A dynamical measure of the black hole mass in a quasar 11 billion years ago

Tight relationships exist in the local Universe between the central stellar properties of galaxies and the mass of their supermassive black hole (SMBH)1-3. These suggest that galaxies and black holes co-evolve, with the main regulation mechanism being energetic feedback from accretion onto the black hole during its quasar phase4-6. A crucial question is how the relationship between black holes and galaxies evolves with time; a key epoch to examine this relationship is at the peaks of star formation and black hole growth 8-12 billion years ago (redshifts 1-3)7. Here we report a dynamical measurement of the mass of the black hole in a luminous quasar at a redshift of 2, with a look back in time of 11 billion years, by spatially resolving the broad-line region (BLR). We detect a 40-μas (0.31-pc) spatial offset between the red and blue photocentres of the Hα line that traces the velocity gradient of a rotating BLR. The flux and differential phase spectra are well reproduced by a thick, moderately inclined disk of gas clouds within the sphere of influence of a central black hole with a mass of 3.2 × 108 solar masses. Molecular gas data reveal a dynamical mass for the host galaxy of 6 × 1011 solar masses, which indicates an undermassive black hole accreting at a super-Eddington rate. This suggests a host galaxy that grew faster than the SMBH, indicating a delay between galaxy and black hole formation for some systems.

[The complete dislocation of the talus or «missing talus».]

The complete dislocation of the talus or «missing talus» corresponds to a simultaneous dislocation of the tibiotalar, talocalcaneal and talonavicular joints, without associated talar fracture. This lesion occurs as part of high energy trauma and accounts for 3 to 5 % of talus injuries. It is most frequently anterolateral and in more than 75 % of cases, this dislocation is open. Among the soft tissue lesions that are often associated with the dislocation, vascular lesions leading to avascular necrosis of the talus are found in almost 100 % of cases. This necrosis is generally well tolerated by the patient. A conservative treatment by reimplantation of the talus after debridement of the site should be performed as a first-line treatment as fast as possible. When the avascular necrosis of the talus is not well tolerated by the patient, a talectomy associated with tibiocalcaneal arthrodesis can be performed as a secondary procedure. Talectomy alone should not be done.

Test of the Einstein Equivalence Principle near the Galactic Center Supermassive Black Hole

During its orbit around the four million solar mass black hole Sagittarius A* the star S2 experiences significant changes in gravitational potential. We use this change of potential to test one part of the Einstein equivalence principle: the local position invariance (LPI). We study the dependency of different atomic transitions on the gravitational potential to give an upper limit on violations of the LPI. This is done by separately measuring the redshift from hydrogen and helium absorption lines in the stellar spectrum during its closest approach to the black hole. For this measurement we use radial velocity data from 2015 to 2018 and combine it with the gravitational potential at the position of S2, which is calculated from the precisely known orbit of S2 around the black hole. This results in a limit on a violation of the LPI of |β_{He}-β_{H}|=(2.4±5.1)×10^{-2}. The variation in potential that we probe with this measurement is six magnitudes larger than possible for measurements on Earth, and a factor of 10 larger than in experiments using white dwarfs. We are therefore testing the LPI in a regime where it has not been tested before.

Large granulation cells on the surface of the giant star π1 Gruis

Convection plays a major part in many astrophysical processes, including energy transport, pulsation, dynamos and winds on evolved stars, in dust clouds and on brown dwarfs. Most of our knowledge about stellar convection has come from studying the Sun: about two million convective cells with typical sizes of around 2,000 kilometres across are present on the surface of the Sun-a phenomenon known as granulation. But on the surfaces of giant and supergiant stars there should be only a few large (several tens of thousands of times larger than those on the Sun) convective cells, owing to low surface gravity. Deriving the characteristic properties of convection (such as granule size and contrast) for the most evolved giant and supergiant stars is challenging because their photospheres are obscured by dust, which partially masks the convective patterns. These properties can be inferred from geometric model fitting, but this indirect method does not provide information about the physical origin of the convective cells. Here we report interferometric images of the surface of the evolved giant star π¹ Gruis, of spectral type S5,7. Our images show a nearly circular, dust-free atmosphere, which is very compact and only weakly affected by molecular opacity. We find that the stellar surface has a complex convective pattern with an average intensity contrast of 12 per cent, which increases towards shorter wavelengths. We derive a characteristic horizontal granule size of about 1.2 × 10¹¹ metres, which corresponds to 27 per cent of the diameter of the star. Our measurements fall along the scaling relations between granule size, effective temperature and surface gravity that are predicted by simulations of stellar surface convection.

