803 research outputs found
Measuring antibiotic availability and use in 20 low- and middle-income countries
Objective To assess antibiotic availability and use in health facilities in low- and middle-income countries, using the service provision assessment and service availability and readiness assessment surveys.
Methods We obtained data on antibiotic availability at 13 561 health facilities in 13 service provision assessment and 8 service availability and readiness assessment surveys. In 10 service provision assessment surveys, child consultations with health-care providers were observed, giving data on antibiotic use in 22 699 children. Antibiotics were classified as access, watch or reserve, according to the World Health Organization’s AWaRe categories. The percentage of health-care facilities across countries with specific antibiotics available and the proportion of children receiving antibiotics for key clinical syndromes were estimated.
Findings The surveys assessed the availability of 27 antibiotics (19 access, 7 watch, 1 unclassified). Co-trimoxazole and metronidazole were most widely available, being in stock at 89.5% (interquartile range, IQR: 11.6%) and 87.1% (IQR: 15.9%) of health facilities, respectively. In contrast, 17 other access and watch antibiotics were stocked, by fewer than a median of 50% of facilities. Of the 22 699 children observed, 60.1% (13 638) were prescribed antibiotics (mostly co-trimoxazole or amoxicillin). Children with respiratory conditions were most often prescribed antibiotics (76.1%; 8972/11 796) followed by undifferentiated fever (50.1%; 760/1518), diarrhoea (45.7%; 1293/2832) and malaria (30.3%; 352/1160).
Conclusion Routine health facility surveys provided a valuable data source on the availability and use of antibiotics in low- and middle-income countries. Many access antibiotics were unavailable in a majority of most health-care facilities
The Local Group Census: planetary nebulae in Sextans B
Five planetary nebulae (PNe) have been discovered in the nearby dwarf
irregular galaxy. Emission line images were obtained using the Wide Field
Camera of the 2.5m Isaac Newton Telescope (INT) at La Palma (Spain). The
candidate PNe were identified by their point-like appearance and relatively
strong [OIII] emission-line fluxes. They are located within a galactocentric
distance of 2.8 arcmin, corresponding to 1.1 kpc at the distance of Sextans B.
Luminosities are in the range 1800--5600Lsolar. Sextans B is one of the
smallest dwarf irregular galaxies with a PN population. The number of PNe
detected suggest an enhanced star formation rate between 1 and 5 Gyr ago.Comment: 7 pages, 2 figure
Gallus GBrowse: a unified genomic database for the chicken
Gallus GBrowse (http://birdbase.net/cgi-bin/gbrowse/gallus/) provides online access to genomic and other information about the chicken, Gallus gallus. The information provided by this resource includes predicted genes and Gene Ontology (GO) terms, links to Gallus In Situ Hybridization Analysis (GEISHA), Unigene and Reactome, the genomic positions of chicken genetic markers, SNPs and microarray probes, and mappings from turkey, condor and zebra finch DNA and EST sequences to the chicken genome. We also provide a BLAT server (http://birdbase.net/cgi-bin/webBlat) for matching user-provided sequences to the chicken genome. These tools make the Gallus GBrowse server a valuable resource for researchers seeking genomic information regarding the chicken and other avian species
HII regions within a compact high velocity cloud. A nearly star-less dwarf galaxy?
Within the SECCO survey we identified a candidate stellar counterpart to the
Ultra Compact High Velocity Cloud (UCHVC) HVC274.68+74.70-123, that was
suggested by Adams et al. (2013) as a possible mini-halo within the Local Group
of galaxies. The spectroscopic follow-up of the brightest sources within the
candidate reveals the presence of two HII regions whose radial velocity is
compatible with physical association with the UVHVC. The available data does
not allow us to give a definite answer on the nature of the newly identified
system. A few alternative hypotheses are discussed. However, the most likely
possibility is that we have found a new faint dwarf galaxy residing in the
Virgo cluster of galaxies, which we name SECCO-1. Independently of its actual
distance, SECCO-1 displays a ratio of neutral hydrogen mass to V luminosity of
M_{HI}/L_V>= 20, by far the largest among local dwarfs. Hence, it appears as a
nearly star-less galaxy and it may be an example of the missing links between
normal dwarfs and the dark mini halos that are predicted to exist in large
numbers according to the currently accepted cosmological model.Comment: Accepted for publication in ApJ Letters. Pdflatex, emulateapj.cls. 6
pages, 3 figures, 2 table
Consumption of oral antibiotic formulations for young children according to the WHO Access, Watch, Reserve (AWaRe) antibiotic groups: an analysis of sales data from 70 middle-income and high-income countries
Background
The 2017 WHO Model List of Essential Medicines for Children (EMLc) groups antibiotics as Access, Watch, or Reserve, based on recommendations of their use as first-choice and second-choice empirical treatment for the most common infections. This grouping provides an opportunity to review country-level antibiotic consumption and a potential for stewardship. Therefore, we aimed to review 2015 levels of oral antibiotic consumption by young children globally.
