Antifungal stewardship in the UK: where are we now?

Background: Antifungal stewardship (AFS) is the judicious use of today's antifungal agents with the aim of improving patient outcomes and preserving their future effectiveness. Antifungal resistance (AFR) is increasing globally, with more patients at risk of Invasive Fungal Disease (IFD), highlighting the urgent need to standardize AFS practices in the UK. The aim of this position paper is to understand the current AFS landscape in the UK.

Hospital-treated serious and invasive aspergillosis and candidiasis infections during the COVID-19 pandemic: a retrospective analysis of Hospital Episode Statistics data from England.

Objectives: To investigate the impact of COVID-19 on the burden of hospital-treated and infections in England.

Design: A retrospective study using Hospital Episodes Statistics data to estimate the burden of serious and invasive fungal infections (SIFIs) in all patients admitted in England during March 2018-February 2020 (pre-COVID-19) and during March 2020-October 2021 (the COVID-19 period).

Setting: Hospitals in England.

Practice-relevant model validation: distributional parameter risk analysis in financial model risk management.

An objective of model validation within organisations is to provide guidance on model selection decisions that balance the operational effectiveness and structural complexity of competing models. We consider a practice-relevant model validation scenario where a financial quantitative analysis team seeks to decide between incumbent and alternative models on the basis of parameter risk. We devise a model risk management methodology that gives a meaningful distributional assessment of parameter risk in a setting where market calibration and historical estimation procedures must be jointly applied.

A model of gross primary productivity based on satellite data suggests formerly afforested peatlands undergoing restoration regain full photosynthesis capacity after five to ten years.

Peatlands are an important terrestrial carbon store, but disturbance has resulted in the degradation of many peatland ecosystems and caused them to act as a net carbon source. Restoration work is being undertaken but monitoring the success of these schemes can be difficult and costly using traditional field-based methods. A landscape-scale alternative is to use satellite data to assess the condition of peatlands and to estimate gaseous carbon fluxes.

The uncertain climate footprint of wetlands under human pressure.

Significant climate risks are associated with a positive carbon-temperature feedback in northern latitude carbon-rich ecosystems, making an accurate analysis of human impacts on the net greenhouse gas balance of wetlands a priority. Here, we provide a coherent assessment of the climate footprint of a network of wetland sites based on simultaneous and quasi-continuous ecosystem observations of CO2 and CH4 fluxes. Experimental areas are located both in natural and in managed wetlands and cover a wide range of climatic regions, ecosystem types, and management practices.

Joint control of terrestrial gross primary productivity by plant phenology and physiology.

Terrestrial gross primary productivity (GPP) varies greatly over time and space. A better understanding of this variability is necessary for more accurate predictions of the future climate-carbon cycle feedback. Recent studies have suggested that variability in GPP is driven by a broad range of biotic and abiotic factors operating mainly through changes in vegetation phenology and physiological processes.

Spatial and Seasonal Variation of dissolved organic carbon (DOC) concentrations in Irish streams: importance of soil and topography characteristics.

Dissolved organic carbon (DOC) concentrations have increased in many sites in Europe and North America in recent decades. High DOC concentrations can damage the structure and functions of aquatic ecosystems by influencing water chemistry. This study investigated the spatial and seasonal variation of DOC concentrations in Irish streams across 55 sites at seven time occasions over 1 year (2006/2007).

Seasonal exports of phosphorus from intensively fertilised nested grassland catchments.

We carried out a one year (2002) study of phosphorus (P) loss from soil to water in three nested grassland catchments with known P input in chemical fertilizer and animal liquid slurry applications. Chemical fertilizer was applied to the grasslands between March and September and animal slurry was applied over the twelve months. The annual chemical P fertilizer applications for the 17 and 211 ha catchments were 16.

Urothelial carcinoma of the bladder with asynchronous metastases to both testes.

Urothelial carcinoma (UC) or transitional cell carcinoma (TCC) of the bladder has a high likelihood of metastasis, and the more common sites of distant metastasis are bone, liver and lung. Metastasis to the testis is extremely rare. We identified five cases of bladder UC metastasing to the testis in the literature, none of which occurred bilaterally.

Convergence of potential net ecosystem production among contrasting C3 grasslands.

Metabolic theory and body size constraints on biomass production and decomposition suggest that differences in the intrinsic potential net ecosystem production (NEPPOT ) should be small among contrasting C3 grasslands and therefore unable to explain the wide range in the annual apparent net ecosystem production (NEPAPP ) reported by previous studies. We estimated NEPPOT for nine C3 grasslands under contrasting climate and management regimes using multiyear eddy covariance data. NEPPOT converged within a narrow range, suggesting little difference in the net carbon dioxide uptake capacity among C3 grasslands.

