Testing for sexually transmitted infections in general practice: cross-sectional study

Background: Primary care is an important provider of sexual health care in England. We sought to explore the extent of testing for chlamydia and HIV in general practice and its relation to associated measures of sexual health in two contrasting geographical settings.Methods: We analysed chlamydia and HIV testing data from 64 general practices and one genitourinary medicine (GUM) clinic in Brent (from mid-2003 to mid-2006) and 143 general practices and two GUM clinics in Avon (2004). We examined associations between practice testing status, practice characteristics and hypothesised markers of population need (area level teenage conception rates and Index of Multiple Deprivation, IMD scores).Results: No HIV or chlamydia testing was done in 19% (12/64) of general practices in Brent, compared to 2.1% (3/143) in Avon. In Brent, the mean age of general practitioners (GPs) in Brent practices that tested for chlamydia or HIV was lower than in those that had not conducted testing. Practices where no HIV testing was done had slightly higher local teenage conception rates (median 23.5 vs. 17.4/1000 women aged 15-44, p = 0.07) and served more deprived areas (median IMD score 27.1 vs. 21.8, p = 0.05). Mean yearly chlamydia and HIV testing rates, in practices that did test were 33.2 and 0.6 (per 1000 patients aged 15-44 years) in Brent, and 34.1 and 10.3 in Avon, respectively. In Brent practices only 20% of chlamydia tests were conducted in patients aged under 25 years, compared with 39% in Avon.Conclusions: There are substantial geographical differences in the intensity of chlamydia and HIV testing in general practice. Interventions to facilitate sexually transmitted infection and HIV testing in general practice are needed to improve access to effective sexual health care. The use of routinely-collected laboratory, practice-level and demographic data for monitoring sexual health service provision and informing service planning should be more widely evaluated

Use of sonic tomography to detect and quantify wood decay in living trees.

Premise of the studyField methodology and image analysis protocols using acoustic tomography were developed and evaluated as a tool to estimate the amount of internal decay and damage of living trees, with special attention to tropical rainforest trees with irregular trunk shapes.Methods and resultsLiving trunks of a diversity of tree species in tropical rainforests in the Republic of Panama were scanned using an Argus Electronic PiCUS 3 Sonic Tomograph and evaluated for the amount and patterns of internal decay. A protocol using ImageJ analysis software was used to quantify the proportions of intact and compromised wood. The protocols provide replicable estimates of internal decay and cavities for trees of varying shapes, wood density, and bark thickness.ConclusionsSonic tomography, coupled with image analysis, provides an efficient, noninvasive approach to evaluate decay patterns and structural integrity of even irregularly shaped living trees

Radio continuum emission in the northern Galactic plane: Sources and spectral indices from the THOR survey

Context. Radio continuum surveys of the Galactic plane can find and characterize Hii regions, supernova remnants (SNRs), planetary nebulae (PNe), and extragalactic sources. A number of surveys at high angular resolution (≤2500) at different wavelengths exist to study the interstellar medium (ISM), but no comparable high-resolution and high-sensitivity survey exists at long radio wavelengths around 21 cm. Aims. Our goal is to investigate the 21 cm radio continuum emission in the northern Galactic plane at <2500 resolution. Methods.We observed a large percentage of the Galactic plane in the first quadrant of the MilkyWay (l = 14:0..67:4° and jbj ≤ 1:25°) with the Karl G. Jansky Very Large Array (VLA) in the C-configuration covering six continuum spectral windows (SPW). These data provide a detailed view on the compact as well as extended radio emission of our Galaxy and thousands of extragalactic background sources. Results.We used the BLOBCAT software and extracted 10 916 sources. After removing spurious source detections caused by the side lobes of the synthesized beam, we classified 10 387 sources as reliable detections. We smoothed the images to a common resolution of 2500 and extracted the peak flux density of each source in each SPW to determine the spectral indices (assuming I(v)/∞). By cross-matching with catalogs of Hii regions, SNRs, PNe, and pulsars, we found radio counterparts for 840 Hii regions, 52 SNRs, 164 PNe, and 38 pulsars. We found 79 continuum sources that are associated with X-ray sources. We identified 699 ultra-steep spectral sources (1:3) that could be high-redshift galaxies. About 9000 of the sources we extracted are not classified specifically, but based on their spatial and spectral distribution, a large percentage of these are likely to be extragalactic background sources. More than 7750 sources do not have counterparts in the SIMBAD database and more than 3760 sources do not have counterparts in the NED database. Conclusions. Studying the long wavelengths centimeter continuum emission and the associated spectral indices allows us to characaterize a large percentage of Galactic and extragalactic radio sources in the area of the northern inner Milky Way. This database will be extremely useful for future studies of a diverse set of astrophysical objects.The National Radio Astronomy Observatory is a facility of the National Science Foundation operated under cooperative agreement by Associated Universities, Inc. Y. W., H. B., S. B., and J. D. S. acknowledge support from the European Research Council under the Horizon 2020 Framework Program via the ERC Consolidator Grant CSF-648505, and RSK via the ERC AdvancedGrant 339177 (STARLIGHT). H.B. and M.R. acknowledge support from the Deutsche Forschungsgemeinschaft in the Collaborative Research Center (SFB 881) “The Milky Way 74 System” (subproject B1, B2, B8), and from the Priority Program SPP 1573 “Physics of the Interstellar Medium” (grant numbers KL 1358/18.1, KL 1358/19.2). F.B. acknowledges funding from the European Union’s Horizon 2020 research and innovation programme (grant agreement No 726384). The authors thank J. Mottram, M. Fouesneau and K. Meisenheimer for productive and fruitful discussions. This research made use of Astropy and affiliated packages, a community-developed core Python package for Astronomy (Astropy Collaboration 2018), Python package SciPy, APLpy, an open-source plotting package for Python (Robitaille & Bressert 2012), and software TOPCAT (Taylor 2005)

