The Sex and Race Specific Relationship between Anthropometry and Body Fat Composition Determined from Computed Tomography: Evidence from the Multi-Ethnic Study of Atherosclerosis.

BackgroundFew studies have investigated the relationship of anthropometric measurements with computed tomography (CT) body fat composition, and even fewer determined if these relationships differ by sex and race.MethodsCT scans from 1,851 participants in the population based Multi-Ethnic Study of Atherosclerosis were assessed for visceral and subcutaneous fat areas by semi-automated segmentation of body compartments. Regression models were used to investigate relationships for anthropometry with visceral and subcutaneous fat separately by sex and race/ethnicity.ResultsParticipants were 50% female, 41% Caucasian, 13% Asian, 21% African American, and 25% Hispanic. For visceral fat, the positive relationship with weight (p = 0.028), waist circumference (p<0.001), waist to hip ratio (p<0.001), and waist to height ratio (p = 0.05) differed by sex, with a steeper slope for men. That is, across the range of these anthropometric measures the rise in visceral fat is faster for men than for women. Additionally, there were differences by race/ethnicity in the relationship with height (p<0.001), weight (p<0.001), waist circumference (p<0.001), hip circumference (p = 0.006), and waist to hip ratio (p = 0.001) with the Hispanic group having shallower slopes. For subcutaneous fat, interaction by sex was found for all anthropometric indices at p<0.05, but not for race/ethnicity.ConclusionThe relationship between anthropometry and underlying adiposity differs by sex and race/ethnicity. When anthropometry is used as a proxy for visceral fat in research, sex-specific models should be used

Turbulent Convection in Stellar Interiors. II. The Velocity Field

We analyze stellar convection with the aid of 3D hydrodynamic simulations, introducing the turbulent cascade into our theoretical analysis. We devise closures of the Reynolds-decomposed mean field equations by simple physical modeling of the simulations (we relate temperature and density fluctuations via coefficients); the procedure (CABS, Convection Algorithms Based on Simulations) is terrestrially testable and is amenable to systematic improvement. We develop a turbulent kinetic energy equation which contains both nonlocal and time dependent terms, and is appropriate if the convective transit time is shorter than the evolutionary time scale. The interpretation of mixing-length theory (MLT) as generally used in astrophysics is incorrect; MLT forces the mixing length to be an imposed constant. Direct tests show that the damping associated with the flow is that suggested by Kolmogorov. The eddy size is approximately the depth of the convection zone, and this dissipation length corresponds to the "mixing length". New terms involving local heating by turbulent dissipation should appear in the stellar evolution equations. The enthalpy flux ("convective luminosity") is directly connected to the buoyant acceleration, and hence the velocity scale. MLT tends to systematically underestimate this velocity scale. Quantitative comparison with a variety of 3D simulations reveals a previously recognized consistency. Examples of application to stellar evolution will be presented in subsequent papers in this series.Comment: 47 pages, 7 figures, accepted by Ap

Cancer Experience of Care Improvement Collaboratives in the National Health Service in England

NHS England started the work described in this article with the ambition of using insight and feedback from the adult National Cancer Patient Experience Survey to grow coproduced service improvements leading to improved patient centred quality outcomes in experience for cancer patients. Based on the Institute for Healthcare Improvement’s Breakthrough Collaborative Series, the approach of the Cancer Experience of Care Improvement Collaboratives (CIC) in the English healthcare system was developed, initially with 19 NHS provider organisation teams in 2019 as a face-to-face model, then developing into two collaboratives with an additional 15 NHS provider organisation teams in Cohort 2 and 8 teams in Rare & Less Common Cancers in a virtual framework. Each cohort has reported improvements in patient experience, staff experience and team working, but more fundamentally, have been able to describe a cultural shift in the way they work, together with people, leaving a lasting impact and legacy of this work. Key learning has been recognised with the increasing emphasis on involving people with relevant lived experience as partners and colleagues in the collaborative, alongside flexibility, responsiveness and adaptability as key to enabling project teams to continue where COVID-19 pressures allowed to participate. Experience Framework This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this len

