Portable multi-sensor air quality monitoring platform for personal exposure studies

© 1998-2012 IEEE. Poor air quality is considered among the main causes of millions of premature deaths annually, about 8 million in 2012 according to the World Health Organization [1]. Several epidemiological studies have found a relationship between exposure beyond specified limits and burden of disease [2]. These and many more have led to an increased and urgent need to both monitor and consequently limit personal exposure to harmful pollutants [3]. There is a generalized attention from different governmental agencies globally to limit anthropogenic emissions via legislations and policies. City councils, including for instance in Cambridge, UK, promote new policies that help accelerate switching from combustion engines to electric vehicles both for public and for private transport, accompanied by installation of a distributed urban network of rapid charging points by 2020 [4], along with imposition of road taxes, and exemption from the same based on vehicles' emission of polluting gases and smaller particulate matter (PM2.5). Besides, reduction of indoor wood burning for heating, as one of the largest sources of indoor particulate matter, also has the potential to drastically reduce PM2.5 exposure levels. Citizens are nowadays more conscious of and attentive to their personal exposure to polluting agents and environments and prone to adopt cleaner solutions for living, transport, energy generation and heating. Adoption of personal exposure monitoring devices on an individual level therefore offers multiple benefits and is motivated by the willingness to continue making healthier choices in everyday life consistently. Access to high resolution data of personal exposure with high space and time accuracy is however difficult to achieve with currently available centralized or public network of monitoring stations. Providing individuals with portable devices for air quality monitoring that operate in real time and allow them to monitor and record their personalized exposure levels in combination with conventional geolocation offering a half-meter or less space resolution may become a unique instrument and breakthrough, not only for the individuals, but also for the city councils, and other government agencies to shape and fine-tune their policies for control of air quality in urban, industrial and rural areas. This is possible with the use of both existing and emerging technologies for autonomous sensors, data communication and modern mobile networks, including Internet of Things

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

SPARC 2018 Internationalisation and collaboration : Salford postgraduate annual research conference book of abstracts

Welcome to the Book of Abstracts for the 2018 SPARC conference. This year we not only celebrate the work of our PGRs but also the launch of our Doctoral School, which makes this year’s conference extra special. Once again we have received a tremendous contribution from our postgraduate research community; with over 100 presenters, the conference truly showcases a vibrant PGR community at Salford. These abstracts provide a taster of the research strengths of their works, and provide delegates with a reference point for networking and initiating critical debate. With such wide-ranging topics being showcased, we encourage you to take up this great opportunity to engage with researchers working in different subject areas from your own. To meet global challenges, high impact research inevitably requires interdisciplinary collaboration. This is recognised by all major research funders. Therefore engaging with the work of others and forging collaborations across subject areas is an essential skill for the next generation of researchers

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

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Portable multi-sensor air quality monitoring platform for personal exposure studies

© 1998-2012 IEEE. Poor air quality is considered among the main causes of millions of premature deaths annually, about 8 million in 2012 according to the World Health Organization [1]. Several epidemiological studies have found a relationship between exposure beyond specified limits and burden of disease [2]. These and many more have led to an increased and urgent need to both monitor and consequently limit personal exposure to harmful pollutants [3]. There is a generalized attention from different governmental agencies globally to limit anthropogenic emissions via legislations and policies. City councils, including for instance in Cambridge, UK, promote new policies that help accelerate switching from combustion engines to electric vehicles both for public and for private transport, accompanied by installation of a distributed urban network of rapid charging points by 2020 [4], along with imposition of road taxes, and exemption from the same based on vehicles' emission of polluting gases and smaller particulate matter (PM2.5). Besides, reduction of indoor wood burning for heating, as one of the largest sources of indoor particulate matter, also has the potential to drastically reduce PM2.5 exposure levels. Citizens are nowadays more conscious of and attentive to their personal exposure to polluting agents and environments and prone to adopt cleaner solutions for living, transport, energy generation and heating. Adoption of personal exposure monitoring devices on an individual level therefore offers multiple benefits and is motivated by the willingness to continue making healthier choices in everyday life consistently. Access to high resolution data of personal exposure with high space and time accuracy is however difficult to achieve with currently available centralized or public network of monitoring stations. Providing individuals with portable devices for air quality monitoring that operate in real time and allow them to monitor and record their personalized exposure levels in combination with conventional geolocation offering a half-meter or less space resolution may become a unique instrument and breakthrough, not only for the individuals, but also for the city councils, and other government agencies to shape and fine-tune their policies for control of air quality in urban, industrial and rural areas. This is possible with the use of both existing and emerging technologies for autonomous sensors, data communication and modern mobile networks, including Internet of Things

Chitosan–sulfonic acid-catalyzed green synthesis of naphthalene-based azines as potential anticancer agents

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Anterior Segment OCT: High-Resolution Tomography of Corneal and Conjunctival Lesions

Anterior segment high-resolution optical coherence tomography (HR-OCT) plays a pivotal role in the diagnosis of corneal and conjunctival lesions. Ocular surface squamous neoplasia (OSSN), the most common non-pigmented neoplasia of squamous cell origin, has variable appearances which include leukoplakic, papillary, opalescent, and gelatinous presentations. Pigmented lesions entail a lengthy differential, ranging from benign cystic nevi to life-threatening melanomas. The establishment of classic findings of OSSN and other ocular surface lesions on HR-OCT has greatly facilitated the identification of ocular surface pathologies. This chapter serves to outline the characteristic findings attributable to the following ocular surface lesions: ocular surface squamous neoplasia (OSSN), Salzmann’s nodule, pterygium, sebaceous carcinoma, papilloma, lymphoma, amyloid, nevus, melanoma, primary acquired melanosis (PAM), complexion-associated melanosis (CAM), and inclusion cyst. HR-OCT provides morphological views of the lesions that greatly aid in diagnosis, in guiding therapy to full resolution, in detecting early recurrence, and in detecting residual postoperative disease in surgical cases