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The bright radio source, GLEAM J091734$-$001243 (hereafter GLEAM J0917$-$0012), was previously selected as a candidate ultra-high redshift ($z \gt 5$) radio galaxy due to its compact radio size and faint magnitude ($K(\mathrm{AB})=22.7$). Its redshift was not conclusively determined from follow-up millimetre and near-infrared spectroscopy. Here we present new HST WFC3 G141 grism observations which reveal several emission lines including [NeIII]$\lambda$3867, [NeV]$\lambda$3426 and an extended ($\approx 4.8\,$kpc), [OII]$\lambda$3727 line which confirm a redshift of $3.004\pm0.001$. The extended component of the [OII]$\lambda$3727 line is co-spatial with one of two components seen at 2.276 GHz in high resolution ($60\times 20\,$mas) Long Baseline Array data, reminiscent of the alignments seen in local compact radio galaxies. The BEAGLE stellar mass ($\approx 2\times 10^{11}\,\textit{M}_\odot$) and radio luminosity ($L_{\mathrm{500MHz}}\approx 10^{28}\,$W Hz$^{-1}$) put GLEAM J0917$-$0012 within the distribution of the brightest high-redshift radio galaxies at similar redshifts. However, it is more compact than all of them. Modelling of the radio jet demonstrates that this is a young, $\approx 50\,$kyr old, but powerful, $\approx 10^{39}\,$W, compact steep spectrum radio source. The weak constraint on the active galactic nucleus bolometric luminosity from the [NeV]$\lambda$3426 line combined with the modelled jet power tentatively implies a large black hole mass, $\ge 10^9\,\textit{M}_\odot$, and a low, advection-dominated accretion rate, i.e. an Eddington ratio $\le 0.03$. The [NeV]$\lambda$3426/[NeIII]$\lambda$3867 vs [OII]$\lambda$3727/[NeIII]$\lambda$3867 line ratios are most easily explained by radiative shock models with precursor photoionisation. Hence, we infer that the line emission is directly caused by the shocks from the jet and that this radio source is one of the youngest and most powerful known at cosmic noon. We speculate that the star-formation in GLEAM J0917$-$0012 could be on its way to becoming quenched by the jet.
To determine the incidence and characteristics of hospital-based gun violence from 2000–2019.
Methods
A keyword-based search of the Nexis Uni database was conducted to identify hospital based shootings ((“shooting” w/5 “healthcare”) OR (“shooting” w/5 “health care”) OR (“shooting” w/5 “hospital”) OR (“shooting” w/5 “emergency room”) OR (“shooting” w/5 “ER”). Hospital based shootings were defined as any firearms discharge that occurred on hospital grounds in which at least one person was injured. Specialty hospitals and other healthcare facilities were excluded. Demographic, motive, and outcome data from news articles were abstracted by 2 independent reviewers with discrepancies resolved by a third reviewer. Motives were categorized according to a previously published classification schema.
Results
We identified 146 hospital-based shootings. 88 shootings have occurred since 2010. 133 of the shooters were male (91%), with a median age of 46. 77 (53%) shooters were killed, 49 from suicide (34%). Shootings were most frequently motivated by social violence (n=32, 22%).
Conclusions
Hospital-based shootings are not a rare occurrence, with middle-aged male shooters as the most common perpetrators. These events appear to be increasing over time and evidence-based mitigation strategies should be investigated.
We present deep near-infrared $K_\textrm{s}$-band imaging for 35 of the 53 sources from the high-redshift ($z \gt 2$) radio galaxy candidate sample defined in Broderick et al. (2022, PASA, 39, e061). These images were obtained using the High-Acuity Widefield K-band Imager (HAWK-I) on the Very Large Telescope. Host galaxies are detected for 27 of the sources, with $K_\textrm{s} \approx 21.6$–23.0 mag (2$^{\prime\prime}$ diameter apertures; AB). The remaining eight targets are not detected to a median $3\unicode{x03C3}$ depth of $K_\textrm{s} \approx 23.3$ mag (2$^{\prime\prime}$ diameter apertures). We examine the radio and near-infrared flux densities of the 35 sources, comparing them to the known $z \gt 3$ powerful radio galaxies with 500-MHz radio luminosities $L_{500\,\textrm{MHz}} \gt 10^{27}$ W Hz$^{-1}$. By plotting 150-MHz flux density versus $K_\textrm{s}$-band flux density, we find that, similar to the sources from the literature, these new targets have large radio to near-infrared flux density ratios, but extending the distribution to fainter flux densities. Five of the eight HAWK-I deep non-detections have a median $3\unicode{x03C3}$ lower limit of $K_\textrm{s} \gtrsim 23.8$ mag (1$.\!^{\prime\prime}$5 diameter apertures); these five targets, along with a further source from Broderick et al. (2022, PASA, 39, e061) with a deep non-detection ($K_\textrm{s} \gtrsim 23.7$ mag; $3\unicode{x03C3}$; 2$^{\prime\prime}$ diameter aperture) in the Southern H-ATLAS Regions $K_\textrm{s}$-band Survey, are considered candidates to be ultra-high-redshift ($z \gt 5$) radio galaxies. The extreme radio to near-infrared flux density ratios ($\gt 10^5$) for these six sources are comparable to TN J0924$-$2201, GLEAM J0856$+$0223 and TGSS J1530$+$1049, the three known powerful radio galaxies at $z \gt 5$. For a selection of galaxy templates with different stellar masses, we show that $z \gtrsim 4.2$ is a plausible scenario for our ultra-high-redshift candidates if the stellar mass $M_\textrm{*} \gtrsim 10^{10.5}$ M$_\odot$. In general, the 35 targets studied have properties consistent with the previously known class of infrared-faint radio sources. We also discuss the prospects for finding more UHzRG candidates from wide and deep near-infrared surveys.
