A systematic cross-search for radio/infrared counterparts of XMM-Newton sources

We present a catalog of cross-correlated radio, infrared and X-ray sources using a very restrictive selection criteria with an IDL-based code developed by us. The significance of the observed coincidences was evaluated through Monte Carlo simulations of synthetic sources following a well-tested protocol. We found 3320 coincident radio/X-ray sources with a high statistical significance characterized by the sum of error-weighted coordinate differences. For 997 of them, 2MASS counterparts were found. The percentage of chance coincidences is less than 1%. X-ray hardness ratios of well-known populations of objects were used to provide a crude representation of their X-ray spectrum and to make a preliminary diagnosis of the possible nature of unidentified X-ray sources. The results support the fact that the X-ray sky is largely dominated by Active Galactic Nuclei at high galactic latitudes (|b| >= 10^\circ). At low galactic latitudes (|b| <= 10^\circ) most of unidentified X-ray sources (~94%) lie at |b| <= 2^\circ. This result suggests that most of the unidentified sources found toward the Milky Way plane are galactic objects. Well-known and unidentified sources were classified in different tables with their corresponding radio/infrared and X-ray properties. These tables are intended as a useful tool for researchers interested in particular identifications.Comment: Accepted for publication in Ap&SS. 47 pages, 10 figures. On-line material: figures and table

How tightly controlled do fluctuations in blood glucose levels need to be to reduce the risk of developing complications in people with Type 1 diabetes?

In 2011, the James Lind Alliance published a ‘top 10’ list of priorities for Type 1 diabetes research based on a structured consultation process. Whether reducing fluctuations in blood glucose can prevent long‐term microvascular and macrovascular complications was one of these. In this narrative review, 8 years on, we have assessed the updated evidence for the assertion that increased glucose variability plays an independent and clinically important role in the complications of Type 1 diabetes, over and above mean blood glucose and the effects of hypoglycaemia: the ‘glucose variability hypothesis’. Although studies in cultured cells and ex vivo vessels have been suggestive, most studies in Type 1 diabetes have been small and/or cross‐sectional, and based on ‘finger‐prick’ glucose measurements that capture glucose variability only in waking hours and are affected by missing data. A recent analysis of the Diabetes Control and Complications Trial that formally imputed missing data found no independent effect of short‐term glucose variability on long‐term complications. Few other high‐quality longitudinal studies have directly addressed the glucose variability hypothesis in Type 1 diabetes. We conclude that there is little substantial evidence to date to support this hypothesis in Type 1 diabetes, although increasing use of continuous glucose monitoring provides an opportunity to test it more definitively. In the meantime, we recommend that control of glycaemia in Type 1 diabetes should continue to focus on the sustained achievement of target HbA1c and avoidance of hypoglycaemia

How tightly controlled do fluctuations in blood glucose levels need to be to reduce the risk of developing complications in people with Type 1 diabetes?

In 2011, the James Lind Alliance published a ‘top 10’ list of priorities for Type 1 diabetes research based on a structured consultation process. Whether reducing fluctuations in blood glucose can prevent long‐term microvascular and macrovascular complications was one of these. In this narrative review, 8 years on, we have assessed the updated evidence for the assertion that increased glucose variability plays an independent and clinically important role in the complications of Type 1 diabetes, over and above mean blood glucose and the effects of hypoglycaemia: the ‘glucose variability hypothesis’. Although studies in cultured cells and ex vivo vessels have been suggestive, most studies in Type 1 diabetes have been small and/or cross‐sectional, and based on ‘finger‐prick’ glucose measurements that capture glucose variability only in waking hours and are affected by missing data. A recent analysis of the Diabetes Control and Complications Trial that formally imputed missing data found no independent effect of short‐term glucose variability on long‐term complications. Few other high‐quality longitudinal studies have directly addressed the glucose variability hypothesis in Type 1 diabetes. We conclude that there is little substantial evidence to date to support this hypothesis in Type 1 diabetes, although increasing use of continuous glucose monitoring provides an opportunity to test it more definitively. In the meantime, we recommend that control of glycaemia in Type 1 diabetes should continue to focus on the sustained achievement of target HbA1c and avoidance of hypoglycaemia

Effectiveness and cost-effectiveness of daily all-over-body application of emollient during the first year of life for preventing atopic eczema in high-risk children (The BEEP trial): protocol for a randomised controlled trial.

