The spectral and timing properties of an oscillating hot thermal corona are investigated. This oscillation is assumed to be due to a magneto-acoustic wave propagating within the corona and triggered ...by an external, non-specified, excitation. A cylindrical geometry is adopted and, neglecting the rotation, the wave equation is solved for different boundary conditions. The resulting X-ray luminosity, through thermal Comptonization of embedded soft photons, is then computed analytically, assuming linear dependence between the local pressure disturbance and the radiative modulation. These calculations are also compared to Monte Carlo simulations. The main results of this study are as follows. (1) The corona plays the role of a low bandpass medium, its response to a white noise excitation being a flat-top noise power spectral density (PSD) at low frequencies and a red noise at high frequency. (2) Resonant peaks are present in the PSD. Their powers depend on the boundary conditions chosen and, more specifically, on the impedance adaptation with the external medium at the corona inner boundary. (3) The flat-top noise level and break as well as the resonant peak frequencies are inversely proportional to the external radius rj. (4) Computed rms and f-spectra exhibit an overall increase in the variability with energy. Comparison with observed variability features, especially in the hard-intermediate states of X-ray binaries, are discussed.
•FeSO4 and colloidal nZVI are compared in the immobilization of Cr(VI) in a contaminated industrial soil.•Colloidal nZVI resulted in a faster and more efficient Cr(VI) reduction with respect to ...FeSO4.•The effect of the reduction treatment on metal mobilization and bioavailability was assessed by sequential extractions.•The mechanisms and the factors affecting the process are discussed.
Iron sulphate (FeSO4) and colloidal nano zero-valent iron (nZVI) as reducing agents were compared, with the aim of assessing their effectiveness in hexavalent chromium Cr(VI) removal from a contaminated industrial soil. Experiments were performed on soil samples collected from an industrial site where a nickel contamination, caused by a long-term productive activity, was also verified. The influence of reducing agents amount with respect to chromium content and the effectiveness of deoxygenation of the slurry were discussed.
The soil was fully characterized before and after each test, and sequential extractions were performed to assess chemico-physical modifications and evaluate metals mobility induced by washing.
Results show that both the reducing agents successfully lowered the amount of Cr(VI) in the soil below the threshold allowed by Italian Environmental Regulation for industrial reuse. Cr(VI) reduction by colloidal nZVI proved to be faster and more effective: the civil reuse of soil Cr(VI)<2mg/kg was only achieved using colloidal nZVI within 60min adopting a nZVI/Cr(VI) molar ratio of 30. The reducing treatment resulted in an increase in the amount of chromium in the oxide–hydroxide fraction, thus confirming a mechanism of chromium-iron hydroxides precipitation.
In addition, a decrease of nickel (Ni) and lead (Pb) content in soil was also observed when acidic conditions were established.
We present a pooled update of two large, multicenter MM-009 and MM-010 placebo-controlled randomized phase III trials that included 704 patients and assessed lenalidomide plus dexamethasone versus ...dexamethasone plus placebo in patients with relapsed/refractory multiple myeloma (MM). Patients in both studies were randomized to receive 25 mg daily oral lenalidomide or identical placebo, plus 40 mg oral dexamethasone. In this pooled analysis, using data up to unblinding (June 2005 for MM-009 and August 2005 for MM-010), treatment with lenalidomide plus dexamethasone significantly improved overall response (60.6 vs 21.9%, P<0.001), complete response rate (15.0 vs 2.0%, P<0.001), time to progression (median of 13.4 vs 4.6 months, P<0.001) and duration of response (median of 15.8 months vs 7 months, P<0.001) compared with dexamethasone-placebo. At a median follow-up of 48 months for surviving patients, using data up to July 2008, a significant benefit in overall survival (median of 38.0 vs 31.6 months, P=0.045) was retained despite 47.6% of patients who were randomized to dexamethasone-placebo receiving lenalidomide-based treatment after disease progression or study unblinding. Low beta(2)-microglobulin and low bone marrow plasmacytosis were associated with longer survival. In conclusion, these data confirm the significant response and survival benefit with lenalidomide and dexamethasone.
In patients with distal symmetric polyneuropathy we assessed non-nociceptive Abeta- and nociceptive Adelta-afferents to investigate their role in the development of neuropathic pain. We screened 2240 ...consecutive patients with sensory disturbances and collected 150 patients with distal symmetric polyneuropathy (68 with pain and 82 without). All patients underwent the Neuropathic Pain Symptom Inventory to rate ongoing, paroxysmal and provoked pains, a standard nerve conduction study (NCS) to assess Abeta-fibre function, and laser-evoked potentials (LEPs) to assess Adelta-fibre function. Patients with pain had the same age (P>0.50), but a longer delay since symptom onset than those without (P<0.01). Whereas the LEP amplitude was significantly lower in patients with pain than in those without (P<0.0001), NCS data did not differ between groups (P>0.50). LEPs were more severely affected in patients with ongoing pain than in those with provoked pain (P<0.0001). Our findings indicate that the impairment of Abeta-fibres has no role in the development of ongoing or provoked pain. In patients with ongoing pain the severe LEP suppression and the correlation between pain intensity and LEP attenuation may indicate that this type of pain reflects damage to nociceptive axons. The partially preserved LEPs in patients with provoked pain suggest that this type of pain is related to the abnormal activity arising from partially spared and sensitised nociceptive terminals. Because clinical and neurophysiological abnormalities followed similar patterns regardless of aetiology, pain should be classified and treated on mechanism-based grounds.
