Term admissions to neonatal units in England: a role for transitional care? A retrospective cohort study

Objective To identify the primary reasons for term admissions to neonatal units in England, to determine risk factors for admissions for jaundice and to estimate the proportion who can be cared for in a transitional setting without separation of mother and baby. Design Retrospective observational study using neonatal unit admission data from the National Neonatal Research Database and data of live births in England from the Office for National Statistics. Setting All 163 neonatal units in England 2011–2013. Participants 133 691 term babies born ≥37 weeks gestational age and admitted to neonatal units in England. Primary and secondary outcomes Primary reasons for admission, term babies admitted for the primary reason of jaundice, patient characteristics, postnatal age at admission, total length of stay, phototherapy, intravenous fluids, exchange transfusion and kernicterus. Results Respiratory disease was the most common reason for admission overall, although jaundice was the most common reason for admission from home (22% home vs 5% hospital). Risk factors for admission for jaundice include male, born at 37 weeks gestation, Asian ethnicity and multiple birth. The majority of babies received only a brief period of phototherapy, and only a third received intravenous fluids, suggesting that some may be appropriately managed without separation of mother and baby. Admission from home was significantly later (3.9 days) compared with those admitted from elsewhere in the hospital (1.7 days) (p<0.001). Conclusion Around two-thirds of term admissions for jaundice may be appropriately managed in a transitional care setting, avoiding separation of mother and baby. Babies with risk factors may benefit from a community midwife postnatal visit around the third day of life to enable early referral if necessary. We recommend further work at the national level to examine provision and barriers to transitional care, referral pathways between primary and secondary care, and community postnatal care

Public Inquiries on Counterterrorism: An Independent Appraisal of New Zealand's Royal Commission of Inquiry into the Christchurch Terrorist Attack

Draft-in-progress; please do not distribute further or citeEven though elected leaders of liberal democracies respond to major terrorist attacks by commissioning public inquiries, scholars have not yet fully explored these inquiries as a practice of the War on Terror. By undertaking an independent appraisal of the Royal Commission of Inquiry into the Terrorist Attack on Christchurch Mosques on 15 March 2019 we seek to introduce empirical evidence of an important case of investigatory oversight to the more critical terrorism studies literature. Specifically, we examine how the Royal Commissioners interpreted their Terms of Reference, explore the ways in which they engaged with New Zealand’s security agencies as well as with various individuals, groups and communities beyond the public sector, and assess the quality of their recommendations. We argue that the Commissioners positioned themselves publicly as undertaking a remedial intervention in New Zealand’s counterterrorism effort, but their inquiry was, in fact, designed to reassure the public that the current security dispensation is largely fit for purpose and does not need major reform. The inquiry did little more than enable two carefully chosen Commissioners, imbued with a veneer of professional detachment but lacking in subject-matter expertise, to call for a strengthening of state security institutions, entrenching the hierarchies that already prevail within the national security system while shielding parliamentarians from accusations of disinterest, negligence or acts of omission. Consequently, New Zealand is no better off when it comes to its ability to understand the nature and scale of the threat posed by terrorism or to respond to an array of routine, as well as novel and surprise, security challenges

n-Dimensional QoS Framework for Real-Time Service-Oriented Architectures

Service-Orientation has long provided an effective mechanism to integrate heterogeneous systems in a loosely coupled fashion as services. However, with the emergence of Internet of Things (IoT) there is a growing need to facilitate the integration of real-time services executing in non-controlled, non-real-time, environments such as the Cloud. With the need to integrate both cyberphysical systems as hardware-in-the-loop (HIL) components and also with Simulation as a Service (SIMaaS) the execution performance and response-times of the services must be managed. This paper presents a mathematical framework that captures the relationship between the host execution environment and service performance allowing the estimation of Quality of Service (QoS) under dynamic Cloud workloads. A formal mathematical definition is provided and this is evaluated against existing techniques from both the Cloud and Real-Time Service Oriented Architecture (RT-SOA) domains. The proposed approach is evaluated against the existing techniques through simulation and demonstrates a reduction of QoS violation percentage by 22% with respect to response-times as well as reducing the number of Micro-Service (uS) instances with QoS violations by 27%

DIVIDER: Modelling and Evaluating Real-Time Service-Oriented Cyberphysical Co-Simulations

The ability to reliably distribute simulations across a distributed system and seamlessly integrate them as a workflow regardless of their level of abstraction is critical to improving the quality of product manufacturing. This paper presents the DIVIDER architecture for managing and maintaining real-time performance simulations integrated through SOAs. The described approach captures features present in complex workflow patterns such as asynchronous arbitrary cycles and estimates the worst case execution time in the context of the interfering execution environment

Ignition of flammable hydrogen/air mixtures by high mass mechanical impact of Magnox contaminated surfaces

Magnox and its corrosion products are a major constituent of some legacy nuclear waste storage silos which generate hydrogen. An experimental study investigates the likelihood of ignition of hydrogen/air when large mass projectiles impact rusty surfaces with Magnox contamination. Ignition is observed with 50kg projectiles impacting a 45º Magnox-smeared rusty anvil plate with KE as low as 40J. Theoretical calculations relating to the angled impacts reveal that they involve substantial tangential energy losses associated with frictional heating of the impact surfaces. It is shown that these energy losses are particularly dependent on the shape of the projectile since projectile geometry determines the radius of gyration and the relationship of centre of gravity to the impact point. In conclusion, the projectile shape is likely to be of greater importance than the mass (i.e. for a given impact energy) because of its direct bearing on the magnitude of the tangential energy loss

