Case report: Multisystem inflammatory syndrome in children associated with COVID-19, macrophage activation syndrome, and incomplete Kawasaki disease

BackgroundMultisystem inflammatory syndrome in children (MIS-C), is a severe complication of coronavirus disease 2019 (COVID-19), characterized by persistent fever, systemic inflammatory response, and organ failure. MIS-C with a history of COVID-19 may share clinical features with other well-defined syndromes such as macrophage activation syndrome, Kawasaki disease, hemophagocytic syndrome and toxic shock syndrome.Case 1An 11-year-old male with a history of hypothyroidism and precocious puberty with positive antibody test for COVID-19 was admitted for fever, poor general condition, severe respiratory distress, refractory shock, and multiple organ failure. His laboratory examination showed elevated inflammatory parameters, and bone marrow aspirate showed hemophagocytosis.Case 2A 13-year-old male with a history of attention deficit hyperactivity disorder and cognitive delay presented clinical manifestations of Kawasaki disease, fever, conjunctival congestion, exanthema, and hyperemia in oral mucosa, tongue, and genitals, with refractory shock and multiple organ failure. Reverse transcriptase polymerase chain reaction (RT-PCR) and antibodies for COVID-19 were negative, inflammation parameters were elevated, and bone marrow aspirate showed hemophagocytosis. Patients required intensive care with invasive mechanical ventilation, vasopressor support, intravenous gamma globulin, systemic corticosteroids, low molecular weight heparin, antibiotics, and monoclonal antibodies and, patient 2 required renal replacement therapy.ConclusionsMultisystemic inflammatory syndrome in children can have atypical manifestations, and identifying them early is very important for the timely treatment and prognosis of patients

Impact of hospital characteristics on implementation of a Pediatric Early Warning System in resource-limited cancer hospitals

BackgroundPediatric Early Warning Systems (PEWS) aid in identification of deterioration in hospitalized children with cancer but are underutilized in resource-limited settings. Proyecto EVAT is a multicenter quality improvement (QI) collaborative in Latin America to implement PEWS. This study investigates the relationship between hospital characteristics and time required for PEWS implementation.MethodsThis convergent mixed-methods study included 23 Proyecto EVAT childhood cancer centers; 5 hospitals representing quick and slow implementers were selected for qualitative analysis. Semi-structured interviews were conducted with 71 stakeholders involved in PEWS implementation. Interviews were recorded, transcribed and translated to English, then coded using a priori and novel codes. Thematic content analysis explored the impact of hospital characteristics and QI experience on time required for PEWS implementation and was supplemented by quantitative analysis exploring the relationship between hospital characteristics and implementation time.ResultsIn both quantitative and qualitative analysis, material and human resources to support PEWS significantly impacted time to implementation. Lack of resources produced various obstacles that extended time necessary for centers to achieve successful implementation. Hospital characteristics, such as funding structure and type, influenced PEWS implementation time by determining their resource-availability. Prior hospital or implementation leader experience with QI, however, helped facilitate implementation by assisting implementers predict and overcome resource-related challenges.ConclusionsHospital characteristics impact time required to implement PEWS in resource-limited childhood cancer centers; however, prior QI experience helps anticipate and adapt to resource challenges and more quickly implement PEWS. QI training should be a component of strategies to scale-up use of evidence-based interventions like PEWS in resource-limited settings

Ítacas: sentidos, territorios y experiencias investigativas en Comunicación Social.

El programa de Comunicación Social de UNIMINUTO produce nuevo conocimiento desde enfoques multidisciplinares en las líneas de Educación, transformación social e innovación; Desarrollo humano y comunicación; Innovaciones sociales y productivas; y Gestión social, participación y desarrollo comunitario, las cuales aportan y fortalecen el perfil profesional e investigador de docentes y estudiantes del programa. Los resultados de las reflexiones que realizan los profesores y estudiantes se plantean como ejercicios introspectivos desde la investigación en comunicación social. Esta publicación busca divulgar el trabajo investigativo de profesores y estudiantes, especialmente este primer número representa el inicio de un camino que esperamos derive en la formación posgradual en niveles superiores de nuestros investigadores y aporte a la comprensión de la comunicación digital en este mundo globalizado. Desde una perspectiva amplia de la producción académica, la investigación se entiende como una mixtura de enfoques (cualitativo y cuantitativo), incluyendo los emergentes, además de variadas estrategias de recolección de información que resultan coherentes con los intereses investigativos del programa y los objetivos propuestos en la ruta de fortalecimento académico, para la articulación adecuada entre la formación y el desarrollo de propuestas científicas. Es así como el grupo de investigación Comunicación, Convergencia y Desarrollo asume la responsabilidad de conducir cada proyecto de investigación propuesto, de acuerdo con los propósitos de formación y la amplia comprensión del campo de la comunicación

Ítacas: sentidos, territorios y experiencias investigativas en Comunicación Social.

El programa de Comunicación Social de UNIMINUTO produce nuevo conocimiento desde enfoques multidisciplinares en las líneas de Educación, transformación social e innovación; Desarrollo humano y comunicación; Innovaciones sociales y productivas; y Gestión social, participación y desarrollo comunitario, las cuales aportan y fortalecen el perfil profesional e investigador de docentes y estudiantes del programa. Los resultados de las reflexiones que realizan los profesores y estudiantes se plantean como ejercicios introspectivos desde la investigación en comunicación social. Esta publicación busca divulgar el trabajo investigativo de profesores y estudiantes, especialmente este primer número representa el inicio de un camino que esperamos derive en la formación posgradual en niveles superiores de nuestros investigadores y aporte a la comprensión de la comunicación digital en este mundo globalizado. Desde una perspectiva amplia de la producción académica, la investigación se entiende como una mixtura de enfoques (cualitativo y cuantitativo), incluyendo los emergentes, además de variadas estrategias de recolección de información que resultan coherentes con los intereses investigativos del programa y los objetivos propuestos en la ruta de fortalecimento académico, para la articulación adecuada entre la formación y el desarrollo de propuestas científicas. Es así como el grupo de investigación Comunicación, Convergencia y Desarrollo asume la responsabilidad de conducir cada proyecto de investigación propuesto, de acuerdo con los propósitos de formación y la amplia comprensión del campo de la comunicación

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Measurements of the Higgs boson production and decay rates and coupling strengths using pp collision data at √S=7 and 8 TeV in the ATLAS experiment

Combined analyses of the Higgs boson production and decay rates as well as its coupling strengths to vector bosons and fermions are presented. The combinations include the results of the analyses of the H -> gamma gamma, ZZ*, WW*, Z gamma, b (b) over bar, tau tau and mu mu decay modes, and the constraints on the associated production with a pair of top quarks and on the off-shell coupling strengths of the Higgs boson. The results are based on the LHC proton-proton collision datasets, with integrated luminosities of up to 4.7 fb(-1) at root s = 7 TeV and 20.3 fb(-1) at root s = 8 TeV, recorded by the ATLAS detector in 2011 and 2012. Combining all production modes and decay channels, the measured signal yield, normalised to the Standard Model expectation, is 1.18(-0.14)(+0.15). The observed Higgs boson production and decay rates are interpreted in a leading-order coupling framework, exploring a wide range of benchmark coupling models both with and without assumptions on the Higgs boson width and on the Standard Model particle content in loop processes. The data are found to be compatible with the Standard Model expectations for a Higgs boson at a mass of 125.36 GeV for all models considered