Aims. Observations of shell-type supernova remnants (SNRs) in the GeV to multi-TeV γ-ray band, coupled with those at millimetre radio wavelengths, are motivated by the search for cosmic-ray ...accelerators in our Galaxy. The old-age mixed-morphology SNR W 28 (distance ~2 kpc) is a prime target due to its interaction with molecular clouds along its northeastern boundary and other clouds situated nearby. Methods. We observed the W 28 field (for ~40 h) at very high energy (VHE) γ-ray energies ($E > 0.1$ TeV) with the HESS. Cherenkov telescopes. A reanalysis of EGRET $E > 100$ MeV data was also undertaken. Results from the NANTEN 4 m telescope Galactic plane survey and other CO observations were used to study molecular clouds. Results. We have discovered VHE γ-ray emission (HESS J1801-233) coincident with the northeastern boundary of W 28 and a complex of sources (HESS J1800-240A, B and C) ~0.5° south of W 28 in the Galactic disc. The EGRET source (GRO J1801-2320) is centred on HESS J1801-233 but may also be related to HESS J1800-240 given the large EGRET point spread function. The VHE differential photon spectra are well fit by pure power laws with indices Γ ~2.3 to 2.7. The spectral indices of HESS J1800-240A, B, and C are consistent within statistical errors. All VHE sources are ~10′ in intrinsic radius except for HESS J1800-240C, which appears pointlike. The NANTEN 12CO($J = 1{-}0$) data reveal molecular clouds positionally associating with the VHE emission, spanning a ~15 km s-1 range in local standard of rest velocity. Conclusions. The VHE/molecular cloud association could indicate a hadronic origin for HESS J1801-233 and HESS J1800-240, and several cloud components in projection may contribute to the VHE emission. The clouds have components covering a broad velocity range encompassing the distance estimates for W 28 (~2 kpc) and extending up to ~4 kpc. Assuming hadronic origin and distances of 2 and 4 kpc for cloud components, the required cosmic-ray density enhancement factors (with respect to the solar value) are in the range ~10 to ~30. If situated at 2 kpc distance, such cosmic-ray densities may be supplied by SNRs like W 28. Additionally and/or alternatively, particle acceleration may come from several catalogued SNRs and SNR candidates, the energetic ultra compact HII region W 28A2, and the HII regions M 8 and M 20, along with their associated open clusters. Further sub-mm observations would be recommended to probe in detail the dynamics of the molecular clouds at velocites > 10 km s-1 and their possible connection to W 28.
Background
Fatigue in inflammatory bowel disease (IBD) is poorly controlled, with few existing interventions. Psychotherapy interventions for IBD fatigue show promise; however, due to mixed findings ...in efficacy and attrition, current interventions need improvement. Some research shows beliefs about psychotherapy and stigma toward psychotherapy may impact engagement in psychotherapy interventions.
Aims
This study aimed to examine the effects of IBD activity, fatigue, mental health status, previous experience with psychotherapy, and stigma toward psychotherapy on willingness to use psychotherapy as a fatigue intervention.
Methods
An online cross-sectional survey was conducted, and linear regression models were used to examine willingness to engage in psychotherapy for fatigue.
Results
Overall, 834 participants completed the survey. Regression analysis examining demographics, mental health status, IBD activity, fatigue, pain, antidepressant use, psychotherapy experience, and self-worth intervention efficacy belief significantly explained 25% of variance in willingness to use psychotherapy for fatigue. Significant factors included antidepressant use (
b
= .21,
p
< .01), pain (
b
= − .05,
p
< .001), and self-worth intervention belief (
b
= − .27,
p
< .001), which uniquely explained 18% of variance in the outcome.
Conclusions
Willingness to engage in psychotherapy for fatigue in IBD appears to be driven by expectations related to specific self-worth beliefs, rather than stigma, IBD activity, or any prior experience with psychotherapy. Clinicians should directly address these expectations with their patients.
Extinction of classically and instrumentally conditioned behaviors, such as conditioned fear and drug-seeking behavior, is a process of active learning, and recent studies indicate that potentiation ...of glutamatergic transmission facilitates extinction learning. In this study, the authors investigated the effects of the Type-5 metabotropic glutamate receptors (mGluR5) positive allosteric modulator 3-cyano-N-(1,3-diphenyl-1H-pyrazol-5-yl)benzamide (CDPPB) on the extinction of cocaine-seeking behavior in rats with a history of intravenous cocaine self-administration. To assess its effects on acquisition and consolidation of extinction learning, CDPPB (60 mg/kg) or vehicle was administered either 20 min prior to, or immediately following, each of 10 extinction sessions, respectively. When administered prior to each extinction session, CDPPB produced a significant reduction in the number of active lever presses on all 10 days of extinction training as compared to vehicle-treated animals. When administered following each extinction session, a significant reduction in the number of active lever presses was observed on the 2nd through 10th day of extinction. Both treatment regimens also reduced the number of extinction-training sessions required to meet extinction criteria. Pre- or postextinction-training administration of CDPPB did not alter responding on the inactive lever and had no effects on open field locomotor activity. These data indicate that positive allosteric modulation of mGluR5 receptors facilitates the acquisition and consolidation of extinction learning following cocaine self-administration and may provide a novel pharmacological approach to enhancing extinction learning when combined with cue exposure therapy for the treatment of cocaine addiction.
