Context.
Characterising the large-scale structure in the Universe from present times to the high redshift epoch of reionisation is essential to constraining the cosmology, the history of star ...formation, and reionisation, to measuring the gas content of the Universe, and to obtaining a better understanding of the physical processes that drive galaxy formation and evolution. Using the integrated emission from unresolved galaxies or gas clouds, line intensity mapping (LIM) provides a new observational window to measure the larger properties of structures. This very promising technique motivates the community to plan for LIM experiments.
Aims.
We describe the development of a large field-of-view instrument, named CONCERTO (for CarbON CII line in post-rEionisation and ReionisaTiOn epoch), operating in the range 130–310 GHz from the APEX 12-m telescope (5100 m above sea level). CONCERTO is a low-resolution spectrometer based on the lumped element kinetic inductance detectors (LEKID) technology. Spectra are obtained using a fast Fourier transform spectrometer (FTS), coupled to a dilution cryostat with a base temperature of 0.1 K. Two two kilo-pixel arrays of LEKID are mounted inside the cryostat that also contains the cold optics and the front-end electronics.
Methods.
We present, in detail, the technological choices leading to the instrumental concept, together with the design and fabrication of the instrument and preliminary laboratory tests on the detectors. We also give our best estimates for CONCERTO sensitivity and give predictions for two of the main scientific goals of CONCERTO, that is, a CII-intensity mapping survey and observations of galaxy clusters.
Results.
We provide a detailed description of the instrument design. Based on realistic comparisons with existing instruments developed by our group (NIKA, NIKA2, and KISS), and on the laboratory characterisation of our detectors, we provide an estimate for CONCERTO sensitivity on the sky. Finally, we describe, in detail, two of the main scientific goals offered by CONCERTO at APEX.
Bivalirudin is an alternative to unfractionated heparin (UFH) anticoagulation during percutaneous coronary intervention. Previously, we have reported clinical benefit on major bleeding in favor of ...bivalirudin compared with UFH monotherapy but inconclusive results on mortality. Controversial data have been reported in the last 2 years. We conducted an updated meta-analysis including randomized trials and observational studies, which evaluated ischemic and bleeding outcomes for bivalirudin compared with UFH-only during percutaneous coronary intervention. We included 18 observational studies and 12 randomized trials published from 2003 to 2015. Primary outcomes were major adverse cardiovascular events within 30 days including death, myocardial infarction, and urgent revascularization and stent thrombosis, major bleeding, and transfusion. Overall, we found a significant risk reduction with bivalirudin for major bleeding (odds ratio OR 0.59, 95% confidence interval CI 0.49 to 0.71, p <0.0001) and for transfusion (OR 0.79, 95% CI 0.66 to 0.95, p = 0.01) and similar risk for major adverse cardiovascular events (OR 0.98, 95% CI 0.86 to 1.12, p = 0.80). However, there was a substantial increased risk of stent thrombosis associated with bivalirudin (OR 1.52, 95% CI 1.11 to 2.08, p = 0.009). No impact on mortality was found. Meta-regression analyses on major bleeding suggested that bivalirudin was more effective than UFH at doses >60 IU/kg and independent of radial access. In conclusion, compared with UFH monotherapy, bivalirudin remains associated with less bleeding risk but higher stent thrombosis risk. Further study remains required to define its role in current antithrombotic armamentarium.
•Whooping cough is a highly contagious respiratory illness frequent in Mexico.•Pertussis infection is common in adolescents and young adults, but it’s often underreported.•Mexican adolescents and ...young adults aren’t routinely vaccinated against pertussis.•Key challenges include selecting cut-off values for seropositivity.•Anti-PT IgG seroprevalence was 3.9%, representing 1.5M seropositive 10-25y Mexicans.•2012 findings reported less seropositive individuals than 2006 survey analysis.•This study observes large number of pertussis susceptible young adults in Mexico.