[History of cancer and chemotherapy before chemotherapy]

Chemotherapy stands today for cancer. In 1909, Paul Ehrlich (1854-1915) advocates the use of arsphenamine by infusion. So, he is considered as the father of chemotherapy. In fact, the first to have thought through chemotherapy was Sir Christopher Wren (1632-1723). In 1676, ideas and experiments on animals had sufficiently progressed to allow Michel Ettmuller (1644-1683) to publish the first edition of his book and several others were printed until 1753. In this book, he describes the first intravenous treatment, it sets the first indications, dosages and different products which can be used. However this method has been forgotten until the late 19th century.

RNAi-mediated germline knockdown of FABP4 increases body weight but does not improve the deranged nutrient metabolism of diet-induced obese mice

Objective:

To investigate the impact of reduced adipocyte fatty acid-binding protein 4 (FABP4) in control of body weight, glucose and lipid homeostasis in diet-induced obese (DIO) mice.

Methods:

We applied RNA interference (RNAi) technology to generate FABP4 germline knockdown mice to investigate their metabolic phenotype.

Results:

RNAi-mediated knockdown reduced FABP4 mRNA expression and protein levels by almost 90% in adipocytes of standard chow-fed mice. In adipocytes of DIO mice, RNAi reduced FABP4 expression and protein levels by 70 and 80%, respectively. There was no increase in adipocyte FABP5 expression in FABP4 knockdown mice. The knockdown of FABP4 significantly increased body weight and fat mass in DIO mice. However, FABP4 knockdown did not affect plasma glucose and lipid homeostasis in DIO mice; nor did it improve their insulin sensitivity.

Conclusion:

Our data indicate that robust knockdown of FABP4 increases body weight and fat mass without improving glucose and lipid homeostasis in DIO mice.

Imaging the Surface of Altair

Spatially resolving the surfaces of nearby stars promises to advance our knowledge of stellar physics. Using optical long-baseline interferometry, we constructed a near-infrared image of the rapidly rotating hot star Altair with a resolution of <1 milliarcsecond. The image clearly reveals the strong effect of gravity darkening on the highly distorted stellar photosphere. Standard models for a uniformly rotating star cannot explain our findings, which appear to result from differential rotation, alternative gravity-darkening laws, or both.

An integrative genomics approach to the reconstruction of gene networks in segregating populations

The reconstruction of genetic networks in mammalian systems is one of the primary goals in biological research, especially as such reconstructions relate to elucidating not only common, polygenic human diseases, but living systems more generally. Here we propose a novel gene network reconstruction algorithm, derived from classic Bayesian network methods, that utilizes naturally occurring genetic variations as a source of perturbations to elucidate the network. This algorithm incorporates relative transcript abundance and genotypic data from segregating populations by employing a generalized scoring function of maximum likelihood commonly used in Bayesian network reconstruction problems. The utility of this novel algorithm is demonstrated via application to liver gene expression data from a segregating mouse population. We demonstrate that the network derived from these data using our novel network reconstruction algorithm is able to capture causal associations between genes that result in increased predictive power, compared to more classically reconstructed networks derived from the same data.

