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A developing application of laser-driven currents is the generation of magnetic fields of picosecond–nanosecond duration with magnitudes exceeding
. Single-loop and helical coil targets can direct laser-driven discharge currents along wires to generate spatially uniform, quasi-static magnetic fields on the millimetre scale. Here, we present proton deflectometry across two axes of a single-loop coil ranging from 1 to 2 mm in diameter. Comparison with proton tracking simulations shows that measured magnetic fields are the result of kiloampere currents in the coil and electric charges distributed around the coil target. Using this dual-axis platform for proton deflectometry, robust measurements can be made of the evolution of magnetic fields in a capacitor coil target.
We report daptomycin minimum inhibitory concentrations (MICs) for vancomycin-resistant Enterococcus faecium isolated from bloodstream infections over a 4-year period. The daptomycin MIC increased over time hospital-wide for initial isolates and increased over time within patients, culminating in 40% of patients having daptomycin-nonsusceptible isolates in the final year of the study.
Introduction: Atrial fibrillation (AF) is the most common sustained arrhythmia affecting 1-2% of the population. Oral anticoagulation (OAC) reduces stroke risk by 60-80% in AF patients, but only 50% of indicated patients receive OAC. Many patients present to the ED with AF due to arrhythmia symptoms, however; lack of OAC prescription in the ED has been identified as a significant gap in the care of AF patients. Methods: This was a multi-center, pragmatic, three-phase before-after study, in three Canadian sites. Patients who presented to the ED with electrocardiographically (ECG) documented, nonvalvular AF and were discharged home were included. Phase 1 was a retrospective chart review to determine OAC prescription of AF patients in each ED; Phase 2 was a low-intensity knowledge translation intervention where a simple OAC-prescription tool for ED physicians with subsequent short-term OAC prescription was used, as well as an AF patient education package and a letter to family physicians; phase 3 incorporated Phase 2 interventions, but added immediate follow-up in a community AF clinic. The primary outcome of the study was the rate of new OAC prescriptions at ED discharge in AF patients who were OAC eligible and were not on OAC at presentation. Results: A total of 632 patients were included from June, 2015-November, 2016. ED census ranged from 30000-68000 annual visits. Mean age was 71±15, 67±12, 67±13 years, respectively. 47.5% were women, most responsible ED diagnosis was AF in 75.8%. The mean CHA2DS2-VASc score was 2.6±1.8, with no difference amongst groups. There were 266 patients eligible for OAC and were not on this at presentation. In this group, the prescription of new OAC was 15.8% in Phase 1 as compared to 54% and 47%, in Phases 2 and 3, respectively. After adjustment for center, components of the CHA2DS2-VASc score, prior risk of bleeding and most responsible ED diagnosis, the odds ratio for new OAC prescription was 8.0 (95%CI (3.5,18.3) p<0.001) for Phase 3 vs 1, and 10.0 (95%CI (4.4,22.9) p<0.001), for Phase 2 vs 1). No difference in OAC prescription was seen between Phases 2 and 3. Conclusion: Use of a simple OAC-prescription tool was associated with an increase in new OAC prescription in the ED for eligible patients with AF. Further testing in a rigorous study design to assess the effect of this practice on stroke prevention in the AF patients who present to the ED is indicated.
A 10-year descriptive analysis of morbidity and mortality associated with water-related activities in the Top End, Northern Territory (NT), Australia.
An outdoor, water-orientated lifestyle characterises the Top End due to its tropical climate, lengthy coastline, many inland-waterways, and common domestic-pool ownership. However, the water holds many dangers: from drowning to the prospect of crocodile attacks.
Data were retrospectively collected from two sources: the Trauma Registry (TR), Royal Darwin Hospital, NT and the National Coronial Information System. Inclusion criteria: all mortality or injury with an Injury Severity Score (ISS) ≥9 from water-related activity in the Top End. Exclusion criteria: envenomation. Data included: demographics, geographical location, time/mechanism of injury, injury narrative/outcome, alcohol consumption, ISS, and Indigenous race.
Ninety-five deaths occurred from 1/1/2005–12/31/2014; 87 prehospital (92%). The leading three mechanisms of injury for the 138 TR admissions were drowning (40%), falling/diving (35%), and watercraft events (14%). Median age 27 (0-90); 78% males. There were 74 children (<16 years) including 20 deaths. Indigenous Australians represent 30% of the NT population, but had 43% of deaths and 12% of admissions. Deaths from crocodile attacks are increasing with 14 deaths from 2005-2014, compared to 10 deaths from 1971-2004 (Caldicutt). Alcohol was recorded in 31% of admissions and 52% of deaths in those age >16. The Top End’s crude rate of drowning averaged over 10 years was 4.36/100,000/annum, compared to 1.31/100,000/annum in Australia.
Alcohol plays a major role in the Top End’s water-related harm, associated with all mechanisms and over one-half of adult deaths. Also striking is increasing crocodile fatalities, possibly caused by population recovery from endangered to plentiful, since hunting ceased in 1971. Local authorities/advocates push water-safety and crocodile-awareness programs. However, the lure of tropical waters combined with alcohol remains a risk to life and limb. Further public health campaigns focusing on these issues are called for.
There is increasing recognition that perinatal anxiety disorders are both common and potentially serious for mother and child. Obsessive–compulsive disorder (OCD) can be triggered or exacerbated in the postpartum period, with mothers reporting significant effects on parenting tasks. However, there is little evidence concerning their effective treatment or the impact of successful treatment on parenting.
A total of 34 mothers with OCD and a baby of 6 months old were randomized into either time-intensive cognitive–behaviour therapy (iCBT) or treatment as usual (TAU). iCBT took place after randomization at 6 months postpartum and was completed by 9 months. Maternal symptomatology, sensitivity in mother–infant interactions and parenting were assessed at baseline and reassessed at 12 months postpartum. At 12 months attachment was also assessed using Ainsworth's Strange Situation Procedure. A healthy control group of mothers and infants (n = 37) underwent the same assessments as a benchmark.
iCBT was successful in ameliorating maternal symptoms of OCD (controlled effect size = 1.31–1.90). However, mother–infant interactions were unchanged by treatment and remained less sensitive in both OCD groups than a healthy control group. The distribution of attachment categories was similar across both clinical groups and healthy controls with approximately 72% classified as secure in each group.
iCBT is an effective intervention for postpartum OCD. Sensitive parenting interactions are affected by the presence of postpartum OCD and this is not improved by successful treatment of OCD symptoms. However, the overall attachment bond appears to be unaffected. Longitudinal studies are needed to explore the impact of postpartum OCD as the child develops.
The present study is the first record of twinning in Lagenorhynchus acutus and indeed any Lagenorhynchus sp. Both foetuses were male and located in the left uterine horn, had distinct grossly normal placentas and amniotic sacs, and were therefore likely dizygotic twins. The twins were an incidental finding in an animal that died of a systemic Brucella ceti infection.
The non-axisymmetric structure of an unstable Stewartson shear layer generated via a differential rotation between flush disks and a cylindrical enclosure is investigated numerically using both three-dimensional direct numerical simulation and a quasi-two-dimensional model. Previous literature has only considered the depth-independent quasi-two-dimensional model due to its low computational cost. The three-dimensional model implemented here highlights the supercritical instability responsible for the polygonal deformation of the shear layer in the linear and nonlinear growth regimes and reveals that linear stability analysis is capable of accurately determining the preferred azimuthal wavenumber for flow conditions near the onset of instability. This agreement is lost for sufficiently forced flows where nonlinear effects encourage the coalescence of vortices towards lower-wavenumber structures. Time-dependent flows are found for large Reynolds numbers defined based on the Stewartson layer thickness and azimuthal velocity differential. However, this temporal behaviour is not solely characterized by Reynolds number but is rather a function of both the Rossby and Ekman numbers. At high Ekman and Rossby numbers, unsteady flow emerges through a small-scale azimuthal destabilization of the axial jets within the Stewartson layers; at low Ekman numbers, unsteady flow emerges through a modulation in the strength of one of the axial vortices rolled up by non-axisymmetric instability of the Stewartson layer.
Data were extracted from the case records of UK patients admitted with laboratory-confirmed influenza A(H1N1)pdm09. White and non-White patients were characterized by age, sex, socioeconomic status, pandemic wave and indicators of pre-morbid health status. Logistic regression examined differences by ethnicity in patient characteristics, care pathway and clinical outcomes; multivariable models controlled for potential confounders. Whites (n = 630) and non-Whites (n = 510) differed by age, socioeconomic status, pandemic wave of admission, pregnancy, recorded obesity, previous and current smoking, and presence of chronic obstructive pulmonary disease. After adjustment for a priori confounders non-Whites were less likely to have received pre-admission antibiotics [adjusted odds ratio (aOR) 0·43, 95% confidence interval (CI) 0·28–0·68, P < 0·001) but more likely to receive antiviral drugs as in-patients (aOR 1·53, 95% CI 1·08–2·18, P = 0·018). However, there were no significant differences by ethnicity in delayed admission, severity at presentation for admission, or likelihood of severe outcome.
