Testing reflection features in 4U 1705-44 with XMM-Newton, BeppoSAX and RXTE in the hard and soft state

We use data of the bright atoll source 4U 1705-44 taken with XMM-Newton, BeppoSAX and RXTE both in the hard and in the soft state to perform a self-consistent study of the reflection component in this source. Although the data from these X-ray observatories are not simultaneous, the spectral decomposition is shown to be consistent among the different observations, when the source flux is similar. We therefore select observations performed at similar flux levels in the hard and soft state in order to study the spectral shape in these two states in a broad band (0.1-200 keV) energy range, with good energy resolution, and using self-consistent reflection models. These reflection models provide a good fit for the X-ray spectrum both in the hard and in the soft state in the whole spectral range. We discuss the differences in the main spectral parameters we find in the hard and the soft state, respectively, providing evidence that the inner radius of the optically thick disk slightly recedes in the hard state.Comment: Accepted for publication in A&A, 20 pages, 12 figure

Discriminative capacity and construct validity of the Clock Drawing Test in Mild Cognitive Impairment and Alzheimer's disease

OBJECTIVES: The aim of this study was to analyze the psychometric and diagnostic properties of the Clock Drawing Test (CDT), scored according to the Babins, Rouleau, and Cahn scoring systems, for Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD) screening, and develop corresponding cutoff scores. Additionally, we assessed the construct validity of the CDT through exploratory and confirmatory factor analysis. METHODS: We developed a cross-sectional study of ambulatory MCI and AD patients, divided in two clinical groups (450 MCI and 250 mild AD patients) and a normal control group (N = 400). All participants were assessed with the CDT, Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) for convergent validity. RESULTS: The selected scoring systems presented adequate validity and reliability values. The proposed cutoff scores showed 60 to 65% sensitivity and 58 to 62% specificity to identify MCI patients. The corresponding values for AD were 84 to 90% sensitivity and 76 to 78% specificity. Exploratory and confirmatory factor analysis revealed that the Babins scoring system had good construct validity and allowed us to propose a three-factor model for this system. CONCLUSIONS: Our results confirmed the complexity of the CDT and support it as a cognitive screening instrument particularly sensitive to AD. The use of the CDT with MCI patients should be interpreted with more caution due to the lower sensitivity and specificity for milder forms of cognitive impairment.info:eu-repo/semantics/publishedVersio

Asymptotic expansions of the solutions of the Cauchy problem for nonlinear parabolic equations

Let $u$ be a solution of the Cauchy problem for the nonlinear parabolic equation $$\partial_t u=\Delta u+F(x,t,u,\nabla u) \quad in \quad{\bf R}^N\times(0,\infty), \quad u(x,0)=\varphi(x)\quad in \quad{\bf R}^N,$$ and assume that the solution $u$ behaves like the Gauss kernel as $t\to\infty$. In this paper, under suitable assumptions of the reaction term $F$ and the initial function $\varphi$, we establish the method of obtaining higher order asymptotic expansions of the solution $u$ as $t\to\infty$. This paper is a generalization of our previous paper, and our arguments are applicable to the large class of nonlinear parabolic equations

The association of elevated blood pressure during ischaemic exercise with sport performance in Master athletes with and without morbidity

Background An exaggerated exercise blood pressure (BP) is associated with a reduced exercise capacity. However, its connection to physical performance during competition is unknown. Aim To examine BP responses to ischaemic handgrip exercise in Master athletes (MA) with and without underlying morbidities and to assess their association with athletic performance during the World Master Track Cycling Championships 2019. Methods Forty-eight Master cyclists [age 59±13yrs; weekly training volume 10.4±4.1 h/week; handgrip maximum voluntary contraction (MVC) 46.3±11.5 kg] divided into 2 matched groups (24 healthy MA and 24 MA with morbidity) and 10 healthy middle-aged non-athlete controls (age 48.3±8.3 years; MVC 40.4±14.8 kg) performed 5 min of forearm occlusion including 1 min handgrip isometric contraction (40%MVC) followed by 5 min recovery. Continuous beat-by-beat BP was recorded using fnger plethysmography. Age-graded performance (AGP) was calculated to compare race performances among MA. Healthy Master cyclists were further grouped into middle-age (age 46.2±6.4 years; N:12) and old-age (age 65.0±7.7 years; N:12) for comparison with middle-aged non-athlete controls. Results Healthy and morbidity MA groups showed similar BP responses during forearm occlusion and AGP (90.1±4.3% and 91.0±5.3%, p>0.05, respectively). Healthy and morbidity MA showed modest correlation between the BP rising slope for 40%MVC ischaemic exercise and AGP (r=0.5, p<0.05). MA showed accelerated SBP recovery after cessation of ischaemic handgrip exercise compared to healthy non-athlete controls. Conclusion Our fndings associate long-term athletic training with improved BP recovery following ischaemic exercise regardless of age or reported morbidity. Exaggerated BP in Master cyclists during ischaemic exercise was associated with lower AGP during the World Master Cycling Championships

Comparison of Home-Blenderized Formula and Commercial Enteral Formulas for Gastrostomy Tube-Fed Children: A Retrospective, Prospective Cohort Study.

