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We sought to define the prevalence of echocardiographic abnormalities in long-term survivors of paediatric hematopoietic stem cell transplantation and determine the utility of screening in asymptomatic patients. We analysed echocardiograms performed on survivors who underwent hematopoietic stem cell transplantation from 1982 to 2006. A total of 389 patients were alive in 2017, with 114 having an echocardiogram obtained ⩾5 years post-infusion. A total of 95 patients had echocardiogram performed for routine surveillance. The mean time post-hematopoietic stem cell transplantation was 13 years. Of 95 patients, 77 (82.1%) had ejection fraction measured, and 10/77 (13.0%) had ejection fraction z-scores ⩽−2.0, which is abnormally low. Those patients with abnormal ejection fraction were significantly more likely to have been exposed to anthracyclines or total body irradiation. Among individuals who received neither anthracyclines nor total body irradiation, only 1/31 (3.2%) was found to have an abnormal ejection fraction of 51.4%, z-score −2.73. In the cohort of 77 patients, the negative predictive value of having a normal ejection fraction given no exposure to total body irradiation or anthracyclines was 96.7% at 95% confidence interval (83.3–99.8%). Systolic dysfunction is relatively common in long-term survivors of paediatric hematopoietic stem cell transplantation who have received anthracyclines or total body irradiation. Survivors who are asymptomatic and did not receive radiation or anthracyclines likely do not require surveillance echocardiograms, unless otherwise indicated.
Alteplase is an effective treatment for ischaemic stroke patients, and it is widely available at all primary stroke centres. The effectiveness of alteplase is highly time-dependent. Large tertiary centres have reported significant improvements in their door-to-needle (DTN) times. However, these same improvements have not been reported at community hospitals.
Red Deer Regional Hospital Centre (RDRHC) is a community hospital of 370 beds that serves approximately 150,000 people in their acute stroke catchment area. The RDRHC participated in a provincial DTN improvement initiative, and implemented a streamlined algorithm for the treatment of stroke patients. During this intervention period, they implemented the following changes: early alert of an incoming acute stroke patient to the neurologist and care team, meeting the patient immediately upon arrival, parallel work processes, keeping the patient on the Emergency Medical Service stretcher to the CT scanner, and administering alteplase in the imaging area. Door-to-needle data were collected from July 2007 to December 2017.
A total of 289 patients were treated from July 2007 to December 2017. In the pre-intervention period, 165 patients received alteplase and the median DTN time was 77 minutes [interquartile range (IQR): 60–103 minutes]; in the post-intervention period, 104 patients received alteplase and the median DTN time was 30 minutes (IQR: 22–42 minutes) (p < 0.001). The annual number of patients that received alteplase increased from 9 to 29 in the pre-intervention period to annual numbers of 41 to 63 patients in the post-intervention period.
Community hospitals staffed with community neurologists can achieve median DTN times of 30 minutes or less.
A new optical delivery system has been developed for the (scanning) transmission electron microscope. Here we describe the in situ and “rapid ex situ” photothermal heating modality of the system, which delivers >200 mW of optical power from a fiber-coupled laser diode to a 3.7 μm radius spot on the sample. Selected thermal pathways can be accessed via judicious choices of the laser power, pulse width, number of pulses, and radial position. The long optical working distance mitigates any charging artifacts and tremendous thermal stability is observed in both pulsed and continuous wave conditions, notably, no drift correction is applied in any experiment. To demonstrate the optical delivery system’s capability, we explore the recrystallization, grain growth, phase separation, and solid state dewetting of a Ag0.5Ni0.5 film. Finally, we demonstrate that the structural and chemical aspects of the resulting dewetted films was assessed.
We observed pediatric S. aureus hospitalizations decreased 36% from 26.3 to 16.8 infections per 1,000 admissions from 2009 to 2016, with methicillin-resistant S. aureus (MRSA) decreasing by 52% and methicillin-susceptible S. aureus decreasing by 17%, among 39 pediatric hospitals. Similar decreases were observed for days of therapy of anti-MRSA antibiotics.
