RESPOND – A patient-centred program to prevent secondary falls in older people presenting to the emergency department with a fall: Protocol for a multi-centre randomised controlled trial

Introduction: Participation in falls prevention activities by older people following presentation to the Emergency Department (ED) with a fall is suboptimal. This randomised controlled trial (RCT) will test the RESPOND program which is designed to improve older persons’ participation in falls prevention activities through delivery of patient-centred education and behaviour change strategies. Design and setting: An RCT at two tertiary referral EDs in Melbourne and Perth, Australia. Participants: Five-hundred and twenty eight community-dwelling people aged 60-90 years presenting to the ED with a fall and discharged home will be recruited. People who: require an interpreter or hands-on assistance to walk; live in residential aged care or >50 kilometres from the trial hospital; have terminal illness, cognitive impairment, documented aggressive behaviour or history of psychosis; are receiving palliative care; or are unable to use a telephone will be excluded. Methods: Participants will be randomly allocated to the RESPOND intervention or standard care control group. RESPOND incorporates: (1) home-based risk factor assessment; (2) education, coaching, goal setting, and follow-up telephone support for management of one or more of four risk factors with evidence of effective intervention; and (3) healthcare provider communication and community linkage delivered over six months. Primary outcomes are falls and fall injuries per-person-year. Discussion: RESPOND builds on prior falls prevention learnings and aims to help individuals make guided decisions about how they will manage their falls risk. Patient-centred models have been successfully trialled in chronic and cardiovascular disease however evidence to support this approach in falls prevention is limited. Trial registration. The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000336684)

Fiber-optical analogue of the event horizon

The physics at the event horizon resembles the behavior of waves in moving media. Horizons are formed where the local speed of the medium exceeds the wave velocity. We use ultrashort pulses in microstructured optical fibers to demonstrate the formation of an artificial event horizon in optics. We observed a classical optical effect, the blue-shifting of light at a white-hole horizon. We also show by theoretical calculations that such a system is capable of probing the quantum effects of horizons, in particular Hawking radiation.Comment: MEDIA EMBARGO. This paper is subject to the media embargo of Scienc

Colloidal stabilization via nanoparticle haloing

We present a detailed numerical study of effective interactions between micron-sized silica spheres, induced by highly charged zirconia nanoparticles. It is demonstrated that the effective interactions are consistent with a recently discovered mechanism for colloidal stabilization. In accordance with the experimental observations, small nanoparticle concentrations induce an effective repulsion that counteracts the intrinsic van der Waals attraction between the colloids and thus stabilizes the suspension. At higher nanoparticle concentrations an attractive potential is recovered, resulting in reentrant gelation. Monte Carlo simulations of this highly size-asymmetric mixture are made possible by means of a geometric cluster Monte Carlo algorithm. A comparison is made to results obtained from the Ornstein-Zernike equations with the hypernetted-chain closure

Comparative analysis of assembly algorithms to optimize biosynthetic gene cluster identification in novel marine actinomycete genomes

Many marine sponges harbor dense communities of microbes that aid in the chemical defense of these nonmotile hosts. Metabolites that comprise this chemical arsenal can have pharmaceutically-relevant activities such as antibacterial, antiviral, antifungal and anticancer properties. Previous investigation of the Caribbean giant barrel sponge Xestospongia muta revealed a microbial community including novel Actinobacteria, a phylum well known for its production of antibiotic compounds. This novel assemblage was investigated for its ability to produce compounds that inhibit M. tuberculosis by using a bioinformatics approach. Microbial extracts were tested for their ability to inhibit growth of M. tb and genomes of the 11 strains that showed anti-M. tb activity including Micrococcus (n=2), Micromonospora (n=4), Streptomyces (n=3), and Brevibacterium spp. (n=2) were sequenced by using Illumina MiSeq. Three assembly algorithms/pipelines (SPAdes, A5-miseq and Shovill) were compared for their ability to construct contigs with minimal gaps to maximize the probability of identifying complete biosynthetic gene clusters (BGCs) present in the genomes. Although A5-miseq and Shovill usually assembled raw reads into the fewest contigs, after necessary post-assembly filtering, SPAdes generally produced the most complete genomes with the fewest contigs. This study revealed the strengths and weaknesses of the different assemblers based on their ease of use and ability to be manipulated based on output format. None of the assembly methods handle contamination well and high-quality DNA is a prerequisite. BGCs of compounds with known anti-TB activity were identified in all Micromonospora and Streptomyces strains (genomes > 5 Mb), while no such BGCs were identified in Micrococcus or Brevibacterium strains (genomes < 5 Mb). The majority of the putative BGCs identified were located on contig edges, emphasizing the inability of short-read assemblers to resolve repeat regions and supporting the need for long-read sequencing to fully resolve BGCs

New limb-darkening coefficients and synthetic photometry for model-atmosphere grids at Galactic, LMC, and SMC abundances

New grids of Atlas9 models have been calculated using revised convection parameters and updated opacity-distribution functions, for chemical compositions intended to be representative of solar, [M/H] = +0.3, +0.5, Large Magellanic Cloud (LMC), and Small Magellanic Cloud (SMC) abundances. The grids cover T(eff) = 3.5-50kK, from log(g) = 5.0 to the effective Eddington limit. Limb-darkening coefficients and synthetic photometry are presented in the UBVRIJHKLM, uvby, ugriz, WFCAM, Hipparcos/Tycho, and Kepler passbands for these models, and for Castelli's comparable `new-ODF' grids. Flux distributions are given for the new models. The sensitivity of limb-darkening coefficients to the adopted physics is illustrated

First records of Hyalomma rufipes and Ixodes neitzi (Acari: Ixodidae) found on large carnivores in South Africa

Ixodid ticks (Acari: Ixodidae) are important disease vectors for large carnivores, but the composition of the tick communities that parasitize carnivores is poorly understood. We collected ticks from leopards (Panthera pardus) and brown hyenas (Hyaena brunnea) in the Soutpansberg Mountains, South Africa, to determine which species feed on these carnivores. We identified a total of eight tick species belonging to six genera, and recorded Ixodes neitzi and Hyalomma rufipes on P. pardus for the first time

The solar photospheric abundance of hafnium and thorium. Results from CO5BOLD 3D hydrodynamic model atmospheres

Context: The stable element hafnium (Hf) and the radioactive element thorium (Th) were recently suggested as a suitable pair for radioactive dating of stars. The applicability of this elemental pair needs to be established for stellar spectroscopy. Aims: We aim at a spectroscopic determination of the abundance of Hf and Th in the solar photosphere based on a \cobold 3D hydrodynamical model atmosphere. We put this into a wider context by investigating 3D abundance corrections for a set of G- and F-type dwarfs. Method: High-resolution, high signal-to-noise solar spectra were compared to line synthesis calculations performed on a solar CO5BOLD model. For the other atmospheres, we compared synthetic spectra of CO5BOLD 3D and associated 1D models. Results: For Hf we find a photospheric abundance A(Hf)=0.87+-0.04, in good agreement with a previous analysis, based on 1D model atmospheres. The weak Th ii 401.9 nm line constitutes the only Th abundance indicator available in the solar spectrum. It lies in the red wing of an Ni-Fe blend exhibiting a non-negligible convective asymmetry. Accounting for the asymmetry-related additional absorption, we obtain A(Th)=0.09+-0.03, consistent with the meteoritic abundance, and about 0.1 dex lower than obtained in previous photospheric abundance determinations. Conclusions: Only for the second time, to our knowledge, has am non-negligible effect of convective line asymmetries on an abundance derivation been highlighted. Three-dimensional hydrodynamical simulations should be employed to measure Th abundances in dwarfs if similar blending is present, as in the solar case. In contrast, 3D effects on Hf abundances are small in G- to mid F-type dwarfs and sub-giants, and 1D model atmospheres can be conveniently used.Comment: A&A, in pres

