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As the pathophysiology of Covid-19 emerges, this paper describes dysphagia as a sequela of the disease, including its diagnosis and management, hypothesised causes, symptomatology in relation to viral progression, and concurrent variables such as intubation, tracheostomy and delirium, at a tertiary UK hospital.
During the first wave of the Covid-19 pandemic, 208 out of 736 patients (28.9 per cent) admitted to our institution with SARS-CoV-2 were referred for swallow assessment. Of the 208 patients, 102 were admitted to the intensive treatment unit for mechanical ventilation support, of which 82 were tracheostomised. The majority of patients regained near normal swallow function prior to discharge, regardless of intubation duration or tracheostomy status.
Dysphagia is prevalent in patients admitted either to the intensive treatment unit or the ward with Covid-19 related respiratory issues. This paper describes the crucial role of intensive swallow rehabilitation to manage dysphagia associated with this disease, including therapeutic respiratory weaning for those with a tracheostomy.
While fetal alcohol spectrum disorder (FASD) has primarily been thought of as a neurodevelopmental condition, research is beginning to highlight its ‘whole-body’ implications. Accordingly, the current study sought to provide a snapshot of potential health issues. Caregivers of children (median age of 12 years) with an FASD diagnosis were invited to participate in an online survey. Information relating to sample demographics, FASD status of the child and health outcomes were collected. The prevalence of health conditions reported in the FASD sample was compared against national prevalence data. Multiple linear regression utilising a stepwise approach was used to investigate potential predictors of the number of diagnosed health conditions. Survey data were from an international cohort (n = 197), with the majority of respondents based in Australia (40.2%) or the United States (27.7%). The most commonly reported diagnosed health conditions were eye conditions (44.7%), asthma (34.5%), heart conditions (34.0%) and skin conditions (27.4%). Binomial testing indicated the proportion of children diagnosed with these disorders was generally higher in the current FASD population, compared to national prevalence data. Indicators of metabolic dysfunction including diabetes and obesity were not significantly different compared to national prevalence data. Age of FASD diagnosis, existence of comorbid mental health conditions and the primary caregiver being in paid work were identified as being associated with the prevalence of diagnosed health conditions. Overall, the study has provided an up-to-date snapshot of health problems reported in a sample of children with FASD, confirming their increased risk of adverse health outcomes.
Serious mental illness (SMI) is associated with poorer cancer outcomes. Reasons for such inequalities are unclear; those with this comorbidity receive fewer specialist interventions and die earlier than the general population. Further exploratory work is required.
Exploring the experience of SMI and cancer from the perspective of those affected by this comorbidity and those caring for them professionally or informally.
Semi-structured interviews were conducted with ‘key patients’ living with SMI who had received a cancer diagnosis (n = 7), significant others who had supported key patients (n = 4) and healthcare professionals who had worked with at least one KP (n = 17). A panel of patients and professionals ratified interview guides. Interviews were analysed thematically.
Mental health professionals were more confident in their knowledge of the needs of this population than oncology professionals, but were challenged by working with patients with major physical health needs. Key patients’ mental health appeared to remain stable after cancer diagnosis, and they expressed altruism towards others with comorbid cancer and SMI. Significant others and healthcare professionals were more likely to critique systemic aspects of care than were key patients.
Professionals feel challenged when working outside of their usual job role. Training needs include mental illness awareness in an oncology setting. Improved coordination and communication is required, encompassing significant others as well as professional groups. SMI may protect against the psychological impact of cancer. Key patients were keen to provide advice and support to others in similar situations. Further research is needed into these areas.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
This article produces the first findings on changes in household and family structure in England and Wales during 1851–1911, using the recently available Integrated Census Microdata (I-CeM) – a complete count database of individual-level data extending to some 188 million records. As such, it extends and updates the important overview article published in Continuity and Change by Michael Anderson in 1988. The I-CeM data shed new light on transitions in household structure and family life during this period, illustrating both continuities and change in a number of key areas: family composition; single parent families; living alone; extended households; childhood; leaving home and marriage patterns.
Both elevated blood pressure and/or depression increase the risk of cardiovascular disease and mortality. This study in treated elderly hypertensive patients explored the incidence of depression, its association (pre-existing and incident) with mortality and predictors of incident depression.
Data from 6,083 hypertensive patients aged ≥65 years enrolled in the Second Australian National Blood Pressure study were used. Participants were followed for a median of 10.8 years (including 4.1 years in-trial) and classified into: “no depression,” “pre-existing” and “incident” depression groups based on either being “diagnosed with depressive disorders” and/or “treated with an anti-depressant drug” at baseline or during in-trial period. Further, we redefined “depression” restricted to presence of both conditions for sensitivity analyses. For the current study, end-points were all-cause and any cardiovascular mortality.
