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Aim: The Townsville Hospital and Health Service is the regional referral centre for children in the north of Queensland. Aboriginal and Torres Strait Islander (ATSI) people make up 7–10% of the population. Increasing numbers of children with paediatric thoracic empyema (pTE) are being referred to Townsville Hospital and Health Service for management. This study aims to describe the incidence rates, epidemiology, microbiology and trends of this disease in North Queensland over a 10-year period. Methods: A retrospective chart review of all children (1 month to 16 years), admitted in the years 2007–2016, with community-acquired pTE was conducted. International Classification of Diseases codes were used to identify the patients. Epidemiological and microbiological data were extracted from records. Results: Of the 123 cases identified, incidence rates per 100 000 were 8.5 (95% confidence interval (CI) 8.4–8.6) in all children and much higher at 19.8 (95% CI: 19.5–21.9) in ATSI children. The under 5 years age group had the highest rate (24.5; 95% CI: 24.4–24.6). There was a progressive rise in incidence during the 10-year period, with the highest incidence of 15.2 (95% CI: 15.1–15.2) occurring in 2016. A pathogen was isolated in 76% of cases. Non-multi-resistant methicillin-resistant Staphylococcus aureus was the most common pathogen isolated in 22 of 64 ATSI children (34%), while Streptococcus pneumoniae was the most common pathogen isolated in 27 of 59 non-ATSI children (46%). Conclusions: A high and increasing incidence of pTE in North Queensland is being observed. ATSI children have higher incidence rates and are more likely to have non-multi-resistant methicillin-resistant Staphylococcus aureus as a causative agent.

Minimizing arthropod exposure (e.g. mosquito and tick bites) is vital to protect health of outdoor workers. Personal protective measures can help protect against exposure. Here, the quantity of permethrin was evaluated for different fabric types after washing. Cone and petri dish exposure assays were used to investigate the knockdown/mortality of permethrin-susceptible and permethrin-resistant populations of mosquitoes. Permethrin-treated clothing was effective against the tested mosquito population that was susceptible to permethrin but not a permethrin-resistant population. Permethrin quantity was significantly highest in the 100% cotton fabric and for the 0 wash group. Permethrin quantity in fabrics decreased with washing. No significant differences (p > 0.05) were observed in knockdown/mortality rates for either exposure method. The protective effect of permethrin-treated clothing against mosquitoes is impacted by many factors, e.g. wash frequency, fabric type, and the susceptibility/resistance status of local mosquito populations.

Policies promoting the localisation of economic benefits are commonly deployed in support of energy transitions. However, localisation policies can face challenges in ensuring alignment with energy transition goals while adapting to changes in the technological and market environment. We use the Australian Capital Territory’s localisation policy, tied to a reverse auction feed-in tariff, as an exploratory case to examine a localisation policy that underwent repeated updates to adapt to changed conditions. We find the inclusion of a review requirement can support localisation policies remaining congruent with energy transition goals throughout updates. In doing so, we contribute to understanding of how energy transition policies can be deliberatively designed to accelerate the deployment of low carbon technologies.

Mosquitoes exposed to sublethal doses of insecticides may be selected for resistance to insecticide active ingredients (AIs). Mosquitoes are exposed to AIs through agricultural, public/private mosquito control programs, homeowners, and other sources. Hence, mosquito control programs should routinely measure the resistance/susceptibility status of mosquito populations of public health concern. The objectives here were to determine resistance status for six AIs used in adult mosquito control in the United States to assess how resistance/susceptibility differs between AI, mosquito species (states where > 1 species collected), and between years (some populations sampled for 2 yr). Field-collected eggs from 21 mosquito populations of six different species or hybrid species (Aedes albopictus Skuse [Diptera: Culicidae], Aedes aegypti L. [Diptera: Culicidae], Culex nigripalpus Theobald, Culex pipiens L. [Diptera: Culicidae], Culex quinquefasciatus Say [Diptera: Culicidae], Cx. pipiens/quinquefasciatus) were obtained. Centers for Disease Control and Prevention bottle bioassays were used to assess the resistance/susceptibility status for six AIs (bifenthrin, deltamethrin, etofenprox, malathion, permethrin, and phenothrin). World Health Organization guidelines were used to classify mosquitoes as susceptible (98-100% mortality at diagnostic time [DT]), possibly resistant (80-97% mortality at DT), or resistant (

Objective To determine the effect of secondary penicillin prophylaxis on echocardiographic diagnosed valvular changes in patients with rheumatic heart disease or history of acute rheumatic fever in the Townsville Health district. Design Patients with known were identified from the North Queensland register, serial echocardiogram results and number of secondary penicillin prophylaxis doses received in 2014 were collated. Descriptive statistics were utilised. Setting Townsville Hospital and outreach clinics within the Townsville Health catchment zone. Participants All patients diagnosed with acute rheumatic fever or rheumatic heart disease between 2010 and October 2013 who had serial echocardiograms prior to and post commencement of secondary penicillin prophylaxis were included. All patients were of Aboriginal or Torres Strait Islander descent. Main outcome measure Progression of echocardiographic valvular changes and association with secondary penicillin prophylaxis compliance. Compliance with secondary penicillin prophylaxis among the study population was a secondary outcome measure. Results Twenty-three patients were recruited. Only those patients who were compliant with secondary penicillin prophylaxis had any improvement in valvular changes on echocardiogram. Four of six patients without any baseline valvular involvement developed new valvular changes. Seventy percent of patients received >75% of secondary penicillin prophylaxis doses. Conclusions This small study of patients in Townsville suggests that with good secondary penicillin prophylaxis compliance there is regression of some cardiac lesions over time in people with rheumatic heart disease. Furthermore the natural history of acute rheumatic fever in the Indigenous population is progressive requiring strict adherence to secondary penicillin prophylaxis. Prospective studies or use of data from the nationwide RHD register and standardised reporting of cardiac echocardiograms will provide more robust evidence.

