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In March 2018, the US Department of Defense (DOD) added the smallpox vaccination, using ACAM2000, to its routine immunizations, increasing the number of persons receiving the vaccine. The following month, Fort Hood reported a cluster of 5 myopericarditis cases. The Centers for Disease Control and Prevention and the DOD launched an investigation.
The investigation consisted of a review of medical records, establishment of case definitions, causality assessment, patient interviews, and active surveillance. A 2-sided exact rate ratio test was used to compare myopericarditis incidence rates.
This investigation identified 4 cases of probable myopericarditis and 1 case of suspected myopericarditis. No alternative etiology was identified as a cause. No additional cases were identified. There was no statistically significant difference in incidence rates between the observed cluster (5.23 per 1000 vaccinated individuals, 95% CI: 1.7–12.2) and the ACAM2000 clinical trial outcomes for symptomatic persons, which was 2.29 per 1000 vaccinated individuals (95% CI: 0.3–8.3).
Vaccination with ACAM2000 is the presumptive cause of this cluster. Caution should be exercised before considering vaccination campaigns for smallpox given the clinical morbidity and costs incurred by a case of myopericarditis. Risk of myopericarditis should be carefully weighed with risk of exposure to smallpox.
The user's gaze can provide important information for human–machine interaction, but the analysis of manual gaze data is extremely time-consuming, inhibiting wide adoption in usability studies. Existing methods for automated areas of interest (AOI) analysis cannot be applied to tangible products with a screen-based user interface (UI), which have become ubiquitous in everyday life. The objective of this paper is to present and evaluate a method to automatically map the user's gaze to dynamic AOIs on tangible screen-based UIs based on computer vision and deep learning. This paper presents an algorithm for automated Dynamic AOI Mapping (aDAM), which allows the automated mapping of gaze data recorded with mobile eye tracking to the predefined AOIs on tangible screen-based UIs. The evaluation of the algorithm is performed using two medical devices, which represent two extreme examples of tangible screen-based UIs. The different elements of aDAM are examined for accuracy and robustness, as well as the time saved compared to manual mapping. The break-even point for an analyst's effort for aDAM compared to manual analysis is found to be 8.9 min gaze data time. The accuracy and robustness of both the automated gaze mapping and the screen matching indicate that aDAM can be applied to a wide range of products. aDAM allows, for the first time, automated AOI analysis of tangible screen-based UIs with AOIs that dynamically change over time. The algorithm requires some additional initial input for the setup and training, but analyzed gaze data duration and effort is only determined by computation time and does not require any additional manual work thereafter. The efficiency of the approach has the potential for a broader adoption of mobile eye tracking in usability testing for the development of new products and may contribute to a more data-driven usability engineering process in the future.
The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services.
This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures.
As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.
Traditional perspectives on the study of aging and cognition have focused on what has been characterized as “cold cognition.” However, recent theoretical and empirical advances have emphasized the need to examine age differences in the factors that energize and direct cognitive activity (i.e., “hot cognition”). In the present chapter, the roles of goals and motivation are considered in terms of both explaining age differences in performance and characterizing adaptive functioning in later life. As an illustration of goal influences, three different perspectives associated with normative changes in goals across adulthood – social cognitive goals, socioemotional goals, and goal priorities – are discussed, along with their impact on cognition. The impact of aging on motivational processes associated with energizing, directing, and sustaining actions directed toward achieving goals is then considered, using selective engagement as an organizational framework.
Patients with antisocial personality disorder incur high costs on society, and are at high risk of dropping out of treatment and are often excluded from treatment, yet very little research has been conducted on how to best help these patients.
To test a six-session psychoeducation program, Impulsive Lifestyle Counselling, in outpatients with substance use disorders and antisocial personality disorder.
To test the efficacy of the intervention versus treatment as usual in community outpatient treatment for substance use disorders.