CMZoom III: Spectral Line Data Release

We present an overview and data release of the spectral line component of the SMA Large Program, \textit{CMZoom}. \textit{CMZoom} observed $^{12}$CO(2-1), $^{13}$CO(2-1) and C$^{18}$O(2-1), three transitions of H$_{2}$CO, several transitions of CH$_{3}$OH, two transitions of OCS and single transitions of SiO and SO, within gas above a column density of N(H$_2$)$\ge 10^{23}$\,cm$^{-2}$ in the Central Molecular Zone (CMZ; inner few hundred pc of the Galaxy). We extract spectra from all compact 1.3\,mm \emph{CMZoom} continuum sources and fit line profiles to the spectra. We use the fit results from the H$_{2}$CO 3(0,3)-2(0,2) transition to determine the source kinematic properties. We find $\sim 90$\% of the total mass of \emph{CMZoom} sources have reliable kinematics. Only four compact continuum sources are formally self-gravitating. The remainder are consistent with being in hydrostatic equilibrium assuming that they are confined by the high external pressure in the CMZ. Based on the mass and density of virially bound sources, and assuming star formation occurs within one free-fall time with a star formation efficiency of $10\% - 75\%$, we place a lower limit on the future embedded star-formation rate of $0.008 - 0.06$\,M$_{\odot}$\,yr$^{-1}$. We find only two convincing proto-stellar outflows, ruling out a previously undetected population of very massive, actively accreting YSOs with strong outflows. Finally, despite having sufficient sensitivity and resolution to detect high-velocity compact clouds (HVCCs), which have been claimed as evidence for intermediate mass black holes interacting with molecular gas clouds, we find no such objects across the large survey area.Comment: 44 pages, 41 figure

Main-sequence stars masquerading as Young Stellar Objects in the central molecular zone

In contrast to most other galaxies, star formation rates in the Milky Way can be estimated directly from young stellar objects (YSOs). In the central molecular zone the star formation rate calculated from the number of YSOs with 24 μm emission is up to an order of magnitude higher than the value estimated from methods based on diffuse emission (such as free-free emission). Whether this effect is real or whether it indicates problems with either or both star formation rate measures is not currently known. In this paper, we investigate whether estimates based on YSOs could be heavily contaminated by more evolved objects such as main-sequence stars. We present radiative transfer models of YSOs and of main-sequence stars in a constant ambient medium which show that the main-sequence objects can indeed mimic YSOs at 24 μm. However, we show that in some cases the main-sequence models can be marginally resolved at 24 μm, whereas the YSO models are always unresolved. Based on the fraction of resolved MIPS 24 μm sources in the sample of YSOs previously used to compute the star formation rate, we estimate the fraction of misclassified "YSOs" to be at least 63%, which suggests that the star formation rate previously determined from YSOs is likely to be at least a factor of three too high

Intrinsically Red Sources Observed by Spitzer in the Galactic Midplane

We present a highly reliable flux-limited census of 18,949 point sources in the Galactic midplane that have intrinsically red mid-infrared colors. These sources were selected from the Spitzer Space Telescope Galactic Legacy Infrared Midplane Survey Extraordinaire (GLIMPSE) I and II surveys of 274 deg2 of the Galactic midplane, and consist mostly of high- and intermediate-mass young stellar objects (YSOs) and asymptotic giant branch (AGB) stars. The selection criteria were carefully chosen to minimize the effects of position-dependent sensitivity, saturation, and confusion. The distribution of sources on the sky and their location in the Infrared Array Camera and the Multiband Image Photometer for Spitzer 24 μm color-magnitude and color-color space are presented. Using this large sample, we find that YSOs and AGB stars can be mostly separated by simple color-magnitude selection criteria into approximately 50%-70% of YSOs and 30%-50% of AGB stars. Planetary nebulae and background galaxies together represent at most 2%-3% of all the red sources. 1004 red sources in the GLIMPSE II region, mostly AGB stars with high mass-loss rates, show significant (≥0.3 mag) variability at 4.5 and/or 8.0 μm. With over 11,000 likely YSOs and over 7000 likely AGB stars, this is to date the largest uniform census of AGB stars and high- and intermediate-mass YSOs in the Milky Way Galaxy

