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Fungal hyphae associated with tree roots extending into the surrounding substrate are suspected to have to contaminated buried plant material with recent carbon in two examples and to have resulted in erroneously young radiocarbon ages. This problem might be overcome by choosing sampling sites far from trees or by analyzing the lignin component of samples, although the latter is presently difficult.
Background: Hospital-onset bacteremia and fungemia (HOB) may be a preventable hospital-acquired condition and a potential healthcare quality measure. We developed and evaluated a tool to assess the preventability of HOB and compared it to a more traditional consensus panel approach. Methods: A 10-member healthcare epidemiology expert panel independently rated the preventability of 82 hypothetical HOB case scenarios using a 6-point Likert scale (range, 1= “Definitively or Almost Certainly Preventable” to 6= “Definitely or Almost Certainly Not Preventable”). Ratings on the 6-point scale were collapsed into 3 categories: Preventable (1–2), Uncertain (3–4), or Not preventable (5–6). Consensus was defined as concurrence on the same category among ≥70% expert raters. Cases without consensus were deliberated via teleconference, web-based discussion, and a second round of rating. The proportion meeting consensus, overall and by predefined HOB source attribution, was calculated. A structured HOB preventability rating tool was developed to explicitly account for patient intrinsic and extrinsic healthcare-related risks (Fig. 1). Two additional physician reviewers independently applied this tool to adjudicate the same 82 case scenarios. The tool was iteratively revised based on reviewer feedback followed by repeat independent tool-based adjudication. Interrater reliability was evaluated using the Kappa statistic. Proportion of cases where tool-based preventability category matched expert consensus was calculated. Results: After expert panel round 1, consensus criteria were met for 29 cases (35%), which increased to 52 (63%) after round 2. Expert consensus was achieved more frequently for respiratory or surgical site infections than urinary tract and central-line–associated bloodstream infections (Fig. 2a). Most likely to be rated preventable were vascular catheter infections (64%) and contaminants (100%). For tool-based adjudication, following 2 rounds of rating with interim tool revisions, agreement between the 2 reviewers was 84% for cases overall (κ, 0.76; 95% CI, 0.64–0.88]), and 87% for the 52 cases with expert consensus (κ, 0.79; 95% CI, 0.65–0.94). Among cases with expert consensus, tool-based rating matched expert consensus in 40 of 52 (77%) and 39 of 52 (75%) cases for reviewer 1 and reviewer 2, respectively. The proportion of cases rated “uncertain“ was lower among tool-based adjudicated cases with reviewer agreement (15 of 69) than among cases with expert consensus (23 of 52) (Fig. 2b). Conclusions: Healthcare epidemiology experts hold varying perspectives on HOB preventability. Structured tool-based preventability rating had high interreviewer reliability, matched expert consensus in most cases, and rated fewer cases with uncertain preventability compared to expert consensus. This tool is a step toward standardized assessment of preventability in future HOB evaluations.
Life events play a role in the development of childhood depression. According to the literature major depression lowers subjective quality of life (QL). There are few studies about factors decreasing QL in general and even less on child and adolescent samples. The relationship between mental disorders and QL is not well studied either. In the present research we studied the quality of life in a school population and the relationship of QL to the number of stressful life events (SLE) and the severity of depressive symptoms.
The sample consisted of 9 elementary schools in Hungary. 2620 children were tested between 7-15 years of age (mean age: 10.45 years (s.d. 2.2). There were 1160 boys (44%) and 1460 girls (56%). Stressful life events were collected by parental report, depressive symptoms were assessed by short version of CDI, quality of life was measured by self-report and parental questionnaires (ILK).
Both stressful life events and depressive symptoms have a significant negative effect on subjective QL overall and individual QL domains. The effect of depressive symptom severity is much larger than that of the SLE. When comparing the parent and child opinions about the QL of the child, we can see that depressive symptoms are more important in childrens' opinion while SLE is more negative in parents' opinion. Stressful life events effect subjective QL directly (50%), indirectly (50%) through depressive symptoms. A complex study of the QL in childhood onset mental disorders would be important.
The thickness of glaciers in High-Mountain Asia (HMA) is critical in determining when the ice reserve will be lost as these glaciers thin but is remarkably poorly known because very few measurements have been made. Through a series of ground-based and airborne field tests, we have adapted a low-frequency ice-penetrating radar developed originally for Antarctic over-snow surveys, for deployment as a helicopter-borne system to increase the number of measurements. The manoeuvrability provided by helicopters and the ability of our system to detect glacier beds through thick, dirty, temperate ice makes it well suited to increase greatly the sample of measurements available for calibrating ice thickness models on the regional and global scale. The Bedmap Himalayas radar-survey system can reduce the uncertainty in present-day ice volumes and therefore in projections of when HMA's river catchments will lose this hydrological buffer against drought.
Ponds that form on sea ice can cause it to thin or break-up, which can promote calving from an adjacent ice shelf. Studies of sea ice ponds have predominantly focused on Arctic ponds formed by in situ melting/ponding. Our study documents another mechanism for the formation of sea ice ponds. Using Landsat 8 and Sentinel-2 images from the 2015–16 to 2018–19 austral summers, we analyze the evolution of sea ice ponds that form adjacent to the McMurdo Ice Shelf, Antarctica. We find that each summer, meltwater flows from the ice shelf onto the sea ice and forms large (up to 9 km2) ponds. These ponds decrease the sea ice's albedo, thinning it. We suggest the added mass of runoff causes the ice to flex, potentially promoting sea-ice instability by the ice-shelf front. As surface melting on ice shelves increases, we suggest that ice-shelf surface hydrology will have a greater effect on sea-ice stability.
The dominant conceptions of emotional intelligence can be categorized into “ability” models and “mixed” models. Ability models view emotional intelligence as a construct related to other intelligences and consisting of a set of mental abilities whereas mixed models view emotional intelligence as a blend of standard personality traits and various abilities. In this chapter, we review these models of emotional intelligence, including the measures associated with each, and provide a brief summary of the debate between ability models and mixed models. Narrowing in on the ability conception of emotional intelligence, we then discuss its behavioral and neural correlates, development, and malleability, as well as a school-based intervention designed to promote these skills. We conclude with an exploration of possibilities for the emotional intelligence research landscape in the next thirty years.
Translocation and rehabilitation programmes are critical tools for wildlife conservation. These methods achieve greater impact when integrated in a combined strategy for enhancing population or ecosystem restoration. During 2002–2016 we reared 37 orphaned southern sea otter Enhydra lutris nereis pups, using captive sea otters as surrogate mothers, then released them into a degraded coastal estuary. As a keystone species, observed increases in the local sea otter population unsurprisingly brought many ecosystem benefits. The role that surrogate-reared otters played in this success story, however, remained uncertain. To resolve this, we developed an individual-based model of the local population using surveyed individual fates (survival and reproduction) of surrogate-reared and wild-captured otters, and modelled estimates of immigration. Estimates derived from a decade of population monitoring indicated that surrogate-reared and wild sea otters had similar reproductive and survival rates. This was true for males and females, across all ages (1–13 years) and locations evaluated. The model simulations indicated that reconstructed counts of the wild population are best explained by surrogate-reared otters combined with low levels of unassisted immigration. In addition, the model shows that 55% of observed population growth over this period is attributable to surrogate-reared otters and their wild progeny. Together, our results indicate that the integration of surrogacy methods and reintroduction of juvenile sea otters helped establish a biologically successful population and restore a once-impaired ecosystem.
In recent years, the discovery of massive quasars at
has provided a striking challenge to our understanding of the origin and growth of supermassive black holes in the early Universe. Mounting observational and theoretical evidence indicates the viability of massive seeds, formed by the collapse of supermassive stars, as a progenitor model for such early, massive accreting black holes. Although considerable progress has been made in our theoretical understanding, many questions remain regarding how (and how often) such objects may form, how they live and die, and how next generation observatories may yield new insight into the origin of these primordial titans. This review focusses on our present understanding of this remarkable formation scenario, based on the discussions held at the Monash Prato Centre from November 20 to 24, 2017, during the workshop ‘Titans of the Early Universe: The Origin of the First Supermassive Black Holes’.