Pragmatic randomized trial in 13 outpatient community substance abuse treatment uptake areas. Patients were interviewed by blinded interviewers 3, 9 and 15 months post-randomization and tracked through a national substance abuse treatment register. Mixed effects regression were used to assess substance use and self-reported aggression and Cox regression was used to assess risk of dropout.
A total of 175 patients was randomized. At 3-month follow-up, patients randomized to intervention reported more days abstinent and less drug use severity than patients randomized to treatment as usual. In addition, patients randomized to intervention were at lower risk of dropout after intervention. In addition, patients randomized to intervention were more likely to report having received help for antisocial personality disorder at follow-up interviews.
A brief psychoeducational intervention may improve outcomes for outpatients with antisocial personality disorder.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
We investigate the relationship between environment and star formation main sequence (the relationship between stellar mass and star formation rate) to shed new light on the effects of the environments on star-forming galaxies. We use the large VLA-COSMOS 3 GHz catalogue that consist of star-forming galaxies (SFGs) and active galactic nuclei (AGN) in three different environments (field, filament, cluster) and for different galaxy types. We examine for the first time a comparative analysis for the distribution of SFGs with respect to the star formation main sequence (MS) consensus region from the literature, taking into account galaxy environment and using radio selected sample at 0.1 ≤ z ≤ 1.2 drawn from one of the deepest COSMOS radio surveys. We find that, as observed previously, SFRs increase with redshift independent on the environments. Furthermore, we observe that SFRs versus M* relation is flat in all cases, irrespective of the redshift and environments.
The present research aimed to describe perceptions and behaviours around the consumption of water and sugar-sweetened beverages (SSB) by youths.
A formative, qualitative study which conducted four focus groups. Transcripts were analysed and themes related to reasons youths drink SSB and water, and conversely do not drink SSB and water, were analysed to reveal thematic clusters around sensory factors, environment and policy, access, marketing and role model influences, and health risks.
A rural, tri-ethnic community in New Mexico, USA.
Middle- and high-school students, parents and teachers.
Although youths and adults were aware of the health risks of soda, they did not translate this information to other SSB, including sports drinks and sweetened tea. Moreover, their perceptions of risks of dyes outweighed their concern with sugar. Youths and adults were aware of water’s health benefits, but they focused on short-term benefits. Youths and adults perceived water as unappealing. Adults were also concerned with water safety and access.
This formative research has implications for decreasing SSB consumption and simultaneously increasing water intake among youths in rural communities. Addressing unique access and safety concerns related to water in rural communities, as well as increasing awareness of the risks of all types of SSB, can work together in a positive feedback loop to change perceptions and behaviours with long-term health consequences. Specific policy suggestions include strengthening school policies to restrict all types of SSB and water promotion efforts that address access, safety and health benefits.
The spatial-intensity profile of light reflected during the interaction of an intense laser pulse with a microstructured target is investigated experimentally and the potential to apply this as a diagnostic of the interaction physics is explored numerically. Diffraction and speckle patterns are measured in the specularly reflected light in the cases of targets with regular groove and needle-like structures, respectively, highlighting the potential to use this as a diagnostic of the evolving plasma surface. It is shown, via ray-tracing and numerical modelling, that for a laser focal spot diameter smaller than the periodicity of the target structure, the reflected light patterns can potentially be used to diagnose the degree of plasma expansion, and by extension the local plasma temperature, at the focus of the intense laser light. The reflected patterns could also be used to diagnose the size of the laser focal spot during a high-intensity interaction when using a regular structure with known spacing.
Does Kantian moral agency require phenomenal consciousness? More to the point, can firms (and other highly organized collectives) be Kantian moral agents—bound by Kantian obligations—in the absence of consciousness? After sketching the mechanics of my account of corporate agents, I consider three increasingly demanding accounts of Kantian moral agency, concluding that corporate agents can meet each successively higher threshold. They can (1) act on universalizable principles and treat humanity as an end in itself; (2) give such principles to themselves, treat their own ‘humanity’ as an end itself, and act out of respect for the law; and (3) to the extent necessary, draw on empathically generated information and insights to inflect their performance, all in the absence of phenomenal consciousness. I close by rejecting two further arguments that phenomenal consciousness is nonetheless conceptually or practically necessary for Kantian moral agency.
