General Practitioners' Perceptions of the Use of Wearable Electronic Health Monitoring Devices: Qualitative Analysis of Risks and Benefits.

The rapid diffusion of wearable electronic health monitoring devices (wearable devices or wearables) among lay populations shows that self-tracking and self-monitoring are pervasively expanding, while influencing health-related practices. General practitioners are confronted with this phenomenon, since they often are the expert-voice that patients will seek. This article aims to explore general practitioners' perceptions of the role of wearable devices in family medicine and of their benefits, risks, and challenges associated with their use. It also explores their perceptions of the future development of these devices. Data were collected during a medical conference among 19 Swiss general practitioners through mind maps. Maps were first sketched at the conference and their content was later compared with notes and reports written during the conference, which allowed for further integration of information. This tool represents an innovative methodology in qualitative research that allows for time-efficient data collection and data analysis. Data analysis highlighted that wearable devices were described as user-friendly, adaptable devices that could enable performance monitoring and support medical research. Benefits included support for patients' empowerment and education, behavior change facilitation, better awareness of personal medical history and body functioning, efficient information transmission, and connection with the patient's medical network; however, general practitioners were concerned by a lack of scientific validation, lack of clarity over data protection, and the risk of stakeholder-associated financial interests. Other perceived risks included the promotion of an overly medicalized health culture and the risk of supporting patients' self-diagnosis and self-medication. General practitioners also feared increased pressure on their workload and a compromised doctor-patient relationship. Finally, they raised important questions that can guide wearables' future design and development, highlighting a need for general practitioners and medical professionals to be involved in the process. Wearables play an increasingly central role in daily health-related practices, and general practitioners expressed a desire to become more involved in the development of such technologies. Described as useful information providers, wearables were generally positively perceived and did not seem to pose a threat to the doctor-patient relationship. However, general practitioners expressed their concern that wearables may fuel a self-monitoring logic, to the detriment of patients' autonomy and overall well-being. While wearables can contribute to health promotion, it is crucial to clarify the logic underpinning the design of such devices. Through the analysis of group discussions, this study contributes to the existing literature by presenting general practitioners' perceptions of wearable devices. This paper provides insight on general practitioners' perception to be considered in the context of product development and marketing

Spitzer-IRAC GLIMPSE of high mass protostellar objects. I Infrared point sources and nebulae

The GLIMPSE archive was used to obtain 3.6--8.0micron, point source photometry and images for 381 massive protostellar candidates lying in the Galactic mid-plane. The colours, magnitudes and spectral indicies of sources in each of the 381 target fields were analysed and compared with the predictions of 2D radiative transfer model simulations. Although no discernable embedded clusters were found in any targets, multiple sources or associations of redenned young stellar objects were found in many sources indicating multiplicity at birth. The spectral index ($\alpha$) of these point sources in 3.6--8.0mum bands display large values of $\alpha$=2--5. A color-magnitude analog plot was used to identify 79 infrared counterparts to the HMPOs. Compact nebulae are found in 75% of the detected sources with morphologies that can be well described by core-halo, cometary, shell-like and bipolar geometries similar to those observed in ultra-compact HII regions. The IRAC band SEDs of the IR counterparts of HMPOs are best described to represent YSOs with a mass range of 8--20\msun in their Class I stages when compared with 2D radiative transfer models. They also suggest that the high $\alpha$ values represent reprocessed star/star+disk emission that is arising in the dense envelopes. Thus we are witnessing the luminous envelopes around the protostars rather than their photospheres or disks. We argue that the compact infrared nebulae likely reflect the underlying physical structure of the dense cores and are found to imitate the morphologies of known UCHII regions. Our results favour models of continuuing accretion involving both molecular and ionised accretion components to build the most massive stars rather than purely molecular rapid accretion flows.Comment: 13 pages, 7 figures, accepted by A&

Corrigendum: Translating planetary health principles into sustainable primary care services.

[This corrects the article DOI: 10.3389/fpubh.2022.931212.]