An emerging body of literature has contributed to understanding behavioral spillover; however, a limited range of behaviors and psychological pathways have been studied. The current study investigates whether starting to compost, a relatively difficult behavior receiving limited attention in the spillover literature, results in spillover to household waste prevention behaviors, including food, energy, and water waste prevention. It also tests cognitive accessibility as a new mediator in the spillover process, and advances an integrative process model to address methodological inconsistencies in the spillover literature. Data are from a 2015 longitudinal field experiment to increase composting. Participants ( N = 284) were residents of Costa Mesa, California, who received a structural intervention (i.e., curbside organic waste bins) and procedural information about composting. Positive spillover was observed. Additionally, cognitive accessibility partially mediated the relationship between composting and energy and water waste–prevention behaviors. Future research should adopt a consistent definition of spillover and explore additional pathways.

OBJECTIVE Late-onset sepsis (LOS) in neonates contributes significantly to both morbidity and mortality. To determine the incidence of LOS, risk factors for disease and the impact on subsequent hospital course, we evaluated a cohort of 6340 neonates admitted to the neonatal intensive care unit and of neonates (3-28 days) admitted from the community between January 2005 and January 2016. METHODS This was a retrospective case review of all neonates admitted with suspected LOS who had positive blood culture and/or cerebrospinal fluid cultures, for an organism determined to be a pathogen. RESULTS Of 6340 neonates who survived beyond 3 days, 2271 (35.8%) had 1 or more blood cultures collected for suspected LOS. Of these, 146 (6.4%) positive blood cultures were thought to represent true bacteremia. The vast majority of infections (73%) were caused by Gram-positive organisms, with coagulase-negative staphylococci accounting for 39.8% of infections. Late-onset neonatal sepsis occurred predominantly in the 24-28-week age group (75.9%) and in neonates who weighed less than 1000 g (73.6%). The incubation time for positive blood cultures for Gram-negative sepsis was less (13 hours) when compared with Gram-positive sepsis (20 hours). Thrombocytopenia, elevated C-reactive protein and chorioamnionitis were consistently associated with late-onset Gram-negative sepsis (P < 0.05). Eight neonates (6%) died secondary to LOS. CONCLUSIONS LOS contributes significantly to mortality and morbidity in neonates and remains a challenge to clinicians. Necessary steps to reduce late-onset neonatal sepsis should be undertaken.

Policy means are shaped not only by policy goals, but also by the groups of actors targeted through policies for change. Yet the importance of targets is not visible in current frameworks describing policy development. The article advances a modified version of Howlett and Cashore’s nested model of policy instrument choice that makes explicit the centrality of targets as a bridging step between policy means and ends. It illustrates application of this target-centered framework for comparative policy analysis through three evaluations of transformative environmental policy regimes implemented in the United States, New Zealand, and Germany. Target-centered analysis provides insights into the development of each policy by separating out target and client selection from the goals and means of each policy, and shows how including targets as an explicit step in policy analysis clarifies and extends our understanding of both formulation and reform. In particular, distinguishing the calibration of policy ...

Chikungunya, dengue, and Zika viruses (CHIKV, family Togaviridae, genus Alphavirus; DENV and ZIKV, family Flaviviridae, genus Flavivirus) are arboviruses that cause human epidemics. Due to the lack of vaccines for many mosquito-borne diseases, there is a need for mosquito control. In the US and other regions, residual barrier insecticide sprays are applied to foliage where female mosquitoes rest and/or sugar feed between blood meals. Residual sprays are an important control method for anthropogenic day-active sylvan mosquitoes such as Aedes albopictus (vector of CHIKV, DENV, and ZIKV) that are difficult to control using ultralow-volume sprays applied only at dusk or dawn when these mosquitoes are not active. In this exploratory study, we analyzed the extent to which ingestion of a sublethal dose of the active ingredient bifenthrin affected vector competence (i.e., infection, dissemination, and transmission) of Ae. albopictus for DENV and ZIKV. Two incubation periods (IPs; 7 and 14 d) were tested at 28°C for insecticide-fed and sugar-fed mosquitoes. We show that mosquitoes that were fed bifenthrin (0.128 µg/mL) mixed with sucrose solution exhibited significantly lower DENV infection rates and body titers after a 14-d IP. During the 7-d IP, one mosquito (sugar group) transmitted ZIKV. During the 14-d IP, 100% of mosquitoes showed body and leg ZIKV infections, and one mosquito (sugar+bifenthrin group) transmitted ZIKV. This is a preliminary communication, and more studies will be required to further investigate these findings. We expect the findings of this small-scale study to spur larger-scale investigations of the impacts of insecticides on mechanisms regulating vector competence, and exposure to other active ingredients, and aid in development of new insecticides.

We present the radio luminosity function (RLF) of optically-selected quasars below 1~mJy, constructed by applying a Bayesian-fitting stacking technique to objects well below the nominal radio flux-density limit. We test the technique using simulated data, confirming that we can reconstruct the RLF over three orders of magnitude below the typical $5\sigma$ detection threshold. We apply our method to 1.4-GHz flux-densities from the Faint Images of the Radio Sky at Twenty-cm survey (FIRST), extracted at the positions of optical quasars from the Sloan Digital Sky Survey (SDSS) over seven redshift bins up to $z=2.15$ {and measure the RLF down to two orders of magnitude below the FIRST detection threshold}. In the lowest redshift bin ($0.2, Comment: 20 pages, 14 figures, 5 tables

We present a detailed analysis of the radio galaxy PKS 2250-351, a giant of 1.2 Mpc projected size, its host galaxy, and its environment. We use radio data from the Murchison Widefield Array, the upgraded Giant Metre-wavelength Radio Telescope, the Australian Square Kilometre Array Pathfinder, and the Australia Telescope Compact Array to model the jet power and age. Optical and infra-red data come from the Galaxy And Mass Assembly (GAMA) survey and provide information on the host galaxy and environment. GAMA spectroscopy confirms that PKS 2250-351 lies at z=0.2115 in the irregular, and likely unrelaxed, cluster Abell 3936. We find its host is a massive, `red and dead' elliptical galaxy with negligible star formation but with a highly obscured active galactic nucleus dominating the mid-infrared emission. Assuming it lies on the local M-sigma relation it has an Eddington accretion rate of lambda_EDD~0.014. We find that the lobe-derived jet power (a time-averaged measure) is an order of magnitude greater than the hotspot-derived jet power (an instantaneous measure). We propose that over the lifetime of the observed radio emission (~300 Myr) the accretion has switched from an inefficient advection dominated mode to a thin-disc efficient mode, consistent with the decrease in jet power. We also suggest that the asymmetric radio morphology is due to its environment, with the host of PKS 2250-351 lying to the west of the densest concentration of galaxies in Abell 3936., Comment: 16 pages and 8 figures, accepted for publication in PASA

