Different Evolutionary Stages in the Massive Star Forming Region S255 Complex

To understand evolutionary and environmental effects during the formation of high-mass stars, we observed three regions of massive star formation at different evolutionary stages that reside in the same natal molecular cloud. Methods. The three regions S255IR, S255N and S255S were observed at 1.3 mm with the Submillimeter Array (SMA) and followup short spacing information was obtained with the IRAM 30m telescope. Near infrared (NIR) H + K-band spectra and continuum observations were taken for S255IR with VLT-SINFONI to study the different stellar populations in this region. The combination of millimeter (mm) and near infrared data allow us to characterize different stellar populations within the young forming cluster in detail. While we find multiple mm continuum sources toward all regions, their outflow, disk and chemical properties vary considerably. The most evolved source S255IR exhibits a collimated bipolar outflow visible in CO and H2 emission, the outflows from the youngest region S255S are still small and rather confined in the regions of the mm continuum peaks. Also the chemistry toward S255IR is most evolved exhibiting strong emission from complex molecules, while much fewer molecular lines are detected in S255N, and in S255S we detect only CO isotopologues and SO lines. Also, rotational structures are found toward S255N and S255IR. Furthermore, a comparison of the NIR SINFONI and mm data from S255IR clearly reveal two different (proto) stellar populations with an estimated age difference of approximately 1 Myr. A multi-wavelength spectroscopy and mapping study reveals different evolutionary phases of the star formation regions. We propose the triggered outside-in collapse star formation scenario for the bigger picture and the fragmentation scenario for S255IR.Comment: 23 pages,25 figures, accepted by A&

Sequential Star Formation in RCW 34: A Spectroscopic Census of the Stellar Content of High-mass Star-forming Regions

We present VLT/SINFONI integral field spectroscopy of RCW 34 along with Spitzer/IRAC photometry of the surroundings. RCW 34 consists of three different regions. A large bubble has been detected on the IRAC images in which a cluster of intermediate- and low-mass class II objects is found. At the northern edge of this bubble, an HII region is located, ionized by 3 OB stars. Intermediate mass stars (2 - 3 Msun) are detected of G- and K- spectral type. These stars are still in the pre-main sequence (PMS) phase. North of the HII region, a photon-dominated region is present, marking the edge of a dense molecular cloud traced by H2 emission. Several class 0/I objects are associated with this cloud, indicating that star formation is still taking place. The distance to RCW 34 is revised to 2.5 +- 0.2 kpc and an age estimate of 2 - 1 Myrs is derived from the properties of the PMS stars inside the HII region. The most likely scenario for the formation of the three regions is that star formation propagates from South to North. First the bubble is formed, produced by intermediate- and low-mass stars only, after that, the HII region is formed from a dense core at the edge of the molecular cloud, resulting in the expansion as a champagne flow. More recently, star formation occurred in the rest of the molecular cloud. Two different formation scenarios are possible: (a) The bubble with the cluster of low- and intermediate mass stars triggered the formation of the O star at the edge of the molecular cloud which in turn induces the current star-formation in the molecular cloud. (b) An external triggering is responsible for the star-formation propagating from South to North. [abridged]Comment: 19 pages, 11 figures, accepted by Ap

Length of stay and associated costs of obesity related hospital admissions in Ireland

BACKGROUND: Obesity is the cause of other chronic diseases, psychological problems, obesity shortens the lifespan and puts strain on health systems. The risk associated with childhood obesity in particular, which will accelerate the development of adult morbidity and mortality, has been identified as an emerging public health problem. METHODS: To estimate the length of stay and associated hospital costs for obesity related illnesses a cost of illness study was set up. All discharges from all acute hospitals in the Republic of Ireland from 1997 to 2004 with a principal or secondary diagnostic code for obesity for all children from 6 to 18 years of age and for adults were collected.A discharge frequency was calculated by dividing obesity related discharges by the total number of diagnoses (principal and secondary) for each year. The hospital costs related to obesity was calculated based on the total number of days care. RESULTS: The discharge frequency of obesity related conditions increased from 1.14 in 1997 to 1.49 in 2004 for adults and from 0.81 to 1.37 for children. The relative length of stay (number of days in care for obesity related conditions per 1000 days of hospital care given) increased from 1.47 in 1997 to 4.16 in 2004 for children and from 3.68 in 1997 to 6.74 in 2004 for adults.Based on the 2001 figures for cost per inpatient bed day, the annual hospital cost was calculated to be 4.4 Euromillion in 1997, increasing to 13.3 Euromillion in 2004. At a 20% variable hospital cost the cost ranges from 0.9 Euromillion in 1997 to 2.7 Euromillion in 2004; a 200% increase. CONCLUSION: The annual increase in the proportion of hospital discharges related to obesity is alarming. This increase is related to a significant increase in economic costs. This paper emphasises the need for action at an early stage of life. Health promotion and primary prevention of obesity should be high on the political agenda

Circumstellar disks and planets. Science cases for next-generation optical/infrared long-baseline interferometers

We present a review of the interplay between the evolution of circumstellar disks and the formation of planets, both from the perspective of theoretical models and dedicated observations. Based on this, we identify and discuss fundamental questions concerning the formation and evolution of circumstellar disks and planets which can be addressed in the near future with optical and infrared long-baseline interferometers. Furthermore, the importance of complementary observations with long-baseline (sub)millimeter interferometers and high-sensitivity infrared observatories is outlined.Comment: 83 pages; Accepted for publication in "Astronomy and Astrophysics Review"; The final publication is available at http://www.springerlink.co

