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With the rapid expansion of the Infection Prevention Control/Healthcare Epidemiology (IPC/HE) fields over recent decades, the pivotal roles of IPC/HE in hospital regulation, quality improvement, patient safety, and healthcare finances have become increasingly apparent. Consequently, the demand for effective IPC/HE leaders has surged.1,2 Training in IPC/HE is essential for all infectious diseases (ID) fellows (both adult and pediatric), including those planning a career in hospital epidemiology as well as those planning to focus on general ID, transplant, HIV, etc. ID fellows, however, have historically felt ill-prepared in IPC/HE. Joiner et al’s survey highlighted this gap, revealing that only half of respondents felt adequately trained in infection control, despite half of them participating in infection control in their practice.3 IPC/HE fellow education is not currently standardized, and most IPC/HE training is led by individual mentors and healthcare facilities.
Neuropsychological disorders, including anxiety, depression, and dementia, are significant public health problems among older adults. While psychotropics are effective treatments, long-term treatment often has adverse side effects(1). Many patients often seek healthy food consumption as an alternative preventive strategy. Dietary fibre has been suggested for many health benefits, including cardiometabolic health and anti-inflammation, which may influence neurological health through the gut-brain axis(2). However, fibre’s role in neuropsychological health outcomes in older people is unclear. This study examined the potential role of dietary fibre intake and consumption of fibre-rich foods in neurological health outcomes in older Australians. We utilised data from the Ageing Study (MAS) of 1,037 participants aged 70–90(3). At baseline, dietary fibre, whole grains, fresh fruit, vegetables, and nuts and legumes consumption was estimated using the Cancer Council of Victoria food frequency questionnaire. The intake amount was further derived into tertiles (T), with T1 in the lower 33rd%tile and T3 in the upper 33rd%tile. Depressive symptoms (Geriatric Depression Scale), anxiety symptoms (Goldberg Anxiety Scale), and psychological distress (Kessler Psychological Distress Scale) were assessed. Linear regression models were used to estimate beta coefficients for the associations cross-sectionally. Incident dementia was defined using diagnostic criteria, clinical assessments, and a consensus panel review. Nine hundred and sixty-three participants were followed up from the baseline (2005) until wave 4 (2011) [median: 5.8 (IQR: 3.1–5.9) years; 97 incident cases). Incident depression was defined as diagnoses by healthcare professionals and treatments for depression. Eight hundred and nine participants were followed up from the baseline (2005) until wave 3 (2009) [median: 3.9 (IQR: 1.9–4.0) years; 109 incident cases). Cox proportional hazard models were used to estimate hazard ratios (95% CIs). All models were adjusted for demographic characteristics, lifestyle factors, and health history. Among 963 participants (mean age: 78.5; 5.8% females) in the cross-sectional analysis, compared with T1, higher vegetable intake was associated with fewer depressive symptoms (T2: β = 0.52; T3: β= −0.53; both p < 0.05), psychological distress (T2: β = −0.59; T3: β = −1.13; both p < 0.05), and anxiety symptoms (T3: β = −0.37; p = 0.03). Combined intake of vegetables and fruit was inversely associated with fewer psychological distress symptoms (T2: β = −0.55; p = 0.06; T3: β = −1.3; p < 0.05). In the highest tertile, dietary fibre was associated with fewer depressive symptoms (T3: β = −0.47; p = 0.04). In the longitudinal analysis, dietary fibre intake was associated with a 43–56% lower risk of incident dementia (T2 vs T1: adj.HR = 0.57; 95% CI: 0.31–1.03; T3 vs T1: adj.HR = 0.44; 95% CI: 0.19–1.01). Intakes of whole grains, fruit, nuts and legumes were not associated with the outcomes assessed. In a cohort of older Australians, dietary fibre intake appeared to be protective in reducing depressive symptoms cross-sectionally and the risk of incident dementia longitudinally. Additionally, vegetable consumption was associated with fewer symptoms related to depression, anxiety, and distress cross-sectionally.
