Electric Charge in Interaction with Magnetically Charged Black Holes

We examine the angular momentum of an electric charge e placed at rest outside a dilaton black hole with magnetic charge Q. The electromagnetic angular momentum which is stored in the electromagnetic field outside the black hole shows several common features regardless of the dilaton coupling strength, though the dilaton black holes are drastically different in their spacetime structure depending on it. First, the electromagnetic angular momentum depends on the separation distance between the two objects and changes monotonically from eQ to 0 as the charge goes down from infinity to the horizon, if rotational effects of the black hole are discarded. Next, as the black hole approaches extremality, however, the electromagnetic angular momentum tends to be independent of the distance between the two objects. It is then precisely $eQ$ as in the electric charge and monopole system in flat spacetime. We discuss why these effects are exhibited and argue that the above features are to hold in widely generic settings including black hole solutions in theories with more complicated field contents, by addressing the no hair theorem for black holes and the phenomenon of field expulsion exhibited by extremal black holes.Comment: 26 pages, 4 figures ; Typos are corrected and a reference is adde

Development and Validation of eRADAR: A Tool Using EHR Data to Detect Unrecognized Dementia.

ObjectivesEarly recognition of dementia would allow patients and their families to receive care earlier in the disease process, potentially improving care management and patient outcomes, yet nearly half of patients with dementia are undiagnosed. Our aim was to develop and validate an electronic health record (EHR)-based tool to help detect patients with unrecognized dementia (EHR Risk of Alzheimer's and Dementia Assessment Rule [eRADAR]).DesignRetrospective cohort study.SettingKaiser Permanente Washington (KPWA), an integrated healthcare delivery system.ParticipantsA total of 16 665 visits among 4330 participants in the Adult Changes in Thought (ACT) study, who undergo a comprehensive process to detect and diagnose dementia every 2 years and have linked KPWA EHR data, divided into development (70%) and validation (30%) samples.MeasurementsEHR predictors included demographics, medical diagnoses, vital signs, healthcare utilization, and medications within the previous 2 years. Unrecognized dementia was defined as detection in ACT before documentation in the KPWA EHR (ie, lack of dementia or memory loss diagnosis codes or dementia medication fills).ResultsOverall, 1015 ACT visits resulted in a diagnosis of incident dementia, of which 498 (49%) were unrecognized in the KPWA EHR. The final 31-predictor model included markers of dementia-related symptoms (eg, psychosis diagnoses, antidepressant fills), healthcare utilization pattern (eg, emergency department visits), and dementia risk factors (eg, cerebrovascular disease, diabetes). Discrimination was good in the development (C statistic = .78; 95% confidence interval [CI] = .76-.81) and validation (C statistic = .81; 95% CI = .78-.84) samples, and calibration was good based on plots of predicted vs observed risk. If patients with scores in the top 5% were flagged for additional evaluation, we estimate that 1 in 6 would have dementia.ConclusionThe eRADAR tool uses existing EHR data to detect patients with good accuracy who may have unrecognized dementia. J Am Geriatr Soc 68:103-111, 2019

DNA repair gene XRCC1 polymorphisms and bladder cancer risk

BACKGROUND: Cigarette smoking and chemical occupational exposure are the main known risk factors for bladder transitional cell carcinoma (TCC). Oxidative DNA damage induced by carcinogens present in these exposures requires accurate base excision repair (BER). The XRCC1 protein plays a crucial role in BER by acting as a scaffold for other BER enzymes. Variants in the XRCC1 gene might alter protein structure or function or create alternatively spliced proteins which may influence BER efficiency and hence affect individual susceptibility to bladder cancer. Recent epidemiological studies have shown inconsistent associations between these polymorphisms and bladder cancer. To clarify the situation, we conducted a comprehensive analysis of 14 XRCC1 polymorphisms in a case-control study involving more than 1100 subjects. RESULTS: We found no evidence of an association between any of the 14 XRCC1 polymorphisms and bladder cancer risk. However, we found carriage of the variant Arg280His allele to be marginally associated with increased bladder cancer risk compared to the wild-type genotype (adjusted odds ratio [95% confidence interval], 1.50 [0.98–2.28], p = 0.06). The association was stronger for current smokers such that individuals carrying the variant 280His allele had a two to three-fold increased risk of bladder cancer compared to those carrying the wildtype genotype (p = 0.09). However, the evidence for gene-environment interaction was not statistically significant (p = 0.45). CONCLUSION: We provide no evidence of an association between polymorphisms in XRCC1 and bladder cancer risk, although our study had only limited power to detect the association for low frequency variants, such as Arg280His

