ABSTRACT
A number of works infer radial temperature profiles of envelopes surrounding young stellar objects using several rotational transitions in a pixel-by-pixel or azimuthally averaged basis. ...However, in many cases the assumption that the rotational temperature is constant along the line of sight is made, while this is not the case when a partially resolved envelope, assumed to be spherically symmetric, is used to obtain values of temperature for different projected radii. This kind of analysis (homogeneous analysis) is intrinsically inconsistent. By using a spherical envelope model to interpret NH3 (1,1) and (2,2) observations, we tested how robust it is to infer radial temperature profiles of an envelope. The temperature and density of the model envelope are power laws of radius, but the density can be flat for an inner central part. The homogeneous analysis was applied to obtain radial temperature profiles, and resulted that for small projected radii, where the optical depth of the lines is high, the homogeneous temperature can be much higher than the actual envelope temperature. In general, for larger projected radii, both the temperature and the temperature power-law index can be underestimated by as much as 40 per cent, and 0.15, respectively. We applied this study to the infrared dark cloud G14.225–0.506 for which the radial temperature profile was previously derived from the dust emission at submillimetre wavelengths and the spectral energy distribution. As expected, the homogeneous analysis underestimated both the temperature and the temperature power-law index.
In the accounts compiled in this book, ethnography occurs through processes of material and social interventions that turn the field into a site for epistemic collaboration. Through creative ...interventions that unfold what we term as “fieldwork devices”—such as coproduced books, the circulation of repurposed data, co-organized events, authorization protocols, relational frictions, and social rhythms—anthropologists engage with their counterparts in the field in the construction of joint anthropological problematizations. In these situations, the traditional tropes of the fieldwork encounter (i.e. immersion and distance) give way to a narrative of intervention, where the aesthetics of collaboration in the production of knowledge substitutes or intermingles with participant observation. Building on this, the book proposes the concept of “experimental collaborations” to describe and conceptualize this distinctive ethnographic modality.
Here we present deep (16 Jy beam−1), very high (40 mas) angular resolution 1.14 mm, polarimetric, Atacama Large Millimeter/submillimeter Array (ALMA) observations toward the massive protostar driving ...the HH 80-81 radio jet. The observations clearly resolve the disk oriented perpendicularly to the radio jet, with a radius of 0 171 (∼291 au at 1.7 kpc distance). The continuum brightness temperature, the intensity profile, and the polarization properties clearly indicate that the disk is optically thick for a radius of R 170 au. The linear polarization of the dust emission is detected almost all along the disk, and its properties suggest that dust polarization is produced mainly by self-scattering. However, the polarization pattern presents a clear differentiation between the inner (optically thick) part of the disk and the outer (optically thin) region of the disk, with a sharp transition that occurs at a radius of ∼0 1 (∼170 au). The polarization characteristics of the inner disk suggest that dust settling has not occurred yet with a maximum dust grain size between 50 and 500 m. The outer part of the disk has a clear azimuthal pattern but with a significantly higher polarization fraction compared to the inner disk. This pattern is broadly consistent with the self-scattering of a radiation field that is beamed radially outward, as expected in the optically thin outer region, although contribution from non-spherical grains aligned with respect to the radiative flux cannot be excluded.
Abstract
We present new Atacama Large Millimeter/submillimeter Array 0.98 mm observations of the continuum emission and several molecular lines toward the high-mass protostellar system GGD 27-MM1, ...driving the HH 80-81 radio jet. The detailed analysis of the continuum and the CH
3
CN molecular emission allows us to separate the contributions from the dust content of the disk (extending up to 190 au), the molecular content of the disk (extending from 140–360 au), and the content of the envelope, revealing the presence of several possible accretion streamers (also seen in other molecular tracers, such as CH
3
OH). We analyze the physical properties of the system, producing temperature and column density maps, and radial profiles for the disk and the envelope. We qualitatively reproduce the trajectories and line-of-sight velocities of the possible streamers using a theoretical model approach. An ad hoc model of a flared disk comprising a hot dust disk embedded in cold gas fits the H
2
S emission, which revealed the molecular disk as a crescent shape with a prominent central absorption. Another fit to the central absorption spectrum suggests that the absorption is probably caused by different external cold layers from the envelope or the accretion streamers. Finally, the analysis of the rotation pattern of the different molecular transitions in the molecular disk suggests that there is an inner zone devoid of molecular content.
