Telerehabilitation Feasibility in Total Joint Replacement

Despite documented benefits, many Total Joint Replacement (TJR) patients find it difficult to access rehabilitation following discharge from hospital. One solution to improve access for TJR patients is telerehabilitation. This study aimed to assess the feasibility of introducing a telerehabilitation program for TJR patients.   TJR patients at QEII Jubilee Hospital were invited to complete a questionnaire regarding their access, feelings towards and preferences in using technology. Seventy-five patients were recruited. Most patients had computer access (72%) and internet (69%) at home. Sixty-five percent of participants were willing to participate in telerehabilitation. A significant difference was found between older and younger patients. Watching videos on an electronic device was the preferred method for a technology-based home exercise program and phone call the preferred method of communication.  Results indicate telerehabilitation in the TJR population is feasible from the perspective of access to, feelings toward, and preferences for technology.Keywords: Hip replacement, Knee replacement, Telerehabilitation, Telemedicine, Total joint replacemen

SN 2007gr: a Normal Type Ic Supernova with a Mildly Relativistic Radio Jet?

A nearby type Ic supernova, SN 2007gr was observed with the EVN in two epochs 60 days apart (second observation also included the Green Bank Telescope). In both cases one of the EVN stations was the Westerbork Synthesis Radio Telescope (WSRT), which recorded the observational data not only in the VLBI mode, but also in its normal interferometric mode. Thus it provided an important reference observation. In the first epoch the fluxes measured by the VLBI network and the WSRT alone match well. However in the second epoch the peak brightness observed in the VLBI experiment is much lower than the total flux recorded by the WSRT. There could be multiple reasons for this discrepancy: a resolution effect, coherence losses in VLBI, or extended emission contaminating the WSRT measurement. With new WSRT observations we costrain the level of background emission and find that there is still a difference between the corrected total flux density and the VLBI peak brightness. If one assumes that this is dominated by resolution, this would correspond to an average apparent expansion speed of ~0.4c

Management of the Acute Scrotum in a District General Hospital: 10-Year Experience

The acutely painful scrotum is a common urologic emergency. The primary objective of management is to avoid testicular loss. This requires a high index of clinical suspicion and prompt surgical intervention. In our series conducted between January 1996 and December 2005, 119 patients (age range: 4–62 years) underwent emergency operative exploration for acute scrotal pain. The most common finding was torted cyst of Morgagni (63/119, 52.9%), followed by testicular torsion (41/119, 34.4%). The majority of testicular torsions occurred in the pubertal group (22/41, 53.6%). Only one patient in this group had an unsalvageable testis necessitating orchidectomy, a testicular loss rate in torsion of 2.4%. There were no postoperative wound infections or scrotal haematomas. Testicular salvage depends critically on early surgical intervention, so the delay incurred in diagnostic imaging may extend the period of ischaemia. Furthermore, all radiological investigations have a certain false-negative rate. We advocate immediate surgical exploration of the acute scrotum. We report a low orchidectomy rate (2.4%) in testicular torsion

SMA and Spitzer Observations of Bok Glouble CB17: A Candidate First Hydrostatic Core?

We present high angular resolution SMA and Spitzer observations toward the Bok globule CB17. SMA 1.3mm dust continuum images reveal within CB17 two sources with an angular separation of about 21" (about 5250 AU at a distance of 250 pc). The northwestern continuum source, referred to as CB17 IRS, dominates the infrared emission in the Spitzer images, drives a bipolar outflow extending in the northwest-southeast direction, and is classified as a low luminosity Class0/I transition object (L_bol ~ 0.5 L_sun). The southeastern continuum source, referred to as CB17 MMS, has faint dust continuum emission in the SMA 1.3mm observations (about 6 sigma detection; ~3.8 mJy), but is not detected in the deep Spitzer infrared images at wavelengths from 3.6 to 70 micron. Its bolometric luminosity and temperature, estimated from its spectral energy distribution, are less than 0.04 L_sun and 16 K, respectively. The SMA CO(2-1) observations suggest that CB17 MMS may drive a low-velocity molecular outflow (about 2.5 km/s), extending in the east-west direction. Comparisons with prestellar cores and Class0 protostars suggest that CB17 MMS is more evolved than prestellar cores but less evolved than Class0 protostars. The observed characteristics of CB17 MMS are consistent with the theoretical predictions from radiative/magneto hydrodynamical simulations of a first hydrostatic core, but there is also the possibility that CB17 MMS is an extremely low luminosity protostar deeply embedded in an edge-on circumstellar disk. Further observations are needed to study the properties of CB17 MMS and to address more precisely its evolutionary stage.Comment: 33 pages, 11 figures, to be published by Ap

