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- Abdo, A. A., et al.
(författare)
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FERMI LARGE AREA TELESCOPE OBSERVATIONS OF MISALIGNED ACTIVE GALACTIC NUCLEI
- 2010
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Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 720:1, s. 912-922
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Tidskriftsartikel (refereegranskat)abstract
- Analysis is presented for 15 months of data taken with the Large Area Telescope (LAT) on the Fermi Gamma-ray Space Telescope for 11 non-blazar active galactic nuclei (AGNs), including seven FRI radio galaxies and four FRII radio sources consisting of two FRII radio galaxies and two steep spectrum radio quasars. The broad line FRI radio galaxy 3C 120 is reported here as a gamma-ray source for the first time. The analysis is based on directional associations of LAT sources with radio sources in the 3CR, 3CRR, and MS4 (collectively referred to as 3C-MS) catalogs. Seven of the eleven LAT sources associated with 3C-MS radio sources have spectral indices larger than 2.3 and, except for the FRI radio galaxy NGC 1275 that shows possible spectral curvature, are well described by a power law. No evidence for time variability is found for any sources other than NGC 1275. The gamma-ray luminosities of FRI radio galaxies are significantly smaller than those of the BL Lac objects detected by the LAT, whereas the gamma-ray luminosities of the FRII sources are quite similar to those of FSRQs, which could reflect different beaming factors for the gamma-ray emission. A core dominance (CD) study of the 3CRR sample indicates that sources closer to the jet axis are preferentially detected with the Fermi LAT, insofar as the gamma-ray-detected misaligned AGNs have larger CD at a given average radio flux. The results are discussed in view of the AGN unification scenario.
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| 2. |
- Singh, K. P., et al.
(författare)
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Clinical standards for the management of adverse effects during treatment for TB
- 2023
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Ingår i: The International Journal of Tuberculosis and Lung Disease. - : International Union Against Tuberculosis and Lung Disease. - 1027-3719 .- 1815-7920. ; 27:7, s. 506-519
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Adverse effects (AE) to TB treatment cause morbidity, mortality and treatment interruption. The aim of these clinical standards is to encourage best practise for the diagnosis and management of AE.METHODS: 65/81 invited experts participated in a Delphi process using a 5-point Likert scale to score draft standards.RESULTS: We identified eight clinical standards. Each person commencing treatment for TB should: Standard 1, be counselled regarding AE before and during treatment; Standard 2, be evaluated for factors that might increase AE risk with regular review to actively identify and manage these; Standard 3, when AE occur, carefully assessed and possible allergic or hypersensitiv-ity reactions considered; Standard 4, receive appropriate care to minimise morbidity and mortality associated with AE; Standard 5, be restarted on TB drugs after a serious AE according to a standardised protocol that includes active drug safety monitoring. In addition: Standard 6, healthcare workers should be trained on AE including how to counsel people undertaking TB treatment, as well as active AE monitoring and management; Standard 7, there should be active AE monitoring and reporting for all new TB drugs and regimens; and Standard 8, knowledge gaps identified from active AE monitoring should be systematically addressed through clinical research.CONCLUSION: These standards provide a person -centred, consensus-based approach to minimise the impact of AE TB treatment.
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| 7. |
- Alffenaar, J. W. C., et al.
(författare)
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Clinical standards for the dosing and management of TB drugs
- 2022
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Ingår i: The International Journal of Tuberculosis and Lung Disease. - Paris, France : International Union Against Tuberculosis and Lung Disease. - 1027-3719 .- 1815-7920. ; 26:6, s. 483-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Optimal drug dosing is important to ensure adequate response to treatment, prevent development of drug resistance and reduce drug toxicity. The aim of these clinical standards is to provide guidance on 'best practice' for dosing and management of TB drugs.Methods: A panel of 57 global experts in the fields of microbiology, pharmacology and TB care were identified; 51 participated in a Delphi process. A 5-point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all participants.Results: Six clinical standards were defined: Standard 1, defining the most appropriate initial dose for TB treatment; Standard 2, identifying patients who may be at risk of sub-optimal drug exposure; Standard 3, identifying patients at risk of developing drug-related toxicity and how best to manage this risk; Standard 4, identifying patients who can benefit from therapeutic drug monitoring (TDM); Standard 5, highlighting education and counselling that should be provided to people initiating TB treatment; and Standard 6, providing essential education for healthcare professionals. In addition, consensus research priorities were identified.Conclusion: This is the first consensus-based Clinical Standards for the dosing and management of TB drugs to guide clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment to improve patient care.
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| 8. |
- Borisov, S, et al.
