A qualitative analysis of the effectiveness of telehealthcare devices (i) are they meeting the needs of end-users?

Background: There are many telehealthcare devices currently available ranging from personal alarms, automated pill dispensers and fall detectors through to monitoring devices for blood sugar, blood pressure and heart rate. Many devices remain unused once acquired or shortly after a period of initial use. Methods: The study used a qualitative design involving focus groups and interviews. End users’ opinions of telehealthcare devices were examined through focus groups along with the views of market experts and key supply chain players through telephone interviews to ascertain their views on the devices. The data were recorded, transcribed and analysed thematically. Results: Amongst the wide range of user issues associated with telehealthcare devices two themes merited particular attention: design characteristics and the lack of focus on end-user needs. Our findings suggested that few telehealthcare devices appear to be developed based on the principles of user-centred design. Consequently, many were non-intuitive to use, with the majority of the focus group participants not recognising the purpose of the devices from their appearance alone. Conclusions: Greater input from real end-users rather than “proxy” users such as carers, professional users or technologists is required when developing telehealthcare devices or systems. Design should be focussed on intuitive use to enable the user to successfully achieve what is required from the devices. This may require the existing supplier—driven market focus to be challenged, but could improve the contribution of technology to improving healthcare

A Detection of Cosmological 21 cm Emission from CHIME in Cross-correlation with eBOSS Measurements of the Lyman-α\alpha Forest

We report the detection of 21 cm emission at an average redshift $\bar{z} = 2.3$ in the cross-correlation of data from the Canadian Hydrogen Intensity Mapping Experiment (CHIME) with measurements of the Lyman-$\alpha$ forest from eBOSS. Data collected by CHIME over 88 days in the $400-500$~MHz frequency band ($1.8 < z < 2.5$) are formed into maps of the sky and high-pass delay filtered to suppress the foreground power, corresponding to removing cosmological scales with $k_\parallel \lesssim 0.13\ \text{Mpc}^{-1}$ at the average redshift. Line-of-sight spectra to the eBOSS background quasar locations are extracted from the CHIME maps and combined with the Lyman-$\alpha$ forest flux transmission spectra to estimate the 21 cm-Lyman-$\alpha$ cross-correlation function. Fitting a simulation-derived template function to this measurement results in a $9\sigma$ detection significance. The coherent accumulation of the signal through cross-correlation is sufficient to enable a detection despite excess variance from foreground residuals $\sim6-10$ times brighter than the expected thermal noise level in the correlation function. These results are the highest-redshift measurement of \tcm emission to date, and set the stage for future 21 cm intensity mapping analyses at $z>1.8$

CHIME/FRB Discovery of 25 Repeating Fast Radio Burst Sources

We present the discovery of 25 new repeating fast radio burst (FRB) sources found among CHIME/FRB events detected between 2019 September 30 and 2021 May 1. The sources were found using a new clustering algorithm that looks for multiple events co-located on the sky having similar dispersion measures (DMs). The new repeaters have DMs ranging from $\sim$220 pc cm$^{-3}$ to $\sim$1700 pc cm$^{-3}$, and include sources having exhibited as few as two bursts to as many as twelve. We report a statistically significant difference in both the DM and extragalactic DM (eDM) distributions between repeating and apparently nonrepeating sources, with repeaters having lower mean DM and eDM, and we discuss the implications. We find no clear bimodality between the repetition rates of repeaters and upper limits on repetition from apparently nonrepeating sources after correcting for sensitivity and exposure effects, although some active repeating sources stand out as anomalous. We measure the repeater fraction and find that it tends to an equilibrium of $2.6_{-2.6}^{+2.9}$% over our exposure thus far. We also report on 14 more sources which are promising repeating FRB candidates and which merit follow-up observations for confirmation.Comment: Submitted to ApJ. Comments are welcome and follow-up observations are encouraged

