The Blanco Cosmology Survey (BCS) is a 60 night imaging survey of ~80 deg super(2) of the southern sky located in two fields: (alpha, delta) = (5 hr, -55degrees) and (23 hr, -55degrees). The survey ...was carried out between 2005 and 2008 in griz bands with the Mosaic2 imager on the Blanco 4 m telescope. The primary aim of the BCS survey is to provide the data required to optically confirm and measure photometric redshifts for Sunyaev-Zel'dovich effect selected galaxy clusters from the South Pole Telescope and the Atacama Cosmology Telescope. We process and calibrate the BCS data, carrying out point-spread function-corrected model-fitting photometry for all detected objects. The median 10sigma galaxy (point-source) depths over the survey in griz are approximately 23.3 (23.9), 23.4 (24.0), 23.0 (23.6), and 21.3 (22.1), respectively. The astrometric accuracy relative to the USNO-B survey is ~45 mas. We calibrate our absolute photometry using the stellar locus in grizJ bands, and thus our absolute photometric scale derives from the Two Micron All Sky Survey, which has ~2% accuracy. The scatter of stars about the stellar locus indicates a systematic floor in the relative stellar photometric scatter in griz that is ~1.9%, ~2.2%, ~2.7%, and ~2.7%, respectively. A simple cut in the AstrOmatic star-galaxy classifier spread_model produces a star sample with good spatial uniformity. We use the resulting photometric catalogs to calibrate photometric redshifts for the survey and demonstrate scatter deltaz/(1 + z) = 0.054 with an outlier fraction eta < 5% to z ~ 1. We highlight some selected science results to date and provide a full description of the released data products.
We present a Chandra X-ray observation of G12.82-0.02, a shell-like radio supernova remnant coincident with the TeV gamma-ray source HESS J1813-178. We resolve the X-ray emission from the colocated ...Advanced Satellite for Cosmology and Astrophysics (ASCA) source into a point source surrounded by structured diffuse emission that fills the interior of the radio shell. The morphology of the diffuse emission strongly resembles that of a pulsar wind nebula. The spectrum of the compact source is well characterized by a power law with index Gamma approximately 1.3, typical of young and energetic rotation-powered pulsars. For a distance of 4.5 kpc, consistent with the X-ray absorption and an association with the nearby star formation region W33, the 2-10 keV X-ray luminosities of the putative pulsar and nebula are L sub(PSR) = 3.2 x 10 super(38) ergs s super(-1) and L sub(PWN) = 1.4 x 10 super(34) ergs s super(-1), respectively. Both the flux ratio of L sub(PWN)/L sub(PSR) = 4.3 and the total luminosity of this system predict a pulsar spin-down power of E > 10 super(37) ergs s super(-1), placing it among the 10 most energetic young pulsars in the Galaxy. A deep search for radio pulsations using the Parkes telescope sets an upper limit of approximately 0.07 mJy at 1.4 GHz for periods unk50 ms. We discuss the energetics of this source and consider briefly the proximity of bright H II regions to this and several other High Energy Stereoscopic System (H.E.S.S.) sources, which may produce their TeV emission via inverse Compton scattering.
Summary Background Children with osteogenesis imperfecta are often treated with intravenous bisphosphonates. We aimed to assess the safety and efficacy of risedronate, an orally administered ...third-generation bisphosphonate, in children with the disease. Methods In this multicentre, randomised, parallel, double-blind, placebo-controlled trial, children aged 4–15 years with osteogenesis imperfecta and increased fracture risk were randomly assigned by telephone randomisation system in a 2:1 ratio to receive either daily risedronate (2·5 or 5 mg) or placebo for 1 year. Study treatment was masked from patients, investigators, and study centre personnel. Thereafter, all children received risedronate for 2 additional years in an open-label extension. The primary efficacy endpoint was percentage change in lumbar spine areal bone mineral density (BMD) at 1 year. The primary efficacy analysis was done by ANCOVA, with treatment, age group, and pooled centre as fixed effects, and baseline as covariate. Analyses were based on the intention-to-treat population, which included all patients who were randomly assigned and took at least one dose of assigned study treatment. The trial is registered with ClinicalTrials.gov , number NCT00106028. Findings Of 147 patients, 97 were randomly assigned to the risedronate group and 50 to the placebo group. Three patients from the risedronate group and one from the placebo group did not receive study treatment, leaving 94 and 49 in the intention-to-treat population, respectively. The mean increase in lumbar spine areal BMD after 1 year was 16·3% in the risedronate group and 7·6% in the placebo group (difference 8·7%, 95% CI 5·7–11·7; p<0·0001). After 1 year, clinical fractures had occurred in 29 (31%) of 94 patients in the risedronate group and 24 (49%) of 49 patients in the placebo group (p=0·0446). During years 2 and 3 (open-label phase), clinical fractures were reported in 46 (53%) of 87 patients in the group that had received risedronate since the start of the study, and 32 (65%) of 49 patients in the group that had been given placebo during the first year. Adverse event profiles were otherwise similar between the two groups, including frequencies of reported upper-gastrointestinal and selected musculoskeletal adverse events. Interpretation Oral risedronate increased areal BMD and reduced the risk of first and recurrent clinical fractures in children with osteogenesis imperfecta, and the drug was generally well tolerated. Risedronate should be regarded as a treatment option for children with osteogenesis imperfecta. Funding Alliance for Better Bone Health (Warner Chilcott and Sanofi).
