Risk factors for mortality from imported falciparum malaria in the United Kingdom over 20 years: an observational study

Objectives To determine which travellers with malaria are at greatest risk of dying, highlighting factors which can be used to target health messages to travellers. Design Observational study based on 20 years of UK national data. Setting National register of malaria cases. Participants 25 054 patients notified with Plasmodium falciparum malaria, of whom 184 died, between 1987 and 2006. Main outcome measures Comparison between those with falciparum malaria who died and non-fatal cases, including age, reason for travel, country of birth, time of year diagnosed, malaria prophylaxis used. Results Mortality increased steadily with age, with a case fatality of 25/548 (4.6%) in people aged >65 years, adjusted odds ratio 10.68 (95% confidence interval 6.4 to 17.8), P<0.001 compared with 18–35 year olds. There were no deaths in the ≤5 year age group. Case fatality was 3.0% (81/2740 cases) in tourists compared with 0.32% (26/8077) in travellers visiting friends and relatives (adjusted odds ratio 8.2 (5.1 to 13.3), P<0.001). Those born in African countries with endemic malaria had a case fatality of 0.4% (36/8937) compared with 2.4% (142/5849) in others (adjusted odds ratio 4.6 (3.1 to 9.9), P<0.001). Case fatality was particularly high from the Gambia. There was an inverse correlation in mortality between region of presentation and number of cases seen in the region (R2=0.72, P<0.001). Most delay in fatal cases was in seeking care. Conclusions Most travellers acquiring malaria are of African heritage visiting friends and relatives. In contrast the risks of dying from malaria once acquired are highest in the elderly, tourists, and those presenting in areas in which malaria is seldom seen. Doctors often do not think of these as high risk groups for malaria; for this reason they are important groups to target in pre-travel advice

Japan’s pursuit of meritocracy, cosmopolitanism, and global rankings in higher education:a Bourdieusian interpretation

Through the market-based conception of neoliberal performativity, an interlocking set of socio-economic agendas integrate higher education (HE) in state-level systems of production and accumulation. Within the scope of globalism, the capacity to develop competitive human capital emerges as a proxy indicator of achievement amongst institutions of higher learning. Through this elaborate symbolic structure, Japanese reforms aimed at bolstering “global” soft skills, including English, cosmopolitanism, and interculturality, function alongside an ideological arms race to enhance university rankings and individual investment in education. Invoking a Bourdieusian perspective, this conceptual inquiry suggests that stakeholders consider the secondary effects of asymmetrical efforts towards “élite” education, globalism, and world-class attainment, whereby accompanying policy reform propagates hegemony both locally and internationally. Additionally, the emergence of global soft skills as essential cultural capital challenges the supposed meritocracy of Japan’s HE system. Indeed, the “effort-based-reward” symbolic contract permeating much of the neoliberal discourse fails to account for the functional reality of class-distinguished taste. From this perspective, valuable cultural resources orientate towards a globally conscious, highly-credentialed middle-class privileged in social, economic, and cultural capital, thereby disadvantaging the majority of learners inevitably excluded from study at prestigious, brand-name universities.</p

System Identification Methods for Aeroelastic Rotor Models. G.U. Aero Report 9507

No abstract available

Quaternary sea level changes in Scotland

This paper summarises developments in understanding sea level change during the Quaternary in Scotland since the publication of the Quaternary of Scotland Geological Conservation Review volume Quaternary of Scotland in 1993. We present a review of progress in methodology, particularly in the study of sediments in isolation basins and estuaries as well as in techniques in the field and laboratory, which have together disclosed greater detail in the record of relative sea level (RSL) change than was available in 1993. However, progress in determining the record of RSL change varies in different areas. Studies of sediments and stratigraphy offshore on the continental shelf have increased greatly, but the record of RSL change there remains patchy. Studies onshore have resulted in improvements in the knowledge of rock shorelines, including the processes by which they are formed, but much remains to be understood. Studies of Late Devensian and Holocene RSLs around present coasts have improved knowledge of both the extent and age range of the evidence. The record of RSL change on the W and NW coasts has disclosed a much longer dated RSL record than was available before 1993, possibly with evidence of Meltwater Pulse 1A, while studies in estuaries on the E and SW coasts have disclosed widespread and consistent fluctuations in Holocene RSLs. Evidence for the meltwater pulse associated with the Early Holocene discharge of Lakes Agassiz-Ojibway in N America has been found on both E and W coasts. The effects of the impact of storminess, in particular in cliff-top storm deposits, have been widely identified. Further information on the Holocene Storegga Slide tsunami has enabled a better understanding of the event but evidence for other tsunami events on Scottish coasts remains uncertain. Methodological developments have led to new reconstructions of RSL change for the last 2000 years, utilising state-of-the-art GIA models and alongside coastal biostratigraphy to determine trends to compare with modern tide gauge and documentary evidence. Developments in GIA modelling have provided valuable information on patterns of land uplift during and following deglaciation. The studies undertaken raise a number of research questions which will require addressing in future work

