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Neutrophil–lymphocyte ratio has been associated with clinical outcomes in several groups of cardiac patients, including patients with coronary artery disease, cardiac failure, and cardiac transplant recipients. We hypothesised that pre- and/or post-operative haematological cell counts are associated with clinical outcomes in children undergoing cardiac surgery for CHD. We performed a post hoc analysis of data collected as part of a prospective observational cohort study (n = 83, data available n = 47) of children evaluated for glucocorticoid receptor levels after cardiac surgery (July 2015–January 2016). The association of neutrophil–lymphocyte ratio with low cardiac output syndrome, time to inotrope free, and vasoactive-inotropic score was examined using proportional odds analysis, cox regression, and linear regression models, respectively. A majority (80%) of patients were infants (median/interquartile range 4.1/0.2–7.6 months) with conotruncal (36%) and left-sided obstructed lesions (28%). Two patients required mechanical circulatory support and three died. Higher pre-operative neutrophil–lymphocyte ratio was associated with higher cumulative odds of severe/moderate versus mild low cardiac output on post-operative day 1 (odds ratio 2.86; 95% confidence interval 1.18–6.93; p = 0.02). Pre-operative neutrophil–lymphocyte ratio was not significantly associated with time to inotrope free or vasoactive-inotrope score. Post-operative neutrophil–lymphocyte ratio was also not associated with outcomes. In children after congenital heart surgery, higher pre-operative neutrophil–lymphocyte ratio was associated with a higher chance of low cardiac output in the early post-operative period. Pre-operative neutrophil–lymphocyte ratio maybe a useful prognostic marker in children undergoing congenital heart surgery.
SCALA is a physical calibration device for the SuperNova Integral Field Spectrograph (SNIFS), mounted to the University Hawaii 2.2m telescope on Mauna Kea. For type Ia supernova (SN Ia) cosmology programs, an improved fundamental calibration directly translates into improved cosmological constraints. The aim of SCALA is to perform a fundamental calibration of the CALSPEC (Bohlin 2014) standard stars, which are currently calibrated relative to white dwarf model atmospheres.
In a maternity hospital in which the umbilicus and trunk of healthy newborn infants were treated with 0·33% hexachlorophane dusting powder, the hexachlorophane content of blood was measured in mothers before delivery, in infants' umbilical samples at birth, and at 8 days of age in capillary blood samples. One mother and her baby had rather high blood concentrations of hexachlorophane, probably derived from a toilet preparation used before admission to hospital. Hexachlorophane was absent or barely detectable in the other mothers' blood and in the infants' umbilical blood. The hexachlorophane concentrations in the blood of 8-day-old infants ranged from nil to 0·166 μg./ml. (mean 0·066 μg./ml.). These were much less than the concentrations reported to be toxic in animals.
In a previous trial now reported here, a dusting powder containing chlorhexidine instead of hexachlorophane was found to delay the separation of the umbilical cord.
The Nearby Supernova Factory aims at discovering and stud- ying
a large sample of nearby (0.03 < z < 0.08) thermonuclear
supernovae. Potential targets are extracted from the unbiased
Palomar-QUEST survey, and follow-up spectro-photometric observations
are performed using the dedicated Supernovae Integral-Field
Spectrograph. The current sample comprises more than 2700
flux-calibrated optical spectra (320-1000 nm) from 181 supernovæ
followed over their full life-time. Specific operation and
data-reduction issues are discussed, and first scientific results
from this unprecedented dataset are presented.
We report a longitudinal, prospective, multicentre cohort study designed to measure the outcomes of gastrostomy tube feeding in children with cerebral palsy (CP). Fifty-seven children with CP (28 females, 29 males; median age 4y 4mo, range 5mo to 17y 3mo) were assessed before gastrostomy placement, and at 6 and 12 months afterwards. Three-quarters of the children enrolled (43 of 57) had spastic quadriplegia; other diagnoses included mixed CP (6 of 57), hemiplegia (3 of 57), undiagnosed severe neurological impairment (3 of 57), ataxia (1 of 57), and extrapyramidal disorder (1 of 57). Only 7 of 57 (12%) could sit independently, and only 3 of 57 (5%) could walk unaided. Outcome measures included growth/anthropometry, nutritional intake, general health, and complications of gastrostomy feeding. At baseline, half of the children were more than 3SD below the average weight for their age and sex when compared with the standards for typically-developing children. Weight increased substantially over the study period; the median weight z score increased from –3 before gastrostomy placement to –2.2 at 6 months and –1.6 at 12 months. Almost all parents reported a significant improvement in their child's health after this intervention and a significant reduction in time spent feeding. Statistically significant and clinically important increases in weight gain and subcutaneous fat deposition were noted. Serious complications were rare, with no evidence of an increase in respiratory complications.