Recent high angular resolution ( 40 mas) ALMA observations at 1.14 mm resolve a compact (R 200 au), flattened dust structure perpendicular to the HH 80-81 jet emanating from the GGD 27-MM1 high-mass ...protostar, making it a robust candidate for a true accretion disk. The jet-disk system (HH 80-81/GGD 27-MM1) resembles those found in association with low- and intermediate-mass protostars. We present radiative transfer models that fit the 1.14 mm ALMA dust image of this disk, which allow us to obtain its physical parameters and predict its density and temperature structure. Our results indicate that this accretion disk is compact (Rdisk 170 au) and massive ( 5 M ), at about 20% of the stellar mass of 20 M . We estimate the total dynamical mass of the star-disk system from the molecular line emission, finding a range between 21 and 30 M , which is consistent with our model. We fit the density and temperature structures found by our model with power-law functions. These results suggest that accretion disks around massive stars are more massive and hotter than their low-mass siblings, but they still are quite stable. We also compare the temperature distribution in the GGD 27-MM1 disk with that found in low- and intermediate-mass stars and discuss possible implications for the water snow line. We have also carried out a study of the distance based on Gaia DR2 data and the population of young stellar objects in this region and from the extinction maps. We conclude that the source distance is within 1.2 and 1.4 kpc, closer than what was derived in previous studies (1.7 kpc).
To assess the impact of a nurse-driven patient empowerment intervention on anxiety and depression of patients during ICU discharge.
A prospective, multicenter, randomized clinical trial.
Three ICUs ...(1 medical, 1 medical and surgical, and 1 coronary) of three tertiary hospitals.
Adults admitted to the ICU greater than 18 years old for greater than or equal to 48 hours with preserved consciousness, the ability to communicate and without delirium, who were randomized to receive the nurse-driven patient empowerment intervention (NEI) (intervention group IG or standard of care control group (CG)) before ICU discharge.
The NEI consisted of an individualized intervention with written information booklets, combined with verbal information, mainly about the ICU process and transition to the ward, aimed at empowering patients in the transition process from the ICU to the general ward.
Patients completed the Hospital Anxiety and Depression Scale before and after (up to 1 wk) ICU discharge. IG ( n = 91) and CG ( n = 87) patients had similar baseline characteristics. The NEI was associated with a significant reduction in anxiety and depression ( p < 0.001) and the presence of depression ( p = 0.006). Patients with comorbidities and those without family or friends had greater reductions in anxiety and depression after the NEI. After the intervention, women and persons with higher education levels had lower negative outcomes.
We found that a NEI before ICU discharge can decrease anxiety and depression in critically ill survivors. The long-term effect of this intervention should be assessed in future trials.
NCT04527627 ( https://clinicaltrials.gov/ct2/show/NCT04527627 ).
We present subarcsecond angular resolution observations carried out with the Submillimeter Array (SMA) at 880 m centered at the B0-type protostar GGD27 MM1, the driving source of the parsec scale HH ...80-81 jet. We constrain its polarized continuum emission to 0.8% at this wavelength. Its submillimeter spectrum is dominated by sulfur-bearing species tracing a rotating-disk-like structure (SO and SO2 isotopologues mainly), but also shows HCN-bearing and CH3OH lines, which trace the disk and the outflow cavity walls excavated by the HH 80-81 jet. The presence of many sulfurated lines could indicate the presence of shocked gas at the disk's centrifugal barrier or that MM1 is a hot core at an evolved stage. The resolved SO2 emission traces the disk kinematics very well and we fit the SMA observations using a thin-disk Keplerian model, which gives the inclination (47°), the inner ( 170 au) and outer (∼950-1300 au) radii, and the disk's rotation velocity (3.4 km s−1 at a putative radius of 1700 au). We roughly estimate a protostellar dynamical mass of 4-18 . MM2 and WMC cores show, comparatively, an almost empty spectra, suggesting that they are associated with extended emission detected in previous low-angular resolution observations, and therefore indicating youth (MM2) or the presence of a less massive object (WMC).
