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The detection of the Epoch of Reionization (EoR) delay power spectrum using a 'foreground avoidance method' highly depends on the instrument chromaticity. The systematic effects induced by the radio telescope spread the foreground signal in the delay domain, which contaminates the EoR window theoretically observable. Applied to the Hydrogen Epoch of Reionization Array (HERA), this paper combines detailed electromagnetic and electrical simulations in order to model the chromatic effects of the instrument, and quantify its frequency and time responses. In particular, the effects of the analogue receiver, transmission cables, and mutual coupling are included. These simulations are able to accurately predict the intensity of the reflections occurring in the 150-m cable which links the antenna to the backend. They also show that electromagnetic waves can propagate from one dish to another one through large sections of the array due to mutual coupling. The simulated system time response is attenuated by a factor 104 after a characteristic delay which depends on the size of the array and on the antenna position. Ultimately, the system response is attenuated by a factor 105 after 1400 ns because of the reflections in the cable, which corresponds to characterizable ka-modes above 0.7 $h\,\,\rm {Mpc}^{-1}$ at 150 MHz. Thus, this new study shows that the detection of the EoR signal with HERA Phase I will be more challenging than expected. On the other hand, it improves our understanding of the telescope, which is essential to mitigate the instrument chromaticity.

Characterizing the epoch of reionization (EoR) at z 6 via the redshifted 21 cm line of neutral Hydrogen (H i) is critical to modern astrophysics and cosmology, and thus a key science goal of many current and planned low-frequency radio telescopes. The primary challenge to detecting this signal is the overwhelmingly bright foreground emission at these frequencies, placing stringent requirements on the knowledge of the instruments and inaccuracies in analyses. Results from these experiments have largely been limited not by thermal sensitivity but by systematics, particularly caused by the inability to calibrate the instrument to high accuracy. The interferometric bispectrum phase is immune to antenna-based calibration and errors therein, and presents an independent alternative to detect the EoR H i fluctuations while largely avoiding calibration systematics. Here, we provide a demonstration of this technique on a subset of data from the Hydrogen Epoch of Reionization Array (HERA) to place approximate constraints on the brightness temperature of the intergalactic medium (IGM). From this limited data, at z=7.7 we infer "1σ"upper limits on the IGM brightness temperature to be ≤ 316 "pseudo"mK at κ =0.33 "pseudo"h Mpc-1 (data-limited) and ≤ 1000 "pseudo"mK at κ =0.875 "pseudo"h Mpc-1 (noise-limited). The "pseudo"units denote only an approximate and not an exact correspondence to the actual distance scales and brightness temperatures. By propagating models in parallel to the data analysis, we confirm that the dynamic range required to separate the cosmic H i signal from the foregrounds is similar to that in standard approaches, and the power spectrum of the bispectrum phase is still data-limited (at 106 dynamic range) indicating scope for further improvement in sensitivity as the array build-out continues.

The key challenge in the observation of the redshifted 21-cm signal from cosmic reionization is its separation from the much brighter foreground emission. Such separation relies on the different spectral properties of the two components, although, in real life, the foreground intrinsic spectrum is often corrupted by the instrumental response, inducing systematic effects that can further jeopardize the measurement of the 21-cm signal. In this paper, we use Gaussian Process Regression to model both foreground emission and instrumental systematics in ∼2 h of data from the Hydrogen Epoch of Reionization Array. We find that a simple co-variance model with three components matches the data well, giving a residual power spectrum with white noise properties. These consist of an 'intrinsic' and instrumentally corrupted component with a coherence scale of 20 and 2.4 MHz, respectively (dominating the line-of-sight power spectrum over scales kâ ≤ 0.2 h cMpc-1) and a baseline-dependent periodic signal with a period of ∼1 MHz (dominating over kâ ∼0.4-0.8 h cMpc-1), which should be distinguishable from the 21-cm Epoch of Reionization signal whose typical coherence scale is ∼0.8 MHz.

In 21-cm cosmology, precision calibration is key to the separation of the neutral hydrogen signal from very bright but spectrally smooth astrophysical foregrounds. The Hydrogen Epoch of Reionization Array (HERA), an interferometer specialized for 21-cm cosmology and now under construction in South Africa, was designed to be largely calibrated using the self-consistency of repeated measurements of the same interferometric modes. This technique, known as redundant-baseline calibration resolves most of the internal degrees of freedom in the calibration problem. It assumes, however, on antenna elements with identical primary beams placed precisely on a redundant grid. In this work, we review the detailed implementation of the algorithms enabling redundant-baseline calibration and report results with HERA data.We quantify the effects of real-world non-redundancy and how they compare to the idealized scenario in which redundant measurements differ only in their noise realizations. Finally, we study how non-redundancy can produce spurious temporal structure in our calibration solutions-both in data and in simulations-and present strategies for mitigating that structure.

