Integrated surveillance systems for antibiotic resistance in a One Health context: a scoping review

Antibiotic resistance (ABR) has emerged as a major threat to health. Properly informed decisions to mitigate this threat require surveillance systems that integrate information on resistant bacteria and antibiotic use in humans, animals, and the environment, in line with the One Health concept. Despite a strong call for the implementation of such integrated surveillance systems, we still lack a comprehensive overview of existing organizational models for integrated surveillance of ABR. To address this gap, we conducted a scoping review to characterize existing integrated surveillance systems for ABR.The literature review was conducted using the PRISMA guidelines. The selected integrated surveillance systems were assessed according to 39 variables related to their organization and functioning, the socio-economic and political characteristics of their implementation context, and the levels of integration reached, together with their related outcomes. We conducted two distinct, complementary analyses on the data extracted: a descriptive analysis to summarize the characteristics of the integrated surveillance systems, and a multiple-correspondence analysis (MCA) followed by a hierarchical cluster analysis (HCA) to identify potential typology for surveillance systems.The literature search identified a total of 1330 records. After the screening phase, 59 references were kept from which 14 integrated surveillance systems were identified. They all operate in high-income countries and vary in terms of integration, both at informational and structural levels. The different systems combine information from a wide range of populations and commodities -in the human, animal and environmental domains, collection points, drug-bacterium pairs, and rely on various diagnostic and surveillance strategies. A variable level of collaboration was found for the governance and/or operation of the surveillance activities. The outcomes of integration are poorly described and evidenced. The 14 surveillance systems can be grouped into four distinct clusters, characterized by integration level in the two dimensions. The level of resources and regulatory framework in place appeared to play a major role in the establishment and organization of integrated surveillance.This study suggests that operationalization of integrated surveillance for ABR is still not well established at a global scale, especially in low and middle-income countries and that the surveillance scope is not broad enough to obtain a comprehensive understanding of the complex dynamics of ABR to appropriately inform mitigation measures. Further studies are needed to better characterize the various integration models for surveillance with regard to their implementation context and evaluate the outcome of these models

Development of Non-Destructive Condition Monitoring Techniques for Low-Voltage Cables

NRC publication: Ye

IqYmune® is an effective maintenance treatment for multifocal motor neuropathy: A randomised, double-blind, multi-center cross-over non-inferiority study vs Kiovig®—The LIME Study

Intravenous immunoglobulin (IVIg) is the gold-standard for maintenance treatment of multifocal motor neuropathy (MMN). This phase III, randomised, double-blind, multi-centre, active-control, crossover study, aimed to evaluate the non-inferiority of IqYmune\uae relative to Kiovig\uae, primarily based on efficacy criteria. Twenty-two adult MMN patients, treated with any brand of IVIg (except Kiovig\uae or IqYmune\uae) at a stable maintenance dose within the range of 1 to 2 g/kg every 4 to 8 weeks, were randomised to receive either Kiovig\uae followed by IqYmune\uae, or IqYmune\uae followed by Kiovig\uae. Each product was administered for 24 weeks. The primary endpoint was the difference between IqYmune\uae and Kiovig\uae in mean assessments of modified Medical Research Council (MMRC) 10 sum score (strength of 5 upper-limb and 5 lower-limb muscle groups, on both sides, giving a score from 0 to 100) during the evaluation period (non-inferiority margin of \u394 = 2). A linear mixed model analysis demonstrated the non-inferiority of IqYmune\uae relative to Kiovig\uae, independently of the covariates (value at baseline, treatment period, and treatment sequence). The estimated \u201cIqYmune\uae 12 Kiovig\uae\u201d difference was 120.01, with a 95% confidence interval (CI) 120.51 to 0.48. The number of adverse reactions (ARs) and the percentage of patients affected were similar for the two products: 39 ARs in 10 patients with IqYmune\uae vs 32 ARs in 11 patients with Kiovig\uae. No thromboembolic events nor haemolysis nor renal impairment were observed. In this first clinical trial comparing two IVIg brands for maintenance treatment of MMN, efficacy and tolerability of both brands were similar

Facteurs prédictifs de l’arrêt des premières lignes de traitement antirétroviral hautement efficace (HAART) : approches comparatives du modèle à risque compétitif et du modèle de Cox dans la cohorte NADIS®, Toulouse, France

International audienc

Workshop report on Stakeholder Validation of Selected Adaptation Interventions in Senegal, Dakar, Senegal, 11 July 2023