Depression and dementia represent significant public health issues, affecting approximately 1 in 10 and 1 in 12 older Australians, respectively. While current pharmacological treatments are effective in relieving symptoms, they often entail undesirable adverse effects, including gastrointestinal issues and bradycardia(1,2). This highlights the need for primary preventative measures, including food- and nutrition-based approaches. Chronic brain inflammation is believed to interfere with the gut–brain axis(3). Consumption of fermented dairy products rich in beneficial gut microbes may attenuate this inflammation and offer protective health benefits. This study aimed to examine whether fermented dairy intake could mitigate the risk of incident depression and dementia. Utilising data from the Sydney Memory and Ageing Study I of 1037 participants 70–90 years, 816 participants (mean age: 76.7) were followed from 2005 until 2012 for incident depression, and 974 participants (mean age: 80.7) were followed up from 2005 until 2014 for incident dementia. Fermented dairy intake was assessed using the Dietary Questionnaire for Epidemiological Studies version 2 and categorised yoghurt and regular cheese into quartiles (Q) and low-fat cheese into consumers/non-consumers, with no consumption as the reference group. Depression diagnoses were assessed via self-reported physician-diagnosed history, medication use, service utilisation, and heavy alcohol use. Dementia diagnoses followed the criteria in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. Cox proportional hazards models examined the associations between fermented dairy intake and the risk of incident depression/dementia. Additionally, linear regression models were applied to assess for depressive symptoms score (measured by the Geriatric Depression Scale-15) and psychological distress score (measured by the Kessler Psychological Distress Scale-10). All models were adjusted for sociodemographic, lifestyle factors, and medical histories. Over a median follow-up of 3.9 and 5.8 years, 120 incident depression and 100 incident dementia cases occurred, respectively. Those who consumed high yoghurt (Q4: 145.8–437.4 g/day) and low-fat cheese (consumers: 0.4–103.1g/day) intakes were associated with a lower risk of incident depression, both compared to non-consumers (yoghurt: adj.HR: 0.38, 95% CI: 0.19–0.77; low-fat cheese: adj.HR: 0.50; 95% CI: 0.29–0.86). They were also associated with lower depressive symptom scores (yoghurt: adj.β = −0.46; 95% CI: −0.84, −0.07; low-fat cheese: adj.β = −0.42; 95% CI: −0.73, −0.11). However, those who consumed a higher intake of regular cheese (Q4: 14.7–86.1 g/day) had an elevated risk of incident depression (adj.HR: 1.88; 95% CI: 1.02, 3.47), and those in Q2 (0.1–7.2 g/day) had significantly higher depressive symptom scores (adj.β = 0.42; 95% CI: 0.05, 0.78). No significant findings were found for psychological distress scores or incident dementia. Our findings of a cohort of older Australians suggest that higher yoghurt and low-fat cheese intakes may reduce incident depression and depressive symptoms, while a higher intake of regular cheese may increase these risks.
In Paper I, we presented an overview of the Southern-sky MWA Rapid Two-metre (SMART) survey, including the survey design and search pipeline. While the combination of MWA’s large field-of-view and the voltage capture system brings a survey speed of ${\sim} 450\, {\textrm{deg}}^{2}\,\textrm{h}^{-1}$, the progression of the survey relies on the availability of compact configuration of the Phase II array. Over the past few years, by taking advantage of multiple windows of opportunity when the compact configuration was available, we have advanced the survey to 75% of the planned sky coverage. To date, about 10% of the data collected thus far have been processed for a first-pass search, where 10 min of observation is processed for dispersion measures out to 250 ${\textrm{pc cm}}^{-3}$, to realise a shallow survey that is largely sensitive to long-period pulsars. The ongoing analysis has led to two new pulsar discoveries, as well as an independent discovery and a rediscovery of a previously incorrectly characterised pulsar, all from ${\sim} 3\% $ of the data for which candidate scrutiny is completed. In this sequel to Paper I, we describe the strategies for further detailed follow-up including improved sky localisation and convergence to timing solution, and illustrate them using example pulsar discoveries. The processing has also led to re-detection of 120 pulsars in the SMART observing band, bringing the total number of pulsars detected to date with the MWA to 180, and these are used to assess the search sensitivity of current processing pipelines. The planned second-pass (deep survey) processing is expected to yield a three-fold increase in sensitivity for long-period pulsars, and a substantial improvement to millisecond pulsars by adopting optimal de-dispersion plans. The SMART survey will complement the highly successful Parkes High Time Resolution Universe survey at 1.2–1.5 GHz, and inform future large survey efforts such as those planned with the low-frequency Square Kilometre Array (SKA-Low).
