The World City of Gaming

There are many routes to world city status. Most places get there by being financial, trade, or manufacturing hubs, or as is the case with the biggest and most connected world cities, a concentration of all three. Las Vegas took a different path. It achieved world city status via one key sector—gaming

Inclusion of 'minor' trauma cases provides a better estimate of the total burden of injury: Queensland Trauma Registry provides a unique perspective

Introduction Injury is recognised as a frequent cause of preventable mortality and morbidity; however, incidence estimates focusing only on the extent of mortality and major trauma may seriously underestimate the magnitude of the total injury burden. There currently exists a paucity of information regarding minor trauma, and the aim of this study was to increase awareness of the contribution of minor trauma cases to the total burden of injury. Methods The demographics, injury details, acute care factors and outcomes of both minor trauma cases and major trauma cases were evaluated using data from the state-wide trauma registry in Queensland, Australia, from 2005 to 2010. The impact of changes in Abbreviated Injury Scale (AIS) versions on the classification of minor and major injury cases was also assessed. Results Over the 6-year period, minor cases [Injury Severity Score (ISS) ≤ 12] accounted for almost 90% of all trauma included on the Queensland Trauma Registry (QTR). These cases utilised more than half a million acute care bed days, underwent more than 66,500 operations, and accounted for more than 48,000 patient transport episodes via road ambulance, fixed wing aircraft, or helicopter. Furthermore, more than 5800 minor trauma cases utilised in-hospital rehabilitation services; almost 3000 were admitted to an ICU; and more than 20,000 were admitted to hospital for greater than one week. When using the contemporary criteria for classifying trauma (AIS 08), the proportion of cases classified as minor trauma (87.7%) and major trauma (12.3%) were similar to the proportion using the traditional criteria for AIS90 (87.9% and 12.1%, respectively). Conclusions This evaluation of minor trauma cases admitted to public hospitals in Queensland detected high levels of demand placed on trauma system resources in terms of acute care bed days, operations, ICU admissions, in-hospital rehabilitation services and patient transportation, and which are all associated with high cost. These data convincingly demonstrate the significant burden of injury imposed by minor trauma cases serious enough to be admitted to hospital

Wave Functions and Energies of Magnetopolarons in Semiconductor Quantum Wells

The classification of magnetopolarons in semiconductor quantum wells (QW) is represented. Magnetopolarons appear due to the Johnson - Larsen effect. The wave functions of usual and combined magnetopolarons are obtained by the diodanalization of the Schrodinger equation.Comment: 7 pages, 2 figure

A new physical interpretation of optical and infrared variability in quasars

Changing-look quasars are a recently identified class of active galaxies in which the strong UV continuum and/or broad optical hydrogen emission lines associated with unobscured quasars either appear or disappear on timescales of months to years. The physical processes responsible for this behaviour are still debated, but changes in the black hole accretion rate or accretion disk structure appear more likely than changes in obscuration. Here we report on four epochs of spectroscopy of SDSS J110057.70-005304.5, a quasar at a redshift of $z=0.378$ whose UV continuum and broad hydrogen emission lines have faded, and then returned over the past $\approx$20 years. The change in this quasar was initially identified in the infrared, and an archival spectrum from 2010 shows an intermediate phase of the transition during which the flux below rest-frame $\approx$3400\AA\ has decreased by close to an order of magnitude. This combination is unique compared to previously published examples of changing-look quasars, and is best explained by dramatic changes in the innermost regions of the accretion disk. The optical continuum has been rising since mid-2016, leading to a prediction of a rise in hydrogen emission line flux in the next year. Increases in the infrared flux are beginning to follow, delayed by a $\sim$3 year observed timescale. If our model is confirmed, the physics of changing-look quasars are governed by processes at the innermost stable circular orbit (ISCO) around the black hole, and the structure of the innermost disk. The easily identifiable and monitored changing-look quasars would then provide a new probe and laboratory of the nuclear central engine.Comment: 13 pages, 4 figures, 3 tables. Published in MNRAS. All code and data links on GitHub, https://github.com/d80b2t/WISE_L

Clinical implications for patients treated inappropriately for community-acquired pneumonia in the emergency department

BACKGROUND: Community-acquired pneumonia (CAP) is one of the most common infections presenting to the emergency department (ED). Increasingly, antibiotic resistant bacteria have been identified as causative pathogens in patients treated for CAP, especially in patients with healthcare exposure risk factors. METHODS: We retrospectively identified adult subjects treated for CAP in the ED requiring hospital admission (January 2003-December 2011). Inappropriate antibiotic treatment, defined as an antibiotic regimen that lacked in vitro activity against the isolated pathogen, served as the primary end point. Information regarding demographics, severity of illness, comorbidities, and antibiotic treatment was recorded. Logistic regression was used to determine factors independently associated with inappropriate treatment. RESULTS: The initial cohort included 259 patients, 72 (27.8%) receiving inappropriate antibiotic treatment. There was no difference in hospital mortality between patients receiving inappropriate and appropriate treatment (8.3% vs. 7.0%; p = 0.702). Hospital length of stay (10.3 ± 12.0 days vs. 7.0 ± 8.9 days; p = 0.017) and 30-day readmission (23.6% vs. 12.3%; p = 0.024) were greater among patients receiving inappropriate treatment. Three variables were independently associated with inappropriate treatment: admission from long-term care (AOR, 9.05; 95% CI, 3.93-20.84), antibiotic exposure in the previous 30 days (AOR, 1.85; 95% CI, 1.35-2.52), and chronic obstructive pulmonary disease (AOR, 2.05; 95% CI, 1.52-2.78). CONCLUSION: Inappropriate antibiotic treatment of presumed CAP in the ED negatively impacts patient outcome and readmission rate. Knowledge of risk factors associated with inappropriate antibiotic treatment of presumed CAP could advance the management of patients with pneumonia presenting to the ED and potentially improve patient outcomes