National Human Rights Institutions (NHRIs) are one of the most important institutional developments of recent years. NHRIs can play a key role in promoting and protecting human rights. They are able to do so by the unique position they occupy between government, civil society and nongovernmental organisations. Their codification in the Paris Principles and endorsement by the United Nations General Assembly in 1993 has changed the human rights landscape globally.

Spectral variability of radio sources encodes information about the conditions of intervening media, source structure, and emission processes. With new low-frequency radio interferometers observing over wide fractional bandwidths, studies of spectral variability for a large population of extragalactic radio sources are now possible. Using two epochs of observations from the GaLactic and Extragalactic All-sky Murchison Widefield Array (GLEAM) survey that were taken one year apart, we search for spectral variability across 100--230 MHz for 21,558 sources. We present methodologies for detecting variability in the spectrum between epochs and for classifying the type of variability: either as a change in spectral shape or as a uniform change in flux density across the bandwidth. We identify 323 sources with significant spectral variability over a year-long timescale. Of the 323 variable sources, we classify 51 of these as showing a significant change in spectral shape. Variability is more prevalent in peaked-spectrum sources, analogous to gigahertz-peaked spectrum and compact steep-spectrum sources, compared to typical radio galaxies. We discuss the viability of several potential explanations of the observed spectral variability, such as interstellar scintillation and jet evolution. Our results suggest that the radio sky in the megahertz regime is more dynamic than previously suggested., Comment: Accepted for publication in MNRAS

The low-frequency linearly-polarised radio source population is largely unexplored. However, a renaissance in low-frequency polarimetry has been enabled by pathfinder and precursor instruments for the Square Kilometre Array. In this second paper from the POlarised GaLactic and Extragalactic All-Sky Murchison Widefield Array (MWA) Survey -- the POlarised GLEAM Survey, or POGS -- we present the results from our all-sky MWA Phase I Faraday Rotation Measure survey. Our survey covers nearly the entire Southern sky in the Declination range $-82^{\circ}$ to $+30^{\circ}$ at a resolution between around three and seven arcminutes (depending on Declination) using data in the frequency range 169$-$231 MHz. We have performed two targeted searches: the first covering 25,489 square degrees of sky, searching for extragalactic polarised sources; the second covering the entire sky South of Declination $+30^{\circ}$, searching for known pulsars. We detect a total of 517 sources with 200 MHz linearly-polarised flux densities between 9.9 mJy and 1.7 Jy, of which 33 are known radio pulsars. All sources in our catalogues have Faraday rotation measures in the range $-328.07$ rad m$^{-2}$ to $+279.62$ rad m$^{-2}$. The Faraday rotation measures are broadly consistent with results from higher-frequency surveys, but with typically more than an order of magnitude improvement in the precision, highlighting the power of low-frequency polarisation surveys to accurately study Galactic and extragalactic magnetic fields. We discuss the properties of our extragalactic and known-pulsar source population, how the sky distribution relates to Galactic features, and identify a handful of new pulsar candidates among our nominally extragalactic source population., Comment: Replacement of previous version. Only change is minor updates to catalogues (see ancillary files) which now contain bib code of finalised manuscript (published in PASA). Manuscript has 31 pages, 10 figures, 5 tables. Four Appendices are included in the ancillary material, showing further Figures, continuum spectra for a handful of selected sources, and RM spectra for all 517 sources

The Murchison Widefield Array (MWA) has observed the entire southern sky (Declination, $\delta $ 10 deg) to define the GLEAM 4-Jy (G4Jy) Sample. This is a complete sample of the 'brightest' radio-sources ($S_{\mathrm{151MHz}} >$ 4 Jy), the majority of which are active galactic nuclei with powerful radio-jets. Crucially, low-frequency observations allow the selection of such sources in an orientation-independent way (i.e. minimising the bias caused by Doppler boosting, inherent in high-frequency surveys). We then use higher-resolution radio images, and information at other wavelengths, to morphologically classify the brightest components in GLEAM. We also conduct cross-checks against the literature, and perform internal matching, in order to improve sample completeness (which is estimated to be $>$ 95.5%). This results in a catalogue of 1,863 sources, making the G4Jy Sample over 10 times larger than that of the revised Third Cambridge Catalogue of Radio Sources (3CRR; $S_{\mathrm{178MHz}} >$ 10.9 Jy). Of these G4Jy sources, 78 are resolved by the MWA (Phase-I) synthesised beam ($\sim$2 arcmin at 200 MHz), and we label 67% of the sample as 'single', 26% as 'double', 4% as 'triple', and 3% as having 'complex' morphology at $\sim$1 GHz (45-arcsec resolution). Alongside this, our value-added catalogue provides mid-infrared source associations (subject to 6-arcsec resolution at 3.4 micron) for the radio emission, as identified through visual inspection and thorough checks against the literature. As such, the G4Jy Sample can be used as a reliable training set for cross-identification via machine-learning algorithms. [Abstract abridged for arXiv submission.], Comment: 57 pages (30 MB in size), 23 figures, 16 tables, accepted for publication in PASA, and now updated to match the final proof. Full-resolution images will be used for the published version, available through the journal. To keep up-to-date regarding the G4Jy Sample, bookmark https://github.com/svw26/G4Jy

