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

Coronal loop widths and pressure scale heights

The scale heights of stratification and the widths of steady solar coronal loops exhibit properties unexplained by standard theory: observed scale heights are often much greater than static theory predicts, while the nearly-constant widths of loop emission signatures defy theoretical expectations for large flux tubes in stratified media. In this work we relate the cross-sectional profile of a coronal flux tube to its density scale height in steady-state plasma flow regimes. Steady flows may shorten or lengthen the scale height according to how the tube cross-sectional area varies with arclength. In a near-potential corona the flux tubes are expected to be sufficiently expansive in many active regions for scale heights to be increased by steady flows. On the other hand, cases where scale lengths are actually increased to observed sizes form a small part of the solution space, close to regimes where density profiles reverse. Therefore, although steady flows are the only steady process known to be capable of extending scale heights significantly, they are not expected to be not responsible for the majority of extended active region scale heights

Smartphone Distraction: Italian Validation of the Smartphone Distraction Scale (SDS)

This work aimed to validate the use of the Smartphone Distraction Scale (SDS) in Italy. The SDS was devised to assess distraction related to smartphone use in adult populations. A cross-sectional study was conducted among n = 609 adults (females = 76.4%; mean age = 30.26; SD age = 9.90). An assessment of the factorial structure of the Italian version was carried out using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The four factors identified by Throuvala and colleagues were confirmed (i.e., attention impulsiveness, online vigilance, multitasking and emotion regulation). Reliability was assessed using Cronbach's alpha coefficient (0.703-0.889). The scale's scores showed significant linear correlations with validated instruments, including the Mobile Phone Problematic Use Scale (MPPUS)and the Cognitive Failures Questionnaire (CFQ). A multivariate analysis of variance showed significant differences in the means among participants belonging to different age groups (born before 1995 vs. born after 1996). In summary, the good psychometric properties observed led us to assume that this instrument can be applied and used in Italian studies to assess the cognitive dimension of distraction related to the use of smartphones

Studies of new antiferroelectric liquid crystal based on quantum-chemical model

Physical properties of new thermotropic antiferroelectric liquid crystal have been studied. Experiments were done by use of complementary methods such as differential scanning calorimetry, polarizing optical microscopy and X-ray powder diffractometry. Acquired data from X-ray powder diffractometry was examined under application of quantum chemical approach. It has been found that compound studied exhibits stable enantiotropic antiferroelectric SmC_{A}^{*} phase in the wide temperature range while ferroelectric phase SmC^{*} is very narrow

Signatures of Alfven waves in the polar coronal holes as seen by EIS/Hinode

Context. We diagnose the properties of the plume and interplume regions in a polar coronal hole and the role of waves in the acceleration of the solar wind. Aims. We attempt to detect whether Alfven waves are present in the polar coronal holes through variations in EUV line widths. Methods. Using spectral observations performed over a polar coronal hole region with the EIS spectrometer on Hinode, we study the variation in the line width and electron density as a function of height. We use the density sensitive line pairs of Fe xii 186.88 A & 195.119 A and Fe xiii 203.82 A & 202.04 A . Results. For the polar region, the line width data show that the nonthermal line-of-sight velocity increases from 26 km/s at 1000 above the limb to 42 km/s some 15000 (i.e. 110,000 km) above the limb. The electron density shows a decrease from 3:3 10^9 cm^-3 to 1:9 10^8 cm^-3 over the same distance. Conclusions. These results imply that the nonthermal velocity is inversely proportional to the quadratic root of the electron density, in excellent agreement with what is predicted for undamped radially propagating linear Alfven waves. Our data provide signatures of Alfven waves in the polar coronal hole regions, which could be important for the acceleration of the solar wind.Comment: 5 pages, 11 figures. Astronomy and Astrophysics Letters (accepted) http://www.aanda.org/articles/aa/pdf/forth/aa12242-09.pd

Transverse oscillations of two parallel coronal loops

Context. Collective oscillations of two or more coronal magnetic loops are observed very often. Aims. We study the eigenmodes of oscillations of a system consisting of two parallel magnetic loops. Methods. The linearised MHD equations for a cold plasma are solved analytically in bicylindrical coordinates using the longwavelength approximation. A dispersion equation determining the frequencies of eigenmodes is derived and solved analytically. Results. Two solutions of the dispersion relation were found. The higher frequency corresponds to the antisymmetric mode polarised in the direction parallel to the line connecting the loop centres, and the symmetric mode polarised in the perpendicular direction. Depending on the polarisation of modes corresponding to the lower frequency, the systems of two parallel loops are classified as standard and anomalous. In standard systems the lower frequency corresponds to the symmetric mode polarised in the direction parallel to the line connecting the loop centres, and the antisymmetric mode polarised in the perpendicular direction. In anomalous systems the lower frequency corresponds to the antisymmetric mode polarised in the direction parallel to the line connecting the loop centres, and the symmetric mode polarised in the perpendicular direction. The limiting case of two identical loops is studied. The results for this case are compared with recent numerical results

COVID-19: Is There Evidence for the Use of Herbal Medicines as Adjuvant Symptomatic Therapy?

