Illness in Returned Travelers and Immigrants/Refugees: The 6-Year Experience of Two Australian Infectious Diseases Units.

BACKGROUND: Data comparing returned travelers and immigrants/refugees managed in a hospital setting is lacking. METHODS: We prospectively collected data on 1,106 patients with an illness likely acquired overseas who presented to two hospital-based Australian infectious diseases units over a 6-year period. RESULTS: Eighty-three percent of patients were travelers and 17% immigrants/refugees. In travelers, malaria (19%), gastroenteritis/diarrhea (15%), and upper respiratory tract infection (URTI) (7%) were the most common diagnoses. When compared with immigrants/refugees, travelers were significantly more likely to be diagnosed with gastroenteritis/diarrhea [odds ratio (OR) 8], malaria (OR 7), pneumonia (OR 6), URTI (OR 3), skin infection, dengue fever, typhoid/paratyphoid fever, influenza, and rickettsial disease. They were significantly less likely to be diagnosed with leprosy (OR 0.03), chronic hepatitis (OR 0.04), tuberculosis (OR 0.05), schistosomiasis (OR 0.3), and helminthic infection (OR 0.3). In addition, travelers were more likely to present within 1 month of entry into Australia (OR 96), and have fever (OR 8), skin (OR 6), gastrointestinal (OR 5), or neurological symptoms (OR 5) but were less likely to be asymptomatic (OR 0.1) or have anaemia (OR 0.4) or eosinophilia (OR 0.3). Diseases in travelers were more likely to have been acquired via a vector (OR 13) or food and water (OR 4), and less likely to have been acquired via the respiratory (OR 0.2) or skin (OR 0.6) routes. We also found that travel destination and classification of traveler can significantly influence the likelihood of a specific diagnosis in travelers. Six percent of travelers developed a potentially vaccine-preventable disease, with failure to vaccinate occurring in 31% of these cases in the pretravel medical consultation. CONCLUSIONS: There are important differences in the spectrum of illness, clinical features, and mode of disease transmission between returned travelers and immigrants/refugees presenting to hospital-based Australian infectious diseases units with an illness acquired overseas

The Distance to Nova V959 Mon from VLA Imaging

Determining reliable distances to classical novae is a challenging but crucial step in deriving their ejected masses and explosion energetics. Here we combine radio expansion measurements from the Karl G. Jansky Very Large Array with velocities derived from optical spectra to estimate an expansion parallax for nova V959 Mon, the first nova discovered through its gamma-ray emission. We spatially resolve the nova at frequencies of 4.5-36.5 GHz in nine different imaging epochs. The first five epochs cover the expansion of the ejecta from 2012 October to 2013 January, while the final four epochs span 2014 February to 2014 May. These observations correspond to days 126 through 199 and days 615 through 703 after the first detection of the nova. The images clearly show a non-spherical ejecta geometry. Utilizing ejecta velocities derived from 3D modelling of optical spectroscopy, the radio expansion implies a distance between 0.9 +/- 0.2 and 2.2 +/- 0.4 kpc, with a most probable distance of 1.4 +/- 0.4 kpc. This distance implies a gamma-ray luminosity much less than the prototype gamma-ray-detected nova, V407 Cyg, possibly due to the lack of a red giant companion in the V959 Mon system. V959 Mon also has a much lower gamma-ray luminosity than other classical novae detected in gamma-rays to date, indicating a range of at least a factor of 10 in the gamma-ray luminosities for these explosions.Comment: 11 pages, 8 figures, 3 tables, submitted to ApJ 2015-01-21, under revie

Outcomes of a remote, decentralized health center-based HIV/AIDS antiretroviral program in Zambia, 2003 to 2007

