Seroprevalence and Severity of 2009 Pandemic Influenza A H1N1 in Taiwan

BACKGROUND: This study is to determine the seroprevalence of the pandemic influenza A H1N1 virus (pH1N1) in Taiwan before and after the 2009 pandemic, and to estimate the relative severity of pH1N1 infections among different age groups. METHODOLOGY/PRINCIPAL FINDINGS: A total of 1544 and 1558 random serum samples were collected from the general population in Taiwan in 2007 and 2010, respectively. Seropositivity was defined by a hemagglutination inhibition titer to pH1N1 (A/Taiwan/126/09) ≥1:40. The seropositivity rate of pH1N1 among the unvaccinated subjects and national surveillance data were used to compare the proportion of infections that led to severe diseases and fatalities among different age groups. The overall seroprevalence of pH1N1 was 0.91% (95% confidence interval [CI] 0.43-1.38) in 2007 and significantly increased to 29.9% (95% CI 27.6-32.2) in 2010 (p<0.0001), with the peak attack rate (55.4%) in 10-17 year-old adolescents, the lowest in elderly ≥65 years (14.1%). The overall attack rates were 20.6% (188/912) in unvaccinated subjects. Among the unvaccinated but infected populations, the estimated attack rates of severe cases per 100,000 infections were significantly higher in children aged 0-5 years (54.9 cases, odds ratio [OR] 4.23, 95% CI 3.04-5.90) and elderly ≥ 65 years (22.4 cases, OR 2.76, 95% CI 1.99-3.83) compared to adolescents aged 10-17 years (13.0 cases). The overall case-fatality rate was 0.98 per 100,000 infections without a significant difference in different age groups. CONCLUSIONS/SIGNIFICANCE: Pre-existing immunity against pH1N1 was rarely identified in Taiwanese at any age in 2007. Young children and elderly--the two most lower seroprotection groups showed the greatest vulnerability to clinical severity after the pH1N1 infections. These results imply that both age groups should have higher priority for immunization in the coming flu season

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

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

Graphene Oxide-PES-Based Mixed Matrix Membranes for Controllable Antibacterial Activity against Salmonella typhi and Water Treatment

The present work is focused on preparation, characterization, and antibacterial activity evaluation of graphene oxide/polyethersulfone mixed matrix filtration membranes. Graphene oxide (GO) was synthesized via improved Hummer’s method and characterized by XRD, FTIR, and SEM. FT-IR spectra showed the presence of carboxylic acid and hydroxyl groups on GO nanosheets. Different concentrations of the synthesized GO at 0.25, 0.5, and 1.0 wt. % were incorporated in polyethersulfone (PES) matrix via phase inversion method to fabricate GO-PES membranes. Increasing porosity and formation of wider, finger-like channels were observed with increased GO concentrations relative to pristine membranes as evident from scanning electron microscopy (SEM) micrographs of the fabricated membranes. However, membranes prepared with 1 wt. % GO appear to contain aggregation and narrowing of pore morphology. GO-incorporated membranes demonstrated enhanced flux, water-retaining capacities, and wettability as compared to pristine PES membranes. Shake flask and colony counting methods were employed to carry out antibacterial testing of synthesized GO and fabricated GO-PES membranes against Salmonella typhi (S. typhi)—a gram-negative bacteria present in water that is known as causative agent of typhoid. Synthesized GO showed significant reduction up to 70.8% in S. typhi cell count. In the case of fabricated membranes, variable concentrations of GO are observed to significantly influence the percentage viability of S. typhi, with reduction percentages observed at 41, 60, and 69% for 0.25, 0.5, and 1.0 wt. % GO-incorporated membranes relative to 17% in the case of pristine PES membranes. The results indicate a good potential for applying GO/PES composite membranes for water filtration application