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We investigated healthcare worker (HCW) behavior with regard to a voluntary methicillin-resistant Staphylococcus aureus (MRSA) staff screening during a MRSA outbreak in a neonatal ward. Avoiding MRSA transmission from HCWs to patients was the most important reason for participation. Inconvenient screening time was the most frequently cited reason for nonparticipation.
Additive manufacturing is a revolutionary three-dimensional (3D) printing technology that has applications in a vast number of fields from aerospace to biological engineering. In the field of bioengineering, it was recently discovered that the principles used in 3D bioprinting of organs and tissues could also be used to 3D print biological materials produced by genetically engineered bacteria. This new technology requires the development of modified bio-ink and optimized printing parameters to promote bacterial physiology while allowing printability. In this article, we highlight the recent advancements in additive manufacturing of engineered living materials using bacteria and their potential applications. We will discuss recent progress and significance of additive manufacturing of proteins and polypeptides produced in situ by engineered bacteria to make multifunctional materials. Finally, we discuss the challenges and prospects of this technology and highlight some of the biomaterials that may benefit from additive manufacturing with bacteria.
Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.
Determination of antibodies against ToRCH antigens at the beginning of pregnancy allows assessment of both the maternal immune status and the risks to an adverse pregnancy outcome. Age-standardised seroprevalences were determined in sera from 1009 women of childbearing age residing in Mexico, Brazil, Germany, Poland, Turkey or China using a multiparametric immunoblot containing antigen substrates for antibodies against Toxoplasma gondii, rubella virus, cytomegalovirus (CMV), herpes simplex viruses (HSV-1, HSV-2), Bordetella pertussis, Chlamydia trachomatis, parvovirus B19, Treponema pallidum and varicella zoster virus (VZV). Seroprevalences for antibodies against HSV-1 were >90% in samples from Brazil and Turkey, whereas the other four countries showed lower mean age-adjusted seroprevalences (range: 62.5–87.9%). Samples from Brazilian women showed elevated seroprevalences of antibodies against HSV-2 (40.1%), C. trachomatis (46.8%) and B. pertussis (56.6%) compared to the other five countries. Seroprevalences of anti-T. gondii antibodies (0.5%) and anti-parvovirus B19 antibodies (7.5%) were low in samples from Chinese women, compared to the other five countries. Samples from German women revealed a low age-standardised seroprevalence of anti-CMV antibodies (28.8%) compared to the other five countries. These global differences in immune status of women in childbearing age advocate country-specific prophylaxis strategies to avoid infection with ToRCH pathogens.
A new high time resolution observing mode for the Murchison Widefield Array (MWA) is described, enabling full polarimetric observations with up to
$30.72\,$
MHz of bandwidth and a time resolution of
${\sim}$
$0.8\,\upmu$
s. This mode makes use of a polyphase synthesis filter to ‘undo’ the polyphase analysis filter stage of the standard MWA’s Voltage Capture System observing mode. Sources of potential error in the reconstruction of the high time resolution data are identified and quantified, with the
$S/N$
loss induced by the back-to-back system not exceeding
$-0.65\,$
dB for typical noise-dominated samples. The system is further verified by observing three pulsars with known structure on microsecond timescales.
To understand a sentence, it is crucial to understand who is doing what. The interplay of morphological case marking, argument serialization, and animacy provides linguistic cues for the processing system to rapidly identify the thematic roles of the arguments. The present event-related brain potential (ERP) study investigates on-line brain responses during argument identification in Zurich German, a High Alemannic dialect, and in Fering, a North Frisian variety, which both exhibit reduced case systems as compared to Standard German. Like Standard German, Zurich German and Fering are Continental West Germanic varieties, and indeed argument processing in sentences with an object-before-subject order engenders a qualitatively similar ERP pattern of a scrambling negativity followed by a P600 in all tested varieties. However, the P600 component—a late positive ERP response, which has been linked to the categorization of task-relevant stimuli—is selectively affected by the most prominent cue for argument identification in each variety, which is case marking in Standard German, but animacy in Zurich German and Fering. Thus, even closely related varieties may employ different processing strategies based on the language-specific availability of syntactic and semantic cues for argument identification.*
A subcommittee of the Hawaii Governor's Joint Task Force on Rat Lungworm Disease developed preliminary guidelines for the diagnosis and treatment of neuroangiostrongyliasis (NAS) in 2018 (Guidelines, 2018). This paper reviews the main points of those guidelines and provides updates in areas where our understanding of the disease has increased. The diagnosis of NAS is described, including confirmation of infection by real-time polymerase chain reaction (RTi-PCR) to detect parasite DNA in the central nervous system (CNS). The treatment literature is reviewed with recommendations for the use of corticosteroids and the anthelminthic drug albendazole. Long-term sequelae of NAS are discussed and recommendations for future research are proposed.
