Multicenter Evaluation of the Novel ETEST Fosfomycin for Antimicrobial Susceptibility Testing of Enterobacterales, Enterococcus faecalis, and Staphylococcus Species.

Fosfomycin is a phosphonic acid derivative active against a wide spectrum of Gram-positive and Gram-negative pathogens. It is used for the treatment of uncomplicated urinary tract infections (uUTI) or severe infections by oral or intravenous (i.v.) administration. In order to improve its performance and robustness, the fosfomycin strip, an antibiotic gradient diffusion strip, was redeveloped and evaluated in the multicenter study summarized in this paper. ETEST fosfomycin (ETEST FO) clinical performance was evaluated by three study sites on 152 Enterococcus faecalis, 100 Staphylococcus spp. and 330 Enterobacterales in comparison with the CLSI and EUCAST agar dilution reference method. Referring to FDA performance criteria, the ETEST FO achieved 91.0% of essential (EA) and 99.0% of categorical agreement (CA) for Escherichia coli. In addition, 98.0% EA and 93.4% CA were achieved for E. faecalis, with no very major errors (VME) or major errors (ME). According to EUCAST breakpoints for intravenous fosfomycin use, Enterobacterales and Staphylococcus spp. also met ISO acceptance criteria for EA and CA (EA 91.5%, 94.0%, respectively, and CA 98.0% for both). A VME rate of 8.8% was observed for Enterobacterales but the MICs were within EA. A trend to predict lower MICs for Citrobacter spp., E. coli and Salmonella enterica and to predict higher MICs for Klebsiella pneumoniae MICs was observed, while ETEST FO should not be used for Enterobacter cloacae, because of low EA and a high VME rate. The study results support the efficiency of the novel ETEST FO, making it an easy-to-handle tool as a substitute to the classical agar dilution method.

Search for the exit: Voyager 1 at heliosphere's border with the galaxy.

We report measurements of energetic (>40 kiloelectron volts) charged particles on Voyager 1 from the interface region between the heliosheath, dominated by heated solar plasma, and the local interstellar medium, which is expected to contain cold nonsolar plasma and the galactic magnetic field. Particles of solar origin at Voyager 1, located at 18.5 billion kilometers (123 astronomical units) from the Sun, decreased by a factor of >10(3) on 25 August 2012, while those of galactic origin (cosmic rays) increased by 9.3% at the same time. Intensity changes appeared first for particles moving in the azimuthal direction and were followed by those moving in the radial and antiradial directions with respect to the solar radius vector. This unexpected heliospheric "depletion region" may form part of the interface between solar plasma and the galaxy.

Mediation of the solar wind termination shock by non-thermal ions.

Broad regions on both sides of the solar wind termination shock are populated by high intensities of non-thermal ions and electrons. The pre-shock particles in the solar wind have been measured by the spacecraft Voyager 1 (refs 1-5) and Voyager 2 (refs 3, 6). The post-shock particles in the heliosheath have also been measured by Voyager 1 (refs 3-5). It was not clear, however, what effect these particles might have on the physics of the shock transition until Voyager 2 crossed the shock on 31 August-1 September 2007 (refs 7-9). Unlike Voyager 1, Voyager 2 is making plasma measurements. Data from the plasma and magnetic field instruments on Voyager 2 indicate that non-thermal ion distributions probably have key roles in mediating dynamical processes at the termination shock and in the heliosheath. Here we report that intensities of low-energy ions measured by Voyager 2 produce non-thermal partial ion pressures in the heliosheath that are comparable to (or exceed) both the thermal plasma pressures and the scalar magnetic field pressures. We conclude that these ions are the >0.028 MeV portion of the non-thermal ion distribution that determines the termination shock structure and the acceleration of which extracts a large fraction of bulk-flow kinetic energy from the incident solar wind.

Voyager 1 in the foreshock, termination shock, and heliosheath.