Foreground power dominates the measurements of interferometers that seek a statistical detection of highly-redshifted H i emission from the Epoch of Reionization (EoR). The chromaticity of the instrument creates a boundary in the Fourier transform of frequency (proportional to k ∥) between spectrally smooth emission, characteristic of the strong synchrotron foreground (the "wedge"), and the spectrally structured emission from H i in the EoR (the "EoR window"). Faraday rotation can inject spectral structure into otherwise smooth polarized foreground emission, which through instrument effects or miscalibration could possibly pollute the EoR window. For instruments pursuing a "foreground avoidance" strategy of simply measuring in the EoR window, and not attempting to model and remove foregrounds, as is the plan for the first stage of the Hydrogen Epoch of Reionization Array (HERA), characterizing the intrinsic instrument polarization response is particularly important. Using data from the HERA 19-element commissioning array, we investigate the polarization response of this new instrument in the power-spectrum domain. We perform a simple image-based calibration based on the unpolarized diffuse emission of the Global Sky Model, and show that it achieves qualitative redundancy between the nominally redundant baselines of the array and reasonable amplitude accuracy. We construct power spectra of all fully polarized coherencies in all pseudo-Stokes parameters, and discuss the achieved isolation of foreground power due to the intrinsic spectral smoothness of the foregrounds, the instrument chromaticity, and the calibration. We compare to simulations based on an unpolarized diffuse sky model and detailed electromagnetic simulations of the dish and feed, confirming that in Stokes I, the calibration does not add significant spectral structure beyond that expected from the interferometer array configuration and the modeled primary beam response. Furthermore, this calibration is stable over the 8 days of observations considered. Excess power is seen in the power spectra of the linear polarization Stokes parameters, which is not easily attributable to leakage via the primary beam, and results from some combination of residual calibration errors and actual polarized emission. Stokes V is found to be highly discrepant from the expectation of zero power, strongly pointing to the need for more accurate polarized calibration.

In this erratum, we retract the upper limits on the 21 cm power spectrum presented in the published article. The published article reported an upper limit on δ 212(k ) of (22.4 mK)2 at z= 8.4 in the range 0.15 < k < 0.5h Mpc-1. This analysis underestimated the level of signal loss, or attenuation of the target cosmological 21 cm signal associated with the chosen power spectrum estimator, and also underestimated the statistical error on those estimates. A revised result, with a new analysis, is presented in M. K. Kolopanis et al. (2018, in preparation). Below, we briefly summarize the errors in the original analysis and how they are corrected. For an indepth analysis and discussion of the errors, we refer the reader to Cheng et al. (2018). Signal loss was expected in the original analysis because the covariance matrices, C, used to weight the un-normalized bandpower estimates, qa, in (Formula Presented) were empirically estimated from a time-averaged finite ensemble of the data, x, such that (Formula Presented). While the true covariance C leads to an inherently unbiased lossless estimator of the power spectrum, using an empirically estimated Ĉ can lead to signal loss. Specifically, weighting data by an empirically estimated covariance carries the risk of overfitting and downweighting EoR fluctuations that are coupled to the data. In Cheng et al. (2018), it is shown that these couplings are especially strong in the fringe-rate filtered PAPER-64 data set. The first and most impactful error relates to the method by which signal loss was estimated. To assess signal loss from the empirically estimated covariance matrix, different realizations of mock cosmological signals e of known amplitudes are added to the original data to form a new data vector, (Formula Presented). New covariance matrices, (Formula Presented) are used to estimate un-normalized bandpowers (Formula Presented), which can be written as (Formula Presented). The normalized power estimate can then be compared to the known injected power in e to estimate signal loss. The key error in the previous analysis was to assume that, since e was statistically independent of x, that the two middle crossterms in Equation (2) would average to zero in an ensemble. However, as shown in Cheng et al. (2018) and Switzer et al. (2015), these cross-terms can contain significant negative power because Ĉr contains information that correlates the two vectors. Ignoring these cross-terms leads to a significant underestimate of signal loss. As a result, we presented negligible signal loss in our original analysis, when in fact approximately 99.99% of the signal was removed (Cheng et al. 2018). Correcting for the actual signal loss is the biggest factor revising the upper limit on 21 D2 . The second mistake made in the original analysis was to underestimate the statistical errors in the reported power spectrum estimates. The original analysis used a bootstrap resampling technique on power spectral measurements over the baseline and time axes. However, fringe-rate filtering introduces significant correlations in the data along the time axis. As is discussed in Cheng et al. (2018), bootstrapping across correlated samples can result in a significant underestimate of the variation in the data if the number of resamplings is not equal to the number of independent samples in the data, as in the case of the original analysis. The error bars associated with this oversampling were underestimated by approximately a factor of 2 (in mK). The revised analysis in M. K. Kolopanis et al. (2018, in preparation) only applies bootstrap resampling across the baseline axis to avoid this problem. The mistake in estimating the statistical errors should have become apparent when comparing results to our theoretical thermal noise sensitivity. Unfortunately, a third miscalculation was made in estimating the thermal noise sensitivity. As detailed in Cheng et al. (2018), this miscalculation stemmed from numerous small mismatches between the idealized analysis pipeline used to estimate sensitivity and the actual analysis applied to the data. As a result, our estimated thermal noise sensitivity was approximately a factor of 3 low (in mK), leading to the mistaken impression that our error bars were consistent with the level of thermal noise. In summary, we retract the power spectrum results shown in Figures 18 and 20 in the published article. Results that relied on the original limits, including those presented in Figure 21, are retracted. Additionally, the companion paper to the original manuscript, Pober et al. (2015), used the original limits to place constraints on the spin temperature of the intergalactic medium (IGM) at z=8.4. Our revised limits do not place significant constraints on the IGM temperature, and the results of Figure 4 from Pober et al. (2015) should be disregarded. However, we note that their analysis would still be relevant should a future experiment place constraints on the 21 cm signal similar to those claimed in the published article. An updated analysis of this same data set is presented in M. K. Kolopanis et al. (2018, in preparation), where these revised results are put into context with measurements at other redshifts.

