Study protocol for a multicentre longitudinal mixed methods study to explore the Outcomes of ChildrEn and fAmilies in the first year after paediatric Intensive Care: the OCEANIC study.

INTRODUCTION: Annually in the UK, 20 000 children become very ill or injured and need specialist care within a paediatric intensive care unit (PICU). Most children survive. However, some children and their families may experience problems after they have left the PICU including physical, functional and/or emotional problems. It is unknown which children and families experience such problems, when these occur or what causes them. The aim of this mixed-method longitudinal cohort study is to understand the physical, functional, emotional and social impact of children surviving PICU (aged: 1 month-17 years), their parents and siblings, during the first year after a PICU admission. METHODS AND ANALYSIS: A quantitative study involving 300 child survivors of PICU; 300 parents; and 150-300 siblings will collect data (using self-completion questionnaires) at baseline, PICU discharge, 1, 3, 6 and 12 months post-PICU discharge. Questionnaires will comprise validated and reliable instruments. Demographic data, PICU admission and treatment data, health-related quality of life, functional status, strengths and difficulties behaviour and post-traumatic stress symptoms will be collected from the child. Parent and sibling data will be collected on the impact of paediatric health conditions on the family's functioning capabilities, levels of anxiety and social impact of the child's PICU admission. Data will be analysed using descriptive and inferential statistics. Concurrently, an embedded qualitative study involving semistructured interviews with 24 enrolled families at 3 months and 9 months post-PICU discharge will be undertaken. Framework analysis will be used to analyse the qualitative data. ETHICS AND DISSEMINATION: The study has received ethical approval from the National Health Services Research Ethics Committee (Ref: 19/WM/0290) and full governance clearance. This will be the first UK study to comprehensively investigate physical, functional, emotional and social consequences of PICU survival in the first-year postdischarge.Clinical Trials Registration Number: ISRCTN28072812 [Pre-results]

Risk, Unexpected Uncertainty, and Estimation Uncertainty: Bayesian Learning in Unstable Settings

Recently, evidence has emerged that humans approach learning using Bayesian updating rather than (model-free) reinforcement algorithms in a six-arm restless bandit problem. Here, we investigate what this implies for human appreciation of uncertainty. In our task, a Bayesian learner distinguishes three equally salient levels of uncertainty. First, the Bayesian perceives irreducible uncertainty or risk: even knowing the payoff probabilities of a given arm, the outcome remains uncertain. Second, there is (parameter) estimation uncertainty or ambiguity: payoff probabilities are unknown and need to be estimated. Third, the outcome probabilities of the arms change: the sudden jumps are referred to as unexpected uncertainty. We document how the three levels of uncertainty evolved during the course of our experiment and how it affected the learning rate. We then zoom in on estimation uncertainty, which has been suggested to be a driving force in exploration, in spite of evidence of widespread aversion to ambiguity. Our data corroborate the latter. We discuss neural evidence that foreshadowed the ability of humans to distinguish between the three levels of uncertainty. Finally, we investigate the boundaries of human capacity to implement Bayesian learning. We repeat the experiment with different instructions, reflecting varying levels of structural uncertainty. Under this fourth notion of uncertainty, choices were no better explained by Bayesian updating than by (model-free) reinforcement learning. Exit questionnaires revealed that participants remained unaware of the presence of unexpected uncertainty and failed to acquire the right model with which to implement Bayesian updating

Validity of the Polar V800 heart rate monitor to measure RR intervals at rest

Purpose To assess the validity of RR intervals and short-term heart rate variability (HRV) data obtained from the Polar V800 heart rate monitor, in comparison to an electrocardiograph (ECG). Method Twenty participants completed an active orthostatic test using the V800 and ECG. An improved method for the identification and correction of RR intervals was employed prior to HRV analysis. Agreement of the data was assessed using intra-class correlation coefficients (ICC), Bland–Altman limits of agreement (LoA), and effect size (ES). Results A small number of errors were detected between ECG and Polar RR signal, with a combined error rate of 0.086 %. The RR intervals from ECG to V800 were significantly different, but with small ES for both supine corrected and standing corrected data (ES 0.999 for both supine and standing corrected intervals. When analysed with the same HRV software no significant differences were observed in any HRV parameters, for either supine or standing; the data displayed small bias and tight LoA, strong ICC (>0.99) and small ES (≤0.029). Conclusions The V800 improves over previous Polar models, with narrower LoA, stronger ICC and smaller ES for both the RR intervals and HRV parameters. The findings support the validity of the Polar V800 and its ability to produce RR interval recordings consistent with an ECG. In addition, HRV parameters derived from these recordings are also highly comparable

Exploring the Higgs Portal with 10/fb at the LHC

We consider the impact of new exotic colored and/or charged matter interacting through the Higgs portal on Standard Model Higgs boson searches at the LHC. Such Higgs portal couplings can induce shifts in the effective Higgs-gluon-gluon and Higgs-photon-photon couplings, thus modifying the Higgs production and decay patterns. We consider two possible interpretations of the current LHC Higgs searches based on ~ 5/fb of data at each detector: 1) a Higgs boson in the mass range (124-126) GeV and 2) a `hidden' heavy Higgs boson which is underproduced due to the suppression of its gluon fusion production cross section. We first perform a model independent analysis of the allowed sizes of such shifts in light of the current LHC data. As a class of possible candidates for new physics which gives rise to such shifts, we investigate the effects of new scalar multiplets charged under the Standard Model gauge symmetries. We determine the scalar parameter space that is allowed by current LHC Higgs searches, and compare with complementary LHC searches that are sensitive to the direct production of colored scalar states.Comment: 27 pages, 11 figures; v2: references added, correction to scalar form factor, numerical results updated with Moriond 2012 data, conclusions unchange

