A One-Health integrated approach to control fascioliasis in the Cajamarca valley of Peru

Fasciola hepatica infection is reported from many Latin American countries, with very high prevalence rates in both humans and livestock in the Andean countries. Due to its environmental characteristics, particularly suitable for liver fluke infection, the Cajamarca valley of Peru has often been chosen as a model to study the epidemiology of liver fluke infection in the Andes. In this paper we describe the profile of a project aimed at a multidisciplinary and integrated approach for the control of fascioliasis in animals and humans in this valley. The One-Health integrated approach applied here is based on accurate and sensitive diagnostics, namely the FLOTAC, and the use of geospatial tools for epidemiological scrutiny

Percepción de los estudiantes de la Universidad Sergio Arboleda sobre la policía nacional de Colombia

Desde el año 2014, la Universidad Sergio Arboleda en conjunto con la Policía Nacional de Colombia, ha venido implementado un programa para mejorar la percepción de estudiantes universitarios respecto a la institución policial, dentro del contexto social colombiano, mediante el uso del deporte y actividades lúdicas. El presente artículo, representa una descripción y análisis sobre la efectividad de dicho programa. Se desarrollaron e implementaron instrumentos y métodos mixtos entre 59 estudiantes universitarios, tales como encuestas y grupos focales. En general, se encontró que los participantes mejoraron su percepción respecto a la Policía Nacional, y a su rol en la sociedad luego de experiencias en actividades compartidas. Los resultados sugieren que, una interacción basada en deporte y esparcimiento, entre el cuerpo de policía y la ciudadanía, especialmente en los segmentos más jóvenes, logra una percepción positiva, que facilita la confianza entre los ciudadanos hacia los funcionarios y la institución policial

Efectos de la posición de plantación y la aplicación de Azospirillum brasilense en el crecimiento inicial de la yuca (Manihot esculenta crantz).

This work aimed to evaluate the effect of the strick planting position and Azospirillum brasilense application on the initial growth of cassava. The assay was carried out following a completely randomized experimental design, with factorial arrangement (planting positions [horizontal (HP) and vertical (PV)] and the A. brasilense [with (+Azos) and without (-Azos)]). The sprouting percentage (SP) was evaluated from 11 to 35 days after planting (DAP). After 30 DAP, the following variables were evaluated: sprouts number (SN), sprouts height (SH), number of leaflets (NL), length of leaflets (LL), and vegetative vigor (VV). Cassava plants positioning significantly influenced the initial growth. PV promotes a greater sprouting, 63% in 17 DAP, over the PH which was only 3% of the visible shoots during the same period. Here we show for the first time that PV promoted the highest values combined with -Azos in the variables SH (an increase of 17%) and VV (an increase of 61%). The PH, in combination with +Azos, stimulated the NL in 20%. The sub-division into three VV groups allowed identify the existence of differences among the treatments which were not seen in an independent ANOVA being VV an important variable for the initial growth evaluation in cassava.El trabajo tuvo como objetivo evaluar el efecto de la posición del propágulo de yuca y la aplicación de Azospirillum brasilense en el desarrollo inicial de la plántula. El experimento se realizó siguiendo un diseño completamente aleatorizado, con arreglo factorial (posición del propágulo [horizontal (PH) y vertical (PV)] y A. Brasilense [con (+Azos) y sin (-Azos)]. El porcentaje de brotación (PB) se evaluó de 11 a 35 días después de la siembra (DAP). Luego de 30 DAP, se evaluaron las siguientes variables: número de brotes (NB), altura de brotes (AB), número de folíolos (NF), longitud de folíolos (LF) y vigor vegetal (VV). La posición de las plantas de yuca influyó significativamente en el crecimiento inicial. La PV promueve una mayor brotación, 63% en 17 DAP, sobre la PH que fue del orden de 3% de los brotes visibles en el mismo período. En el trabajo se muestra que la PV promovió los valores más altos combinados con -Azos en las variables AB (aumento de 17%) y VV (aumento de 61%). La PH, en combinación con +Azos, estimuló el NF en 20%. La subdivisión en tres grupos de VV permitió identificar de forma visual diferencias entre tratamientos, que no se observaron en un ANOVA independiente. La VV es una variable importante para la evaluación del desarrollo inicial de la yuca

