A Multi-coloured survey of NGC 253 with XMM-Newton

There is a large body of work that has used the excellent Chandra observations of nearby galaxies with neglible low mass X-ray binary (LMXB) populations. This has culminated in a ``Universal'' X-ray luminosity function (XLF) for high mass X-ray binaries (HMXBs). However, a number of methods have been used to convert from source intensities to luminosities when creating these XLFs. We have taken advantage of the XMM-Newton observations of the nearby starbursting spiral galaxy NGC 253 to test some of these methods. We find the luminosities derived from these various methods to vary by a factor of $\sim$3. We also find the most influential factor in the conversion from intensity to luminosity to be the absorption. We therefore conclude that a more consistent approach is required for determining the true Universal XLF for HMXBs. Ideally, this would involve individual spectral fitting of each X-ray source. Certainly, the line-of-sight absorption should be determined from the observations rather than assuming Galactic absorption. We find the best approach for obtaining an XLF from low-count data to be the splitting of the X-ray sources into two or more intensity intervals, and obtaining a conversion from intensity to flux for each group from spectral modelling of the summed spectrum of that group.Comment: To appear in the proceedings of "X-rays from Nearby Galaxies", 4-7 Septembeer 2007, 4 page

Cumulative luminosity functions of the X-ray point source population in M31

We present preliminary results from a detailed analysis of the X-ray point sources in the XMM-Newton survey of M31. These sources are expected to be mostly X-ray binaries. We have so far studied 225 of the 535 sources found by automated source detection. Only sources which were present in all three EPIC images were considered. X-ray binaries are identified by their energy spectrum and power density spectrum. Unlike in other surveys we have obtained source luminosities from freely fit emission models. We present uncorrected luminosity functions of the sources analysed so far.Comment: 2 pages, 1 figure. To appear in proceedings of IAUS23

XMM-Newton reveals ~100 new LMXBs in M31 from variability studies

We have conducted a survey of X-ray sources in XMM-Newton observations of M31, examining their power density spectra (PDS) and spectral energy distributions (SEDs). Our automated source detection yielded 535 good X-ray sources; to date, we have studied 225 of them. In particular, we examined the PDS because low mass X-ray binaries (LMXBs) exhibit two distinctive types of PDS. At low accretion rates, the PDS is characterised by a broken power law, with the spectral index changing from ~0 to ~1 at some frequency in the range \~0.01--1 Hz; we refer to such PDS as Type A. At higher accretion rates, the PDS is described by a simple power law; we call these PDS Type B. Of the 225 sources studied to date, 75 exhibit Type A variability, and are almost certainly LMXBs, while 6 show Type B but not Type A, and are likely LMXBs. Of these 81 candidate LMXBs, 71 are newly identified in this survey; furthermore, they are mostly found near the centre of M31. Furthermore, most of the X-ray population in the disc are associated with the spiral arms, making them likely high mass X-ray binaries (HMXBs). In general these HMXBs do not exhibit Type A variability, while many central X-ray sources (LMXBs) in the same luminosity range do. Hence the PDS may distinguish between LMXBs and HMXBs in this luminosity range.Comment: 4 pages, 2 figures. To appear in proceedings of IAUS230: "Populations of High Energy Sources in Galaxies", 14-19 August 2005, Dublin, Eds E.J.A. Meurs and G. Fabbian

A multi-coloured survey of NGC 253 with XMM-Newton: testing the methods used for creating luminosity functions from low-count data

NGC 253 is a local, star-bursting spiral galaxy with strong X-ray emission from hot gas, as well as many point sources. We have conducted a spectral survey of the X-ray population of NGC 253 using a deep XMM-Newton observation.NGC 253 only accounts for ~20% of the XMM-Newton EPIC field of view, allowing us to identify ~100 X-ray sources that are unlikely to be associated with NGC\thinspace 253. Hence we were able to make a direct estimate of contamination from e.g. foreground stars and background galaxies. X-ray luminosity functions (XLFs) of galaxy populations are often used to characterise their properties. There are several methods for estimating the luminosities of X-ray sources with few photons. We have obtained spectral fits for the brightest 140 sources in the 2003 XMM-Newton observation of NGC 253, and compare the best fit luminosities of those 69 non-nuclear sources associated with NGC 253 with luminosities derived using other methods. We find the luminosities obtained from these various methods to vary systematically by a factor of up to three for the same data; this is largely due to differences in absorption. We therefore conclude that assuming Galactic absorption is probably unwise; rather, one should measure the absorption for the population. A remarkable correlation has been reported between the XLFs of galaxies and their star formation rates. However, the XLFs used in that study were obtained using several different methods. If the sample galaxies were revisited and a single method were applied, then this correlation may become stronger still.Comment: Accepted for publication in the Monthly Notices of the Royal Astronomical Society (MNRAS). 17 pages, 7 figure

