Acquisition of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) carriage after exposure to systemic antimicrobials during travel: systematic review and meta-analysis

BACKGROUND: International travel is an important risk factor for colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE). Antimicrobial use during travel likely amplifies this risk, yet to what extent, and whether it varies by antimicrobial class, has not been established. METHODS: We conducted a systematic review that included prospective cohorts reporting both receipt of systemic antimicrobials and acquired ESBL-PE isolated from stool or rectum during international travel. We performed a random effects meta-analysis to estimate odds of acquiring ESBL-PE due to antimicrobials during travel, overall and by antimicrobial class. RESULTS: Fifteen studies were included. The study population was mainly female travellers from high income countries recruited primarily from travel clinics. Participants travelled most frequently to Asia and Africa with 10% reporting antimicrobial use during travel. The combined odds ratio (OR) for ESBL-PE acquisition during travel was 2.37 for antimicrobial use overall (95% confidence interval [CI], 1.69 to 3.33), but there was substantial heterogeneity between studies. Fluoroquinolones were the antibiotic class associated with the highest combined OR of ESBL-PE acquisition, compared to no antimicrobial use (OR 4.68, 95% CI, 2.34 to 9.37). CONCLUSIONS: The risk of ESBL-PE colonization during travel is increased substantially with exposure to antimicrobials, especially fluoroquinolones. While a small proportion of colonized individuals will develop a resistant infection, there remains the potential for onward spread among returning travellers. Public health efforts to decrease inappropriate antimicrobial usage during travel are warranted

Alteração vocal auto-referida em professores: prevalência e fatores associados

OBJETIVO: Estimar a prevalência de alteração vocal auto-referida em professores e identificar fatores associados. MÉTODOS: Estudo transversal com amostra de 393 professores do ensino fundamental de Florianópolis, SC, por meio de questionário autoaplicado em 2009. Foi realizada análise multivariável de regressão de Poisson estimando-se as razões de prevalência e intervalos de 95% de confiança. RESULTADOS: A prevalência de alteração vocal foi de 47,6% (IC95% 42,6;52,5). Após o ajuste, permaneceram associados à maior prevalência de alteração vocal ser do sexo feminino e a presença de rinite/sinusite e faringite. CONCLUSÕES: Foi observada elevada prevalência de alteração vocal auto-referida entre os professores estudados.OBJETIVO: Estimar la prevalencia de alteración vocal auto-referida en profesores e identificar factores asociados. MÉTODOS: Estudio transversal con muestra de 393 profesores de enseñanza fundamental de Florianópolis, Sur de Brasil, por medio de cuestionario auto-aplicado en 2009. Se realizó análisis multivariable de regresión de Poisson, estimándose las tasas de prevalencia e intervalos de 95% de confianza. RESULTADOS: La prevalencia de alteración vocal fue de 47,6% (IC95% 42,6;52,5). Posterior al ajuste, permanecieron asociados a la mayor prevalencia de alteración vocal ser del sexo femenino y la presencia de rinitis/sinusitis y faringitis. CONCLUSIONES: Se observó elevada prevalencia de alteración vocal auto-referida entre los profesores estudiados.OBJECTIVE: To estimate the prevalence of self-reported voice problems and to identify associated factors. METHODS: A cross-sectional study was carried out in a sample of 393 public elementary and middle school teachers in Florianópolis, Southern Brazil, in 2009. A self-administered questionnaire was used. A multivariable Poisson regression model was performed to estimate prevalence ratios and their related 95% confidence intervals. RESULTS: The prevalence of voice problems was 47.6% (95%CI 42.6;52.5). In the final adjusted analysis the following variables remained associated with a higher prevalence of voice problems: being female and the presence of rhinitis/sinusitis and pharyngitis. CONCLUSIONS: A high prevalence of self-reported voice problems was found among the teachers studied

