Bleeding from ruptured hepatic metastases as a cause of syncope in an octogenarian: a case report

<p>Abstract</p> <p>Introduction</p> <p>Acute hemoperitoneum as a result of hemorrhage from liver metastases is an uncommon but serious condition. The use of appropriate imaging is important in the diagnosis and can have a profound impact on subsequent management. This case is important because the presentation was of recurrent syncopal episodes with an unusual underlying cause. This case highlights the need to consider this diagnosis in the differential in patients presenting with collapse in the acute setting.</p> <p>Case presentation</p> <p>We present the case of an 85-year-old Caucasian man who was admitted following a collapse episode and was found to be persistently hypotensive despite aggressive resuscitation. An acute intra-peritoneal bleed originating from hepatic metastases from an unknown primary was identified promptly with computed tomography imaging and was subsequently managed conservatively.</p> <p>Conclusions</p> <p>This case aims to convey key teaching points: (A) the need to consider intra-abdominal hemorrhage in the differential diagnosis when assessing patients with collapse; and (B) the use of appropriate imaging such as computed tomography can facilitate a prompt diagnosis and appropriate management steps can then be taken accordingly.</p

The Galactic Center: A Laboratory for Fundamental Astrophysics and Galactic Nuclei

As the closest example of a galactic nucleus, the Galactic center presents an exquisite laboratory for learning about supermassive black holes (SMBH) and their environs. Detailed studies of stellar dynamics deep in the potential well of a galaxy, with exisiting and future large ground-based telescopes, offer several exciting directions in the coming decade. First, it will be possible to obtain precision measurements of the Galaxy's central potential, providing both a unique test of General Relativity (GR) and a detection of the extended dark matter distribution that is predicted to exist around the SMBH. Tests of gravity have not previously been possible on the mass scale of a SMBH. Similarly, only upper limits on the extended matter distribution on small scales currently exist; detection of dark matter on these scales is an important test of Lambda-CDM and the detection of stellar remnants would reveal a population that may dominate the stellar dynamics on the smallest scales. Second, our detailed view of the SMBH and its local gas and stellar environment provides insight into how SMBHs at the centers of galaxies form, grow and interact with their environs as well as on the exotic processes at work in the densest stellar clusters in the Universe. The key questions, still unanswered, of when and how SMBHs formed in the early universe, and the myriad ways in which feedback from SMBHs can affect structure formation, can be informed by directly observing the physical processes operating at the SMBH.Comment: An ASTRO2010 White Paper. Animations and high resolution images can be found at http://www.astro.ucla.edu/~ghezgroup/gc/pictures/Future_GCorbits.shtm

Intermediate and extreme mass-ratio inspirals — astrophysics, science applications and detection using LISA

Black hole binaries with extreme (gtrsim104:1) or intermediate (~102–104:1) mass ratios are among the most interesting gravitational wave sources that are expected to be detected by the proposed laser interferometer space antenna (LISA). These sources have the potential to tell us much about astrophysics, but are also of unique importance for testing aspects of the general theory of relativity in the strong field regime. Here we discuss these sources from the perspectives of astrophysics, data analysis and applications to testing general relativity, providing both a description of the current state of knowledge and an outline of some of the outstanding questions that still need to be addressed. This review grew out of discussions at a workshop in September 2006 hosted by the Albert Einstein Institute in Golm, Germany

The 2014 interferometric imaging beauty contest

This is the final version of the article. Available from SPIE via the DOI in this record.From Conference Volume 9146: Optical and Infrared Interferometry IV. Jayadev K. Rajagopal; Michelle J. Creech-Eakman; Fabien Malbet. Montréal, Quebec, Canada, June 22, 2014Here we present the results of the 6th biennial optical interferometry imaging beauty contest. Taking advantage of a unique opportunity, the red supergiant VY CMa and the Mira variable R Car were observed in the astronomical H-band with three 4-telescope configurations of the VLTI-AT array using the PIONIER instrument. The community was invited to participate in the subsequent image reconstruction and interpretation phases of the project. Ten groups submitted entries to the beauty contest, and we found reasonable consistency between images obtained from independent workers using quite different algorithms. We also found that significant differences existed between the submitted images, much greater than in past beauty contests that were all based on simulated data. A novel crowd-sourcing" method allowed consensus median images to be constructed, filtering likely artifacts and retaining real features." We definitively detect strong spots on the surfaces of both stars as well as distinct circumstellar shells of emission (likely water/CO) around R Car. In a close contest, Joel Sanchez (IAA-CSIC/Spain) was named the winner of the 2014 interferometric imaging beauty contest. This process has shown that new comers" can use publicly-available imaging software to interpret VLTI/PIONIER imaging data, as long as sufficient observations are taken to have complete uv coverage { a luxury that is often missing. We urge proposers to request adequate observing nights to collect sufficient data for imaging and for time allocation committees to recognise the importance of uv coverage for reliable interpretation of interferometric data. We believe that the result of the proposed broad international project will contribute to inspiring trust in the image reconstruction processes in optical interferometry