Ablation of Long-standing Persistent Atrial Fibrillation

Atrial fibrillation (AF) is the most commonly encountered arrhythmia in the clinical setting affecting nearly 6 million people in United States and the numbers are only expected to rise as the population continues to age. Broadly it is classified into paroxysmal, persistent and longstanding persistent AF. Electrical, structural and autonomic remodeling are some of the diverse pathophysiological mechanisms that contribute to the persistence of AF. Our review article emphasizes particularly on long standing persistent atrial fibrillation (LSPAF) aspect of the disease which poses a great challenge for electrophysiologists. While pulmonary vein isolation (PVI) has been established as a successful ablation strategy for paroxysmal AF, same cannot be said for LSPAF owing to its long duration, complexity of mechanisms, multiple triggers and substrate sites that are responsible for its perpetuation. The article explains different approaches currently being adopted to achieve freedom from atrial arrhythmias. These mainly include ablation techniques chiefly targeting complex fractionated atrial electrograms (CFAE), rotors, linear lesions, scars and even considering hybrid approaches in a few cases while exploring the role of delayed enhancement magnetic resonance imaging (deMRI) in the pre-procedural planning to improve the overall short and long term outcomes of catheter ablation

Comparison of Suspected and Confirmed Internal External Ventricular Drain-Related Infections:A Prospective Multicenter United Kingdom Observational Study

BACKGROUND: Diagnosis of internal external ventricular drain (EVD)-related infections (iERI) is an area of diagnostic difficulty. Empiric treatment is often initiated on clinical suspicion. There is limited guidance around antimicrobial management of confirmed versus suspected iERI. METHODS: Data on patients requiring EVD insertion were collected from 21 neurosurgical units in the United Kingdom from 2014 to 2015. Confirmed iERI was defined as clinical suspicion of infection with positive cerebrospinal fluid (CSF) culture and/or Gram stain. Cerebrospinal fluid, blood, and clinical parameters and antimicrobial management were compared between the 2 groups. Mortality and Modified Rankin Scores were compared at 30 days post-EVD insertion. RESULTS: Internal EVD-related infection was suspected after 46 of 495 EVD insertions (9.3%), more common after an emergency insertion. Twenty-six of 46 were confirmed iERIs, mostly due to Staphylococci (16 of 26). When confirmed and suspected infections were compared, there were no differences in CSF white cell counts or glucose concentrations, nor peripheral blood white cell counts or C-reactive protein concentrations. The incidence of fever, meningism, and seizures was also similar, although altered consciousness was more common in people with confirmed iERI. Broad-spectrum antimicrobial usage was prevalent in both groups with no difference in median duration of therapy (10 days [interquartile range {IQR}, 7–24.5] for confirmed cases and 9.5 days [IQR, 5.75–14] for suspected, P = 0.3). Despite comparable baseline characteristics, suspected iERI was associated with lower mortality and better neurological outcomes. CONCLUSIONS: Suspected iERI could represent sterile inflammation or lower bacterial load leading to false-negative cultures. There is a need for improved microbiology diagnostics and biomarkers of bacterial infection to permit accurate discrimination and improve antimicrobial stewardship

Unexpected Tolerance of α-Cleavage of the Prion Protein to Sequence Variations

The cellular form of the prion protein, PrPC, undergoes extensive proteolysis at the α site (109K↓H110). Expression of non-cleavable PrPC mutants in transgenic mice correlates with neurotoxicity, suggesting that α-cleavage is important for PrPC physiology. To gain insights into the mechanisms of α-cleavage, we generated a library of PrPC mutants with mutations in the region neighbouring the α-cleavage site. The prevalence of C1, the carboxy adduct of α-cleavage, was determined for each mutant. In cell lines of disparate origin, C1 prevalence was unaffected by variations in charge and hydrophobicity of the region neighbouring the α-cleavage site, and by substitutions of the residues in the palindrome that flanks this site. Instead, α-cleavage was size-dependently impaired by deletions within the domain 106–119. Almost no cleavage was observed upon full deletion of this domain. These results suggest that α-cleavage is executed by an α-PrPase whose activity, despite surprisingly limited sequence specificity, is dependent on the size of the central region of PrPC

Dynamical structure factors of S=1/2S=1/2 two-leg spin ladder systems

We investigate dynamical properties of $S=1/2$ two-leg spin ladder systems. In a strong coupling region, an isolated mode appears in the lowest excited states, while in a weak coupling region, an isolated mode is reduced and the lowest excited states become a lower bound of the excitation continuum. We find in the system with equal intrachain and interchain couplings that due to a cyclic four-spin interaction, the distribution of the weights for the dynamical structure factor and characteristics of the lowest excited states are strongly influenced. The dynamical properties of two systems proposed for ${\rm SrCu_2O_3}$ are also discussed.Comment: 5 pages, 6 figure

Tensile bond strength and SEM analysis of enamel etched with Er:YAG laser and phosphoric acid: a comparative study In vitro