We describe system verification tests and early science results from the pulsar processor (PTUSE) developed for the newly commissioned 64-dish SARAO MeerKAT radio telescope in South Africa. MeerKAT is a high-gain (
${\sim}2.8\,\mbox{K Jy}^{-1}$
) low-system temperature (
${\sim}18\,\mbox{K at }20\,\mbox{cm}$
) radio array that currently operates at 580–1 670 MHz and can produce tied-array beams suitable for pulsar observations. This paper presents results from the MeerTime Large Survey Project and commissioning tests with PTUSE. Highlights include observations of the double pulsar
$\mbox{J}0737{-}3039\mbox{A}$
, pulse profiles from 34 millisecond pulsars (MSPs) from a single 2.5-h observation of the Globular cluster Terzan 5, the rotation measure of Ter5O, a 420-sigma giant pulse from the Large Magellanic Cloud pulsar PSR
$\mbox{J}0540{-}6919$
, and nulling identified in the slow pulsar PSR J0633–2015. One of the key design specifications for MeerKAT was absolute timing errors of less than 5 ns using their novel precise time system. Our timing of two bright MSPs confirm that MeerKAT delivers exceptional timing. PSR
$\mbox{J}2241{-}5236$
exhibits a jitter limit of
$<4\,\mbox{ns h}^{-1}$
whilst timing of PSR
$\mbox{J}1909{-}3744$
over almost 11 months yields an rms residual of 66 ns with only 4 min integrations. Our results confirm that the MeerKAT is an exceptional pulsar telescope. The array can be split into four separate sub-arrays to time over 1 000 pulsars per day and the future deployment of S-band (1 750–3 500 MHz) receivers will further enhance its capabilities.
Introducing more customized products causes complexity costs, which are hard to estimate and measure. Researchers and practitioners have therefore developed approaches to measure these costs. This paper reviews the current approaches and reveals a lack of a holistic view on the underlying problem and, hence, deficits to certain economic questions. We therefore suggest using the Extended Axiomatic Design (EAD) framework as an interdisciplinary model that adresses the economic consequences of variety-induced complexity.
Climate change can cause geographic displacement of the ecological niche of a species, so that similar species that previously did not coexist could begin to face new interactions. Such geographic displacement and increased competition can also be exacerbated by anthropic intervention. Until less than 100 years ago, Vultur gryphus and Coragyps atratus did not coexist. Nowadays, possibly as a result of climate change, changes in the distributions of both species created areas where they are now sympatric. Through ecological niche modeling, we evaluated the possible effects that future scenarios of climate change and human influence would have on the distribution and sympatry between the two species. Our models predict that the current distribution of V. gryphus will be reduced between 18% and 24% by 2050 and between 21% and 32% by 2070. Additionally, they predict that the distribution of C. atratus will be reduced by 31–52% by the year 2050 and 15–60% by 2070. The two algorithms predict a reduction in the areas of sympatry. However, for the northern Andes the overlap between the two species will increase, reaching up to 70% in the year 2070. The distribution of C. atratus will move towards higher areas in the altitudinal gradient, and this will generate an increase in the current sympatry between both species. No clear trend was observed on the effect of human influences on the areas of overlap between the scenarios evaluated. The possible effects of climate change and anthropic intervention in future scenarios found in this study highlight the need to include these effects in future analyses and conservation programs of V. gryphus and other threatened vultures.
