162 research outputs found
Characteristics and Outcomes of Patients Discharged Directly Home From the Pediatric Intensive Care Unit
Introduction: Patients admitted to the pediatric intensive care unit (PICU) typically transfer to an acute care floor prior to discharge (ACD). Various circumstances, including rapid clinical improvement, technology dependence, or capacity constraints, may lead to discharge directly to home from a PICU (DDH). This practice has been studied in adult intensive care units, but research is lacking for PICU patients. Methods: We aimed to describe characteristics and outcomes of patients requiring PICU admission who experienced DDH versus ACD. We conducted a retrospective cohort study of patients ≤18 years old admitted to our academic, tertiary care PICU between 1/1/15 and 12/31/20. Patients who died or were transferred to another facility were excluded. Baseline characteristics (including home ventilator dependence) and markers of illness severity, specifically the need for vasoactive infusion or new mechanical ventilation, were compared between groups. Admission diagnoses were categorized using the Pediatric Clinical Classification System (PECCS). Our primary outcome was hospital readmission within 30 days. Results: Of 4042 PICU admissions during the study period, 768 (19%) were DDH. Baseline demographic characteristics were similar, although DDH patients were more likely to have a tracheostomy (30% vs 5%, P < .01) and require a home ventilator at discharge (24% vs 1%, P < .01). DDH was associated with being less likely to have required a vasoactive infusion (7% vs 11%, P < .01), shorter median length of stay (LOS) (2.1 days vs 5.9 days, P < .01) and increased rate of readmission within 30 days of discharge (17% vs 14%, P < .05). However, repeat analysis after removing ventilator-dependent patients at discharge (n = 202) showed no difference in rates of readmission (14% vs 14%, P = .88). Conclusions: Direct discharge home from the PICU is a common practice. DDH and ACD groups had similar 30-day readmission rate when patient admissions with home ventilator dependence were excluded
Outcomes of a randomized controlled trial assessing a smartphone Application to reduce unmet needs among people diagnosed with CancEr (ACE)
© 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. Background: Smartphone technology represents an opportunity to deliver practical solutions for people affected by cancer at a scale that was previously unimaginable, such as information, appointment monitoring, and improved access to cancer support services. This study aimed to determine whether a smartphone application (app) reduced the unmet needs among people newly diagnosed with cancer. Methods: A single blind, multisite randomized controlled trial to determine the impact of an app-based, 4-month intervention. Newly diagnosed cancer patients were approached at three health service treatment clinics. Results: Eighty-two people were randomized (intervention; n = 43 and control; n = 39), average age was 59.5 years (SD: 12.9); 71% female; 67% married or in a de facto relationship. At baseline, there were no differences in participants’ characteristics between the groups. No significant effects, in reducing unmet needs, were demonstrated at the end of intervention (4-month) or 12-month follow-up. Overall, 94% used the app in weeks 1-4, which decreased to 41% in weeks 13-16. Mean app use time per participant: Cancer Information, 6.9 (SD: 18.9) minutes; Appointment Schedule, 5.1 (SD: 9.6) minutes; Cancer Services 1.5 minutes (SD: 6.8); Hospital Navigation, 1.4 (SD: 2.8) minutes. Conclusions: Despite consumer involvement in the design of this smartphone technology, the app did not reduce unmet needs. This may have been due to the study being underpowered. To contribute to a meaningful understanding and improved implementation of smartphone technology to support people affected by cancer, practical considerations, such as recruitment issues and access to, and confidence with, apps, need to be considered. Australian New Zealand Clinical Trials Registration (ACTRN) Trial Registration: 12616001251415; WEF 7/9/2016
The inflammatory microenvironment in colorectal neoplasia
Peer reviewedPublisher PD
Open Ocean Deep Sea
The deep sea comprises the seafloor, water column and biota therein below aspecified depth contour. There are differences in views among experts and agencies regarding the appropriate depth to delineate the “deep sea”. This chapter uses a 200 metre depth contour as a starting point, so that the “deep sea” represents 63 per cent of the Earth’s surface area and about 98.5 per cent of Earth’s habitat volume (96.5 per cent of which is pelagic). However, much of the information presented in this chapter focuses on biodiversity of waters substantially deeper than 200 m. Many of the other regional divisions of Chapter 36 include treatments of shelf and slope biodiversity in continental-shelf and slope areas deeper than 200m. Moreover Chapters 42 and 45 on coldwater corals and vents and seeps, respectively, and 51 on canyons, seamounts and other specialized morphological habitat types address aspects of areas in greater detail. The estimates of global biodiversity of the deep sea in this chapter do include all biodiversity in waters and the seafloor below 200 m. However, in the other sections of this chapter redundancy with the other regional chapters is avoided, so that biodiversity of shelf, slope, reef, vents, and specialized habitats is assessed in the respective regional or thematic chapters.