Advanced LIGO data contains numerous noise transients, or "glitches", that have been shown to reduce the sensitivity of matched filter searches for gravitational waves from compact binaries by increasing the rate at which random coincidences occur. The presence of these transients has precipitated extensive work to establish that observed gravitational wave events are astrophysical in nature. We discuss the response of the PyCBC search for gravitational waves from stellar mass binaries to various common glitches that were observed during Advanced LIGO's first and second observing runs. We show how these transients can mimic waveforms from compact binary coalescences and quantify the likelihood that a given class of glitches will create a trigger in the search pipeline. We explore the specific waveform parameters that are most similar to different glitch classes and demonstrate how knowledge of these similarities can be used when evaluating the significance of gravitational-wave candidates., Comment: 16 pages, 6 figures

We present MeerKAT 1000 MHz and 1400 MHz observations of a bright radio galaxy in the southern hemisphere, ESO~137-006. The galaxy lies at the centre of the massive and merging Norma galaxy cluster. The MeerKAT continuum images (rms ~0.02 mJy/beam at ~10" resolution) reveal new features that have never been seen in a radio galaxy before: collimated synchrotron threads of yet unknown origin, which link the extended and bent radio lobes of ESO~137-006. The most prominent of these threads stretches in projection for about 80 kpc and is about 1 kpc in width. The radio spectrum of the threads is steep, with a spectral index of up to $\alpha\simeq 2$ between 1000 MHz and 1400 MHz., Comment: 5 pages, 4 figures, accepted for publication in A&A letters

OBJECTIVE The purpose of the present study was to compare psychometric properties of the Substance Abuse (SUB) Scale on the Korean Minnesota Multiphasic Personality Inventory-Adolescent-Restructured Form (MMPI-A-RF) with those on the Korean MMPI-A (the Alcohol/Drug Problem Acknowledgment Scale [ACK]), the Alcohol/Drug Problem Proneness Scale [PRO], and the MacAndrew Alcoholism Scale-Revised Scale [MAC-R]). METHOD Participants consisted of 237 Korean adolescent psychiatric patients whose scores on these measures were compared in terms of internal consistency and predictive validity. RESULTS Scores on SUB exhibited superior internal consistency to that of the MMPI-A substance abuse scales. Further, scores on SUB predicted substance abuse more accurately than did the optimal combination of scores on the MMPI-A substance abuse scales. CONCLUSION Results provide strong support for the use of the Korean MMPI-A-RF SUB scale when assessing substance abuse in Korean youth.

Chronic limb-threatening ischemia (CLTI) is associated with mortality, amputation, and impaired quality of life. These Global Vascular Guidelines (GVG) are focused on definition, evaluation, and management of CLTI with the goals of improving evidence-based care and highlighting critical research needs. The term CLTI is preferred over critical limb ischemia, as the latter implies threshold values of impaired perfusion rather than a continuum. CLTI is a clinical syndrome defined by the presence of peripheral artery disease (PAD) in combination with rest pain, gangrene, or a lower limb ulceration >2 weeks duration. Venous, traumatic, embolic, and nonatherosclerotic etiologies are excluded. All patients with suspected CLTI should be referred urgently to a vascular specialist. Accurately staging the severity of limb threat is fundamental, and the Society for Vascular Surgery Threatened Limb Classification system, based on grading of Wounds, Ischemia, and foot Infection (WIfI) is endorsed. Objective hemodynamic testing, including toe pressures as the preferred measure, is required to assess CLTI. Evidence-based revascularization (EBR) hinges on three independent axes: Patient risk, Limb severity, and ANatomic complexity (PLAN). Average-risk and high-risk patients are defined by estimated procedural and 2-year all-cause mortality. The GVG proposes a new Global Anatomic Staging System (GLASS), which involves defining a preferred target artery path (TAP) and then estimating limb-based patency (LBP), resulting in three stages of complexity for intervention. The optimal revascularization strategy is also influenced by the availability of autogenous vein for open bypass surgery. Recommendations for EBR are based on best available data, pending level 1 evidence from ongoing trials. Vein bypass may be preferred for average-risk patients with advanced limb threat and high complexity disease, while those with less complex anatomy, intermediate severity limb threat, or high patient risk may be favored for endovascular intervention. All patients with CLTI should be afforded best medical therapy including the use of antithrombotic, lipid-lowering, antihypertensive, and glycemic control agents, as well as counseling on smoking cessation, diet, exercise, and preventive foot care. Following EBR, long-term limb surveillance is advised. The effectiveness of nonrevascularization therapies (eg, spinal stimulation, pneumatic compression, prostanoids, and hyperbaric oxygen) has not been established. Regenerative medicine approaches (eg, cell, gene therapies) for CLTI should be restricted to rigorously conducted randomizsed clinical trials. The GVG promotes standardization of study designs and end points for clinical trials in CLTI. The importance of multidisciplinary teams and centers of excellence for amputation prevention is stressed as a key health system initiative.

Purkinje neurons express voltage-gated Na channels and auxiliary proteins that facilitate rapid firing. White et al. find that Na current in isolated Purkinje cells is unaffected by loss of NaVβ4 subunits, but transient current is briefer and resurgent current is reduced without the FGF14 protein., Voltage-gated Na channels of Purkinje cells are specialized to maintain high availability during high-frequency repetitive firing. They enter fast-inactivated states relatively slowly and undergo a voltage-dependent open-channel block by an intracellular protein (or proteins) that prevents stable fast inactivation and generates resurgent Na current. These properties depend on the pore-forming α subunits, as well as modulatory subunits within the Na channel complex. The identity of the factors responsible for open-channel block remains a question. Here we investigate the effects of genetic mutation of two Na channel auxiliary subunits highly expressed in Purkinje cells, NaVβ4 and FGF14, on modulating Na channel blocked as well as inactivated states. We find that although both NaVβ4 and the FGF14 splice variant FGF14-1a contain sequences that can generate resurgent-like currents when applied to Na channels in peptide form, deletion of either protein, or both proteins simultaneously, does not eliminate resurgent current in acutely dissociated Purkinje cell bodies. Loss of FGF14 expression does, however, reduce resurgent current amplitude and leads to an acceleration and stabilization of inactivation that is not reversed by application of the site-3 toxin, anemone toxin II (ATX). Tetrodotoxin (TTX) sensitivity is higher for resurgent than transient components of Na current, and loss of FGF14 preferentially affects a highly TTX-sensitive subset of Purkinje α subunits. The data suggest that NaV1.6 channels, which are known to generate the majority of Purkinje cell resurgent current, bind TTX with high affinity and are modulated by FGF14 to facilitate open-channel block.

