We examined the effect of an antimicrobial stewardship program (ASP), procalcitonin testing and rapid blood-culture identification on hospital mortality in a prospective quality improvement project in critically ill septic adults. Secondarily, we have reported antimicrobial guideline concordance, acceptance of ASP interventions, and antimicrobial and health-resource utilization.

This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.

Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.

The association between methicillin-resistant Staphylococcus aureus (MRSA) colonisation and/or infection with increased morbidity and mortality among hospital patients has long been recognised. We sought to build on previous studies to identify modifiable risk factors associated with the acquisition of MRSA colonisation and infection by conducting a retrospective cohort study on patients admitted through the Emergency Department of an acute tertiary-care general hospital in Singapore which implemented universal on-admission MRSA screening. Patients were assigned to the acquisition or non-acquisition group depending on whether they acquired MRSA during their admission. We used logistic regression models with a patient being in the acquisition group as the binary outcome to identify factors associated with MRSA acquisition. A total of 1302 acquisition and 37 949 non-acquisition group patients were analysed. Fifteen variables were included in the multivariate model. A dose–response relationship between length of stay and odds of MRSA acquisition was observed, with a length of stay 3 weeks or more (Adj OR 11.78–57.36, all P < 0.001) being the single biggest predictor of MRSA acquisition. Other variables significantly associated with MRSA acquisition were: male gender, age 65 or greater, previous MRSA colonisation or infection, exposure to certain antibiotics and surgery, and history of diabetes.

It is unclear which of four popular contemporary diet patterns is best for weight maintenance among postmenopausal women. Four dietary patterns were characterised among postmenopausal women aged 49–81 years (mean 63·6 (sd 7·4) years) from the Women’s Health Initiative Observational Study: (1) a low-fat diet; (2) a reduced-carbohydrate diet; (3) a Mediterranean-style (Med) diet; and (4) a diet consistent with the US Department of Agriculture’s Dietary Guidelines for Americans (DGA). Discrete-time hazards models were used to compare the risk of weight gain (≥10 %) among high adherers of each diet pattern. In adjusted models, the reduced-carbohydrate diet was inversely related to weight gain (OR 0·71; 95 % CI 0·66, 0·76), whereas the low-fat (OR 1·43; 95 % CI 1·33, 1·54) and DGA (OR 1·24; 95 % CI 1·15, 1·33) diets were associated with increased risk of weight gain. By baseline weight status, the reduced-carbohydrate diet was inversely related to weight gain among women who were normal weight (OR 0·72; 95 % CI 0·63, 0·81), overweight (OR 0·67; 95 % CI 0·59, 0·76) or obese class I (OR 0·63; 95 % CI 0·53, 0·76) at baseline. The low-fat diet was associated with increased risk of weight gain in women who were normal weight (OR 1·28; 95 % CI 1·13, 1·46), overweight (OR 1·60; 95 % CI 1·40, 1·83), obese class I (OR 1·73; 95 % CI 1·43, 2·09) or obese class II (OR 1·44; 95 % CI 1·08, 1·92) at baseline. These findings suggest that a low-fat diet may promote weight gain, whereas a reduced-carbohydrate diet may decrease risk of postmenopausal weight gain.

One of the ways to obtain a detailed 3D ISM map is by gathering interstellar (IS) absorption data toward widely distributed background target stars at known distances (line-of-sight/LOS data). The radial and angular evolution of the LOS measurements allow the inference of the ISM spatial distribution. For a better spatial resolution, one needs a large number of the LOS data. It requires building fast tools to measure IS absorption. One of the tools is a global analysis that fit two different diffuse interstellar bands (DIBs) simultaneously. We derived the equivalent width (EW) ratio of the two DIBs recorded in each spectrum of target stars. The ratio variability can be used to study IS environmental conditions or to detect DIB family.

Stresses at the surface and at depth are calculated for a stretch of Byrd Glacier, Antarctica. The calculations are based on photogrammetrically determined velocities and elevations (Brecher 1986) and on radio-echo-determined ice thicknesses. The results take the form of maps of drags from each valley wall, of normal forces laterally and longitudinally, and of basal drag. Special challenges in the calculation are the numerical gridding of velocity (ensuring that unreasonable short-wavelength features do not develop in the calculation) and inference of ice thicknesses where there are no data.

The results show important variations in basal drag. For the floating part, basal drag is near zero, as expected. Within the grounded part, longitudinal components of basal drag are very variable, reaching 300 kPa, with a dominant wavelength of 10 km. Generally these drag maxima correlate with maxima in driving stress, and the across-glacier component of basal drag is usually small. An important exception occurs in the center of the grounded part of the glacier, where the flow shows major deviations from the axis of the valley.