An X-ray spectral survey of the disc of M31 with XMM-Newton

We present the results of a complete spectral survey of the X-ray point sources detected in five XMM-Newton observations along the major axis of M31 but avoiding the central bulge, aimed at establishing the population characteristics of X-ray sources in this galaxy. We obtained background subtracted spectra and lightcurves for each of the 335 X-ray point sources detected across the five observations from 2002. We also correlate our source list with those of earlier X-ray surveys and radio, optical and infra-red catalogues. Sources with more than 50 source counts are individually spectrally fit in order to create the most accurate luminosity functions of M31 to date. Based on the spectral fitting of these sources with a power law model, we observe a broad range of best fit photon index. From this distribution of best fit index, we identify 16 strong high mass X-ray binary system candidates in M31. We show the first cumulative luminosity functions created using the best fit spectral model to each source with more than 50 source counts in the disc of M31. The cumulative luminosity functions show a prominent, statistically significant flattening in the X-ray luminosity LX interval 37.0 \lesssim log LX erg s-1 \lesssim 37.5. Such a feature may also be present in the X-ray populations of several other galaxies, but at a much lower statistical significance. We investigate the number of AGN present in our source list and find that above LX ~1.4x1036 erg s-1 the observed population is statistically dominated by the point source population of M31.Comment: accepted by A&A. 24 pages, 6 figures, 7 table

Management of work-relevant upper limb disorders: a review

Background Upper limb disorders (ULDs) are clinically challenging and responsible for considerable work loss. There is a need to determine effective approaches for their management. Aim To determine evidence-based management strategies for work-relevant ULDs and explore whether a biopsychosocial approach is appropriate. Methods Literature review using a best evidence synthesis. Data from articles identified through systematic searching of electronic databases and citation tracking were extracted into evidence tables. The information was synthesized into high-level evidence statements, which were ordered into themes covering classification/diagnosis, epidemiology, associations/risks and management/treatment, focusing on return to work or work retention and taking account of distinctions between non-specific complaints and specific diagnoses. Results Neither biomedical treatment nor ergonomic workplace interventions alone offer an optimal solution; rather, multimodal interventions show considerable promise, particularly for occupational outcomes. Early return to work, or work retention, is an important goal for most cases and may be facilitated, where necessary, by transitional work arrangements. The emergent evidence indicates that successful management strategies require all the players to be onside and acting in a coordinated fashion; this requires engaging employers and workers to participate. Conclusions The biopsychosocial model applies: biological considerations should not be ignored, but psychosocial factors are more influential for occupational outcomes. Implementation of interventions that address the full range of psychosocial issues will require a cultural shift in the way the relationship between upper limb complaints and work is conceived and handled. Dissemination of evidence-based messages can contribute to the needed cultural shift

Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls

Background The risk factors for recovery from COVID-19 dyspnoea are poorly understood. We investigated determinants of recovery from dyspnoea in adults with COVID-19 and compared these to determinants of recovery from non-COVID-19 dyspnoea. Methods We used data from two prospective cohort studies: PHOSP-COVID (patients hospitalised between March 2020 and April 2021 with COVID-19) and COVIDENCE UK (community cohort studied over the same time period). PHOSP-COVID data were collected during hospitalisation and at 5-month and 1-year follow-up visits. COVIDENCE UK data were obtained through baseline and monthly online questionnaires. Dyspnoea was measured in both cohorts with the Medical Research Council Dyspnoea Scale. We used multivariable logistic regression to identify determinants associated with a reduction in dyspnoea between 5-month and 1-year follow-up. Findings We included 990 PHOSP-COVID and 3309 COVIDENCE UK participants. We observed higher odds of improvement between 5-month and 1-year follow-up among PHOSP-COVID participants who were younger (odds ratio 1.02 per year, 95% CI 1.01–1.03), male (1.54, 1.16–2.04), neither obese nor severely obese (1.82, 1.06–3.13 and 4.19, 2.14–8.19, respectively), had no pre-existing anxiety or depression (1.56, 1.09–2.22) or cardiovascular disease (1.33, 1.00–1.79), and shorter hospital admission (1.01 per day, 1.00–1.02). Similar associations were found in those recovering from non-COVID-19 dyspnoea, excluding age (and length of hospital admission). Interpretation Factors associated with dyspnoea recovery at 1-year post-discharge among patients hospitalised with COVID-19 were similar to those among community controls without COVID-19. Funding PHOSP-COVID is supported by a grant from the MRC-UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19. The views expressed in the publication are those of the author(s) and not necessarily those of the National Health Service (NHS), the NIHR or the Department of Health and Social Care. COVIDENCE UK is supported by the UK Research and Innovation, the National Institute for Health Research, and Barts Charity. The views expressed are those of the authors and not necessarily those of the funders

A novel formulation of inhaled sodium cromoglicate (PA101) in idiopathic pulmonary fibrosis and chronic cough: a randomised, double-blind, proof-of-concept, phase 2 trial

Background Cough can be a debilitating symptom of idiopathic pulmonary fibrosis (IPF) and is difficult to treat. PA101 is a novel formulation of sodium cromoglicate delivered via a high-efficiency eFlow nebuliser that achieves significantly higher drug deposition in the lung compared with the existing formulations. We aimed to test the efficacy and safety of inhaled PA101 in patients with IPF and chronic cough and, to explore the antitussive mechanism of PA101, patients with chronic idiopathic cough (CIC) were also studied. Methods This pilot, proof-of-concept study consisted of a randomised, double-blind, placebo-controlled trial in patients with IPF and chronic cough and a parallel study of similar design in patients with CIC. Participants with IPF and chronic cough recruited from seven centres in the UK and the Netherlands were randomly assigned (1:1, using a computer-generated randomisation schedule) by site staff to receive PA101 (40 mg) or matching placebo three times a day via oral inhalation for 2 weeks, followed by a 2 week washout, and then crossed over to the other arm. Study participants, investigators, study staff, and the sponsor were masked to group assignment until all participants had completed the study. The primary efficacy endpoint was change from baseline in objective daytime cough frequency (from 24 h acoustic recording, Leicester Cough Monitor). The primary efficacy analysis included all participants who received at least one dose of study drug and had at least one post-baseline efficacy measurement. Safety analysis included all those who took at least one dose of study drug. In the second cohort, participants with CIC were randomly assigned in a study across four centres with similar design and endpoints. The study was registered with ClinicalTrials.gov (NCT02412020) and the EU Clinical Trials Register (EudraCT Number 2014-004025-40) and both cohorts are closed to new participants. Findings Between Feb 13, 2015, and Feb 2, 2016, 24 participants with IPF were randomly assigned to treatment groups. 28 participants with CIC were enrolled during the same period and 27 received study treatment. In patients with IPF, PA101 reduced daytime cough frequency by 31·1% at day 14 compared with placebo; daytime cough frequency decreased from a mean 55 (SD 55) coughs per h at baseline to 39 (29) coughs per h at day 14 following treatment with PA101, versus 51 (37) coughs per h at baseline to 52 (40) cough per h following placebo treatment (ratio of least-squares [LS] means 0·67, 95% CI 0·48–0·94, p=0·0241). By contrast, no treatment benefit for PA101 was observed in the CIC cohort; mean reduction of daytime cough frequency at day 14 for PA101 adjusted for placebo was 6·2% (ratio of LS means 1·27, 0·78–2·06, p=0·31). PA101 was well tolerated in both cohorts. The incidence of adverse events was similar between PA101 and placebo treatments, most adverse events were mild in severity, and no severe adverse events or serious adverse events were reported. Interpretation This study suggests that the mechanism of cough in IPF might be disease specific. Inhaled PA101 could be a treatment option for chronic cough in patients with IPF and warrants further investigation