An ALMA Search for Substructure, Fragmentation, and Hidden Protostars in Starless Cores in Chamaeleon I

We present an Atacama Large Millimeter/submillimeter Array (ALMA) 106 GHz (Band 3) continuum survey of the complete population of dense cores in the Chamaeleon I molecular cloud. We detect a total of 24 continuum sources in 19 different target fields. All previously known Class 0 and Class I protostars in Chamaeleon I are detected, whereas all of the 56 starless cores in our sample are undetected. We show that the Spitzer+Herschel census of protostars in Chamaeleon I is complete, with the rate at which protostellar cores have been misclassified as starless cores calculated as <1/56, or < 2%. We use synthetic observations to show that starless cores collapsing following the turbulent fragmentation scenario are detectable by our ALMA observations when their central densities exceed ~10^8 cm^-3, with the exact density dependent on the viewing geometry. Bonnor-Ebert spheres, on the other hand, remain undetected to central densities at least as high as 10^10 cm^-3. Our starless core non-detections are used to infer that either the star formation rate is declining in Chamaeleon I and most of the starless cores are not collapsing, matching the findings of previous studies, or that the evolution of starless cores are more accurately described by models that develop less substructure than predicted by the turbulent fragmentation scenario, such as Bonnor-Ebert spheres. We outline future work necessary to distinguish between these two possibilities.Comment: Accepted by Ap

The effects of computerised cognitive training on post-CABG delirium and cognitive change: A prospective randomised controlled trial

Background: Cognitive impairments, including delirium, are common after coronary artery bypass grafting (CABG). Improving cognition pre- and post-operatively using computerised cognitive training (CCT) may be an effective approach to improve cognitive outcomes in CABG patients. Objectives: Investigate the effect of remotely supervised CCT on cognitive outcomes, including delirium, in older adults undergoing CABG surgery. Methods: Thirty-six participants, were analysed in a single-blinded randomised controlled trial (CCT Intervention: n = 18, Control: n = 18). CCT was completed by the intervention group pre-operatively (every other day, 45–60-minute sessions until surgery) and post-operatively, beginning 1-month post-CABG (3 x 45–60-minute sessions/week for 12-weeks), while the control group maintained usual care plus weekly phone calls. Cognitive assessments were conducted pre- and post-operatively at multiple follow-ups (discharge, 4-months and 6-months). Post-operative delirium incidence was assessed daily until discharge. Cognitive change data were calculated at each follow-up for each cognitive test (Addenbrooke’s Cognitive Examination III and CANTAB; z-scored). Results: Adherence to the CCT intervention (completion of three pre-operative or 66% of post-operative sessions) was achieved in 68% of pre-CABG and 59% of post-CABG participants. There were no statistically significant effects of CCT on any cognitive outcome, including delirium incidence. Conclusion: Adherence to the CCT program was comparatively higher than previous feasibility studies, possibly due to the level of supervision and support provided (blend of face-to-face and home-based training, with support phone calls). Implementing CCT interventions both pre- and post-operatively is feasible in those undergoing CABG. No statistically significant benefits from the CCT interventions were identified for delirium or cognitive function post-CABG, likely due to the sample size available (study recruitment greatly impacted by COVID-19). It also may be the case that multimodal intervention would be more effective

