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Increasing emphasis is given on involving patients in health technology assessment (HTA). While this is mainly done at the level of regional and national HTA agencies, this tendency is also emerging in local HTA units. In this study, we provide the results of a survey conducted in local HTA units in the province of Quebec, Canada. The aim of the survey was to provide an overview of local HTA unit practices to involve patients, users, caregivers, and citizens in their process, their interest in doing so, and their information needs for this.
The survey was conducted in 2017 with a response rate of eleven units over a possibility of twelve.
Three units out of eleven (27.3 percent) never involved patients or members of the public in their processes and all indicated that they will involve them in the next few years. The three most important needs for support identified in the HTA units were in: recruiting and selecting patients; integrating experiential knowledge; and knowing and implementing the best methods and practices for partnership.
Patient involvement in local HTA units is quickly evolving and that is why they urgently need tools to involve more effectively patients and members of the public in their process.
Raw milk cheeses are commonly consumed in France and are also a common source of foodborne outbreaks (FBOs). Both an FBO surveillance system and a laboratory-based surveillance system aim to detect Salmonella outbreaks. In early August 2018, five familial FBOs due to Salmonella spp. were reported to a regional health authority. Investigation identified common exposure to a raw goats' milk cheese, from which Salmonella spp. were also isolated, leading to an international product recall. Three weeks later, on 22 August, a national increase in Salmonella Newport ST118 was detected through laboratory surveillance. Concomitantly isolates from the earlier familial clusters were confirmed as S. Newport ST118. Interviews with a selection of the laboratory-identified cases revealed exposure to the same cheese, including exposure to batches not included in the previous recall, leading to an expansion of the recall. The outbreak affected 153 cases, including six cases in Scotland. S. Newport was detected in the cheese and in the milk of one of the producer's goats. The difference in the two alerts generated by this outbreak highlight the timeliness of the FBO system and the precision of the laboratory-based surveillance system. It is also a reminder of the risks associated with raw milk cheeses.
We present TreeFrog, a massively parallel halo merger tree builder that is capable comparing different halo catalogues and producing halo merger trees. The code is written in c++11, use the MPI and OpenMP API’s for parallelisation, and includes python tools to read/manipulate the data products produced. The code correlates binding energy sorted particle ID lists between halo catalogues, determining optimal descendant/progenitor matches using multiple snapshots, a merit function that maximises the number of shared particles using pseudo-radial moments, and a scheme for correcting halo merger tree pathologies. Focusing on VELOCIraptor catalogues for this work, we demonstrate how searching multiple snapshots spanning a dynamical time significantly reduces the number of stranded halos, those lacking a descendant or a progenitor, critically correcting poorly resolved halos. We present a new merit function that improves the distinction between primary and secondary progenitors, reducing tree pathologies. We find FOF accretion rates and merger rates show similar mass ratio dependence. The model merger rates from Poole, et al. [2017, 472, 3659] agree with the measured net growth of halos through mergers.
We present VELOCIraptor, a massively parallel galaxy/(sub)halo finder that is also capable of robustly identifying tidally disrupted objects and separate stellar halos from galaxies. The code is written in C++11, use the Message Passing Interface (MPI) and OpenMP Application Programming Interface (API) for parallelisation, and includes python tools to read/manipulate the data products produced. We demonstrate the power of the VELOCIraptor (sub)halo finder, showing how it can identify subhalos deep within the host that have negligible density contrasts to their parent halo. We find a subhalo mass-radial distance dependence: large subhalos with mass ratios of ≳10−2 are more common in the central regions than smaller subhalos, a result of dynamical friction and low tidal mass loss rates. This dependence is completely absent in (sub)halo finders in common use, which generally search for substructure in configuration space, yet is present in codes that track particles belonging to halos as they fall into other halos, such as hbt+. VELOCIraptor largely reproduces the dependence seen without tracking, finding a similar radial dependence to hbt+ in well-resolved halos from our limited resolution fiducial simulation.
Merger trees harvested from cosmological N-body simulations encode the assembly histories of dark matter halos over cosmic time and are a fundamental component of semi-analytical models of galaxy formation. The ability to compare the tools used to construct merger trees, namely halo finders and tree building algorithms, in an unbiased and systematic manner is critical to assess the quality of merger trees. In this paper, we present the dendrogram, a novel method to visualise merger trees, which provides a comprehensive characterisation of a halo’s assembly history—tracking subhalo orbits, halo merger events, and the general evolution of halo properties. We show the usefulness of the dendrogram as a diagnostic tool of merger trees by comparing halo assembly simulation analysed with three different halo finders—VELOCIraptor, AHF, and Rockstar—and their associated tree builders. Based on our analysis of the resulting dendrograms, we highlight how they have been used to motivate improvements to VELOCIraptor. The dendrogram software is publicly available online, at: https://github.com/rhyspoulton/MergerTree-Dendrograms.
