Faecal carriage of antibiotic resistant Escherichia coli in asymptomatic children and associations with primary care antibiotic prescribing: a systematic review and meta-analysis

Background The faecal reservoir provides optimal conditions for the transmission of resistance genes within and between bacterial species. As key transmitters of infection within communities, children are likely important contributors to endemic community resistance. We sought to determine the prevalence of antibiotic-resistant faecal Escherichia coli from asymptomatic children aged between 0 and 17 years worldwide, and investigate the impact of routinely prescribed primary care antibiotics to that resistance. Methods A systematic search of Medline, Embase, Cochrane and Web of Knowledge databases from 1940 to 2015. Pooled resistance prevalence for common primary care antibiotics, stratified by study country OECD status. Random-effects meta-analysis to explore the association between antibiotic exposure and resistance. Results Thirty-four studies were included. In OECD countries, the pooled resistance prevalence to tetracycline was 37.7 % (95 % CI: 25.9–49.7 %); ampicillin 37.6 % (24.9–54.3 %); and trimethoprim 28.6 % (2.2–71.0 %). Resistance in non-OECD countries was uniformly higher: tetracycline 80.0 % (59.7–95.3 %); ampicillin 67.2 % (45.8–84.9 %); and trimethoprim 81.3 % (40.4–100 %). We found evidence of an association between primary care prescribed antibiotics and resistance lasting for up to 3 months post-prescribing (pooled OR: 1.65, 1.36–2.0). Conclusions Resistance to many primary care prescribed antibiotics is common among faecal E. coli carried by asymptomatic children, with higher resistance rates in non-OECD countries. Despite tetracycline being contra-indicated in children, tetracycline resistance rates were high suggesting children could be important recipients and transmitters of resistant bacteria, or that use of other antibiotics is leading to tetracycline resistance via inter-bacteria resistance transmission

Impacts of hemispheric solar geoengineering on tropical cyclone frequency

Solar geoengineering refers to a range of proposed methods for counteracting global warming by artificially reducing sunlight at Earth’s surface. The most widely known SG proposal is stratospheric aerosol injection (SAI) which has impacts analogous to those from volcanic eruptions. Observations following major volcanic eruptions indicate that aerosol enhancements confined to a single hemisphere effectively modulate North Atlantic tropical cyclone (TC) activity in the following years. Here we investigate the effects of both single-hemisphere and global SAI scenarios on North Atlantic TC activity using the HadGEM2-ES general circulation model and various TC identification methods. We show that a robust result from all of the methods is that SAI applied to the southern hemisphere would enhance TC frequency relative to a global SAI application, and vice versa for SAI in the northern hemisphere. Our results reemphasize the perils of regional geoengineering and should motivate policymakers to regulate large-scale unilateral geoengineering deployments

Forecasting the extreme rainfall, low temperatures, and strong winds associated with the northern Queensland floods of February 2019

From late January to early February 2019, a quasi-stationary monsoon depression situated over northeast Australia caused devastating floods, killing an estimated 625,000 head of cattle in northwest Queensland, and inundating over 3 000 homes in the coastal city of Townsville. The monsoon depression lasted ~10 days, driving daily rainfall accumulations exceeding 200 mm/day, maximum temperatures 8–10 °C below normal, and wind gusts above 70 km/h. In this study, the atmospheric conditions during the event and its predictability on the weekly to subseasonal range are investigated. Results show that during the event, the tropical convective signal of the Madden-Julian Oscillation was over the western Pacific, and likely contributed to the heavy rainfall, however the El Niño-Southern Oscillation was not in the usual phase for increased rainfall over Queensland. Over the northern Tasman Sea, an anticyclone helped maintain a positive phase of the Southern Annular Mode and promote onshore easterly flow. Somewhat consistent with these climate drivers, the monthly rainfall outlook for February issued by the Australian Bureau of Meteorology on 31 January provided no indication of the event, yet forecasts, not available to the public, of weekly-averaged conditions by the Bureau's dynamical subseasonal-to-seasonal (S2S) prediction system were more successful. For the week of 31 January to 6 February the prediction system forecast a more than doubling of the probability of extreme (highest quintile) weekly rainfall a week prior to the event, along with increased probabilities of extremely low (lowest quintile) maximum temperatures and extreme (highest quintile) wind speeds. Ensemble-mean weekly rainfall amounts, however, were considerably underestimated by the prediction system, even in forecasts initialised at the start of the peak flooding week, consistent with other state-of-the-art dynamical S2S prediction systems. Despite this, one of the individual ensemble members of the Bureau's prediction system did manage to forecast close to 85% of the magnitude of the rainfall across the most heavily impacted region of northwest Queensland a week before the event. Predicting this exceptional event beyond two weeks appears beyond our current capability despite the dynamical system forecasts showing good skill in forecasting the broad-scale atmospheric conditions north of Australia a week prior

