Nationwide antibiogram analysis using NCCLS M39-A guidelines

This is the published version, also available here: http://dx.doi.org/10.1128/JCM.43.6.2629-2634.2005.Lack of standardization in antibiogram (ABGM) preparation (the overall profile of antimicrobial susceptibility results of a microbial species to a battery of antimicrobial agents) has not been addressed until recently. The objective of this study was to analyze current antibiograms using the recently published NCCLS M39-A guidelines for preparation of antibiograms to identify areas for improvement in the reporting of antibiogram susceptibility data. Antibiograms from across the United States were obtained by various methods, including direct mailings, Internet searches, and professional contacts. Each ABGM collected was analyzed using prospectively defined elements from the M39-A guidelines. Additionally, seven quality indicators were also evaluated to look for the reporting of any atypical or inappropriate susceptibility data. The 209 antibiograms collected from 149 institutions showed at least 85% compliance to 5 of the 10 M39-A elements analyzed. Clinically relevant elements not met included annual analysis, duplicate isolate notation, and the exclusion of organisms with fewer than 10 isolates. As for the quality indicators evaluated, unexpected results included the 7% of antibiograms that reported 0% ampicillin susceptibility for Klebsiella pneumoniae. These findings suggest that antibiograms should be reviewed thoroughly by infectious disease specialists (physicians and pharmacists), clinical microbiologists, and infection control personnel for identification of abnormal findings prior to distribution

Evaporation, seepage and water quality management in storage dams: a review of research methods

One of the most significant sources of water wastage in Australia is loss from small storage dams, either by seepage or evaporation. Over much of Australia, evaporative demand routinely exceeds precipitation. This paper outlines first, methodologies and measurement techniques to quantify the rate of evaporative loss from fresh water storages. These encompass high-accuracy water balance monitoring; determination of the validity of alternative estimation equations, in particular the FAO56 Penman- Monteith ETo methodology; and the commencement of CFD modeling to determine a 'dam factor' in relation to practical atmospheric measurement techniques. Second, because the application of chemical monolayers is the only feasible alternative to the high cost of physically covering the storages to retard evaporation, the use of cetyl alcohol-based monolayers is reviewed, and preliminary research on their degradation by photolytic action, by wind break-up and by microbial degradation reported. Similarly, preliminary research on monolayer visualisation techniques for field application is reported; and potential enhancement of monolayers by other chemicals and attendant water quality issues are considered

Antibiotic prescribing in UK out-of-hours primary care services: a realist-informed scoping review of training and guidelines for healthcare professionals

Background: Antibiotic overuse has contributed to antimicrobial resistance, which is a global public health problem. In the UK, despite the fall in rates of antibiotic prescription since 2013, prescribing levels remain high in comparison with other European countries. Prescribing in out-of-hours (OOH) care provides unique challenges for prudent prescribing, for which professionals may not be prepared. Aim: To explore the guidance available to professionals on prescribing antibiotics for common infections in OOH primary care within the UK, with a focus on training resources, guidelines, and clinical recommendations. Design & setting: A realist-informed scoping review of peer-reviewed articles and grey literature. Method: The review focused on antibiotic prescribing OOH (for example, clinical guidelines and training videos). General prescribing guidance was searched whenever OOH-focused resources were unavailable. Electronic databases and websites of national agencies and professional societies were searched following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Findings were organised according to realist review components, that is, mechanisms, contexts, and outcomes. Results: In total, 46 clinical guidelines and eight training resources were identified. Clinical guidelines targeted adults and children, and included recommendations on prescription strategy, spectrum of the antibiotic prescribed, communication with patients, treatment duration, and decision-making processes. No clinical guidelines or training resources focusing specifically on OOH were found. Conclusion: The results highlight a lack of knowledge about whether existing resources address the challenges faced by OOH antibiotic prescribers. Further research is needed to explore the training needs of OOH health professionals, and whether further OOH-focused resources need to be developed given the rates of antibiotic prescribing in this setting

Rotation of planet-harbouring stars

The rotation rate of a star has important implications for the detectability, characterisation and stability of any planets that may be orbiting it. This chapter gives a brief overview of stellar rotation before describing the methods used to measure the rotation periods of planet host stars, the factors affecting the evolution of a star's rotation rate, stellar age estimates based on rotation, and an overview of the observed trends in the rotation properties of stars with planets.Comment: 16 pages, 4 figures: Invited review to appear in 'Handbook of Exoplanets', Springer Reference Works, edited by Hans J. Deeg and Juan Antonio Belmont

Near-infrared line imaging of the starburst galaxies NGC 520, NGC 1614 and NGC 7714

We present high spatial resolution (0.6 arcsec) near-infrared broad-band JHK images and Br_gamma 2.1661 micron and H_2 1-0 S(1) 2.122 micron emission line images of the nuclear regions in the interacting starburst galaxies NGC 520, NGC 1614 and NGC 7714. The near-infrared emission line and radio morphologies are in general agreement, although there are differences in details. In NGC 1614, we detect a nuclear double structure in Br_gamma, in agreement with the radio double structure. We derive average extinctions of A(K) = 0.41 and A(K) = 0.18 toward the nuclear regions of NGC 1614 and NGC 7714, respectively. For NGC 520, the extinction is much higher, A(K) = 1.2 - 1.6. The observed H_2/Br_gamma ratios indicate that the main excitation mechanism of the molecular gas is fluorescence by intense UV radiation from clusters of hot young stars, while shock excitation can be ruled out. The starburst regions in all galaxies exhibit small Br_gamma equivalent widths. Assuming a constant star formation model, even with a lowered upper mass cutoff of M_u = 30 M_o, results in rather old ages (10 - 40 Myr), in disagreement with the clumpy near-infrared morphologies. We prefer a model of an instantaneous burst of star formation with M_u = 100 M_o, occurring 6 - 7 Myr ago, in agreement with previous determinations and with the detection of W-R features in NGC 1614 and NGC 7714. Finally, we note a possible systematic difference in the amount of hot molecular gas between starburst and Seyfert galaxies.Comment: 13 pages, A&A, accepte

