MRSA eradication of newly acquired lower respiratory tract infection in cystic fibrosis

UK cystic fibrosis (CF) guidelines recommend eradication of methicillin-resistant Staphylococcus aureus (MRSA) when cultured from respiratory samples. As there is no clear consensus as to which eradication regimen is most effective, we determined the efficacy of eradication regimens used in our CF centre and long-term clinical outcome. All new MRSA positive sputum cultures (n=37) that occurred between 2000 and 2014 were reviewed. Eradication regimen characteristics and clinical, microbiological and long-term outcome data were collected. Rifampicin plus fusidic acid was the most frequently used regimen (24 (65%) out of 37 patients), with an overall success rate of 79% (19 out of 24 patients). Eradication failure was more likely in patients with an additional MRSA-positive peripheral screening swab (p=0.03) and was associated with worse survival (p=0.04). Our results demonstrate the feasibility and clinical benefits of MRSA eradication. As peripheral colonisation was associated with lower eradication success, strategies combining systemic and topical treatments should be considered to optimise outcomes in CF patients

The correlation of dust and gas emission in star-forming environments

We present ammonia maps of portions of the W3 and Perseus molecular clouds in order to compare gas emission with submillimetre continuum thermal emission which are commonly used to trace the same mass component in star-forming regions, often under the assumption of local thermodynamic equilibrium (LTE). The Perseus and W3 star-forming regions are found to have significantly different physical characteristics consistent with the difference in size scales traced by our observations. Accounting for the distance of the W3 region does not fully reconcile these differences, suggesting that there may be an underlying difference in the structure of the two regions. Peak positions of submillimetre and ammonia emission do not correlate strongly. Also, the extent of diffuse emission is only moderately matched between ammonia and thermal emission. Source sizes measured from our observations are consistent between regions, although there is a noticeable difference between the submillimetre source sizes with sources in Perseus being significantly smaller than those in W3. Fractional abundances of ammonia are determined for our sources which indicate a dip in the measured ammonia abundance at the positions of peak submillimetre column density. Virial ratios are determined which show that our sources are generally bound in both regions, although there is considerable scatter in both samples. We conclude that sources in Perseus are bound on smaller scales than in W3 in a way that may reflect their previous identification as low- and high-mass, respectively. Our results indicate that assumptions of local thermal equilibrium and/or the coupling of the dust and gas phases in star-forming regions may not be as robust as commonly assumed

The Lesser Role of Shear in Galactic Star Formation Insight from the Galactic Ring Survey

We analyze the role played by shear in regulating star formation in the Galaxy on the scale of individual molecular clouds. The clouds are selected from the 13 CO J = 1-0 line of the Galactic Ring Survey. For each cloud, we estimate the shear parameter which describes the ability of density perturbations to grow within the cloud. We find that for almost all molecular clouds considered, there is no evidence that shear is playing a significant role in opposing the effects of self-gravity. We also find that the shear parameter of the clouds does not depend on their position in the Galaxy. Furthermore, we find no correlations between the shear parameter of the clouds with several indicators of their star formation activity. No significant correlation is found between the shear parameter and the star formation efficiency of the clouds which is measured using the ratio of the massive young stellar objects luminosities, measured in the Red MSX survey, to the cloud mass. There are also no significant correlations between the shear parameter and the fraction of their mass that is found in denser clumps which is a proxy for their clump formation efficiency, nor with their level of fragmentation expressed in the number of clumps per unit mass. Our results strongly suggest that shear is playing only a minor role in affecting the rates and efficiencies at which molecular clouds convert their gas into dense cores and thereafter into stars. © 2012. The American Astronomical Society. All rights reserved