In higher order settings, control-flow analysis aims to model the propagation of both data and control by finitely approximating program behaviors across all possible executions. The polyvariance of an analysis describes the number of distinct abstract representations, or variants, for each syntactic entity (e.g., functions, variables, or intermediate expressions). Monovariance, one of the most basic forms of polyvariance, maintains only a single abstract representation for each variable or expression. Other polyvariant strategies allow a greater number of distinct abstractions and increase analysis complexity with the aim of increasing analysis precision. For example, k-call sensitivity distinguishes flows by the most recent k call sites, k-object sensitivity by a history of allocation points, and argument sensitivity by a tuple of dynamic argument types. From this perspective, even a concrete operational semantics may be thought of as an unboundedly polyvariant analysis. In this paper, we develop a unified methodology that fully captures this design space. It is easily tunable and guarantees soundness regardless of how tuned. We accomplish this by extending the method of abstracting abstract machines, a systematic approach to abstract interpretation of operational abstract-machine semantics. Our approach permits arbitrary instrumentation of the underlying analysis and arbitrary tuning of an abstract-allocation function. We show that the design space of abstract allocators both unifies and generalizes existing notions of polyvariance. Simple changes to the behavior of this function recapitulate classic styles of analysis and yield novel combinations and variants.
Hill (Twin Research and Human Genetics, Vol. 21, 2018, 84–88) presented a critique of our recently published paper in Cell Reports entitled ‘Large-Scale Cognitive GWAS Meta-Analysis Reveals Tissue-Specific Neural Expression and Potential Nootropic Drug Targets’ (Lam et al., Cell Reports, Vol. 21, 2017, 2597–2613). Specifically, Hill offered several interrelated comments suggesting potential problems with our use of a new analytic method called Multi-Trait Analysis of GWAS (MTAG) (Turley et al., Nature Genetics, Vol. 50, 2018, 229–237). In this brief article, we respond to each of these concerns. Using empirical data, we conclude that our MTAG results do not suffer from ‘inflation in the FDR [false discovery rate]’, as suggested by Hill (Twin Research and Human Genetics, Vol. 21, 2018, 84–88), and are not ‘more relevant to the genetic contributions to education than they are to the genetic contributions to intelligence’.
Light-absorbing impurities (LAI) can darken snow and ice surfaces, reduce snow/ice albedo and accelerate melt. Efforts to allocate the relative contribution of different LAI to snow/ice albedo reductions have been limited by uncertainties in the optical properties of LAI. We developed a new method to measure LAI spectral reflectance at the submicron scale by modifying a Hyperspectral Imaging Microscope Spectrometer (HIMS). We present the instrument's internal calibration, and the overall small influence of a particle's orientation on its measured reflectance spectrum. We validated this new method through the comparison with a field spectroradiometer by measuring different standard materials. Measurements with HIMS at the submicron scale and the bulk measurements of the same standard materials with the field spectroradiometer are in good agreement with an average deviation between the spectra of 3.2% for the 400–1000 nm wavelength range. The new method was used (1) to identify BC (black carbon), mineral dust including hematite and the humic substances present in an environmental sample from Plaine Morte glacier and (2) to collect the individual reflectance spectra of each of these types of impurity. The results indicate that this method is applicable to heterogeneous samples such as the LAI found in snow and ice.
High definition video from a towed camera system was used to describe the deep-sea benthic habitats within an elongate depression located at the western margin of Rockall Bank in the Hatton–Rockall Basin. At depths greater than 1190 m, an extensive area (10 km long by 1.5 km wide) of what appeared to be reduced sediments, bacterial mats and flocculent matter indicated possible cold-seep habitat. Plumes of sediment-rich fluid were observed alongside raised elongate features that gave topographic relief to the otherwise flat seafloor. In the deepest section of the depression (1215 m) dense flocculent matter was observed suspended in the water column, in places obscuring the seabed. Away from the bacterial mats, the habitat changed rapidly to sediments dominated by tube-dwelling polychaete worms and then to deep-sea sedimentary habitats more typical for the water depth (sponges and burrowing megafauna in areas of gentle slopes, and coral gardens on steeper slopes).
