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Using space-VLBI to probe gravity around Sgr A*

CONTEXT: The Event Horizon Telescope (EHT) will soon provide the first high-resolution images of the Galactic Centre supermassive black hole candidate Sagittarius A* (Sgr A*), enabling us to probe gravity in the strong-field regime. In addition to studying the accretion process in extreme environments, the obtained data and reconstructed images could be used to investigate the underlying spacetime structure. In its current configuration, EHT is able to distinguish between a rotating Kerr black hole and a horizon-less object such as a boson star. Future developments can increase the ability of EHT to tell different spacetimes apart. AIMS: We investigate the capability of an advanced EHT concept, including an orbiting space antenna, to image and distinguish different spacetimes around Sgr A*. METHODS: We used general-relativistic magneto-hydrodynamical simulations of accreting compact objects (Kerr and dilaton black holes as well as boson stars) and computed their radiative signatures via general-relativistic radiative transfer. To facilitate a comparison with upcoming and future EHT observations, we produced realistic synthetic data including the source variability, diffractive, and refractive scattering while incorporating the observing array, including a space antenna. From the generated synthetic observations, we dynamically reconstructed black hole shadow images using regularised maximum entropy methods. We employed a genetic algorithm to optimise the orbit of the space antenna with respect to improved imaging capabilities and u − v-plane coverage of the combined array (ground array and space antenna) and developed a new method to probe the source variability in Fourier space. RESULTS: The inclusion of an orbiting space antenna improves the capability of EHT to distinguish the spin of Kerr black holes and dilaton black holes based on reconstructed radio images and complex visibilities

State-of-the-art energetic and morphological modelling of the launching site of the M87 jet

M87 has been the target of numerous astronomical observations across the electromagnetic spectrum, and very long baseline interferometry has resolved an edge-brightened jet1,2,3,4. However, the origin and formation of its jets remain unclear. In our current understanding, black holes (BH) are the driving engine of jet formation5, and indeed the recent Event Horizon Telescope observations revealed a ring-like structure in agreement with theoretical models of accretion onto a rotating Kerr BH6. In addition to the spin of the BH being a potential source of energy for the launching mechanism, magnetic fields are believed to play a key role in the formation of relativistic jets7,8. A priori, the spin, a⋆, of the BH in M87⋆ is unknown; however, when accounting for the estimates of the X-ray luminosity and jet power, values of |a_{*}| ≳ 0.5 appear favoured6. Besides the properties of the accretion flow and the BH spin, the radiation microphysics including the particle distribution (thermal6 and non-thermal^{9,10}) as well as the particle acceleration mechanism11 play a crucial role. We show that general relativistic magnetohydrodynamic simulations and general relativistic radiative transfer calculations can reproduce the broadband spectrum from the radio to the near-infrared regime and simultaneously match the observed collimation profile of M87, thus allowing us to set rough constraints on the dimensionless spin of M87* to be 0.5 ≲ a⋆ ≲ 1.0, with higher spins being possibly favoured

Specific cortical and subcortical grey matter regions are associated with insomnia severity