21 cm cosmology is a promising new probe of the evolution of visible matter in our universe, especially during the poorly constrained Cosmic Dawn and Epoch of Reionization. However, in order to separate the 21 cm signal from bright astrophysical foregrounds, we need an exquisite understanding of our telescopes so as to avoid adding spectral structure to spectrally smooth foregrounds. One powerful calibration method relies on repeated simultaneous measurements of the same interferometric baseline to solve for the sky signal and for instrumental parameters simultaneously. However, certain degrees of freedom are not constrained by asserting internal consistency between redundant measurements. In this paper, we review the origin of these degeneracies of redundant-baseline calibration and demonstrate how they can source unwanted spectral structure in our measurement and show how to eliminate that additional, artificial structure. We also generalize redundant calibration to dual-polarization instruments, derive the degeneracy structure, and explore the unique challenges to calibration and preserving spectral smoothness presented by a polarized measurement.

Spectral structures due to the instrument response is the current limiting factor for the experiments attempting to detect the redshifted 21 cm signal from the Epoch of Reionization (EoR). Recent advances in the delay spectrum methodology for measuring the redshifted 21 cm EoR power spectrum brought new attention to the impact of an antenna’s frequency response on the viability of making this challenging measurement. The delay spectrum methodology provides a somewhat straightforward relationship between the time-domain response of an instrument that can be directly measured and the power spectrum modes accessible to a 21 cm EoR experiment. In this paper, we derive the explicit relationship between antenna reflection coefficient (S11) measurements made by a Vector Network Analyzer (VNA) and the extent of additional foreground contaminations in delay space. In the light of this mathematical framework, we examine the chromaticity of a prototype antenna element that will constitute the Hydrogen Epoch of Reionization Array (HERA) between 100 and 200 MHz. These reflectometry measurements exhibit additional structures relative to electromagnetic simulations, but we find that even without any further design improvement, such an antenna element will support measuring spatial k modes with line-of-sight components of k∥ > 0.2h Mpc− 1. We also find that when combined with the powerful inverse covariance weighting method used in optimal quadratic estimation of redshifted 21 cm power spectra the HERA prototype elements can successfully measure the power spectrum at spatial modes as low as k∥ > 0.1h Mpc− 1. This work represents a major step toward understanding the HERA antenna element and highlights a straightforward method for characterizing instrument response for future experiments designed to detect the 21 cm EoR power spectrum.

We present ALMA [CI]($1-0$) (rest frequency 492 GHz) observations for asample of 13 strongly-lensed dusty star-forming galaxies originally discoveredat 1.4mm in a blank-field survey by the South Pole Telescope. We compare thesenew data with available [CI] observations from the literature, allowing a studyof the ISM properties of $\sim 30$ extreme dusty star-forming galaxies spanninga redshift range $2 < z < 5$. Using the [CI] line as a tracer of the molecularISM, we find a mean molecular gas mass for SPT-DSFGs of $6.6 \times 10^{10}$M$_{\odot}$. This is in tension with gas masses derived via low-$J$ $^{12}$COand dust masses; bringing the estimates into accordance requires either (a) anelevated CO-to-H$_2$ conversion factor for our sample of $\alpha_{\rm CO} \sim2.5$ and a gas-to-dust ratio $\sim200$, or (b) an high carbon abundance $X_{\rmCI} \sim 7\times10^{-5}$. Using observations of a range of additional atomicand molecular lines (including [CI], [CII], and multiple transitions of CO), weuse a modern Photodissociation Region code (3D-PDR) to assess the physicalconditions (including the density, UV radiation field strength, and gastemperature) within the ISM of the DSFGs in our sample. We find that the ISMwithin our DSFGs is characterised by dense gas permeated by strong UV fields.We note that previous efforts to characterise PDR regions in DSFGs may havesignificantly underestimated the density of the ISM. Combined, our analysissuggests that the ISM of extreme dusty starbursts at high redshift consists ofdense, carbon-rich gas not directly comparable to the ISM of starbursts in thelocal Universe.

We present ALMA [CI]($1-0$) (rest frequency 492 GHz) observations for asample of 13 strongly-lensed dusty star-forming galaxies originally discoveredat 1.4mm in a blank-field survey by the South Pole Telescope. We compare thesenew data with available [CI] observations from the literature, allowing a studyof the ISM properties of $\sim 30$ extreme dusty star-forming galaxies spanninga redshift range $2 < z < 5$. Using the [CI] line as a tracer of the molecularISM, we find a mean molecular gas mass for SPT-DSFGs of $6.6 \times 10^{10}$M$_{\odot}$. This is in tension with gas masses derived via low-$J$ $^{12}$COand dust masses; bringing the estimates into accordance requires either (a) anelevated CO-to-H$_2$ conversion factor for our sample of $\alpha_{\rm CO} \sim2.5$ and a gas-to-dust ratio $\sim200$, or (b) an high carbon abundance $X_{\rmCI} \sim 7\times10^{-5}$. Using observations of a range of additional atomicand molecular lines (including [CI], [CII], and multiple transitions of CO), weuse a modern Photodissociation Region code (3D-PDR) to assess the physicalconditions (including the density, UV radiation field strength, and gastemperature) within the ISM of the DSFGs in our sample. We find that the ISMwithin our DSFGs is characterised by dense gas permeated by strong UV fields.We note that previous efforts to characterise PDR regions in DSFGs may havesignificantly underestimated the density of the ISM. Combined, our analysissuggests that the ISM of extreme dusty starbursts at high redshift consists ofdense, carbon-rich gas not directly comparable to the ISM of starbursts in thelocal Universe.

