A global point prevalence survey of antimicrobial use in neonatal intensive care units: The no-more-antibiotics and resistance (NO-MAS-R) study

Background: Global assessment of antimicrobial agents prescribed to infants in the neonatal intensive care unit (NICU) may inform antimicrobial stewardship efforts. Methods: We conducted a one-day global point prevalence study of all antimicrobials provided to NICU infants. Demographic, clinical, and microbiologic data were obtained including NICU level, census, birth weight, gestational/chronologic age, diagnoses, antimicrobial therapy (reason for use; length of therapy), antimicrobial stewardship program (ASP), and 30-day in-hospital mortality. Findings: On July 1, 2019, 26 of infants (580/2,265; range, 0�100; median gestational age, 33 weeks; median birth weight, 1800 g) in 84 NICUs (51, high-income; 33, low-to-middle income) from 29 countries (14, high-income; 15, low-to-middle income) in five continents received �1 antimicrobial agent (92, antibacterial; 19, antifungal; 4, antiviral). The most common reasons for antibiotic therapy were �rule-out� sepsis (32) and �culture-negative� sepsis (16) with ampicillin (40), gentamicin (35), amikacin (19), vancomycin (15), and meropenem (9) used most frequently. For definitive treatment of presumed/confirmed infection, vancomycin (26), amikacin (20), and meropenem (16) were the most prescribed agents. Length of therapy for culture-positive and �culture-negative� infections was 12 days (median; IQR, 8�14) and 7 days (median; IQR, 5�10), respectively. Mortality was 6 (42, infection-related). An NICU ASP was associated with lower rate of antibiotic utilization (p = 0·02). Interpretation: Global NICU antibiotic use was frequent and prolonged regardless of culture results. NICU-specific ASPs were associated with lower antibiotic utilization rates, suggesting the need for their implementation worldwide. Funding: Merck & Co.; The Ohio State University College of Medicine Barnes Medical Student Research Scholarship © 2021 The Author

Combined radar observations of equatorial electrojet irregularities at Jicamarca

Daytime equatorial electrojet plasma irregularities were investigated using five distinct radar diagnostics at Jicamarca including range-time-intensity (RTI) mapping, Faraday rotation, radar imaging, oblique scattering, and multiple-frequency scattering using the new AMISR prototype UHF radar. Data suggest the existence of plasma density striations separated by 3–5 km and propagating slowly downward. The striations may be caused by neutral atmospheric turbulence, and a possible scenario for their formation is discussed. The Doppler shifts of type 1 echoes observed at VHF and UHF frequencies are compared and interpreted in light of a model of Farley Buneman waves based on kinetic ions and fluid electrons with thermal effects included. Finally, the up-down and east-west asymmetries evident in the radar observations are described and quantified

Orographic effects on snow deposition patterns in mountainous terrain

Orographic lifting of air masses and other topographically modified flows induce cloud and precipitation formation at larger scales and preferential deposition of precipitation at smaller scales. In this study, we examine orographic effects on small-scale snowfall patterns in Alpine terrain. A polarimetric X-band radar was deployed in the area of Davos (Switzerland) to determine the spatial variability of precipitation. In order to relate measured precipitation fields to flow dynamics, we model flow fields with the atmospheric prediction model Advanced Regional Prediction System. Additionally, we compare radar reflectivity fields with snow accumulation at the surface as modeled by Alpine3D. We investigate the small-scale precipitation dynamics for one heavy snowfall event in March 2011 at a high resolution of 75 m. The analysis of the vertical and horizontal distribution of radar reflectivity at horizontal polarization and differential reflectivity shows polarimetric signatures of orographic snowfall enhancement near the summit region. Increasing radar reflectivity at horizontal polarization over the windward slopes toward the crest and downwind decreasing reflectivity over the leeward slopes is observed. The temporal variation of the location of maximum concentration of snow particles is partly attributed to the effect of preferential deposition of snowfall: For situations with strong horizontal winds, the concentration maximum is shifted from the ridge crest toward the leeward slopes. Qualitatively, we discuss the relative role of cloud microphysics such as the seeder-feeder mechanism versus atmospheric particle transport in generating the observed snow deposition at the ground. Key Points Orographic snowfall enhancement near the summit region Preferred snow deposition on leeward slopes Snow drift affects reflectivity patterns observed by rada

On new two-dimensional UHF radar observations of equatorial spread F at the Jicamarca Radio Observatory

