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Clinical Enterobacteriacae isolates with a colistin minimum inhibitory concentration (MIC) ≥4 mg/L from a United States hospital were screened for the mcr-1 gene using real-time polymerase chain reaction (RT-PCR) and confirmed by whole-genome sequencing. Four colistin-resistant Escherichia coli isolates contained mcr-1. Two isolates belonged to the same sequence type (ST-632). All subjects had prior international travel and antimicrobial exposure.
Using existing data from clinical registries to support clinical trials and other prospective studies has the potential to improve research efficiency. However, little has been reported about staff experiences and lessons learned from implementation of this method in pediatric cardiology.
We describe the process of using existing registry data in the Pediatric Heart Network Residual Lesion Score Study, report stakeholders’ perspectives, and provide recommendations to guide future studies using this methodology.
The Residual Lesion Score Study, a 17-site prospective, observational study, piloted the use of existing local surgical registry data (collected for submission to the Society of Thoracic Surgeons-Congenital Heart Surgery Database) to supplement manual data collection. A survey regarding processes and perceptions was administered to study site and data coordinating center staff.
Survey response rate was 98% (54/55). Overall, 57% perceived that using registry data saved research staff time in the current study, and 74% perceived that it would save time in future studies; 55% noted significant upfront time in developing a methodology for extracting registry data. Survey recommendations included simplifying data extraction processes and tailoring to the needs of the study, understanding registry characteristics to maximise data quality and security, and involving all stakeholders in design and implementation processes.
Use of existing registry data was perceived to save time and promote efficiency. Consideration must be given to the upfront investment of time and resources needed. Ongoing efforts focussed on automating and centralising data management may aid in further optimising this methodology for future studies.
How do social networks moderate the way political information influences electoral accountability? We propose a simple model in which incumbent malfeasance revelations can facilitate coordination around less malfeasant challenger parties in highly connected voter networks, even when voters update favorably about incumbent party malfeasance. We provide evidence from Mexico of this mechanism by leveraging a field experiment in a context where the provision of incumbent malfeasance information increased support for incumbent parties, despite voters continuing to believe that challengers were less malfeasant than incumbents. Combining this experiment with detailed family network data, we show that—consistent with the model—the increase in incumbent party vote share due to information provision was counteracted by coordination around less malfeasant challengers in precincts with greater network connectedness. Individual-level data further demonstrate that networks facilitated explicit and tacit coordination among voters. These findings suggest that networks can help voters coordinate around information to help remove poorly performing politicians.
A prototype instrument, which provides x-ray powder diffraction and x-ray fluorescence analysis in a compact unit, has been developed to support the needs of NASA for planetary exploration. The instrument uses a 9-watt Fe-anodc x-ray tube and CCD in a fixed geometry for recording powder patterns with a 2θ range of 35°. The fluorescence spectrum for elements below Fe is collected simultaneously with the diffraction data. A shuttered Cd-109 isotopic source with emissions at 22 and 80 keV is used to excite higher energy fluorescence.
The low-energy limit for discriminating single photon events was found to be ∼1.5 keV. Al-K could be distinguished from a pure sample, but the spectrum below 6 keV was degraded by the read noise of the CCD, which introduced spectral artifacts. Diffraction peaks from halite had a FWHM of ∼1°(2θ), with major contributions to the width from the use of slit collimation on the source and the low tilt angle of the sample.
In Scotland, the base of the Ballagan Formation has traditionally been placed at the first grey mudstone within a contiguous Late Devonian to Carboniferous succession. This convention places the Devonian–Carboniferous boundary within the Old Red Sandstone (ORS) Kinnesswood Formation. The consequences of this placement are that tetrapods from the Ballagan Formation were dated as late Tournaisian in age and that the ranges of typically Devonian fish found in the Kinnesswood Formation continued into the Carboniferous. The Pease Bay specimen of the fish Remigolepis is from the Kinnesswood Formation. Comparisons with its range in Greenland, calibrated against spores, show it was Famennian in age. Detailed palynological sampling at Burnmouth from the base of the Ballagan Formation proves that the early Tournaisian spore zones (VI and HD plus Cl 1) are present. The Schopfites species that occurs through most of the succession is Schopfites delicatus rather than Schopfites claviger. The latter species defines the late Tournaisian CM spore zone. The first spore assemblage that has been found in Upper ‘ORS' strata underlying the Ballagan Formation (Preston, Whiteadder Water), contains Retispora lepidophyta and is from the early latest Famennian LL spore zone. The spore samples are interbedded with volcaniclastic debris, which shows that the Kelso Volcanic Formation is, in part, early latest Famennian in age. These findings demonstrate that the Ballagan Formation includes most of the Tournaisian with the Devonian–Carboniferous boundary positioned close to the top of the Kinnesswood Formation. The Stage 6 calcrete at Pease Bay can be correlated to the equivalent section at Carham, showing that it represents a time gap equivalent to the latest Famennian glaciation(s). Importantly, some of the recently described Ballagan Formation tetrapods are older than previously dated and now fill the key early part of Romer's Gap.
