5,912 research outputs found

    Dark matter cores in the Fornax and Sculptor dwarf galaxies: joining halo assembly and detailed star formation histories

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    We combine the detailed Star Formation Histories of the Fornax and Sculptor dwarf Spheroidals with the Mass Assembly History of their dark matter (DM) halo progenitors to estimate if the energy deposited by Supernova type II (SNeII) is sufficient to create a substantial DM core. Assuming the efficiency of energy injection of the SNeII into DM particles is ϵgc=0.05\epsilon_{\rm gc}=0.05, we find that a single early episode, zzinfallz \gtrsim z_{\rm infall}, that combines the energy of all SNeII due to explode over 0.5 Gyr, is sufficient to create a core of several hundred parsecs in both Sculptor and Fornax. Therefore, our results suggest that it is energetically plausible to form cores in Cold Dark Matter (CDM) halos via early episodic gas outflows triggered by SNeII. Furthermore, based on CDM merger rates and phase-space density considerations, we argue that the probability of a subsequent complete regeneration of the cusp is small for a substantial fraction of dwarf-size haloes.Comment: ApJL accepted versio

    Impredicative Encodings of (Higher) Inductive Types

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    Postulating an impredicative universe in dependent type theory allows System F style encodings of finitary inductive types, but these fail to satisfy the relevant {\eta}-equalities and consequently do not admit dependent eliminators. To recover {\eta} and dependent elimination, we present a method to construct refinements of these impredicative encodings, using ideas from homotopy type theory. We then extend our method to construct impredicative encodings of some higher inductive types, such as 1-truncation and the unit circle S1

    Rotavirus genetic diversity, disease association, and temporal change in hospitalized rural Kenyan children

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    Background. The effectiveness of rotavirus vaccines will be dependent on the immunity conferred against prevalent and emergent variants causing severe diarrheal disease. Longitudinal surveillance of disease-causing strains is a prerequisite to intervention. Methods. Molecular characterization was conducted on rotavirus-positive stool samples from children admitted with diarrhea to a rural district hospital during 2002-2004. Extracted viral RNA was separated by polyacrylamide gel electrophoresis, and rotavirus VP4 (P types) and VP7 (G types) specificities were determined. Results. Among 558 investigated cases, the predominant genotype was P[8]G1 (42%), followed by P[8]G9 (15%), P[4]G8 (7%), P[6]G8 (6%), and P[8]G8 (4%), with 10% mixed strains. Overall, there were 6 different P types and 7 G types. No association was identified between genotype and child age, sex, or severity of diarrhea. The P and G genotypes and polyacrylamide gel electropherotypes showed significant temporal variation in frequency: P[8]G1 decreased from 51% (95% confidence interval [CI], 43%-58%) in 2002 to 30% (95% CI, 24%-37%) in 2004, and P[4]G8 increased from 2% (95% CI, 0%-5%) in 2002 to 13% (95% CI, 9%-19%). Quarterly data revealed seasonally endemic and emergence and/or decay patterns. Conclusions. Our study of rotavirus strains causing severe diarrhea in rural Kenyan children showed a predominance of P[8]G1 and confirms the importance of G8 and G9 strains in sub-Saharan Africa. Considerable genetic diversity of rotavirus strains was observed, including substantial mixed and unusual types, coupled with significant temporal strain variation and emergence. These results warn of variable vaccine efficacy and the need for long-term surveillance of circulating rotavirus genotypes

    Emergency front-of-neck access in infants: A pragmatic crossover randomized control trial comparing two approaches on a simulated rabbit model.

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    BACKGROUND Rapid-sequence tracheotomy and scalpel-bougie tracheotomy are two published approaches for establishing emergency front-of-neck access in infants. It is unknown whether there is a difference in performance times and success rates between the two approaches. AIMS The aim of this cross-over randomized control trial study was to investigate whether the two approaches were equivalent for establishing tracheal access in rabbit cadavers. The underlying hypothesis was that the time to achieve the tracheal access is the same with both techniques. METHODS Between May and September 2022, thirty physicians (pediatric anesthesiologists and intensivists) were randomized to perform front-of-neck access using one and then the other technique: rapid-sequence tracheotomy and scalpel-bougie tracheotomy. After watching training videos, each technique was practiced four times followed by a final tracheotomy during which study measurements were obtained. Based on existing data, an equivalence margin was set at ∆ = ±10 s for the duration of the procedure. The primary outcome was defined as the duration until tracheal tube placement was achieved successfully. Secondary outcomes included success rate, structural injuries, and subjective participant self-evaluation. RESULTS The median duration of the scalpel-bougie tracheotomy was 48 s (95% CI: 37-57), while the duration of the rapid-sequence tracheotomy was 59 s (95% CI: 49-66, p = .07). The difference in the median duration between the two approaches was 11 s (95% CI: -4.9 to 29). The overall success rate was 93.3% (95% CI: 83.8%-98.2%). The scalpel-bougie tracheotomy resulted in significantly fewer damaged tracheal rings and was preferred among participants. CONCLUSIONS The scalpel-bougie tracheotomy was slightly faster than the rapid-sequence tracheotomy and favored by participants, with fewer tracheal injuries. Therefore, we propose the scalpel-bougie tracheostomy as a rescue approach favoring the similarity to the adult approach for small children. The use of a comparable equipment kit for both children and adults facilitates standardization, performance, and logistics. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT05499273

    The Utility of a Pediatric COVID-19 Online Forward Triage Tool in Switzerland.

