7,071 research outputs found
First hospital outbreak of the globally emerging Candida auris in a European hospital
Background: Candida auris is a globally emerging multidrug resistant fungal pathogen causing nosocomial transmission. We report an ongoing outbreak of C. auris in a London cardio-thoracic center between April 2015 and July 2016. This is the first report of C. auris in Europe and the largest outbreak so far. We describe the identification, investigation and implementation of control measures. Methods: Data on C. auris case demographics, environmental screening, implementation of infection prevention/control measures, and antifungal susceptibility of patient isolates were prospectively recorded then analysed retrospectively. Speciation of C. auris was performed by MALDI-TOF and typing of outbreak isolates performed by amplified fragment length polymorphism (AFLP). Results: This report describes an ongoing outbreak of 50 C. auris cases over the first 16 month (April 2015 to July 2016) within a single Hospital Trust in London. A total of 44 % (n = 22/50) patients developed possible or proven C. auris infection with a candidaemia rate of 18 % (n = 9/50). Environmental sampling showed persistent presence of the yeast around bed space areas. Implementation of strict infection and prevention control measures included: isolation of cases and their contacts, wearing of personal protective clothing by health care workers, screening of patients on affected wards, skin decontamination with chlorhexidine, environmental cleaning with chorine based reagents and hydrogen peroxide vapour. Genotyping with AFLP demonstrated that C. auris isolates from the same geographic region clustered. Conclusion: This ongoing outbreak with genotypically closely related C. auris highlights the importance of appropriate species identification and rapid detection of cases in order to contain hospital acquired transmission
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Wintertime Transport of Reactive Trace Gases From East Asia Into the Deep Tropics
Spread Supersymmetry
In the multiverse the scale of SUSY breaking, \tilde{m} = F_X/M_*, may scan
and environmental constraints on the dark matter density may exclude a large
range of \tilde{m} from the reheating temperature after inflation down to
values that yield a LSP mass of order a TeV. After selection effects, the
distribution for \tilde{m} may prefer larger values. A single environmental
constraint from dark matter can then lead to multi-component dark matter,
including both axions and the LSP, giving a TeV-scale LSP lighter than the
corresponding value for single-component LSP dark matter.
If SUSY breaking is mediated to the SM sector at order X^* X, only squarks,
sleptons and one Higgs doublet acquire masses of order \tilde{m}. The gravitino
mass is lighter by a factor of M_*/M_Pl and the gaugino masses are suppressed
by a further loop factor. This Spread SUSY spectrum has two versions; the
Higgsino masses are generated in one from supergravity giving a wino LSP and in
the other radiatively giving a Higgsino LSP. The environmental restriction on
dark matter fixes the LSP mass to the TeV domain, so that the squark and
slepton masses are order 10^3 TeV and 10^6 TeV in these two schemes. We study
the spectrum, dark matter and collider signals of these two versions of Spread
SUSY. The Higgs is SM-like and lighter than 145 GeV; monochromatic photons in
cosmic rays arise from dark matter annihilations in the halo; exotic short
charged tracks occur at the LHC, at least for the wino LSP; and there are the
eventual possibilities of direct detection of dark matter and detailed
exploration of the TeV-scale states at a future linear collider. Gauge coupling
unification is as in minimal SUSY theories.
If SUSY breaking is mediated at order X, a much less hierarchical spectrum
results---similar to that of the MSSM, but with the superpartner masses 1--2
orders of magnitude larger than in natural theories.Comment: 20 pages, 5 figure
Return to driving after traumatic brain injury : a British perspective
Primary Objective: to identify current legal situation, and professional practice in assisting persons with traumatic brain injury (TBI) to return to safe driving after injury.
Methods and Procedures
A brief review of relevant literature, a description of the current statutory and quasi-statutory authorities regulating return to driving after TBI in the UK, and a description of the nature and resolution of clinical and practical dilemmas facing professionals helping return to safe driving after TBI. Each of the 15 UK mobility centres was contacted and literature requested; in addition a representative of each centre responded to a structured telephone survey.
Main Outcome and Results: The current situation in Great Britain is described, with a brief analysis of the strengths and weaknesses both of the current statutory situation, and also the practical situation (driving centres), with suggestions for improvements in practice.
Conclusion
Although brain injury may cause serious limitations in driving ability, previous drivers are not routinely assessed or advised regarding return to driving after TBI
Supporting carers of stroke survivors to reduce carer burden: development of the Preparing is Caring intervention using Intervention Mapping
BACKGROUND:
Burden is well documented among carers of stroke survivors, yet current evidence is insufficient to determine if any strategies reduce this negative outcome. Existing interventions for carers of stroke survivors typically involve supporting carers according to their individual needs through face-to-face interactions and provision of information including workbooks or educational guides. To date, no interventions have been developed using a method which systematically incorporates evidence, behaviour change theories, and stakeholder involvement to change the behaviours of carers and relevant individuals who support carers. This study aimed to develop a programme plan for a theory and evidence-based intervention to reduce burden in carers of stroke survivors.
