Second Data Release from the European Pulsar Timing Array: Challenging the Ultralight Dark Matter Paradigm.

Pulsar Timing Array experiments probe the presence of possible scalar or pseudoscalar ultralight dark matter particles through decade-long timing of an ensemble of galactic millisecond radio pulsars. With the second data release of the European Pulsar Timing Array, we focus on the most robust scenario, in which dark matter interacts only gravitationally with ordinary baryonic matter. Our results show that ultralight particles with masses 10^{-24.0} eV≲m≲10^{-23.3} eV cannot constitute 100% of the measured local dark matter density, but can have at most local density ρ≲0.3 GeV/cm^{3}.

Management of liver failure in a haemophilic patient co-infected with human immunodeficiency and hepatitis C viruses.

We present a case of liver failure in a haemophilic patient coinfected with transfusion acquired human immunodeficiency (HIV) and hepatitis C (HCV) viruses. The case illustrates the interaction of multiple viruses with accelerated progression to end stage liver disease and ultimately death. We report the impact on the patient management of two liver biopsies, which diagnosed an initial drug induced hepatitis and subsequently an atypical HCV related hepatitis.

Clinical experience with the use of clotting factor concentrates in oral anticoagulation reversal.

We report the clinical experience of a large Haemophilia Centre and Haemostasis Unit in reversing oral anticoagulation (OAC) using clotting factor concentrates. This is a retrospective study extending over 2 years (January 1996-December 1997). Reversal was performed using a combination of factor IX and factor VII concentrates administered by intravenous infusion. in a dose varying between 12 i.u./kg and 50 i.u./kg. We identified 20 episodes of OAC reversal in 18 patients, with a prevalence of 10 reversal episodes/1000 OAC patients/year. The median age was 77 years old (range 53-92 years). Indications for OAC reversal were divided into major bleeds (muscle haematoma [9], haematuria [3], subarachnoid haemorrhage [1], oesophageal bleeding [1], haemoptysis [1], haemarthrosis [1]); minor bleeds (extensive bruising [9], epistaxis [3], oral cavity bleeding [1]); and emergency invasive investigation (2). Pre-reversal, the international normalized ration (INR) was greater than 6.0 in 15/18 patients. Post-infusion. there was an immediate reduction in the INR towards normal (mean 1.3; range 1.1-2.3). There were no thrombotic complications or other adverse effects. The median use of factor 9 A concentrate was 2300 units/patient (range 570-4195), at a cost of 645 Pounds/patient and for factor VII concentrate 2200 units/patient (range 815-3630), at a cost of 664 Pounds/patient. Clotting factor concentrates provide a safe, rapid and effective means for OAC reversal and although expensive it is the treatment of choice in the over anticoagulated, bleeding patient.