Introduction: Inhaled toxins from tobacco smoking, cannabis leaf smoking as well as vaping/e-cigarette products use are known causes of cardio-respiratory injury. While tobacco smoking has decreased among Canadian adults, there are now several other forms of legal inhalant products. While legal, the evidence of benefit and safety of vaping is limited. Of concern, cases of e-cigarette or vaping products use associated lung injury (EVALI) have been accumulating in the U.S. and now in Canada. Despite this, very little is known about the inhalation exposure of emergency department (ED) patients; this study was designed to explore lung health in the ED. Methods: We investigated the prevalence of exposure to vaping, tobacco and cannabis among patients presenting to a Canadian ED from July to November 2019. Ambulatory (CTAS 2 to 5), stable, adult (≥ 17 years) patients were prospectively identified and invited to complete a survey addressing factors related to lung health (previous diagnosis of respiratory conditions and respiratory symptoms at the ED presentation) and information on current exposure to vaping, tobacco and cannabis smoking. Categorical variables are reported as frequencies and percentages; continuous variables are reported as medians with interquartile range (IQR). The study was approved by the Health Research Ethics Board. Results: Overall, 1024 (71%) of 1433 eligible patients completed the survey. The median age was 43.5 (IQR: 29, 60), and 51% were female. A total of 351 (31%) participants reported having been previously diagnosed with ≥1 respiratory conditions, and 177 (17%) were visiting the ED as a result of ≥1 respiratory symptoms (e.g., cough, shortness of breath, wheezing). Daily tobacco smoking was reported by 190 (19%), and 83 (8%) reported using vaping/e-cigarette products. Cannabis use within 30 days was described by 80 (15%) respondents. Exposure to tobacco and vaping products was reported by 39 (4%) participants, 63 (6%) reported using tobacco in combination with cannabis smoking, and 3% reported combining vaping and cannabis use. Conclusion: Patients seeking care in the ED are exposed to a large quantity of inhaled toxins. Vaping products, considered the cause of the most recent epidemic of severe lung injury, are used in isolation and in combination with other smoking products in Canada. These exposures should be documented and may increase the risk of lung health injuries and exacerbations of chronic respiratory conditions.
Introduction: In 2018, Canadian postgraduate specialist Emergency Medicine (EM) programs began implementing a competency-based medical education (CBME) assessment system. To support improvement of this assessment program, we sought to evaluate its short-term educational outcomes nationally and within individual programs. Methods: Program-level data from the 2018 resident cohort were amalgamated and analyzed. The number of Entrustable Professional Activity (EPA) assessments (overall and for each EPA) and the timing of resident promotion through program stages was compared between programs and to the guidelines provided by the national EM specialty committee. Total EPA observations from each program were correlated with the number of EM and pediatric EM rotations. Results: Data from 15 of 17 (88.2%) EM programs containing 9,842 EPA observations from 68 of the 77 (88.3%) Canadian EM specialist residents in the 2018 cohort were analyzed. The average number of EPAs observed per resident in each program varied from 92.5 to 229.6 and correlated strongly with the number of blocks spent on EM and pediatric EM (r = 0.83, p < 0.001). Relative to the guidelines outlined by the specialty committee, residents were promoted later than expected and with fewer EPA observations than suggested. Conclusion: We present a new approach to the amalgamation of national and program-level assessment data. There was demonstrable variation in both EPA-based assessment numbers and promotion timelines between programs and with national guidelines. This evaluation data will inform the revision of local programs and national guidelines and serve as a starting point for further reaching outcome evaluation. This process could be replicated by other national assessment programs.
Introduction: Despite being legal in Canada, the vaporized liquid of vaping systems contains several chemicals presenting unknown risks to lung health and little is known about their use in patients visiting the emergency department (ED). This study explores associations between exposure to inhaled products and respiratory presentations in the ED. Methods: A cross-sectional lung health survey among patients presenting to a Canadian ED was conducted, exploring the association between inhaled toxic exposures (e.g., vaping, cannabis and cigarette smoking) and visits related to respiratory symptoms. Eligible participants were ambulatory (CTAS 2 to 5), stable, adults (≥ 17 years) visiting the ED from July to November, 2019. Results are described as frequencies and percentages (categorical variables) and medians with interquartile range (IQR, continuous variables). Univariate and multivariate logistic regression models report associations as odds ratios (OR) with 95% confidence intervals (CIs). The Health Research Ethics Board approved the study. Results: From 1433 eligible patients, 1024 (71%) completed the survey. The median age was 43.5 (IQR: 29, 60), and 51% were female. Overall, 177 (17%) reported ≥1 respiratory symptoms and 83 (8%) reported using any vaping products. In a univariate regression analysis, exposure to vaping was positively associated with ED visits related to respiratory symptoms (OR 2.11, 95% CI: 1.26 to 3.54). In the multivariate model, vaping and a previous diagnosis of ≥1 respiratory conditions showed positive association with respiratory-related ED visits (OR 1.86, 95% CI: 1.03 to 3.33; and OR 2.13, 95% CI: 1.50 to 3.02, respectively). There was evidence of an additive effect of the combined exposure to cigarettes and vaping and respiratory-related ED visits (OR 3.22, 95% CI: 1.61 to 6.43). Smoking cannabis and cigarettes alone were not associated with increased risk of respiratory-related visits. Conclusion: Using vaping products increased the occurrence of respiratory-related ED visits, particularly in people with pre-existing lung conditions. A dose-response relationship exists where the risk is highest in patients inhaling a combination of toxins. Contrary to previous assumptions, the use of vaping products has a negative impact on lung health.
