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The Rapid ASKAP Continuum Survey (RACS) is the first large-area survey to be conducted with the full 36-antenna Australian Square Kilometre Array Pathfinder (ASKAP) telescope. RACS will provide a shallow model of the ASKAP sky that will aid the calibration of future deep ASKAP surveys. RACS will cover the whole sky visible from the ASKAP site in Western Australia and will cover the full ASKAP band of 700–1800 MHz. The RACS images are generally deeper than the existing NRAO VLA Sky Survey and Sydney University Molonglo Sky Survey radio surveys and have better spatial resolution. All RACS survey products will be public, including radio images (with
15 arcsec resolution) and catalogues of about three million source components with spectral index and polarisation information. In this paper, we present a description of the RACS survey and the first data release of 903 images covering the sky south of declination
made over a 288-MHz band centred at 887.5 MHz.
We have previously shown that higher intake of cruciferous vegetables is inversely associated with carotid artery intima-media thickness. To further test the hypothesis that an increased consumption of cruciferous vegetables is associated with reduced indicators of structural vascular disease in other areas of the vascular tree, we aimed to investigate the cross-sectional association between cruciferous vegetable intake and extensive calcification in the abdominal aorta. Dietary intake was assessed, using a FFQ, in 684 older women from the Calcium Intake Fracture Outcome Study. Cruciferous vegetables included cabbage, Brussels sprouts, cauliflower and broccoli. Abdominal aortic calcification (AAC) was scored using the Kauppila AAC24 scale on dual-energy X-ray absorptiometry lateral spine images and was categorised as ‘not extensive’ (0–5) or ‘extensive’ (≥6). Mean age was 74·9 (sd 2·6) years, median cruciferous vegetable intake was 28·2 (interquartile range 15·0–44·7) g/d and 128/684 (18·7 %) women had extensive AAC scores. Those with higher intakes of cruciferous vegetables (>44·6 g/d) were associated with a 46 % lower odds of having extensive AAC in comparison with those with lower intakes (<15·0 g/d) after adjustment for lifestyle, dietary and CVD risk factors (ORQ4 v. Q1 0·54, 95 % CI 0·30, 0·97, P = 0·036). Total vegetable intake and each of the other vegetable types were not related to extensive AAC (P > 0·05 for all). This study strengthens the hypothesis that higher intake of cruciferous vegetables may protect against vascular calcification.
Cognitive impairment is considered a core feature of major depressive disorder (MDD) and research into psychological treatments aiming to address cognitive impairment are gaining momentum. Compared with the well-established research base of cognitive treatment trials in schizophrenia, including meta-analyses, mood disorder research is much more preliminary.
To focus on identifying the important factors to consider in developing larger-scale psychological treatment trials targeting cognitive impairment in mood disorders. Trial design recommendations have been published for cognitive treatment trials in bipolar disorder.
An in-depth discussion of methodological considerations in the development of cognitive treatment trials for MDD.
Methodological considerations include: screening for, and defining, cognitive impairment; mood state when cognitive intervention begins; medication monitoring during cognitive interventions; use of concomitant therapy; level of therapist involvement; duration and dose of treatment; choice of specific cognitive training exercises; home practice; improving adherence; appropriate comparison therapies in clinical trials; and choice of primary outcomes.
As well as guidance for clinical trial development, this review may be helpful for clinicians wanting to provide cognitive interventions for individuals with MDD.
To describe an investigation into 5 clinical cases of carbapenem-resistant Acinetobacter baumannii (CRAB).
Epidemiological investigation supplemented by whole-genome sequencing (WGS) of clinical and environmental isolates.
A tertiary-care academic health center in Boston, Massachusetts.
Patients or participants:
Individuals identified with CRAB clinical infections.
A detailed review of patient demographic and clinical data was conducted. Clinical isolates underwent phenotypic antimicrobial susceptibility testing and WGS. Infection control practices were evaluated, and CRAB isolates obtained through environmental sampling were assessed by WGS. Genomic relatedness was measured by single-nucleotide polymorphism (SNP) analysis.
Four clinical cases spanning 4 months were linked to a single index case; isolates differed by 1–7 SNPs and belonged to a single cluster. The index patient and 3 case patients were admitted to the same room prior to their development of CRAB infection, and 2 case patients were admitted to the same room within 48 hours of admission. A fourth case patient was admitted to a different unit. Environmental sampling identified highly contaminated areas, and WGS of 5 environmental isolates revealed that they were highly related to the clinical cluster.
