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Implementation research for the prevention of antimicrobial resistance and healthcare-associated infections; 2017 Geneva infection prevention and control (IPC)-think tank (part 1)
Background
Around 5–15% of all hospital patients worldwide suffer from healthcare-associated infections (HAIs), and years of excessive antimicrobial use in human and animal medicine have created emerging antimicrobial resistance (AMR). A considerable amount of evidence-based measures have been published to address these challenges, but the largest challenge seems to be their implementation.
Methods
In June 2017, a total of 42 experts convened at the Geneva IPC-Think Tank to discuss four domains in implementation science: 1) teaching implementation skills; 2) fostering implementation of IPC and antimicrobial stewardship (AMS) by policy making; 3) national/international actions to foster implementation skills; and 4) translational research bridging social sciences and clinical research in infection prevention and control (IPC) and AMR.
Results
Although neglected in the past, implementation skills have become a priority in IPC and AMS. They should now be part of any curriculum in health care, and IPC career paths should be created. Guidelines and policies should be aligned with each other and evidence-based, each document providing a section on implementing elements of IPC and AMS in patient care. International organisations should be advocates for IPC and AMS, framing them as patient safety issues and emphasizing the importance of implementation skills. Healthcare authorities at the national level should adopt a similar approach and provide legal frameworks, guidelines, and resources to allow better implementation of patient safety measures in IPC and AMS. Rather than repeating effectiveness studies in every setting, we should invest in methods to improve the implementation of evidence-based measures in different healthcare contexts. For this, we need to encourage and financially support collaborations between social sciences and clinical IPC research.
Conclusions
Experts of the 2017 Geneva Think Tank on IPC and AMS, CDC, and WHO agreed that sustained efforts on implementation of IPC and AMS strategies are required at international, country, and hospital management levels, to provide an adequate multimodal framework that addresses (not exclusively) leadership, resources, education and training for implementing IPC and AMS. Future strategies can build on this agreement to make strategies on IPC and AMS more effective
CONSISE statement on the reporting of Seroepidemiologic Studies for influenza (ROSES-I statement): an extension of the STROBE statement
published_or_final_versio
Structural transformation in vesicles upon hydrolysis of phosphatidylethanolamine and phosphatidylcholine with phospholipase C
This study provides insights into dynamic nanostructural changes in phospholipid systems during hydrolysis with phospholipase C, the fate of the hydrolysis products, and the kinetics of lipolysis. The effect of lipid restructuring of the vesicle was investigated using small-angle X-ray scattering and cryogenic scanning electron microscopy. The rate and extent of phospholipid hydrolysis were quantified using nuclear magnetic resonance. Hydrolysis of two phospholipids, phosphatidylethanolamine (PE) and phosphatidylcholine (PC), results in the cleavage of the molecular headgroup, causing two strikingly different changes in lipid self-assembly. The diacylglycerol product of PC escapes the lipid bilayer, whereas the diacylglycerol product adopts a different configuration within the lipid bilayer of the PE vesicles. These results are then discussed concerning the change of the lipid configuration upon the lipid membrane and its potential implications in vivo, which is of significant importance for the detailed understanding of the fate of lipidic particles and the rational design of enzyme-responsive lipid-based drug delivery systems
Effective practices of international volunteering for health : perspectives from partner organizations
Abstract: The demand for international volunteer experiences to promote global health and nutrition is increasing and numerous studies have documented the experiences of the international volunteers who travel abroad; however, little is known about effective practices from the perspective of partner organizations. This study aims to understand how variables such as the skill-level of volunteers, the duration of service, cultural and language training, and other key variables affect partner organizations’ perceptions of volunteer effectiveness at promoting healthcare and nutrition..
Iceland is an episodic source of atmospheric ice-nucleating particles relevant for mixed-phase clouds.
Ice-nucleating particles (INPs) have the potential to remove much of the liquid water in climatically important mid- to high-latitude shallow supercooled clouds, markedly reducing their albedo. The INP sources at these latitudes are very poorly defined, but it is known that there are substantial dust sources across the high latitudes, such as Iceland. Here, we show that Icelandic dust emissions are sporadically an important source of INPs at mid to high latitudes by combining ice-nucleating active site density measurements of aircraft-collected Icelandic dust samples with a global aerosol model. Because Iceland is only one of many high-latitude dust sources, we anticipate that the combined effect of all these sources may strongly contribute to the INP population in the mid- and high-latitude northern hemisphere. This is important because these emissions are directly relevant for the cloud-phase climate feedback and because high-latitude dust emissions are expected to increase in a warmer climate
Exploring Protein-Protein Interactions as Drug Targets for Anti-cancer Therapy with In Silico Workflows
We describe a computational protocol to aid the design of small molecule and peptide drugs that target protein-protein interactions, particularly for anti-cancer therapy. To achieve this goal, we explore multiple strategies, including finding binding hot spots, incorporating chemical similarity and bioactivity data, and sampling similar binding sites from homologous protein complexes. We demonstrate how to combine existing interdisciplinary resources with examples of semi-automated workflows. Finally, we discuss several major problems, including the occurrence of drug-resistant mutations, drug promiscuity, and the design of dual-effect inhibitors.Fil: Goncearenco, Alexander. National Institutes of Health; Estados UnidosFil: Li, Minghui. Soochow University; China. National Institutes of Health; Estados UnidosFil: Simonetti, Franco Lucio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquímicas de Buenos Aires. Fundación Instituto Leloir. Instituto de Investigaciones Bioquímicas de Buenos Aires; ArgentinaFil: Shoemaker, Benjamin A. National Institutes of Health; Estados UnidosFil: Panchenko, Anna R. National Institutes of Health; Estados Unido
Impact of the June 2018 Saddleworth Moor wildfires on air quality in northern England
The June 2018 Saddleworth Moor fires were some of the largest UK wildfires on record and lasted for approximately three weeks. They emitted large quantities of smoke, trace gases and aerosols which were transported downwind over the highly populated regions of Manchester and Liverpool. Surface observations of PM2.5 indicate that concentrations were 4–5.5 times higher than the recent seasonal average. State-of-the-art satellite measurements of total column carbon monoxide (TCCO) from the TROPOMI instrument on the Sentinel 5—Precursor (S5P) platform, coupled with measurements from a flight of the UK BAe-146–301 research aircraft, are used to quantify the substantial enhancement in emitted trace gases. The aircraft measured plume enhancements with near-fire CO and PM2.5 concentrations >1500 ppbv and >125 μg m−3 (compared to ~100 ppbv and ~5 μg m−3 background concentrations). Downwind fire-plume ozone (O3) values were larger than the near-fire location, indicating O3 production with distance from source. The near-fire O3:CO ratio was (ΔO3/ΔCO) 0.001 ppbv/ppbv, increasing downwind to 0.060–0.105 ppbv/ppbv, suggestive of O3 production enhancement downwind of the fires. Emission rates of CO and CO2 ranged between 1.07 (0.07–4.69) kg s−1 and 13.7 (1.73–50.1) kg s−1, respectively, similar to values expected from a medium sized power station
Is my hand connected to my body? The impact of body continuity and arm alignment on the virtual hand illusion
When a rubber hand is placed on a table top in a plausible position as if part of a person"s body, and is stroked synchronously with the person"s corresponding hidden real hand, an illusion of ownership over the rubber hand can occur (Botvinick and Cohen 1998). A similar result has been found with respect to a virtual hand portrayed in a virtual environment, a virtual hand illusion (Slater et al. 2008). The conditions under which these illusions occur have been the subject of considerable study. Here we exploited the flexibility of virtual reality to examine four contributory factors: visuo-tactile synchrony while stroking the virtual and the real arms, body continuity, alignment between the real and virtual arms, and the distance between them. We carried out three experiments on a total of 32 participants where these factors were varied. The results show that the subjective illusion of ownership over the virtual arm and the time to evoke this illusion are highly dependent on synchronous visuo-tactile stimulation and on connectivity of the virtual arm with the rest of the virtual body. The alignment between the real and virtual arms and the distance between these were less important. It was found that proprioceptive drift was not a sensitive measure of the illusion, but was only related to the distance between the real and virtual arms
Magnetothermodynamics of BPS baby skyrmions
The magnetothermodynamics of skyrmion type matter described by the gauged BPS
baby Skyrme model at zero temperature is investigated. We prove that the BPS
property of the model is preserved also for boundary conditions corresponding
to an asymptotically constant magnetic field. The BPS bound and the
corresponding BPS equations saturating the bound are found. Further, we show
that one may introduce pressure in the gauged model by a redefinition of the
superpotential. Interestingly, this is related to non-extremal type solutions
in the so-called fake supersymmetry method. Finally, we compute the equation of
state of magnetized BSP baby skyrmions inserted into an external constant
magnetic field and under external pressure , i.e., , where
is the "volume" (area) occupied by the skyrmions. We show that the BPS baby
skyrmions form a ferromagnetic medium.Comment: Latex, 39 pages, 14 figures. v2: New results and references added,
physical interpretation partly change
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