We describe the design and deployment of GREENBURST, a commensal Fast Radio Burst (FRB) search system at the Green Bank Telescope. GREENBURST uses the dedicated L-band receiver tap to search over the 960–1 920 MHz frequency range for pulses with dispersion measures out to $10^4\ \rm{pc\,cm}^{-3}$ . Due to its unique design, GREENBURST is capable of conducting searches for FRBs when the L-band receiver is not being used for scheduled observing. This makes it a sensitive single pixel detector capable of reaching deeper in the radio sky. While single pulses from Galactic pulsars and rotating radio transients will be detectable in our observations, and will form part of the database we archive, the primary goal is to detect and study FRBs. Based on recent determinations of the all-sky rate, we predict that the system will detect approximately one FRB for every 2–3 months of continuous operation. The high sensitivity of GREENBURST means that it will also be able to probe the slope of the FRB fluence distribution, which is currently uncertain in this observing band.

Introduction: Vasopressors are routinely utilized to treat systemic shock, a significant source of morbidity and mortality in the pediatric population. Local tissue ischemia has been classically implicated with peripheral use of these medications. However, peripheral administration (PVC) has theoretical benefits, and avoids many of the risks associated with central venous catheter (CVC) placement. There appears to be paucity of literature in pediatrics examining this subject. We conducted a systematic review investigating local tissue complications and extravasations of both PVC and CVC administration in the pediatric population. Specifically we examined the type of vasopressor used, the site used, the duration of the infusion, and finally the overall outcome for patients. Methods: A systematic search was conducted using PubMed, Embase, Cochrane, and CINAHL databases. Terms for IV administration, specific vasopressor use, complication of interest, and pediatric population were combined. We included studies that satisfied our predetermined criteria. All search results were imported into Covidence software where the primary author conducted an initial title and abstract review. Papers that met the pre-identified criteria were selected for full text review. Papers selected for full text review were independently reviewed by two of the authors. Agreement between the authors was measured utilizing a κ statistic. Results: Our search yielded 14784 results, of which 237 were assessed for full text review. The κ between the authors is pending. 13 studies were selected for final inclusion. There were 14 patients with 15 total events. 13 were from PVC use while 2 occurred with CVC's. 11 of the 13 complications associated with PVC administration occurred through extravasation, with 2 events from local ischemia. 9 children were administered dopamine, 1 norepinephrine, and 14 were on multiple vasopressors. 3/13 events were “proximal” or occurring at or above the AC or popliteal fossa while 10/13 events were “distal”. The average time to ischemic injury or extravasation peripherally was 56.1 hours with a range of 1.5 to 360 hours. 9 of the total patients did not have any long-term sequelae. One patient had toe amputations, while two others died because of illness. One CVC patient died as a result extravasation leading to asphyxiation. Conclusion: There is a lack of significant literature reporting serious adverse events related to peripheral or central administration of vasopressors in the pediatric population.

During the summer of 2016, the Hawaii Department of Health responded to the second-largest domestic foodborne hepatitis A virus (HAV) outbreak in the post-vaccine era. The epidemiological investigation included case finding and investigation, sequencing of RNA positive clinical specimens, product trace-back and virologic testing and sequencing of HAV RNA from the product. Additionally, an online survey open to all Hawaii residents was conducted to estimate baseline commercial food consumption. We identified 292 confirmed HAV cases, of whom 11 (4%) were possible secondary cases. Seventy-four (25%) were hospitalised and there were two deaths. Among all cases, 94% reported eating at Oahu or Kauai Island branches of Restaurant Chain A, with 86% of those cases reporting raw scallop consumption. In contrast, a food consumption survey conducted during the outbreak indicated 25% of Oahu residents patronised Restaurant Chain A in the 7 weeks before the survey. Product trace-back revealed a single distributor that supplied scallops imported from the Philippines to Restaurant Chain A. Recovery, amplification and sequence comparison of HAV recovered from scallops revealed viral sequences matching those from case-patients. Removal of product from implicated restaurants and vaccination of those potentially exposed led to the cessation of the outbreak. This outbreak further highlights the need for improved imported food safety.

