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Effective patient engagement is central to patient-centered outcomes research. A well-designed infrastructure supports and facilitates patient engagement, enabling study development and implementation. We sought to understand infrastructure needs from recipients of Patient-Centered Outcomes Research Institute (PCORI) pilot grant awards.
We surveyed recipients of PCORI pilot project awards on self-perceived strengths in engagement infrastructure through PCORI’s Ways of Engaging-Engagement Activity Tool survey, and interviewed leaders of 8 projects who volunteered as exemplars. Descriptive statistics summarized the survey findings. We conducted a thematic analysis of the interview transcripts.
Of the 50 surveyed pilots, 22 answered the engagement infrastructure questions (44% response rate). Survey and interview findings emphasized the importance of committed institutional leadership, ongoing relationships with stakeholder organizations, and infrastructure funding through Clinical and Translational Science Awards, PCORI, and institutional discretionary funds.
These findings highlight the importance of and how to improve upon existing institutional infrastructure.
We have imaged over an extensive field the 3.29-μm emission from the Carina Nebula. This emission arises from polycyclic aromatic hydrocarbons which are excellent tracers of photodissociation regions. The results emphasis the two very different environments of the massive star clusters of the nebula, Trumpler 14 and 16.
Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children.
Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals
Patients ≤18 years old ventilated for ≥1 day
We identified patients with pediatric VAC based on previously proposed criteria. We applied adult temperature, white blood cell count, antibiotic, and culture criteria for IVAC and PVAP to these patients. We matched pediatric VAC patients with controls and evaluated associations with adverse outcomes using Cox proportional hazards models.
In total, 233 pediatric VACs (12,167 ventilation episodes) were identified. In the cardiac ICU (CICU), 62.5% of VACs met adult IVAC criteria; in the pediatric ICU (PICU), 54.2% of VACs met adult IVAC criteria; and in the neonatal ICU (NICU), 20.2% of VACs met adult IVAC criteria. Most patients had abnormal white blood cell counts and temperatures; we therefore recommend simplifying surveillance by focusing on “pediatric VAC with antimicrobial use” (pediatric AVAC). Pediatric AVAC with a positive respiratory diagnostic test (“pediatric PVAP”) occurred in 8.9% of VACs in the CICU, 13.3% of VACs in the PICU, and 4.3% of VACs in the NICU. Hospital mortality was increased, and hospital and ICU length of stay and duration of ventilation were prolonged among all pediatric VAE subsets compared with controls.
We propose pediatric AVAC for surveillance related to antimicrobial use, with pediatric PVAP as a subset of AVAC. Studies on generalizability and responsiveness of these metrics to quality improvement initiatives are needed, as are studies to determine whether lower pediatric VAE rates are associated with improvements in other outcomes.
The high Antarctic plateau provides exceptional conditions for infrared observations on account of the cold, dry and stable atmosphere above the ice surface. This paper describes the scientific goals behind the first program to examine the time-varying universe in the infrared from Antarctica — the Kunlun Infrared Sky Survey (KISS). This will employ a 50cm telescope to monitor the southern skies in the 2.4μmKdark window from China's Kunlun station at Dome A, on the summit of the Antarctic plateau, through the uninterrupted 4-month period of winter darkness. An earlier paper discussed optimisation of the Kdark filter for sensitivity (Li et al. 2016). This paper examines the scientific program for KISS. We calculate the sensitivity of the camera for the extrema of observing conditions that will be encountered. We present the parameters for sample surveys that could then be carried out for a range of cadences and sensitivities. We then discuss several science programs that could be conducted with these capabilities, involving star formation, brown dwarfs and hot Jupiters, exoplanets around M dwarfs, the terminal phases of stellar evolution, fast transients, embedded supernova searches, reverberation mapping of AGN, gamma ray bursts and the detection of the cosmic infrared background.
We present an update on the Mopra Central Molecular Zone Carbon Monoxide (CO) survey, with data taken in 2016 extending the original 3.5° ≥ l ≥ 358.5°, +1.0° ≥ b ≥ -0.5° to 4.0° ≥ l ≥ 358.0°, +1.0° ≥ b ≥ -1.0°. Using the four simultaneously observed lines of 12CO, 13CO, C18O, and C17O Nyquist sampled at 0.6′ spatial and 0.1 km/s spectral resolution, we are building an optical-thickness-corrected three-dimensional model of the diffuse gas, and making cloud mass estimates. This data, as part of the Mopra Southern Galactic Plane CO Survey (Braiding et al. (2015), Burton et al. (2013)), is at the highest resolution available across such a widespread region, and includes the Sagittarius A, Sagittarius B2, Sagittarius C, and G1.3 cloud complexes, as well as Bania’s Clump 2.