We report a case of human fascioliasis in the USA that encountered many diagnostic uncertainties. Numerous tests available for detection of fascioliasis were utilised but the diagnosis remained elusive. Confounders included three negative stool ova and parasite examinations, positive hepatitis A virus IgM antibody, cross-reactive false-positiveEchinococcusIgG antibody, absence of characteristic image findings and unrevealing liver biopsy. Praziquantel was started as empiric treatment for helminth infections, but was ineffective. Due to the rarity of the disease in the USA, serologic testing and triclabendazole were only available from the Centers for Disease Control and Prevention, which led to a delay in diagnosis and treatment.

Chemical structures bearing a molybdenum atom have been suggested for the catalytic reduction of N2 at ambient conditions. Previous computational studies on gas-phase MoN and MoN2 species have focused only on neutral structures. Here, an ab initio electronic structure study on the redox states of small clusters composed of nitrogen and molybdenum is presented. The complete-active space self-consistent field method and its extension via second-order perturbative complement have been applied on [MoN]n and [MoN2]n species (n = 0, 1±, 2±). Three different coordination modes (end-on, side-on, and linear NMoN) have been considered for the triatomic [MoN2]n. Our results demonstrate that the reduced states of such systems lead to a greater degree of N2 activation, which can be the starting point of different reaction channels.

Hirschsprung disease (HD) is a congenital bowel innervation disorder characterized by the absence of ganglion cells in the neural plexus of the colorectal wall. Variant HD describes a heterogeneous group of intestinal innervation disorders in which clinical presentation resembles HD despite the presence of ganglion cells seen in rectal biopsies. We present the first reported case of a rare variant HD, hypoganglionosis isolated in the anorectal canal, diagnosed in an adult who presented with a long history of constipation and treated with proctosigmoidectomy with coloanal anastomosis. Histopathology showed rare ganglion cells isolated in the anorectal canal.

Mutations in the ATP-binding cassette transporter A3 gene (ABCA3) result in severe neonatal respiratory distress syndrome and childhood interstitial lung disease. As most ABCA3 mutations are rare or private, determination of mutation pathogenicity is often based on results from in silico prediction tools, identification in unrelated diseased individuals, statistical association studies, or expert opinion. Functional biologic studies of ABCA3 mutations are needed to confirm mutation pathogenicity and inform clinical decision making. Our objective was to functionally characterize two ABCA3 mutations (p.R288K and p.R1474W) identified among term and late-preterm infants with respiratory distress syndrome with unclear pathogenicity in a genetically versatile model system. We performed transient transfection of HEK293T cells with wild-type or mutant ABCA3 alleles to assess protein processing with immunoblotting. We used transduction of A549 cells with adenoviral vectors, which concurrently silenced endogenous ABCA3 and expressed either wild-type or mutant ABCA3 alleles (p.R288K and p.R1474W) to assess immunofluorescent localization, ATPase activity, and organelle ultrastructure. Both ABCA3 mutations (p.R288K and p.R1474W) encoded proteins with reduced ATPase activity but with normal intracellular localization and protein processing. Ultrastructural phenotypes of lamellar body–like vesicles in A549 cells transduced with mutant alleles were similar to wild type. Mutant proteins encoded by ABCA3 mutations p.R288K and p.R1474W had reduced ATPase activity, a biologically plausible explanation for disruption of surfactant metabolism by impaired phospholipid transport into the lamellar body. These results also demonstrate the usefulness of a genetically versatile, human model system for functional characterization of ABCA3 mutations with unclear pathogenicity.

Objective Post-mortem examination can provide important information about the cause of death and play a significant role in the bereavement process. Autopsies reveal previous unknown medical problems approximately 20–30% of the time. A non-invasive MRI-based post-mortem examination (PM-MRI) may provide an alternative for families who do not consent to an autopsy. Study Design This study was a prospective observational study of recently expired neonates and infants. Subjects underwent a full body MRI scan (brain, chest, abdomen and pelvis) followed by conventional autopsy if the family desired to have one. MRI results were compared to autopsy findings and the ante mortem clinical diagnosis. A follow-up survey was conducted to investigate family perceptions of the PM-MRI process. Result Thirty-one infants underwent full PM-MRI. 19/31 (61%) of infants had complete agreement between the clinician’s impression and PM-MRI. Twenty-four infants also had conventional autopsy, with 14/24 (58%) infants having PM-MRI results consistent with autopsy findings. PM-MRI was superior at detection of free intraperitoneal/intrathoracic air and hepatic iron overload. Whole body PM-MRI did not have the resolution to detect focal/microscopic injury, vascular remodeling and some forms of brain injury. Of those families who remembered the PM-MRI findings, the majority felt that the information was useful. Conclusion PM-MRI studies may provide an important adjunct to conventional autopsy and a substitute when the latter is not possible for personal or religious reasons. Clinicians should be aware of, and communicate with the family, the resolution limits of the whole body PM-MRI to detect certain types of injury.

A pilot survey described the characteristics of anaphylactic events occurring in an initial set of participating U.S. schools during the 2013-2014 school year. This survey was subsequently readministered to large school districts, which were underrepresented in initial results. A cross-sectional survey was administered to the U.S. schools that were participating in the EPIPEN4SCHOOLS® program (Mylan Specialty L.P., Canonsburg, PA) to assess characteristics of anaphylactic events. Data from large school districts were added to initial findings in this comprehensive combined analysis. A total of 1,140 anaphylactic events were reported among 6,574 responding schools. Of 1,063 anaphylactic events with data on who experienced the event, it was observed that it occurred mostly in students (89.5%, 951/1,063). For students, anaphylactic events were reported across all grades, with 44.9% (400/891) occurring in high school students, 18.9% (168/891) in middle school students, and 32.5% (290/891) in elementary school students. Food was identified as the most common trigger (60.1%, 622/1,035). A majority of schools (55.0%, 3,332/6,053) permitted only the school nurse and select staff to administer epinephrine to treat anaphylaxis. The unpredictability of anaphylaxis is emphasized by its high occurrence in individuals with no known allergies (25.0%). A majority of schools permitted only the school nurse and select staff to treat anaphylaxis. Thus, individuals experiencing an anaphylactic event may frequently encounter staff members not being permitted to administer potentially life-saving epinephrine. Epinephrine auto-injectors provided by the EPIPEN4SCHOOLS program were used to treat 38.0% of events. Anaphylaxis can occur in children with no previously known allergies, illustrating the importance of public access to epinephrine.

