Analytical interference by monoclonal immunoglobulins on the direct bilirubin AU Beckman Coulter assay: The benefit of unsuspected diagnosis from spurious results

Background: Monoclonal (M) components can interfere with the direct bilirubin (D-Bil) assay on the AU Beckman Coulter instrumentation and produce spurious results, such as D-Bil values greater than total bilirubin (T-Bil) or very low/negative D-Bil values. If properly detected, this interference may uncover undiagnosed patients with monoclonal gammopathy (MG).Methods: We investigated the interference rate on the D-Bil AU assay in serum samples known to contain M proteins along with their isotype and described the protocol set up in our laboratory to help with the diagnosis of MG based on D-Bil spurious results as first indication.Results: During a period of 4 years, 15.4% (345 of 2235) of serum samples containing M immunoglobulins produced erroneous D-Bil results, although no clear relationship between the magnitude or isotype of the M component and interference could be found. In total 22 new patients were diagnosed with MG based on the analytical artefact with the D-Bil as first indication.Conclusions: The D-Bil interference from MG on the Beckman AU analysers needs to be made known to laboratories in order to prevent clinical confusion and/or additional workup to explain the origin of anomalous results. Although this information may not add to the management of existing patients with serum paraproteins, it can benefit patients that have not been diagnosed with MG by triggering follow up testing to determine if M components are present

The accretion disk in the post period-minimum cataclysmic variable SDSS J080434.20+510349.2

This study of SDSS0804 is primarily concerned with the double-hump shape in the light curve and its connection with the accretion disk in this bounce-back system. Time-resolved photometric and spectroscopic observations were obtained to analyze the behavior of the system between superoutbursts. A geometric model of a binary system containing a disk with two outer annuli spiral density waves was applied to explain the light curve and the Doppler tomography. Observations were carried out during 2008-2009, after the object's magnitude decreased to V~17.7(0.1) from the March 2006 eruption. The light curve clearly shows a sinusoid-like variability with a 0.07 mag amplitude and a 42.48 min periodicity, which is half of the orbital period of the system. In Sept. 2010, the system underwent yet another superoutburst and returned to its quiescent level by the beginning of 2012. This light curve once again showed a double-humps, but with a significantly smaller ~0.01mag amplitude. Other types of variability like a "mini-outburst" or SDSS1238-like features were not detected. Doppler tomograms, obtained from spectroscopic data during the same period of time, show a large accretion disk with uneven brightness, implying the presence of spiral waves. We constructed a geometric model of a bounce-back system containing two spiral density waves in the outer annuli of the disk to reproduce the observed light curves. The Doppler tomograms and the double-hump-shape light curves in quiescence can be explained by a model system containing a massive >0.7Msun white dwarf with a surface temperature of ~12000K, a late-type brown dwarf, and an accretion disk with two outer annuli spirals. According to this model, the accretion disk should be large, extending to the 2:1 resonance radius, and cool (~2500K). The inner parts of the disk should be optically thin in the continuum or totally void.Comment: 12 pages, 15 figures, accepted for publication in A&

An atlas of Calcium triplet spectra of active galaxies

We present a spectroscopic atlas of active galactic nuclei covering the region around the 8498, 8542, 8662 Calcium triplet (CaT) lines. The sample comprises 78 objects, divided into 43 Seyfert 2s, 26 Seyfert 1s, 3 Starburst and 6 normal galaxies. The spectra pertain to the inner ~300 pc in radius, and thus sample the central kinematics and stellar populations of active galaxies. The data are used to measure stellar velocity dispersions (sigma_star) both with cross-correlation and direct fitting methods. These measurements are found to be in good agreement with each-other and with those in previous studies for objects in common. The CaT equivalent width is also measured. We find average values and sample dispersions of W_CaT of 4.6+/-2.0, 7.0 and 7.7+/-1.0 angstrons for Seyfert 1s, Seyfert 2s and normal galaxies, respectively. We further present an atlas of [SIII]\lambda 9069 emission line profiles for a subset of 40 galaxies. These data are analyzed in a companion paper which addresses the connection between stellar and Narrow Line Region kinematics, the behaviour of the CaT equivalent width as a function of sigma_star, activity type and stellar population properties.Comment: 18 pages, 10 figures, accepted for publication in MNRA

Smart Cupboard for Assessing Memory in Home Environment

Sensor systems for the Internet of Things (IoT) make it possible to continuously monitor people, gathering information without any extra effort from them. Thus, the IoT can be very helpful in the context of early disease detection, which can improve peoples'' quality of life by applying the right treatment and measures at an early stage. This paper presents a new use of IoT sensor systemswe present a novel three-door smart cupboard that can measure the memory of a user, aiming at detecting potential memory losses. The smart cupboard has three sensors connected to a Raspberry Pi, whose aim is to detect which doors are opened. Inside of the Raspberry Pi, a Python script detects the openings of the doors, and classifies the events between attempts of finding something without success and the events of actually finding it, in order to measure the user''s memory concerning the objects'' locations (among the three compartments of the smart cupboard). The smart cupboard was assessed with 23 different users in a controlled environment. This smart cupboard was powered by an external battery. The memory assessments of the smart cupboard were compared with a validated test of memory assessment about face-name associations and a self-reported test about self-perceived memory. We found a significant correlation between the smart cupboard results and both memory measurement methods. Thus, we conclude that the proposed novel smart cupboard successfully measured memory

Management of varices and variceal hemorrhage in cirrhosis

Variceal hemorrhage is a lethal complication of cirrhosis, particularly in patients in whom clinical decompensation (i.e., ascites, encephalopathy, a previous episode of hemorrhage, or jaundice) has already developed. Practice guidelines for the management of varices and variceal hemorrhage1 in cirrhosis are mostly based on evidence in the literature that has been summarized and prioritized at consensus conferences..