Low-cost Approaches to Follow-up Cardiac Patients in Low-Income Countries using Public Data Networks

The main characteristics of three approaches to cardiac care using public data networks are presented. All efforts were addressed to get minimum-cost solutions for low-budget public health systems. The first solution was developed to follow-up arrhythmic patients between medical consultations, setting a more closed patient-physician relationship, and a daily recording of cardiac rhythm changes. It is based on a personal battery-powered device for one-channel ECG recording, minimizing electrode setting and operation complexity. An ECG recording taken daily allows a detailed analysis anytime without the patient’s traveling to a health institution. A second solution was aimed at monitoring high-risk cardiac patients. A 24-h portable device capable of monitoring heart rate and sudden falls, typically associated with cardiac syncope, was developed. When any cardiac event or fall is detected, an urgent message is sent to relatives and the medical emergency care system asking for help. The third system implemented is oriented to the study of different cardiac parameters in people who suffer from heart disease or in those who are prone to suffering from it. Twelve-lead ECG is recorded periodically by each patient and trend graphics reflect ECG parameters strongly associated with cardiac disturbances, such as sudden death and ischemia. This approach allows the detection of the first troubling electrocardiographic deviations, making possible early medical intervention

Road safety evaluation through automatic extraction of road horizontal alignments from Mobile LiDAR System and inductive reasoning based on a decision tree

13 p.Safe roads are a necessity for any society because of the high social costs of traffic accidents. This challenge is addressed by a novel methodology that allows us to evaluate road safety from Mobile LiDAR System data, taking advantage of the road alignment due to its influence on the accident rate. Automation is obtained through an inductive reasoning process based on a decision tree that provides a potential risk assessment. To achieve this, a 3D point cloud is classified by an iterative and incremental algorithm based on a 2.5D and 3D Delaunay triangulation, which apply different algorithms sequentially. Next, an automatic extraction process of road horizontal alignment parameters is developed to obtain geometric consistency indexes, based on a joint triple stability criterion. Likewise, this work aims to provide a powerful and effective preventive and/or predictive tool for road safety inspections. The proposed methodology was implemented on three stretches of Spanish roads, each with different traffic conditions that represent the most common road types. The developed methodology was successfully validated through as-built road projects, which were considered as “ground truth.”S

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Oral saliva swab reverse transcription PCR for Covid-19 in the paediatric population

8Pág. Centro de Investigación en Sanidad Animal (CISA)To evaluate the performance of oral saliva swab (OSS) reverse transcription PCR (RT-PCR) compared with RT-PCR and antigen rapid diagnostic test (Ag-RDT) on nasopharyngeal swabs (NPS) for SARS-CoV-2 in children.The study was funded by: Project PI20/00095, from the Instituto de Salud Carlos III (Ministry of Economy, Industry and Competitiveness) and cofounded by the European Regional Development Fund, by Infanta Sofia University Hospital and Henares University Hospital Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), and by SERMAS-Fundación para la Investigación Biomédica del Hospital 12 de Octubre. EC-C is supported by the Spanish Society of Paediatrics (Asociación Española de Pediatría); Grant COVID-19 EPICO-AEP 2020. JMM is funded by SERMAS-Fundación para la Investigación Biomédica del Hospital Infanta Sofía y del Henares and by Universidad Europea de Madrid, Spain. MdlS is funded by Grant Cantera de Investigación Santander, Fundación Universidad Europea de Madrid, Spain. ED is funded by the Juan de la Cierva–Incorporación granted by the Spanish Ministry of Science and Innovation. DB-G is funded by the Spanish Ministry of Science and Innovation—Instituto de Salud Carlos III and Fondos FEDER by ’Contratos para la intensificación de la actividad investigadora en el Sistema Nacional de Salud, 2020 (INT20/00086)’.Peer reviewe

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication