An international prospective study of INICC analyzing the incidence and risk factors for catheter-associated urinary tract infections in 235 ICUs across 8 Asian Countries

Background: Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in 235 ICUs in 8 Asian countries: India, Malaysia, Mongolia, Nepal, Pakistan, the Philippines, Thailand, and Vietnam. Methods: From January 1, 2014, to February 12, 2022, we conducted a prospective cohort study. To estimate CAUTI incidence, the number of UC days was the denominator, and CAUTI was the numerator. To estimate CAUTI RFs, we analyzed 11 variables using multiple logistic regression. Results: 84,920 patients hospitalized for 499,272 patient days acquired 869 CAUTIs. The pooled CAUTI rate per 1,000 UC-days was 3.08; for those using suprapubic-catheters (4.11); indwelling-catheters (2.65); trauma-ICU (10.55), neurologic-ICU (7.17), neurosurgical-ICU (5.28); in lower- middle-income countries (3.05); in upper-middle-income countries (1.71); at public-hospitals (5.98), at private-hospitals (3.09), at teaching-hospitals (2.04). The following variables were identified as CAUTI RFs: Age (adjusted odds ratio [aOR] = 1.01; 95% CI = 1.01-1.02; P < .0001); female sex (aOR = 1.39; 95% CI = 1.21-1.59; P < .0001); using suprapubic-catheter (aOR = 4.72; 95% CI = 1.69-13.21; P < .0001); length of stay before CAUTI acquisition (aOR = 1.04; 95% CI = 1.04-1.05; P < .0001); UC and device utilization-ratio (aOR = 1.07; 95% CI = 1.01-1.13; P = .02); hospitalized at trauma-ICU (aOR = 14.12; 95% CI = 4.68-42.67; P < .0001), neurologic-ICU (aOR = 14.13; 95% CI = 6.63-30.11; P < .0001), neurosurgical-ICU (aOR = 13.79; 95% CI = 6.88-27.64; P < .0001); public-facilities (aOR = 3.23; 95% CI = 2.34-4.46; P < .0001). Discussion: CAUTI rate and risk are higher for older patients, women, hospitalized at trauma-ICU, neurologic-ICU, neurosurgical-ICU, and public facilities. All of them are unlikely to change. Conclusions: It is suggested to focus on reducing the length of stay and the Urinary catheter device utilization ratio, avoiding suprapubic catheters, and implementing evidence-based CAUTI prevention recommendations

Alcohol use and burden for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. Methods Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. Findings Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2.2% (95% uncertainty interval [UI] 1.5-3.0) of age-standardised female deaths and 6.8% (5.8-8.0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3.8% (95% UI 3.2-4-3) of female deaths and 12.2% (10.8-13-6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2.3% (95% UI 2.0-2.6) and male attributable DALYs were 8.9% (7.8-9.9). The three leading causes of attributable deaths in this age group were tuberculosis (1.4% [95% UI 1. 0-1. 7] of total deaths), road injuries (1.2% [0.7-1.9]), and self-harm (1.1% [0.6-1.5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27.1% (95% UI 21.2-33.3) of total alcohol-attributable female deaths and 18.9% (15.3-22.6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0.0-0.8) standard drinks per week. Interpretation Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.Peer reviewe

Estimating phenotypic stability for relevant yield and quality traits in French bean (Phaseolus vulgaris L.) using AMMI analysis

The presence of strong G x E (genotype by environment interaction) is a major hurdle for selecting superior genotypes when genotypes are placed into new and unfamiliar production systems. Genotype or cultivar (s) with high yield potential and having less adaptability and stability to particular environment is never a suitable choice for a breeder and farmer particularly. Purposefully, four successive seasons were chosen to enumerate the phenotypic stability of 27 French bean genotypes for yield and quality traits by involving modern statistical tools like AMMI (Additive Main Effect and Multiplicative Interaction), GGE [G + (G x E)] and cluster analysis. AMMI analysis of variance witnessed magnitude of G, E and G x E was 81.94%, 11.58% and 6.48% of the total variation respectively. The IPCA I (Interaction Principal Component Axes) was contributed with 55.44%, 73.60%, 71.81%, 81.69% and 72.16% G x E variations of days to 50% flowering, pod length, number of pods per plant, average pod weight and pod yield respectively. For qualitative traits i.e., protein content (mg/100g FW), total soluble solids (%) and total phenol content (mg GAE/g FW) the involvement of IPCA I to total genotype by environment interaction variations were 89.55%, 96.07% and 66.52% respectively. The AMMI biplot revealed French bean genotypes viz., IC632961, Arka Sukomal, IIHR-PV-29, IIHR-PV-30 having low AMMI stability value and higher mean value for relevant yield and quality traits in both late kharif and rabi as two mega-environments. Multivariate analysis demonstrated significant higher contribution of pod yield associated traits towards total variations and positive correlation between them. The 27 French bean genotypes formed five groups as per Euclidean distance and the clustering revealed the nature of diversity of French bean genotypes viz., IC 632961, IIHR-B-PV-24, Arka Sukomal, Arka Arjun, Ayoka and Phalguni in response to changing environments and can be utilized in future breeding programme. The study revealed pole type French bean genotypes viz., IC 632961, Arka Sukomal and bush type French bean genotypes viz., IIHR-B-PV-29, IIHR-B-PV-30 could be promising for utilization in future breeding programmes for the concerned traits

Scalable Pillar[5]arene-Integrated Poly(arylate-amide) Molecular Sieve Membranes to Separate Light Gases

Molecular sieve membranes and their analogues could potentially transform energy-intensive gas separation processes. However, many such membranes suffer from either limited process ability or physical stability including plasticization of semi-flexible microstructures. Here, we report on a new variation of all-polymer-based molecular sieve membranes that could tackle these specific challenges. These membranes were prepared by the interfacial polymerization of pillar[5]arene, m-phenylenediamine, and trimesoyl chloride to create characteristic poly(arylate-amide) heteropolymer microstructures. Pillar[S]arenes were crosslinked into the films with net weight fractions of up to similar to 47%, wherein the, 4.7 angstrom cavities of pillar[5]arenes were interconnected with similar to 2.8 angstrom apertures. These microstructures provided preferred permeation paths for smaller molecules (He and H-2) among the tested light gases (He, H-2, CO2, O-2, N-2, and CH4) and resulted in significant molecular sieving effects with representative pure gas selectivities of 32 (H-2/CO2), 150 (CO2/CH4), 4600 (H-2/CH4), 13 (O-2/N-2), and 4.7 (N-2/CH4) at 35 degrees C and 10 atm. These separation factors outperform most polymer-based gas separation membranes, while providing membrane features such as thin film barriers, cross-linked polymer backbones, and excellent processability resulting from interfacial polymerization that are critical for large-scale operations.11Nsciescopu