Trauma Early Mortality Prediction Tool (TEMPT) for assessing 28-day mortality.

Background:Prior mortality prediction models have incorporated severity of anatomic injury quantified by Abbreviated Injury Severity Score (AIS). Using a prospective cohort, a new score independent of AIS was developed using clinical and laboratory markers present on emergency department presentation to predict 28-day mortality. Methods:All patients (n=1427) enrolled in an ongoing prospective cohort study were included. Demographic, laboratory, and clinical data were recorded on admission. True random number generator technique divided the cohort into derivation (n=707) and validation groups (n=720). Using Youden indices, threshold values were selected for each potential predictor in the derivation cohort. Logistic regression was used to identify independent predictors. Significant variables were equally weighted to create a new mortality prediction score, the Trauma Early Mortality Prediction Tool (TEMPT) score. Area under the curve (AUC) was tested in the validation group. Pairwise comparison of Trauma Injury Severity Score (TRISS), Revised Trauma Score, Glasgow Coma Scale, and Injury Severity Score were tested against the TEMPT score. Results:There was no difference between baseline characteristics between derivation and validation groups. In multiple logistic regression, a model with presence of traumatic brain injury, increased age, elevated systolic blood pressure, decreased base excess, prolonged partial thromboplastin time, increased international normalized ratio (INR), and decreased temperature accurately predicted mortality at 28 days (AUC 0.93, 95% CI 0.90 to 0.96, P<0.001). In the validation cohort, this score, termed TEMPT, predicted 28-day mortality with an AUC 0.94 (95% CI 0.92 to 0.97). The TEMPT score preformed similarly to the revised TRISS score for severely injured patients and was highly predictive in those having mild to moderate injury. Discussion:TEMPT is a simple AIS-independent mortality prediction tool applicable very early following injury. TEMPT provides an AIS-independent score that could be used for early identification of those at risk of doing poorly following even minor injury. Level of evidence:Level II

Structural validation of oral mucosal tissue using optical coherence tomography

Background: Optical coherence tomography (OCT) is a non-invasive optical technology using near-infrared light to produce cross-sectional tissue images with lateral resolution. Objectives: The overall aims of this study was to generate a bank of normative and pathological OCT data of the oral tissues to allow identification of cellular structures of normal and pathological processes with the aim to create a diagnostic algorithm which can be used in the early detection of oral disorders. Material and methods: Seventy-three patients with 78 suspicious oral lesions were referred for further management to the UCLH Head and Neck Centre, London. The entire cohort had their lesions surgically biopsied (incisional or excisional). The immediate ex vivo phase involved scanning the specimens using optical coherence tomography. The specimens were then processed by a histopathologist. Five tissue structures were evaluated as part of this study, including: keratin cell layer, epithelial layer, basement membrane, lamina propria and other microanatomical structures. Two independent assessors (clinician and pathologist trained to use OCT) assessed the OCT images and were asked to comment on the cellular structures and changes involving the five tissue structures in non-blind fashion. Results: Correct identification of the keratin cell layer and its structural changes was achieved in 87% of the cohort; for the epithelial layer it reached 93.5%, and 94% for the basement membrane. Microanatomical structures identification was 64% for blood vessels, 58% for salivary gland ducts and 89% for rete pegs. The agreement was “good” between the clinician and the pathologist. OCT was able to differential normal from pathological tissue and pathological tissue of different entities in this immediate ex vivo study. Unfortunately, OCT provided inadequate cellular and subcellular information to enable the grading of oral premalignant disorders. Conclusion: This study enabled the creation of OCT bank of normal and pathological oral tissues. The pathological changes identified using OCT enabled differentiation between normal and pathological tissues, and identification of different tissue pathologies. Further studies are required to assess the accuracy of OCT in identification of various pathological processes involving the oral tissues

Temporal Profiles and Spectral Lags of XRF 060218

The spectral and temporal properties of the non-thermal emission ofthe nearby XRF 060218 in 0.3-150 keV band are studied. We show that both the spectral energy distribution and the light curve properties suggest the same origin of the non-thermal emission detected by {\em Swift} BAT and XRT. This event has the longest pulse duration and spectral lag observed to date among the known GRBs. The pulse structure and its energy dependence are analogous to typical GRBs. By extrapolating the observed spectral lag to the {\em CGRO/BATSE} bands we find that the hypothesis that this event complies with the same luminosity-lag relation with bright GRBs cannot be ruled out at $2\sigma$ significance level. These intriguing facts, along with its compliance with the Amati-relation, indicate that XRF 060218 shares the similar radiation physics as typical GRBs.Comment: 9 pages in emulateapj format, including 4 figures and 1 table, accepted for publication in ApJ Letter

The Ratio of Total to Selective Extinction Toward Baade's Window

We measure the ratio of total to selective extinction, R_{VI}=A_V/E(V-I), toward Baade's Window by comparing the VIK colors of 132 Baade's Window G and K giants from Tiede, Frogel, & Terndrup with the solar-neighborhood (V-I),(V-K) relation from Bessell & Brett. We find R_{VI}=2.283 +/- 0.016, and show that our measurement has no significant dependence on stellar type from G0 to K4. Adjusting the Paczynski et al. determination of the centroid of the dereddened Baade's Window clump for this revised value of $R_{VI}$, we find I_{0,RC}=14.43 and (V-I)_{0,RC}=1.058. This implies a distance to the Baade's Window clump of d_{BW} = 8.63 +/- 0.16 kpc, where the error bar takes account of statistical but not systematic uncertainties.Comment: 8 pages, 1 figure, submitted to Ap