We report a cluster of highly resistant Acinetobacter baumannii that occurred in a burn ICU over 5 months and then spread to a separate ICU. Two case patients developed infections classified as community acquired under standard epidemiological definitions, but WGS revealed clonality, highlighting the risk of burn patients for early-onset nosocomial infections. An extensive investigation identified the role of environmental reservoirs.
The evidence supporting the efficacy of antibiotic therapy in the treatment of chronic rhinosinusitis is not compelling. A limited number of studies show that the changes in the nasal microbiome in patients following drug therapy are unpredictable and variable. The evidence for the impact of oral antibiotics on the gut microbiota is stronger, possibly as a result of differences in drug distribution to various sites around the body. There are few studies on sinus mucosal and mucus levels of oral antibiotics used in the treatment of chronic rhinosinusitis. The distribution dependent effects of antibiotics on the sinonasal microbiome is unclear.
This review highlights that relative drug concentrations and their efficacy on microbiota at different sites is an important subject for future studies investigating chronic rhinosinusitis.
Disaster Medicine (DM) education for Emergency Medicine (EM) residents is highly variable due to time constraints, competing priorities, and program expertise. The investigators’ aim was to define and prioritize DM core competencies for EM residency programs through consensus opinion of experts and EM professional organization representatives.
Investigators utilized a modified Delphi methodology to generate a recommended, prioritized core curriculum of 40 DM educational topics for EM residencies.
The DM topics recommended and outlined for inclusion in EM residency training included: patient triage in disasters, surge capacity, introduction to disaster nomenclature, blast injuries, hospital disaster mitigation, preparedness, planning and response, hospital response to chemical mass-casualty incident (MCI), decontamination indications and issues, trauma MCI, disaster exercises and training, biological agents, personal protective equipment, and hospital response to radiation MCI.
This expert-consensus-driven, prioritized ranking of DM topics may serve as the core curriculum for US EM residency programs.
Changes in glacier length and extent are indicators of contemporary and archives of past climate changes, but this common climate proxy presents a challenge for inferring a climate signal. Modeling studies suggest that length fluctuations can occur due to interannual climate variability within an unchanging mean climate and that changes in interannual climate variability can also drive changes in average length. This paper quantifies the impacts of interannual climate variability on average glacier length and mass balance, using a flowline model coupled to a simplified mass-balance model. Results illustrate that changes in the magnitude of interannual temperature variability can non-linearly affect the mean glacier length through a mass-balance asymmetry between warm and cold years. This asymmetry is present in models where melt only initiates after a temperature threshold is crossed. Glaciers susceptible to this asymmetry can be identified based on the shape of their mass-balance profiles. The presence of mass-balance asymmetries in glaciological databases is evaluated, but current records are too short for high statistical resolving power. While the asymmetry in this study can affect the average length and mass-balance, its impacts are small, and paleoclimate interpretations from glacier-length changes are likely not notably influenced by this process.
Lipid-based nutrient supplements (LNS) may be beneficial for malnourished HIV-infected patients starting antiretroviral therapy (ART). We assessed the effect of adding vitamins and minerals to LNS on body composition and handgrip strength during ART initiation. ART-eligible HIV-infected patients with BMI <18·5 kg/m2 were randomised to LNS or LNS with added high-dose vitamins and minerals (LNS-VM) from referral for ART to 6 weeks post-ART and followed up until 12 weeks. Body composition by bioelectrical impedance analysis (BIA), deuterium (2H) diluted water (D2O) and air displacement plethysmography (ADP), and handgrip strength were determined at baseline and at 6 and 12 weeks post-ART, and effects of LNS-VM v. LNS at 6 and 12 weeks investigated. BIA data were available for 1461, D2O data for 479, ADP data for 498 and handgrip strength data for 1752 patients. Fat mass tended to be lower, and fat-free mass correspondingly higher, by BIA than by ADP or D2O. At 6 weeks post-ART, LNS-VM led to a higher regain of BIA-assessed fat mass (0·4 (95 % CI 0·05, 0·8) kg), but not fat-free mass, and a borderline significant increase in handgrip strength (0·72 (95 % CI −0·03, 1·5) kg). These effects were not sustained at 12 weeks. Similar effects as for BIA were seen using ADP or D2O but no differences reached statistical significance. In conclusion, LNS-VM led to a higher regain of fat mass at 6 weeks and to a borderline significant beneficial effect on handgrip strength. Further research is needed to determine appropriate timing and supplement composition to optimise nutritional interventions in malnourished HIV patients.