Role of PPARs in the regulation of obesity-related insulin sensitivity and inflammation

Peroxisome proliferator-activated receptors (PPARs) are nuclear receptor isoforms with key roles in the regulation of lipid and glucose metabolism. Synthetic ligands for PPAR gamma (and PPAR alpha) have effects of promoting insulin sensitization in the context of obesity. Recent evidence suggests that activation of PPAR delta might produce similar effects. Both PPAR gamma and PPAR alpha have also been shown to produce selected anti-inflammatory effects and to reduce the progression of atherosclerosis in animals (alpha and gamma) or in humans (alpha). Mechanisms underlying insulin-sensitizing effects are complex. For PPAR gamma, direct effects on adipose tissue lipid metabolism with secondary benefits in liver and/or muscle (lipid levels and insulin signaling) have been implicated. For PPAR alpha, accelerated lipid catabolism may contribute to reduced muscle or liver 'steatosis'. Anti-inflammatory mechanisms as contributors to the beneficial metabolic effects of PPAR activation are also worth considering for the following reasons: (1) obesity and insulin resistance are associated with a proinflammatory milieu. (2) PPAR gamma has clear effects to oppose the effects of tumor necrosis factor-alpha (TNFalpha) in adipocytes. (3) effects of PPAR ligands on cytokine-mediated signaling (eg via NF-kappa B) may be expected to enhance insulin action. (4) Adipose production of several molecules that are implicated as markers or mediators of inflammation is reduced. (5) In humans, treatment with either PPAR alpha or PPAR gamma agonists has been shown to reduce circulating levels of proteins that serve as markers of inflammation. (6) Adiponectin, a fat-derived circulating factor that has been implicated as having anti-inflammatory activity, is induced by PPAR gamma agonism.

Anterior elbow dislocation with recurrent instability

Anterior elbow dislocations are often associated with severe soft tissue lesions. The mechanism of dislocation is usually an anteriorly directed blow on the proximal ulna after a fall on a flexed elbow. Simple anterior elbow dislocations are traditionally treated by closed reduction followed by a short period of immobilisation. Fracture-dislocations are usually unstable after reduction and necessitate surgical management. The authors report a case of acute anterior dislocation with a concomitant radial head fracture that was complicated by recurrent instability. The literature is reviewed to discuss a treatment strategy.

Measurement of B --> K*gamma branching fractions and charge asymmetries

The branching fractions of the exclusive decays B0-->K(*0)gamma and B+-->K(*+)gamma are measured from a sample of (22.74+/-0.36)x10(6) BB decays collected with the BABAR detector at the PEP-II asymmetric e(+)e(-) collider. We find B (B0-->K(*0)gamma) = [4.23+/-0.40(stat)+/-0.22(syst)]x10(-5), B(B+-->K(*+)gamma) = [3.83+/-0.62(stat)+/-0.22(syst)]x10(-5) and constrain the CP-violating charge asymmetry to be -0.170<A(CP)(B-->K(*)gamma)<0.082 at 90% C.L.

Hyperglycemia-induced production of acute phase reactants in adipose tissue

Chronic elevation of systemic levels of acute phase reactants and inflammatory cytokines found in patients with diabetes and the often-associated metabolic syndrome X (hypertriglyceridemia, low serum high density lipoprotein cholesterol, hypertension, and accelerated atherosclerosis) may be responsible for the increased incidence of cardiovascular problems in this population. Here we examine the contribution of adipose tissue to the systemic elevation of acute phase reactants associated with chronic hyperglycemia. We demonstrate that adipose tissue expresses a number of acute phase reactants at high levels, including serum amyloid A3 (SAA3), alphal-acid glycoprotein, the lipocalin 24p3 as well as plasminogen activator inhibitor-1 (PAI-1). Additionally, we show SAA3 is expressed at low levels under normal conditions but in the diabetic state is dramatically up-regulated in adipose tissue while down-regulated in liver. Furthermore, pro-inflammatory stimuli and high glucose can lead to the induction of SAA3 in adipose tissue in vivo as well as in the 3T3-L1 adipocyte cell line. Adipose tissue may therefore play a major role in the pathogenic sequelae of Type II diabetes, in particular the cardiovascular problems associated with prolonged hyperglycemia.