Excluding Electroweak Baryogenesis in the MSSM

In the context of the MSSM the Light Stop Scenario (LSS) is the only region of parameter space that allows for successful Electroweak Baryogenesis (EWBG). This possibility is very phenomenologically attractive, since it allows for the direct production of light stops and could be tested at the LHC. The ATLAS and CMS experiments have recently supplied tantalizing hints for a Higgs boson with a mass of ~ 125 GeV. This Higgs mass severely restricts the parameter space of the LSS, and we discuss the specific predictions made for EWBG in the MSSM. Combining data from all the available ATLAS and CMS Higgs searches reveals a tension with the predictions of EWBG even at this early stage. This allows us to exclude EWBG in the MSSM at greater than (90) 95% confidence level in the (non-)decoupling limit, by examining correlations between different Higgs decay channels. We also examine the exclusion without the assumption of a ~ 125 GeV Higgs. The Higgs searches are still highly constraining, excluding the entire EWBG parameter space at greater than 90% CL except for a small window of m_h ~ 117 - 119 GeV.Comment: 24 Pages, 4 Figures (v3: fixed typos, minor corrections, added references

Rpgrip1 is required for rod outer segment development and ciliary protein trafficking in zebrafish

The authors would like to thank the Royal Society of London, the National Eye Research Centre, the Visual Research Trust, Fight for Sight, the W.H. Ross Foundation, the Rosetrees Trust, and the Glasgow Children’s Hospital Charity for supporting this work. This work was also supported by the Deanship of Scientific Research at King Saud University for funding this research (Research Project) grant number ‘RGP – VPP – 219’.Mutations in the RPGR-interacting protein 1 (RPGRIP1) gene cause recessive Leber congenital amaurosis (LCA), juvenile retinitis pigmentosa (RP) and cone-rod dystrophy. RPGRIP1 interacts with other retinal disease-causing proteins and has been proposed to have a role in ciliary protein transport; however, its function remains elusive. Here, we describe a new zebrafish model carrying a nonsense mutation in the rpgrip1 gene. Rpgrip1homozygous mutants do not form rod outer segments and display mislocalization of rhodopsin, suggesting a role for RPGRIP1 in rhodopsin-bearing vesicle trafficking. Furthermore, Rab8, the key regulator of rhodopsin ciliary trafficking, was mislocalized in photoreceptor cells of rpgrip1 mutants. The degeneration of rod cells is early onset, followed by the death of cone cells. These phenotypes are similar to that observed in LCA and juvenile RP patients. Our data indicate RPGRIP1 is necessary for rod outer segment development through regulating ciliary protein trafficking. The rpgrip1 mutant zebrafish may provide a platform for developing therapeutic treatments for RP patients.Publisher PDFPeer reviewe

Higgs decay to dark matter in low energy SUSY: is it detectable at the LHC ?

Due to the limited statistics so far accumulated in the Higgs boson search at the LHC, the Higgs boson property has not yet been tightly constrained and it is still allowed for the Higgs boson to decay invisibly to dark matter with a sizable branching ratio. In this work, we examine the Higgs decay to neutralino dark matter in low energy SUSY by considering three different models: the minimal supersymmetric standard model (MSSM), the next-to-minimal supersymmetric standard models (NMSSM) and the nearly minimal supersymmetric standard model (nMSSM). Under current experimental constraints at 2-sigma level (including the muon g-2 and the dark matter relic density), we scan over the parameter space of each model. Then in the allowed parameter space we calculate the branching ratio of the SM-like Higgs decay to neutralino dark matter and examine its observability at the LHC by considering three production channels: the weak boson fusion VV->h, the associated production with a Z-boson pp->hZ+X or a pair of top quarks pp->htt_bar+X. We find that in the MSSM such a decay is far below the detectable level; while in both the NMSSM and nMSSM the decay branching ratio can be large enough to be observable at the LHC.Comment: Version in JHE

Satisfaction with care as a quality-of-life predictor for stroke patients and their caregivers

Purpose: We sought to identify indicators associated with the quality of life (QoL) of stroke patients and caregivers. Methods: The cross-sectional study was conducted at nine Dutch stroke service facilities involving 251 stroke patients and their caregivers. We used the EuroQol (EQ-5D) and Satisfaction with Stroke Care questionnaires, and included the variables (1) disability at hospital admission, (2) length of hospital stay, (3) demographic data, and (4) caregivers' relationship with stroke patients. The Actor-Partner (patient-caregiver) Interdependence Model (APIM) was used to examine dependence between patients' and caregivers' QoL scores through dyad membership. Results: Patients' age was significantly related to their QoL, and caregivers' age and educational level were significantly related to their QoL. Patients' disability on hospital admission and length of stay were associated with patients' QoL, and their disability on admission was related to caregivers' QoL. No relationship was found between length of stay and caregivers' QoL. Satisfaction with care was associated with both patients' and caregivers' QoL. Conclusions: The APIM distinguished the different roles of patients and caregivers while acknowledging the interdependence of their QoL scores. Satisfaction with care was identified as important indicator of stroke patients' and caregivers' QoL

Search For Heavy Pointlike Dirac Monopoles

We have searched for central production of a pair of photons with high transverse energies in $p\bar p$ collisions at $\sqrt{s} = 1.8$ TeV using $70 pb^{-1}$ of data collected with the D\O detector at the Fermilab Tevatron in 1994--1996. If they exist, virtual heavy pointlike Dirac monopoles could rescatter pairs of nearly real photons into this final state via a box diagram. We observe no excess of events above background, and set lower 95% C.L. limits of $610, 870, or 1580 GeV/c^2$ on the mass of a spin 0, 1/2, or 1 Dirac monopole.Comment: 12 pages, 4 figure