186 research outputs found
Baryon Octet magnetic moments in PT: More on the importance of the Decuplet
We address the impact of treating the decuplet of spin-3/2 baryons as an
explicit degree of freedom in the chiral expansion of the magnetic moments of
the octet of spin-1/2 baryons. We carry out a complete calculation of the octet
moments to O(1/\lamchic), including decuplet contributions to the chiral loops.
In contrast to results of previous analyses, we find that inclusion of the
decuplet preserves the convergence behavior of the chiral expansion implied by
power counting arguments.Comment: 17 pages, 2 figures. Includes axodraw.sty needed for figures Minor
typos correcte
East Midlands Research into Ageing Network (EMRAN) Discussion Paper Series
Academic geriatric medicine in Leicester
.
There has never been a better time to consider joining us. We have recently appointed a
Professor in Geriatric Medicine, alongside Tom Robinson in stroke and Victoria Haunton,
who has just joined as a Senior Lecturer in Geriatric Medicine. We have fantastic
opportunities to support students in their academic pursuits through a well-established
intercalated BSc programme, and routes on through such as ACF posts, and a successful
track-record in delivering higher degrees leading to ACL post. We collaborate strongly
with Health Sciences, including academic primary care. See below for more detail on our
existing academic set-up.
Leicester Academy for the Study of Ageing
We are also collaborating on a grander scale, through a joint academic venture focusing
on ageing, the ‘Leicester Academy for the Study of Ageing’ (LASA), which involves the
local health service providers (acute and community), De Montfort University; University
of Leicester; Leicester City Council; Leicestershire County Council and Leicester Age UK.
Professors Jayne Brown and Simon Conroy jointly Chair LASA and have recently been
joined by two further Chairs, Professors Kay de Vries and Bertha Ochieng. Karen
Harrison Dening has also recently been appointed an Honorary Chair.
LASA aims to improve outcomes for older people and those that care for them that takes
a person-centred, whole system perspective. Our research will take a global perspective,
but will seek to maximise benefits for the people of Leicester, Leicestershire and Rutland,
including building capacity. We are undertaking applied, translational, interdisciplinary
research, focused on older people, which will deliver research outcomes that address
domains from: physical/medical; functional ability, cognitive/psychological; social or
environmental factors. LASA also seeks to support commissioners and providers alike for
advice on how to improve care for older people, whether by research, education or
service delivery. Examples of recent research projects include: ‘Local History Café’
project specifically undertaking an evaluation on loneliness and social isolation; ‘Better
Visits’ project focused on improving visiting for family members of people with dementia
resident in care homes; and a study on health issues for older LGBT people in Leicester.
Clinical Geriatric Medicine in Leicester
We have developed a service which recognises the complexity of managing frail older
people at the interface (acute care, emergency care and links with community services).
There are presently 17 consultant geriatricians supported by existing multidisciplinary
teams, including the largest complement of Advance Nurse Practitioners in the country.
Together we deliver Comprehensive Geriatric Assessment to frail older people with
urgent care needs in acute and community settings.
The acute and emergency frailty units – Leicester Royal Infirmary
This development aims at delivering Comprehensive Geriatric Assessment to frail older
people in the acute setting. Patients are screened for frailty in the Emergency
Department and then undergo a multidisciplinary assessment including a consultant
geriatrician, before being triaged to the most appropriate setting. This might include
admission to in-patient care in the acute or community setting, intermediate care
(residential or home based), or occasionally other specialist care (e.g. cardiorespiratory).
Our new emergency department is the county’s first frail friendly build and includes
fantastic facilities aimed at promoting early recovering and reducing the risk of hospital
associated harms.
There is also a daily liaison service jointly run with the psychogeriatricians (FOPAL); we
have been examining geriatric outreach to oncology and surgery as part of an NIHR
funded study.
We are home to the Acute Frailty Network, and those interested in service developments
at the national scale would be welcome to get involved.
Orthogeriatrics
There are now dedicated hip fracture wards and joint care with anaesthetists,
orthopaedic surgeons and geriatricians. There are also consultants in metabolic bone
disease that run clinics.
Community work
Community work will consist of reviewing patients in clinic who have been triaged to
return to the community setting following an acute assessment described above.
Additionally, primary care colleagues refer to outpatients for sub-acute reviews. You will
work closely with local GPs with support from consultants to deliver post-acute, subacute,
intermediate and rehabilitation care services.
