Thirteen years follow-up after radical transsternal thymectomy for myasthenia gravis. Do short-term results predict long-term outcome?

Objective: Long-term evaluation of efficacy and quality of life after radical surgical approach for myasthenia gravis (MG). Comparison between short-term follow-up and long-term outcome. Methods: All patients (n=26, 16 men and 10 women, mean age: 40.7 years) underwent total transsternal thymectomy for MG between 1986 and 1989. Prospective analysis of the patients for short-term follow-up (mean 22.4 months) was published in 1991. The same group of patients was reevaluated in 2001 (range of follow-up 11.4-15.2 years) and assessed according to the classification of Osserman and Oosterhuis. Results: Mean follow-up was 13.0 years (range 11.4-15.2 years). Two patients were lost from follow-up and one died 4 years after thymectomy for reasons unrelated to MG (n=23). No early or late postoperative mortality was observed. One sternal osteomyelitis occurred. Late postoperative morbidity included sternal instabilities (n=2), mild residual thoracic pain (n=6), and hypertrophic scars (n=7). Five patients were rehospitalized for aggravating MG and needed plasmapheresis (n=3) and intubation (n=1). Thirteen patients (56.5%) showed objective clinical improvement, including six patients (26.1%) with complete remission. Eleven patients (47.8%) do not take any medication at all. Because some late relapse may occur several years after operation, the rate of improvement decreased slightly, whereas the difference between short and long-term follow-up was not statistically significant (P=0.405). Twenty patients (87%) returned to work, including part-time occupation (n=4). Fourteen patients (61%) are performing sports regularly. Conclusions: Our data confirm that radical, transsternal thymectomy is an effective and safe therapeutic modality for MG. Short-term results seem to deteriorate over time, therefore long-term studies for minimally invasive approaches have to prove equal results before replacing the standard procedur

Irradiation induced elongation of Fe nanoparticles embedded in silica films

© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Irradiation with swift heavy ions causes the deformation of Ferric nanoparticles in direction of the ion beam. Fe nanoparticles with mean diameter of about 20 nm were prepared by gas flow sputtering and subsequently confined within silica films. Two silica films wherein two different densities of Fe nanoparticles are encapsulated were irradiated with 50 MeV Ag ions with fluences of few 1014 ions.cm−2 at 300 K and normal incidence. Transmission electron microscopy analysis shows that the spherical Fe nanoparticles are deformed into prolate nanorods aligned in direction of the incident ion beam. The depth distribution profiles of irradiated particles reveal the presence of a critical fluence above which the elongation kinetics becomes dependent on the nanoparticles density. Analysis indicates that for the lower density particles, a saturation length is reached under irradiation to fluence between 3–4 × 1014 ions.cm−2. However, for the higher density, collective growth into aligned nanowires is presumed to take place. Hysteresis curves of the saturation magnetization and coercivity indicate an increasing magnetic anisotropy, which can be correlated with the deformation of nanoparticles in the direction of the ion beam

Resource Competition on Integral Polymatroids

We study competitive resource allocation problems in which players distribute their demands integrally on a set of resources subject to player-specific submodular capacity constraints. Each player has to pay for each unit of demand a cost that is a nondecreasing and convex function of the total allocation of that resource. This general model of resource allocation generalizes both singleton congestion games with integer-splittable demands and matroid congestion games with player-specific costs. As our main result, we show that in such general resource allocation problems a pure Nash equilibrium is guaranteed to exist by giving a pseudo-polynomial algorithm computing a pure Nash equilibrium.Comment: 17 page

High-Energy Neutrino Astronomy

Kilometer-scale neutrino detectors such as IceCube are discovery instruments covering nuclear and particle physics, cosmology and astronomy. Examples of their multidisciplinary missions include the search for the particle nature of dark matter and for additional small dimensions of space. In the end, their conceptual design is very much anchored to the observational fact that Nature accelerates protons and photons to energies in excess of $10^{20}$ and $10^{13}$ eV, respectively. The cosmic ray connection sets the scale of cosmic neutrino fluxes. In this context, we discuss the first results of the completed AMANDA detector and the reach of its extension, IceCube. Similar experiments are under construction in the Mediterranean. Neutrino astronomy is also expanding in new directions with efforts to detect air showers, acoustic and radio signals initiated by super-EeV neutrinos.Comment: 9 pages, Latex2e, uses ws-procs975x65standard.sty (included), 4 postscript figures. To appear in Proceedings of Thinking, Observing, and Mining the Universe, Sorrento, Italy, September 200

