Prevalence and Risk Factors for Upper Airway Obstruction after Pediatric Cardiac Surgery

Objective To determine the prevalence of and risk factors for extrathoracic upper-airway obstruction after pediatric cardiac surgery. Study design A retrospective chart review was performed on 213 patients younger than 18 years of age who recovered from cardiac surgery in our multidisciplinary intensive care unit in 2012. Clinically significant upper-airway obstruction was defined as postextubation stridor with at least one of the following: receiving more than 2 corticosteroid doses, receiving helium-oxygen therapy, or reintubation. Multivariate logistic regression analysis was performed to determine independent risk factors for this complication. Results Thirty-five patients (16%) with extrathoracic upper-airway obstruction were identified. On bivariate analysis, patients with upper-airway obstruction had greater surgical complexity, greater vasoactive medication requirements, and longer postoperative durations of endotracheal intubation. They also were more difficult to calm while on mechanical ventilation, as indicated by greater infusion doses of narcotics and greater likelihood to receive dexmedetomidine or vecuronium. On multivariable analysis, adjunctive use of dexmedetomedine or vecuronium (OR 3.4, 95% CI 1.4-8) remained independently associated with upper-airway obstruction. Conclusion Extrathoracic upper-airway obstruction is relatively common after pediatric cardiac surgery, especially in children who are difficult to calm during endotracheal intubation. Postoperative upper-airway obstruction could be an important outcome measure in future studies of sedation practices in this patient population

Are the black hole masses in Narrow Line Seyfert 1 galaxies actually small?

Narrow Line Seyfert 1 galaxies (NLS1s) are generally considered peculiar objects among the broad class of Type 1 active galactic nuclei, due to the relatively small width of the broad lines, strong X-ray variability, soft X-ray continua, weak [OIII], and strong FeII line intensities. The mass M_BH of the central massive black hole (MBH) is claimed to be lighter than expected from known MBH-host galaxy scaling relations, while the accretion rate onto the MBH larger than the average value appropriate to Seyfert 1 galaxies. In this Letter, we show that NLS1 peculiar M_BH and L/L_Edd turn out to be fairly standard, provided that the broad line region is allowed to have a disc-like, rather than isotropic, geometry. Assuming that NLS1s are rather ``normal'' Seyfert 1 objects seen along the disc axis, we could estimate the typical inclination angles from the fraction of Seyfert 1 classified as NLS1s, and compute the geometrical factor relating the observed FWHM of broad lines to the virial mass of the MBH. We show that the geometrical factor can fully account for the "black hole mass deficit" observed in NLS1s, and that L/L_Edd is (on average) comparable to the value of the more common broad line Seyfert 1 galaxies.Comment: 5 pages, 3 figures. Accepted for publication in MNRAS Letters. Wrong version was uploaded! Check for the correct one in the replacemen

Gravitational couplings of orientifold planes

We reanalyse the gravitational couplings of the perturbative orientifold planes $Op^-$, $Op^+$ (and D-branes). We first compute their $D_{-1}$ instantonic corrections for $p=3$. Then, by using U-dualities, we obtain the Wess-Zumino terms of orientifolds with RR flux for $p \leq 5$. The expressions for the effective actions can be partially checked via M-theory. We point out a previous oversimplification and we show in fact that the difficulty still stands in the way of the full computation of 7 Brane instanton corrections.Comment: 13 pages, 1 figure, 2 tables. 3 references adde

MOST detects variability on tau Bootis possibly induced by its planetary companion

(abridged) There is considerable interest in the possible interaction between parent stars and giant planetary companions in 51 Peg-type systems. We demonstrate from MOST satellite photometry and Ca II K line emission that there has been a persistent, variable region on the surface of tau Boo A which tracked its giant planetary companion for some 440 planetary revolutions and lies ~68deg (phi=0.8) in advance of the sub-planetary point. The light curves are folded on a range of periods centered on the planetary orbital period and phase dependent variability is quantified by Fourier methods and by the mean absolute deviation (MAD) of the folded data for both the photometry and the Ca II K line reversals. The region varies in brightness on the time scale of a rotation by ~1 mmag. In 2004 it resembled a dark spot of variable depth, while in 2005 it varied between bright and dark. Over the 123 planetary orbits spanned by the photometry the variable region detected in 2004 and in 2005 are synchronised to the planetary orbital period within 0.0015 d. The Ca II K line in 2001, 2002 and 2003 also shows enhanced K-line variability centered on phi=0.8, extending coverage to some 440 planetary revolutions. The apparently constant rotation period of the variable region and its rapid variation make an explanation in terms of conventional star spots unlikely. The lack of complementary variability at phi=0.3 and the detection of the variable region so far in advance of the sub-planetary point excludes tidal excitation, but the combined photometric and Ca II K line reversal results make a good case for an active region induced magnetically on the surface of tau Boo A by its planetary companion.Comment: 7 pages, 7 figures; accepted for publication in A&

Space Station Engineering Design Issues

Space Station Freedom topics addressed include: general design issues; issues related to utilization and operations; issues related to systems requirements and design; and management issues relevant to design

