The reionization of the universe by stars and quasars is expected to be a highly inhomogeneous process. Moreover, the fluctuations of the matter density field also lead to inhomogeneities of the free ...electron distribution. These patterns gave rise to secondary CMB anisotropies through Thomson scattering of photons by free electrons. In this article we present an analytic model, based on our previous work which tackled the reionization history of the universe, which allows us to describe the generation of these secondary CMB anisotropies. We take into account the "patchy pattern"of reionization (HII bubbles), the cross-correlations of these ionized regions, the small-scale fluctuations of the matter density field and the contribution from collapsed objects. For an open universe, we find that the angular correlation function $C(\theta)$ displays a very slow decline from $C(0) \sim 6 10^{-13}$ up to the scale $\theta \sim 10^{-3}$ rad where it shows a sharp drop. On the other hand, the power-spectrum $l(l+1)C_l/(2\pi)$ (and the "local average"Sl) exhibits a plateau of height ∼10-13 in the range $10^3 < l < 10^6$. We find that for large wavenumbers $l > 10^4$ the signal is dominated by the contribution from collapsed halos while for $l < 10^4$ it is governed by the large-scale correlations of HII bubbles. This implies that one cannot discriminate reionization by stars from a quasar-driven scenario since the size of ionized regions never dominates the behaviour of the anisotropies. Moreover, the secondary CMB anisotropies arise from a broad range of redshifts ($7.5 < z < 10$ for the IGM and $0< z< 7$ for galactic halos). Thus, we find that the generation of these anisotropies involves several intricate processes and they are close to the resolution limit of current numerical simulations. The signal expected in our model might bias the cosmological parameter estimation from CMB experiments such as Planck or MAP, and could be detected by future mm-wavelength interferometers (e.g., ALMA).
We describe different methods for estimating the bispectrum of cosmic microwave background data. In particular, we construct a minimum-variance estimator for the flat-sky limit and compare results ...with previously studied frequentist methods. Application to the MAXIMA data set shows consistency with primordial Gaussianity. Weak quadratic non-Gaussianity is characterized by a tunable parameter fNL, corresponding to non-Gaussianity at a level of ∼10−5fNL (the ratio of non-Gaussian to Gaussian terms), and we find limits of fNL= 1500 ± 950 for the minimum-variance estimator and fNL= 2700 ± 1650 for the usual frequentist estimator. These are the tightest limits on primordial non-Gaussianity, which include the full effects of the radiation transfer function.
Tropical forests are among the most biodiverse biomes on the planet. Nevertheless, quantifying the abundance and species richness within megadiverse groups is a significant challenge. We designed a ...study to address this challenge by documenting the variability of the insect fauna across a vertical canopy gradient in a Central Amazonian tropical forest. Insects were sampled over two weeks using 6-m Gressitt-style Malaise traps set at five heights (0 m-32 m-8 m intervals) on a metal tower in a tropical forest north of Manaus, Brazil. The traps contained 37,778 specimens of 18 orders of insects. Using simulation approaches and nonparametric analyses, we interpreted the abundance and richness of insects along this gradient. Diptera, Hymenoptera, and Coleoptera had their greatest abundance at the ground level, whereas Lepidoptera and Hemiptera were more abundant in the upper levels of the canopy. We identified species of 38 of the 56 families of Diptera, finding that 527 out of 856 species (61.6%) were not sampled at the ground level. Mycetophilidae, Tipulidae, and Phoridae were significantly more diverse and/or abundant at the ground level, while Tachinidae, Dolichopodidae, and Lauxaniidae were more diverse or abundant at upper levels. Our study suggests the need for a careful discussion of strategies of tropical forest conservation based on a much more complete understanding of the three-dimensional distribution of its insect diversity.
The primary objective of the study was to understand the public's perception of the effectiveness of Rhode Island's public health emergency response plans by using municipal H1N1 vaccination clinics ...conducted in Rhode Island in January and February 2010 as a basis for public reaction. The effect of previous exercises on public perception was also examined.
A survey of 926 H1N1 vaccination clinic attendees was conducted via mail during the period between March 18 and May 1, 2010.
A total of 579 surveys were returned, rendering a response rate of 62.5%. The majority of clinic attendees traveled ≤10 mi to the vaccination clinic (90.48%). The average self-reported wait time inside the clinic was 19.16 minutes, and 69.84% of respondents expected to have waited longer before attending the clinic. The self-reported wait time was negatively correlated with patient-reported overall clinic satisfaction. A total of 98.08% of respondents believed that the signage used at the clinics was easy to follow, 100% of respondents believed that the clinic staff was courteous and respectful, and 82.35% of respondents reported that they would rate the clinic they attended as excellent.