We use the Atacama Large Millimeter/submillimeter Array (ALMA) in Cycle 1 to determine spectroscopic redshifts of high-redshift dusty star-forming galaxies (DSFGs) selected by their 1.4 mm continuum emission in the South Pole Telescope (SPT) survey. We present ALMA 3 mm spectral scans between 84 and 114 GHz for 15 galaxies and targeted ALMA 1 mm observations for an additional eight sources. Our observations yield 30 new line detections from CO, [C i], [N ii], H2O and NH3. We further present Atacama Pathfinder Experiment [C ii] and CO mid-J observations for seven sources for which only a single line was detected in spectral-scan data from ALMA Cycle 0 or Cycle 1. We combine the new observations with previously published and new millimeter/submillimeter line and photometric data of the SPT-selected DSFGs to study their redshift distribution. The combined data yield 39 spectroscopic redshifts from molecular lines, a success rate of >85%. Our sample represents the largest data set of its kind today and has the highest spectroscopic completeness among all redshift surveys of high-z DSFGs. The median of the redshift distribution is z = 3.9 ±0.4, and the highest-redshift source in our sample is at z = 5.8. We discuss how the selection of our sources affects the redshift distribution, focusing on source brightness, selection wavelength, and strong gravitational lensing. We correct for the effect of gravitational lensing and find the redshift distribution for 1.4 mm selected sources with a median redshift of z = 3.1 ±0.3. Comparing to redshift distributions selected at shorter wavelengths from the literature, we show that selection wavelength affects the shape of the redshift distribution.

We present constraints on both the kinetic temperature of the intergalactic medium (IGM) at z = 8.4, and on models for heating the IGM at high-redshift with X-ray emission from the first collapsed objects. These constraints are derived using a semi-analytic method to explore the new measurements of the 21 cm power spectrum from the Donald C. Backer Precision Array for Probing the Epoch of Reionization (PAPER), which were presented in a companion paper, Ali et al. Twenty-one cm power spectra with amplitudes of hundreds of mK2 can be generically produced if the kinetic temperature of the IGM is significantly below the temperature of the cosmic microwave background (CMB); as such, the new results from PAPER place lower limits on the IGM temperature at z = 8.4. Allowing for the unknown ionization state of the IGM, our measurements find the IGM temperature to be above ≈5 K for neutral fractions between 10% and 85%, above ≈7 K for neutral fractions between 15% and 80%, or above ≈10 K for neutral fractions between 30% and 70%. We also calculate the heating of the IGM that would be provided by the observed high redshift galaxy population, and find that for most models, these galaxies are sufficient to bring the IGM temperature above our lower limits. However, there are significant ranges of parameter space that could produce a signal ruled out by the PAPER measurements; models with a steep drop-off in the star formation rate density at high redshifts or with relatively low values for the X-ray to star formation rate efficiency of high redshift galaxies are generally disfavored. The PAPER measurements are consistent with (but do not constrain) a hydrogen spin temperature above the CMB temperature, a situation which we find to be generally predicted if galaxies fainter than the current detection limits of optical/NIR surveys are included in calculations of X-ray heating.

In this paper, we report new limits on 21 cm emission from cosmic reionization based on a 135 day observing campaign with a 64-element deployment of the Donald C. Backer Precision Array for Probing the Epoch of Reionization in South Africa. This work extends the work presented in Parsons et al. with more collecting area, a longer observing period, improved redundancy-based calibration, improved fringe-rate filtering, and updated power-spectral analysis using optimal quadratic estimators. The result is a new 2σ upper limit on Δ2(k) of (22.4 mK)2 in the range < k < 0.5h Mpc-1 at z = 8.4. This represents a three-fold improvement over the previous best upper limit. As we discuss in more depth in a forthcoming paper, this upper limit supports and extends previous evidence against extremely cold reionization scenarios. We conclude with a discussion of implications for future 21 cm reionization experiments, including the newly funded Hydrogen Epoch of Reionization Array.

We present [C II] observations of 20 strongly lensed dusty star-forming galaxies at 2.1 < z < 5.7 using Atacama Pathfinder EXperiment and Herschel. The sources were selected on their 1.4 mm flux (S1.4mm > 20 mJy) from the South Pole Telescope (SPT) survey, with far-infrared (FIR) luminosities determined from extensive photometric data. The [CII] line is robustly detected in 17 sources, all but one being spectrally resolved. 11 out of 20 sources observed in [C II] also have low-J CO detections from Australia Telescope Compact Array. A comparison with mid- and high-J CO lines from Atacama Large Millimeter/submillimeter Array reveals consistent [C II] and CO velocity profiles, suggesting that there is little differential lensing between these species. The [C II], low-J CO and FIR data allow us to constrain the properties of the interstellar medium. We find [C II] to CO(1-0) luminosity ratios in the SPT sample of 5200 ± 1800, with significantly less scatter than in other samples. This line ratio can be best described by a medium of [C II] and CO emitting gas with a higher [C II] than CO excitation temperature, high CO optical depth τ CO(1-0) ≫ 1, and low to moderate [CII] optical depth τ[C II]≲ 1. The geometric structure of photodissociation regions allows for such conditions.