Proper management of glufosinate in glufosinate-resistant crop technologies is needed to mitigate the likelihood of resistance evolution. Antagonism may result from mixtures of glufosinate and other commonly used POST herbicides in soybean and cotton. Two experiments were conducted at the Arkansas Agricultural Research and Extension Center in Fayetteville, AR, in 2015 and 2016 to evaluate mixtures of glufosinate + clethodim and glufosinate + glyphosate on barnyardgrass, broadleaf signalgrass, johnsongrass, and large crabgrass. Furthermore, droplet spectra analyses were conducted to determine if droplet size was associated with identification of herbicide interactions. Antagonism was dependent on the herbicide rates and the weed species. For barnyardgrass and large crabgrass control 4 wk after treatment, glufosinate + glyphosate was antagonistic at all rates evaluated. When large crabgrass was evaluated, some mixtures (e.g., 595 g ha–1 glufosinate + 76 g ha–1 clethodim) had a significant reduction in control relative to one of the herbicides applied alone. Glufosinate (451 and 595 g ai ha–1) + glyphosate (867 and 1,735 g ae ha–1) was antagonistic at all four possible rate combinations for broadleaf signalgrass control. Fewer instances of antagonism were observed for seedling johnsongrass control than for other species, but certain treatments were identified as antagonistic (e.g., glufosinate at 451 g ai ha–1 + clethodim at 76 g ai ha–1). Overall, antagonism was less likely and greater control was observed when the highest rates of both herbicides in a given mixture were used. The addition of glyphosate or clethodim to glufosinate can increase the volume median diameter and decrease the percentage volume of fines, compared to glufosinate alone. The droplet spectra analyses indicate that the glufosinate performance may be negatively affected by the addition of glyphosate or clethodim.
The present study, conducted in collaboration between the Departments of Psychiatry in Swiss Universities and the World Health Organization, had two main goals: to develop assessment methods which could subsequently be used in the Swiss centres in a standard manner; and to make arrangements for continuing collaboration between the centres in Switzerland and the acquisition of new knowledge about the distinctions between depression and cognitive impairment. For this aim, three different groups of elderly patients of either sex were selected during the period of November 1989 to July 1991 for inclusion in the study. The first two groups included the first ten patients of either sex over 60 years of age consecutively contacting the participating institutions and showing depression with or without clinically significant symptoms of cognitive impairment; the control group included patients showing no depression or clinically significant symptoms of cognitive impairment. A total of 125 patients were included in the initial evaluation, 69 of which were reassessed at a seven-month follow up (on average). Each patient was administered a number of clinician-rated or self-report instruments for the assessment of depression, cognitive impairment, disabilities, physical status and onset of disorders. The study has shown that a variety of instruments can be used for the reliable assessment of depression or cognitive impairment in the elderly; but the instruments for the assessment of depression differentiate only poorly between patients with or without cognitive impairment. Because of the importance of identifying both depressed and cognitively impaired patients among the elderly, different assessment instruments targeted at the different symptom clusters need to be administered simultaneously.
Responsiveness of quality of life (QOL) assessments in chronic schizophrenic patients was investigated by a quasi-experimental pilot study. Satisfaction ratings were assessed over five time points with an externally imposed disturbing stimulus at the second time point. Despite a markedly high stability, the disturbance provoked a temporally limited decrease in QOL.
Self-ratings of psychotic experiences might be biased by depressive symptoms.
Method
Data from a large naturalistic multicentre trial on depressed inpatients (n = 488) who were assessed on a biweekly basis until discharge were analyzed. Self-rated psychotic symptoms as assessed with the 90-Item Symptom Checklist (SCL-90) were correlated with the SCL-90 total score, the SCL-90 depression score, the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale 21 item (HAMD-21) total score, the Montgomery Åsberg Depression Rating Scale (MADRS) total score and the clinician-rated paranoid-hallucinatory score of the Association for Methodology and Documentation in Psychiatry (AMDP) scale.
