Approaching zero : temporal effects of a restrictive antibiotic policy on hospital-acquired Clostridium difficile, extended-spectrum β-lactamase-producing coliforms and meticillin-resistant Staphylococcus aureus

A restrictive antibiotic policy banning routine use of ceftriaxone and ciprofloxacin was implemented in a 450-bed district general hospital following an educational campaign. Monthly consumption of nine antibiotics was monitored in defined daily doses (DDDs) per 1000 patient-occupied bed-days (1000 pt-bds) 9 months before until 16 months after policy introduction. Hospital-acquired Clostridium difficile, meticillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum -lactamase (ESBL)- producing coliform cases per month/1000 pt-bds were identified and reviewed throughout the hospital. Between the first and final 6 months of the study, average monthly consumption of ceftriaxone reduced by 95% (from 46.213 to 2.129 DDDs/1000 pt-bds) and that for ciprofloxacin by 72.5% (109.804 to 30.205 DDDs/1000 pt-bds). Over the same periods, hospital-acquisition rates for C. difficile reduced by 77% (2.398 to 0.549 cases/1000 pt-bds), for MRSA by 25% (1.187 to 0.894 cases/1000 pt-bds) and for ESBL-producing coliforms by 17% (1.480 to 1.224 cases/1000 pt-bds). Time-lag modelling confirmed significant associations between ceftriaxone and C. difficile cases at 1 month (correlation 0.83; P < 0.005), and between ciprofloxacin and ESBL-producing coliform cases at 2 months (correlation 0.649; P = 0.002). An audit performed 3 years after the policy showed sustained reduction in C. difficile rates (0.259 cases/1000 pt-bds), with additional decreases for MRSA (0.409 cases/1000 pt-bds) and ESBL-producing coliforms (0.809 cases/1000 pt-bds). In conclusion, banning two antibiotics resulted in an immediate and profound reduction in hospital-acquired C. difficile, with possible longer-term effects on MRSA and ESBL-producing coliform rates. Antibiotic stewardship is fundamental in the control of major hospital pathogens

Order Parameter Description of the Anderson-Mott Transition

An order parameter description of the Anderson-Mott transition (AMT) is given. We first derive an order parameter field theory for the AMT, and then present a mean-field solution. It is shown that the mean-field critical exponents are exact above the upper critical dimension. Renormalization group methods are then used to show that a random-field like term is generated under renormalization. This leads to similarities between the AMT and random-field magnets, and to an upper critical dimension $d_{c}^{+}=6$ for the AMT. For $d<6$, an $\epsilon = 6-d$ expansion is used to calculate the critical exponents. To first order in $\epsilon$ they are found to coincide with the exponents for the random-field Ising model. We then discuss a general scaling theory for the AMT. Some well established scaling relations, such as Wegner's scaling law, are found to be modified due to random-field effects. New experiments are proposed to test for random-field aspects of the AMT.Comment: 28pp., REVTeX, no figure

The Anderson-Mott Transition as a Random-Field Problem

The Anderson-Mott transition of disordered interacting electrons is shown to share many physical and technical features with classical random-field systems. A renormalization group study of an order parameter field theory for the Anderson-Mott transition shows that random-field terms appear at one-loop order. They lead to an upper critical dimension $d_{c}^{+}=6$ for this model. For $d>6$ the critical behavior is mean-field like. For $d<6$ an $\epsilon$-expansion yields exponents that coincide with those for the random-field Ising model. Implications of these results are discussed.Comment: 8pp, REVTeX, db/94/

Vector bundles on the projective line and finite domination of chain complexes

Finitely dominated chain complexes over a Laurent polynomial ring in one indeterminate are characterised by vanishing of their Novikov homology. We present an algebro-geometric approach to this result, based on extension of chain complexes to sheaves on the projective line. We also discuss the K-theoretical obstruction to extension.Comment: v1: 11 page

The effect of rare regions on a disordered itinerant quantum antiferromagnet with cubic anisotropy

