To evaluate the 2-year efficacy and safety of Kahook dual-blade (KDB) goniotomy in patients with medically uncontrolled glaucoma.
This was a retrospective case-series study of 90 consecutive patients ...with primary open-angle glaucoma (POAG) or pseudoexfoliation glaucoma (PEXG) that underwent KDB goniotomy alone (KDB-alone group) or KDB goniotomy in combination with phacoemulsification (KDB-phaco group) during 2019-2020. All patients were uncontrolled on three or more medications. Surgical success was defined as an IOP reduction ≥20% and/or a reduction of one or more medications at 24 months. We also report IOP levels and number of medications from baseline to 24 months, as well as the need for further glaucoma interventions.
At 24 months, mean IOP had reduced from 24.8±8.3 to 15.0±5.3 mmHg in the KDB-alone group (
<0.001) and from 22.3±5.8 to 13.9±3.0 mmHg in the KDB-phaco group (
<0.001). Medications had reduced from 3.5±0.6 to 3.1±0.9 in the KDB-alone group (
=0.047) and from 3.3±0.5 to 2.3±1.1 in the KDB-phaco group (
<0.001). An IOP reduction ≥20% and/or a reduction with one or more medications was achieved by 47% of eyes in the KDB-alone group and by 76% of eyes in the KDB-phaco group. Eyes with PEXG and POAG responded equally well to the success criteria. During the 24-month follow-up, additional glaucoma surgery or transscleral photocoagulation was performed in 28% of eyes in the KDB-alone group and in 12% of eyes in the KDB-phaco group.
In patients with medically uncontrolled glaucoma, KDB had a significant IOP-lowering effect after 24 months, but success rates were higher when KDB was performed in combination with cataract surgery compared to stand-alone treatment.
We construct a model of three‐dimensional P wave velocity structure in the crust and mantle that is global in extent, but with detailed upper mantle heterogeneities throughout the greater Middle East ...region. Fully three‐dimensional ray tracing is employed to achieve accurate travel time predictions of P and Pn arrivals, requiring the characterization of irregular and discontinuous boundaries. Therefore, we explicitly represent undulating seismic discontinuities in the crust and upper mantle within a spherical tessellation modeling framework. The tessellation‐based model architecture is hierarchical in that fine node sampling is achieved by recursively subdividing a base level tessellation. Determining the required node spacing to effectively model a given set of data is problematic, given the uneven sampling of seismic data and the differing wavelengths of actual seismic heterogeneity. To address this problem, we have developed an inversion process called Progressive Multilevel Tessellation Inversion (PMTI) that exploits the hierarchical nature of the tessellation‐based design and allows the data to determine the level of model complexity. PMTI serves as an alternative to existing multiresolution approaches and robustly images regional trends while allowing localized details to emerge where resolution is sufficient. To demonstrate our complete modeling concept, we construct a velocity model based on teleseismic P travel time data for global events and regional Pn travel time data for events occurring throughout the Middle East. Input data are a product of the statistical procedure called Bayesloc that simultaneously models all components of a multievent system including event locations, origin times, and arrival times (described in the Myers et al. (2011) companion paper). The initial tomographic image provides a new glimpse of the complex upper mantle velocity anomalies associated with the convergence of the Arabian and Indian plates with Eurasia. More important for event monitoring, the model accurately predicts both teleseismic and regional travel times for events occurring within the Middle East region.
Key Points
A global‐scale 3‐D P wave tomography model is constructed
Bayesian approach to seismic event location produces consistent data
New detailed velocity structure emerges beneath the Middle East
The connection of buildings to the Internet broadband network is becoming commonplace. The establishment of such an infrastructure enables the development of a range of new energy, environment and ...health-related services for people in their homes and workplaces. Telecommunications companies and utilities are actively developing examples of such services, and local authorities and health care providers are supporting trial deployments. Several of the services can be enabled or enhanced through the application of building modelling and simulation. This paper describes the infrastructure for the e-services under test within a European research project and shows the potential for simulation support for these services.