A computational study was performed both of a single agglomerate and of the collision of two agglomerates in a shear flow. The agglomerates were extracted from a direct numerical simulation of a turbulent agglomeration process, and had the loosely packed fractal structure typical of agglomerate structures formed in turbulent agglomeration processes. The computation was performed using a discrete-element method for adhesive particles with four-way coupling, accounting both for forces between the fluid and the particles (and vice versa) as well as force transmission directly between particles via particle collisions. In addition to understanding and characterizing the particle dynamics, the study focused on illuminating the fluid flow field induced by the agglomerate in the presence of a background shear and the effect of collisions on this particle-induced flow. Perhaps the most interesting result of the current work was the observation that the flow field induced by a particle agglomerate rotating in a shear flow has the form of two tilted vortex rings with opposite-sign circulation. These rings are surrounded by a sea of stretched vorticity from the background shear flow. The agglomerate rotates in the shear flow, but at a slower rate than the ambient fluid elements. In the computations with two colliding agglomerates, we observed cases resulting in agglomerate merger, bouncing and fragmentation. However, the bouncing cases were all observed to also result in an exchange of particles between the two colliding agglomerates, so that they were influenced both by elastic rebound of the agglomerate structures as well as by tearing away of particulate matter between the agglomerates. Overall, the problems of agglomerate–flow interaction and of the collision of two agglomerates in a shear flow are considerably richer in physical phenomena and more complex than can be described by the common approximation that represents each agglomerate by an ‘equivalent sphere’.
The lower Mississippian Ballagan Formation of northern Britain is one of only two successions worldwide to yield the earliest known tetrapods with terrestrial capability following the end-Devonian mass extinction event. Studies of the sedimentary environments and habitats in which these beasts lived have been an integral part of a major research project into how, why and under what circumstances this profound step in the evolution of life on Earth occurred. Here, a new palaeogeographic map is constructed from outcrop data integrated with new and archived borehole material. The map shows the extent of a very low-relief coastal wetland developed along the tropical southern continental margin of Laurussia. Coastal floodplains in the Midland Valley and Tweed basins were separated from the marginal marine seaway of the Northumberland–Solway Basin to the south by an archipelago of more elevated areas. A complex mosaic of sedimentary environments was juxtaposed, and included fresh and brackish to saline and hypersaline lakes, a diverse suite of floodplain palaeosols and a persistent fluvial system in the east of the region. The strongly seasonal climate led to the formation of evaporite deposits alternating with flooding events, both meteoric and marine. Storm surges drove marine floods from the SW into both the western Midland Valley and Northumberland–Solway Basin; marine water also flooded into the Tweed Basin and Tayside in the east. The Ballagan Formation is a rare example in the geological record of a tropical, seasonal coastal wetland that contains abundant, small-scale evaporite deposits. The diverse sedimentary environments and palaeosol types indicate a network of different terrestrial and aquatic habitats in which the tetrapods lived.
Low levels of education are a powerful predictor of anti-immigration
sentiment. However, there is little consensus on the interpretation
of this correlation: is it causal or is it an artifact of selection
bias? We address this question by exploiting six major compulsory
schooling reforms in five Western European countries—Denmark,
France, Great Britain, the Netherlands, and Sweden—that have
recently experienced politically influential anti-immigration
movements. On average, we find that compelling students to remain in
secondary school for at least an additional year decreases
anti-immigration attitudes later in life. Instrumental variable
estimates demonstrate that, among such compliers, an additional year
of secondary schooling substantially reduces the probability of
opposing immigration, believing that immigration erodes a country’s
quality of life, and feeling close to far-right anti-immigration
parties. These results suggest that rising post-war educational
attainment has mitigated the rise of anti-immigration movements. We
discuss the mechanisms and implications for future research
examining anti-immigration sentiment.
Older adults represent the highest proportion of gamblers (Ontario Lottery and Gaming Corporation [OLG], 2012). Unpartnered older adults may be more socially isolated and lonely (Dykstra & de Jong Gierveld, 2004), thus more likely to be at risk for problem gambling (McQuade & Gill, 2012). We examined whether gambling to socialize or from loneliness and going to the casino with friends/family mediate the relation between marital status and problem gambling. Data from a random sample of older adults at gambling venues across Southwestern Ontario indicated that gambling with family/friends and gambling due to loneliness mediated the relationship between marital status and problem gambling. Relative to those married, unpartnered older adults were less likely to gamble with family/friends, more likely to gamble due to loneliness, and had higher problem gambling. Prevention and treatment initiatives should examine ways to decrease loneliness and social isolation among older adults and offer alternative social activities.