A total of 592 people reported gastrointestinal illness following attendance at Street Spice, a food festival held in Newcastle-upon-Tyne, North East England in February/March 2013. Epidemiological, microbiological and environmental investigations were undertaken to identify the source and prevent further cases. Several epidemiological analyses were conducted; a cohort study; a follow-up survey of cases and capture re-capture to estimate the true burden of cases. Indistinguishable isolates of Salmonella Agona phage type 40 were identified in cases and on fresh curry leaves used in one of the accompaniments served at the event. Molecular testing indicated entero-aggregative Escherichia coli and Shigella also contributed to the burden of illness. Analytical studies found strong associations between illness and eating food from a particular stall and with food items including coconut chutney which contained fresh curry leaves. Further investigation of the food supply chain and food preparation techniques identified a lack of clear instruction on the use of fresh uncooked curry leaves in finished dishes and uncertainty about their status as a ready-to-eat product. We describe the investigation of one of the largest outbreaks of food poisoning in England, involving several gastrointestinal pathogens including a strain of Salmonella Agona not previously seen in the UK.

Background: NURTURE (NCT02386553) is an ongoing open-label single-arm efficacy/safety study of intrathecal nusinersen in infants who initiate treatment in a presymptomatic stage of spinal muscular atrophy (SMA). Methods: Enrolled infants were age ≤6 weeks at first dose, clinically presymptomatic, had genetically diagnosed SMA, and 2 or 3 copies of SMN2. Primary endpoint is time to death or respiratory intervention (≥6 hours/day continuously for ≥7 days or tracheostomy). Results: As of July 5, 2017, 25 infants (2 copies SMN2, n=15;3 copies, n=10) were enrolled. All infants were alive. Two infants (both with 2 copies SMN2) required respiratory intervention (but not tracheostomy or permanent ventilation) during an acute, reversible viral infection and thus met the primary -endpoint. At last visit, 22/24 (92%) infants had achieved WHO motor milestones sitting without support and 8/16 (50%;2 SMN2, n=3/11;3 SMN2, n=5/5) on study >13 months achieved walking alone. AEs were reported in 24/25 (96%) infants; most 20/25 (80%) had AEs that were mild/moderate in severity; 9 had serious AEs. Four infants had an AE possibly related to study drug, which resolved despite continued treatment. No new safety concerns were identified. Conclusions: Nusinersen continued to benefit infants who initiated treatment in a presymptomatic stage of SMA.

Study Support: Biogen

To understand increasing rates of hepatitis C virus (HCV) infection in Tennessee, we conducted testing, risk factor analysis and a nested case–control study among persons who use drugs. During June–October 2016, HCV testing with risk factor assessment was conducted in sexually transmitted disease clinics, family planning clinics and an addiction treatment facility in eastern Tennessee; data were analysed by using multivariable logistic regression. A nested case–control study was conducted to assess drug-using risks and behaviours among persons who reported intranasal or injection drug use (IDU). Of 4753 persons tested, 397 (8.4%) were HCV-antibody positive. HCV infection was significantly associated with a history of both intranasal and IDU (adjusted odds ratio (aOR) 35.4, 95% confidence interval (CI) 24.1–51.9), IDU alone (aOR 52.7, CI 25.3–109.9), intranasal drug use alone (aOR 2.6, CI 1.8–3.9) and incarceration (aOR 2.7, CI 2.0–3.8). By 4 October 2016, 574 persons with a reported history of drug use; 63 (11%) were interviewed further. Of 31 persons who used both intranasal and injection drugs, 26 (84%) reported previous intranasal drug use, occurring 1–18 years (median 5.5 years) before their first IDU. Our findings provide evidence that reported IDU, intranasal drug use and incarceration are independent indicators of risk for past or present HCV infection in the study population.

This paper describes the design and fabrication of a range of ‘gas cell’ microtargets produced by the Target Fabrication Group in the Central Laser Facility (CLF) for academic access experiments on the Orion laser facility at the Atomic Weapons Establishment (AWE). The experiments were carried out by an academic consortium led by Imperial College London. The underlying target methodology was an evolution of a range of targets used for experiments on radiative shocks and involved the fabrication of a precision machined cell containing a number of apertures for interaction foils or diagnostic windows. The interior of the cell was gas-filled before laser irradiation. This paper details the assembly processes, thin film requirements and micro-machining processes needed to produce the targets. Also described is the implementation of a gas-fill system to produce targets that are filled to a pressure of 0.1–1 bar. The paper discusses the challenges that are posed by such a target.

