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Shiga toxin-producing Escherichia coli (STEC) is a group of bacteria that causes gastrointestinal illness and occasionally causes large foodborne outbreaks. It represents a major public health concern due to its ability to cause severe illness which can sometimes be fatal. This study was undertaken as part of a rapid investigation into a national foodborne outbreak of STEC O145. On 22 May 2024, United Kingdom (UK) public health agencies and laboratories identified an increase in stool specimens submissions and patients testing positive for Shiga toxin-producing E. coli (STEC). Whole genome sequencing (WGS) identified serotype O145:H28 stx2a/eae belonging to the same five single nucleotide polymorphism (SNP) single linkage cluster as the causative agent. By 3 July 2024, 288 cases had been linked to the cluster. Most cases were adults (87%) and females (57%), 49% were hospitalized with a further 10% attending emergency care. Descriptive epidemiology and analytical studies were conducted which identified consumption of nationally distributed pre-packed sandwiches as a common food exposure. The implicated food business operators voluntarily recalled ready-to-eat sandwiches and wraps containing lettuce on 14 June 2024.
When a contaminated liquid evaporates from within a porous material, the impurities or dirt accumulate and deposit within the pore space. This occurs during the cleaning of filters and fouling of textiles, and is related to the ‘coffee-ring’ problem. To investigate how and where dirt is deposited in the pore space, we present a model for the motion of an evaporation front through a porous material, and the related accumulation, transport, and deposition of dirt, assuming that the liquid remains stationary. For physically relevant parameters, vapour transport out of the porous material is quasi-steady and we derive a single ordinary differential equation describing the motion of the evaporation front in time. Model solutions exhibit spatially non-uniform profiles of the deposited dirt-layer thickness through the porous material. The dirt accumulation and evaporation problems are coupled: deposited dirt hinders vapour transport through the porous material, slowing the evaporation. We identify two scenarios in which the porous material becomes clogged with dirt. Accumulation of suspended dirt at the evaporating interface along with slow dirt diffusion results in the deposited dirt layers clogging the pores at the evaporating interface, halting the drying and trapping liquid in the porous material. Alternatively, slow dirt deposition results in the suspended dirt being pushed far into the porous material by the evaporation, eventually leaving only dirt (with no liquid) in the pore space. We investigate the dynamics of both clogging scenarios, characterising the parameter regimes for which each occurs. Both clogging scenarios must be avoided in practice since they may be detrimental to future filter efficacy or textile breathability.
Advanced laryngeal cancers are clinically complex; there is a paucity of modern decision-making models to guide tumour-specific management. This pilot study aims to identify computed tomography-based radiomic features that may predict survival and enhance prognostication.
Methods
Pre-biopsy, contrast-enhanced computed tomography scans were assembled from a retrospective cohort (n = 72) with advanced laryngeal cancers (T3 and T4). The LIFEx software was used for radiomic feature extraction. Two features: shape compacity (irregularity of tumour volume) and grey-level zone length matrix – grey-level non-uniformity (tumour heterogeneity) were selected via least absolute shrinkage and selection operator-based Cox regression and explored for prognostic potential.
Results
A greater shape compacity (hazard ratio 2.89) and grey-level zone length matrix – grey-level non-uniformity (hazard ratio 1.64) were significantly associated with worse 5-year disease-specific survival (p < 0.05). Cox regression models yielded a superior C-index when incorporating radiomic features (0.759) versus clinicopathological variables alone (0.655).
Conclusions
Two radiomic features were identified as independent prognostic biomarkers. A multi-centre prospective study is necessary for further exploration. Integrated radiomic models may refine the treatment of advanced laryngeal cancers.
A porous material that has been contaminated with a hazardous chemical agent is typically decontaminated by applying a cleanser solution to the surface and allowing the cleanser to react into the porous material, neutralising the agent. The agent and cleanser are often immiscible fluids and so, if the porous material is initially saturated with agent, a reaction front develops with the decontamination reaction occurring at this interface between the fluids. We investigate the effect of different initial agent configurations within the pore space on the decontamination process. Specifically, we compare the decontamination of a material initially saturated by the agent with the situation when, initially, the agent only coats the walls of the pores (referred to as the ‘agent-on-walls’ case). In previous work (Luckins et al., European Journal of Applied Mathematics, 31(5):782–805, 2020), we derived homogenised models for both of these decontamination scenarios, and in this paper we explore the solutions of these two models. We find that, for an identical initial volume of agent, the decontamination time is generally much faster for the agent-on-walls case compared with the initially saturated case, since the surface area on which the reaction can occur is greater. However for sufficiently deep spills of contaminant, or sufficiently slow reaction rates, decontamination in the agent-on-walls scenario can be slower. We also show that, in the limit of a dilute cleanser with a deep initial agent spill, the agent-on-walls model exhibits behaviour akin to a Stefan problem of the same form as that arising in the initially saturated model. The decontamination time is shown to decrease with both the applied cleanser concentration and the rate of the chemical reaction. However, increasing the cleanser concentration is also shown to result in lower decontamination efficiency, with an increase in the amount of cleanser chemical that is wasted.
