English Language Testing for Citizenship

The proposed changes to citizenship requirements in Australia have an increased focus on English language competency and on ‘Australian’ values. The dominance of the English language on the global stage can reinforce the hegemonic nature of the English language, which is becoming increasingly embedded in the image of an Australian citizen. This raises questions on what is motivating the centrality of English language testing for citizenship, and how these shape conceptions of Australian identity. This research is a thematic content analysis of media releases from newspapers, government statements and other grey materials on the recent changes to Australia’s citizenship requirements, particularly English language testing. The research found that English language testing can be seen as a form of cultural hegemony, which is shaped by a discourse of social integration and border security. Implications for understanding diversity and working with diverse language groups are explored in light of the English language testing and citizenship discourses in Australia

Clinical review: Early patient mobilization in the ICU

Early mobilization (EM) of ICU patients is a physiologically logical intervention to attenuate critical illness-associated muscle weakness. However, its long-term value remains controversial. We performed a detailed analytical review of the literature using multiple relevant key terms in order to provide a comprehensive assessment of current knowledge on EM in critically ill patients. We found that the term EM remains undefined and encompasses a range of heterogeneous interventions that have been used alone or in combination. Nonetheless, several studies suggest that different forms of EM may be both safe and feasible in ICU patients, including those receiving mechanical ventilation. Unfortunately, these studies of EM are mostly single center in design, have limited external validity and have highly variable control treatments. In addition, new technology to facilitate EM such as cycle ergometry, transcutaneous electrical muscle stimulation and video therapy are increasingly being used to achieve such EM despite limited evidence of efficacy. We conclude that although preliminary low-level evidence suggests that EM in the ICU is safe, feasible and may yield clinical benefits, EM is also labor-intensive and requires appropriate staffing models and equipment. More research is thus required to identify current standard practice, optimal EM techniques and appropriate outcome measures before EM can be introduced into the routine care of critically ill patients

On Infrared Excesses Associated With Li-Rich K Giants

Infrared (IR) excesses around K-type red giants (RGs) have previously been discovered using IRAS data, and past studies have suggested a link between RGs with overabundant Li and IR excesses, implying the ejection of circumstellar shells or disks. We revisit the question of IR excesses around RGs using higher spatial resolution IR data, primarily from WISE. Our goal was to elucidate the link between three unusual RG properties: fast rotation, enriched Li, and IR excess. We have 316 targets thought to be K giants, about 40% of which we take to be Li-rich. In 24 cases with previous detections of IR excess at low spatial resolution, we believe that source confusion is playing a role, in that either (a) the source that is bright in the optical is not responsible for the IR flux, or (b) there is more than one source responsible for the IR flux as measured in IRAS. We looked for IR excesses in the remaining sources, identifying 28 that have significant IR excesses by ~20 um (with possible excesses for 2 additional sources). There appears to be an intriguing correlation in that the largest IR excesses are all in Li-rich K giants, though very few Li-rich K giants have IR excesses (large or small). These largest IR excesses also tend to be found in the fastest rotators. There is no correlation of IR excess with the carbon isotopic ratio, 12C/13C. IR excesses by 20 um, though relatively rare, are at least twice as common among our sample of Li-rich K giants. If dust shell production is a common by-product of Li enrichment mechanisms, these observations suggest that the IR excess stage is very short-lived, which is supported by theoretical calculations. Conversely, the Li-enrichment mechanism may only occasionally produce dust, and an additional parameter (e.g., rotation) may control whether or not a shell is ejected.Comment: 73 pages, 21 figures (some of which substantially degraded to meet arXiv file size requirements), accepted to AJ. Full table 1 (and full-res figures) available upon request to the autho

Early marine survival of steelhead smolts in Puget Sound

Smolt-to adult survival rates for Puget Sound steelhead populations have declined substantially over the last 25 years and remain at or near historic lows. From 2006-2009, nearly 1,400 steelhead smolts from 9 watersheds within Puget Sound were tracked from river mouth to the Pacific Ocean using acoustic telemetry to: (1) estimate early marine survival through Puget Sound, (2) identify common areas of abnormally high mortality along the migration route, and (3) to identify factors that may influence survival. Cormac-Jolly-Seber mark-recapture models were used to jointly estimate survival and detection rate at telemetry arrays. Estimated survival rates from river mouths to near the Pacific Ocean ranged from 1.5% (Skokomish River hatchery smolts in 2009) to 34.0% (Big Beef Creek wild smolts in 2006), and averaged 14.9% for all populations. Factors influencing survival included population, migration segment, migration year, and rearing type (i.e., hatchery or wild), while geographic region, body length, and tag type (i.e., 7mm or 9mm) showed lesser effects. Comparison of survival rates between migration segments implicated central Puget Sound and Admiralty Inlet as potential areas of heightened mortality. Early marine survival rates estimated here are very low considering that steelhead smolts spend only about two to three weeks in Puget Sound before entering the Pacific Ocean. Mortality in Puget Sound may be a major driver behind low observed smolt-to adult survival rates. This study addresses a major gap in steelhead marine life history knowledge and can help to inform future Puget Sound steelhead recovery planning efforts