BACKGROUND: There is an increasing awareness that sleep disturbances are a risk factor for dementia. Prior case-control studies suggested that brain grey matter (GM) changes involving cortical (i.e, prefrontal areas) and subcortical structures (i.e, putamen, thalamus) could be associated with insomnia status. However, it remains unclear whether there is a gradient association between these regions and the severity of insomnia in older adults who could be at risk for dementia. Since depressive symptoms and sleep apnea can both feature insomnia-related factors, can impact brain health and are frequently present in older populations, it is important to include them when studying insomnia. Therefore, our goal was to investigate GM changes associated with insomnia severity in a cohort of healthy older adults, taking into account the potential effect of depression and sleep apnea as well. We hypothesized that insomnia severity is correlated with 1) cortical regions responsible for regulation of sleep and emotion, such as the orbitofrontal cortex and, 2) subcortical regions, such as the putamen. METHODS: 120 healthy subjects (age 74.8±5.7 years old, 55.7% female) were recruited from the Hillblom Healthy Aging Network at the Memory and Aging Center, UCSF. All participants were determined to be cognitively healthy following a neurological evaluation, neuropsychological assessment and informant interview. Participants had a 3T brain MRI and completed the Insomnia Severity Index (ISI), Geriatric Depression Scale (GDS) and Berlin Sleep Questionnaire (BA) to assess sleep apnea. Cortical thickness (CTh) and subcortical volumes were obtained by the CAT12 toolbox within SPM12. We studied the correlation of CTh and subcortical volumes with ISI using multiple regressions adjusted by age, sex, handedness and MRI scan type. Additional models adjusting by GDS and BA were also performed. RESULTS: ISI and GDS were predominantly mild (4.9±4.2 and 2.5±2.9, respectively) and BA was mostly low risk (80%). Higher ISI correlated with lower CTh of the right orbitofrontal, right superior and caudal middle frontal areas, right temporo-parietal junction and left anterior cingulate cortex (p<0.001, uncorrected FWE). When adjusting by GDS, right ventral orbitofrontal and temporo-parietal junction remained significant, and left insula became significant (p<0.001, uncorrected FWE). Conversely, BA showed no effect. The results were no longer significant following FWE multiple comparisons. Regarding subcortical areas, higher putamen volumes were associated with higher ISI (p<0.01). CONCLUSIONS: Our findings highlight a relationship between insomnia severity and brain health, even with relatively mild insomnia, and independent of depression and likelihood of sleep apnea. The results extend the previous literature showing the association of specific GM areas (i.e, orbitofrontal, insular and temporo-parietal junction) not just with the presence of insomnia, but across the spectrum of severity itself. Moreover, our results suggest subcortical structures (i.e., putamen) are involved as well. Longitudinal studies are needed to clarify how these insomnia-related brain changes in healthy subjects align with an increased risk of dementia

Pediculosis and the Pediatrician

Head lice commonly evoke feelings of disgust, revulsion, anger, and shame among parents and patients. There should, however, be no great cause for such alarm if a physician suspects pediculosis capitis. The recent introduction of several new pediculicidal drugs now allows a choice among four distinct therapeutic agents, which should substantially improve control of isolated cases and epidemics. Physicians must be aware that consumer groups are pressing public health authorities and drug manufacturers to establish proper treatment standards and safety warnings for the use of these agents. In addition, some controversy surrounds the use of lindane in children. This paper reviews the epidemiology and clinical appearance of pediculosis capitis in children, with emphasis on these recent developments. Pubic lice ( Phthirus pubis ) and body lice ( Pedicutus humanus corporis ), both of which are much less common pediatric infestations, are mentioned only briefly.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72607/1/j.1525-1470.1984.tb00447.x.pd

Ten steps or climbing a mountain: A study of Australian health professionals' perceptions of implementing the baby friendly health initiative to protect, promote and support breastfeeding

Background: The Baby Friendly Hospital (Health) Initiative (BFHI) is a global initiative aimed at protecting, promoting and supporting breastfeeding and is based on the ten steps to successful breastfeeding. Worldwide, over 20,000 health facilities have attained BFHI accreditation but only 77 Australian hospitals (approximately 23%) have received accreditation. Few studies have investigated the factors that facilitate or hinder implementation of BFHI but it is acknowledged this is a major undertaking requiring strategic planning and change management throughout an institution. This paper examines the perceptions of BFHI held by midwives and nurses working in one Area Health Service in NSW, Australia. Methods: The study used an interpretive, qualitative approach. A total of 132 health professionals, working across four maternity units, two neonatal intensive care units and related community services, participated in 10 focus groups. Data were analysed using thematic analysis. Results: Three main themes were identified: ‘Belief and Commitment’; ‘Interpreting BFHI’ and ‘Climbing a Mountain’. Participants considered the BFHI implementation a high priority; an essential set of practices that would have positive benefits for babies and mothers both locally and globally as well as for health professionals. It was considered achievable but would take commitment and hard work to overcome the numerous challenges including a number of organisational constraints. There were, however, differing interpretations of what was required to attain BFHI accreditation with the potential that misinterpretation could hinder implementation. A model described by Greenhalgh and colleagues on adoption of innovation is drawn on to interpret the findings. Conclusion: Despite strong support for BFHI, the principles of this global strategy are interpreted differently by health professionals and further education and accurate information is required. It may be that the current processes used to disseminate and implement BFHI need to be reviewed. The findings suggest that there is a contradiction between the broad philosophical stance and best practice approach of this global strategy and the tendency for health professionals to focus on the ten steps as a set of tasks or a checklist to be accomplished. The perceived procedural approach to implementation may be contributing to lower rates of breastfeeding continuation

