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Background Our study aimed to describe the incidence, epidemiology of respiratory viruses and outcomes in hospital acquired viral respiratory infections (HAVRI). Methods We conducted a retrospective observational study on all adults and children with hospital acquired viral respiratory infections between July 2012 and April 2019. Clinical and microbiological data were collected in a major tertiary level hospital in North Queensland. Morbidity indicators were the length of stay, need for intensive care and mechanical ventilation. Length of stay was analyzed with the Kruskal-Wallis test and mortality with the Chi-Square test. Results A total of 283 patients tested positive for a respiratory virus and fulfilled the criteria for a hospital acquired infection. Individuals in the younger age group were more likely to be admitted to intensive care and need mechanical ventilation. A higher mortality was found with individuals in the older age category. The morbidity and mortality did not differ based on the virus type. Influenza A was the most common respiratory virus associated with hospital acquired viral respiratory infections. Conclusion Hospital acquired viral respiratory infections contribute significantly to morbidity and mortality regardless of the virus species.

While the transvaginal placement of synthetic mesh has been used to treat pelvic floor disorders for over 20 years, this surgical technique is still a point of deliberation among experts in the field. Placing mesh through a vaginal incision for the treatment of stress incontinence is widely considered to be the standard procedure for surgical treatment of this condition. However, new techniques – such as single-incision slings – are still somewhat controversial. Vaginal mesh for prolapse is perhaps one of the most debated surgical techniques in gynecology since the turn of the millennium, with one of the common criticisms being that there is a paucity of quality outcome data associated with this technique. The goal of this chapter is to review and interpret these outcomes.

The Palomar Transient Factory is a project making use of a Schmidt 48 inch telescope located on the Palomar Mountain, which is surveying the sky with dynamical cadences. It was deployed in 2009 and the observed sky region is over 1200 square degrees. We have studied the long-term periodic variabilities of the known galactic cataclysmic variables (CVs). More than 20 of the sources had been found to have long term periodic signals, ranging from several tens of days to several hundreds of days. Some possible scenarios are proposed to explain the results, such as a magnetic eld change of the companion star, precession of the accretion disk, triple systems and superoutburst cycles. Some preliminary discussion will be presented in this article.

Cyanide toxicity is a rare complication of sodium nitroprusside that can be difficult to diagnose in critically ill patients. We describe a case of cyanide toxicity after cardiac surgery that presented as lactic acidosis after discontinuation of nitroprusside.

Background: Adequate exposure of the proximal humerus is necessary to address atypical or complex proximal humerus fractures and orthopedic tumors. Surgical management may be difficult through existing approaches due to their limited nature and the delicate neurovascular anatomy of the shoulder. The deltoid lift, a previously described extensile approach, can be incorporated into the surgeon’s armamentarium as an alternative exposure to the proximal humerus. The objective of this study was to quantify and compare the humeral exposure achieved through the deltoid lift with the standard direct lateral deltoid-splitting, anterolateral acromial, and deltopectoral approaches in terms of surface area and exposure of key anatomic landmarks. Methods: Each approach was performed a minimum of 8 times on 18 cadaveric specimens. After identifying landmarks, exposure area of exposed humerus was quantified using digital images and ImageJ software. Results: The deltoid lift yielded an average exposure area of 46 cm2. Comparison of the exposure area for the deltoid lift against each of the other approaches yielded statistical significance ( P < .01). The exposure provided was 2-folds greater than that of the next most extensive approach. All anatomic landmarks were directly visible through the deltoid lift as compared with the remaining approaches, through which only 1 landmark was directly visualized and only 2 of the 3 remaining were palpable through the approach. Conclusions: The deltoid lift extensile surgical exposure to the proximal humerus provides the largest humeral exposure with the greatest visibility of landmarks relative to the 3 most widely utilized standard approaches.