Abstract We describe a mode for two-dimensional UHF (445 MHz) radar observations of F-region irregularities using the 14-panel version of the advanced modular incoherent scatter radar (AMISR-14). We also present and discuss examples of observations made by this mode. AMISR-14 is installed at the Jicamarca Radio Observatory (JRO, 11.95°S, 76.87°W, ~ 0.5° dip latitude) in Peru and, therefore, allows studies of ionospheric irregularities at the magnetic equator. The new mode takes advantage of the electronic beam-steering capability of the system to scan the equatorial F-region in the east–west direction. Therefore, it produces two-dimensional views of the spatial distribution of sub-meter field-aligned density irregularities in the magnetic equatorial plane. The scans have a temporal resolution of 20 s and allow observations over a zonal distance of approximately 400 km at main F-region heights. While the system has a lower angular and range resolution than interferometric in-beam VHF radar imaging observations available at Jicamarca, it allows a wider field-of-view than that allowed with the VHF system. Here, we describe the mode, and present and discuss examples of observations made with the system. We also discuss implications of these observations for studies of ESF at the JRO. Graphical abstrac

The impact of the Hunga Tonga–Hunga Ha’apai volcanic eruption on the Peruvian atmosphere: from the sea surface to the ionosphere

Abstract The eruption of the Hunga Tonga Hunga Ha’apai volcano on 15 January 2022 significantly impacted the lower and upper atmosphere globally. Using multi-instrument observations, we described disturbances from the sea surface to the ionosphere associated with atmospheric waves generated by the volcanic eruption. Perturbations were detected in atmospheric pressure, horizontal magnetic field, equatorial electrojet (EEJ), ionospheric plasma drifts, total electron content (TEC), mesospheric and lower thermospheric (MLT) neutral winds, and ionospheric virtual height measured at low magnetic latitudes in the western South American sector (mainly in Peru). The eastward Lamb wave propagation was observed at the Jicamarca Radio Observatory on the day of the eruption at 13:50 UT and on its way back from the antipodal point (westward) on the next day at 07:05 UT. Perturbations in the horizontal component of the magnetic field (indicative of EEJ variations) were detected between 12:00 and 22:00 UT. During the same period, GNSS-TEC measurements of traveling ionospheric disturbances (TIDs) coincided approximately with the arrival time of Lamb and tsunami waves. On the other hand, a large westward variation of MLT winds occurred near 18:00 UT over Peru. However, MLT perturbations due to possible westward waves from the antipode have not been identified. In addition, daytime vertical plasma drifts showed an unusual downward behavior between 12:00 and 16:00 UT, followed by an upward enhancement between 16:00 and 19:00 UT. Untypical daytime eastward zonal plasma drifts were observed when westward drifts were expected. Variations in the EEJ are highly correlated with perturbations in the vertical plasma drift exhibiting a counter-equatorial electrojet (CEEJ) between 12:00 and 16:00 UT. These observations of plasma drifts and EEJ are, so far, the only ground-based radar measurements of these parameters in the western South American region after the eruption. We attributed the ion drift and EEJ perturbations to large-scale thermospheric wind variations produced by the eruption, which altered the dynamo electric field in the Hall and Pedersen regions. These types of multiple and simultaneous observations can contribute to advancing our understanding of the ionospheric processes associated with natural hazard events and the interaction with lower atmospheric layers. Graphical Abstrac

Multifrequency Radar Observations Collected in Southern France during HyMeX-SOP1

International audienceThe radar network deployed in Southern France during the first Special Observing Period (SOP1) of the Hydrometeorological Cycle in the Mediterranean Experiment (HyMeX) was designed to precisely document the 3-D structure of moist upstream flow impinging on complex terrain as a function of time, height and along-barrier distance as well as surface rainfall patterns associated with orographic precipitation events. This deployment represents one of the most ambitious field experiments yet endeavoring to collect high quality observations of thunderstorms and precipitation systems developing over and in the vicinity of a major mountain chain. Radar observations collected during HyMeX represent a valuable, and potentially unique, dataset that will be used to improve our knowledge of physical processes at play within coastal orographic heavy precipitating systems as well as to develop, and evaluate, novel radar-based products for research and operational activities. This article provides a concise description of this radar network and discusses innovative research ideas based upon preliminary analyses of radar observations collected during this field project with emphasis on the synergetic use of dual-polarimetric radar measurements collected at multiple frequencies