Observation of CP violation in the B(0) meson system

We present an updated measurement of time-dependent CP-violating asymmetries in neutral B decays with the BABAR detector at the PEP-II asymmetric B Factory at SLAC. This result uses an additional sample of Upsilon(4S) decays collected in 2001, bringing the data available to 32 x 10(6) BB macro pairs. We select events in which one neutral B meson is fully reconstructed in a final state containing charmonium and the flavor of the other neutral B meson is determined from its decay products. The amplitude of the CP-violating asymmetry, which in the standard model is proportional to sin2 beta, is derived from the decay time distributions in such events. The result sin2 beta = 0.59+/-0.14(stat)+/-0.05(syst) establishes CP violation in the B(0) meson system. We also determine absolute value of lambda = 0.93+/-0.09(stat)+/-0.03(syst), consistent with no direct CP violation.

Differential gene regulation in human versus rodent hepatocytes by peroxisome proliferator-activated receptor (PPAR) alpha. PPAR alpha fails to induce peroxisome proliferation-associated genes in human cells independently of the level of receptor expresson

We compared the ability of rat and human hepatocytes to respond to fenofibric acid and a novel potent phenylacetic acid peroxisome proliferator-activated receptor (PPAR) alpha agonist (compound 1). Fatty acyl-CoA oxidase (FACO) activity and mRNA were increased after treatment with either fenofibric acid or compound 1 in rat hepatocytes. In addition, apolipoprotein CIII mRNA was decreased by both fenofibric acid and compound 1 in rat hepatocytes. Both agonists decreased apolipoprotein CIII mRNA in human hepatocytes; however, very little change in FACO activity or mRNA was observed. Furthermore, other peroxisome proliferation (PP)-associated genes including peroxisomal 3-oxoacyl-CoA thiolase (THIO), peroxisomal enoyl-CoA hydratase/3-hydroxyacyl-CoA dehydrogenase (HD), peroxisomal membrane protein-70 (PMP-70) were not regulated by PPAR alpha agonists in human hepatocytes. Moreover, other genes that are regulated by PPAR alpha ligands in human hepatocytes such as mitochondrial HMG-CoA synthase and carnitine palmitoyl transferase-1 (CPT-1) were also regulated in HepG2 cells by PPAR alpha agonists. Several stably transfected HepG2 cell lines were established that overexpressed human PPAR alpha to levels between 6- and 26-fold over normal human hepatocytes. These PPAR alpha-overexpressing cells had higher basal mRNA levels of mitochondrial HMG-CoA synthase and CPT-1; however, basal FACO mRNA levels and other PP-associated genes including THIO, HD, or PMP-70 mRNA were not substantially affected. In addition, FACO, THIO, HD, and PMP-70 mRNA levels did not increase in response to PPAR alpha agonist treatment in the PPAR alpha-overexpressing cells, although mitochondrial HMG-CoA synthase and CPT-1 mRNAs were both induced. These results suggest that other factors besides PPAR alpha levels determine the species-specific response of human and rat hepatocytes to the induction of PP.

Integrated Optics for Astronomical Interferometry. III. Optical Validation of a Planar Optics Two-Telescope Beam Combiner

The optical characterization of a fiber-connected planar optics beam combiner dedicated to astronomical interferometry for two telescopes is presented. The beam combiner, fully integrated on a single 5 mm x 40 mm glass chip, is tested as the central part of an astronomical instrument. The single-mode waveguides are made by silver-ion-exchange technology upon glass substrates and provide spatial filtering, which improves the visibility measurement accuracy by selecting only the fundamental mode of the beams at the telescope focal plane. A global optical throughput of 43% is measured, and the sources of losses are identified and examined in detail. Solutions for improving this throughput are proposed. High and stable contrasts are obtained with a 1.55-mum laser diode (?96%) and with a white-light source (~92%) in the astronomical H filter (1.43 mum; 1.77 mum). The need for accurate control of differential instrumental polarization is demonstrated. In this context the intrinsic polarization-maintaining property of the planar optics component is characterized. This validation of the important potential uses of integrated planar optics should be valuable for future design of optical telescope arrays.

