MBIRA - Mortality from Bacterial Infections Resistant to Antibiotics study - underlying data

Antimicrobial resistance is a major global health concern, but there is limited data linking laboratory resistance testing to clinical outcomes, especially from Low-and-Middle-Income countries, including African nations. This is a project collecting prospective data about bloodstream infections caused by Enterobacterales bacteria in African hospitals in 2020-22. A central focus was the impact of 3rd generation cephalosporin (3GC) resistance on patient mortality. In the main study, n=8 hospitals in eight different countries contributed to this project. Preliminary work involved collection of descriptive information from these 8 hospitals, including access to antibiotics in hospital pharmacies. Information was collected for infected patients and matched non-infected patients in same hospitals. The MBIRA study collected data about hospitals, patients, bacterial isolates and antibiotic use. The “mbira_hospital” dataset contains information collected as a one-off event as part of the “hospital” form and the “mbira_pharmacy” contains information on antibiotic availability in pharmacies that were collected each month. Further datasets will be made available at a later date

Flexible and tenacious goal pursuit lead to improving well-being in an aging population: A ten-year cohort study

Background: Previous research has shown that tendencies to tenaciously pursue goals and flexibly adapt goals independently relate to well-being in adults in mid-to-late life, but research has not tested whether these tendencies interact. For example, tenacity may only predict well-being in combination with flexibility. This research tests whether these tendencies interact to predict changes in health-related outcomes. Methods: A large cohort of people (n=5,666), initially aged 55-56, completed measures of flexibility, tenacity, health-related outcomes (physical health, depression, hostility), as well as demographics. Participants provided follow-up data on all measures ten years later. Moderation analysis was used to test whether flexibility and tenacity interacted to predict changes in the health-related outcomes over the period. Results: The interaction between tenacity and flexibility significantly predicted changes in depression, hostility, and physical ill-health symptoms over ten years, such that highly flexible and tenacious individuals experienced the largest decreases in symptoms of depression, hostility, and physical ill-health. Conclusions: The interaction between flexibility and tenacity predicts greater well-being, such that one is most protective when an individual also scores highly on the other. The combination of flexibility and tenacity in the pursuit of personal goals may mean individuals can enjoy gains associated with goal pursuit without the detrimental effects of persevering in blocked goals

Belief in a Just World: Consumer Intentions and Behaviors Toward Ethical Products

Although consumers report positive attitudes toward ethical goods, their intentions and behaviors often do not follow suit. Just-world theory highlights the conditions under which consumers are most likely to prefer fair-trade products. This theory proposes that people are motivated to construe the world as a just place where people get what they deserve. In the current research, when people are confronted with high levels of injustice (communicated need is high) and avenues for justice restoration seem uncertain or unavailable, assisting others by supporting fair trade decreases. However, highlighting how injustice can be redressed through purchases enhances fair-trade support under conditions of high need. The effects are moderated by justice sensitivity factors, such as just-world beliefs and whether the product type (indulgence vs. necessity) makes the injustice of consumer privilege salient. The results suggest that communicating high need when requesting consumer prosocial actions can sometimes backfire. Marketers employing high need appeals should heighten perceptions of justice restoration potential and activate fairness-related thoughts through product positioning to encourage fair-trade purchases

Longitudinal Assessment of an ELISPOT Test for Mycobacterium tuberculosis Infection

Philip Hill and colleagues report that both ELISPOT conversion and reversion occur afterM. tuberculosis exposure in an endemic country and that the ELISPOT results agree poorly with results from the tuberculin skin test

Coccolithophore ecology in the tropical and subtropical Atlantic Ocean: New perspectives from the Atlantic Meridional Transect (AMT) programme

Coccolithophore species composition was determined in 199 samples collected from the upper 300 m of the Atlantic Ocean, spanning temperate, tropical and subtropical waters in both hemispheres during four Atlantic Meridional Transect (AMT) cruises over the period 2003 to 2005. Of the 171 taxa observed, 140 consistently represented less than 5% of total cell numbers, and were classed as rare. Multivariate statistical techniques were used on the common taxa to assess variability in community composition vertically in the water column, horizontally across hydrographic provinces (subtropical gyres, equatorial waters, temperate waters), and temporally between cruises. Sharper gradients of statistical dissimilarity in species composition occurred vertically over a few tens of metres than horizontally over hundreds of kilometres. Three floral groups were identified from analysis of the depth of normalised abundance maxima in the subtropical gyres and equatorial waters: the upper euphotic zone (UEZ, >10% surface irradiance); the lower euphotic zone (LEZ, 10-1% surface irradiance); and the sub-euphotic zone (SEZ, <1% surface irradiance). The LEZ includes the deep chlorophyll maximum (DCM) and nutricline, and was characterised by species such as Emiliania huxleyi and Gephyrocapsa ericsonii which were also abundant at higher latitudes. It is suggested that this pattern reflects similarities in the light (and inorganic nutrient) conditions between the LEZ and temperate waters. The SEZ is below the depth where light is thought to be sufficient to support photosynthesis, suggesting that deep-dwelling species such as Florisphaera profunda and Gladiolithus spp. may be mixotrophic or phagotrophic, although conclusive proof will need to be gained experimentally. Mixotrophy could also be an important nutritional strategy for species abundant (Umbellosphaera spp., holococcolithophores) in the UEZ where inorganic nutrient concentrations are depleted and limiting to growth, although other nutritional strategies, such as the use of organic nutrients, are also possible. Statistical differences were also found in the species composition between the different cruises, with high levels of similarity for similar timed cruises (May or September-October). Few individual taxa showed significant variability in abundance over the time-span of sampling, except species such as E. huxleyi and G. ericsonii at higher latitudes. In subtropical and equatorial waters, high levels of species richness and low levels of species dominance remained throughout the sampling period indicating that seasonal fluctuations reflected differences in the whole coccolithophore community rather than in just one or a few species. Multivariate analyses of the taxa classified as rare also indicated some level of temporal, as well as vertical, zonation. Such insights into coccolithophore ecology and community composition provide important new perspectives that require innovative research to fully understand their impact on ocean biogeochemistry

