54 research outputs found
Improvement of cast nephropathy with plasma exchange depends on the diagnosis and on reduction of serum free light chains
Cast nephropathy is the most common cause of renal disease in multiple myeloma, however, treatment with plasma exchange remains controversial even after 3 randomized controlled studies. We sought to determine the importance of diagnostic confirmation and goal directed therapy in the treatment of cast nephropathy in forty patients with confirmed multiple myeloma and renal failure who underwent plasma exchange. A positive renal response was defined as a decrease by half in the presenting serum creatinine and dialysis independence. No baseline differences were noted between eventual renal responders and non-responders. Three quarters of the patients with biopsy proven cast nephropathy resolved their renal disease when the free light chains present in the serum were reduced by half or more but there was no significant response when the reduction was less. The median time to a response was about 2 months. In patients without cast nephropathy, renal recovery occurred despite reductions in free light chain levels of the serum. No association was found between free light chains in the serum, urinary monoclonal proteins, overall proteinuria and cast nephropathy. We found that the relationship between renal recovery and free light chain reduction was present only in patients with biopsy proven cast nephropathy showing the importance of extracorporeal light chain removal in this disease
Observing Supermassive Black Holes across cosmic time: from phenomenology to physics
In the last decade, a combination of high sensitivity, high spatial
resolution observations and of coordinated multi-wavelength surveys has
revolutionized our view of extra-galactic black hole (BH) astrophysics. We now
know that supermassive black holes reside in the nuclei of almost every galaxy,
grow over cosmological times by accreting matter, interact and merge with each
other, and in the process liberate enormous amounts of energy that influence
dramatically the evolution of the surrounding gas and stars, providing a
powerful self-regulatory mechanism for galaxy formation. The different
energetic phenomena associated to growing black holes and Active Galactic
Nuclei (AGN), their cosmological evolution and the observational techniques
used to unveil them, are the subject of this chapter. In particular, I will
focus my attention on the connection between the theory of high-energy
astrophysical processes giving rise to the observed emission in AGN, the
observable imprints they leave at different wavelengths, and the methods used
to uncover them in a statistically robust way. I will show how such a combined
effort of theorists and observers have led us to unveil most of the SMBH growth
over a large fraction of the age of the Universe, but that nagging
uncertainties remain, preventing us from fully understating the exact role of
black holes in the complex process of galaxy and large-scale structure
formation, assembly and evolution.Comment: 46 pages, 21 figures. This review article appears as a chapter in the
book: "Astrophysical Black Holes", Haardt, F., Gorini, V., Moschella, U and
Treves A. (Eds), 2015, Springer International Publishing AG, Cha
Star Formation and Dynamics in the Galactic Centre
The centre of our Galaxy is one of the most studied and yet enigmatic places
in the Universe. At a distance of about 8 kpc from our Sun, the Galactic centre
(GC) is the ideal environment to study the extreme processes that take place in
the vicinity of a supermassive black hole (SMBH). Despite the hostile
environment, several tens of early-type stars populate the central parsec of
our Galaxy. A fraction of them lie in a thin ring with mild eccentricity and
inner radius ~0.04 pc, while the S-stars, i.e. the ~30 stars closest to the
SMBH (<0.04 pc), have randomly oriented and highly eccentric orbits. The
formation of such early-type stars has been a puzzle for a long time: molecular
clouds should be tidally disrupted by the SMBH before they can fragment into
stars. We review the main scenarios proposed to explain the formation and the
dynamical evolution of the early-type stars in the GC. In particular, we
discuss the most popular in situ scenarios (accretion disc fragmentation and
molecular cloud disruption) and migration scenarios (star cluster inspiral and
Hills mechanism). We focus on the most pressing challenges that must be faced
to shed light on the process of star formation in the vicinity of a SMBH.Comment: 68 pages, 35 figures; invited review chapter, to be published in
expanded form in Haardt, F., Gorini, V., Moschella, U. and Treves, A.,
'Astrophysical Black Holes'. Lecture Notes in Physics. Springer 201
Large expert-curated database for benchmarking document similarity detection in biomedical literature search
Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe
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