Objective: To develop evidence based recommendations for the management of ankylosing spondylitis (AS) as a combined effort of the ‘ASsessment in AS’ international working group and the European ...League Against Rheumatism. Methods: Each of the 22 participants was asked to contribute up to 15 propositions describing key clinical aspects of AS management. A Delphi process was used to select 10 final propositions. A systematic literature search was then performed to obtain scientific evidence for each proposition. Outcome data for efficacy, adverse effects, and cost effectiveness were abstracted. The effect size, relative risk, number needed to treat, and incremental cost effectiveness ratio were calculated. On the basis of the search results, 10 major recommendations for the management of AS were constructed. The strength of recommendation was assessed based on the strength of the literature evidence, risk-benefit trade-off, and clinical expertise. Results: The final recommendations considered the use of non-steroidal anti-inflammatory drugs (NSAIDs) (conventional NSAIDs, coxibs, and co-prescription of gastroprotective agents), disease modifying antirheumatic drugs, treatments with biological agents, simple analgesics, local and systemic steroids, non-pharmacological treatment (including education, exercise, and physiotherapy), and surgical interventions. Three general recommendations were also included. Research evidence (categories I–IV) supported 11 interventions in the treatment of AS. Strength of recommendation varied, depending on the category of evidence and expert opinion. Conclusion: Ten key recommendations for the treatment of AS were developed and assessed using a combination of research based evidence and expert consensus. Regular updating will be carried out to keep abreast of new developments in the management of AS.
Imaging an exotic state
Among the most intriguing of the many phases of cuprate superconductors is the so-called pair density wave (PDW) state. PDW is characterized by a spatially modulated density ...of Cooper pairs and can be detected with a scanning tunneling microscope equipped with a superconducting tip. Liu
et al.
used Josephson tunneling microscopy, modified for the task, to detect PDW in niobium diselenide, a superconductor with a layered hexagonal structure. The PDW state is expected to appear in other transition metal dichalcogenides as well.
Science
, abd4607, this issue p.
1447
Josephson tunneling microscopy is used to detect an unusual state in NbSe
2
, a layered superconductor.
Pair density wave (PDW) states are defined by a spatially modulating superconductive order parameter. To search for such states in transition-metal dichalcogenides (TMDs), we used high-speed atomic-resolution scanned Josephson-tunneling microscopy. We detected a PDW state whose electron-pair density and energy gap modulate spatially at the wave vectors of the preexisting charge density wave (CDW) state. The PDW couples linearly to both the
s
-wave superconductor and the CDW and exhibits commensurate domains with discommensuration phase slips at the boundaries, conforming those of the lattice-locked commensurate CDW. Nevertheless, we found a global
δ
Φ
≅
±
2
π
/
3
phase difference between the PDW and CDW states, possibly owing to the Cooper-pair wave function orbital content. Our findings presage pervasive PDW physics in the many other TMDs that sustain both CDW and superconducting states.
An unidentified quantum fluid designated the pseudogap (PG) phase is produced by electron-density depletion in the CuO
antiferromagnetic insulator. Current theories suggest that the PG phase may be a ...pair density wave (PDW) state characterized by a spatially modulating density of electron pairs. Such a state should exhibit a periodically modulating energy gap Formula: see text in real-space, and a characteristic quasiparticle scattering interference (QPI) signature Formula: see text in wavevector space. By studying strongly underdoped Bi
Sr
CaDyCu
O
at hole-density ~0.08 in the superconductive phase, we detect the 8a
-periodic Formula: see text modulations signifying a PDW coexisting with superconductivity. Then, by visualizing the temperature dependence of this electronic structure from the superconducting into the pseudogap phase, we find the evolution of the scattering interference signature Formula: see text that is predicted specifically for the temperature dependence of an 8a
-periodic PDW. These observations are consistent with theory for the transition from a PDW state coexisting with d-wave superconductivity to a pure PDW state in the Bi
Sr
CaDyCu
O
pseudogap phase.
Plasma parcels are observed propagating from the Sun out to the large coronal heights monitored by the Heliospheric Imagers (HI) instruments onboard the NASA STEREO spacecraft during September 2007. ...The source region of these out‐flowing parcels is found to corotate with the Sun and to be rooted near the western boundary of an equatorial coronal hole. These plasma enhancements evolve during their propagation through the HI cameras' fields of view and only becoming fully developed in the outer camera field of view. We provide evidence that HI is observing the formation of a Corotating Interaction Region (CIR) where fast solar wind from the equatorial coronal hole is interacting with the slow solar wind of the streamer belt located on the western edge of that coronal hole. A dense plasma parcel is also observed near the footpoint of the observed CIR at a distance less than 0.1AU from the Sun where fast wind would have not had time to catch up slow wind. We suggest that this low‐lying plasma enhancement is a plasma parcel which has been disconnected from a helmet streamer and subsequently becomes embedded inside the corotating interaction region.