Chondrichthyan teeth from a new locality in the Scottish Borders supply additional evidence of Early Carboniferous chondrichthyans in the UK. The interbedded dolostones and siltstones of the Ballagan Formation exposed along Whitrope Burn are interpreted as representing a restricted lagoonal environment that received significant amounts of land-derived sediment. This site is palynologically dated to the latest Tournaisian–early Viséan. The diverse dental fauna documented here is dominated by large crushing holocephalan toothplates, with very few, small non-crushing chondrichthyan teeth. Two new taxa are named and described. Our samples are consistent with worldwide evidence that chondrichthyan crushing faunas are common following the Hangenberg extinction event. The lagoonal habitat represented by Whitrope Burn may represent a temporary refugium that was host to a near-relict fauna dominated by large holocephalan chondrichthyans with crushing dentitions. Many of these had already become scarce in other localities by the Viséan and become extinct later in the Carboniferous. This fauna provides evidence of early endemism or niche separation within European chondrichthyan faunas at this time. This evidence points to a complex picture in which the diversity of durophagous chondrichthyans is controlled by narrow spatial shifts in niche availability over time.
On August 25, 2017, Hurricane Harvey made landfall near Corpus Christi, Texas. The ensuing unprecedented flooding throughout the Texas coastal region affected millions of individuals.1 The statewide response in Texas included the sheltering of thousands of individuals at considerable distances from their homes. The Dallas area established large-scale general population sheltering as the number of evacuees to the area began to amass. Historically, the Dallas area is one familiar with “mega-sheltering,” beginning with the response to Hurricane Katrina in 2005.2 Through continued efforts and development, the Dallas area had been readying a plan for the largest general population shelter in Texas. (Disaster Med Public Health Preparedness. 2019;13:33–37)
In situ observations of precipitation days (days when snow or rain was reported in routine synoptic observations) from Faraday/Vernadsky station on the western side of the Antarctic Peninsula, and fields from the 40 year European Centre for Medium-Range Weather Forecasts re-analysis (ERA-40) project are used to investigate precipitation and atmospheric circulation changes around the Antarctic Peninsula. It is shown that the number of precipitation days is a good proxy for mean sea-level pressure (MSLP) over the Amundsen–Bellingshausen Sea. The annual total of precipitation days at the station has been increasing at a statistically significant rate of +12.4 days decade–1 since the early 1950s, with the greatest increase taking place during the summer and autumn. This is the time of year when the Southern Annular Mode (SAM) has experienced its greatest shift to a positive phase, with MSLP values decreasing in the Antarctic coastal zone. The lower pressures in the circumpolar trough have resulted in greater ascent and increased precipitation at Faraday/Vernadsky.
Daily precipitation fields and annual means from the European Centre for Medium-range Weather Forecasts re-analysis exercise are used to examine the distribution and variability of precipitation across the Antarctic Peninsula. The annual mean precipitation field from the model agrees well with the available ice-core data and suggests that the maximum accumulation for the area is on the western side of the barrier at about the 200 m level where the annual total is close to 1.3 m w.e. The Peninsula is shown to be a very effective barrier to the zonal movement of precipitating weather systems, which results in quite different atmospheric flow regimes being responsible for significant precipitation events on other side of the divide. Frontal depressions are the primary source of large daily snowfall totals on both sides of the Peninsula. On the southern coast of the Bellingshausen Sea, major snowfall events are often linked to strong northerly flow when the atmospheric circulation is blocked. Predominantly northerly flow is also responsible for significant snowfall on the Ronne Ice Shelf, which often occurs in association with lee cyclogenesis events to the east of the- Peninsula.
In this study we correlate temporal features within the electrical conductivity (acidity) traces of four shallow firn cores obtained from the southern Antarctic Peninsula to synoptic-scale variations in the regional climate, as depicted by a numerical weather prediction model. It is demonstrated that the three high-acidity features present within the 1992-93 accumulation correspond to periods of significant precipitation, a hypothesis supported by the association of these events with strong onshore winds, ideal for transporting the biogenically derived sources of precipitation acidity to the core sites. The longitudinal location of depressions within the Bellingshausen Sea is shown to be the principal factor governing the volume of precipitation that they give over the western Peninsula. Annual accumulation in the model is ~25% lower than revealed by the cores; although there are too many uncertainties to provide a definite reason for the deviation, the smoothed model orography and inaccurate land-sea mask are believed to be significant factors. It is postulated that the acidity pattern within southern Peninsula cores may reveal an El Niño-Southern Oscillation signal.