313 (5%) participants had pre-existing depression and a further 916 (15%) participants developed depression during the trial period (incidence 4% per annum). Increased (hazard-ratio, 95% confidence-interval) all-cause mortality was observed among those with either pre-existing (1.23, 1.01–1.50; p = 0.03) or incident (1.26, 1.12–1.41; p < 0.001) depression compared to those without. For cardiovascular mortality, a 24% increased risk (1.24, 1.05–1.47; p = 0.01) was observed among those with incident depression. The sensitivity analyses, using the restricted depression definition showed similar associations. Incident depression was associated with being female, aged ≥75 years, being an active smoker at study entry, and developing new diabetes during the study period.
This elderly cohort had a high incidence of depression irrespective of their randomised antihypertensive regimen. Both pre-existing and incident depression were associated with increased mortality.
Knowledge of the effects of burial depth and burial duration on seed viability and, consequently, seedbank persistence of Palmer amaranth (Amaranthus palmeri S. Watson) and waterhemp [Amaranthus tuberculatus (Moq.) J. D. Sauer] ecotypes can be used for the development of efficient weed management programs. This is of particular interest, given the great fecundity of both species and, consequently, their high seedbank replenishment potential. Seeds of both species collected from five different locations across the United States were investigated in seven states (sites) with different soil and climatic conditions. Seeds were placed at two depths (0 and 15 cm) for 3 yr. Each year, seeds were retrieved, and seed damage (shrunken, malformed, or broken) plus losses (deteriorated and futile germination) and viability were evaluated. Greater seed damage plus loss averaged across seed origin, burial depth, and year was recorded for lots tested at Illinois (51.3% and 51.8%) followed by Tennessee (40.5% and 45.1%) and Missouri (39.2% and 42%) for A. palmeri and A. tuberculatus, respectively. The site differences for seed persistence were probably due to higher volumetric water content at these sites. Rates of seed demise were directly proportional to burial depth (α=0.001), whereas the percentage of viable seeds recovered after 36 mo on the soil surface ranged from 4.1% to 4.3% compared with 5% to 5.3% at the 15-cm depth for A. palmeri and A. tuberculatus, respectively. Seed viability loss was greater in the seeds placed on the soil surface compared with the buried seeds. The greatest influences on seed viability were burial conditions and time and site-specific soil conditions, more so than geographical location. Thus, management of these weed species should focus on reducing seed shattering, enhancing seed removal from the soil surface, or adjusting tillage systems.
Palmer amaranth (Amaranthus palmeri S. Watson) is a problematic weed encountered in U.S. cotton (Gossypium hirsutum L.) and soybean [Glycine max (L.) Merr.] production, with infestations spreading northward. This research investigated the influence of planting date (early, mid-, and late season) and population (AR, IN, MO, MS, NE, and TN) on A. palmeri growth and reproduction at two locations. All populations planted early or midseason at Throckmorton Purdue Agricultural Center (TPAC) and Arkansas Agriculture Research and Extension Center (AAREC) measured 196 and 141 cm or more, respectively. Amaranthus palmeri height did not exceed 168 and 134 cm when planted late season at TPAC and AAREC, respectively. Early season planted A. palmeri from NE grew to 50% of maximum height 8 to 13 d earlier than all other populations under TPAC conditions. In addition, the NE population planted early, mid-, and late season achieved 50% inflorescence emergence 5, 4, and 6 d earlier than all other populations, respectively. All populations established at TPAC produced fewer than 100,000 seeds plant−1. No population planted at TPAC and AAREC produced more than 740 and 1,520 g plant−1 of biomass at 17 and 19 wk after planting, respectively. Planting date influenced the distribution of male and female plants at TPAC, but not at AAREC. Amaranthus palmeri from IN and MS planted late season had male-to-female plant ratios of 1.3:1 and 1.7:1, respectively. Amaranthus palmeri introduced to TPAC from NE can produce up to 7,500 seeds plant−1 if emergence occurs in mid-July. An NE A. palmeri population exhibited biological characteristics allowing it to be highly competitive if introduced to TPAC due to a similar latitudinal range, but was least competitive when introduced to AAREC. Although A. palmeri originating from different locations can vary biologically, plants exhibited environmental plasticity and could complete their life cycle and contribute to spreading populations.
Family-based strategies to reduce the risk of overweight in childhood are needed in the Caribbean.
To investigate the associations between parental characteristics and risk of overweight and explore possible mechanisms.