The aim of this prospective cohort study was to evaluate the impact of gastrostomy tube feeding on the quality of life of carers of children with cerebral palsy (CP). Short-Form 36 version II was used to measure quality of life in carers of 57 Caucasian children with CP (28 females, 29 males; median age 4y 4mo, range 5mo to 17y 3mo) six and 12 months after insertion of a gastrostomy tube. Responses were calibrated against a normative dataset (Oxford Healthy Life Survey III). Six months after gastrostomy feeding was started, a substantial rise in mean domain scores for mental health, role limitations due to emotional problems, physical functioning, social functioning, and energy/vitality were observed. At 12 months after gastrostomy placement, carers reported significant improvements in social functioning, mental health, energy/vitality (mean increase >9.8 points; p<0.03), and in general health perception (mean increase 6.35 points; p=0.045) compared with results at baseline. Moreover, the values obtained for these domains at 12 months were not significantly different from the normal reference standard. Carers reported a significant reduction in feeding times, increased ease of drug administration, and reduced concern about their child's nutritional status. This study has demonstrated a significant, measurable improvement in the quality of life of carers after insertion of a gastrostomy feeding tube.
Ultraluminous infrared galaxies (ULIRGs) have luminosities (1012L⊙) once exclusive to QSOs. This suggests they might be the early, dust-enshrouded stages of QSOs. ULIRGs have ∼ 3.5× the space density of QSOs at the present epoch. Quasars reached their peak space density at z ∼ 2, so if ULIRGs are QSO precursors, there should be a dramatic increase in their space density up to z ∼ 2. The small number of known ULIRGs makes it difficult to explore links between ULIRGs and QSOs, much less measure their evolution. To do so, a large sample of ULIRG candidates must be identified. The IRAS FSC contains ∼ 60,000 probable galaxies, of which 1%–3% should have LFIR > 1012L⊙. We discuss an efficient and reliable method which uses IRAS-VLA-APS cross-identification and flux ratios to mine the FSC for likely ULIRGs.
We have used the Automated Plate Scanner (APS) at the University of Minnesota to digitize glass copies of the blue and red plates of the original Palomar Observatory Sky Survey (POSS I) with |b| > 20°. The APS Image Database is a database of all digitized images larger than the photographic noise threshold. It includes all of the matched images in the object catalog, as well as those unmatched images above the noise threshold. The matched image data of the catalog has the advantage of confirming the reality of the image. This is especially important for small images near the plate limit. But these are not all of the detected real images; very blue or very red faint objects may be excluded by this matching requirement. The image database allows information on them to be retrieved, and is therefore a valuable complement to the object catalog. The operation of the APS and the scanning procedures are described in detail in Pennington et al. (1993). We are now processing plate data into the image database. A set of query forms, a tutorial and documentation can be found at http://isis.spa.umn.edu/IDB/homepage.idb.html.
A great deal of energy in recent months has been expended in worrying about energy. The procurement, allocation, utilization, and conservation of energy sources have been probed countless times and viewed from almost every possible vantage point. The word “energy” now shares the stage with the word “environment.”
The Afghan war blue books of 1839 have usually been regarded as classic examples of the way official documents can be mutilated by skilful and unscrupulous editing almost to the point of forgery. Sir William Kaye's monumental and authoritative history of the first Afghan war, published in 1851, contains this crushing indictment:
I cannot, indeed, suppress the utterance of my abhorrence of this system of grabling the official correspondece of public men-sending the letters of a statesman or diplomatist into the world mutilated, emasculated-the very pith and substance of them cut is palmed upon the world has not one redeeming feature.