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Non-tuberculous mycobacterium encephalitis is rare. Since 2013, a global outbreak of Mycobacterium chimaera infection has been attributed to point-source contamination of heater cooler units used in cardiac surgery. Disseminated M. chimaera infection has presented many unique challenges, including non-specific clinical presentations with delays in diagnosis, and a high mortality rate among predominantly immunocompetent adults. Here, we describe three patients with fatal disseminated Mycobacterium chimaera infection showing initially non-specific, progressively worsening neurocognitive decline, including confusion, delirium, depression and apathy. Autopsy revealed widespread granulomatous encephalitis of the cerebrum, brain stem and spinal cord, along with granulomatous chorioretinitis. Cerebral involvement and differentiation between mycobacterial granulomas and microangiopathic changes can be assessed best on MRI with contrast enhancement. The prognosis of M. chimaera encephalitis appears to be very poor, but might be improved by increased awareness of this new syndrome and timely antimicrobial treatment.
This presentation will enable the learner to:
1.Describe the clinical, radiological and neuropathological findings of Mycobacterium chimaera encephalitis
2.Be aware of this rare form of encephalitis, and explain its diagnosis, prognosis and management
The discovery of the first electromagnetic counterpart to a gravitational wave signal has generated follow-up observations by over 50 facilities world-wide, ushering in the new era of multi-messenger astronomy. In this paper, we present follow-up observations of the gravitational wave event GW170817 and its electromagnetic counterpart SSS17a/DLT17ck (IAU label AT2017gfo) by 14 Australian telescopes and partner observatories as part of Australian-based and Australian-led research programs. We report early- to late-time multi-wavelength observations, including optical imaging and spectroscopy, mid-infrared imaging, radio imaging, and searches for fast radio bursts. Our optical spectra reveal that the transient source emission cooled from approximately 6 400 K to 2 100 K over a 7-d period and produced no significant optical emission lines. The spectral profiles, cooling rate, and photometric light curves are consistent with the expected outburst and subsequent processes of a binary neutron star merger. Star formation in the host galaxy probably ceased at least a Gyr ago, although there is evidence for a galaxy merger. Binary pulsars with short (100 Myr) decay times are therefore unlikely progenitors, but pulsars like PSR B1534+12 with its 2.7 Gyr coalescence time could produce such a merger. The displacement (~2.2 kpc) of the binary star system from the centre of the main galaxy is not unusual for stars in the host galaxy or stars originating in the merging galaxy, and therefore any constraints on the kick velocity imparted to the progenitor are poor.
Expert judgement is frequently used within general insurance. It tends to be a method of last resort and used where data is sparse, non-existent or non-applicable to the problem under consideration. Whilst such judgements can significantly influence the end results, their quality is highly variable. The use of the term “expert judgement” itself can lend a generous impression of credibility to what may be a little more than a guess. Despite the increased emphasis placed on the importance of robust expert judgements in regulation, actuarial research to date has focussed on the more technical or data-driven methods, with less emphasis on how to use and incorporate softer information or how best to elicit judgements from others in a way that reduces cognitive biases. This paper highlights the research that the Getting Better Judgement Working Party has conducted in this area. Specifically, it covers the variable quality of expert judgement, both within and outside the regulatory context, and presents methods that may be applied to improve its formation. The aim of this paper is to arm the insurance practitioner with tools to distinguish between low-quality and high-quality judgements and improve the robustness of judgements accordingly, particularly for highly material circumstances.
Impairments in key neuropsychological domains (e.g. working memory, attention) and social cognitive deficits have been implicated as intermediate (endo) phenotypes for bipolar disorder (BD), and should therefore be evident in unaffected relatives.
Neurocognitive and social cognitive ability was examined in 99 young people (age range 16–30 years) with a biological parent or sibling diagnosed with the disorder [thus deemed to be at risk (AR) of developing BD], compared with 78 healthy control (HC) subjects, and 52 people with a confirmed diagnosis of BD.
