762 research outputs found
Selective digestive decontamination is superior to oropharyngeal chlorhexidine in preventing pneumonia and reducing mortality in critically ill patients
CC Sculptoris: A superhumping intermediate polar
We present high speed optical, spectroscopic and Swift X-ray observations
made during the dwarf nova superoutburst of CC Scl in November 2011. An orbital
period of 1.383 h and superhump period of 1.443 h were measured, but the
principal new finding is that CC Scl is a previously unrecognised intermediate
polar, with a white dwarf spin period of 389.49 s which is seen in both optical
and Swift X-ray light curves only during the outburst. In this it closely
resembles the old nova GK Per, but unlike the latter has one of the shortest
orbital periods among intermediate polars.Comment: Accepted for publication in MNRAS; 11 pages, 19 figure
Male breast cancer
Male breast cancer (MBC) is a rare disease representing less than 1% of all breast cancers (BC) and less than 1% of cancers in men. Age at presentation is mostly in the late 60s. MBC is recognized as an estrogen-driven disease, specifically related to hyperestrogenism. About 20% of MBC patients have family history for BC. Mutations in BRCA1 and, predominantly, BRCA2, account for approximately 10% of MBC cases.
Because of its rarity, MBC is often compared with female BC (FBC). Based on age-frequency distribution, age-specific incidence rate patterns and prognostic factors profiles, MBC is considered similar to late-onset, postmenopausal estrogen/progesterone receptor positive (ER+/PR+) FBC. However, clinical and pathological characteristics of MBC do not exactly overlap FBC. Compared with FBC, MBC has been reported to occur later in life, present at a higher stage, and display lower histologic grade, with a higher proportion of ER+ and PR+ tumors.
Although rare, MBC remains a substantial cause for morbidity and mortality in men, probably because of its occurrence in advanced age and delayed diagnosis. Diagnosis and treatment of MBC generally is similar to that of FBC. Men tend to be treated with mastectomy rather than breast-conserving surgery. The backbone of adjuvant therapy or palliative treatment for advanced disease is endocrine, mostly tamoxifen.
Use of FBC-based therapy led to the observation that treatment outcomes for MBC are worse and that survival rates for MBC do not improve like FBC. These different outcomes may suggest a non-appropriate utilization of treatments and that different underlying pathogenetic mechanisms may exist between male and female BC
Expansion history and f(R) modified gravity
We attempt to fit cosmological data using modified Lagrangians
containing inverse powers of the Ricci scalar varied with respect to the
metric. While we can fit the supernova data well, we confirm the behaviour at medium to high redshifts reported elsewhere and argue
that the easiest way to show that this class of models are inconsistent with
the data is by considering the thickness of the last scattering surface. For
the best fit parameters to the supernova data, the simplest 1/R model gives
rise to a last scattering surface of thickness , inconsistent
with observations.Comment: accepted in JCAP, presentation clarified, results and conclusions
unchange
The Luminosity and Mass Functions of Low-Mass Stars in the Galactic Disk: I. The Calibration Region
We present measurements of the luminosity and mass functions of low-mass
stars constructed from a catalog of matched Sloan Digital Sky Survey (SDSS) and
2 Micron All Sky Survey (2MASS) detections. This photometric catalog contains
more than 25,000 matched SDSS and 2MASS point sources spanning ~30 square
degrees on the sky. We have obtained follow-up spectroscopy, complete to J=16,
of more than 500 low mass dwarf candidates within a 1 square degree sub-sample,
and thousands of additional dwarf candidates in the remaining 29 square
degrees. This spectroscopic sample verifies that the photometric sample is
complete, uncontaminated, and unbiased at the 99% level globally, and at the
95% level in each color range. We use this sample to derive the luminosity and
mass functions of low-mass stars over nearly a decade in mass (0.7 M_sun > M_*
> 0.1 M_sun). We find that the logarithmically binned mass function is best fit
with an M_c=0.29 log-normal distribution, with a 90% confidence interval of
M_c=0.20--0.50. These 90% confidence intervals correspond to linearly binned
mass functions peaking between 0.27 M_sun and 0.12 M_sun, where the best fit MF
turns over at 0.17 M_sun. A power law fit to the entire mass range sampled
here, however, returns a best fit of alpha=1.1 (where the Salpeter slope is
alpha = 2.35). These results agree well with most previous investigations,
though differences in the analytic formalisms adopted to describe those mass
functions can give the false impression of disagreement. Given the richness of
modern-day astronomical datasets, we are entering the regime whereby stronger
conclusions can be drawn by comparing the actual datapoints measured in
different mass functions, rather than the results of analytic analyses that
impose structure on the data a priori. (abridged)Comment: Accepted for publication in the Astronomical Journal. 21 pages,
emulateapj format, 12 figures. Figures 1, 4, 11 and 12 degraded for astroph;
full resolution version available for download at
http://www.cfa.harvard.edu/~kcovey
Reconstruction of the Scalar-Tensor Lagrangian from a LCDM Background and Noether Symmetry
We consider scalar-tensor theories and reconstruct their potential U(\Phi)
and coupling F(\Phi) by demanding a background LCDM cosmology. In particular we
impose a background cosmic history H(z) provided by the usual flat LCDM
parameterization through the radiation (w_{eff}=1/3), matter (w_{eff}=0) and
deSitter (w_{eff}=-1) eras. The cosmological dynamical system which is
constrained to obey the LCDM cosmic history presents five critical points in
each era, one of which corresponding to the standard General Relativity (GR).