Australia has a diverse and unique native flora with thousands of edible plant taxa, many of which are wild relatives of important food crops. These have the potential to diversify and improve the sustainability of Australian farming systems. However, the current level of domestication and cultivation of Australian plants as food crops is extremely limited by global standards. This review examines the current status and potential for future de novo domestication and large-scale cultivation of Australian plants as food crops. This is done in the context of international new crop development and factors that impact the success or failure of such efforts. Our review finds considerable potential for native Australian plants to be developed as food crops, but the industry faces several significant challenges. The current industry focuses on niche food markets that are susceptible to oversupply. It also suffers from inconsistent quantity and quality of product, which is attributed to a reliance on wild harvesting and the cultivation of unimproved germplasm. More active cultivation is necessary for industry growth, but attempts have historically failed due to poorly adapted germplasm and a lack of agronomic information. The de novo domestication and large-scale cultivation of Australian plants as food crops will require an investment in publicly supported multidisciplinary research and development programmes. Research programmes must prioritize the exploration of plants throughout Australia and the collection and evaluation of germplasm. Programmes must also seek to engage relevant stakeholders, pursue participatory research models and provide appropriate engagement and benefit-sharing opportunities with Indigenous Australian communities.
This paper reports the preliminary results from three seasons of excavations in the Christian cemetery by the Tunisian-British Bulla Regia Archaeological Project. In 2017–2019, excavations in, and around, the Late Antique church in the western cemetery uncovered a complex funerary landscape with a variety of different tomb types, including mosaic caisson tombs, simple masonry tombs, amphora tombs, and earthen graves and multiple funerary mensae. The mosaics, inscriptions and finds (ceramics, glass, coins) studied in 2022 support a fourth to seventh century date for the main period of use of the cemetery.
Background:Clostridioides difficile infection (CDI) is a serious healthcare-associated infection responsible for >12,000 US deaths annually. Overtesting can lead to antibiotic overuse and potential patient harm when patients are colonized with C. difficile, but not infected, yet treated. National guidelines recommend when testing is appropriate; occasionally, guideline-noncompliant testing (GNCT) may be warranted. A multidisciplinary group at UNC Medical Center (UNCMC) including the antimicrobial stewardship program (ASP) used a best-practice alert in 2020 to improve diagnostic stewardship, to no effect. Evidence supports use of hard stops for this purpose, though less is known about provider acceptance. Methods: Beginning in May 2022, UNCMC implemented a hard stop in its electronic medical record system (EMR) for C. difficile GNCT orders, with exceptions to be approved by an ASP attending physician. Requests were retrospectively reviewed May–November 2022 to monitor for adverse patient outcomes and provider hard-stop compliance. The team exported data from the EMR (Epic Systems) and generated descriptive statistics in Microsoft Excel. Results: There were 85 GNCT orders during the study period. Most tests (62%) were reviewed by the ASP, and 38% sought non-ASP or no approval. Of the tests reviewed by the ASP, 33 (62%) were approved and 20 (38%) were not. Among tests not approved by the ASP, no patients subsequently received CDI-directed antibiotics, and 1 patient (5%) warranted same-admission CDI testing (negative). Of tests that circumvented ASP review, 18 (56%) ordering providers received a follow-up email from an associate chief medical officer to determine the rationale. No single response type dominated: 3 (17%) were unaware of the ASP review requirement, 2 (11%) indicated their patient’s uncharted refusal of laxatives, 2 (11%) indicated another patient-specific reason. Provider avoidance of the ASP approval mechanism decreased 38%, from 53% of noncompliant tests in month 1 to 33% of tests in month 6. Total tests orders dropped 15.5% from 1,129 during the same period in 2021 to 954 during the study period (95% CI, 13.4%–17.7%). Compliance with the guideline component requiring at least a 48-hour laxative-free interval prior to CDI testing increased from 85% (95% CI, 83%–87%) to 95% (95% CI, 93%–96%). CDI incidence rates decreased from 0.52 per 1,000 patient days (95% CI, 0.41–0.65) to 0.41 (95% CI, 0.32–0.53), though the change was neither significant at P = .05 nor attributable to any 1 intervention. Conclusions: Over time and with feedback to providers circumventing the exception process, providers accepted and used the hard stop, improving diagnostic stewardship and avoiding unneeded treatment.