Prevalence of Molar-Incisor Hypomineralization In Milwaukee, Wisconsin, USA: A Pilot Study

Purpose: This pilot study investigated the prevalence of Molar-Incisor Hypomineralization (MIH) in third-grade school children in Milwaukee Wisconsin, USA. Methods: A convenience sample of third-grade school children in the Milwaukee Public School System (MPS) participated in the study. Calibrated examiners trained on the European Academy of Paediatric Dentistry (EAPD) MIH recommendations examined the children between December 1, 2014 and June 30, 2015. Children were examined at their schools using a flashlight and mirror after receiving consent from parents/caregivers and assent from each child. Findings were recorded onto a standardized form by one of five trained examiners. Summary statistics were calculated, and bivariate analysis were done to identify factors associated with MIH. Results: A total of 375 children (average age =8.66 years, range 7–12) were examined, 60% females and 41% Hispanics. Overall, 36 (9.6%) of the children demonstrated findings consistent with the diagnosis of MIH. Among the teeth with MIH defects, severe defects were higher in lower molars. There were no statistically significant differences between those with and without MIH by sex, race/ethnicity, and socioeconomic status in this study. Conclusion: The study revealed that 9.6% of the children examined were affected by MIH. Future studies should focus on statewide and/or nationwide surveys in the United States to ascertain the extent and severity of the condition

Reflexive and volitional saccadic eye movements and their changes in age and progressive supranuclear palsy

BACKGROUND AND OBJECTIVES: Saccades, rapid movements of the eyes towards a visual or remembered target, are useful in understanding the healthy brain and the pathology of neurological conditions such as progressive supranuclear palsy (PSP). We set out to investigate the parameters of horizontal reflexive and volitional saccades, both visually guided and memory-guided, over a 1 min epoch in healthy individuals and PSP patients. METHODS: An experimental paradigm tested reflexive, volitional visually guided, and volitional memory-guided saccades in young healthy controls (n = 14; 20-31 years), PSP patients (n = 11; 46-75 years) and older age-matched healthy controls (n = 6; 56-71 years). The accuracy and velocity of saccades was recorded using an EyeBrain T2® video eye tracker and analyses performed using the MyEyeAnalysis® software. Two-way analysis of variance (ANOVA) was used to identify significant effects (p < 0.01) between young and older controls to investigate the effects of ageing upon saccades, and between PSP patients and age-matched controls to study the effects of PSP upon saccades. RESULTS: In both healthy individuals and PSP patients, volitional saccades are slower and less accurate than reflexive saccades. In PSP patients, accuracy is lower across all saccade types compared to age-matched controls, but velocity is lower only for reflexive saccades. Crucially, there is no change in accuracy or velocity of consecutive saccades over short (one-minute) timescales in controls or PSP patients. CONCLUSIONS: Velocity and accuracy of saccades in PSP does not decrease over one-minute timescales, contrary to that previously observed in Parkinson's Disease (PD), suggesting a potential clinical biomarker for the distinction of PSP from PD

Early mobilization and recovery in mechanically ventilated patients in the ICU: a bi-national, multi-centre, prospective cohort study

