Non-tuberculous mycobacterium encephalitis is rare. Since 2013, a global outbreak of Mycobacterium chimaera infection has been attributed to point-source contamination of heater cooler units used in cardiac surgery. Disseminated M. chimaera infection has presented many unique challenges, including non-specific clinical presentations with delays in diagnosis, and a high mortality rate among predominantly immunocompetent adults. Here, we describe three patients with fatal disseminated Mycobacterium chimaera infection showing initially non-specific, progressively worsening neurocognitive decline, including confusion, delirium, depression and apathy. Autopsy revealed widespread granulomatous encephalitis of the cerebrum, brain stem and spinal cord, along with granulomatous chorioretinitis. Cerebral involvement and differentiation between mycobacterial granulomas and microangiopathic changes can be assessed best on MRI with contrast enhancement. The prognosis of M. chimaera encephalitis appears to be very poor, but might be improved by increased awareness of this new syndrome and timely antimicrobial treatment.

Interest in electronic hand hygiene monitoring systems (EHHMSs) is now widespread throughout the infection control community. We tested 2 types of EHHMS for accuracy. The type B EHHMS captured more HH events with superior accuracy. Hospitals considering an EHHMS should assess the technology’s ability to accurately capture HH performance in the clinical workflow.

We present a broad study of linear, clustered, noble gas puffs irradiated with the frequency doubled (527 nm) Titan laser at Lawrence Livermore National Laboratory. Pure Ar, Kr, and Xe clustered gas puffs, as well as two mixed-gas puffs consisting of KrAr and XeKrAr gases, make up the targets. Characterization experiments to determine gas-puff density show that varying the experimental parameter gas-delay timing (the delay between gas puff initialization and laser-gas-puff interaction) provides a simple control over the gas-puff density. X-ray emission (>1.4 keV) is studied as a function of gas composition, density, and delay timing. Xe gas puffs produce the strongest peak radiation in the several keV spectral region. The emitted radiation was found to be anisotropic, with smaller X-ray flux observed in the direction perpendicular to both laser beam propagation and polarization directions. The degree of anisotropy is independent of gas target type but increases with photon energy. X-ray spectroscopic measurements estimate plasma parameters and highlight their difference with previous studies. Electron beams with energy in excess of 72 keV are present in the noble gas-puff plasmas and results indicate that Ar plays a key role in their production. A drastic increase in harder X-ray emissions (X-ray flash effect) and multi-MeV electron-beam generation from Xe gas-puff plasma occurred when the laser beam was focused on the front edge of the linear gas puff.

There are no estimates of the heritability of phenotypic udder traits in suckler sheep, which produce meat lambs, and whether these are associated with resilience to mastitis. Mastitis is a common disease which damages the mammary gland and reduces productivity. The aims of this study were to investigate the feasibility of collecting udder phenotypes, their heritability and their association with mastitis in suckler ewes. Udder and teat conformation, teat lesions, intramammary masses (IMM) and litter size were recorded from 10 Texel flocks in Great Britain between 2012 and 2014; 968 records were collected. Pedigree data were obtained from an online pedigree recording system. Univariate quantitative genetic parameters were estimated using animal and sire models. Linear mixed models were used to analyse continuous traits and generalised linear mixed models were used to analyse binary traits. Continuous traits had higher heritabilities than binary with teat placement and teat length heritability (h2) highest at 0.35 (SD 0.04) and 0.42 (SD 0.04), respectively. Udder width, drop and separation heritabilities were lower and varied with udder volume. The heritabilities of IMM and teat lesions (sire model) were 0.18 (SD 0.12) and 0.17 (SD 0.11), respectively. All heritabilities were sufficiently high to be in a selection programme to increase resilience to mastitis in the population of Texel sheep. Further studies are required to investigate genetic relationships between traits and to determine whether udder traits predict IMM, and the potential benefits from including traits in a selection programme to increase resilience to chronic mastitis.

This paper investigates the synergies and trade-offs between passive aeroelastic tailoring and adaptive aeroelastic deformation of a transport composite wing for fuel burn minimisation. This goal is achieved by optimising thickness and stiffness distributions of constitutive laminates, jig-twist shape and distributed control surface deflections through different segments of a nominal “cruise-climb” mission. Enhanced aerostructural efficiency is sought both passively and adaptively as a means of aerodynamic load redistribution, which, in turn, is used for manoeuvre load relief and minimum drag dissipation. Passive shape adaptation is obtained by embedding shear-extension and bend-twist couplings in the laminated wing skins. Adaptive camber changes are provided via full-span trailing-edge flaps. Optimised design solutions are found using a bi-level approach that integrates gradient-based and particle swarm optimisations in order to tailor structural properties at rib-bay level and retrieve blended stacking sequences. Performance benefits from the combination of passive aeroelastic tailoring with adaptive control devices are benchmarked in terms of fuel burn and a payload-range efficiency. It is shown that the aeroservoelastically tailored composite design allows for significant weight and fuel burn improvements when compared to a similar all-metallic wing. Additionally, the trailing-edge flap augmentation can extend the aircraft performance envelope and improve the overall cruise span efficiency to nearly optimal lift distributions.

Prisoner's Dilemma (PD) games have become a well-established paradigm for studying the mechanisms by which cooperative behavior may evolve in societies consisting of selfish individuals. Recent research has focused on the effect of spatial and connectivity structure in promoting the emergence of cooperation in scenarios where individuals play games with their neighbors, using simple “memoryless” rules to decide their choice of strategy in repeated games. While heterogeneity and structural features such as clustering have been seen to lead to reasonable levels of cooperation in very restricted settings, no conditions on network structure have been established, which robustly ensure the emergence of cooperation in a manner that is not overly sensitive to parameters such as network size, average degree, or the initial proportion of cooperating individuals. Here, we consider a natural random network model, with parameters that allow us to vary the level of “community” structure in the network, as well as the number of high degree hub nodes. We investigate the effect of varying these structural features and show that, for appropriate choices of these parameters, cooperative behavior does now emerge in a truly robust fashion and to a previously unprecedented degree. The implication is that cooperation (as modelled here by PD games) can become the social norm in societal structures divided into smaller communities, and in which hub nodes provide the majority of inter-community connections.