Data from a parenting intervention were analysed. Parental characteristics were obtained by questionnaire at enrolment. At 18 months, 501 infants (82.9% of cohort) had weight and length measured using standardized methods. The association of parents’ characteristics with risk of infant overweight was assessed using random-effects logistic regression. Four focus groups among mothers in Jamaica were conducted to explore mechanisms.
Overall, 20.6% of infants were ‘at risk of overweight’. Fathers were present in 52% of households. Fathers’ presence [OR (95% CI) 0.60 (0.37–0.96)] was associated with reduced risk of overweight independent of socioeconomic status. Mothers reported that fathers encouraged healthier practices.
Fathers may be important agents of change in intervention strategies to prevent childhood overweight.
We introduce the newly developed database of circumstellar maser sources. Until now, the compilations comprehensively including the three major maser species in evolved stars (i.e., SiO, H2O, OH) has been practically limited only to the Benson’s catalog (Benson et al. 1990), which was published more than a quarter of a century ago. For OH masers alone, there exists the University of Hamburg (UH) database, but there is no updated compilation work for H2O and SiO masers. In order to utilize the information of masers in actual studies, it is highly desirable to have a database containing all the three masers. We are currently constructing a database covering SiO, H2O and OH masers. This database consists of a web-service, which accesses compiled maser observations in available archives and combines them with the data we newly collected and IR databases. The archives currently used are the OH maser archive from Engels & Bunzel (2015), and H2O and SiO archives, which are currently under construction. So far, the information of about 27,000 observations (about 10,000 objects) has been implemented. We also have a plan to extend the database by including higher transitions and other types of objects, such as young stellar objects, in future. In this paper, we briefly summarize, (1) outline of the data collected, and (2) future development plans of the eDAMS system. The URL of the database is as follows: http://maserdb.ins.urfu.ru/
The dwarf galaxies in the Local Group (LG) reveal a surprising amount of spatial structuring. In particular, almost all non-satellite dwarfs belong to one of two planes that show a very pronounced symmetry. In order to determine if these structures in the LG are dynamically stable or, alternatively, if they only represent transient alignments, proper motion measurements of these galaxies are required. A viable method to derive proper motions is offered by VLBI studies of 22-GHz water (and 6.7-GHz methanol) maser lines in star-forming regions.
In 2016, in the framework of the Early Science Program of the Sardinia Radio Telescope (SRT), we have conducted an extensive observational campaign to map the entire optical body of all the LG dwarf galaxies that belong to the two planes, at C and K band, in a search for methanol and water maser emission.
Here, we outline the project and present its first results on 3 targets, NGC 6822, IC 1613, and WLM. While no luminous maser emission has been detected in these galaxies, a number of interesting weaker detections has been obtained, associated with particularly active star forming regions. In addition, we have produced deep radio continuum maps for these galaxies, aimed at investigating their star forming activity and providing an improved assessment of star formation rates in these galaxies.
In our attempt to investigate the basic active galactic nucleus (AGN) paradigm requiring a centrally located supermassive black hole (SMBH), a close to Keplerian accretion disk and a jet perpendicular to its plane, we have searched for radio continuum in galaxies with H2O megamasers in their disks. We observed 18 such galaxies with the Very Large Baseline Array in C band (5 GHz, ~2 mas resolution) and we detected 5 galaxies at 8 σ or higher levels. For those sources for which the maser data is available, the positions of masers and those of the 5 GHz radio continuum sources coincide within the uncertainties, and the radio continuum is perpendicular to the maser disk’s orientation within the position angle uncertainties.
The Central Molecular Zone (CMZ), the inner 450 pc of our Galaxy, is an exceptional region where the volume and column densities, gas temperatures, velocity dispersions, etc. are much higher than in the Galactic plane. It has been suggested that the formation of stars and clusters in this area is related to the orbital dynamics of the gas. The complex kinematic structure of the molecular gas was revealed by spectral line observations. However, these results are limited to the line-of-sight-velocities. To fully understand the motions of the gas within the CMZ, we have to know its location in 6D space (3D location + 3D motion). Recent orbital models have tried to explain the inflow of gas towards and its kinematics within this region. With parallax and proper motion measurements of masers in the CMZ we can discriminate among these models and constrain how our Galactic Center is fed with gas.