Introduction: The aim of this study was to investigate current mobilization practice, strength at ICU discharge and functional recovery at 6 months among mechanically ventilated ICU patients. Method: This was a prospective, multi-centre, cohort study conducted in twelve ICUs in Australia and New Zealand. Patients were previously functionally independent and expected to be ventilated for >48 hours. We measured mobilization during invasive ventilation, sedation depth using the Richmond Agitation and Sedation Scale (RASS), co-interventions, duration of mechanical ventilation, ICU-acquired weakness (ICUAW) at ICU discharge, mortality at day 90, and 6-month functional recovery including return to work. Results: We studied 192 patients (mean age 58.1 ± 15.8 years; mean Acute Physiology and Chronic Health Evaluation (APACHE) (IQR) II score, 18.0 (14 to 24)). Mortality at day 90 was 26.6% (51/192). Over 1,351 study days, we collected information during 1,288 planned early mobilization episodes in patients on mechanical ventilation for the first 14 days or until extubation (whichever occurred first). We recorded the highest level of early mobilization. Despite the presence of dedicated physical therapy staff, no mobilization occurred in 1,079 (84%) of these episodes. Where mobilization occurred, the maximum levels of mobilization were exercises in bed (N = 94, 7%), standing at the bed side (N = 11, 0.9%) or walking (N = 26, 2%). On day three, all patients who were mobilized were mechanically ventilated via an endotracheal tube (N = 10), whereas by day five 50% of the patients mobilized were mechanically ventilated via a tracheostomy tube (N = 18). In 94 of the 156 ICU survivors, strength was assessed at ICU discharge and 48 (52%) had ICU-acquired weakness (Medical Research Council Manual Muscle Test Sum Score (MRC-SS) score <48/60). The MRC-SS score was higher in those patients who mobilized while mechanically ventilated (50.0 ± 11.2 versus 42.0 ± 10.8, P = 0.003). Patients who survived to ICU discharge but who had died by day 90 had a mean MRC score of 28.9 ± 13.2 compared with 44.9 ± 11.4 for day-90 survivors (P <0.0001). Conclusions: Early mobilization of patients receiving mechanical ventilation was uncommon. More than 50% of patients discharged from the ICU had developed ICU-acquired weakness, which was associated with death between ICU discharge and day-90

Interleukin-6 as a prognostic biomarker of clinical outcomes after traumatic brain injury: a systematic review

Background Traumatic brain injury (TBI) is a major cause of mortality and morbidity worldwide. There are currently no early biomarkers for prognosis in routine clinical use. Interleukin-6 (IL-6) is a potential biomarker in the context of the established role of neuroinflammation in TBI recovery. Therefore, a systematic review of the literature was performed to assess and summarise the evidence for IL-6 secretion representing a useful biomarker for clinical outcome. Methods A multi-database literature search between January 1946 and July 2021 was performed. Studies were included if they reported adult TBI patients with IL-6 concentration in serum, cerebrospinal fluid (CSF) and/or brain parenchyma analysed with respect to functional outcome and/or mortality. A synthesis without meta-analysis is reported. Results 15 studies were included, reporting 699 patients. Most patients were male (71.7%) and the pooled mean age was 40.8 years. 78.1% sustained severe TBI. Eleven studies reported IL-6 levels in serum, six in CSF and one in parenchyma. Five studies on serum demonstrated higher IL-6 concentrations were associated with poorer outcomes and five showed no signification association. In CSF studies, one found higher IL-6 levels were associated with poorer outcome, one found them to predict better outcomes, and three found no association. Greater parenchymal IL-6 was associated with better outcomes. Conclusion Despite some inconsistency in findings, it appears that exaggerated IL-6 secretion predicts poor outcomes after TBI. Future efforts require standardisation of IL-6 measurement practices as well as assessment of the importance of IL-6 concentration dynamics with respect to clinical outcomes, ideally within large prospective studies. Prospero registration number CRD4202127120

LSST: from Science Drivers to Reference Design and Anticipated Data Products

(Abridged) We describe here the most ambitious survey currently planned in the optical, the Large Synoptic Survey Telescope (LSST). A vast array of science will be enabled by a single wide-deep-fast sky survey, and LSST will have unique survey capability in the faint time domain. The LSST design is driven by four main science themes: probing dark energy and dark matter, taking an inventory of the Solar System, exploring the transient optical sky, and mapping the Milky Way. LSST will be a wide-field ground-based system sited at Cerro Pach\'{o}n in northern Chile. The telescope will have an 8.4 m (6.5 m effective) primary mirror, a 9.6 deg$^2$ field of view, and a 3.2 Gigapixel camera. The standard observing sequence will consist of pairs of 15-second exposures in a given field, with two such visits in each pointing in a given night. With these repeats, the LSST system is capable of imaging about 10,000 square degrees of sky in a single filter in three nights. The typical 5$\sigma$ point-source depth in a single visit in $r$ will be $\sim 24.5$ (AB). The project is in the construction phase and will begin regular survey operations by 2022. The survey area will be contained within 30,000 deg$^2$ with $\delta<+34.5^\circ$, and will be imaged multiple times in six bands, $ugrizy$, covering the wavelength range 320--1050 nm. About 90\% of the observing time will be devoted to a deep-wide-fast survey mode which will uniformly observe a 18,000 deg$^2$ region about 800 times (summed over all six bands) during the anticipated 10 years of operations, and yield a coadded map to $r\sim27.5$. The remaining 10\% of the observing time will be allocated to projects such as a Very Deep and Fast time domain survey. The goal is to make LSST data products, including a relational database of about 32 trillion observations of 40 billion objects, available to the public and scientists around the world.Comment: 57 pages, 32 color figures, version with high-resolution figures available from https://www.lsst.org/overvie