What Matters Most to Patients and Rheumatologists? A Discrete Choice Experiment in Rheumatoid Arthritis

Introduction: To determine patient and rheumatologist preferences for rheumatoid arthritis (RA) treatment attributes in Spain and to evaluate their attitude towards shared decision-making (SDM). Methods: Observational, descriptive, exploratory and cross-sectional study based on a discrete choice experiment (DCE). To identify the attributes and their levels, a literature review and two focus groups (patients [P] = 5; rheumatologists [R] = 4) were undertaken. Seven attributes with 2–4 levels were presented in eight scenarios. Attribute utility and relative importance (RI) were assessed using a conditional logit model. Patient preferences for SDM were assessed using an ad hoc questionnaire. Results: Ninety rheumatologists [52.2% women; mean years of experience 18.1 (SD: 9.0); seeing an average of 24.4 RA patients/week (SD: 15.3)] and 137 RA patients [mean age: 47.5 years (SD: 10.7); 84.0% women; mean time since diagnosis of RA: 14.2 years (SD: 11.8) and time in treatment: 13.2 years (SD: 11.2), mean HAQ score 1.2 (SD: 0.7)] participated in the study. In terms of RI, rheumatologists and RA patients viewed: time with optimal QoL: R: 23.41%/P: 35.05%; substantial symptom improvement: R: 13.15%/P: 3.62%; time to onset of treatment action: R: 16.24%/P: 13.56%; severe adverse events: R: 10.89%/P: 11.20%; mild adverse events: R: 4.16%/P: 0.91%; mode of administration: R: 25.23%/P: 25.00%; and added cost: R: 6.93%/P: 10.66%. Nearly 73% of RA patients were involved in treatment decision-making to a greater or lesser extent; however, 27.4% did not participate at all. Conclusion: Both for rheumatologists and patients, the top three decision-making drivers are time with optimal quality, treatment mode of administration and time to onset of action, although in different ranking order. Patients were willing to be more involved in the treatment decision-making process

Long-term observations of the pulsars in 47 Tucanae - II. Proper motions, accelerations and jerks

This paper is the second in a series where we report the results of the long-term timing of the millisecond pulsars (MSPs) in 47 Tucanae with the Parkes 64-m radio telescope. We obtain improved timing parameters that provide additional information for studies of the cluster dynamics: a) the pulsar proper motions yield an estimate of the proper motion of the cluster as a whole ($\mu_{\alpha}\, = \, 5.00\, \pm \, 0.14\, \rm mas \, yr^{-1}$, $\mu_{\delta}\, = \, -2.84\, \pm \, 0.12\, \rm mas \, yr^{-1}$) and the motion of the pulsars relative to each other. b) We measure the second spin-period derivatives caused by the change of the pulsar line-of-sight accelerations; 47 Tuc H, U and possibly J are being affected by nearby objects. c) For ten binary systems we now measure changes in the orbital period caused by their acceleration in the gravitational field of the cluster. From all these measurements, we derive a cluster distance no smaller than $\sim\,$4.69 kpc and show that the characteristics of these MSPs are very similar to their counterparts in the Galactic disk. We find no evidence in favour of an intermediate mass black hole at the centre of the cluster. Finally, we describe the orbital behaviour of the four "black widow" systems. Two of them, 47 Tuc J and O, exhibit orbital variability similar to that observed in other such systems, while for 47 Tuc I and R the orbits seem to be remarkably stable. It appears, therefore, that not all "black widows" have unpredictable orbital behaviour.Comment: 21 pages in journal format, 9 figures, 4 tables, accepted for publication in MNRAS, several clarifications made and typos fixe

Long-term observations of the pulsars in 47 Tucanae. I. A study of four elusive binary systems