We investigate the physical conditions of the gas, atomic and molecular, in the filaments in the context of Photo-Dissociation Regions (PDRs) using the KOSMA-PDR mode of clumpy clouds. We also compare the [CII] vs. [NII] integrated intensity predictions in Abel et al. 2005 for HII regions and adjacent PDRs in the Galactic disk, and check for their applicability under the extreme physical conditions present in the GC. Our preliminary results show that observed integrated intensities are well reproduced by the PDR model. The gas is exposed to a relatively low Far-UV field between 102 – 103 Draine fields. The total volume hydrogen density is well constrained between 104 – 105 cm−3. The hydrogen ionization rate due to cosmic-rays varies between 10−15 and 4× 10−15 s−1, with the highest value ~ 10−14 s−1 found towards G0.07+0.04. Our results show that the line-of-sight contribution to the total distance of the filaments to the Arches Cluster is not negligible. The spatial distribution of the [CII]/[NII] ratio shows that the integrated intensity ratios are fairly homogeneously distributed for values below 10 in energy units. Calculations including variation on the [C/N] abundance ratio show that tight constraints on this ratio are needed to reproduce the observations.
Division VI of the International Astronomical Union deals with Interstellar Matter, and incorporates Commission 34. It gathers astronomers studying the diffuse matter in space between the stars, ranging from primordial intergalactic clouds via dust and neutral and ionised gas in galaxies to the densest molecular clouds and the processes by which stars are formed. There are approximately 730 members. The working groups in Planetary Nebulae and Cosmochemistry have served us well in organising periodic seminars in these subject areas. However, the Organising Committee has recognised that other developing areas of the ISM are not properly represented in the current organisation. In January 1997, the Division formed a new ISM working group on Star Forming Regions including cross-divisional representation to monitor progress in their fields and to help develop proposals for future IAU Symposia or Colloquia. In the future, especially in view of the rapid developments in spaceborne X-ray and IR astronomy, Division VI also hopes to form other working groups on the Hot ISM and the Extragalactic ISM.
This paper discusses the observation of molecular hydrogen line emission outside near-infrared wavelengths, and in particular the opportunities afforded to molecular astrophysics by studies in the mid- and far-infrared.
Spectroscopic imaging of the SNR RCW 103 has revealed extensive emission in near-infrared lines of H2and [Fe II], where the blast wave is encountering a molecular cloud. The H2 appears to be located outside the [FeII], a morphology which challenges our understanding of shock wave physics. It is suggested that reverse shocks may be responsible for the phenomenom.
We demonstrate the presence of a cluster of hot, population I stars at the very centre of the Galaxy, using the depth of the first overtone band of CO and the presence of emission in He I 2 ·058 μm and [Fell] 1·644μm to identify stars. The cluster is very compact and comprises at least several hundred stars. They lie close to the nonthermal radio source Sgr A* and dominate the luminosity and mass loss of the Galactic core. Their presence suggests that a starburst occurred at the Galactic centre.
The AAT’S new IR array camera, IRIS, has been used to image the Galactic Centre in the He I (2.058μm), H+ Br γ(2.166μm) and H2 1-0 S(l) (2.122μm) emission lines. The case is presented for UV-excitation of the molecular gas, as opposed to shocks.
The dry, cold, tenuous and stable air above the Antarctic Plateau provides superb conditions for the conduct of many classes of astronomical observations. We review in particular the rationale for undertaking near-IR, mm and particle astronomy in Antarctica, disciplines where telescopes are now operating at the US Amundsen-Scott South Pole Station.
We report on an initial survey of the cores of the Rho Ophiuchus and R Coronae Australis clouds, made with the AAT’s new IR array camera, IRIS. No turnover is seen in the initial luminosity function for ρ Oph to the sensitivity limit of the survey. Some implications for the low mass end of the initial mass function are discussed.
We describe a versatile infrared camera/spectrograph, IRIS, designed and constructed at the Anglo-Australian Observatory for use on the Anglo-Australian Telescope. A variety of optical configurations can be selected under remote control to provide several direct image scales and a few low-resolution spectroscopic formats. Two cross-dispersed transmission echelles are of novel design, as is the use of a modified Bowen-Burch system to provide a fast f/ratio in the widest-field option. The drive electronics includes a choice of readout schemes for versatility, and continuous display when the array is not taking data, to facilitate field acquisition and focusing.
The linearity of the detector has been studied in detail. Although outwardly good, slight nonlinearities prevent removal of fixed-pattern noise from the data without application of a cubic linearising function.
Specific control and data-reduction software has been written. We describe also a scanning mode developed for spectroscopic imaging.
The thermal emission from a cold, dense molecular cloud peaks in the far IR, and the spectrum is rich in molecular lines in the submillimetre and millimetre bands. Observation of these bands is hindered, however, by atmospheric water vapour, which absorbs the incoming radiation. Ground-based mm observations from Australia, where the atmospheric water vapour content typically contains ~10 mm precipitable (ppt) H2O, can only probe a few of the molecular transitions from the heavier molecules, such as CO, CS, HCO+ and HCN. Sub-mm observations would enable the higher rotational lines from many of these molecules to be studied, and open up other spectral features to scrutiny, such as the lines from hydrides (e.g. CaH, NH, SH) and neutral carbon at 370 and 610 μm. However, they cannot be made from Australia. While sites such as Mauna Kea, which has ~1 mm ppt H2O on the best days, open the sub-mm band to partial viewing, their utility is limited in comparison to the opportunities possible from the Antarctic Plateau. Here the column of H2O drops to 100–250 μm.