| 1. |
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| 2. |
- Bravo, L, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 3. |
- Tabiri, S, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 4. |
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| 5. |
- Glasbey, JC, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 6. |
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| 7. |
- Khatri, C, et al.
(författare)
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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
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Tidskriftsartikel (refereegranskat)abstract
- Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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| 8. |
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- 2019
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Tidskriftsartikel (refereegranskat)
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| 9. |
- Shimwell, T. W., et al.
(författare)
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The LOFAR Two-metre Sky Survey: II. First data release
- 2019
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 622
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Forskningsöversikt (refereegranskat)abstract
- The LOFAR Two-metre Sky Survey (LoTSS) is an ongoing sensitive, high-resolution 120-168 MHz survey of the entire northern sky for which observations are now 20% complete. We present our first full-quality public data release. For this data release 424 square degrees, or 2% of the eventual coverage, in the region of the HETDEX Spring Field (right ascension 10h45m00s to 15h30m00s and declination 45°00′00″ to 57°00′00″) were mapped using a fully automated direction-dependent calibration and imaging pipeline that we developed. A total of 325 694 sources are detected with a signal of at least five times the noise, and the source density is a factor of ∼10 higher than the most sensitive existing very wide-area radio-continuum surveys. The median sensitivity is S144 MHz = 71 μJy beam -1 and the point-source completeness is 90% at an integrated flux density of 0.45 mJy. The resolution of the images is 6″ and the positional accuracy is within 0.2″. This data release consists of a catalogue containing location, flux, and shape estimates together with 58 mosaic images that cover the catalogued area. In this paper we provide an overview of the data release with a focus on the processing of the LOFAR data and the characteristics of the resulting images. In two accompanying papers we provide the radio source associations and deblending and, where possible, the optical identifications of the radio sources together with the photometric redshifts and properties of the host galaxies. These data release papers are published together with a further ∼20 articles that highlight the scientific potential of LoTSS.
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| 10. |
- Bethlehem, RAI, et al.
(författare)
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Brain charts for the human lifespan
- 2022
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 604:79057906, s. 525-
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Tidskriftsartikel (refereegranskat)abstract
- Over the past few decades, neuroimaging has become a ubiquitous tool in basic research and clinical studies of the human brain. However, no reference standards currently exist to quantify individual differences in neuroimaging metrics over time, in contrast to growth charts for anthropometric traits such as height and weight1. Here we assemble an interactive open resource to benchmark brain morphology derived from any current or future sample of MRI data (http://www.brainchart.io/). With the goal of basing these reference charts on the largest and most inclusive dataset available, acknowledging limitations due to known biases of MRI studies relative to the diversity of the global population, we aggregated 123,984 MRI scans, across more than 100 primary studies, from 101,457 human participants between 115 days post-conception to 100 years of age. MRI metrics were quantified by centile scores, relative to non-linear trajectories2 of brain structural changes, and rates of change, over the lifespan. Brain charts identified previously unreported neurodevelopmental milestones3, showed high stability of individuals across longitudinal assessments, and demonstrated robustness to technical and methodological differences between primary studies. Centile scores showed increased heritability compared with non-centiled MRI phenotypes, and provided a standardized measure of atypical brain structure that revealed patterns of neuroanatomical variation across neurological and psychiatric disorders. In summary, brain charts are an essential step towards robust quantification of individual variation benchmarked to normative trajectories in multiple, commonly used neuroimaging phenotypes.
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- Bryant, J. M., et al.
(författare)
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Emergence and spread of a human-transmissible multidrug-resistant nontuberculous mycobacterium
- 2016
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 354:6313, s. 751-757
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Tidskriftsartikel (refereegranskat)abstract
- Lung infections with Mycobacterium abscessus, a species of multidrug-resistant nontuberculous mycobacteria, are emerging as an important global threat to individuals with cystic fibrosis (CF), in whom M. abscessus accelerates inflammatory lung damage, leading to increased morbidity and mortality. Previously, M. abscessus was thought to be independently acquired by susceptible individuals from the environment. However, using whole-genome analysis of a global collection of clinical isolates, we show that the majority of M. abscessus infections are acquired through transmission, potentially via fomites and aerosols, of recently emerged dominant circulating clones that have spread globally. We demonstrate that these clones are associated with worse clinical outcomes, show increased virulence in cell-based and mouse infection models, and thus represent an urgent international infection challenge.
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| 15. |
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| 16. |
- Calcutt, Hannah, 1988, et al.
(författare)
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The ALMA-PILS survey: first detection of methyl isocyanide (CH3NC) in a solar-type protostar
- 2018
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 617
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Tidskriftsartikel (refereegranskat)abstract
- Methyl isocyanide (CH3NC) is the isocyanide with the largest number of atoms confirmed in the interstellar medium (ISM), but it is not an abundant molecule, having only been detected towards a handful of objects. Conversely, its isomer, methyl cyanide (CH3CN), is one of the most abundant complex organic molecules detected in the ISM, with detections in a variety of low- and high-mass sources. We use ALMA observations from the Protostellar Interferometric Line Survey (PILS) to search for methyl isocyanide and compare its abundance with that of its isomer methyl cyanide. We use a new line catalogue from the Cologne Database for Molecular Spectroscopy (CDMS) to identify methyl isocyanide lines. We also model the chemistry with an updated version of the three-phase chemical kinetics model MAGICKAL, presenting the first chemical modelling of methyl isocyanide to date. We detect methyl isocyanide for the first time in a solar-type protostar, IRAS 16293-2422 B, and present upper limits for its companion protostar, IRAS 16293-2422 A. Methyl isocyanide is found to be at least 20 times more abundant in source B compared to source A, with a CH3CN/CH3NC abundance ratio of 200 in IRAS 16293-2422 B and >5517 in IRAS 16293-2422 A. We also present the results of a chemical model of methyl isocyanide chemistry in both sources, and discuss the implications on methyl isocyanide formation mechanisms and the relative evolutionary stages of both sources.
