nanoSTAIR: a new strategic proposal to impulse standardization in nanotechnology research

Nanotechnology is considered one of the key technologies of the 21st century within Europe and a Key-Enabling Technology (KET) by Horizon 2020. Standardization has been identified in H2020 as one of the innovation-support measures by bridging the gap between research and the market, and helping the fast and easy transfer of research results to the European and international market. The development of new and improved standards requires high quality technical information, creating a fundamental interdependency between the standardization and research communities. In the frame of project nanoSTAIR (GA 319092), the present paper describes the European scenario on research and standardization in nanotechnology and presents a proposal of a European strategy (nanoSTAIR) to impulse direct "pipelines" between research and standardization. In addition, strategic actions focused on integration of standardization in the R&D projects, from the early stages of the design of a future business (Project Proposal), are also described.European Commission, through the Seventh Framework Programme (GA 319092)

Operational research in Malawi: making a difference with cotrimoxazole preventive therapy in patients with tuberculosis and HIV.

BACKGROUND: In Malawi, high case fatality rates in patients with tuberculosis, who were also co-infected with HIV, and high early death rates in people living with HIV during the initiation of antiretroviral treatment (ART) adversely impacted on treatment outcomes for the national tuberculosis and ART programmes respectively. This article i) discusses the operational research that was conducted in the country on cotrimoxazole preventive therapy, ii) outlines the steps that were taken to translate these findings into national policy and practice, iii) shows how the implementation of cotrimoxazole preventive therapy for both TB patients and HIV-infected patients starting ART was associated with reduced death rates, and iv) highlights lessons that can be learnt for other settings and interventions. DISCUSSION: District and facility-based operational research was undertaken between 1999 and 2005 to assess the effectiveness of cotrimoxazole preventive therapy in reducing death rates in TB patients and subsequently in patients starting ART under routine programme conditions. Studies demonstrated significant reductions in case fatality in HIV-infected TB patients receiving cotrimoxazole and in HIV-infected patients about to start ART. Following the completion of research, the findings were rapidly disseminated nationally at stakeholder meetings convened by the Ministry of Health and internationally through conferences and peer-reviewed scientific publications. The Ministry of Health made policy changes based on the available evidence, following which there was countrywide distribution of the updated policy and guidelines. Policy was rapidly moved to practice with the development of monitoring tools, drug procurement and training packages. National programme performance improved which showed a significant decrease in case fatality rates in TB patients as well as a reduction in early death in people with HIV starting ART. SUMMARY: Key lessons for moving this research endeavour through to policy and practice were the importance of placing operational research within the programme, defining relevant questions, obtaining "buy-in" from national programme staff at the beginning of projects and having key actors or "policy entrepreneurs" to push forward the policy-making process. Ultimately, any change in policy and practice has to benefit patients, and the ultimate judge of success is whether treatment outcomes improve or not

Disaster Situation and Humanitarian Emergency – In-Between Responses to the Refugee Crisis in Germany

In 2015, the needs of hundreds of thousands of refugees who arrived in Germany could only be met by deploying all available civil protection units. This article presents procedures and practices of state and non-state formal actors in the field of civil protection and related crisis management structures implemented and established across the board in the municipalities, the Federal Government and mass shelters, in particular in Bavaria. From a disaster research and humanitarian studies perspective we use the concept of “patterns of interpretation” to analyse the application of the “humanitarian emergency” and the “disaster situation” procedures to discuss whether the situation can really be categorized as “either-or” or whether the coexistence of the two served a function in managing such a complex situation. Finally, we discuss some developments that occurred after 2015/16 and consider the extent to which these developments shift or expand the existing patterns of interpretation

The effect of HIV on morbidity and mortality in children with severe malarial anaemia