Two single-nucleotide polymorphisms (SNPs) (rs4281084 and rs12155594) within the neuregulin-1 (NRG1) gene have been associated with psychosis transition. However, the neurobiological changes associated with these SNPs remain unclear. We aimed to determine what relationship these two SNPs have on lateral ventricular volume and white matter integrity, as abnormalities in these brain structures are some of the most consistent in schizophrenia.
Structural (n = 370) and diffusion (n = 465) magnetic resonance imaging data were obtained from affected and unaffected individuals predominantly of European descent. The SNPs rs4281084, rs12155594, and their combined allelic load were examined for their effects on lateral ventricular volume, fractional anisotropy (FA) as well as axial (AD) and radial (RD) diffusivity. Additional exploratory analyses assessed NRG1 effects on gray matter volume, cortical thickness, and surface area throughout the brain.
Individuals with a schizophrenia age of onset ⩽25 and a combined allelic load ⩾3 NRG1 risk alleles had significantly larger right (up to 50%, padj = 0.01) and left (up to 45%, padj = 0.05) lateral ventricle volumes compared with those with allelic loads of less than three. Furthermore, carriers of three or more risk alleles, regardless of age of onset and case status, had significantly reduced FA and elevated RD but stable AD in the frontal cortex compared with those carrying fewer than three risk alleles.
Our findings build on a growing body of research supporting the functional importance of genetic variation within the NRG1 gene and complement previous findings implicating the rs4281084 and rs12155594 SNPs as markers for psychosis transition.
Magnetic reconnection can occur in current sheets separating magnetic fields sheared by any angle and of arbitrarily different amplitudes. In such asymmetric and non-coplanar systems, it is not yet understood what the orientation of the X-line will be. Studying how this orientation is determined locally by the reconnection process is important to understand systems such as the Earth magnetopause, where reconnection occurs in regions with large differences in upstream plasma and field properties. This study aims at determining what the local X-line orientation is for different upstream magnetic shear angles in an asymmetric set-up relevant to the Earth’s magnetopause. We use two-dimensional hybrid simulations and vary the simulation plane orientation with regard to the fixed magnetic field profile and search for the plane maximizing the reconnection rate. We find that the plane defined by the bisector of upstream fields maximizes the reconnection rate and this appears not to depend on the magnetic shear angle, domain size or upstream plasma and asymmetries.
Tangential current sheets are ubiquitous in space plasmas and yet hard to describe with a kinetic equilibrium. In this paper, we use a semi-analytical model, the BAS model, which provides a steady ion distribution function for a tangential asymmetric current sheet and we prove that an ion kinetic equilibrium produced by this model remains steady in a fully kinetic particle-in-cell simulation even if the electron distribution function does not satisfy the time independent Vlasov equation. We then apply this equilibrium to look at the dependence of magnetic reconnection simulations on their initial conditions. We show that, as the current sheet evolves from a symmetric to an asymmetric upstream plasma, the reconnection rate is impacted and the X line and the electron flow stagnation point separate from one another and start to drift. For the simulated systems, we investigate the overall evolution of the reconnection process via the classical signatures discussed in the literature and searched in the Magnetospheric MultiScale data. We show that they seem robust and do not depend on the specific details of the internal structure of the initial current sheet.
To determine the clinical diagnoses associated with the National Healthcare Safety Network (NHSN) pneumonia (PNEU) or lower respiratory infection (LRI) surveillance events
Retrospective chart review
A convenience sample of 8 acute-care hospitals in Pennsylvania
All patients hospitalized during 2011–2012
Medical records were reviewed from a random sample of patients reported to the NHSN to have PNEU or LRI, excluding adults with ventilator-associated PNEU. Documented clinical diagnoses corresponding temporally to the PNEU and LRI events were recorded.
