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We apply two methods to estimate the 21-cm bispectrum from data taken within the Epoch of Reionisation (EoR) project of the Murchison Widefield Array (MWA). Using data acquired with the Phase II compact array allows a direct bispectrum estimate to be undertaken on the multiple redundantly spaced triangles of antenna tiles, as well as an estimate based on data gridded to the uv-plane. The direct and gridded bispectrum estimators are applied to 21 h of high-band (167–197 MHz; z = 6.2–7.5) data from the 2016 and 2017 observing seasons. Analytic predictions for the bispectrum bias and variance for point-source foregrounds are derived. We compare the output of these approaches, the foreground contribution to the signal, and future prospects for measuring the bispectra with redundant and non-redundant arrays. We find that some triangle configurations yield bispectrum estimates that are consistent with the expected noise level after 10 h, while equilateral configurations are strongly foreground-dominated. Careful choice of triangle configurations may be made to reduce foreground bias that hinders power spectrum estimators, and the 21-cm bispectrum may be accessible in less time than the 21-cm power spectrum for some wave modes, with detections in hundreds of hours.
After five positive randomized controlled trials showed benefit of mechanical thrombectomy in the management of acute ischemic stroke with emergent large-vessel occlusion, a multi-society meeting was organized during the 17th Congress of the World Federation of Interventional and Therapeutic Neuroradiology in October 2017 in Budapest, Hungary. This multi-society meeting was dedicated to establish standards of practice in acute ischemic stroke intervention aiming for a consensus on the minimum requirements for centers providing such treatment. In an ideal situation, all patients would be treated at a center offering a full spectrum of neuroendovascular care (a level 1 center). However, for geographical reasons, some patients are unable to reach such a center in a reasonable period of time. With this in mind, the group paid special attention to define recommendations on the prerequisites of organizing stroke centers providing medical thrombectomy for acute ischemic stroke, but not for other neurovascular diseases (level 2 centers). Finally, some centers will have a stroke unit and offer intravenous thrombolysis, but not any endovascular stroke therapy (level 3 centers). Together, these level 1, 2, and 3 centers form a complete stroke system of care. The multi-society group provides recommendations and a framework for the development of medical thrombectomy services worldwide.
The ability to prcbe the structure of a polymer during deformation is of considerable technological interest as it lends an insight into the mechanisms involved in polymer processing. The behaviour of Liquid Crystalline Polymers (LCP's) during shear flow has generated much experimental interest by virtue of their unusual behaviour compared to that of simpler polymeric melts. The theory developed by Doi attempts to explain the observed phenomena in terms of considering interactions of rigid-rods Exact solutions to the Doi theory have been compared to experimental procedures using lyotropic LCP systems. Although much of the available data relates to mechanical measurements, the comparisons with quantitative structural data can provide useful insight.
This research addresses dementia and driving cessation, a major life event for affected individuals, and an immense challenge in primary care. In Australia, as with many other countries, it is primarily general practitioners (GPs) who identify changes in cognitive functioning and monitor driving issues with their patients with dementia. Qualitative evidence from studies with family members and other health professionals shows it is a complicated area of practice. However we still know little from GPs about how they manage the challenges with their patients and the strategies that they use to facilitate driving cessation.
Data were collected through five focus groups with 29 GPs at their primary care practices in metropolitan and regional Queensland, Australia. A semi-structured topic guide was used to direct questions addressing decision factors and management strategies. Discussions were audio recorded, transcribed verbatim and thematically analyzed.
Regarding the challenges of raising driving cessation, four key themes emerged. These included: (i) Considering the individual; (ii) GP-patient relationships may hinder or help; (iii) Resources to support raising driver retirement; and (iv) Ethical dilemmas and ethical considerations. The impact of discussing driving cessation on GPs is discussed.
The findings of this study contribute to further understanding the experiences and needs of primary care physicians related to managing driving retirement with their patients with dementia. Results support a need for programs regarding identification and assessment of fitness to drive, to upskill health professionals and particularly GPs to manage the complex issues around dementia and driving cessation, and explore cost-effective and timely delivery of such support to patients.