We present the average rest-frame spectrum of high-redshift dusty, star-forming galaxies from 250 to 770 GHz. This spectrum was constructed by stacking Atacama Large Millimeter/submillimeter Array (ALMA) 3 mm spectra of 22 such sources discovered by the South Pole Telescope and spanning z = 2.0-5.7. In addition to multiple bright spectral features of 12CO, [C I], and H 2O, we also detect several faint transitions of 13CO, HCN, HNC, HCO+, and CN, and use the observed line strengths to characterize the typical properties of the interstellar medium of these high-redshift starburst galaxies. We find that the 13CO brightness in these objects is comparable to that of the only other z > 2 star-forming galaxy in which 13CO has been observed. We show that the emission from the high-critical density molecules HCN, HNC, HCO+, and CN is consistent with a warm, dense medium with T kin 55 K and cm-3. High molecular hydrogen densities are required to reproduce the observed line ratios, and we demonstrate that alternatives to purely collisional excitation are unlikely to be significant for the bulk of these systems. We quantify the average emission from several species with no individually detected transitions, and find emission from the hydride CH and the linear molecule CCH for the first time at high redshift, indicating that these molecules may be powerful probes of interstellar chemistry in high-redshift systems. These observations represent the first constraints on many molecular species with rest-frame transitions from 0.4 to 1.2 mm in star-forming systems at high redshift, and will be invaluable in making effective use of ALMA in full science operations. © 2014. The American Astronomical Society. All rights reserved..

We present observations of SPT-S J053816-5030.8, a gravitationally lensed dusty star-forming galaxy (DSFG) at z = 2.7817 that was first discovered at millimeter wavelengths by the South Pole Telescope. SPT 0538-50 is typical of the brightest sources found by wide-field millimeter-wavelength surveys, being lensed by an intervening galaxy at moderate redshift (in this instance, at z = 0.441). We present a wide array of multi-wavelength spectroscopic and photometric data on SPT 0538-50, including data from ALMA, Herschel PACS and SPIRE, Hubble, Spitzer, the Very Large Telescope, ATCA, APEX, and the Submillimeter Array. We use high-resolution imaging from the Hubble Space Telescope to de-blend SPT 0538-50, separating DSFG emission from that of the foreground lens. Combined with a source model derived from ALMA imaging (which suggests a magnification factor of 21 ± 4), we derive the intrinsic properties of SPT 0538-50, including the stellar mass, far-IR luminosity, star formation rate, molecular gas mass, and - using molecular line fluxes - the excitation conditions within the interstellar medium. The derived physical properties argue that we are witnessing compact, merger-driven star formation in SPT 0538-50 similar to local starburst galaxies and unlike that seen in some other DSFGs at this epoch. © 2013. The American Astronomical Society. All rights reserved..

We present observations of SPT-S J053816-5030.8, a gravitationally lensed dusty star-forming galaxy (DSFG) at z = 2.7817 that was first discovered at millimeter wavelengths by the South Pole Telescope. SPT 0538-50 is typical of the brightest sources found by wide-field millimeter-wavelength surveys, being lensed by an intervening galaxy at moderate redshift (in this instance, at z = 0.441). We present a wide array of multi-wavelength spectroscopic and photometric data on SPT 0538-50, including data from ALMA, Herschel PACS and SPIRE, Hubble, Spitzer, the Very Large Telescope, ATCA, APEX, and the Submillimeter Array. We use high-resolution imaging from the Hubble Space Telescope to de-blend SPT 0538-50, separating DSFG emission from that of the foreground lens. Combined with a source model derived from ALMA imaging (which suggests a magnification factor of 21 ± 4), we derive the intrinsic properties of SPT 0538-50, including the stellar mass, far-IR luminosity, star formation rate, molecular gas mass, and - using molecular line fluxes - the excitation conditions within the interstellar medium. The derived physical properties argue that we are witnessing compact, merger-driven star formation in SPT 0538-50 similar to local starburst galaxies and unlike that seen in some other DSFGs at this epoch. © 2013. The American Astronomical Society. All rights reserved..

Background: Low muscle mass is common in hospitalized patients. It is associated with adverse clinical outcomes. Reported prevalence varies widely due to non-universally accepted diagnostic criteria and the heterogeneity of the populations studied. Non-surgical ill patients are underrepresented in the literature., Aims: To estimate the prevalence of low muscle index and its impact on survival in patients admitted to an internal medicine unit., Methods: We prospectively enrolled patients with abdominal CT scans on admission to the Internal Medicine ward. We assessed muscle mass index (L3MI) at the level of the L3 lumbar vertebra. The primary outcome was to estimate the prevalence of low muscle mass on admission. Secondary outcomes were to determine the relationship of low L3MI with hospital mortality, length of stay, nosocomial infections, and hospital readmission., Results: One hundred and seven patients were included. The prevalence of low L3MI was 46.7%. An L3MI of 46.3 cm 2 /m 2 in men and 40.9 cm 2 /m 2 in women predicted death at one year with a sensitivity of 66% and a specificity of 78% (AUC = 0.62 [95% CI 0.38-0.86]) and 69 and 66% (AUC of 0.63 [95% IC 0.47-0.78]), respectively. In-hospital mortality, death at 60, 90, and 360 d, and hospital readmission were significantly higher in patients with low L3MI., Conclusion: Almost half of the patients admitted to an internal medicine ward have low muscle mass index. The cutoff point of 40.9 cm 2 /m 2 in females and 46.3 cm 2 /m 2 in males predicts relevant clinical variables. We established the better L3MI cutoff value to predict 12-month mortality., Competing Interests: Conflicts of interest In compliance with the International Committee of Medical Journal Editors (ICMJE) Uniform Disclosure Form, all authors declare that they have received no financial support from any organization for the work submitted. None of the researchers has any current or prior relationship with financial or commercial institutions interested in publishing this paper., (Copyright © 2024 Instituto Mexicano del Seguro Social (IMSS). Published by Elsevier Inc. All rights reserved.)