We present a highly detailed study of calving dynamics at Tunabreen, a tidewater glacier in Svalbard. A time-lapse camera was trained on the terminus and programmed to capture images every 3 seconds over a 28-hour period in August 2015, producing a highly detailed record of 34 117 images from which 358 individual calving events were distinguished. Calving activity is characterised by frequent events (12.8 events h−1) that are small relative to the spectrum of calving events observed, demonstrating the prevalence of small-scale calving mechanisms. Five calving styles were observed, with a high proportion of calving events (82%) originating at, or above, the waterline. The tidal cycle plays a key role in the timing of calving events, with 68% occurring on the falling limb of the tide. Calving activity is concentrated where meltwater plumes surface at the glacier front, and a ~ 5 m undercut at the base of the glacier suggests that meltwater plumes encourage melt-under-cutting. We conclude that frontal ablation at Tunabreen may be paced by submarine melt rates, as suggested from similar observations at glaciers in Svalbard and Alaska. Using submarine melt rate to calculate frontal ablation would greatly simplify estimations of tidewater glacier losses in prognostic models.
Izapa is famous for its monumental architecture and extensive corpus of carved stelae dated to the Late Formative Guillén phase (300–100 cal b.c.). The site was first established, however, as the capital of a kingdom during the second half of the Middle Formative period (750–300 cal b.c.). Little is known of the first centuries of the site's occupation or how this early kingdom coalesced with Izapa as its capital. In 2012, the Izapa Regional Settlement Project (IRSP) excavated 21 test units and ran 10 radiocarbon accelerator mass spectrometry (AMS) dates in order to begin correcting this lacuna. These excavations were the first at the site to screen soil matrices and recover artifact samples that can be quantitatively analyzed.
We undertook excavations in areas north and south of Group B, the original center of Izapa. This work dates the northern expansion of the site's main platform (under Mound 30a) to the Terminal Formative Itstapa phase (cal a.d. 100–300) that resulted in a doubling of the platform's size. Further, we documented that there were three distinct construction episodes in the Terminal Formative expansion and that a central staircase and ramp were built of stone during the second episode. Buried below the Terminal Formative platform expansion was a white clay surface built during the Escalón phase (750–500 cal b.c.) and used through to Guillén times. At the long, linear Mound 62 that defines the eastern edge of Izapa's site core, we documented two episodes of Guillén-phase monumental construction. Buried below this construction fill at Mound 62, a hearth feature and stone alignment are dated to the late Middle Formative based on radiocarbon assays and the results of ceramic analysis. Excavations at Mound 72 and 73 documented that Izapa's E-Group (newly recognized with lidar [light detection and ranging] data) was established in the late Middle Formative period and then significantly augmented during the Guillén phase. The architectural program at Izapa saw its apogee during the Late Formative period, but was first established during the preceding centuries of the Middle Formative. Ten new AMS dates confirm the dating of the Escalón, Frontera, and Guillén phases to 750–100 cal b.c.
Ceramic analysis allowed us to differentiate quantitatively between midden deposits and construction fill through the site's occupation and to recognize domestic versus public spaces during the first centuries of the Izapa kingdom's coalescence. We identify late Middle Formative period middens based on the high density of ceramics in addition to good surface preservation of sherds and a lack of temporal mixing of types. The designation of high-artifact density middens contrasts with the contents of Late and Terminal Formative construction fill with lower ceramic sherd densities and mixing of temporally diagnostic types. Off-mound contexts (where construction fill was mined) had even lower ceramic densities than construction fill and the sherds were very eroded. Analysis of ceramic remains from late Middle Formative period midden deposits also allowed us to infer differences in public and domestic areas of the site during the first centuries of its occupation. Formal and metric variables from these ceramic assemblages identify dish-to-jar ratios that differentiate domestic contexts (with an assortment of vessel forms) from more publically oriented areas of the site (with more serving dishes). The differential distribution of rim diameters of fancy and plain dishes allows us to identify areas of Izapa where domestic activities predominate and indicate that more publically oriented feasting practices occurred at the site center near the main pyramid (Mound 30a) during the late Middle Formative period.
Patients with tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collaterals are at risk for prolonged hospitalisation after unifocalisation. Feeding problems after congenital heart surgery are associated with longer hospital stay. We sought to determine the impact of baseline, intra-operative, and postoperative factors on the need for feeding tube use at the time of discharge.
We included patients with the aforementioned diagnosis undergoing unifocalisation from ages 3 months to 4 years from 2010 to 2016. We excluded patients with a pre-existing feeding tube. Patients discharged with an enteric tube were included in the feeding tube group. We compared the feeding tube group with the non-feeding-tube group by univariable and multi-variable logistic regression.