Background/purpose Hirschsprung disease (HD) is diagnosed by rectal biopsy, with suction rectal biopsy (SRB), the preferred technique in neonates. Reported SRB adequacy has varied overall with concern for decreased diagnostic yield in older children. The study aim was to assess SRB adequacy by age in children with the current device used at our institution. Methods Following IRB approval, a retrospective cohort of children (1 to 18years) evaluated by SRB for HD was identified through billing records. Data regarding demographics, procedure, results, and complications were collected and analyzed using SPSS. Results 56 children (median age 3.9years) underwent SRB with an 80.4% overall success rate. Patients older than 5years had 90.5% adequacy rate compared to 74.3% in those younger. Univariate analysis revealed weak association of inadequate specimens with younger age and males, and no association with insurance, race/ethnicity, weight–height or BMI percentile, sedation type, or procedure location. SRB under general anesthesia (GA) had 100% adequacy ( n =6). Patients with inadequate initial biopsy achieved diagnosis by SRB with increased sedation ( n =5) or full thickness biopsy under GA ( n =5). Conclusion With adequacy of 80.4% overall and 90.5% for patients greater than 5years, SRB is effective in evaluating the older child for HD.

We have used the Karl G. Jansky Very Large Array to image ~100 sq. deg. of SDSS Stripe 82 at 1-2 GHz. The survey consists of 1,026 snapshot observations of 2.5 minutes duration, using the hybrid CnB configuration. The survey has good sensitivity to diffuse, low surface brightness structures and extended radio emission, making it highly synergistic with existing 1.4 GHz radio observations of the region. The principal data products are continuum images, with 16 x 10 arcsecond resolution, and a catalogue containing 11,782 point and Gaussian components resulting from fits to the thresholded Stokes-I brightness distribution, forming approximately 8,948 unique radio sources. The typical effective 1{\sigma} noise level is 88 {\mu}Jy / beam. Spectral index estimates are included, as derived from the 1 GHz of instantaneous bandwidth. Astrometric and photometric accuracy are in excellent agreement with existing narrowband observations. A large-scale simulation is used to investigate clean bias, which we extend into the spectral domain. Clean bias remains an issue for snapshot surveys with the VLA, affecting our total intensity measurements at the ~1{\sigma} level. Statistical spectral index measurements are in good agreement with existing measurements derived from matching separate surveys at two frequencies. At flux densities below ~35{\sigma} the median in-band spectral index measurements begin to exhibit a bias towards flatness that is dependent on both flux density and the intrinsic spectral index. In-band spectral curvature measurements are likely to be unreliable for all but the very brightest components. Image products and catalogues are publicly available via an FTP server., Comment: 20 pages, 14 figures, 3 tables, accepted for publication in MNRAS

Hydrogen as a fuel is clean burning, but production can cause substantial greenhouse emissions. Some buyers will prefer to pay a higher price to ensure purchase of low-embedded emissions hydrogen, but it is impossible to determine embedded emissions by examining the end product. Certification of embedded emissions will thus play a key role in the future of hydrogen as a low-emission energy carrier. The boundaries of the supply-chain elements covered in the emissions accounting of certification schemes will have substantial implications for emission-reduction incentives and international tradability. We review the boundary definitions of existing and emerging hydrogen certification schemes. Further, we provide an evidence-based assessment of the magnitude of emissions likely to occur within each boundary of the supply chain. We find varying approaches to boundary definitions in the surveyed schemes. The exclusion of feedstock or transport elements risks ignoring major fractions of supply-chain emissions. In order to balance tradability and emissions-reduction incentives, we recommend that hydrogen certification schemes be designed to follow a modular approach. This type of modular approach would place those with decision-making power over the relevant piece of the supply chain in the position of certifying the emissions within that supply-chain boundary.

Electric vehicle (EV) acceptance varies across political ideologies. EV symbolic attributes, or the extent to which people perceive EVs to reinforce aspects of their identities, are among the strongest predictors of EV adoption intentions, and may contribute to this group difference. The primary objectives of this study are to better understand the role of social (in this case, political) identity in symbolic attribute perceptions, and how these variables work together to influence EV adoption intentions. Among 545 survey respondents from the state of Ohio in the United States, Democrats are more willing to adopt EVs than Republicans. This relationship is mediated by symbolic attribute perceptions. Specifically, Democrats have stronger EV symbolic attribute perceptions than Republicans, and these perceptions predict adoption intentions. Using an identity framework, this study advances our understanding of the psychological mechanisms that help explain differences in EV adoption intent amongst U.S. Democrats vs. Republicans, and offers guidance for targeted marketing efforts to enhance EV uptake.

Background Asthma exacerbation risk increases with worsening asthma control. Prevailing numerical control tools evaluate only current symptom impairment despite the importance of also assessing risk based on exacerbation history. An easy-to-use questionnaire addressing impairment and risk domains of control is needed. Objective To validate a composite asthma control tool that includes impairment and risk assessments (Asthma Impairment and Risk Questionnaire [AIRQ]). Methods Four-hundred forty-two patients aged ≥12 years with physician-diagnosed asthma who were followed in specialty practices completed 15 impairment and risk questions with dichotomized yes/no responses. Patients spanned all Global Initiative for Asthma severities and were classified as well-controlled, not well-controlled, or very poorly controlled according to a standard of Asthma Control Test (ACT) score plus prior-year exacerbations. Logistic regression analyses identified questions with the greatest predictive validity to discriminate among patients and determine cut points for these 3 classifications. Results The final AIRQ comprises 10 equally weighted yes/no impairment and risk questions. The final 10-item models yielded receiver operating characteristic curves of 0.94 to identify well-controlled versus not well-/very poorly controlled and 0.93 to identify well-/not well-controlled versus very poorly controlled asthma, as reflected by the ACT plus prior-year exacerbations standard. Cut points of 0-1, 2-4, and 5-10 best represented well-, not well-, and very poorly controlled asthma. Conclusions AIRQ is a rigorously validated composite measure designed to identify adults and adolescents with varying degrees of asthma control. Ongoing investigations will determine test-retest reliability, responsiveness to change, and predictive ability for future exacerbations.