Wearable robotic devices (WRD) are still struggling to fulfill their vast potential. Inadequate daily life usability is one of the main hindrances to increased technology acceptance. Improving usability evaluation practices during the development of WRD could help address these limitations. In this work, we present the design and validation of a novel online platform aiming to fill this gap, the Interactive Usability Toolbox (IUT). This platform consists of a public website that offers an interactive, context-specific search within a database of 154 user research methods and educational information about usability. In a dedicated study, the effect of this platform to support usability evaluation was investigated. Twelve WRD experts were asked to complete the task of defining usability evaluation protocols for two specific use cases. The platform was provided to support one of the use cases. The quality and composition of the proposed protocols were assessed by (i) two blinded reviewers, (ii) the participants themselves, and (iii) the study coordinators. We showed that using the IUT significantly affected the proposed evaluation focus, shifting protocols from mainly effectiveness-oriented to more user-focused studies. The protocol quality, as rated by the external reviewers, remained equivalent to those designed with conventional strategies. A mixed-method usability evaluation of the platform yielded an overall positive image, with detailed suggestions for further improvements. The IUT is expected to positively affect the evaluation and development of WRD through its educational value, the context-specific recommendations supporting ongoing benchmarking endeavors, and highlighting the value of qualitative user research.
Evaporation within porous media is both a multiscale and interface-driven process, since the phase change at the evaporating interfaces within the pores generates a vapour flow and depends on the transport of vapour through the porous medium. While homogenised models of flow and chemical transport in porous media allow multiscale processes to be modelled efficiently, it is not clear how the multiscale effects impact the interface conditions required for these homogenised models. In this paper, we derive a homogenised model, including effective interface conditions, for the motion of an evaporation front through a porous medium, using a combined homogenisation and boundary layer analysis. This analysis extends previous work for a purely diffusive problem to include both gas flow and the advective–diffusive transport of material. We investigate the effect that different microscale models describing the chemistry of the evaporation have on the homogenised interface conditions. In particular, we identify a new effective parameter, $\mathcal{L}$, the average microscale interface length, which modifies the effective evaporation rate in the homogenised model. Like the effective diffusivity and permeability of a porous medium, $\mathcal{L}$ may be found by solving a periodic cell problem on the microscale. We also show that the different microscale models of the interface chemistry result in fundamentally different fine-scale behaviour at, and near, the interface.
Over a 4-year period, the antimicrobial stewardship team reviewed all positive (PCR+/Tox+) and indeterminate (PCR+/Tox−) cases with the most responsible physician for classification of patients as infection or colonization. Among 501 indeterminate samples, 213 (43%) were considered to be clinical infection, suggesting the need for ongoing clinical assessment of indeterminates.
Despite increasing evidence for the effectiveness of individual psychological interventions for bipolar disorder, research on older adults is lacking. We report the first randomised controlled trial of psychological therapy designed specifically for older adults with bipolar disorder.
Aims
To evaluate the feasibility and acceptability of recovery-focused therapy, designed in collaboration with older people living with bipolar disorder.
Method
A parallel, two-armed, randomised controlled trial comparing treatment as usual with up to 14 sessions of recovery-focused therapy plus treatment as usual, for older adults with bipolar disorder.
Results
Thirty-nine participants (67% female, mean age 67 years) were recruited over a 17-month period. Feasibility and acceptability of recruitment, retention (>80% observer-rated outcomes at both 24 and 48 weeks) and intervention processes were demonstrated. The majority of participants started therapy when offered, adhered to the intervention (68% attended all sessions and 89% attended six or more sessions) and reported positive benefits. Clinical assessment measures provide evidence of a signal for effectiveness on a range of outcomes including mood symptoms, time to relapse and functioning. No trial-related serious adverse events were identified.
Conclusions
Recovery-focused therapy is feasible, acceptable and has the potential to improve a range of outcomes for people living with bipolar disorder in later life. A large-scale trial is warranted to provide a reliable estimate of its clinical and cost-effectiveness.