Sub-second periodicity in a fast radio burst

Fast radio bursts (FRBs) are millisecond-duration flashes of radio waves that are visible at distances of billions of light-years. The nature of their progenitors and their emission mechanism remain open astrophysical questions. Here we report the detection of the multi-component FRB 20191221A and the identification of a periodic separation of 216.8(1) ms between its components with a significance of 6.5 sigmas. The long (~3 s) duration and nine or more components forming the pulse profile make this source an outlier in the FRB population. Such short periodicity provides strong evidence for a neutron-star origin of the event. Moreover, our detection favours emission arising from the neutron-star magnetosphere, as opposed to emission regions located further away from the star, as predicted by some models.Comment: Updated to conform to the accepted versio

The NANOGrav 12.5 yr Data Set: Search for Gravitational Wave Memory

We present the results of a Bayesian search for gravitational wave (GW) memory in the NANOGrav 12.5 yr data set. We find no convincing evidence for any gravitational wave memory signals in this data set. We find a Bayes factor of 2.8 in favor of a model that includes a memory signal and common spatially uncorrelated red noise (CURN) compared to a model including only a CURN. However, further investigation shows that a disproportionate amount of support for the memory signal comes from three dubious pulsars. Using a more flexible red-noise model in these pulsars reduces the Bayes factor to 1.3. Having found no compelling evidence, we go on to place upper limits on the strain amplitude of GW memory events as a function of sky location and event epoch. These upper limits are computed using a signal model that assumes the existence of a common, spatially uncorrelated red noise in addition to a GW memory signal. The median strain upper limit as a function of sky position is approximately 3.3 × 10−14. We also find that there are some differences in the upper limits as a function of sky position centered around PSR J0613−0200. This suggests that this pulsar has some excess noise that can be confounded with GW memory. Finally, the upper limits as a function of burst epoch continue to improve at later epochs. This improvement is attributable to the continued growth of the pulsar timing array

The NANOGrav 15 yr Data Set: Search for Transverse Polarization Modes in the Gravitational-wave Background

Recently we found compelling evidence for a gravitational-wave background with Hellings and Downs (HD) correlations in our 15 yr data set. These correlations describe gravitational waves as predicted by general relativity, which has two transverse polarization modes. However, more general metric theories of gravity can have additional polarization modes, which produce different interpulsar correlations. In this work, we search the NANOGrav 15 yr data set for evidence of a gravitational-wave background with quadrupolar HD and scalar-transverse (ST) correlations. We find that HD correlations are the best fit to the data and no significant evidence in favor of ST correlations. While Bayes factors show strong evidence for a correlated signal, the data does not strongly prefer either correlation signature, with Bayes factors ∼2 when comparing HD to ST correlations, and ∼1 for HD plus ST correlations to HD correlations alone. However, when modeled alongside HD correlations, the amplitude and spectral index posteriors for ST correlations are uninformative, with the HD process accounting for the vast majority of the total signal. Using the optimal statistic, a frequentist technique that focuses on the pulsar-pair cross-correlations, we find median signal-to-noise ratios of 5.0 for HD and 4.6 for ST correlations when fit for separately, and median signal-to-noise ratios of 3.5 for HD and 3.0 for ST correlations when fit for simultaneously. While the signal-to-noise ratios for each of the correlations are comparable, the estimated amplitude and spectral index for HD are a significantly better fit to the total signal, in agreement with our Bayesian analysis

