A multinational survey of companion animal veterinary clinicians: How can antimicrobial stewardship guidelines be optimised for the target stakeholder?

Antimicrobial stewardship initiatives are widely regarded as a cornerstone for ameliorating the global health impact of antimicrobial resistance. Within companion animal health, such efforts have largely focused on development and dissemination of antimicrobial stewardship guidelines (ASGs). However, there have been few attempts to understand veterinarian attitudes towards and knowledge of ASGs or to determine how awareness regarding ASGs might best be increased. An online survey regarding ASGs was formulated for veterinarians who treat companion animals. The survey was distributed across 46 European and associated countries between 12 January and 30 June, 2022. In total, 2271 surveys were completed, with 64.9% of respondents (n = 1474) reporting awareness and usage of at least one ASG. Respondents from countries with greater awareness of ASGs tended to report more appropriate use of antimicrobials (Spearman's rank coefficient = 0.6084, P ≤ 0.001), with respondents from countries with country-specific ASGs tending to score highest across both awareness and appropriate use domains. Respondents prioritised guidance around antimicrobial choice (82.0%, n = 1863), duration of treatment (66.0%, n = 1499), and dosage (51.9%, n = 1179) for inclusion in future ASGs, with 78.0% (n = 1776) of respondents preferring ASGs to be integrated into their patient management system. Awareness of ASGs and their use in companion animal veterinary practice appears to be greater than previously reported, with respondents tending to report antimicrobial prescription decision making broadly in line with current clinical recommendations. However, further initiatives aimed at maximising accessibility to ASGs both within countries and individual veterinary practices are recommended. [Abstract copyright: Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Burden of infectious disease studies in Europe and the United Kingdom: a review of methodological design choices

This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results

Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic and patient outcomes? An observation from the Defining Antibiotic Levels in Intensive care unit patients (DALI) cohort

Objectives:We utilized the database of the Defining Antibiotic Levels in Intensive care unit patients (DALI) study to statistically compare the pharmacokinetic/pharmacodynamic and clinical outcomes between prolonged-infusion and intermittent-bolus dosing of piperacillin/tazobactam and meropenem in critically ill patients using inclusion criteria similar to those used in previous prospective studies.Methods: This was a post hoc analysis of a prospective, multicentre pharmacokinetic point-prevalence study (DALI), which recruited a large cohort of critically ill patients from 68 ICUs across 10 countries.Results: Of the 211 patients receiving piperacillin/tazobactam and meropenem in the DALI study, 182 met inclusion criteria. Overall, 89.0% (162/182) of patients achieved the most conservative target of 50% fT(> MIC) (time over which unbound or free drug concentration remains above the MIC). Decreasing creatinine clearance and the use of prolonged infusion significantly increased the PTA for most pharmacokinetic/pharmacodynamic targets. In the subgroup of patients who had respiratory infection, patients receiving beta-lactams via prolonged infusion demonstrated significantly better 30 day survival when compared with intermittent-bolus patients [86.2% (25/29) versus 56.7% (17/30); P=0.012]. Additionally, in patients with a SOFA score of >= 9, administration by prolonged infusion compared with intermittent-bolus dosing demonstrated significantly better clinical cure [73.3% (11/15) versus 35.0% (7/20); P=0.035] and survival rates [73.3% (11/15) versus 25.0% (5/20); P=0.025].Conclusions: Analysis of this large dataset has provided additional data on the niche benefits of administration of piperacillin/tazobactam and meropenem by prolonged infusion in critically ill patients, particularly for patients with respiratory infections

a review of methodological design choices

Publisher Copyright: © 2023 Cambridge University Press. All rights reserved.This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the Disability-Adjusted Life Years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3,053 studies of which 2,948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.publishersversionepub_ahead_of_prin

Burden of infectious disease studies in Europe and the United Kingdom: a review of methodological design choices.

This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results

3D P-Torus: Wavelength-Based Switching in Packet Granularity for Edge Data Center Networks

In this paper, we introduce 3D P-Torus, a novel intra-DC architecture, based on the 3-dimensional torus topology, that utilizes wavelength switching at the packet level to achieve improved latency and throughput performance compared to earlier variants of the P-Torus architecture and other wavelength switching intra-DC architectures. By a single-hop communication design between On-Rack Switches, 3D P-Torus achieves great latency and throughput performance, as calculated through detailed simulations. All buffering needs are covered through electronic buffering, avoiding hard to implement and expensive optical buffering. 3D P-Torus can support, with no need for amplification, medium-sized-DCs up to 10k servers, making it an excellent candidate for Edge Data Centers, taking into account its excellent low end-to-end latency. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd

Physical Layer Security in Optical Networks

In this paper we’ll discuss technological alternatives related to physical layer security of optical communication systems and networks. In the introduction, an overview of confidentiality and availability issues of the optical networks will be discussed, focusing mainly in the physical layer-related solutions. In the following paragraphs we’ll provide two distinct approaches for the physical layer encryption. The first is based on a One-Time-Pad implementation using synchronized true random sequences. The second uses cryptographic keys generated by Photonic Physical Unclonable Function devices for scrambling the Orthogonal Frequency Division Multiplexing subcarriers. © 2020, IFIP International Federation for Information Processing

P-Torus: Wavelength-based switching in packet granularity for intra-data-center networks

In this work we introduce P-Torus, a wavelength switching architecture for intra-data-center networks that exploits optical-packet-based transport and is based on 2D torus interconnected clusters. P-Torus does not require optical buffers, as all buffering takes place at the end hosts. The proposed architecture combines torus connectivity richness, time-slotted operation, and efficient wavelength routing in order to provide single-hop, contentionless, and low-latency interconnection among all top-of-rack switches. Wavelength switching is performed in wavelength or waveband granularity with the use of fast wavelength-tunable transmitters, in compliance with the optimal solution of the routing and wavelength assignment problem of the generic torus topology. Numerical simulations are carried out to evaluate the latency and throughput performance of the proposed architecture. Results show that P-Torus exhibits low end-to-end latency and high throughput, even under a high load, in uniform and hot-spot traffic scenarios. This work also includes cost and power consumption analyses showing that P-Torus has significant benefits over other contemporary wavelength-based switching architectures. Comparative simulations and cost analysis validate that P-Torus provides a very good trade-off between performance and cost compared to other wavelength-based switching architectures targeting small to medium data centers, up to 10,000 servers. © 2019 OSA

The COVID-19 Pandemic Enhanced Virology Research in Greece

The emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presented an unprecedented public health threat, being the cause of one of the most devastating pandemics in history [...

Random number generation from a secure photonic physical unclonable hardware module

In this work, a photonic physical unclonable function module, based on an optical waveguide, is demonstrated. The physical scrambling mechanism is based on the random and complex coherent interference of high order optical transverse modes. The proposed scheme allows the generation of random bit- strings, through a simple wavelength tuning of the laser source, that are suitable for a variety of cryptographic applications. The experimental data are evaluated in terms of unpredictability, employing typical information theory benchmark tests and the NIST statistical suit. © 2018, The Author(s)