Near-Infrared Photometry and Radio Continuum Study of the Massive Star Forming Regions IRAS 21413+5442 and IRAS 21407+5441

IRAS 21413+5442 and IRAS 21407+5441 are two massive star forming regions of high luminosity, likely associated with each other. Near-infrared photometry on these two IRAS sources was performed at UKIRT using the UFTI under excellent seeing conditions yielding an angular resolution of $\sim$ 0.5 arcsec. Our results reveal details of stellar content to a completeness limit (90%) of J = 18.5, H = 18.0, and K = 17.5 mag in the two regions. In IRAS 21413+5442, we identify a late O type star, having large (H-K) color, to be near the centre of the CO jets observed by earlier authors. The UKIRT images reveal in IRAS 21407+5441, a faint but clear compact HII region around a central high - intermediate mass star cluster. We have detected a number of sources with large (H-K) color which are not detected in J band. We also present the GMRT radio continuum map at 1.28 GHz covering the entire region surrounding the two star forming clouds. The radio continuum fluxes are used to estimate the properties of HII regions which seem to support our near-IR photometric results. Based on our radio continuum map and the archival MSX 8.2 $\mu$m image, we show that the two IRAS sources likely belong to the same parent molecular cloud and conjecture that a high mass star of large IR colors, present in between the two sources, might have triggered star formation in this region. However one can not rule out the alternative possibility that Star A could be a nearby foreground star.Comment: 12 pages, 7 figures, accepted for publication in MNRA

SEOM clinical guidelines for the treatment of head and neck cancer (2017)

Head and neck cancer (HNC) is defined as malignant tumours located in the upper aerodigestive tract and represents 5% of oncologic cases in adults in Spain. More than 90% of these tumours have squamous histology. In an effort to incorporate evidence obtained since 2013 publication, Spanish Society of Medical Oncology (SEOM) presents an update of HNC diagnosis and treatment guideline. The eighth edition of TNM classification, published in January 2017, introduces important changes for p16-positive oropharyngeal tumours, for lip and oral cavity cancer and for N3 category. In addition, there are new data about induction chemotherapy and the role of immunotherapy in HNC

Multi-frequency GMRT Observations of the HII regions S 201, S 206, and S 209 : Galactic Temperature Gradient

We present radio continuum images of three Galactic HII regions, S 201, S 206, and S 209 near 232, 327, and 610 MHz using the Giant Meterwave Radio Telescope (GMRT). The GMRT has a mix of short and long baselines, therefore, even though the data have high spatial resolution, the maps are still sensitive to diffuse extended emission. We find that all three HII regions have bright cores surrounded by diffuse envelopes. We use the high resolution afforded by the data to estimate the electron temperatures and emission measures of the compact cores of these HII regions. Our estimates of electron temperatures are consistent with a linear increase of electron temperature with Galacto-centric distance for distances up to 18 kpc (the distance to the most distant HII region in our sample).Comment: Accepted for publication in Astronomy & Astrophysics, 13 figures, 6 pages, Late

ISOCAM view of the starburst galaxies M82, NGC253, and NGC1808

We present results of mid-infrared 5.0-16.5 micron spectrophotometric imaging of the starburst galaxies M82, NGC253, and NGC1808 from the ISOCAM instrument on board the Infrared Space Observatory. The mid-infrared spectra of the three galaxies are very similar in terms of features present. The > 11 micron continuum attributed to very small dust grains (VSGs) exhibits a large spread in intensity relative to the short-wavelength emission. We find that the 15 micron dust continuum flux density correlates well with the fine-structure [ArII] 6.99 micron line flux and thus provides a good quantitative indicator of the level of star formation activity. By contrast, the 5-11 micron region dominated by emission from polycyclic aromatic hydrocarbons (PAHs) has a nearly invariant shape. Variations in the relative intensities of the PAH features are nevertheless observed, at the 20%-100% level. We illustrate extinction effects on the shape of the mid-infrared spectrum of obscured starbursts, emphasizing the differences depending on the applicable extinction law and the consequences for the interpretation of PAH ratios and extinction estimates. The relative spatial distributions of the PAH, VSG, and [ArII] 6.99 micron emission between the three galaxies exhibit remarkable differences. The < 1 kpc size of the mid-infrared source is much smaller than the optical extent of our sample galaxies and 70%-100% of the IRAS 12 micron flux is recovered within the ISOCAM < 1.5 arcmin squared field of view, indicating that the nuclear starburst dominates the total mid-infrared emission while diffuse light from quiescent disk star formation contributes little.Comment: 25 pages, 12 figures, accepted for publication in Astronomy and Astrophysics; Figs. 3, 4, 5, 6, 7, 9, 10, 12 appear after Sect.