Voyager 1 (V1) began measuring precursor energetic ions and electrons from the heliospheric termination shock (TS) in July 2002. During the ensuing 2.5 years, average particle intensities rose as V1 penetrated deeper into the energetic particle foreshock of the TS. Throughout 2004, V1 observed even larger, fluctuating intensities of ions from 40 kiloelectron volts (keV) to >/=50 megaelectron volts per nucleon and of electrons from >26 keV to >/=350 keV. On day 350 of 2004 (2004/350), V1 observed an intensity spike of ions and electrons that was followed by a sustained factor of 10 increase at the lowest energies and lesser increases at higher energies, larger than any intensities since V1 was at 15 astronomical units in 1982. The estimated solar wind radial flow speed was positive (outward) at approximately +100 kilometers per second (km s(-1)) from 2004/352 until 2005/018, when the radial flows became predominantly negative (sunward) and fluctuated between approximately -50 and 0 km s(-1) until about 2005/110; they then became more positive, with recent values (2005/179) of approximately +50 km s(-1). The energetic proton spectrum averaged over the postshock period is apparently dominated by strongly heated interstellar pickup ions. We interpret these observations as evidence that V1 was crossed by the TS on 2004/351 (during a tracking gap) at 94.0 astronomical units, evidently as the shock was moving radially inward in response to decreasing solar wind ram pressure, and that V1 has remained in the heliosheath until at least mid-2005.

Dynamics of Saturn's magnetosphere from MIMI during Cassini's orbital insertion.

The Magnetospheric Imaging Instrument (MIMI) onboard the Cassini spacecraft observed the saturnian magnetosphere from January 2004 until Saturn orbit insertion (SOI) on 1 July 2004. The MIMI sensors observed frequent energetic particle activity in interplanetary space for several months before SOI. When the imaging sensor was switched to its energetic neutral atom (ENA) operating mode on 20 February 2004, at approximately 10(3) times Saturn's radius RS (0.43 astronomical units), a weak but persistent signal was observed from the magnetosphere. About 10 days before SOI, the magnetosphere exhibited a day-night asymmetry that varied with an approximately 11-hour periodicity. Once Cassini entered the magnetosphere, in situ measurements showed high concentrations of H+, H2+, O+, OH+, and H2O+ and low concentrations of N+. The radial dependence of ion intensity profiles implies neutral gas densities sufficient to produce high loss rates of trapped ions from the middle and inner magnetosphere. ENA imaging has revealed a radiation belt that resides inward of the D ring and is probably the result of double charge exchange between the main radiation belt and the upper layers of Saturn's exosphere.

Voyager 1 exited the solar wind at a distance of approximately 85 Au from the Sun.

The outer limit of the Solar System is often considered to be at the distance from the Sun where the solar wind changes from supersonic to subsonic flow. Theory predicts that a termination shock marks this boundary, with locations ranging from a few to over 100 au (1 Au approximately 1.5 x 10(8) km, the distance from Earth to the Sun). 'Pick-up ions' that originate as interstellar neutral atoms should be accelerated to tens of MeV at the termination shock, generating anomalous cosmic rays. Here we report a large increase in the intensity of energetic particles in the outer heliosphere, as measured by an instrument on the Voyager 1 spacecraft. We argue that the spacecraft exited the supersonic solar wind and passed into the subsonic region (possibly beyond the termination shock) on about 1 August 2002 at a distance of approximately 85 Au (heliolatitude approximately 34 degrees N), then re-entered the supersonic solar wind about 200 days later at approximately 87 au from the Sun. We show that the composition of the ions accelerated at the putative termination shock is that of anomalous cosmic rays and of interstellar pick-up ions.

Electron beams and ion composition measured at Io and in its torus.

Intense, magnetic field-aligned, bidirectional, energetic (>15 kiloelectron volts) electron beams were discovered by the Galileo energetic particles detector during the flyby of Io. These beams can carry sufficient energy flux into Jupiter's atmosphere to produce a visible aurora at the footprint of the magnetic flux tube connecting Io to Jupiter. Composition measurements through the torus showed that the spatial distributions of protons, oxygen, and sulfur are different, with sulfur being the dominant energetic (> approximately 10 kiloelectron volts per nucleon) ion at closest approach.

Over the southern solar pole: low-energy interplanetary charged particles.

