Revolutionizing cancer treatment by boosting dendritic cell vaccine efficacy with graphene oxide

Dendritic cells (DCs) are potent antigen presenting cells that play a crucial role in stimulating T cell responses against cancer. DC vaccines have been utilized as an immunotherapy approach for cancer treatment, but their effectiveness is hampered by challenges in the tumor microenvironment. Graphene oxide (GO), a cutting-edge carbon-based nanomaterial, has shown promise in modulating DC activation and function. This review highlights the recent advancements in DC vaccines and explores how GO can enhance their efficacy for cancer treatment. By leveraging the unique properties of GO, such as its biocompatibility and immunomodulatory effects, DC vaccines can potentially be optimized to overcome the limitations of the tumor microenvironment and achieve improved outcomes in cancer immunotherapy

Electronic communication of cells with a surface mediated by boronic acid saccharide interactions

The fabrication of a molecularly tailored surface functionalised with a saccharide binding motif, a phenyl boronic acid derivative is reported.The functionalised surface facilitated the transfer of electrons, via unique electronic interactions mediated by the presence of the boronic acid, from a macrophage cell line. This is the first example of eukaryotic cellular-electrical communication mediated by the binding of cells via their cell–surface saccharide units

From earthquakes to island area: multi‐scale effects upon local diversity

Tropical forests occupy small coral atolls to the vast Amazon basin. They occur across bioregions with different geological and climatic history. Differences in area and bioregional history shape species immigration, extinction and diversification. How this effects local diversity is unclear. The Indonesian archipelago hosts thousands of tree species whose coexistence should depend upon these factors. Using a novel dataset of 215 Indonesian forest plots, across fifteen islands ranging in area from 120 to 785 000 km$^{2}$, we apply Gaussian mixed effects models to examine the simultaneous effects of environment, earthquake proximity, island area and bioregion upon tree diversity for trees ≥ 10 cm diameter at breast height. We find that tree diversity declines with precipitation seasonality and increases with island area. Accounting for the effects of environment and island area we show that the westernmost bioregion Sunda has greater local diversity than Wallacea, which in turn has greater local diversity than easternmost Sahul. However, when the model includes geological activity (here proximity to major earthquakes), bioregion differences are reduced. Overall, results indicate that multi‐scale, current and historic effects dictate tree diversity. These multi‐scale drivers should not be ignored when studying biodiversity gradients and their impacts upon ecosystem function

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Parametric Study of an Electromagnetic Energy Harvester

This paper presents two important parameters for an electromagnetic energy harvester exploiting various shaker excitation frequencies: (1) number of turns of the coil and (2) length of the beams for the device. This system consists of a cantilever beam based which represent a spring element of the system, permanent NdFeB magnet, coil system and wiring system to be connected to the data acquisition system. It is found that the induced voltage is proportional to the increment of the number of turns and the length of beams. The expected resonance happens at 300 Hz for case (1) and 100 Hz for case (2). The maximum voltage produced by this device is 915.395 millivolts for length 13 cm at 100 Hz excitation and 275.058 millivolts for 1050 turns at 300 Hz excitation. Experimental data have demonstrated that the geometry and number of turns of the coil would affect the performance of the energy harvester while excitation frequency as a non-physical factor also contributes to its effectiveness

A multi-objective optimization of FCL and DOCR settings to mitigate distributed generations impacts on distribution networks

&lt;p&gt;Despite providing increased reliability and power quality in meeting the load demand, the integration of DGs has imposed challenges on the protection system. High penetration of DGs changes the overall network impedance and increases the fault current level in the network. Consequently, some buses are exposed to critical conditions, violate the circuit breakers (CB) handling capacity, and affect the existing relay coordination settings. To mitigate these adverse impacts, fault current limiters (FCL) can be a potential solution to minimize the short circuit current within permissible switchgear-rated limits. Due to its expensive cost, it is crucial to ensure the optimal FCL placement and sizing, and at the same time maintain the effectiveness of the protection performance during various network operation states. This research formulates FCL and directional overcurrent relay (DOCR) settings as a combined protection coordination scheme optimized by a multi-objective hybrid optimization technique. The proposed formulation aims to determine the minimal FCL sizing with minimum investment cost to satisfy the relay coordination constraints at high fault-level buses, irrespective of &lt;a href="https://www.sciencedirect.com/topics/engineering/distributed-power-generation"&gt;DG&lt;/a&gt; locations and network operating state. User-defined relay characteristics (UDC) are employed to intensify the DOCR coordination performance and obtain minimum operating time, where the conventional inverse relay constants (A&amp;B) are optimized with (TSM &amp; Ipu). The combined UDC relay settings and FCL problem formulation solution attained by MO-hybrid optimization can lessen the escalated electromagnetic stresses, costly switchgear replacement, and relay maloperation. The performance of the proposed technique is assessed by implementing it on the radial (IEEE-33 Bus) and meshed (IEEE 30-Bus) DNs with optimized FCL sizing and relay settings. The optimal results demonstrate the effectiveness of the proposed technique in maintaining the relay coordination performance in the presence of DGs and FCL under an ON/OFF grid connection.&lt;/p&gt

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe