Predicting Ebola infection: A malaria-sensitive triage score for Ebola virus disease.

The non-specific symptoms of Ebola Virus Disease (EVD) pose a major problem to triage and isolation efforts at Ebola Treatment Centres (ETCs). Under the current triage protocol, half the patients allocated to high-risk "probable" wards were EVD(-): a misclassification speculated to predispose nosocomial EVD infection. A better understanding of the statistical relevance of individual triage symptoms is essential in resource-poor settings where rapid, laboratory-confirmed diagnostics are often unavailable. This retrospective cohort study analyses the clinical characteristics of 566 patients admitted to the GOAL-Mathaska ETC in Sierra Leone. The diagnostic potential of each characteristic was assessed by multivariate analysis and incorporated into a statistically weighted predictive score, designed to detect EVD as well as discriminate malaria. Of the 566 patients, 28% were EVD(+) and 35% were malaria(+). Malaria was 2-fold more common in EVD(-) patients (p<0.05), and thus an important differential diagnosis. Univariate analyses comparing EVD(+) vs. EVD(-) and EVD(+)/malaria(-) vs. EVD(-)/malaria(+) cohorts revealed 7 characteristics with the highest odds for EVD infection, namely: reported sick-contact, conjunctivitis, diarrhoea, referral-time of 4-9 days, pyrexia, dysphagia and haemorrhage. Oppositely, myalgia was more predictive of EVD(-) or EVD(-)/malaria(+). Including these 8 characteristics in a triage score, we obtained an 89% ability to discriminate EVD(+) from either EVD(-) or EVD(-)/malaria(+). This study proposes a highly predictive and easy-to-use triage tool, which stratifies the risk of EVD infection with 89% discriminative power for both EVD(-) and EVD(-)/malaria(+) differential diagnoses. Improved triage could preserve resources by identifying those in need of more specific differential diagnostics as well as bolster infection prevention/control measures by better compartmentalizing the risk of nosocomial infection

Predicting Ebola Severity: A Clinical Prioritization Score for Ebola Virus Disease.

Despite the notoriety of Ebola virus disease (EVD) as one of the world's most deadly infections, EVD has a wide range of outcomes, where asymptomatic infection may be almost as common as fatality. With increasingly sensitive EVD diagnosis, there is a need for more accurate prognostic tools that objectively stratify clinical severity to better allocate limited resources and identify those most in need of intensive treatment. This retrospective cohort study analyses the clinical characteristics of 158 EVD(+) patients at the GOAL-Mathaska Ebola Treatment Centre, Sierra Leone. The prognostic potential of each characteristic was assessed and incorporated into a statistically weighted disease score. The mortality rate among EVD(+) patients was 60.8% and highest in those aged <5 or >25 years (p<0.05). Death was significantly associated with malaria co-infection (OR = 2.5, p = 0.01). However, this observation was abrogated after adjustment to Ebola viral load (p = 0.1), potentially indicating a pathologic synergy between the infections. Similarly, referral-time interacted with viral load, and adjustment revealed referral-time as a significant determinant of mortality, thus quantifying the benefits of early reporting as a 12% mortality risk reduction per day (p = 0.012). Disorientation was the strongest unadjusted predictor of death (OR = 13.1, p = 0.014) followed by hiccups, diarrhoea, conjunctivitis, dyspnoea and myalgia. Including these characteristics in multivariate prognostic scores, we obtained a 91% and 97% ability to discriminate death at or after triage respectively (area under ROC curve). This study proposes highly predictive and easy-to-use prognostic tools, which stratify the risk of EVD mortality at or after EVD triage

Understorey plant community and light availability in conifer plantations and natural hardwood forests in Taiwan

Questions: What are the effects of replacing mixed species natural forests with Cryptomeria japonica plantations on understorey plant functional and species diversity? What is the role of the understorey light environment in determining understorey diversity and community in the two types of forest? Location: Subtropical northeast Taiwan. Methods: We examined light environments using hemispherical photography, and diversity and composition of understorey plants of a 35‐yr C. japonica plantation and an adjacent natural hardwood forest. Results: Understorey plant species richness was similar in the two forests, but the communities were different; only 18 of the 91 recorded understorey plant species occurred in both forests. Relative abundance of plants among different functional groups differed between the two forests. Relative numbers of shade‐tolerant and shade‐intolerant seedling individuals were also different between the two forest types with only one shade‐intolerant seedling in the plantation compared to 23 seedlings belonging to two species in the natural forest. In the natural forest 11 species of tree seedling were found, while in the plantation only five were found, and the seedling density was only one third of that in the natural forest. Across plots in both forests, understorey plant richness and diversity were negatively correlated with direct sunlight but not indirect sunlight, possibly because direct light plays a more important role in understorey plant growth. Conclusions: We report lower species and functional diversity and higher light availability in a natural hardwood forest than an adjacent 30‐yr C. japonica plantation, possibly due to the increased dominance of shade‐intolerant species associated with higher light availability. To maintain plant diversity, management efforts must be made to prevent localized losses of shade‐adapted understorey plants

The Superconductivity, Intragrain Penetration Depth and Meissner Effect of RuSr2(Gd,Ce)2Cu2O10+delta

The hole concentration (p)(delta), the transition temperature Tc, the intragrain penetration depth lambda, and the Meissner effect were measured for annealed RuSr2(Gd,Ce)2Cu2O10+delta samples. The intragrain superconducting transition temperature Tc} varied from 17 to 40 K while the p changed by only 0.03 holes/CuO2. The intragrain superfluid-density 1/lambda^2 and the diamagnetic drop of the field-cooled magnetization across Tc (the Meissner effect), however, increased more than 10 times. All of these findings are in disagreement with both the Tc vs. p and the Tc vs. 1/lambda^2 correlations proposed for homogeneous cuprates, but are in line with a possible phase-separation and the granularity associated with it.Comment: 7 pages, 6 figures, accepted for publication in Phys. Rev. B (May 2, 2002

Upper critical field for underdoped high-T_c superconductors. Pseudogap and stripe--phase

We investigate the upper critical field in a stripe--phase and in the presence of a phenomenological pseudogap. Our results indicate that the formation of stripes affects the Landau orbits and results in an enhancement of $H_{c2}$. On the other hand, phenomenologically introduced pseudogap leads to a reduction of the upper critical field. This effect is of particular importance when the magnitude of the gap is of the order of the superconducting transition temperature. We have found that a suppression of the upper critical field takes place also for the gap that originates from the charge--density waves.Comment: 7 pages, 5 figure

Transformation elastodynamics and active exterior acoustic cloaking

This chapter consists of three parts. In the first part we recall the elastodynamic equations under coordinate transformations. The idea is to use coordinate transformations to manipulate waves propagating in an elastic material. Then we study the effect of transformations on a mass-spring network model. The transformed networks can be realized with "torque springs", which are introduced here and are springs with a force proportional to the displacement in a direction other than the direction of the spring terminals. Possible homogenizations of the transformed networks are presented, with potential applications to cloaking. In the second and third parts we present cloaking methods that are based on cancelling an incident field using active devices which are exterior to the cloaked region and that do not generate significant fields far away from the devices. In the second part, the exterior cloaking problem for the Laplace equation is reformulated as the problem of polynomial approximation of analytic functions. An explicit solution is given that allows to cloak larger objects at a fixed distance from the cloaking device, compared to previous explicit solutions. In the third part we consider the active exterior cloaking problem for the Helmholtz equation in 3D. Our method uses the Green's formula and an addition theorem for spherical outgoing waves to design devices that mimic the effect of the single and double layer potentials in Green's formula.Comment: Submitted as a chapter for the volume "Acoustic metamaterials: Negative refraction, imaging, lensing and cloaking", Craster and Guenneau ed., Springe

Ion-beam-induced reconstruction of amorphous GaN

Wurtzite GaN can be rendered amorphous by high-dose heavy-ion bombardment. We show here that relatively low-dose reirradiation of such amorphous GaN (a-GaN) with MeV light ions can significantly change some of the physical properties of a-GaN. In particular, light-ion reirradiation of a-GaN results in (i) an increase in material density, (ii) the suppression of complete decomposition during postimplantation annealing, (iii) a significant increase in the values of hardness and Young's modulus, and (iv) an apparent decrease in the absorption of visible light. Transmission electronmicroscopy shows that a-GaN remains completely amorphous after light-ion reirradiation. Therefore, we attribute the above effects of light-ion reirradiation to an ion-beam-induced atomic-level reconstruction of the amorphous phase. Results indicate that electronic energy loss of light ions is responsible for the changes in the mechanical properties and for the suppression of thermally induced decomposition of a-GaN. However, the changes in the density of a-GaN appear to be controlled by the nuclear energy loss of light ions

Study of CP violation in Dalitz-plot analyses of B0 --> K+K-KS, B+ --> K+K-K+, and B+ --> KSKSK+

We perform amplitude analyses of the decays $B^0 \to K^+K^-K^0_S$, $B^+ \rightarrow K^+K^-K^+$, and $B^+ \to K^0_S K^0_S K^+$, and measure CP-violating parameters and partial branching fractions. The results are based on a data sample of approximately $470\times 10^6$ $B\bar{B}$ decays, collected with the BABAR detector at the PEP-II asymmetric-energy $B$ factory at the SLAC National Accelerator Laboratory. For $B^+ \to K^+K^-K^+$, we find a direct CP asymmetry in $B^+ \to \phi(1020)K^+$ of $A_{CP}= (12.8\pm 4.4 \pm 1.3)$, which differs from zero by $2.8 \sigma$. For $B^0 \to K^+K^-K^0_S$, we measure the CP-violating phase $\beta_{\rm eff} (\phi(1020)K^0_S) = (21\pm 6 \pm 2)^\circ$. For $B^+ \to K^0_S K^0_S K^+$, we measure an overall direct CP asymmetry of $A_{CP} = (4 ^{+4}_{-5} \pm 2)$. We also perform an angular-moment analysis of the three channels, and determine that the $f_X(1500)$ state can be described well by the sum of the resonances $f_0(1500)$, $f_2^{\prime}(1525)$, and $f_0(1710)$.Comment: 35 pages, 68 postscript figures. v3 - minor modifications to agree with published versio

Managing to lead in private enterprise in China: Work values, demography and the development of trust

Previous work on trust has focused on employee trust in management. However, issues of how leaders develop trust in their followers in leader-member exchange (LMX) are under-explored. Based on theories of leader-member exchange, attribution and industrial convergence, this study investigates how the work values of leaders influence the development of their trust in followers and how this is moderated by demographic factors. A survey of 219 leaders was conducted in privately owned enterprises in China. The findings suggest that the work value of centralization is negatively related to leader trust in follower predictability. Group orientation and formalization are positively related to the development of trust in follower good faith. Moreover, age and level of formal education are found to moderate significantly the relationships between leader work values and development of their trust in followers within the context of China. Copyright © 2007 SAGE Publications