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Candida auris has emerged as a major nosocomial pathogen due to multidrug resistance (MDR), outbreak potential, and high mortality in critically ill patients. Identifying risk factors for C. auris candidemia is essential for prevention and infection control. In this single-centre, retrospective case–control study, we analysed adults with C. auris candidemia (n = 52) and matched controls (n = 104) hospitalized between February 2019 and October 2024. Matching was based on hospital unit and blood culture timing. Clinical and epidemiological variables were compared, and multivariate logistic regression identified independent risk factors. Antifungal susceptibility and 14- and 28-day all-cause mortality were evaluated as secondary outcomes. Independent risk factors included recent hospitalization (odds ratio (OR): 7.93), prolonged hospital stay (OR: 1.01), prior broad-spectrum antibiotic use (OR: 46.20), central venous catheter (CVC) (OR: 3.88), sepsis (OR: 9.43), and high Candida Colonization Index (OR: 14.10). All-cause mortality at 14 and 28 days was 30.8% and 46.2%, respectively. Fluconazole resistance was 96%, while 8.7% of isolates were pandrug resistant. C. auris candidemia represents a serious clinical challenge with substantial mortality and modifiable risk factors. Strengthening antimicrobial stewardship, colonization surveillance, and early recognition in high-risk patients may reduce its impact.
Cet essai critique s’adresse aux coopérants volontaires potentiels et poursuit principalement un objectif didactique. Rédigé dans un langage accessible, il synthétise des réflexions critiques élaborées par l’auteur sur plusieurs décennies, en rapport avec le développement international tel qu’il est perçu depuis le Canada, et la coopération volontaire en particulier, en examinant leurs discours, intentions et leurs non-dits. L’auteur, anthropologue social spécialiste des populations marginales des hauteurs asiatiques, propose aux futurs coopérants une réflexion appuyée qui transcende les utopies intéressées promues par l’État et l’industrie du développement, ainsi que par son idéologie, le développementisme.
Sums of the ratings that judges assign to wines are a near universal method of determining the winners and losers of wine competitions. Sums are easy to calculate and easy to communicate, but seven flaws make sums of ratings a perilous guide to relative quality or preference. Stars & Bars combinatorics show that the same sum can be the result of billions of compositions of ratings and that those compositions, for the same sum, can contain dispersion that ranges from universal consensus to apparent randomness to polar disagreement. Order preference models can address both order and dispersion, and an example using a Plackett–Luce model yields maximum likelihood estimates of top-choice probabilities that are a defensible guide to relative quality or preference.
This study traces the evolution and the fate of two Icelandic glaciers, Hofsjökull eystri in the southeast and Okjökull in the west, from their Little Ice Age maximum (∼1890) to the present. Glacier maximum extents were reconstructed using historical maps, written descriptions, geomorphological evidence, and aerial and satellite imagery. Time series of digital elevation models and a 2025 radio echo sounding survey provide further insight into changes in surface area, volume and bedrock topography. Despite similar latitudes (∼64.4°N) and elevation ranges (∼900–1150 m a.s.l.), the glaciers reside in different climate regimes. Both glaciers covered ∼7 km2 in the 1940s. Since then, Okjökull has been declared vanished and Hofsjökull eystri has lost ∼70% of its area and ∼90% of its volume, with a maximum thickness of 55 m in 2024. Projections suggest that, at the current rate of thinning, Hofsjökull eystri will disappear entirely within the next 30–45 years.