Background: The FIRST Trial is a 5-year study funded by the Agency for Healthcare Research and Quality. Our investigation is situated within a more extensive study to restrict fluoroquinolone antibiotics by requiring providers to obtain authorization from an infectious disease physician before prescribing fluoroquinolones. Our research team is performing a systematic evaluation to identify organizational characteristics and influencers of the fluoroquinolone preprescription authorization implementation process to understand variables that may facilitate or hinder implementation success. Methods: To address this critical gap, we present a qualitative analysis from our ongoing, multisite research project aimed at systematically assessing the adoption of an antimicrobial stewardship intervention in the form of an EHR-integrated best-practice alert (BPA) at each site to identify work system factors that impact uptake and variability in the implementation of the BPA at each location. The evaluation provides a detailed explanation of activities through the implementation process (eg, before implementation, during implementation, and after implementation) to assess how an organization effectively negotiates the phases and transitions, ultimately influencing the impact of the intervention. We have used a contextual determinant framework (CFIR) that has enabled us to perform a systematic and comprehensive exploration and identification of potential explanatory themes or variables to shed light on the complex social phenomenon of implementation. Results: Participants who will be a part of our poster presentation will learn about implementing a BPA, the potential barriers to implementation, and strategies for overcoming these barriers. Stakeholders within our study include site coordinators, medical doctors, nurses, pharmacists, and clinical informaticists. Our analysis synthesizes their experiences implementing and sustaining this evidence-based antimicrobial stewardship intervention. It includes (1) a detailed description of the process of change, (2) work-system factors (eg, inner setting and outer setting) that they believe influenced the success of the intervention, (3) barriers and facilitators (eg, CFIR constructs) within the implementation process; and (4) description of how these could have influenced the outcomes of interest (eg, implementation and intervention effectiveness). Conclusions: Our research is expected to advance patient safety research and initiatives by providing a more robust approach to performing systematic intervention evaluations. By outlining stakeholders’ experiences within our study, implementation leaders within healthcare systems will utilize our findings to aid them in their design and implementation process when designing and implementing similar types of healthcare interventions.
Recent arguments claim that behavioral science has focused – to its detriment – on the individual over the system when construing behavioral interventions. In this commentary, we argue that tackling economic inequality using both framings in tandem is invaluable. By studying individuals who have overcome inequality, “positive deviants,” and the system limitations they navigate, we offer potentially greater policy solutions.
Approximately 80 million people live with chronic hepatitis B virus (HBV) infection in the WHO Africa Region. The natural history of HBV infection in this population is poorly characterised, and may differ from patterns observed elsewhere due to differences in prevailing genotypes, environmental exposures, co-infections, and host genetics. Existing research is largely drawn from small, single-centre cohorts, with limited follow-up time. The Hepatitis B in Africa Collaborative Network (HEPSANET) was established in 2022 to harmonise the process of ongoing data collection, analysis, and dissemination from 13 collaborating HBV cohorts in eight African countries. Research priorities for the next 5 years were agreed upon through a modified Delphi survey prior to baseline data analysis being conducted. Baseline data on 4,173 participants with chronic HBV mono-infection were collected, of whom 38.3% were women and the median age was 34 years (interquartile range 28–42). In total, 81.3% of cases were identified through testing of asymptomatic individuals. HBeAg-positivity was seen in 9.6% of participants. Follow-up of HEPSANET participants will generate evidence to improve the diagnosis and management of HBV in this region.
We present the case of a five-year-old child with an inlet ventricular septal defect, subpulmonic stenosis, hypoplastic right ventricle, and straddling tricuspid valve who received a successful one-stage biventricular repair with right ventricular rehabilitation, right ventricular outflow tract augmentation, papillary muscle transposition, ventricular septal defect closure, and fenestrated atrial septation. This report outlines the surgical decision making and operative technique.
A prominent argument holds that the chief purpose of municipal civil service reform in the United States was to dislodge the overrepresentation of recent immigrants in city government. Using new data on all municipal employees from 1850 to 1940 and employing three research designs, we detect no evidence that the share of local government jobs held by foreign-born whites decreased following the introduction of reforms. Instead, we show that foreign-born whites—Irish immigrants in particular—experienced substantial gains in local government employment, concentrated in blue-collar occupations in small- and medium-sized municipalities. Our results call for a revisionist interpretation of Progressive Era reforms by questioning generalizations drawn from the experience of the largest cities in the United States. For most municipalities, instead, civil service reform in fact opened avenues to representation for members of foreign-born constituencies who had previously been locked out of government jobs.
