White blood cell count and C-reactive protein together remain useful for diagnosis and staging of acute appendicitis in children

Background. Acute appendicitis (AA) is the most common acute surgical condition of the abdomen, and the most commonly misdiagnosed.Objective. To analyse the white blood cell count (WBCC) and C-reactive protein (CRP) contribution to the diagnosis of AA in children.Methods. This was a retrospective study of 943 consecutive patients operated on with the preoperative diagnosis of AA, in whom preoperative WBCC and CRP had both been measured. Postoperatively, the patients were divided into three groups: normal appendix (no AA), simple AA and complicated AA.Results. Of the 943 patients, 616 (65.3%) had simple AA. The mean (standard deviation (SD)) age for this group was 9.8 (3.2) years (p<0.01 v. complicated AA), the mean WBCC was 16.5 (5.0) × 109/L (p<0.01 v. complicated AA and no AA), and the mean CRP level was 304.8 (409.5) nmol/L (p<0.01 v. complicated AA). The mean age of the patients with complicated AA (283/943, 30.0%) was 7.9 (3.7) years, the mean WBCC was 17.7 (6.2) × 109/L (p<0.01 v. no AA) and the mean CRP level was 1 076.2 (923.8) nmol/L (p<0.01 v. no AA). The mean age of the patients with no AA (44/943, 4.7%) was 8.8 (3.2) years, the mean WBCC was 13.1 (5.3) × 109/L and the mean CRP was 361.9 (447.6) nmol/L. The WBCC was normal in 113/899 patients with appendicitis (12.6%) and CRP in 139 (15.5%). Both the WBCC and CRP were normal in 17 patients with appendicitis (1.9%). The best receiver operating characteristic (ROC) curve was obtained for WBCC when comparing all AA with no AA: cut-off point 15.0 × 109/L, sensitivity 65%, specificity 68%, area under the curve 0.70. The best ROC curve for CRP was obtained when comparing simple AA with complicated AA: cut-off point 361.9 nmol/L, sensitivity 74%, specificity 74%, area under the curve 0.81.Conclusions. The WBCC is helpful in diagnosing simple AA and CRP in diagnosing complicated AA. If both are normal, AA is very unlikely. Together the WBCC and CRP are useful tools in diagnosing and staging AA

Results from EDGES High-Band: II. Constraints on Parameters of Early Galaxies

We use the sky-average spectrum measured by EDGES High-Band ($90-190$ MHz) to constrain parameters of early galaxies independent of the absorption feature at $78$~MHz reported by Bowman et al. (2018). These parameters represent traditional models of cosmic dawn and the epoch of reionization produced with the 21cmFAST simulation code (Mesinger & Furlanetto 2007, Mesinger et al. 2011). The parameters considered are: (1) the UV ionizing efficiency ($\zeta$), (2) minimum halo virial temperature hosting efficient star-forming galaxies ($T^{\rm min}_{\rm vir}$), (3) integrated soft-band X-ray luminosity ($L_{\rm X\,<\,2\,keV}/{\rm SFR}$), and (4) minimum X-ray energy escaping the first galaxies ($E_{0}$), corresponding to a typical H${\rm \scriptstyle I}$ column density for attenuation through the interstellar medium. The High-Band spectrum disfavors high values of $T^{\rm min}_{\rm vir}$ and $\zeta$, which correspond to signals with late absorption troughs and sharp reionization transitions. It also disfavors intermediate values of $L_{\rm X\,<\,2\,keV}/{\rm SFR}$, which produce relatively deep and narrow troughs within the band. Specifically, we rule out $39.4<\log_{10}\left(L_{\rm X\,<\,2\,keV}/{\rm SFR}\right)<39.8$ ($95\%$ C.L.). We then combine the EDGES High-Band data with constraints on the electron scattering optical depth from Planck and the hydrogen neutral fraction from high-$z$ quasars. This produces a lower degeneracy between $\zeta$ and $T^{\rm min}_{\rm vir}$ than that reported in Greig & Mesinger (2017a) using the Planck and quasar constraints alone. Our main result in this combined analysis is the estimate $4.5$~$\leq \log_{10}\left(T^{\rm min}_{\rm vir}/\rm K\right)\leq$~$5.7$ ($95\%$ C.L.). We leave for future work the evaluation of $21$~cm models using simultaneously data from EDGES Low- and High-Band.Comment: Accepted in Ap