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| 17. |
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| 18. |
- Rowbotham, S. E., et al.
(författare)
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Inositol in the MAnaGemENt of abdominal aortic aneurysm (IMAGEN) : Study protocol for a randomised controlled trial
- 2017
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Ingår i: Trials. - : BioMed Central Ltd.. - 1745-6215. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: An abdominal aortic aneurysm (AAA) is a focal dilation of the abdominal aorta and is associated with a risk of fatal rupture. Experimental studies suggest that myo-inositol may exert beneficial effects on AAAs through favourable changes to biological pathways implicated in AAA pathology. The aim of the Inositol in the MAnaGemENt of abdominal aortic aneurysm (IMAGEN) trial is to assess if myo-inositol will reduce AAA growth. Methods/design: IMAGEN is a multi-centre, prospective, parallel-group, randomised, double-blind, placebo-controlled trial. A total of 164 participants with an AAA measuring ≥ 30 mm will be randomised to either 2 g of myo-inositol or identical placebo twice daily for 12 months. The primary outcome measure will be AAA growth estimated by increase in total infrarenal aortic volume measured on computed tomographic scans. Secondary outcome measures will include AAA diameter assessed by computed tomography and ultrasound, AAA peak wall stress and peak wall rupture index, serum lipids, circulating AAA biomarkers, circulating RNAs and health-related quality of life. All analysis will be based on the intention-to-treat principle at the time of randomisation. All patients who meet the eligibility criteria, provide written informed consent and are enrolled in the study will be included in the primary analysis, regardless of adherence to dietary allocation. Discussion: Currently, there is no known medical therapy to limit AAA progression. The IMAGEN trial will be the first randomised trial, to our knowledge, to assess the value of myo-inositol in limiting AAA growth.
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| 19. |
- Arzoumanian, Doris, et al.
(författare)
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Dust polarized emission observations of NGC 6334: BISTRO reveals the details of the complex but organized magnetic field structure of the high-mass star-forming hub-filament network
- 2021
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 647
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Tidskriftsartikel (refereegranskat)abstract
- Context. Molecular filaments and hubs have received special attention recently thanks to new studies showing their key role in star formation. While the (column) density and velocity structures of both filaments and hubs have been carefully studied, their magnetic field (B-field) properties have yet to be characterized. Consequently, the role of B-fields in the formation and evolution of hub-filament systems is not well constrained. Aims. We aim to understand the role of the B-field and its interplay with turbulence and gravity in the dynamical evolution of the NGC 6334 filament network that harbours cluster-forming hubs and high-mass star formation. Methods. We present new observations of the dust polarized emission at 850 μm toward the 2 pc × 10 pc map of NGC 6334 at a spatial resolution of 0.09 pc obtained with the James Clerk Maxwell Telescope (JCMT) as part of the B-field In STar-forming Region Observations (BISTRO) survey. We study the distribution and dispersion of the polarized intensity (PI), the polarization fraction (PF), and the plane-of-The-sky B-field angle (χB_POS) toward the whole region, along the 10 pc-long ridge and along the sub-filaments connected to the ridge and the hubs. We derived the power spectra of the intensity and χBPOS along the ridge crest and compared them with the results obtained from simulated filaments. Results. The observations span 3 orders of magnitude in Stokes I and PI and 2 orders of magnitude in PF (from 0.2 to 20%). A large scatter in PI and PF is observed for a given value of I. Our analyses show a complex B-field structure when observed over the whole region ( 10 pc); however, at smaller scales (1 pc), χBPOS varies coherently along the crests of the filament network. The observed power spectrum of χBPOS can be well represented with a power law function with a slope of-1.33 ± 0.23, which is 20% shallower than that of I. We find that this result is compatible with the properties of simulated filaments and may indicate the physical processes at play in the formation and evolution of star-forming filaments. Along the sub-filaments, χBPOS rotates frombeing mostly perpendicular or randomly oriented with respect to the crests to mostly parallel as the sub-filaments merge with the ridge and hubs. This variation of the B-field structure along the sub-filaments may be tracing local velocity flows of infalling matter in the ridge and hubs. Our analysis also suggests a variation in the energy balance along the crests of these sub-filaments, from magnetically critical or supercritical at their far ends to magnetically subcritical near the ridge and hubs. We also detect an increase in PF toward the high-column density (NH2 â 1023 cm-2) star cluster-forming hubs. These latter large PF values may be explained by the increase in grain alignment efficiency due to stellar radiation from the newborn stars, combined with an ordered B-field structure. Conclusions. These observational results reveal for the first time the characteristics of the small-scale (down to 0.1 pc) B-field structure of a 10 pc-long hub-filament system. Our analyses show variations in the polarization properties along the sub-filaments that may be tracing the evolution of their physical properties during their interaction with the ridge and hubs. We also detect an impact of feedback from young high-mass stars on the local B-field structure and the polarization properties, which could put constraints on possible models for dust grain alignment and provide important hints as to the interplay between the star formation activity and interstellar B-fields.
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| 20. |
- Coutens, A., et al.
(författare)
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First detection of cyanamide (NH2CN) towards solar-type protostars
- 2018
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 612
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Tidskriftsartikel (refereegranskat)abstract
- Searches for the prebiotically relevant cyanamide (NH 2 CN) towards solar-type protostars have not been reported in the literature. We present here the first detection of this species in the warm gas surrounding two solar-type protostars, using data from the Atacama Large Millimeter/Submillimeter Array Protostellar Interferometric Line Survey (PILS) of IRAS 16293-2422 B and observations from the IRAM Plateau de Bure Interferometer of NGC 1333 IRAS2A. We also detected the deuterated and 13 C isotopologs of NH 2 CN towards IRAS 16293-2422 B. This is the first detection of NHDCN in the interstellar medium. Based on a local thermodynamic equilibrium analysis, we find that the deuteration of cyanamide (∼1.7%) is similar to that of formamide (NH 2 CHO), which may suggest that these two molecules share NH 2 as a common precursor. The NH 2 CN/NH 2 CHO abundance ratio is about 0.2 for IRAS 16293-2422 B and 0.02 for IRAS2A, which is comparable to the range of values found for Sgr B2. We explored the possible formation of NH 2 CN on grains through the NH 2 + CN reaction using the chemical model MAGICKAL. Grain-surface chemistry appears capable of reproducing the gas-phase abundance of NH 2 CN with the correct choice of physical parameters.
