Cs3Sm7Se12

The title compound, tricaesium hepta­samarium(III) dodeca­selenide, is setting a new starting point for realization of the channel structure of the Cs3 M 7Se12 series, now with M = Sm, Gd–Er. This Cs3Y7Se12-type arrangement is structurally based on the Z-type sesquiselenides M 2Se3 adopting the Sc2S3 structure. Thus, the structural set-up of Cs3Sm7Se12 consists of edge- and vertex-connected [SmSe6]9− octa­hedra [d Ø(Sm3+ – Se2−) = 2.931 Å], forming a rock-salt-related network [Sm7Se12]3− with channels along [001] that are apt to take up monovalent cations (here Cs+) with coordination numbers of 7 + 1 for one and of 6 for the second cation. The latter cation has a trigonal–prismatic coordination and shows half-occupancy, resulting in an impossible short distance [2.394 (4) Å] between symmetrically coupled Cs+ cations of the same kind. While one Sm atom occupies Wyckoff position 2b with site symmetry ..2/m, all other 11 crystallographically different atoms (namely 2 × Cs, 3 × Sm and 6 × Se) are located at Wyckoff positions 4g with site symmetry ..m

Prenatal human skin expresses the antimicrobial peptide RNase 7

Antimicrobial peptides and proteins (AMPs) play important roles in skin immune defense due to their capacity to inhibit growth of microbes. During intrauterine life, the skin immune system has to acquire the prerequisites to protect the newborn from infection in the hostile environment after birth, which includes the production of skin AMPs. The aim of this study was to analyze the expression of RNase 7, HBD-2/3 and psoriasin during human skin development, thus, providing a deeper insight about the maturity of a fundamental component of the innate immune system. We found low RNase 7 expression levels in the periderm but no expression of HBD-2/3 and psoriasin in first trimester human skin using immunohistochemistry. At the end of the second trimester, RNase 7 is expressed weakly in all epidermal layers with a marked signal in the stratum corneum. HBD-3 and psoriasin are focally expressed while HBD-2 is not detectable. Analysis of supernatants from cultured prenatal skin cells showed that in contrast to adult control, RNase 7 and psoriasin are not found in prenatal skin, suggesting that AMPs are detectable but are not secreted. This study shows the differential expression of AMPs in developing, non-perturbed human prenatal skin. It is conceivable that the combined expression of RNase 7, HBD-3 and psoriasin in fetal skin constitutes a developmental program to exert a broad spectrum of antimicrobial activity to maintain sterility in the amniotic cavity

Potenziale für industrieübergreifendes Flottenlernen – KI-Mobilitätsdatenplattform zur Risikominimierung des automatisierten Fahrens

Ob in Transport, Logistik, im Individualverkehr oder im öffentlichen Nahverkehr – Verkehrsträger erreichen dank Künstlicher Intelligenz immer höhere Automatisierungsgrade. Automatisiertes Fahren kann helfen, die Verkehrssicherheit zu erhöhen, Verkehrsflüsse zu optimieren und Schadstoffemissionen zu reduzieren. Durch immer leistungsfähigere Verfahren der KI und des Maschinellen Lernens wird die Technologie des automatisierten Fahrens zunehmend verbessert, sodass sie in mehr als 99 Prozent der Situationen in Real-Tests funktioniert. Ein Restrisiko für mögliches Fehlverhalten tritt im Zusammenhang mit sogenannten Edge und Corner Cases (Grenz- und Übergangsfälle) auf. Für diese selten auftretenden Sonderfälle sind KI-Systeme unter Umständen nicht ausreichend trainiert und getestet. Um die Potenziale des industrieübergreifenden Flottenlernens zu erschließen, schlagen die Expertinnen und Experten der Arbeitsgruppe Mobilität und intelligente Verkehrssysteme der Plattform Lernende Systeme daher die Gründung einer gemeinschaftlichen KI-Mobilitätsdatenplattform vor. Diese Plattform soll den Austausch von Mobilitätsdaten ermöglichen und zur Risikominimierung beim automatisierten Fahren beitragen

The race for Ebola drugs: pharmaceuticals, security and global health governance

The international Ebola response mirrors two broader trends in global health governance: (1) the framing of infectious disease outbreaks as a security threat; and (2) a tendency to respond by providing medicines and vaccines. This article identifies three mechanisms that interlink these trends. First, securitisation encourages technological policy responses. Second, it creates an exceptional political space in which pharmaceutical development can be freed from constraints. Third, it creates an institutional architecture that facilitates pharmaceutical policy responses. The ways in which the securitisation of health reinforces pharmaceutical policy strategies must, the article concludes, be included in ongoing efforts to evaluate them normatively and politically

