A 5 item version of the Compliance Questionnaire for Rheumatology (CQR5) successfully identifies low adherence to DMARDs

© 2013 Hughes et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedTaking DMARDs as prescribed is an essential part of self-management for patients with Rheumatoid Arthritis. To date, the Compliance Questionnaire for Rheumatology (CQR) is the only self-report adherence measure created specifically for and validated in rheumatic diseases. However, the factor structure of the CQR has not been reported and it can be considered lengthy at 19 items. The aim of this study was to test the factor structure of the CQR and reduce the number of items whilst retaining robust explanation of non-adherence to DMARDs. Such a reduction would increase the clinical utility of the scale, to identify patients with sub-optimal adherence to DMARDs in the clinic as well as for research purposes.Peer reviewe

The use of biorefinery by-products and natural detritus as feed sources for Oysters (Crassostrea gigas) juveniles

New research is currently underway to explore the potential of macroalgae for the production of biofuels. Marine biofuels in general and macroalgae in particular, offer a number of advantages over terrestrial biofuels including reduced competition for freshwater resources and for land use. Sugars can be extracted from macroalgae and processed into biofuels by anaerobic digestion and fermentation. This process generates significant waste biomass, which, if used, could improve the economic sustainability of the biorefinery sector. Bivalves’ aquaculture relies heavily on the production of unicellular algae to feed juvenile individuals and this can represent a bottleneck for the bivalve industry especially in locations where sunlight is limited. Previous research explored the use of macroalgae derived digestate as alternative or integrative feed for juvenile bivalves, exploiting the notion that organic particulate matter (detritus) is an integral part of this animal class natural diet. The prospect of using waste products from the emerging biorefinery industry to solve a bottleneck for aquaculture businesses and, by so doing, improving profitability of both, is an exciting one. In this paper we describe the main nutritional profiles (Protein, Lipid, Carbohydrates and Fatty acids) of the tested diets and investigate the potential for the use of a biorefinery a by-product as replacement option for bivalves’ production, by benchmarking it against aquaculture industry standards (live microalgae and commercially available algae paste) and natural detritus constituted by farmed sea urchin digesta. Both the digestate and the natural detritus supported the survival and growth of bivalve spat, especially when used at 50% inclusion rate, over the course of 4-week preliminary trials. Data suggest that a synergistic effect of the nutritional profiles of the diets employed may underpin the observed results

Detection of a Substantial Molecular Gas Reservoir in a brightest cluster galaxy at z = 1.7

We report the detection of CO(2-1) emission coincident with the brightest cluster galaxy (BCG) of the high-redshift galaxy cluster SpARCS1049+56, with the Redshift Search Receiver (RSR) on the Large Millimetre Telescope (LMT). We confirm a spectroscopic redshift for the gas of z = 1.7091+/-0.0004, which is consistent with the systemic redshift of the cluster galaxies of z = 1.709. The line is well-fit by a single component Gaussian with a RSR resolution-corrected FWHM of 569+/-63 km/s. We see no evidence for multiple velocity components in the gas, as might be expected from the multiple image components seen in near-infrared imaging with the Hubble Space Telescope. We measure the integrated flux of the line to be 3.6+/-0.3 Jy km/s and, using alpha_CO = 0.8 Msun (K km s^-1 pc^2)^-1 we estimate a total molecular gas mass of 1.1+/-0.1x10^11 Msun and a M_H2/M_star ~ 0.4. This is the largest gas reservoir detected in a BCG above z > 1 to date. Given the infrared-estimated star formation rate of 860+/-130 Msun/yr, this corresponds to a gas depletion timescale of ~0.1Gyr. We discuss several possible mechanisms for depositing such a large gas reservoir to the cluster center -- e.g., a cooling flow, a major galaxy-galaxy merger or the stripping of gas from several galaxies -- but conclude that these LMT data are not sufficient to differentiate between them.Comment: accepted for publication in ApJ Letter