Rhode Islanders prefer local public health service sites. There was a minor difference in the overall satisfaction of respondents who attended municipal clinics that had exercised emergency plans before activation for H1N1 vaccinations and those municipalities that had not previously exercised. The lack of difference between the practicing and nonpracticing points-of-dispensing may be caused by the standardization of municipal emergency plans, uniformity in the guidance and support of each clinic provided by the Rhode Island Department of Health, and municipalities that had not previously exercised had the opportunity to observe those that had exercised. Having thorough mass dispensing plans in place in advance of a public health emergency is as important as having exercised a point-of-dispensing before a real-world activation.
Acute renal replacement therapy (RRT) is indicated when metabolic and fluid demands exceed total kidney capacity, and demand for kidney function is determined by non-renal comorbidities, severity of ...acute disease and solute and fluid burden; therefore, the criteria for commencing RRT and dialysis in intensive care units (ICUs) may be different to those outside ICUs.
We investigated whether criteria for commencing acute RRT and dialysis outside ICU were different to those in ICU and whether these differences affected patient mortality in either setting.
We performed a retrospective observational study evaluating acute kidney injury (AKI), Kidney Disease Improving Global Outcome 3 (KDIGO3) in adult patients undergoing RRT "in and outside" ICU from 2012 to 2018, in a Brazilian teaching hospital.
We evaluated 913 adults with AKI KDIGO3 undergoing RRT; 629 (68.9%) outside ICU and 284 (31.1%) in ICU. Infections were the main cause of hospitalisation (34.4%). Septic and ischaemic AKI were the main aetiologies of AKI (50.8% and 32.9%, respectively), metabolic and fluid demand to capacity imbalance were the main indications for dialysis (69.7%), and intermittent haemodialysis (IHD) was the primary dialysis method (59.2%). The general mortality rate after 30 days was 59%. There were no differences in gender, age and main diagnosis between groups. Both groups were different in acute tubular necrosis index specific scores (ATN-ISS), AKI aetiology, elderly population, indications for dialysis, dialysis methods and mortality rates. In ICU, patients older than 65 years old, with septic AKI were more prevalent (49.1 versus 41.4%, and 55.1 versus 37.5%, respectively), while ischaemic and nephrotoxic AKI were less frequent (24.3 versus 37 and 10.2 versus 16.3%, respectively), and ATN-ISS was higher (0.74 ± 0.31 versus 0.58 ± 0.16). Similarly, metabolic and fluid demand to capacity imbalance as an indication for acute RRT, prolonged intermittent haemodialysis (PIRRT) and continuous renal replacement therapy (CRRT) were more frequent, while peritoneal dialysis (PD) was less frequent (74.6 versus 69.7%, 31.6 versus 22.4%, and 5.3 versus 17.8%, respectively), and mortality was higher (69 versus 54.7%, respectively). Logistic regression revealed that age, septic AKI and being "in" ICU were factors associated with death.
The criteria for commencing RRT and dialysis in ICU were different to those outside ICU; however, they did not impact on patient outcomes.
Background: There are multiple equations for predicting resting energy expenditure (REE), but how accurate they are in severe acute kidney injury (AKI) patients is not clear. Our aim was to determine ...if predictive equations for estimated REE accurately reflect the requirements of AKI patients. Methods: We included in this prospective and observational study AKI patients AKIN-3 assessed by indirect calorimetry (IC). Bland-Altman, intraclass correlation coefficient and precision (percentagem of predicted values within 10% of measured values) were performed to compare REE by equations with REE measured by IC. Results: IC was applied in 125 AKI patients. The mean age was 62.5 ± 16.6 and 65.6% were male. Mean REE measured was 2,029.11 ± 760.4 kcal/day. There were low precision, and poor agreement between measured and predicted REE by the Harris-Benedict (HB), Mifflin, Ireton-Jones, Penn state, American College of Chest Physicians, and Faisy equations. HB without using injury factor was the least precise (18% of precision). Modified Penn state equation had the best precision, although the precision rate was only 41%. For all equations, the limits of agreement range were large leading to the potential under or overfeeding of individual patients. Conclusion: None of these equations accurately estimated measured REE in severe AKI patients and most of them underestimated energy needs.
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