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| 21. |
- Deane, R. P., et al.
(författare)
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The VLBA CANDELS GOODS-North Survey -I. survey design, processing, data products, and source counts
- 2024
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Ingår i: Monthly Notices of the Royal Astronomical Society. - 0035-8711 .- 1365-2966. ; 529:3, s. 2428-2442
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Tidskriftsartikel (refereegranskat)abstract
- The past decade has seen significant advances in wide-field cm-wave very long baseline interferometry (VLBI), which is timely given the wide-area, synoptic survey-driven strategy of major facilities across the electromagnetic spectrum. While wide-field VLBI poses significant post-processing challenges that can severely curtail its potential scientific yield, man y dev elopments in the km-scale connected-element interferometer sphere are directly applicable to addressing these. Here we present the design, processing, data products, and source counts from a deep (11 μJy beam -1 ), quasi-uniform sensitivity, contiguous wide-field (160 arcmin 2 ) 1.6 GHz VLBI surv e y of the CANDELS GOODS-North field. This is one of the best-studied extragalactic fields at milli-arcsecond resolution and, therefore, is well-suited as a comparative study for our Tera-pixel VLBI image. The derived VLBI source counts show consistency with those measured in the COSMOS field, which broadly traces the AGN population detected in arcsecond-scale radio surv e ys. Ho we ver, there is a distinctive flattening in the S 1.4GHz ∼100-500 μJy flux density range, which suggests a transition in the population of compact faint radio sources, qualitatively consistent with the excess source counts at 15 GHz that is argued to be an unmodelled population of radio cores. This surv e y approach will assist in deriving robust VLBI source counts and broadening the disco v ery space for future wide-field VLBI surv e ys, including VLBI with the Square Kilometre Array, which will include new large field-of-view antennas on the African continent at ≲1000 km baselines. In addition, it may be useful in the design of both monitoring and/or rapidly triggered VLBI transient programmes.
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| 22. |
- Eswaraiah, Chakali, et al.
(författare)
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The JCMT BISTRO Survey: Revealing the Diverse Magnetic Field Morphologies in Taurus Dense Cores with Sensitive Submillimeter Polarimetry
- 2021
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Ingår i: Astrophysical Journal Letters. - : American Astronomical Society. - 2041-8213 .- 2041-8205. ; 912:2
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Tidskriftsartikel (refereegranskat)abstract
- We have obtained sensitive dust continuum polarization observations at 850 μm in the B213 region of Taurus using POL-2 on SCUBA-2 at the James Clerk Maxwell Telescope as part of the B-fields in STar-forming Region Observations (BISTRO) survey. These observations allow us to probe magnetic field (B-field) at high spatial resolution (∼2000 au or ∼0.01 pc at 140 pc) in two protostellar cores (K04166 and K04169) and one prestellar core (Miz-8b) that lie within the B213 filament. Using the Davis-Chandrasekhar-Fermi method, we estimate the B-field strengths in K04166, K04169, and Miz-8b to be 38 ± 14, 44 ± 16, and 12 ± 5 μG, respectively. These cores show distinct mean B-field orientations. The B-field in K04166 is well ordered and aligned parallel to the orientations of the core minor axis, outflows, core rotation axis, and large-scale uniform B-field, in accordance with magnetically regulated star formation via ambipolar diffusion taking place in K04166. The B-field in K04169 is found to be ordered but oriented nearly perpendicular to the core minor axis and large-scale B-field and not well correlated with other axes. In contrast, Miz-8b exhibits a disordered B-field that shows no preferred alignment with the core minor axis or large-scale field. We found that only one core, K04166, retains a memory of the large-scale uniform B-field. The other two cores, K04169 and Miz-8b, are decoupled from the large-scale field. Such a complex B-field configuration could be caused by gas inflow onto the filament, even in the presence of a substantial magnetic flux.
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| 23. |
- Hardie, C.M., et al.
(författare)
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Prevalence and risk factors for nerve injury following shoulder dislocation
- 2023
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Ingår i: Musculoskeletal Surgery. - : Springer. - 2035-5106 .- 2035-5114. ; 107:3, s. 345-350
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Tidskriftsartikel (refereegranskat)abstract
- Background: The glenohumeral joint dislocation can be associated with major nerve injury. The reported prevalence and risk factors for major nerve injury are variable and this injury can have a severe and life-long impact on the patient. The objectives of this study were to analyse the prevalence of major nerve injury following shoulder dislocation and examine risk factors. Management and outcomes of nerve injury were explored.Methods: A 1 year retrospective cohort study of 243 consecutive adults who presented with a shoulder dislocation was performed. Data were collected on patient demographics, timings of investigations, treatment, follow-up, and nerve injury prevalence and management. The primary outcome measure was prevalence of nerve injury. Risk factors for this were analysed using appropriate tests with Stata SE15.1.Results: Of 243 patients with shoulder dislocation, 14 (6%) had neurological deficit. Primary dislocation (p = 0.004) and older age (p = 0.02) were significantly associated with major nerve injury. Sex, time to successful reduction and force of injury were not associated with major nerve injury in this cohort. Patients with nerve injury made functional recovery to varying degrees. Recurrent shoulder dislocation was common accounting for 133/243 (55%) attendances.Conclusions: Shoulder dislocation requires careful assessment and timely management in the ED. A 6% rate of nerve injury following shoulder dislocation was at the lower border of reported rates (5–55%), and primary dislocation and older age were identified as risk factors for nerve injury. We emphasise the importance of referring patients with suspected major nerve injury to specialist services.
