The Centers for Medicare and Medicaid mandated that nursing homes implement antibiotic stewardship programs (ASPs) by November 2017. We conducted surveys of Wisconsin nursing-home stewardship practices before and after this mandate. Our comparison of these surveys shows an overall increase in ASP implementation efforts, but it also highlights areas for further improvement.

The mechanics underlying ice–skate friction remain uncertain despite over a century of study. In the 1930s, the theory of self-lubrication from frictional heat supplanted an earlier hypothesis that pressure melting governed skate friction. More recently, researchers have suggested that a layer of abraded wear particles or the presence of quasi-liquid molecular layers on the surface of ice could account for its slipperiness. Here, we assess the dominant hypotheses proposed to govern ice–skate friction and describe experiments conducted in an indoor skating rink aimed to provide observations to test these hypotheses. Our results indicate that the brittle failure of ice under rapid compression plays a strong role. Our observations did not confirm the presence of full-contact water films and are more consistent with the presence of lubricating ice-rich slurries at discontinuous high-pressure zones (HPZs). The presence of ice-rich slurries supporting skates through HPZs merges pressure-melting, abrasion and lubricating films as a unified hypothesis for why skates are so slippery across broad ranges of speeds, temperatures and normal loads. We suggest tribometer experiments to overcome the difficulties of investigating these processes during actual skating trials.

We present an overview of the Middle Ages Galaxy Properties with Integral Field Spectroscopy (MAGPI) survey, a Large Program on the European Southern Observatory Very Large Telescope. MAGPI is designed to study the physical drivers of galaxy transformation at a lookback time of 3–4 Gyr, during which the dynamical, morphological, and chemical properties of galaxies are predicted to evolve significantly. The survey uses new medium-deep adaptive optics aided Multi-Unit Spectroscopic Explorer (MUSE) observations of fields selected from the Galaxy and Mass Assembly (GAMA) survey, providing a wealth of publicly available ancillary multi-wavelength data. With these data, MAGPI will map the kinematic and chemical properties of stars and ionised gas for a sample of 60 massive ( ${>}7 \times 10^{10} {\mathrm{M}}_\odot$ ) central galaxies at $0.25 < z <0.35$ in a representative range of environments (isolated, groups and clusters). The spatial resolution delivered by MUSE with Ground Layer Adaptive Optics ( $0.6-0.8$ arcsec FWHM) will facilitate a direct comparison with Integral Field Spectroscopy surveys of the nearby Universe, such as SAMI and MaNGA, and at higher redshifts using adaptive optics, for example, SINS. In addition to the primary (central) galaxy sample, MAGPI will deliver resolved and unresolved spectra for as many as 150 satellite galaxies at $0.25 < z <0.35$ , as well as hundreds of emission-line sources at $z < 6$ . This paper outlines the science goals, survey design, and observing strategy of MAGPI. We also present a first look at the MAGPI data, and the theoretical framework to which MAGPI data will be compared using the current generation of cosmological hydrodynamical simulations including EAGLE, Magneticum, HORIZON-AGN, and Illustris-TNG. Our results show that cosmological hydrodynamical simulations make discrepant predictions in the spatially resolved properties of galaxies at $z\approx 0.3$ . MAGPI observations will place new constraints and allow for tangible improvements in galaxy formation theory.

The population of the recently-described Whenua Hou diving petrel Pelecanoides whenuahouensis comprises c. 200 adults that all breed in a single 0.018 km2 colony in a dune system vulnerable to erosion. The species would therefore benefit from the establishment of a second breeding population through a translocation. However, given the small size of the source population, it is essential that translocations are informed by carefully targeted monitoring data. We therefore modelled nest survival at the remaining population in relation to potential drivers (distance to sea and burrow density of conspecifics and a competitor) across three breeding seasons with varying climatic conditions as a result of the southern oscillation cycle. We also documented breeding phenology and burrow attendance, and measured chicks, to generate growth curves. We estimated egg survival at 0.686, chick survival at 0.890, overall nest survival at 0.612, and found no indication that nest survival was affected by distance to sea or burrow density. Whenua Hou diving petrels laid eggs in mid October, eggs hatched in late November, and chicks fledged in mid January at c. 86% of adult weight. Burrow attendance (i.e. feeds) decreased from 0.94 to 0.65 visits per night as chicks approached fledging. Nest survival and breeding biology were largely consistent among years despite variation in climate. Nest survival estimates will facilitate predictions about future population trends and suitability of prospective translocation sites. Knowledge of breeding phenology will inform the timing of collection of live chicks for translocation, and patterns of burrow attendance combined with growth curves will structure hand-rearing protocols. A tuhinga whakarāpopoto (te reo Māori abstract) can be found in the Supplementary material.

A young adult with late diagnosis of scimitar syndrome underwent infradiaphragmatic baffling of the scimitar vein to left atrium through an intra-atrial tunnel using PhotoFix® bovine pericardium with recurrent extensive fibrovascular granulation of the patch causing pulmonary and systemic venous obstruction leading to eventual explantation of the bovine pericardium.

