Circumstellar environment of RX Puppis

The symbiotic Mira, RX Pup, shows long-term variations in its mean light level due to variable obscuration by circumstellar dust. The last increase in extinction towards the Mira, between 1995 and 2000, has been accompanied by large changes in the degree of polarization in the optical and red spectral range. The lack of any obvious associated changes in the position angle may indicate the polarization variations are driven by changes in the properties of the dust grains (e.g. variable quantity of dust and variable particle size distribution, due to dust grain formation and growth) rather than changes in the viewing geometry of the scattering region(s), e.g. due to the binary rotation.Comment: Paper presented at Torun 2000 conference on Post-AGB objects as a phase of stellar evolution; 8 pages, 3 figure

Development of a neutron radiography simulation model

Measurement models of NDE techniques have been developed with the purpose of proving the capabilities of NDE techniques for finding flaws. The models take NDE parameters such as ultrasonic frequency, probe diameter, and angle of incidence, and predict the response from the flaw. Models are also a part of quantitative NDE, i.e., the ability to size and characterize flaws and or materials

Debris cover and surface melt at a temperate maritime alpine glacier: Franz Josef Glacier, New Zealand

Melt rates on glaciers are strongly influenced by the presence of supraglacial debris, which can either enhance or reduce ablation relative to bare ice. Most recently, Franz Josef Glacier has entered into a phase of strong retreat and downwasting, with the increasing emergence of debris on the surface in the ablation zone. Previously at Franz Josef Glacier, melt has only been measured on bare ice. During February 2012, a network of 11 ablation stakes was drilled into locations of varying supraglacial debris thickness on the lower glacier. Mean ablation rates over 9 days varied over the range 1.2–10.1 cm d−1, and were closely related to debris thickness. Concomitant observations of air temperature allowed the application of a degree-day approach to the calculation of melt rates, with air temperature providing a strong indicator of melt. Degree-day factors (d f) varied over the range 1.1–8.1 mm d−1 °C−1 (mean of 4.4 mm d−1 °C−1), comparable with rates reported in other studies. Mapping of the current debris cover revealed 0.7 km2 of the 4.9 km2 ablation zone surface was debris-covered, with thicknesses ranging 1–50 cm. Based on measured debris thicknesses and d f, ablation on debris-covered areas of the glacier is reduced by a total of 41% which equates to a 6% reduction in melt overall across the entire ablation zone. This study highlights the usefulness of a short-term survey to gather representative ablation data, consistent with numerous overseas ablation studies on debris-covered glaciers

Continuous 14 Day Infusional Ifosfamide for Management of Soft-Tissue and Bone Sarcoma: A Single Centre Retrospective Cohort Analysis

Ifosfamide is used to treat soft-tissue sarcoma (STS) and bone sarcoma (BS), with improved efficacy at doses above 9 g/m2/cycle. To mitigate treatment-associated toxicity with higher doses, continuous infusional ifosfamide is increasingly used. However, clinical outcome data remain limited. Single-centre retrospective analysis of patients treated with four-weekly infusional ifosfamide (14 g/m^{2}/14 days) between August 2012 and February 2019 was conducted. Radiological response, progression-free survival (PFS), overall survival (OS) and toxicity were evaluated. Eighty patients were treated-46 with STS and 34 with BS. Patients received a median of three cycles of infusional ifosfamide (1-24). Overall disease control rate (DCR) in STS was 50% (23 of 46 patients), with a median PFS of 3.8 months, and median OS of 13.0 months. In synovial sarcoma (SS), DCR was 80% (12/15), median PFS 8.1 months and median OS 20.9 months. Overall DCR in BS (34 patients) was 30%, with a median PFS of 2.5 months and median OS of 6.2 months. Five patients (6%) stopped treatment due to toxicity alone within the first two cycles. A further 10 patients stopped treatment due to toxicity during later treatment cycles (12%) and 18 patients (23%) required dose modification. Forty-five patients (56%) experienced grade (G) 3/4 haematological toxicity, with 12 episodes of febrile neutropenia and one treatment-related death. Twenty-seven patients (34%) experienced G3/4 non-haematological toxicity, most commonly nausea and vomiting (10, 13%). In summary, infusional ifosfamide has efficacy in STS, most notable in SS. Benefit appears limited in BS. Treatment is associated with toxicity that requires specialist supportive care