Background: Current recommendations for the self-management of SARS-Cov-2 disease (COVID-19) include self-isolation, rest, hydration, and the use of NSAID in case of high fever only. It is expected that many patients will add other symptomatic/adjuvant treatments, such as herbal medicines. Aims: To provide a benefits/risks assessment of selected herbal medicines traditionally indicated for “respiratory diseases” within the current frame of the COVID-19 pandemic as an adjuvant treatment. Method: The plant selection was primarily based on species listed by the WHO and EMA, but some other herbal remedies were considered due to their widespread use in respiratory conditions. Preclinical and clinical data on their efficacy and safety were collected from authoritative sources. The target population were adults with early and mild flu symptoms without underlying conditions. These were evaluated according to a modified PrOACT-URL method with paracetamol, ibuprofen, and codeine as reference drugs. The benefits/risks balance of the treatments was classified as positive, promising, negative, and unknown. Results: A total of 39 herbal medicines were identified as very likely to appeal to the COVID-19 patient. According to our method, the benefits/risks assessment of the herbal medicines was found to be positive in 5 cases (Althaea officinalis, Commiphora molmol, Glycyrrhiza glabra, Hedera helix, and Sambucus nigra), promising in 12 cases (Allium sativum, Andrographis paniculata, Echinacea angustifolia, Echinacea purpurea, Eucalyptus globulus essential oil, Justicia pectoralis, Magnolia officinalis, Mikania glomerata, Pelargonium sidoides, Pimpinella anisum, Salix sp, Zingiber officinale), and unknown for the rest. On the same grounds, only ibuprofen resulted promising, but we could not find compelling evidence to endorse the use of paracetamol and/or codeine. Conclusions: Our work suggests that several herbal medicines have safety margins superior to those of reference drugs and enough levels of evidence to start a clinical discussion about their potential use as adjuvants in the treatment of early/mild common flu in otherwise healthy adults within the context of COVID-19. While these herbal medicines will not cure or prevent the flu, they may both improve general patient well-being and offer them an opportunity to personalize the therapeutic approaches

Brewing of filter coffee

We report progress on mathematical modelling of coffee grounds in a drip filter coffee machine. The report focuses on the evolution of the shape of the bed of coffee grounds during extraction with some work also carried out on the chemistry of extraction. This work was sponsored by Philips who are interested in understanding an observed correlation between the final shape of the coffee grounds and the quality of the coffee. We used experimental data gathered by Philips and ourselves to identify regimes in the coffee brewing process and relevant regions of parameter space. Our work makes it clear that a number of separate processes define the shape of the coffee bed depending on the values of the parameters involved e.g. the size of the grains and the speed of fluid flow during extraction. We began work on constructing mathematical models of the redistribution of the coffee grounds specialised to each region and on a model of extraction. A variety of analytic and numerical tools were used. Furthermore our research has progressed far enough to allow us to begin to exploit connections between this problem and other areas of science, in particular the areas of sedimentology and geomorphology, where the processes we have observed in coffee brewing have been studied

Epigenome-wide association study reveals decreased average methylation levels years before breast cancer diagnosis

Interest in the potential of DNA methylation in peripheral blood as a biomarker of cancer risk is increasing. We aimed to assess whether epigenome-wide DNA methylation measured in peripheral blood samples obtained before onset of the disease is associated with increased risk of breast cancer. We report on three independent prospective nested case-control studies from the European Prospective Investigation into Cancer and Nutrition (EPIC-Italy; n = 162 matched case-control pairs), the Norwegian Women and Cancer study (NOWAC; n = 168 matched pairs), and the Breakthrough Generations Study (BGS; n = 548 matched pairs). We used the Illumina 450k array to measure methylation in the EPIC and NOWAC cohorts. Whole-genome bisulphite sequencing (WGBS) was performed on the BGS cohort using pooled DNA samples, combined to reach 50× coverage across ~16 million CpG sites in the genome including 450k array CpG sites. Mean β values over all probes were calculated as a measurement for epigenome-wide methylation