AB - The deep sea comprises the seafloor, water column and biota therein below aspecified depth contour. There are differences in views among experts and agencies regarding the appropriate depth to delineate the “deep sea”. This chapter uses a 200 metre depth contour as a starting point, so that the “deep sea” represents 63 per cent of the Earth’s surface area and about 98.5 per cent of Earth’s habitat volume (96.5 per cent of which is pelagic). However, much of the information presented in this chapter focuses on biodiversity of waters substantially deeper than 200 m. Many of the other regional divisions of Chapter 36 include treatments of shelf and slope biodiversity in continental-shelf and slope areas deeper than 200m. Moreover Chapters 42 and 45 on coldwater corals and vents and seeps, respectively, and 51 on canyons, seamounts and other specialized morphological habitat types address aspects of areas in greater detail. The estimates of global biodiversity of the deep sea in this chapter do include all biodiversity in waters and the seafloor below 200 m. However, in the other sections of this chapter redundancy with the other regional chapters is avoided, so that biodiversity of shelf, slope, reef, vents, and specialized habitats is assessed in the respective regional or thematic chapters.https://nsuworks.nova.edu/occ_facbooks/1050/thumbnail.jp
A Joint Search for Gravitational Wave Bursts with AURIGA and LIGO
The first simultaneous operation of the AURIGA detector and the LIGO
observatory was an opportunity to explore real data, joint analysis methods
between two very different types of gravitational wave detectors: resonant bars
and interferometers. This paper describes a coincident gravitational wave burst
search, where data from the LIGO interferometers are cross-correlated at the
time of AURIGA candidate events to identify coherent transients. The analysis
pipeline is tuned with two thresholds, on the signal-to-noise ratio of AURIGA
candidate events and on the significance of the cross-correlation test in LIGO.
The false alarm rate is estimated by introducing time shifts between data sets
and the network detection efficiency is measured with simulated signals with
power in the narrower AURIGA band. In the absence of a detection, we discuss
how to set an upper limit on the rate of gravitational waves and to interpret
it according to different source models. Due to the short amount of analyzed
data and to the high rate of non-Gaussian transients in the detectors noise at
the time, the relevance of this study is methodological: this was the first
joint search for gravitational wave bursts among detectors with such different
spectral sensitivity and the first opportunity for the resonant and
interferometric communities to unify languages and techniques in the pursuit of
their common goal.Comment: 18 pages, IOP, 12 EPS figure
Search for Gravitational Waves Associated with 39 Gamma-Ray Bursts Using Data from the Second, Third, and Fourth LIGO Runs
We present the results of a search for short-duration gravitational-wave
bursts associated with 39 gamma-ray bursts (GRBs) detected by gamma-ray
satellite experiments during LIGO's S2, S3, and S4 science runs. The search
involves calculating the crosscorrelation between two interferometer data
streams surrounding the GRB trigger time. We search for associated
gravitational radiation from single GRBs, and also apply statistical tests to
search for a gravitational-wave signature associated with the whole sample. For
the sample examined, we find no evidence for the association of gravitational
radiation with GRBs, either on a single-GRB basis or on a statistical basis.