We present an overview of the Southern-sky MWA Rapid Two-metre (SMART) pulsar survey that exploits the Murchison Widefield Array’s large field of view and voltage-capture system to survey the sky south of 30$^{\circ}$ in declination for pulsars and fast transients in the 140–170 MHz band. The survey is enabled by the advent of the Phase II MWA’s compact configuration, which offers an enormous efficiency in beam-forming and processing costs, thereby making an all-sky survey of this magnitude tractable with the MWA. Even with the long dwell times employed for the survey (4800 s), data collection can be completed in $<$100 h of telescope time, while still retaining the ability to reach a limiting sensitivity of $\sim$2–3 mJy (at 150 MHz, near zenith), which is effectively 3–5 times deeper than the previous-generation low-frequency southern-sky pulsar survey, completed in the 1990s. Each observation is processed to generate $\sim$5000–8000 tied-array beams that tessellate the full $\sim 610\, {\textrm{deg}^{2}}$ field of view (at 155 MHz), which are then processed to search for pulsars. The voltage-capture recording of the survey also allows a multitude of post hoc processing options including the reprocessing of data for higher time resolution and even exploring image-based techniques for pulsar candidate identification. Due to the substantial computational cost in pulsar searches at low frequencies, the survey data processing is undertaken in multiple passes: in the first pass, a shallow survey is performed, where 10 min of each observation is processed, reaching about one-third of the full-search sensitivity. Here we present the system overview including details of ongoing processing and initial results. Further details including first pulsar discoveries and a census of low-frequency detections are presented in a companion paper. Future plans include deeper searches to reach the full sensitivity and acceleration searches to target binary and millisecond pulsars. Our simulation analysis forecasts $\sim$300 new pulsars upon the completion of full processing. The SMART survey will also generate a complete digital record of the low-frequency sky, which will serve as a valuable reference for future pulsar searches planned with the low-frequency Square Kilometre Array.
The cooperative guidance problem of multiple inferior missiles intercepting a hypersonic target with the specific impact angle constraint in the two-dimensional plane is addressed in this paper, taking into consideration variations in a missile’s speed. The guidance law is designed with two subsystems: the direction of line-of-sight (LOS) and the direction of normal to LOS. In the direction of LOS, by applying the algebraic graph theory and the consensus theory, the guidance command is designed to make the system convergent in a finite time to satisfy the goal of cooperative interception. In the direction of normal to LOS, the impact angle is constrained to transform into the LOS angle at the time of interception. In view of the difficulty of measuring unknown target acceleration information in real scenarios, the guidance command is designed by utilising a super-twisting algorithm based on a nonsingular fast-terminal sliding mode (NFTSM) surface. Numerical simulation results manifest that the proposed guidance law performs efficiently and the guidance commands are free of chattering. In addition, the overall performance of this guidance law is assessed with Monte Carlo runs in the presence of measurement errors. The simulation results demonstrate that the robustness can be guaranteed, and that overall efficiency and accuracy in intercepting the hypersonic target are achieved.
The Variables and Slow Transients Survey (VAST) on the Australian Square Kilometre Array Pathfinder (ASKAP) is designed to detect highly variable and transient radio sources on timescales from 5 s to $\sim\!5$ yr. In this paper, we present the survey description, observation strategy and initial results from the VAST Phase I Pilot Survey. This pilot survey consists of $\sim\!162$ h of observations conducted at a central frequency of 888 MHz between 2019 August and 2020 August, with a typical rms sensitivity of $0.24\ \mathrm{mJy\ beam}^{-1}$ and angular resolution of $12-20$ arcseconds. There are 113 fields, each of which was observed for 12 min integration time, with between 5 and 13 repeats, with cadences between 1 day and 8 months. The total area of the pilot survey footprint is 5 131 square degrees, covering six distinct regions of the sky. An initial search of two of these regions, totalling 1 646 square degrees, revealed 28 highly variable and/or transient sources. Seven of these are known pulsars, including the millisecond pulsar J2039–5617. Another seven are stars, four of which have no previously reported radio detection (SCR J0533–4257, LEHPM 2-783, UCAC3 89–412162 and 2MASS J22414436–6119311). Of the remaining 14 sources, two are active galactic nuclei, six are associated with galaxies and the other six have no multi-wavelength counterparts and are yet to be identified.