A cross-sectional study of patients living with HIV/ AIDS treated during 2003 to 2007 in decentralized, rural health centers in Zambia was performed to measure virological outcomes after 12 months of antiretroviral therapy and identify factors associated with virological failure. Data from 228 patients who started antiretroviral therapy >12 months prior were analyzed. In all, 93% received stavudine + lamivudine + nevirapine regimens, and median antiretroviral therapy duration was 23.5 months (interquartile range 20-28). Of the 205 patients tested for viral load, 177 (86%) had viral load <1000 copies/mL. Probability of developing virological failure (viral load >1000 copies/mL) was 8.9% at 24 months and 19.6% at 32 months. Predictors for virological failure were <100% adherence, body mass index <18.5 kg/m(2), and women <40 years old. Of those with virological failure who underwent 3 to 6 months of intensive adherence counseling, 45% obtained virological success. In a remote, resource-limited setting in decentralized health centers, virological and immunological assessments of patients on antiretroviral therapy >12 months showed that positive health outcomes are achievable

Particle size segregation in granular flow in silos

Segregation and layering of alumina in storage silos are investigated, with a view to predicting output quality versus time, given known variations in input quality on emplacement. A variety of experiments were conducted, existing relevant publications were reviewed, and the basis for an algorithm for predicting the effect of withdrawing from a central flowing region, in combination with variations in quality due to geometric, layering and segregation effects, is described in this report

Quantum process tomography of a controlled-NOT gate

We demonstrate complete characterization of a two-qubit entangling process - a linear optics controlled-NOT gate operating with coincident detection - by quantum process tomography. We use maximum-likelihood estimation to convert the experimental data into a physical process matrix. The process matrix allows accurate prediction of the operation of the gate for arbitrary input states, and calculation of gate performance measures such as the average gate fidelity, average purity and entangling capability of our gate, which are 0.90, 0.83 and 0.73, respectively.Comment: 4 pages, 2 figures. v2 contains new data corresponding to improved gate operation. Figure quality slightly reduced for arXi

Lattice realizations of unitary minimal modular invariant partition functions

The conformal spectra of the critical dilute A-D-E lattice models are studied numerically. The results strongly indicate that, in branches 1 and 2, these models provide realizations of the complete A-D-E classification of unitary minimal modular invariant partition functions given by Cappelli, Itzykson and Zuber. In branches 3 and 4 the results indicate that the modular invariant partition functions factorize. Similar factorization results are also obtained for two-colour lattice models.Comment: 18 pages, Latex, with minor corrections and clarification

The Effect of Multiple Transverse Modes in Self-Mixing Sensors Based on Vertical-Cavity Surface-Emitting Lasers

In this work we investigate the effect of multiple transverse modes, such as those found in Vertical-Cavity Surface-Emitting Lasers, in self-mixing sensors. We show that the sensitivity of the system and the accuracy of the measurement changes periodically with target distance

Management strategies for adult patients with dental anxiety in the dental clinic: a systematic review

Anxiety is an adaptive emotional response to potentially threatening or dangerous situations; moderated by the sympathetic nervous system. Dental anxiety is common and presents before, during or after dental treatment. The physiological response includes an increase in heart rate, blood pressure, respiratory rate, and cardiac output. Consequently, extensive distress leads to avoidance of dental treatment and multiple failed appointments, impacting both oral and general health. Dental anxiety can generate a variety of negative consequences for both the dentist and the patient. Evidence-based strategies are essential for mitigating and relieving anxiety in the dental clinic. Psychotherapeutic behavioural strategies can modify the patient's experience through a minimally invasive approach with nil or negligible side effects, depending on patient characteristics, anxiety level and clinical situations. These therapies involve muscle relaxation, guided imagery, physiological monitoring, utilizing biofeedback, hypnosis, acupuncture, distraction and desensitization. Pharmacological intervention utilizes either relative analgesia (nitrous oxide), conscious intravenous sedation or oral sedation, which can have undesirable side effects, risks and contraindications. These modalities increase the cost and availability of dental treatment

Constraining ^(26)Al+p resonances using ^(26)Al(^3He,d)^(27)Si

The ^(26)Al(^3He,d)^(27)Si reaction was measured from 0°≤θ_(c.m.)≤35° at E(^3He)=20 MeV using a quadrupole-dipole-dipole-dipole magnetic spectrometer. States in ^(27)Si were observed above the background at 7652 and 7741 keV and upper limits were set for the state at 7592 keV. Implications for the ^(26)Al(p,γ)^(27)Si stellar reaction rate are discussed