal cancer and reported at least one of the outcomes of interest. The analyses followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement checklist. Only prospective randomized studies were considered. The body of evidence emerging from this study was evaluated using the Grading of Recommendations Assessment Development and Evaluation (GRADE) system. Outcome measures (mean and median values, standard deviations, and interquartile ranges) were extracted for each surgical treatment. Pooled estimates of the mean differences were calculated using random effects models to consider potential inter-study heterogeneity and to adopt a more conservative approach. The pooled effect was considered significant if p <0.05. Results Five clinical trials were found eligible for the analyses. A positive involvement of CRM was found in 49 LRRs (8.5%) out of 574 patients and in 30 ORRs out of 557 patients (5.4%) RR was 1.55 (95% CI, 0.99–2.41; p = 0.05) with no heterogeneity (I2 = 0%). Incorrect mesorectal excision was observed in 56 out of 507 (11%) patients who underwent LRR and in 41 (8.4%) out of 484 patients who underwent ORR; RR was 1.30 (95% CI, 0.89–1.91; p = 0.18) with no heterogeneity (I2 = 0%). Regarding other pathologic outcomes, no significant difference between LRR and ORR was observed in the number of lymph nodes harvested or concerning the distance to the distal margin. As expected, a significant difference was found in the operating time for ORR with a mean difference of 41.99 (95% CI, 24.18, 59.81; p <0.00001; heterogeneity: I2 = 25%). However, no difference was found for blood loss. Additionally, no significant differences were found in postoperative outcomes such as postoperative hospital stay and postoperative complications. The overall quality of the evidence was rated as high. Conclusion Despite the spread of laparoscopy with dedicated surgeons and the development of even more precise surgical tools and technologies, the pathological results of laparoscopic surgery are still comparable to those of open ones. Additionally, concerning the pathological data (and particularly CRM), open surgery guarantees better results as compared to laparoscopic surgery. These results must be a starting point for future evaluations which consider the association between ‘‘successful resection” and long-term oncologic outcomes. The introduction of other minimally invasive techniques for rectal cancer surgery, such as robotic resection or transanal TME (taTME), has revealed new scenarios and made open and even laparoscopic surgery obsolete

Systematic review of irreversible electroporation role in management of locally advanced pancreatic cancer

Background: Ablative techniques provide in patients with locally advanced pancreatic cancer (LAPC) symptomatic relief, survival benefit and potential downsizing. Irreversible Electroporation (IRE) represents potentially an ideal solution as no thermal tissue damage occurs. The purpose of this review is to present an overview on safety, feasibility, oncological results, survival and quality of life improvement obtained by IRE. Methods: A systematic search was performed in PubMed, regarding the use of IRE on PC in humans for studies published in English up to March 2019. Results: 15 original studies embodying 691 patients with unresectable LAPC who underwent IRE were included. As emerged, IRE works better on tumour sizes between 3–4 cm. Oncological results are promising: median OS from diagnosis or treatment up to 27 months. Two groups investigated borderline resectable tumours treated with IRE before resection with margin attenuation, whereas IRE has proved to be effective in pain control. Conclusions: Electroporation is bringing new hopes in LAPC management. The first aim of IRE is to offer a palliative treatment. Further efforts are needed for patient selection, as well as the use of IRE for ‘margin accentuation’ during surgical resection. Even if promising, IRE needs to be validated in large, randomized, prospective series