2024 roadmap for sustainable batteries

Modern batteries are highly complex devices. The cells contain many components—which in turn all have many variations, both in terms of chemistry and physical properties. A few examples: the active materials making the electrodes are coated on current collectors using solvents, binders and additives; the multicomponent electrolyte, contains salts, solvents, and additives; the electrolyte can also be a solid ceramic, polymer or a glass material; batteries also contain a separator, which can be made of glass fibres, polymeric, ceramic, composite, etc. Moving up in scale all these components are assembled in cells of different formats and geometries, coin cells and Swagelok cells for funamental testing and understanding, and pouch, prismatic and cylindrical cells for application. Given this complexity dictated by so many components and variations, there is no wonder that addressing the crucial issue of true sustainability is an extremely challenging task. How can we make sure that each component is sustainable? How can the performance can be delivered using more sustainable battery components? What actions do we need to take to address battery sustainability properly? How do we actually qualify and quantify the sustainability in the best way possible? And perhaps most importantly; how can we all work—academia and battery industry together—to enable the latter to manufacture more sustainable batteries for a truly cleaner future? This Roadmap assembles views from experts from academia, industry, research institutes, and other organisations on how we could and should achieve a more sustainable battery future. The palette has many colours: it discusses the very definition of a sustainable battery, the need for diversification beyond lithium-ion batteries (LIBs), the importance of sustainability assessments, the threat of scarcity of raw materials and the possible impact on future manufacturing of LIBs, the possibility of more sustainable cells by electrode and electrolyte chemistries as well as manufacturing, the important role of new battery chemistries, the crucial role of AI and automation in the discovery of the truly sustainable batteries of the future and the importance of developimg a circular battery economy

2024 roadmap for sustainable batteries

Modern batteries are highly complex devices. The cells contain many components-which in turn all have many variations, both in terms of chemistry and physical properties. A few examples: the active materials making the electrodes are coated on current collectors using solvents, binders and additives; the multicomponent electrolyte, contains salts, solvents, and additives; the electrolyte can also be a solid ceramic, polymer or a glass material; batteries also contain a separator, which can be made of glass fibres, polymeric, ceramic, composite, etc. Moving up in scale all these components are assembled in cells of different formats and geometries, coin cells and Swagelok cells for funamental testing and understanding, and pouch, prismatic and cylindrical cells for application. Given this complexity dictated by so many components and variations, there is no wonder that addressing the crucial issue of true sustainability is an extremely challenging task. How can we make sure that each component is sustainable? How can the performance can be delivered using more sustainable battery components? What actions do we need to take to address battery sustainability properly? How do we actually qualify and quantify the sustainability in the best way possible? And perhaps most importantly; how can we all work-academia and battery industry together-to enable the latter to manufacture more sustainable batteries for a truly cleaner future? This Roadmap assembles views from experts from academia, industry, research institutes, and other organisations on how we could and should achieve a more sustainable battery future. The palette has many colours: it discusses the very definition of a sustainable battery, the need for diversification beyond lithium-ion batteries (LIBs), the importance of sustainability assessments, the threat of scarcity of raw materials and the possible impact on future manufacturing of LIBs, the possibility of more sustainable cells by electrode and electrolyte chemistries as well as manufacturing, the important role of new battery chemistries, the crucial role of AI and automation in the discovery of the truly sustainable batteries of the future and the importance of developimg a circular battery economy

Scalable, ambient atmosphere roll-to-roll manufacture of encapsulated large area, flexible organic tandem solar cell modules

Inline printing and coating methods have been demonstrated to enable a high technical yield of fully roll-to-roll processed polymer tandem solar cell modules. We demonstrate generality by employing different material sets and also describe how the ink systems must be carefully co-developed in order to reach the ambitious objective of a fully printed and coated 14-layer flexible tandem solar cell stack. The roll-to-roll methodologies involved are flexographic printing, rotary screen printing, slot-die coating, X-ray scattering, electrical testing and UV-lamination. Their combination enables the manufacture of completely functional devices in exceptionally high yields. Critical to the ink and process development is a carefully chosen technology transfer to industry method where first a roll coater is employed enabling contactless stack build up, followed by a small roll-to-roll coater fitted to an X-ray machine enabling in situ studies of wet ink deposition and drying mechanisms, ultimately elucidating how a robust inline processed recombination layer is key to a high technical yield. Finally, the transfer to full roll-to-roll processing is demonstrated

