Trends in pediatric adjusted shock index predict morbidity and mortality in children with severe blunt injuries

Purpose The utility of measuring the pediatric adjusted shock index (SIPA) at admission for predicting severity of blunt injury in pediatric patients has been previously reported. However, the utility of following SIPA after admission is not well described. Methods The trauma registry from a level-one pediatric trauma center was queried from January 1, 2010 to December 31, 2015. Patients were included if they were between 4 and 16 years old at the time of admission, sustained a blunt injury with an Injury Severity Score ≥ 15, and were admitted less than 12 h after their injury (n = 286). Each patient's SIPA was then calculated at 0, 12, 24, 36, and 48 h after admission and then categorized as elevated or normal at each time frame based upon previously reported values. Trends in outcome variables as a function of time from admission for patients with an abnormal SIPA to normalize as well as patients with a normal admission SIPA to abnormal were analyzed. Results In patients with a normal SIPA at arrival, 18.4% of patients who developed an elevated SIPA at 12 h after admission died, whereas 2.4% of patients who maintained a normal SIPA throughout the first 48 h of admission died (p < 0.01). Among patients with an elevated SIPA at arrival, increased length of time to normalize SIPA correlated with increased length of stay (LOS) and intensive care unit (ICU) LOS. Similarly, elevation of SIPA after arrival in patients with a normal initial SIPA correlated to increased LOS and ICU LOS. Conclusions Patients with a normal SIPA at time of arrival who then have an elevated SIPA in the first 24 h of admission are at increased risk for morbidity and mortality compared to those whose SIPA remains normal throughout the first 48 h of admission. Similarly, time to normalize an elevated admission SIPA appears to directly correlate with LOS, ICU LOS, and other markers of morbidity across a mixed blunt trauma population. Whether trending SIPA early in the hospital course serves only as a marker for injury severity or if it has utility as a resuscitation metric has not yet been determined

Adolescent Psychological Assets and Cardiometabolic Health Maintenance in Adulthood: Implications for Health Equity

Background Positive cardiometabolic health (CMH) is defined as meeting recommended levels of multiple cardiometabolic risk factors in the absence of manifest disease. Prior work finds that few individuals—particularly members of minoritized racial and ethnic groups—meet these criteria. This study investigated whether psychological assets help adolescents sustain CMH in adulthood and explored interactions by race and ethnicity. Methods and Results Participants were 3478 individuals in the National Longitudinal Study of Adolescent Health (49% female; 67% White, 15% Black, 11% Latinx, 6% other [Native American, Asian, or not specified]). In Wave 1 (1994–1995; mean age=16 years), data on 5 psychological assets (optimism, happiness, self‐esteem, belongingness, and feeling loved) were used to create a composite asset index (range=0–5). In Waves 4 (2008; mean age=28 years) and 5 (2016–2018; mean age=38 years), CMH was defined using 7 clinically assessed biomarkers. Participants with healthy levels of ≥6 biomarkers at Waves 4 and 5 were classified as maintaining CMH over time. The prevalence of CMH maintenance was 12%. Having more psychological assets was associated with better health in adulthood (odds ratio [OR]linear trend, 1.12 [95% CI, 1.01–1.25]). Subgroup analyses found substantive associations only among Black participants (OR, 1.35 [95% CI, 1.00–1.82]). Additionally, there was some evidence that racial and ethnic disparities in CMH maintenance may be less pronounced among participants with more assets. Conclusions Youth with more psychological assets were more likely to experience favorable CMH patterns 2 decades later. The strongest associations were observed among Black individuals. Fostering psychological assets in adolescence may help prevent cardiovascular disease and play an underappreciated role in shaping health inequities

The SAMI Galaxy Survey: Revising the Fraction of Slow Rotators in IFS Galaxy Surveys