Percolation theory can be used to study the flow-related properties of various porous systems. In particular, recently developed membranes from silica nanoparticles with surface grafted polymer brushes represent a quintessential hard-sphere soft-shell system for which fluid-flow behavior can be illuminated via a percolation framework. However, a critical parameter in membrane design involves the maximum pass-through size of particles. While percolation theory considers path connectedness of a system, little explicit consideration is given to the size of the paths that traverse the space. This paper employs a hard-sphere soft-shell percolation model to investigate maximum particle pass-through size of membranes. A pixelated (as opposed to continuous) representation of the geometry is created, and combined with readily available homology software to analyze percolation behavior. The model is validated against previously published results. For a given sphere volume fraction, the maximum diameter of a percolating path is determined by applying iterative dilations to the spheres until the percolation threshold is reached. A simple approximate relationship between maximum particle size and sphere volume fraction is derived for application to membrane design. Experimental particle cutoff size results for the polymer modified silica nanoparticle membranes were used as a partial verification of the model created in this paper. The presence of a distribution of sphere sizes (naturally created by the manufacturing process) is found to have negligible effect, compared to results for a single sphere size.

Several lines of evidence strongly suggest that AAA is a specific antigen-driven T-cell inflammatory disease with a strong genetic component. We tested the hypothesis that γ- and δ-chain TCR transcripts are clonally expanded in AAA lesions. Previously, we showed clonally expanded α-chain (PloS One 2019;14:e0218990) and β-chain (J Immunol. 2014; 192:4897) TCR transcripts in AAA lesions of patients with AAA. We employed two-sided VγI-, VγII-, Vδ1- and Vδ2-specific PCR followed by cloning and sequencing of amplified transcripts to examine whether VγI-, VγII-, Vδ1- and Vδ2-TCR transcripts, respectively, were clonally expanded in aneurysmal lesions of patients with AAA. Clonally expanded VγI-, VγII-, Vδ1- and Vδ2-TCR transcripts were identified in AAA aneurysmal lesions. We identified multiple identical copies of: (i) VγI-TCR transcripts in 16 of 18 patients (range of identical transcripts 30% to 80% in individual patients); (ii) VγII-TCR transcripts in 15 of 15 patients (range of identical transcripts 39% to 80%);.(iii) Vδ1-TCR transcripts in 12 of 12 patients (range of identical transcripts 29% to 94%); and (iv) Vδ2-TCR transcripts in 10 of 10 patients (range of identical transcripts 40% to 91%). These results were statistically significant. PBMC from normal donors (methodological controls) contained almost exclusively unique VγI-, VγII- and Vδ2-TCR transcripts. In contrast, Vδ1 transcripts from PBMC from certain normal donors contained clonally expanded T cells, in agreement with previous reports. In conclusion, clonally expanded γδ TCR-expressing T cells were found in aneurysmal lesions of patients with AAA. These T cells may play an important role in the pathogenesis of AAA. Supported in part by grant RO1 HL64340 from NIH.

AAA is often a life-threatening disease with poorly understood pathogenesis. We examined gene expression profiles between AAA and normal aorta specimens by cDNA microarray analysis. AAA wall specimens from 5 patients with AAA and grossly normal aortic walls from 3 transplant donors were employed in this study. Total RNA was extracted from each specimen, RT into cDNA, and labeled with phosphorus α-32P. cDNA probes were then hybridized onto human cardiovascular microarray and analyzed by densitometry. Quantitative differences of some genes were further explored by SYBR green-mediated qRT-PCR analysis. Pairwise comparisons of both microarray and qRT-PCR results were made by Student t-test. Most of the 588 genes studied had similar expression among AAA specimens and control aortas, however, 25 genes were upregulated and 26 downregulated. Expression of MMP-9, TIMP3, collagen 1A1 (COL1A1), COL6A3, COL15A1, decorin, MCP 1, Apo E, Apo D, H19 and others was increased. Expression of COL4A4, biglycan, caveolin 3, galectin 1, LDL receptor-related protein 1, extracellular SOD 3, ANP receptor A precursor and others was decreased. Most qRT-PCR results agreed well with those from microarray analysis, with few exceptions. A number of genes that have been previously postulated to participate in AAA pathogenesis, have been upregulated or their expression has been altered. We also revealed some genes that have not been yet studied in human AAA. Of note, H19, one of the most highly up-regulated transcripts in two mouse aneurysm models, was also significantly upregulated in human AAA. These results indicate that many genes involved in different cellular functions might contribute to the pathogenesis of AAA. Supported in part by grant RO1 HL64340 from NIH.

Rheumatic heart disease, as a result of a single or recurrent episode of acute rheumatic fever (ARF), remains a significant cause of morbidity and mortality in northern and remote Australia; ARF has a peak incidence among 5-14-year-old Aboriginal and Torres Strait Islander children. Long-term regular benzathine penicillin G injections are the only currently successful secondary prevention strategy; however, rates of adherence remain critically low. In contrast, rates of adherence to immunisations on the National Immunisation Program (NIP) Schedule are high, even among this target population. This article compares strategies used to implement and improve ARF secondary prophylaxis with those used in the NIP. Some successful NIP strategies, such as Service Incentive Payment for health providers, home-visiting delivery models and integration into the National Immunisation Register, if applied to ARF secondary prophylaxis have the potential to improve benzathine penicillin G adherence.