Low vaccination rates and under-detection of pertussis infections in adolescents and young adults have an impact on the transmission of pertussis to infants. In this study, the proportion of adolescents and young adults with IgG antibodies against B. pertussis antigens, representing recent infection or vaccination, was estimated in a population-based probabilistic survey in Mexico.
Sera and data from 1,581 subjects, including 1,102 adolescents and 479 young adults (10–19 and 20–25 years old, respectively) randomly selected from Mexico’s 2012 National Health and Nutrition Survey, were analyzed. IgG antibodies against pertussis toxin (PT) were measured with the CDC/FDA ELISA. A subset of 234 samples was additionally tested with Bp-IgG PT ELISA kit (EUROIMMUN AG, Lubeck, Germany). Threshold values from corresponding test kits were used to identify recent infection or vaccination.
Overall anti-PT IgG seroprevalence was 3.9% (95% CI: 2.3–6.3); 3.1% (95% CI: 1.9–5.0) in adolescents, and 4.9% (95% CI: 2.2–11) in young adults. Seroprevalence did not significantly vary by sex, socioeconomic status, region or rural/urban location. Compared to the CDC/FDA ELISA, the EUROIMMUN test showed a 76% sensitivity and 88% specificity. The weighted estimates represent a considerable burden of recent infection in adolescents and young adults; however, most adolescents and adults were seronegative and, therefore, susceptible to pertussis infection.
Since booster vaccination to B. pertussis after toddlerhood is not recommended in the Mexican national policy, anti-PT IgG seropositivity may be reasonably attributed to recent infection. Assessing pertussis seroprevalence requires careful consideration of the diagnostic test threshold interpretation and epidemiological model used.
Transradial approach (TRA) is the default access site for diagnostic angiography and intervention in many centers. Repeat ipsilateral radial artery access late after index procedure has been ...associated with failures. It is unknown whether early (≤30 days) and very early (<24 hours) repeat radial access is technically feasible and safe. Study population consisted of consecutive patients undergoing repeat (≥2) procedures within 30 days in a high-volume TRA center. Transradial access failure and resulting femoral approach was categorized as primary (no repeat attempt) or secondary (crossover). Timing of repeat access and reasons for failure were recorded. From November 2012 to December 2014, repeat catheterization by TRA was performed twice in 573 of 626 patients (92%) (median delay 4 2 to 9 days), 3 times in 29 of 38 (76%) patients (median delay 15 5 to 26 days), and 4 times in 1 patient within 21 days. When repeat catheterization occurred during the first 24 hours following the index procedure, 53% and 75% of patients had second and third procedures using the same ipsilateral radial artery, respectively. Primary radial failure occurred in 5.8% for second attempt and 13% for a third attempt, whereas crossovers were noted in 2.7% and 2.6%, respectively. Main reasons for failed re-access of ipsilateral radial artery were related either to operator's reluctance to repeat attempt (primary failure) or to issues with puncture site (crossover). In a high-volume TRA center, patients who required repeat catheterization within 24 hours and within the first 30 days had the same radial artery re-accessed in the majority of cases.
Resumen La reconstrucción posterior a una cirugía oncológica resectiva maxilar es todo un desafío. Debido a esto, existen diversas técnicas quirúrgicas cuyo objetivo apunta a mantener no solo la ...funcionalidad, sino también la estética facial, especialmente en el área del reborde infraorbitario. El injerto de hueso calvarial es una opción segura y versátil para realizar una reconstrucción primaria en el reborde infraorbitario. Esta técnica está indicada en aquellos pacientes en los cuales la resección cutánea y exenteración orbitaria no son necesarias. Por este motivo, a continuación, analizaremos este tipo de injerto a propósito de un caso clínico en el que se usó asociado a un colgajo pediculado de fascia temporoparietal.