Background— Pulmonary vein (PV) –encircling radiofrequency ablation frequently is effective in vagal atrial fibrillation (AF), and there is evidence that PVs may be particularly prone to cholinergically induced arrhythmia mechanisms. However, PV ablation procedures also can affect intracardiac autonomic ganglia. The present study examined the relative role of PVs versus peri-PV autonomic ganglia in an experimental vagal AF model. Methods and Results— Cholinergic AF was studied under carbachol infusion in coronary perfused canine left atrial PV preparations in vitro and with cervical vagal stimulation in vivo. Carbachol caused dose-dependent AF promotion in vitro, which was not affected by excision of all PVs. Sustained AF could be induced easily in all dogs during vagal nerve stimulation in vivo both before and after isolation of all PVs with encircling lesions created by a bipolar radiofrequency ablation clamp device. PV elimination had no effect on atrial effective refractory period or its responses to cholinergic stimulation. Autonomic ganglia were identified by bradycardic and/or tachycardic responses to high-frequency subthreshold local stimulation. Ablation of the autonomic ganglia overlying all PV ostia suppressed the effective refractory period–abbreviating and AF-promoting effects of cervical vagal stimulation, whereas ablation of only left- or right-sided PV ostial ganglia failed to suppress AF. Dominant-frequency analysis suggested that the success of ablation in suppressing vagal AF depended on the elimination of high-frequency driver regions. Conclusions— Intact PVs are not needed for maintenance of experimental cholinergic AF. Ablation of the autonomic ganglia at the base of the PVs suppresses vagal responses and may contribute to the effectiveness of PV-directed ablation procedures in vagal AF.

Obtaining adequate exposure of the proximal humerus for anatomic reduction of complex intra-articular fractures or in the surgical treatment of tumor may be difficult. Here we describe a novel approach to the proximal humerus: the deltoid lift, and perform a cadaveric analysis objectively quantifying the exposure. The deltoid lift offers significantly greater exposure to the proximal humerus as compared with the deltopectoral approach.

Detection of a finite-state Markov signal in additive white Gaussian noise (AWGN) can be done in an intuitive manner by applying an appropriate filter and using an energy detector. One might not expect this heuristic approach to signal detection to be optimal. However, in this paper, we show that for a certain type of finite-state Markov signal, namely, the discrete-time (DT) random telegraph, this filtered energy detector is approximately optimal under the following conditions of: symmetric transition probabilities, low signal-to-noise ratio (SNR), long observation time, and small probability of transition between two consecutive time instances. When these last three conditions hold, but the transition probabilities are not symmetric, we show that a variant of the filtered energy detector is approximately optimal. It is also shown, under low SNR conditions, that the likelihood ratio test (LRT) for a finite-state DT Markov signal in AWGN reduces to the matched filter statistic with the minimum mean-squared-error (MMSE) predictor signal values used in place of the known signal values. Using this result, we propose a general methodology for obtaining an approximation to the LRT of a finite-state DT Markov signal in AWGN. Specifically, instead of the conditional mean (also MMSE) estimators, affine estimators with lowest mean squared error are used. This work is relevant to magnetic resonance force microscopy, an emerging technology that uses ultrasensitive force sensing to detect magnetic resonance. Sensitivity down to the single spin level was demonstrated in a recent experiment.