We present high angular resolution (∼80 mas) ALMA continuum images of the SN 1987A system, together with CO J = 2 1, J = 6 5, and SiO J = 5 4 to J = 7 6 images, which clearly resolve the ejecta (dust ...continuum and molecules) and ring (synchrotron continuum) components. Dust in the ejecta is asymmetric and clumpy, and overall the dust fills the spatial void seen in H images, filling that region with material from heavier elements. The dust clumps generally fill the space where CO J = 6 5 is fainter, tentatively indicating that these dust clumps and CO are locationally and chemically linked. In these regions, carbonaceous dust grains might have formed after dissociation of CO. The dust grains would have cooled by radiation, and subsequent collisions of grains with gas would also cool the gas, suppressing the CO J = 6 5 intensity. The data show a dust peak spatially coincident with the molecular hole seen in previous ALMA CO J = 2 1 and SiO J = 5 4 images. That dust peak, combined with CO and SiO line spectra, suggests that the dust and gas could be at higher temperatures than the surrounding material, though higher density cannot be totally excluded. One of the possibilities is that a compact source provides additional heat at that location. Fits to the far-infrared-millimeter spectral energy distribution give ejecta dust temperatures of 18-23 K. We revise the ejecta dust mass to Mdust = 0.2-0.4 for carbon or silicate grains, or a maximum of <0.7 for a mixture of grain species, using the predicted nucleosynthesis yields as an upper limit.
Unraveling the macroevolutionary history of bryophytes, which arose soon after the origin of land plants but exhibit substantially lower species richness than the more recently derived angiosperms, ...has been challenged by the scarce fossil record. Here we demonstrate that overall estimates of net species diversification are approximately half those reported in ferns and ∼30% those described for angiosperms. Nevertheless, statistical rate analyses on time-calibrated large-scale phylogenies reveal that mosses and liverworts underwent bursts of diversification since the mid-Mesozoic. The diversification rates further increase in specific lineages towards the Cenozoic to reach, in the most recently derived lineages, values that are comparable to those reported in angiosperms. This suggests that low diversification rates do not fully account for current patterns of bryophyte species richness, and we hypothesize that, as in gymnosperms, the low extant bryophyte species richness also results from massive extinctions.
The first St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) Expert Panel identified and reviewed the available evidence for the ten most important areas of controversy in advanced ...prostate cancer (APC) management. The successful registration of several drugs for castration-resistant prostate cancer and the recent studies of chemo-hormonal therapy in men with castration-naïve prostate cancer have led to considerable uncertainty as to the best treatment choices, sequence of treatment options and appropriate patient selection. Management recommendations based on expert opinion, and not based on a critical review of the available evidence, are presented. The various recommendations carried differing degrees of support, as reflected in the wording of the article text and in the detailed voting results recorded in supplementary Material, available at Annals of Oncology online. Detailed decisions on treatment as always will involve consideration of disease extent and location, prior treatments, host factors, patient preferences as well as logistical and economic constraints. Inclusion of men with APC in clinical trials should be encouraged.
By exploiting data from the STEREO/heliospheric imagers (HI) we extend a well‐established technique developed for coronal analysis by producing time‐elongation plots that reveal the nature of solar ...transient activity over a far more extensive region of the heliosphere than previously possible from coronagraph images. Despite the simplicity of these plots, their power in demonstrating how the plethora of ascending coronal features observed near the Sun evolve as they move antisunward is obvious. The time‐elongation profile of a transient tracked by HI can, moreover, be used to establish its angle out of the plane‐of‐the‐sky; an illustration of such analysis reveals coronal mass ejection material that can be clearly observed propagating out to distances beyond 1AU. This work confirms the value of the time‐elongation format in identifying/characterising transient activity in the inner heliosphere, whilst also validating the ability of HI to continuously monitor solar ejecta out to and beyond 1AU.
If strong electron-electron interactions between neighboring Fe atoms mediate the Cooper pairing in iron-pnictide superconductors, then specific and distinct anisotropic superconducting energy gaps Δ ...j (K⃗) should appear on the different electronic bands i. Here, we introduce intraband Bogoliubov quasiparticle scattering interference (QPI) techniques for determination of Δ j (K⃗) in such materials, focusing on lithium iron arsenide (LiFeAs). We identify the three hole-like bands assigned previously as γ, α₂ and αⁱ, and we determine the anisotropy, magnitude, and relative orientations of their Δ j (K⃗). These measurements will advance quantitative theoretical analysis of the mechanism of Cooper pairing in iron-based superconductivity.
The most essential characteristic of any fluid is the velocity field, and this is particularly true for macroscopic quantum fluids1. Although rapid advances2–7 have occurred in quantum fluid velocity ...field imaging8, the velocity field of a charged superfluid—a superconductor—has never been visualized. Here we use superconducting-tip scanning tunnelling microscopy9–11 to image the electron-pair density and velocity fields of the flowing electron-pair fluid in superconducting NbSe2. Imaging of the velocity fields surrounding a quantized vortex12,13 finds electronic fluid flow with speeds reaching 10,000 km h–1. Together with independent imaging of the electron-pair density via Josephson tunnelling, we visualize the supercurrent density, which peaks above 3 × 107 A cm–2. The spatial patterns in electronic fluid flow and magneto-hydrodynamics reveal hexagonal structures coaligned to the crystal lattice and quasiparticle bound states14, as long anticipated15–18. These techniques pave the way for electronic fluid flow visualization studies of other charged quantum fluids.Atomic-scale visualization of the superfluid velocity field, the electron-pair density and the superfluid current density in an electron-pair superfluid surrounding an Abrikosov vortex in a superconducting sample of NbSe2 is demonstrated, using superconducting-tip scanning tunnelling microscopy.
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