Strengthening surveillance systems for Antimicrobial Resistance in Urinary Tract infections in Kenya – Report from Fleming Fund fellowship programme

Background: Urinary Tract Infection (UTI) is one of the most common reasons for outpatient attendance and antibiotic use worldwide. Tackling the problem of antimicrobial resistance (AMR) in Low- and Middle-Income Countries such as Kenya requires laboratory surveillance systems that can correctly identify bacterial pathogens from urine samples and perform antimicrobial susceptibility testing (AST). In Kenya, there are many shortcomings in public-sector microbiology laboratories, including limited professional expertise in the clinical interpretation of urine samples. Methods: This project aimed to deliver training on identification and AST for staff at five hospital laboratories participating in the Kenyan AMR surveillance network. We made local needs assessments, delivered practical training sessions face-to-face and administered written and practical competency assessments for all participants. Results: Trainings were conducted between November 2021 and January 2022 with a total of 13 laboratory staff trained. Participants had previously received a median of 2.3 months (IQR 1-7 months) of training time in microbiology. There was a substantial improvement in written assessment scores from a median of 46/100 pre-training (IQR 36-64) to a median of 90/100 post-training (IQR 85-92). The largest improvements were seen amongst staff with the lowest prior levels of microbiology training (MLS Diploma), though improvements were also seen for staff with BSc and MSc qualifications. Practical assessment included use of standardized organisms – all participants performed well in this practical assessment. Conclusion: We found that prior to the training, all staff performed relatively poorly on a standardized assessment regarding knowledge and processing of urine samples. However, all staff substantially improved following this 5-day training delivered by a single trainer. We estimated that the cost of delivering this training for one hospital was approximately KES 500,000. Training microbiology staff in the accurate processing of urine sample will be an important activity for a Kenyan AMR surveillance system. These training materials, if delivered by an experienced trainer, can achieve a clear improvement in knowledge levels and practical competence

Performance Testing and Analysis of Synchronous Reluctance Motor Utilizing Dual-phase Magnetic Material

While interior permanent magnet (1PM) machines have been considered the state-of-the art for traction motors, synchronous reluctance (SynRel) motors with advanced materials can provide a competitive alternative. 1PM machines typically utilize Neodymium 1ron Boron (NdFeB) permanent magnets, which pose an issue in terms of price, sustainability, demagnetization at higher operating temperatures, and uncontrolled generation. On the other hand, SynRel machines do not contain any magnets and are free from these issues. However, the absence of magnets as well the presence of bridges and centerposts limit the flux-weakening capability of a SynRel machine and limit the achievable constant power speed ratio (CPSR) without having to significantly oversize the machine and/or the power converter. 1n this paper, a new material referred to as the dual-phase magnetic material where nonmagnetic regions can be selectively introduced within each lamination will be evaluated for SynRel designs. The dual-phase feature of this material enables non-magnetic bridges and posts, eliminating one of the key limitations of the SynRel designs in terms of torque density and flux-weakening. This paper will present, the design, analysis and test results of an advanced proof-of-concept SynRel design utilizing dual-phase material with traction applications as the ultimate target application

Ex-smokers with and without COPD: Investigating CT Pulmonary Vascular, Airway, Pulmonary Artery and Aorta Measurements

RATIONALE: Pulmonary hypertension is characterized by increased pressure in the pulmonary artery, and is a key contributor to worsening symptoms in individuals with chronic obstructive pulmonary disease (COPD). The pulmonary artery to aorta diameter ratio (PA:Ao), measured using computed tomography (CT), is a biomarker of pulmonary hypertension; however, longitudinal changes in this measurement and its relationship to pulmonary vascular and airway structural changes is not well understood. Our objective was to investigate longitudinal changes in PA:Ao and its relationship with CT pulmonary vascular and airway abnormalities, airflow limitation and exercise-capacity

Observation of oscillatory relaxation in the Sn-terminated surface of epitaxial rock-salt SnSe {111}\{111\} topological crystalline insulator

Topological crystalline insulators have been recently predicted and observed in rock-salt structure SnSe $\{111\}$ thin films. Previous studies have suggested that the Se-terminated surface of this thin film with hydrogen passivation, has a reduced surface energy and is thus a preferred configuration. In this paper, synchrotron-based angle-resolved photoemission spectroscopy, along with density functional theory calculations, are used to demonstrate conclusively that a rock-salt SnSe $\{111\}$ thin film epitaxially-grown on \ce{Bi2Se3} has a stable Sn-terminated surface. These observations are supported by low energy electron diffraction (LEED) intensity-voltage measurements and dynamical LEED calculations, which further show that the Sn-terminated SnSe $\{111\}$ thin film has undergone a surface structural relaxation of the interlayer spacing between the Sn and Se atomic planes. In sharp contrast to the Se-terminated counterpart, the observed Dirac surface state in the Sn-terminated SnSe $\{111\}$ thin film is shown to yield a high Fermi velocity, $0.50\times10^6$m/s, which suggests a potential mechanism of engineering the Dirac surface state of topological materials by tuning the surface configuration.Comment: 12 pages, 13 figures, supplementary materials include

Six weeks of high intensity interval training (HIIT) facilitates a four year preservation of aerobic capacity in sedentary older males: A reunion study