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| 24. |
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| 25. |
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| 26. |
- Neld, A., et al.
(författare)
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Reliable detection and characterization of low-frequency polarized sources in the LOFAR M51 field
- 2018
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 617
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Tidskriftsartikel (refereegranskat)abstract
- The new generation of broad-band radio continuum surveys will provide large data sets with polarization information. New algorithms need to be developed to extract reliable catalogs of linearly polarized sources that can be used to characterize those sources and produce a dense rotation measure (RM) grid to probe magneto-ionized structures along the line of sight via Faraday rotation. Aims. The aim of the paper is to develop a computationally efficient and rigorously defined source-finding algorithm for linearly polarized sources. Methods. We used a calibrated data set from the LOw Frequency ARray (LOFAR) at 150 MHz centered on the nearby galaxy M 51 to search for polarized background sources. With a new imaging software, we re-imaged the field at a resolution of 18″ × 15″ and cataloged a total of about 3000 continuum sources within 2.5° of the center of M 51. We made small Stokes Q and U images centered on each source brighter than 100 mJy in total intensity (201 sources) and used RM synthesis to create corresponding Faraday cubes that were analyzed individually. For each source, the noise distribution function was determined from a subset of the measurements at high Faraday depths where no polarization is expected; the peaks in polarized intensity in the Faraday spectrum were identified and the p-value of each source was calculated. Finally, the false discovery rate method was applied to the list of p-values to produce a list of polarized sources and quantify the reliability of the detections. We also analyzed sources fainter than 100 mJy but that were reported as polarized in the literature at at least another radio frequency. Results. Of the 201 sources that were searched for polarization, six polarized sources were detected confidently (with a false discovery rate of 5%). This corresponds to a number density of one polarized source per 3.3 square degrees, or 0.3 source per square degree. Increasing the false discovery rate to 50% yields 19 sources. A majority of the sources have a morphology that is indicative of them being double-lobed radio galaxies, and the ones with literature redshift measurements have 0.5 < z < 1.0. Conclusions. We find that this method is effective in identifying polarized sources, and is well suited for LOFAR observations. In the future, we intend to develop it further and apply it to larger data sets such as the LOFAR Two-meter Survey of the whole northern sky, LOTSS, and the ongoing deep LOFAR observations of the GOODS-North field.
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| 27. |
- O'Sullivan, S. P., et al.
(författare)
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The Faraday Rotation Measure Grid of the LOFAR Two-metre Sky Survey: Data Release 2
- 2023
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Ingår i: Monthly Notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 519:4, s. 5723-5742
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Tidskriftsartikel (refereegranskat)abstract
- A Faraday rotation measure (RM) catalogue, or RM Grid, is a valuable resource for the study of cosmic magnetism. Using the second data release (DR2) from the LOFAR Two-metre Sky Survey (LoTSS), we have produced a catalogue of 2461 extragalactic high-precision RM values across 5720 deg(2) of sky (corresponding to a polarized source areal number density of similar to 0.43 deg(-2)). The linear polarization and RM properties were derived using RM synthesis from the Stokes Q and U channel images at an angular resolution of 20 arcsec across a frequency range of 120 to 168 MHz with a channel bandwidth of 97.6 kHz. The fraction of total intensity sources (>1 mJy beam(-1)) found to be polarized was similar to 0.2 percent. The median detection threshold was 0.6 mJy beam(-1) (8 sigma(QU)), with a median RM uncertainty of 0.06 rad m(-2) (although a systematic uncertainty of up to 0.3 radm(-2) is possible, after the ionosphere RM correction). The median degree of polarization of the detected sources is 1.8 percent, with a range of 0.05 percent to 31 percent. Comparisons with cm-wavelength RMs indicate minimal amounts of Faraday complexity in the LoTSS detections, making them ideal sources for RM Grid studies. Host galaxy identifications were obtained for 88 percent of the sources, along with redshifts for 79 percent (both photometric and spectroscopic), with the median redshift being 0.6. The focus of the current catalogue was on reliability rather than completeness, and we expect future versions of the LoTSS RM Grid to have a higher areal number density. In addition, 25 pulsars were identified, mainly through their high degrees of linear polarization.
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| 28. |
- Ruiz, N. Herrera, et al.
(författare)
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Lofar deep fields: Probing a broader population of polarized radio galaxies in elais-n1
- 2021
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 648
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Tidskriftsartikel (refereegranskat)abstract
- We present deep polarimetric observations of the European Large Area ISO Survey-North 1 (ELAIS-N1) field using the Low Frequency Array (LOFAR) at 114.9-177.4 MHz. The ELAIS-N1 field is part of the LOFAR Two-metre Sky Survey deep fields data release I. For six eight-hour observing epochs, we align the polarization angles and stack the 20″-resolution Stokes Q, U-parameter data cubes. This produces a 16 deg2 image with 1σQU sensitivity of 26 μJy beam-1 in the central area. In this paper, we demonstrate the feasibility of the stacking technique, and we generate a catalog of polarized sources in ELAIS-N1 and their associated Faraday rotation measures (RMs). While in a single-epoch observation we detect three polarized sources, this number increases by a factor of about three when we consider the stacked data, with a total of ten sources. This yields a surface density of polarized sources of one per 1.6 deg2. The Stokes I images of three of the ten detected polarized sources have morphologies resembling those of FR I radio galaxies. This represents a greater fraction of this type of source than previously found, which suggests that more sensitive observations may help with their detection.
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| 29. |
- Anderson, M. M., et al.