The Fermi Large Area Telescope (LAT) has opened the way for comparative studies of cosmic rays (CRs) and high-energy objects in the Milky Way (MW) and in other, external, star-forming galaxies. Using ...2 yr of observations with the Fermi LAT, Local Group galaxy M31 was detected as a marginally extended gamma-ray source, while only an upper limit has been derived for the other nearby galaxy M33. We revisited the gamma-ray emission in the direction of M31 and M33 using more than 7 yr of LAT Pass 8 data in the energy range 0.1 - 100 GeV , presenting detailed morphological and spectral analyses. M33 remains undetected, and we computed an upper limit of 2.0 × 10 − 12 erg cm − 2 s − 1 on the 0.1 - 100 GeV energy flux (95% confidence level). This revised upper limit remains consistent with the observed correlation between gamma-ray luminosity and star formation rate tracers and implies an average CR density in M33 that is at most half of that of the MW. M31 is detected with a significance of nearly 10 . Its spectrum is consistent with a power law with photon index Γ = 2.4 0.1 stat + syst and a 0.1 - 100 GeV energy flux of ( 5.6 0.6 stat + syst ) × 10 − 12 erg cm − 2 s − 1 . M31 is detected to be extended with a 4 significance. The spatial distribution of the emission is consistent with a uniform-brightness disk with a radius of 0 4 and no offset from the center of the galaxy, but nonuniform intensity distributions cannot be excluded. The flux from M31 appears confined to the inner regions of the galaxy and does not fill the disk of the galaxy or extend far from it. The gamma-ray signal is not correlated with regions rich in gas or star formation activity, which suggests that the emission is not interstellar in origin, unless the energetic particles radiating in gamma rays do not originate in recent star formation. Alternative and nonexclusive interpretations are that the emission results from a population of millisecond pulsars dispersed in the bulge and disk of M31 by disrupted globular clusters or from the decay or annihilation of dark matter particles, similar to what has been proposed to account for the so-called Galactic center excess found in Fermi-LAT observations of the MW.
RC-networks for the description of heat transfer in thermally activated building constructions have been developed. Both a simplified star-network as well as a triangular network has been used. While ...the star-network is less complex than the triangular network it can only be used for a restricted type of construction such as activated concrete slabs. The triangular network can be used both for surface radiant systems such as floor heating and ceiling cooling as well as for concrete core conditioning. The triangular RC-network therefore can cover a wide range of application but since it is more complicated to optimize it will require a more complex pre-processor to build and optimize the RC-network if placed in a simulation environment.
First Fermi-LAT Solar Flare Catalog Ajello, M.; Baldini, L.; Bastieri, D. ...
The Astrophysical journal. Supplement series,
02/2021, Volume:
252, Issue:
2
Journal Article
Peer reviewed
Open access
We present the first Fermi-Large Area Telescope (LAT) solar flare catalog covering the 24th solar cycle. This catalog contains 45 Fermi-LAT solar flares (FLSFs) with emission in the γ-ray energy band ...(30 MeV-10 GeV) detected with a significance of ≥5 over the years 2010-2018. A subsample containing 37 of these flares exhibits delayed emission beyond the prompt-impulsive hard X-ray phase, with 21 flares showing delayed emission lasting more than two hours. No prompt-impulsive emission is detected in four of these flares. We also present in this catalog observations of GeV emission from three flares originating from active regions located behind the limb of the visible solar disk. We report the lightcurves, spectra, best proton index, and localization (when possible) for all FLSFs. The γ-ray spectra are consistent with the decay of pions produced by >300 MeV protons. This work contains the largest sample of high-energy γ-ray flares ever reported and provides a unique opportunity to perform population studies on the different phases of the flare and thus allowing a new window in solar physics to be opened.
We report on the Fermi-LAT detection of high-energy emission from the behind-the-limb (BTL) solar flares that occurred on 2013 October 11, and 2014 January 6 and September 1. The Fermi-LAT ...observations are associated with flares from active regions originating behind both the eastern and western limbs, as determined by STEREO. All three flares are associated with very fast coronal mass ejections (CMEs) and strong solar energetic particle events. We present updated localizations of the >100 MeV photon emission, hard X-ray (HXR) and EUV images, and broadband spectra from 10 keV to 10 GeV, as well as microwave spectra. We also provide a comparison of the BTL flares detected by Fermi-LAT with three on-disk flares and present a study of some of the significant quantities of these flares as an attempt to better understand the acceleration mechanisms at work during these occulted flares. We interpret the HXR emission to be due to electron bremsstrahlung from a coronal thin-target loop top with the accelerated electron spectra steepening at semirelativistic energies. The >100 MeV gamma-rays are best described by a pion-decay model resulting from the interaction of protons (and other ions) in a thick-target photospheric source. The protons are believed to have been accelerated (to energies >10 GeV) in the CME environment and precipitate down to the photosphere from the downstream side of the CME shock and landed on the front side of the Sun, away from the original flare site and the HXR emission.