Standby and Off-Mode Energy Losses In New Appliances Measured in Shops

Selina project website at http://selina-project.eu PDF available online at http://selina-project.eu/files/SELINA_book.pdfInternational audienceThis document provides an overview of the most important results of the Intelligent Energy Europe (IEE) Project SELINA - Standby and Off-Mode Energy Losses In New Appliances Measured in Shops. Standby power is a general term commonly used to describe the low power modes in which many electrical and electronic products are, when not performing their main function. For more than a decade, it has been recognized that the energy consumption in low power modes for electrical and electronic products is an important issue because it represent permanent loads (sometimes up to 24 hours per day) of a huge number of products. With the 1 W standby initiative of the International Energy Agency (IEA), several low power mode measurement campaigns have been led on a regular basis in a number of countries outside and inside Europe Union (EU). Based on these results and on the Energy-using Products Study Lot 6, the EU has prepared new regulation to limit the standby and off-mode power consumption of non-networked household electronic and electrical equipment, which is being applied since January 2010. The IEE project SELINA carried out a large scale monitoring campaign in shops in order to characterise the low power modes of new appliances being sold in the EU market. In order to ensure consistency of the collected data, a common measurement methodology was developed and the same high resolution measurement equipment was used by all partners. This document analyzes the results of more than 6000 different equipments measured in the 12 EU countries involved in the project. Standby and off-mode values by product categories were analysed and compared with data from other regions of the World. The measurements were also benchmarked against the new 2010/2013 EU standby and off mode regulation thresholds and the impact of the EU regulation is discussed. It was found that 18.5% of the equipments, whose off-mode power was measured, do not respect the EU regulation threshold of 1 W. When the measurements are compared to the 2013 threshold of 0.5 W, this percentage raises up to 41.5%. Regarding standby mode input power, 31% of the measured products did not comply with EU regulation limit for the 2010 threshold. When the standby measured values are compared to the 2013 limit, the number of products over the EU regulation target increases to 66.4%. When comparing the 2009 and 2010 measurements, only a slight decrease of the share of appliances exceeding the EU regulation limits was observed. In parallel with the measurement campaign, an awareness study of the retailers was carried out. This survey helps to understand the customers' buying motivations and the influence of retailers' advice in their choices. The results of the survey show that, despite of retailer's consciousness about the energy consumption and energy labels of the products, other types of sales arguments like the appliance price or functionalities are more frequently used to sell a product. This could be due to lack of visible information in shops related to the equipment energy consumption. Furthermore, the results show that retailers try to adapt their advice to the customers' needs (price and product functionalities). The retailers admitted that publishing more information regarding the energy consumption of products and some kind of cost saving calculator/reference would make the clients to opt for more efficient equipments. Based on the survey results and on the analysis of different existing policies targeting electrical and electronic products in Europe, examples of policies to improve the low power modes situation of the EU market are reviewed. The survey on measures enhancing the market transformation towards more energy-efficient electrical appliances showed a wide range of actions and policy tools in the SELINA partner countries. In national workshops, which mainly took place in the late summer/early autumn 2010, these measures were presented and discussed with all relevant national stakeholders. In most countries, information campaigns (esp. brochures, leaflets, websites, and national labels) are the dominating measure type. In some countries, however, financial subsidies for very energy-efficient appliances, often paid by an energy utility and not by the government, play an important role, too (e.g. in the Czech Republic or Switzerland). In general, the impact of a financial programme is easier to quantify than the single impact of an information campaign, which often serves as an accompanying measure for regulations (labels, minimum efficiency standards) or fiscal and financial measures. International cooperation with key institutions outside the EU, involved in similar efforts, such as the IEA Implementing Agreement 4E (Efficient Electrical End-use Equipment) with an Annex on Standby, the Energy Star/EPA in USA, the Australia Standby Initiative and the Swiss Federal Office of Energy, were used to promote synergies in the definition of common approaches to characterize the market and to define realistic and cost-effective performance targets which can be achieved in a short time frame. Special care is required when promoting low standby consumption products (without consideration of other attributes) to ensure that there are no perverse effects such as the inadvertent promotion of products with low active mode efficiency and high energy consumption. It is desirable to follow a vertical approach to standby, where low power modes are combined with active modes to give total energy consumption. This approach is particularly preferable for products where the total energy consumption is significant. The definition of usage patterns under such a vertical approach is necessarily product specific and this could vary by region or country. The new technologies offer many opportunities for energy savings potential but there are also some threats which need to be recognized and understood. There is a strong need to ensure that energy saving paradigms and strategies become a core consideration in future product designs. It is recognized that equipments connected to networks are of growing importance. It is recommended that increased efforts to compile data and measurements, of networked products, from a variety of sources in order to obtain better information on networked product characteristics, needs to be made. An online database was created so that everyone can access the input power values, in the different equipment low power modes, of the more than 6000 equipments measured. A Standby Calculator Tool was also developed and can be accessed through the project website. It can be used to calculate the consumed energy, the annual cost and the equivalent CO2 emissions. In order to compare the results in an easy way, a diagram that shows the energy consumption of the different models is presented. Furthermore, the values for the most efficient device are also showed, in order to have an additional comparison. One of the main objectives of this project was to identify effective market transformation policies initiatives targeted at all the key stakeholders involved in the manufacture, distribution, sales, purchasing and operation of appliances with standby and off-mode losses. As a result of the future policy actions that may appear after the end of the project, considering loads in networked mode, it is expected to achieve very large cost-effective savings of electricity (80 TWh projected by 2020) and carbon emissions (30 MTons of CO2 by 2020)

