Analytical solutions for radiation-driven winds in massive stars - II: The δ-slow regime

Accurate mass-loss rates and terminal velocities from massive stars winds are essential to obtain synthetic spectra from radiative transfer calculations and to determine the evolutionary path of massive stars. From a theoretical point of view, analytical expressions for the wind parameters and velocity profile would have many advantages over numerical calculations that solve the complex non-linear set of hydrodynamic equations. In a previous work, we obtained an analytical description for the fast wind regime. Now, we propose an approximate expression for the line-force in terms of new parameters and obtain a velocity profile closed-form solution (in terms of the Lambert W function) for the δ-slow regime. Using this analytical velocity profile, we were able to obtain the mass-loss rates based on the m-CAK theory. Moreover, we established a relation between this new set of line-force parameters with the known stellar and m-CAK line-force parameters. To this purpose, we calculated a grid of numerical hydrodynamical models and performed a multivariate multiple regression. The numerical and our descriptions lead to good agreement between their values.Fil: Araya, I.. Universidad Mayor; ChileFil: Christen, A.. Universidad de Valparaíso; ChileFil: Cure, M.. Universidad de Valparaíso; ChileFil: Cidale, Lydia Sonia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Astrofísica La Plata. Universidad Nacional de La Plata. Facultad de Ciencias Astronómicas y Geofísicas. Instituto de Astrofísica La Plata; ArgentinaFil: Venero, Roberto Oscar José. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Astrofísica La Plata. Universidad Nacional de La Plata. Facultad de Ciencias Astronómicas y Geofísicas. Instituto de Astrofísica La Plata; ArgentinaFil: Arcos, C.. Universidad de Valparaíso; ChileFil: Gormaz Matamala, A.. Universidad de Valparaíso; Chile. Universidad Adolfo Ibañez; ChileFil: Haucke, Maximiliano. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Astrofísica La Plata. Universidad Nacional de La Plata. Facultad de Ciencias Astronómicas y Geofísicas. Instituto de Astrofísica La Plata; ArgentinaFil: Escarate, P.. Universidad Austral de Chile; ChileFil: Clavería, H.. Pontificia Universidad Católica de Valparaíso; Chil

Analytical solutions for radiation-driven winds in massive stars II : The δ-slow regime

Accurate mass-loss rates and terminal velocities from massive stars winds are essential to obtain synthetic spectra from radiative transfer calculations and to determine the evolutionary path of massive stars. From a theoretical point of view, analytical expressions for the wind parameters and velocity profile would have many advantages over numerical calculations that solve the complex non-linear set of hydrodynamic equations. In a previous work, we obtained an analytical description for the fast wind regime. Now, we propose an approximate expression for the line-force in terms of new parameters and obtain a velocity profile closed-form solution (in terms of the Lambert W function) for the δ-slow regime. Using this analytical velocity profile, we were able to obtain the mass-loss rates based on the m-CAK theory. Moreover, we established a relation between this new set of line-force parameters with the known stellar and m-CAK line-force parameters. To this purpose, we calculated a grid of numerical hydrodynamical models and performed a multivariate multiple regression. The numerical and our descriptions lead to good agreement between their values.Facultad de Ciencias Astronómicas y GeofísicasInstituto de Astrofísica de La Plat

Features and frequency of use of electronic health records in primary care across 20 countries:a cross-sectional study

Objectives: Variation exists in the capabilities of electronic healthcare records (EHRs) systems and the frequency of their use by primary care physicians (PCPs) from different settings. We aimed to examine the factors associated with everyday EHRs use by PCPs, characterise the EHRs features available to PCPs, and to identify the impact of practice settings on feature availability. Study design: Cross-sectional study. Methods: PCPs from 20 countries completed cross-sectional online survey between June and September 2020. Responses which reported frequency of EHRs use were retained. Associations between everyday EHRs use and PCP and practice factors (country, urbanicity, and digital maturity) were explored using multivariable logistic regression analyses. The effect of practice factors on the variation in availability of ten EHRs features was estimated using Cramer's V. Results: Responses from 1520 out of 1605 PCPs surveyed (94·7%) were retained. Everyday EHRs use was reported by 91·2% of PCPs. Everyday EHRs use was associated with PCPs working &gt;28 h per week, having more years of experience using EHRs, country of employment, and higher digital maturity. EHRs features concerning entering, and retrieving data were available to most PCPs. Few PCPs reported having access to tools for ‘interactive patient education’ (37·3%) or ‘home monitoring and self-testing of chronic conditions’ (34·3%). Country of practice was associated with availability of all EHRs features (Cramer's V range: 0·2–0·6), particularly with availability of tools enabling patient EHRs access (Cramer's V: 0·6, P &lt; 0.0001). Greater feature availability of EHRs features was observed with greater digital maturity. Conclusions: EHRs features intended for patient use were uncommon across countries and levels of digital maturity. Systems-level research is necessary to identify the country-specific barriers impeding the implementation of EHRs features in primary care, particularly of EHRs features enabling patient interaction with EHRs, to develop strategies to improve systems-wide EHRs use.</p

Multiple health behaviour change primary care intervention for smoking cessation, physical activity and healthy diet in adults 45 to 75 years old (EIRA study): a hybrid effectiveness-implementation cluster randomised trial

