Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

The visualization of hypertrophic pachymeningitis in antineutrophil cytoplasmic antibody-associated granulomatosis with polyangiitis on contrast-enhanced FLAIR

Hypertrophic pachymeningitis is a rare inflammatory condition that leads to the thickening of the dura mater, either due to unknown or identifiable secondary causes. Granulomatosis with polyangiitis is a notable causative agent, and hypertrophic pachymeningitis is the initial presentation in certain cases. The diagnosis of hypertrophic pachymeningitis is aided by contrast-enhanced MRI, although distinguishing between normal and abnormal dural enhancement can be challenging using contrast-enhanced T1WI. This study highlights the case of an 80-year-old woman diagnosed with hypertrophic pachymeningitis secondary to antineutrophil cytoplasmic antibody-associated granulomatosis with polyangiitis, where contrast-enhanced FLAIR played a crucial role in distinctly identifying abnormal dural enhancement and differentiating it from normal dura. In conclusion, although contrast-enhanced T1WI remains indispensable, contrast-enhanced FLAIR can serve as a valuable complementary tool in MRI study sequences for the diagnosis of hypertrophic pachymeningitis

Two case reports of two interventional radiology techniques for the treatment of stage II empyema: Hydrodissection and guidewire-dissection

Empyema is an infection of the pleural space that is classified into 3 stages. Video-assisted thoracoscopic surgery is recommended as the first-line approach for stage II acute empyema. The purpose of video-assisted thoracoscopic surgery is also achieved with hydrodissection and guidewire-dissection by breaking the septa mechanically in the pleural cavity. Hydrodissection and guidewire-dissection are techniques in which a contrast medium is administered at high pressure and a guidewire is inserted into the pleural cavity to break the septa, respectively. Hydrodissection and guidewire-dissection might be minimally invasive alternatives for the treatment of septated empyema

津軽海峡における鯨類目視調査

津軽海峡の鯨類に関する知見は極めて乏しい。本研究では津軽海峡の鯨類の鯨種，それらの出現頻度を明らかにするため，2003年4月から2004年11月まで函館・青森間を運行するフェリーからの目視調査を実施した。58日6,102kmの目視調査により，合計415群3,010 個体の鯨類の発見があった。発見はカマイルカが優占し，マイルカ，イシイルカ，ハンドウイルカ、ネズミイルカ、コビレゴンドウ等が発見された。カマイルカの来遊のピークは5～6月の年一回であった

Unilateral Chronic Lung Allograft Dysfunction Assessed by Biphasic Computed Tomographic Volumetry in Bilateral Living-donor Lobar Lung Transplantation

Background. Early diagnosis of unilateral chronic lung allograft dysfunction (CLAD) is difficult because the unaffected contralateral lung functions as a reservoir in bilateral living-donor lobar lung transplantation (LDLLT). We previously reported the usefulness of 133Xe ventilation scintigraphy for detection of unilateral change, but the supply of 133Xe has been stopped globally. The present study aimed to examine the usefulness of inspiratory and expiratory computed tomography (I/E CT) volumetry for detection of unilateral change in CLAD patients. Methods. This was a retrospective single-center, observational study using prospectively collected data. A total of 58 patients who underwent bilateral LDLLT from August 2008 to February 2017 were analyzed. Respiratory function tests, I/E CT were prospectively conducted. ΔLung volume was defined as the value obtained by subtracting expiratory lung volume from inspiratory lung volume. Results. Fourteen (24%) cases were clinically diagnosed with CLAD, of which 10 (71%) were diagnosed as unilateral CLAD. ΔLung volume of bilateral lungs strongly correlated with forced vital capacity (r = 0.92, P < 0.01) and forced expiratory volume in 1 second (r = 0.80, P < 0.01). Regardless the phenotypes (bronchiolitis obliterans syndrome or restrictive allograft syndrome) of CLAD, Δlung volume onset/baseline significantly decreased compared with that in the non-CLAD group. Among the 10 unilateral CLAD patients, 3 with clinically suspected unilateral rejection yet did not show a 20% decline in forced expiratory volume in 1 second. In 2 of these, Δlung volume of unilateral lungs on the rejection side decreased by 20% or more. Conclusions. Our findings suggest that I/E CT volumetry may be useful for assessment and early diagnosis of unilateral CLAD after bilateral LDLLT

A case of complete atrioventricular block: The use of magnetic resonance imaging conditional pacemakers for diagnosing cardiac sarcoidosis

A 50-year-old man presented to the emergency department with repeated episodes of faintness and exertional dyspnea, and was found to have an atrioventricular (AV) block. Chest radiography and transthoracic echocardiography results were normal, without any evidence of heart failure, wall motion abnormalities, interventricular septum thinning, or bilateral hilar lymphadenopathy. A temporary pacemaker was implanted, followed by a permanent pacemaker. Chest computed tomography with contrast enhancement did not show abnormalities, including patent coronary arteries, lymph node adenopathy, and pulmonary abnormalities. Thus, an MRI conditional dual chamber pacemaker and leads were implanted. Six weeks following the implant, a cardiac MRI was performed to test for cardiac sarcoidosis. Although cine imaging showed normal left and right ventricular function, late gadolinium enhancement demonstrated multiple enhanced uptakes. Based on the results of the cardiac MRI, PET, and gallium scintigraphy, the most likely diagnosis was cardiac sarcoidosis. Although no abnormal findings were found on physical examination, blood work, chest radiography, and transthoracic echocardiogram, multiple regions of delayed enhancement were observed in the cardiac MRI. Thus, MRI conditional pacemakers are a useful tool for diagnosing cardiac sarcoidosis and early therapeutic intervention

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to &lt; 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of &amp; GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P &lt; 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo