The (In)Effectiveness of Incentives - A Field Experiment on the Adoption of Personal Electronic Health Records

Medication errors are the third-leading cause of death in the US; however, a large number of these cases could be prevented through better medication management. The aging population and the associated high number of individuals taking multiple medications regularly makes medication management even more important. Personal electronic health records (PHRs) can improve medication management significantly and thus increase patient safety. Despite unequivocal benefits for individuals, healthcare professionals, governments, insurers, and employers, the adoption rate of PHRs remains low. Therefore, we seek to identify measures that motivate individuals to adopt PHRs. Drawing on justice theory, we show that incentives in terms of personalization, as well as the signal of fair information practices, increase the adoption rate of PHRs. These effects are mediated by perceived benefits and privacy concerns, respectively. Based on counterintuitive findings on the effects of monetary compensation we start a discussion on the complexity and context-dependency of different incentives

Toolkits for innovation: how digital technologies empower users in new product development

In recent decades, toolkits for innovation have been increasingly used to integrate users into new product development processes. They promise to empower users in these processes by providing design freedom and iterative learning for the transformation of ideas into products. Despite these potential benefits, little is known about how these often digital toolkits compare to traditional design methods, and what role previous experience of users in new product development plays. To compare the effectiveness of toolkits for innovation with physical product modeling, we conducted a two-stage laboratory experiment in the form of an innovation challenge. One hundred non-expert and 46 expert users created new product designs, which were subsequently evaluated by an independent jury. Our results show that users with no experience in digital or physical design tasks develop more innovative product ideas when using a digital toolkit for innovation than when they use physical product modeling, while expert users seem to be able to use both methods with equal success. We, thereby, show that toolkits for innovation are a powerful way to translate users' solution information into a prototype. Moreover, our results indicate that the usage of a digital toolkit for innovation decreases the quality gap between the designs of non-expert and expert users in new product development

Whole genome sequence-based characterisation of Shiga toxin-producing Escherichia coli isolated from game meat originating from several European countries

Game meat is becoming increasingly popular but may be contaminated with pathogenic bacteria such as Shiga toxin-producingEscherichia coli(STEC). STEC cause gastrointestinal illnesses including diarrhoea, haemorrhagic colitis (HC), and the haemolytic uremic syndrome (HUS). The aim of this study was to assess the occurrence of STEC in 92 meat samples from chamois (n = 2), red deer (n = 27), roe deer (n = 38), and wild boar (n = 25), from Switzerland and other European countries. After enrichment, Shiga-toxin encoding genes (stx) were detected by PCR in 78 (84%) of the samples and STEC were isolated from 23 (25%) of the same samples. Nine different serotypes and eight different sequence types (STs) were found, with O146:H28 ST738 (n = 10) and O110:H31 ST812 (n = 5) predominating. None of the STEC belonged to the so-called top-five serogroups O26, O103, O111, O145, and O157. Subtyping ofstxidentifiedstx1c(n = 9),stx2a(n = 1),stx2b(n = 19),stx2e(n = 2), andstx2g(n = 1). Additional virulence factors (VFs) comprisedehx(n = 12),iha(n = 21),sta1(n = 1), andsubAB(n = 19). None of the isolates contained theeaegene. Twenty-one STEC contained VFs associated with extra-intestinal pathogenicE. coli(ExPEC). Overall, the pathogenic potential of STEC in game meat is moderate, though the isolation of one STEC strain carryingstx2a, and of STEC/ExPEC hybrids suggests a role of game meat as a potential source of STEC infections in humans. Therefore, detailed knowledge of the safe handling and preparation of game meat is needed to prevent foodborne infections

Spread of vancomycin-resistant Enterococcus faecium ST133 in the aquatic environment in Switzerland