This study examined the effects of USDA carcass maturity on sensory properties of LM steaks produced by cattle representing 2 dental age classes. Carcasses identified for use in the experiment were ...produced by steers and heifers classified as either <30 mo of age (MOA) or ≥30 MOA at the time of slaughter using dentition. Within each dental age class, carcasses were selected to represent 2 maturity groups and 3 marbling categories, resulting in 12 dental age × maturity × marbling subclasses, each consisting of 50 carcasses. Maturity groups consisted of carcasses classified by USDA graders as either A to A (A) overall maturity or B to D (B-D) overall maturity; marbling categories consisted of carcasses with instrument marbling scores of Slight to Slight (SL), Small to Small (SM), or Modest to Moderate (MT-MD). Carcasses were selected in pairs so that each carcass chosen to represent the B-D-maturity group was paired with an A-maturity carcass of the same sex and marbling score (±50 marbling units). Strip loin (LM) steaks were obtained from both sides of each carcass. After a 14-d aging period, 1 LM steak was measured for Warner-Bratzler shear force (WBSF) and slice shear force (SSF), whereas the other LM steak was used for sensory analysis by a trained descriptive attribute panel. No differences ( > 0.05) in LM tenderness, juiciness, or flavor were detected between carcass maturity groups in either dental age class. Advanced dental age (≥30 MOA), however, was associated with more intense ( < 0.05) grassy and bloody/serumy flavors and decreased ( < 0.05) tenderness within the SL marbling group. Marbling score effectively stratified carcasses (MT-MD > SM > SL) according to differences ( < 0.0001) in LM tenderness, juiciness, beefy/brothy flavor, and buttery/beef fat flavor. In addition, increased marbling was associated with lesser ( < 0.01) intensities of bloody/serumy, livery/organy, and grassy flavors as well as smaller ( < 0.0001) values for WBSF and SSF. Results of this study suggest that USDA carcass maturity does not effectively identify differences in LM sensory attributes in the population of beef carcasses routinely offered for grading in today's U.S. commercial beef processing facilities.
Tracheal intubation (TI) is a common procedure in critical care, often performed with a Macintosh curved blade used for direct laryngoscopy (DL). Minimal evidence informs the choice between Macintosh ...blade sizes during TI. We hypothesized that Macintosh 4 blade would have higher first-attempt success than Macintosh 3 blade during DL.
Retrospective analysis using a propensity score and inverse probability weighting of data from six prior multicenter randomized trials.
Adult patients who underwent nonelective TI at participating emergency departments and ICUs. We compared the first-pass success of TI with DL in subjects intubated with a size 4 Macintosh blade on the first TI attempt to subjects with a size 3 Macintosh blade on the first TI attempt.
Among 979 subjects, 592 (60.5%) had TI using DL with a Macintosh blade, of whom 362 (37%) were intubated with a size 4 blade and 222 (22.7%) with a size 3 blade. We used inverse probability weighting with a propensity score for analyzing data. We found that patients intubated with a size 4 blade had a worse (higher) Cormack-Lehane grade of glottic view than patients intubated with a size 3 blade (adjusted odds ratio aOR, 1.458; 95% CI, 1.064-2.003;
= 0.02). Patients intubated with a size 4 blade had a lower first pass success than those with a size 3 blade (71.1% vs 81.2%; aOR, 0.566; 95% CI, 0.372-0.850;
= 0.01).
In critically ill adults undergoing TI using DL with a Macintosh blade, patients intubated using a size 4 blade on first attempt had a worse glottic view and a lower first pass success than patients intubated with a size 3 Macintosh blade. Further prospective studies are needed to examine the optimal approach to selecting laryngoscope blade size during TI of critically ill adults.