Introduction: The ECG diagnosis of acute coronary occlusion (ACO) in the setting of ventricular paced rhythm (VPR) is purported to be impossible. However, VPR has a similar ECG morphology to LBBB. The validated Smith-modified Sgarbossa criteria (MSC) have high sensitivity (Sens) and specificity (Spec) for ACO in LBBB. MSC consist of 1 of the following in 1 lead: concordant ST Elevation (STE) 1 mm, concordant ST depression 1 mm in V1-V3, or ST/S ratio <−0.25 (in leads with 1 mm STE). We hypothesized that the MSC will have higher Sens for diagnosis of ACO in VPR when compared to the original Sgarbossa criteria. We report preliminary findings of the Paced Electrocardiogram Requiring Fast Emergency Coronary Therapy (PERFECT) study Methods: The PERFECT study is a retrospective, multicenter, international investigation of ED patients from 1/2008 - 12/2016 with VPR on the ECG and symptoms suggestive of acute coronary syndrome (e.g. chest pain or shortness of breath). Data from four sites are presented. Acute myocardial infarction (AMI) was defined by the Third Universal Definition of AMI. A blinded cardiologist adjudicated ACO, defined as thrombolysis in myocardial infarction score 0 or 1 on coronary angiography; a pre-defined subgroup of ACO patients with peak cardiac troponin (cTn) >100 times the 99% upper reference limit (URL) of the cTn assay was also analyzed. Another blinded physician measured all ECGs. Statistics were by Mann Whitney U, Chi-square, and McNemars test. Results: The ACO and No-AMI groups consisted of 15 and 79 encounters, respectively. For the ACO and No-AMI groups, median age was 78 [IQR 72-82] vs. 70 [61-75] and 13 (86%) vs. 48 (61%) patients were male. The median peak cTn ratio (cTn/URL) was 260 [33-663] and 0.5 [0-1.3] for ACO vs. no-AMI. The Sens and Spec for the MSC and the original Sgarbossa criteria were 67% (95%CI 39-87) vs. 46% (22-72; p=0.25) and 99% (92-100) vs. 99% (92-100; p=0.5). In pre-defined subgroup analysis of ACO patients with peak cTn >100 times the URL (n=10), the Sens was 90% (54-100) for the MSC vs. 60% (27- 86) for original Sgarbossa criteria (p=0.25). Conclusion: ACO in VPR is an uncommon condition. The MSC showed good Sens for diagnosis of ACO in the presence of VPR, especially among patients with high peak cTn, and Spec was excellent. These methods and results are consistent with studies that have used the MSC to diagnose ACO in LBBB.
Bedding-plane assemblages of Ediacaran fossils from Mistaken Point, Newfoundland, are among the oldest known records of complex multicellular life on Earth (dated to ~565 Ma). The in situ preservation of these sessile but otherwise deeply enigmatic organisms means that statistical analyses of specimen positions can be used to illuminate their underlying ecological dynamics, including the interactions between taxa.
Fossil assemblages on Mistaken Point D and E surfaces were mapped to millimeter accuracy using differentiated GPS. Spatial correlations between 10 well-defined taxa (Bradgatia, Charniid, Charniodiscus, Fractofusus, Ivesheadiomorphs, Lobate Discs, Pectinifrons, Plumeropriscum, Hiemalora, and Thectardis) were identified using Bayesian network inference (BNI), and then described and analyzed using spatial point-process analysis. BNI found that the E-surface community had a complex web of interactions and associations between taxa, with all but one taxon (Thectardis) interacting with at least one other. The unique spatial distribution of Thectardis supports previous, morphology-based arguments for its fundamentally distinct nature. BNI revealed that the D-surface community showed no interspecific interactions or associations, a pattern consistent with a homogeneous environment.
On the E surface, all six of the abundant taxonomic groups (Fractofusus, Bradgatia, Charniid, Charniodiscus, Thectardis, and Plumeropriscum) were found to have a unique set of interactions with other taxa, reflecting a broad range of underlying ecological responses. Four instances of habitat associations were detected between taxa, of which two (Charniodiscus–Plumeropriscum and Plumeropriscum–Fractofusus) led to weak competition for resources. One case of preemptive competition between Charniid and Lobate Discs was detected. There were no instances of interspecific facilitation. Ivesheadiomorph interactions mirror those of Fractofusus and Charniodiscus, identifying them as a form-taxonomic grouping of degradationally homogenized taphomorphs. The absence of increased fossil abundance in proximity to these taphomorphs argues against scavenging or saprophytic behaviors dominating the E-surface community.
We present techniques developed to calibrate and correct Murchison Widefield Array low-frequency (72–300 MHz) radio observations for polarimetry. The extremely wide field-of-view, excellent instantaneous (u, v)-coverage and sensitivity to degree-scale structure that the Murchison Widefield Array provides enable instrumental calibration, removal of instrumental artefacts, and correction for ionospheric Faraday rotation through imaging techniques. With the demonstrated polarimetric capabilities of the Murchison Widefield Array, we discuss future directions for polarimetric science at low frequencies to answer outstanding questions relating to polarised source counts, source depolarisation, pulsar science, low-mass stars, exoplanets, the nature of the interstellar and intergalactic media, and the solar environment.
To explore the trends in infection control peer-reviewed journals, mainstream media, and blogs written by infection control professionals
Narrative and scoping reviews
Narrative and scoping reviews were performed to identify trending infection prevention and control topics from international journals, national news websites, newspapers, and so-called grey literature throughout 2015. Data were analyzed using word frequencies, and results are displayed in word clouds.
