Recent laboratory tests of a hard x-ray solar flare polarimeter

We report on the development of a Compton scatter polarimeter for measuring the linear polarization of hard X-rays (50 - 300 keV) from solar flares. Such measurements would be useful for studying the directivity (or beaming) of the electrons that are accelerated in solar flares. We initially used a simple prototype polarimeter to successfully demonstrate the reliability of our Monte Carlo simulation code and to demonstrate our ability to generate a polarized photon source in the lab. We have recently fabricated a science model based on a modular design concept that places a self-contained polarimeter module on the front-end of a 5-inch position- sensitive PMT (PSPMT). The PSPMT is used to determine the Compton interaction location within an annular array of small plastic scintillator elements. Some of the photons that scatter within the plastic scintillator array are subsequently absorbed by a small centrally-located array of CsI(Tl) crystals that is read out by an independent multi-anode PMT. The independence of the two PMT readout schemes provides appropriate timing information for event triggering. We are currently testing this new polarimeter design in the laboratory to evaluate the performance characteristics of this design. Here we present the initial results from these laboratory tests. The modular nature of this design lends itself toward its accommodation on a balloon or spacecraft platform. A small array of such modules can provide a minimum detectable polarization (MDP) of less than 1% in the integrated 50 - 300 keV energy range for X-class solar flares

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Introduction

The purpose of this book is to relay the personal experience of Foreign Accent Syndrome (FAS). We seek to portray the broad and diverse experiences of those who have experienced this curious but compelling disorder; and who better to speak about this than those individuals who have lived with FAS themselves? For those who have, or have had FAS and for those who encounter these individuals, whether in clinic, home or the media, we also offer some insights from the history of FAS and comments from the science behind the condition

Vowels In Foreign Accent Syndrome

In this chapter, the main findings for vowel production in Foreign Accent Syndrome, comparing and contrasting results for consonant production, will be reviewed. A review of this literature will demonstrate that vowel production is more consistently affected by FAS than consonant production. Foreign Accent Syndrome (FAS) is a rare neurological speech disorder presenting with a foreign-sounding accent. It results from neurological insult such as stroke or traumatic brain injury. To date, a few cases of FAS report concomitant diagnoses of aphasia (Whitaker, 1982; Graff -Radford, Cooper, Colsher, & Damasio, 1986; Ardila, Rosselli, & Ardila, 1988; Kurowski, Blumstein, & Alexander, 1996). However, it is important to distinguish FAS as a disorder characterized solely by impairment of speech, rather than one of language or cognition. According to Whitaker (1982): “Most aphasic patients retain their accent, or dialect, which they had prior to the onset of disease” (p. 195). A thorough review of the literature portrays FAS as a disorder characterized by some degree of variation in symptomatology, etiology, and speech characteristics across case studies

An Atypical Case Of Foreign Accent Syndrome

A new case of Foreign Accent Syndrome is described. This American woman presented with a British- or Australian- sounding accent after stroke, which resulted in a lacunar infarct in the left internal capsule. The atypical etiology and apparent changes in lexical use are described. It is hypothesized that an abnormally tense vocal tract posture may account for phonetic changes in vowel quality and a higher average fundamental frequency. © 2006 Taylor & Francis

Foreign Accent Syndromes; The Stories People Have To Tell

What does it feel like to wake up one day speaking with a foreign accent from a country one has never visited? Why does someone wake up doing this? This book seeks to portray the broad and diverse experiences of individuals with a rare neurological speech disorder called Foreign Accent Syndrome (FAS). Through a combination of personal testimony and scientific commentary, the book aims to shed unprecedented light on the understanding of FAS by elucidating the complex links between how the brain produces speech, how listeners perceive speech and the role that accent plays in our perception of self and others. The first part of the book provides a comprehensive introduction to FAS and covers a number of key subject areas, including: • The definition and phenomenology of FAS • A history of research on FAS • The causes and psychosocial consequences of FAS • A guide to further reading and a glossary of specialized terms. The chapters in part two provide a unique insight into the condition through personal testimony and accounts from family members. This collection of 28 testimonies from across the world underlines the importance of listening carefully to patients explain their cases, and in their own words. The final section contains a questionnaire for use by clinicians to support case history taking. The authors are two leading global experts on FAS, and this is the first volume of its kind to provide such a broad and comprehensive examination of this rare and poorly understood condition. It will be of great interest to practising clinicians in neurology, psychiatry, psychology and speech and language therapy/pathology, as well as students in health disciplines relevant to neurorehabilitation, linguists and also to families and caregivers

Foreign Accent Syndromes

What does it feel like to wake up one day speaking with a foreign accent from a country one has never visited? Why does someone wake up doing this? This book seeks to portray the broad and diverse experiences of individuals with a rare neurological speech disorder called Foreign Accent Syndrome (FAS). Through a combination of personal testimony and scientific commentary, the book aims to shed unprecedented light on the understanding of FAS by elucidating the complex links between how the brain produces speech, how listeners perceive speech and the role that accent plays in our perception of self and others. The first part of the book provides a comprehensive introduction to FAS and covers a number of key subject areas, including: • The definition and phenomenology of FAS • A history of research on FAS • The causes and psychosocial consequences of FAS • A guide to further reading and a glossary of specialized terms. The chapters in part two provide a unique insight into the condition through personal testimony and accounts from family members. This collection of 28 testimonies from across the world underlines the importance of listening carefully to patients explain their cases, and in their own words. The final section contains a questionnaire for use by clinicians to support case history taking. The authors are two leading global experts on FAS, and this is the first volume of its kind to provide such a broad and comprehensive examination of this rare and poorly understood condition. It will be of great interest to practising clinicians in neurology, psychiatry, psychology and speech and language therapy/pathology, as well as students in health disciplines relevant to neurorehabilitation, linguists and also to families and caregivers

Preliminary Investigation Of Voice Onset Time Production In Persons With Dysphagia

The purpose of this study was to determine whether voice onset time (VOT) values of persons with dysphagia differed from those of a person with normal swallow function. Five male subjects with dysphagia (average age = 80.6 years) and a control subject (age = 79 years) read 18 consonant-vowel-consonant words in quasi-random order. These syllables began with the voiced and voiceless cognates from the three stop places of articulation (i.e., bilabial, alveolar, and velar). These consonants were followed by the vowels /i/, /a/, and /u/. Digital audio tape recordings were performed and speech was digitized onto disk. Measurements were completed using BLISS software implemented on a 486 microcomputer. Averages and standard deviations of the VOT measures for the six stop consonants were compared between the two experimental groups. For the dysphagic speakers, average VOT values for voiceless stops were shorter, and there were larger negative VOT values for voiced stops. Standard deviations for the VOT productions pf the dysphagic subjects were smaller. Statistical comparisons showed significant differences between individual dysphagic speakers and the normal control for three of the five subjects. These preliminary data suggest that dysphagia affects the fine motor control required for accurate VOT production in speech