The management of lifeguards in natural acuatic spaces (beaches)

Este estudio nace con la necesidad de establecer criterios básicos y descripción de recomendaciones para mejorar el nivel de atención de los socorristas acuáticos profesionales en los espacios acuáticos naturales, concretamente en el trabajo realizado en las playas, con el objetivo de aumentar la seguridad de estas zonas de baño. El estudio se ha desarrollado en la Comunidad Autónoma de Cataluña, concretamente en tres playas de varios municipios de la provincia de Barcelona. Se puede afirmar que tras esta investigación la mayor parte de los socorristas acuáticos que han participado en el estudio valoraron positivamente las medidas y criterios propuestos, asumiendo que con los mismos se puede desempeñar mejor su trabajoThis study arises from the need to establish basic criteria and the description of recommendations to improve the level of responsiveness of lifeguards in natural aquatic areas, specifically in the work done on the beaches, in order to increase the safety of these bathing areas. The study was developed Cataluña, in three beaches of different municipalities in the province of Barcelona. We can aver after this research that most of the lifeguards who participated in the study value positively the proposed measures and criteria, through the assumption that these features help improve their wor

Coastal police of Vigo; A quasi-experimental pilot study about rescue and CPR

El ahogamiento es una de las principales causas de muerte en el mundo y en España. Los socorristas ejercen una labor de prevención y vigilancia pero su labor es estacional y temporal. En muchos lugares, la primera respuesta a la emergencia, cuando los socorristas no están de servicio, depende de la policía, a la que se le requiere habilidades de rescate y reanimación cardiopulmonar (RCP). El objetivo de este estudio es determinar la capacidad de rescate y efecto de la fatiga sobre la calidad de la RCP de un grupo de diez policías costeros cuya área de influencia es el litoral de Vigo. El diseño fue cuasi-experimental con dos factores (pretest basal/postest rescate). Los policías pudieron realizar el rescate acuático rápido y seguro 417 ± 54,5 seg, a nivel de lactacidema se registró 12,27 ± 2,36 mmol. La fatiga inducida por el rescate afectó negativamente a la calidad de la compresiones en la RCP (p = 0,002)Drowning is a leading cause of death worldwide and in Spain. Lifeguards exert vigilance and prevention efforts but their work is seasonal and temporary. In many places the first emergency response when lifeguards are not on duty, depends on the police, which are required rescue skills and cardiopulmonary resuscitation (CPR). The objective of this study is to determine the ability of lifesaving and effect of fatigue on the quality of CPR of a group of ten coastal police whose area of influence is the coast of Vigo. The design was quasiexperimental with two factors (basal pretest / posttest rescue). Cops with basic training could perform fast and safe water rescue 417 ± 54.5 seconds, lactate level was recorded 12.27 ± 2.36 mmol. Induced fatigue during resuce effort had a nevative effect on the quality of compressions in CPR (p = 0.002

The postoperative morbidity index: a quantitative weighing of postoperative complications applied to urological procedures

Background: The reporting of post-operative complications in the urological field is lacking of a uniform quantitative measure to assess severity, which is essential in the analysis of surgical outcomes. The purpose of this study was to evaluate the feasibility of estimating quantitative severity weighing of post-operative complications after common urologic procedures. Methods: Using a large healthcare system\u27s quality database, complications were identified in eleven common urologic procedures (e.g., insertion or replacement of inflatable penile prosthesis, nephroureterectomy, partial nephrectomy, percutaneous nephrostomy tube placement, radical cystectomy, radical prostatectomy, renal/ureteral/bladder extracorporeal shockwave lithotripsy (ESWL), transurethral destruction of bladder lesion, transurethral prostatectomy, transurethral removal of ureteral obstruction, and ureteral catheterization) from January 1, 2011 to December 31, 2011. Complications were classified by the Expanded Accordion Severity Grading System, which was then quantified by validated severity weighting scores. The Postoperative Morbidity Index (PMI) for each procedure was calculated where an index of 0 would indicate no complication in any patient and an index of 1 would indicate that all patients died. Results: This study included 654 procedures of which 148 (22%) had one or more complications. As would be expected, a more complex procedure like radical cystectomy possessed a higher PMI (0.267), while a simpler procedure like percutaneous nephrostomy tube placement possessed a lower PMI (0.011). The PMI of the additional nine procedures fell within the range of these PMIs. These PMIs could be used to compare surgeons, hospitals or procedures. Conclusions: Quantitative severity weighing of post-operative complications for urologic procedures is feasible and may provide exceptionally informative data related to outcomes