External-environmental and internal-health early-life predictors of adolescent development

External-environmental and internal-health early-life predictors of adolescent development Authors' preprin

Peer support for women with gynaecological cancer

This thesis is presented in three parts. Part One is a literature review of the key issues faced by women with gynaecological cancer, the need for psychosocial interventions, and the effectiveness of psychosocial interventions in meeting this need. Part Two presents the empirical paper. This paper explores how a new peer support service for women with gynaecological cancer was experienced by both the peer helpers and the women they were supporting. In Part Three, the issues and challenges raised during the completion of the empirical study are discussed

The Quintuplet Cluster: Extended Structure and Tidal Radius

The Quintuplet star cluster is one of only three known young ($<10$ Myr) massive (M $>10^4$ M$_\odot$) clusters within $\sim100$ pc of the Galactic Center. In order to explore star cluster formation and evolution in this extreme environment, we analyze the Quintuplet's dynamical structure. Using the HST WFC3-IR instrument, we take astrometric and photometric observations of the Quintuplet covering a $120''\times120''$ field-of-view, which is $19$ times larger than those of previous proper motion studies of the Quintuplet. We generate a catalog of the Quintuplet region with multi-band, near-infrared photometry, proper motions, and cluster membership probabilities for $10,543$ stars. We present the radial density profile of $715$ candidate Quintuplet cluster members with $M\gtrsim4.7$ M$_\odot$ out to $3.2$ pc from the cluster center. A $3\sigma$ lower limit of $3$ pc is placed on the tidal radius, indicating the lack of a tidal truncation within this radius range. Only weak evidence for mass segregation is found, in contrast to the strong mass segregation found in the Arches cluster, a second and slightly younger massive cluster near the Galactic Center. It is possible that tidal stripping hampers a mass segregation signature, though we find no evidence of spatial asymmetry. Assuming that the Arches and Quintuplet formed with comparable extent, our measurement of the Quintuplet's comparatively large core radius of $0.62^{+0.10}_{-0.10}$ pc provides strong empirical evidence that young massive clusters in the Galactic Center dissolve on a several Myr timescale.Comment: 25 pages (21-page main text, 4-page appendix), 18 figures, submitted to Ap

Transcriptomic and proteomic analyses of Desulfovibrio vulgaris biofilms: carbon and energy flow contribute to the distinct biofilm growth state.

BackgroundDesulfovibrio vulgaris Hildenborough is a sulfate-reducing bacterium (SRB) that is intensively studied in the context of metal corrosion and heavy-metal bioremediation, and SRB populations are commonly observed in pipe and subsurface environments as surface-associated populations. In order to elucidate physiological changes associated with biofilm growth at both the transcript and protein level, transcriptomic and proteomic analyses were done on mature biofilm cells and compared to both batch and reactor planktonic populations. The biofilms were cultivated with lactate and sulfate in a continuously fed biofilm reactor, and compared to both batch and reactor planktonic populations.ResultsThe functional genomic analysis demonstrated that biofilm cells were different compared to planktonic cells, and the majority of altered abundances for genes and proteins were annotated as hypothetical (unknown function), energy conservation, amino acid metabolism, and signal transduction. Genes and proteins that showed similar trends in detected levels were particularly involved in energy conservation such as increases in an annotated ech hydrogenase, formate dehydrogenase, pyruvate:ferredoxin oxidoreductase, and rnf oxidoreductase, and the biofilm cells had elevated formate dehydrogenase activity. Several other hydrogenases and formate dehydrogenases also showed an increased protein level, while decreased transcript and protein levels were observed for putative coo hydrogenase as well as a lactate permease and hyp hydrogenases for biofilm cells. Genes annotated for amino acid synthesis and nitrogen utilization were also predominant changers within the biofilm state. Ribosomal transcripts and proteins were notably decreased within the biofilm cells compared to exponential-phase cells but were not as low as levels observed in planktonic, stationary-phase cells. Several putative, extracellular proteins (DVU1012, 1545) were also detected in the extracellular fraction from biofilm cells.ConclusionsEven though both the planktonic and biofilm cells were oxidizing lactate and reducing sulfate, the biofilm cells were physiologically distinct compared to planktonic growth states due to altered abundances of genes/proteins involved in carbon/energy flow and extracellular structures. In addition, average expression values for multiple rRNA transcripts and respiratory activity measurements indicated that biofilm cells were metabolically more similar to exponential-phase cells although biofilm cells are structured differently. The characterization of physiological advantages and constraints of the biofilm growth state for sulfate-reducing bacteria will provide insight into bioremediation applications as well as microbially-induced metal corrosion

Pop-out and pop-in: Visual working memory advantages for unique items

Attentional control is thought to play a critical role in determining the amount of information that can be stored and retrieved from visual working memory (VWM). We tested whether and how task-irrelevant feature-based salience, known to affect the control of visual attention, affects VWM performance. Our results show that features of a task-irrelevant color singleton are more likely to be recalled from VWM than non-singleton items and that this increased memorability comes at a cost to the other items in the display. Furthermore, the singleton effect in VWM was negatively correlated with an individual’s baseline VWM capacity. Taken together, these results suggest that individual differences in VWM storage capacity may be partially attributable to the ability to ignore differences in task-irrelevant physical salience