Stroke Medicine
24/7 thrombolysis and TIA services. The latter is considered one of the best in the UK
and along with the high standard of vascular surgery locally means one of the best
performances regarding carotid intervention
Tuberculosis of the breast with erythema nodosum: a case report
<p>Abstract</p> <p>Introduction</p> <p>There has been an increasing number of tuberculosis cases worldwide, but tuberculosis of the breast remains rare. In rare cases this is seen with a cutaneous manifestation of erythema nodosum.</p> <p>Case presentation</p> <p>We report the case of a 33-year-old Chinese woman with tuberculosis of the left breast accompanied by erythema nodosum on the anterior aspect of both lower legs. Due to her poor clinical response to conventional therapy, and the histopathological findings of fine needle aspiration cytology, there were strong indications of tuberculosis. Her clinical diagnosis was confirmed by molecular detection of <it>Mycobacterium tuberculosis </it>complex by polymerase chain reaction. The diagnosis was further confirmed by a second polymerase chain reaction test of erythema nodosum which tested positive for <it>Mycobacterium tuberculosis</it> complex. She received anti-tuberculous therapy for 18 months, and finally underwent residual lumpectomy. During her follow-up examination after 12 months, no evidence of either residual or recurrent disease was present.</p> <p>Conclusion</p> <p>Histopathological features and a high index of clinical suspicion are necessary to confirm a diagnosis of tuberculosis of the breast. Anti-tuberculous therapy with or without simple surgical intervention is the core treatment.</p
The nature of the compact HII region Sh 2-89 and its stellar content
We present an analysis of the structure and properties of the compact HII
region Sh 2-89, and certain of the young stellar objects (YSOs) within this
regime, using mid-infrared (MIR) mapping derived from the Spitzer Space
Telescope (SST) and visual slit spectroscopy of the inner regions of the
source. We show that the region has a bipolar structure, and contains a variety
of Class I and II YSOs. Much of the MIR emission appears to be dominated by PAH
emission bands, which cause strong increases in flux in the 5.8 and 8.0 microns
photometric channels, whilst the variation of H_alpha, [NII] at 6583 A, [SII]
at 6716+6731 A, and MIR emission profiles confirms the presence of complex
ionisation fronts, and ionisation stratification.Comment: 12 pages, 6 figures, Accepted for publication in MNRAS. 33 pages in
arXi
Enzymology of the branched-chain amino acid oxidation disorders: the valine pathway
Valine is one of the three branched-chain amino acids which undergoes oxidation within mitochondria. In this paper, we describe the current state of knowledge with respect to the enzymology of the valine oxidation pathway and the different disorders affecting oxidation
Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study
Introduction
Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty has been unclear.
Methods
This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS) and delirium on risk of increased care requirements on discharge, adjusting for the same variables.
Results
Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, interquartile range [IQR] 54–83; 55.2% male). The risk of death increased independently with increasing age (>80 versus 18–49: hazard ratio [HR] 3.57, confidence interval [CI] 2.54–5.02), frailty (CFS 8 versus 1–3: HR 3.03, CI 2.29–4.00) inflammation, renal disease, cardiovascular disease and cancer, but not delirium. Age, frailty (CFS 7 versus 1–3: odds ratio 7.00, CI 5.27–9.32), delirium, dementia and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9.
Conclusion
Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age
Response of a CMS HGCAL silicon-pad electromagnetic calorimeter prototype to 20-300 GeV positrons
The Compact Muon Solenoid Collaboration is designing a new high-granularity
endcap calorimeter, HGCAL, to be installed later this decade. As part of this
development work, a prototype system was built, with an electromagnetic section
consisting of 14 double-sided structures, providing 28 sampling layers. Each
sampling layer has an hexagonal module, where a multipad large-area silicon
sensor is glued between an electronics circuit board and a metal baseplate. The
sensor pads of approximately 1 cm are wire-bonded to the circuit board and
are readout by custom integrated circuits. The prototype was extensively tested
with beams at CERN's Super Proton Synchrotron in 2018. Based on the data
collected with beams of positrons, with energies ranging from 20 to 300 GeV,
measurements of the energy resolution and linearity, the position and angular
resolutions, and the shower shapes are presented and compared to a detailed
Geant4 simulation
Growth And The Growth Hormone-Insulin Like Growth Factor 1 Axis In Children With Chronic Inflammation:Current Evidence, Gaps In Knowledge And Future Directions
Growth failure is frequently encountered in children with chronic inflammatory conditions like juvenile idiopathic arthritis, inflammatory bowel disease and cystic fibrosis. Delayed puberty and attenuated pubertal growth spurt is often seen during adolescence. The underlying inflammatory state mediated by pro-inflammatory cytokines, prolonged use of glucocorticoid and suboptimal nutrition contribute to growth failure and pubertal abnormalities. These factors can impair growth by their effects on the growth hormone-insulin like growth factor axis and also directly at the level of the growth plate via alterations in chondrogenesis and local growth factor signaling. Recent studies on the impact of cytokines and glucocorticoid on the growth plate studies further advanced our understanding of growth failure in chronic disease and provided a biological rationale of growth promotion. Targeting cytokines using biologic therapy may lead to improvement of growth in some of these children but approximately one third continue to grow slowly. There is increasing evidence that the use of relatively high dose recombinant human growth hormone may lead to partial catch up growth in chronic inflammatory conditions, although long term follow-up data is currently limited. In this review, we comprehensively review the growth abnormalities in children with juvenile idiopathic arthritis, inflammatory bowel disease and cystic fibrosis, systemic abnormalities of the growth hormone-insulin like growth factor axis and growth plate perturbations. We also systematically reviewed all the current published studies of recombinant human growth hormone in these conditions and discuss the role of recombinant human insulin like growth factor-1
The effect of laminate lay-up on the flutter speed of composite wings.
This paper presents an analytical study on optimization of a laminated composite
wing structure for achieving a maximum flutter speed and a minimum weight
without strength penalty. The investigation is carried out within the range of
incompressible airflow and subsonic speed. In the first stage of the
optimization, attention has been paid mainly to the effect on flutter speed of
the bending, torsion and, more importantly, the bending-torsional coupling
rigidity, which is usually associated with asymmetric laminate lay-up. The study
has shown that the torsional rigidity plays a dominant role, while the coupling
rigidity has also quite a significant effect on the flutter speed. In the second
stage of the optimization, attention has been paid to the weight and laminate
strength of the wing structure, which is affected by the variation in laminate
lay-up in the first stage. Results from a thin-walled wing box made of laminated
composite material show that up to 18 per cent increase in flutter speed and 13
per cent reduction in weight can be achieved without compromising the strength.
The investigation has shown that a careful choice of initial lay-up and design
variables leads to a desirable bending, torsional and coupling rigidities, with
the provision of an efficient approach when achieving a maximum flutter speed
with a minimum mass of a composite wing
- …