(författare)
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Caltech-NRAO Stripe 82 Survey (CNSS). III. The First Radio-discovered Tidal Disruption Event, CNSS J0019+00
- 2020
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Ingår i: Astrophysical Journal. - : American Astronomical Society. - 1538-4357 .- 0004-637X. ; 903:2
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Tidskriftsartikel (refereegranskat)abstract
- We present the discovery of a nuclear transient with the Caltech-NRAO Stripe 82 Survey (CNSS), a dedicated radio transient survey carried out with the Karl G. Jansky Very Large Array (VLA). This transient, CNSS J001947.3+003527, exhibited a turn-on over a timescale of less than or similar to 1 yr, increasing in flux density at 3 GHz from <0.14 mJy in 2014 February to 4.4 0.1 mJy in 2015 March, reaching a peak luminosity of around 2015 October. The association of CNSS J0019+00 with the nucleus (Gaia and our very-long baseline interferometry positions are consistent to within 1 pc) of a nearby S0 Seyfert galaxy at 77 Mpc, together with the radio spectral evolution, implies that this transient is most likely a tidal disruption event (TDE). Our equipartition analysis indicates the presence of a similar to 15,000 km s(-1) outflow, having energy similar to 10(49) erg. We derive the radial density profile for the circumnuclear material in the host galaxy to be proportional to R-2.5. All of these properties suggest resemblance with radio-detected thermal TDEs like ASASSN-14li and XMMSL1 J0740-85. No significant X-ray or optical emission is detected from CNSS J0019+00, although this may simply be due to the thermal emission being weak during our late-time follow-up observations. From the CNSS survey we have obtained the first unbiased measurement of the rate of radio TDEs, R(>500 mu Jy) of about 2 x 10(-3) deg(-2), or equivalently a volumetric rate of about 10 Gpc(-3) yr(-1). This rate implies that all-sky radio surveys such as the VLA Sky Survey and those planned with ASKAP, will find many tens of radio TDEs over the next few years.
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| 30. |
- Calcutt, H., et al.
(författare)
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The ALMA-PILS survey: complex nitriles towards IRAS 16293-2422
- 2018
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 616
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Tidskriftsartikel (refereegranskat)abstract
- Context. Complex organic molecules are readily detected in the inner regions of the gaseous envelopes of forming protostars. Their detection is crucial to understanding the chemical evolution of the Universe and exploring the link between the early stages of star formation and the formation of solar system bodies, where complex organic molecules have been found in abundance. In particular, molecules that contain nitrogen are interesting due to the role nitrogen plays in the development of life and the compact scales such molecules have been found to trace around forming protostars. Aims. The goal of this work is to determine the inventory of one family of nitrogen-bearing organic molecules, complex nitriles (molecules with a -C N functional group) towards two hot corino sources in the low-mass protostellar binary IRAS 16293-2422. This work explores the abundance differences between the two sources, the isotopic ratios, and the spatial extent derived from molecules containing the nitrile functional group. Methods. Using data from the Protostellar Interferometric Line Survey (PILS) obtained with ALMA, we determine abundances and excitation temperatures for the detected nitriles. We also present a new method for determining the spatial structure of sources with high line density and large velocity gradients-Velocity-corrected INtegrated emission (VINE) maps. Results. We detect methyl cyanide (CH3CN) as well as five of its isotopologues, including CHD2CN, which is the first detection in the interstellar medium (ISM). We also detect ethyl cyanide (C2H5CN), vinyl cyanide (C2H3CN), and cyanoacetylene (HC3N). We find that abundances are similar between IRAS 16293A and IRAS 16293B on small scales except for vinyl cyanide which is only detected towards the latter source. This suggests an important difference between the sources either in their evolutionary stage or warm-up timescales. We also detect a spatially double-peaked emission for the first time in molecular emission in the A source, suggesting that this source is showing structure related to a rotating toroid of material. Conclusions. With high-resolution observations, we have been able to show for the first time a number of important similarities and differences in the nitrile chemistry in these objects. These illustrate the utility of nitriles as potential tracers of the physical conditions in star-forming regions.
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| 31. |
- Coutens, A., et al.
(författare)
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The ALMA-PILS survey: First detections of deuterated formamide and deuterated isocyanic acid in the interstellar medium
- 2016
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 590
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Tidskriftsartikel (refereegranskat)abstract
- Formamide (NH2CHO) has previously been detected in several star-forming regions and is thought to be a precursor for different prebiotic molecules. Its formation mechanism is still debated, however. Observations of formamide, related species, and their isopotologues may provide useful clues to the chemical pathways leading to their formation. The Protostellar Interferometric Line Survey (PILS) represents an unbiased, high angular resolution and sensitivity spectral survey of the low-mass protostellar binary IRAS 16293-2422 with the Atacama Large Millimeter/submillimeter Array (ALMA). For the first time, we detect the three singly deuterated forms of NH2CHO (NH2CDO, cis-and trans-NHDCHO), as well as DNCO towards the component B of this binary source. The images reveal that the different isotopologues are all present in the same region. Based on observations of the 13C isotopologues of formamide and a standard 12C/13C ratio, the deuterium fractionation is found to be similar for the three different forms with a value of about 2%. The DNCO/HNCO ratio is also comparable to the D/H ratio of formamide (~1%). These results are in agreement with the hypothesis that NH2CHO and HNCO are chemically related through grain-surface formation.
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| 32. |
- Eastwood, Michael W., et al.