We describe the deployment and first tests on sky of CONCERTO, a large field-of-view (18.6 arc-min) spectral-imaging instrument. The instrument operates in the range 130–310 GHz from the APEX ...12-metres telescope located at 5100 m a.s.l. on the Chajnantor plateau. Spectra with R=
ν
/
Δ
ν
≤
300
are obtained using a fast (2.5 Hz mechanical frequency) Fourier Transform Spectrometer (FTS), coupled to a continuous dilution cryostat with a base temperature of 60 mK. Two 2152-pixels arrays of Lumped Element Kinetic Inductance Detectors (LEKID) are installed in the cryostat that also contains the cold optics and the front-end electronics. CONCERTO, installed in April 2021, generates more than 20k spectra per second during observations. We describe the final development phases, the installation and the first results obtained on sky.
Resumen Introducción: El olfato tiene una gran importancia en la calidad de vida. Los accesos quirúrgicos selares pueden realizarse por vía transcraneal, transeptal y transnasal, y pueden generar ...hiposmia al incluir resecciones que afectan a la mucosa olfatoria. Objetivo: Determinar la existencia de alteración persistente en el olfato ocasionado por los accesos quirúrgicos transeptal y transnasal en pacientes operados por adenoma hipofisiario en el Instituto de Neurocirugía Dr. Asenjo. Material y Método: Estudio prospectivo de cohorte con comparación de resultados olfatorios (“sniffin’ sticks” versión extendida) y encuesta SNOT-22 pre y poscirugía por adenoma hipofisiario por vía transeptal o transnasal. Se utilizaron medidas estadísticas de comparación de pruebas pareadas paramétricas y no paramétricas según las características de las variables evaluadas. Resultados: Se reclutaron 60 pacientes, completando el seguimiento 39. En 21 se realizó acceso transeptal y en 18 transnasal. Al analizar el total de pacientes y por cada técnica quirúrgica, no hubo diferencias significativas en los puntajes del “sniffin’ sticks” versión extendida y tampoco en SNOT-22. Conclusión: La literatura describe incidencia de hiposmia posoperatoria muy variable, entre 0% y 88%, con mediciones subjetivas y objetivas. Existe una predilección por la técnica endoscópica a nivel internacional, por lo que cuenta con estudios de mejor calidad. A nivel nacional existen dos estudios previos que han encontrado tasas de hiposmia posoperatoria de 10% y 14%. En este estudio no hubo diferencias significativas en los puntajes obtenidos en la prueba de olfato entre el pre y posoperatorio.
Background: Chronic obstructive pulmonary disease (COPD) is a preventable and usually progressive lung disease that affects millions of people worldwide and is the sixth leading cause of death in the ...Americas. Viral and bacterial respiratory tract infections and air pollution may cause acute exacerbations of COPD (AE-COPD) ranging from mild, moderate to severe. The greatest proportion of the overall COPD burden on the health system is due to disease exacerbations. There is limited evidence regarding the etiology and burden of AE-COPD in Latin America (LATAM). Methods: To respond to this gap in evidence, an Advisory Board with regional pneumologists and infectious disease experts was convened in September 2018 in Panama City, Panama, to: 1) review the burden of AE-COPD in LATAM; 2) evaluate the etiology of AE-COPD in LATAM; and 3) assess and compare the local/regional guidelines to confirm the etiology, characterize, and manage AE-COPD. Results: The results of the meeting showed that there is a high prevalence of AE-COPD in LATAM countries, limited evidence on etiology data, and discrepancies in the case definitions and symptomology (ie, severity) classifications used in LATAM. Conclusion: The Advisory Board discussions further resulted in recommendations for future research on the impact on the epidemiology and burden of disease, on establishing standardized AE-COPD case definition guidelines, and on studying the etiology of both moderate and severe AE-COPD cases. Keywords: COPD, exacerbations, diagnosis, epidemiology, etiology, consensus
Using two populations of Aegla araucaniensis, one syntopic with two congeneric species (A. abtao and A. denticulata) and the other no, we assessed agonistic behavioural variations associated with ...interspecific competition (type of interaction, intensity of aggression, and frequency of dominance in two- and three-species encounters). In general, there was a low level of aggression among interacting individuals. The frequency of agonistic responses tended significantly towards more aggressive behaviours in A. araucaniensis that are not naturally exposed to interspecific competition compared with those that are. The competitive hierarchy was dominated by A. abtao, followed by both populations of A. araucaniensis. Aegla denticulata was always the subordinate species. We can conclude that: (1) the dominance hierarchy is coherent with the distribution patterns of the species in their natural habitat; (2) unlike other species of freshwater decapods, the nature of the studied aeglids is fundamentally passive; (3) in A. araucaniensis, interspecific competition can generate changes in the expression of behavioural traits; (4) in decapod crustaceans, the hierarchies of dominance may be established by conditions other than fighting abilities and/or intensity of agonistic interactions.