The correlation of dust and gas emission in star-forming environments

This is the final version of the article. Available from the publisher via the DOI in this record.We present ammonia maps of portions of the W3 and Perseus molecular clouds in order to compare gas emission with submillimetre continuum thermal emission which are commonly used to trace the same mass component in star-forming regions, often under the assumption of local thermodynamic equilibrium (LTE). The Perseus and W3 star-forming regions are found to have significantly different physical characteristics consistent with the difference in size scales traced by our observations. Accounting for the distance of theW3 region does not fully reconcile these differences, suggesting that there may be an underlying difference in the structure of the two regions. Peak positions of submillimetre and ammonia emission do not correlate strongly. Also, the extent of diffuse emission is only moderately matched between ammonia and thermal emission. Source sizes measured from our observations are consistent between regions, although there is a noticeable difference between the submillimetre source sizes with sources in Perseus being significantly smaller than those in W3. Fractional abundances of ammonia are determined for our sources which indicate a dip in the measured ammonia abundance at the positions of peak submillimetre column density. Virial ratios are determined which show that our sources are generally bound in both regions, although there is considerable scatter in both samples. We conclude that sources in Perseus are bound on smaller scales than in W3 in a way that may reflect their previous identification as low-and high-mass, respectively. Our results indicate that assumptions of local thermal equilibrium and/or the coupling of the dust and gas phases in star-forming regions may not be as robust as commonly assumed. © 2014 The Authors Published by Oxford University Press on behalf of the Royal Astronomical Society.The authors would like to thank Neal Evans and Erik Rosolowsky for insightful and thorough comments on this work which have considerably improved its quality. The authors acknowledge the data analysis facilities provided by the Starlink Project under continual development by the JAC. In addition, the following Starlink packages have been used: Kappa, Cupid, GAIA, Convert and Coco. We would like to thank the helpful staff of the GBT in the collection of data used in this paper related to the project GBT10C_024. LKM is supported by a STFC postdoctoral grant (ST/G001847/1) and DJE is supported by a STFC PhD studentship. This research would not have been possible without the SIMBAD astronomical data base service operated at CDS, Strasbourg, France and the NASA Astrophysics Data System Bibliographic Services

The Red MSX Source Survey: The Massive Young Stellar Population of Our Galaxy

We present the Red MSX Source survey, the largest statistically selected catalog of young massive protostars and H II regions to date. We outline the construction of the catalog using mid- and near-infrared color selection. We also discuss the detailed follow up work at other wavelengths, including higher spatial resolution data in the infrared. We show that within the adopted selection bounds we are more than 90% complete for the massive protostellar population, with a positional accuracy of the exciting source of better than 2 arcsec. We briefly summarize some of the results that can be obtained from studying the properties of the objects in the catalog as a whole; we find evidence that the most massive stars form: (1) preferentially nearer the Galactic center than the anti-center; (2) in the most heavily reddened environments, suggestive of high accretion rates; and (3) from the most massive cloud cores

A distance-limited sample of massive molecular outflows

We have observed 99 mid-infrared-bright, massive young stellar objects and compact H ii regions drawn from the Red MSX source survey in the J = 3−2 transition of 12CO and 13CO, using the James Clerk Maxwell Telescope. 89 targets are within 6 kpc of the Sun, covering a representative range of luminosities and core masses. These constitute a relatively unbiased sample of bipolar molecular outflows associated with massive star formation. Of these, 59, 17 and 13 sources (66, 19 and 15 per cent) are found to have outflows, show some evidence of outflow, and have no evidence of outflow, respectively. The time-dependent parameters of the high-velocity molecular flows are calculated using a spatially variable dynamic time-scale. The canonical correlations between the outflow parameters and source luminosity are recovered and shown to scale with those of low-mass sources. For coeval star formation, we find the scaling is consistent with all the protostars in an embedded cluster providing the outflow force, with massive stars up to ∼30 M⊙ generating outflows. Taken at face value, the results support the model of a scaled-up version of the accretion-related outflow-generation mechanism associated with discs and jets in low-mass objects with time-averaged accretion rates of ∼10−3 M⊙ yr−1 on to the cores. However, we also suggest an alternative model, in which the molecular outflow dynamics are dominated by the entrained mass and are unrelated to the details of the acceleration mechanism. We find no evidence that outflows contribute significantly to the turbulent kinetic energy of the surrounding dense cores

Microscopic Observation Drug Susceptibility Assay for Rapid Diagnosis of Lymph Node Tuberculosis and Detection of Drug Resistance.

