NIVELES SONOROS EN LA ZONA HOSPITALARIA DEL BARRIO LA EXPOSICIÓN - CIUDAD DE PANAMÁ.

Noise is one of the main pollutants affecting the health and quality of life of the population, in the city, due to its constant economic growth and technological development. Panama, due to its socioeconomic characteristics, is a developing country and this pollutant is chronically affecting the population. Therefore, this study seeks to quantify the perception of the population through a survey and to measure the sound pressure levels and their spatial distribution in the hospital area of La Exposition in Panama City. Preliminarily revealing that the study area is exposed to levels that exceed 65 dB, recommended by WHO, in addition, the survey made evident the lack of general knowledge on the subject. This allows us to recommend to the competent authorities the need to review the application and supervision of the existing norms in our country, to facilitate a better control of this pollutantEl ruido es uno de los principales contaminantes que afecta la salud y calidad de vida de la población, principalmente de la urbe; por su constante crecimiento económico y desarrollo tecnológico. Panamá por sus características socioeconómicas es un país en desarrollo y este contaminante está afectando a la población, de manera crónica. Por ello, este estudio busca cuantificar la percepción de la población, mediante una encuesta y medir los niveles de presión sonora y su distribución espacial, en la zona hospitalaria del barrio La Exposición en la ciudad de Panamá. Revelando preliminarmente que el área de estudio se encuentra expuesta a niveles que sobrepasan los 65 dB, recomendados por la OMS, además, la encuesta hizo evidente la carencia de conocimientos generales del tema. Lo que permite recomendar a las autoridades competentes la necesidad de realizar una revisión a la aplicación y supervisión de las normas existentes en nuestro país, que facilite un mejor control a este contaminante.&nbsp

NIVELES SONOROS EN LA ZONA HOSPITALARIA DEL BARRIO LA EXPOSICIÓN - CIUDAD DE PANAMÁ.

El ruido es uno de los principales contaminantes que afecta la salud y calidad de vida de la población, principalmente de la urbe; por su constante crecimiento económico y desarrollo tecnológico. Panamá por sus características socioeconómicas es un país en desarrollo y este contaminante está afectando a la población, de manera crónica. Por ello, este estudio busca cuantificar la percepción de la población, mediante una encuesta y medir los niveles de presión sonora y su distribución espacial, en la zona hospitalaria del barrio La Exposición en la ciudad de Panamá. Revelando preliminarmente que el área de estudio se encuentra expuesta a niveles que sobrepasan los 65 dB, recomendados por la OMS, además, la encuesta hizo evidente la carencia de conocimientos generales del tema. Lo que permite recomendar a las autoridades competentes la necesidad de realizar una revisión a la aplicación y supervisión de las normas existentes en nuestro país, que facilite un mejor control a este contaminante.

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

Pleiotropic Effects of Deubiquitinating Enzyme Ubp5 on Growth and Pathogenesis of Cryptococcus neoformans

Ubiquitination is a reversible protein modification that influences various cellular processes in eukaryotic cells. Deubiquitinating enzymes remove ubiquitin, maintain ubiquitin homeostasis and regulate protein degradation via the ubiquitination pathway. Cryptococcus neoformans is an important basidiomycete pathogen that causes life-threatening meningoencephalitis primarily in the immunocompromised population. In order to understand the possible influence deubiquitinases have on growth and virulence of the model pathogenic yeast Cryptococcus neoformans, we generated deletion mutants of seven putative deubiquitinase genes. Compared to other deubiquitinating enzyme mutants, a ubp5Δ mutant exhibited severely attenuated virulence and many distinct phenotypes, including decreased capsule formation, hypomelanization, defective sporulation, and elevated sensitivity to several external stressors (such as high temperature, oxidative and nitrosative stresses, high salts, and antifungal agents). Ubp5 is likely the major deubiquitinating enzyme for stress responses in C. neoformans, which further delineates the evolutionary divergence of Cryptococcus from the model yeast S. cerevisiae, and provides an important paradigm for understanding the potential role of deubiquitination in virulence by other pathogenic fungi. Other putative deubiquitinase mutants (doa4Δ and ubp13Δ) share some phenotypes with the ubp5Δ mutant, illustrating functional overlap among deubiquitinating enzymes in C. neoformans. Therefore, deubiquitinating enzymes (especially Ubp5) are essential for the virulence composite of C. neoformans and provide an additional yeast survival and propagation advantage in the host

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

Turbidity and fecal indicator bacteria in recreational marine waters increase following the 2018 Woolsey Fire.