For 2015, our search identified 6 news websites with a total of published 116 articles, 71 articles from selected newspapers, and 214 publications from infection control websites. In total, 1,059 journal articles were initially identified; 98 articles were anonymous and thus were excluded, leaving 961 articles in the reviews. The terms ‘superbug’ and ‘antibiotics’ were most commonly used in titles of news websites and newspapers, whereas the terms ‘infection’ and ‘prevention’ were most commonly used in infection control websites or blogs. The word frequency differences among the 4 selected journals reflected their respective specialties.
In infection prevention and control, the integration of a range of mediums is necessary to best serve public interests. Whether the aim is advocacy, general health information dissemination, or warnings of imminent risk, health researchers have access to multiple forums with different strengths through which to influence public risk perceptions and responses.
Introduction: In Ottawa, STEMI patients are transported directly to percutaneous coronary intervention (PCI) by advanced care paramedics (ACPs), primary care paramedics (PCPs), or transferred from PCP to ACP crew (ACP-intercept). PCPs have a limited skill set to address complications during transport.The objective of this study was to determine what clinically important events (CIEs) occurred in STEMI patients transported for primary PCI via a PCP crew, and what proportion of such events could only be treated by ACP protocols. Methods: We conducted a health record review of STEMI patients transported for primary PCI from Jan 1, 2011-Dec 21, 2015. Ottawa has a single PCI center and its EMS system employs both PCP and ACP paramedics. We identified consecutive STEMI bypass patients transported by PCP-only and ACP-intercept using the dispatch database. A data extraction form was piloted and used to extract patient demographics, transport times, and primary outcomes: CIEs and interventions performed during transport, and secondary outcomes: hospital diagnosis, and mortality. CIEs were reviewed by two investigators to determine if they would be treated differently by ACP protocols. We present descriptive statistics. Results: We identified 967 STEMI bypass cases among which 214 (118 PCP-only and 96 ACP-intercept) met all inclusion criteria. Characteristics were: mean age 61.4 years, 78% male, 31.8% anterior and 44.4% inferior infarcts, mean response time 6 min, total paramedic contact time 29 min, and in cases of ACP-intercept 7 min of PCP-only contact time.A CIE occurred in 127 (59%) of cases: SBP<90 mmHg 26.2%, HR<60 30.4%, HR>100 20.6%, malignant arrhythmias 7.5%, altered mental status 6.5%, airway intervention 2.3%, 2 patients (0.9%) arrested, both survived. Of the CIE identified, 54 (42.5%) could be addressed differently by ACP vs PCP protocols (25.2% of total cases). The majority related to fluid boluses for hypotension (44 cases; 35% of CIE). ACP intervention for CIEs within the ACP intercept group was 51.6%. There were 6 in-hospital deaths (2.8%) with no difference in transport crew type. Conclusion: CIEs are common in STEMI bypass patients however a smaller proportion of such CIE would be addressed differently by ACP protocols compared to PCP protocols. The vast majority of CIE appeared to be transient and of limited clinical significance.
Despite the known heightened risk and burden of various somatic diseases in people with depression, very little is known about physical health multimorbidity (i.e. two or more physical health co-morbidities) in individuals with depression. This study explored physical health multimorbidity in people with clinical depression, subsyndromal depression and brief depressive episode across 43 low- and middle-income countries (LMICs).
Cross-sectional, community-based data on 190 593 individuals from 43 LMICs recruited via the World Health Survey were analysed. Multivariable logistic regression analysis was done to assess the association between depression and physical multimorbidity.
Overall, two, three and four or more physical health conditions were present in 7.4, 2.4 and 0.9% of non-depressive individuals compared with 17.7, 9.1 and 4.9% among people with any depressive episode, respectively. Compared with those with no depression, subsyndromal depression, brief depressive episode and depressive episode were significantly associated with 2.62, 2.14 and 3.44 times higher odds for multimorbidity, respectively. A significant positive association between multimorbidity and any depression was observed across 42 of the 43 countries, with particularly high odds ratios (ORs) in China (OR 8.84), Laos (OR 5.08), Ethiopia (OR 4.99), the Philippines (OR 4.81) and Malaysia (OR 4.58). The pooled OR for multimorbidity and depression estimated by meta-analysis across 43 countries was 3.26 (95% confident interval 2.98–3.57).
Our large multinational study demonstrates that physical health multimorbidity is increased across the depression spectrum. Public health interventions are required to address this global health problem.
There is a need for clinical tools to identify cultural issues in diagnostic assessment.
To assess the feasibility, acceptability and clinical utility of the DSM-5 Cultural Formulation Interview (CFI) in routine clinical practice.