In this study, 132 patients with lymphadenopathy were investigated. Fifty-two (39.4%) were diagnosed with tuberculosis (TB). The microscopic observation drug susceptibility (MODS) assay provided rapid (13 days), accurate diagnosis (sensitivity, 65.4%) and reliable drug susceptibility testing (DST). Despite its lower sensitivity than that of other methods, its faster results and simultaneous DST are advantageous in resource-poor settings, supporting the incorporation of MODS into diagnostic algorithms for extrapulmonary TB

The RMS survey: near-IR spectroscopy of massive young stellar objects

Near-infrared H- and K-band spectra are presented for 247 objects, selected from the Red MSX Source (RMS) survey as potential young stellar objects (YSOs). 195 (∼80 per cent) of the targets are YSOs, of which 131 are massive YSOs (L BOL > 5×10 3 L ⊙ , M > 8 M ⊙ ). This is the largest spectroscopic study of massive YSOs to date, providing a valuable resource for the study of massive star formation. In this paper, we present our exploratory analysis of the data. The YSOs observed have a wide range of embeddedness (2.7 < A V < 114), demonstrating that this study covers minimally obscured objects right through to very red, dusty sources. Almost all YSOs show some evidence for emission lines, though there is a wide variety of observed properties. The most commonly detected lines are Brγ, H 2 , fluorescent Fe ii, CO bandhead, [Fe ii] and He i 2-1 1 S- 1 P, in order of frequency of occurrence. In total, ∼40 per cent of the YSOs display either fluorescent Fe ii 1.6878 μm or CO bandhead emission (or both), indicative of a circumstellar disc; however, no correlation of the strength of these lines with bolometric luminosity was found. We also find that ∼60 per cent of the sources exhibit [Fe ii] or H 2 emission, indicating the presence of an outflow. Three quarters of all sources have Brγ in emission. A good correlation with bolometric luminosity was observed for both the Brγ and H 2 emission line strengths, covering 1 < L BOL < 3.5 × 10 5 L ⊙ . This suggests that the emission mechanism for these lines is the same for low-, intermediate- and high-mass YSOs, i.e. high-mass YSOs appear to resemble scaled-up versions of low-mass YSOs. © 2013 The Authors Published by Oxford University Press on behalf of the Royal Astronomical Society

The Sphaleron Rate in SU(N) Gauge Theory

The sphaleron rate is defined as the diffusion constant for topological number NCS = int g^2 F Fdual/32 pi^2. It establishes the rate of equilibration of axial light quark number in QCD and is of interest both in electroweak baryogenesis and possibly in heavy ion collisions. We calculate the weak-coupling behavior of the SU(3) sphaleron rate, as well as making the most sensible extrapolation towards intermediate coupling which we can. We also study the behavior of the sphaleron rate at weak coupling at large Nc.Comment: 18 pages with 3 figure

Early and efficient detection of Mycobacterium tuberculosis in sputum by microscopic observation of broth cultures.

Early, efficient and inexpensive methods for the detection of pulmonary tuberculosis are urgently needed for effective patient management as well as to interrupt transmission. These methods to detect M. tuberculosis in a timely and affordable way are not yet widely available in resource-limited settings. In a developing-country setting, we prospectively evaluated two methods for culturing and detecting M. tuberculosis in sputum. Sputum samples were cultured in liquid assay (micro broth culture) in microplate wells and growth was detected by microscopic observation, or in Löwenstein-Jensen (LJ) solid media where growth was detected by visual inspection for colonies. Sputum samples were collected from 321 tuberculosis (TB) suspects attending Bugando Medical Centre, in Mwanza, Tanzania, and were cultured in parallel. Pulmonary tuberculosis cases were diagnosed using the American Thoracic Society diagnostic standards. There were a total of 200 (62.3%) pulmonary tuberculosis cases. Liquid assay with microscopic detection detected a significantly higher proportion of cases than LJ solid culture: 89.0% (95% confidence interval [CI], 84.7% to 93.3%) versus 77.0% (95% CI, 71.2% to 82.8%) (p = 0.0007). The median turn around time to diagnose tuberculosis was significantly shorter for micro broth culture than for the LJ solid culture, 9 days (interquartile range [IQR] 7-13), versus 21 days (IQR 14-28) (p<0.0001). The cost for micro broth culture (labor inclusive) in our study was US $4.56 per sample, versus US$11.35 per sample for the LJ solid culture. The liquid assay (micro broth culture) is an early, feasible, and inexpensive method for detection of pulmonary tuberculosis in resource limited settings