Treatment patterns and standardized outcome assessments among patients with inflammatory conditions of the pouch in a prospective multicenter registry

BACKGROUND: Much of our understanding about the natural history of pouch-related disorders has been generated from selected populations. We designed a geographically diverse, prospective registry to study the disease course among patients with 1 of 4 inflammatory conditions of the pouch. The primary objectives in this study were to demonstrate the feasibility of a prospective pouch registry and to evaluate the predominant treatment patterns for pouch-related disorders. METHODS: We used standardized diagnostic criteria to prospectively enroll patients with acute pouchitis, chronic antibiotic-dependent pouchitis (CADP), chronic antibiotic refractory pouchitis (CARP), or Crohn\u27s disease (CD) of the pouch. We obtained detailed clinical and demographic data at the time of enrollment, along with patient-reported outcome (PRO) measures. RESULTS: We enrolled 318 patients (10% acute pouchitis, 27% CADP, 12% CARP, and 51% CD of the pouch). Among all patients, 55% were on a biologic or small molecule therapy. Patients with CD of the pouch were more likely to use several classes of therapy ( CONCLUSIONS: In a population where most patients had refractory inflammatory conditions of the pouch, we established a framework to evaluate PROs and clinical effectiveness. This infrastructure will be valuable for long-term studies of real-world effectiveness for pouch-related disorders

Mental health and other factors associated with work productivity post injury in the UK: multicentre cohort study

Introduction: Mental health conditions are a major contributor to productivity loss and are common post-injury. This study quantifies post-injury productivity loss and its association with pre and post-injury mental health, injury, demographic, health, social and other factors. Methods: Multi-centre, longitudinal study recruiting hospitalised 16-69-year-old employed individuals with unintentional injuries, followed-up at 1,2,4 and 12 months. Participants completed questionnaires on injury, demographic factors, health (including mental health), social factors, other factors and on-the-job productivity upon return to work (RTW). Odds ratios were estimated for above median productivity loss, using random effects logistic regression. Results: 217 adults had made a RTW at 2,4 or 12-months post-injury: 29% at 2-months, 66% at 4-months, and 83% at 12-months. Productivity loss reduced over time: 3.3% of working time at 2-months, 1.7% at 4-months, 1% at 12-months. Significantly higher productivity loss was associated with pre-injury psychiatric conditions (OR 21.40, 95% CI: 3.50, 130.78) and posttraumatic stress avoidance symptoms at 1-month (OR for one-unit increase in score 1.15, 95%CI 1.07, 1.22). Significantly lower productivity loss was associated with male gender (OR 0.32, 95%CI 0.14, 0.74), upper and lower limb injuries (vs other body regions, OR 0.15, 95% CI: 0.03, 0.81), and sports injuries (vs. home, OR 0.18, 95% CI: 0.04, 0.78). Pre-injury psychiatric conditions and gender remained significant in analysis of multiply imputed data. Conclusions: Unintentional injury results in substantial productivity loss. Those with pre-injury psychiatric conditions, females and posttraumatic stress avoidance symptoms experience greater productivity loss and may require additional support to successfully RTW

Exact Hypersurface-Homogeneous Solutions in Cosmology and Astrophysics

A framework is introduced which explains the existence and similarities of most exact solutions of the Einstein equations with a wide range of sources for the class of hypersurface-homogeneous spacetimes which admit a Hamiltonian formulation. This class includes the spatially homogeneous cosmological models and the astrophysically interesting static spherically symmetric models as well as the stationary cylindrically symmetric models. The framework involves methods for finding and exploiting hidden symmetries and invariant submanifolds of the Hamiltonian formulation of the field equations. It unifies, simplifies and extends most known work on hypersurface-homogeneous exact solutions. It is shown that the same framework is also relevant to gravitational theories with a similar structure, like Brans-Dicke or higher-dimensional theories.Comment: 41 pages, REVTEX/LaTeX 2.09 file (don't use LaTeX2e !!!) Accepted for publication in Phys. Rev.

Harnessing the NEON data revolution to advance open environmental science with a diverse and data-capable community

It is a critical time to reflect on the National Ecological Observatory Network (NEON) science to date as well as envision what research can be done right now with NEON (and other) data and what training is needed to enable a diverse user community. NEON became fully operational in May 2019 and has pivoted from planning and construction to operation and maintenance. In this overview, the history of and foundational thinking around NEON are discussed. A framework of open science is described with a discussion of how NEON can be situated as part of a larger data constellation—across existing networks and different suites of ecological measurements and sensors. Next, a synthesis of early NEON science, based on \u3e100 existing publications, funded proposal efforts, and emergent science at the very first NEON Science Summit (hosted by Earth Lab at the University of Colorado Boulder in October 2019) is provided. Key questions that the ecology community will address with NEON data in the next 10 yr are outlined, from understanding drivers of biodiversity across spatial and temporal scales to defining complex feedback mechanisms in human–environmental systems. Last, the essential elements needed to engage and support a diverse and inclusive NEON user community are highlighted: training resources and tools that are openly available, funding for broad community engagement initiatives, and a mechanism to share and advertise those opportunities. NEON users require both the skills to work with NEON data and the ecological or environmental science domain knowledge to understand and interpret them. This paper synthesizes early directions in the community’s use of NEON data, and opportunities for the next 10 yr of NEON operations in emergent science themes, open science best practices, education and training, and community building