Empirical mass-loss rates and clumping properties of Galactic early-type O supergiants

International audienceAims. We investigate the impact of optically thick clumping on spectroscopic stellar wind diagnostics in O supergiants and constrain wind parameters associated with porosity in velocity space. This is the first time the effects of optically thick clumping have been investigated for a sample of massive hot stars, using models which include a full optically thick clumping description. Methods. We re-analyse existing spectroscopic observations of a sample of eight O supergiants previously analysed with the non-local-thermodynamic-equilibrium (NLTE) atmosphere code CMFGEN. Using a genetic algorithm wrapper around the NLTE atmosphere code FASTWIND we obtain simultaneous fits to optical and ultraviolet spectra and determine photospheric properties, chemical surface abundances and wind properties. Results. We provide empirical constraints on a number of wind parameters including the clumping factors, mass-loss rates and terminal wind velocities. Additionally, we establish the first systematic empirical constraints on velocity filling factors and interclump densities. These are parameters that describe clump distribution in velocity-space and density of the interclump medium in physical-space, respectively. We observe a mass-loss rate reduction of a factor of 3.6 compared to theoretical predictions from Vink et al. (2000), and mass-loss rates within a factor 1.4 of theoretical predictions from Björklund et al. (2021). Conclusions. We confirm that including optically thick clumping allows simultaneous fitting of optical recombination lines and ultraviolet resonance lines, including the unsaturated ultraviolet phosphorus lines (P v λλ1118-1128), without reducing the phosphorus abundance. We find that, on average, half of the wind velocity field is covered by dense clumps. We also find that these clumps are 25 times denser than the average wind, and that the interclump medium is 3-10 times less dense than the mean wind. The former result agrees well with theoretical predictions, the latter suggests that lateral filling-in of radially compressed gas might be critical for setting the scale of the rarefied interclump matter

The coMforT study of a trauma-informed mindfulness intervention for women who have experienced domestic violence and abuse:a protocol for an intervention refinement and individually randomised parallel feasibility trial

Background Domestic violence and abuse (DVA) is common and destructive to health. Post-traumatic stress disorder (PTSD) is a major mental health consequence of DVA. People who have experienced DVA have specific needs, arising from the repeated and complex nature of the trauma. The National Institute for Health and Care Excellence recommends more research on the effectiveness of psychological interventions for people who have experienced DVA. There is growing evidence that mindfulness-based interventions may help trauma symptoms. Methods Intervention refinement and randomized controlled feasibility trial. A prototype trauma-informed mindfulness-based cognitive therapy (TI-MBCT) intervention will be co-produced following qualitative interviews and consensus exercise with stakeholders. Participants in the feasibility trial will be recruited from DVA agencies in two geographical regions and randomized to receive either TI-MBCT or usual care (self-referral to the Improving Access to Psychological Therapies (IAPT) service). TI-MBCT will be delivered as a group-based eight-week program. It will not be possible to blind the participants or the assessors to the study allocation. The following factors will inform the feasibility of progressing to a fully powered trial: recruitment, retention, intervention fidelity, and the acceptability of the intervention and trial design to participants. We will also test the feasibility of measuring the following participant outcomes before and 6 months post-randomization: PTSD, dissociative symptoms, depression, anxiety, DVA re-victimization, self-compassion, and mother-reported child health. Process evaluation and economic analysis will be embedded within the feasibility trial. Discussion This study will lead to the development of a TI-MBCT intervention for DVA survivors with PTSD and inform the feasibility and design of a fully powered randomized controlled trial (RCT). The full trial will aim to determine the effectiveness and cost-effectiveness of a TI-MBCT intervention in improving the clinically important symptoms of PTSD in DVA survivors

Is HR 6819 a triple system containing a black hole? -- An alternative explanation