Of the 56 patients studied, 41% used tube feeding. Median age and weight z-score were similar in the two groups. A chromosome 22q11 deletion was associated with the need for a feeding tube (22q11 deletion in 39% versus 15%, p=0.05). Median cardiopulmonary bypass time in the feeding tube group was longer (335 versus 244 minutes, p=0.04). Prolonged duration of mechanical ventilation was associated with feeding tube use (48 versus 3%, p=0.001). On multi-variable analysis, prolonged mechanical ventilation was associated with feeding tube use (odds ratio 10.2, 95% confidence intervals 1.6; 63.8).
Among patients with tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collaterals who were feeding by mouth before surgery, prolonged mechanical ventilation after unifocalisation surgery was associated with feeding tube use at discharge. Anticipation of feeding problems in this population and earlier feeding tube placement may reduce hospital length of stay.
Theoretical models and observations suggest that primordial Stellar Black Holes (Pop-III-BHs) were prolifically formed in HMXBs, which are powerful relativistic jet sources of synchrotron radiation called Microquasars (MQs).
Large populations of BH-HMXB-MQs at cosmic dawn produce a smooth synchrotron cosmic radio background (CRB) that could account for the excess amplitude of atomic hydrogen absorption at z∼17, recently reported by EDGES.
BH-HMXB-MQs at cosmic dawn precede supernovae, neutron stars and dust. BH-HMXB-MQs promptly inject into the IGM hard X-rays and relativistic jets, which overtake the slowly expanding HII regions ionized by progenitor Pop-III stars, heating and partially ionizing the IGM over larger distance scales.
BH-HMXBs are channels for the formation of Binary-Black-Holes (BBHs). The large masses of BBHs detected by gravitational waves, relative to the masses of BHs detected by X-rays, and the high rates of BBH-mergers, are consistent with high formation rates of BH-HMXBs and BBHs in the early universe.
In order to understand the progenitor of rotation powered pulsars, we compare them with High-mass X-ray binary (HMXB) pulsars, (or X-ray pulsars), in the Small Magellanic Cloud. The plot of period period vs. period derivative shows that isolated neutron stars could be evolved from HMXBs. The pulsars with long spin period might spin up to 0.001-1 s. The mechanism is a third-body interaction that detaches the donor, leaving an isolated, small period neutron star behind.
GX 301–2, a bright high-mass X-ray binary with an orbital period of 41.5 days, exhibits stable periodic orbital intensity modulations with a strong pre-periastron X-ray flare. Several models have been proposed to explain the accretion at different orbital phases. In Islam & Paul (2014), we presented results from an orbital resolved spectroscopic study of GX 301–2 using data from MAXI Gas Slit Camera. We have found a strong orbital dependence of the absorption column density and equivalent width of the iron emission line. A very large equivalent width of the iron line along with a small value of the column density in the orbital phase range 0.1–0.3 after the periastron passage indicates the presence of high density accretion stream. We aim to further investigate the characteristics of the accretion stream with an AstroSat observation of the system.
. High Mass X-ray Binaries (HMXB) have been revealed by a wealth of multi-wavelength observations, from X-ray to optical and infrared domain. After describing the 3 different kinds of HMXB, we focus on 3 HMXB hosting supergiant stars: IGR J16320-4751, IGR J16465-4507 and IGR J16318-4848, respectively called “The Good”, “The Bad” and “The Ugly”. We review in these proceedings what the observations of these sources have brought to light concerning our knowledge of HMXB, and what part still remains in the dark side. Many questions are still pending, related to accretion processes, stellar wind properties in these massive and active stars, and the overall evolution due to transfer of mass and angular momentum between the companion star and the compact object. Future observations should be able to answer these questions, which constitute the dark side of HMXB.
Highly magnetized accretion disks are present in high-mass X-ray binaries (HMXBs). A potential mechanism to explain the transition between the High/Soft and Low/Hard states observed in HMXBs can be attributed to fast magnetic reconnection induced in the turbulent corona. In this work, we present results of global general relativistic MHD (GRMHD) simulations of accretion disks around black holes that show that fast reconnection events can naturally arise in the coronal region of these systems in presence of turbulence triggered by MHD instabilities, indicating that such events can be a potential mechanism to explain the transient non-thermal emission in HMXBs. To find the zones of fast reconnection, we have employed an algorithm to identify the presence of current sheets in the turbulent regions and computed statistically the magnetic reconnection rates in these locations obtaining average reconnection rates consistent with the predictions of the theory of turbulence-induced fast reconnection.