Explaining the effect of rapid internationalization on horizontal foreign divestment in the retail sector. An extended penrosean perspective

Building on and extending Penrosean logic we argue that rapid international expansion by firms might lead to a breach of Penrosean constraints on efficient expansion and to subsequent divestment of international operations to bring firm scope back into Penrosean constraints. We further predict that intra-regional concentration and international experience moderate the above effect because they influence firms ability to avoid a breach of Penrosean constraints and/or weaken the consequences of such a breach. Using data on the international expansion and divestment of large retail MNEs over the period 2003-2012 we find empirical support for the proposed extended Penrose effect in explaining international divestment as well as for the moderating effects of intra-regional concentration and international experience. Our study contributes to the development of Penrosean logic and to our understanding of the factors that drive firms to divest overseas operations

Carbapenem resistance expressed by Gram-negative bacilli isolated from a cohort of Libyan patients

Background and objectives: Carbapenem-resistant Enterobacteriaceae (CRE) and other Gram-negative bacteria are among the most common pathogens responsible for both community and hospital acquired infection. The global spread of cephalosporinases in Enterobacteriaceae has led to the increased use of carbapenems resulting in the emergence and rapid spread of CRE. This has become an alarming public health concern, yet the condition in Libya remains unclear. The aim of this study was to obtain a better understanding of CRE strains prevalent in Libyan patients by investigating their phenotypic characteristics and antibiograms. Methods: Gram-negative bacterial species were collected from Misrata Central Hospital, Misrata Cancer Centre and Privet Pathology Laboratories. Clinical samples and swabs were obtained from hospitalised and non-hospitalised patients and from mechanical ventilation and suction machines. Patients who had received antibiotic therapy for at least three days prior to the study were excluded. The identification and characterization of the isolated species were achieved using the growth characteristics on MacConkey and blood agar, spot tests and API 20E or API 20NE biochemical testing systems. Screening for carbapenem resistance was performed using the disk diffusion method with carbapenem 10 μg and cephalosporin 30 μg disks and minimum inhibitory concentrations (MIC) determined using the Sensititre Gram-negative Xtra plate format (GNX2F). All strains demonstrating resistance or reduced susceptibility to one of the four carbapenems were subjected to carbapenememase activity detection using the RAPIDEC CARBA NP test, Modified Hodge test and carbapenem inactivation methods. Results: A total of one hundred and forty isolates representing fourteen bacterial species were isolated from 140 non-duplicated specimens. Clinical specimens included urine samples (96/140, 68.57%), sputum (15/140, 10.71%), surgical wound swabs (18/140, 12.85%), foot swabs from diabetes mellitus (DM) patients (6/140, 4.29%), ear swabs (3/140, 2.14%) and wound swabs (2/140, 1.43%). Thirty-four (24.29%) isolates demonstrated resistance to at least one of the four carbapenems with Klebsiella pneumoniae representing 73.53% (25 isolates) of all carbapenem resistant species, followed by 8.82% for Pseudomonas aeruginosa (3 isolates), 5.88% for both Proteus mirabilis (2 isolates) and Escherichia coli (2 isolates) and 2.94% for both Citrobacter koseri (1 isolate) and Rahnella aquatilis (1 isolate). The other isolates were either susceptible or cephalosporinase producers. Conclusion: This study has revealed the high rate of carbapenem resistance amongst Libyan patients and emphasizes the crucial need for accurate screening, identification and susceptibility testing to prevent further spread of nosocomial and community acquired resistance. This may be achieved through the establishment of antibiotic stewardship programmes along with firm infection control practices.National Research Foundation of South Africa; Libyan GovernmentWeb of Scienc

The set constraint/cfl reachability connection in practice

Many program analyses can be reduced to graph reachability problems involving a limited form of context-free language reachability called Dyck-CFL reachability. We show a new reduction from Dyck-CFL reachability to set constraints that can be used in practice to solve these problems. Our reduction is much simpler than the general reduction from context-free language reachability to set constraints. We have implemented our reduction on top of a set constraints toolkit and tested its performance on a substantial polymorphic flow analysis application