The Pediatric Sepsis Biomarker Risk Model (PERSEVERE) Biomarkers Predict Clinical Deterioration and Mortality in Immunocompromised Children Evaluated for Infection

Pediatric sepsis and bacterial infection cause significant morbidity and mortality worldwide, with immunocompromised patients being at particularly high risk of rapid deterioration and death. This study evaluated if PERSEVERE, PERSEVERE-II, or the PERSEVERE biomarkers, can reliably estimate the risk of clinical deterioration and 28-day mortality among immunocompromised pediatric patients. This is a single-center prospective cohort study conducted from July 2016 through September 2017 incorporating 400 episodes of suspected bacterial infection from the inpatient units at Cincinnati Children's Hospital Medical Center, a large, tertiary care children's hospital. The primary analysis assessed clinical deterioration within 72 hours of evaluation for infection. Secondarily, we assessed 28-day mortality. Clinical deterioration was seen in 15% of subjects. Twenty-eight day mortality was 5%, but significantly higher among critically ill patients. Neither PERSEVERE nor PERSEVERE-II performed well to predict clinical deterioration or 28-day mortality, thus we derived new stratification models using the PERSEVERE biomarkers with both high sensitivity and negative predictive value. In conclusion, we evaluated previously validated biomarker risk models in a novel population of largely non-critically ill immunocompromised pediatric patients, and attempted to stratify patients based on a new outcome metric, clinical deterioration. The new highly predictive models indicate common physiologic pathways to clinical deterioration or death from bacterial infection

Non-linear microwave impedance of short and long Josephson Junctions

The non-linear dependence on applied $ac$ field ($b_{\omega}$) or current ($i_{\omega}$) of the microwave (ac) impedance $R_{\omega}+iX_{\omega}$ of both short and long Josephson junctions is calculated under a variety of excitation conditions. The dependence on the junction width is studied, for both field symmetric (current anti-symmetric) and field anti-symmetric (current symmetric) excitation configurations.The resistance shows step-like features every time a fluxon (soliton) enters the junction, with a corresponding phase slip seen in the reactance. For finite widths the interference of fluxons leads to some interesting effects which are described. Many of these calculated results are observed in microwave impedance measurements on intrinsic and fabricated Josephson junctions in the high temperature superconductors, and new effects are suggested. When a $$ field ($b_{dc}$) or current ($i_{dc}$) is applied, interesting phase locking effects are observed in the ac impedance $Z_{\omega}$. In particular an almost periodic dependence on the dc bias is seen similar to that observed in microwave experiments at very low dc field bias. These results are generic to all systems with a $\cos (\phi)$ potential in the overdamped limit and subjected to an ac drive.Comment: 7 pages, 11 figure

Tailoring Single and Multiphoton Probabilities of a Single Photon On-Demand Source

As typically implemented, single photon sources cannot be made to produce single photons with high probability, while simultaneously suppressing the probability of yielding two or more photons. Because of this, single photon sources cannot really produce single photons on demand. We describe a multiplexed system that allows the probabilities of producing one and more photons to be adjusted independently, enabling a much better approximation of a source of single photons on demand.Comment: 4 pages, LaTex, 2 figures, twocolumn and RevTex Style for PR

Principles of Stakes Fairness in Sport

Fairness in sport is not just about assigning the top prizes to the worthiest competitors. It is also about the way the prize structure itself is organised. For many sporting competitions, although it may be acceptable for winners to receive more than losers, it can seem unfair for winners to take everything and for losers to get nothing. Yet this insight leaves unanswered some difficult questions about what stakes fairness requires and which principles of stakes fairness are appropriate for particular competitions. In this article I specify a range of different principles of stakes fairness (ten in total) that could regulate sporting competitions. I also put forward a theoretical method for pairing up appropriate principles of stakes fairness with given sporting competitions. Specifically, I argue that the underlying rationales for holding sporting competitions can provide useful guides for identifying appropriate principles of stakes fairness. I then seek to clarify and work through some of the implications of this method for a sample of real world controversies over sporting prize structures. I also attempt to refine the method in response to two possible objections from indeterminacy and relativism. Finally, I compare and contrast my conclusions with more general philosophical debates about justice

On Deciding Local Theory Extensions via E-matching

Satisfiability Modulo Theories (SMT) solvers incorporate decision procedures for theories of data types that commonly occur in software. This makes them important tools for automating verification problems. A limitation frequently encountered is that verification problems are often not fully expressible in the theories supported natively by the solvers. Many solvers allow the specification of application-specific theories as quantified axioms, but their handling is incomplete outside of narrow special cases. In this work, we show how SMT solvers can be used to obtain complete decision procedures for local theory extensions, an important class of theories that are decidable using finite instantiation of axioms. We present an algorithm that uses E-matching to generate instances incrementally during the search, significantly reducing the number of generated instances compared to eager instantiation strategies. We have used two SMT solvers to implement this algorithm and conducted an extensive experimental evaluation on benchmarks derived from verification conditions for heap-manipulating programs. We believe that our results are of interest to both the users of SMT solvers as well as their developers