Methods
We analysed wholesale antibiotic sales in 70 middle-income and high-income countries in 2015. We identified oral antibiotic formulations appropriate for use in young children (defined as child-appropriate formulations [CAFs]) using wholesale data from the IQVIA-Multinational Integrated Data Analysis System database, and we estimated 2015 antibiotic consumption in reference to the 2017 WHO EMLc Access, Watch, Reserve (AWaRe) antibiotic groups. We used three metrics for assessment of intra-country patterns: access percentage, defined as the number of CAF standard units of Access antibiotics divided by the total number of CAF standard units; amoxicillin index, defined as the number of amoxicillin CAF standard units divided by the total number of CAF standard units; and access-to-watch index, defined as the ratio of Access-to-Watch CAF standard units.
Findings
The overall median volume of CAF antibiotic standard units sold in 2015 per country was 74·5 million (IQR 12·4–210·7 million). The median access percentage among the 70 countries was 76·3% (IQR 62·6–84·2). The amoxicillin index was low (median 30·7%, IQR 14·3–47·3). The median access-to-watch index was 6·0 (IQR 3·1–9·8). CAF antibiotic consumption patterns were highly variable between the 70 countries, without a clear difference between high-income and middle-income countries.
Interpretation
Antibiotics in the Access group have a key role in treating young children globally. A simple combination of metrics based on the AWaRe groups can be informative on individual countries' patterns of antibiotic consumption and stewardship opportunities. These metrics could support countries in the development of programmes to improve access to core Access antibiotics, particularly amoxicillin.
Funding
Global Antibiotic R&D Partnership (German Federal Ministry of Health, Médecins Sans Frontières, Netherlands Ministry of Health, Welfare and Sport, and UK Department for International Development)
Global access to affordable direct oral anticoagulants
Poor control of cardiovascular disease accounts for a substantial proportion of the disease burden in developing countries, but often essential anticoagulant medicines for preventing strokes and embolisms are not widely available. In 2019, direct oral anticoagulants were added to the World Health Organization's WHO Model list of essential medicines. The aims of this paper are to summarize the benefits of direct oral anticoagulants for patients with cardiovascular disease and to discuss ways of increasing their usage internationally. Although the cost of direct oral anticoagulants has provoked debate, the affordability of introducing these drugs into clinical practice could be increased by: price negotiation; pooled procurement; competitive tendering; the use of patent pools; and expanded use of generics. In 2017, only 14 of 137 countries that had adopted national essential medicines lists included a direct oral anticoagulant on their lists. This number could increase rapidly if problems with availability and affordability can be tackled. Once the types of patient likely to benefit from direct oral anticoagulants have been clearly defined in clinical practice guidelines, coverage can be more accurately determined and associated costs can be better managed. Government action is required to ensure that direct oral anticoagulants are covered by national budgets because the absence of reimbursement remains an impediment to achieving universal coverage. Tackling cardiovascular disease with the aid of direct oral anticoagulants is an essential component of efforts to achieve the World Health Organization's target of reducing premature deaths due to noncommunicable disease by 25% by 2025
Classifying antibiotics in the WHO Essential Medicines List for optimal use—be AWaRe
International audienc
Smoking, haptoglobin and fertility in humans
A prospective study on two samples of consecutive puerperae (total n° 667) from two populations has been carried out in order to investigate the possible effect of smoking habit on relationship between fertility and haptoglobin phenotype
Nonequilibrium Quantum Thermodynamics of a Particle Trapped in a Controllable Time-Varying Potential
Many advanced quantum techniques feature non-Gaussian dynamics, and the ability to manipulate the system in that domain is the next stage in many experiments. One example of meaningful non-Gaussian dynamics is that of a double-well potential. Here we study the dynamics of a levitated nanoparticle undergoing the transition from a harmonic potential to a double well in a realistic setting, subjected to both thermalization and localization. We characterize the dynamics of the nanoparticle from a thermodynamic point of view, investigating the dynamics with the Wehrl entropy production and its rates. Furthermore, we investigate coupling regimes where the the quantum effect and thermal effect are of the same magnitude, and look at suitable squeezing of the initial state that provides the maximum coherence. The effects and the competitions of the unitary and the dissipative parts onto the system are demonstrated. We quantify the requirements to relate our results to a bonafide experiment with the presence of the environment, and discuss the experimental interpretations of our results in the end
The Local Group Census: planetary nebulae in IC 10, Leo A and Sextans A
In the framework of our narrow-band survey of the Local Group galaxies, we
present the results of the search for planetary nebulae (PNe) in the dwarf
irregular galaxies IC10, LeoA and SextansA. Using the standard on-band/off-band
technique, sixteen new candidate PNe have been discovered in the closest
starburst galaxy, IC10. The optical size of this galaxy is estimated to be much
larger than previously thought, considering the location of the new PNe in an
area of 3.6 kpc X 2.7 kpc. We also confirm the results of previous studies for
the other two dwarf irregular galaxies, with the detection of one candidate PN
in LeoA and another one in SextansA. We review the number of planetary nebulae
discovered in the Local Group to date and their behaviour with metallicity. We
suggest a possible fall in the observed number of PNe when [Fe/H]-1.0,
which might indicate that below this point the formation rate of PNe is much
lower than for stellar populations of near Solar abundances. We also find
non-negligible metallicity effects on the [OIII] luminosity of the brightest PN
of a galaxy.Comment: 10 pages, 4 figures, A&A accepte
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