The Homogeneity of Interstellar Oxygen in the Galactic Disk

We present an analysis of high resolution HST Space Telescope Imaging Spectrograph (STIS) observations of O I 1356 and H I Lyman-alpha absorption in 36 sight lines that probe a variety of Galactic disk environments and include paths that range over nearly 4 orders of magnitude in f(H_2), over 2 orders of magnitude in mean sight line density, and that extend up to 6.5 kpc in length. Consequently, we have undertaken the study of gas-phase O/H abundance ratio homogeneity using the current sample and previously published Goddard High-Resolution Spectrograph (GHRS) results. Two distinct trends are identified in the 56 sight line sample: an apparent decrease in gas-phase oxygen abundance with increasing mean sight line density and a gap between the mean O/H ratio for sight lines shorter and longer than about 800 pc. The first effect is a smooth transition between two depletion levels associated with large mean density intervals; it is centered near a density of 1.5 cm^-3 and is similar to trends evident in gas-phase abundances of other elements. Paths less dense than the central value exhibit a mean O/H ratio of log_10 (O/H) = -3.41+/-0.01 (or 390+/-10 ppm), which is consistent with averages determined for several long, low-density paths observed by STIS (Andre et al. 2003) and short low-density paths observed by FUSE (Moos et al. 2002). Sight lines of higher mean density exhibit an average O/H value of log_10 (O/H) = -3.55+/-0.02 (284+/-12 ppm). The datapoints for low-density paths are scattered more widely than those for denser sight lines, due to O/H ratios for paths shorter than 800 pc that are generally about 0.10 dex lower than the values for longer ones.Comment: 33 pages, including 8 figures and 4 tables; accepted for publication in ApJ, tentatively in Oct 200

Acceptability and Feasibility of Universal Offer of Rapid Point of Care Testing for HIV in an Acute Admissions Unit: Results of the RAPID Project

UK guidance recommend all acute medical admissions be offered an HIV test. Our aim was to determine whether a dedicated staff member using a multimedia tool, a model found to be effective in the USA, is an acceptable, feasible, and cost-effective model when translated to a UK setting

FUSE Measurements of Far Ultraviolet Extinction. I. Galactic Sight Lines

We present extinction curves that include data down to far ultraviolet wavelengths (FUV; 1050 - 1200 A) for nine Galactic sight lines. The FUV extinction was measured using data from the Far Ultraviolet Spectroscopic Explorer. The sight lines were chosen for their unusual extinction properties in the infrared through the ultraviolet; that they probe a wide range of dust environments is evidenced by the large spread in their measured ratios of total-to-selective extinction, R_V = 2.43 - 3.81. We find that extrapolation of the Fitzpatrick & Massa relationship from the ultraviolet appears to be a good predictor of the FUV extinction behavior. We find that predictions of the FUV extinction based upon the Cardelli, Clayton & Mathis (CCM) dependence on R_V give mixed results. For the seven extinction curves well represented by CCM in the infrared through ultraviolet, the FUV extinction is well predicted in three sight lines, over-predicted in two sight lines, and under-predicted in 2 sight lines. A Maximum Entropy Method analysis using a simple three component grain model shows that seven of the nine sight lines in the study require a larger fraction of grain materials to be in dust when FUV extinction is included in the models. Most of the added grain material is in the form of small (radii < 200 A) grains.Comment: Accepted for publication in the Astrophysical Journal. 31 pages with 7 figure

Can a Respiratory Severity Score Accurately Assess Respiratory Distress in Children with Bronchiolitis in a Resource-Limited Setting?

You are the resident on call for the acute pediatric ward in a district hospital in a resource-limited setting. A 9-month-old male infant presents with a 3-day history of coryza and cough followed by difficulty in breathing. The infant is admitted to the acute ward for observation but does not need supplementary oxygen or fluid support. During the ward-round it was felt that his condition at presentation did not warrant admission. You are concerned that by being admitted unnecessarily this infant was put at an unnecessary risk of nosocomial infection. Furthermore, the care is paid for by the family and bed spaces are lacking. You wonder if there is a valid and reliable respiratory distress severity score that may help to accurately assess respiratory distress as a useful adjunct for clinical decision making, to help reduce unnecessary admissions in children with bronchiolitis

Observation of interstellar lithium in the low-metallicity Small Magellanic Cloud

The primordial abundances of light elements produced in the standard theory of Big Bang nucleosynthesis (BBN) depend only on the cosmic ratio of baryons to photons, a quantity inferred from observations of the microwave background. The predicted primordial 7Li abundance is four times that measured in the atmospheres of Galactic halo stars. This discrepancy could be caused by modification of surface lithium abundances during the stars' lifetimes or by physics beyond the Standard Model that affects early nucleosynthesis. The lithium abundance of low-metallicity gas provides an alternative constraint on the primordial abundance and cosmic evolution of lithium that is not susceptible to the in situ modifications that may affect stellar atmospheres. Here we report observations of interstellar 7Li in the low-metallicity gas of the Small Magellanic Cloud, a nearby galaxy with a quarter the Sun's metallicity. The present-day 7Li abundance of the Small Magellanic Cloud is nearly equal to the BBN predictions, severely constraining the amount of possible subsequent enrichment of the gas by stellar and cosmic-ray nucleosynthesis. Our measurements can be reconciled with standard BBN with an extremely fine-tuned depletion of stellar Li with metallicity. They are also consistent with non-standard BBN.Comment: Published in Nature. Includes main text and Supplementary Information. Replaced with final title and abstrac