Underrepresentation of Black biomedical researchers demonstrates continued racial inequity and lack of diversity in the field. The Black Voices in Research curriculum was designed to provide effective instructional materials that showcase inclusive excellence, facilitate the dialog about diversity and inclusion in biomedical research, enhance critical thinking and reflection, integrate diverse visions and worldviews, and ignite action. Instructional materials consist of short videos and discussion prompts featuring Black biomedical research faculty and professionals. Pilot evaluation of instructional content showed that individual stories promoted information relevance, increased knowledge, and created behavioral intention to promote diversity and inclusive excellence in biomedical research.

The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.

We study the evolution of unidirectional water waves from a randomly forced input condition with uncorrelated Fourier components. We examine the kurtosis of the linearised free surface as a convenient proxy for the probability of a rogue wave. We repeat the laboratory experiments of Onorato et al. (Phys. Rev. E, vol. 70, 2004, 067302), both experimentally and numerically, and extend the parameter space in our numerical simulations. We consider numerical simulations based on the modified nonlinear Schrödinger equation and the fully nonlinear water wave equations, which are in good agreement. For low steepness, existing analytical models based on the nonlinear Schrödinger equation (NLS) are found to be accurate. For cases which are steep or have very narrow bandwidths, these analytical models over-predict the rate at which excess kurtosis develops. In these steep cases, the kurtosis in both our experiments and numerical simulations peaks before returning to an equilibrium level. Such transient maxima are not predicted by NLS-based analytical models. Above a certain threshold of steepness, the steady-state value of kurtosis is primarily dependent on the spectral bandwidth. We also examine how the average shape of extreme events is modified by nonlinearity over the evolution distance, showing significant asymmetry during the initial evolution, which is greatly reduced once the spectrum has reached equilibrium. The locations of the maxima in asymmetry coincide approximately with the locations of the maxima in kurtosis.

We have investigated steep three-dimensional surface gravity wave groups formed by dispersive focusing using a fully nonlinear potential flow solver. We find that third-order resonant interactions result in rapid energy transfers to higher wavenumbers and reduced directional spreading during focusing, followed by spectral broadening during defocusing, forming steep wave groups with augmented kinematics and a prolonged lifespan. If the wave group is initially narrow-banded, quasi-degenerate interactions arise, characterised by energy transfers along the resonance angle, ${\pm }35.26^{\circ }$, of the Phillips ‘figure-of-eight’ loop. Spectral broadening due to the quasi-degenerate interactions facilitates non-degenerate interactions, characterised by oblique energy transfers at approximately ${\pm }55^{\circ }$ to the spectral peak. We consider the influence of steepness, finite depth, directional spreading and the high-wavenumber tail on spectral evolution. Steepness is found to augment both the quasi-degenerate and non-degenerate interactions similarly. However, a reduction in depth is found to weaken the quasi-degenerate interactions more severely than the non-degenerate interactions. We observe that increased directional spreading reduces spectral evolution, partially because wave groups with more spreading focus for a shorter duration due to linear dispersion. However, we also find that directional spreading reduces the peak rates of energy transfer. Inclusion of the high-wavenumber tail of the Joint North Sea Wave Project spectrum further reduces rates of energy transfer compared with a Gaussian wavenumber spectrum. Thus, directional spreading and the high-wavenumber tail may be integral to a form of spectral equilibrium that reduces rapid energy transfers during a steep wave event.

In 2017, transgender woman Danica Roem stunned political observers in Virginia by unseating a long-time anti-LGBTQ legislator from a conservative district in the Virginia House of Delegates.1 She was the first openly transgender person elected and seated to a state legislature. Delegate Roem’s election was historic in LGBTQ political representation, but it also occurred in a period when backlash against the LGBTQ community seemed to be growing (Taylor, Lewis, and Haider-Markel 2018). These two threads led us to ask: How are LGBTQ candidates achieving historic successes even as forces seem mobilized against them?

We study direct numerical simulations of turbulence arising from the interaction of an initial background shear, a linear background stratification and an external body force. In each simulation the turbulence produced is spatially intermittent, with dissipation rates varying over orders of magnitude in the vertical. We focus analysis on the statistically quasi-steady states achieved by applying large-scale body forcing to the domain, and compare flows forced by internal gravity waves with those forced by vertically uniform vortical modes. By considering the turbulent energy budgets for each simulation, we find that the injection of potential energy from the wave forcing permits a reversal in the sign of the mean buoyancy flux. This change in the sign of the buoyancy flux is associated with large, convective density overturnings, which in turn lead to more efficient mixing in the wave-forced simulations. The inhomogeneous dissipation in each simulation allows us to investigate localised correlations between the kinetic and potential energy dissipation rates. These correlations lead us to the conclusion that an appropriate definition of an instantaneous mixing efficiency, $\unicode[STIX]{x1D702}(t):=\unicode[STIX]{x1D712}/(\unicode[STIX]{x1D712}+\unicode[STIX]{x1D700})$ (where $\unicode[STIX]{x1D700}$ and $\unicode[STIX]{x1D712}$ are the volume-averaged turbulent viscous dissipation rate and fluctuation density variance destruction rate respectively) in the wave-forced cases is independent of an appropriately defined local turbulent Froude number, consistent with scalings proposed for low Froude number stratified turbulence.