Carbon radio recombination lines from gigahertz to megahertz frequencies towards Orion A

Context. The combined use of carbon radio recombination lines (CRRLs) and the 158 $\mu$m-[CII] line is a powerful tool for the study of the energetics and physical conditions (e.g., temperature and density) of photodissociation regions (PDRs). However, there are few observational studies that exploit this synergy. Aims. Here we explore the relation between CRRLs and the 158 $\mu$m-[CII] line in light of new observations and models. Methods. We present new and existing observations of CRRLs in the frequency range 0.15--230 GHz with ALMA, VLA, the GBT, Effelsberg 100m, and LOFAR towards Orion~A (M42). We complement these observations with SOFIA observations of the 158 $\mu$m-[CII] line. We studied two PDRs: the foreground atomic gas, known as the Veil, and the dense PDR between the HII region and the background molecular cloud. Results. In the Veil we are able to determine the gas temperature and electron density, which we use to measure the ionization parameter and the photoelectric heating efficiency. In the dense PDR, we are able to identify a layered PDR structure at the surface of the molecular cloud to the south of the Trapezium cluster. There we find that the radio lines trace the colder portion of the ionized carbon layer, the C$^{+}$/C/CO interface. By modeling the emission of the $158$~$\mu$m-[CII] line and CRRLs as arising from a PDR we derive a thermal pressure $>5\times10^{7}$ K cm$^{-3}$ and a radiation field $G_{0}\approx10^{5}$ close to the Trapezium. Conclusions. This work provides additional observational support for the use of CRRLs and the 158 $\mu$m-[CII] line as complementary tools to study dense and diffuse PDRs, and highlights the usefulness of CRRLs as probes of the C$^{+}$/C/CO interface.Comment: 18 pages, 16 figures, accepted for publication in A&

Post-discharge Telemonitoring of Physical Activity, Vital Signs, and Patient-Reported Symptoms in Older Patients Undergoing Cancer Surgery

BACKGROUND: Postoperative home monitoring could potentially detect complications early, but evidence in oncogeriatric surgery is scarce. Therefore, we evaluated whether post-discharge physical activity, vital signs, and patient-reported symptoms are related to post-discharge complications and hospital readmissions in older patients undergoing cancer surgery. METHODS: In this observational cohort study, we monitored older patients (≥65 years of age) undergoing cancer surgery, for 2 weeks post-discharge using tablet-based applications and connected devices. Outcome measures were post-discharge complications and readmissions; physical activity and patient-reported symptoms over time; and threshold violations for physical activity (step count 38°C; blood pressure 150/100 mmHg; heart rate 100 bpm; weight -5% or +5% of weight at discharge); and patient-reported symptoms (pain score greater than the previous day; presence of dyspnea, vomiting, dizziness, fever). RESULTS: Of 58 patients (mean age 72 years), 24 developed a post-discharge complication and 13 were readmitted. Measured parameters indicated 392 threshold violations out of 5379 measurements (7.3%) in 40 patients, mostly because of physical inactivity. Patients with readmissions had lower physical activity at discharge and at day 9 after discharge and violated a physical activity threshold more often. Patients with post-discharge complications had a higher median pain score compared with patients without these adverse events. No differences in threshold violations of other parameters were observed between patients with and without post-discharge complications and readmissions. CONCLUSION: Our results show the potential of telemonitoring older patients after cancer surgery but confirm that detecting post-discharge complications is complex and multifactorial

Perioperative telemonitoring of older adults with cancer:Can we connect them all?

OBJECTIVES: Although the increasing cancer incidence in older patients is widely recognised, older patients remain underrepresented in clinical cancer trials and eHealth studies. The aim of this research is to identify technological and patient-related barriers to inclusion of this population in a clinical eHealth study. MATERIAL AND METHODS: This is a retrospective analysis of a prospective cohort study with older patients (≥ 65 years) undergoing cancer-related surgery, who were identified for a perioperative telemonitoring study. Reasons for ineligibility and refusal had been prospectively registered. Characteristics and postoperative outcomes were compared between participants and non-participants. RESULTS: Between May 2018 and March 2020, 151 patients were assessed for eligibility, resulting in 65 participants and 86 non-participants. The main reason for ineligibility was lack of internet access at home (n = 16), while main reasons for refusal were perceived high mental burden (n = 46) and insufficient digital skills (n = 12). Compared with participants, non-participants were significantly older (mean age 75 vs. 73, p = 0.01); more often female (64% vs. 35%, p = 0.00), unmarried (42% vs. 8%, p = 0.01) living alone (38% vs. 19%, p = 0.02); had a higher ASA classification (43% vs. 19%, p = 0.00); often had polypharmacy (67% vs. 43%, p = 0.00); and were more often discharged to skilled nursing facilities (0% vs. 15%, p = 0.00). CONCLUSION: Our results confirm the underrepresentation of older female patients with little support from a partner and higher comorbidity. We should be aware of technological and patient-related barriers to including older adults with cancer, in order to avoid further dividing patients with low and high digital health literacy

Task Force 7: Training Guidelines for Research in Pediatric Cardiology

Aim of the study. The aim of the study was to analyze the benefit from adjuvant radiotherapy in patients with vulvar cancer and a single positive node without extra capsular spread. Materials and methods. The Study population comprised data of 75 patients with vulvar cancer and one lymph node metastasis. The patients were treated in three different university centers in Amsterdam, Groningen and Rotterdam between 1984 and 2005. Results. Out of 75 patients, 31 (41%) were treated with adjuvant radiotherapy. Both disease-free survival (DFS) and disease-specific survival (DSS) were comparable between the groups who did and who did not receive adjuvant radiotherapy (HR 0.98, 95% CI 0.45-2.14, p=0.97 and HR = 1.02, 95% CI 0.42-2.47, p = 0.96). Conclusion. We could not demonstrate any beneficial effect of adjuvant radiotherapy in the group Of patients with one intra capsular metastasis. (C) 2009 Elsevier Inc. All rights reserved