Results also show that side drag is roughly constant at 250 kPa along both margins of the glacier, tension from the ice shelf is about 100 kPa, and tension in the grounded part cycles between 250 and 150kPa. Calculated deep velocities are too large and this is attributed to deficiencies in the conventional isotropic flow law used.

Epitaxial Ge films are useful as a substrate for high-efficiency solar cell applications. It is possible to grow epitaxial Ge films on low cost, cube textured Ni(001) sheets using CaF2(001) as a buffer layer. Transmission electron microscopy (TEM) analysis indicates that the CaF2(001) lattice has a 45o in-plane rotation relative to the Ni(001) lattice. The in-plane epitaxy relationships are CaF2[110]//Ni[100] and CaF2[ $\bar 1$ 10]//Ni[010]. Energy dispersive spectroscopy (EDS) shows a sharp interface between Ge/CaF2 as well as between CaF2/Ni. Electron backscatter diffraction (EBSD) shows that the Ge(001) film has a large grain size (∼50 μm) with small angle grain boundaries (< 8o). The epitaxial Ge thin film has the potential to be used as a substrate to grow high quality III-V and II-VI semiconductors for optoelectronic applications.

A theoretical framework for low-frequency electromagnetic (drift-)kinetic turbulence in a collisionless, multi-species plasma is presented. The result generalises reduced magnetohydrodynamics (RMHD) and kinetic RMHD (Schekochihin et al., Astrophys. J. Suppl. Ser., vol. 182, 2009, pp. 310–377) to the case where the mean distribution function of the plasma is pressure-anisotropic and different ion species are allowed to drift with respect to each other – a situation routinely encountered in the solar wind and presumably ubiquitous in hot dilute astrophysical plasmas such as the intracluster medium. Two main objectives are achieved. First, in a non-Maxwellian plasma, the relationships between fluctuating fields (e.g. the Alfvén ratio) are order-unity modified compared to the more commonly considered Maxwellian case, and so a quantitative theory is developed to support quantitative measurements now possible in the solar wind. Beyond these order-unity corrections, the main physical feature of low-frequency plasma turbulence survives the generalisation to non-Maxwellian distributions: Alfvénic and compressive fluctuations are energetically decoupled, with the latter passively advected by the former; the Alfvénic cascade is fluid, satisfying RMHD equations (with the Alfvén speed modified by pressure anisotropy and species drifts), whereas the compressive cascade is kinetic and subject to collisionless damping (and for a bi-Maxwellian plasma splits into three independent collisionless cascades). Secondly, the organising principle of this turbulence is elucidated in the form of a conservation law for the appropriately generalised kinetic free energy. It is shown that non-Maxwellian features in the distribution function reduce the rate of phase mixing and the efficacy of magnetic stresses, and that these changes influence the partitioning of free energy amongst the various cascade channels. As the firehose or mirror instability thresholds are approached, the dynamics of the plasma are modified so as to reduce the energetic cost of bending magnetic-field lines or of compressing/rarefying them. Finally, it is shown that this theory can be derived as a long-wavelength limit of non-Maxwellian slab gyrokinetics.

The rapid rise in syphilis cases has prompted a number of public health campaigns to assist men who have sex with men (MSM) recognize and present early with symptoms. This study aimed to investigate the temporal trend of the duration of self-report symptoms and titre of rapid plasma reagin (RPR) in MSM with infectious syphilis. Seven hundred and sixty-one syphilis cases in MSM diagnosed at the Melbourne Sexual Health Centre (MSHC) from 2007–2013 were reviewed. Median duration of symptoms and RPR titres in each year were calculated. The median durations of symptoms with primary and secondary syphilis were 9 [interquartile range (IQR) 6–14] days and 14 (IQR 7–30) days, respectively. The overall median titre of RPR in secondary syphilis (median 128, IQR 64–256) was higher than in primary syphilis (median 4, IQR 1–32) and in early latent syphilis (median 32, IQR 4–64). The median duration of symptoms for primary syphilis, secondary syphilis and titre of RPR level did not change over time. Public health campaigns were not associated with a significant shorter time from onset of symptoms to treatment. Alternative strategies such as more frequent testing of MSM should be promoted to control the syphilis epidemic in Australia.

The phenomena of surface instabilities in a thin power-law fluid during spin coating are investigated. The set of Navier-Stokes equations with non-Newtonian behavior in the region of low Reynolds number serves as a mathematical description of the physical systems. Long-wave perturbation analysis is proposed to derive an evolution equation of the Ostwald de-Waele type fluid to govern the propagation of surface waves. Weakly nonlinear dynamics of film flow is studied by the multiple scales method. The amplitude of instability is determined by a Ginzburg-Landau equation. The study reveals that the degree of power-law index plays a vital role in stabilizing the film flow. The shear-thinning fluid is more unstable than the shear-thickening fluid in the stability analysis. Further, the nonlinear wave speed in the supercritical stability region decreases with increasing values of power-law index.