Beam Performance of Tracking Detectors with Industrially Produced GEM Foils

Three Gas-Electron-Multiplier tracking detectors with an active area of 10 cm x 10 cm and a two-dimensional, laser-etched orthogonal strip readout have been tested extensively in particle beams at the Meson Test Beam Facility at Fermilab. These detectors used GEM foils produced by Tech-Etch, Inc. They showed an efficiency in excess of 95% and spatial resolution better than 70 um. The influence of the angle of incidence of particles on efficiency and spatial resolution was studied in detail.Comment: 8 pages, 9 figures, accepted by Nuclear Instruments and Methods in Physics Research

Deep VLA Observations of the Cluster 1RXS J0603.3+4214 in the Frequency Range of 1–2 GHz

We report L-band VLA observations of 1RXS J0603.3+4214, a cluster that hosts a bright radio relic, known as the Toothbrush, and an elongated giant radio halo. These new observations allow us to study the surface brightness distribution down to one arcsec resolution with very high sensitivity. Our images provide an unprecedented detailed view of the Toothbrush, revealing enigmatic filamentary structures. To study the spectral index distribution, we complement our analysis with published LOFAR and GMRT observations. The bright `brush' of the Toothbrush shows a prominent narrow ridge to its north with a sharp outer edge. The spectral index at the ridge is in the range $-0.70\leq\alpha\leq-0.80$. We suggest that the ridge is caused by projection along the line of sight. With a simple toy model for the smallest region of the ridge, we conclude that the magnetic field is below $5\,\rm\mu G$ and varies significantly across the shock front. Our model indicates that the actual Mach number is higher than that obtained from the injection index and agrees well with the one derived from the overall spectrum, namely ${\cal M}=3.78^{+0.3}_{-0.2}$. The radio halo shows an average spectral index of $\alpha=-1.16\pm0.05$ and a slight gradient from north to south. The southernmost part of the halo is steeper and possibly related to a shock front. Excluding the southernmost part, the halo morphology agrees very well with the X-ray morphology. A power-law correlation is found between the radio and X-ray surface brightnessComment: 23 pages, 21 figures, accepted for publication in Ap

IACT observations of gamma-ray bursts: prospects for the Cherenkov Telescope Array

Gamma rays at rest frame energies as high as 90 GeV have been reported from gamma-ray bursts (GRBs) by the Fermi Large Area Telescope (LAT). There is considerable hope that a confirmed GRB detection will be possible with the upcoming Cherenkov Telescope Array (CTA), which will have a larger effective area and better low-energy sensitivity than current-generation imaging atmospheric Cherenkov telescopes (IACTs). To estimate the likelihood of such a detection, we have developed a phenomenological model for GRB emission between 1 GeV and 1 TeV that is motivated by the high-energy GRB detections of Fermi-LAT, and allows us to extrapolate the statistics of GRBs seen by lower energy instruments such as the Swift-BAT and BATSE on the Compton Gamma-ray Observatory. We show a number of statistics for detected GRBs, and describe how the detectability of GRBs with CTA could vary based on a number of parameters, such as the typical observation delay between the burst onset and the start of ground observations. We also consider the possibility of using GBM on Fermi as a finder of GRBs for rapid ground follow-up. While the uncertainty of GBM localization is problematic, the small field-of-view for IACTs can potentially be overcome by scanning over the GBM error region. Overall, our results indicate that CTA should be able to detect one GRB every 20 to 30 months with our baseline instrument model, assuming consistently rapid pursuit of GRB alerts, and provided that spectral breaks below 100 GeV are not a common feature of the bright GRB population. With a more optimistic instrument model, the detection rate can be as high as 1 to 2 GRBs per year.Comment: 28 pages, 24 figures, 4 tables, submitted to Experimental Astronom

Congestion Games with Complementarities

We study a model of selfish resource allocation that seeks to incorporate dependencies among resources as they exist in modern networked environments. Our model is inspired by utility functions with constant elasticity of substitution (CES) which is a well-studied model in economics. We consider congestion games with different aggregation functions. In particular, we study $L_p$ norms and analyze the existence and complexity of (approximate) pure Nash equilibria. Additionally, we give an almost tight characterization based on monotonicity properties to describe the set of aggregation functions that guarantee the existence of pure Nash equilibria.Comment: The final publication is available at Springer via http://dx.doi.org/10.1007/978-3-319-57586-5_1