94 research outputs found
Revising the Local Bubble Model due to Solar Wind Charge Exchange X-ray Emission
The hot Local Bubble surrounding the solar neighborhood has been primarily
studied through observations of its soft X-ray emission. The measurements were
obtained by attributing all of the observed local soft X-rays to the bubble.
However, mounting evidence shows that the heliosphere also produces diffuse
X-rays. The source is solar wind ions that have received an electron from
another atom. The presence of this alternate explanation for locally produced
diffuse X-rays calls into question the existence and character of the Local
Bubble. This article addresses these questions. It reviews the literature on
solar wind charge exchange (SWCX) X-ray production, finding that SWCX accounts
for roughly half of the observed local 1/4 keV X-rays found at low latitudes.
This article also makes predictions for the heliospheric O VI column density
and intensity, finding them to be smaller than the observational error bars.
Evidence for the continued belief that the Local Bubble contains hot gas
includes the remaining local 1/4 keV intensity, the observed local O VI column
density, and the need to fill the local region with some sort of plasma. If the
true Local Bubble is half as bright as previously thought, then its electron
density and thermal pressure are 1/square-root(2) as great as previously
thought, and its energy requirements and emission measure are 1/2 as great as
previously thought. These adjustments can be accommodated easily, and, in fact,
bring the Local Bubble's pressure more in line with that of the adjacent
material. Suggestions for future work are made.Comment: 9 pages, refereed, accepted for publication in the proceedings of the
"From the Outer Heliosphere to the Local Bubble: Comparisons of New
Observations with Theory" conference and in Space Science Review
Observation of exclusive DVCS in polarized electron beam asymmetry measurements
We report the first results of the beam spin asymmetry measured in the
reaction e + p -> e + p + gamma at a beam energy of 4.25 GeV. A large asymmetry
with a sin(phi) modulation is observed, as predicted for the interference term
of Deeply Virtual Compton Scattering and the Bethe-Heitler process. The
amplitude of this modulation is alpha = 0.202 +/- 0.028. In leading-order and
leading-twist pQCD, the alpha is directly proportional to the imaginary part of
the DVCS amplitude.Comment: 6 pages, 5 figure
The Science of Sungrazers, Sunskirters, and Other Near-Sun Comets
This review addresses our current understanding of comets that venture close to the Sun, and are hence exposed to much more extreme conditions than comets that are typically studied from Earth. The extreme solar heating and plasma environments that these objects encounter change many aspects of their behaviour, thus yielding valuable information on both the comets themselves that complements other data we have on primitive solar system bodies, as well as on the near-solar environment which they traverse. We propose clear definitions for these comets: We use the term near-Sun comets to encompass all objects that pass sunward of the perihelion distance of planet Mercury (0.307 AU). Sunskirters are defined as objects that pass within 33 solar radii of the Sun’s centre, equal to half of Mercury’s perihelion distance, and the commonly-used phrase sungrazers to be objects that reach perihelion within 3.45 solar radii, i.e. the fluid Roche limit. Finally, comets with orbits that intersect the solar photosphere are termed sundivers. We summarize past studies of these objects, as well as the instruments and facilities used to study them, including space-based platforms that have led to a recent revolution in the quantity and quality of relevant observations. Relevant comet populations are described, including the Kreutz, Marsden, Kracht, and Meyer groups, near-Sun asteroids, and a brief discussion of their origins. The importance of light curves and the clues they provide on cometary composition are emphasized, together with what information has been gleaned about nucleus parameters, including the sizes and masses of objects and their families, and their tensile strengths. The physical processes occurring at these objects are considered in some detail, including the disruption of nuclei, sublimation, and ionisation, and we consider the mass, momentum, and energy loss of comets in the corona and those that venture to lower altitudes. The different components of comae and tails are described, including dust, neutral and ionised gases, their chemical reactions, and their contributions to the near-Sun environment. Comet-solar wind interactions are discussed, including the use of comets as probes of solar wind and coronal conditions in their vicinities. We address the relevance of work on comets near the Sun to similar objects orbiting other stars, and conclude with a discussion of future directions for the field and the planned ground- and space-based facilities that will allow us to address those science topics
School-Based Programs to Reduce Bullying and Victimization
School bullying has serious short-term and long-term effects on children’s physical
and mental health. Various anti-bullying programs have been implemented world
wide and, more rarely, evaluated. Previous narrative reviews, summarizing the work
done on bullying prevention, as well as previous meta-analyses of anti-bullying
programs, are limited. The definition of school bullying includes several key
elements: physical, verbal, or psychological attack or intimidation that is intended
to cause fear, distress, or harm to the victim; an imbalance of power (psychological
or physical), with a more powerful child (or children) oppressing less powerful ones;
and repeated incidents between the same children over a prolonged period. School
bullying can occur in school or on the way to or from school. It is not bullying when
two persons of the same strength (physical, psychological, or verbal) victimize each
other. This report presents a systematic review and meta-analysis of the effectiveness of
programs designed to reduce school bullying perpetration and victimization (i.e.