Hendra virus (HeV) continues to cause fatal infection in horses and threaten infection in close-contact humans in eastern Australia. Species of Pteropus bats (flying-foxes) are the natural reservoir of the virus. We caught and sampled flying-foxes from a multispecies roost in southeast Queensland, Australia on eight occasions between June 2013 and June 2014. The effects of sample date, species, sex, age class, body condition score (BCS), pregnancy and lactation on HeV antibody prevalence, log-transformed median fluorescent intensity (lnMFI) values and HeV RNA status were assessed using unbalanced generalised linear models. A total of 1968 flying-foxes were sampled, comprising 1012 Pteropus alecto, 742 P. poliocephalus and 214 P. scapulatus. Sample date, species and age class were each statistically associated with HeV RNA status, antibody status and lnMFI values; BCS was statistically associated with HeV RNA status and antibody status. The findings support immunologically naïve sub-adult P. alecto playing an important role in maintaining HeV infection at a population level. The biological significance of the association between BCS and HeV RNA status, and BCS and HeV antibody status, is less clear and warrants further investigation. Contrary to previous studies, we found no direct association between HeV infection and pregnancy or lactation. The findings in P. poliocephalus suggest that HeV exposure in this species may not result in systemic infection and virus excretion, or alternatively, may reflect assay cross-reactivity with another (unidentified) henipavirus.
Surface debris covers much of the western portion of the McMurdo Ice Shelf and has a strong influence on the local surface albedo and energy balance. Differential ablation between debris-covered and debris-free areas creates an unusual heterogeneous surface of topographically low, high-ablation, and topographically raised (‘pedestalled’), low-ablation areas. Analysis of Landsat and MODIS satellite imagery from 1999 to 2018, alongside field observations from the 2016/2017 austral summer, shows that pedestalled relict lakes (‘pedestals’) form when an active surface meltwater lake that develops in the summer, freezes-over in winter, resulting in the lake-bottom debris being masked by a high-albedo, superimposed, ice surface. If this ice surface fails to melt during a subsequent melt season, it experiences reduced surface ablation relative to the surrounding debris-covered areas of the ice shelf. We propose that this differential ablation, and resultant hydrostatic and flexural readjustments of the ice shelf, causes the former supraglacial lake surface to become increasingly pedestalled above the lower topography of the surrounding ice shelf. Consequently, meltwater streams cannot flow onto these pedestalled features, and instead divert around them. We suggest that the development of pedestals has a significant influence on the surface-energy balance, hydrology and flexure of the ice shelf.
Medical procedures and patient care activities may facilitate environmental dissemination of healthcare-associated pathogens such as methicillin-resistant Staphylococcus aureus (MRSA).
Observational cohort study of MRSA-colonized patients to determine the frequency of and risk factors for environmental shedding of MRSA during procedures and care activities in carriers with positive nares and/or wound cultures. Bivariate analyses were performed to identify factors associated with environmental shedding.
A Veterans Affairs hospital.
This study included 75 patients in contact precautions for MRSA colonization or infection.
Of 75 patients in contact precautions for MRSA, 55 (73%) had MRSA in nares and/or wounds and 25 (33%) had positive skin cultures. For the 52 patients with MRSA in nares and/or wounds and at least 1 observed procedure, environmental shedding of MRSA occurred more frequently during procedures and care activities than in the absence of a procedure (59 of 138, 43% vs 8 of 83, 10%; P < .001). During procedures, increased shedding occurred ≤0.9 m versus >0.9 m from the patient (52 of 138, 38% vs 25 of 138, 18%; P = .0004). Contamination occurred frequently on surfaces touched by personnel (12 of 38, 32%) and on portable equipment used for procedures (25 of 101, 25%). By bivariate analysis, the presence of a wound with MRSA was associated with shedding (17 of 29, 59% versus 6 of 23, 26%; P = .04).
Environmental shedding of MRSA occurs frequently during medical procedures and patient care activities. There is a need for effective strategies to disinfect surfaces and equipment after procedures.
To examine the ways in which sugar-containing beverages are being portrayed as ‘better-for-you’ (BFY) via features on product labels.
Cross-sectional audit of beverage labels.
Adelaide, Australia. Data on beverage labels were collected from seventeen grocery stores during September to November 2016.
The content of 945 sugar-containing beverages labels were analysed for explicit and implicit features positioning them as healthy or BFY.
The mean sugar content of beverages was high at 8·3 g/100 ml and most sugar-containing beverages (87·7 %) displayed features that position them as BFY. This was most commonly achieved by indicating the beverages are natural (76·8 %), or contain reduced or natural energy/sugar content (48·4 %), or through suggesting that they contribute to meeting bodily needs for nutrition (28·9 %) or health (15·1 %). Features positioning beverages as BFY were more common among certain categories of beverages, namely coconut waters, iced teas, sports drinks and juices.
A large proportion of sugar-containing beverages use features on labels that position them as healthy or BFY despite containing high amounts of sugar.
We present very detailed images of the photosphere of an AGB star obtained with the PIONIER instrument, installed at the Very Large Telescope Interferometer (VLTI). The images show a well defined stellar disc populated by a few convective patterns. Thanks to the high precision of the observations we are able to derive the contrast and granulation horizontal scale of the convective pattern for the first time in a direct way. Such quantities are then compared with scaling relations between granule size, effective temperature, and surface gravity that are predicted by simulations of stellar surface convection.
The optimal approach to unifocalisation in pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (pulmonary artery/ventricular septal defect/major aortopulmonary collaterals) remains controversial. Moreover, the impact of collateral vessel disease burden on surgical decision-making and late outcomes remains poorly defined. We investigated our centre’s experience in the surgical management of pulmonary artery/ventricular septal defect/major aortopulmonary collaterals.
Materials and methods
Between 1996 and 2015, 84 consecutive patients with pulmonary artery/ventricular septal defect/major aortopulmonary collaterals underwent unifocalisation. In all, 41 patients received single-stage unifocalisation (Group 1) and 43 patients underwent multi-stage repair (Group 2). Preoperative collateral vessel anatomy, branch pulmonary artery reinterventions, ventricular septal defect status, and late right ventricle/left ventricle pressure ratio were evaluated.
Median follow-up was 4.8 compared with 5.7 years for Groups 1 and 2, respectively, p = 0.65. Median number of major aortopulmonary collaterals/patient was 3, ranging from 1 to 8, in Group 1 compared with 4, ranging from 1 to 8, in Group 2, p = 0.09. Group 2 had a higher number of lobar/segmental stenoses within collateral vessels (p = 0.02). Group 1 had fewer catheter-based branch pulmonary artery reinterventions, with 5 (inter-quartile range from 1 to 7) per patient, compared with 9 (inter-quartile range from 4 to 14) in Group 2, p = 0.009. Among patients who achieved ventricular septal defect closure, median right ventricle/left ventricle pressure was 0.48 in Group 1 compared with 0.78 in Group 2, p = 0.03. Overall mortality was 6 (17%) in Group 1 compared with 9 (21%) in Group 2.
Single-stage unifocalisation is a promising repair strategy in select patients, achieving low rates of reintervention for branch pulmonary artery restenosis and excellent mid-term haemodynamic outcomes. However, specific anatomic substrates of pulmonary artery/ventricular septal defect/major aortopulmonary collaterals may be better suited to multi-stage repair. Preoperative evaluation of collateral vessel calibre and function may help inform more patient-specific surgical management.
Escherichia coli O157:H7 is the largest cause of hemolytic uremic syndrome (HUS). Previous studies proposed that HUS risk varies across the E. coli O157:H7 phylogenetic tree (hypervirulent clade 8), but the role of age in the association is unknown. We determined phylogenetic lineage of E. coli O157:H7 isolates from 1160 culture-confirmed E. coli O157:H7 cases reported in Washington State, 2004–2015. Using generalised estimating equations, we tested the association between phylogenetic lineage and HUS. Age was evaluated as an effect modifier. Among 1082 E. coli O157:H7 cases with both phylogenetic lineage and HUS status (HUS n = 76), stratified analysis suggested effect modification by age. Lineages IIa and IIb, relative to Ib, did not appear associated with HUS in children 0–9-years-old. For cases 10–59-years-old, lineages IIa and IIb appeared to confer increased risk of HUS, relative to lineage Ib. The association reversed in ⩾60-year-olds. Results were similar for clade 8. Phylogenetic lineage appears to be associated with HUS risk only among those ⩾10-years-old. Among children <10, the age group most frequently affected, lineage does not explain progression to HUS. However, lineage frequency varied across age groups, suggesting differences in exposure and/or early disease manifestation.