To describe the investigation and control of a rare cluster of Klebsiella pneumoniae carbapenemase–producing Citrobacter freundii in a hospital in southern Florida.
An epidemiologic investigation, review of infection prevention procedures, and molecular studies including whole genome sequencing were conducted.
An outbreak of K. pneumoniae carbapenemase–3-producing C. freundii was identified at a tertiary hospital in Florida in 2014. Of the 6 cases identified, 3 occurred in the same intensive care unit and were caused by the same clone. For 2 of the 3 remaining cases, the isolates had low carbapenem minimum inhibitory concentrations and were unrelated by whole genome sequencing. As a response to the outbreak, supplementary environmental cleaning was implemented, including closure and terminal cleaning of the unit where the 3 cases clustered, in addition to the infection control bundle already in place at the time. No further cases were identified after these additional interventions.
Although C. freundii is not a species that commonly demonstrates carbapenem resistance, our findings suggest that carbapenemase-producing C. freundii may be underdetected even when active surveillance is in place and has a potential to cause hospital outbreak.
Limiting the post-weaning intake of the young rabbit is known to improve its resistance to digestive disorders, whereas a degradation of its housing hygiene is assumed to have a negative impact on its health. This study aims at providing insights into the mechanism of digestive health preservation regarding both host (growth and immune response) and its symbiotic digestive microbiota. A 2×2 factorial design from weaning (day 28) to day 64 was set up: ad libitum intake or restricted intake at 70% of ad libitum, and high v. low hygiene of housing (n=105 per group). At day 36 and day 45, 15 animals/group were subcutaneously immunized with ovalbumin (OVA) to assess their specific immune response. Blood was sampled at 36, 45, 57 and 64 days of age to determine total and anti-OVA immunoglobulin type G (IgG) and haptoglobin levels. The cecal bacterial community was explored (18 per group) by 454 pyrosequencing of genes coding for the 16S ribosomal RNA, whereas cecal pH, NH3 and volatile fatty acid (VFA) concentrations were measured to characterize fermentative activity. A 30% reduction in feed intake reduced the growth by only 17% (P<0.001), and improved the feed conversion ratio by 15% (P<0.001), whereas the degradation of hygiene conditions slightly decreased the feed intake in ad libitum fed rabbits (−3.5%, P<0.02). As poor hygiene conditions did not affect weight gain, feed conversion was improved from day 42 (P<0.05). Restricted feeding led to a lower mortality between day 28 and day 40 (P=0.047), whereas degraded hygiene conditions decreased overall morbidity (7.8% v. 16.6%; P<0.01). Both a reduced intake and low hygiene conditions of housing affected microbiota composition and especially dominant genera belonging to the Ruminococcaceae family (P<0.01). Moreover, low hygiene was associated with a higher Ruminococcaceae/Lachnospiraceae ratio (3.7 v. 2.4; P<0.05). Cecal total VFA and pH were increased (+19%; P<0.001) and decreased (−0.1 pH unit; P<0.05), respectively, in feed-restricted rabbits. Neither specific anti-OVA IgG nor haptoglobin was affected by treatments. Total IgG concentrations were the highest in animals raised in poor hygiene conditions after 8 days of restriction, but decreased after 19 days of restriction in high hygiene conditions (−2.15%; P<0.05). In conclusion, the degradation of hygiene conditions failed to induce a systematic specific and inflammatory response in rabbit, but reduced morbidity instead. Our results suggest that the microbiota composition would be a helpful source of biomarkers of digestive health.
Screen-printed organic electrochemical transistors (OECTs) were tested as glucose and lactate sensors. The intrinsic amplification of the device allowed it to detect metabolites in low molecular range and validation tests were made on real human sweat. The development of an organically modified sol–gel solid electrolyte paves the way for all printed OECT-based biosensors.
Cu90Ag10 alloys were subjected to severe plastic deformation at temperatures ranging from 25 to 400 °C and strain rates ranging from 0.1 to 6.25 s−1 using high-pressure torsion. The deformed samples were characterized by x-ray diffraction, transmission electron microscopy, and atom-probe tomography. A dynamic competition between shear-induced mixing and thermally activated decomposition led to the self-organization of the Cu–Ag system at length scales varying from a few atomic distances at room temperature to ≈50 nm at 400 °C. Steady-state microstructural length scales were minimally affected by varying the strain rate, although at 400 °C, the grain morphology did depend on strain-rate. Our results show that diffusion below 300 °C is dominated by nonequilibrium vacancies, and by comparison with previous Kinetic Monte Carlo simulations [D. Schwen et al., J. Mater. Res.28, 2687–2693 (2013)], their concentration could be obtained.