Er:YAG laser has been studied as a potential tool for restorative dentistry due to its ability to selectively remove oral hard tissue with minimal or no thermal damage to the surrounding tissues. The purpose of this study was to evaluate in vitro the tensile bond strength (TBS) of an adhesive/composite resin system to human enamel surfaces treated with 37% phosphoric acid, Er:YAG laser (lambda=2.94 mum) with a total energy of 16 J (80 mJ/pulse, 2Hz, 200 pulses, 250 ms pulse width), and Er:YAG laser followed by phosphoric acid etching. Analysis of the treated surfaces was performed by scanning electron microscopy (SEM) to assess morphological differences among the groups. TBS means (in MPa) were as follows: Er:YAG laser + acid (11.7 MPa) > acid (8.2 MPa) > Er:YAG laser (6.1 MPa), with the group treated with laser+acid being significantly from the other groups (p=0.0006 and p= 0.00019, respectively). The groups treated with acid alone and laser alone were significantly different from each other (p=0.0003). The SEM analysis revealed morphological changes that corroborate the TBS results, suggesting that the differences in TBS means among the groups are related to the different etching patterns produced by each type of surface treatment. The findings of this study indicate that the association between Er:YAG laser and phosphoric acid can be used as a valuable resource to increase bond strength to laser-prepared enamel.A tecnologia a laser tem sido estudada como uma ferramenta potencial para uso em odontologia devido à sua habilidade em remover tecido ósseo com um mínimo ou nenhum dano aos tecidos vizinhos. O objetivo deste estudo é comparar in vitro a resistência à tração do sistema adesivo em esmalte tratado com ácido fosfórico a 37 %, laser Er:YAG (lambda=2,94 mim) com energia total de 16 J (80 mJ/pulso, 2 Hz, 200 pulsos e largura de pulso de 250 ms) e com a combinação laser Er:YAG seguido por ácido fosfórico. O teste de resistência à tração foi usado para comparar a resistência à tração em cada grupo. Foi também realizada microscopia eletrônica de varredura para permitir a análise das diferenças morfológicas entre os grupos. Foram obtidos os seguintes valores médios de resistência para os grupos tratados com: laser (6,1 MPa), ácido fosfórico (8,2 MPa) e laser mais ácido (11,7 Mpa). Amostras tratadas com laser e ácido apresentaram valores maiores de resistência do que amostras com laser ou ácido isoladamente. A análise da microscopia eletrônica revelou diferenças que corroboram os resultados, demonstrando que diferenças de resistência entre os grupos são devidas às diferenças entre os padrões superficiais resultantes. Nossos resultados sugerem que a combinação do laser Er:YAG com ácido fosfórico pode ser usada como um método para aumentar a resistência à tração do sistema esmalte resina

No association between islet cell antibodies and coxsackie B, mumps, rubella and cytomegalovirus antibodies in non-diabetic individuals aged 7–19 years

Viral antibodies were tested in a cohort of 44 isletcell antibody-positive individuals age 7–19 years, and 44 of their islet cell antibody-negative age and sex-matched classmates selected from a population study of 4208 pupils who had been screened for islet cell antibodies. Anti-coxsackie B1-5 IgM responses were detected in 14 of 44 (32%) of the islet cell antibody-positive subjects and in 7 of 44 (16%) control subjects. This difference did not reach the level of statistical significance. None of the islet cell antibody-positive subjects had specific IgM antibodies to mumps, rubella, or cytomegalovirus. There was also no increase in the prevalence or the mean titres of anti-mumps-IgG or IgA and anti-cytomegalovirus-IgG in islet cell antibody-positive subjects compared to control subjects. These results do not suggest any association between islet cell antibodies, and possibly insulitis, with recent mumps, rubella or cytomegalo virus infection. Further studies are required to clarify the relationship between islet cell antibodies and coxsackie B virus infections

Dynamical structure factors of the magnetization-plateau state in the S=1/2S=1/2 bond-alternating spin chain with a next-nearest-neighbor interaction

We calculate the dynamical structure factors of the magnetization-plateau state in the $S=1/2$ bond-alternating spin chain with a next-nearest-neighbor interaction. The results show characteristic behaviors depending on the next-nearest-neighbor interaction $\alpha$ and the bond-alternation $\delta$. We discuss the lower excited states in comparison with the exact excitation spectrums of an effective Hamiltonian. From the finite size effects, characteristics of the lowest excited states are investigated. The dispersionless mode of the lowest excitation appears in adequate sets of $\alpha$ and $\delta$, indicating that the lowest excitation is localized spatially and forms an isolated mode below the excitation continuum. We further calculate the static structure factors. The largest intensity is located at $q=\pi$ for small $\delta$ in fixed $\alpha$. With increasing $\delta$, the wavenumber of the largest intensity shifts towards $q=\pi/2$, taking the incommensurate value.Comment: to appear in Phys. Rev. B (2001