We study the quantum phase transition of an itinerant antiferromagnet with cubic anisotropy in the presence of quenched disorder, paying particular attention to the locally ordered spatial regions that form in the Griffiths region. We derive an effective action where these rare regions are described in terms of static annealed disorder. A one loop renormalization group analysis of the effective action shows that for order parameter dimensions $p<4$ the rare regions destroy the conventional critical behavior. For order parameter dimensions $p>4$ the critical behavior is not influenced by the rare regions, it is described by the conventional dirty cubic fixed point. We also discuss the influence of the rare regions on the fluctuation-driven first-order transition in this system.Comment: 6 pages RevTe

Properties of the random field Ising model in a transverse magnetic field

We consider the effect of a random longitudinal field on the Ising model in a transverse magnetic field. For spatial dimension $d > 2$, there is at low strength of randomness and transverse field, a phase with true long range order which is destroyed at higher values of the randomness or transverse field. The properties of the quantum phase transition at zero temperature are controlled by a fixed point with no quantum fluctuations. This fixed point also controls the classical finite temperature phase transition in this model. Many critical properties of the quantum transition are therefore identical to those of the classical transition. In particular, we argue that the dynamical scaling is activated, i.e, the logarithm of the diverging time scale rises as a power of the diverging length scale

On the critical behavior of disordered quantum magnets: The relevance of rare regions

The effects of quenched disorder on the critical properties of itinerant quantum antiferromagnets and ferromagnets are considered. Particular attention is paid to locally ordered spatial regions that are formed in the presence of quenched disorder even when the bulk system is still in the paramagnetic phase. These rare regions or local moments are reflected in the existence of spatially inhomogeneous saddle points of the Landau-Ginzburg-Wilson functional. We derive an effective theory that takes into account small fluctuations around all of these saddle points. The resulting free energy functional contains a new term in addition to those obtained within the conventional perturbative approach, and it comprises what would be considered non-perturbative effects within the latter. A renormalization group analysis shows that in the case of antiferromagnets, the previously found critical fixed point is unstable with respect to this new term, and that no stable critical fixed point exists at one-loop order. This is contrasted with the case of itinerant ferromagnets, where we find that the previously found critical behavior is unaffected by the rare regions due to an effective long-ranged interaction between the order parameter fluctuations.Comment: 16 pp., REVTeX, epsf, 2 figs, final version as publishe

Propagation inhibition and wave localization in a 2D random liquid medium

Acoustic propagation and scattering in water containing many parallel air-filled cylinders is studied. Two situations are considered and compared: (1) wave propagating through the array of cylinders, imitating a traditional experimental setup, and (2) wave transmitted from a source located inside the ensemble. We show that waves can be blocked from propagation by disorders in the first scenario, but the inhibition does not necessarily imply wave localization. Furthermore, the results reveal the phenomenon of wave localization in a range of frequencies.Comment: Typos in Fiures are correcte

Conductivity Due to Classical Phase Fluctuations in a Model For High-T_c Superconductors

We consider the real part of the conductivity, \sigma_1(\omega), arising from classical phase fluctuations in a model for high-T_c superconductors. We show that the frequency integral of that conductivity, \int_0^\infty \sigma_1 d\omega, is non-zero below the superconducting transition temperature $T_c$, provided there is some quenched disorder in the system. Furthermore, for a fixed amount of quenched disorder, this integral at low temperatures is proportional to the zero-temperature superfluid density, in agreement with experiment. We calculate \sigma_1(\omega) explicitly for a model of overdamped phase fluctuations.Comment: 4pages, 2figures, submitted to Phys.Rev.

Spin glass models with Kac interactions

In this paper I will review my work on disordered systems -spin glass model with two body and $p>2$ body interactions- with long but finite interaction range $R$. I will describe the relation of these model with Mean Field Theory in the Kac limit and some attempts to go beyond mean field.Comment: Proceedings of the Stat-phys23 conferenc