CarbON CII line in post-rEionisation and ReionisaTiOn epoch (CONCERTO) instrument is a low-resolution mapping spectrometer based on lumped element kinetic inductance detector (LEKIDs) technology, ...operating at 130--310\,GHz. It was installed on the 12-metre APEX telescope in Chile in April 2021 and was in operation until May 2023. CONCERTO's main goals were the observation of CII -emission line fluctuations at high redshift and of the Sunyaev–Zel'dovich (SZ) signal from galaxy clusters. We present the data processing algorithms and the performance of CONCERTO in continuum by analysing the data from the commissioning and scientific observations. We developed a standard data processing pipeline to proceed from the raw data to continuum maps. Using a large dataset of calibrators (Uranus, Mars, and quasars) acquired in 2021 and 2022 at the APEX telescope across a wide range of atmospheric conditions, we measured the CONCERTO continuum performance and tested its stability against observing conditions. Further, using observations on the COSMOS field and observations targeting a distant sub-millimetre galaxy in the UDS field, we assessed the robustness of the CONCERTO performance on faint sources and compared our measurements with expectations. The beam pattern is characterised by an effective full width at half maximum (FWHM) of $31.9 and $34.4 for high-frequency (HF) and low-frequency (LF) bands, respectively. The main beam is slightly elongated with a mean eccentricity of 0.46. Two error beams of $ and $ are characterised, allowing us to estimate a main beam efficiency of $ 0.52$. The field of view is accurately reconstructed and presents coherent distortions between the HF and LF arrays. LEKID parameters were robustly determined for 80<!PCT!> of the read tones. Cross-talks between LEKIDs are the first cause of flagging, followed by an excess of eccentricity for sim 10<!PCT!> of the LEKIDs, all located in a given region of the field of view. Of the 44 scans of Uranus selected for the absolute photometric calibration, 72.5$<!PCT!>$ and 78.2$<!PCT!>$ of the LEKIDs were selected as valid detectors with a probability $>$70$<!PCT!>$. By comparing the Uranus measurements with a model, we obtain calibration factors of 19.5pm Hz/Jy Hz/Jy for HF and LF, respectively. The point-source continuum measurement uncertainties are 3.0<!PCT!> and 3.4<!PCT!> for the HF and LF bands, ignoring the uncertainty in the model (which is $<2<!PCT!>$). This demonstrates the accuracy of the methods we deployed to process the data. Finally, the RMS of CONCERTO maps is verified to evolve as proportional to the inverse square root of the integration time. The measured noise-equivalent flux densities (NEFDs) for HF and LF are 115pm 2\,mJy/beamcdot $ and 95pm 1\,mJy/beamcdot $, respectively, obtained using CONCERTO data on the COSMOS field for a mean precipitable water vapour (pwv) and elevation of 0.81\,mm and 55.7\,deg . CONCERTO has unique capabilities in fast dual-band spectral mapping at sim 30 arcsecond resolution and with a sim 18.5-arcminute instantaneous field of view. CONCERTO's performance in continuum is perfectly in line with expectations.
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