Water in Comets 71P/Clark and C/2004 B1 (LINEAR) with Spitzer

We present 5.5 to 7.6 micron spectra of comets 71P/Clark (2006 May 27.56 UT, r_h = 1.57 AU pre-perihelion) and C/2004 B1 (LINEAR) (2005 October 15.22 UT, r_h = 2.21 AU pre-perihelion and 2006 May 16.22 UT, r_h = 2.06 AU post-perihelion) obtained with the Spitzer Space Telescope. The nu_2 vibrational band of water is detected with a signal-to-noise ratio of 11 to 50. Fitting the spectra using a fluorescence model of water emission yields a water rotational temperature of < 18 K for 71P/Clark and approximately less than or equivalent to 14 +/- 2 K (pre-perihelion) and 23 +/- 4 K (post-perihelion) for C/2004 B1 (LINEAR). The water ortho-to-para ratio in C/2004 B1 (LINEAR) is measured to be 2.31 +/- 0.18, which corresponds to a spin temperature of 26^{+3}_{-2} K. Water production rates are derived. The agreement between the water model and the measurements is good, as previously found for Spitzer spectra of C/2003 K4 (LINEAR). The Spitzer spectra of these three comets do not show any evidence for emission from PAHs and carbonate minerals, in contrast to results reported for comets 9P/Tempel~1 and C/1995 O1 (Hale-Bopp).Comment: 16 pages, 1 table, 7 figures, ApJ accepted 200

Towards integration of environmental and health impact assessments for wild capture fishing and farmed fish with particular reference to public health and occupational health dimensions

The paper offers a review and commentary, with particular reference to the production of fish from wild capture fisheries and aquaculture, on neglected aspects of health impact assessments which are viewed by a range of international and national health bodies and development agencies as valuable and necessary project tools. Assessments sometimes include environmental health impact assessments but rarely include specific occupational health and safety impact assessments especially integrated into a wider public health assessment. This is in contrast to the extensive application of environmental impact assessments to fishing and the comparatively large body of research now generated on the public health effects of eating fish. The value of expanding and applying the broader assessments would be considerable because in 2004 the United Nations Food and Agriculture Organization reports there were 41,408,000 people in the total ‘fishing’ sector including 11,289,000 in aquaculture. The paper explores some of the complex interactions that occur with regard to fishing activities and proposes the wider adoption of health impact assessment tools in these neglected sectors through an integrated public health impact assessment tool

[O/Fe] Estimates for Carbon-Enhanced Metal-Poor Stars from Near-IR Spectroscopy

We report on oxygen abundances determined from medium-resolution near-IR spectroscopy for a sample of 57 carbon-enhanced metal-poor (CEMP) stars selected from the Hamburg/ESO survey. The majority of our program stars exhibit oxygen-to-iron ratios in the range +0.5 < [O/Fe]< +2.0. The [O/Fe] values for this sample are statistically compared to available high-resolution estimates for known CEMP stars, as well as to high-resolution estimates for a set of carbon-normal metal-poor stars. Carbon, nitrogen, and oxygen abundance patterns for a sub-sample of these stars are compared to yield predictions for very metal-poor asymptotic giant-branch abundances in the recent literature. We find that the majority of our sample exhibit patterns that are consistent with previously studied CEMP stars having s-process-element enhancements, and thus have very likely been polluted by carbon- and oxygen-enhanced material transferred from a metal-poor asymptotic giant-branch companion.Comment: 16 pages, 8 figures, accepted by A

Paper 1: Conceptualizing the transition from advanced to consultant practitioner: career promotion or significant life event?

Background The diversification of nursing and allied health profession (AHP) roles has seen unprecedented growth as organizations have sought to optimize limited health care resources. Within the UK health care system, the nonmedical consultant is viewed as the pinnacle of the clinical career ladder. Yet, nearly 15 years after their introduction, recruitment to these positions remains slow. Criticisms of nonmedical consultant practice include a lack of role clarity, a failure to work across the four domains of consultant practice, a lack of suitable applicants, and poor preparedness of new appointments. Although there is evidence exploring the nature and effectiveness of established consultant roles, little research addresses the development phase of aspiring consultants. Objectives To explore the transitional journey experienced by trainee consultant radiographers as they move from advanced to consultant practitioner within a locally devised consultant development programme. Design Longitudinal qualitative enquiry. Methods and Settings Five trainee consultant radiographers were recruited to a locally devised consultant practice development program within a single UK hospital trust. Semistructured interviews were undertaken at 1, 6, and 12 months with the trainees. Results A challenging journey was recounted involving five key emotional stages that occurred in a consistent and predictable order (ie, elation, denial, doubt, crisis, and recovery). The identified stages had close parallels with Hopson's Life Events model, suggesting that transition to consultant practice is a significant life event rather than a straightforward job promotion. Conclusions Current emphasis on the four domains of practice, although providing a clear framework for expected external role outcomes, overlooks the importance of the internal or subjective career development on the perceived success or failure of the role. Employers, educators, and professional bodies have a responsibility to facilitate aspirational consultants to explore and enhance their internal career development, offering more time to define themselves and their role with support to guide them through the transition journey