Millimeter-Wave Line Ratios and Sub-beam Volume Density Distributions

We explore the use of mm-wave emission line ratios to trace molecular gas density when observations integrate over a wide range of volume densities within a single telescope beam. For observations targeting external galaxies, this case is unavoidable. Using a framework similar to that of Krumholz and Thompson (2007), we model emission for a set of common extragalactic lines from lognormal and power law density distributions. We consider the median density of gas producing emission and the ability to predict density variations from observed line ratios. We emphasize line ratio variations, because these do not require knowing the absolute abundance of our tracers. Patterns of line ratio variations have the prospect to illuminate the high-end shape of the density distribution, and to capture changes in the dense gas fraction and median volume density. Our results with and without a high density power law tail differ appreciably; we highlight better knowledge of the PDF shape as an important area. We also show the implications of sub-beam density distributions for isotopologue studies targeting dense gas tracers. Differential excitation often implies a significant correction to the naive case. We provide tabulated versions of many of our results, which can be used to interpret changes in mm-wave line ratios in terms of changes in the underlying density distributions.Comment: 24 pages, 16 figure, Accepted for publication in the Astrophysical Journal, two online tables temporarily available at http://www.astronomy.ohio-state.edu/~leroy.42/densegas_table2.txt and http://www.astronomy.ohio-state.edu/~leroy.42/densegas_table3.tx

Self-directed self-management interventions to prevent or address distress in young people with long-term physical conditions: a rapid review.

Background: Comorbid distress in adolescents and young adults with physical long‐ term conditions (LTCs) is common but can be difficult to identify and manage. Self‐ directed self‐management interventions to reduce distress and improve wellbeing may be beneficial. It is unknown, however, which intervention characteristics are successful in supporting young people. This rapid review aimed to identify characteristics of self‐directed self‐management interventions that aimed, in whole or part, to address distress, wellbeing or self‐efficacy in this population. Methods: A systematic search was conducted for relevant controlled studies in six databases. Data on study settings, population, intervention characteristics, outcome measures, process measures and summary effects were extracted. The risk of bias was assessed using the Cochrane Risk of Bias tool v1, and the strength of evidence was rated (informed by Grading of Recommendations, Assessment, Development and Evaluations). Patient and public involvement members supported the review process, including interpretation of results. The rapid review was registered with PROSPERO (ID: CRD42021285867). Results: Fourteen studies were included, all of which were randomised trials. Heterogeneity was identified in the health conditions targeted; type of intervention; outcome measures; duration of intervention and follow‐up. Three had distress, wellbeing or self‐efficacy as their primary outcome. Four modes of delivery were identified across interventions—websites, smartphone applications, text messages and workbooks; and within these, 38 individual components. Six interventions had a significant benefit in mental health, wellbeing or self‐efficacy; however, intervention characteristics were similar for beneficial and non‐beneficial interventions. Conclusions: There is a paucity of interventions directly targeting distress and wellbeing in young people with physical LTCs. In those identified, the heterogeneity of interventions and study design makes it difficult to identify which characteristics result in positive outcomes. We propose the need for high‐quality, evidence‐based self‐management interventions for this population; including (1) more detailed reporting of intervention design, content and delivery; (2) robust process evaluation; (3) a core outcome set for measuring mental health and wellbeing for self‐ management interventions and (4) consistency in follow up periods. Public Contribution: Seven young people with an LTC were involved throughout the rapid review, from the development of the review protocol where they informed the focus and aims, with a central role in the interpretation of findings.peer-reviewe

The Relationship Between Molecular Gas, HI, and Star Formation in the Low-Mass, Low-Metallicity Magellanic Clouds

The Magellanic Clouds provide the only laboratory to study the effect of metallicity and galaxy mass on molecular gas and star formation at high (~20 pc) resolution. We use the dust emission from HERITAGE Herschel data to map the molecular gas in the Magellanic Clouds, avoiding the known biases of CO emission as a tracer of H$_{2}$. Using our dust-based molecular gas estimates, we find molecular gas depletion times of ~0.4 Gyr in the LMC and ~0.6 SMC at 1 kpc scales. These depletion times fall within the range found for normal disk galaxies, but are shorter than the average value, which could be due to recent bursts in star formation. We find no evidence for a strong intrinsic dependence of the molecular gas depletion time on metallicity. We study the relationship between gas and star formation rate across a range in size scales from 20 pc to ~1 kpc, including how the scatter in molecular gas depletion time changes with size scale, and discuss the physical mechanisms driving the relationships. We compare the metallicity-dependent star formation models of Ostriker, McKee, and Leroy (2010) and Krumholz (2013) to our observations and find that they both predict the trend in the data, suggesting that the inclusion of a diffuse neutral medium is important at lower metallicity.Comment: 24 pages, 14 figures, accepted for publication in ApJ. FITS files of the dust-based estimates of the H2 column densities for the LMC and SMC (shown in Figures 2 and 3) will be available online through Ap