Collaboration across the Clinical and Translational Science Award (CTSA) consortium is essential for advancing translational science, yet institutional silos often hinder data-sharing and benchmarking efforts. This study examines the viability of a voluntary, multi-hub analysis of the CTSA education common metric on trainee and scholar engagement across five New York City-based sites or “hubs.” Using a structured framework for collaboration and field-tested operational guidelines, a team of evaluators dubbed “The Gotham Group” pooled de-identified common education data to assess post-training research engagement and demographic representation. Their primary objective was to establish a sustainable model for independent data-sharing without national mandates or technical support. A secondary goal was to reassess the metric’s usefulness as an impact benchmark. Results showed that NYC education engagement percentages remained stable despite institutional differences, suggesting the metric’s viability for regional comparison. More importantly, the collaboration itself proved as valuable as its outcomes, fostering professional relationships, facilitating knowledge exchange, and strengthening evaluation capacity within and across the hubs. This study highlights the potential of voluntary data-sharing partnerships to overcome data silos and to create valuable networks driving continuous improvement in translational science.
Invasive candidiasis including candidemia is a common healthcare-associated infections with significant morbidity and mortality. The USA does not have mandatory national surveillance for mucocutaneous or invasive candidiasis which complicates estimation of epidemiology and outcomes. The aim of this project was to describe the epidemiology, mortality, and Candida-associated hospital readmissions in hospitalized patients with Candida species infections.
Methods:
This secondary database analysis used clinical microbiology data from adults hospitalized at three large health systems (25-hospitals) in the Greater Houston area totaling over 1.6 million hospitalization days per year from 2018 to 2023. Proportion and rates of Candida cultures per 10,000 hospitalization days were calculated. Risk factors for mortality and Candida-associated readmissions were assessed by multivariable logistic regression.
Results:
Within the study period, 7514 hospitalized patients aged 64 ± 16 years (mean± standard deviation (SD)) with 10,183 unique Candida cultures were identified. Majority of Candida cultures were nosocomial (59%) with wide variability in mean time to positive culture (9 ± 44 days) after admission. Candida specimens were from blood (32%), abdomen (29%), or mucocutaneous (24%) cultures and most commonly C. albicans (44%) or C. glabrata (21%). C. auris increased significantly from 2% of cultures from 2018–20 to 5% in 2021–23 (p < 0.0001). Length of hospital stay was 21 ± 34 days and inpatient mortality was 17%. Multivariable analyses identified hospitalization variables and Candida species predictive of inpatient all-cause mortality and Candida-associated readmissions after initial hospitalization.
Conclusion:
These analyses highlight the significant burden of candidiasis and the emergence of new strains, including C. auris. Ongoing surveillance can refine burden estimates and assess the impact of stewardship and infection control interventions.
To understand patterns of cannabis use and self-management experiences in patients with chronic disease during the post-legalization period in Thailand and to quantify such experiences and perceptions.
Background:
Patients with chronic disease are a population in which disease self-management is potentially involved with the use of complementary and alternative medicines (CAMs). The recent changes in cannabis regulation in Thailand have allowed retail selling and home cultivation. Cannabis is a medicinal herb in many traditional Thai recipes and is often adopted as a CAM in the chronic disease population. The adoption of cannabis products as part of CAM could lead to changes in chronic disease outcomes.
Methods:
Exploratory-sequential mixed methods were used in this study. A descriptive qualitative study was conducted to acquire a basic understanding of the patients’ experiences. Semi-structured in-depth interviews were conducted, and thematic analysis was applied. Subsequently, a cross-sectional study was conducted to quantify the patterns of cannabis use and self-management experience in patients with diabetes and/or hypertension.
Findings:
Eleven patients were interviewed, and 124 patients participated in the cross-sectional study. Most of the participants were male, married, and identified as Buddhist. Many patients believed that cannabis could improve their health, while fewer considered it a threat to their health. In general, the patients viewed cannabis as a way to enhance their quality of life and treat chronic diseases. Some patients embraced the principles of CAM. They primarily used cannabis tea daily to manage diabetes or hypertension, with their approaches being more complementary than alternative. However, only one-third (34.7%) were aware of potential drug interactions with their concurrent medications.