The systematic review examined the phenomenon of trust during public health emergency events. The literature reviewed was field studies done with people directly affected or likely to be affected by such events and included quantitative, qualitative, mixed-method, and case study primary studies in English (N = 38) as well as Arabic, Chinese, French, Russian, and Spanish (all non-English N = 30). Studies were mostly from high- and middle-income countries, and the event most covered was infectious disease. Findings from individual studies were first synthesized within methods and evaluated for certainty/confidence, and then synthesized across methods. The final set of 11 findings synthesized across methods identified a set of activities for enhancing trust and showed that it is a multi-faceted and dynamic concept.
An acute gastroenteritis (AGE) outbreak caused by a norovirus occurred at a hospital in Shanghai, China, was studied for molecular epidemiology, host susceptibility and serological roles. Rectal and environmental swabs, paired serum samples and saliva specimens were collected. Pathogens were detected by real-time polymerase chain reaction and DNA sequencing. Histo-blood group antigens (HBGA) phenotypes of saliva samples and their binding to norovirus protruding proteins were determined by enzyme-linked immunosorbent assay. The HBGA-binding interfaces and the surrounding region were analysed by the MegAlign program of DNAstar 7.1. Twenty-seven individuals in two care units were attacked with AGE at attack rates of 9.02 and 11.68%. Eighteen (78.2%) symptomatic and five (38.4%) asymptomatic individuals were GII.6/b norovirus positive. Saliva-based HBGA phenotyping showed that all symptomatic and asymptomatic cases belonged to A, B, AB or O secretors. Only four (16.7%) out of the 24 tested serum samples showed low blockade activity against HBGA-norovirus binding at the acute phase, whereas 11 (45.8%) samples at the convalescence stage showed seroconversion of such blockade. Specific blockade antibody in the population played an essential role in this norovirus epidemic. A wide HBGA-binding spectrum of GII.6 supports a need for continuous health attention and surveillance in different settings.
Metabolic syndrome - a significant risk factor for cardiovascular morbidity and mortality - is twice as prevalent among psychiatric patients (21-63%) as general populations (20-24%). Although there is an inherent illness-associated metabolic risk, medications do contribute. Atypicals vary in metabolic risk from high (clozapine, olanzapine), moderate (risperidone, quetiapine) to low (aripiprazole, ziprasidone) (ADA, 2004). Few studies have comprehensively measured cardiovascular risk or directly compared antipsychotics. Limited controlled data show that antipsychotic-induced metabolic abnormalities may be reversible, rationalizing the switch to a lower-risk agent (DeNayer, 2004). Non-HDL-cholesterol encompasses all atherogenic cholesterols and provides a marker of CV risk: an increase of 29ng/dL in diabetics is associated with 50% increased risk (Jiang, 2004). Non-HDL-cholesterol is independently associated with increased risk of non-fatal myocardial infarction and angina.
Aim:
This study will provide cross-European data from 13 countries on MS rates in schizophrenia and will assess antipsychotic metabolic profiles and benefits of antipsychotic switching.
Methods:
In this ongoing, 16-week, open-label, European multicentre study, 258 schizophrenia patients treated for ≥3 months with olanzapine, risperidone or quetiapine and who have MS will be randomized to switch to aripiprazole (Week 1: 5mg/day; Week 2: 10mg/day; flexible 10-30mg/day after Week 2) or continue with previous antipsychotic. the primary objective is to demonstrate superiority of aripiprazole versus atypicals on mean percentage change of fasting non-HDL-cholesterol from baseline to Week 16.
Conclusion:
This study will provide the first direct and comprehensive comparison of metabolic risk with various atypicals in Europe and should impact the future management of schizophrenia.
Amorphous Mg-Fe silicates are produced from microwave-dried sol-gels and their thermal crystallisation is studied via in situ synchrotron X-ray powder diffraction. Mg-pyroxene crystallised to forsterite, enstatite and cristobalite. The inclusion of 10% Fe formed only forsterite at much higher temperature, while pure Mg-olivine crystallised at a lower temperature than Mg-pyroxene. Cristobalite is observed as a high-temperature crystallite in the pure-Mg compositions. Crystallisation activation energies are derived and discussed in relation to protoplanetary disks.
During 2016 February, CSIRO Astronomy and Space Science and the Max-Planck-Institute for Radio Astronomy installed, commissioned, and carried out science observations with a phased array feed receiver system on the 64-m diameter Parkes radio telescope. Here, we demonstrate that the phased array feed can be used for pulsar observations and we highlight some unique capabilities. We demonstrate that the pulse profiles obtained using the phased array feed can be calibrated and that multiple pulsars can be simultaneously observed. Significantly, we find that an intrinsic polarisation leakage of −31 dB can be achieved with a phased array feed beam offset from the centre of the field of view. We discuss the possibilities for using a phased array feed for future pulsar observations and for searching for fast radio bursts with the Parkes and Effelsberg telescopes.