Effects of warning signals and fixation point offsets on the latencies of pro- versus antisaccades: implications for an interpretation of the gap effect

The present study was designed to evaluate whether fixation point offsets have the same effects on the average latencies of prosaccades (responses towards target) and antisaccades (responses away from target). Gap and overlap conditions were run with and without an acoustic warning signal. The ‘gap effect’ was taken to be the difference in mean reaction time between gap and overlap trials. This effect was dramatically reduced by the presentation of the warning signal. Without this signal, fixation offsets can serve as warning signals themselves, which artifactually inflates the magnitude of the gap effect. The warning effect of fixation offsets was equivalent for pro and antisaccades. A significant gap effect is still evident with the acoustic warning signal; however, in this case it is associated primarily with prosaccades. These results replicate and extend our previous work demonstrating that, if their warning effects are controlled, the facilitatory effects of fixation point offsets are response dependent, and suggesting the existence of a component process (fixation release) which is closely linked with the processing architecture underlying target-directed saccades.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46531/1/221_2004_Article_BF00231715.pd

Autologous lipoaspirate as a new treatment of vulvar lichen sclerosus:A review on literature

Lichen sclerosus (LS) is a chronic inflammatory dermatosis that mostly affects the genital and anal skin areas. Symptoms may vary from pruritis and pain to sexual dysfunction; however, LS can also be asymptomatic. LS occurs at all ages and in both sexes. Approximately 5% of all women affected by vulvar LS will develop vulvar squamous cell carcinoma. Topical treatment is safe but less effective resulting in chronic course in most patients, who suffer from persistent itching and pain. In severe cases of therapy-resistant LS, there is no adequate treatment. Fat grafting is a novel regenerative therapy to reduce dermal fibrosis. The therapeutic effect of adipose tissue grafts for LS is already investigated in various pioneering studies. This review provides an overview of these studies and the putative mechanisms-of-action of fat grafting to treat LS

Lofar low-band antenna observations of the 3C 295 and boötes fields : Source counts and ultra-steep spectrum sources

© 2018 The American Astronomical Society. All rights reserved.We present Low Frequency Array (LOFAR) Low Band observations of the Boötes and 3C 295 fields. Our images made at 34, 46, and 62 MHz reach noise levels of 12, 8, and 5 mJy beam-1, making them the deepest images ever obtained in this frequency range. In total, we detect between 300 and 400 sources in each of these images, covering an area of 17-52 deg2. From the observations, we derive Euclidean-normalized differential source counts. The 62 MHz source counts agree with previous GMRT 153 MHz and Very Large Array 74 MHz differential source counts, scaling with a spectral index of -0.7. We find that a spectral index scaling of -0.5 is required to match up the LOFAR 34 MHz source counts. This result is also in agreement with source counts from the 38 MHz 8C survey, indicating that the average spectral index of radio sources flattens toward lower frequencies. We also find evidence for spectral flattening using the individual flux measurements of sources between 34 and 1400 MHz and by calculating the spectral index averaged over the source population. To select ultra-steep spectrum (α < -1.1) radio sources that could be associated with massive high-redshift radio galaxies, we compute spectral indices between 62 MHz, 153 MHz, and 1.4 GHz for sources in the Boötes field. We cross-correlate these radio sources with optical and infrared catalogs and fit the spectral energy distribution to obtain photometric redshifts. We find that most of these ultra-steep spectrum sources are located in the 0.7 ≲ z ≲ 2.5 range.Peer reviewe

Searching for the largest bound atoms in space

(abridged) Radio recombination lines (RRLs) at frequencies $\nu$ < 250 MHz trace the cold, diffuse phase of the ISM. Next generation low frequency interferometers, such as LOFAR, MWA and the future SKA, with unprecedented sensitivity, resolution, and large fractional bandwidths, are enabling the exploration of the extragalactic RRL universe. We observed the radio quasar 3C 190 (z~1.2) with the LOFAR HBA. In reducing this data for spectroscopic analysis, we have placed special emphasis on bandpass calibration. We devised cross-correlation techniques to significantly identify the presence of RRLs in a low frequency spectrum. We demonstrate the utility of this method by applying it to existing low-frequency spectra of Cassiopeia A and M 82, and to the new observations of 3C 190. RRLs have been detected in the foreground of 3C 190 at z = 1.12355 (assuming a carbon origin), owing to the first detection of RRLs outside of the local universe (first reported in Emig et al. 2019). Towards the Galactic supernova remnant Cas A, we uncover three new detections: (1) C$\epsilon$-transitions ($\Delta$n = 5) for the first time at low radio frequencies, (2) H$\alpha$-transitions at 64 MHz with a FWHM of 3.1 km/s, the most narrow and one of the lowest frequency detections of hydrogen to date, and (3) C$\alpha$ at v$_{LSR}$ = 0 km/s in the frequency range 55-78 MHz for the first time. Additionally we recover C$\alpha$, C$\beta$, C$\gamma$, and C$\delta$ from the -47 km/s and -38 km/s components. In the nearby starburst galaxy, M 82, we do not find a significant feature. Our current searches for RRLs in LOFAR observations are limited to narrow (< 100 km/s) features, owing to the relatively small number of channels available for continuum estimation. Future strategies making use of larger contiguous frequency coverage would aid calibration to deeper sensitivities and broader features.Comment: 21 pages, 21 figures, accepted in A&