The ultra-long period Cepheids (ULPCs) are classical Cepheids with pulsation periods exceeding $\approx 80$ days. The intrinsic brightness of ULPCs are ~1 to ~3 mag brighter than their shorter period counterparts. This makes them attractive in future distance scale work to derive distances beyond the limit set by the shorter period Cepheids. We have initiated a program to search for ULPCs in M31, using the single-band data taken from the Palomar Transient Factory, and identified eight possible candidates. In this work, we presented the VI-band follow-up observations of these eight candidates. Based on our VI-band light curves of these candidates and their locations in the color-magnitude diagram and the Period-Wesenheit diagram, we verify two candidates as being truly ULPCs. The six other candidates are most likely other kinds of long-period variables. With the two confirmed M31 ULPCs, we tested the applicability of ULPCs in distance scale work by deriving the distance modulus of M31. It was found to be $\mu_{M31,ULPC}=24.30\pm0.76$ mag. The large error in the derived distance modulus, together with the large intrinsic dispersion of the Period-Wesenheit (PW) relation and the small number of ULPCs in a given host galaxy, means that the question of the suitability of ULPCs as standard candles is still open. Further work is needed to enlarge the sample of calibrating ULPCs and reduce the intrinsic dispersion of the PW relation before re-considering ULPCs as suitable distance indicators., Comment: 13 pages, with 14 Figures and 4 Tables (one online table). AJ accepted

In spite of the recent explosive growth in the use of office and network equipment, there has been no recent study (until this one) that estimates in detail how much electricity is consumed by that equipment in the United States. In this study, we examined energy use by office equipment and network equipment at the end of 1999. We classified office equipment into 11 types; for each type we estimated annual energy consumption for residential, commercial, and industrial use by combining estimates of stock, power requirements, usage, and saturation of power management. We also classified network equipment into six types and estimated the annual energy consumption for each type. We found that total direct power use by office and network equipment is about 74 TWh per year, which is about 2% of total electricity use in the US. When electricity used by telecommunications equipment and electronics manufacturing is included, that figure rises to 3% of all electricity use. More than 70% of the 74 TWh/year is dedicated to office equipment for commercial use. We also found that power management currently saves 23 TWh/year, and complete saturation and proper functioning of power management would achieve additional savings of 17 TWh/year. Furthermore, complete saturation of night shutdown for equipment not required to operate at night would reduce power use by an additional 7 TWh/year. Finally, we compared our current estimate with our 1995 forecast for 1999. We found that the total difference between our current estimate and the previous forecast is less than 15% and identified the factors that led to inaccuracies in the previous forecast. We also conducted a sensitivity analysis of the uncertainties in our current forecast and identified the data sets that have the largest impact on our current estimate of energy use.

This paper analyses the evolution of carbon emissions from the manufacturing sectors of 13 IEA countries, based on national data at the 2 or 3 sector ISIC level of disaggregation. We carry out an Adaptive-Weighting-Divisia decomposition of changes into factors representing sub-sectoral branch energy intensities, output mix or structure, final fuel mix, and utility fuel mix. We also carry out a detailed comparison of emissions by country and sub-sector for 1994. We find that by the mid-1990s, emissions from manufacturing in most countries were close to their 1973 levels. The main reasons were lower branch energy intensities and in some countries changes in utility fuel mix. Changes in the mix of output had small downward effects in a few large countries (Japan and the United States), while these shifts increased emissions in others (Australia, Norway, Netherlands). Fuel mix changes lowered emissions slightly, principally through moves away from coal and oil towards gas. The comparison of countries shows that after overall output, energy intensities explain most of the differences in per capita emissions from manufacturing. Fuel mix and utility fuel mix play an important role for some countries with very CO 2 — free power sectors (Sweden, Norway, France) or CO 2 intensive power sectors (Australia). Some of the differences in energy intensities, however, arise because of hidden sub-sectoral mix effects that cannot be resolved at the 3-digit ISIC level of disaggregation. Emissions have been rising since 1990, largely because energy intensities are not falling as fast as they did before 1990. What this means for the Kyoto Accord and other concerns related to global carbon emissions remains to be seen.

Patterns of the evolution of aggregate carbon intensity from residential end uses show greater variability than other sectors. For some countries in this analysis, this measure exhibits significant decreases, while for other countries this measure exhibits significant increases over the period of analysis. The Adaptive Weighted Divisia rolling base year index specification is applied to carbon emissions from the residential sector for 10 OECD countries for the period 1970–1993. Decreases in aggregate carbon intensity for six of the countries range less than 8% to almost 72%, and may be attributed to changes in three different factors. However, for all of the countries, decreases are offset by shifts in end-use structure toward more carbon-intensive activities. These shifts are driven by an increase in the number of households with a corresponding increase in floor space, acquisition of greater numbers of major appliances and by an increase in the ‘other’ energy consumption category.