Background Blenderized gastrostomy tube feedings (BGTFs) consist of pureed table foods and liquids that are administered as enteral tube feedings. Compared to commercial enteral formulas (CEFs), BGTF has been shown to have fewer side effects. Despite these results, apprehensions have been raised about microbial contamination, nutritional deficiencies or surplus, risk of gastrostomy tube (GT) blockages, and lack of consistency in clinical outcomes. The goal of this retrospective, prospective, 18-month-long study is to report the clinical and nutritional outcomes of GT-dependent pediatric patients who attended a multidisciplinary feeding clinic. Methodology After Institutional Review Board (IRB) approval and consent were obtained, 25 children who were receiving tube feeding via G were enrolled in a retrospective, prospective, observational, cohort study from August 2019 to February 2021. A multidisciplinary team was formed, and multivariate logistic regression was performed comparing subjects on BGTF versus CEF, per os diet versus nil per os, CEF versus homemade blenderized tube feeding (HBTF) versus blenderized tube feeding (BTF), and how they compared at the beginning and end of the study. Results The mean age of the patients was 4.4 years (SD ±2.2). Gastroesophageal reflux disease (GERD) and short bowel syndrome (SBS) were the most common comorbid gastrointestinal (GI) conditions. Of the 25 patients enrolled in the study, seven were initially on BGTF, while 14 ended the study on BGTF. There were no statistically significant differences in malnutrition status, feeding intolerance, emergency room visits, hospitalizations, and GT blockages between all different comparison groups when comparing between the CEF versus HBTF versus commercial blenderized tube feeding (CBTF) groups. Of the patients who were in the BGTF group, there was a resolution of vitamin A deficiency, vitamin D deficiency, and anemia (n = 1). In total, two patients had resolved vitamin deficiencies, namely, vitamins A and D. Conclusions When comparing BGTF and CEF, there was no statistically significant difference in outcomes. This study suggests that BGTF is at least equivalent to CEF in clinical outcomes, meaning BGTF should be considered standard nutrition for GT-dependent patients

Transforming growth factor β1 T29C gene polymorphism and hypertension: Relationship with cardiovascular and renal damage

Distribution of T29C TGFβ1 gene polymorphism was analysed in 260 hypertensive and 134 normotensive subjects. Circulating TGFβ1 and procollagen type III levels, microalbuminuria, left ventricular geometry and function were evaluated in all the hypertensives subgrouped according to T29C TGFβ1 gene polymorphism. Circulating TGFβ1 by ELISA technique, procollagen type III by a specific radioimmunoassay, microalbuminuria by radioimmunoassay, left ventricular geometry and function by echocardiography were determined. All groups were comparable for gender, age and sex. Regarding T29C TGFβ1 gene polymorphism, prevalence of TC or CC genotypes was significantly (p &lt; 0.05) higher in hypertensives than normotensives. TC and CC hypertensives were characterized by a higher prevalence of subjects with microalbuminuria (p &lt; 0.001 TC vs TT; p &lt; 0.05 CC vs TT), left ventricular hypertrophy (p &lt; 0.01 TC and CC vs TT), and by increased levels of procollagen type III (p &lt; 0.05 TC and CC vs TT). TC hypertensives were also characterized by a significant increase (p &lt; 0.05) of LVM and LVM/h2.7 and of urinary albumin excretion (p &lt; 0.05) values than those detectable in TT hypertensives. Our data suggest that T29C TGFβ1 gene polymorphism was associated to clinical characteristics suitable to recognize hypertensives with a higher severity of hypertension

The broad iron Kalpha line of Cygnus X-1 as seen by XMM-Newton in the EPIC-pn modified timing mode

We present the analysis of the broadened, flourescent iron Kalpha line in simultaneous XMM-Newton and RXTE data from the black hole Cygnus X-1. The XMM-Newton data were taken in a modified version of the timing mode of the EPIC-pn camera. In this mode the lower energy threshold of the instrument is increased to 2.8 keV to avoid telemetry drop outs due to the brightness of the source, while at the same time preserving the signal-to-noise ratio in the Fe Kalpha band. We find that the best-fit spectrum consists of the sum of an exponentially cut off power-law and relativistically smeared, ionized reflection. The shape of the broadened Fe Kalpha feature is due to strong Compton broadening combined with relativistic broadening. Assuming a standard, thin accretion disk, the black hole is close to rotating maximally.Comment: Astron. Astrophys., in pres

Hemochromatosis Mimicked Gaucher Disease: Role of Hyperferritinemia in Evaluation of a Clinical Case

Gaucher disease is a disorder of lysosomes caused by a functional defect of the glucocere-brosidase enzyme. The disease is mainly due to mutations in the GBA1 gene, which determines the gradual storage of glucosylceramide substrate in the patient’s macrophages. In this paper, we describe the case of a 38-year-old man who clinically presented with hyperferritinemia, thrombocytopenia, leukopenia, anemia and mild splenomegaly; a diagnosis of hemochromatosis was made 10 years earlier. Re-evaluation of the clinical case led to a suspicion of Gaucher disease, which was confirmed by enzymatic analysis, which was found to be below the normal range, and genetic evaluation, which identified compound heterozygosity N370S/RecNciI. We know that patients suffering from Gaucher disease can also have high ferritin levels. Even if the mechanism underlying the changes in iron metabolism is not yet elucidated, the chronic mild inflammatory state present in these patients probably causes the storage of ferritin in macrophages, resulting in hyperferritinemia. Therefore, in the presence of few typical signs and symptoms of the disease should raise an alarm bell in the clinicians, inducing clinical suspicion of Gaucher disease. Misdiagnosis and diagnostic delay in metabolic diseases could cause irreversible organ damage and delay the start of specific therapy for these patients