The Boltzmann kinetic equation is considered to compute the transport coefficients associated with the mass flux of intruders in a granular gas. Intruders and granular gas are immersed in a gas of elastic hard spheres (molecular gas). We assume that the granular particles are sufficiently rarefied so that the state of the molecular gas is not affected by the presence of the granular gas. Thus, the gas of elastic hard spheres can be considered as a thermostat (or bath) at a fixed temperature $T_g$. In the absence of spatial gradients, the system achieves a steady state where the temperature of the granular gas $T$ differs from that of the intruders $T_0$ (energy non-equipartition). Approximate theoretical predictions for the temperature ratio $T_0/T_g$ and the kurtosis $c_0$ associated with the intruders compare very well with Monte Carlo simulations for conditions of practical interest. For states close to the steady homogeneous state, the Boltzmann equation for the intruders is solved by means of the Chapman–Enskog method to first order in the spatial gradients. As expected, the diffusion transport coefficients are given in terms of the solutions of a set of coupled linear integral equations which are approximately solved by considering the first Sonine approximation. In dimensionless form, the transport coefficients are nonlinear functions of the mass and diameter ratios, the coefficients of restitution and the (reduced) bath temperature. Interestingly, previous results derived from a suspension model based on an effective fluid–solid interaction force are recovered when $m/m_g\to \infty$ and $m_0/m_g\to \infty$, where $m$, $m_0$ and $m_g$ are the masses of the granular particles, intruders and molecular gas particles, respectively. Finally, as an application of our results, thermal diffusion segregation is exhaustively analysed.
Linear-stability modelling suggests that all sufficiently large riblets promote maximally growing spanwise rollers (García-Mayoral & Jiménez 2011 J. Fluid Mech. vol. 678, 317–347), yet direct numerical simulations (DNS) have shown that this is not the case (Endrikat et al. 2021 J. Fluid Mech. vol. 913, A37) some riblet shapes do not form spanwise rollers at all. Thus, the drag-reduction breakdown across all riblet shapes cannot be solely attributed to maximally growing spanwise rollers, prompting a reappraisal of the modelling. In this paper, comparing DNS data with riblet-resolving linear-stability predictions shows that the spanwise rollers are actually marginal modes, not maximally growing instabilities. This riblet-resolved linear analysis also predicts that not all riblet shapes promote spanwise rollers, in agreement with DNS, and unlike earlier linear-stability modelling, which relied on a one-dimensional (1-D) mean flow and on an over-simplified effective wall-admittance boundary condition. These riblet-resolved calculations further inform how to capture the effect of the riblet shape in a 1D model. Once captured, predictions with an effective boundary condition match riblet-resolved results, but still do not indicate what features of the riblet geometry promote the roller instability. Thus, the wall admittance is measured near the riblet crests, in both the riblet-resolved linear analysis and DNS, to show that the in-groove dynamics is dominated by a balance between the overlying pressure and unsteady inertia, and not viscous diffusion, as previously assumed. This pressure–unsteady-inertia balance sets the linear scaling of the wall admittance with riblet size, as observed in DNS, and is a key factor in setting the streamwise wavelength of the spanwise rollers. Furthermore, modelling this pressure–unsteady-inertia balance in the wall admittance reveals the role of riblet slenderness in promoting spanwise rollers, which provides the missing link in previous correlations between the riblet geometry and the presence or lack of rollers.
We investigate Lighthill’s proposed turbulent mechanism for near-wall concentration of spanwise vorticity by calculating mean flows conditioned on motion away from or toward the wall in an (friction Reynolds number) ${\textit{Re}}_\tau =1000$ database of plane-parallel channel flow. Our results corroborate Lighthill’s proposal throughout the entire logarithmic layer, but extended by counter-flows that help explain anti-correlation of vorticity transport by advection and by stretching/tilting. We present evidence also for Lighthill’s hypothesis that the vorticity transport in the log layer is a ‘cascade process’ through a scale hierarchy of eddies, with intense competition between transport outward from and inward to the wall. Townsend’s model of attached eddies of hairpin-vortex type accounts for half of the vorticity cascade, whereas we identify necklace type or ’shawl vortices’ that envelop turbulent sweeps as supplying the other half.