Paradigmatic de novo GRIN1 variants recapitulate pathophysiological mechanisms underlying GRIN1-related disorder clinical spectrum

Background: GRIN-related disorders (GRD), the so-called grinpathies, is a group of rare encephalopathies caused by mutations affecting GRIN genes (mostly GRIN1, GRIN2A and GRIN2B genes), which encode for the GluN subunit of the N-methyl D-aspartate (NMDA) type ionotropic glutamate receptors. A growing number of functional studies indicate that GRIN-encoded GluN1 subunit disturbances can be dichotomically classified into gain- and loss-of-function, although intermediate complex scenarios are often present. Methods: In this study, we aimed to delineate the structural and functional alterations of GRIN1 disease-associated variants, and their correlations with clinical symptoms in a Spanish cohort of 15 paediatric encephalopathy patients harbouring these variants. Results: Patients harbouring GRIN1 disease-associated variants have been clinically deeplyphenotyped. Further, using computational and in vitro approaches, we identified different critical checkpoints affecting GluN1 biogenesis (protein stability, subunit assembly and surface trafficking) and/or NMDAR biophysical properties, and their association with GRD clinical symptoms. Conclusions: Our findings show a strong correlation between GRIN1 variants-associated structural and functional outcomes. This structural-functional stratification provides relevant insights of genotypephenotype association, contributing to future precision medicine of GRIN1-related encephalo

Quasiexperimental intervention study protocol to optimise the use of new antibiotics in Spain: the NEW_SAFE project

Introduction Ceftaroline, tedizolid, dalbavancin, ceftazidime-avibactam and ceftolozane-tazobactam are novel antibiotics used to treat infections caused by multidrug-resistant pathogens (MDR). Their use should be supervised and monitored as part of an antimicrobial stewardship programme (ASP). Appropriate use of the new antibiotics will be improved by including consensual indications for their use in local antibiotic guidelines, together with educational interventions providing advice to prescribers to ensure that the recommendations are clearly understood. Methods and analysis This study will be implemented in two phases. First, a preliminary historical cohort (2017-2019) of patients from 13 Andalusian hospitals treated with novel antibiotics will be analysed. Second, a quasiexperimental intervention study will be developed with an interrupted time-series analysis (2020-2021). The intervention will consist of an educational interview between prescribers and ASP leaders at each hospital to reinforce the proper use of novel antibiotics. The educational intervention will be based on a consensus guideline designed and disseminated by leaders after the retrospective cohort data have been analysed. The outcomes will be acceptance of the intervention and appropriateness of prescription. Incidence of infection and colonisation with MDR organisms as well as incidence ofClostridioides difficileinfection will also be analysed. Changes in prescription quality between periods and the safety profile of the antibiotics in terms of mortality rate and readmissions will also be measured. Ethics and dissemination Ethical approval will be obtained from the Andalusian Coordinating Institutional Review Board. The study is being conducted in compliance with the protocol and regulatory requirements consistent with International Council of Harmonisation E6 Good Clinical Practice and the ethical principles of the latest version of the Declaration of Helsinki. The results will be published in peer-reviewed journals and disseminated at national and international conferences

A Viral Discovery Methodology for Clinical Biopsy Samples Utilising Massively Parallel Next Generation Sequencing

Here we describe a virus discovery protocol for a range of different virus genera, that can be applied to biopsy-sized tissue samples. Our viral enrichment procedure, validated using canine and human liver samples, significantly improves viral read copy number and increases the length of viral contigs that can be generated by de novo assembly. This in turn enables the Illumina next generation sequencing (NGS) platform to be used as an effective tool for viral discovery from tissue samples

Quasiexperimental intervention study protocol to optimise the use of new antibiotics in Spain: the NEW_SAFE project