The NANOGrav 15-year Data Set: Evidence for a Gravitational-Wave Background

We report multiple lines of evidence for a stochastic signal that is correlated among 67 pulsars from the 15-year pulsar-timing data set collected by the North American Nanohertz Observatory for Gravitational Waves. The correlations follow the Hellings-Downs pattern expected for a stochastic gravitational-wave background. The presence of such a gravitational-wave background with a power-law-spectrum is favored over a model with only independent pulsar noises with a Bayes factor in excess of $10^{14}$, and this same model is favored over an uncorrelated common power-law-spectrum model with Bayes factors of 200-1000, depending on spectral modeling choices. We have built a statistical background distribution for these latter Bayes factors using a method that removes inter-pulsar correlations from our data set, finding $p = 10^{-3}$ (approx. $3\sigma$) for the observed Bayes factors in the null no-correlation scenario. A frequentist test statistic built directly as a weighted sum of inter-pulsar correlations yields $p = 5 \times 10^{-5} - 1.9 \times 10^{-4}$ (approx. $3.5 - 4\sigma$). Assuming a fiducial $f^{-2/3}$ characteristic-strain spectrum, as appropriate for an ensemble of binary supermassive black-hole inspirals, the strain amplitude is $2.4^{+0.7}_{-0.6} \times 10^{-15}$ (median + 90% credible interval) at a reference frequency of 1/(1 yr). The inferred gravitational-wave background amplitude and spectrum are consistent with astrophysical expectations for a signal from a population of supermassive black-hole binaries, although more exotic cosmological and astrophysical sources cannot be excluded. The observation of Hellings-Downs correlations points to the gravitational-wave origin of this signal.Comment: 30 pages, 18 figures. Published in Astrophysical Journal Letters as part of Focus on NANOGrav's 15-year Data Set and the Gravitational Wave Background. For questions or comments, please email [email protected]

Prestroke Factors Associated with Poststroke Mortality and Recovery in Older Women in the Women's Health Initiative

OBJECTIVES: We sought to examine pre-stroke lifestyle factorsassociated with post-stroke mortalityand recovery in older women. DESIGN: Longitudinal prospective cohort study. SETTING: The Women’s Health Initiative (clinical trials and observational study), 40 clinical centers in the U.S. PARTICIPANTS: WHI participants, women aged 50–79, who were stroke-free at baseline 1993–1998, with incident stroke prior to 2005. MEASUREMENTS: Participants were followed for mortality through 2010. Pre-stroke characteristics were from the most proximal examination before the stroke event. Annual follow-up for clinical events ascertained hospitalization for stroke which was subsequently physician-adjudicated with medical records. Multivariable regression models analyzed factors associated with post-stroke mortality and post-stroke recovery at hospital discharge (post-stroke Glasgow score), adjusting for stroke type. RESULTS: Of 3,173 women with incident stroke, 1,111 (35%) died. Overweight and obese BMI pre-stroke was associated with reduced post-stroke mortality (vs. normal BMI, obese BMI hazards ratio, HR=0.69, 95% confidence interval (CI)=0.53–0.88; overweight BMI: HR=0.72, 95%CI=0.58–0.90); underweight pre-stroke BMI had borderline increased post-stroke mortality (HR=2.02, 95%CI=0.98–4.16).Other pre-stroke factors associated with post-stroke mortality included diabetes (HR=1.28, 95%CI=1.01–1.64), current smoking (vs. nonsmoker, hazard ratio (HR)=2.13, 95%CI=1.53–3.00), physical inactivity (vs. >150 minutes exercise/week, HR=1.39, 95%CI=1.09–1.78) and lowest physical function quartile (vs. highest, HR=1.54, 95%CI=1.18–2.02). Pre-stroke diabetes was associated with reduced odds of good recovery post-stroke (odds ratio (OR)= 0.60, 95%CI= 0.44–0.82). Current hormone use pre-stroke was associated with increased odds of moderate vs. severe disability post-stroke (OR=1.29, 95%CI=1.00–1.66). CONCLUSION: Potentially modifiable factors pre-stroke, including smoking, diabetes and underweight BMI, were associated with increased post-stroke mortality in older women. Pre-stroke overweight or obese BMI and physical activity were associated with reduced post-stroke mortality in older women

A Detection of Cosmological 21 cm Emission from CHIME in Cross-correlation with eBOSS Measurements of the Lyα Forest

We report the detection of 21 cm emission at an average redshift $\bar{z}=2.3$ in the cross-correlation of data from the Canadian Hydrogen Intensity Mapping Experiment (CHIME) with measurements of the Ly α forest from eBOSS. Data collected by CHIME over 88 days in the 400–500 MHz frequency band (1.8 1.8