A Portrait of Cold Gas in Galaxies at 60pc Resolution and a Simple Method to Test Hypotheses That Link Small-Scale ISM Structure to Galaxy-Scale Processes

The cloud-scale density, velocity dispersion, and gravitational boundedness of the interstellar medium (ISM) vary within and among galaxies. In turbulent models, these properties play key roles in the ability of gas to form stars. New high fidelity, high resolution surveys offer the prospect to measure these quantities across galaxies. We present a simple approach to make such measurements and to test hypotheses that link small-scale gas structure to star formation and galactic environment. Our calculations capture the key physics of the Larson scaling relations, and we show good correspondence between our approach and a traditional "cloud properties" treatment. However, we argue that our method is preferable in many cases because of its simple, reproducible characterization of all emission. Using, low-J 12CO data from recent surveys, we characterize the molecular ISM at 60pc resolution in the Antennae, the Large Magellanic Cloud, M31, M33, M51, and M74. We report the distributions of surface density, velocity dispersion, and gravitational boundedness at 60pc scales and show galaxy-to-galaxy and intra-galaxy variations in each. The distribution of flux as a function of surface density appears roughly lognormal with a 1sigma width of ~0.3 dex, though the center of this distribution varies from galaxy to galaxy. The 60pc resolution line width and molecular gas surface density correlate well, which is a fundamental behavior expected for virialized or free-falling gas. Varying the measurement scale for the LMC and M31, we show that the molecular ISM has higher surface densities, lower line widths, and more self-gravity at smaller scales.Comment: Accepted for publication in the Astrophysical Journal, 36 pages (24+appendix), 21 figures (12+appendix), until publication high resolution version at http://www.astronomy.ohio-state.edu/~leroy.42/cloudscale.pd

Healthcare professionals’ priorities for training to identify and manage distress experienced by young people with a stoma due to inflammatory bowel disease: a consensus study using online nominal group technique

Young people with a stoma due to inflammatory bowel disease (IBD) commonly experience distress; however, this is not always well managed in clinical settings. More effective support may/is likely to reduce the possibility of individuals experiencing sustained distress, which may engender depression or anxiety. This study aimed to gain consensus among a multidisciplinary group of healthcare professionals (HCPs) on priorities for training in the identification and management of distress in this population. One of the authors is a young person with a stoma. Design Participants were recruited through Twitter (X) and the researchers’ clinical/research contacts. Two consensus group meetings were conducted using Nominal Group Technique, involving participants generating, discussing and rating on a Likert scale, topics for inclusion in an HCP training package. Setting Online video conferencing. Participants were located across England, with one based in the USA. Participants Nineteen HCPs participated: three general practitioners, three stoma nurses, two IBD nurses, nine clinical psychologists and two gastroenterologists. Results Twenty-five topics were generated by participants; 19 reached consensus of ≥80%, that is, a mean of ≥5.6 on a 7-point Likert scale. These included: recognising and validating different levels of, and variation in, distress; tackling stigma and normalising having a stoma; everyday practicalities of stoma management, including food and sleep; opening and holding conversations about stoma-related distress; considering the impact of different cultural beliefs on adaptation after stoma surgery; training in simple techniques for gauging the patient’s distress during clinical encounters; having conversations about body image; and myth-busting common fears, such as odour. Conclusions This study is the first to identify HCP training priorities for managing stoma-related distress in young people. Consensus was reached for 19 topics, reflecting the varied needs of young people with a stoma. Findings will inform development of a training package for HCPs treating young people with IBD and a stoma.peer-reviewe

Mirror Position Determination for the Alignment of Cherenkov Telescopes

Imaging Atmospheric Cherenkov Telescopes (IACTs) need imaging optics with large apertures to map the faint Cherenkov light emitted in extensive air showers onto their image sensors. Segmented reflectors fulfill these needs using mass produced and light weight mirror facets. However, as the overall image is the sum of the individual mirror facet images, alignment is important. Here we present a method to determine the mirror facet positions on a segmented reflector in a very direct way. Our method reconstructs the mirror facet positions from photographs and a laser distance meter measurement which goes from the center of the image sensor plane to the center of each mirror facet. We use our method to both align the mirror facet positions and to feed the measured positions into our IACT simulation. We demonstrate our implementation on the 4 m First Geiger-mode Avalanche Cherenkov Telescope (FACT).Comment: 11 figures, small ray tracing performance simulation, and implementation demonstratio