The QUIET Instrument

The Q/U Imaging ExperimenT (QUIET) is designed to measure polarization in the Cosmic Microwave Background, targeting the imprint of inflationary gravitational waves at large angular scales (~ 1 degree). Between 2008 October and 2010 December, two independent receiver arrays were deployed sequentially on a 1.4 m side-fed Dragonian telescope. The polarimeters which form the focal planes use a highly compact design based on High Electron Mobility Transistors (HEMTs) that provides simultaneous measurements of the Stokes parameters Q, U, and I in a single module. The 17-element Q-band polarimeter array, with a central frequency of 43.1 GHz, has the best sensitivity (69 uK sqrt(s)) and the lowest instrumental systematic errors ever achieved in this band, contributing to the tensor-to-scalar ratio at r < 0.1. The 84-element W-band polarimeter array has a sensitivity of 87 uK sqrt(s) at a central frequency of 94.5 GHz. It has the lowest systematic errors to date, contributing at r < 0.01. The two arrays together cover multipoles in the range l= 25-975. These are the largest HEMT-based arrays deployed to date. This article describes the design, calibration, performance of, and sources of systematic error for the instrument

Analysis of sloppiness in model simulations: unveiling parameter uncertainty when mathematical models are fitted to data

This work introduces a Bayesian approach to assess the sensitivity of model outputs to changes in parameter values, constrained by the combination of prior beliefs and data. This novel approach identifies stiff parameter combinations that strongly affect the quality of the model-data fit while simultaneously revealing which of these key parameter combinations are informed primarily from the data or are also substantively influenced by the priors. We focus on the very common context in complex systems where the amount and quality of data are low compared to the number of model parameters to be collectively estimated, and showcase the benefits of our technique for applications in biochemistry, ecology, and cardiac electrophysiology. We also show how stiff parameter combinations, once identified, uncover controlling mechanisms underlying the system being modeled and inform which of the model parameters need to be prioritized in future experiments for improved parameter inference from collective model-data fitting

First Season QUIET Observations: Measurements of CMB Polarization Power Spectra at 43 GHz in the Multipole Range 25 <= ell <= 475

The Q/U Imaging ExperimenT (QUIET) employs coherent receivers at 43GHz and 95GHz, operating on the Chajnantor plateau in the Atacama Desert in Chile, to measure the anisotropy in the polarization of the CMB. QUIET primarily targets the B modes from primordial gravitational waves. The combination of these frequencies gives sensitivity to foreground contributions from diffuse Galactic synchrotron radiation. Between 2008 October and 2010 December, >10,000hours of data were collected, first with the 19-element 43GHz array (3458hours) and then with the 90-element 95GHz array. Each array observes the same four fields, selected for low foregrounds, together covering ~1000deg^2. This paper reports initial results from the 43GHz receiver which has an array sensitivity to CMB fluctuations of 69uK sqrt(s). The data were extensively studied with a large suite of null tests before the power spectra, determined with two independent pipelines, were examined. Analysis choices, including data selection, were modified until the null tests passed. Cross correlating maps with different telescope pointings is used to eliminate a bias. This paper reports the EE, BB and EB power spectra in the multipole range ell=25-475. With the exception of the lowest multipole bin for one of the fields, where a polarized foreground, consistent with Galactic synchrotron radiation, is detected with 3sigma significance, the E-mode spectrum is consistent with the LCDM model, confirming the only previous detection of the first acoustic peak. The B-mode spectrum is consistent with zero, leading to a measurement of the tensor-to-scalar ratio of r=0.35+1.06-0.87. The combination of a new time-stream double-demodulation technique, Mizuguchi-Dragone optics, natural sky rotation, and frequent boresight rotation leads to the lowest level of systematic contamination in the B-mode power so far reported, below the level of r=0.1Comment: 19 pages, 14 figures, higher quality figures are available at http://quiet.uchicago.edu/results/index.html; Fixed a typo and corrected statistical error values used as a reference in Figure 14, showing our systematic uncertainties (unchanged) vs. multipole; Revision to ApJ accepted version, this paper should be cited as "QUIET Collaboration et al. (2011)

