Quinolone resistance mutations in the faecal microbiota of Swedish travellers to India

Background: International travel contributes to the spread of antibiotic resistant bacteria over the world. Most studies addressing travel-related changes in the faecal flora have focused on specific mobile resistance genes, or depended on culturing of individual bacterial isolates. Antibiotic resistance can, however, also spread via travellers colonized by bacteria carrying chromosomal antibiotic resistance mutations, but this has received little attention so far. Here we aimed at exploring the abundance of chromosomal quinolone resistance mutations in Escherichia communities residing in the gut of Swedish travellers, and to determine potential changes after visiting India. Sweden is a country with a comparably low degree of quinolone use and quinolone resistance, whereas the opposite is true for India. Methods: Massively parallel amplicon sequencing targeting the quinolone-resistance determining region of gyrA and parC was applied to total DNA extracted from faecal samples. Paired samples were collected from 12 Swedish medical students before and after a 4-15 week visit to India. Twelve Indian residents were included for additional comparisons. Methods known resistance mutations were common in Swedes before travel as well as in Indians, with a trend for all mutations to be more common in the Indian sub group. There was a significant increase in the abundance of the most common amino acid substitution in GyrA (S83L, from 44 to 72 %, p = 0.036) in the samples collected after return to Sweden. No other substitution, including others commonly associated with quinolone resistance (D87N in GyrA, S80I in ParC) changed significantly. The number of distinct genotypes encoded in each traveller was significantly reduced after their visit to India for both GyrA (p = 0.0020) and ParC (p = 0.0051), indicating a reduced genetic diversity, similar to that found in the Indians. Conclusions: International travel can alter the composition of the Escherichia communities in the faecal flora, favouring bacteria carrying certain resistance mutations, and, thereby, contributes to the global spread of antibiotic resistance. A high abundance of specific mutations in Swedish travellers before visiting India is consistent with the hypothesis that these mutation have no fitness cost even in the absence of an antibiotic selection pressure

Chapter 11 Circular Economy on Bioplastics and Biobased Polymers

Biobased biodegradable polymers are emerging as an alternative to fossil fuel-based plastics. Biodegradable Polymers, Blends and Biocomposites: Trends and Applications discusses trends in the development of microbial/other renewable source-based bioplastic products, their blends and biocomposites applications in various industrial fields. It covers biodegradable polymeric materials preparation, extraction, formulation, modification of properties, product development and applications and end-of-life options. Furthermore, the book discusses topics like bioplastic resources, isolation procedures, utilization at commercial level and markets and economy. Features: Explains emerging application possibilities of biobased biodegradable polymers. Provides detailed application notes on agricultural waste-based bioplastics. Covers microbial and agro-based biocomposites and their applications. Summarizes bioplastic degradation and blending research. Discusses application possibilities of biobased biodegradable polymers. The book is aimed at researchers and graduate students in polymers and composites

Test Suite Reduction Using HGS Based Heuristic Approach

Regression testing is performed throughout the software lifecycle to uncover the faults as early as possible and to ensure that changes do not have any adverse effect in the software that is operational. Test suites once developed are reused and updated frequently. As the software evolves, test cases in the test suite may become redundant. The reason behind this is that the requirements covered by newly added test cases may also be covered by the existing test cases. This redundant nature of test suite increases the cost of executing the same. Further, resource and time constraints impose the necessity to develop techniques to minimize test suites by removing redundant test cases. Few heuristic approaches have been used to solve the test suite minimization problem. Even though solutions exist, still the redundancy of test case remains. In order to solve this problem, this paper proposes two Harrold-Gupta-Soffa (HGS) based heuristic algorithms namely, Non Redundant HGS and Enhanced HGS. The former utilizes the redundant strategy available with Greedy, Redundant, Essential (GRE) to get rid of redundancy, whereas the latter selects a test case for higher cardinalities based on overall coverage of unmarked associated testing sets and thus arrives at reduced, non-redundant test suite. The experiments show that the proposed algorithms always select smaller size of test suite, compared to the existing HGS heuristics

HUBUNGAN ANTARA TINGKAT KECERDASAN SPIRITUAL DENGAN TINGKAT STRES PADA MAHASISWA FAKULTAS KESEHATAN MASYARAKAT UNIVERSITAS SAM RATULANGI MANADO