In this paper we examine manufacturing energy use in 13 OECD countries over the period 1971–1995. We describe changes in aggregate energy intensity using the Adaptive Weighting Divisia decomposition method. We contrast the development in the periods after the oil price shocks of 1973 and 1979 with the period of relatively stable energy prices after the oil price crash of 1986. The results show that manufacturing output grew in most countries, pushing up energy use. The share of electricity increased in almost every sector, while there was a clear trend away from oil and coal towards natural gas. Changes in the structure of output drove up energy use between 1973 and 1994 in some countries and down in others. Changes in energy intensities had a profound and downward effect on manufacturing energy use in all countries. However, contrasting the period after oil prices fell in 1986 with earlier years we see that for most countries the rate of energy intensity decline slowed slightly but did not reverse with falling prices. In a few countries efficiency improvements continued to have a strong effect. This suggests that even without higher prices improvements of energy efficiency seems to take place.

Historical patterns of aggregate carbon intensity from freight are different than those from other sectors. While aggregate carbon intensity declined for all other sectors, aggregate carbon intensity for freight increased. The Adaptive Weighted Divisia rolling base year index specification is applied to carbon emissions from the freight sector of 10 OECD countries for the period 1970–1993. Increases in aggregate carbon intensity for nine of the countries range from less than 20% to over 150% and may be primarily attributed to shifts in modal structure toward more carbon-intensive modes. These increases in aggregate carbon intensity are driven primarily by an increase in activity, which parallels the growth in GDP. Furthermore, changes in fuel price and vehicle purchase taxes do not appear to be effective instruments for reducing energy consumption for this end use. Alternative policy options, including less-carbon intensive fuels and technologies, and reduced congestion, appear to be better choices.

Over the 1970s and 1980s, emissions of carbon dioxide from energy use fell in per capita, per unit GDP, and in some cases in absolute terms in 10 industrialized countries studied by LBNL. These declines were driven principally by falling end-use energy intensities and the decreasing carbon content of energy. By the early 1990s, however, a slowdown in the decline of intensities and the continued growth of GDP and energy services activity have reversed the trends in absolute emissions. LBNL concludes that CO 2 emissions will continue to rise in the future unless energy intensities and/or the carbon content of energy can be decreased at an accelerated rate via policy changes, technological innovation and/or behavioural adaptation.

Ultra-long-period Cepheids (ULPCs) are important in distance-scale studies due to their potential for determining distance beyond ~100 Mpc. We performed a comprehensive search for ULPCs in M31, a local benchmark to calibrate the distance ladders. We use data from the Palomar Transient Factory (PTF), which has imaged M31 using a 1.2-m telescope equipped with a ~7.26 deg2 field-of-view (FOV) camera, usually with daily sampling, since the beginning of 2010. The large FOV, together with the regular monitoring, enables us to probe ULPCs in the bulge, disk, and even out to the halo of M31. Using a difference imaging analysis technique, we found and characterized 3 promising ULPC candidates based on their luminosities, amplitudes and Fourier parameters. The mean absolute magnitude for these 3 ULPC candidates, calibrated with latest M31 distance, is M_R=-6.47mag. Two out of the 3 ULPC candidates have been reported in literature, however their published periods from Magnier et al. are about half of the periods we found in this work. The third ULPC candidate is a new discovery. We studied 5 other candidates and determined that they are probably Mira-like or ultra-long-period variables, but not ULPCs., 6 pages, 2 tables and 7 figures. Published in IEEE Xplore for 2013 IEEE International Conference on Space Science and Communication (IconSpace2013) Proceeding of the 2013 IEEE International Conference on Space Science and Communication (IconSpace), pg. 1