<p>Abstract</p> <p>Background</p> <p>Malaria and HIV are common causes of mortality in sub-Saharan Africa. The effect of HIV infection on morbidity and mortality in children with severe malarial anaemia was assessed.</p> <p>Methods</p> <p>Children <5 years old were followed as part of a prospective cohort study to assess the transfusion-associated transmission of blood-borne pathogens at Mulago Hospital, Kampala, Uganda. All children were hospitalized with a diagnosis of severe malarial anaemia requiring blood transfusion. Survival to different time points post-transfusion was compared between HIV-infected and uninfected children. Generalized estimating equations were used to analyse repeated measurement outcomes of morbidity, adjusting for confounders.</p> <p>Findings</p> <p>Of 847 children, 78 (9.2%) were HIV-infected. Median follow-up time was 162 days (inter-quartile range: 111, 169). HIV-infected children were more likely to die within 7 days (Hazard ratio [HR] = 2.86, 95% Confidence interval [CI] 1.30–6.29, P = 0.009) and within 28 days (HR = 3.70, 95% CI 1.91–7.17, P < 0.001) of an episode of severe malarial anaemia, and were more likely to die in the 6 months post-transfusion (HR = 5.70, 95% CI 3.54–9.16, P < 0.001) compared to HIV-uninfected children. HIV-infected children had more frequent re-admissions due to malaria within 28 days (Incidence rate ratio (IRR) = 3.74, 95% CI 1.41–9.90, P = 0.008) and within 6 months (IRR = 2.66, 95% CI 1.17 – 6.07, P = 0.02) post-transfusion than HIV-uninfected children.</p> <p>Conclusion</p> <p>HIV-infected children with severe malarial anaemia suffered higher all-cause mortality and malaria-related mortality than HIV-uninfected children. Children with HIV and malaria should receive aggressive treatment and further evaluation of their HIV disease, particularly with regard to cotrimoxazole prophylaxis and antiretroviral therapy.</p

Neopterin and procalcitonin are suitable biomarkers for exclusion of severe Plasmodium falciparum disease at the initial clinical assessment of travellers with imported malaria

Background. Most clinicians in developed, non-malaria endemic countries have limited or no experience in making clinical assessments of malaria disease severity and subsequent decisions regarding the need for parenteral therapy or high-level monitoring in febrile patients with imported malaria. In the present study, the diagnostic accuracy of plasma soluble Triggering Receptor Expressed on Myeloid cells 1 (TREM-1), neopterin and procalcitonin levels as biomarkers for severe Plasmodium falciparum disease was evaluated in 104 travellers with imported malaria (26 patients with non-P. falciparum malaria, 64 patients with uncomplicated P. falciparum malaria and 14 patients with severe P. falciparum malaria). Methods. TREM-1, neopterin and procalcitonin were determined in serum using commercially available ELISA or EIA tests. The diagnostic performance of these biomarkers for severe disease was compared with plasma lactate, a well-validated parameter for disease severity in patients with malaria, as reference. Severe malaria was defined according to the modified WHO criteria. Results. No significant differences in TREM-1 levels were detected between the different patient groups. Patients with severe P. falciparum malaria had significantly higher neopterin and procalcitonin levels on admission when compared to patients with uncomplicated P. falciparum malaria or non-P. falciparum malaria. Receiver Operating Characteristic (ROC) curve analysis showed that neopterin had the highest Area-Under-the-ROC curve (AUROC 0.85) compared with plasma lactate (AUROC 0.80) and procalcitonin (AUROC 0.78). At a cut-off point of 10.0 ng/ml, neopterin had a positive and negative predictive value of 0.38 and 0.98 whereas procalcitonin, at a cut-off point of 0.9 ng/ml, had a positive and negative predictive value of 0.30 and 1.00. Conclusion. Although the diagnostic value of neopterin and procalcitonin is limited, the high negative predictive value of both neopterin and procalcitonin may be helpful for a rapid exclusion of severe malaria disease on admission. This may be a valuable tool for physicians only occasionally dealing with ill-returned travellers from malaria-endemic regions and who need to decide on subsequent oral anti-malarial treatment or timely referral to a specialized centre for high-level monitoring and intensified parenteral treatment

Designing and Implementing a Network for Sensing Water Quality and Hydrology across Mountain to Urban Transitions

Water resources are increasingly impacted by growing human populations, land use, and climate changes, and complex interactions among biophysical processes. In an effort to better understand these factors in semiarid northern Utah, United States, we created a real-time observatory consisting of sensors deployed at aquatic and terrestrial stations to monitor water quality, water inputs, and outputs along mountain to urban gradients. The Gradients Along Mountain to Urban Transitions (GAMUT) monitoring network spans three watersheds with similar climates and streams fed by mountain winter-derived precipitation, but that differ in urbanization level, land use, and biophysical characteristics. The aquatic monitoring stations in the GAMUT network include sensors to measure chemical (dissolved oxygen, specific conductance, pH, nitrate, and dissolved organic matter), physical (stage, temperature, and turbidity), and biological components (chlorophyll-a and phycocyanin). We present the logistics of designing, implementing, and maintaining the network; quality assurance and control of numerous, large datasets; and data acquisition, dissemination, and visualization. Data from GAMUT reveal spatial differences in water quality due to urbanization and built infrastructure; capture rapid temporal changes in water quality due to anthropogenic activity; and identify changes in biological structure, each of which are demonstrated via case study datasets