To investigate the influence of laser trabeculoplasty (LTP) on subsequent surgery with combined phacoemulsification/Kahook Dual Blade goniotomy (phaco-KDB) in patients with open-angle glaucoma or ...intraocular hypertension.PurposeTo investigate the influence of laser trabeculoplasty (LTP) on subsequent surgery with combined phacoemulsification/Kahook Dual Blade goniotomy (phaco-KDB) in patients with open-angle glaucoma or intraocular hypertension.Patients undergoing phaco-KDB between 2019 and 2021 were divided into previously LTP treated and previously non-LTP treated, and LTP-treatment included argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT). The primary goal was to investigate if previous LTP influenced later surgical outcome of phaco-KDB. The secondary goal was to investigate if the outcome of LTP could be predictive of the outcome of subsequent phaco-KDB. We also compared IOP- and medication reductions between LTP and non-LTP treated patients.Patients and MethodsPatients undergoing phaco-KDB between 2019 and 2021 were divided into previously LTP treated and previously non-LTP treated, and LTP-treatment included argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT). The primary goal was to investigate if previous LTP influenced later surgical outcome of phaco-KDB. The secondary goal was to investigate if the outcome of LTP could be predictive of the outcome of subsequent phaco-KDB. We also compared IOP- and medication reductions between LTP and non-LTP treated patients.A total of 111 LTP treated patients were compared to 139 non-LTP treated patients. In LTP treated patients, surgical success of phaco-KDB was 82.9%, compared to 88.5% in non-LTP treated patients (P=0.20). Reductions in IOP and medications were similar between groups. Furthermore, within the LTP group, patients with successful LTP-treatment had a subsequent surgical success of phaco-KDB in 80.7%, compared to 83.0% in patients with unsuccessful LTP-treatment (P=0.765).ResultsA total of 111 LTP treated patients were compared to 139 non-LTP treated patients. In LTP treated patients, surgical success of phaco-KDB was 82.9%, compared to 88.5% in non-LTP treated patients (P=0.20). Reductions in IOP and medications were similar between groups. Furthermore, within the LTP group, patients with successful LTP-treatment had a subsequent surgical success of phaco-KDB in 80.7%, compared to 83.0% in patients with unsuccessful LTP-treatment (P=0.765).Previous LTP treatment does not predict the outcome of phaco-KDB. Furthermore, no correlation was found between the LTP effect and a later surgical success of phaco-KDB.ConclusionPrevious LTP treatment does not predict the outcome of phaco-KDB. Furthermore, no correlation was found between the LTP effect and a later surgical success of phaco-KDB.
The Large Area Telescope on board the Fermi Gamma-ray Space Telescope has collected the largest ever sample of high-energy cosmic-ray electron and positron events since the beginning of its ...operation. Potential anisotropies in the arrival directions of cosmic-ray electrons or positrons could be a signature of the presence of nearby sources. We use almost seven years of data with energies above 42 GeV processed with the Pass 8 reconstruction. The present data sample can probe dipole anisotropies down to a level of 10^{-3}. We take into account systematic effects that could mimic true anisotropies at this level. We present a detailed study of the event selection optimization of the cosmic-ray electrons and positrons to be used for anisotropy searches. Since no significant anisotropies have been detected on any angular scale, we present upper limits on the dipole anisotropy. The present constraints are among the strongest to date probing the presence of nearby young and middle-aged sources.
Gamma Rays from Fast Black-hole Winds Ajello, M.; Baldini, L.; Ballet, J. ...
The Astrophysical journal,
2021, Volume:
921, Issue:
2
Journal Article
Peer reviewed
Open access
Abstract
Massive black holes at the centers of galaxies can launch powerful wide-angle winds that, if sustained over time, can unbind the gas from the stellar bulges of galaxies. These winds may be ...responsible for the observed scaling relation between the masses of the central black holes and the velocity dispersion of stars in galactic bulges. Propagating through the galaxy, the wind should interact with the interstellar medium creating a strong shock, similar to those observed in supernovae explosions, which is able to accelerate charged particles to high energies. In this work we use data from the Fermi Large Area Telescope to search for the
γ
-ray emission from galaxies with an ultrafast outflow (UFO): a fast (
v
∼ 0.1 c), highly ionized outflow, detected in absorption at hard X-rays in several nearby active galactic nuclei (AGN). Adopting a sensitive stacking analysis we are able to detect the average
γ
-ray emission from these galaxies and exclude that it is due to processes other than UFOs. Moreover, our analysis shows that the
γ
-ray luminosity scales with the AGN bolometric luminosity and that these outflows transfer ∼0.04% of their mechanical power to
γ
-rays. Interpreting the observed
γ
-ray emission as produced by cosmic rays (CRs) accelerated at the shock front, we find that the
γ
-ray emission may attest to the onset of the wind–host interaction and that these outflows can energize charged particles up to the transition region between galactic and extragalactic CRs.
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