METHODS:
Informed by evidence from two systematic reviews and 33 qualitative interviews, the first four stages of Intervention Mapping were used to guide the intervention development process: 1) needs assessment; 2) identifying outcomes and objectives; 3) selecting theoretical methods and practical applications; and 4) creating a programme plan. Structured and facilitated involvement from stakeholders, including carers, researchers, and professionals from health and community services was integral to the intervention development process. Stakeholders helped to prioritise the focus of the intervention, develop the goals, outcomes and objectives for the programme, and generate and refine intervention ideas.
RESULTS:
Stakeholders prioritised the need for carers to feel prepared before and during the transition from hospital to home as key to reducing burden. The proposed intervention âPreparing is Caringâ targets this need and involves providing and signposting carers to relevant information and support for practical and emotional needs. This is to be delivered before, during, and immediately after the stroke survivorâs transition from hospital to home by a person taking on a single point of contact role. It is comprised of multiple theory-based components including: training packages for information and support providers working with carers and wider staff teams, plus elements to support carers to feel prepared.
CONCLUSIONS:
We have developed a comprehensive programme plan for a multiple-component, theory and evidence informed behaviour change intervention aimed at preparing carers before and during the transition from hospital to home. Future work is required to refine, implement and evaluate the Preparing is Caring intervention
Higgs boson enhancement effects on squark-pair production at the LHC
We study the Higgs boson effects on third-generation squark-pair production
in proton-proton collision at the CERN Large Hadron Collider (LHC), including
\Stop \Stop^*, \Stop\Sbot^*, and \Sbot \Sbot^*. We found that substantial
enhancement can be obtained through s-channel exchanges of Higgs bosons at
large , at which the enhancement mainly comes from , , and initial states. We compute the complete set of electroweak
(EW) contributions to all production channels. This completes previous
computations in the literature. We found that the EW contributions can be
significant and can reach up to 25% in more general scenarios and at the
resonance of the heavy Higgs boson. The size of Higgs enhancement is comparable
or even higher than the PDF uncertainties and so must be included in any
reliable analysis. A full analytical computation of all the EW contributions is
presented.Comment: 23 pages, 7 figures, 1 tabl
A Universal Lifetime Distribution for Multi-Species Systems
Lifetime distributions of social entities, such as enterprises, products, and
media contents, are one of the fundamental statistics characterizing the social
dynamics. To investigate the lifetime distribution of mutually interacting
systems, simple models having a rule for additions and deletions of entities
are investigated. We found a quite universal lifetime distribution for various
kinds of inter-entity interactions, and it is well fitted by a
stretched-exponential function with an exponent close to 1/2. We propose a
"modified Red-Queen" hypothesis to explain this distribution. We also review
empirical studies on the lifetime distribution of social entities, and
discussed the applicability of the model.Comment: 10 pages, 6 figures, Proceedings of Social Modeling and Simulations +
Econophysics Colloquium 201
Perturbation drives changing metapopulation dynamics in a top marine predator
Funding: O.E.G. was supported by the Marine Alliance for Science and Technology for Scotland, funded by the Scottish Funding Council (grant no. HR09011). E.L.C. was supported by a Newton Fellowship (Royal Society of London), Marie Curie Fellowship (EU Horizon2020) and a Rutherford Discovery Fellowship (Royal Society of New Zealand). A.J.H. and D.J.F.R. were supportedby NERC (grant no. SMRU 10/001).Metapopulation theory assumes a balance between local decays/extinctions and local growth/new colonisations. Here we investigate whether recent population declines across part of the UK harbour seal range represent normal metapopulation dynamics or are indicative of perturbations potentially threatening the metapopulation viability, using 20 years of population trends, location tracking data (n = 380), and UK-wide, multi-generational population genetic data (n = 269). First, we use microsatellite data to show that two genetic groups previously identified are distinct metapopulations: northern and southern. Then, we characterize the northern metapopulation dynamics in two different periods, before and after the start of regional declines (pre-/peri-perturbation). We identify source-sink dynamics across the northern metapopulation, with two putative source populations apparently supporting three likely sink populations, and a recent metapopulation-wide disruption of migration coincident with the perturbation. The northern metapopulation appears to be in decay, highlighting that changes in local populations can lead to radical alterations in the overall metapopulation's persistence and dynamics.PostprintPeer reviewe
Using coloured filters to reduce the symptoms of visual stress in children with reading delay
Background: Meares Irlen Syndrome (MIS), otherwise known as âvisual stressâ, is one condition that can cause difficulties with reading. Aim: This study aimed to compare the effect of two coloured-filter systems on the symptoms of visual stress in children with reading delay. Methods: The study design was a pre-test, post-test, randomized head-to-head comparison of two filter systems on the symptoms of visual stress in school children. A total of 68 UK mainstream schoolchildren with significant impairment in reading ability completed the study. Results: The filter systems appeared to have a large effect on the reported symptoms between pre and post three-month time points (d = 2.5, r = 0.78). Both filter types appeared to have large effects (Harris d = 1.79, r = 0.69 and DRT d = 3.22, r = 0.85). Importantly, 35% of participantsâ reported that their symptoms had resolved completely; 72% of the 68 children appeared to gain improvements in three or more visual stress symptoms. Conclusion and significance: The reduction in symptoms, which appeared to be brought about by the use of coloured filters, eased the visual discomfort experienced by these children when reading. This type of intervention therefore has the potential to facilitate occupational engagement
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