Study protocol for Women of Color and Asthma Control: A randomized controlled trial of an asthma-management intervention for African American women

<p>Abstract</p> <p>Background</p> <p>Among adults in the United States, asthma prevalence is disproportionately high among African American women; this group also experiences the highest levels of asthma-linked mortality and asthma-related health care utilization. Factors linked to biological sex (e.g., hormonal fluctuations), gender roles (e.g., exposure to certain triggers) and race (e.g., inadequate access to care) all contribute to the excess asthma burden in this group, and also shape the context within which African American women manage their condition. No prior interventions for improving asthma self-management have specifically targeted this vulnerable group of asthma patients. The current study aims to evaluate the efficacy of a culturally- and gender-relevant asthma-management intervention among African American women.</p> <p>Methods/Design</p> <p>A randomized controlled trial will be used to compare a five-session asthma-management intervention with usual care. This intervention is delivered over the telephone by a trained health educator. Intervention content is informed by the principles of self-regulation for disease management, and all program activities and materials are designed to be responsive to the specific needs of African American women. We will recruit 420 female participants who self-identify as African American, and who have seen a clinician for persistent asthma in the last year. Half of these will receive the intervention. The primary outcomes, upon which the target sample size is based, are number of asthma-related emergency department visits and overnight hospitalizations in the last 12 months. We will also assess the effect of the intervention on asthma symptoms and asthma-related quality of life. Data will be collected via telephone survey and medical record review at baseline, and 12 and 24 months from baseline.</p> <p>Discussion</p> <p>We seek to decrease asthma-related health care utilization and improve asthma-related quality of life in African American women with asthma, by offering them a culturally- and gender-relevant program to enhance asthma management. The results of this study will provide important information about the feasibility and value of this program in helping to address persistent racial and gender disparities in asthma outcomes.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01117805">NCT01117805</a></p

Higher body mass index may induce asthma among adolescents with pre-asthmatic symptoms: a prospective cohort study

<p>Abstract</p> <p>Background</p> <p>Limited studies have prospectively examined the role of body mass index (BMI) as a major risk factor for asthma during adolescence. This study investigates whether BMI is associated with increased risk of developing physician-diagnosed asthma during 12-month follow-up among adolescents with undiagnosed asthma-like symptoms at baseline.</p> <p>Methods</p> <p>A total of 4,052 adolescents with undiagnosed asthma-like symptoms at baseline were re-examined after a 12-month follow-up. Asthma cases were considered confirmed only after diagnosis by a physician based on the New England core and International Study of Asthma and Allergies in Childhood (ISAAC) criteria video questionnaires, and accompanying pulmonary function tests. Logistic regression analyses were used to evaluate the relationship of BMI and the risk of acquiring asthma.</p> <p>Results</p> <p>The results indicated that girls with higher BMI were at an increased risk of developing asthma during the 12-month follow-up. The odds ratios for girls developing physician-diagnosed asthma were 1.75 (95% CI = 1.18-2.61) and 1.12 (95% CI = 0.76-1.67), respectively, for overweight and obesity as compared to the normal weight reference group after adjustment for other covariates. A similar relationship was not observed for overweight and obese boys who were also significantly more active than their female counterparts.</p> <p>Conclusions</p> <p>Increased BMI exaggerates the risk of acquiring asthma in symptomatic adolescent females but not in adolescent males. Thus, gender is an important modifier of BMI-related asthma risk. Additional research will be required to determine whether the increased asthma risk results from genetic, physiological or behavioural differences.</p

Gene-Gene and Gene-Environmental Interactions of Childhood Asthma: A Multifactor Dimension Reduction Approach

Background: The importance of gene-gene and gene-environment interactions on asthma is well documented in literature, but a systematic analysis on the interaction between various genetic and environmental factors is still lacking. Methodology/Principal Findings: We conducted a population-based, case-control study comprised of seventh-grade children from 14 Taiwanese communities. A total of 235 asthmatic cases and 1,310 non-asthmatic controls were selected for DNA collection and genotyping. We examined the gene-gene and gene-environment interactions between 17 singlenucleotide polymorphisms in antioxidative, inflammatory and obesity-related genes, and childhood asthma. Environmental exposures and disease status were obtained from parental questionnaires. The model-free and non-parametrical multifactor dimensionality reduction (MDR) method was used for the analysis. A three-way gene-gene interaction was elucidated between the gene coding glutathione S-transferase P (GSTP1), the gene coding interleukin-4 receptor alpha chain (IL4Ra) and the gene coding insulin induced gene 2 (INSIG2) on the risk of lifetime asthma. The testing-balanced accuracy on asthma was 57.83 % with a cross-validation consistency of 10 out of 10. The interaction of preterm birth and indoor dampness had the highest training-balanced accuracy at 59.09%. Indoor dampness also interacted with many genes, including IL13, beta-2 adrenergic receptor (ADRB2), signal transducer and activator of transcription 6 (STAT6). We also used likelihood ratio tests for interaction and chi-square tests to validate our results and all tests showed statistical significance