Background: Ataluren is the first drug to treat the underlying cause of nmDMD. Methods: Phase 2 and 3 studies of ataluren in nmDMD were reviewed, with efficacy and safety/tolerability findings summarized. Results: Ataluren nmDMD trials include: a Phase 2a proof-of-concept study (N=38); a Phase 2b randomized controlled trial (RCT) (N=174); an ongoing US-based open-label safety extension study (N=108); an ongoing non-US-based open-label safety/efficacy extension study (N=94); and a Phase 3 RCT, ACT DMD (N=228), whose primary endpoint was change in six-minute walk distance (6MWD) over 48 weeks. The proof-of-concept study demonstrated increased dystrophin production in post-treatment muscle biopsies from ataluren-treated patients with nmDMD. The Phase 2b results demonstrated an ataluren treatment effect in 6MWD, timed function tests, and other measures of physical functioning, The Phase 3 ACT DMD results demonstrated an ataluren treatment effect in patients with nmDMD in both primary and secondary endpoints, particularly in those with a baseline 6MWD of 300-400m. Ataluren was consistently well-tolerated in all three trials, as well as in the ongoing extension studies. Trial findings will be presented in detail. Conclusions: The totality of the results demonstrates that ataluren enables nonsense mutation readthrough in the dystrophin mRNA, producing functional dystrophin and slowing disease progression.
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.
Both maternal 25-hydroxyvitamin D (25(OH)D) concentrations during pregnancy andplacental amino acid transporter gene expression have been associated withdevelopment of the offspring in terms of body composition and bone structure.Several amino acid transporter genes have vitamin D response elements in theirpromoters suggesting the possible linkage of these two mechanisms. We aimed toestablish whether maternal 25(OH)D and vitamin D-binding protein (VDBP) levelsrelate to expression of placental amino acid transporters. RNA was extractedfrom 102 placental samples collected in the Southampton Women's Survey,and gene expression was analysed using quantitative real-time PCR. Geneexpression data were normalised to the geometric mean of three housekeepinggenes, and related to maternal factors and childhood body composition. Maternalserum 25(OH)D and VDBP levels were measured by radioimmunoassay. Maternal25(OH)D and VDBP levels were positively associated with placental expression ofspecific genes involved in amino acid transport. Maternal 25(OH)D and VDBPconcentrations were correlated with the expression of specific placental aminoacid transporters, and thus may be involved in the regulation of amino acidtransfer to the fetus. The positive correlation of VDBP levels and placentaltransporter expression suggests that delivery of vitamin D to the placenta maybe important. This exploratory study identifies placental amino acidtransporters which may be altered in response to modifiable maternal factors andprovides a basis for further studies.
Cannabis use is associated with an increased risk of developing a psychotic disorder but the temporal relationship between cannabis use and onset of illness is unclear. The objective of this study was to assess prospectively the influence of cannabis use on transition to psychosis in people at ultra-high risk (UHR) for the disorder.
Method
Lifetime and continued cannabis use was assessed in a consecutively ascertained sample of 182 people (104 male, 78 female) at UHR for psychosis. Individuals were then followed clinically for 2 years to determine their clinical outcomes.
Results
Lifetime cannabis use was reported by 134 individuals (73.6%). However, most of these individuals had stopped using cannabis before clinical presentation (n = 98, 73.1%), usually because of adverse effects. Among lifetime users, frequent use, early-onset use and continued use after presentation were all associated with an increase in transition to psychosis. Transition to psychosis was highest among those who started using cannabis before the age of 15 years and went on to use frequently (frequent early-onset use: 25%; infrequent or late-onset use: 5%; χ21 = 10.971, p = 0.001). However, within the whole sample, cannabis users were no more likely to develop psychosis than those who had never used cannabis (cannabis use: 12.7%; no use: 18.8%; χ21 = 1.061, p = 0.303).
Conclusions
In people at UHR for psychosis, lifetime cannabis use was common but not related to outcome. Among cannabis users, frequent use, early-onset use and continued use after clinical presentation were associated with transition to psychosis.