This paper suggests a method for bootstrapping the multiple linear regression model
Y
=
β
1
+
β
2
x
2
+
⋯
+
β
p
x
p
+
e
after variable selection. We develop asymptotic theory for some common least ...squares variable selection estimators such as forward selection with
C
p
. Then hypothesis testing is done using three confidence regions, one of which is new. Theory suggests that the three confidence regions tend to have coverage at least as high as the nominal coverage if the sample size is large enough.
Purpose
The Working Group on Patient Safety and Quality of the Spanish Society of Radiation Oncology, revised the most relevant national and international recommendations, selecting a series of ...important aspects for patient safety, evaluating whether they are included in Spanish legislation
Materials and methods
We have considered a concept as relevant to the patient safety in radiotherapy if so defined in at least 8 of the 16 documents reviewed.
Results
12 subjects were selected: training and qualification, human resources, protocols, safety culture, communication, peer review, accreditation: audits, checklists, areas without interruptions, maps of processes and risks, prospective risk analysis, notification, registration and incident learning, and quality control of the equipment.
Conclusions
At the legislative level, as well as the professional organizations and the health center directorates, the implementation of safety culture must continue to be fostered. Only in this environment will the tools and measures to increase patient safety be effective. The current Spanish legislation must be revised and updated, in accordance with directive 2013/59/EURATOM and the Patient Safety Strategy 2015–2020 of the Spanish National Health System, introducing the obligation to perform risk analysis and incidents management. Audits and accreditations must be carried out, thus raising the general level of practice of the specialty. In this process, the Spanish Society of Radiation Oncology must continue playing its fundamental role, collaborating with the institutions and the rest of the scientific societies involved in the radiotherapy process, issuing recommendations on patient safety and disseminating the safety culture in our specialty.
The measurement of an excess in the cosmic-ray electron spectrum between 300 and 800 GeV by the ATIC experiment has – together with the PAMELA detection of a rise in the positron fraction up to ...≈100 GeV – motivated many interpretations in terms of dark matter scenarios; alternative explanations assume a nearby electron source like a pulsar or supernova remnant. Here we present a measurement of the cosmic-ray electron spectrum with H.E.S.S. starting at 340 GeV. While the overall electron flux measured by H.E.S.S. is consistent with the ATIC data within statistical and systematic errors, the H.E.S.S. data exclude a pronounced peak in the electron spectrum as suggested for interpretation by ATIC. The H.E.S.S. data follow a power-law spectrum with spectral index of 3.0±0.1(stat.)± 0.3(syst.), which steepens at about 1 TeV.
Standard triplicate blood pressure (BP) measurements pose time barriers to hypertension screening, especially in resource‐limited settings. We assessed the implications of simplified approaches using ...fewer measurements with adults (≥18 years old) not using anti‐hypertensive medications from the US National Health and Nutrition Examination Survey 1999‐2016 (n = 30 614), and two datasets from May Measurement Month 2017‐2018 (n = 14 795 for Nepal and n = 6 771 for India). We evaluated the proportion of misclassification of hypertension when employing the following simplified approaches: using only 1st BP, only 2nd BP, 2nd if 1st BP in a given range (otherwise using 1st), and average of 1st and 2nd BP. Hypertension was defined as average of 2nd and 3rd systolic BP ≥140 and/or diastolic BP ≥90 mm Hg. Using only the 1st BP, the proportion of missed hypertension ranged from 8.2%–12.1% and overidentified hypertension from 4.3%–9.1%. Using only 2nd BP reduced the misclassification considerably (corresponding estimates, 4.9%–6.4% for missed hypertension and 2.0%–4.4% for overidentified hypertension) but needed 2nd BP in all participants. Using 2nd BP if 1st BP ≥130/80 demonstrated similar estimates of missed hypertension (3.8%–8.1%) and overidentified hypertension (2.0%–3.9%), but only required a 2nd BP in 33.8%–59.8% of participants. In conclusion, a simplified approach utilizing 1st BP supplemented by 2nd BP in some individuals has low misclassification rates and requires approximately half of the total number of measurements compared to the standard approach, and thus can facilitate screening in resource‐constrained settings.
PDF