The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research. HiTOP is a living model that undergoes revision as new data become available. Here we discuss advantages and practical considerations of using this system in psychiatric practice and research. We especially highlight limitations of HiTOP and ongoing efforts to address them. We describe differences and similarities between HiTOP and existing diagnostic systems. Next, we review the types of evidence that informed development of HiTOP, including populations in which it has been studied and data on its validity. The paper also describes how HiTOP can facilitate research on genetic and environmental causes of psychopathology as well as the search for neurobiologic mechanisms and novel treatments. Furthermore, we consider implications for public health programs and prevention of mental disorders. We also review data on clinical utility and illustrate clinical application of HiTOP. Importantly, the model is based on measures and practices that are already used widely in clinical settings. HiTOP offers a way to organize and formalize these techniques. This model already can contribute to progress in psychiatry and complement traditional nosologies. Moreover, HiTOP seeks to facilitate research on linkages between phenotypes and biological processes, which may enable construction of a system that encompasses both biomarkers and precise clinical description.
We present the data and initial results from the first pilot survey of the Evolutionary Map of the Universe (EMU), observed at 944 MHz with the Australian Square Kilometre Array Pathfinder (ASKAP) telescope. The survey covers $270 \,\mathrm{deg}^2$ of an area covered by the Dark Energy Survey, reaching a depth of 25–30 $\mu\mathrm{Jy\ beam}^{-1}$ rms at a spatial resolution of $\sim$11–18 arcsec, resulting in a catalogue of $\sim$220 000 sources, of which $\sim$180 000 are single-component sources. Here we present the catalogue of single-component sources, together with (where available) optical and infrared cross-identifications, classifications, and redshifts. This survey explores a new region of parameter space compared to previous surveys. Specifically, the EMU Pilot Survey has a high density of sources, and also a high sensitivity to low surface brightness emission. These properties result in the detection of types of sources that were rarely seen in or absent from previous surveys. We present some of these new results here.
The Critically Endangered Chapman's pygmy chameleon Rhampholeon chapmanorum is endemic to the low elevation rainforest of the Malawi Hills in southern Malawi. Much of this forest has been converted to agriculture and it was uncertain whether chameleon populations have persisted. We used current and historical satellite imagery to identify remaining forest patches and assess deforestation. We then surveyed forest patches for the presence of this chameleon, and assessed its genetic diversity and structure. We estimated that 80% of the forest has been destroyed since 1984, although we found extant populations of the chameleon in each of the patches surveyed. Differentiation of genetic structure was strong between populations, suggesting that gene flow has been impaired. Genetic diversity was not low, but this could be the result of a temporal lag as well as lack of sensitivity in the mitochondrial marker used. Overall, the impact of forest loss is assumed to have led to a large demographic decline, with forest fragmentation preventing gene flow.
We report on the design and first results from experiments looking at the formation of radiative shocks on the Shenguang-II (SG-II) laser at the Shanghai Institute of Optics and Fine Mechanics in China. Laser-heating of a two-layer CH/CH–Br foil drives a $\sim 40$ km/s shock inside a gas cell filled with argon at an initial pressure of 1 bar. The use of gas-cell targets with large (several millimetres) lateral and axial extent allows the shock to propagate freely without any wall interactions, and permits a large field of view to image single and colliding counter-propagating shocks with time-resolved, point-projection X-ray backlighting ($\sim 20$ μm source size, 4.3 keV photon energy). Single shocks were imaged up to 100 ns after the onset of the laser drive, allowing to probe the growth of spatial nonuniformities in the shock apex. These results are compared with experiments looking at counter-propagating shocks, showing a symmetric drive that leads to a collision and stagnation from $\sim 40$ ns onward. We present a preliminary comparison with numerical simulations with the radiation hydrodynamics code ARWEN, which provides expected plasma parameters for the design of future experiments in this facility.
Herbivore distribution throughout Africa is strongly linked to mean annual precipitation. We use that relationship to predict functional group composition of herbivore communities during the last glacial maximum (ca. 21 ka) on the now submerged Palaeo-Agulhas Plain (PAP), South Africa. We used metabolic large herbivore biomass (MLHB) from 39 South African protected areas, in five functional groups (characterized by behavior and physiology). We examined how modern factors influenced MLHB and considered the effects of biome, annual rainfall, percentage winter rainfall, and protected area size. Overall, biome was the most important factor influencing the relationship between MLHB and rainfall. In general, MLHB increased with rainfall, but not for the grassland biome. Outside grasslands, most functional groups’ metabolic biomass increased with increasing rainfall, irrespective of biome, except for medium-sized social mixed feeder species in savanna and thicket. Protected area size was influential for medium-sized social mixed feeders and large browsers and rainfall influenced medium-sized social mixed feeders, offering some perspectives on spatial constraints on past large herbivore biomass densities. These results improve our understanding of the likely herbivore community composition and relative biomass structure on the PAP, an essential driver of how early humans utilized large mammals as a food resource.