Case studies of well-documented snake reintroductions are limited, despite their potential value for conservation and ecosystem recovery. The Endangered woma Aspidites ramsayi is a large boid snake that has declined considerably and is now threatened throughout much of central Australia. We describe a trial release of captive-bred womas into the feral predator-free Arid Recovery Reserve in northern South Australia. All of the reintroduced womas were killed within 4 months, with predation by the mulga snake Pseudechis australis confirmed or implied in all cases. Lessons learned for the conditioning of captive-bred snakes for wild release and the role of the mulga snake in structuring Australian arid-zone snake assemblages are discussed.
The pro-inflammatory cytokine tumour necrosis factor alpha (TNF-α) is associated with malaria virulence (disease severity) in both rodents and humans. We are interested in whether parasite genetic diversity influences TNF-mediated effects on malaria virulence. Here, primary infections with genetically distinct Plasmodium chabaudi chabaudi (P.c.c.) clones varied in the virulence and cytokine responses induced in female C57BL/6 mice. Even when parasitaemia was controlled for, a greater day 7 TNF-α response was induced by infection with more virulent P.c.c. clones. Since many functions of TNF-α are exerted through TNF receptor 1 (TNFR1), a TNFR-1 fusion protein (TNFR-Ig) was used to investigate whether TNFR1 blockade eliminated clone virulence differences. We found that TNFR-1 blockade ameliorated the weight loss but not the anaemia induced by malaria infection, regardless of P.c.c. clone. We show that distinct P.c.c. infections induced significantly different plasma interferon gamma (IFN-γ), interleukin 6 (IL-6) and interleukin 10 (IL-10) levels. Our results demonstrate that regardless of P.c.c. genotype, blocking TNFR1 signalling protected against weight loss, but had negligible effects on both anaemia and asexual parasite kinetics. Thus, during P.c.c. infection, TNF-α is a key mediator of weight loss, independent of parasite load and across parasite genotypes.
Globally accelerating rates of species loss make it imperative that relationships between biodiversity and ecosystem function are analysed, yet resolution of these interactions has presented one of the most intractable challenges in ecological research.
Because biodiversity in soil is considerably greater than that above ground, and the identities and functions of many soil microorganisms are uncharacterised, the difficulties involved in establishing diversity–function relationships in the below-ground environment are compounded.
For some keystone groups of soil microorganisms, prominent among which are the mycorrhizal fungi, diversity–function relationships are starting to be elucidated. Mycorrhizal symbionts are present in virtually all terrestrial ecosystems where they are major components of the soil microbial biomass.
There is increasing evidence that mycorrhizal diversity is of central importance in agro-ecosystem functioning, and that intensification of agriculture and forestry, combined with air and soil pollution, is reducing their diversity and compromising their functioning. Two lines of evidence support the case that mycorrhizal diversity is of major functional significance, namely (1) that mycorrhizal associations are multi-functional and exhibit complementarity, assisting plants in nutrient acquisition, mediating carbon transfer between plants and protecting their roots from pathogens; and (2) that on the basis of emerging evidence of a combination of high specificity and dependency in many mycorrhizal associations, especially those involving myco-heterotrophic plants, it is hypothesised that the extent of functional ‘redundancy’ is low.
It is now recognised that the accelerating rates of species extinctions, which are arising from progressive intensification of land use, pose a global threat to biodiversity (Pimm et al. 1995).
To estimate the magnitude and distribution of self-reported, acute gastrointestinal illness in a Canadian-based population, we conducted a retrospective, cross-sectional telephone survey of approximately 3500 randomly selected residents of the city of Hamilton (Ontario, Canada) from February 2001 to February 2002. The observed monthly prevalence was 10% (95% CI 9·94–10·14) and the incidence rate was 1·3 (95% CI 1·1–1·4) episodes per person-year; this is within the range of estimates from other developed countries. The prevalence was higher in females and in those aged <10 years and 20–24 years. Overall, prevalence peaked in April and October, but a different temporal distribution was observed for those aged <10 years. Although these data were derived from one community, they demonstrate that the epidemiology of acute gastrointestinal illness in a Canadian-based population is similar to that reported for other developed countries.