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    Background To offset the burden on the health system, hospitals set up telehealth interventions, such as online forward triage tools (OFTT). The website www.coronabambini.ch was developed to specifically address the needs of children and their families in Switzerland and to facilitate the decision to test, isolate, attend school, or access the health care system. Methods Video interviews were held with key informants (n = 20) from a population of parents, teachers, guardians, as well as doctors who had used the child-specific COVID-19 OFTT and had consented to a further study. Convenience and quota sampling were done to include a variety of key informants. Interviews were recorded, transcribed verbatim, and analyzed for themes. Results Three main themes emerged: i) the usefulness of the OFTT to the users, ii) expectation management and importance of stakeholder involvement in OFTT development, and iii) OFTT limitations. Conclusion Our study highlights opportunities, limitations, and lessons to consider when developing a pediatric COVID-19 OFTT. The involvement of stakeholders, parents, teachers, and health care providers in the design, set up, implementation, and evaluation of telehealth interventions is critical as this can help with expectation management and enhance OFTT utility

    Peri-operative red blood cell transfusion in neonates and infants: NEonate and children audiT of anaesthesia pRactice IN Europe: A prospective European multicentre observational study.

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    BACKGROUND Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN A multicentre observational study. SETTING The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT02350348

    Bisimulation of Labeled State-to-Function Transition Systems of Stochastic Process Languages

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    Labeled state-to-function transition systems, FuTS for short, admit multiple transition schemes from states to functions of finite support over general semirings. As such they constitute a convenient modeling instrument to deal with stochastic process languages. In this paper, the notion of bisimulation induced by a FuTS is proposed and a correspondence result is proven stating that FuTS-bisimulation coincides with the behavioral equivalence of the associated functor. As generic examples, the concrete existing equivalences for the core of the process algebras ACP, PEPA and IMC are related to the bisimulation of specific FuTS, providing via the correspondence result coalgebraic justification of the equivalences of these calculi.Comment: In Proceedings ACCAT 2012, arXiv:1208.430

    Effects of Isomer Ratio on Pmdi Resin Reactivity and Oriented Strandboard Properties

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    The effect of varying 2,4'-MDI to 4,4'-MDI isomer ratio in diphenylmethane diisocyanate (pMDI) adhesives was investigated. In addition to probing resin cure kinetics, oriented strandboard panels were produced to investigate the effect of isomer ratio on panel properties. With one exception, differential scanning calorimetry results showed a trend of increasing activation energy with increasing 4,4'-MDI content—the opposite of what was predicted. Results of internal bond testing indicate that increasing 4,4'-MDI content gave higher internal bond strength, but no correlation was evident between resin and panel density, MOR, MOE, or 24-h thickness swell. It is important to note that isomer ratio was not the only variable within the resin series; oligomer content and hence viscosity increased as 4,4'-MDI content increased, which complicated the analysis

    Public health communication: Attitudes, experiences, and lessons learned from users of a COVID-19 digital triage tool for children

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    Background: The pandemic has made public health communication even more daunting because acceptance and implementation of official guidelines and recommendations hinge on this. The situation becomes even more precarious when children are involved. Our child-specific COVID-19 online forward triage tool (OFTT) revealed some of the public health communication challenges. We aimed to explore attitudes, experiences, and challenges faced by OFTT users and their families, in regard to public health recommendations. Methods: We selected key informants (n = 20) from a population of parents, teachers, guardians, as well as doctors who had used the child-specific COVID-19 OFTT and had consented to a further study. Videos rather than face-face interviews were held. Convenience and quota sampling were performed to include a variety of key informants. Interviews were recorded, transcribed verbatim, and analyzed for themes. Results: Several themes emerged, namely; (1) definition and expectations of high-risk persons, (2) quarantine instructions and challenges, (3) blurred division of responsibility between authorities and parents, (4) a novel condition and the evolution of knowledge, (5) definition and implications of socioeconomic status, (6) new normal and societal divisions, and (7) the interconnectedness of these factors-systems thinking. Conclusion: As the virus is evolving and circumstances are changing rapidly, the communication of public health to the different interest groups becomes, both an art and science, even more so when using a new technological communication channel: an OFTT. A myriad of interconnected factors seems to influence attitudes toward public health recommendations, which calls for systems thinking in public health communication
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