Mixed-methods evaluation of field trial data from six countries. The CFI was administered to diagnostically diverse psychiatric out-patients during a diagnostic interview. In post-evaluation sessions, patients and clinicians completed debriefing qualitative interviews and Likert-scale questionnaires. The duration of CFI administration and the full diagnostic session were monitored.
Mixed-methods data from 318 patients and 75 clinicians found the CFI feasible, acceptable and useful. Clinician feasibility ratings were significantly lower than patient ratings and other clinician-assessed outcomes. After administering one CFI, however, clinician feasibility ratings improved significantly and subsequent interviews required less time.
The CFI was included in DSM-5 as a feasible, acceptable and useful cultural assessment tool.
A relatively lightweight and simple airborne system for surface elevation profiling of glaciers in narrow mountain valleys has been developed and tested. The aircraft position is determined by kinematic global positioning system (GPS) methods. The distance to the glacier surface is determined with a laser ranger. The accuracy is about 0.3 m, sufficient to permit future changes to be observed over short time intervals. Long-term changes can be estimated by comparison of profiles with existing maps. Elevation profiles obtained in 1993–94 from three glaciers in central and south-central Alaska are compared with maps made about 1950. The resulting area-averaged, seasonally corrected thickness changes during the interval are: Gulkana Glacier (central Alaska Range)–11 m, Worthington Glacier (central Chugach Mountains) +7 m, and Bear Lake Glacier (Kenai Mountains) −12 m. All three glaciers retreated during the interval of comparison. The estimated uncertainty in the average thickness change is ±5 m. which is mainly due to errors in the existing maps. Constraints on the accuracy of the maps are obtained by profiling in proglacial areas.
Worldwide, dating rock art is difficult to achieve because of the frequent lack of datable material and the difficulty of removing contamination from samples. Our research aimed to select the paints that would be the most likely to be successfully radiocarbon dated and to estimate the quantity of paint needed depending on the nature of the paint and the weathering and alteration products associated with it. To achieve this aim, a two-step sampling strategy, coupled with a multi-instrument characterization (including SEM-EDS, Raman spectroscopy, and FTIR spectroscopy analysis) and a modified acid-base-acid (ABA) pretreatment, was created. In total, 41 samples were dated from 14 sites in three separate regions of southern Africa. These novel protocols ensure that the 14C chronology produced was robust and could also be subsequently applied to different regions with possible variations in paint preparation, geology, weathering conditions, and contaminants.
We describe the performance of the Boolardy Engineering Test Array, the prototype for the Australian Square Kilometre Array Pathfinder telescope. Boolardy Engineering Test Array is the first aperture synthesis radio telescope to use phased array feed technology, giving it the ability to electronically form up to nine dual-polarisation beams. We report the methods developed for forming and measuring the beams, and the adaptations that have been made to the traditional calibration and imaging procedures in order to allow BETA to function as a multi-beam aperture synthesis telescope. We describe the commissioning of the instrument and present details of Boolardy Engineering Test Array’s performance: sensitivity, beam characteristics, polarimetric properties, and image quality. We summarise the astronomical science that it has produced and draw lessons from operating Boolardy Engineering Test Array that will be relevant to the commissioning and operation of the final Australian Square Kilometre Array Path telescope.
White matter (WM) impairments have been reported in patients with bipolar disorder (BD) and those at high familial risk of developing BD. However, the distribution of these impairments has not been well characterized. Few studies have examined WM integrity in young people early in the course of illness and in individuals at familial risk who have not yet passed the peak age of onset.
WM integrity was examined in 63 BD subjects, 150 high-risk (HR) individuals and 111 participants with no family history of mental illness (CON). All subjects were aged 12 to 30 years.
This young BD group had significantly lower fractional anisotropy within the genu of the corpus callosum (CC) compared with the CON and HR groups. Moreover, the abnormality in the genu of the CC was also present in HR participants with recurrent major depressive disorder (MDD) (n = 16) compared with CON participants.
Our findings provide important validation of interhemispheric abnormalities in BD patients. The novel finding in HR subjects with recurrent MDD – a group at particular risk of future hypo/manic episodes – suggests that this may potentially represent a trait marker for BD, though this will need to be confirmed in longitudinal follow-up studies.
Understanding resilience is important to creating and maintaining health in the workplace, and the focal article by Britt, Shen, Sinclair, Grossman, and Klieger (2016) raises valuable questions and recommendations for research in the field. In this commentary we consider several issues not discussed by Britt et al. but critical to understanding resilience in organizational settings. In particular, we discuss the utility of process-oriented models and, specifically, the role of self-regulatory processes as foundational mechanisms of resiliency. We agree with many of Britt et al.’s recommendations and provide additional perspectives and information based on recent research on resiliency in military personnel experiencing cross-cultural adversity, in executives experiencing unwanted career transitions, and in recent immigrants searching for employment.