ABSTRACT
We present multiwavelength fast timing observations of the black hole X-ray binary MAXI J1820+070 (ASASSN-18ey), taken with the Karl G. Jansky Very Large Array (VLA), Atacama Large ...Millimeter/Sub-Millimeter Array (ALMA), Very Large Telescope (VLT), New Technology Telescope (NTT), Neutron Star Interior Composition Explorer (NICER), and XMM–Newton. Our data set simultaneously samples 10 different electromagnetic bands (radio – X-ray) over a 7-h period during the hard state of the 2018–2019 outburst. The emission we observe is highly variable, displaying multiple rapid flaring episodes. To characterize the variability properties in our data, we implemented a combination of cross-correlation and Fourier analyses. We find that the emission is highly correlated between different bands, measuring time-lags ranging from hundreds of milliseconds between the X-ray/optical bands to minutes between the radio/sub-mm bands. Our Fourier analysis also revealed, for the first time in a black hole X-ray binary, an evolving power spectral shape with electromagnetic frequency. Through modelling these variability properties, we find that MAXI J1820+070 launches a highly relativistic ($\Gamma =6.81^{+1.06}_{-1.15}$) and confined ($\phi =0.45^{+0.13}_{-0.11}$ deg) jet, which is carrying a significant amount of power away from the system (equivalent to $\sim 0.6 \, L_{1-100{\rm keV}}$). We additionally place constraints on the jet composition and magnetic field strength in the innermost jet base region. Overall, this work demonstrates that time-domain analysis is a powerful diagnostic tool for probing jet physics, where we can accurately measure jet properties with time-domain measurements alone.
Postherpetic neuralgia (PHN) is a debilitating chronic pain condition, yet there is a lack of knowledge regarding underlying brain activity. Here we identify brain regions involved in spontaneous ...pain of PHN (
n
=
11) and determine its modulation with Lidoderm therapy (patches of 5% lidocaine applied to the PHN affected body part). Continuous ratings of fluctuations of spontaneous pain during fMRI were contrasted to ratings of fluctuations of a bar observed during scanning, at three sessions: (1) pre-treatment baseline, (2) after 6
h of Lidoderm treatment, and (3) after 2 weeks of Lidoderm use. Overall brain activity for spontaneous pain of PHN involved affective and sensory-discriminative areas: thalamus, primary and secondary somatosensory, insula and anterior cingulate cortices, as well as areas involved in emotion, hedonics, reward, and punishment: ventral striatum, amygdala, orbital frontal cortex, and ventral tegmental area. Generally, these activations decreased at sessions 2 and 3, except right anterior insular activity which increased with treatment. The sensory and affective activations only responded to the short-term treatment (6
h of Lidoderm); while the ventral striatum and amygdala (reward-related regions) decreased mainly with longer-term treatment (2 weeks of Lidoderm). Pain properties: average magnitude of spontaneous pain, and responses on Neuropathic Pain Scale (NPS), decreased with treatment. The ventral striatal and amygdala activity best reflected changes in NPS, which was modulated only with longer-term treatment. The results show a specific brain activity pattern for PHN spontaneous pain, and implicate areas involved in emotions and reward as best reflecting changes in pain with treatment.
ABSTRACT
We report on a multiepoch campaign of rapid optical/X-ray timing observations of the superbright 2018 outburst of MAXI J1820+070, a black hole low-mass X-ray binary system. The observations ...spanned 80 d in the initial hard state and were taken with NTT/ULTRACAM and GTC/HiPERCAM in the optical (usgsrsiszs filters at time resolutions of 8–300 Hz) and with ISS/NICER in X-rays. We find (i) a growing anticorrelation between the optical and X-ray light curves, (ii) a steady, positive correlation at an optical lag of ∼0.2 s (with a longer lag at longer wavelengths) present in all epochs, and (iii) a curious positive correlation at negative optical lags in the last, X-ray softest epoch, with longer wavelengths showing a greater correlation and a more negative lag. To explain these, we postulate the possible existence of two synchrotron-emitting components – a compact jet and a hot flow. In our model, the significance of the jet decreases over the outburst, while the hot flow remains static (thus, relatively, increasing in significance). We also discuss a previously discovered quasi-periodic oscillation and note how it creates coherent optical time lags, stronger at longer wavelengths, during at least two epochs.