Stres dapat menyebabkan masalah kesehatan fisik serta mental dan bahkan dapat berujung pada kematian akibat bunuh diri. Kecerdasan spiritual ialah kemampuan guna memahami serta mengurai problematika pemaknaan serta nilai, yang berperan penting dalam membantu mereduksi stres, sehingga meningkatkan daya tahan individu dalam menghadapi tekanan. Penelitian ini memiliki tujuan guna mengetahui hubungannya diantara tingkat kecerdasan spiritual dan tingkat stres kepada mahasiswa Fakultas Kesehatan Masyarakat Universitas Sam Ratulangi Manado. Kajian ini menggunakan studi kuantitatif melalui metode survei analitik maupun pendekatan cross-sectional. Sampel terdiri atas 262 mahasiswa angkatan 2021 yang berada pada semester VI. Hasil penelitian menunjukkan bahwasanya uji korelasi Spearman menghasilkan nilai r= -0,207 serta p= 0,001 (<0,05), memperlihatkan terdapatnya korelasi besar di kecerdasan spiritual dan tingkat stres pada kekuatan hubungan lemah serta arah yang negatif atau tidak searah. Dalam hal ini, meningginya tingkat kecerdasan spiritual mahasiswa, merendah pula tingkat stres yang dirasakan

Fresh and hardened properties of self-compacting concrete modified with lightweight and recycled aggregates

A produção de concretos auto compactáveis de baixa massa específica tornou-se um grande desafio para a engenharia civil, principalmente quanto à dosagem e manutenção das resistências mecânicas. Nesse contexto, o objetivo deste trabalho foi analisar concretos autoadensáveis (CAA) produzidos com agregados leves e reciclados. Fixou-se as dosagens de sílica ativa, pó de pedra, pedrisco, argila expandida e superplastificante, variando-se a porcentagem do resíduo de borracha em 5% e 10%, em substituição ao agregado miúdo. As amostras foram submetidas aos ensaios de espalhamento, viscosidade, habilidade passante, resistências à compressão e à tração por compressão diametral e, massa específica. Verificou-se que os CAA produzidos apresentaram coesão e trabalhabilidade adequados, bem como atendem as condições normativas para uso em peças pré-moldadas e estruturais1117684COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESsem informaçã

Impact of Time Optimization Intervention on Work Execution and Burnout among Nurses Working at Intensive Care Unit

Introduction: time optimization techniques are essential tools that have to make self-governance in order to complete any task on given time universally. The intensive care nurses (ICN) face many challenges at work due to fluid environment. Purpose: Time optimization benefits good work execution by reducing burnout among ICN.Method: multicenter quantitative experimental one group pre-test- Post-test design. Questionnaires were answered by ICNs(self-report) and also bythe shift incharge, and ICU incharge about the ICNs on work execution and Burnout, before and after nurse–guided time optimization video teaching.Results: participants were from two blocks (n =50). Nurse–guided time optimization showed fair work execution and burnout dropped from very high to average burnout. There was a weak positive correlation between work execution and burnout. Good compliance with time optimization sheet was found among ICNs.Conclusions and Contributions to the Field: time optimization and burnout were common problems in ICU. Nurse–guided time optimization intervention was an effective strategy in bridging the gap between the planning and execution of nursing care. However, burnout depends on various factors like long hours, stressful environment and family burden apart from time optimization. Continuous practice of these interventions with time optimization sheet will develop the nurse to become proficient in rendering quality care to critically ill patient

Pretreatment of plastic waste: Removal of colorants from hdpe using biosolvents

UIDB/50011/2020 UIDP/50011/2020 CA18220, 2020.00647.CEECIND UIDB/50006/2020 UIDP/50006/2020Plastics recycling remains a challenge due to the relatively low quality of the recycled material, since most of the developed recycling processes cannot deal with the additives present in the plastic matrix, so the recycled products end up in lower-grade applications. The application of volatile organic solvents for additives removal is the preferred choice. In this study, pretreatment of plastic packaging waste to remove additives using biosolvents was investigated. The plastic waste used was high-density polyethylene (HDPE) with blue and orange colorants (pigment and/or dye). The first step was to identify the type of colorants present in the HDPE, and we found that both plastics presented only one colorant that was actually a pigment. Then, limonene, a renewable solvent, was used to solubilize HDPE. After HDPE dissolution, a wide range of alcohols (mono-, di-, and tri-alcohols) was evaluated as antisolvents in order to selectively precipitate the polymer and maximize its purity. The use of limonene as solvent for plastic dissolution, in combination with poly-alcohols with an intermediate alkyl chain length and a large number of hydroxyl (OH) groups, was found to work best as an antisolvent (1,2,3-propanetriol and 1,2,4-butanetriol), leading to a removal of up to 94% and 100% of the blue and orange pigments, respectively. Finally, three cycles of extraction were carried out, proving the capability of the solvent and antisolvent to be recovered and reused, ensuring the economic viability and sustainability of the process. This pretreatment provides a secondary source of raw materials and revenue for the recycling process, which may lead to an increase in the quality of recycled polymers, contributing to the development of an economical and sustainable recycling process.publishersversionpublishe