(författare)
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The Radio Sky at Meter Wavelengths: M-mode Analysis Imaging with the OVRO-LWA
- 2018
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Ingår i: Astronomical Journal. - : American Astronomical Society. - 1538-3881 .- 0004-6256. ; 156:1
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Tidskriftsartikel (refereegranskat)abstract
- A host of new low-frequency radio telescopes seek to measure the 21 cm transition of neutral hydrogen from the early universe. These telescopes have the potential to directly probe star and galaxy formation at redshifts 20 ≳ z ≳ 7 but are limited by the dynamic range they can achieve against foreground sources of low-frequency radio emission. Consequently, there is a growing demand for modern, high-fidelity maps of the sky at frequencies below 200 MHz for use in foreground modeling and removal. We describe a new wide-field imaging technique for drift-scanning interferometers: Tikhonov-regularized m-mode analysis imaging. This technique constructs images of the entire sky in a single synthesis imaging step with exact treatment of wide-field effects. We describe how the CLEAN algorithm can be adapted to deconvolve maps generated by m-mode analysis imaging. We demonstrate Tikhonov-regularized m-mode analysis imaging using the Owens Valley Radio Observatory Long Wavelength Array (OVRO-LWA) by generating eight new maps of the sky north of δ = -30° with 15′ angular resolution at frequencies evenly spaced between 36.528 and 73.152 MHz and ∼800 mJy beam-1thermal noise. These maps are a 10-fold improvement in angular resolution over existing full-sky maps at comparable frequencies, which have angular resolutions ≥2°. Each map is constructed exclusively from interferometric observations and does not represent the globally averaged sky brightness. Future improvements will incorporate total power radiometry, improved thermal noise, and improved angular resolution due to the planned expansion of the OVRO-LWA to 2.6 km baselines. These maps serve as a first step on the path to the use of more sophisticated foreground filters in 21 cm cosmology incorporating the measured angular and frequency structure of all foreground contaminants.
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| 33. |
- Fayolle, E. C., et al.
(författare)
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Protostellar and cometary detections of organohalogens
- 2017
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Ingår i: Nature Astronomy. - : Springer Science and Business Media LLC. - 2397-3366. ; 1:10, s. 703-708
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Tidskriftsartikel (refereegranskat)abstract
- Organohalogens, a class of molecules that contain at least one halogen atom bonded to carbon, are abundant on the Earth where they are mainly produced through industrial and biological processes(1). Consequently, they have been proposed as biomarkers in the search for life on exoplanets(2). Simple halogen hydrides have been detected in interstellar sources and in comets, but the presence and possible incorporation of more complex halogen-containing molecules such as organohalogens into planet-forming regions is uncertain(3,4). Here we report the interstellar detection of two isotopologues of the organohalogen CH3Cl and put some constraints on CH3F in the gas surrounding the low-mass protostar IRAS 16293-2422, using the Atacama Large Millimeter/submillimeter Array (ALMA). We also find CH3Cl in the coma of comet 67P/Churyumov-Gerasimenko (67P/C-G) by using the Rosetta Orbiter Spectrometer for Ion and Neutral Analysis (ROSINA) instrument. The detections reveal an efficient pre-planetary formation pathway of organohalogens. Cometary impacts may deliver these species to young planets and should thus be included as a potential abiotical production source when interpreting future organohalogen detections in atmospheres of rocky planets.
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| 34. |
- Fazey, Ioan, et al.
(författare)
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Transforming knowledge systems for life on Earth : Visions of future systems and how to get there
- 2020
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Ingår i: Energy Research & Social Science. - : Elsevier. - 2214-6296 .- 2214-6326. ; 70
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Tidskriftsartikel (refereegranskat)abstract
- Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent.
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| 35. |
- Heald, G., et al.
(författare)
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Magnetism science with the square kilometre array
- 2020
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Ingår i: Galaxies. - : MDPI AG. - 2075-4434. ; 8:8
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Tidskriftsartikel (refereegranskat)abstract
- The Square Kilometre Array (SKA) will answer fundamental questions about the origin, evolution, properties, and influence of magnetic fields throughout the Universe. Magnetic fields can illuminate and influence phenomena as diverse as star formation, galactic dynamics, fast radio bursts, active galactic nuclei, large-scale structure, and dark matter annihilation. Preparations for the SKA are swiftly continuing worldwide, and the community is making tremendous observational progress in the field of cosmic magnetism using data from a powerful international suite of SKA pathfinder and precursor telescopes. In this contribution, we revisit community plans for magnetism research using the SKA, in light of these recent rapid developments. We focus in particular on the impact that new radio telescope instrumentation is generating, thus advancing our understanding of key SKA magnetism science areas, as well as the new techniques that are required for processing and interpreting the data. We discuss these recent developments in the context of the ultimate scientific goals for the SKA era.
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| 36. |
- Jorgensen, J. K., et al.
(författare)
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The ALMA Protostellar Interferometric Line Survey (PILS) First results from an unbiased submillimeter wavelength line survey of the Class 0 protostellar binary IRAS 16293-2422 with ALMA
- 2016
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 595, s. Art no A117-
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Tidskriftsartikel (refereegranskat)abstract
- Context. The inner regions of the envelopes surrounding young protostars are characterized by a complex chemistry, with prebiotic molecules present on the scales where protoplanetary disks eventually may form. The Atacama Large Millimeter/submillimeter Array (ALMA) provides an unprecedented view of these regions zooming in on solar system scales of nearby protostars and mapping the emission from rare species. Aims. The goal is to introduce a systematic survey, the Protostellar Interferometric Line Survey (PILS), of the chemical complexity of one of the nearby astrochemical templates, the Class 0 protostellar binary IRAS 16293 2422, using ALMA in order to understand the origin of the complex molecules formed in its vicinity. In addition to presenting the overall survey, the analysis in this paper focuses on new results for the prebiotic molecule glycolaldehyde, its isomers, and rarer isotopologues and other related molecules. Methods. An unbiased spectral survey of IRAS 16293 2422 covering the full frequency range from 329 to 363 GHz (0.8 mm) has been obtained with ALMA, in addition to a few targeted observations at 3.0 and 1.3 mm. The data consist of full maps of the protostellar binary system with an angular resolution of 0.5 '' (60 AU diameter), a spectral resolution of 0.2 km s(-1), and a sensitivity of 4-5 mJy beam(-1) km s(-1), which is approximately two orders of magnitude better than any previous studies. Results. More than 10 000 features are detected toward one component in the protostellar binary, corresponding to an average line density of approximately one line per 3 km s(-1). Glycolaldehyde; its isomers, methyl formate and acetic acid; and its reduced alcohol, ethylene glycol, are clearly detected and their emission well-modeled with an excitation temperature of 300 K. For ethylene glycol both lowest state conformers, aGg' and gGg', are detected, the latter for the first time in the interstellar medium (ISM). The abundance of glycolaldehyde is comparable to or slightly larger than that of ethylene glycol. In comparison to the Galactic Center these two species are over-abundant relative to methanol, possibly an indication of formation of the species at low temperatures in CO-rich ices during the infall of the material toward the central protostar. Both C-13 and the deuterated isotopologues of glycolaldehyde are detected, also for the first time ever in the ISM. For the deuterated species, a D/H ratio of approximate to 5% is found with no differences between the deuteration in the different functional groups of glycolaldehyde, in contrast to previous estimates for methanol and recent suggestions of significant equilibration between water and-OH functional groups at high temperatures. Measurements of the C-13-species lead to a C-12:C-13 ratio of approximate to 30, lower than the typical ISM value. This low ratio may reflect an enhancement of (CO)-C-13 in the ice due to either ion-molecule reactions in the gas before freeze-out or to differences in the temperatures where (CO)-C-12 and (CO)-C-13 ices sublimate. Conclusions. The results reinforce the importance of low-temperature grain surface chemistry for the formation of prebiotic molecules seen here in the gas after sublimation of the entire ice mantle. Systematic surveys of the molecules thought to be chemically related, as well as the accurate measurements of their isotopic composition, hold strong promise for understanding the origin of prebiotic molecules in the earliest stages of young stars.
