To compare the diagnostic performance of PET with the amyloid ligand Pittsburgh compound B (PiB-PET) to fluorodeoxyglucose (FDG-PET) in discriminating between Alzheimer disease (AD) and ...frontotemporal lobar degeneration (FTLD).
Patients meeting clinical criteria for AD (n = 62) and FTLD (n = 45) underwent PiB and FDG-PET. PiB scans were classified as positive or negative by 2 visual raters blinded to clinical diagnosis, and using a quantitative threshold derived from controls (n = 25). FDG scans were visually rated as consistent with AD or FTLD, and quantitatively classified based on the region of lowest metabolism relative to controls.
PiB visual reads had a higher sensitivity for AD (89.5% average between raters) than FDG visual reads (77.5%) with similar specificity (PiB 83%, FDG 84%). When scans were classified quantitatively, PiB had higher sensitivity (89% vs 73%) while FDG had higher specificity (83% vs 98%). On receiver operating characteristic analysis, areas under the curve for PiB (0.888) and FDG (0.910) were similar. Interrater agreement was higher for PiB (κ = 0.96) than FDG (κ = 0.72), as was agreement between visual and quantitative classification (PiB κ = 0.88-0.92; FDG κ = 0.64-0.68). In patients with known histopathology, overall classification accuracy (2 visual and 1 quantitative classification per patient) was 97% for PiB (n = 12 patients) and 87% for FDG (n = 10).
PiB and FDG showed similar accuracy in discriminating AD and FTLD. PiB was more sensitive when interpreted qualitatively or quantitatively. FDG was more specific, but only when scans were classified quantitatively. PiB slightly outperformed FDG in patients with known histopathology.
We present first results from a series of NuSTAR observations of the black hole X-ray binary V404 Cyg obtained during its summer 2015 outburst, primarily focusing on observations during the height of ...this outburst activity. The NuSTAR data show extreme variability in both the flux and spectral properties of the source. This is partly driven by strong and variable line-of-sight absorption, similar to previous outbursts. The latter stages of this observation are dominated by strong flares, reaching luminosities close to Eddington. During these flares, the central source appears to be relatively unobscured and the data show clear evidence for a strong contribution from relativistic reflection, providing a means to probe the geometry of the innermost accretion flow. Based on the flare properties, analogies with other Galactic black hole binaries, and also the simultaneous onset of radio activity, we argue that this intense X-ray flaring is related to transient jet activity during which the ejected plasma is the primary source of illumination for the accretion disk. If this is the case, then our reflection modeling implies that these jets are launched in close proximity to the black hole (as close as a few gravitational radii), consistent with expectations for jet launching models that tap either the spin of the central black hole, or the very innermost accretion disk. Our analysis also allows us to place the first constraints on the black hole spin for this source, which we find to be (99% statistical uncertainty, based on an idealized lamp-post geometry).
ABSTRACT
MAXI J1820+070 (optical counterpart ASASSN-18ey) is a black hole candidate discovered through its recent very bright outburst. The low extinction column and long duration at high flux allow ...detailed measurements of the accretion process to be made. In this work, we compare the evolution of X-ray spectral and timing properties through the initial hard state of the outburst. We show that the inner accretion disc, as measured by relativistic reflection, remains steady throughout this period of the outburst. Nevertheless, subtle spectral variability is observed, which is well explained by a change in coronal geometry. However, characteristic features of the temporal variability – low-frequency roll-over and quasi-periodic oscillation frequency – increase drastically in frequency, as the outburst proceeds. This suggests that the variability time-scales are governed by coronal conditions rather than solely by the inner disc radius. We also find a strong correlation between X-ray luminosity and coronal temperature. This can be explained by electron pair production with a changing effective radius and a non-thermal electron fraction of $\sim 20$ per cent.
In this 24-week trial, glucosamine and chondroitin sulfate were not more effective, alone or in combination, than placebo in controlling pain in patients with osteoarthritis of the knee. In secondary ...analyses, however, in the subgroup of patients with moderate-to-severe osteoarthritis, those given both glucosamine and chondroitin sulfate were more likely than those given placebo to have a decrease in pain (79 percent vs. 54 percent).
In this trial, glucosamine and chondroitin sulfate were not more effective, alone or in combination, than placebo in controlling pain in patients with osteoarthritis of the knee.
Osteoarthritis is the most common of the arthritides, affecting at least 20 million Americans, a number that is expected to double over the next two decades.
1
,
2
Currently available medical therapies primarily address the treatment of joint pain in patients with osteoarthritis.
3
Analgesics as well as traditional and cyclooxygenase-2–selective nonsteroidal antiinflammatory drugs (NSAIDs) have suboptimal effectiveness,
4
,
5
and there is some question about their safety, especially in the light of recent reports of increased cardiovascular risk.
6
–
8
The dietary supplements glucosamine and chondroitin sulfate have been advocated, especially in the lay media, as safe and effective options for the management . . .