Long-term implications of acutely increased cardiorespiratory fitness following short-term exercise interventions in older adults are unknown. In this study, we examined peak oxygen uptake (VO2peak) after 4-years of ‘free-living’ after a high intensity interval training (HIIT) intervention. Seventeen lifelong exercisers (LEX) and 17 previously sedentary (SED) males (55–74 years of age in 2012) were tested four years (phase D) after our previous experiment which included 6-weeks of aerobic moderate intensity exercise (phase B), followed by 6-weeks of HIIT (phase C). At all stages, a standard incremental exercise protocol on a cycle ergometer was completed to determine VO2peak. SED (P = 1.000, Cohen's d = 0.01) and LEX (P = 1.000, Cohen's d = 0.11) VO2peak at phase D was not different from phase A (enrolment). SED experienced a large decrease in VO2peak from phase C to phase D (32 ± 6 ml·kg·min−1 to 27 ± 6 ml·kg·min−1 [P < 0.001, Cohen's d = 0.81]). LEX experienced a small decrease in VO2peak from phase C to phase D (42 ± 7 ml·kg·min−1 to 39 ± 9 ml·kg·min−1 [P < 0.001, Cohen's d = 0.46]). At phase D, LEX had greater VO2peak than SED (P < 0.001, Cohen's d = 1.73). The proportion of subjects who reported discontinuing training, maintaining moderate training, and maintaining HIIT differed between groups (P = 0.023), with LEX self-reporting more HIIT, and SED self-reporting more discontinuation from exercise. Those who continued exercising experienced a reduction in VO2peak over the four years from 39 ± 7 ml·kg·min−1 to 36 ± 9 ml·kg·min−1 (N = 25, P < 0.001, Cohen's d = 0.37), and those who discontinued exercising also experienced a reduction in VO2peak from 30 ± 7 ml·kg·min−1 to 25 ± 9 ml·kg·min−1 (N = 9, P = 0.003, Cohen's d = 0.62). Four years after completing a brief period of aerobic exercise and HIIT, older males demonstrated a preservation of VO2peak, irrespective of training status (LEX or SED). However, LEX exhibited greater VO2peak than SED after 4-years of unsupervised ‘free-living’. Notably, participants who discontinued exercising experienced a greater reduction in VO2peak. These data suggest that a 6 weeks of supervised HIIT can facilitate the long term. © 2021 Elsevier Inc

A Muscle Cell-Macrophage Axis Involving Matrix Metalloproteinase 14 Facilitates Extracellular Matrix Remodeling with Mechanical Loading

The extracellular matrix (ECM) in skeletal muscle plays an integral role in tissue development, structural support, and force transmission. For successful adaptation to mechanical loading, remodeling processes must occur. In a large cohort of older adults, transcriptomics revealed that genes involved in ECM remodeling, including matrix metalloproteinase 14 (MMP14), were the most upregulated following 14 weeks of progressive resistance exercise training (PRT). Using single-cell RNA-seq, we identified macrophages as a source of Mmp14 in muscle following a hypertrophic exercise stimulus in mice. In vitro contractile activity in myotubes revealed that the gene encoding cytokine leukemia inhibitory factor (LIF) is robustly upregulated and can stimulate Mmp14 expression in macrophages. Functional experiments confirmed that modulation of this muscle cell-macrophage axis facilitated Type I collagen turnover. Finally, changes in LIF expression were significantly correlated with MMP14 expression in humans following 14 weeks of PRT. Our experiments reveal a mechanism whereby muscle fibers influence macrophage behavior to promote ECM remodeling in response to mechanical loading

Genetic inhibition of neurotransmission reveals role of glutamatergic input to dopamine neurons in high-effort behavior

Midbrain dopamine neurons are crucial for many behavioral and cognitive functions. As the major excitatory input, glutamatergic afferents are important for control of the activity and plasticity of dopamine neurons. However, the role of glutamatergic input as a whole onto dopamine neurons remains unclear. Here we developed a mouse line in which glutamatergic inputs onto dopamine neurons are specifically impaired, and utilized this genetic model to directly test the role of glutamatergic inputs in dopamine-related functions. We found that while motor coordination and reward learning were largely unchanged, these animals showed prominent deficits in effort-related behavioral tasks. These results provide genetic evidence that glutamatergic transmission onto dopaminergic neurons underlies incentive motivation, a willingness to exert high levels of effort to obtain reinforcers, and have important implications for understanding the normal function of the midbrain dopamine system.Fil: Hutchison, M. A.. National Institutes of Health; Estados UnidosFil: Gu, X.. National Institutes of Health; Estados UnidosFil: Adrover, Martín Federico. National Institutes of Health; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; ArgentinaFil: Lee, M. R.. National Institutes of Health; Estados UnidosFil: Hnasko, T. S.. University of California at San Diego; Estados UnidosFil: Alvarez, V. A.. National Institutes of Health; Estados UnidosFil: Lu, W.. National Institutes of Health; Estados Unido

Sleep in wildland firefighters: what do we know and why does it matter?

Wildland firefighters perform physical work while being subjected to multiple stressors and adverse, volatile working environments for extended periods. Recent research has highlighted sleep as a significant and potentially modifiable factor impacting operational performance. The aim of this review was to (1) examine the existing literature on firefighters’ sleep quantity and quality during wildland firefighting operations; (2) synthesise the operational and environmental factors that impact on sleep during wildland firefighting; and (3) assess how sleep impacts aspects of firefighters’ health and safety, including mental and physical health, physical task performance, physical activity and cognitive performance. Firefighters’ sleep is restricted during wildfire deployments, particularly when shifts have early start times, are of long duration and when sleeping in temporary accommodation. Shortened sleep impairs cognitive but not physical performance under simulated wildfire conditions. The longer-term impacts of sleep restriction on physiological and mental health require further research. Work shifts should be structured, wherever possible, to provide regular and sufficient recovery opportunities (rest during and sleep between shifts), especially in dangerous working environments where fatigue-related errors have severe consequences. Fire agencies should implement strategies to improve and manage firefighters’ sleep and reduce any adverse impacts on firefighters’ work