Simulating gravitational-wave bursts with sine-gaussian waveforms, we set upper
limits on the root-sum-square of the gravitational-wave strain amplitude of
such waveforms at the times of the GRB triggers. We also demonstrate how a
sample of several GRBs can be used collectively to set constraints on
population models. The small number of GRBs and the significant change in
sensitivity of the detectors over the three runs, however, limits the
usefulness of a population study for the S2, S3, and S4 runs. Finally, we
discuss prospects for the search sensitivity for the ongoing S5 run, and beyond
for the next generation of detectors.Comment: 24 pages, 10 figures, 14 tables; minor changes to text and Fig. 2;
accepted by Phys. Rev.
Search for gravitational waves from binary inspirals in S3 and S4 LIGO data
We report on a search for gravitational waves from the coalescence of compact
binaries during the third and fourth LIGO science runs. The search focused on
gravitational waves generated during the inspiral phase of the binary
evolution. In our analysis, we considered three categories of compact binary
systems, ordered by mass: (i) primordial black hole binaries with masses in the
range 0.35 M(sun) < m1, m2 < 1.0 M(sun), (ii) binary neutron stars with masses
in the range 1.0 M(sun) < m1, m2 < 3.0 M(sun), and (iii) binary black holes
with masses in the range 3.0 M(sun)< m1, m2 < m_(max) with the additional
constraint m1+ m2 < m_(max), where m_(max) was set to 40.0 M(sun) and 80.0
M(sun) in the third and fourth science runs, respectively. Although the
detectors could probe to distances as far as tens of Mpc, no gravitational-wave
signals were identified in the 1364 hours of data we analyzed. Assuming a
binary population with a Gaussian distribution around 0.75-0.75 M(sun), 1.4-1.4
M(sun), and 5.0-5.0 M(sun), we derived 90%-confidence upper limit rates of 4.9
yr^(-1) L10^(-1) for primordial black hole binaries, 1.2 yr^(-1) L10^(-1) for
binary neutron stars, and 0.5 yr^(-1) L10^(-1) for stellar mass binary black
holes, where L10 is 10^(10) times the blue light luminosity of the Sun.Comment: 12 pages, 11 figure
All-sky search for periodic gravitational waves in LIGO S4 data
We report on an all-sky search with the LIGO detectors for periodic
gravitational waves in the frequency range 50-1000 Hz and with the frequency's
time derivative in the range -1.0E-8 Hz/s to zero. Data from the fourth LIGO
science run (S4) have been used in this search. Three different semi-coherent
methods of transforming and summing strain power from Short Fourier Transforms
(SFTs) of the calibrated data have been used. The first, known as "StackSlide",
averages normalized power from each SFT. A "weighted Hough" scheme is also
developed and used, and which also allows for a multi-interferometer search.
The third method, known as "PowerFlux", is a variant of the StackSlide method
in which the power is weighted before summing. In both the weighted Hough and
PowerFlux methods, the weights are chosen according to the noise and detector
antenna-pattern to maximize the signal-to-noise ratio. The respective
advantages and disadvantages of these methods are discussed. Observing no
evidence of periodic gravitational radiation, we report upper limits; we
interpret these as limits on this radiation from isolated rotating neutron
stars. The best population-based upper limit with 95% confidence on the
gravitational-wave strain amplitude, found for simulated sources distributed
isotropically across the sky and with isotropically distributed spin-axes, is
4.28E-24 (near 140 Hz). Strict upper limits are also obtained for small patches
on the sky for best-case and worst-case inclinations of the spin axes.Comment: 39 pages, 41 figures An error was found in the computation of the C
parameter defined in equation 44 which led to its overestimate by 2^(1/4).
The correct values for the multi-interferometer, H1 and L1 analyses are 9.2,
9.7, and 9.3, respectively. Figure 32 has been updated accordingly. None of
the upper limits presented in the paper were affecte
Search for gravitational wave bursts in LIGO's third science run
We report on a search for gravitational wave bursts in data from the three
LIGO interferometric detectors during their third science run. The search
targets subsecond bursts in the frequency range 100-1100 Hz for which no
waveform model is assumed, and has a sensitivity in terms of the
root-sum-square (rss) strain amplitude of hrss ~ 10^{-20} / sqrt(Hz). No
gravitational wave signals were detected in the 8 days of analyzed data.Comment: 12 pages, 6 figures. Amaldi-6 conference proceedings to be published
in Classical and Quantum Gravit
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