We examined the prospective associations of objective and subjective measures of stress during pregnancy with infant stress reactivity and regulation, an early-life predictor of psychopathology. In a racially and ethnically diverse low-income sample of 151 mother–infant dyads, maternal reports of stressful life events (SLE) and perceived stress (PS) were collected serially over gestation and the early postpartum period. Infant reactivity and regulation at 6 months of age was assessed via maternal report of temperament (negativity, surgency, and regulation) and infant parasympathetic nervous system physiology (respiratory sinus arrhythmia [RSA]) during the Still Face Paradigm. Regression models predicting infant temperament showed higher maternal prenatal PS predicted lower surgency and self-regulation but not negativity. Regression models predicting infant physiology showed higher numbers of SLE during gestation predicted greater RSA reactivity and weaker recovery. Tests of interactions revealed SLE predicted RSA reactivity only at moderate to high levels of PS. Thus, findings suggest objective and subjective measures of maternal prenatal stress uniquely predict infant behavior and physiology, adjusting for key pre- and postnatal covariates, and advance the limited evidence for such prenatal programming within high-risk populations. Assessing multiple levels of maternal stress and offspring stress reactivity and regulation provides a richer picture of intergenerational transmission of adversity.
Whether monozygotic (MZ) and dizygotic (DZ) twins differ from each other in a variety of phenotypes is important for genetic twin modeling and for inferences made from twin studies in general. We analyzed whether there were differences in individual, maternal and paternal education between MZ and DZ twins in a large pooled dataset. Information was gathered on individual education for 218,362 adult twins from 27 twin cohorts (53% females; 39% MZ twins), and on maternal and paternal education for 147,315 and 143,056 twins respectively, from 28 twin cohorts (52% females; 38% MZ twins). Together, we had information on individual or parental education from 42 twin cohorts representing 19 countries. The original education classifications were transformed to education years and analyzed using linear regression models. Overall, MZ males had 0.26 (95% CI [0.21, 0.31]) years and MZ females 0.17 (95% CI [0.12, 0.21]) years longer education than DZ twins. The zygosity difference became smaller in more recent birth cohorts for both males and females. Parental education was somewhat longer for fathers of DZ twins in cohorts born in 1990–1999 (0.16 years, 95% CI [0.08, 0.25]) and 2000 or later (0.11 years, 95% CI [0.00, 0.22]), compared with fathers of MZ twins. The results show that the years of both individual and parental education are largely similar in MZ and DZ twins. We suggest that the socio-economic differences between MZ and DZ twins are so small that inferences based upon genetic modeling of twin data are not affected.
When using bifunctional core@shell catalysts, the stability of both the shell and core–shell interface is crucial for catalytic applications. In the present study, we elucidate the stability of a CuO/ZnO/Al2O3@ZSM-5 core@shell material, used for one-stage synthesis of dimethyl ether from synthesis gas. The catalyst stability was studied in a hierarchical manner by complementary environmental transmission electron microscopy (ETEM), scanning electron microscopy (SEM) and in situ hard X-ray ptychography with a specially designed in situ cell. Both reductive activation and reoxidation were applied. The core–shell interface was found to be stable during reducing and oxidizing treatment at 250°C as observed by ETEM and in situ X-ray ptychography, although strong changes occurred in the core on a 10 nm scale due to the reduction of copper oxide to metallic copper particles. At 350°C, in situ X-ray ptychography indicated the occurrence of structural changes also on the µm scale, i.e. the core material and parts of the shell undergo restructuring. Nevertheless, the crucial core–shell interface required for full bifunctionality appeared to remain stable. This study demonstrates the potential of these correlative in situ microscopy techniques for hierarchically designed catalysts.