In multiple myeloma (MM), health-related quality of life (HRQoL) data is becoming increasingly important, owing to improved survival outcomes and the impact of treatment-related toxicity on HRQoL. ...Researchers are more frequently including HRQoL assessments in clinical trials, but analysis and reporting of this data has not been consistent. A systematic literature review assessed the effect of novel agents (thalidomide, bortezomib and lenalidomide) on HRQoL in MM patients, and evaluated the subsequent reporting of these HRQoL results. A relatively small body of literature addresses HRQoL data in MM patients treated with novel MM therapeutic agents: 9 manuscripts and 15 conference proceedings. The literature demonstrates the complementary value of HRQoL when assessing clinical response, progression, overall survival and toxicity. However, weaknesses and inconsistencies in analysis and presentation of HRQoL data were observed, often complicating interpretation of the impact of treatment on HRQoL in MM. Further evaluation of HRQoL in MM patients treated with novel agents is required in larger cohorts, and ideally in head-to-head comparative studies. Additionally, the development of standardised MM-specific best practice guidelines in HRQoL data collection and analysis is recommended. These would ensure that future data are more useful in guiding predictive models and clinical decisions.
ABSTRACT
SMSS J114447.77-430859.3 (z = 0.83) has been identified in the SkyMapper Southern Survey as the most luminous quasar in the last $\sim 9\, \rm Gyr$ . In this paper, we report on the ...eROSITA/Spectrum–Roentgen–Gamma (SRG) observations of the source from the eROSITA All Sky Survey, along with presenting results from recent monitoring performed using Swift, XMM-Newton, and NuSTAR. The source shows a clear variability by factors of ∼10 and ∼2.7 over time-scales of a year and of a few days, respectively. When fit with an absorbed power law plus high-energy cutoff, the X-ray spectra reveal a Γ = 2.2 ± 0.2 and $E_{\rm cut}=23^{+26}_{-5}\, \rm keV$ . Assuming Comptonization, we estimate a coronal optical depth and electron temperature of $\tau =2.5-5.3\, (5.2-8)$ and $kT=8-18\, (7.5-14)\, \rm keV$ , respectively, for a slab (spherical) geometry. The broadband SED is successfully modelled by assuming either a standard accretion disc illuminated by a central X-ray source, or a thin disc with a slim disc emissivity profile. The former model results in a black hole mass estimate of the order of $10^{10}\, \mathrm{ M}_\odot$ , slightly higher than prior optical estimates; meanwhile, the latter model suggests a lower mass. Both models suggest sub-Eddington accretion when assuming a spinning black hole, and a compact ($\sim 10\, r_{\rm g}$ ) X-ray corona. The measured intrinsic column density and the Eddington ratio strongly suggest the presence of an outflow driven by radiation pressure. This is also supported by variation of absorption by an order of magnitude over the period of $\sim 900 \ \rm d$ .
This randomized, phase III, open-label, multicenter study compared carfilzomib monotherapy against low-dose corticosteroids and optional cyclophosphamide in relapsed and refractory multiple myeloma ...(RRMM). Relapsed and refractory multiple myeloma patients were randomized (1:1) to receive carfilzomib (10-min intravenous infusion; 20 mg/m
on days 1 and 2 of cycle 1; 27 mg/m
thereafter) or a control regimen of low-dose corticosteroids (84 mg of dexamethasone or equivalent corticosteroid) with optional cyclophosphamide (1400 mg) for 28-day cycles. The primary endpoint was overall survival (OS). Three-hundred and fifteen patients were randomized to carfilzomib (n=157) or control (n=158). Both groups had a median of five prior regimens. In the control group, 95% of patients received cyclophosphamide. Median OS was 10.2 (95% confidence interval (CI) 8.4-14.4) vs 10.0 months (95% CI 7.7-12.0) with carfilzomib vs control (hazard ratio=0.975; 95% CI 0.760-1.249; P=0.4172). Progression-free survival was similar between groups; overall response rate was higher with carfilzomib (19.1 vs 11.4%). The most common grade ⩾3 adverse events were anemia (25.5 vs 30.7%), thrombocytopenia (24.2 vs 22.2%) and neutropenia (7.6 vs 12.4%) with carfilzomib vs control. Median OS for single-agent carfilzomib was similar to that for an active doublet control regimen in heavily pretreated RRMM patients.
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