Political scientists increasingly use instrumental variable (IV) methods, and must often choose between operationalizing their endogenous treatment variable as discrete or continuous. For theoretical and data availability reasons, researchers frequently coarsen treatments with multiple intensities (e.g., treating a continuous treatment as binary). I show how such coarsening can substantially upwardly bias IV estimates by subtly violating the exclusion restriction assumption, and demonstrate that the extent of this bias depends upon the first stage and underlying causal response function. However, standard IV methods using a treatment where multiple intensities are affected by the instrument–even when fine-grained measurement at every intensity is not possible–recover a consistent causal estimate without requiring a stronger exclusion restriction assumption. These analytical insights are illustrated in the context of identifying the long-run effect of high school education on voting Conservative in Great Britain. I demonstrate that coarsening years of schooling into an indicator for completing high school upwardly biases the IV estimate by a factor of three.
A large literature examining advanced and consolidating democracies suggests that education increases political participation. However, in electoral authoritarian regimes, educated voters may instead deliberately disengage. If education increases critical capacities, political awareness, and support for democracy, educated citizens may believe that participation is futile or legitimizes autocrats. We test this argument in Zimbabwe—a paradigmatic electoral authoritarian regime—by exploiting cross-cohort variation in access to education following a major educational reform. We find that education decreases political participation, substantially reducing the likelihood that better-educated citizens vote, contact politicians, or attend community meetings. Consistent with deliberate disengagement, education’s negative effect on participation dissipated following 2008’s more competitive election, which (temporarily) initiated unprecedented power sharing. Supporting the mechanisms underpinning our hypothesis, educated citizens experience better economic outcomes, are more interested in politics, and are more supportive of democracy, but are also more likely to criticize the government and support opposition parties.
Fontan survivors have depressed cardiac index that worsens over time. Serum biomarker measurement is minimally invasive, rapid, widely available, and may be useful for serial monitoring. The purpose of this study was to identify biomarkers that correlate with lower cardiac index in Fontan patients.
Methods and results
This study was a multi-centre case series assessing the correlations between biomarkers and cardiac magnetic resonance-derived cardiac index in Fontan patients ⩾6 years of age with biochemical and haematopoietic biomarkers obtained ±12 months from cardiac magnetic resonance. Medical history and biomarker values were obtained by chart review. Spearman’s Rank correlation assessed associations between biomarker z-scores and cardiac index. Biomarkers with significant correlations had receiver operating characteristic curves and area under the curve estimated. In total, 97 cardiac magnetic resonances in 87 patients met inclusion criteria: median age at cardiac magnetic resonance was 15 (6–33) years. Significant correlations were found between cardiac index and total alkaline phosphatase (−0.26, p=0.04), estimated creatinine clearance (0.26, p=0.02), and mean corpuscular volume (−0.32, p<0.01). Area under the curve for the three individual biomarkers was 0.63–0.69. Area under the curve for the three-biomarker panel was 0.75. Comparison of cardiac index above and below the receiver operating characteristic curve-identified cut-off points revealed significant differences for each biomarker (p<0.01) and for the composite panel [median cardiac index for higher-risk group=2.17 L/minute/m2 versus lower-risk group=2.96 L/minute/m2, (p<0.01)].
Higher total alkaline phosphatase and mean corpuscular volume as well as lower estimated creatinine clearance identify Fontan patients with lower cardiac index. Using biomarkers to monitor haemodynamics and organ-specific effects warrants prospective investigation.
The discovery of an unusual early medieval plough coulter in a well-dated Anglo-Saxon settlement context in Kent suggests that continentally derived technology was in use in this powerful kingdom centuries before heavy ploughs were first depicted in Late Saxon manuscripts. The substantial investment required to manufacture the coulter, the significant damage and wear that it sustained during use and the circumstances of its ultimate ritual deposition are explored. Investigative conservation, high-resolution recording and metallographic analysis illuminate the form, function and use-life of the coulter. An examination of the deposition contexts of plough-irons in early medieval northern Europe sheds important new light on the ritual actions of plough symbolism in an age of religious hybridity and transformation.
Despite its prevalence, little is known about when parties buy turnout. We emphasize the problem of parties monitoring local brokers with incentives to shirk. Our model suggests that parties extract greater turnout buying effort from their brokers where they can better monitor broker performance and where favorable voters would not otherwise turn out. Exploiting exogenous variation in the number of polling stations—and thus electoral information about broker performance—in Mexican electoral precincts, we find that greater monitoring capacity increases turnout and votes for the National Action Party (PAN) and the Institutional Revolutionary Party (PRI). Consistent with our theoretical predictions, the effect of monitoring capacity on PRI votes varies nonlinearly with the distance of voters to the polling station: it first increases because rural voters—facing larger costs of voting—generally favor the PRI, before declining as the cost of incentivizing brokers increases. This nonlinearity is not present for the PAN, who stand to gain less from mobilizing rural voters.