Interstellar Iron and Silicon Depletions in Translucent Sight Lines

We report interstellar FeII and SiII column densities toward six translucent sight lines (A_V >~ 1) observed with the Space Telescope Imaging Spectrograph (STIS). The abundances were determined from the absorption of SiII] at 2335 Angstroms, and several weak Fe transitions including the first reported detections of the 2234 Angstrom line. We derive an empirical f-value for the FeII 2234 Angstrom transition of log(f lambda) = -1.54 +/- 0.05. The observed sight lines sample a variety of extinction characteristics as indicated by their R_V values, which range from 2.6 - 5.8. The dust-phase abundances of both Si and Fe are positively correlated with the small-grain population (effective radii smaller than a few hundred micron) toward the targets. The physical conditions along the sight lines suggest that this relationship may be due to differences in the survival of small particles in some interstellar environments. The chemical composition of the small grains could either resemble dust mantles or be silicate rich.Comment: accepted for publication in Ap

Field testing two existing, standardized respiratory severity scores (LIBSS and ReSViNET) in infants presenting with acute respiratory illness to tertiary hospitals in Rwanda - a validation and inter-rater reliability study.

INTRODUCTION: There is a substantial burden of respiratory disease in infants in the sub-Saharan Africa region. Many health care providers (HCPs) that initially receive infants with respiratory distress may not be adequately skilled to differentiate between mild, moderate and severe respiratory symptoms, which may contribute to poor management and outcome. Therefore, respiratory severity scores have the potential to contributing to address this gap. OBJECTIVES: to field-test the use of two existing standardized bronchiolitis severity scores (LIBSS and ReSViNET) in a population of Rwandan infants (1-12 months) presenting with respiratory illnesses to urban, tertiary, pediatric hospitals and to assess the severity of respiratory distress in these infants and the treatments used. METHODS: A cross-sectional, validation study, was conducted in four tertiary hospitals in Rwanda. Infants presenting with difficulty in breathing were included. The LIBSS and ReSViNET scores were independently employed by nurses and residents to assess the severity of disease in each infant. RESULTS: 100 infants were recruited with a mean age of seven months. Infants presented with pneumonia (n = 51), bronchiolitis (n = 36) and other infectious respiratory illnesses (n = 13). Thirty-three infants had severe disease and survival was 94% using nurse applied LIBSS. Regarding inter-rater reliability, the intra-class correlation coefficient (ICC) for LIBSS and ReSViNET between nurses and residents was 0.985 (95% CI: 0.98-0.99) and 0.980 (0.97-0.99). The convergent validity (Pearson's correlation) between LIBSS and ReSViNET for nurses and residents was R = 0.836 (p<0.001) and R = 0.815 (p<0.001). The area under the Receiver Operator Curve (aROC) for admission to PICU or HDU was 0.956 (CI: 0.92-0.99, p<0.001) and 0.880 (CI: 0.80-0.96, p<0.001) for nurse completed LIBSS and ReSViNET respectively. CONCLUSION: LIBSS and ReSViNET were designed for infants with bronchiolitis in resource-rich settings. Both LIBSS and ReSViNET demonstrated good reliability and validity results, in this cohort of patients presenting to tertiary level hospitals. This early data demonstrate that these two scores have the potential to be used in conjunction with clinical reasoning to identify infants at increased risk of clinical deterioration and allow timely admission, treatment escalation and therefore support resource allocation in Rwanda

Origin and evolution of the light nuclides

After a short historical (and highly subjective) introduction to the field, I discuss our current understanding of the origin and evolution of the light nuclides D, He-3, He-4, Li-6, Li-7, Be-9, B-10 and B-11. Despite considerable observational and theoretical progress, important uncertainties still persist for each and every one of those nuclides. The present-day abundance of D in the local interstellar medium is currently uncertain, making it difficult to infer the recent chemical evolution of the solar neighborhood. To account for the observed quasi-constancy of He-3 abundance from the Big Bang to our days, the stellar production of that nuclide must be negligible; however, the scarce observations of its abundance in planetary nebulae seem to contradict this idea. The observed Be and B evolution as primaries suggests that the source composition of cosmic rays has remained quasi-constant since the early days of the Galaxy, a suggestion with far reaching implications for the origin of cosmic rays; however, the main idea proposed to account for that constancy, namely that superbubbles are at the source of cosmic rays, encounters some serious difficulties. The best explanation for the mismatch between primordial Li and the observed "Spite-plateau" in halo stars appears to be depletion of Li in stellar envelopes, by some yet poorly understood mechanism. But this explanation impacts on the level of the recently discovered early ``Li-6 plateau'', which (if confirmed), seriously challenges current ideas of cosmic ray nucleosynthesis.Comment: 18 pages, 9 figs. Invited Review in "Symposium on the Composition of Matter", honoring Johannes Geiss on the occasion of his 80th birthday (Grindelwald, Switzerland, Sept. 2006), to be published in Space Science Series of ISS