International Guillain-Barré Syndrome Outcome Study (IGOS): protocol of a prospective observational cohort study on clinical and biological predictors of disease course and outcome in Guillain-Barré syndrome

Guillain-Barré syndrome (GBS) is an acute polyradiculoneuropathy with a highly variable clinical presentation, course, and outcome. The factors that determine the clinical variation of GBS are poorly understood which complicates the care and treatment of individual patients. The protocol of the ongoing International GBS Outcome Study (IGOS), a prospective, observational, multi-centre cohort study that aims to identify the clinical and biological determinants and predictors of disease onset, subtype, course and outcome of GBS is presented here. Patients fulfilling the diagnostic criteria for GBS, regardless of age, disease severity, variant forms, or treatment, can participate if included within two weeks after onset of weakness. Information about demography, preceding infections, clinical features, diagnostic findings, treatment, course and outcome is collected. In addition, cerebrospinal fluid and serial blood samples for serum and DNA is collected at standard time points. The original aim was to include at least 1000 patients with a follow-up of 1-3 years. Data are collected via a web-based data entry system and stored anonymously. IGOS started in May 2012 and by January 2017 included more than 1400 participants from 143 active centres in 19 countries across 5 continents. The IGOS data/biobank is available for research projects conducted by expertise groups focusing on specific topics including epidemiology, diagnostic criteria, clinimetrics, electrophysiology, antecedent events, antibodies, genetics, prognostic modelling, treatment effects and long-term outcome of GBS. The IGOS will help to standardize the international collection of data and biosamples for future research of GBS. ClinicalTrials.gov Identifier: NCT01582763

Vortex Interactions and Thermally Induced Crossover from Type-I to Type-II Superconductivity

We have computed the effective interaction between vortices in the Ginzburg-Landau model from large-scale Monte-Carlo simulations, taking thermal fluctuations of matter fields and gauge fields fully into account close to the critical temperature. We find a change, in the form of a crossover, from attractive to repulsive effective vortex interactions in an intermediate range of Ginzburg-Landau parameters $\kappa \in [0.76-1]/\sqrt{2}$ upon increasing the temperature in the superconducting state. This corresponds to a thermally induced crossover from \typeI to \typeII superconductivity around a temperature $T_{\rm{Cr}}(\kappa)$, which we map out in the vicinity of the metal-to-superconductor transition. In order to see this crossover, it is essential to include amplitude fluctuations of the matter field, in addition to phase-fluctuations and gauge-field fluctuations. We present a simple physical picture of the crossover, and relate it to observations in \metal{Ta} and \metal{Nb} elemental superconductors which have low-temperature values of $\kappa$ in the relevant range.Comment: 9 pages, 6 figures. Accepted for publication in Physical Review

Spin-Peierls Dimerization of a s=1/2 Heisenberg Antiferromagnet on a Square Lattice

Dimerization of a spin-half Heisenberg antiferromagnet on a square lattice is investigated for several possible dimerized configurations, some of which are shown to have lower ground state energies than the others. In particular, the lattice deformations resulting in alternate stronger and weaker couplings along both the principal axes of a square lattice are shown to result in a larger gain in magnetic energy. In addition, a `columnar' configuration is shown to have a lower ground state energy and a faster increase in the energy gap parameter than a `staggered' configuration. The inclusion of unexpanded exchange coupling leads to a power law behaviour for the magnetic energy gain and energy gap, which is qualitatively different from that reported earlier. Instead of increasing as $\delta ^{x}$, the two quantities depend on $\delta$ as $\delta ^{\nu}/| \ln \delta | .$ This is true both in the near critical regime $(0\leq \delta \leq 0.1)$ as well as in the far regime $(0\leq \delta <1)$. It is suggested that the unexpanded exchange coupling is as much a source of the logarithmic dependence as a correction due to the contribution of umklapp processes. Staggered magnetization is shown to follow the same $\delta$-dependence in all the configurations in the small $\delta$-regime, while for $0\leq \delta <1$, it follows the power law $\delta ^{x}$.Comment: 12 pages, 7 Postscript figures, RevTex forma

The Digital Life of Walkable Streets

Walkability has many health, environmental, and economic benefits. That is why web and mobile services have been offering ways of computing walkability scores of individual street segments. Those scores are generally computed from survey data and manual counting (of even trees). However, that is costly, owing to the high time, effort, and financial costs. To partly automate the computation of those scores, we explore the possibility of using the social media data of Flickr and Foursquare to automatically identify safe and walkable streets. We find that unsafe streets tend to be photographed during the day, while walkable streets are tagged with walkability-related keywords. These results open up practical opportunities (for, e.g., room booking services, urban route recommenders, and real-estate sites) and have theoretical implications for researchers who might resort to the use social media data to tackle previously unanswered questions in the area of walkability.Comment: 10 pages, 7 figures, Proceedings of International World Wide Web Conference (WWW 2015