BACKGROUND: Atopic eczema (AE) is a common skin problem that impairs quality of life and is associated with the development of other atopic diseases including asthma, food allergy and allergic rhinitis. AE treatment is a significant cost burden for health care providers. The purpose of the trial is to investigate whether daily application of emollients for the first year of life can prevent AE developing in high-risk infants (first-degree relative with asthma, AE or allergic rhinitis). METHODS: This is a protocol for a pragmatic, two-arm, randomised controlled, multicentre trial. Up to 1400 term infants at high risk of developing AE will be recruited through the community, primary and secondary care in England. Participating families will be randomised in a 1:1 ratio to receive general infant skin-care advice, or general skin-care advice plus emollients with advice to apply daily to the infant for the first year of life. Families will not be blinded to treatment allocation. The primary outcome will be a blinded assessment of AE at 24 months of age using the UK Working Party Diagnostic Criteria for Atopic Eczema. Secondary outcomes are other definitions of AE, time to AE onset, severity of AE (EASI and POEM), presence of other allergic diseases including food allergy, asthma and hay fever, allergic sensitisation, quality of life, cost-effectiveness and safety of the emollients. Subgroup analyses are planned for the primary outcome according to filaggrin genotype and the number of first-degree relatives with AE and other atopic diseases. Families will be followed up by online and postal questionnaire at 3, 6, 12 and 18 months with a face-to-face visit at 24 months. Long-term follow-up until 60 months will be via annual questionnaires. DISCUSSION: This trial will demonstrate whether skin-barrier enhancement through daily emollient for the first year of life can prevent AE from developing in high-risk infants. If effective, this simple and cheap intervention has the potential to result in significant cost savings for health care providers throughout the world by preventing AE and possibly other associated allergic diseases. TRIAL REGISTRATION: ISRCTN registry; ID: ISRCTN21528841 . Registered on 25 July 2014

Nature of Sonoluminescence: Noble Gas Radiation Excited by Hot Electrons in "Cold" Water

We show that strong electric fields occurring in water near the surface of collapsing gas bubbles because of the flexoelectric effect can provoke dynamic electric breakdown in a micron-size region near the bubble and consider the scenario of the SBSL. The scenario is: (i) at the last stage of incomplete collapse of the bubble the gradient of pressure in water near the bubble surface has such a value and sign that the electric field arising from the flexoelectric effect exceeds the threshold field of the dynamic electrical breakdown of water and is directed to the bubble center; (ii) mobile electrons are generated because of thermal ionization of water molecules near the bubble surface; (iii) these electrons are accelerated in ''cold'' water by the strong electric fields; (iv) these hot electrons transfer noble gas atoms dissolved in water to high-energy excited states and optical transitions between these states produce SBSL UV flashes in the trasparency window of water; (v) the breakdown can be repeated several times and the power and duration of the UV flash are determined by the multiplicity of the breakdowns. The SBSL spectrum is found to resemble a black-body spectrum where temperature is given by the effective temperature of the hot electrons. The pulse energy and some other characteristics of the SBSL are found to be in agreement with the experimental data when realistic estimations are made.Comment: 11 pages (RevTex), 1 figure (.ps

The role of the supply chain in the elimination and reduction of construction rework and defects: an action research approach

Since 2007, Ireland has suffered a circa 80% reduction in construction output. This has resulted in bankruptcy, unemployment and bad debt. Contractors have attached greater emphasis to production efficiency and cost reduction as a means of survival. An Action Research (AR) strategy was used in this research to improve processes adopted by a SME contractor for the control of defects in its supply chain. It is conservatively estimated that rework, typically accounts for, circa 5% of total project costs. Rework is wasteful and presents an obvious target for improvement. The research reported here concerns the (first) diagnosing stage of the AR cycle only, involving: observation of fieldwork, analysis of contract documents, and semi-structured interviews with supply chain members. The results indicate potential for supply chain participants to identify root causes of defects and propose solutions, having regard to best practice to avoid re-occurrence. A lack of collaborative forums to contribute to production improvement was identified. Additionally the processes, used to collect, manage and disseminate data were unstructured and uncoordinated, indicating scope for developing more efficient methods. The research indicates good understanding of the potential benefits for supply chain collaboration but suggests that the tools and knowledge to collaborate are currently lacking in the SME sector

Patient experience of the process to diagnosis of chronic limb‐threatening ischaemia: a qualitative study

