Transition from radiatively inefficient to cooling dominated phase in two temperature accretion discs around black holes

We investigate the transition of a radiatively inefficient phase of a viscous two temperature accreting flow to a cooling dominated phase and vice versa around black holes. Based on a global sub-Keplerian accretion disc model in steady state, including explicit cooling processes self-consistently, we show that general advective accretion flow passes through various phases during its infall towards a black hole. Bremsstrahlung, synchrotron and inverse Comptonization of soft photons are considered as possible cooling mechanisms. Hence the flow governs a much lower electron temperature ~10^8 - 10^{9.5}K compared to the hot protons of temperature ~10^{10.2} - 10^{11.8}K in the range of the accretion rate in Eddington units 0.01 - 100. Therefore, the solutions may potentially explain the hard X-rays and the gamma-rays emitted from AGNs and X-ray binaries. We finally compare the solutions for two different regimes of viscosity and conclude that a weakly viscous flow is expected to be cooling dominated compared to its highly viscous counterpart which is radiatively inefficient. The flow is successfully able to reproduce the observed luminosities of the under-fed AGNs and quasars (e.g. Sgr A*), ultra-luminous X-ray sources (e.g. SS433), as well as the highly luminous AGNs and ultra-luminous quasars (e.g. PKS 0743-67) at different combinations of the mass accretion rate and ratio of specific heats.Comment: 13 pages including 8 figures; couple of typos corrected; to appear in Research in Astronomy and Astrophysic

Transition from radiatively inefficient to cooling dominated phase in two temperature accretion discs around black holes

We investigate the transition of a radiatively inefficient phase of a viscous two temperature accreting flow to a cooling dominated phase and vice versa around black holes. Based on a global sub-Keplerian accretion disc model in steady state, including explicit cooling processes self-consistently, we show that general advective accretion flow passes through various phases during its infall towards a black hole. Bremsstrahlung, synchrotron and inverse Comptonization of soft photons are considered as possible cooling mechanisms. Hence the flow governs a much lower electron temperature ~10^8 - 10^{9.5}K compared to the hot protons of temperature ~10^{10.2} - 10^{11.8}K in the range of the accretion rate in Eddington units 0.01 - 100. Therefore, the solutions may potentially explain the hard X-rays and the gamma-rays emitted from AGNs and X-ray binaries. We finally compare the solutions for two different regimes of viscosity and conclude that a weakly viscous flow is expected to be cooling dominated compared to its highly viscous counterpart which is radiatively inefficient. The flow is successfully able to reproduce the observed luminosities of the under-fed AGNs and quasars (e.g. Sgr A*), ultra-luminous X-ray sources (e.g. SS433), as well as the highly luminous AGNs and ultra-luminous quasars (e.g. PKS 0743-67) at different combinations of the mass accretion rate and ratio of specific heats.Comment: 13 pages including 8 figures; couple of typos corrected; to appear in Research in Astronomy and Astrophysic

Pharmacoepidemiological survey of schizophrenia in Central India

Background:Schizophrenia is a chronic and debilitating psychiatric illness affecting around 0.3-0.7% of people at some point in their life. The rate of schizophrenia and related disorders is affected by some environmental factors and social variables. Therefore, pharmacoepidemiological survey of patients suffering from schizophrenia was carried out to analyze the sociodemographic profile and drug prescribing pattern.Methods:A prospective observational study was conducted in psychiatry OPD of a tertiary care hospital for nine months. Diagnosis of schizophrenia was made according to DSM IV-TR criteria. Prescriptions were analyzed for socio demographic details, distribution of subsets of disease and psychotropic drugs prescribed.Results:Amongst 196 cases analyzed, 55.61% were males, 69.9% were below 40 years, 52.04% unmarried, 61.22% belonged to low income group, 82.14% unemployed and 58.16% came from urban locality. Paranoid schizophrenia (79.59%) was the most common diagnosis and a total of 402 psychotropic drugs were prescribed. Average number of psychotropic drugs per prescription was 2.05. Atypical antipsychotics (80.09%) were prescribed more commonly than typical antipsychotics; olanzapine (42.48%) was the commonest antipsychotic drug followed by risperidone (21.68%), haloperidol (19.91%), quetiapine (7.96%), aripiprazole (4.42%) and clozapine (3.54%). As an adjunctive treatment escitalopram, clonazepam and carbamazepine were the commonly prescribed antidepressant, anxiolytic and antimanic agent respectively.Conclusion:Low socioeconomic status, unemployment, urban locality and living alone are the sociodemographic factors associated with schizophrenia. The treatment pattern observed correlates with the changing trends in the treatment of schizophrenia world over.