Spatial distribution of potentially bioavailable metals in surface soils of a contaminated sports ground in Galway, Ireland.

Assessing the environmental risk of metal contamination in soils requires the determination of both total (TCs) and bioavailable (BCs) element concentrations. A total of 200 surface (0-10 cm) soil samples were collected from an urban sports ground (South Park) in Galway, Ireland, a former landfill and dumping site, which is currently under remediation. The potential BCs of metals were measured using ethylene-diamine-tetra-acetic acid (EDTA) extraction followed by inductively coupled plasma-optical emission spectrometry analysis, while the TCs were determined using portable X-ray fluorescence spectrometry.

Thermal optimality of net ecosystem exchange of carbon dioxide and underlying mechanisms.

• It is well established that individual organisms can acclimate and adapt to temperature to optimize their functioning. However, thermal optimization of ecosystems, as an assemblage of organisms, has not been examined at broad spatial and temporal scales. • Here, we compiled data from 169 globally distributed sites of eddy covariance and quantified the temperature response functions of net ecosystem exchange (NEE), an ecosystem-level property, to determine whether NEE shows thermal optimality and to explore the underlying mechanisms.

Long-term estimation of soil heat flux by single layer soil temperature.

Soil heat flux is one of the important components of surface energy balance. In this study, long-term estimation of soil heat flux from single layer soil temperature was carried out by the traditional sinusoidal analytical method and the half-order time derivative method of Wang and Bras [Wang and Bras (1999) J Hydrol 216:214-226]. In order to understand the characteristics of soil heat flux and to examine the performances of the two methods, a field experiment was conducted at a temperate and humid grassland in Cork, Ireland.

A comparison of SWAT, HSPF and SHETRAN/GOPC for modelling phosphorus export from three catchments in Ireland.

Recent extensive water quality surveys in Ireland revealed that diffuse phosphorus (P) pollution originating from agricultural land and transported by runoff and subsurface flows is the primary cause of the deterioration of surface water quality. P transport from land to water can be described by mathematical models that vary in modelling approach, complexity and scale (plot, field and catchment). Here, three mathematical models (soil water and analysis tools (SWAT), hydrological simulation program-FORTRAN (HSPF) and système hydrologique Européen TRANsport (SHETRAN)/grid oriented phosphorus component (GOPC)) of diffuse P pollution have been tested in three Irish catchments to explore their suitability in Irish conditions for future use in implementing the European Water Framework Directive.

Ethnicity and clinical psychiatric diagnosis in childhood.

This paper focuses on whether a consistent difference by ethnicity existed in the clinical diagnosis of children and adolescents in two behavioral health service environments and reviews plausible explanations for such a difference. Key measures were clinical diagnosis and ethnicity, abstracted from the administrative dataset of a New Jersey behavioral health care organization during 2000-2002, and a data collection conducted for the State of Indiana during 1991-1992. Sample sizes were 5,394 and 10,437, respectively.

Aging and outpatient service use among persons with schizophrenia-spectrum disorders in a statewide behavioral healthcare system.

This investigation explored the demographic and service use correlates of age among young, midlife, and older adults diagnosed with schizophrenia-spectrum disorders (N = 513), using the administrative data set of a statewide behavioral healthcare system. More African Americans persons were represented in the younger groups (age 18-35, 36-44) than in the older group (age 45 and older). Nearly two thirds of persons with schizophrenia-spectrum disorders seeking outpatient treatment were younger than 45.

Correlates of health insurance among persons with schizophrenia in a statewide behavioral health care system.

This study explored the demographic and service use correlates of insurance status among 539 persons with schizophrenia-spectrum disorders by using the administrative data set of a statewide behavioral health care system. Lack of health insurance was prevalent in the sample (20 percent) and was associated with younger age, Latino ethnicity, and male sex. Persons who did not have insurance were less likely to use a community-based service and more likely to use only crisis or emergency services than persons who had public or private insurance.

Transposon Tn5 encodes streptomycin resistance in nonenteric bacteria.

Strains of Caulobacter crescentus, Pseudomonas putida, Acinetobacter calcoaceticus, Rhizobium meliloti, and Rhodopseudomonas sphaeroides carrying the kanamycin resistance-encoding transposon Tn5 were 15 to 500 times more resistant to streptomycin than transposon-free strains. The streptomycin resistance determinant, which is separable from the kanamycin resistance determinant of Tn5, was not expressed in Escherichia coli or Klebsiella aerogenes.