The fraction of galaxies supported by internal rotation compared to galaxies stabilized by internal pressure provides a strong constraint on galaxy formation models. In integral field spectroscopy surveys, this fraction is biased because survey instruments typically only trace the inner parts of the most massive galaxies. We present aperture corrections for the two most widely used stellar kinematic quantities $V/\sigma$ and $\lambda_{R}$. Our demonstration involves integral field data from the SAMI Galaxy Survey and the ATLAS$^{\rm{3D}}$ Survey. We find a tight relation for both $V/\sigma$ and $\lambda_{R}$ when measured in different apertures that can be used as a linear transformation as a function of radius, i.e., a first-order aperture correction. We find that $V/\sigma$ and $\lambda_{R}$ radial growth curves are well approximated by second order polynomials. By only fitting the inner profile (0.5$R_{\rm{e}}$), we successfully recover the profile out to one $R_{\rm{e}}$ if a constraint between the linear and quadratic parameter in the fit is applied. However, the aperture corrections for $V/\sigma$ and $\lambda_{R}$ derived by extrapolating the profiles perform as well as applying a first-order correction. With our aperture-corrected $\lambda_{R}$ measurements, we find that the fraction of slow rotating galaxies increases with stellar mass. For galaxies with $\log M_{*}/M_{\odot}>$ 11, the fraction of slow rotators is $35.9\pm4.3$ percent, but is underestimated if galaxies without coverage beyond one $R_{\rm{e}}$ are not included in the sample ($24.2\pm5.3$ percent). With measurements out to the largest aperture radius the slow rotator fraction is similar as compared to using aperture corrected values ($38.3\pm4.4$ percent). Thus, aperture effects can significantly bias stellar kinematic IFS studies, but this bias can now be removed with the method outlined here.Comment: Accepted for Publication in the Monthly Notices of the Royal Astronomical Society. 16 pages and 11 figures. The key figures of the paper are: 1, 4, 9, and 1

The SAMI Galaxy Survey: mass-kinematics scaling relations

We use data from the Sydney-AAO Multi-object Integral-field spectroscopy (SAMI) Galaxy Survey to study the dynamical scaling relation between galaxy stellar mass $M_*$ and the general kinematic parameter $S_K = \sqrt{K V_{rot}^2 + \sigma^2}$ that combines rotation velocity $V_{rot}$ and velocity dispersion $\sigma$. We show that the $\log M_* - \log S_K$ relation: (1)~is linear above limits set by properties of the samples and observations; (2)~has slightly different slope when derived from stellar or gas kinematic measurements; (3)~applies to both early-type and late-type galaxies and has smaller scatter than either the Tully-Fisher relation ($\log M_* - \log V_{rot}$) for late types or the Faber-Jackson relation ($\log M_* - \log\sigma$) for early types; and (4)~has scatter that is only weakly sensitive to the value of $K$, with minimum scatter for $K$ in the range 0.4 and 0.7. We compare $S_K$ to the aperture second moment (the `aperture velocity dispersion') measured from the integrated spectrum within a 3-arcsecond radius aperture ($\sigma_{3^{\prime\prime}}$). We find that while $S_{K}$ and $\sigma_{3^{\prime\prime}}$ are in general tightly correlated, the $\log M_* - \log S_K$ relation has less scatter than the $\log M_* - \log \sigma_{3^{\prime\prime}}$ relation.Comment: 14 pages, 8 figures, Accepted 2019 May 22. Received 2019 May 18; in original form 2019 January

Intrinsic Absorption in the Spectrum of NGC 7469: Simultaneous Chandra, FUSE, and STIS Observations

We present simultaneous X-ray, far-ultraviolet, and near-ultraviolet spectra of the Seyfert 1 galaxy NGC 7469 obtained with the Chandra X-Ray Observatory, the Far Ultraviolet Spectroscopic Explorer, and the Space Telescope Imaging Spectrograph on the Hubble Space Telescope. Previous non-simultaneous observations of this galaxy found two distinct UV absorption components, at -560 and -1900 km/s, with the former as the likely counterpart of the X-ray absorber. We confirm these two absorption components in our new UV observations, in which we detect prominent O VI, Ly alpha, N V, and C IV absorption. In our Chandra spectrum we detect O VIII emission, but no significant O VIII or O VII absorption. We also detect a prominent Fe K alpha emission line in the Chandra spectrum, as well as absorption due to hydrogen-like and helium-like neon, magnesium, and silicon at velocities consistent with the -560 km/s UV absorber. The FUSE and STIS data reveal that the H I and C IV column densities in this UV- and X-ray- absorbing component have increased over time, as the UV continuum flux decreased. We use measured H I, N V, C IV, and O VI column densities to model the photoionization state of both absorbers self-consistently. We confirm the general physical picture of the outflow in which the low velocity component is a highly ionized, high density absorber with a total column density of 10^20 cm^-2, located near the broad emission line region, although due to measurable columns of N V and C IV, we assign it a somewhat smaller ionization parameter than found previously, U~1. The high velocity UV component is of lower density, log N=18.6, and likely resides farther from the central engine as we find its ionization parameter to be U=0.08.Comment: Minor correction to abstract; STScI eprint #1683; 50 pages, incl. 19 figures, 4 tables; Accepted to Ap