Introduction Delays exist at each stage of the chronic limb-threatening ischaemia (CLTI) care pathway, but there is little known about patient factors influencing delay to diagnosis of CLTI. This study explores the experiences and perceptions of patients recently diagnosed with CLTI. Methods A qualitative interview study was conducted. Sixteen participants underwent semi-structured interviews. Reflexive thematic analysis was performed on the data, aiming to understand factors which can influence delay in the CLTI care pathway. Results Five interrelated themes were developed: CLTI is a devastating condition; Reluctance to ask for help; When we are empowered we get better care; Luck plays a role in the process to diagnosis; and Vascular units can do better, comprising sub-themes of information transfer—consider communication and arterial versus non-arterial centres—proximity isn't everything. Conclusions The five themes generated from the interview data describe factors relevant to delay given meaning by participants who have lived experience of CLTI. Theme content should be noted by clinicians, commissioners and providers looking to improve care pathways for patients with CLTI. The importance of awareness for the public, patients and clinicians linked ideas in some themes and interventions to raise awareness should be considered

Energetic particle influence on the Earth's atmosphere

This manuscript gives an up-to-date and comprehensive overview of the effects of energetic particle precipitation (EPP) onto the whole atmosphere, from the lower thermosphere/mesosphere through the stratosphere and troposphere, to the surface. The paper summarizes the different sources and energies of particles, principally galactic cosmic rays (GCRs), solar energetic particles (SEPs) and energetic electron precipitation (EEP). All the proposed mechanisms by which EPP can affect the atmosphere are discussed, including chemical changes in the upper atmosphere and lower thermosphere, chemistry-dynamics feedbacks, the global electric circuit and cloud formation. The role of energetic particles in Earth’s atmosphere is a multi-disciplinary problem that requires expertise from a range of scientific backgrounds. To assist with this synergy, summary tables are provided, which are intended to evaluate the level of current knowledge of the effects of energetic particles on processes in the entire atmosphere

The symptom to assessment pathway for suspected chronic limb-threatening ischaemia (CLTI) affects quality of care: a process mapping exercise

Background: Delays in the pathway from first symptom to treatment of chronic limb-threatening ischaemia (CLTI) are associated with worse mortality and limb loss outcomes. This study examined the processes used by vascular services to provide urgent care to patients with suspected CLTI referred from the community. Methods: Vascular surgery units from various regions in England were invited to participate in a process mapping exercise. Clinical and non-clinical staff at participating units were interviewed, and process maps were created that captured key staff and structures used to create processes for referral receipt, triage and assessment at the units. Results: Twelve vascular units participated, and process maps were created after interviews with 45 participants. The units offered multiple points of access for urgent referrals from general practitioners and other community clinicians. Triage processes were varied, with units using different mixes of staff (including medical staff, podiatrists and s) and this led to processes of varying speed. The organisation of clinics to provide slots for ‘urgent’ patients was also varied, with some adopting hot clinics, while others used dedicated slots in routine clinics. Service organisation could be further complicated by separate processes for patients with and without diabetes, and because of the organisation of services regionally into vascular networks that had arterial and non-arterial centres. Conclusions: For referred patients with symptoms of CLTI, the points of access, triage and assessment processes used by vascular units are diverse. This reflects the local context and ingenuity of vascular units but can lead to complex processes. It is likely that benefits might be gained from simplification

Understanding delays in chronic limb‐threatening ischaemia care: Application of the theoretical domains framework to identify factors affecting primary care clinicians' referral behaviours

Introduction Patients in the community with suspected Chronic limb-threatening ischaemia (CLTI) should be urgently referred to vascular services for investigation and management. The Theoretical Domains Framework (TDF) allows identification of influences on health professional behaviour in order to inform future interventions. Here, the TDF is used to explore primary care clinicians' behaviours with regards to recognition and referral of CLTI. Methods Semi-structured interviews were conducted with 20 podiatrists, nurses and general practitioners in primary care. Directed content analysis was performed according to the framework method. Utterances were coded to TDF domains, and belief statements were defined by grouping similar utterances. Relevance of domains was confirmed according to belief frequency, presence of conflicting beliefs and the content of the beliefs indicating relevance. Results Nine TDF domains were identified as relevant to primary care clinicians: Knowledge, Environmental context and resources, Memory, Decision and attention processes, Beliefs about capabilities, Skills, Emotions, Reinforcement and Behavioural regulation. Relationships across domains were identified, including how primary care clinician confidence and working in a highly pressurized environment can affect behaviour. Conclusion We have identified key barriers and enablers to timely recognition and referral behaviour. These beliefs identify targets for theory-driven behaviour change interventions to reduce delays in CLTI pathways