This article addresses critical gaps in the literature on crisis-driven policy change in international organisations. While existing studies focus on elite decision-making and institutional resilience, the role of frontline crisis managers remains under-explored in International Relations. Using the European migration and refugee crisis as a case study and drawing on insights from organisation studies and the sociology of the professions, the article introduces a novel theoretical framework that foregrounds improvisation by first responders and the ex-post stabilisation of their spontaneous policy solutions at headquarters. In addition to reconstructing and illustrating the mechanisms that link frontline action to changed policies, the article identifies theoretical conditions shaping the likelihood and direction of informal policy change from the ground up. By highlighting bottom-up dynamics in crises, it not only advances theoretical debates on crisis politics, but also proposes a new research agenda for analysing the transformative role of field-level practices in global politics.
This paper provides a historiographical periodization of China’s Long 1980s (1978–1992) by conceptualizing its political and intellectual contexts and illustrating the reformism–conservatism dichotomy across key events throughout this period. The identification of China’s Long 1980s not only illuminates China’s policy trajectories and ideological landscape back then and ever since but also enriches the global scholarship of modernity, Marxism and 20th-century communist experiences.
John Evelyn (1620–1706), in Tyrannus, or, the mode in a discourse of sumptuary lawes (1661), decried the foreign fashions that threatened the English economy and symbolized Restoration extravagance. He supposedly instilled these beliefs in his daughter Mall (1665–85), with whom he co-authored the Mundus muliebris: or, the ladies dressing-room unlock’d (1690), a remarkable satire that expressed contempt at the frivolous new modes of apparel adopted by elite women. Yet, incongruously, many of these same ridiculed styles appear in the family’s accounts and correspondence. Indeed, the purchasing habits of Evelyn’s wife, Mary (1635–1709), and daughters reveal a firm commitment to maintaining a fashionable appearance. This article recovers the unexplored attitudes of the Evelyn women towards clothing consumption and the varied ways they maintained their wardrobes. A close reading of the Mundus muliebris alongside the family’s accounts, bills, and correspondence reveals the seminal, paradoxical role of dress as highly contentious yet socially ubiquitous. Through its biographical framework, the article highlights how private consumption practices within elite households like that of the Evelyns challenge the prevalence of published narratives attacking elite women’s fashion. In turn, it reveals the dangers of taking these polemical texts at face value.
When the row and column variables consist of the same category in a two-way contingency table, it is called a square contingency table. Since square contingency tables have an association structure due to the concentration of observed values near the main diagonal, a primary objective is to examine symmetric relationships and transitions between variables. Various models and measures have been proposed to analyze these structures to understand the changes between two variables’ behavior at two-time points or cohorts. This is necessary for a detailed investigation of individual categories and their interrelationships, such as shifts in brand preferences. We propose a novel approach to correspondence analysis (CA) for evaluating departures from symmetry in square contingency tables with nominal categories, using a modified divergence statistic. This approach ensures that well-known divergence statistics can also be visualized and regardless of the divergence statistics used, the CA plot consists of two principal axes with equal contribution rates. Notably, the scaling of the departures from symmetry provided by the modified divergence statistic is independent of sample size, allowing for meaningful comparisons and unification of results across different tables. Confidence regions are also constructed to enhance the accuracy of the CA plot.
This work concerns representations of a finite flat group scheme G defined over a noetherian commutative ring R. The focus is on lattices, namely, finitely generated G-modules that are projective as R-modules, and on the full subcategory of all G-modules projective over R generated by the lattices. The stable category of such G-modules is a rigidly-compactly generated, tensor triangulated category. The main result is that this stable category is stratified and costratified by the natural action of the cohomology ring of G. Applications include formulas for computing the support and cosupport of tensor products and the module of homomorphisms, and a classification of the thick ideals in the stable category of lattices.