Wildfires increase runoff and sediment yields that impact downstream ecosystems. While the effects of wildfire on stream water quality are well documented, oceanic responses to wildfire remain poorly understood. Therefore, this study investigated oceanic responses to the 2018 Woolsey Fire using satellite remote sensing and in situ data analyses. We examined 2016-2020 turbidity plume (n = 192) and 2008-2020 fecal indicator bacteria (FIB, n = 15,015) measurements at variable proximity to the Woolsey Fire.&nbsp;Shifts in coastal water quality were more pronounced in the "inside" region, which drained the burn area. The inside region experienced 2018-2019 plume surface area monthly means that were 10 and 9 times greater than 2016-2017 and 2017-2018 monthly means, respectively. Further, linear regressions showed that 2018-2019 three-day precipitation totals produced plumes of greater surface area. We also noted statistically significant increases in the inside region in 2018-2019 total coliform and Enterococcus monthly means that were 9 and 53 times greater than 2008-2018 monthly means, respectively. These results indicate that sediment and microbial inputs to coastal ecosystems can increase substantially post-wildfire at levels relevant to public and environmental health, and underscore the benefit of considering remote sensing and in situ measurements for water quality monitoring

PEM Fuel Cell Technology (Semester Unknown) IPRO 318: PEMFuelCellTechnologyIPRO318Poster1Sp09

1. Evaluate the feasibility of PEM fuel cells in commercial application, including military and defense, automotive, aerospace, and other specialties 2. Investigate industrial and commercial technicalities of PEM fuel cells and study methods of improving the robustness of catalysts and reducing fuel impurities 3. Compare and contrast the performance and cost of fuel cell and internal combustion engines 4. Design and incorporate a PEM fuel cell system into commercial application and perform a cost and benefit analysis utilizing engineering design principlesDeliverable

PEM Fuel Cell Technology (Semester Unknown) IPRO 318: PEMFuelCellTechnologyIPRO318FinalReportSp09

1. Evaluate the feasibility of PEM fuel cells in commercial application, including military and defense, automotive, aerospace, and other specialties 2. Investigate industrial and commercial technicalities of PEM fuel cells and study methods of improving the robustness of catalysts and reducing fuel impurities 3. Compare and contrast the performance and cost of fuel cell and internal combustion engines 4. Design and incorporate a PEM fuel cell system into commercial application and perform a cost and benefit analysis utilizing engineering design principlesDeliverable

PEM Fuel Cell Technology (Semester Unknown) IPRO 318: PEMFuelCellTechnologyIPRO318ProjectPlanSp09

1. Evaluate the feasibility of PEM fuel cells in commercial application, including military and defense, automotive, aerospace, and other specialties 2. Investigate industrial and commercial technicalities of PEM fuel cells and study methods of improving the robustness of catalysts and reducing fuel impurities 3. Compare and contrast the performance and cost of fuel cell and internal combustion engines 4. Design and incorporate a PEM fuel cell system into commercial application and perform a cost and benefit analysis utilizing engineering design principlesDeliverable

PEM Fuel Cell Technology (Semester Unknown) IPRO 318

1. Evaluate the feasibility of PEM fuel cells in commercial application, including military and defense, automotive, aerospace, and other specialties 2. Investigate industrial and commercial technicalities of PEM fuel cells and study methods of improving the robustness of catalysts and reducing fuel impurities 3. Compare and contrast the performance and cost of fuel cell and internal combustion engines 4. Design and incorporate a PEM fuel cell system into commercial application and perform a cost and benefit analysis utilizing engineering design principlesDeliverable