Objectives The global dissemination of vancomycin-resistant enterococci (VRE) has become a serious public-health concern. Although outbreaks are typically caused by nosocomial transmission, contaminated food and water may contribute to the spread of VRE. The aim of this study was to assess the presence of VRE in flowing surface water bodies in Switzerland and to characterise the isolates. Methods Surface water was sampled from rivers, streams and canals throughout Switzerland and was screened for the presence of VRE. Whole-genome sequencing was used to identify antimicrobial resistance genes and the phylogenetic similarity of the obtained isolates. Results VRE were detected in 6 (3.1%) of 191 water samples. The six VRE-containing samples were all collected near treated wastewater discharge sites. The six isolates were identified as Enterococcus faecium sequence type 133 (ST133) and harboured the vancomycin resistance-conferring vanA gene cluster on transposon Tn1546. They showed a close phylogenetic relationship to ST133 swine faecal isolates obtained during a previously reported screening in Switzerland. Conclusion Our results suggest that surface water contributes to the environmental dissemination of VRE. Repeated identification of ST133 clones in geographically distinct water sampling sites and swine faecal samples collected in slaughterhouses may indicate a local dominance of this VRE lineage in Switzerland

Caries management using silver diamine fluoride and providing domiciliary dental care for dependent older adults: A qualitative study of Swiss dentists

OBJECTIVES Maintaining the oral health of dependent older adults is challenging, with limited access to dental care and limited focus on preventive oral health programmes. This study aimed to evaluate the attitudes of General Dental Practitioners (GDPs), working in Switzerland, to caring for dependent older adults with a focus on the use of silver diamine fluoride (SDF) as a caries preventive agent and more widely on the provision of domiciliary dental care (DDC). METHODS Seventeen GDPs working in Switzerland were interviewed. Each interview was semi-structured by a topic guide, digitally recorded, and transcribed. The transcribed data were analysed using a thematic analysis. RESULTS Three major themes to the widespread use of SDF in this population were identified: lack of basic knowledge including indications for use; aesthetic concerns and product availability. Those who had knowledge about the product believed that using it in the treatment of frail older adults had advantages, especially in the preservation and/or prolongation of the life of teeth without invasive treatments. The biggest barrier was its availability. The GDPs identified three major barriers related to DDC provision: lack of infrastructure, poor financial rewards and safety concerns (patient and operator safety). Those who provided this service stated that they were doing it because of self-motivation, kindness, or as a role in community service. CONCLUSIONS The potential use of SDF was viewed positively by the majority of the GDPs interviewed but confusion exists over its availability in Switzerland, and other barriers were identified to more widespread use in this patient group. The GDPs interviewed in this study reported that a lack of infrastructure and a low level of remuneration continue to be barriers to more of them undertaking DDC for dependent older adults

Cyanine platelet single crystals: Growth, crystal structure and optical spectra

© the Owner Societies. Crystalline organic semiconducting materials are much in demand for multiple electronic and optoelectronic device applications. Here, solution grown ultrathin rhombic crystals of a trimethine carbocyanine anionic dye are used to establish relationships between structural and optical properties. The dye crystallized in the monoclinic space group P21/c featuring alternating layers of molecules in two different herringbone type patterns, with perchlorate counterions located mostly within one of the two layers. Micro transmittance spectroscopy revealed a broadened spectrum compared to those obtained in solution and in an amorphous thin film. Using polarized light, transmission spectroscopy revealed strong low-energy and weak high-energy bands polarized along the crystallographic b- and c-axis, respectively. Using the extended dipole approximation, significant exciton couplings are predicted between neighboring molecules in the crystal, of the order of the intrinsic monomer reorganization energies associated with nuclear relaxation after excitation, depicting a complex spectral scenario. The exciton coupling pattern explains the relative energies of the b- and c-polarized components but the observed intensities are opposite to expectations based on chromophore alignment within the crystal

Environmental dissemination of carbapenemase-producing Enterobacteriaceae in rivers in Switzerland

The aquatic environment takes on a key role in the dissemination of antimicrobial-resistant Enterobacteriaceae. This study assesses the occurrence of carbapenemase-producing Enterobacteriaceae (CPE) in freshwater samples from rivers, inland canals, and streams throughout Switzerland, and characterizes the isolated strains using phenotypic and NGS-based genotypic methods. CPE producing KPC-2 (n = 2), KPC-3 (n = 1), NDM-5 (n = 3), OXA-48 (n = 3), OXA-181 (n = 6), and VIM-1 (n = 2) were detected in 17/164 of the water samples. Seven Escherichia coli had sequence types (STs) that belonged to extra-intestinal pathogenic clonal lineages ST38, ST73, ST167, ST410, and ST648. The majority (16/17) of the carbapenemase genes were located on plasmids, including the widespread IncC (n = 1), IncFIIA (n = 1), and IncFIIB plasmids (n = 4), the epidemic IncL (n = 1) and IncX3 (n = 5) plasmids, a rare Col156 plasmid (n = 1), and the mosaic IncFIB, IncR, and IncQ plasmids (n = 3). Plasmids were composed of elements that were identical to those of resistance plasmids retrieved from clinical and veterinary isolates locally and worldwide. Our data show environmental dissemination of high-risk CPE clones in Switzerland. Epidemic and mosaic-like plasmids carrying clinically relevant carbapenemase genes are replicating and evolving pollutants of river ecosystems, representing a threat to public health and environmental integrity

