Childhood vision impairment and blindness in West Africa: public health measures and implications for systemic health

Childhood blindness is an issue of global health impact, affecting approximately 2 million children worldwide. Vision 2020 and the United Nations Sustainable Development Goals previously identified childhood blindness as a key issue in the twentieth century, and while public health measures are underway, the precise etiologies and management require ongoing investigation and care, particularly within resource-limited settings such as sub-Saharan Africa. We systematically reviewed the literature on childhood blindness in West Africa to identify the anatomic classification and etiologies, particularly those causes of childhood blindness with systemic health implications. Treatable causes included cataract, refractive error, and corneal disease. Systemic etiologies identified included measles, rubella, vitamin A deficiency, and Ebola virus disease. While prior public health measures including vitamin A supplementation and vaccination programs have been deployed in most countries with reported data, multiple studies reported preventable or reversible etiologies of blindness and vision impairment. Ongoing research is necessary to standardize reporting for anatomies and/or etiologies of childhood blindness to determine the necessity of further development and implementation of public health measures that would ameliorate childhood blindness and vision impairment.

Multidisciplinary guidance for safe tracheostomy care during the COVID-19 pandemic: the NHS National Patient Safety Improvement Programme (NatPatSIP)

The COVID-19 pandemic is causing a significant increase in the number of patients requiring relatively prolonged invasive mechanical ventilation and an associated surge in patients who need a tracheostomy to facilitate weaning from respiratory support. In parallel, there has been a global increase in guidance from professional bodies representing staff who care for patients with tracheostomies at different points in their acute hospital journey, rehabilitation and recovery. Of concern are the risks to healthcare staff of infection arising from tracheostomy insertion and caring for patients with a tracheostomy. Hospitals are also facing extraordinary demands on critical care services such that many patients who require a tracheostomy will be managed outside established intensive care or head and neck units and cared for by staff with little tracheostomy experience. These concerns led NHS England and NHS Improvement to expedite the National Patient Safety Improvement Programme's 'Safe Tracheostomy Care' workstream as part of the NHS COVID-19 response. Supporting this workstream, UK stakeholder organisations involved in tracheostomy care were invited to develop consensus guidance based on: expert opinion; the best available published literature; and existing multidisciplinary guidelines. Topics with direct relevance for frontline staff were identified. This consensus guidance includes: infectivity of patients with respect to tracheostomy indications and timing; aerosol-generating procedures and risks to staff; insertion procedures; and management following tracheostomy.

High-accuracy measurement of the blackbody radiation frequency shift of the ground-state hyperfine transition in 133Cs

We report a high-accuracy direct measurement of the blackbody radiation shift of the 133Cs ground-state hyperfine transition. This frequency shift is one of the largest systematic frequency biases encountered in realizing the current definition of the International System of Units (SI) second. Uncertainty in the blackbody radiation frequency shift correction has led to its being the focus of intense theoretical effort by a variety of research groups. Our experimental measurement of the shift used three primary frequency standards operating at different temperatures. We achieved an uncertainty a factor of five smaller than the previous best direct measurement. These results tend to validate the claimed accuracy of the recently calculated values.

Testing local position invariance with four cesium-fountain primary frequency standards and four NIST hydrogen masers

We report the most sensitive tests to date of the assumption of local position invariance (LPI) underlying general relativity, based on a 7 yr comparison of cesium and hydrogen atomic clocks (frequency standards). The latest results place an upper limit that is over 20 times smaller than the previous most sensitive tests; this is consistent with the null shift predicted by LPI. The result is based on precise comparisons of frequencies of four hydrogen masers maintained by NIST, with four independent Cs fountain clocks--one at NIST and three in Europe--as the Sun's gravitational potential at Earth's surface varies due to Earth's orbital eccentricity.

Precision atomic spectroscopy for improved limits on variation of the fine structure constant and local position invariance

We report tests of local position invariance and the variation of fundamental constants from measurements of the frequency ratio of the 282-nm 199Hg+ optical clock transition to the ground state hyperfine splitting in 133Cs. Analysis of the frequency ratio of the two clocks, extending over 6 yr at NIST, is used to place a limit on its fractional variation of <5.8x10(-6) per change in normalized solar gravitational potential. The same frequency ratio is also used to obtain 20-fold improvement over previous limits on the fractional variation of the fine structure constant of |alpha/alpha|<1.3x10(-16) yr-1, assuming invariance of other fundamental constants. Comparisons of our results with those previously reported for the absolute optical frequency measurements in H and 171Yb+ vs other 133Cs standards yield a coupled constraint of -1.5x10(-15)<alpha/alpha<0.4x10(-15) yr-1 and -2.7x10(-15)<d/dtlnmicroCs/microB<8.6x10(-15) yr-1.

Around-the-World Relativistic Sagnac Experiment

In 1971 Hafele and Keating carried portable atomic clocks east and then west around the world and verified the Sagnac effect, a special relativity effect attributable to the earth's rotation. In the study reported here observations of the effect were made by using electromagnetic signals instead of portable clocks to make clock comparisons. Global Positioning System satellites transmit signals that can be viewed simultaneously from remote stations on the earth; thus an around-the-world Sagnac experiment can be performed with electromagnetic signals. The effect is larger than that occurring when portable clocks are used. The average error over a 3-month experiment was only 5 nanoseconds.