Lung involvement is the leading cause of death in systemic sclerosis (SSc), but lung transplantation (LT) for systemic disease remains controversial. Our objective was to comprehensively evaluate ...post-LT outcomes for SSc compared to idiopathic pulmonary fibrosis (IPF). We retrospectively evaluated bilateral LT recipients (LTRs) with SSc or IPF at our centre between January 1, 2003 and December 31, 2007. The primary end-point was all-cause mortality at 1 yr post-LT. Secondary end-points included assessments of acute rejection (AR), pulmonary function, infection and chronic rejection. 14 patients with SSc and 38 patients with IPF underwent LT. Apart from a younger SSc cohort (53.2 versus 58.8 yrs; p = 0.02), the two groups were well matched. 1-yr all-cause mortality was no different between SSc (6.6%) and IPF (13.1%) groups, after adjusting for age (p = 0.62). Rates of (AR) ≥2 were significantly increased for the SSc compared with the IPF group (hazard ratio (HR) 2.91; p = 0.007). Other end-points, including chronic rejection, infection and pulmonary function, showed no differences. SSc LTRs experience similar survival 1 yr post-LT when compared to IPF. AR rates may be significantly higher in the SSc group. Longer follow-up is necessary to determine the effects of gastrointestinal dysfunction and AR on late allograft function in SSc LTR.
SN2010da/NGC 300 ULX-1 was first detected as a supernova impostor in 2010 May and was recently discovered to be a pulsating ultraluminous X-ray source. In this Letter, we present Very Large ...Telescope/X-shooter spectra of this source obtained in 2018 October, covering the wavelength range 350-2300 nm. The J- and H-bands clearly show the presence of a red supergiant (RSG) donor star that is best matched by a MARCS stellar atmosphere with Teff = 3650-3900 K and log(Lbol/L ) = 4.25 0.10, which yields a stellar radius R = 310 70R . To fit the full spectrum, two additional components are required: a blue excess that can be fitted either by a hot blackbody (T 20,000 K) or a power law (spectral index 4) and is likely due to X-ray emission reprocessed in the outer accretion disk or the donor star; and a red excess that is well fitted by a blackbody with a temperature of ∼1100 K, and is likely due to warm dust in the vicinity of SN2010da. The presence of an RSG in this system implies an orbital period of at least 0.8-2.1 yr, assuming Roche-lobe overflow. Given the large donor-to-compact object mass ratio, orbital modulations of the radial velocity of the RSG are likely undetectable. However, the radial velocity amplitude of the neutron star is large enough (up to 40-60 km s−1) to potentially be measured in the future, unless the system is viewed at a very unfavorable inclination.
Abstract
We report on a timing and spectral analysis of a 50 ks NuSTAR observation of IGR J16320−4751 (= AX J1631.9−4752), a high-mass X-ray binary hosting a slowly rotating neutron star. In this ...observation from 2015, the spin period was 1308.8 ± 0.4 s giving a period derivative
P
̇
∼
2
×
10
−
8
s s
−1
when compared with the period measured in 2004. In addition, the pulsed fraction decreased as a function of energy, as opposed to the constant trend that was seen previously. This suggests a change in the accretion geometry of the system during the intervening 11 yr. The phase-averaged spectra were fit with the typical model for accreting pulsars: a power law with an exponential cutoff. This left positive residuals at 6.4 keV attributable to the known iron K
α
line, as well as negative residuals around 14 keV from a candidate cyclotron line detected at a significance of 5
σ
. We found no significant differences in the spectral parameters across the spin period, other than the expected changes in flux and component normalizations. A flare lasting around 5 ks was captured during the first half of the observation, where the X-ray emission hardened and the local column density decreased. Finally, the binary orbital period was refined to 8.9912 ± 0.0078 days thanks to Swift/BAT monitoring data from 2005–2022.
ABSTRACT We present spectral analyses of five Nuclear Spectroscopic Telescope Array and Swift observations of GX 339-4 taken during a failed outburst during the summer of 2013. These observations ...cover Eddington luminosity fractions in the range 0.9%-6%. Throughout this outburst GX 339-4 stayed in the hard state and all five observations show similar X-ray spectra, with a hard power law with a photon index near 1.6, and significant contribution from reflection. Using simple reflection models we find unrealistically high iron abundances. Allowing for different photon indices for the continuum incident on the reflector relative to the underlying observed continuum results in a statistically better fit and reduced iron abundances. With a photon index around 1.3, the input power law on the reflector is significantly harder than that which is directly observed. We study the influence of different emissivity profiles and geometries and consistently find an improvement when using separate photon indices. The inferred inner accretion disk radius is strongly model dependent, but we do not find evidence for a truncation radius larger than in any model. The data do not allow independent spin constraints, but the results are consistent with the literature (i.e., ). Our best-fit models indicate an inclination angle in the range 40°-60°, consistent with limits on the orbital inclination but higher than reported in the literature using standard reflection models. The iron line around 6.4 keV is clearly broadened, and we detect a superimposed narrow core as well. This core originates from a fluorescent region outside the influence of the strong gravity of the black hole. Additionally, we discuss possible geometries.
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