To provide evidence-based guidance on the optimum management of chronic pain in adult cancer survivors.
An ASCO-convened expert panel conducted a systematic literature search of studies investigating ...chronic pain management in cancer survivors. Outcomes of interest included symptom relief, pain intensity, quality of life, functional outcomes, adverse events, misuse or diversion, and risk assessment or mitigation.
A total of 63 studies met eligibility criteria and compose the evidentiary basis for the recommendations. Studies tended to be heterogeneous in terms of quality, size, and populations. Primary outcomes also varied across the studies, and in most cases, were not directly comparable because of different outcomes, measurements, and instruments used at different time points. Because of a paucity of high-quality evidence, many recommendations are based on expert consensus.
Clinicians should screen for pain at each encounter. Recurrent disease, second malignancy, or late-onset treatment effects in any patient who reports new-onset pain should be evaluated, treated, and monitored. Clinicians should determine the need for other health professionals to provide comprehensive pain management care in patients with complex needs. Systemic nonopioid analgesics and adjuvant analgesics may be prescribed to relieve chronic pain and/or to improve function. Clinicians may prescribe a trial of opioids in carefully selected patients with cancer who do not respond to more conservative management and who continue to experience distress or functional impairment. Risks of adverse effects of opioids should be assessed. Clinicians should clearly understand terminology such as tolerance, dependence, abuse, and addiction as it relates to the use of opioids and should incorporate universal precautions to minimize abuse, addiction, and adverse consequences. Additional information is available at www.asco.org/chronic-pain-guideline and www.asco.org/guidelineswiki.
Postherpetic neuralgia (PHN) is a debilitating chronic pain condition often accompanied by a sensation of pain when the affected region is touched (tactile allodynia). Here we identify brain regions ...involved in stimulus-induced touch-evoked pain (dynamical mechanical allodynia, DMA), compare brain activity between DMA and spontaneous pain (described earlier for the same patients in Geha PY, Baliki MN, Chialvo DR, Harden RN, Paice JA, Apkarian AV. Brain activity for spontaneous pain of postherpetic neuralgia and its modulation by lidocaine patch therapy. Pain 2007;128:88–100), delineate regions that specifically code the magnitude of perceived allodynia, and show the transformation of allodynia-related information in the brain as a time-evolving network. Eleven PHN patients were studied for DMA and its modulation with Lidoderm therapy (patches of 5% lidocaine applied to the PHN affected body part). Continuous ratings of pain while the affected body part was brushed during fMRI were contrasted with non-painful touch when brushing was applied to an equivalent opposite body site, and with fluctuations of a bar observed during scanning, at three sessions relative to Lidoderm treatment. Lidoderm treatment did not decrease DMA ratings but did decrease spontaneous pain. Multiple brain areas showed preferential activity for allodynia. However, mainly responses in the bilateral putamen and left medial temporal gyrus were related to the magnitude of allodynia. Both DMA and spontaneous pain perceptions were best represented within the same sub-cortical structures but with minimal overlap, implying that PHN pain modulates behavioral learning and hedonics. These results have important clinical implications regarding adequate therapy.
The management of cancer pain Paice, Judith A.; Ferrell, Betty
CA: a cancer journal for clinicians,
May/June 2011, Letnik:
61, Številka:
3
Journal Article
We report on simultaneous sub-second optical and X-ray timing observations of the low-mass X-ray binary black hole candidate MAXI J1820+070. The bright 2018 outburst rise allowed simultaneous ...photometry in five optical bands (ugrizs) with HiPERCAM/GTC (Optical) atf rame rates over 100 Hz, together with NICER/ISS observations (X-rays). Intense (factor of2) red flaring activity in the optical is seen over a broad range of time-scales down to∼10 ms. Cross-correlating the bands reveals a prominent anticorrelation on time-scales of ∼seconds, and a narrow sub-second correlation at a lag of≈+165 ms (optical lagging X-rays). This lag increases with optical wavelength, and is approximately constant over Fourier frequencies of∼0.3–10 Hz. These features are consistent with an origin in the inner accretion flow and jet base within∼5000 Gravitational radii. An additional∼+5 s lag feature may be ascribable to disc reprocessing. MAXI J1820+070 is the third black hole transient to display a clear∼0.1 s optical lag, which may be common feature in such objects. The sub-second lag variation with wavelength is novel, and may allow constraints on internal shock jet stratification models.
