From Local Covalent Bonding to Extended Electric Field Interactions in Proton Hydration.

Seemingly simple yet surprisingly difficult to probe, excess protons in water constitute complex quantum objects with strong interactions with the extended and dynamically changing hydrogen-bonding network of the liquid. Proton hydration plays pivotal roles in energy transport in hydrogen fuel cells and signal transduction in transmembrane proteins. While geometries and stoichiometry have been widely addressed in both experiment and theory, the electronic structure of these specific hydrated proton complexes has remained elusive. Here we show, layer by layer, how utilizing novel flatjet technology for accurate x-ray spectroscopic measurements and combining infrared spectral analysis and calculations, we find orbital-specific markers that distinguish two main electronic-structure effects: Local orbital interactions determine covalent bonding between the proton and neigbouring water molecules, while orbital-energy shifts measure the strength of the extended electric field of the proton.

Trajectories of psychological distress after prison release: implications for mental health service need in ex-prisoners.

BACKGROUND: Understanding individual-level changes in mental health status after prison release is crucial to providing targeted and effective mental health care to ex-prisoners. We aimed to describe trajectories of psychological distress following prison discharge and compare these trajectories with mental health service use in the community. METHOD: The Kessler Psychological Distress Scale (K10) was administered to 1216 sentenced adult prisoners in Queensland, Australia, before prison release and approximately 1, 3 and 6 months after release. We used group-based trajectory modeling to identify K10 trajectories after release. Contact with community mental health services in the year following release was assessed via data linkage. RESULTS: We identified five trajectory groups, representing consistently low (51.1% of the cohort), consistently moderate (29.8%), high increasing (11.6%), high declining (5.5%) and consistently very high (1.9%) psychological distress. Mood disorder, anxiety disorder, history of self-harm and risky drug use were risk factors for the high increasing, very high and high declining trajectory groups. Women were over-represented in the high increasing and high declining groups, but men were at higher risk of very high psychological distress. Within the high increasing and very high groups, 25% of participants accessed community mental health services in the first year post-release, for a median of 4.4 contact hours. CONCLUSIONS: For the majority of prisoners with high to very high psychological distress, distress persists after release. However, contact with mental health services in the community appears low. Further research is required to understand barriers to mental health service access among ex-prisoners.

Quantifying differences in the epidemic curves from three influenza surveillance systems: a nonlinear regression analysis.

Influenza surveillance enables systematic collection of data on spatially and demographically heterogeneous epidemics. Different data collection mechanisms record different aspects of the underlying epidemic with varying bias and noise. We aimed to characterize key differences in weekly incidence data from three influenza surveillance systems in Melbourne, Australia, from 2009 to 2012: laboratory-confirmed influenza notified to the Victorian Department of Health, influenza-like illness (ILI) reported through the Victorian General Practice Sentinel Surveillance scheme, and ILI cases presenting to the Melbourne Medical Deputising Service. Using nonlinear regression, we found that after adjusting for the effects of geographical region and age group, characteristics of the epidemic curve (including season length, timing of peak incidence and constant baseline activity) varied across the systems. We conclude that unmeasured factors endogenous to each surveillance system cause differences in the disease patterns recorded. Future research, particularly data synthesis studies, could benefit from accounting for these differences.

Dusk-Dawn Asymmetries in SuperDARN Convection Maps.

The Super Dual Auroral Radar Network (SuperDARN) is a collection of radars built to study ionospheric convection. We use a 7-year archive of SuperDARN convection maps, processed in 3 different ways, to build a statistical understanding of dusk-dawn asymmetries in the convection patterns. We find that the data set processing alone can introduce a bias which manifests itself in dusk-dawn asymmetries. We find that the solar wind clock angle affects the balance in the strength of the convection cells. We further find that the location of the positive potential foci is most likely observed at latitudes of 78° for long periods (>300 min) of southward interplanetary magnetic field (IMF), as opposed to 74° for short periods (<20 min) of steady IMF. For long steady dawnward IMF the median is also at 78°. For long steady periods of duskward IMF, the positive potential foci tends to be at lower latitudes than the negative potential and vice versa during dawnward IMF. For long periods of steady Northward IMF, the positive and negative cells can swap sides in the convection pattern. We find that they move from ∼0-9 MLT to 15 MLT or ∼15-23 MLT to 10 MLT, which reduces asymmetry in the average convection cell locations for Northward IMF. We also investigate the width of the region in which the convection returns to the dayside, the return flow width. Asymmetries in this are not obvious, until we select by solar wind conditions, when the return flow region is widest for the negative convection cell during Southward IMF.

