Isolation frequency and susceptibility pattern of non-O1 and non-O139 Vibrio cholerae in a tertiary health care laboratory, 1999-2012

In the past decade the importance of non-O1 and non-O139 strains of Vibrio cholerae has been highlighted globally. This study aimed to evaluate the frequency and antimicrobial susceptibility profile of non-O1 and non-O139 V. cholerae in Pakistan. Data of stool specimens yielding growth of non-O1 and non-O139 V. cholerae isolated at a national referral laboratory from 1999 to 2012 were retrospectively analysed and evaluated for resistance to ampicillin, tetracycline, chloramphenicol, co-trimoxazole and ofloxacin. A total of 95 800 stool samples submitted over 1999-2012 yielded 3668 strains of V. cholerae, of which 6% were non-O1 and non-O139 V. cholerae. A high isolation rate was found in the summer season, with a peak in the year 2003. Antimicrobial susceptibility data revealed increasing resistance to co-trimoxazole and ampicillin, but strains remained highly susceptible to ofloxacin. Active surveillance of serotypes and antimicrobial susceptibility is essential to predict future epidemics and define measures to curtail the disease

Impact of antibiotic usage on resistance in microorganisms; urinary tract infections with E-coli as a case in point

Objectives: In this study, we sought to establish a correlation between consumption of flouoroquinolones in our hospital and the emergence of ofloxacin resistant strains of E. coli in the urinary specimens. Data of all urinary samples, received at Aga Khan University Hospital between January 1995 and December 2002, was retrieved and analyzed. Specimens yielding E-coli as an isolate were included in this study. Methods: E. coli Isolates showing \u3e103 colonies were identified using standard microbiological techniques. Antibiotic susceptibility of E. coli was tested using Kirby Bauer disc diffusion method. Antimicrobial usage data, obtained through hospital Pharmacy as unit utilized per year for Quinolones in different medical and surgical units was available only for the period of 1997- 2002. Results: Among 32,722 urinary specimens E. coli (53%) was the most frequent isolate. Steady increase in the number of ofloxacin resistant E. coli was noted, 24% in 1995 to 55% in 2002. Maximum quinolone resistant E. coli have been observed in Medical units, 41% in 1997 increasing to 70% in 2002, followed by Surgery units (35% to 54%) and Pediatrics (12 to 38%). Sharp increase in ofloxacin consumption in our hospital, 1997 (28613 units) to 2002 (96880 units) has been observed. Trends in quinolone resistance correlate significantly with utilization in the same period as shown by linear regression. Conculsion: E. coli resistance against most antibiotics has been on a rise particularly for quinolones. The utilization of quinolones correlates with increasing resistance in our hospitalized patients

How Does Institutional Quality Moderate the Impact of Tourism on Economic Growth? Startling Evidence from High Earners and Tourism-Dependent Economies

Over the years, policymakers in tourism-reliant economies have been saddled with the mandate to not only accelerate economic growth, but also increase the living standards of domestic citizens. Tourism development has been highlighted in extant literature as a route to attaining sustainable economic growth. Past studies affirm that tourism contributes significantly to both the wealth of nations and cultural diffusion. However, whether institutional quality moderates the impact of tourism on economic growth has yet to be given sufficient academic attention. The study uses data from 2002 to 2017 and the generalised method of moments (GMM) methodology, while the Dumitrescu-Hurlin panel causality test is applied to check the robustness of results. The empirical results show that a 1% increase in tourist arrivals or air transport led to a 0.41% and 0.17% increase in economic growth, respectively. However, when particular governance variables are taken into consideration, this impact is reduced to -0.09% and -0.02% for both tourism proxies. This implies that the influence of governance on the tourism-led growth hypothesis through an interaction term between institutional quality and tourist arrivals was found to reverse the impact of tourism on growth from positive to negative in both high-earning and tourism-dependent countries. While infrastructure also contributes to economic growth, its impact is slightly higher in top earners than in tourism-dependent economies. The results of the study suggest that weak institutions in both country groups allow corrupt practices, which diverts the positive impact tourism should have on economic growth

Energy policy simulation in times of crisis: Revisiting the impact of renewable and non-renewable energy production on environmental quality in Germany