Comparative attainment of 5-year undergraduate and 4-year graduate entry medical students moving into foundation training

Background Graduate entry medicine is a recent innovation in UK medical training. Evidence is sparse at present as to progress and attainment on these programmes. Shared clinical rotations, between an established 5-year and a new graduate entry course, provide the opportunity to compare achievement on clinical assessments. To compare completion and attainment on clinical phase assessments between students on a 4-year graduate entry course and an established 5-year undergraduate medicine course. Methods Overall completion rates for the 4 and 5 year courses, fails at first attempt, and scores on 14 clinical assessments, were compared between 171 graduate-entry and 450 undergraduate medical students at the University of Nottingham, comprising two graduating cohorts. Percentage assessment marks were converted to z-scores separately for each graduating year and the normalised marks then combined into a single dataset. Z-score transformed percentage marks were analysed by multivariate analysis of variance and univariate analyses of variance for each summative assessment. Numbers of fails at first attempt were analysed aggregated across all assessments initially, then separately for each assessment using χ2. Results Completion rates were around 90% overall and significantly higher in the graduate entry course. Failures of assessments overall were similar, but a higher proportion of graduate entry students failed the final OSLER. Mean performance on clinical assessments showed a significant overall difference, made up of lower performance on 4 of 5 knowledge-based exams (as well as higher performance on the first exam) by the graduate entry group, but similar levels of performance on all the skills-based and attitudinal assessments. Conclusions High completion rates are encouraging. The lower performance in some knowledge-based exams may reflect lower prior educational attainment, a substantially different demographic profile (age, gender), or an artefact of the first 2 years of a new graduate entry programme

The dental implications of bisphosphonates and bone disease

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.In 2002/2003 a number of patients presented to the South Australian Oral and Maxillofacial Surgery Unit with unusual non-healing extraction wounds of the jaws. All were middle-aged to elderly, medically compromised and on bisphosphonates for bone pathology. Review of the literature showed similar cases being reported in the North American oral and maxillofacial surgery literature. This paper reviews the role of bisphosphonates in the management of bone disease. There were 2.3 million prescriptions for bisphosphonates in Australia in 2003. This group of drugs is very useful in controlling bone pain and preventing pathologic fractures. However, in a small number of patients on bisphosphonates, intractable, painful, non-healing exposed bone occurs following dental extractions or denture irritation. Affected patients are usually, but not always, over 55 years, medically compromised and on the potent nitrogen containing bisphosphonates, pamidronate (Aredia/Pamisol), alendronate (Fosamax) and zolendronate (Zometa) for nonosteoporotic bone disease. Currently, there is no simple, effective treatment and the painful exposed bone may persist for years. The main complications are marked weight loss from difficulty in eating and severe jaw and neck infections. Possible preventive and therapeutic strategies are presented although at this time there is no evidence of their effectiveness. Dentists must ask about bisphosphonate usage for bone disease when recording medical histories and take appropriate actions to avoid the development of this debilitating condition in their patients