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| 37. |
- Lykke, J. M., et al.
(författare)
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The ALMA-PILS survey: First detections of ethylene oxide, acetone and propanal toward the low-mass protostar IRAS 16293-2422
- 2017
-
Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 597, s. A53-
-
Tidskriftsartikel (refereegranskat)abstract
- Context. One of the open questions in astrochemistry is how complex organic and prebiotic molecules are formed. The unsurpassed sensitivity of the Atacama Large Millimeter/submillimeter Array (ALMA) takes the quest for discovering molecules in the warm and dense gas surrounding young stars to the next level. Aims. Our aim is to start the process of compiling an inventory of oxygen-bearing complex organic molecules toward the solar-type Class 0 protostellar binary IRAS 16293-2422 from an unbiased spectral survey with ALMA, Protostellar Interferometric Line Survey (PILS). Here we focus on the new detections of ethylene oxide (c-C2H4O), acetone (CH3COCH3), and propanal (C2H5CHO). Methods. With ALMA, we surveyed the spectral range from 329 to 363 GHz at 0.5? (60 AU diameter) resolution. Using a simple model for the molecular emission in local thermodynamical equilibrium, the excitation temperatures and column densities of each species were constrained. Results. We successfully detect propanal (44 lines), ethylene oxide (20 lines) and acetone (186 lines) toward one component of the protostellar binary, IRAS 16293B. The high resolution maps demonstrate that the emission for all investigated species originates from the compact central region close to the protostar. This, along with a derived common excitation temperature of Tex ? 125 K, is consistent with a coexistence of these molecules in the same gas. Conclusions. The observations mark the first detections of acetone, propanal and ethylene oxide toward a low-mass protostar. The relative abundance ratios of the two sets of isomers, a CH3COCH3/C2H5CHO ratio of 8 and a CH3CHO/c-C2H4O ratio of 12, are comparable to previous observations toward high-mass protostars. The majority of observed abundance ratios from these results as well as those measured toward high-mass protostars are up to an order of magnitude above the predictions from chemical models. This may reflect either missing reactions or uncertain rates in the chemical networks. The physical conditions, such as temperatures or densities, used in the models, may not be applicable to solar-type protostars either.
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| 38. |
- Manry, Jérémy, et al.
(författare)
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The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies.
- 2022
-
Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 1091-6490. ; 119:21
-
Tidskriftsartikel (refereegranskat)abstract
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection fatality rate (IFR) doubles with every 5 y of age from childhood onward. Circulating autoantibodies neutralizing IFN-α, IFN-ω, and/or IFN-β are found in ∼20% of deceased patients across age groups, and in ∼1% of individuals aged <70 y and in >4% of those >70 y old in the general population. With a sample of 1,261 unvaccinated deceased patients and 34,159 individuals of the general population sampled before the pandemic, we estimated both IFR and relative risk of death (RRD) across age groups for individuals carrying autoantibodies neutralizing type I IFNs, relative to noncarriers. The RRD associated with any combination of autoantibodies was higher in subjects under 70 y old. For autoantibodies neutralizing IFN-α2 or IFN-ω, the RRDs were 17.0 (95% CI: 11.7 to 24.7) and 5.8 (4.5 to 7.4) for individuals <70 y and ≥70 y old, respectively, whereas, for autoantibodies neutralizing both molecules, the RRDs were 188.3 (44.8 to 774.4) and 7.2 (5.0 to 10.3), respectively. In contrast, IFRs increased with age, ranging from 0.17% (0.12 to 0.31) for individuals <40 y old to 26.7% (20.3 to 35.2) for those ≥80 y old for autoantibodies neutralizing IFN-α2 or IFN-ω, and from 0.84% (0.31 to 8.28) to 40.5% (27.82 to 61.20) for autoantibodies neutralizing both. Autoantibodies against type I IFNs increase IFRs, and are associated with high RRDs, especially when neutralizing both IFN-α2 and IFN-ω. Remarkably, IFRs increase with age, whereas RRDs decrease with age. Autoimmunity to type I IFNs is a strong and common predictor of COVID-19 death.
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| 39. |
- Mooley, K., et al.