(författare)
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Surveillance of adverse events in the treatment of drug-resistant tuberculosis: first global report
- 2019
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Ingår i: The European respiratory journal. - : European Respiratory Society (ERS). - 1399-3003 .- 0903-1936. ; 54:6
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Tidskriftsartikel (refereegranskat)abstract
- The World Health Organization (WHO) recommends that countries implement pharmacovigilance and collect information on active drug safety monitoring (aDSM) and management of adverse events.The aim of this prospective study was to evaluate the frequency and severity of adverse events to anti-tuberculosis (TB) drugs in a cohort of consecutive TB patients treated with new (i.e. bedaquiline, delamanid) and repurposed (i.e. clofazimine, linezolid) drugs, based on the WHO aDSM project. Adverse events were collected prospectively after attribution to a specific drug together with demographic, bacteriological, radiological and clinical information at diagnosis and during therapy. This interim analysis included patients who completed or were still on treatment at time of data collection.Globally, 45 centres from 26 countries/regions reported 658 patients (68.7% male, 4.4% HIV co-infected) treated as follows: 87.7% with bedaquiline, 18.4% with delamanid (6.1% with both), 81.5% with linezolid and 32.4% with clofazimine. Overall, 504 adverse event episodes were reported: 447 (88.7%) were classified as minor (grade 1–2) and 57 (11.3%) as serious (grade 3–5). The majority of the 57 serious adverse events reported by 55 patients (51 out of 57, 89.5%) ultimately resolved. Among patients reporting serious adverse events, some drugs held responsible were discontinued: bedaquiline in 0.35% (two out of 577), delamanid in 0.8% (one out of 121), linezolid in 1.9% (10 out of 536) and clofazimine in 1.4% (three out of 213) of patients. Serious adverse events were reported in 6.9% (nine out of 131) of patients treated with amikacin, 0.4% (one out of 221) with ethionamide/prothionamide, 2.8% (15 out of 536) with linezolid and 1.8% (eight out of 498) with cycloserine/terizidone.The aDSM study provided valuable information, but implementation needs scaling-up to support patient-centred care.
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| 12. |
- Abidi, S, et al.
(författare)
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Standardised shorter regimens versus individualised longer regimens for rifampin- or multidrug-resistant tuberculosis
- 2020
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Ingår i: The European respiratory journal. - : European Respiratory Society (ERS). - 1399-3003 .- 0903-1936. ; 55:3
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Tidskriftsartikel (refereegranskat)abstract
- We sought to compare the effectiveness of two World Health Organization (WHO)-recommended regimens for the treatment of rifampin- or multidrug-resistant (RR/MDR) tuberculosis (TB): a standardised regimen of 9–12 months (the “shorter regimen”) and individualised regimens of ≥20 months (“longer regimens”).We collected individual patient data from observational studies identified through systematic reviews and a public call for data. We included patients meeting WHO eligibility criteria for the shorter regimen: not previously treated with second-line drugs, and with fluoroquinolone- and second-line injectable agent-susceptible RR/MDR-TB. We used propensity score matched, mixed effects meta-regression to calculate adjusted odds ratios and adjusted risk differences (aRDs) for failure or relapse, death within 12 months of treatment initiation and loss to follow-up.We included 2625 out of 3378 (77.7%) individuals from nine studies of shorter regimens and 2717 out of 13 104 (20.7%) individuals from 53 studies of longer regimens. Treatment success was higher with the shorter regimen than with longer regimens (pooled proportions 80.0% versus 75.3%), due to less loss to follow-up with the former (aRD −0.15, 95% CI −0.17– −0.12). The risk difference for failure or relapse was slightly higher with the shorter regimen overall (aRD 0.02, 95% CI 0–0.05) and greater in magnitude with baseline resistance to pyrazinamide (aRD 0.12, 95% CI 0.07–0.16), prothionamide/ethionamide (aRD 0.07, 95% CI −0.01–0.16) or ethambutol (aRD 0.09, 95% CI 0.04–0.13).In patients meeting WHO criteria for its use, the standardised shorter regimen was associated with substantially less loss to follow-up during treatment compared with individualised longer regimens and with more failure or relapse in the presence of resistance to component medications. Our findings support the need to improve access to reliable drug susceptibility testing.
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| 18. |
- De Marco, B., et al.
(författare)
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The inner flow geometry in MAXI J1820+070 during hard and hard-intermediate states
- 2021
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 654
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Tidskriftsartikel (refereegranskat)abstract
- Context. We present a systematic X-ray spectral-timing study of the recently discovered, exceptionally bright black hole X-ray binary system MAXI J1820+070. Our analysis focuses on the first part of the 2018 outburst, covering the rise throughout the hard state, the bright hard and hard-intermediate states, and the transition to the soft-intermediate state. Aims. We address the issue of constraining the geometry of the innermost accretion flow and its evolution throughout an outburst. Methods. We employed two independent X-ray spectral-timing methods applied to archival NICER data of MAXI J1820+070. We first identified and tracked the evolution of a characteristic frequency of soft X-ray thermal reverberation lags (lags of the thermally reprocessed disc emission after the irradiation of variable hard X-ray photons). This frequency is sensitive to intrinsic changes in the relative distance between the X-ray source and the disc. Then, we studied the spectral evolution of the quasi-thermal component responsible for the observed thermal reverberation lags. We did so by analysing high-frequency covariance spectra, which single out spectral components that vary in a linearly correlated way on the shortest sampled timescales and are thus produced in the innermost regions of the accretion flow. Results. The frequency of thermal reverberation lags steadily increases throughout most of the outburst, implying that the relative distance between the X-ray source and the disc decreases as the source softens. However, near transition this evolution breaks, showing a sudden increase (decrease) in lag amplitude (frequency). On the other hand, the temperature of the quasi-thermal component in covariance spectra, due to disc irradiation and responsible for the observed soft reverberation lags, consistently increases throughout all the analysed observations. Conclusions. This study proposes an alternative interpretation to the recently proposed contracting corona scenario. Assuming a constant height for the X-ray source, the steady increase in the reverberation lag frequency and in the irradiated disc temperature in high-frequency covariance spectra can be explained in terms of a decrease in the disc inner radius as the source softens. The behaviour of thermal reverberation lags near transition might be related to the relativistic plasma ejections detected at radio wavelengths, suggesting a causal connection between the two phenomena. Throughout most of the hard and hard-intermediate state, the disc is consistent with being truncated (with an inner radius Rin 10 Rg), reaching close to the innermost stable circular orbit only near transition.
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