This article, based on an oral presentation by the author at the BSA’s annual general meeting in February 2025, summarizes the activities of the British School at Athens with a focus on the calendar year 2024. It gives us great pleasure to present the innovative and varied work of BSA-sponsored field and research projects, the Fitch Laboratory, Knossos Research Centre, Archive, and Library as well as the inspiring work of the School students, post docs, and fellows.
The rooster-headed man in a mosaic at Brading Roman Villa on the Isle of Wight is a mystery that has attracted a dizzying range of explanations since its discovery in 1879. Three broad theories have found favour — that he represents a deity, an exotic beast to be hunted, or a hunter either with a rooster-related name or mocking the emperor Constantius Gallus. In this article I outline the problems with these theories before offering an alternative explanation — that this figure is a damnatus, and the scene an imaginative execution, a so-called ‘fatal charade’. This suggestion both facilitates a more holistic interpretation of the mosaic, and rehabilitates earlier suggestions long summarily dismissed.
Over 100 archaeological survey projects – of various kinds – have taken place in Greece over the last quarter century, making it one of the most intensively studied countries in Europe from the perspective of landscape archaeology, defined by various types of interest in settlement patterns and human–environmental interaction at spatial scales beyond the individual site. This article examines the practice of survey archaeology in Greece over the last 25 years, with a particular focus on projects that have taken place in the last 10 years. More broadly, it presents large-scale trends in surveys since their coalescence as a systematic form of archaeological research in the late 1950s, based on a dataset of 204 individual projects, mapped and classified according to type, spatial scale, methods, and chronology. Surveys in the twenty-first century exhibit considerable variety in methods and goals, with many characterized by smaller spatial scales, the integration of various types of remote sensing, and a focus on archaeological sites; we see fewer of the large-scale, diachronic regional surveys that became widespread in the later twentieth century. This variety – along with the increasing production and availability of high-quality, multi-modal data – should be applauded, though regional analysis remains a critical strength and important goal for landscape archaeologists in Greece. Lingering problems include publication lag, digital data availability and interoperability, and (occasional) over-emphasis on methodology as an end in and of itself, sometimes at the expense of historical and anthropological research questions. Promising developments for the future concern: (1) the investigation of landscapes that have received little attention from systematic surveys (highlands, mountains, forests, uninhabited islands), especially via remote sensing; (2) the publication, reanalysis, and interpretation of ‘legacy’ datasets; and (3) the integration of survey datasets across multiple scales to address ‘big-picture’ questions in the history and archaeology of Greece, as well as themes of wider significance.
The topic of urban revolt in medieval Ireland has been overlooked by wider scholarship. This article offers the first detailed analysis of a revolt which occurred in Galway in the late fourteenth century. The basis of this study is a twentieth-century transcription made of an extract from a plea roll of the king’s bench in Ireland before the latter’s destruction in 1922, which records the judicial proceedings taken against one of the town’s rebels and provides an under-exploited (and not entirely reliable) narrative of the key facts of this rebellion. This article locates the actions of Galway townspeople within a wider European pattern of protest and rebellion in the second half of the fourteenth century and, more specifically, places the revolt in the context of contemporary political events in Ireland and England. The events in Galway should be viewed as a genuinely ‘popular’ revolt, challenging assumptions about the presumed loyalty of towns and cities in medieval Ireland to the English crown and its local representatives.
This article comparatively examines expertise and policy-making related to school maturity in postwar Czechoslovakia and Poland. Through an analysis of published sources and archival material, it traces the intensive development of pedagogical and psychological expertise about school maturity from the early 1960s onward and examines how that development influenced the policies introduced in both countries in the late 1960s and early 1970s. Using the concept of the expertise as a network as our analytical lens, we show that despite considerable differences in education systems and particular features of expertise in the two countries, pedagogical expertise affected policies in a very similar way through intensive networking, leading to the introduction of measures such as preparatory departments and compensatory classes in Czechoslovakia and early enrollment in Poland. We argue that educational policy-making in post-Stalinist Czechoslovakia and Poland was largely expert-driven. Nevertheless, there were limitations on the experts’ influence, as not all the proposed changes were introduced.