Only verbal intelligence and affective response inhibition were significantly impaired in AR relative to HC participants; the BD participants showed significant deficits in attention tasks compared with HCs. Neither AR nor BD patients showed impairments in general intellectual ability, working memory, visuospatial or language ability, relative to HC participants. Analysis of BD-I and BD-II cases separately revealed deficits in attention and immediate memory in BD-I patients (only), relative to HCs. Only the BD (but not AR) participants showed impaired emotion recognition, relative to HCs.
Selective cognitive deficits in the capacity to inhibit negative affective information, and general verbal ability may be intermediate markers of risk for BD; however, the extent and severity of impairment in this sample was less pronounced than has been reported in previous studies of older family members and BD cases. These findings highlight distinctions in the cognitive profiles of AR and BD participants, and provide limited support for progressive cognitive decline in association with illness development in BD.
Specific roles of individual CDPKs vary, but in general they mediate essential biological functions necessary for parasite survival. A comparative analysis of the structure-activity relationships (SAR) of Neospora caninum, Eimeria tenella and Babesia bovis calcium-dependent protein kinases (CDPKs) together with those of Plasmodium falciparum, Cryptosporidium parvum and Toxoplasma gondii was performed by screening against 333 bumped kinase inhibitors (BKIs). Structural modelling and experimental data revealed that residues other than the gatekeeper influence compound–protein interactions resulting in distinct sensitivity profiles. We subsequently defined potential amino-acid structural influences within the ATP-binding cavity for each orthologue necessary for consideration in the development of broad-spectrum apicomplexan CDPK inhibitors. Although the BKI library was developed for specific inhibition of glycine gatekeeper CDPKs combined with low inhibition of threonine gatekeeper human SRC kinase, some library compounds exhibit activity against serine- or threonine-containing CDPKs. Divergent BKI sensitivity of CDPK homologues could be explained on the basis of differences in the size and orientation of the hydrophobic pocket and specific variation at other amino-acid positions within the ATP-binding cavity. In particular, BbCDPK4 and PfCDPK1 are sensitive to a larger fraction of compounds than EtCDPK1 despite the presence of a threonine gatekeeper in all three CDPKs.
Chronic disease patients are at high risk of developing serious influenza-related complications. This study investigated the prevalence of seasonal influenza vaccination (IV) and associated factors in such patients. A random sample of 704 Chinese adults with chronic disease was anonymously interviewed by telephone; 35·8% of them had ever taken up IV and 22·7% did so during the last flu season. The most frequently mentioned facilitator was recommendation made by a healthcare worker (HCW). Knowledge that IV is required annually, perceived severe health impacts of influenza, and recommendation made by a HCW were positively associated with previous IV and intention to take up IV in the next year, while perceived side-effects was inversely associated with previous IV and intention to take up IV. The coverage of IV in this study population was low. HCWs should clarify IV-related health beliefs in chronic disease patients and actively advise them to take up IV.
Sputtered TaSix films on GaAs have been examined as potential refractory Schottky barrier contacts suitable for self-aligned gate fabrication of GaAs MESFETs. The thermal stability of electrical and physical characteristics has been studied following furnace annealing or rapid thermal processing of contacts with compositions near Ta5Si3 (x=06). The electrical characteristics, interface interdiffusion, and evaporation loss of Ga and As through the contact have been examined. The barrier heights of 30-min furnaceannealed contacts were found to increase with temperature over the range 600 to 900°C. The Schottky barrier heights after rapid thermal processing (RTP) of the contacts were fixed at 0.78 eV for temperatures in the range 700 to 900°C. A major finding of this work is that the Schottky barrier contact maintains its integrity even though the equivalent of at least 5 monolayers of Ga and As have decomposed and evaporated through the contact.
This paper describes an experimental and theoretical analysis of the near-field thermal performance of a backfilled disposal vault in which the waste containers are emplaced in boreholes and surrounded by a bentonite-sand buffer. Effects of heat and moisture diffusion on the thermal performance of clay-based buffer and backfills were studied by means of laboratory scale experiments. The bentonite-sand buffer exhibited cracking due to desiccation. The impact of such cracking on the perforamnce of buffer as an engineered barrier is being investigated.
An integrated finite difference computer code ‘TRUCHAM’ was written to analyze the transient heat and moisture flow regime in a disposal vault and was validated by a scale model heater experiment. It is hoped that with proper characterization of the material properties ‘TRUCHAM’ can be employed as a useful tool in assessing the thermal response of the prototype disposal vault. Further work is needed to integrate the effects of heat and moisture on the shrinkage and expansion of clay-based buffer and backfills.
We present evidence in this study that the moving species under ion mixing conditions are affected by the implantation damage distribution in the sample. This observation holds for metal-semiconductor, metal-metal and semiconductorsemiconductor systems. The direction of thermal annealing and atomic transport appears to play a role in ion-mixing as well. When these two factors are in the same direction, only one dominant moving species is observed. When these two factors are in opposite directions, both constituents can contribute to the atomic transport in ion mixing.
Single probe infrared low coherence optical interferometry has been proven to be an effective tool for characterization of thin and ultra-thin semiconductor Si and compound materials wafers. Its application was however limited to wafers transparent at probing wavelength, and having relatively smooth surfaces. Purpose of this paper is to present an extension of low coherence interferometry to characterization of non-transparent wafers, and wafers with rough surfaces.
The cause of the initial band bending on a clean n-GaAs(llO) surface of so-called “poor quality cleavage” has been controversial. To study this problem, a new type of geometric factor multi-metal evaporator has been designed, which enables us to obtain reproducible metal coverages as low as 10−4 monolayers. By following the early stages of band bending induced by the deposition of noble metals Cu, Ag and Au on n-GaAs (110) surfaces of different cleavage quality, it is found that a certain amount of initial band bending of a clean GaAs(llO) surface of poor quality cleavage corresponds to a certain amount of noble metal coverage (usually lower than 0.01 ML). This phenomenon can be explained in the following way. Any initial band bending on a clean n-GaAs(HO) surface is due to surface defect states created by the cleaving. These cleavage induced defects may be of the same nature as the interface states created by deposited noble metal atoms. Our experimental results will be discussed in the framework of the unified defect model of the Schottky barrier formation on III-V semiconductors.
Interdiffusion, reactions and microstructure in Ti-Cu-Ti trilayer thin films deposited on silicon wafers have been investigated by Rutherford backscattering, and cross-sectional TEM techniques in the temperature range of 350 to 500 °C. The formation of intcrmetallic compounds was found to be symmetric at both interfaces in Ti-Cu-Ti film package. TiCu compound formed first at low temperature and was followed by TiCu3 at higher temperatures. The stress in Ti-Cu film has also been measured in-situ as functions of both temperature and annealing time by thin fused quartz bending-cantilever beam technique. The stress in metallic Ti-Cu film couple on fused quartz was tensile. The stress increased as both annealing time and temperature increased and followed a parabolic relationship with time due to the growth of the intermetallic compound TiCu3 It was possible to calculate stress in the TiCu3 layer from the changes of stress in the bilayer thin film. The stress in TiCu3 was computed to be at about 3 times larger than the stress in the unreacted Ti-Cu thin film couple.
The addition of Ta into thin sputtered films of CoCr greatly affects the microstructure and magnetic properties. Grain size, crystallographic preferred orientation and hysteresis parameters have been studied using transmission electron microscopy, electron diffraction, X-ray diffraction, polar Kerr effect and vibrating sample magnetometry techniques. Crystallographic preferred orientation is enhanced and is accompanied by increased perpendicular magnetic anisotropy. An extremely fine-grained microstructure is produced giving rise to films which show no morphological growth features. Thus the observed magnetocrystalline anisotropy is not attributed to columnar growth. Orientation in these films can be further increased by using under-layers of non-ferromagnetic CoCrTa alloys. The mechanism by which this occurs is discussed.