The heliosphere instrument for spectrum, composition, and anisotropy (HISCALE) recorded the fluxes of low-energy ions and electrons (> 50 kiloelectron volts) when Ulysses crossed the southern solar polar region and revealed that the large-scale structure of the heliosphere to at least approximately -75 degrees was significantly influenced by the near-equatorial heliospheric current sheet. Electrons in particular were accelerated by the current sheet-produced and poleward-propagating interplanetary reverse shock at helioradii far from the Ulysses location. At heliolatitudes higher than approximately -75 degrees on the Ulysses ascent to the pole and approximately -50 degrees on the descent, small, less regular enhancements of the lowest energy electron fluxes were measured whose relations to the current sheet were less clear. The anomalous component of low-energy (approximately 2 to 5 megaelectron volts per nucleon) oxygen flux at the highest heliolatitudes was found to be approximately 10(-8) [per square centimeter per second per steradian (per kiloelectronvolt per nucleon)]; the anomalous Ne/O ratio was approximately 0.25.

The hot plasma environment at jupiter: ulysses results.

Measurements of the hot plasma environment during the Ulysses flyby of Jupiter have revealed several new discoveries related to this large rotating astrophysical system. The Jovian magnetosphere was found by Ulysses to be very extended, with the day-side magnetopause located at approximately 105 Jupiter radii. The heavy ion (sulfur, oxygen, and sodium) population in the day-side magnetosphere increased sharply at approximately 86 Jupiter radii. This is somewhat more extended than the "inner" magnetosphere boundary region identified by the Voyager hot plasma measurements. In the day-side magnetosphere, the ion fluxes have the anisotropy direction expected for corotation with the planet, with the magnitude of the anisotropy increasing when the spacecraft becomes more immersed in the hot plasma sheet. The relative abundances of sulfur, oxygen, and sodium to helium decreased somewhat with decreasing radial distance from the planet on the day-side, which suggests that the abundances of the Jupiter-derived species are dependent on latitude. In the dusk-side, high-latitude region, intense fluxes of counter-streaming ions and electrons were discovered from the edge of the plasma sheet to the dusk-side magnetopause. These beams of electrons and ions were found to be very tightly aligned with the magnetic field and to be superimposed on a time- and space-variable isotropic hot plasma background. The currents carried by the measured hot plasma particles are typically approximately 1.6 x 10(-4) microamperes per square meter or approximately 8 x 10(5) amperes per squared Jupiter radius throughout the high-latitude magnetosphere volume. It is likely that the intense particle beams discovered at high Jovian latitudes produce auroras in the polar caps of the planet.

Energetic particles at venus: galileo results.

At Venus the Energetic Particles Detector (EPD) on the Galileo spacecraft measured the differential energy spectra and angular distributions of ions >22 kiloelectron volts (keV) and electrons > 15 keV in energy. The only time particles were observed by EPD was in a series of episodic events [0546 to 0638 universal time (UT)] near closest approach (0559:03 UT). Angular distributions were highly anisotropic, ordered by the magnetic field, and showed ions arriving from the hemisphere containing Venus and its bow shock. The spectra showed a power law form with intensities observed into the 120- to 280-keV range. Comparisons with model bow shock calculations show that these energetic ions are associated with the venusian foreshock-bow shock region. Shock-drift acceleration in the venusian bow shock seems the most likely process responsible for the observed ions.

Rapidly progressive dementia in a patient with the Lewy body variant of Alzheimer's disease.

A 65-year-old woman presented with a mild memory impairment, spatial disorientation, and poor task initiation. Progression was rapid over 3 months. She developed severe apathy, delusions, extrapyramidal features, and psychometrically quantified cognitive deterioration. Her brain showed many neocortical neuritic plaques and neurofibrillary tangles along with neocortical and brainstem Lewy bodies and temporal lobe spongiform vacuolization. This case is the most rapid deterioration documented of a patient with Alzheimer's disease and Lewy bodies.

Hot Plasma and Energetic Particles in Neptune's Magnetosphere.