Compton Thick AGN in the XMM-COSMOS survey

Heavily obscured, Compton Thick (CT, NH>10^24 cm^-2) AGN may represent an important phase in AGN/galaxy co-evolution and are expected to provide a significant contribution to the cosmic X-ray background (CXB). Through direct X-ray spectra analysis, we selected 39 heavily obscured AGN (NH>3x10^23 cm^-2) in the 2 deg^2 XMM-COSMOS survey. After selecting CT AGN based on the fit of a simple absorbed two power law model to the XMM data, the presence of CT AGN was confirmed in 80% of the sources using deeper Chandra data and more complex models. The final sample of CT AGN comprises 10 sources spanning a large range of redshift and luminosity. We collected the multi-wavelength information available for all these sources, in order to study the distribution of SMBH and host properties, such as BH mass (M_BH), Eddington ratio (\lambda_Edd), stellar mass (M*), specific star formation rate (sSFR) in comparison with a sample of unobscured AGN. We find that highly obscured sources tend to have significantly smaller M_BH and higher \lambda_edd with respect to unobscured ones, while a weaker evolution in M* is observed. The sSFR of highly obscured sources is consistent with the one observed in the main sequence of star forming galaxies, at all redshift. We also present optical spectra, spectral energy distribution (SED) and morphology for the sample of 10 CT AGN: all the available optical spectra are dominated by the stellar component of the host galaxy, and a highly obscured torus component is needed in the SED of the CT sources. Exploiting the high resolution Hubble-ACS images available, we conclude that these highly obscured sources have a significantly larger merger fraction with respect to other X-ray selected samples of AGN. Finally we discuss implications in the context of AGN/galaxy co-evolutionary models, and compare our results with the predictions of CXB synthesis models.Comment: Revised version after referee comments. Accepted for publication in Astronomy & Astrophysics on 25 November 2014. 23 pages, 2 tables, 16 figure

The evolving AGN duty cycle in galaxies since z ∼ 3 as encoded in the X-ray luminosity function

We present a new modeling of the X-ray luminosity function (XLF) of active galactic nuclei (AGNs) out to z ~ 3, dissecting the contributions of main-sequence (MS) and starburst (SB) galaxies. For each galaxy population, we convolved the observed galaxy stellar mass (M sstarf) function with a grid of M sstarf-independent Eddington ratio (λ EDD) distributions, normalized via empirical black hole accretion rate (BHAR) to star formation rate (SFR) relations. Our simple approach yields an excellent agreement with the observed XLF since z ~ 3. We find that the redshift evolution of the observed XLF can only be reproduced through an intrinsic flattening of the λ EDD distribution and with a positive shift of the break λ*, consistent with an antihierarchical behavior. The AGN accretion history is predominantly made by massive (1010 44.36 + 1.28 × (1 + z). We infer that the probability of finding highly accreting (λ EDD > 10%) AGNs significantly increases with redshift, from 0.4% (3.0%) at z = 0.5%–6.5% (15.3%) at z = 3 for MS (SB) galaxies, implying a longer AGN duty cycle in the early universe. Our results strongly favor a M sstarf-dependent ratio between BHAR and SFR, as BHAR/SFR ∝ ${M}_{\star }^{0.73[+0.22,-0.29]}$, supporting a nonlinear BH buildup relative to the host. Finally, this framework opens potential questions on super-Eddington BH accretion and different λ EDD prescriptions for understanding the cosmic BH mass assembly

Evidence for Cold-stream to Hot-accretion Transition as Traced by Ly alpha Emission from Groups and Clusters at 2 < z < 3.3

We present Keck Cosmic Web Imager observations of giant Ly alpha halos surrounding nine galaxy groups and clusters at 2 < z < 3.3, including five new detections and one upper limit. We find observational evidence for the cold-stream to hot-accretion transition predicted by theory by measuring a decrease in the ratio between the spatially extended Ly alpha luminosity and the expected baryonic accretion rate (BAR), with increasing elongation above the transition mass (M-stream). This implies a modulation of the share of BAR that remains cold, diminishing quasi-linearly (logarithmic slope of 0.97 +/- 0.19, 5 sigma significance) with the halo to M-stream mass ratio. The integrated star formation rates (SFRs) and active galactic nucleus (AGN) bolometric luminosities display a potentially consistent decrease, albeit significant only at 2.6 sigma and 1.3 sigma, respectively. The higher scatter in these tracers suggests the Ly alpha emission might be mostly a direct product of cold accretion in these structures rather than indirect, mediated by outflows and photoionization from SFR and AGNs; this is also supported by energetics considerations. Below M-stream (cold-stream regime), we measure L (Ly alpha) /BAR = 10(40.51 +/- 0.16) erg s(-1) M-circle dot(-1) yr, consistent with predictions, and SFR/BAR = 10(-0.54 +/- 0.23): on average, 30(-10)(+20) M-stream (hot-accretion regime), L-Ly alpha is set by M-stream (within 0.2 dex scatter in our sample), independent of the halo mass but rising 10-fold from z = 2 to 3.Peer reviewe