Actividad antioxidante de Blechnum chilense (Kaulf.) Mett., Curcuma domestica Valeton y Tagetes verticillata Lag. & Rodríguez

Debido al creciente interés mundial en el mejoramiento de la salud humana los antioxidantes provenientes de plantas medicinales y alimenticias se han convertido en compuestos de gran interés. La búsqueda de nuevas fuentes de antioxidantes es importante para el mejor uso de la biodiversidad. El objetivo de este trabajo fue evaluar la actividad antioxidante y el contenido de fenoles totales usando el método de Folin-Ciocalteu y la actividad inhibitoria del radical DPPH de fracciones y extractos de Blechnum chilense (Kaulf.) Mett, Curcuma domestica Valeton y Tagetes verticillata Lag. &amp; Rodr. Las fracciones acuosa-metanólica y EtOAc de B. chilense, seguida del extracto EtOAc de C. domestica, mostraron una cantidad importante de compuestos fenólicos. La prueba con DPPH mostró que la actividad secuestrante más importante, comparada con la del extracto metanólico de Aristotelia chilensis (Molina) Stuntz, fue la del extracto de T. verticillata, seguido de la fracción EtOAc de B. chilense y el extracto EtOAc de C. domestica, con resultados similares a la fracción hexánica de B. chilense y el extracto obtenido con éter de petróleo de C. domestica, superando todas la actividad secuestrante de DPPH del α-tocoferol. Los resultados sugieren que todas las plantas estudiadas podrían ser nuevas fuentes de antioxidantes y se está trabajando para la identificación de los compuestos responsables de la actividad

DEPRESIÓN, IMPACTO EN LA CALIDAD DE VIDA EN SUJETOS CON EPOC QUE ASISTEN A UN CENTRO MÉDICO INTEGRAL OPORTUNA EN BARRANQUILLA

Introducción: La Enfermedad Pulmonar Obstructiva Crónica (EPOC), de acuerdo a datos de la organización mundial de la salud (OMS), reportó en el año 2016 una carga en la morbilidad de 251 millones de casos y 3,17 millones de muertes a causa de esta alteración, lo que representa el 5% de todas las muertes registradas a nivel mundial; se estima que 65 millones de personas padecen Epoc moderado a severo, la cual es una patología frecuente, prevenible y tratable.Objetivo: Determinar el grado de depresión en pacientes con Epoc y su relación con la calidad de vida.Materiales y Métodos: El tipo de este estudio es descriptivo correlacional. Los instrumentos utilizados en la recolección de datos son el cuestionario de Cat, por medio del cual se evalúa la calidad de vida, y el inventario de Depresión de Beck, que nos arroja el nivel de depresión en los adultos mayores con diagnóstico de Epoc que asisten a un camino en barranquilla.Resultados: Participaron en este estudio 14 pacientes diagnosticados con EPOC. La edad promedio de los pacientes 66,5+12,3 y el 58,2% pertenecían al sexo masculino; en cuanto al estrato socioeconómico el 100% pertenecía al estrato 2, el 11,8% todavía fuma, el 35,6% convive con un fumador y el 5,9% fuma de 1-10 cigarros al día. En cuanto a la asociación de los síntomas respiratorios y depresión el 35,7% de los sujetos sintomáticos presentaron depresión de moderada a grave