Inward Bound: Studying the Galactic Centre with NAOS/CONICA

We report on the first results obtained using adaptive optics measurements of the Galactic Centre done with NAOS/CONICA.Comment: 19 pages, 7 figure

First Simultaneous NIR/X-ray Detection of a Flare from SgrA*

We report on the first simultaneous near-infrared/X-ray detection of the Sgr A* counterpart which is associated with the massive black hole at the center of the Milky Way. The observations have been carried out using the NACO adaptive optics (AO) instrument at the European Southern Observatory's Very Large Telescope and the ACIS-I instrument aboard the Chandra X-ray Observatory. We also report on quasi-simultaneous observations at a wavelength of 3.4 mm using the Berkeley-Illinois-Maryland Association (BIMA) array. A flare was detected in the X-domain with an excess 2-8 keV luminosity of about 6$\times10^{33}$ erg/s. A fading flare of Sgr A* with $>$2 times the interim-quiescent flux was also detected at the beginning of the NIR observations, that overlapped with the fading part of the X-ray flare. Compared to 8-9 hours before the NIR/X-ray flare we detected a marginally significant increase in the millimeter flux density of Sgr A* during measurements about 7-9 hours afterwards. We find that the flaring state can be conveniently explained with a synchrotron self-Compton model involving up-scattered sub-millimeter photons from a compact source component, possibly with modest bulk relativistic motion. The size of that component is assumed to be of the order of a few times the Schwarzschild radius. The overall spectral indices $\alpha_{NIR/X-ray}$ ($S_{\nu}$$\propto$$\nu^{-\alpha}$) of both states are quite comparable with a value of $\sim$1.3. Since the interim-quiescent X-ray emission is spatially extended, the spectral index for the interim-quiescent state is probably only a lower limit for the compact source Sgr A*. A conservative estimate of the upper limit of the time lag between the ends of the NIR and X-ray flare is of the order of 15 minutes.Comment: Reviewed version; minor changes; added quasi-simultaneous submm observation

REST is a hypoxia-responsive transcriptional repressor

Cellular exposure to hypoxia results in altered gene expression in a range of physiologic and pathophysiologic states. Discrete cohorts of genes can be either up- or down-regulated in response to hypoxia. While the Hypoxia-Inducible Factor (HIF) is the primary driver of hypoxia-induced adaptive gene expression, less is known about the signalling mechanisms regulating hypoxia-dependent gene repression. Using RNA-seq, we demonstrate that equivalent numbers of genes are induced and repressed in human embryonic kidney (HEK293) cells. We demonstrate that nuclear localization of the Repressor Element 1-Silencing Transcription factor (REST) is induced in hypoxia and that REST is responsible for regulating approximately 20% of the hypoxia-repressed genes. Using chromatin immunoprecipitation assays we demonstrate that REST-dependent gene repression is at least in part mediated by direct binding to the promoters of target genes. Based on these data, we propose that REST is a key mediator of gene repression in hypoxia

Psychological well-being in Europe after the outbreak of war in Ukraine

The Russian invasion of Ukraine on February 24, 2022, has had devastating effects on the Ukrainian population and the global economy, environment, and political order. However, little is known about the psychological states surrounding the outbreak of war, particularly the mental well-being of individuals outside Ukraine. Here, we present a longitudinal experience-sampling study of a convenience sample from 17 European countries (total participants = 1,341, total assessments = 44,894, countries with >100 participants = 5) that allows us to track well-being levels across countries during the weeks surrounding the outbreak of war. Our data show a significant decline in well-being on the day of the Russian invasion. Recovery over the following weeks was associated with an individual’s personality but was not statistically significantly associated with their age, gender, subjective social status, and political orientation. In general, well-being was lower on days when the war was more salient on social media. Our results demonstrate the need to consider the psychological implications of the Russo-Ukrainian war next to its humanitarian, economic, and ecological consequences

A global experience-sampling method study of well-being during times of crisis : The CoCo project

We present a global experience-sampling method (ESM) study aimed at describing, predicting, and understanding individual differences in well-being during times of crisis such as the COVID-19 pandemic. This international ESM study is a collaborative effort of over 60 interdisciplinary researchers from around the world in the “Coping with Corona” (CoCo) project. The study comprises trait-, state-, and daily-level data of 7490 participants from over 20 countries (total ESM measurements = 207,263; total daily measurements = 73,295) collected between October 2021 and August 2022. We provide a brief overview of the theoretical background and aims of the study, present the applied methods (including a description of the study design, data collection procedures, data cleaning, and final sample), and discuss exemplary research questions to which these data can be applied. We end by inviting collaborations on the CoCo dataset