The SAMI Galaxy Survey: Global stellar populations on the size-mass plane

We present an analysis of the global stellar populations of galaxies in the SAMI Galaxy Survey. Our sample consists of 1319 galaxies spanning four orders of magnitude in stellar mass and includes all morphologies and environments. We derive luminosity-weighted, single stellar population equivalent stellar ages, metallicities and alpha enhancements from spectra integrated within one effective radius apertures. Variations in galaxy size explain the majority of the scatter in the age--mass and metallicity--mass relations. Stellar populations vary systematically in the plane of galaxy size and stellar mass, such that galaxies with high stellar surface mass density are older, more metal-rich and alpha-enhanced than less dense galaxies. Galaxies with high surface mass densities have a very narrow range of metallicities, however, at fixed mass, the spread in metallicity increases substantially with increasing galaxy size (decreasing density). We identify residual correlations with morphology and environment. At fixed mass and size, galaxies with late-type morphologies, small bulges and low Sersic n are younger than early-type, high n, high bulge-to-total galaxies. Age and metallicity both show small residual correlations with environment; at fixed mass and size, galaxies in denser environments or more massive halos are older and somewhat more metal rich than those in less dense environments. We connect these trends to evolutionary tracks within the size--mass plane.Comment: 25 pages, 18 figures, MNRAS in press Corrected typo in author lis

The Social Determinants of Ideal Cardiovascular Health: A Global Systematic Review

This systematic review synthesizes research published from January 2010-July 2022 on the social determinants of ideal cardiovascular health (CVH) carried out around the world and compares trends in high-income countries (HICs) to those in low- and middle-income countries (LMICs). 41 studies met inclusion criteria (n = 28 HICs, n = 13 LMICs). Most were from the United States (n = 22) and cross-sectional (n = 33), and nearly all evaluated associations among adults. Among studies conducted in LMICs, nearly all were from middle-income countries and only one was carried out in low-income country. Education (n = 24) and income/wealth (n = 17) were the most frequently examined social determinants in both HICs and LMICs. Although most studies assessed ideal CVH using reliable and valid methods (n = 24), only 7 used criteria pre-defined by the American Heart Association to characterize ideal levels of each CVH metric. Despite heterogeneity in how outcome measures were derived and analyzed, consistent associations were evident between multiple markers of higher social status (i.e. greater education, income/wealth, socioeconomic status, racial/ethnic majority status) and greater levels of ideal CVH across both country contexts. Gaps in the literature include evidence from LMICs and HICs other than the United States, longitudinal research, and investigations of a wider array of social determinants beyond education and income/wealth

Achieving consensus on priority items for paediatric palliative care outcome measurement: Results from a modified Delphi survey, engagement with a children’s research involvement group and expert item generation

Background: There is no validated outcome measure for use in children’s palliative care outside sub-Saharan Africa. Stakeholders must be involved in the development of such measures to ensure face and content validity. Aim: To gain expert stakeholder consensus on items for inclusion in a paediatric palliative care outcome measure to establish face and content validity. Design: This study was conducted in two phases following Rothrock and COSMIN guidance on patient-reported outcome measure development. Phase 1: Three-round modified Delphi survey to establish consensus on priority items. Phase 2: Item generation meeting with key stakeholders to develop initial measure versions. A young person’s advisory group was also consulted on priority outcomes. Setting and participants: Delphi survey: Parents and professionals with experience of caring for a child with a life-limiting condition. Young person’s advisory group: young people age 10–20 years. Item generation meeting: bereaved parents, academics and clinicians. Results: Phase 1: Delphi survey (n = 82). Agreement increased from Kendall’s W = 0.17 to W = 0.61, indicating movement towards consensus. Agreement between professional and parent ranking was poor (Cohen’s kappa 0.13). Professionals prioritised physical symptoms, whereas parents prioritised psychosocial and practical concerns. Advisory group: Children (n = 22) prioritised items related to living a ‘normal life’ in addition to items prioritised by adult participants. Phase 2: Five age/developmental stage appropriate child and proxy-reported versions of C-POS, containing 13 items, were drafted. Conclusions: This study highlights the importance and feasibility of involving key stakeholders in PROM item generation, as important differences were found in the priority outcomes identified by children, parents and professionals

Exploring Play and Creativity in Pre-schooler's use of apps: Final Project Report

This report outlines the key findings of a co-produced study, developed in collaboration between academics at the Universities of Sheffield and Edinburgh, the BBC (CBeebies), Monteney Pirmary School and the children’s media companies Dubit and Foundling Bird (Appendix 1 outlines the project team members and Advisory Board members). The project was co-produced in that all project partners contributed to the development of the project aims and objectives and were involved in data collection, analysis and dissemination. The aim of the study was to identify pre-school children’s (aged 0-5) uses of and responses to tablet apps in terms of the impact on their play and creativity