Background: This study aimed to evaluate the effectiveness of a) a Multiple Health Behaviour Change (MHBC) intervention on reducing smoking, increasing physical activity and adherence to a Mediterranean dietary pattern in people aged 45–75 years compared to usual care; and b) an implementation strategy. Methods: A cluster randomised effectiveness-implementation hybrid trial-type 2 with two parallel groups was conducted in 25 Spanish Primary Health Care (PHC) centres (3062 participants): 12 centres (1481 participants) were randomised to the intervention and 13 (1581 participants) to the control group (usual care). The intervention was based on the Transtheoretical Model and focused on all target behaviours using individual, group and community approaches. PHC professionals made it during routine care. The implementation strategy was based on the Consolidated Framework for Implementation Research (CFIR). Data were analysed using generalised linear mixed models, accounting for clustering. A mixed-methods data analysis was used to evaluate implementation outcomes (adoption, acceptability, appropriateness, feasibility and fidelity) and determinants of implementation success. Results: 14.5% of participants in the intervention group and 8.9% in the usual care group showed a positive change in two or all the target behaviours. Intervention was more effective in promoting dietary behaviour change (31.9% vs 21.4%). The overall adoption rate by professionals was 48.7%. Early and final appropriateness were perceived by professionals as moderate. Early acceptability was high, whereas final acceptability was only moderate. Initial and final acceptability as perceived by the participants was high, and appropriateness moderate. Consent and recruitment rates were 82.0% and 65.5%, respectively, intervention uptake was 89.5% and completion rate 74.7%. The global value of the percentage of approaches with fidelity =50% was 16.7%. Eight CFIR constructs distinguished between high and low implementation, five corresponding to the Inner Setting domain. Conclusions: Compared to usual care, the EIRA intervention was more effective in promoting MHBC and dietary behaviour change. Implementation outcomes were satisfactory except for the fidelity to the planned intervention, which was low. The organisational and structural contexts of the centres proved to be significant determinants of implementation effectiveness. Trial registration: ClinicalTrials.gov, NCT03136211. Registered 2 May 2017, “retrospectively registered”. © 2021, The Author(s)

External validation of multidimensional prognostic indices (ADO, BODEx and DOSE) in a primary care international cohort (PROEPOC/COPD cohort)

Background: Due to the heterogeneous and systemic nature of the chronic obstructive pulmonary disease (COPD), the new guidelines are oriented toward individualized attention. Multidimensional scales could facilitate its proper clinical and prognostic assessment, but not all of them were validated in an international primary care cohort, different from the original ones used for model development. Therefore, our main aim is to assess the prognostic capacity of the ADO, BODEx and DOSE indices in primary care for predicting mortality in COPD patients and to validate the models obtained in subgroups of patients, classified by revised Global Initiative for Chronic Obstructive Lung Disease (2011) and updated Spanish Guideline (2014). Besides, we want to confirm that the prognostic capacity of all indices increases if the number of exacerbations is substituted by the interval between them and to assess the impact on health of the patient''s lifestyle, social network and adherence to treatment. Methods: Design: External validation of scales, open and prospective cohort study in primary care. Setting: 36 health centres in 6 European high, medium and low income countries. Subjects: 477 patients diagnosed with COPD, captured in clinical visit by their General Practitioner/Nurse. Predictors: Detailed patient history, exacerbations, lung function test and questionnaires at baseline. Outcomes: Exacerbations, all-cause mortality and specific mortality, within 5 years of recruitment. Analysis: Multivariate logistic regression and Cox regression will be used. Possible non-linear effect of the indices will be studied by using Structured Additive Regression models with penalised splines. Subsequently, we will assess different aspects of the regression models: discrimination, calibration and diagnostic precision. Clinical variables modulated in primary care and the interval between exacerbations will be considered and incorporated into the analysis. Discussion: The Research Agenda for General Practice/Family Medicine highlights that the evidence on predictive values of prognostic indices in primary care is scarce. A prospective cohort like that of PROEPOC/COPD provides good opportunities for research into COPD and make communication easier between family practitioners, nursing staff, pneumologists and other professionals, supporting a multi-disciplinary approach to the treatment of these patients. Trial registration:ISRCTN52402811. Date: 15/01/2015. Prospectively registered

One consensual depression diagnosis tool to serve many countries: a challenge! A RAND/UCLA methodology

Objective From a systematic literature review (SLR), it became clear that a consensually validated tool was needed by European General Practitioner (GP) researchers in order to allow multi-centred collaborative research, in daily practice, throughout Europe. Which diagnostic tool for depression, validated against psychiatric examination according to the DSM, would GPs select as the best for use in clinical research, taking into account the combination of effectiveness, reliability and ergonomics? A RAND/UCLA, which combines the qualities of the Delphi process and of the nominal group, was used. GP researchers from different European countries were selected. The SLR extracted tools were validated against the DSM. The Youden index was used as an effectiveness criterion and Cronbach’s alpha as a reliability criterion. Ergonomics data were extracted from the literature. Ergonomics were tested face-to-face. Results The SLR extracted 7 tools. Two instruments were considered sufficiently effective and reliable for use: the Hospital Anxiety and Depression Scale and the Hopkins Symptoms Checklist-25 (HSCL-25). After testing face-to-face, HSCL-25 was selected. A multicultural consensus on one diagnostic tool for depression was obtained for the HSCL-25. This tool will provide the opportunity to select homogeneous populations for European collaborative research in daily practice

Jota aragonesa : Huesca

Etiqueta granate.En etiqueta: "Spanish", "Istrumental Trio"Intérpretes: Intérpretes : Los Armónicos, trío de guitarras y bandurrias.Impresionado en Barcelona.Fuente de ingreso: César Rodríguez XaixoDisco grabado por una cara