We initiated a long-term and highly frequent monitoring project toward 442 methanol masers at 6.7 GHz (Dec >−30 deg) using the Hitachi 32-m radio telescope in December 2012. The observations have been carried out daily, monitoring a spectrum of each source with intervals of 9–10 days. In September 2015, the number of the target sources and intervals were redesigned into 143 and 4–5 days, respectively. This monitoring provides us complete information on how many sources show periodic flux variations in high-mass star-forming regions, which have been detected in 20 sources with periods of 29.5–668 days so far (e.g., Goedhart et al. 2004). We have already obtained new detections of periodic flux variations in 31 methanol sources with periods of 22–409 days. These periodic flux variations must be a unique tool to investigate high-mass protostars themselves and their circumstellar structure on a very tiny spatial scale of 0.1–1 au.
W49 A is a star-forming region (SFR) found in the constellation of Aquila. It contains 3 active regions: W49 North (W49 N), W49 South West (W49 SW) and W49 South (W49 S). We present preliminary results from two epochs (e-)MERLIN observations of all ground-state OH masers towards the star-forming region (SFR) complex W49 A. The first epoch of observations was done in full-polarization mode with MERLIN in 2005 while the second epoch was obtained only in dual circular polarization during the test observations of the upgraded e-MERLIN in 2013. The overall maser spatial distributions in both epochs are in good agreement. We found several new high velocity maser features up to +34 km s−1 and −28 km s−1. The magnetic field strengths are between 1.1 to 10.8 mG. All three sources show evidence of magnetic field reversal.
We present a case study of a single high-mass protostar associated with an infrared quiet massive clump selected from the ATLASGAL survey. The thermal dust emission reveals a single collapsing object associated with a prominent molecular outflow. We detect bright emission from a torsionally excited state transition of CH3OH offset from the protostar that is well explained by shocks at the transition from the infalling envelope onto an accretion disk.
We have compiled the X-ray characteristic properties for a unique and homogeneous sample of Type 2 AGN with water megamaser activity observed by XMM-Newton and for a control sample of non-maser galaxies, both analyzed in a uniform way. A comparison of the luminosity distributions confirms previous results (from smaller and/or less systematic studies) that water maser galaxies appear more luminous than non-maser sources. In addition, the maser phenomenon is associated with more complex X-ray spectra, higher column densities and higher equivalent widths of the Fe Kα line. Both a sufficiently luminous X-ray source and a high absorbing column density in the line of sight favor the appearance of the water megamaser phenomenon in AGN.
From 2014 to 2015, we conducted a total of 469 days observation of the 6.7 GHz methanol maser in a star forming region G33.641-0.228, known to be a bursting maser source. As a result, eleven bursts were detected. On MJD 57364, the flux density grew by more than six times w.r.t the day before. Moreover, during the largest burst, the flux density repeatedly increased and decreased rapidly with time-scale as short as 0.24 day. Since these characteristics of the burst are similar to the solar burst, we speculate that the burst of the 6.7 GHz methanol maser in G33.641-0.228 might occur with a similar mechanism of the solar burst.
Many accretion disks surrounding supermassive black holes in nearby AGN are observed to host 22 GHz water maser activity. We have analyzed single-dish 22 GHz spectra taken with the GBT to identify 32 such “Keplerian disk systems,” which we used to investigate maser excitation and explore the possibility of disk reverberation. Our results do not support a spiral shock model for population inversion in these disks, and we find that any reverberating signal propagating radially outwards from the AGN must constitute <10% of the total observed maser variability. Additionally, we have used ALMA to begin exploring the variety of sub-mm water megamasers that are also predicted, and in the case of the 321 GHz transition found, to be present in these accretion disks. By observing multiple masing transitions within a single system, we can better constrain the physical conditions (e.g., gas temperature and density) in the accretion disk.
We present the results from the Australian Long Baseline Array (LBA) observations of the ground- and excited-state OH masers at high resolutions towards the massive star-forming region G351.417+0.645 in 2012. We obtain the most accurate spatial gradient of magnetic fields at ground state transitions and verify the reliability of magnetic field strengths measured from previous lower resolution observations. In comparison with previous LBA observations in 2001 at 6.0 GHz, we identified several matched Zeeman pairs. We found that the OH maser features have no significant change of magnetic field strengths and directions with small internal proper motions, implying quite stable physical conditions. Additionally, we found that 1665- and 6035-MHz OH maser features reveal the same trend of reversal of magnetic fields. Moreover, we also analyzed the physical conditions at different locations from the coincidence of different OH maser transitions based on current OH maser models.
We report on the astrometric registration of VLBI images of the SiO and H2O masers in OH 231.8+4.2, the iconic Proto-Planetary Nebula also known as the Calabash nebula, using the KVN and Source/Frequency Phase Referencing. This, for the first time, robustly confirms the alignment of the SiO masers, close to the AGB star, which drives the bi-lobe structure with the water masers in the out-flow.