4,348 research outputs found

    10-minute consultation - Gastro-oesophageal reflux disease

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    Copyright © 2002, BMJJanusz Jankowski, Roger Jones, Brendan Delaney and John Den

    Freshly Formed Dust in the Cassiopeia A Supernova Remnant as Revealed by the Spitzer Space Telescope

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    We performed Spitzer Infrared Spectrograph mapping observations covering nearly the entire extent of the Cassiopeia A supernova remnant (SNR), producing mid-infrared (5.5-35 micron) spectra every 5-10". Gas lines of Ar, Ne, O, Si, S and Fe, and dust continua were strong for most positions. We identify three distinct ejecta dust populations based on their continuum shapes. The dominant dust continuum shape exhibits a strong peak at 21 micron. A line-free map of 21 micron-peak dust made from the 19-23 micron range closely resembles the [Ar II], [O IV], and [Ne II] ejecta-line maps implying that dust is freshly formed in the ejecta. Spectral fitting implies the presence of SiO2, Mg protosilicates, and FeO grains in these regions. The second dust type exhibits a rising continuum up to 21 micron and then flattens thereafter. This ``weak 21 micron'' dust is likely composed of Al2O3 and C grains. The third dust continuum shape is featureless with a gently rising spectrum and is likely composed of MgSiO3 and either Al2O3 or Fe grains. Using the least massive composition for each of the three dust classes yields a total mass of 0.02 Msun. Using the most-massive composition yields a total mass of 0.054 Msun. The primary uncertainty in the total dust mass stems from the selection of the dust composition necessary for fitting the featureless dust as well as 70 micron flux. The freshly formed dust mass derived from Cas A is sufficient from SNe to explain the lower limit on the dust masses in high redshift galaxies.Comment: 8 figures: Accepted for the publication in Ap

    Time Variability in the X-ray Nebula Powered by Pulsar B1509-58

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    We use new and archival Chandra and ROSAT data to study the time variability of the X-ray emission from the pulsar wind nebula (PWN) powered by PSR B1509-58 on timescales of one week to twelve years. There is variability in the size, number, and brightness of compact knots appearing within 20" of the pulsar, with at least one knot showing a possible outflow velocity of ~0.6c (assuming a distance to the source of 5.2 kpc). The transient nature of these knots may indicate that they are produced by turbulence in the flows surrounding the pulsar. A previously identified prominent jet extending 12 pc to the southeast of the pulsar increased in brightness by 30% over 9 years; apparent outflow of material along this jet is observed with a velocity of ~0.5c. However, outflow alone cannot account for the changes in the jet on such short timescales. Magnetohydrodynamic sausage or kink instabilities are feasible explanations for the jet variability with timescale of ~1.3-2 years. An arc structure, located 30"-45" north of the pulsar, shows transverse structural variations and appears to have moved inward with a velocity of ~0.03c over three years. The overall structure and brightness of the diffuse PWN exterior to this arc and excluding the jet has remained the same over the twelve year span. The photon indices of the diffuse PWN and possibly the jet steepen with increasing radius, likely indicating synchrotron cooling at X-ray energies.Comment: accepted to ApJ, 14 pages, 8 figure

    Adapting primary care for new migrants: a formative assessment

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    Background: Immigration rates have increased recently in the UK. Migrant patients may have particular needs that are inadequately met by existing primary care provision. In the absence of national guidance, local adaptations are emerging in response to these new demands. Aim: To formatively assess the primary care services offered to new migrants and the ways in which practitioners and practices are adapting to meet need. Design & setting: Online survey and case studies of current practice across primary care in the UK. Case studies were selected from mainstream and specialist general practice as well as primary care provision in the third sector. Method: Non-probability sample survey of primary care practitioners (n = 70) with descriptive statistical analysis. Qualitative case studies (n = 8) selected purposively; in-depth exploration of organisational and practitioner adaptations to services. Analysis is structured around the principles of equitable care. Results: Survey results indicated that practitioners focused on working with communities and external agencies and adapting processes of, for example, screening, vaccination, and health checks. Lack of funding was cited most frequently as a barrier to service development (n = 51; 73%). Case studies highlighted the prominence partnership working and of an organisational and practitioner focus on equitable care. Adaptations centred on addressing wider social determinants, trauma, and violence, and additional individual needs; and on delivering culturally-competent care. Conclusion: Despite significant resource constraints, some primary care services are adapting to the needs of new migrants. Many adapted approaches can be characterised as equity-oriented
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