Ultrasonography as an aid to diagnosis and treatment in a rural African hospital: a prospective study of 1,119 cases

The aim of this study was to assess the utility of ultrasonography in a rural African hospital in Cameroon with scarce resources. A prospective questionnaire was administered and completed for each of the 1,119 consecutive cases included in the study. Among these 1,119 cases, the diagnosis made by clinicians and by echography could be verified by another means for 323 patients. Ultrasonography showed abnormal findings in 78% of the cases. In the group of 323 patients in which the diagnosis made by echography could be verified, it was correct in 95.4% of the cases, erroneous in 4.6% of the cases, judged useful for diagnosis in 67.8% of the cases, and not contributive in 27.6% of the cases. Ultrasonography was judged useful when treatment was decided upon in 62% of the cases. This study demonstrated the value of ultrasonography in the context of a developing country and the conditions by which its use could be delineated.

[Hepatitis C: from pathogenesis to treatment]

Hepatitis C virus (HCV) belongs to the greater family of Flaviviridae. It is probably responsible for the majority of NANB hepatitis. Serologic evidence in the term of antibodies against certain parts of HCV persists in 60 to 100% of patients with NANB hepatitis after blood transfusion. The evidence for the existence of a second virus responsible for NANB has not been excluded as inactivation-studies would suggest. HCV is also a common cause for sporadic acute hepatitis. It is the purpose of this article to present diagnosis, course and treatment of this form of hepatitis.

[Psychiatric morbidity in the medical service of a non-university general hospital]

The aim of this study was to assess the nature and extent of psychiatric pathology in the internal medicine service of a small general hospital. During a three months' period, 315 consecutive patients were enrolled in this prospective study. 92 persons (29% of the admitted patients) exhibited a psychiatric disorder which was recognized by the internists and then discussed with the psychiatric team. The disorders were diagnosed according to the DSM-III-R classification. The age of the patients with psychiatric disorders was lower (median 56 years versus 63 years) and women were more numerous. In 75% of cases the psychiatric problem influenced medical management. A psychiatric consultation was indicated in 12%. Concerning the nature of this pathology, 29% of the 120 diagnoses established in these 92 patients were linked to the use of psychoactive substances; alcohol and male sex predominated. Among the women, anxio-depressive and personality disorders predominated. Two-thirds of the patients were sent to a general practitioner following their discharge from the hospital. The role of the general hospital as a site of care for these patients is discussed. It can be considered positive if a good climate of cooperation exists with the psychiatric team.

[Blood pressure measurement during tachyarhythmia: validation of a graduated measuring technique with an intra-arterial technique]

Use of the usual technique to measure blood pressure is known to be unsatisfactory in tachyarrhythmia. An easy and non-invasive technique, called the stage by stage method, has therefore been proposed. The aim of the present study is to verify the precision of this method by comparison with intraarterial measurements. The study was performed in 9 tachyarrhythmic patients with heart rate over 90/min and wide systolic pulse amplitude variations. For systolic pressure, the results show an excellent correlation between the blood pressure values obtained by the stage by stage method and those obtained by intraarterial measurements (r = 0.99; p > 0.01). For diastolic pressure, the best practical approximation is the value of the last stage before all sounds have disappeared plus 5 mm Hg. We conclude that the bedside stage by method is worth performing in patients presenting with tachyarrhythmia and wide systolic pressure variations from one systole to the other.

Historia morbi atrocis--2 new cases of spontaneous rupture of the esophagus (Boerhaave syndrome)

We report the case of two patients hospitalized within a few weeks of each other and both presenting with spontaneous rupture of the esophagus whose evolution proved fatal. We take the opportunity of drawing attention to this rare and challenging disease, which is often diagnosed too late.

Right arm involvement and pain extension can help to differentiate coronary diseases from chest pain of other origin: a prospective emergency ward study of 278 consecutive patients admitted for chest pain

In a prospective study of 278 consecutive patients admitted to an emergency ward for chest pain, the 115 clinical and paraclinical parameters available at the time of admission were evaluated by computer comparison with the final diagnoses. The most valuable items for making the diagnosis were classified according to their sensitivity, specificity and predictive value. Among the 278 patients, 100 individuals had myocardial infarctions (MI), 47 had unstable angina, 25 had stable angina and 106 patients had a non-coronary disease. The twelve most sensitive items for distinguishing MI from other conditions were the following: sudden onset of pain (70%); duration of more than 60 min (88%); constriction and squeezing (79%); oppression (75%); prior anginal attacks (61%); sex male (72%); age over 60 years (74%); abnormal heart auscultation (62%); abnormal electrocardiogram (ECG) (98%); segment (ST) disturbances (86%); increased glucose level (77%); CKMB fraction greater than 6% of total creatine kinase (CK) level (63%). Among the twelve most specific items, also with the best positive predictive value, irradiation in the right arm is of most importance; among the 51 patients with right arm involvement, 48 suffered from a coronary disease and 41 from a myocardial infarction. The largest extension of pain was reported in the latter group. It is concluded that chest pain with a wide irradiation involving the right arm strongly suggests that a myocardial infarction is ongoing.