Contrasting prefrontal cortex contributions to episodic memory dysfunction in behavioural variant frontotemporal dementia and alzheimer's disease

Recent evidence has questioned the integrity of episodic memory in behavioural variant frontotemporal dementia (bvFTD), where recall performance is impaired to the same extent as in Alzheimer's disease (AD). While these deficits appear to be mediated by divergent patterns of brain atrophy, there is evidence to suggest that certain prefrontal regions are implicated across both patient groups. In this study we sought to further elucidate the dorsolateral (DLPFC) and ventromedial (VMPFC) prefrontal contributions to episodic memory impairment in bvFTD and AD. Performance on episodic memory tasks and neuropsychological measures typically tapping into either DLPFC or VMPFC functions was assessed in 22 bvFTD, 32 AD patients and 35 age- and education-matched controls. Behaviourally, patient groups did not differ on measures of episodic memory recall or DLPFC-mediated executive functions. BvFTD patients were significantly more impaired on measures of VMPFC-mediated executive functions. Composite measures of the recall, DLPFC and VMPFC task scores were covaried against the T1 MRI scans of all participants to identify regions of atrophy correlating with performance on these tasks. Imaging analysis showed that impaired recall performance is associated with divergent patterns of PFC atrophy in bvFTD and AD. Whereas in bvFTD, PFC atrophy covariates for recall encompassed both DLPFC and VMPFC regions, only the DLPFC was implicated in AD. Our results suggest that episodic memory deficits in bvFTD and AD are underpinned by divergent prefrontal mechanisms. Moreover, we argue that these differences are not adequately captured by existing neuropsychological measures

Survival and health economic outcomes in heart failure diagnosed at hospital admission versus community settings: a propensity-matched analysis

BACKGROUND AND AIMS: Most patients with heart failure (HF) are diagnosed following a hospital admission. The clinical and health economic impacts of index HF diagnosis made on admission to hospital versus community settings are not known. METHODS: We used the North West London Discover database to examine 34 208 patients receiving an index diagnosis of HF between January 2015 and December 2020. A propensity score-matched (PSM) cohort was identified to adjust for differences in socioeconomic status, cardiovascular risk and pre-diagnosis health resource utilisation cost. Outcomes were stratified by two pathways to index HF diagnosis: a 'hospital pathway' was defined by diagnosis following hospital admission; and a 'community pathway' by diagnosis via a general practitioner or outpatient services. The primary clinical and health economic endpoints were all-cause mortality and cost-consequence differential, respectively. RESULTS: The diagnosis of HF was via hospital pathway in 68% (23 273) of patients. The PSM cohort included 17 174 patients (8582 per group) and was matched across all selected confounders (p>0.05). The ratio of deaths per person-months at 24 months comparing community versus hospital diagnosis was 0.780 (95% CI 0.722 to 0.841, p<0.0001). By 72 months, the ratio of deaths was 0.960 (0.905 to 1.020, p=0.18). Diagnosis via hospital pathway incurred an overall extra longitudinal cost of £2485 per patient. CONCLUSIONS: Index diagnosis of HF through hospital admission continues to dominate and is associated with a significantly greater short-term risk of mortality and substantially increased long-term costs than if first diagnosed in the community. This study highlights the potential for community diagnosis-early, before symptoms necessitate hospitalisation-to improve both clinical and health economic outcomes

Time Estimation Predicts Mathematical Intelligence

Background: Performing mental subtractions affects time (duration) estimates, and making time estimates disrupts mental subtractions. This interaction has been attributed to the concurrent involvement of time estimation and arithmetic with general intelligence and working memory. Given the extant evidence of a relationship between time and number, here we test the stronger hypothesis that time estimation correlates specifically with mathematical intelligence, and not with general intelligence or working-memory capacity. Methodology/Principal Findings: Participants performed a (prospective) time estimation experiment, completed several subtests of the WAIS intelligence test, and self-rated their mathematical skill. For five different durations, we found that time estimation correlated with both arithmetic ability and self-rated mathematical skill. Controlling for non-mathematical intelligence (including working memory capacity) did not change the results. Conversely, correlations between time estimation and non-mathematical intelligence either were nonsignificant, or disappeared after controlling for mathematical intelligence. Conclusions/Significance: We conclude that time estimation specifically predicts mathematical intelligence. On the basis of the relevant literature, we furthermore conclude that the relationship between time estimation and mathematical intelligence is likely due to a common reliance on spatial ability