Zero refractive index in space-time acoustic metamaterials

New scientific investigations of artificially structured materials and experiments have exhibit wave manipulation to the extreme. In particular, zero refractive index metamaterials have been on the front line of wave physics research for their unique wave manipulation properties and application potentials. Remarkably, in such exotic materials, time-harmonic fields have infinite wavelength and do not exhibit any spatial variations in their phase distribution. This unique feature can be achieved by forcing a Dirac cone to the center of the Brillouin zone ( point), as previously predicted and experimentally demonstrated in time-invariant metamaterials by means of accidental degeneracy between three different modes. In this article, we propose a different approach that enables true conical dispersion at with twofold degeneracy, and generates zero index properties. We break time-reversal symmetry and exploit a space-time modulation scheme to demonstrate a time-Floquet acoustic metamaterial with zero refractive index. This behavior, predicted using stroboscopic analysis, is confirmed by fullwave finite elements simulations. Our results establish the relevance of space-time metamaterials as a novel reconfigurable platform for wave control

Are scabies and impetigo “normalised”? A cross-sectional comparative study of hospitalised children in northern Australia assessing clinical recognition and treatment of skin infections

<div><p>Background</p><p>Complications of scabies and impetigo such as glomerulonephritis and invasive bacterial infection in Australian Aboriginal children remain significant problems and the overall global burden of disease attributable to these skin infections remains high despite the availability of effective treatment. We hypothesised that one factor contributing to this high burden is that skin infection is under-recognised and hence under-treated, in settings where prevalence is high.</p><p>Methods</p><p>We conducted a prospective, cross-sectional study to assess the burden of scabies, impetigo, tinea and pediculosis in children admitted to two regional Australian hospitals from October 2015 to January 2016. A retrospective chart review of patients admitted in November 2014 (mid-point of the prospective data collection in the preceding year) was performed. Prevalence of documented skin infection was compared in the prospective and retrospective population to assess clinician recognition and treatment of skin infections.</p><p>Results</p><p>158 patients with median age 3.6 years, 74% Aboriginal, were prospectively recruited. 77 patient records were retrospectively reviewed. Scabies (8.2% vs 0.0%, OR N/A, p = 0.006) and impetigo (49.4% vs 19.5%, OR 4.0 (95% confidence interval [CI 2.1–7.7) were more prevalent in the prospective analysis. Skin examination was only documented in 45.5% of cases in the retrospective review. Patients in the prospective analysis were more likely to be prescribed specific treatment for skin infection compared with those in the retrospective review (31.6% vs 5.2%, OR 8.5 (95% CI 2.9–24.4).</p><p>Conclusions</p><p>Scabies and impetigo infections are under-recognised and hence under-treated by clinicians. Improving the recognition and treatment of skin infections by clinicians is a priority to reduce the high burden of skin infection and subsequent sequelae in paediatric populations where scabies and impetigo are endemic.</p></div

Impetigo microbiology.

<p>The figure represents a total of 41 culture positive microbiological samples from prospectively assessed patients with crusted or purulent impetigo.</p

Prevalence by age group (prospective).

<p>Prevalence by age group (prospective).</p

Prevalence by admission reason (prospective).

<p>Prevalence by admission reason (prospective).</p

Risk factors for skin infection (prospective only–univariate logistic analysis).

<p>Risk factors for skin infection (prospective only–univariate logistic analysis).</p

Baseline characteristics–prospective vs retrospective.

<p>Baseline characteristics–prospective vs retrospective.</p

Hospital admissions for skin infections among Western Australian children and adolescents from 1996 to 2012

<div><p>The objective of this study was to describe the occurrence of skin infection associated hospitalizations in children born in Western Australia (WA). We conducted a retrospective cohort study of all children born in WA between 1996 and 2012 (n = 469,589). Of these, 31,348 (6.7%) were Aboriginal and 240,237 (51.2%) were boys. We report the annual age-specific hospital admission rates by geographical location and diagnostic category. We applied log-linear regression modelling to analyse changes in temporal trends of hospitalizations. Hospitalization rates for skin infections in Aboriginal children (31.7/1000 child-years; 95% confidence interval [CI] 31.0–32.4) were 15.0 times higher (95% CI 14.5–15.5; P<0.001) than those of non-Aboriginal children (2.1/1000 child-years; 95% CI 2.0–2.1). Most admissions in Aboriginal children were due to abscess, cellulitis and scabies (84.3%), while impetigo and pyoderma were the predominant causes in non-Aboriginal children (97.7%). Admissions declined with age, with the highest rates for all skin infections observed in infants. Admissions increased with remoteness. Multiple admissions were more common in Aboriginal children. Excess admissions in Aboriginal children were observed during the wet season in the Kimberley and during summer in metropolitan areas. Our study findings show that skin infections are a significant cause of severe disease, requiring hospitalization in Western Australian children, with Aboriginal children at a particularly high risk. Improved community-level prevention of skin infections and the provision of effective primary care are crucial in reducing the burden of skin infection associated hospitalizations. The contribution of sociodemographic and environmental risk factors warrant further investigation.</p></div

Age-specific hospitalisations in Western Australian Aboriginal and non-Aboriginal children discharged with a principal and/or additional diagnosis of skin infections, 1996–2012.

<p>Age-specific hospitalisations in Western Australian Aboriginal and non-Aboriginal children discharged with a principal and/or additional diagnosis of skin infections, 1996–2012.</p

Summary statistics of available studies by age grouping.

<p>Summary statistics of available studies by age grouping.</p