The low-energy charged particle (LECP) instrument on Voyager 2 measured within the magnetosphere of Neptune energetic electrons (22 kiloelectron volts /=0.5 MeV per nucleon) energies, using an array of solid-state detectors in various configurations. The results obtained so far may be summarized as follows: (i) A variety of intensity, spectral, and anisotropy features suggest that the satellite Triton is important in controlling the outer regions of the Neptunian magnetosphere. These features include the absence of higher energy (>/=150 keV) ions or electrons outside 14.4 R(N) (where R(N) = radius of Neptune), a relative peak in the spectral index of low-energy electrons at Triton's radial distance, and a change of the proton spectrum from a power law with gamma >/= 3.8 outside, to a hot Maxwellian (kT [unknown] 55 keV) inside the satellite's orbit. (ii) Intensities decrease sharply at all energies near the time of closest approach, the decreases being most extended in time at the highest energies, reminiscent of a spacecraft's traversal of Earth's polar regions at low altitudes; simultaneously, several spikes of spectrally soft electrons and protons were seen (power input approximately 5 x 10(-4) ergs cm(-2) s(-1)) suggestive of auroral processes at Neptune. (iii) Composition measurements revealed the presence of H, H(2), and He(4), with relative abundances of 1300:1:0.1, suggesting a Neptunian ionospheric source for the trapped particle population. (iv) Plasma pressures at E >/= 28 keV are maximum at the magnetic equator with beta approximately 0.2, suggestive of a relatively empty magnetosphere, similar to that of Uranus. (v) A potential signature of satellite 1989N1 was seen, both inbound and outbound; other possible signatures of the moons and rings are evident in the data but cannot be positively identified in the absence of an accurate magnetic-field model close to the planet. Other results indude the absence of upstream ion increases or energetic neutrals [particle intensity (j) < 2.8 x 10(-3) cm(-2) s(-1) keV(-1) near 35 keV, at approximately 40 R(N)] implying an upper limit to the volume-averaged atomic H density at R 22 keV) input on Neptune is approximately 3 x 10(7) W, surprisingly small when compared to energy input into the atmosphere of Jupiter, Saturn, and Uranus.

The magnetosphere of uranus: hot plasma and radiation environment.

The low-energy charged-particle (LECP) instrument on Voyager 2 measured lowenergy electrons and ions near and within the magnetosphere of Uranus. Initial analysis of the LECP measurements has revealed the following. (i) The magnetospheric particle population consists principally of protons and electrons having energies to at least 4 and 1.2 megaelectron volts, respectively, with electron intensities substantially excceding proton intensities at a given energy. (ii) The intensity profile for both particle species shows evidence that the particles were swept by planetry satellites out to at least the orbit of Titania. (iii) The ion and electron spectra may be described by a Maxwellian core at low energies (less than about 200 kiloelectron volts) and a power law at high energies (greater than about 590 kiloelectron volts; exponentmicro, 3 to 10) except inside the orbit of Miranda, where power-law spectra (micro approximately 1.1 and 3.1 for electrons and protons, respectively) are observed. (iv) At ion energies between 0.6 and 1 megaelectron volt per nucleon, the composition is dominated by protons with a minor fraction (about 10(-3)) of molecular hydrogen; the lower limit for the ratio of hydrogen to helium is greater than 10(4). (v) The proton population is sufficiently intense that fluences greater than 10(16) per square centimeter can accumulate in 10(4) to 10(') years; such fluences are sufficient to polymerize carbon monoxide and methane ice surfaces. The overall morphology of Uranus' magnetosphere resembles that of Jupiter, as evidenced by the fact that the spacecraft crossed the plasma sheet through the dawn magnetosheath twice per planetary rotation period (17.3 hours). Uranus' magnetosphere differs from that of Jupiter and of Saturn in that the plasma 1 is at most 0.1 rather than 1. Therefore, little distortion ofthe field is expected from particle loading at distances less than about 15 Uranus radii.

Low-Energy Hot Plasma and Particles in Saturn's Magnetosphere.