Objectives: The aim of this study was to evaluate the reliability and validity of three computerized neurocognitive assessment tools (CNTs; i.e., ANAM, DANA, and ImPACT) for assessing mild traumatic brain injury (mTBI) in patients recruited through a level I trauma center emergency department (ED). Methods: mTBI (n=94) and matched trauma control (n=80) subjects recruited from a level I trauma center emergency department completed symptom and neurocognitive assessments within 72 hr of injury and at 15 and 45 days post-injury. Concussion symptoms were also assessed via phone at 8 days post-injury. Results: CNTs did not differentiate between groups at any time point (e.g., M 72-hr Cohen’s d=−.16, .02, and .00 for ANAM, DANA, and ImPACT, respectively; negative values reflect greater impairment in the mTBI group). Roughly a quarter of stability coefficients were over .70 across measures and test–retest intervals in controls. In contrast, concussion symptom score differentiated mTBI vs. control groups acutely), with this effect size diminished over time (72-hr and day 8, 15, and 45 Cohen’s d=−.78, −.60, −.49, and −.35, respectively). Conclusions: The CNTs evaluated, developed and widely used to assess sport-related concussion, did not yield significant differences between patients with mTBI versus other injuries. Symptom scores better differentiated groups than CNTs, with effect sizes weaker than those reported in sport-related concussion studies. Nonspecific injury factors, and other characteristics common in ED settings, likely affect CNT performance across trauma patients as a whole and thereby diminish the validity of CNTs for assessing mTBI in this patient population. (JINS, 2017, 23, 293–303)
This paper presents the first major data release and survey description for the ANU WiFeS SuperNovA Programme. ANU WiFeS SuperNovA Programme is an ongoing supernova spectroscopy campaign utilising the Wide Field Spectrograph on the Australian National University 2.3-m telescope. The first and primary data release of this programme (AWSNAP-DR1) releases 357 spectra of 175 unique objects collected over 82 equivalent full nights of observing from 2012 July to 2015 August. These spectra have been made publicly available via the WISEREP supernova spectroscopy repository.
We analyse the ANU WiFeS SuperNovA Programme sample of Type Ia supernova spectra, including measurements of narrow sodium absorption features afforded by the high spectral resolution of the Wide Field Spectrograph instrument. In some cases, we were able to use the integral-field nature of the Wide Field Spectrograph instrument to measure the rotation velocity of the SN host galaxy near the SN location in order to obtain precision sodium absorption velocities. We also present an extensive time series of SN 2012dn, including a near-nebular spectrum which both confirms its ‘super-Chandrasekhar’ status and enables measurement of the sub-solar host metallicity at the SN site.
Eta Carinae is the most massive active binary within 10,000 light-years and is famous for the largest non-terminal stellar explosion ever recorded. Observations reveal that the supermassive (~120 M⊙) binary, consisting of an LBV and either a WR or extreme O star, undergoes dramatic changes every 5.54 years due to the stars’ very eccentric orbits (e ≈ 0.9). Many of these changes are caused by a dynamic wind-wind collision region (WWCR) between the stars, plus expanding fossil WWCRs formed one, two, and three 5.54-year cycles ago. The fossil WWCRs can be spatially and spectrally resolved by the Hubble Space Telescope/Space Telescope Imaging Spectrograph (HST/STIS). Starting in June 2009, we used the HST/STIS to spatially map Eta Carinae’s fossil WWCRs across one full orbit, following temporal changes in several forbidden emission lines (e.g. [Feiii] 4659 Å, [Feii] 4815 Å), creating detailed data cubes at multiple epochs. Multiple wind structures were imaged, revealing details about the binary’s orbital motion, photoionization properties, and recent (~5 − 15 year) mass-loss history. These observations allow us to test 3-D hydrodynamical and radiative-transfer models of the interacting winds. Our observations and models strongly suggest that the wind and photoionization properties of Eta Carinae’s binary have not changed substantially over the past several orbital cycles. They also provide a baseline for following future changes in Eta Carinae, essential for understanding the late-stage evolution of this nearby supernova progenitor. For more details, see Gull et al. (2016) and references therein.