Background Vector-borne diseases are an important cause of morbidity and mortality in the USA. Effective, convenient prevention methods are needed. Long-lasting permethrin-impregnated (LLPI) clothing can prevent tick bites, however, additional information is needed on the real-world effectiveness and safety of this preventative measure. Methods In this pilot study, we recruited state and county park employees from North Carolina to wear LLPI uniforms for three months during the summer of 2016. We collected spot urine samples for biomonitoring of permethrin metabolites at one week, one month and three months after first use of the LLPI uniform. Following three months of wear, we collected pants and socks and analyzed them for permethrin content and mortality to ticks and mosquitoes. Results Thirteen park employees were included in the analysis. Bioactive amounts of permethrin remained in all clothing swatches tested, although there was great variability. Tick mortality was high, with 78% of pant and 88% of sock swatches having mean knockdown percentages ≥ 85%. In contrast, mosquito mortality was low. Over the study period, the absorbed dosage of permethrin averaged < 4 μg/kg/d of body weight based on measurements of three metabolites. Conclusions LLPI clothing retained permethrin and bioactivity against ticks after three months of use in real-world conditions. The estimated absorbed dosage of permethrin was well below the U.S. EPA level of concern, suggesting that LLPI clothing can be used safely by outdoor workers for tick bite prevention. Electronic supplementary material The online version of this article (10.1186/s13071-019-3314-1) contains supplementary material, which is available to authorized users.

AAA is a life-threatening vascular disease and one of the ten leading causes of death of 55–74 years old men and women. Although autoimmunity may be responsible for the initiation and/or progression of the disease, limited information is available about the pathogenesis of AAA. Mononuclear infiltrates comprised mostly of T and B cells and monocytes are present in AAA lesions. We have reported (J. Immunol. 192:4897, 2014) that clonally expanded beta-chain TCR transcripts are present in AAA lesions, providing evidence suggesting that AAA is a specific antigen-driven T-cell disease. In addition to the beta-chain TCR, there are several reasons to study the clonality and the repertoire of the alpha-chain TCR in AAA. Alpha-chain TCR transcripts from AAA lesions from these patients were amplified by the non-palindromic adaptor-PCR (NPA-PCR)/Vα-specific PCR and/or the Vα-specific PCR and the amplified transcripts were cloned and sequenced. Sequence analysis revealed substantial proportions of identical alpha-chain TCR transcripts in 4 of 5 AAA patients, demonstrating that clonally expanded T cells are present in these AAA lesions. These results are statistically significant. These T-cell clones very likely have undergone proliferation and clonal expansion in vivo in response to specific, although, as yet unidentified, antigen(s) (self or non-self) recognized by the T-cell clones. Three of 5 patients with AAA were typed by DNA-based HLA-typing and all expressed DRB1 alleles positive for the DRbGln70 amino acid residue, reported to be associated with AAA. Clonally expanded T cells in AAA lesions were found in all these 3 patients. These findings provide additional evidence suggesting that AAA is a specific antigen-driven T-cell disease.

Radio observations allow us to identify a wide range of active galactic nuclei (AGN), which play a significant role in the evolution of galaxies. Amongst AGN at low radio-luminosities is the 'radio-quiet' quasar (RQQ) population, but how they contribute to the total radio emission is under debate, with previous studies arguing that it is predominantly through star formation. In this talk, SVW summarised the results of recent papers on RQQs, including the use of far-infrared data to disentangle the radio emission from the AGN and that from star formation. This provides evidence that black-hole accretion, instead, dominates the radio emission in RQQs. In addition, we find that this accretion-related emission is correlated with the optical luminosity of the quasar, whilst a weaker luminosity-dependence is evident for the radio emission connected with star formation. What remains unclear is the process by which this accretion-related emission is produced. Understanding this for RQQs will then allow us to investigate how this type of AGN influences its surroundings. Such studies have important implications for modelling AGN feedback, and for determining the accretion and star-formation histories of the Universe., Comment: 5 pages, 2 figures, proceedings of IAU Symposium 356 on "Nuclear Activity in Galaxies Across Cosmic Time", October 2019

Background The Philippines is ranked 3rd globally for tuberculosis incidence (554/100,000 population). The tuberculosis ward at San Lazaro Hospital, Manila receives 1,800?2,000 admissions of acutely unwell patients per year with high mortality. Objectives of this prospective cohort study were to quantify the association of under-nutrition (primary) and diabetes (secondary) with inpatient mortality occurring between 3?28 days of hospital admission in patients with suspected or previously diagnosed TB. Methods and results We enrolled 360 adults (18 years); 348 were eligible for the primary analysis (alive on day 3). Clinical, laboratory, anthropometric and enhanced tuberculosis diagnostic data were collected at admission with telephone tracing for mortality up to 6 months post-discharge. In the primary analysis population (mean age 45 years, SD = 15.0 years, 70% male), 58 (16.7%) deaths occurred between day 3?28 of admission; 70 (20.1%) between day 3 and discharge and documented total post-day 3 mortality including follow-up was 96 (27.6%). In those in whom it could be assessed,body mass index (BMI) ranged from 11.2?30.6 kg/m2 and 141/303 (46.5%) had moderate/severe undernutrition (BMI, PLOS ONE, 14(6), e0218193; 2019

We report the preparation and characterization of charged nanoporous membranes by self-assembly of "hairy" silica nanoparticles (HNPs) functionalized with polyelectrolyte copolymer brushes. We show that HNP membranes possess high water flux, have well-defined pore sizes, and rejection up to 80% of charged species in solution. The properties of these membranes can be tuned by controlling the length and composition of polymer brushes and the electrolyte concentration in solution. We demonstrate that membrane pore sizes undergo changes of up to 40% in response to changes in the ionic strength of the salt solution. Using MD computer simulations of a coarse-grained model, we link these tunable properties to the conformations of polymer chains in the spaces between randomly packed HNPs. As polymer length increases, the polymers fill the interparticle gaps, and the pore size decreases markedly. On the basis of their straightforward fabrication and tunable properties, HNP membranes may find applications in size- and charge-selective separations, water desalination, and responsive devices.