Cerebrospinal fluid lactate in 78 cases of adult meningitis

In a retrospective study of 78 cases of adult meningitis, the CSF lactate was measured on the first spinal tap (ST); 25 had a bacterial meningitis, 28 a viral meningitis; 22 other cases had been on antibiotics prior to admission; 3 cases had meningitis of rare aetiology. The median CSF lactate level among the 25 bacterial cases amounted to 13.6 mmol/l (range: 3.5-24.5) whereas it remained low in the 28 viral cases: 2.7 mmol/l (range: 1.4-4.2). These differences are highly significant. The comparison of the CSF lactate level with the other tests routinely performed showed that the CSF lactate level had the highest sensitivity, specificity and predictive values. The CSF lactate level on the first ST had no prognostic value, but a rapid decrease of the CSF lactate during the treatment is indicative of good prognosis. Among the pretreated cases, a high lactate level could be an indication that bacteria were the causal agents. In conclusion, the measurement of the CSF lactate, quickly performed and inexpensive, is worth performing when a meningitis is suspected, as it appears to be the best way of distinguishing bacterial from non-bacterial meningitis.

[Practical consequences of ambulatory registration of blood pressure]

Ambulatory recorded blood pressure (BP) has been shown to correlate better with secondary target-organ damage than casual blood pressure, and has demonstrated that ambulatory BP cannot be predicted on the basis of casual BP measurements by the physician. To assess whether these recordings have practical repercussions on diagnosis and treatment, 182 patients (74 female/108 male) aged 16 to 84 years (mean 51.9 +/- 14.8 SD), all referred by their physicians to the investigation unit of the hospital, underwent ambulatory BP measurements using the portable Remler M2000 BP recorder. The mean systolic blood pressure was above 140 mm Hg in 96 patients (53%) and the mean diastolic blood pressure above 90 mm Hg in 81 (45%). -3 to 9 months later, multiple choice questionnaires were sent to the 34 physicians who had referred patients and had meanwhile received recording results without comments. The questions were designed ascertain the indication for BP recording in each patient and the changes undertaken in the light of the results. In 27% of the cases the assumed diagnosis was not confirmed and in 40.8% of the cases the planned or prescribed treatment was obviated or withdrawn. This percentage corresponds to the data previously published describing 30 to 40% of patients as hypertensive only in the physician's office. This latter percentage shows that ambulatory BP recordings contribute to the practical assessment of patients with mild to moderate elevation of office BP.

[Pressure determination in tachycardia. Improved approximation using a stage-by-stage technic]

In heart arrhythmia, and especially tachyarrhythmia, blood pressure measurements are known to be approximate. The current recommendations proved to be unsatisfactory in a group of 23 patients in whom they were tested systematically. A simple atraumatic bedside method, developed from the standard method of measuring blood pressure by sphygmomanometer and called the "stage by stage" measurement method, is presented.

[Syncope of undetermined origin]

A 48-year-old man with no significant medical history suddenly suffered, when walking, a sensation of thoracic pressure and severe dyspnea, soon followed by loss of consciousness without seizure. On hospitalization the following abnormal features were found: moderate cyanosis and cutaneous erythematous lesions; a blood gas analysis with moderate hypoxemia and slight compensated metabolic acidosis; and on chest X-ray a small band of atelectasis of the left lower lobe. An ECG, a continuous 24 hours Holter ECG recording and pulmonary scintigraphy were within normal limits. During the next few days the patient had several syncopal attacks without detectable cause. Two biopsies were then performed which established the diagnosis.