The standard model of low-mass star formation applied to massive stars: multiwavelength modelling of IRAS 20126+4104

In order to investigate whether massive stars form similarly to their low-mass counterparts, we have used the standard envelope plus disc geometry successfully applied to low-mass protostars to model the near-IR to submillimetre spectral energy distribution (SED) and several mid-IR images of the embedded massive star IRAS 20126+4104. We have used a Monte Carlo radiative transfer dust code to model the continuum absorption, emission and scattering through two azimuthally symmetric dust geometries, the first consisting of a rotationally flattened envelope with outflow cavities, and the second which also includes a flared accretion disc. Our results show that the envelope plus disc model reproduces the observed SED and images more accurately than the model without a disc, although the latter model more closely reproduces the morphology of the mid-IR emission within a radius of 1.1 arcsec or ∼1800 au. We have put forward several possible causes of this discontinuity, including inner truncation of the disc due to stellar irradiation or precession of the outflow cavity. Our best-fitting envelope plus disc model has a disc radius of 9200 au. We find that it is unlikely that the outer regions of such a disc would be in hydrostatic or centrifugal equilibrium, however we calculate that the temperatures within the disc would keep it stable to fragmentation

Ionized Gas Towards Molecular Clumps: Physical Properties of Massive Star Forming Regions

We have conducted a search for ionized gas at 3.6 cm, using the Very Large Array, toward 31 Galactic intermediate- and high-mass clumps detected in previous millimeter continuum observations. In the 10 observed fields, 35 H II regions are identified, of which 20 are newly discovered. Many of the H II regions are multiply peaked indicating the presence of a cluster of massive stars. We find that the ionized gas tends to be associated toward the millimeter clumps; of the 31 millimeter clumps observed, nine of these appear to be physically related to ionized gas, and a further six have ionized gas emission within 1'. For clumps with associated ionized gas, the combined mass of the ionizing massive stars is compared to the clump masses to provide an estimate of the instantaneous star formation efficiency. These values range from a few percent to 25%, and have an average of 7% ± 8%. We also find a correlation between the clump mass and the mass of the ionizing massive stars within it, which is consistent with a power law. This result is comparable to the prediction of star formation by competitive accretion that a power-law relationship exists between the mass of the most massive star in a cluster and the total mass of the remaining stars

Short-term outcomes of community-based adolescent weight management: The Loozit® Study

<p>Abstract</p> <p>Background</p> <p>The Loozit^®Study is a randomised controlled trial investigating extended support in a 24 month community-based weight management program for overweight to moderately obese, but otherwise healthy, 13 to 16 year olds.</p> <p>Methods</p> <p>This pre-post study examines the two month outcomes of the initial Loozit^®group intervention received by both study arms. Adolescents (n = 151; 48% male) and their parents separately attended seven weekly group sessions focused on lifestyle modification. At baseline and two months, adolescents' anthropometry, blood pressure, and fasted blood sample were assessed. Primary outcomes were two month changes in body mass index (BMI) z-score and waist-to-height-ratio (WHtR). Secondary outcomes included changes in metabolic profile, self-reported dietary intake/patterns, physical and sedentary activities, psychological characteristics and social status. Changes in outcome measures were assessed using paired samples t-tests for continuous variables or McNemar's test for dichotomous categorical variables.</p> <p>Results</p> <p>Of the 151 adolescents who enrolled, 130 (86%) completed the two month program. Among these 130 adolescents (47% male), there was a statistically significant (P < 0.01) reduction in mean [95% CI] BMI (0.27 kg/m²[0.41, 0.13]), BMI z-score (0.05 [0.06, 0.03]), WHtR (0.02 [0.03, 0.01]), total cholesterol (0.14 mmol/L [0.24, 0.05]) and low-density lipoprotein cholesterol (0.12 mmol/L [0.21, 0.04]). There were improvements in all psychological measures, the majority of the dietary intake measures, and some physical activities (P < 0.05). Time spent watching TV and participating in non-screen sedentary activities decreased (P < 0.05).</p> <p>Conclusions</p> <p>The Loozit^®program may be a promising option for stabilizing overweight and improving various metabolic factors, psychological functioning and lifestyle behaviors in overweight adolescents in a community setting.</p> <p>Trial registration</p> <p>Australian New Zealand Clinical Trials Registry</p> <p><a href="http://www.anzctr.org.au/trial_view.aspx?ID=1277">ACTRNO12606000175572</a></p

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London