In the lower American Southeast, regional scale social interactions burgeoned alongside the growth of nucleated villages, widespread mound-building projects, and conspicuous mortuary ceremonialism during the Middle and Late Woodland periods (ca. A.D. 100–800). A premier material for understanding the scale and significance of social interactions across the southern landscape comes from Swift Creek Complicated Stamped pottery, a ubiquitous class of material culture that provides direct evidence of connections between specific sites at a multitude of scales and in myriad contexts. By combining design data and determinations of vessel provenance through Neutron Activation Analysis of a total of 825 sherds and 130 clay samples, this research ascertains types of social interaction and their predominant directions and levels of intensity across multiple ecological, social, and cultural contexts. The results indicate two main patterns: first, that vessels were frequently transported from habitation sites and civic-ceremonial centers to distant burial mounds; and second, that people traveled to ceremonial centers from outlying villages for events that included the exchange of wooden paddles. These patterns reveal a high level of social coordination within integrated networks that were inextricable from the region-wide trends toward population aggregation and heightened monumentality and rituality.
The Two Micron All Sky Survey (2MASS) has observed a number of Wolf-Rayet stars and galaxies at J (1.25 μm), H (1.65 μm), and Ks (2.17 μm), as part of its systematic coverage of the entire sky with automated 1.3-m telescopes at Mt. Hopkins, AZ, and CTIO, Chile. The cameras observe the sky in the three channels simultaneously, using 256 x 256 HgCdTe-detector arrays. The survey samples the sky in 6° x 8.'3 tiles. The 2MASS Production Processing System transforms the raw binary survey data to final atlas images and source extractions with precise photometric calibration and astrometric positions. The survey's 10σ sensitivity is 15.8 mag at J, 15.1 at H, and 14.3 at Ks. In this poster we will present results from our analysis of several objects. We have observed WR stars both with and without associated ring nebulae. 2MASS imaging of the WR galaxies is far less affected by extinction, which can obscure much of the star formation activity. We will place these starburst dwarf galaxies in context with other galaxies, based on their near-IR colors and properties.
We have analyzed time-series data for 160 stars in the old open cluster M67. Approximately 400 CCD frames from two nights on the Burrell Schmidt have been reduced differentially relative to an ensemble of seventeen stable stars. We present data on two new variables and evidence of four new suspected variable stars in M67.
To determine the effect of graft choice (allograft, bone-patellar tendon-bone autograft, or hamstring autograft) on deep tissue infections following anterior cruciate ligament (ACL) reconstructions.
Retrospective cohort study.
SETTING AND POPULATION
Patients from 6 US health plans who underwent ACL reconstruction from January 1, 2000, through December 31, 2008.
We identified ACL reconstructions and potential postoperative infections using claims data. A hierarchical stratified sampling strategy was used to identify patients for medical record review to confirm ACL reconstructions and to determine allograft vs autograft tissue implanted, clinical characteristics, and infection status. We estimated infection rates overall and by graft type. We used logistic regression to assess the association between infections and patients’ demographic characteristics, comorbidities, and choice of graft.
On review of 1,452 medical records, we found 55 deep wound infections. With correction for sampling weights, infection rates varied by graft type: 0.5% (95% CI, 0.3%-0.8%) with allografts, 0.6% (0.1%–1.5%) with bone-patellar tendon-bone autografts, and 2.5% (1.9%–3.1%) with hamstring autograft. After adjusting for potential confounders, we found an increased infection risk with hamstring autografts compared with allografts (odds ratio, 5.9; 95% CI, 2.8–12.8). However, there was no difference in infection risk among bone-patellar tendon-bone autografts vs allografts (odds ratio, 1.2; 95% CI, 0.3–4.8).
The overall risk for deep wound infections following ACL reconstruction is low but it does vary by graft type. Infection risk was highest in hamstring autograft recipients compared with allograft recipients and bone-patellar tendon-bone autograft recipients.