For the past couple of decades, the Parkes radio telescope has been regularly observing the millisecond pulsars in 47 Tucanae (47 Tuc). This long-term timing program was designed to address a wide range of scientific issues related to these pulsars and the globular cluster where they are located. In this paper, the first of a series, we address one of these objectives: the characterization of four previously known binary pulsars for which no precise orbital parameters were known, namely 47 Tuc P, V, W and X (pulsars 47 Tuc R and Y are discussed elsewhere). We determined the previously unknown orbital parameters of 47 Tuc V and X and greatly improved those of 47 Tuc P and W. For pulsars W and X we obtained, for the first time, full coherent timing solutions across the whole data span, which allowed a much more detailed characterization of these systems. 47 Tuc W, a well-known tight eclipsing binary pulsar, exhibits a large orbital period variability, as expected for a system of its class. 47 Tuc X turns out to be in a wide, extremely circular, 10.9-day long binary orbit and its position is ~3.8 arcmin away from the cluster center, more than three times the distance of any other pulsar in 47 Tuc. These characteristics make 47 Tuc X a very different object with respect to the other pulsars of the cluster.Comment: Accepted for publication by MNRAS, 18 pages, 11 figure

A Cosmic Census of Radio Pulsars with the SKA

The Square Kilometre Array (SKA) will make ground breaking discoveries in pulsar science. In this chapter we outline the SKA surveys for new pulsars, as well as how we will perform the necessary follow-up timing observations. The SKA's wide field-of-view, high sensitivity, multi-beaming and sub-arraying capabilities, coupled with advanced pulsar search backends, will result in the discovery of a large population of pulsars. These will enable the SKA's pulsar science goals (tests of General Relativity with pulsar binary systems, investigating black hole theorems with pulsar-black hole binaries, and direct detection of gravitational waves in a pulsar timing array). Using SKA1-MID and SKA1-LOW we will survey the Milky Way to unprecedented depth, increasing the number of known pulsars by more than an order of magnitude. SKA2 will potentially find all the Galactic radio-emitting pulsars in the SKA sky which are beamed in our direction. This will give a clear picture of the birth properties of pulsars and of the gravitational potential, magnetic field structure and interstellar matter content of the Galaxy. Targeted searches will enable detection of exotic systems, such as the ~1000 pulsars we infer to be closely orbiting Sgr A*, the supermassive black hole in the Galactic Centre. In addition, the SKA's sensitivity will be sufficient to detect pulsars in local group galaxies. To derive the spin characteristics of the discoveries we will perform live searches, and use sub-arraying and dynamic scheduling to time pulsars as soon as they are discovered, while simultaneously continuing survey observations. The large projected number of discoveries suggests that we will uncover currently unknown rare systems that can be exploited to push the boundaries of our understanding of astrophysics and provide tools for testing physics, as has been done by the pulsar community in the past.Comment: 20 pages, 7 figures, to be published in: "Advancing Astrophysics with the Square Kilometre Array", Proceedings of Science, PoS(AASKA14)04

RANITIDINE CONTROLLED RELEASE ANTI-REFLUX SUSPENSION FOR GASTRO-OESOPHAGEAL REFLUX DISEASE AND IT’S IN VITRO EVALUATION

Objective: The aim of this work was to develop triple action controlled release anti-reflux suspension of ranitidine and its in-vitro evaluation of anti-reflux and controlled release properties. Methods: The formulation was optimized using sodium alginate as a gelling agent along with calcium carbonate, sodium bicarbonate, magnesium hydroxide, aluminium hydroxide as alkalizing agents and colloidal microcrystalline cellulose (MCC) as a suspending agent at various concentrations and arrived at an optimized formulation for its best quality attributes. To avoid initial release in water before administration, ranitidine coated MCC sphere was incorporated into powder formulation and subjected to in vitro characteristics like raft strength, acid neutralizing capacity, pH, viscosity and dissolution study. The obtained results were assessed using Minitab 17 statistical software to conclude the study design. Results: Formulation containing 300 mg of ranitidine along with 750 mg alginate has shown better anti-reflux characteristics like raft strength 18±2g, acid neutralizing capacity 17±1 mEq compared to other formulations. This formulation has also shows zero-order controlled release in the simulated gastric fluid (SGF) up to 10 h compared to the formulation without alginate. Further, to this optimized formulation has shown negligible change in the assay of ranitidine even after 3 mo at 40 °C temperature and 75% RH. Conclusion: The developed stable sustained release powder for suspension has the combined therapeutic efficacy as an antacid and anti-reflux drug suitable for the management and treatment of gastro-oesophageal reflux disease (GERD) unlike the existing drugs possessing only reflux resistance action