Rocky Mountain spotted fever (RMSF) is an ongoing public health crisis in Mexico, particularly in states bordering the United States. The national highest incidence and mortality of RMSF occur in this region, resulting in a case-fatality rate that ranges annually between 10% and 50%, primarily affecting vulnerable groups such as children, elderly adults, and persons living in poverty. Multiple biological, environmental, and social determinants can explain its growing presence throughout the country and how it challenges the health system and society. It is necessary to integrate resources and capacities from health authorities, research centers, and society to succeed in dealing with this problem. Through a scientific symposium, a group of academicians, U.S. health officials, and Mexican health authorities met on November 8-10, 2023, in Hermosillo, Mexico, to discuss the current situation of RMSF across the country and the challenges associated with its occurrence. An urgent call for action to improve national capacity against RMSF in the aspects of epidemiological and acarological surveillance, diagnosis, medical care, case and outbreak prevention, health promotion, and research was urged by the experts. The One Health approach is a proven multidisciplinary strategy to integrate policies and interventions to mitigate and prevent the burden of cases, deaths, and suffering caused by RMSF in Mexico.

Introduction: In the context of the COVID-19 pandemic, there is concern regarding the impact of the influenza season., Objective: To analyze the impact of influenza immunization history on patients with SARS-CoV-2 infection., Methods: Patients older than 18 years with COVID-19, registered between March and August 2020, were included. Data were analyzed using Fisher's exact test and Student's t-test. To evaluate the impact on mortality, a logistic regression model was used; the relationship between the percentage of patients who received the influenza vaccine and mortality was determined with Pearson's correlation coefficient., Results: 16,879 participants were included; 17 % had a history of influenza vaccination. Mortality was lower in the group with a history of vaccination (3.5 % vs. 7 %, p < 0.0001). The vaccination rate had an inverse relationship with the mortality rate (Pearson's r: -0.922, p = 0.026)., Conclusions: Previous influenza immunization was an independent protective factor for mortality in patients with COVID-19. Although further studies are needed to determine a causal relationship, it would be reasonable to increase influenza immunization in the general population., (Copyright: © 2020 Permanyer.)

Increased T helper (Th)1/Th17 immune responses are a hallmark of Crohn's disease (CD) immunopathogenesis. CD90+ (myo-)fibroblasts (MFs) are abundant cells in the normal (N) intestinal mucosa contributing to mucosal tolerance via suppression of Th1 cell activity through cell surface membrane-bound PD-L1 (mPD-L1). CD-MFs have a decreased level of mPD-L1. Consequently, mPD-L1-mediated suppression of Th1 cells by CD-MFs is decreased, yet the mechanism responsible for the reduction in mPDL-1 is unknown. Increased expression of matrix metalloproteinases (MMPs) has been reported in CD. Herein we observed that when compared to N- and ulcerative colitis (UC)-MFs, CD-MFs increase in LPS-inducible levels of MMP-7 and -9 with a significant increase in both basal and inducible MMP-10. A similar pattern of MMP expression was observed in the CD-inflamed mucosa. Treatment of N-MFs with a combination of recombinant human MMP-7, -9 and -10 significantly decreased mPD-L1. In contrast, inhibition of MMP activity with MMP inhibitors or anti-MMP-10 neutralizing antibodies restores mPD-L1 on CD-MFs. CD-MFs demonstrated reduced capacity to suppress Th1 and Th17 responses from activated CD4+ T cells. By contrast, supplementation of the CD-MF:T-cell co-cultures with MMP inhibitors or anti-MMP neutralizing antibodies restored the CD-MF-mediated suppression. Our data suggest that (i) increased MMP-10 expression by CD-MFs and concomitant cleavage of PD-L1 from the surface of CD-MFs are likely to be one of the factors contributing to the decrease of mPD-L1-mediated suppression of Th1/Th17 cells in CD; and (ii) MMPs are likely to have a significant role in the intestinal mucosal immune responses., (© The Japanese Society for Immunology. 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Invasive respiratory support is a cornerstone of Critical Care Medicine, however, protocols for withdrawal of mechanical ventilation are still far from perfect. Failure to extubation occurs in up to 20% of patients, despite a successful spontaneous breathing trial (SBT)., Methods: We prospectively included ventilated patients admitted to medical and surgical intensive care unit in a university hospital in northern Mexico. At the end of a successful SBT, we measured diaphragmatic shortening fraction (DSF) by the formula: diaphragmatic thickness at the end of inspiration - diaphragmatic thickness at the end of expiration/diaphragmatic thickness at the end of expiration×100, and the presence of B-lines in five regions of the right and left lung. The primary objective was to determine whether analysis of DSF combined with pulmonary ultrasound improves prediction of extubation failure., Results: Eighty-two patients were included, 24 (29.2%) failed to extubation. At univariate analysis, DSF (Youden's J: >30% [sensibility and specificity 62 and 50%, respectively]) and number of B-lines regions (Youden's J: >1 zone [sensibility and specificity 66 and 92%, respectively]) were significant related to extubation failure (area under the curve 0.66 [0.52-0.80] and 0.81 [0.70-0.93], respectively). At the binomial logistic regression, only the number of B-lines regions remains significantly related to extubation failure (OR 5.91 [2.33-14.98], P<.001)., Conclusion: In patients with a successfully SBT, the absence of B-lines significantly decreases the probability of extubation failure. Diaphragmatic shortening fraction analysis does not add predictive power over the use of pulmonary ultrasound., (Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)