The low-energy charged particle instrument on Voyager 2 measured low-energy electrons and ions (energies greater, similar 22 and greater, similar 28 kiloelectron volts, respectively) in Saturn's magnetosphere. The magnetosphere structure and particle population were modified from those observed during the Voyager 1 encounter in November 1980 but in a manner consistent with the same global morphology. Major results include the following. (i) A region containing an extremely hot ( approximately 30 to 50 kiloelectron volts) plasma was identified and extends from the orbit of Tethys outward past the orbit of Rhea. (ii) The low-energy ion mantle found by Voyager 1 to extend approximately 7 Saturn radii inside the dayside magnetosphere was again observed on Voyager 2, but it was considerably hotter ( approximately 30 kiloelectron volts), and there was an indication of a cooler ( < 20 kiloelectron volts) ion mantle on the nightside. (iii) At energies greater, similar 200 kiloelectron volts per nucleon, H(1), H(2), and H(3) (molecular hydrogen), helium, carbon, and oxygen are important constituents in the Saturnian magnetosphere. The presence of both H(2) and H(3) suggests that the Saturnian ionosphere feeds plasma into the magnetosphere, but relative abundances of the energetic helium, carbon, and oxygen ions are consistent with a solar wind origin. (iv) Low-energy ( approximately 22 to approximately 60 kiloelectron volts) electron flux enhancements observed between the L shells of Rhea and Tethys by Voyager 2 on the dayside were absent during the Voyager 1 encounter. (v) Persistent asymmetric pitch-angle distributions of electrons of 60 to 200 kiloelectron volts occur in the outer magnetosphere in conjunction with the hot ion plasma torus. (vi) The spacecraft passed within approximately 1.1 degrees in longitude of the Tethys flux tube outbound and observed it to be empty of energetic ions and electrons; the microsignature of Enceladus inbound was also observed. (vii) There are large fluxes of electrons of approximately 1.5 million electron volts and smaller fluxes of electrons of approximately 10 million electron volts and of protons greater, similar 54 million electron volts inside the orbits of Enceladus and Mimas; all were sharply peaked perpendicular to the local magnetic field. (viii) In general, observed satellite absorption signatures were not located at positions predicted on the basis of dipole magnetic field models.

Erosion of galilean satellite surfaces by jovian magnetosphere particles.

The Galilean satellites of Jupiter-Io (J1), Europa (J2), Ganymede (J3), and Callisto (J4)-are embedded in the intense ion and electron fluxes of the Jovian magnetosphere. The effect of these particles on the icy surfaces of the outer three satellites depends on the fluxes and the efficiency of the sputtering of water ice by such particles. Recent laboratory measurements provided data on the erosion of water ice by energetic particles and showed that it occurs much faster than would be expected from normal sputtering theory. The Voyager spacecraft encounters with Jupiter provided the first measurements of ion fluxes (energies greater, similar 30 kiloelectron volts) in the vicinity of the Galilean satellites. Using the laboratory sputtering data together with particle measurements from the Voyager 1 low-energy charged particle experiment, the effects of erosion on the surfaces of J2 to J4 are estimated. It is shown that the surface of Europa could be eroded by as much as 100 meters over an eon (10(9) years). Column densities of water vapor that could be produced around the three satellites from particle bombardment of their surfaces are also calculated, and the sources and losses of oxygen in the gravitationally bound gas produced by sputtering or sublimation are estimated.

Low-Energy Charged Particles in Saturn's Magnetosphere: Results from Voyager 1.

The low-energy charged particle instrument on Voyager 1 measured low-energy electrons and ions (energies >/= 26 and >/= 40 kiloelectron volts, respectively) in Saturn's magnetosphere. The first-order ion anisotropies on the dayside are generally in the corotation direction with the amplitude decreasing with decreasing distance to the planet. The ion pitch-angle distributions generally peak at 90 degrees , whereas the electron distributions tend to have field-aligned bidirectional maxima outside the L shell of Rhea. A large decrease in particle fluxes is seen near the L shell of Titan, while selective particle absorption (least affecting the lowest energy ions) is observed at the L shells of Rhea, Dione, and Tethys. The phase space density of ions with values of the first invariant in the range approximately 300 to 1000 million electron volts per gauss is consistent with a source in the outer magnetosphere. The ion population at higher energies (>/= 200 kiloelectron volts per nucleon) consists primarily of protons, molecular hydrogen, and helium. Spectra of all ion species exhibit an energy cutoff at energies >/= 2 million electron volts. The proton-to-helium ratio at equal energy per nucleon is larger (up to approximately 5 x 10(3)) than seen in other magnetospheres and is consistent with a local (nonsolar wind) proton source. In contrast to the magnetospheres of Jupiter and Earth, there are no lobe regions essentially devoid of particles in Saturn's nighttime magnetosphere. Electron pitch-angle distributions are generally bidirectional andfield-aligned, indicating closed field lines at high latitudes. Ions in this region are generally moving toward Saturn, while in the magnetosheath they exhibit strong antisunward streaming which is inconsistent with purely convective flows. Fluxes of magnetospheric ions downstream from the bow shock are present over distances >/= 200 Saturn radii from the planet. Novel features identified in the Saturnian magnetosphere include a mantle of low-energy particles extending inward from the dayside magnetopause to approximately 17 Saturn radii, at least two intensity dropouts occurring approximately 11 hours apart in the nighttime magnetosphere, and a pervasive population of energetic molecular hydrogen.