The <i>Herschel</i> view of the massive star-forming region NGC 6334

Aims: Fundamental to any theory of high-mass star formation are gravity and turbulence. Their relative importance, which probably changes during cloud evolution, is not known. By investigating the spatial and density structure of the high-mass star-forming complex NGC 6334 we aim to disentangle the contributions of turbulence and gravity. Methods: We used Herschel PACS and SPIRE imaging observations from the HOBYS key programme at wavelengths of 160, 250, 350, and 500 μm to construct dust temperature and column density maps. Using probability distribution functions (PDFs) of the column density determined for the whole complex and for four distinct sub-regions (distinguished on the basis of differences in the column density, temperature, and radiation field), we characterize the density structure of the complex. We investigate the spatial structure using the Δ-variance, which probes the relative amount of structure on different size scales and traces possible energy injection mechanisms into the molecular cloud. Results: The Δ-variance analysis suggests that the significant scales of a few parsec that were found are caused by energy injection due to expanding HII regions, which are numerous, and by the lengths of filaments seen everywhere in the complex. The column density PDFs have a lognormal shape at low densities and a clearly defined power law at high densities for all sub-regions whose slope is linked to the exponent α of an equivalent spherical density distribution. In particular with α = 2.37, the central sub-region is largly dominated by gravity, caused by individual collapsing dense cores and global collapse of a larger region. The collapse is faster than free-fall (which would lead only to α = 2) and thus requires a more dynamic scenario (external compression, flows). The column density PDFs suggest that the different sub-regions are at different evolutionary stages, especially the central sub-region, which seems to be in a more evolved stage

Radio Sources in Low-Luminosity Active Galactic Nuclei.IV. Radio Luminosity Function, Importance of Jet Power, and Radio Properties of the Complete Palomar Sample

We present the completed results of a high resolution radio imaging survey of all (~200) low-luminosity active galactic nuclei (LLAGNs) and AGNs in the Palomar Spectroscopic Sample. The high incidences of pc-scale radio nuclei, with T(brightness) >=10^7 K, and sub-parsec jets argue for accreting black holes in >=50% of all LINERs and low-luminosity Seyferts; there is no evidence against all LLAGNs being mini-AGNs. The radio luminosity function (RLF) of Palomar Sample LLAGNs and AGNs extends three orders of magnitude below, and is continuous with, that of `classical' AGNs. We find marginal evidence for a low-power turnover in the RLF; nevertheless LLAGNs are responsible for a significant fraction of present day mass accretion. Adopting the jet model of Falcke & Biermann, we show that the accretion energy output in LLAGNs is dominated by the energy in the observed jets rather than the radiated bolometric luminosity. The Palomar LLAGNs and AGNs follow the same scaling between jet power and narrow line region (NLR) luminosity as the pc to kpc jets in powerful radio galaxies. Eddington ratios of <= 10^{-1} - 10^{-5} are implied in jet models of the radio emission. We find evidence that, in analogy to Galactic black hole candidates, LINERs are in a `low/hard' state (gas poor nuclei, low Eddington ratio, ability to launch collimated jets) while low-luminosity Seyferts are in a `high' state (gas rich nuclei, higher Eddington ratio, less likely to launch collimated jets). The jets are energetically more significant than supernovae in the LLAGN host galaxies, and are potentially able to deposit sufficient energy into the innermost parsecs to significantly slow the gas supply to the accretion disk.Comment: Results and content same as pervious submission; language and wording updated for clarity. To appear in A&

Radio Sources in Low-Luminosity Active Galactic Nuclei. III. "AGNs" in a Distance-Limited Sample of "LLAGNs"

(abbreviated): This paper presents the results of a high resolution radio imaging survey of all known (96) low-luminosity active galactic nuclei (LLAGNs) at D<19Mpc. We find that almost half of all LINERs and low-luminosity Seyferts have flat-spectrum radio cores when observed at 150mas resolution. Higher (2mas) resolution observations of a flux-limited subsample have provided a 100% (16 of 16) detection rate of pc-scale radio cores, with implied brightness temperatures > 10^8 K. The five LLAGNs with the highest core radio fluxes also have pc-scale `jets.' Compact radio cores are almost exclusively found in massive ellipticals and in type1 nuclei. The core radio power is correlated with the nuclear optical `broad' Halpha luminosity, the nuclear optical `narrow' emission line luminosity and width, and with the galaxy luminosity. In these correlations LLAGNs fall close to the low-luminosity extrapolations of more powerful AGNs. About half of all LLAGNs with multiple epoch data show significant inter-year radio variability. Investigation of a sample of ~150 nearby bright galaxies, most of them LLAGNs, shows that the nuclear (<150mas size) radio power is strongly correlated with both the black hole mass and the galaxy bulge luminosity; linear regression fits to all ~150 galaxies give: log P(2cm) = 1.31 log M_blackhole + 8.77 and log P(2cm) = 1.89 log L_B(bulge) - 0.17. Low accretion rates are implied in both advection- and jet-type models. In brief, all evidence points towards the presence of accreting massive black holes in a large fraction, perhaps all, of LLAGNs.Comment: to appear in A&