In this paper, we examine for the first time in the literature the implications of energy policy alternatives for Germany considering the aftermath of coronavirus as well as Electricity and Gas energy supply shortages. Whilst several policy options are open to the government, the choice of investment in renewable energy generation versus disinvestment in non-renewable energy such as coal energy generation provides divergent impacts in the long term. We utilize data from British Petroleum and the World Bank Development Indicator database for Germany covering 1981 to 2020 to explore a Carbon function by applying a battery of Autoregressive distributed lag model (ARDL), dynamic ARDL and Kernel-Based Regularized Least squares approaches. The particular policy tested is the pledge by Germany to decrease emissions by ∼100% in 2050, and this was integrated through the estimation of dynamic ARDL estimation. The simulation result shows that a ＋61% shock in renewable energy production decreases carbon emissions unlike coal energy production which increases carbon emissions in the beginning but the carbon emissions decrease thereafter. The findings highlight the inevitability of cutting down on coal production, and recommends energy investment alternatives. Hence, Germany's energy policy should contemplate more thoroughly on these factors

Nickel-doped lanthanum cerate nanomaterials as highly active electrocatalysts

The efficient oxygen evolution reaction (OER) and oxygen reduction reaction (ORR) catalyst materials are crucial in the energy research domain due to their tunability. Structural modification in perovskites such as lanthanum cerates (LaCeO3) upon doping at A or B sites significantly affects the surface activity and enhances the catalysis efficacy. Herein, B-site nickel-doped lanthanum cerate (LaCe1-xNixO3±δ) nanopowders were applied as ORR indicators in high-temperature electrochemical impedance spectroscopy for solid-oxide fuel cell (SOFC) tests and in cyclic voltammetric OER investigations in alkaline medium. The integration into SOFC applications, via solid-state EIS in a co-pressed three-layered cell with LCNiO as cathode, is investigated in an oxygen–methane environment and reveals augmented conductivity with temperatures of 700–850°C. The higher electrokinetic parameters—including diffusion coefficients, Do heterogeneous rate constant, ko, and peak current density for OER in KOH-methanol at a LCNiO-9-modified glassy carbon electrode—serve as robust gauges of catalytic performance. CV indicators and EIS conductivities of LaCe1-xNixO3±δ nanomaterials indicate promising potencies for electrocatalytic energy applications. Copyright © 2022 Butt, Erum, Mujtaba, Medvedev and Janjua.Quaid-i-Azam University, QAUHigher Education Commision, Pakistan, HEC, (14-4768)The authors highly acknowledge the financial support from Quaid-i-Azam University, Islamabad, and the Higher Education Commission of Pakistan under project No. 14-4768

Nonconcordance between Clinical and Head CT Findings: The Specter of Overdiagnosis

Background:. It is unclear whether history and physical examination findings can predict abnormalities on head computed tomography (CT) believed to indicate increased risk of lumbar-puncture- (LP-) induced brain herniation. The objectives of this study were to (1) identify head CT findings felt to be associated with increased risk of brain herniation and (2) to assess the ability of history and physical examination to predict those findings. Methods:. Using a modified Delphi survey technique, an expert panel defined CT abnormalities felt to predict increased risk of LP-induced brain herniation. Presence of such findings on CT was compared with history and physical examination (H&P) variables in 47 patients. Results:. No H&P variable predicted “high-risk” CT; combining H&P variables to improve sensitivity led to extremely low specificity and still failed to identify all patients with high-risk CT. Conclusions:. “High-risk” CT is not uncommon in patients with clinical characteristics known to predict an absence of actual risk from LP, and thus it may not be clinically relevant. “Overdiagnosis” will be increasingly problematic as technological advances identify increasingly subtle deviations from “normal.