The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.
Cerebral multi-morbidity is common in older people with dementia, including people with dementia with Lewy bodies (DLB). We describe the first Australian-based, longitudinal observational biomarker study of DLB.
Aims:
To investigate the frequency and influence of Alzheimer’s disease (AD) pathology (amyloid-β and tau) and cerebrovascular disease on clinical symptoms and disease outcome in DLB.
Methods:
The study will recruit 100 people with mild to moderate probable DLB, who will undergo comprehensive clinical and cognitive assessments. Scales targeting DLB-specific clinical features (such as cognitive fluctuations and rapid eye movement sleep behaviour disorder) are administered. Biomarker protocols incorporate blood sampling (including ApoE genotyping and systemic inflammatory markers), molecular imaging (amyloid-β [18F-NAV 4694], tau [18F-MK6240], VMAT2 [18F-AV133] PET scans), 3-tesla magnetic resonance imaging and optional lumbar puncture. Clinical assessments are completed 6 - monthly and imaging 18-monthly. Participants are also invited to register for post-mortem brain tissue donation.
Results:
Thirty participants with probable DLB have been enrolled to date (mean age 75.4 years, range 64-82; 87% male). All participants have mild to moderate cognitive impairment (mean MMSE 25, range 17-30). Approximately 64% of the participants were amyloid-β positive. Study procedure tolerability has been excellent with no adverse events reported.
Conclusions:
There is significant overlap of AD-related proteinopathies in people with DLB. Understanding the impact of multi-morbidity is essential in the development of effective treatment strategies. This study supports the feasibility of intensive, longitudinal biomarker studies in DLB in the Australian setting.
The criteria for objective memory impairment in mild cognitive impairment (MCI) are vaguely defined. Aggregating the number of abnormal memory scores (NAMS) is one way to operationalise memory impairment, which we hypothesised would predict progression to Alzheimer’s disease (AD) dementia.
Methods:
As part of the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing, 896 older adults who did not have dementia were administered a psychometric battery including three neuropsychological tests of memory, yielding 10 indices of memory. We calculated the number of memory scores corresponding to z ≤ −1.5 (i.e., NAMS) for each participant. Incident diagnosis of AD dementia was established by consensus of an expert panel after 3 years.
Results:
Of the 722 (80.6%) participants who were followed up, 54 (7.5%) developed AD dementia. There was a strong correlation between NAMS and probability of developing AD dementia (r = .91, p = .0003). Each abnormal memory score conferred an additional 9.8% risk of progressing to AD dementia. The area under the receiver operating characteristic curve for NAMS was 0.87 [95% confidence interval (CI) .81–.93, p < .01]. The odds ratio for NAMS was 1.67 (95% CI 1.40–2.01, p < .01) after correcting for age, sex, education, estimated intelligence quotient, subjective memory complaint, Mini-Mental State Exam (MMSE) score and apolipoprotein E ϵ4 status.
Conclusions:
Aggregation of abnormal memory scores may be a useful way of operationalising objective memory impairment, predicting incident AD dementia and providing prognostic stratification for individuals with MCI.
In the 2015 review paper ‘Petawatt Class Lasers Worldwide’ a comprehensive overview of the current status of high-power facilities of ${>}200~\text{TW}$ was presented. This was largely based on facility specifications, with some description of their uses, for instance in fundamental ultra-high-intensity interactions, secondary source generation, and inertial confinement fusion (ICF). With the 2018 Nobel Prize in Physics being awarded to Professors Donna Strickland and Gerard Mourou for the development of the technique of chirped pulse amplification (CPA), which made these lasers possible, we celebrate by providing a comprehensive update of the current status of ultra-high-power lasers and demonstrate how the technology has developed. We are now in the era of multi-petawatt facilities coming online, with 100 PW lasers being proposed and even under construction. In addition to this there is a pull towards development of industrial and multi-disciplinary applications, which demands much higher repetition rates, delivering high-average powers with higher efficiencies and the use of alternative wavelengths: mid-IR facilities. So apart from a comprehensive update of the current global status, we want to look at what technologies are to be deployed to get to these new regimes, and some of the critical issues facing their development.