Characterizing precursors to stellar clusters with Herschel

Context. Despite their profound effect on the universe, the formation of massive stars and stellar clusters remains elusive. Recent advances in observing facilities and computing power have brought us closer to understanding this formation process. In the past decade, compelling evidence has emerged that suggests infrared dark clouds (IRDCs) may be precursors to stellar clusters. However, the usual method for identifying IRDCs is biased by the requirement that they are seen in absorption against background mid-IR emission, whereas dust continuum observations allow cold, dense pre-stellar-clusters to be identified anywhere. Aims: We aim to understand what dust temperatures and column densities characterize and distinguish IRDCs, to explore the population of dust continuum sources that are not IRDCs, and to roughly characterize the level of star formation activity in these dust continuum sources. Methods: We use Hi-GAL 70 to 500 $m data to identify dust continuum sources in the ell = 30deg and ell = 59deg Hi-GAL science demonstration phase (SDP) fields, to characterize and subtract the Galactic cirrus emission, and perform pixel-by-pixel modified blackbody fits on cirrus-subtracted Hi-GAL sources. We utilize archival Spitzer data to indicate the level of star-forming activity in each pixel, from mid-IR-dark to mid-IR-bright. Results: We present temperature and column density maps in the Hi-GAL ell = 30deg and ell = 59deg SDP fields, as well as a robust algorithm for cirrus subtraction and source identification using Hi-GAL data. We report on the fraction of Hi-GAL source pixels which are mid-IR-dark, mid-IR-neutral, or mid-IR-bright in both fields. We find significant trends in column density and temperature between mid-IR-dark and mid-IR-bright pixels; mid-IR-dark pixels are about 10 K colder and have a factor of 2 higher column density on average than mid-IR-bright pixels. We find that Hi-GAL dust continuum sources span a range of evolutionary states from pre- to star-forming, and that warmer sources are associated with more star formation tracers. Additionally, there is a trend of increasing temperature with tracer type from mid-IR-dark at the coldest, to outflow/maser sources in the middle, and finally to 8 and 24$m bright sources at the warmest. Finally, we identify five candidate IRDC-like sources on the far-side of the Galaxy. These are cold (20 K), high column density (N(H$_2$) gt 10$^22$ cm$^-2$) clouds identified with Hi-GAL which, despite bright surrounding mid-IR emission, show little to no absorption at 8 $m. These are the first inner Galaxy far-side candidate IRDCs of which the authors are aware. Herschel in an ESA space observatory with science instruments provided by European-led Principal Investigator consortia and with important participation by NASA.The FITS files discussed in the paper would be released publicly WITH the Hi-GAL data (on the Hi-GAL website) when the Hi-GAL data is released publicly.Peer reviewe

An Unusual Mode of DNA Duplex Association: Watson-Crick Interaction of All-Purine Deoxyribonucleic Acids

SummaryNucleic acid duplexes associating through purine-purine base pairing have been constructed and characterized in a remarkable demonstration of nucleic acids with mixed sequence and a natural backbone in an alternative duplex structure. The antiparallel deoxyribose all-purine duplexes associate specifically through Watson-Crick pairing, violating the nucleobase size-complementarity pairing convention found in Nature. Sequence-specific recognition displayed by these structures makes the duplexes suitable, in principle, for information storage and replication fundamental to molecular evolution in all living organisms. All-purine duplexes can be formed through association of purines found in natural ribonucleosides. Key to the formation of these duplexes is the N3-H tautomer of isoguanine, preferred in the duplex, but not in aqueous solution. The duplexes have relevance to evolution of the modern genetic code and can be used for molecular recognition of natural nucleic acids

Term admissions to neonatal units in England: a role for transitional care? A retrospective cohort study

Objective To identify the primary reasons for term admissions to neonatal units in England, to determine risk factors for admissions for jaundice and to estimate the proportion who can be cared for in a transitional setting without separation of mother and baby. Design Retrospective observational study using neonatal unit admission data from the National Neonatal Research Database and data of live births in England from the Office for National Statistics. Setting All 163 neonatal units in England 2011–2013. Participants 133 691 term babies born ≥37 weeks gestational age and admitted to neonatal units in England. Primary and secondary outcomes Primary reasons for admission, term babies admitted for the primary reason of jaundice, patient characteristics, postnatal age at admission, total length of stay, phototherapy, intravenous fluids, exchange transfusion and kernicterus. Results Respiratory disease was the most common reason for admission overall, although jaundice was the most common reason for admission from home (22% home vs 5% hospital). Risk factors for admission for jaundice include male, born at 37 weeks gestation, Asian ethnicity and multiple birth. The majority of babies received only a brief period of phototherapy, and only a third received intravenous fluids, suggesting that some may be appropriately managed without separation of mother and baby. Admission from home was significantly later (3.9 days) compared with those admitted from elsewhere in the hospital (1.7 days) (p<0.001). Conclusion Around two-thirds of term admissions for jaundice may be appropriately managed in a transitional care setting, avoiding separation of mother and baby. Babies with risk factors may benefit from a community midwife postnatal visit around the third day of life to enable early referral if necessary. We recommend further work at the national level to examine provision and barriers to transitional care, referral pathways between primary and secondary care, and community postnatal care