The Progenitor of Supernova 2011dh Has Vanished

We conducted Hubble Space Telescope (HST) Snapshot observations of the Type IIb Supernova (SN) 2011dh in M51 at an age of ~641 days with the Wide Field Camera 3. We find that the yellow supergiant star, clearly detected in pre-SN HST images, has disappeared, implying that this star was almost certainly the progenitor of the SN. Interpretation of the early-time SN data which led to the inference of a compact nature for the progenitor, and to the expected survival of this yellow supergiant, is now clearly incorrect. We also present ground-based UBVRI light curves obtained with the Katzman Automatic Imaging Telescope (KAIT) at Lick Observatory up to SN age ~70 days. From the light-curve shape including the very late-time HST data, and from recent interacting binary models for SN 2011dh, we estimate that a putative surviving companion star to the now deceased yellow supergiant could be detectable by late 2013, especially in the ultraviolet. No obvious light echoes are detectable yet in the SN environment.Comment: 6 pages, new versions of the 3 figures, improved U-band SN photometry, to appear in ApJ Letter

Origin of ferroelectricity in the multiferroic barium fluorides BaMF4

We present a first principles study of the series of multiferroic barium fluorides with the composition BaMF4, where M is Mn, Fe, Co, or Ni. We discuss trends in the structural, electronic, and magnetic properties, and we show that the ferroelectricity in these systems results from the "freezing in" of a single unstable polar phonon mode. In contrast to the case of the standard perovskite ferroelectrics, this structural distortion is not accompanied by charge transfer between cations and anions. Thus, the ferroelectric instability in the multiferroic barium fluorides arises solely due to size effects and the special geometrical constraints of the underlying crystal structure.Comment: 8 pages, 6 figures, 3 table

Experiences of physical activity: A phenomenological study of individuals with cystic fibrosis

Although extensive research has investigated the benefits of physical activity in cystic fibrosis, minimal exploration of the experiences for individuals from a qualitative, phenomenological perspective has been carried out. The aim of this study was to explore the subjective experiences of physical activity for individuals with cystic fibrosis. The health-care team, at an Adult Cystic Fibrosis Unit in the United Kingdom, recruited 12 participants to take part. Interview data were analysed using interpretative phenomenological analysis. A central theme of ‘self-monitoring’ emerged from the accounts and was embedded in the three super-ordinate themes

High resolution tumor targeting in living mice by means of multispectral optoacoustic tomography

BACKGROUND: Tumor targeting is of high clinical and biological relevance, and major efforts have been made to develop molecular imaging technologies for visualization of the disease markers in tissue. Of particular interest is apoptosis which has a profound role within tumor development and has significant effect on cancer malignancy. METHODS: Herein, we report on targeting of phosphatidylserine-exposing cells within live tumor allograft models using a synthetic near infrared zinc(II)-dipicolylamine probe. Visualization of the probe biodistribution is performed with whole body multispectral optoacoustic tomography (MSOT) system and subsequently compared to results attained by planar and tomographic fluorescence imaging systems. RESULTS: Compared to whole body optical visualization methods, MSOT attains remarkably better imaging capacity by delivering high-resolution scans of both disease morphology and molecular function in real time. Enhanced resolution of MSOT clearly showed that the probe mainly localizes in the vessels surrounding the tumor, suggesting that its tumor selectivity is gained by targeting the phosphatidylserine exposed on the surface of tumor vessels. CONCLUSIONS: The current study demonstrates the high potential of MSOT to broadly impact the fields of tumor diagnostics and preclinical drug development

MOVEABLE, DEPLOYABLE MICROGRID ANALYSIS

This report focuses on the assessment of the feasibility of Moveable, Deployable Microgrids (MODEMs) from an interoperability and sustainment perspective as an alternative solution to traditional backup power methods aimed at bringing critical loads back online after installation microgrid failures or operational energy needs. Prior research into microgrid solutions by MAJ Daniel Varley in his paper “Feasibility Analysis of a Mobile Microgrid Design to Support Department of Defense (DOD) Energy Resilience Goals” identified MODEM as a potential solution. This report utilized the work done by MAJ Varley and further assesses system feasibility. Base and operational energy managers will benefit from MODEMs by having access to multi-energy source systems that are both easily moveable and relatively simplistic in design. As concerns surrounding energy resiliency of defense critical infrastructure by both the DOD and Department of Energy (DOE) mount, as expressed in a March 2022 report by the Electricity Advisory Committee (EAC) titled “Strengthening the Resilience of Defense Critical Infrastructure”, there is a push to identify cost-effective solutions that utilize alternative energy sources in order to improve the overall resiliency of this infrastructure. The MODEM system has the potential to be a viable solution to the resiliency problem.Outstanding ThesisCivilian, Department of the NavyCivilian, Department of the NavyCivilian, Department of the NavyCivilian, Department of the NavyCivilian, Department of the NavyApproved for public release. Distribution is unlimited