Localized modes at a D-brane--O-plane intersection and heterotic Alice strings

We study a system of $N_c$ $D3$-branes intersecting $D7$-branes and $O7$-planes in 1+1-dimensions. We use anomaly cancellation and string dualities to argue that there must be chiral fermion zero-modes on the $D3$-branes which are localized near the $O7$-planes. Away from the orientifold limit we verify this by using index theory as well as explicit construction of the zero-modes. This system is related to F-theory on K3 and heterotic matrix string theory, and the heterotic strings are related to Alice string defects in $\mathcal{N}=4$ Super-Yang-Mills. In the limit of large $N_c$ we find an $AdS_3$ dual of the heterotic matrix string CFT.Comment: 44 pages, typos corrected, version published in JHE

T cell receptor Vbeta gene usage in Thai children with dengue virus infection

T lymphocyte activation during dengue is thought to contribute to the pathogenesis of dengue hemorrhagic fever (DHF). We examined the T cell receptor Vbeta gene usage by a reverse transcriptase-polymerase chain reaction assay during infection and after recovery in 13 children with DHF and 13 children with dengue fever (DF). There was no deletion of specific Vbeta gene families. We detected significant expansions in usage of single Vbeta families in six subjects with DHF and three subjects with DF over the course of infection, but these did not show an association with clinical diagnosis, viral serotype, or HLA alleles. Differences in Vbeta gene usage between subjects with DHF and subjects with DF were of borderline significance. These data suggest that the differences in T cell activation in DHF and DF are quantitative rather than qualitative and that T cells are activated by conventional antigen(s) and not a viral superantigen

Structural correlates of semantic and phonemic fluency ability in first and second languages

Category and letter fluency tasks are commonly used clinically to investigate the semantic and phonological processes central to speech production, but the neural correlates of these processes are difficult to establish with functional neuroimaging because of the relatively unconstrained nature of the tasks. This study investigated whether differential performance on semantic (category) and phonemic (letter) fluency in neurologically normal participants was reflected in regional gray matter density. The participants were 59 highly proficient speakers of 2 languages. Our findings corroborate the importance of the left inferior temporal cortex in semantic relative to phonemic fluency and show this effect to be the same in a first language (L1) and second language (L2). Additionally, we show that the pre-supplementary motor area (pre-SMA) and head of caudate bilaterally are associated with phonemic more than semantic fluency, and this effect is stronger for L2 than L1 in the caudate nuclei. To further validate these structural results, we reanalyzed previously reported functional data and found that pre-SMA and left caudate activation was higher for phonemic than semantic fluency. On the basis of our findings, we also predict that lesions to the pre-SMA and caudate nuclei may have a greater impact on phonemic than semantic fluency, particularly in L2 speakers

The Pan-STARRS Moving Object Processing System

We describe the Pan-STARRS Moving Object Processing System (MOPS), a modern software package that produces automatic asteroid discoveries and identifications from catalogs of transient detections from next-generation astronomical survey telescopes. MOPS achieves > 99.5% efficiency in producing orbits from a synthetic but realistic population of asteroids whose measurements were simulated for a Pan-STARRS4-class telescope. Additionally, using a non-physical grid population, we demonstrate that MOPS can detect populations of currently unknown objects such as interstellar asteroids. MOPS has been adapted successfully to the prototype Pan-STARRS1 telescope despite differences in expected false detection rates, fill-factor loss and relatively sparse observing cadence compared to a hypothetical Pan-STARRS4 telescope and survey. MOPS remains >99.5% efficient at detecting objects on a single night but drops to 80% efficiency at producing orbits for objects detected on multiple nights. This loss is primarily due to configurable MOPS processing limits that are not yet tuned for the Pan-STARRS1 mission. The core MOPS software package is the product of more than 15 person-years of software development and incorporates countless additional years of effort in third-party software to perform lower-level functions such as spatial searching or orbit determination. We describe the high-level design of MOPS and essential subcomponents, the suitability of MOPS for other survey programs, and suggest a road map for future MOPS development.Comment: 57 Pages, 26 Figures, 13 Table

The Two Variables in The Triple System HR 6469=V819 Her: One Eclipsing, One Spotted

A complete BV light curve, from 14 nights of good data obtained with the Vanderbilt University-Tennessee State University (VU-TSU) automatic telescope, are presented and solved with the Wilson-Devinney program. Third light is evaluated, with the companion star brighter by 0.58m in V and 0.11m in B. The eclipses are partial. Inferred color indices yield F2 V and F8 V for the eclipsing pair and G8 IV-III for the distant companion star. After removing the variability due to eclipses, we study the residual variability of the G8 IV-III star over the ten years 1982 to 1992. Each yearly light curve is fit with a two-spot model. Three relatively long-lived spots are identified, with rotation periods of 85.9d, 85.9d, and 86.1d. The weak and intermittent variability is understood because the G8 IV-III star has a Rossby number at the threshold for the onset of heavy spottedness