HR 6819 was recently proposed to be a triple system consisting of an inner B-type giant + black hole binary with an orbital period of 40d and an outer Be tertiary. This interpretation is mainly based on two inferences: that the emission attributed to the outer Be star is stationary, and that the inner star, which is used as mass calibrator for the black hole, is a B-type giant. We re-investigate the properties of HR 6819 by spectral disentangling and an atmosphere analysis of the disentangled spectra to search for a possibly simpler alternative explanation for HR 6819. Disentangling implies that the Be component is not a static tertiary, but rather a component of the binary in the 40-d orbit. The inferred radial velocity amplitudes imply an extreme mass ratio of M_2/M_1 = 15 +/- 3. We infer spectroscopic masses of 0.4$^{+0.3}_{-0.1}$ Msun and 6$^{+5}_{-3}$ Msun for the primary and secondary, which agree well with the dynamical masses for an inclination of i = 32 deg. This indicates that the primary might be a stripped star rather than a B-type giant. Evolutionary modelling suggests that a possible progenitor system would be a tight (P_i ~ 2d) B+B binary system that experienced conservative mass transfer. While the observed nitrogen enrichment of the primary conforms with the predictions of the evolutionary models, we find no indications for the predicted He enrichment. We suggest that HR 6819 is a binary system consisting of a stripped B-type primary and a rapidly-rotating Be star that formed from a previous mass-transfer event. In the framework of this interpretation, HR 6819 does not contain a black hole. Interferometry can distinguish between these two scenarios by providing an independent measurement of the separation between the visible components.Comment: Submitted to A&A, 13 pages (16 figures and 2 tables); 4 pages supplementary material (4 figures and 4 tables). Comments are welcom

Playing with language, creating complexity:has play contributed to the evolution of complex language?

We argue that enhanced play may have contributed to the emergence of complex language systems in modern humans (Homo sapiens). To support this idea, we first discuss evidence for an expansion of playing behavior connected to the extended childhood of modern human children, and the potential of this period for the transmission of complex cultural traits, including language. We then link two of the most important functions of play-exploration and innovation-to the potential for cumulative cultural evolution in general and for the emergence of complex language in particular. If correct, the shorter childhood of Neanderthals-involving restrictions on time to experiment and innovate-may have restricted their language (and other symbolic) system/s. Consequently, fully investigating the role that play may have had in the transmission of language and the development of symbolic cultures in both modern humans and Neanderthals provides a new avenue of research for Paleolithic archaeology and related disciplines.</p

The partitioning of poleward energy transport response between the atmosphere and Ekman flux to prescribed surface forcing in a simplified GCM

Recent studies have indicated that ocean circulation damps the atmospheric energy transport response to hemispherically differential energy perturbations, thereby muting the shifts of the Inter-Tropical Convergence Zone (ITCZ). Here, we focus on the potential role of Ekman heat transport in modulating this atmospheric response. An idealized representation of Ekman-driven heat transport (FE) is included in an aquaplanet slab ocean coupled to a gray radiation atmospheric model. We first alter the strength of FE in the control climate by tuning the gross stability of the Ekman layer SE. For a wide range of FE, the total poleward transport of energy remains nearly unchanged, but the ocean transports an increasing share for larger SE. The control climate is then perturbed by adding surface cooling in the Southern Hemisphere and warming in the Northern Hemisphere. The Ekman coupling damps the atmospheric energy transport response, as in previous coupled model experiments with full ocean dynamics. The ratio of the changes in Ekman to atmospheric energy transport is determined by the ratio of the gross stability in the Ekman layer to the atmosphere in the control climate, and is insensitive to the amplitude and location of forcing. We find that an unrealistically large SE is needed to reproduce the ratio of the changes in cross-equatorial oceanic to atmospheric energy transport in fully coupled models. The limited damping effect of Ekman transport highlights the need to examine the roles of deep circulation and subtropical gyres, as well as ocean heat uptake processes

The bashful and the boastful : prestigious leaders and social change in Mesolithic Societies

The creation and maintenance of influential leaders and authorities is one of the key themes of archaeological and historical enquiry. However the social dynamics of authorities and leaders in the Mesolithic remains a largely unexplored area of study. The role and influence of authorities can be remarkably different in different situations yet they exist in all societies and in almost all social contexts from playgrounds to parliaments. Here we explore the literature on the dynamics of authority creation, maintenance and contestation in egalitarian societies, and discuss the implications for our interpretation and understanding of the formation of authorities and leaders and changing social relationships within the Mesolithic