Background:
Despite the reported harms and ethical concerns about physical restraint use in the critical care settings, nurses’ intention to apply them is unequal across countries. According to the ...theory of planned behaviour, eliciting nurses’ beliefs regarding the use of physical restraints would provide additional social information about nurses’ intention to perform this practice.
Aim:
To explore the salient behavioural, normative and control beliefs underlying the intention of critical care nurses to use physical restraints from the theory of planned behaviour.
Research design:
A belief elicitation study was conducted.
Participants and research context:
Twenty-six critical care nurses were purposively sampled across gender, work-shift patterns and professional experience in five intensive care units of three hospitals in Spain. Data were obtained from a nine-item open-ended questionnaire and a focus group. Deductive content analysis was performed.
Ethical considerations:
Ethical approval was obtained from the hospital ethics committee. Participants were assured their participation was voluntary.
Findings:
Nurses framed the use of restraints as a way of prioritising patients’ physical safety. They referred to contextual factors as the main reasons to justify their application. Nurses perceived that their decision is approved by other colleagues and the patients’ relatives. Some nurses started advocating against their use, but felt powerless to change this unsafe practice within an unfavourable climate. Control beliefs were linked to patients’ medical condition, availability of alternative solutions, analgo-sedation policies and work organisation.
Discussion:
Safety arguments based on the surrounding work environment were discussed.
Conclusion:
Nurses’ behavioural and control beliefs were related. Nurses should be trained in alternatives to physical restraint use. The impact of analgo-sedation protocols, relatives’ involvement, leadership support and intensive care unit restraint policies on physical restraint practices need to be revised. Further research is required to explore why nurses do not act with moral courage to change this harmful practice.
Abstract Background Trocar site incisional hernia (TSIH) is a common complication after laparoscopic cholecystectomy. The aim of this study was to evaluate the prevalence of TSIH and analyze the ...influence of several risk factors for this complication in a prospective series. Methods From 2007 to 2008, a prospective observational study with 3 years of follow-up was performed including all consecutive patients with cholelithiasis who underwent elective laparoscopic cholecystectomy. A multivariate analysis was performed to identify risk factors for TSIH. Results Overall, 241 patients were included. During a median follow-up period of 46.8 months, 57 patients (25.9%) were diagnosed with umbilical TSIH by physical exam or ultrasound. The multivariate analysis revealed that incision enlargement (odds ratio OR, 14.17; 95% confidence interval CI, 3.61 to 55.51; P < .001), wound infection (OR, 5.62; 95% CI, 2.35 to 13.42; P < .001), diabetes mellitus (OR, 2.79; 95% CI, 1.05 to 7.37; P = .0038), and obesity (OR, 2.71; 95% CI, 1.28 to 5.75; P = .009) contributed to the risk for developing a TSIH. Conclusions Umbilical TSIH is highly prevalent. This study identified several factors that could be useful to introduce preventive measures in high-risk patients.
For the past few decades, there has been great interest in determining if even the most massive stars in our galaxy (namely the spectral O-type stars) are formed in a similar manner as the low- and ...intermediate-mass stars, that is, through the presence of accreting disks and powerful outflows. Here, using sensitive observations of the Atacama Large Millimeter/Submillimeter Array, we report a resolved Keplerian disk (with 15 synthesized beams across its major axis) surrounding the deeply embedded O-type protostar IRAS 16547−4247. The disk shows some asymmetries that could arise because the disk is unstable and fragmenting or because of different excitation conditions within the disk. The enclosed mass estimated from the disk Keplerian radial velocities is 25 3 M . The molecular disk is at the base of an ionized thermal radio jet and is approximately perpendicular to the jet axis orientation. We additionally find the existence of a binary system of compact dusty objects at the center of the accreting disk, which indicates the possible formation of an O-type star and a companion of lower mass. This is not surprising due to the high binary fraction reported in massive stars. Subtracting the contribution of the dusty disk plus the envelope and the companion, we estimated a mass of 20 M for the central star.
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