Two temperature accretion around rotating black holes: Description of general advective flow paradigm in presence of various cooling processes to explain low to high luminous sources

We investigate the viscous two temperature accretion discs around rotating black holes. We describe the global solution of accretion flows with a sub-Keplerian angular momentum profile, by solving the underlying conservation equations including explicit cooling processes selfconsistently. Bremsstrahlung, synchrotron and inverse Comptonization of soft photons are considered as possible cooling mechanisms, for sub-Eddington, Eddington and super-Eddington mass accretion rates around Schwarzschild and Kerr black holes with a Kerr parameter 0.998. It is found that the flow, during its infall from the Keplerian to sub-Keplerian transition region to the black hole event horizon, passes through various phases of advection -- general advective paradigm to radiatively inefficient phase and vice versa. Hence the flow governs much lower electron temperature ~10^8-10^{9.5} K, in the range of accretion rate in Eddington units 0.01 <~ \mdot <~ 100, compared to the hot protons of temperature ~ 10^{10.2} - 10^{11.8}K. Therefore, the solution may potentially explain the hard X-rays and \gamma-rays emitted from AGNs and X-ray binaries. We then show that a weakly viscous flow is expected to be cooling dominated, particularly at the inner region of the disc, compared to its highly viscous counterpart which is radiatively inefficient. With all the solutions in hand, we finally reproduce the observed luminosities of the under-fed AGNs and quasars (e.g. Sgr A^*) to ultra-luminous X-ray sources (e.g. SS433), at different combinations of input parameters such as mass accretion rate, ratio of specific heats. The set of solutions also predicts appropriately the luminosity observed in the highly luminous AGNs and ultra-luminous quasars (e.g. PKS 0743-67).Comment: 25 pages including 22 figures; to appear in MNRA

Comparative evaluation of diode laser versus argon laser photocoagulation in patients with central serous retinopathy: A pilot, randomized controlled trial [ISRCTN84128484]

BACKGROUND: To evaluate the efficacy of diode laser photocoagulation in patients with central serous retinopathy (CSR) and to compare it with the effects of argon green laser. METHODS: Thirty patients with type 1 unilateral CSR were enrolled and evaluated on parameters like best corrected visual acuity (BCVA), direct and indirect ophthalmoscopy, amsler grid for recording scotoma and metamorphopsia, contrast sensitivity using Cambridge low contrast gratings and fluorescein angiography to determine the site of leakage. Patients were randomly assigned into 2 groups according to the statistical random table using sequence generation. In Group 1 (n = 15), diode laser (810 nm) photocoagulation was performed at the site of leakage while in Group 2 (n = 15), eyes were treated with argon green laser (514 nm) using the same laser parameters. Patients were followed up at 4, 8 and 12 weeks after laser. RESULTS: The mean BCVA in group 1 improved from a pre-laser decimal value of 0.29 ± 0.14 to 0.84 ± 0.23 at 4 weeks and 1.06 ± 0.09 at 12 weeks following laser. In group 2, the same improved from 0.32 ± 0.16 to 0.67 ± 0.18 at 4 weeks and 0.98 ± 0.14 at 12 weeks following laser. The improvement in BCVA was significantly better in group 1 (p < 0.0001) at 4 weeks. At 4 weeks following laser, all the patients in group1 were free of scotoma while 6 patients in group 2 had residual scotoma (p < 0.05). The mean contrast sensitivity in group 1 improved from pre-laser value of 98.4 ± 24.77 to 231.33 ± 48.97 at 4 weeks and 306.00 ± 46.57 at 12 weeks following laser. In group 2, the same improved from 130.66 ± 31.95 to 190.66 ± 23.44 at 4 weeks and 215.33 ± 23.25 at 12 weeks. On comparative evaluation, a significantly better (p < 0.001) improvement was noted in group 1. CONCLUSION: Diode laser may be a better alternative to argon green laser whenever laser treatment becomes indicated in patients with central serous retinopathy in terms of faster visual rehabilitation and better contrast sensitivity. In addition, diode laser also has the well-recognized ergonomic and economic advantages