In the cases that differ from GR, the reconstructed coupling and potential are
of the form F(\Phi)\sim \Phi^2 and U(\Phi)\sim F(\Phi)^m where m is a constant.
This class of scalar tensor theories is also theoretically motivated by a
completely independent approach: imposing maximal Noether symmetry on the
scalar-tensor Lagrangian. This approach provides independently: i) the form of
the coupling and the potential as F(\Phi)\sim \Phi^2 and U(\Phi)\sim F(\Phi)^m,
ii) a conserved charge related to the potential and the coupling and iii)
allows the derivation of exact solutions by first integrals of motion.Comment: Added comments, discussion, references. 15 revtex pages, 5 fugure
Clues from nearby galaxies to a better theory of cosmic evolution
The great advances in the network of cosmological tests show that the
relativistic Big Bang theory is a good description of our expanding universe.
But the properties of nearby galaxies that can be observed in greatest detail
suggest a still better theory would more rapidly gather matter into galaxies
and groups of galaxies. This happens in theoretical ideas now under discussion.Comment: published in Natur
Inhalation of β2 agonists impairs the clearance of nontypable Haemophilus influenzae from the murine respiratory tract
BACKGROUND: Nontypable Haemophilus influenzae (NTHi) is a common bacterial pathogen causing human respiratory tract infections under permissive conditions such as chronic obstructive pulmonary disease. Inhalation of β2-receptor agonists is a widely used treatment in patients with chronic obstructive pulmonary disease. The aim of this study was to determine the effect of inhalation of β2 agonists on the host immune response to respiratory tract infection with NTHi. METHODS: Mouse alveolar macrophages were stimulated in vitro with NTHi in the presence or absence of the β2 receptor agonists salmeterol or salbutamol. In addition, mice received salmeterol or salbutamol by inhalation and were intranasally infected with NTHi. End points were pulmonary inflammation and bacterial loads. RESULTS: Both salmeterol and salbutamol inhibited NTHi induced tumor necrosis factor-α (TNFα) release by mouse alveolar macrophages in vitro by a β receptor dependent mechanism. In line, inhalation of either salmeterol or salbutamol was associated with a reduced early TNFα production in lungs of mice infected intranasally with NTHi, an effect that was reversed by concurrent treatment with the β blocker propranolol. The clearance of NTHi from the lungs was impaired in mice treated with salmeterol or salbutamol, an adverse effect that was prevented by propranolol and independent of the reduction in TNFα. CONCLUSION: These data suggest that inhalation of salmeterol or salbutamol may negatively influence an effective clearance of NTHi from the airways
Bacteremic complications of intravascular catheter tip colonization with Gram-negative micro-organisms in patients without preceding bacteremia
Although Gram-negative micro-organisms are frequently associated with catheter-related bloodstream infections, the prognostic value and clinical implication of a positive catheter tip culture with Gram-negative micro-organisms without preceding bacteremia remains unclear. We determined the outcomes of patients with intravascular catheters colonized with these micro-organisms, without preceding positive blood cultures, and identified risk factors for the development of subsequent Gram-negative bacteremia. All patients with positive intravascular catheter tip cultures with Gram-negative micro-organisms at the University Medical Center, Utrecht, The Netherlands, between 2005 and 2009, were retrospectively studied. Patients with Gram-negative bacteremia within 48 h before catheter removal were excluded. The main outcome measure was bacteremia with Gram-negative micro-organisms. Other endpoints were length of the hospital stay, in-hospital mortality, secondary complications of Gram-negative bacteremia, and duration of intensive care admission. A total of 280 catheters from 248 patients were colonized with Gram-negative micro-organisms. Sixty-seven cases were excluded because of preceding positive blood cultures, leaving 213 catheter tips from 181 patients for analysis. In 40 (19%) cases, subsequent Gram-negative bacteremia developed. In multivariate analysis, arterial catheters were independently associated with subsequent Gram-negative bacteremia (odds ratio [OR] = 5.00, 95% confidence interval [CI]: 1.20–20.92), as was selective decontamination of the digestive tract (SDD) (OR = 2.47, 95% CI: 1.07–5.69). Gram-negative bacteremia in patients who received SDD was predominantly caused by cefotaxime (part of the SDD)-resistant organisms. Mortality was significantly higher in the group with subsequent Gram-negative bacteremia (35% versus 20%, OR = 2.12, 95% CI: 1.00–4.49). Patients with a catheter tip colonized with Gram-negative micro-organisms had a high chance of subsequent Gram-negative bacteremia from any cause. This may be clinically relevant, as starting antibiotic treatment pre-emptively in high-risk patients with Gram-negative micro-organisms cultured from arterial intravenous catheters may be beneficial
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