Optical data of meteoritic nano-diamonds from far-ultraviolet to far-infrared wavelengths

We have used different spectroscopic techniques to obtain a consistent quantitative absorption spectrum of a sample of meteoritic nano-diamonds in the wavelength range from the vacuum ultraviolet (0.12 $\mu$m) to the far infrared (100 $\mu$m). The nano-diamonds have been isolated by a chemical treatment from the Allende meteorite (Braatz et al.2000). Electron energy loss spectroscopy (EELS) extends the optical measurements to higher energies and allows the derivation of the optical constants (n & k) by Kramers-Kronig analysis. The results can be used to restrain observations and to improve current models of the environment where the nano-diamonds are expected to have formed. We also show that the amount of nano-diamond which can be present in space is higher than previously estimated by Lewis et al. (1989).Comment: 11 pages, 7 figure

Black hole candidate XTE J1752-223: Swift observations of canonical states during outburst

We present Swift broadband observations of the recently discovered black hole candidate, X-ray transient, XTE J1752-223, obtained over the period of outburst from October 2009 to June 2010. From Swift-UVOT data we confirm the presence of an optical counterpart which displays variability correlated, in the soft state, to the X-ray emission observed by Swift-XRT. The optical counterpart also displays hysteretical behaviour between the states not normally observed in the optical bands, suggesting a possible contribution from a synchrotron emitting jet to the optical emission in the rising hard state. We offer a purely phenomenological treatment of the spectra as an indication of the canonical spectral state of the source during different periods of the outburst. We find that the high energy hardness-intensity diagrams over two separate bands follows the canonical behavior, confirming the spectral states. Our XRT timing analysis shows that in the hard state there is significant variability below 10Hz which is more pronounced at low energies, while during the soft state the level of variability is consistent with being minimal. These properties of XTE J1752-223 support its candidacy as a black hole in the Galactic centre region.Comment: 8 pages, 8 figures; MNRAS in pres

Comprehensive Molecular Testing for Respiratory Pathogens in Community-Acquired Pneumonia.

BACKGROUND: The frequent lack of a microbiological diagnosis in community-acquired pneumonia (CAP) impairs pathogen-directed antimicrobial therapy. This study assessed the use of comprehensive multibacterial, multiviral molecular testing, including quantification, in adults hospitalized with CAP. METHODS: Clinical and laboratory data were collected for 323 adults with radiologically-confirmed CAP admitted to 2 UK tertiary care hospitals. Sputum (96%) or endotracheal aspirate (4%) specimens were cultured as per routine practice and also tested with fast multiplex real-time polymerase-chain reaction (PCR) assays for 26 respiratory bacteria and viruses. Bacterial loads were also calculated for 8 bacterial pathogens. Appropriate pathogen-directed therapy was retrospectively assessed using national guidelines adapted for local antimicrobial susceptibility patterns. RESULTS: Comprehensive molecular testing of single lower respiratory tract (LRT) specimens achieved pathogen detection in 87% of CAP patients compared with 39% with culture-based methods. Haemophilus influenzae and Streptococcus pneumoniae were the main agents detected, along with a wide variety of typical and atypical pathogens. Viruses were present in 30% of cases; 82% of these were codetections with bacteria. Most (85%) patients had received antimicrobials in the 72 hours before admission. Of these, 78% had a bacterial pathogen detected by PCR but only 32% were culture-positive (P < .0001). Molecular testing had the potential to enable de-escalation in number and/or spectrum of antimicrobials in 77% of patients. CONCLUSIONS: Comprehensive molecular testing significantly improves pathogen detection in CAP, particularly in antimicrobial-exposed patients, and requires only a single LRT specimen. It also has the potential to enable early de-escalation from broad-spectrum empirical antimicrobials to pathogen-directed therapy