Listeriosis Caused by Persistence of Listeria monocytogenes Serotype 4b Sequence Type 6 in Cheese Production Environment

A nationwide outbreak of human listeriosis in Switzerland was traced to persisting environmental contamination of a cheese dairy with Listeria monocytogenes serotype 4b, sequence type 6, cluster type 7488. Whole-genome sequencing was used to match clinical isolates to a cheese sample and to samples from numerous sites within the production environment. Listeriosis is a potentially lethal infection, and the elderly population, pregnant women, and immunocompromised persons at particular risk (1). Foods, in particular ready-to-eat foodstuffs, including meat, fish, dairy products, fruits, and vegetables, represent the major vehicle for sporadic cases and outbreaks of listeriosis (2). Listeria monocytogenes serotype 4b sequence type 6 (ST6) has emerged since 1990 as a hypervirulent clone that is associated with particularly worse outcome for case-patients who have Listeria meningitis and therefore poses a particular threat to consumer health (3,4). L. monocytogenes ST6 is increasingly associated with outbreaks, including an outbreak linked to frozen vegetables in 5 countries in Europe during 2015–2018 (5), an outbreak associated with contaminated meat pâté in Switzerland during 2016 (6), and the largest listeriosis outbreak globally, which occurred in South Africa during 2017–2018 (7,8). More recently, the largest outbreak of listeriosis in Europe in the past 25 years was reported in Germany and was traced back to blood sausages contaminated with L. monocytogenes ST6 belonging to a particular clone referred to as Epsilon1a (9). Human listeriosis is a reportable disease in Switzerland. All cases of culture- or PCR-confirmed human listeriosis are reported to the Swiss Federal Office of Public Health (SFOPH). Diagnostic laboratories and regional (cantonal) laboratories forward isolates to the Swiss National Reference Centre for Enteropathogenic Bacteria and Listeria for strain characterization, ensuring early recognition of Listeria clusters among food isolates or human cases. We report an outbreak of listeriosis associated with cheese contaminated with L. monocytogenes 4b ST6 in Switzerland

Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis

Objective To determine the effect of glucosamine, chondroitin, or the two in combination on joint pain and on radiological progression of disease in osteoarthritis of the hip or knee

Serotypes, Antimicrobial Resistance Profiles, and Virulence Factors of Salmonella Isolates in Chinese Edible Frogs (Hoplobatrachus rugulosus) Collected from Wet Markets in Hong Kong

Salmonella is an important agent of gastrointestinal disease in humans. While livestock, such as cattle, poultry, and pigs, are well-recognised animal reservoirs of Salmonella, there is a lack of data on Salmonella in edible frogs, even though frog meat is a popular food worldwide. In this study, 103 live edible Chinese frogs (Hoplobatrachus rugulosus) were collected from wet markets throughout Hong Kong. After euthanasia, faeces or cloacal swabs were examined for Salmonella. Overall, Salmonella spp. were isolated from 67 (65%, CI: 0.554–0.736) of the samples. The serotypes included S. Saintpaul (33%), S. Newport (24%), S. Bareilly (7%), S. Braenderup (4%), S. Hvittingfoss (4%), S. Stanley (10%), and S. Wandsworth (16%). Many isolates were phylogenetically related. A high number of genes encoding for resistance to clinically relevant antimicrobials, and a high number of virulence determinants, were identified. Antimicrobial susceptibility testing (AST) identified multidrug resistance (MDR) in 21% of the isolates. Resistance to ampicillin, ciprofloxacin, nalidixic acid, and tetracycline was common. These results demonstrate that a high percentage of live frogs sold for human consumption in wet markets are carriers of multidrug-resistant Salmonella. Public health recommendations for handling edible frogs should be considered, to mitigate the risk of Salmonella transmission to humans