We present the case of a human immunodeficiency virus (HIV)-infected patient who arrived at our emergency department with fever, headache and exertional dyspnea. Throughout their stay, a chest x-ray was taken and a rounded opacity in his left lung was observed. CT images showed same abnormality and also ground glass opacities were seen. Symptoms and images strongly suggested a pulmonary infection due to pneumocystis jirovecii, however a presence of a round lesion should always lead to neoplasia being suspected. We empirically started treatment based on trimethoprim and sulfamethoxazole. Once available, flexible bronchoscopy and bronchoalveolar lavage was performed and stained preparations from his respiratory specimens confirmed the diagnosis of pulmonary pneumocystis infection. Finally, after 4 days of antibiotic therapy, an important clinical improvement was documented; a new chest x-ray was performed and the previous rounded opacity was absent. This finding strongly suggested a case of round pneumonia., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background and Aims: The role of programmed cell death protein 1 (PD-1) and its ligands in the dysregulation of T helper immune responses observed in the inflammatory bowel disease (IBD) is unclear. Recently, a novel concept emerged that CD90 + colonic (myo)fibroblasts (CMFs), also known as stromal cells, act as immunosuppressors, and are among the key regulators of acute and chronic inflammation. The objective of this study was to determine if the level of the PD-1 ligands is changed in the IBD inflamed colonic mucosa and to test the hypothesis that changes in IBD-CMF-mediated PD-1 ligand-linked immunosuppression is a mechanism promoting the dysregulation of Th1 cell responses., Methods: Tissues and cells derived from Crohn's disease (CD), ulcerative colitis (UC), and healthy individuals (N) were studied in situ, ex vivo , and in culture., Results: A significant increase in programmed death-ligand 1 (PD-L1) was observed in the inflamed UC colonic mucosa when compared to the non-inflamed matched tissue samples, CD, and healthy controls. UC-CMFs were among the major populations in the colonic mucosa contributing to the enhanced PD-L1 expression. In contrast, PD-L1 expression was decreased in CD-CMFs. When compared to CD-CMFs and N-CMFs, UC-CMFs demonstrated stronger suppression of IL-2, Th1 transcriptional factor Tbet, and IFN-γ expression by CD3/CD28-activated CD4 + T cells, and this process was PD-L1 dependent. Similar observations were made when differentiated Th1 cells were cocultured with UC-CMFs. In contrast, CD-CMFs showed reduced capacity to suppress Th1 cell activity and addition of recombinant PD-L1 Fc to CD-CMF:T cell cocultures partially restored the suppression of the Th1 type responses., Conclusion: We present evidence showing that increased PD-L1 expression suppresses Th1 cell activity in UC. In contrast, loss of PD-L1 expression observed in CD contributes to the persistence of the Th1 inflammatory milieu in CD. Our data suggest that dysregulation of the Th1 responses in the inflamed colonic mucosa of IBD patients is promoted by the alterations in PD-L1 expression in the mucosal mesenchymal stromal cell compartment.

Background: Abdominal pain is one of the major symptoms of inflammatory Bowel Disease (IBD). The inflammatory mediators released by colon inflammation are known to sensitize the afferent neurons, which is one of the contributors to abdominal pain. However, not all IBD patients have abdominal pain, and some patients report abdominal pain during remission, suggesting contributions of other pathological factors to abdominal pain in IBD. Epidemiological studies found early-life gastrointestinal infections a risk factor for IBD symptoms and adult-life gastrointestinal infections may trigger the onset of IBD. We investigated the hypothesis that neonatal colon immune challenge followed by an adult colon immune challenge upregulates spinal cord BDNF that aggravates visceral sensitivity over and above that induced by adult colon immune challenge alone., Methods: We induced neonatal and adult colon immune challenges by intraluminal administration of trinitrobenzene sulfonic acid to the rat colon., Key Results: We found that neonatal immune challenge triggers epigenetic programming that upregulates tyrosine hydroxylase in the locus ceruleus when these rats are subjected to an adult colon immune challenge. The upregulation of locus ceruleus tyrosine hydroxylase, upregulates norepinephrine in the cerebrospinal fluid that acts on adrenergic receptors to enhance pCREB binding to the cAMP response element, which recruits histone acetylene transferase (HAT) to the BDNF gene to enhance its transcription resulting in aggravated visceromotor response to colorectal distension. HAT and adrenergic receptor antagonists block the aggravation of visceral sensitivity., Conclusion & Inferences: HAT and adrenergic receptor inhibitors may serve as alternates to opioids and NSAIDS in suppressing abdominal pain in IBD., (© 2017 John Wiley & Sons Ltd.)