The Complete transmission spectrum of WASP-39b with a precise water constraint

This is the author accepted manuscript. The final version is available from American Astronomical Society via the DOI in this record.WASP-39b is a hot Saturn-mass exoplanet with a predicted clear atmosphere based on observations in the optical and infrared. Here we complete the transmission spectrum of the atmosphere with observations in the near-infrared (NIR) over three water absorption features with the Hubble Space Telescope (HST) Wide Field Camera 3 (WFC3) G102 (0.8-1.1 microns) and G141 (1.1-1.7 microns) spectroscopic grisms. We measure the predicted high amplitude H2O feature centered at 1.4 microns, and the smaller amplitude features at 0.95 and 1.2 microns, with a maximum water absorption amplitude of 2.4 planetary scale heights. We incorporate these new NIR measurements into previously published observational measurements to complete the transmission spectrum from 0.3-5 microns. From these observed water features, combined with features in the optical and IR, we retrieve a well constrained temperature Teq = 1030(+30,-20) K, and atmospheric metallicity 151 (+48,-46)x solar which is relatively high with respect to the currently established mass-metallicity trends. This new measurement in the Saturn-mass range hints at further diversity in the planet formation process relative to our solar system giants.This work is based on observations made with the NASA/ESA Hubble Space Telescope that were obtained at the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc. These observations are associated with programs GO-14169 (PI. HR Wakeford) and GO-14260 (PI. D Deming). D.K.S., H.R.W., T.E., B.D., and N.N., acknowledge funding from the European Research Council (ERC) under the European Unions Seventh Framework Programme (FP7/2007-2013)/ERC grant agreement no. 336792. J.G. acknowledges support from Leverhulme Trust. A.L.C. acknowledges support from the STFC. H.R.W. also acknowledges support from the Giacconi Fellowship at the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc

Prognostic value of estimated glomerular filtration rate in hospitalised older patients (over 65) with COVID-19 : a multicentre, European, observational cohort study

Acknowledgements: COPE Team Members (collaborators). Funding: No funding declared for this study. The Study was sponsored by Cardiff University who had no role on the study design, analysis or interpretation of the findings. BC is partially supported by the NIHR Maudsley Biomedical Research Centre at South London Maudsley NHS Foundation Trust, and King's College London. EAR received the Gwyn Seymour Scholarship from the Department of Medicine for the Elderly, NHS Grampian, as part of the Aberdeen Summer Research Scholarship Scheme, Aberdeen Clinical Academic Training Programme, University of Aberdeen.Peer reviewedPublisher PD

Imaging-guided chest biopsies: techniques and clinical results

Background This article aims to comprehensively describe indications, contraindications, technical aspects, diagnostic accuracy and complications of percutaneous lung biopsy. Methods Imaging-guided biopsy currently represents one of the predominant methods for obtaining tissue specimens in patients with lung nodules; in many cases treatment protocols are based on histological information; thus, biopsy is frequently performed, when technically feasible, or in case other techniques (such as bronchoscopy with lavage) are inconclusive. Results Although a coaxial system is suitable in any case, two categories of needles can be used: fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB), with the latter demonstrated to have a slightly higher overall sensitivity, specificity and accuracy. Conclusion Percutaneous lung biopsy is a safe procedure even though a few complications are possible: pneumothorax, pulmonary haemorrhage and haemoptysis are common complications, while air embolism and seeding are rare, but potentially fatal complications

The Origins of African Plasmodium vivax; Insights from Mitochondrial Genome Sequencing

Plasmodium vivax, the second most prevalent of the human malaria parasites, is estimated to affect 75 million people annually. It is very rare, however, in west and central Africa, due to the high prevalence of the Duffy negative phenotype in the human population. Due to its rarity in Africa, previous studies on the phylogeny of world-wide P. vivax have suffered from insufficient samples of African parasites. Here we compare the mitochondrial sequence diversity of parasites from Africa with those from other areas of the world, in order to investigate the origin of present-day African P. vivax. Mitochondrial genome sequencing revealed relatively little polymorphism within the African population compared to parasites from the rest of the world. This, combined with sequence similarity with parasites from India, suggests that the present day African P. vivax population in humans may have been introduced relatively recently from the Indian subcontinent. Haplotype network analysis also raises the possibility that parasites currently found in Africa and South America may be the closest extant relatives of the ancestors of the current world population. Lines of evidence are adduced that this ancestral population may be from an ancient stock of P. vivax in Africa