being bullied). The authors indicate the pitfalls of previous reviews and explain in
detail how the present systematic review and meta-analysis addresses the gaps in
the existing literature on bullying prevention
Serious (violent or chronic) juvenile offenders: A systematic review of treatment effectiveness in secure corrections
Positive results in reducing future offender were found for some of the programs examined that
serve serious (violent or chronic) juvenile offenders in secure corrections. Considering this
general outcome, it is justifiable to continue treating this population. We found that programs
were more effective at reducing serious recidivism than in reducing general recidivism. This
finding shows the importance of including serious recidivism as an outcome measure of efficacy
in all the programmes oriented to reduce the delinquent behaviour of serious offenders. Chronic
and violent offenders are a small part of the offender population yet they are responsible for a
substantive portion of all offenses. Reducing the delinquent behaviour of this group through
secure correctional programming is clearly important that this review suggests that such
programs can be effective
Pharmaceutical care as a strategy to improve the safety and effectiveness of patients? pharmacotherapy at a pharmacy school: a practical proposal
Effects of rare kidney diseases on kidney failure: a longitudinal analysis of the UK National Registry of Rare Kidney Diseases (RaDaR) cohort
Background
Individuals with rare kidney diseases account for 5–10% of people with chronic kidney disease, but constitute more than 25% of patients receiving kidney replacement therapy. The National Registry of Rare Kidney Diseases (RaDaR) gathers longitudinal data from patients with these conditions, which we used to study disease progression and outcomes of death and kidney failure.
Methods
People aged 0–96 years living with 28 types of rare kidney diseases were recruited from 108 UK renal care facilities. The primary outcomes were cumulative incidence of mortality and kidney failure in individuals with rare kidney diseases, which were calculated and compared with that of unselected patients with chronic kidney disease. Cumulative incidence and Kaplan–Meier survival estimates were calculated for the following outcomes: median age at kidney failure; median age at death; time from start of dialysis to death; and time from diagnosis to estimated glomerular filtration rate (eGFR) thresholds, allowing calculation of time from last eGFR of 75 mL/min per 1·73 m2 or more to first eGFR of less than 30 mL/min per 1·73 m2 (the therapeutic trial window).
Findings
Between Jan 18, 2010, and July 25, 2022, 27 285 participants were recruited to RaDaR. Median follow-up time from diagnosis was 9·6 years (IQR 5·9–16·7). RaDaR participants had significantly higher 5-year cumulative incidence of kidney failure than 2·81 million UK patients with all-cause chronic kidney disease (28% vs 1%; p<0·0001), but better survival rates (standardised mortality ratio 0·42 [95% CI 0·32–0·52]; p<0·0001). Median age at kidney failure, median age at death, time from start of dialysis to death, time from diagnosis to eGFR thresholds, and therapeutic trial window all varied substantially between rare diseases.
Interpretation
Patients with rare kidney diseases differ from the general population of individuals with chronic kidney disease: they have higher 5-year rates of kidney failure but higher survival than other patients with chronic kidney disease stages 3–5, and so are over-represented in the cohort of patients requiring kidney replacement therapy. Addressing unmet therapeutic need for patients with rare kidney diseases could have a large beneficial effect on long-term kidney replacement therapy demand.
Funding
RaDaR is funded by the Medical Research Council, Kidney Research UK, Kidney Care UK, and the Polycystic Kidney Disease Charity
Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study
Introduction:
The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures.
Methods:
In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025.
Findings:
Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation.
Interpretation:
After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification.
Funding:
UK Research and Innovation and National Institute for Health Research
Large-scale phenotyping of patients with long COVID post-hospitalization reveals mechanistic subtypes of disease
One in ten severe acute respiratory syndrome coronavirus 2 infections result in prolonged symptoms termed long coronavirus disease (COVID), yet disease phenotypes and mechanisms are poorly understood1. Here we profiled 368 plasma proteins in 657 participants ≥3 months following hospitalization. Of these, 426 had at least one long COVID symptom and 233 had fully recovered. Elevated markers of myeloid inflammation and complement activation were associated with long COVID. IL-1R2, MATN2 and COLEC12 were associated with cardiorespiratory symptoms, fatigue and anxiety/depression; MATN2, CSF3 and C1QA were elevated in gastrointestinal symptoms and C1QA was elevated in cognitive impairment. Additional markers of alterations in nerve tissue repair (SPON-1 and NFASC) were elevated in those with cognitive impairment and SCG3, suggestive of brain–gut axis disturbance, was elevated in gastrointestinal symptoms. Severe acute respiratory syndrome coronavirus 2-specific immunoglobulin G (IgG) was persistently elevated in some individuals with long COVID, but virus was not detected in sputum. Analysis of inflammatory markers in nasal fluids showed no association with symptoms. Our study aimed to understand inflammatory processes that underlie long COVID and was not designed for biomarker discovery. Our findings suggest that specific inflammatory pathways related to tissue damage are implicated in subtypes of long COVID, which might be targeted in future therapeutic trials
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