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

HLA-DR+ leukocytes acquire CD1 antigens in embryonic and fetal human skin and contain functional antigen-presenting cells

Adequate numbers and functional maturity are needed for leukocytes to exhibit a protective role in host defense. During intrauterine life, the skin immune system has to acquire these prerequisites to protect the newborn from infection in the hostile external environment after birth. We investigated the quantitative, phenotypic, and functional development of skin leukocytes and analyzed the factors controlling their proliferation and trafficking during skin development. We show that CD45+ leukocytes are scattered in embryonic human skin and that their numbers continuously increase as the developing skin generates an environment that promotes proliferation of skin resident leukocytes as well as the influx of leukocytes from the circulation. We also found that CD45+HLA-DRhighCD1c+ dendritic cells (DCs) are already present in the epidermis and dermis at 9 wk estimated gestational age (EGA) and that transforming growth factor β1 production precedes Langerin and CD1a expression on CD45+CD1c+ Langerhans cell (LC) precursors. Functionally, embryonic antigen-presenting cells (APCs) are able to phagocytose antigen, to up-regulate costimulatory molecules upon culture, and to efficiently stimulate T cells in a mixed lymphocyte reaction. Collectively, our data provide insight into skin DC biology and the mechanisms through which skin DCs presumably populate the skin during development

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Modulation der Antinozizeption durch S(+)-Ketamin nach Remifentanil basierter Anästhesie: Effekt einer ultra-low-dose perioperativer S(+)-Ketamin-Infusion auf die Entstehung von Hyperalgesie und postoperativem Opioidverbrauch

Hyperalgesia and chronic pain could be attenuated, especially when mu-agonists are administered. By activating protein kinase c the NMDA-receptor gets phosphorylated and opioids may induce prolonged hyperalgesia. NMDA-receptor antagonists, such as S-(+)-ketamine, may have beneficial effects on perioperative pain modulation. We performed a prospective, double-blinded, randomized trial with 47 patients undergoing abdominal surgery. The patients were randomized to 3 groups: preemptive group got preoperative s-ketamine-bolus 0.075 mg/kg, followed by an intraoperative and postoperative s-ketamine infusion with 1 µg/kg/min, stopped 2 hours postoperatively; prophylactic group got postoperative a s-ketamine infusion, wich was started at the end of the surgical procedure; control group got only saline. We followed up morphine consumption, pain scores, sedation, patient satisfaction and side effects up to the forth postoperative day. Regarding the medians, we found an advantage of 32.5 mg less morphine consumption of the preemptive group and 19.9 mg less morphine requirements of the prophylactic group, compared with the control group. The effect was not statistically significant mainly due to the large spread of values. We did not see any ketamine associated side-effects like nightmares, hallucinations, nystagmus or diplopia; general side effects like postoperative vomiting or shivering were less in the preemptive group. The pain scores, sedation and satisfaction did not differ between the groups. We could not find a significant opioid-sparing effect of s-(+)-ketamine, the way we administered. We noted some evidence of a beneficial longterm effect by the preemptive administration. A larger scaled study might have been able to demonstrate differences more clearly, a followed calculation leaded to a need of about 250 patients per group. Perhaps the effects are more to see in the reduction of hyperalgesia than in reduction of morphine requirements