We investigate the nature of the mid-IR excess for 31 intermediate-mass stars that exhibit an 8 mum excess in either the Galactic Legacy Infrared Mid-Plane Survey Extraordinaire or the Mid-Course ...Space Experiment using high-resolution optical spectra to identify stars surrounded by warm circumstellar dust. From these data we determine projected stellar rotational velocities and estimate stellar effective temperatures for the sample. We estimate stellar ages from these temperatures, parallactic distances, and evolutionary models. Using MIPS 24 measurements and stellar parameters we determine the nature of the infrared excess for 19 GLIMPSE stars. We find that 15 stars exhibit H alpha emission and four exhibit H alpha absorption. Assuming that the mid-IR excesses arise in circumstellar disks, we use the H alpha fluxes to model and estimate the relative contributions of dust and free-free emission. Six stars exhibit H alpha fluxes that imply free-free emission can plausibly explain the infrared excess at 24. These stars are candidate classical Be stars. Nine stars exhibit H alpha emission, but their H alpha fluxes are insufficient to explain the infrared excesses at 24, suggesting the presence of a circumstellar dust component. After the removal of the free- free component in these sources, we determine probable disk dust temperatures of image K and fractional infrared luminosities of image. These nine stars may be pre-main-sequence stars with transitional disks undergoing disk clearing. Three of the four sources showing H alpha absorption exhibit circumstellar disk temperatures image300-400 K, image, IR colors image, and are warm debris disk candidates. One of the four H alpha absorption sources has image implying an optically thick outer disk and is a transition disk candidate.
Hypotension affects approximately 40% of critically ill patients undergoing emergency intubation and is associated with an increased risk of death. The objective of this study was to examine the ...association between prophylactic vasopressor administration and the incidence of peri-intubation hypotension and other clinical outcomes.
A secondary analysis of two multicenter randomized clinical trials. The clinical effect of prophylactic vasopressor administration was estimated using a one-to-one propensity-matched cohort of patients with and without prophylactic vasopressors.
Seven emergency departments and 17 ICUs across the United States.
One thousand seven hundred ninety-eight critically ill patients who underwent emergency intubation at the study sites between February 1, 2019, and May 24, 2021.
None.
The primary outcome was peri-intubation hypotension defined as a systolic blood pressure less than 90 mm Hg occurring between induction and 2 minutes after tracheal intubation. A total of 187 patients (10%) received prophylactic vasopressors prior to intubation. Compared with patients who did not receive prophylactic vasopressors, those who did were older, had higher Acute Physiology and Chronic Health Evaluation II scores, were more likely to have a diagnosis of sepsis, had lower pre-induction systolic blood pressures, and were more likely to be on continuous vasopressor infusions prior to intubation. In our propensity-matched cohort, prophylactic vasopressor administration was not associated with reduced risk of peri-intubation hypotension (41% vs 32%;
= 0.08) or change in systolic blood pressure from baseline (-12 vs -11 mm Hg;
= 0.66).
The administration of prophylactic vasopressors was not associated with a lower incidence of peri-intubation hypotension in our propensity-matched analysis. To address potential residual confounding, randomized clinical trials should examine the effect of prophylactic vasopressor administration on peri-intubation outcomes.
Administration of intravenous crystalloid solutions is a fundamental therapy for sepsis, but the effect of crystalloid composition on patient outcomes remains unknown.
To compare the effect of ...balanced crystalloids versus saline on 30-day in-hospital mortality among critically ill adults with sepsis.
Secondary analysis of patients from SMART (Isotonic Solutions and Major Adverse Renal Events Trial) admitted to the medical ICU with an
code for sepsis, using multivariable regression to control for potential confounders.
Of 15,802 patients enrolled in SMART, 1,641 patients were admitted to the medical ICU with a diagnosis of sepsis. A total of 217 patients (26.3%) in the balanced crystalloids group experienced 30-day in-hospital morality compared with 255 patients (31.2%) in the saline group (adjusted odds ratio aOR, 0.74; 95% confidence interval CI, 0.59-0.93;
= 0.01). Patients in the balanced group experienced a lower incidence of major adverse kidney events within 30 days (35.4% vs. 40.1%; aOR, 0.78; 95% CI, 0.63-0.97) and a greater number of vasopressor-free days (20 ± 12 vs. 19 ± 13; aOR, 1.25; 95% CI, 1.02-1.54) and renal replacement therapy-free days (20 ± 12 vs. 19 ± 13; aOR, 1.35; 95% CI, 1.08-1.69) compared with the saline group.
Among patients with sepsis in a large randomized trial, use of balanced crystalloids was associated with a lower 30-day in-hospital mortality compared with use of saline.Clinical trial registered with www.clinicaltrials.gov (NCT02444988).
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