The anaerobic bacterium Dichelobacter nodosus is the principal causative agent of ovine footrot, a mixed bacterial infection of the hoof. Although the bacterium only survives for a few days in soil, this period is crucial for transmission of the disease as sheep are infected by walking through soil or pasture contaminated with infectious bacteria. The D. nodosus genome is only 1.3Mb in size and has a dearth of genes encoding regulatory proteins. A series of genetic elements which integrate into the genome has been identified and we have proposed that these integrated genetic elements control the expression of adjacent genes encoding global regulators of virulence. The intA, intB, intC and intD elements integrate next to csrA or pnpA while the vrl integrates next to ssrA. CsrA, PnpA and the ssrA gene product, a 10SaRNA, have been shown to act as global virulence regulators in other bacteria. We have also identified a bacteriophage, DinoHI, which is integrated into the genome of some D. nodosus strains. Sequence analyses suggest that there are many possible interactions between these integrated genetic elements. The vrl contains a copy of the DinoHI packaging site, indicating that the vrl may be transferred between strains by the bacteriophage. DinoHI and the intB element have a common repressor gene, suggesting that maintenance of the integrated state of these two genetic elements is co-ordinately controlled. Similarly, a DNA segment resembling the bacteriophage P4 immunity region is present on the intA, intC and intD elements and may be responsible for maintaining these three genetic elements in the integrated state. The features of the intD element suggest that it is self-transmissible and also capable of mobilising the intA element. Exchange of sequences between these genetic elements may also occur. We discuss here evidence for a network of interactions between these genetic elements with implications for the control of virulence in D. nodosus.

The application that motivates this paper is molecular imaging at the atomic level. When discretized at sub-atomic distances, the volume is inherently sparse. Noiseless measurements from an imaging technology can be modeled by convolution of the image with the system point spread function (psf). Such is the case with magnetic resonance force microscopy (MRFM), an emerging technology where imaging of an individual tobacco mosaic virus was recently demonstrated with nanometer resolution. We also consider additive white Gaussian noise (AWGN) in the measurements. Many prior works of sparse estimators have focused on the case when H has low coherence; however, the system matrix H in our application is the convolution matrix for the system psf. A typical convolution matrix has high coherence. The paper therefore does not assume a low coherence H. A discrete-continuous form of the Laplacian and atom at zero (LAZE) p.d.f. used by Johnstone and Silverman is formulated, and two sparse estimators derived by maximizing the joint p.d.f. of the observation and image conditioned on the hyperparameters. A thresholding rule that generalizes the hard and soft thresholding rule appears in the course of the derivation. This so-called hybrid thresholding rule, when used in the iterative thresholding framework, gives rise to the hybrid estimator, a generalization of the lasso. Unbiased estimates of the hyperparameters for the lasso and hybrid estimator are obtained via Stein's unbiased risk estimate (SURE). A numerical study with a Gaussian psf and two sparse images shows that the hybrid estimator outperforms the lasso., Comment: 12 pages, 8 figures

Pace mapping has been used to identify the site of origin of focal ventricular arrhythmias. The spatial resolution of pace mapping has not been adequately quantified using currently available three-dimensional mapping systems.The purpose of this study was to determine the spatial resolution of pace mapping in patients with idiopathic ventricular tachycardia or premature ventricular contractions originating in the right ventricular outflow tract.In 16 patients with idiopathic ventricular tachycardia/ectopy from the right ventricular outflow tract, comparisons and classifications of pace maps were performed by two observers (good pace map: match10/12 leads; inadequate pace map: matchor =10/12 leads) and a customized MATLAB 6.0 program (assessing correlation coefficient and normalized root mean square of the difference (nRMSd) between test and template signals). With an electroanatomic mapping system, the correlation coefficient of each pace map was correlated with the distance between the pacing site and the effective ablation site. The endocardial area within the 10-ms activation isochrone was measured.The ablation procedure was effective in all patients. Sites with good pace maps had a higher correlation coefficient and lower nRMSd than sites with inadequate pace maps (correlation coefficient: 0.96 +/- 0.03 vs 0.76 +/- 0.18, P.0001; nRMSd: 0.41 +/- 0.16 vs 0.89 +/- 0.39, P.0001). Using receiver operating characteristic curves, appropriate cutoff values were0.94 for correlation coefficient (sensitivity 81%, specificity 89%) andor =0.54 for nRMSd (sensitivity 76%, specificity 80%). Good pace maps were located a mean of 7.3 +/- 5.0 mm from the effective ablation site and had a mean activation time of -24 +/- 7 ms. However, in 3 (18%) of 16 patients, the best pace map was inadequate at the effective ablation site, with an endocardial activation time at these sites of -25 +/- 12 ms. Pace maps with correlation coefficientor =0.94 were confined to an area of 1.8 +/- 0.6 cm2. The 10-ms isochrone measured 1.2 +/- 0.7 cm2.The spatial resolution of a good pace map for targeting ventricular tachycardia/ectopy is 1.8 cm2 in the right ventricular outflow tract and therefore is inferior to the spatial resolution of activation mapping as assessed by isochronal activation. In approximately 20% of patients, pace mapping is unreliable in identifying the site of origin, possibly due a deeper site of origin and preferential conduction via fibers connecting the focus to the endocardial surface.

Background: Vagal (VG) and atrial tachycardia remodeled (ATR) AF substrates share many features: reduced effective refractory period (ERP), increased ERP heterogeneity and some common molecular mechanisms (I KACh enhancement by acetylcholine release in VG, constitutive I KACh enhancement in ATR). This study compared VG and ATR substrates at comparable ERP abbreviation. Methods: In each of 5 VG dogs, bilateral cervical VG stimulation parameters were adjusted (mean±SD: 3.6±1.7 V and 12.2±1.5 Hz; 0.2 ms) to produce the same mean ERP (at 4 RA and 4 LA sites) as a sex and weight matched ATR dog (RA paced 400 bpm × 7 days). Mean duration of burst pacing induced AF (DAF) and local dominant frequencies (DFs, analyzed by FFT at 240 bipolar electrodes, Fig A ) were determined. Results: Mean ERP was 79±13 ms in VG and 78±13 ms in ATR dogs. DAF was greater in VG than ATR dogs (1056±323 vs 289±510 s *P control, 43±61 s). Despite matched ERPs, there were significant differences in DF distribution (Fig B ): DF was faster (mean DF: 11.8±1.1 Hz VG vs 9.7±1.3 Hz ATR*) and DF variability greater (indicated by SD: 1.8±0.6 Hz VG vs 0.8±0.5 Hz ATR*) in VG dogs. AF drivers reflected by maximum DF zones were adjacent to autonomic ganglia (over RA in 4/5) for VG dogs; in ATR dogs driver zones were less clear and showed variable location. Conclusions: For a comparable atrial ERP, VG AF is faster and more persistent than AF with an ATR substrate. These results are consist with modeling work suggesting that VG-induced hyperpolarization is an important contributor to AF-maintaining rotor stabilization and acceleration, and indicate important differences between these superficially similar AF substrates.

Sparse image reconstruction is of interest in the fields of radioastronomy and molecular imaging. The observation is assumed to be a linear transformation of the image, and corrupted by additive white Gaussian noise. We study the usage of sparse priors in the empirical Bayes framework: it permits the selection of the hyperparameters of the prior in a data-driven fashion. Three sparse image reconstruction methods are proposed. A simulation study was performed using a binary-valued image and a Gaussian point spread function. In the range of signal to noise ratios considered, the proposed methods had better performance than sparse Bayesian learning (SBL).