Introduction: Evidence for the use of non-anesthesiologist-administered propofol for sedation during flexible bronchoscopy is scarce. The main objective of this study was to determine whether non-anesthesiologist-administered propofol balanced sedation was related to higher transcutaneous CO 2 pressure compared with current guideline-based sedation (combination midazolam and opioid). Secondary outcomes were post-procedural recuperation time, patient satisfaction and frequency of adverse events., Methods: In this randomized controlled trial we included data from outpatients aged 18 years or older with an indication for flexible bronchoscopy in a university hospital in northern Mexico., Results: Ninety-one patients were included: 42 in the midazolam group and 49 in the propofol group. During 60min of transcutaneous capnometry monitoring, mean transcutaneous CO 2 pressure values did not differ significantly between groups (43.6 [7.5] vs. 45.6 [9.6]mmHg, P=.281). Propofol was related with a high Aldrete score at 5, 10, and 15min after flexible bronchoscopy (9 [IQR 6-10] vs. 10 [9,10], P=.006; 9 [8-10] vs. 10 [IQR 10-10], P<.001 and 10 [IQR 9-10] vs. 10 [10], respectively) and with high patient satisfaction on a visual analogue scale of 1 (not satisfied) to 10 (very satisfied) (8.41 [1.25] vs. 8.97 [0.98], P=.03). Frequency of adverse events was similar among groups (30.9% vs. 22.4%, P=.47)., Conclusion: Compared with guideline-recommended sedation, non-anesthesiologist-administered propofol balanced sedation is not associated with higher transcutaneous CO 2 pressure or with more frequent adverse effects. Propofol use is associated with faster sedation recovery and with high patient satisfaction., Clinical Trial Registration: NCT02820051., (Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The etiologies of functional dyspepsia symptoms, including postprandial distress syndrome, remain unknown. We tested the hypothesis that neonatal colon inflammation induces postprandial distress syndrome-like symptoms in adult life that associate with increased activation of vagal afferent pathways and forebrain limbic regions., Results: These rats showed a significant decrease in nutrient meal consumption to satiety after an overnight fast, decrease in gastric emptying, decrease in total distance traveled, and decrease in percent distance traveled in midfield versus control rats in open field test, indicating postprandial anxiety- and depression-like behaviors. Adult naïve rats treated with oral iodoacetamide to induce H. pylori-like mild gastritis demonstrated similar postprandial effects as the above rats., Conclusions: We concluded that neonatal colon inflammation is a risk factor for the development of postprandial distress syndrome-like symptoms. While mild gastritis can induce symptoms similar to those of neonatal colon inflammation, gastritis in these rats does not worsen the symptoms.

Background: Predicting mortality in the intensive care unit (ICU) is one of the biggest challenges in critical care medicine. Several studies have linked the presence of eosinopenia with adverse outcomes in different populations., Methods: We performed a case control study to determine whether the eosinophil count at ICU admission was a predictor of hospital mortality. We included data from patients 18 years or older admitted to the medical or surgical ICU in a university hospital in northern of Mexico. Medical records of 86 non-survivors (cases) and 99 discharged alive patients (controls) were randomly reviewed; clinical records of patients with an ICU stay of less than 24 h and those whose information was incomplete were excluded., Results: Median of eosinophil count at ICU admission was 0.013 (interquartile range (IQR) 0.00 to 0.57) K/μL. There was no significant statistical difference in eosinophils at admission between survivors and non-survivors (0.014 [IQR 0.00 to 0.36] vs. 0.010 [IQR 0.00 to 0.57] K/μL, P = 0.35). In the multivariate analysis, APACHE II score at ICU admission and discharge were the only mortality predictors. Survivors had a significantly greater increase in eosinophil count during the first 7 days of ICU stay (0.104 [IQR -0.64 to 0.41] vs. 0.005 [IQR -1.79 to 0.43] K/μL, P = 0.004)., Conclusions: In our study, eosinophil count at ICU admission was not associated with increased hospital mortality. The larger increase in number of eosinophils observed during the first week of ICU stay in surviving patients deserves to be investigated further.

Setting: Diagnostic flexible bronchoscopy performed in hospitalised and ambulatory patients in a tertiary care academic hospital in Monterrey, Mexico., Objective: To determine the effect of the route of insertion of the bronchoscope (oral or nasal) on patient comfort, vocal cord visualisation, local anaesthetic and sedation requirements and possible complications., Design: Prospective study carried out in patients aged ⩾ 18 years with an indication for flexible bronchoscopy. The route of insertion was randomly assigned. Symptoms related to the procedure were evaluated using a questionnaire., Results: Sixty-three patients were included: 32 in the oral insertion group and 31 in the nasal insertion group. There was no statistically significant difference in patient discomfort (1.91 ± 2.95 vs. 2.39 ± 3.56 points on a scale of 1 to 10, P = 0.74) or procedural complications (4 vs. 0 events, P = 0.12) between study groups. Oral insertion was associated with less time to vocal cord visualisation (25.5 ± 156 s vs. 56 ± 61 s, P < 0.01), lower requirement for lidocaine (15 ± 7.50 vs. 16 ± 4 ml, P = 0.01) and fewer insertion failures (0 vs. 6 cases, P < 0.01)., Conclusions: With intravenous sedoanalgesia, route of insertion did not affect patient comfort. However, the oral route was associated with faster vocal cord visualisation, less use of lidocaine and no insertion failure.

Massive present-day early-type (elliptical and lenticular) galaxies probably gained the bulk of their stellar mass and heavy elements through intense, dust-enshrouded starbursts--that is, increased rates of star formation--in the most massive dark-matter haloes at early epochs. However, it remains unknown how soon after the Big Bang massive starburst progenitors exist. The measured redshift (z) distribution of dusty, massive starbursts has long been suspected to be biased low in z owing to selection effects, as confirmed by recent findings of systems with redshifts as high as ~5 (refs 2-4). Here we report the identification of a massive starburst galaxy at z = 6.34 through a submillimetre colour-selection technique. We unambiguously determined the redshift from a suite of molecular and atomic fine-structure cooling lines. These measurements reveal a hundred billion solar masses of highly excited, chemically evolved interstellar medium in this galaxy, which constitutes at least 40 per cent of the baryonic mass. A 'maximum starburst' converts the gas into stars at a rate more than 2,000 times that of the Milky Way, a rate among the highest observed at any epoch. Despite the overall downturn in cosmic star formation towards the highest redshifts, it seems that environments mature enough to form the most massive, intense starbursts existed at least as early as 880 million years after the Big Bang.