Revealing The Millimeter Environment of the New FU Orionis Candidate HBC722 with the Submillimeter Array

We present 230 GHz Submillimeter Array continuum and molecular line observations of the newly discovered FUor candidate HBC722. We report the detection of seven 1.3 mm continuum sources in the vicinity of HBC722, none of which correspond to HBC722 itself. We compile infrared and submillimeter continuum photometry of each source from previous studies and conclude that three are Class 0 embedded protostars, one is a Class I embedded protostar, one is a Class I/II transition object, and two are either starless cores or very young, very low luminosity protostars or first hydrostatic cores. We detect a northwest-southeast outflow, consistent with the previous detection of such an outflow in low-resolution, single-dish observations, and note that its axis may be precessing. We show that this outflow is centered on and driven by one of the nearby Class 0 sources rather than HBC722, and find no conclusive evidence that HBC722 itself is driving an outflow. The non-detection of HBC722 in the 1.3 mm continuum observations suggests an upper limit of 0.02 solar masses for the mass of the circumstellar disk. This limit is consistent with typical T Tauri disks and with a disk that provides sufficient mass to power the burst.Comment: 12 pages, 7 figures, accepted by Ap

The Spitzer c2d survey of Large, Nearby, Interstellar Clouds. V. Chamaeleon II Observed with IRAC

We present IRAC (3.6, 4.5, 5.8, and 8.0 micron) observations of the Chamaeleon II molecular cloud. The observed area covers about 1 square degree defined by $A_V >2$. Analysis of the data in the 2005 c2d catalogs reveals a small number of sources (40) with properties similar to those of young stellaror substellar objects (YSOs). The surface density of these YSO candidates is low, and contamination by background galaxies appears to be substantial, especially for sources classified as Class I or flat SED. We discuss this problem in some detail and conclude that very few of the candidate YSOs in early evolutionary stages are actually in the Cha II cloud. Using a refined set of criteria, we define a smaller, but more reliable, set of 24 YSO candidates.Comment: 19 pages, 10 figures, in press Ap

SMA Observations of Class 0 Protostars: A High-Angular Resolution Survey of Protostellar Binary Systems

We present high angular resolution 1.3 mm and 850 um dust continuum data obtained with the Submillimeter Array toward 33 Class 0 protostars in nearby clouds (distance < 500 pc), which represents so far the largest survey toward protostellar binary/multiple systems. The median angular resolution in the survey is 2.5 arcsec, while the median linear resolution is approximately 600 AU. Compact dust continuum emission is observed from all sources in the sample. Twenty-one sources in the sample show signatures of binarity/multiplicity, with separations ranging from 50 to 5000 AU. The numbers of singles, binaries, triples, and quadruples in the sample are 12, 14, 5, and 2, respectively. The derived multiplicity frequency (MF) and companion star fraction (CSF) for Class 0 protostars are 0.64+/-0.08 and 0.91+/-0.05, respectively, with no correction for completeness. The derived MF and CSF in this survey are approximately two times higher than the values found in the binary surveys toward Class I YSOs, and approximately three (for MF) and four (for CSF) times larger than the values found among MS stars, with a similar range of separations. Furthermore, the observed fraction of high order multiple systems to binary systems in Class 0 protostars (0.50+/-0.09) is also larger than the fractions found in Class I YSOs (0.31+/-0.07) and MS stars (< 0.2). These results suggest that binary properties evolve as protostars evolve, as predicted by numerical simulations. The distribution of separations for Class 0 protostellar binary systems shows a general trend in which companion star fraction increases with decreasing companion separation. We find that 67%+/-8% of the protobinary systems have circumstellar mass ratios below 0.5, implying that unequal-mass systems are preferred in the process of binary star formation. We suggest an empirical sequential fragmentation picture for binary star formation.Comment: 71 pages, 23 figures, to be published by Ap