A linearly stratified fluid contained in a circular cylinder with a linearly sloped base, whose axis is aligned with the rotation axis, is spun-up from a rotation rate $\unicode[STIX]{x1D6FA}-\unicode[STIX]{x0394}\unicode[STIX]{x1D6FA}$ to $\unicode[STIX]{x1D6FA}$ (with $\unicode[STIX]{x0394}\unicode[STIX]{x1D6FA}\ll \unicode[STIX]{x1D6FA}$ ) by Rossby waves propagating across the container. Experimental results presented here, however, show that if the Burger number $S$ is not small, then that spin-up looks quite different from that reported by Pedlosky & Greenspan (J. Fluid Mech., vol. 27, 1967, pp. 291–304) for $S=0$ . That is particularly so if the Burger number is large, since the Rossby waves are then confined to a region of height $S^{-1/2}$ above the sloped base. Axial vortices, ubiquitous features even at tiny Rossby numbers of spin-up in containers with vertical corners (see van Heijst et al. Phys. Fluids A, vol. 2, 1990, pp. 150–159 and Munro & Foster Phys. Fluids, vol. 26, 2014, 026603, for example), are less prominent here, forming at locations that are not obvious a priori, but in the ‘western half’ of the container only, and confined to the bottom $S^{-1/2}$ region. Both decay rates from friction at top and bottom walls and the propagation speed of the waves are found to increase with $S$ as well. An asymptotic theory for Rossby numbers that are not too large shows good agreement with many features seen in the experiments. The full frequency spectrum and decay rates for these waves are discussed, again for large $S$ , and vertical vortices are found to occur only for Rossby numbers comparable to $E^{1/2}$ , where $E$ is the Ekman number. Symmetry anomalies in the observations are determined by analysis to be due to second-order corrections to the lower-wall boundary condition.

An episode of postpartum psychosis can be devastating for a woman and her family, and it is vital we understand the factors involved in the aetiology of this condition. Sleep and circadian rhythm disruption is a plausible candidate but further research is needed that builds on the latest advances in chronobiology and neuroscience.

The Perth Astronomy Research Group (PARG), consisting of members from Curtin University of Technology, Perth Observatory and the University of Western Australia, is in the process of developing an automated supernova search system, using the 61-cm Lowell-Perth reflector, a CCD camera and an 80386-based computer for image analysis. Computer control of the telescope and dome, a liquid-nitrogen-cooled CCD camera, and modified VISTA image analysis software will be completed in late 1990, allowing initial semi-automatic searching of external galaxies, together with CCD photometry of flare stars and newly discovered supernovae. Full-scale automation will be introduced subsequently, in collaboration with the Berkeley group. This paper describes the project, and reports on its current status.

An anecdotal increase in C. perfringens outbreaks was observed in the North East of England during 2012–2014. We describe findings of investigations in order to further understanding of the epidemiology of these outbreaks and inform control measures. All culture-positive (>105 c.f.u./g) outbreaks reported to the North East Health Protection Team from 1 January 2012 to 31 December 2014 were included. Epidemiological (attack rate, symptom profile and positive associations with a suspected vehicle of infection), environmental (deficiencies in food preparation or hygiene practices and suspected vehicle of infection) and microbiological investigations are described. Forty-six outbreaks were included (83% reported from care homes). Enterotoxin (cpe) gene-bearer C. perfringens were detected by PCR in 20/46 (43%) and enterotoxin (by ELISA) and/or enterotoxigenic faecal/food isolates with indistinguishable molecular profiles in 12/46 (26%) outbreaks. Concerns about temperature control of foods were documented in 20/46 (43%) outbreaks. A suspected vehicle of infection was documented in 21/46 (46%) of outbreaks (meat-containing vehicle in 20/21). In 15/21 (71%) identification of the suspected vehicle was based on descriptive evidence alone, in 5/21 (24%) with supporting evidence from an epidemiological study and in 2/21 (10%) with supporting microbiological evidence. C. perfringens-associated illness is preventable and although identification of foodborne outbreaks is challenging, a risk mitigation approach should be taken, particularly in vulnerable populations such as care homes for the elderly.

