ObjectiveUnderstanding how paediatric emergency departments (PEDs) across Europe adapted their healthcare pathways in response to COVID-19 will help guide responses to ongoing waves of COVID-19 and ...potential future pandemics. This study aimed to evaluate service reconfiguration across European PEDs during the initial COVID-19 wave.DesignThis cross-sectional survey included 39 PEDs in 17 countries. The online questionnaire captured (1) study site characteristics, (2) departmental changes and (3) pathways for children with acute illness pre and during the first wave of COVID-19 pandemic (January–May 2020). Number of changes to health services, as a percentage of total possible changes encompassed by the survey, was compared with peak national SARS-CoV-2 incidence rates, and for both mixed and standalone paediatric centres.ResultsOverall, 97% (n=38) of centres remained open as usual during the pandemic. The capacity of 18 out of 28 (68%) short-stay units decreased; in contrast, 2 units (7%) increased their capacity. In 12 (31%) PEDs, they reported acting as receiving centres for diverted children during the pandemic.There was minimal change to the availability of paediatric consultant telephone advice services, consultant supervision of juniors or presence of responsible specialists within the PEDs.There was no relationship between percentage of possible change at each site and the peak national SARS-CoV-2 incidence rate. Mixed paediatric and adult hospitals made 8% of possible changes and standalone paediatric centres made 6% of possible changes (p=0.086).ConclusionOverall, there was limited change to the organisation or delivery of services across surveyed PEDs during the first wave of the COVID-19 pandemic.
FcepsilonRI expression and function is a central aspect of allergic disease. Using bone marrow-derived mouse mast cell populations, we have previously shown that the Th2 cytokine IL-4 inhibits ...FcepsilonRI expression and function. In the current study we show that the Th2 cytokine IL-10 has similar regulatory properties, and that it augments the inhibitory effects of IL-4. FcepsilonRI down-regulation was functionally significant, as it diminished inflammatory cytokine production and IgE-mediated FcepsilonRI up-regulation. IL-10 and IL-4 reduced FcepsilonRI beta protein expression without altering the alpha or gamma subunits. The ability of IL-4 and IL-10 to alter FcepsilonRI expression by targeting the beta-chain, a critical receptor subunit known to modulate receptor expression and signaling, suggests the presence of a Th2 cytokine-mediated homeostatic network that could serve to both initiate and limit mast cell effector function.
Objective The aim of this study was to assess long‐term effects for women following the use of magnesium sulphate for pre‐eclampsia.
Design Assessment at 2–3 years after delivery for women ...recruited to the Magpie Trial (recruitment in 1998–2001, ISRCTN 86938761), which compared magnesium sulphate with placebo for pre‐eclampsia.
Setting Follow up after discharge from hospital at 125 centres in 19 countries across five continents.
Population A total of 7927 women were randomised at the follow‐up centres. Of these women, 2544 were not included for logistic reasons and 601 excluded (109 at a centre where <20% of women were contacted, 466 discharged without a surviving child and 26 opted out). Therefore, 4782 women were selected for follow‐up, of whom 3375 (71%) were traced.
Methods Questionnaire assessment was administered largely by post or in a dedicated clinic. Interview assessment of selected women was performed.
Main outcome measures Death or serious morbidity potentially related to pre‐eclampsia at follow up, other morbidity and use of health service resources.
Results Median time from delivery to follow up was 26 months (interquartile range 19–36). Fifty‐eight of 1650 (3.5%) women allocated magnesium sulphate died or had serious morbidity potentially related to pre‐eclampsia compared with 72 of 1725 (4.2%) women allocated placebo (relative risk 0.84, 95% CI 0.60–1.18).
Conclusions The reduction in the risk of eclampsia following prophylaxis with magnesium sulphate was not associated with an excess of death or disability for the women after 2 years.
A novel series of histamine H
3 receptor antagonists based on the 4-(1
H-imidazol-4-yl)methylpiperidine template displaying low CYP2D6 and CYP3A4 inhibitory profiles has been identified
A novel ...series of histamine H
3 receptor antagonists based on the 4-(1
H-imidazol-4-yl)methylpiperidine template displaying low CYP2D6 and CYP3A4 inhibitory profiles has been identified. Structural features responsible for the reduction of P450 activity, a typical liability of 4-substituted imidazoles, have been established.
A novel series of histamine H3 receptor antagonists based on the 4-(1H-imidazol-4-yl)methylpiperidine template displaying low CYP2D6 and CYP3A4 inhibitory profiles has been identified. Structural ...features responsible for the reduction of P450 activity, a typical liability of 4-substituted imidazoles, have been established.
We perform mode identification for five $\delta$ Scuti stars in the Pleiades
star cluster, using custom light curves from K2 photometry. By creating
\'echelle diagrams, we identify radial and dipole ...mode ridges, comprising a
total of 28 radial and 16 dipole modes across the five stars. We also suggest
possible identities for those modes that lie offset from the radial and dipole
ridges. We calculate non-rotating stellar pulsation models to verify our mode
identifications, finding good agreement within the age and metallicity
constraints of the cluster. We also find that for all stars, the least dense
models are preferred, reflecting the lower density of these oblate, rotating
stars. Three of the five stars show rotationally-split multiplets. We conclude
that the sample shows promise for asteroseismic rotation rates, masses, and
ages with rotating models in the future. Our preliminary modelling also
indicates some sensitivity to the helium abundance.
The degree of alignment between a star's spin axis and the orbital plane of its planets (the stellar obliquity) is related to interesting and poorly understood processes that occur during planet ...formation and evolution. Hot Jupiters orbiting hot stars (\(\gtrsim\)6250 K) display a wide range of obliquities, while similar planets orbiting cool stars are preferentially aligned. Tidal dissipation is expected to be more rapid in stars with thick convective envelopes, potentially explaining this trend. Evolved stars provide an opportunity to test the damping hypothesis, particularly stars that were hot on the main sequence and have since cooled and developed deep convective envelopes. We present the first systematic study of the obliquities of hot Jupiters orbiting subgiants that recently developed convective envelopes using Rossiter-McLaughlin observations. Our sample includes two newly discovered systems in the Giants Transiting Giants Survey (TOI-6029 b, TOI-4379 b). We find that the orbits of hot Jupiters orbiting subgiants that have cooled below \(\sim\)6250 K are aligned or nearly aligned with the spin-axis of their host stars, indicating rapid tidal realignment after the emergence of a stellar convective envelope. We place an upper limit for the timescale of realignment for hot Jupiters orbiting subgiants at \(\sim\)500 Myr. Comparison with a simplified tidal evolution model shows that obliquity damping needs to be \(\sim\)4 orders of magnitude more efficient than orbital period decay to damp the obliquity without destroying the planet, which is consistent with recent predictions for tidal dissipation from inertial waves excited by hot Jupiters on misaligned orbits.
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