[Introduction] Ceftaroline, tedizolid, dalbavancin, ceftazidime-avibactam and ceftolozane-tazobactam are novel antibiotics used to treat infections caused by multidrug-resistant pathogens (MDR). Their use should be supervised and monitored as part of an antimicrobial stewardship programme (ASP). Appropriate use of the new antibiotics will be improved by including consensual indications for their use in local antibiotic guidelines, together with educational interventions providing advice to prescribers to ensure that the recommendations are clearly understood.[Methods and analysis] This study will be implemented in two phases. First, a preliminary historical cohort (2017–2019) of patients from 13 Andalusian hospitals treated with novel antibiotics will be analysed. Second, a quasiexperimental intervention study will be developed with an interrupted time-series analysis (2020–2021). The intervention will consist of an educational interview between prescribers and ASP leaders at each hospital to reinforce the proper use of novel antibiotics. The educational intervention will be based on a consensus guideline designed and disseminated by leaders after the retrospective cohort data have been analysed. The outcomes will be acceptance of the intervention and appropriateness of prescription. Incidence of infection and colonisation with MDR organisms as well as incidence of Clostridioides difficile infection will also be analysed. Changes in prescription quality between periods and the safety profile of the antibiotics in terms of mortality rate and readmissions will also be measured.[Ethics and dissemination] Ethical approval will be obtained from the Andalusian Coordinating Institutional Review Board. The study is being conducted in compliance with the protocol and regulatory requirements consistent with International Council of Harmonisation E6 Good Clinical Practice and the ethical principles of the latest version of the Declaration of Helsinki. The results will be published in peer-reviewed journals and disseminated at national and international conferences.[Trial registration number] NCT03941951; Pre-results.The study is funded by the Consejería de Salud, Junta de Andalucía, grant PI-0077-2018. The investigators also receive funds for research from the Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0001) through the Plan Nacional de I+D+ i 2013‐2016, cofinanced by European Development Regional Fund “A way to achieve Europe”, Operative program Intelligent Growth 2014‐2020

An Influenza A/H1N1/2009 Hemagglutinin Vaccine Produced in Escherichia coli

The A/H1N1/2009 influenza pandemic made evident the need for faster and higher-yield methods for the production of influenza vaccines. Platforms based on virus culture in mammalian or insect cells are currently under investigation. Alternatively, expression of fragments of the hemagglutinin (HA) protein in prokaryotic systems can potentially be the most efficacious strategy for the manufacture of large quantities of influenza vaccine in a short period of time. Despite experimental evidence on the immunogenic potential of HA protein constructs expressed in bacteria, it is still generally accepted that glycosylation should be a requirement for vaccine efficacy.We expressed the globular HA receptor binding domain, referred to here as HA(63-286)-RBD, of the influenza A/H1N1/2009 virus in Escherichia coli using a simple, robust and scalable process. The recombinant protein was refolded and purified from the insoluble fraction of the cellular lysate as a single species. Recombinant HA(63-286)-RBD appears to be properly folded, as shown by analytical ultracentrifugation and bio-recognition assays. It binds specifically to serum antibodies from influenza A/H1N1/2009 patients and was found to be immunogenic, to be capable of triggering the production of neutralizing antibodies, and to have protective activity in the ferret model.Projections based on our production/purification data indicate that this strategy could yield up to half a billion doses of vaccine per month in a medium-scale pharmaceutical production facility equipped for bacterial culture. Also, our findings demonstrate that glycosylation is not a mandatory requirement for influenza vaccine efficacy

Distance-based emission factors from vehicle emission remote sensing measurements

Vehicle emission remote sensing has the potential to provide detailed emissions information at a highly disaggregated level owing to the ability to measure thousands of vehicles in a single day. Fundamentally, vehicle emission remote sensing provides a direct measure of the molar volume ratio of a pollutant to carbon dioxide, from which fuel-based emissions factors can readily be calculated. However, vehicle emissions are more commonly expressed in emission per unit distance travelled e.g. grams per km or mile. To express vehicle emission remote sensing data in this way requires an estimate of the fuel consumption at the time of the emission measurement. In this paper, an approach is developed based on vehicle specific power that uses commonly measured or easily obtainable vehicle information such as vehicle speed, acceleration and mass. We test the approach against 55 independent comprehensive PEMS measurements for Euro 5 and 6 gasoline and diesel vehicles over a wide range of driving conditions and find good agreement between the method and PEMS data. The method is applied to individual vehicle model types to quantify distance-based emission factors. The method will be appropriate for application to larger vehicle emission remote sensing databases, thus extending real-world distance-based vehicle emissions information