Systematic review of antimicrobial drug prescribing in hospitals.

Prudent antibiotic prescribing to hospital inpatients has the potential to reduce the incidences of antimicrobial resistance and healthcare-associated infection. We reviewed the literature from January 1980 to November 2003 to identify rigorous evaluations of interventions to improve hospital antibiotic prescribing. We identified 66 studies with interpretable data of which 16 reported 20 microbiological outcomes: Gram negative resistant bacteria (GNRB), 10 studies; Clostridium difficile associated diarrhoea (CDAD), 5 studies; vancomycin resistant enterococci (VRE), 3 studies and methicillin resistant Staphylococcus aureus (MRSA), 2 studies. Four studies provide good evidence that the intervention changed microbial outcomes with low risk of alternative explanations, eight studies provide less convincing evidence and four studies were negative. The strongest and most consistent evidence was for CDAD but we were able to analyse only the immediate impact of interventions because of nonstandardised durations of follow up. The ability to compare results of studies could be substantially improved by standardising methodology and reporting

Deceleration and Dispersion of Large-scale Coronal Bright Fronts

One of the most dramatic manifestations of solar activity are large-scale coronal bright fronts (CBFs) observed in extreme ultraviolet (EUV) images of the solar atmosphere. To date, the energetics and kinematics of CBFs remain poorly understood, due to the low image cadence and sensitivity of previous EUV imagers and the limited methods used to extract the features. In this paper, the trajectory and morphology of CBFs was determined in order to investigate the varying properties of a sample of CBFs, including their kinematics and pulse shape, dispersion, and dissipation. We have developed a semi-automatic intensity profiling technique to extract the morphology and accurate positions of CBFs in 2.5-10 min cadence images from STEREO/EUVI. The technique was applied to sequences of 171A and 195A images from STEREO/EUVI in order to measure the wave properties of four separate CBF events. Following launch at velocities of ~240-450kms^{-1} each of the four events studied showed significant negative acceleration ranging from ~ -290 to -60ms^{-2}. The CBF spatial and temporal widths were found to increase from ~50 Mm to ~200 Mm and ~100 s to ~1500 s respectively, suggesting that they are dispersive in nature. The variation in position-angle averaged pulse-integrated intensity with propagation shows no clear trend across the four events studied. These results are most consistent with CBFs being dispersive magnetoacoustic waves.Comment: 15 pages, 18 figure

Quantum causal histories

Quantum causal histories are defined to be causal sets with Hilbert spaces attached to each event and local unitary evolution operators. The reflexivity, antisymmetry, and transitivity properties of a causal set are preserved in the quantum history as conditions on the evolution operators. A quantum causal history in which transitivity holds can be treated as ``directed'' topological quantum field theory. Two examples of such histories are described.Comment: 16 pages, epsfig latex. Some clarifications, minor corrections and references added. Version to appear in Classical and Quantum Gravit

Rossby adjustment over a step

The adjustment of a rotating fluid to a geostrophic equilibrium is now a classical problem in the theory of rotating fluids and is associated with the name of Rossby because of his pioneering work in this subject. The case of particular interest here is the one where the fluid is initially at rest but has a discontinuity in surface elevation along a certain line. If the bottom is flat, the adjustment gives rise to a jet flowing along the line of the initial discontinuity, the width of the jet being the Rossby radius of deformation. This paper examines how the flow is modified when the bottom is not flat, but has a step-like discontinuity running perpendicular to the line of the initial jump in surface elevation, giving rise to double Kelvin waves which propagate along the step. Flow is thus diverted parallel to the step, and behind the wave front there is no mass flux across the step.The effect of adding a vertical coast perpendicular to the step is also considered. When the double Kelvin wave propagates offshore, it leaves behind a state with no transport across the step. With propagation toward the coast, however, there is pinching of the longshore current into a narrow boundary layer.The problem is examined using (a) linear analysis, (b) laboratory experiments, and (c) numerical experiments

Irradiation of the secondary star in X-ray Nova Scorpii 1994 (=GRO J1655--40)

We have obtained intermediate resolution optical spectra of the black-hole candidate Nova Sco 1994 in June 1996, when the source was in an X-ray/optical active state (R~15.05). We measure the radial velocity curve of the secondary star and obtain a semi-amplitude of 279+/-10 km/s; a value which is 30 per cent larger than the value obtained when the source is in quiescence. Our large value for K_2 is consistent with 60 +9,-7 per cent of the secondary star's surface being heated; compared to 35 per cent, which is what one would expect if only the inner face of the secondary star were irradiated. Effects such as irradiation-induced flows on the secondary star may be important in explaining the observed large value for K_2.Comment: 5 pages, 2 figures, accepted by MNRA

The application of stochastic machine learning methods in the prediction of skin penetration

Original article can be found at: http://www.sciencedirect.com Copyright ElsevierImproving predictions of skin permeability is a significant problem for which mathematical solutions have been sought for around twenty years. However, the current approaches are limited by the nature of the models chosen and the nature of the dataset. This is an important problem, particularly with the increased use of transdermal and topical drug delivery systems. In this work, we apply K-nearest-neighbour regression, single layer networks, mixture of experts and Gaussian processes to predict the skin permeability coefficient of penetrants. A considerable improvement, both statistically and in terms of the accuracy of predictions, over the current quantitative structure-permeability relationships (QSPRs) was found. Gaussian processes provided the most accurate predictions, when compared to experimentally generated results. It was also shown that using five molecular descriptors - molecular weight, solubility parameter, lipophilicity, the number of hydrogen bonding acceptor and donor groups - can produce better predictions than when using only lipophilicity and the molecular weight, which is an approach commonly found with QSPRs. The Gaussian process regression with five compound features was shown to give the best performance in this work. Therefore, Gaussian processes would appear to provide a viable alternative to the development of predictive models for skin absorption and underpin more realistically mechanistic understandings of the physical process of the percutaneous absorption of exogenous chemicals. (C) 2010 Elsevier B.V. All rights reserved.Peer reviewe

The mass of the neutron star in Cyg X-2 (V1341 Cyg)

Cygnus X-2 is one of the brightest and longest known X-ray sources. We present high resolution optical spectroscopy of Cyg X-2 obtained over 4 years which gives an improved mass function of 0.69 +/- 0.03 Msun (1 sigma error). In addition, we resolve the rotationally broadened absorption features of the secondary star for the first time, deriving a rotation speed of vsin(i) = 34.2 +/- 2.5 km per s (1 sigma error) which leads to a mass ratio of q = M_c/M_x = 0.34 +/- 0.04 (1 sigma error), assuming a tidally-locked and Roche lobe-filling secondary). Hence with the lack of X-ray eclipses (i.e. i <~ 73 degrees) we can set firm 95% confidence lower limits to the neutron star mass of M_x > 1.27 Msun and to the companion star mass of M_c > 0.39 Msun. However, by additionally requiring that the companion must exceed 0.75 Msun (as required theoretically to produce a steady low-mass X-ray binary), then M_x > 1.88 Msun and i < 61 degrees (95% confidence lower and upper limit, respectively), thereby making Cyg X-2 the highest mass neutron star measured to date. If confirmed this would set significant constraints on the equation of state of nuclear matter.Comment: 16 pages, 4 figures, ApJ Letters, accepted, LaTeX, aasms4.st