Visual Acuity and Associated Factors. The Central India Eye and Medical Study

Visual acuity is a major parameter for quality of vision and quality of life. Information on visual acuity and its associated factors in rural societies almost untouched by any industrialization is mostly non-available. It was, therefore, the purpose of our study to determine the distribution of visual acuity and its associated factors in a rural population not marked influenced by modern lifestyle. The population-based Central India Eye and Medical Study included 4711 subjects (aged 30+ years), who underwent a detailed ophthalmologic examination including visual acuity measurement. Visual acuity measurements were available for 4706 subjects with a mean age of 49.5±13.4 years (range: 30–100 years). BCVA decreased significantly (P<0.001) from the moderately hyperopic group (0.08±0.15 logMAR) to the emmetropic group (0.16±0.52 logMAR), the moderately myopic group (0.28±0.33 logMAR), the highly hyperopic group (0.66±0.62 logMAR) and finally the highly myopic group (1.32±0.92 logMAR). In multivariate analysis, BCVA was significantly associated with the systemic parameters of lower age (P<0.001), higher level of education (P<0.001), higher body stature (P<0.001) and higher body mass index (P<0.001), and with the ophthalmic parameters of more hyperopic refractive error (spherical equivalent) (P<0.001), shorter axial length (P<0.001), lower degree of nuclear cataract (P<0.001), and lower intraocular pressure (P = 0.006). The results suggest that in the rural population of Central India, major determinants of visual acuity were socioeconomic background, body stature and body mass index, age, refractive error, cataract and intraocular pressure

Effect of participatory women's groups facilitated by Accredited Social Health Activists on birth outcomes in rural eastern India: A cluster-randomised controlled trial

Background: A quarter of the world's neonatal deaths and 15% of maternal deaths happen in India. Few community-based strategies to improve maternal and newborn health have been tested through the country's government-approved Accredited Social Health Activists (ASHAs). We aimed to test the effect of participatory women's groups facilitated by ASHAs on birth outcomes, including neonatal mortality. Methods: In this cluster-randomised controlled trial of a community interve

What are we measuring? A critique of range of motion methods currently in use for Dupuytren's disease and recommendations for practice

Background: Range of motion is the most frequently reported measure used in practice to evaluate outcomes. A goniometer is the most reliable tool to assess range of motion yet, the lack of consistency in reporting prevents comparison between studies. The aim of this study is to identify how range of motion is currently assessed and reported in Dupuytren’s disease literature. Following analysis recommendations for practice will be made to enable consistency in future studies for comparability. This paper highlights the variation in range of motion reporting in Dupuytren’s disease. Methods: A Participants, Intervention, Comparison, Outcomes and Study design format was used for the search strategy and search terms. Surgery, needle fasciotomy or collagenase injection for primary or recurrent Dupuytren’s disease in adults were included if outcomes were monitored using range of motion to record change. A literature search was performed in May 2013 using subject heading and free-text terms to also capture electronic publications ahead of print. In total 638 publications were identified and following screening 90 articles met the inclusion criteria. Data was extracted and entered onto a spreadsheet for analysis. A thematic analysis was carried out to establish any duplication, resulting in the final range of motion measures identified. Results: Range of motion measurement lacked clarity, with goniometry reportedly used in only 43 of the 90 studies, 16 stated the use of a range of motion protocol. A total of 24 different descriptors were identified describing range of motion in the 90 studies. While some studies reported active range of motion, others reported passive or were unclear. Eight of the 24 categories were identified through thematic analysis as possibly describing the same measure, ‘lack of joint extension’ and accounted for the most frequently used. Conclusions: Published studies lacked clarity in reporting range of motion, preventing data comparison and meta-analysis. Percentage change lacks context and without access to raw data, does not allow direct comparison of baseline characteristics. A clear description of what is being measured within each study was required. It is recommended that range of motion measuring and reporting for Dupuytren’s disease requires consistency to address issues that fall into 3 main categories:- Definition of terms Protocol statement Outcome reportin