We reviewed 250 (30%) of 838 eligible PNEU and LRI events reported to the NHSN; 29 reported events (12%) fulfilled neither PNEU nor LRI case criteria. Differences interpreting radiology reports accounted for most misclassifications. Of 81 PNEU events in adults not on mechanical ventilation, 84% had clinician-diagnosed pneumonia; of these, 25% were attributed to aspiration. Of 43 adult LRI, 88% were in mechanically ventilated patients and 35% had no corresponding clinical diagnosis (infectious or noninfectious) documented at the time of LRI. Of 36 pediatric PNEU events, 72% were ventilator associated, and 70% corresponded to a clinical pneumonia diagnosis. Of 61 pediatric LRI patients, 84% were mechanically ventilated and 21% had no corresponding clinical diagnosis documented.
In adults not on mechanical ventilation and in children, most NHSN-defined PNEU events corresponded with compatible clinical conditions documented in the medical record. In contrast, NHSN LRI events often did not. As a result, substantial modifications to the LRI definitions were implemented in 2015.
By reducing the number of dimensions that light can propagate in from three down to two, one may gain control over the characteristics of propagation. This control can allow for “Stopped Light” (SL), where wavepackets of light are slowed down to a zero group velocity. This is achieved by designing planar metal-dielectric structures that are stacked in one dimension allowing for waveguide modes in the other two, and engineering the dispersion relation of these structures. Stopped light structures can be further optimized to reduce their dispersion and increase the number of spatial frequencies supported, which allows for confinement of electromagnetic energy over volumes smaller than the diffraction limit over fixed regions in space. If this electromagnetic energy is confined over a region that provides gain, the question arises, can amplification of this light energy occur? and indeed can a regime of lasing be entered into? We show that stopped light lasing is indeed possible, despite there being no resonant cavity in 2d to confine the light, and explore the properties of this new type of laser.
The interest of organic farmers in adopting conservation agriculture principles, including minimal soil disturbance, permanent soil cover and crop rotation has been growing since the early 2000s. However, currently there is no network for organic farmers practicing conservation agriculture, and a lack of knowledge on how organic farmers implement conservation agriculture in practice. Consequently, few technical references are available for organic farmers when they start applying conservation agriculture practices, in particular on controlling weeds without the use of herbicides. The main objectives of this study were: (1) to explore the diversity of conservation agriculture techniques (i.e., reduced tillage, no-tillage and green manures) practiced among European farmers, and (2) to identify farmers’ main strategies for implementing conservation agriculture and the agronomic and environmental factors that determine these strategies. Strategies were identified by analyzing survey results on: (1) the type and degree of use of conservation agriculture practices by farmers, and (2) the effects it produces in terms of soil disturbance and soil cover (low, medium and high). We carried out a survey of 159 European organic farmers and collected 125 data sets on management of winter-sown crops. Among the conservation agriculture practices, reduced tillage was used by 89%, no-tillage by 27% and green manure by 74% of the 159 interviewed farmers. Green manures were more frequently used in northern Europe than in the south (below 45°N). Most of the farmers used crop rotations, with a mean duration of 6 years. A wide diversity of conservation agriculture practices were used, with farmers rarely using all three techniques (no-till, reduced till and green manures) within one system. The range of practices was grouped into five strategies ranging from intensive non-inversion tillage without soil cover to very innovative techniques with no-tillage and intercrops. The five strategies for conservation agriculture could be grouped into two larger categories based on weed control approach: (1) intensification of the mechanical work without soil inversion or (2) biological regulation of weeds with cover crops. The diversity of strategies identified in this study shows that organic farmers use innovative approaches to implement conservation agriculture without herbicides. This study's findings will help organic farmers to experiment with innovative practices based on conservation agriculture principles and also benefit conventional farmers who use conservation agriculture practices and would like to reduce or eliminate the use of herbicides.