Hot plasma environment at jupiter: voyager 2 results.

Measurements of the hot (electron and ion energies >/=20 and >/= 28 kiloelectron volts, respectively) plasma environment at Jupiter by the low-energy charged particle (LECP) instrument on Voyager 2 have revealed several new and unusual aspects of the Jovian magnetosphere. The magnetosphere is populated from its outer edge into a distance of at least approximately 30 Jupiter radii (R(J)) by a hot (3 x 10(8) to 5 x 10(8) K) multicomponent plasma consisting primarily of hydrogen, oxygen, and sulfur ions. Outside approximately 30 R(J) the hot plasma exhibits ion densities from approximately 10(-1) to approximately 10(-6) per cubic centimeter and energy densities from approximately 10(-8) to 10(-13) erg per cubic centimeter, suggesting a high beta plasma throughout the region. The plasma is flowing in the corotation direction to the edge of the magnetosphere on the dayside, where it is confined by solar wind pressure, and to a distance of approximately 140 to 160 R(J) on the nightside at approximately 0300 local time. Beyond approximately 150 R(J) the hot plasma flow changes into a "magnetospheric wind" blowing away from Jupiter at an angle of approximately 20 degrees west of the sun-Jupiter line, characterized by a temperature of approximately 3 x 10(8) K (26 kiloelectron volts), velocities ranging from approximately 300 to > 1000 kilometers per second, and composition similar to that observed in the inner magnetosphere. The radial profiles of the ratios of oxygen to helium and sulfur to helium (

Low-energy charged particle environment at jupiter: a first look.

The low-energy charged particle instrument on Voyager was designed to measure the hot plasma (electron and ion energies greater, similar 15 and greater, similar 30 kiloelectron volts, respectively) component of the Jovian magnetosphere. Protons, heavier ions, and electrons at these energies were detected nearly a third of an astronomical unit before encounter with the planet. The hot plasma near the magnetosphere boundary is predominantly composed of protons, oxygen, and sulfur in comparable proportions and a nonthermal power-law tail; its temperature is about 3 x 10(8) K, density about 5 x 10(-3) per cubic centimeter, and energy density comparable to that of the magnetic field. The plasma appears to be corotating throughout the magnetosphere; no hot plasma outflow, as suggested by planetary wind theories, is observed. The main constituents of the energetic particle population ( greater, similar200 kiloelectron volts per nucleon) are protons, helium, oxygen, sulfur, and some sodium observed throughout the outer magnetosphere; it is probable that the sulfur, sodium, and possibly oxygen originate at 1o. Fluxes in the outbound trajectory appear to be enhancedfrom approximately 90 degrees to approximately 130 degrees longitude (System III). Consistent low-energy particle flux periodicities were not observed on the inbound trajectory; both 5-and 10-hour periodicities were observed on the outbound trajectory. Partial absorption of > 10 million electron volts electrons is observed in the vicinity of the Io flux tube.

Venus: an upper limit on intrinsic magnetic dipole moment based on absence of a radiation belt.

On the basis of the absence of energetic electrons (E(e) 45 kiloelectron volts) and protons (E(p) 320 kiloelectron volts) associated with Venus to within a radial distance of 10,150 kilometers from the center of the planet and using a physical similitude argument and the observational and theoretical knowledge of the magnetosphere of Earth, we conclude that the intrinsic magnetic dipole moment of Venus is almost certainly less than 0.01 and probably less than 0.001 of that of Earth. Corresponding upper limits on the magnetic field at the equatorial surface of Venus are about 350 and 35 x 10(-5) gauss, respectively.