In this work we examine the electrical characteristics and the memory properties of metal-alumina-nitride-oxide-silicon (MANOS) devices as a function of the post deposition annealing conditions. Post deposition annealing of the samples was performed at 850 or 1050 °C in nitrogen ambient using two different processes: (1) Furnace annealing for 15 min and (2) rapid thermal annealing for 1 or 5 min. The capacitance equivalent thickness as extracted from the capacitance voltage characteristics depends strongly on the annealing process, being smallest for the furnace annealing. Furthermore, the experimental results indicate that the type of the annealing determines the defect state density of the Al2O3 layer, via which the undesired effect of gate electrode electron injection takes place in the negative voltage regime. For inert ambient annealing the furnace process appears more efficient as compared to RTA.
Ruthenium-nitrosyl (RuII(NO)) complexes are stable in the dark, but exhibit a unique photoreactivity which can lead either to a solid state isomerization from RuII(NO) to RuII(ON), or to a nitric oxide (NO·) release in solution. From our recent discovery of a high yield of isomerization (> 92%) in [RuII(py)4Cl(NO)](PF6)2, we have developed a computational strategy aimed at designing switchable nonlinear optical (NLO) material with high contrast (large difference in the on / off NLO response) in the solid state. Our synthetic targets are terpyridine based RuII chromophores in which various substituents can be introduced to adjust the NLO response which, at best, should be vanishing in the off state. Alternatively, these complexes can undergo a photo-induced NO· release in solution, a possibility which becomes increasingly appealing in relation to the discovery of the numerous biological roles of NO·, in the context of the emergence of the photodynamic therapy. A promising fluorene-terpyridine RuII(NO) complex was investigated, which could find an additional interest in relation to its capability for releasing NO· by a two-photon absorption process.
The behavior of the redox-based resistive switching memories is influenced by chemical interactions between the electrode and the solid electrolyte, as well as by local environment. The existence of different chemical potential gradients is resulting in nanobattery effect lowering the stability of the devices. In order to minimize these effects we introduce a graphene layer at the active electrode – solid electrolyte interface. We observe that graphene is acting as an effective diffusion barrier in the SiO2-based electrochemical metallization cells and acts catalytically on the electrochemical processes prior to resistive switching.
In two lexical decision experiments, we investigated how sentence language affects the bilingual's recognition of target words from the same or a different language. Dutch–English bilinguals read Dutch (L1) or English (L2) sentences, presented word by word, followed by English (Experiment 1) or Dutch (Experiment 2) target words. Targets were Dutch–English cognates or non-cognates in isolation or preceded by sentences providing a high or a low semantic constraint. English cognates were facilitated irrespective of whether they were preceded by high or low constraining English sentences (no language switch) or Dutch sentences (switch). For Dutch cognates, inhibition effects arose in low constraining sentences (irrespective of Dutch or English) and in English (switch) sentences (irrespective of semantic constraint). Thus, under mixed language conditions, sentence constraint modulates target word processing but does not always completely eliminate cross-linguistic effects. The results are interpreted in a BIA+ model that extends monolingual views on sentence comprehension.
We present the first magnetic map of the late-type giant 37 Com. The Least Squares Deconvolution (LSD) method and Zeeman Doppler Imaging (ZDI) inversion technique were applied. The chromospheric activity indicators Hα, S-index, Ca ii IRT and the radial velocity were also measured. The evolutionary status of the star has been studied on the basis of state-of-the-art stellar evolutionary models and chemical abundance analysis. 37 Com appears to be in the core Helium-burning phase.
We performed an observational study of the relation between the interstellar magnetic field alignment and star formation in twenty (20) sky regions containing Bok Globules. The presence of young stellar objects in the globules is verified by a search of infrared sources with spectral energy distribution compatible with a pre main-sequence star. The interstellar magnetic field direction is mapped using optical polarimetry. These maps are used to estimate the dispersion of the interstellar magnetic field direction in each region from a Gaussian fit, σB. In addition to the Gaussian dispersion, we propose a new parameter, η, to measure the magnetic field alignment that does not rely on any function fitting. Statistical tests show that the dispersion of the magnetic field direction is different in star forming globules relative to quiescent globules. Specifically, the less organised magnetic fields occur in regions having young stellar objects.
The structure and dynamics of young stellar object (YSO) accretion shocks depend strongly on the local magnetic field strength and configuration, as well as on the radiative transfer effects responsible for the energy losses. We present the first 3D YSO shock simulations of the interior of the stream, assuming a uniform background magnetic field, a clumpy infalling gas, and an acoustic energy flux flowing at the base of the chromosphere. We study the dynamical evolution and the post-shock structure as a function of the plasma-beta (thermal pressure over magnetic pressure). We find that a strong magnetic field (~hundreds of Gauss) leads to the formation of fibrils in the shocked gas due to the plasma confinement within flux tubes. The corresponding emission is smooth and fully distinguishable from the case of a weak magnetic field (~tenths of Gauss) where the hot slab demonstrates chaotic motion and oscillates periodically.
The Magnetism in Massive Stars (MiMeS) project represents the largest systematic survey of stellar magnetism ever undertaken. Based on a sample of over 550 Galactic B and O-type stars, the MiMeS project has derived the basic characteristics of magnetism in hot, massive stars. Herein we report preliminary results.