We report on the design and characterization of the plasma mirror system installed on the J-KAREN-P laser at the Kansai Photon Science Institute, National Institutes for Quantum Science and Technology. The reflectivity of the single plasma mirror system exceeded 80%. In addition, the temporal contrast was improved by two orders of magnitude at 1 ps before the main pulse. Furthermore, the laser near-field spatial distribution after the plasma mirror was kept constant at plasma mirror fluence of less than 100 kJ/cm2. We also present the results of investigating the difference and the fluctuation in energy, pulse width and pointing stability with and without the plasma mirror system.
Anorexia nervosa (AN) is a psychiatric disorder with complex etiology, with a significant portion of disease risk imparted by genetics. Traditional genome-wide association studies (GWAS) produce principal evidence for the association of genetic variants with disease. Transcriptomic imputation (TI) allows for the translation of those variants into regulatory mechanisms, which can then be used to assess the functional outcome of genetically regulated gene expression (GReX) in a broader setting through the use of phenome-wide association studies (pheWASs) in large and diverse clinical biobank populations with electronic health record phenotypes.
Methods
Here, we applied TI using S-PrediXcan to translate the most recent PGC-ED AN GWAS findings into AN-GReX. For significant genes, we imputed AN-GReX in the Mount Sinai BioMe™ Biobank and performed pheWASs on over 2000 outcomes to test the clinical consequences of aberrant expression of these genes. We performed a secondary analysis to assess the impact of body mass index (BMI) and sex on AN-GReX clinical associations.
Results
Our S-PrediXcan analysis identified 53 genes associated with AN, including what is, to our knowledge, the first-genetic association of AN with the major histocompatibility complex. AN-GReX was associated with autoimmune, metabolic, and gastrointestinal diagnoses in our biobank cohort, as well as measures of cholesterol, medications, substance use, and pain. Additionally, our analyses showed moderation of AN-GReX associations with measures of cholesterol and substance use by BMI, and moderation of AN-GReX associations with celiac disease by sex.
Conclusions
Our BMI-stratified results provide potential avenues of functional mechanism for AN-genes to investigate further.
This chapter surveys the landscape of empirical studies on cross-border trade in knowledge that use data on intellectual property rights (IPRs). Our discussion critically evaluates whether these data support the empirical findings in the studies by identifying where IPRs data are particularly useful and where these data have limitations. Additionally, we discuss the potential value of making greater use of IPRs assignment data. The goal of the chapter is to provide a reference to help policymakers evaluate the trade in knowledge literature, particularly the interpretation of IPRs-based evidence for policy decisions.
We have experimentally improved the temporal contrast of the petawatt J-KAREN-P laser facility. We have investigated how the generation of pre-pulses by post-pulses changes due to the temporal overlap between the stretched pulse and the post-pulse in a chirped-pulse amplification system. We have shown that the time at which the pre-pulse is generated by the post-pulse and its shape are related to the time difference between the stretched main pulse and the post-pulse. With this investigation, we have found and identified the origins of the pre-pulses and have demonstrated the removal of most pre-pulses by eliminating the post-pulse with wedged optics. We have also demonstrated the impact of stretcher optics on the picosecond pedestal. We have realized orders of magnitude enhancement of the pedestal by improving the optical quality of a key component in the stretcher.
We consider the problem of computing the partition function
$\sum _x e^{f(x)}$
, where
$f: \{-1, 1\}^n \longrightarrow {\mathbb R}$
is a quadratic or cubic polynomial on the Boolean cube
$\{-1, 1\}^n$
. In the case of a quadratic polynomial f, we show that the partition function can be approximated within relative error
$0 < \epsilon < 1$
in quasi-polynomial
$n^{O(\ln n - \ln \epsilon )}$
time if the Lipschitz constant of the non-linear part of f with respect to the
$\ell ^1$
metric on the Boolean cube does not exceed
$1-\delta $
, for any
$\delta>0$
, fixed in advance. For a cubic polynomial f, we get the same result under a somewhat stronger condition. We apply the method of polynomial interpolation, for which we prove that
$\sum _x e^{\tilde {f}(x)} \ne 0$
for complex-valued polynomials
$\tilde {f}$
in a neighborhood of a real-valued f satisfying the above mentioned conditions. The bounds are asymptotically optimal. Results on the zero-free region are interpreted as the absence of a phase transition in the Lee–Yang sense in the corresponding Ising model. The novel feature of the bounds is that they control the total interaction of each vertex but not every single interaction of sets of vertices.