Results
At discharge the SCL-90 psychosis score correlated highest with the SCL-90 depression score (0.78, P<0.001) and with the BDI total score (0.64, P<0.001). Moderate correlations were found for the MADRS (0.34, P<0.001), HAMD (0.37, P<0.001) and AMDP depression score (0.33, P<0.001). Only a weak correlation was found between the SCL-90 psychosis score and the AMDP paranoid-hallucinatory syndrome score (0.15, P<0.001). Linear regression showed that change in self-rated psychotic symptoms over the treatment course was best explained by a change in the SCL-90 depression score (P<0.001). The change in clinician-rated AMDP paranoid-hallucinatory score had lesser influence (P = 0.02).
Conclusions
In depressed patients self-rated psychotic symptoms correlate poorly with clinician-rated psychotic symptoms. Caution is warranted when interpreting results from epidemiological surveys using self-rated psychotic symptom questionnaires as indicators of psychotic symptoms. Depressive symptoms which are highly prevalent in the general population might influence such self-ratings.
In the context of untimely access to community formal services, unmet needs of persons with dementia (PwD) and their carers may compromise their quality of life.
Objectives/aims
The Actifcare EU-JPND project (www.actifcare.eu) focuses on access to and (non) utilization of dementia formal care in eight countries (The Netherlands, Germany, United Kingdom, Sweden, Norway, Ireland, Italy, Portugal), as related to unmet needs and quality of life. Evaluations included systematic reviews, qualitative explorations, and a European cohort study (PwD in early/intermediate phases and their primary carers; n = 453 days; 1 year follow-up). Preliminary Portuguese results are presented here (FCT-JPND-HC/0001/2012).
Methods
(1) extensive systematic searches on access to/utilization of services; (2) focus groups of PwD, carers and health/social professionals; (3) prospective study (n = 66 days from e.g., primary care, hospital outpatient services, Alzheimer Portugal).
Results
In Portugal, nationally representative data is scarce regarding health/social services utilization in dementia. There are important barriers to access to community services, according to users, carers and professionals, whose views not always coincide. The Portuguese cohort participants were 66 PwD (62.1% female, 77.3 ± 6.2 years, 55.5% Alzheimer's/mixed subtypes, MMSE 17.8 ± 4.8, CDR1 89.4%) and 66 carers (66.7% female, 64.9 ± 15.0 years, 56.1% spouses), with considerable unmet needs in some domains.
Conclusions
All Actifcare milestones are being reached. The consortium is now analyzing international differences in (un) timely access to services and its impact on quality of life and needs for care (e.g., formal community support is weaker in Portugal than in many European countries). National best-practice recommendations in dementia are also in preparation.
Abstract submitted on behalf of the Actifcare Eu-JPND consortium.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Only few international studies have focused on mental diseases among the hearing-impaired population. However, Fellinger et al. (2012) underline the high discrepancy between the current and future demand of mental treatment and the simultaneous impeded access to health care.
Aims
The aim of this multicenter project is to conduct the first analysis of mental diseases among the hearing-impaired population in Germany in order to quantify and qualify the specific demands of treatment.
Objectives
In order to achieve this aim, we compiled an extensive questionnaire battery.
Methods
This questionnaire battery measured sociodemographic data, non-verbal intelligence, quality of life, perception and suffering from stress, psychosomatic symptoms as well as personality traits.
Results
Our three samples consisted of 21 hearing-impaired patients with a history of mental diseases (EG-HI), 21 hearing-impaired subjects without mental diseases (CG-HI) and 21 hearing participants without any psychological disease (CG-H). Compared to the two control groups, the EG-HI shows significantly higher rates in different fields, i.e. participants perceive a lower quality of life, suffer from more psychosomatic symptoms and show more pronounced personality traits. The two control groups did not differ significantly from each other.
Conclusions
Certain psychological characteristics among hearing-impaired patients can be detected which need to be accounted for in treatment. Furthermore, a hearing impairment is not inevitably linked to a reduced quality of life or even mental disorders. Therefore, future research should focus on risk factors and protective factors which could prevent mental diseases among the hearing-impaired population.
Disclosure of interest
The authors have not supplied their declaration of competing interest.