Copyright © 2016 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. Objective: To characterize sedation weaning patterns in typical practice settings among children recovering from critical illness. Design: A descriptive secondary analysis of data that were prospectively collected during the prerandomization phase (January to July 2009) of a clinical trial of sedation management. Setting: Twenty-two PICUs across the United States. Patients: The sample included 145 patients, aged 2 weeks to 17 years, mechanically ventilated for acute respiratory failure who received at least five consecutive days of opioid exposure. Interventions: None. Measurements and Main Results: Group comparisons were made between patients with an intermittent weaning pattern, defined as a 20% or greater increase in daily opioid dose after the start of weaning, and the remaining patients defined as having a steady weaning pattern. Demographic and clinical characteristics, tolerance to sedatives, and iatrogenic withdrawal symptoms were evaluated. Sixty-six patients (46%) were intermittently weaned; 79 patients were steadily weaned. Prior to weaning, intermittently weaned patients received higher peak and cumulative doses and longer exposures to opioids and benzodiazepines, demonstrated more sedative tolerance (58% vs 41%), and received more chloral hydrate and barbiturates compared with steadily weaned patients. During weaning, intermittently weaned patients assessed for withdrawal had a higher incidence of Withdrawal Assessment Tool-version 1 scores of greater than or equal to 3 (85% vs 46%) and received more sedative classes compared with steadily weaned patients. Conclusions: This study characterizes sedative administration practices for pediatric patients prior to and during weaning from sedation after critical illness. It provides a novel methodology for describing weaning in an at-risk pediatric population that may be helpful in future research on weaning strategies to prevent iatrogenic withdrawal syndrome.

© 2017 Elsevier Inc. Objective To evaluate whether race or ethnicity was independently associated with parental refusal of consent for their child's participation in a multisite pediatric critical care clinical trial. Study design We performed a secondary analyses of data from Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE), a 31-center cluster randomized trial of sedation management in critically ill children with acute respiratory failure supported on mechanical ventilation. Multivariable logistic regression modeling estimated associations between patient race and ethnicity and parental refusal of study consent. Result Among the 3438 children meeting enrollment criteria and approached for consent, 2954 had documented race/ethnicity of non-Hispanic White (White), non-Hispanic Black (Black), or Hispanic of any race. Inability to approach for consent was more common for parents of Black (19.5%) compared with White (11.7%) or Hispanic children (13.2%). Among those offered consent, parents of Black (29.5%) and Hispanic children (25.9%) more frequently refused consent than parents of White children (18.2%, P<.0167 for each). Compared with parents of White children, parents of Black (OR 2.15, 95% CI 1.56-2.95, P<.001) and Hispanic (OR 1.44, 95% CI 1.10-1.88, P=.01) children were more likely to refuse consent. Parents of children offered participation in the intervention arm were more likely to refuse consent than parents in the control arm (OR 2.15, 95% CI 1.37-3.36, P<.001). Conclusions Parents of Black and Hispanic children were less likely to be approached for, and more frequently declined consent for, their child's participation in a multisite critical care clinical trial. Ameliorating this racial disparity may improve the validity and generalizability of study findings. Trial registration ClinicalTrials.gov: NCT00814099.

This white paper addresses the hypothesis of light sterile neutrinos based on recent anomalies observed in neutrino experiments and the latest astrophysical data.

© 2017, The Author(s). Using decays to ϕ-meson pairs, the inclusive production of charmonium states in b-hadron decays is studied with pp collision data corresponding to an integrated luminosity of 3.0fb-1, collected by the LHCb experiment at centre-of-mass energies of 7 and 8 TeV. Denoting by BC≡B(b→CX)×B(C) the inclusive branching fraction of a b hadron to a charmonium state C that decays into a pair of ϕ mesons, ratios RC2C1≡BC1/BC2 are determined as Rηc(1S)χc0=0.147±0.023±0.011, Rηc(1S)χc1=0.073±0.016±0.006, Rηc(1S)χc2=0.081±0.013±0.005, Rχc0χc1=0.50±0.11±0.01, Rχc0χc2=0.56±0.10±0.01 and Rηc(1S)ηc(2S)=0.040±0.011±0.004. Here and below the first uncertainties are statistical and the second systematic. Upper limits at 90% confidence level for the inclusive production of X(3872), X(3915) and χ c2(2 P) states are obtained as Rχc1X(3872)<0.34, Rχc0X(3915)<0.12 and Rχc2χc2(2P)<0.16. Differential cross-sections as a function of transverse momentum are measured for the ηc(1 S) and χc states. The branching fraction of the decay Bs0 is measured for the first time, B(Bs0)=(2.15±0.54±0.28±0.21B)×10-6. Here the third uncertainty is due to the branching fraction of the decay Bs0, which is used for normalization. No evidence for intermediate resonances is seen. A preferentially transverse ϕ polarization is observed. The measurements allow the determination of the ratio of the branching fractions for the ηc(1 S) decays to ϕϕ and pp¯ as B(ηc(1S))/B(ηc(1S)→pp¯)=1.79±0.14±0.32.

© 2019, The Author(s). Using pp collisions corresponding to 3 fb −1 integrated luminosity, recorded by the LHCb experiment at centre-of-mass energies of 7 and 8 TeV, the ratio of branching fractionsℬ(Λb0→ψ(2S)Λ)/ℬ(Λb0→J/ψΛ)=0.513±0.023(stat)±0.016(syst)±0.011(ℬ)is determined. The first uncertainty is statistical, the second is systematic and the third is due to the external branching fractions used.[Figure not available: see fulltext.]