A Measurement of Rb using a Double Tagging Method

The fraction of Z to bbbar events in hadronic Z decays has been measured by the OPAL experiment using the data collected at LEP between 1992 and 1995. The Z to bbbar decays were tagged using displaced secondary vertices, and high momentum electrons and muons. Systematic uncertainties were reduced by measuring the b-tagging efficiency using a double tagging technique. Efficiency correlations between opposite hemispheres of an event are small, and are well understood through comparisons between real and simulated data samples. A value of Rb = 0.2178 +- 0.0011 +- 0.0013 was obtained, where the first error is statistical and the second systematic. The uncertainty on Rc, the fraction of Z to ccbar events in hadronic Z decays, is not included in the errors. The dependence on Rc is Delta(Rb)/Rb = -0.056*Delta(Rc)/Rc where Delta(Rc) is the deviation of Rc from the value 0.172 predicted by the Standard Model. The result for Rb agrees with the value of 0.2155 +- 0.0003 predicted by the Standard Model.Comment: 42 pages, LaTeX, 14 eps figures included, submitted to European Physical Journal

Measurement of the B+ and B-0 lifetimes and search for CP(T) violation using reconstructed secondary vertices

The lifetimes of the B+ and B-0 mesons, and their ratio, have been measured in the OPAL experiment using 2.4 million hadronic Z(0) decays recorded at LEP. Z(0) --> b (b) over bar decays were tagged using displaced secondary vertices and high momentum electrons and muons. The lifetimes were then measured using well-reconstructed charged and neutral secondary vertices selected in this tagged data sample. The results aretau(B+) = 1.643 +/- 0.037 +/- 0.025 pstau(Bo) = 1.523 +/- 0.057 +/- 0.053 pstau(B+)/tau(Bo) = 1.079 +/- 0.064 +/- 0.041,where in each case the first error is statistical and the second systematic.A larger data sample of 3.1 million hadronic Z(o) decays has been used to search for CP and CPT violating effects by comparison of inclusive b and (b) over bar hadron decays, No evidence fur such effects is seen. The CP violation parameter Re(epsilon(B)) is measured to be Re(epsilon(B)) = 0.001 +/- 0.014 +/- 0.003and the fractional difference between b and (b) over bar hadron lifetimes is measured to(Delta tau/tau)(b) = tau(b hadron) - tau((b) over bar hadron)/tau(average) = -0.001 +/- 0.012 +/- 0.008

Measurement of the Michel Parameters in Leptonic Tau Decays

The Michel parameters of the leptonic tau decays are measured using the OPAL detector at LEP. The Michel parameters are extracted from the energy spectra of the charged decay leptons and from their energy-energy correlations. A new method involving a global likelihood fit of Monte Carlo generated events with complete detector simulation and background treatment has been applied to the data recorded at center-of-mass energies close to sqrt(s) = M(Z) corresponding to an integrated luminosity of 155 pb-1 during the years 1990 to 1995. If e-mu universality is assumed and inferring the tau polarization from neutral current data, the measured Michel parameters are extracted. Limits on non-standard coupling constants and on the masses of new gauge bosons are obtained. The results are in agreement with the V-A prediction of the Standard Model.Comment: 32 pages, LaTeX, 9 eps figures included, submitted to the European Physical Journal

A Measurement of the Product Branching Ratio f(b->Lambda_b).BR(Lambda_b->Lambda X) in Z0 Decays

The product branching ratio, f(b->Lambda_b).BR(Lambda_b->Lambda X), where Lambda_b denotes any weakly-decaying b-baryon, has been measured using the OPAL detector at LEP. Lambda_b are selected by the presence of energetic Lambda particles in bottom events tagged by the presence of displaced secondary vertices. A fit to the momenta of the Lambda particles separates signal from B meson and fragmentation backgrounds. The measured product branching ratio is f(b->Lambda_b).BR(Lambda_b->Lambda X) = (2.67+-0.38(stat)+0.67-0.60(sys))% Combined with a previous OPAL measurement, one obtains f(b->Lambda_b).BR(Lambda_b->Lambda X) = (3.50+-0.32(stat)+-0.35(sys))%.Comment: 16 pages, LaTeX, 3 eps figs included, submitted to the European Physical Journal

The Relative Composition of the Inflammatory Infiltrate as an Additional Tool for Synovial Tissue Classification

10.1371/journal.pone.0072494PLoS ONE88-POLN