We present experimental and theoretical results for the adjustment of a fluid (homogeneous or linearly stratified), which is initially rotating as a solid body with angular frequency ${\it\Omega}-{\rm\Delta}{\it\Omega}$ , to a nonlinear increase ${\rm\Delta}{\it\Omega}$ in the angular frequency of all bounding surfaces. The fluid is contained in a cylinder of square cross-section which is aligned centrally along the rotation axis, and we focus on the $O(\mathit{Ro}^{-1}{\it\Omega}^{-1})$ time scale, where $\mathit{Ro}={\rm\Delta}{\it\Omega}/{\it\Omega}$ is the Rossby number. The flow development is shown to be dominated by unsteady separation of a viscous sidewall layer, leading to an eruption of vorticity that becomes trapped in the four vertical corners of the container. The longer-time evolution on the standard ‘spin-up’ time scale, $E^{-1/2}{\it\Omega}^{-1}$ (where $E$ is the associated Ekman number), has been described in detail for this geometry by Foster & Munro (J. Fluid Mech., vol. 712, 2012, pp. 7–40), but only for small changes in the container’s rotation rate (i.e.  $\mathit{Ro}\ll 1$ ). In the linear case, for $\mathit{Ro}\ll E^{1/2}\ll 1$ , there is no sidewall separation. In the present investigation we focus on the fully nonlinear problem, $\mathit{Ro}=O(1)$ , for which the sidewall viscous layers are Prandtl boundary layers and (somewhat unusually) periodic around the container’s circumference. Some care is required in the corners of the container, but we show that the sidewall boundary layer breaks down (separates) shortly after an impulsive change in rotation rate. These theoretical boundary-layer results are compared with two-dimensional Navier–Stokes results which capture the eruption of vorticity, and these are in turn compared to laboratory observations and data. The experiments show that when the Burger number, $S=(N/{\it\Omega})^{2}$ (where $N$ is the buoyancy frequency), is relatively large – corresponding to a strongly stratified fluid – the flow remains (horizontally) two-dimensional on the $O(\mathit{Ro}^{-1}{\it\Omega}^{-1})$ time scale, and good quantitative predictions can be made by a two-dimensional theory. As $S$ was reduced in the experiments, three-dimensional effects were observed to become important in the core of each corner vortex, on this time scale, but only after the breakdown of the sidewall layers.

A scoping review was conducted to identify modifiable non-antimicrobial factors to reduce the occurrence of antimicrobial resistance in cattle populations. Searches were developed to retrieve peer-reviewed published studies in animal, human and in vitro microbial populations. Citations were retained when modifiable non-antimicrobial factors or interventions potentially associated with antimicrobial resistance were described. Studies described resistance in five bacterial genera, species or types, and 40 antimicrobials. Modifiable non-antimicrobial factors or interventions ranged widely in type, and the depth of evidence in animal populations was shallow. Specific associations between a factor or intervention with antimicrobial resistance in a population (e.g. associations between organic systems and tetracycline susceptibility in E. coli from cattle) were reported in a maximum of three studies. The identified non-antimicrobial factors or interventions were classified into 16 themes. Most reported associations between the non-antimicrobial modifiable factors or interventions and antimicrobial resistance were not statistically significant (P > 0·05 and a confidence interval including 1), but when significant, the results were not consistent in direction (increase or decrease in antimicrobial resistance) or magnitude. Research is needed to better understand the impacts of promising modifiable factors or interventions on the occurrence of antimicrobial resistance before any recommendations can be offered or adopted.

Millions of people throughout the tropics consume wild meat. Overhunting reduces food security for people and large predators, yet little is known of the impact of hunting in systems where people and predators target the same prey species. We collate published data on predator diet in Belize with interview data about the consumption of wild and domestic meat by Belizeans, to compare the wild-meat diets of humans, jaguars Panthera onca and pumas Puma concolor and assess the sustainability of the combined offtake by humans and jaguars. Six wild mammal species (nine-banded armadillo Dasypus novemcinctus, paca Cuniculus paca, collared peccary Pecari tajacu, white-lipped peccary Tayassu pecari, red brocket deer Mazama americana and white-tailed deer Odocoileus virginianus) comprised 7% of the animal-protein meals eaten by Belizeans. Overall, 80% of these meals were eaten by 20% of interviewees, suggesting a necessary role of wild meat for the minority. The same species were found in 69 and 86% of jaguar and puma scats, respectively. We estimate a national annual harvest of c. 4,000 tonnes of these six wild mammals by humans and jaguars, of which 78% is hunted by people. Sustainability is difficult to evaluate because prey population data are lacking in Belize. However, simple models suggest that a sustainable harvest at this rate would require higher prey population densities than averages recorded in hunted Neotropical forests. We emphasize the need for robust regional estimates of game species densities, to improve assessments of sustainability and inform hunting regulations. We recommend that the requirements of predators as well as those of people be considered when assessing wild meat harvests.

Since the publication of “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals” in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. It is the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

Since the publication of “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals” in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention(CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

Since the publication of “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals” in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

Infect Control Hosp Epidemiol 2014;35(8):967–977

Since the publication of “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals” in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. It is the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).