Alloyed ohmic contacts (i.e. Au-Ge-Ni) to n-GaAs lead to non-planar interfaces which are unsuitable for devices with shallow junctions and small dimensions. In this study, the fabrication of non-alloyed ohmic contacts (via solid state reactions) is investigated. A layered structure involving the solid phase epitaxy of Ge using a transport medium (PdGe) is shown to produce low (1 — 5 × 10∼6Ω cm2) and reproducible values of contact resistivity. The resultant interface is shown to be abrupt by cross-sectional transmission electron microscopy.
We hypothesize that a primary growth mechanism for the MOCVD growth of GaAsP is a series of surface catalyzed methane elimination reactions, and that they can be affected either thermally or photochemically by the absorption of light from a CO2 TEA laser tuned to an absorption maxima. Our preliminary results show that the laser dramatically alters the morphology and supresses the phosphorus incorporation rate when the laser is tuned to an absorption maxima for the AsH3, We interpret these results to indicate that, for the conditions used, the the primary effect of the laser is photochemical, and that the phosphorus incorporation can be increased by exciting PH3, instead of AsH3,. Once the growth mechanisms are better understood and the growth conditions are optimized GaAs1−xPx/GaAs1-yPy superlattices with atomically abrupt junctions should be able to be grown simply by turning the laser on and off.
An n+ /i/p /i/n amorphous silicon bipolar transistor has been successfully fabricated with a current gain of 12 and a response speed of 30 yS This new structure of bipolar transistor has a very thin base (200Å), therefore, high gain and high speed is obtainable. This device has a very promising applications as a flat panel display transistor and a phototransistor in photosensing element/array and photo coupler. Electrical and optical characteristics have been extensively investigated. Theoretical model and experimental results are plausibly in good agreement.
Variation from the fundamental structure is also been developed, such as the Schottky emitter Al/i/p /i/n bipolar transistor.
Gadolinium silicide with its attractive features of low formation temperature of about 350°C and low Schottky barrier height on n-type single-crystal silicon substrates (ϕnB1∼O.4ev,ϕpB ∼ 0.7ev) was chosen for studying the feasibility of forming shallow uniform contacts. Samples with various compositions prepared by both bilayer evaporation with a configuration of Si(α)/Gd/Si(xtl) and coevaporation with a Si−Gd /Si(xtl)structure were used for studying the contact formation as a function of composition and heat treatment. We found that shallow contact formation can be achieved provided that the following conditions are met: (a) for bilayer evaporation, the atomic ratio of Si(α)/Gd ≥ 2 should be maintained, (b) for coevaporation, the Si to Gd atomic ratio between 1.7 and 2.0 is desired. The bilayer deposition scheme appears to be a more convenient technique to use in practice.
We have explored the possibility of oxidizing a Au/Si composite layer or a Au-Si alloyed layer on SiO2 substrates to form a highly conductive narrow line with a protective SiO2 layer over it. A number of sample configurations and annealing ambients have been investigated. It was found that co-evaporated Au-Si alloys ( ∼30 at. % Au) showed no oxide formation for annealing temperatures between 200°C and 800°C in a flowing O2 ambient (annealing time ≃ 2.25hrs). Samples with a configuration of SiO2/Au/Si showed mixing of the Au and Si layers, but no appreciable oxide formation until after annealing at 800°C in a flowing O2. Samples with a configuration of SiO2/Si/Au, however, showed uniform and smooth oxide growth on top of the Au layer after annealing in air at 200°C. The structural and electrical properties of the self-confined Au lines will be discussed. This process may be potentially useful for narrow interconnects on VLSl chips.