Índice de capacidade para o trabalho e desequilíbrio esforço-recompensa relacionado ao distúrbio de voz em professoras da rede estadual de Alagoas

Resumo: OBJETIVO: verificar a associação entre distúrbio de voz e dados sociodemográficos e organizacionais (situações de violência) do trabalho docente, e entre perda de capacidade para o trabalho e estresse psicossocial no trabalho. MÉTODOS: os participantes [faltou a coleta de voz para definir os grupos com e sem distúrbio de voz] foram solicitados a responder aos questionários Condição de Produção Vocal do Professor, Desequilíbrio Esforço-Recompensa e Índice de Capacidade para o Trabalho. RESULTADO: foi encontrada associação entre distúrbio de voz e os dados sociodemográficos e organizacionais do trabalho no que diz respeito ao tempo que leciona (p=0,028), ao número de escolas em que leciona (p=0,004) e às situações de violência no quesito depredação (p=0,037). Não houve significância entre o distúrbio de voz e os escores dos questionários Desequilíbrio Esforço-Recompensa e Índice de Capacidade para o Trabalho (p>0,05). Houve associação entre os dados sociodemográficos e os questionários Desequilíbrio Esforço-Recompensa e Índice de Capacidade para o Trabalho, relacionada à faixa etária (p=0,042) e à variável "Trabalha em outro local diferente da escola" (p=0,011), respectivamente. CONCLUSÃO: observa-se que professoras que possuem mais de 11 anos de docência, lecionam em duas ou mais escolas e trabalham em escolas que sempre têm depredações e violência contra os funcionários apresentam maiores chances de ter distúrbio de voz. Não houve associação entre a perda da capacidade para o trabalho e a presença do distúrbio de voz. O estresse psicossocial não mostrou significância com a presença do distúrbio de voz, mas apresentou associação com a faixa etária, observando-se Alto Desequilíbrio Esforço-Recompensa nas professoras mais jovens

Travelers' health problems and behavior : prospective study with post-travel follow-up

Background: The annual number of international tourist arrivals has recently exceeded one billion, yet surprisingly few studies have characterized travelers' behavior, illness, and risk factors in a prospective setting. Particularly scarce are surveys of data spanning travel, return, and follow-up of the same cohort. This study examines behavior and illness among travelers while abroad, after return home, and at follow-up. Patterns of behavior connected to type of travel and illness are characterized so as to identify risk factors and provide background data for pre-travel advice. Methods: Volunteers to this prospective cohort study were recruited at visits to a travel clinic prior to departure. Data on the subjects' health and behavior were collected by questionnaires before and after journeys and over a three-week follow-up. In addition, the subjects were asked to fill in health diaries while traveling. Results: The final study population consisted of 460 subjects, 79 % of whom reported illness during travel or on arrival: 69 % had travelers' diarrhea (TD), 17 % skin problems, 17 % fever, 12 % vomiting, 8 % respiratory tract infection, 4 % urinary tract infection, 2 % ear infection, 4 % gastrointestinal complaints other than TD or vomiting, and 4 % other symptoms. Of all subjects, 10 % consulted a doctor and 0.7 % were hospitalized; 18 % took antimicrobials, with TD as the most common indication (64 %). Ongoing symptoms were reported by 25 % of all travelers upon return home. During the three-week follow-up (return rate 51 %), 32 % of respondents developed new-onset symptoms, 20 % visited a doctor and 1.7 % were hospitalized. Factors predisposing to health problems were identified by multivariable analysis: certain regions (Southern Asia, South-Eastern Asia, and Eastern Africa), female gender, young age, and long travel duration. Conclusions: Despite proper preventive measures like vaccinations, malaria prophylaxis, and travel advice, the majority of our subjects fell ill during or after travel. As the symptoms mostly remained mild, health care services were seldom needed. Typical traveler profiles were identified, thereby providing a tool for pre-travel advice. The finding that one third reported new-onset illness during follow-up attests to the importance of advising clients on potential post-travel health problems already during pre-travel visits.Peer reviewe