ITALIAN CANCER FIGURES - REPORT 2015: The burden of rare cancers in Italy = I TUMORI IN ITALIA - RAPPORTO 2015: I tumori rari in Italia

OBJECTIVES: This collaborative study, based on data collected by the network of Italian Cancer Registries (AIRTUM), describes the burden of rare cancers in Italy. Estimated number of new rare cancer cases yearly diagnosed (incidence), proportion of patients alive after diagnosis (survival), and estimated number of people still alive after a new cancer diagnosis (prevalence) are provided for about 200 different cancer entities. MATERIALS AND METHODS: Data herein presented were provided by AIRTUM population- based cancer registries (CRs), covering nowadays 52% of the Italian population. This monograph uses the AIRTUM database (January 2015), which includes all malignant cancer cases diagnosed between 1976 and 2010. All cases are coded according to the International Classification of Diseases for Oncology (ICD-O-3). Data underwent standard quality checks (described in the AIRTUM data management protocol) and were checked against rare-cancer specific quality indicators proposed and published by RARECARE and HAEMACARE (www.rarecarenet.eu; www.haemacare.eu). The definition and list of rare cancers proposed by the RARECAREnet "Information Network on Rare Cancers" project were adopted: rare cancers are entities (defined as a combination of topographical and morphological codes of the ICD-O-3) having an incidence rate of less than 6 per 100,000 per year in the European population. This monograph presents 198 rare cancers grouped in 14 major groups. Crude incidence rates were estimated as the number of all new cancers occurring in 2000-2010 divided by the overall population at risk, for males and females (also for gender-specific tumours).The proportion of rare cancers out of the total cancers (rare and common) by site was also calculated. Incidence rates by sex and age are reported. The expected number of new cases in 2015 in Italy was estimated assuming the incidence in Italy to be the same as in the AIRTUM area. One- and 5-year relative survival estimates of cases aged 0-99 years diagnosed between 2000 and 2008 in the AIRTUM database, and followed up to 31 December 2009, were calculated using complete cohort survival analysis. To estimate the observed prevalence in Italy, incidence and follow-up data from 11 CRs for the period 1992-2006 were used, with a prevalence index date of 1 January 2007. Observed prevalence in the general population was disentangled by time prior to the reference date (≤2 years, 2-5 years, ≤15 years). To calculate the complete prevalence proportion at 1 January 2007 in Italy, the 15-year observed prevalence was corrected by the completeness index, in order to account for those cancer survivors diagnosed before the cancer registry activity started. The completeness index by cancer and age was obtained by means of statistical regression models, using incidence and survival data available in the European RARECAREnet data. RESULTS: In total, 339,403 tumours were included in the incidence analysis. The annual incidence rate (IR) of all 198 rare cancers in the period 2000-2010 was 147 per 100,000 per year, corresponding to about 89,000 new diagnoses in Italy each year, accounting for 25% of all cancer. Five cancers, rare at European level, were not rare in Italy because their IR was higher than 6 per 100,000; these tumours were: diffuse large B-cell lymphoma and squamous cell carcinoma of larynx (whose IRs in Italy were 7 per 100,000), multiple myeloma (IR: 8 per 100,000), hepatocellular carcinoma (IR: 9 per 100,000) and carcinoma of thyroid gland (IR: 14 per 100,000). Among the remaining 193 rare cancers, more than two thirds (No. 139) had an annual IR <0.5 per 100,000, accounting for about 7,100 new cancers cases; for 25 cancer types, the IR ranged between 0.5 and 1 per 100,000, accounting for about 10,000 new diagnoses; while for 29 cancer types the IR was between 1 and 6 per 100,000, accounting for about 41,000 new cancer cases. Among all rare cancers diagnosed in Italy, 7% were rare haematological diseases (IR: 41 per 100,000), 18% were solid rare cancers. Among the latter, the rare epithelial tumours of the digestive system were the most common (23%, IR: 26 per 100,000), followed by epithelial tumours of head and neck (17%, IR: 19) and rare cancers of the female genital system (17%, IR: 17), endocrine tumours (13% including thyroid carcinomas and less than 1% with an IR of 0.4 excluding thyroid carcinomas), sarcomas (8%, IR: 9 per 100,000), central nervous system tumours and rare epithelial tumours of the thoracic cavity (5%with an IR equal to 6 and 5 per 100,000, respectively). The