Developing assessments of surgical skills for the GMC Performance Procedures.

INTRODUCTION: The objectives were to: (i) establish how 'typical' consultant surgeons perform on 'generic' (non-specialist) surgical simulations before their use in the General Medical Council's Performance Procedures (PPs); (ii) measure any differences in performance between specialties; and (iii) compare the performance of group of surgeons in the PPs with the 'typical' group. VOLUNTEERS AND METHODS: Seventy-four consultant volunteers in gastrointestinal surgery (n=21), vascular surgery (n=11), urology (n=10), orthopaedics (n=15), cardiothoracic surgery (n=10) and plastic surgery (n=7), plus 9 surgeons undertaking phase 2 of the PPs undertook 7 simple simulations in the skills laboratory. The scores of the volunteers were analysed by simulation and specialty using ANOVA. The scores of the volunteers were then compared with the scores of the surgeons in the PPs. RESULTS: There were significant differences between simulations, but most volunteers achieved scores of 75-100%. There was a significant simulation by specialty interaction indicating that the scores of some specialties differed on some simulations. The scores of the group of surgeons in the PPs were significantly lower than the reference group for most simulations. CONCLUSIONS: Simple simulations can be used to assess the basic technical skills of consultant surgeons. The simulation by specialty interaction suggests that whilst some skills may be generic, others are not. The lower scores of the surgeons in the PPs suggest that these tests possess criterion validity, i.e. they may help to determine when poor performance is due to lack of technical competence.

The management of von Willebrand's disease-associated gastrointestinal angiodysplasia.

There is a recognized association between von Willebrand's disease and gastrointestinal angiodysplasia. Most previous publications have been reports of the association itself and there is little published on the management and long-term follow-up of affected patients. We report our experience and follow-up of six patients, and review the previous literature.

Choosing a hospital: analysis of consumer tradeoffs.

In today's competitive health care industry, hospital administrators and marketers must determine how important various product/service attributes are to potential consumers and how those attributes influence consumer choice decisions. The authors outline an approach (the analytic hierarchy process) that can be used to assess or predict health care choice decisions by consumers. The analytic hierarchy process is a method for analyzing consumer choice behavior whereby a hierarchical structure is used to determine the relative preferences of consumers for health care alternatives. Marketing strategies based on the study findings are suggested.

Classification and identification of rhodococci.

Ninety-nine representative strains of Rhodococcus were compared through 129 unit characters and the data examined using the simple matching, Jaccard and pattern coefficients. Clustering was achieved using the unweighted pair group method with arithmetic averages algorithm. The numerical classification was not affected by the statistics used or by test error, estimated at 1.95%. Sixteen multimembered and 23 single member clusters were defined by the simple matching coefficient at or above the 89% similarity level. The numerical phenetic data support the taxonomic integrity of all 13 validly described species of Rhodococcus, including Rhodococcus aichiensis. Rapid enzymic tests based upon fluorophores 7-amino-4-methylcoumarin and 4-methylumbelliferone provide valuable data for rhodococcal systematics.

Polyphasic taxonomic study of the genera Gordona and Tsukamurella including the description of Tsukamurella wratislaviensis sp. nov.

Representatives of the genera Gordona and Tsukamurella together with related actinomycetes were the subject of chemotaxonomic, numerical taxonomic and DNA homology studies. In the numerical analysis the organisms were examined for 116 unit characters and the data sorted using the simple matching, Jaccard and pattern coefficients; clustering was achieved using the unweighted pair group method with arithmetic averages algorithm. The numerical groupings were not affected by the statistics used or by test error, estimated at 1.9%. The numerical taxonomic data supported the integrity of the four validly described species of Gordona but indicated that the genus Tsukamurella might encompass a species in addition to Tsukamurella paurometabola. The putative new strains had chemical, enzymic, nutritional and tolerance properties consistent with their assignment to the genus Tsukamurella and formed a DNA homology group corresponding to the one formed by the Tsukamurella paurometabola strains. It is proposed that the new taxon be assigned to the genus Tsukamurella as Tsukamurella wratislaviensis.