Physics Potential of the ICAL detector at the India-based Neutrino Observatory (INO)

The upcoming 50 kt magnetized iron calorimeter (ICAL) detector at the India-based Neutrino Observatory (INO) is designed to study the atmospheric neutrinos and antineutrinos separately over a wide range of energies and path lengths. The primary focus of this experiment is to explore the Earth matter effects by observing the energy and zenith angle dependence of the atmospheric neutrinos in the multi-GeV range. This study will be crucial to address some of the outstanding issues in neutrino oscillation physics, including the fundamental issue of neutrino mass hierarchy. In this document, we present the physics potential of the detector as obtained from realistic detector simulations. We describe the simulation framework, the neutrino interactions in the detector, and the expected response of the detector to particles traversing it. The ICAL detector can determine the energy and direction of the muons to a high precision, and in addition, its sensitivity to multi-GeV hadrons increases its physics reach substantially. Its charge identification capability, and hence its ability to distinguish neutrinos from antineutrinos, makes it an efficient detector for determining the neutrino mass hierarchy. In this report, we outline the analyses carried out for the determination of neutrino mass hierarchy and precision measurements of atmospheric neutrino mixing parameters at ICAL, and give the expected physics reach of the detector with 10 years of runtime. We also explore the potential of ICAL for probing new physics scenarios like CPT violation and the presence of magnetic monopoles.Comment: 139 pages, Physics White Paper of the ICAL (INO) Collaboration, Contents identical with the version published in Pramana - J. Physic

Optimal functional outcome measures for assessing treatment for Dupuytren's disease: A systematic review and recommendations for future practice

This article is available through the Brunel Open Access Publishing Fund. Copyright © 2013 Ball et al.; licensee BioMed Central Ltd.Background: Dupuytren's disease of the hand is a common condition affecting the palmar fascia, resulting in progressive flexion deformities of the digits and hence limitation of hand function. The optimal treatment remains unclear as outcomes studies have used a variety of measures for assessment. Methods: A literature search was performed for all publications describing surgical treatment, percutaneous needle aponeurotomy or collagenase injection for primary or recurrent Dupuytren’s disease where outcomes had been monitored using functional measures. Results: Ninety-one studies met the inclusion criteria. Twenty-two studies reported outcomes using patient reported outcome measures (PROMs) ranging from validated questionnaires to self-reported measures for return to work and self-rated disability. The Disability of Arm, Shoulder and Hand (DASH) score was the most utilised patient-reported function measure (n=11). Patient satisfaction was reported by eighteen studies but no single method was used consistently. Range of movement was the most frequent physical measure and was reported in all 91 studies. However, the methods of measurement and reporting varied, with seventeen different techniques being used. Other physical measures included grip and pinch strength and sensibility, again with variations in measurement protocols. The mean follow-up time ranged from 2 weeks to 17 years. Conclusions: There is little consistency in the reporting of outcomes for interventions in patients with Dupuytren’s disease, making it impossible to compare the efficacy of different treatment modalities. Although there are limitations to the existing generic patient reported outcomes measures, a combination of these together with a disease-specific questionnaire, and physical measures of active and passive individual joint Range of movement (ROM), grip and sensibility using standardised protocols should be used for future outcomes studies. As Dupuytren’s disease tends to recur following treatment as well as extend to involve other areas of the hand, follow-up times should be standardised and designed to capture both short and long term outcomes