Senegal, a country in West Africa and home to over 16 million people is highly vulnerable to the impacts of climate change, which interacts with existing environmental and socio-economic challenges. It is a water-scarce country. Decreasing rainfall frequent and intense droughts are exacerbating water-related impacts of climate change with vulnerable communities in rural areas bearing the highest burden of these impacts. Although agriculture is an important contributor to Senegal’s economy, it is largely rain-fed, thus increasing its vulnerability to the impacts of climate change. Against the backdrop of the increasing impacts of climate change, the CGIAR Initiative on Climate Resilience is setting up a polycentric governance model to enhance resilience against the impacts of climate change in Senegal. The study is part of a broader project titled Building Systemic Resilience Against Climate Variability and Extremes (ClimBeR). ClimBeR comprises four work modules: (1) reducing the risks associated with climate change for agricultural production systems and livelihoods; (2) strengthening the resilience of production systems by recognizing the links between climate, agriculture, security and peace; (3) Developing adaptation tools to inform policy and facilitate investment; (4) Conceptualizing a polycentric and bottom-up governance model. ClimBeR aims to strengthen climate resilience in low- and middle-income countries. This report presents the outcome of a stakeholder workshop held on 11 July 2023 as part of the project implementation. The workshop aimed to inform stakeholders about ClimBeR, share the preliminary results of the mapping exercise which culminated in an inventory of 31 promising, resilient, transformative adaptation interventions in Senegal, and select 3-4 promising, resilient and transformative adaptation interventions in Senegal from a shortlist of 8 interventions. At the end of the workshop, 4 adaptation interventions, including one recommended by the stakeholders outside the 8 preselected interventions were selected. All the selected projects operate across spatial scales with various stakeholders, including households, community members, civil society and non-governmental organisations, and government officials. Three projects focused on food security, while the fourth focused on natural resource management. The next phase of the project entails a detailed mapping of the selected interventions

Integrated surveillance systems for antibiotic resistance in a One Health context: a scoping review

Abstract Background Antibiotic resistance (ABR) has emerged as a major threat to health. Properly informed decisions to mitigate this threat require surveillance systems that integrate information on resistant bacteria and antibiotic use in humans, animals, and the environment, in line with the One Health concept. Despite a strong call for the implementation of such integrated surveillance systems, we still lack a comprehensive overview of existing organizational models for integrated surveillance of ABR. To address this gap, we conducted a scoping review to characterize existing integrated surveillance systems for ABR. Methods The literature review was conducted using the PRISMA guidelines. The selected integrated surveillance systems were assessed according to 39 variables related to their organization and functioning, the socio-economic and political characteristics of their implementation context, and the levels of integration reached, together with their related outcomes. We conducted two distinct, complementary analyses on the data extracted: a descriptive analysis to summarize the characteristics of the integrated surveillance systems, and a multiple-correspondence analysis (MCA) followed by a hierarchical cluster analysis (HCA) to identify potential typology for surveillance systems. Results The literature search identified a total of 1330 records. After the screening phase, 59 references were kept from which 14 integrated surveillance systems were identified. They all operate in high-income countries and vary in terms of integration, both at informational and structural levels. The different systems combine information from a wide range of populations and commodities -in the human, animal and environmental domains, collection points, drug-bacterium pairs, and rely on various diagnostic and surveillance strategies. A variable level of collaboration was found for the governance and/or operation of the surveillance activities. The outcomes of integration are poorly described and evidenced. The 14 surveillance systems can be grouped into four distinct clusters, characterized by integration level in the two dimensions. The level of resources and regulatory framework in place appeared to play a major role in the establishment and organization of integrated surveillance. Conclusions This study suggests that operationalization of integrated surveillance for ABR is still not well established at a global scale, especially in low and middle-income countries and that the surveillance scope is not broad enough to obtain a comprehensive understanding of the complex dynamics of ABR to appropriately inform mitigation measures. Further studies are needed to better characterize the various integration models for surveillance with regard to their implementation context and evaluate the outcome of these models

Penetrating Heart Injury due to Screwdriver Assault

Penetrating heart injuries cause wounds in the cardiac chambers. Most of them are due to gunshot or stabbing by knives. Screwdriver is an uncommon weapon. Authors report a case of stab wound by screwdriver, treated at cardiovascular center in Dakar. This is a 16-year-old boy who experienced physical aggression. He was assaulted with a screwdriver and had stab wound on the anterior wall of the chest. Physical examination showed a screwdriver penetrating the sternum bone over a right angle. He had a mild pericardial blood effusion and a right ventricle wound 5 mm in diameter with transection of the right coronary vein. The screwdriver was removed without cardiopulmonary bypass (CPB) and the ventricle wound repaired by direct suture of stitches reinforced with Teflon pledgets. The right coronary artery was ligated. Postoperative period was free of events. Screwdriver is uncommonly used as a weapon. It is a dangerous device because of its rigid structure and narrow tip

Left Atrium Papillary Fibroelastomas: A Cause of Cerebral Emboli

Papillary fibroelastomas are cardiac benign tumours. Among the benign cardiac tumor, papillary fibroelastomas are reported second after myxomas. Most often diagnosed incidentally, papillary fibroelastomas may embolize to cerebral circulation. Valvular locations are predominant; location in left atrium is rare. In this paper, we present a case of papillary fibroelastoma located in left atrium with symptoms of cerebral embolization. Transoesophageal echocardiography diagnosed a mobile mass. The patient was treated with surgical resection without further embolic complication