ABSTRACT
Astrometric noise (ϵ) in excess of parallax and proper motion is a potential signature of orbital wobble (ω) of individual components in binary star systems. The combination of X-ray ...selection with astrometric noise could then be a powerful tool for robustly isolating accreting binaries in large surveys. Here, we mine the Gaia EDR3 catalogue for Galactic sources with significant values of astrometric noise over the parameter space expected for known and candidate X-ray binaries (XRBs). Cross-matching our sample with the Chandra Source Catalogue returns a primary sample of ≈6500 X-ray sources with significant ϵ. X-ray detection efficiency for objects with significant ϵ is a factor of ≈4.5 times higher than in a matched control sample exhibiting low ϵ. The primary sample branches off the main sequence much more than control objects in colour–mag space, and includes a higher fraction of known binaries, variables, and young stellar object class types. However, values of ϵ reported in the Gaia pipeline releases so far can exceed expectations for individual XRBs with known semimajor axis size and other system parameters. It is likely that other factors (possibly attitude and modelling uncertainties, as well as source variability) currently dominate the observed excess noise in such systems. Confirmation of their nature must therefore await future Gaia releases. The full X-ray matched catalogue is released here to enable legacy follow-up.
Purpose
This case-control study was designed to assess the efficacy of cryotherapy to prevent paclitaxel-induced painful peripheral neuropathy in women with breast cancer.
Methods
Participants served ...as their own paired control, with randomization of the cooled glove/sock to either the dominant or the non-dominant hand/foot, worn for 15 min prior to, during, and 15 min after completion of the paclitaxel infusion. Outcome measures included the Neuropathic Pain Symptom Inventory, the Brief Pain Inventory, and quantitative sensory testing. Data were measured at each of six time points—baseline, post-treatment (approximately 2 weeks after the last paclitaxel infusion), and at the first, fifth, ninth, and final weekly paclitaxel treatments.
Results
Of 29 randomized participants, 20 (69%) received at least one cryotherapy treatment, and 11 (38%) received all four cryotherapy treatments. Ten (34%) participants could not tolerate the cryotherapy, and six (21%) declined further participation at some point during the trial. Only seven participants (24%) were available for the final post-chemotherapy QST and questionnaires. There were no significant differences in measures of neuropathy or pain between treated and untreated hands or feet.
Conclusions
Strategies to prevent painful peripheral neuropathy are urgently needed. In this current trial, dropout due to discomfort precluded adequate power to fully understand the potential benefits of cryotherapy. Much more research is needed to discover safe and effective preventive strategies that can be easily implemented within busy infusion centers.
ABSTRACT
We present a rapid timing analysis of optical (HiPERCAM and ULTRACAM) and X-ray (NICER) observations of the X-ray transient Swift J1858.6−0814 during 2018 and 2019. The optical light curves ...show relatively slow, large amplitude (∼1 mag in gs) ‘blue’ flares (i.e. stronger at shorter wavelengths) on time-scales of ∼minutes as well as fast, small amplitude (∼0.1 mag in gs) ‘red’ flares (i.e. stronger at longer wavelengths) on time-scales of ∼seconds. The ‘blue’ and ‘red’ flares are consistent with X-ray reprocessing and optically thin synchrotron emission, respectively, similar to what is observed in other X-ray binaries. The simultaneous optical versus soft- and hard-band X-ray light curves show time- and energy-dependent correlations. The 2019 March 4 and parts of the June data show a nearly symmetric positive cross-correlations (CCFs) at positive lags consistent with simple X-ray disc reprocessing. The soft- and hard-band CCFs are similar and can be reproduced if disc reprocessing dominates in the optical and one component (disc or synchrotron Comptonization) dominates both the soft and hard X-rays. A part of the 2019 June data shows a very different CCFs. The observed positive correlation at negative lag in the soft band can be reproduced if the optical synchrotron emission is correlated with the hot flow X-ray emission. The observed timing properties are in qualitative agreement with the hybrid inner hot accretion flow model, where the relative role of the different X-ray and optical components that vary during the course of the outburst, as well as on shorter time-scales, govern the shape of the optical/X-ray CCFs.
PDF