Scoping review protocol: Structural racism, housing policy and post-victimization outcomes among female-identifying survivors of intimate partner and sexual violence

Objective: The aim of this scoping review is to investigate the role of structural racism in inequitable post-victimization outcomes in female-identifying Black, Indigenous, and People of Color (BIPOC women) survivors of intimate partner and sexual violence (IP/SV) in the context of housing policy. We will examine how structural racism has been defined and conceptualized as well as frameworks and methods used to study inequitable outcomes of housing policy among survivors of IP/SV. Introduction: Women often face housing instability as a result of IP/SV, and BIPOC women are especially vulnerable to discrimination based on gender and racialized group. Policies have been enacted to protect survivors from housing discrimination; however, policy does not equally or equitably serve BIPOC compared to white people. What is not known is the extent to which this injustice has been studied in the context of housing policies that create unjust and avoidable outcomes for female-identifying BIPOC survivors of IP/SV. Inclusion criteria: Studies that include female-identifying adults (ages 18+) who are survivors of IP/SV. Structural racism in the context of housing policies will be the focus; the relationship between housing policies and post-victimization outcomes will be examined. Methods: The search was conducted in March 2023 using CINAHL, Cochrane, Gender Watch, PsycInfo, Scopus, and Social Science Abstracts. Limiters were English language from 2005+. 4,090 de-duplicated articles were identified. Four scholars conducted title and abstract screening using Covidence. Full text and extraction begins in November 2023. An augmented version of the JBI template will be used to extract data. *update 12/7/2023 - author affiliations update

Inflammation and Invasion in Oral Squamous Cell Carcinoma Cells Exposed to Electronic Cigarette Vapor Extract

Electronic cigarettes (eCig) represent a new avenue of tobacco exposure that involves heating oil-based liquids and the delivery of aerosolized flavors with or without nicotine, yet little is known about their overall health impact. The oral cavity is an anatomic gateway for exposure that can be compromised by activating myriad of signaling networks. Oral squamous cell carcinoma (OSSC) is a common malignancy affecting 30,000 people in the United States each year. Our objective was to determine the impact of eCig and nicotine on gingival OSSC invasion and their secretion of pro-inflammatory molecules. Gingiva-derived Ca9-22 cells and tongue-derived Cal27 cells were exposed to eCig vapor extract (EVE) generated from Red Hot or Green Apple (Apple) flavored eCig solution +/- nicotine for 6 hours. Isolation of protein lysates and collection conditioned media was done after treatment. Real-time cellular invasion was assessed using a RTCA DP instrument. Protein expression was determined using western blot. Compared to controls, we observed: elevated NF-kB, TNF-α, ERK, JNK, MMP-13 and cell invasion by Ca9-22 treated with Apple EVE; increased TNF-α and JNK by Ca9-22 treated with Red Hot EVE; and increased TNF-α and JNK by Cal27 cells treated with both Apple and Red Hot EVE. We conclude that eCig flavoring and nicotine orchestrated differential cell invasion and inflammatory effects. This study provides an important initial step in dissecting mechanisms of cancerous invasion and molecular avenues employed by OSCC

Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 2: The palate of the preterm/low birthweight infant

BACKGROUND: Well-designed clinical studies on the palatal development in preterm and low birthweight infants are desirable because the literature is characterized by contradictory results. It could be shown that knowledge about 'normal' palatal development is still weak as well (Part 1). The objective of this review is therefore to contribute a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. METHODS: An electronic literature search as well as hand searches were performed based on Cochrane search strategies including sources of more than a century in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered for comparison. RESULTS: Seventy-eight out of 155 included articles were analyzed for palatal morphology of preterm infants. Intubation, feeding tubes, feeding mode, tube characteristics, restriction of oral functions, kind of diet, cranial form and birthweight were seen as causes contributing to altered palatal morphology. Changes associated with intubation concern length, depth, width, asymmetry, crossbite, and contour of the palate. The phenomenon 'grooving' has also been described as a complication associated with oral intubation. However, this phenomenon suffers from lack of a clear-cut definition. Head flattening, pressure from the oral tube, pathologic or impaired tongue function, and broadening of the alveolar ridges adjacent to the tube have been raised as causes of 'grooving'. Metrically, the palates of intubated preterm infants remain narrower, which has been examined up to the age of the late mixed dentition. CONCLUSION: There is no evidence that would justify the exclusion of any of the raised causes contributing to palatal alteration. Thus, early orthodontic and logopedic control of formerly orally intubated preterm infants is recommended, as opposed to non-intubated infants. From the orthodontic point of view, nasal intubation should be favored. The role that palatal protection plates and pressure-dispersing pads for the head have in palatal development remains unclear