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

Confidential Truth Finding with Multi-Party Computation

International audienceFederated knowledge discovery and data mining are challenged to assess the trustworthiness of data originating from autonomous sources while protecting confidentiality and privacy. Truth-finding algorithms help corroborate data from disagreeing sources. For each query it receives, a truth-finding algorithm predicts a truth value of the answer, possibly updating the trustworthiness factor of each source. Few works, however, address the issues of confidentiality and privacy. We devise and present a secure secret-sharing-based multi-party computation protocol for pseudo-equality tests that are used in truth-finding algorithms to compute additions depending on a condition. The protocol guarantees confidentiality of the data and privacy of the sources. We also present a variants of a truth-finding algorithm that would make the computation faster when executed using secure multi-party computation. We empirically evaluate the performance of the proposed protocol on a state-of-the-art truth-finding algorithm, 3-Estimates, and compare it with that of the baseline plain algorithm. The results confirm that the secret-sharing-based secure multi-party algorithms are as accurate as the corresponding baselines but for proposed numerical approximations that significantly reduce the efficiency loss incurred

Confidential Truth Finding with Multi-Party Computation (Extended Version)

15-page extended version of a paper published at DEXA 2023Federated knowledge discovery and data mining are challenged to assess the trustworthiness of data originating from autonomous sources while protecting confidentiality and privacy. Truth-finding algorithms help corroborate data from disagreeing sources. For each query it receives, a truth-finding algorithm predicts a truth value of the answer, possibly updating the trustworthiness factor of each source. Few works, however, address the issues of confidentiality and privacy. We devise and present a secure secret-sharing-based multi-party computation protocol for pseudo-equality tests that are used in truth-finding algorithms to compute additions depending on a condition. The protocol guarantees confidentiality of the data and privacy of the sources. We also present variants of truth-finding algorithms that would make the computation faster when executed using secure multi-party computation. We empirically evaluate the performance of the proposed protocol on two state-of-the-art truth-finding algorithms, Cosine, and 3-Estimates, and compare them with that of the baseline plain algorithms. The results confirm that the secret-sharing-based secure multi-party algorithms are as accurate as the corresponding baselines but for proposed numerical approximations that significantly reduce the efficiency loss incurred

First evidences of the flexoelectric responses of PEDOT-PSS polymers

National audienceThe project concerns the field of electroactive polymer films intended to ensure a mechanical to electrical energy conversion. The transduction mechanism considered is the flexoelectric effect, which corresponds to the appearance of an electric polarization induced by a deformation gradient (equal to the curvature) This effect that is different from piezoelectricity is present in all the dielectric (insulator) solids [1]. However, a recent study [2] about flexoelectric effect in oxide thin films revealed a three orders of magnitude enhancement of the effective flexoelectric coefficient accompanied by a large increase in the dielectric constant, after the insulating oxide has been reduced to a semi-conducting sample. Thus, the main objective of the present study is to explore the flexoelectric responses of organic (semi)-conductor films. As a first step films of poly (3, 4-ethylenedioxythiophene- poly (styrene sulfonate) (PEDOT-PSS) have been studied. PEDOT-PSS is a classical conducting polymer used in the elaboration of optoelectronic devices [3].In this way, various commercially available PEDOT-PSS polymer solutions have been deposited by drop casting on stainless steel substrates with different volumes leading to varied polymer thicknesses (µm range). Polymer films were covered with aluminum top electrodes up to 100 nm in thickness using a metal evaporator) and the complex permittivity and conductivity were measured to possibly establish a correlation with the flexoelectric coefficient. This latter has been obtained by current output and deflections measurements of bending cantilever-shaped samples using the lab setup showed in fig.1.1.Merupo, V.I., et al., Flexoelectric response in soft polyurethane films and their use for large curvature sensing. Journal of Applied Physics, 2017. 122(14): p. 144101.2. J. Narvaez, F. Vasquez-Sancho, and G. Catalan, Enhanced flexoelectric-like response in oxide semiconductors. Nature, Sep. 2016. 538: p. 219.3.Kirchmeyer, S. and K. Reuter, Scientific importance, properties and growing applications of poly(3,4-ethylenedioxythiophene). Journal of Materials Chemistry, 2005. 15(21): p. 2077-2088

Confidential Truth Finding with Multi-Party Computation

International audienceFederated knowledge discovery and data mining are challenged to assess the trustworthiness of data originating from autonomous sources while protecting confidentiality and privacy. Truth-finding algorithms help corroborate data from disagreeing sources. For each query it receives, a truth-finding algorithm predicts a truth value of the answer, possibly updating the trustworthiness factor of each source. Few works, however, address the issues of confidentiality and privacy. We devise and present a secure secret-sharing-based multi-party computation protocol for pseudo-equality tests that are used in truth-finding algorithms to compute additions depending on a condition. The protocol guarantees confidentiality of the data and privacy of the sources. We also present a variants of a truth-finding algorithm that would make the computation faster when executed using secure multi-party computation. We empirically evaluate the performance of the proposed protocol on a state-of-the-art truth-finding algorithm, 3-Estimates, and compare it with that of the baseline plain algorithm. The results confirm that the secret-sharing-based secure multi-party algorithms are as accurate as the corresponding baselines but for proposed numerical approximations that significantly reduce the efficiency loss incurred

Revealing the flexoelectric‐like response of poly(3,4‐ethylenedioxythiophene):poly(styrenesulfonate) thin films

International audienc

Enhancing flexoelectricity in PEDOT:PSS polymer films with soft treatments

International audienc

Flexoelectricity in Soft Polymer Films

International audienceFlexoelectricity in matter is a two-way linear electromechanical coupling, like piezoelectricity, but direct flexoelectric effect corresponds to the electric polarization induced by a strain gradient, whereas piezoelectric polarization is related to the strain itself. Similarly, converse flexoelectric effect is defined as an electric field gradient-induced strain or stress and piezoelectric effect is a coupling between strain or stress and electric field. Thus, due to the symmetry-breaking effect of the strain gradient, flexoelectricity may be observed in all dielectrics, while piezoelectricity can only be found in non-centrosymmetric materials. Besides, as strain gradients may dramatically increase when feature scale shrink down to the micro/nano range, flexoelectric response may become large and consequently has been widely studied in oxide thin films. However, strain gradients also inversely scale with elastic stiffness that may make flexoelectricity competitive with piezoelectricity in flexible soft polymer films. Thus, the purpose of the study is to present the experimental determination of thickness dependent flexoelectric coefficients in thermoplastic films and large flexoelectric-like effect in moderately conducting polymer blends