(författare)
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A mildly relativistic wide-angle outflow in the neutron-star merger event GW170817
- 2018
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 554:7691, s. 207-210
-
Tidskriftsartikel (refereegranskat)abstract
- GW170817 was the first gravitational-wave detection of a binary neutron-star merger. It was accompanied by radiation across the electromagnetic spectrum and localized to the galaxy NGC 4993 at a distance of 40 megaparsecs. It has been proposed that the observed γ-ray, X-ray and radio emission is due to an ultra-relativistic jet being launched during the merger (and successfully breaking out of the surrounding material), directed away from our line of sight (off-axis). The presence of such a jet is predicted from models that posit neutron-star mergers as the drivers of short hard-γ-ray bursts. Here we report that the radio light curve of GW170817 has no direct signature of the afterglow of an off-axis jet. Although we cannot completely rule out the existence of a jet directed away from the line of sight, the observed γ-ray emission could not have originated from such a jet. Instead, the radio data require the existence of a mildly relativistic wide-angle outflow moving towards us. This outflow could be the high-velocity tail of the neutron-rich material that was ejected dynamically during the merger, or a cocoon of material that breaks out when a jet launched during the merger transfers its energy to the dynamical ejecta. Because the cocoon model explains the radio light curve of GW170817, as well as the γ-ray and X-ray emission (and possibly also the ultraviolet and optical emission), it is the model that is most consistent with the observational data. Cocoons may be a ubiquitous phenomenon produced in neutron-star mergers, giving rise to a hitherto unidentified population of radio, ultraviolet, X-ray and γ-ray transients in the local Universe.
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| 40. |
- Parker, Thomas D., et al.
(författare)
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Active elite rugby participation is associated with altered precentral cortical thickness
- 2023
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Ingår i: Brain Communications. - 2632-1297. ; 5:6
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Tidskriftsartikel (refereegranskat)abstract
- There is growing concern that elite rugby participation may negatively influence brain health, but the underlying mechanisms are unclear. Cortical thickness is a widely applied biomarker of grey matter structure, but there is limited research into how it may be altered in active professional rugby players. Cross-sectional MRI data from 44 active elite rugby players, including 21 assessed within 1 week of head injury, and 47 healthy controls were analysed. We investigated how active elite rugby participation with and without sub-acute traumatic brain injury influenced grey matter structure using whole cortex and region of interest cortical thickness analyses. Relationships between cortical thickness and biomarkers of traumatic brain injury, including fractional anisotropy, plasma neurofilament light and glial fibrillary acidic protein, were also examined. In whole-cortex analyses, precentral cortical thickness in the right hemisphere was lower in rugby players compared with controls, which was due to reductions in non-injured players. Post hoc region of interest analyses showed non-injured rugby players had reduced cortical thickness in the inferior precentral sulcal thickness bilaterally (P = 0.005) and the left central sulcus (P = 0.037) relative to controls. In contrast, players in the sub-acute phase of mild traumatic brain injury had higher inferior precentral sulcal cortical thickness in the right hemisphere (P = 0.015). Plasma glial fibrillary acidic protein, a marker of astrocyte activation, was positively associated with right inferior precentral sulcal cortical thickness in injured rugby players (P = 0.0012). Elite rugby participation is associated with localized alterations in cortical thickness, specifically in sulcal motor regions. Sub-acute changes after mild traumatic brain injury are associated with evidence of astrocytic activation. The combination of cortical thickness and glial fibrillary acidic protein may be useful in understanding the pathophysiological relationship between sporting head injury and brain health.
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| 41. |
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| 42. |
- Tate, David J., et al.
(författare)
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Curriculum for training in endoscopic mucosal resection in the colon : European Society of Gastrointestinal Endoscopy (ESGE) Position Statement
- 2023
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Ingår i: Endoscopy. - 0013-726X. ; 55:7, s. 645-679
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Tidskriftsartikel (refereegranskat)abstract
- Main recommendations: Endoscopic mucosal resection (EMR) is the standard of care for the complete removal of large (≥ 10mm) nonpedunculated colorectal polyps (LNPCPs). Increased detection of LNPCPs owing to screening colonoscopy, plus high observed rates of incomplete resection and need for surgery call for a standardized approach to training in EMR. 1 Trainees in EMR should have achieved basic competence in diagnostic colonoscopy, < 10-mm polypectomy, pedunculated polypectomy, and common methods of gastrointestinal endoscopic hemostasis. The role of formal training courses is emphasized. Training may then commence in vivo under the direct supervision of a trainer. 2 Endoscopy units training endoscopists in EMR should have specific processes in place to support and facilitate training. 3 A trained EMR practitioner should have mastered theoretical knowledge including how to assess an LNPCP for risk of submucosal invasion, how to interpret the potential difficulty of a particular EMR procedure, how to decide whether to remove a particular LNPCP en bloc or piecemeal, whether the risks of electrosurgical energy can be avoided for a particular LNPCP, the different devices required for EMR, management of adverse events, and interpretation of reports provided by histopathologists. 4 Trained EMR practitioners should be familiar with the patient consent process for EMR. 5 The development of endoscopic non-technical skills (ENTS) and team interaction are important for trainees in EMR. 6 Differences in recommended technique exist between EMR performed with and without electrosurgical energy. Common to both is a standardized technique based upon dynamic injection, controlled and precise snare placement, safety checks prior to the application of tissue transection (cold snare) or electrosurgical energy (hot snare), and interpretation of the post-EMR resection defect. 7 A trained EMR practitioner must be able to manage adverse events associated with EMR including intraprocedural bleeding and perforation, and post-procedural bleeding. Delayed perforation should be avoided by correct interpretation of the post-EMR defect and treatment of deep mural injury. 8 A trained EMR practitioner must be able to communicate EMR procedural findings to patients and provide them with a plan in case of adverse events after discharge and a follow-up plan. 9 A trained EMR practitioner must be able to detect and interrogate a post-endoscopic resection scar for residual or recurrent adenoma and apply treatment if necessary. 10 Prior to independent practice, a minimum of 30 EMR procedures should be performed, culminating in a trainer-guided assessment of competency using a validated assessment tool, taking account of procedural difficulty (e. g. using the SMSA polyp score). 11 Trained practitioners should log their key performance indicators (KPIs) of polypectomy during independent practice. A guide for target KPIs is provided in this document.
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| 43. |
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