remaining (rare male genital tumours, IR: 4 per 100,000; tumours of eye, IR: 0.7 per 100,000; neuroendocrine tumours, IR: 4 per 100,000; embryonal tumours, IR: 0.4 per 100,000; rare skin tumours and malignant melanoma of mucosae, IR: 0.8 per 100,000) each constituted <4% of all solid rare cancers. Patients with rare cancers were on average younger than those with common cancers. Essentially, all childhood cancers were rare, while after age 40 years, the common cancers (breast, prostate, colon, rectum, and lung) became increasingly more frequent. For 254,821 rare cancers diagnosed in 2000-2008, 5-year RS was on average 55%, lower than the corresponding figures for patients with common cancers (68%). RS was lower for rare cancers than for common cancers at 1 year and continued to diverge up to 3 years, while the gap remained constant from 3 to 5 years after diagnosis. For rare and common cancers, survival decreased with increasing age. Five-year RS was similar and high for both rare and common cancers up to 54 years; it decreased with age, especially after 54 years, with the elderly (75+ years) having a 37% and 20% lower survival than those aged 55-64 years for rare and common cancers, respectively. We estimated that about 900,000 people were alive in Italy with a previous diagnosis of a rare cancer in 2010 (prevalence). The highest prevalence was observed for rare haematological diseases (278 per 100,000) and rare tumours of the female genital system (265 per 100,000). Very low prevalence (<10 prt 100,000) was observed for rare epithelial skin cancers, for rare epithelial tumours of the digestive system and rare epithelial tumours of the thoracic cavity. COMMENTS: One in four cancers cases diagnosed in Italy is a rare cancer, in agreement with estimates of 24% calculated in Europe overall. In Italy, the group of all rare cancers combined, include 5 cancer types with an IR>6 per 100,000 in Italy, in particular thyroid cancer (IR: 14 per 100,000).The exclusion of thyroid carcinoma from rare cancers reduces the proportion of them in Italy in 2010 to 22%. Differences in incidence across population can be due to the different distribution of risk factors (whether environmental, lifestyle, occupational, or genetic), heterogeneous diagnostic intensity activity, as well as different diagnostic capacity; moreover heterogeneity in accuracy of registration may determine some minor differences in the account of rare cancers. Rare cancers had worse prognosis than common cancers at 1, 3, and 5 years from diagnosis. Differences between rare and common cancers were small 1 year after diagnosis, but survival for rare cancers declined more markedly thereafter, consistent with the idea that treatments for rare cancers are less effective than those for common cancers. However, differences in stage at diagnosis could not be excluded, as 1- and 3-year RS for rare cancers was lower than the corresponding figures for common cancers. Moreover, rare cancers include many cancer entities with a bad prognosis (5-year RS <50%): cancer of head and neck, oesophagus, small intestine, ovary, brain, biliary tract, liver, pleura, multiple myeloma, acute myeloid and lymphatic leukaemia; in contrast, most common cancer cases are breast, prostate, and colorectal cancers, which have a good prognosis. The high prevalence observed for rare haematological diseases and rare tumours of the female genital system is due to their high incidence (the majority of haematological diseases are rare and gynaecological cancers added up to fairly high incidence rates) and relatively good prognosis. The low prevalence of rare epithelial tumours of the digestive system was due to the low survival rates of the majority of tumours included in this group (oesophagus, stomach, small intestine, pancreas, and liver), regardless of the high incidence rate of rare epithelial cancers of these sites. This AIRTUM study confirms that rare cancers are a major public health problem in Italy and provides quantitative estimations, for the first time in Italy, to a problem long known to exist. This monograph provides detailed epidemiologic indicators for almost 200 rare cancers, the majority of which (72%) are very rare (IR<0.5 per 100,000). These data are of major interest for different stakeholders. Health care planners can find useful information herein to properly plan and think of how to reorganise health care services. Researchers now have numbers to design clinical trials considering alternative study designs and statistical approaches. Population-based cancer registries with good quality data are the best source of information to describe the rare cancer burden in a population