This paper describes the creation of a unique maternal identifier for use in the investigation of perinatal, postneonatal and child outcomes in relation to maternal characteristics. All Midwives’ records of Western Australian (WA) births were routinely linked to registrations of births and deaths for infants born from 1980 to 1992 inclusive, then linked to WA hospital discharge data and to registries of birth defects and cerebral palsy to create a longitudinal health record for each infant. However, since each birth to a woman was recorded as a separate event, there was no way to identify siblings. Probabilistic record linkage, based on information about the mother, was used for this task. Logical inconsistencies within the data were used to test the validity of the linkages between birth records attributed to each mother. Information about the mother from other epidemiological studies and data abstracted from hospital case notes was also used to validate sibships. Linkage of the records of 310,255 births in WA during that period resulted in the formation of 181,133 sibships of one or more children. Pooling the results of all of the validation methods gave an error of 0.9%. Linkage identified 3678 sibships containing multiple births, and 305 sets of maternal twins. Ascertainment of twins and their siblings for an ongoing twin register, the WA Twin Child Health (WATCH) study, was a natural consequence of this process.
This paper reports the anti-cryptosporidial effects of, and concomitant amelioration of the histological changes in the gut of neonatal rats with intestinal cryptosporidiosis treated with the dinitroaniline, oryzalin. The ED50 was determined to be 7 mg/kg using twice daily doses administered for 3 consecutive days. A maximum inhibition of 85.5% was achieved at 25 mg/kg and this inhibition remained constant despite increasing the oryzalin dose to 200 mg/kg. Cryptosporidiosis significantly decreased the intestinal villus/crypt (VC) ratio by approximately 50% (duodenum = 2.3, jejunum = 2.5 and ileum = 1.7) when compared to uninfected untreated controls (duodenum = 4.3, jejunum = 5.9 and ileum = 4.5). Treatment with oryzalin doubled the VC ratio in the duodenum, jejunum and ileum following doses of 5 mg, 50 mg and 200 mg/kg respectively. Oryzalin concentrations in the small intestine contents and plasma were determined, using HPLC, at 0.5, 1 and 2 h after dosing. The much greater dose required to return VC ratios to normal in the ileum (200 mg/kg) compared to the duodenum (6.25 mg/kg) appeared to reflect the decreased concentration of the drug in the distal small intestine. Concentrations of oryzalin equivalent to the in vitro IC50 were maintained for 2 h in the first half of the small intestine following a single dose of 100 mg/kg.
Demand for scents, spices and comparable products from
India and further east was a major incentive for the
naval expeditions which led, after 1497 AD, to the
creation of European empires in the Orient. There
was the same demand in the ancient Mediterranean and
Middle East, to which these goods travelled through
the Red Sea or the Persian Gulf. People in Egypt and
Babylonia in the classical period were both
middlemen and consumers, and this paper draws
attention to the existence of a few alabaster jars
that reflect the trade. They are mainly in the
Department of the Ancient Near East at the British
Museum (previously called the Department of Western
Asiatic Antiquities), and are inscribed in
Babylonian or Greek with the names of scents or
spices. While these inscriptions are unusual,
perhaps many more jars were once inscribed in ink
which is no longer visible.
Seedlings of the myco-heterotrophic orchid Corallorhiza trifida which had been germinated in the field in mesh
bags developed hyphal links and mycorrhizas with Betula pendula and Salix repens, but not with Pinus sylvestris,
when transplanted into soil microcosms. The fungus connecting the myco-heterotroph to Betula and Salix formed
endomycorrhiza in the orchid with typical pelotons, but formed ectomycorrhizas with the autotrophs. The orchid
plants, when linked to Betula and Salix by fungal hyphae, gained 6–14% in weight over 25–28 wk. In microcosms
supporting P. sylvestris, and in control microcosms which lacked autotrophs, the Corallorhiza plants lost 13% of
their weight over the same period. In the course of the 28-wk experimental period new Corallorhiza seedlings, in
addition to those added as part of the experiment, appeared in the microcosms containing Salix and Betula but
not in the Pinus microcosms. Shoots of Betula and Salix plants grown in association with Corallorhiza were fed
with 14CO2, and the movement of the isotope was subsequently traced by a combination of digital autoradiography
and tissue oxidation. Direct transfer of C from both autotrophs to the myco-heterotroph occurred in all cases
where the associates had become connected by a shared fungal symbiont. Orchid seedlings lacking these hyphal
connections, introduced to the microcosms as controls immediately before isotope feeding, failed to assimilate
significant amounts of C. The results provide the first experimental confirmation that growth of Corallorhiza
trifida can be sustained by supply of C received directly from an autotrophic partner through linked fungal