Carbapenem-resistant and OXA-23-producing Acinetobacter baumannii isolates in the United Arab Emirates

ABSTRACTFive carbapenem-resistant Acinetobacter baumannii isolates, collected from the United Arab Emirates in 2006, were investigated to identify the mechanism(s) responsible for carbapenem resistance. Genotyping was performed by pulsed-field gel electrophoresis, and the location of the blaOXA-23 gene was determined by using the endonuclease I CeuI technique and mating-out assays. The four isolates in which the blaOXA-23 gene was located on the chromosome within a Tn2006 composite transposon were clonally related. The single nonclonally related isolate harboured the blaOXA-23 gene on a 70-kb transferable plasmid. This study provides the first description of the dissemination of carbapenem-resistant A. baumannii isolates carrying Tn2006 on their chromosome. It is also the first report of OXA-23-producing A. baumannii isolates in the Middle East

Assessing Expectations: Towards a Toolbox for an Ethics of Emerging Technologies

In recent years, several authors have argued that the desirability of novel technologies should be assessed early, when they are still emerging. Such an ethical assessment of emerging technologies is by definition focused on an elusive object. Usually promises, expectations, and visions of the technology are taken as a starting point. As Nordmann and Rip have pointed out in a recent article, however, ethicists should not take for granted the plausibility of such expectations and visions. In this paper, we explore how the quality of expectations on emerging technologies might be assessed when engaging in a reflection on the desirability of emerging technologies. We propose that an assessment of expectations’ plausibility should focus on statements on technological feasibility, societal usability, and desirability of the expected technology. Whereas the feasibility statement and, to a lesser extent, the usability statements are frequently quite futuristic, the claims on desirability, by contrast, often display a conservative stance towards the future. Assessing the quality of expectations and visions on behalf of emerging technologies requires, then, a careful and well-directed use of both skepticism and imagination. We conclude with a brief overview of the tools and methods ethicists could use to assess claims made on behalf of emerging technologies and improve the ethical reflection on them

Bichromatic UV detection system for atomically-resolved imaging of ions

We present a compact and bichromatic imaging system, located outside of the vacuum chamber of a trapped ion apparatus, that collects the fluorescence of 230.6 nm and 369.5 nm photons simultaneously on a shared EMCCD camera. The system contains two lens doublets, consisting of a sphere and an asphere. It provides a numerical aperture of 0.45 and 0.40 at 230.6 nm and 369.5 nm, respectively, and enables spatially resolved state detection with a large field of view of 300 $\mu$m for long $^{115}$In$^+$/$^{172}$Yb$^+$ Coulomb crystals. Instead of diffraction limited imaging for one wavelength, the focus in this system is on simultaneous single-ion resolved imaging of both species over a large field with special attention to the deep UV wavelength (230.6 nm) and the low scattering rate of In$^+$ ions. The introduced concept is applicable to other dual-species applications

Molecular characterization of multidrug-resistance in Gram-negative bacteria from the Peshawar teaching hospital, Pakistan

Extended-spectrum β-lactamases, carbapenemases, 16S rRNA methylases conferring pan-drug aminoglycoside resistance and colistin resistance were investigated among Gram-negative bacteria recovered from clinical samples (infections) from 200 individuals hospitalized at the Khyber Teaching Hospital of Peshawar, north Pakistan, from December 2017 to March 2018. Out of 65 isolates recovered, 19% were carbapenem resistant and 16% carried a bla NDM-1 gene, confirming the widespread distribution of NDM producers in this country. The association of the NDM carbapenem-resistance determinant, together with the extended-spectrum β-lactamase CTX-M-15 and 16S rRNA methylases, was frequent, explaining the multidrug-resistance pattern observed. All isolates remained susceptible to colistin

Sub-kelvin temperature management in ion traps for optical clocks

The uncertainty of the ac Stark shift due to thermal radiation represents a major contribution to the systematic uncertainty budget of state-of-the-art optical atomic clocks. In the case of optical clocks based on trapped ions, the thermal behavior of the rf-driven ion trap must be precisely known. This determination is even more difficult when scalable linear ion traps are used. Such traps enable a more advanced control of multiple ions and have become a platform for new applications in quantum metrology, simulation and computation. Nevertheless, their complex structure makes it more difficult to precisely determine its temperature in operation and thus the related systematic uncertainty. We present here scalable linear ion traps for optical clocks, which exhibit very low temperature rise under operation. We use a finite-element model refined with experimental measurements to determine the thermal distribution in the ion trap and the temperature at the position of the ions. The trap temperature is investigated at different rf-drive frequencies and amplitudes with an infrared camera and integrated temperature sensors. We show that for typical trapping parameters for $\mathrm{In}^{+}$, $\mathrm{Al}^{+}$, $\mathrm{Lu}^{+}$, $\mathrm{Ca}^{+}$, $\mathrm{Sr}^{+}$ or $\mathrm{Yb}^{+}$ ions, the temperature rise at the position of the ions resulting from rf heating of the trap stays below 700 mK and can be controlled with an uncertainty on the order of a few 100 mK maximum.Comment: 18 page

Management of female genital mutilation / cutting-related obstetric complications: a training evaluation

Although female genital mutilation/cutting (FGM/C) is a prevalent practice in Liberia, healthcare workers lack the capacity to provide adequate care for FGM/C survivors. Therefore, Liberian nurses, physician assistants, midwives and trained traditional midwives were trained in sexual, obstetric and psychosocial care for FGM/C survivors in 2019. Through questionnaires, we assessed knowledge acquisition, trainee attitudes towards FGM/C care and acceptability to implement WHO-endorsed recommendations. The questionnaires were analyzed using descriptive statistics for quantitative data and an inductive approach for qualitative data. A total of 99 female and 34 male trainees participated. Most trainees perceived FGM/C as harmful to women''s health, as a violation of women''s rights and showed a willingness to change their clinical practice. While 82.8% (n = 74/90) perceived their role in advocating against FGM/C, 10.0% (n = 9/90) felt that they should train traditional circumcisers to practice FGM/C safely. The pre-training FGM/C knowledge test demonstrated higher scores among physician assistants (13.86 ± 3.02 points) than among nurses (12.11 ± 3.12 points) and midwives (11.75 ± 2.27 points). After the training, the mean test score increased by 1.69 points, from 12.18 (±2.91) points to 13.87 (±2.65) points. The trainings successfully increased theoretical knowledge of FGM/C-caused health effects and healthcare workers'' demonstrated willingness to implement evidence-based guidelines when providing care to FMG/C survivors

Clinical outcomes of stents versus balloon angioplasty in non-acute coronary artery disease: A meta-analysis of randomized controlled trials

Aims To evaluate whether stents as compared to balloon angioplasty reduce mortality in patients with non-acute coronary artery disease. Methods and results We identified randomized controlled trials comparing stents to balloon angioplasty for the treatment of non-acute coronary artery disease by searching major medical databases from 1979 to March 2002. Two independent reviewers selected and extracted data from trials that had to report data on death and myocardial infarction. Nineteen trials, with a total of 8004 patients, fulfilled our inclusion criteria. For 1000 patients treated with stents rather than balloon angioplasty, 3 (95% CI 0-6), 5 (95% CI 0-9), and 6 (95% CI -1-12) additional lives were saved at 30 days, 6 and 12 months. At 12 months, for 1000 patients treated with stents rather than balloon angioplasty 46 (95% CI 25-66) additional target vessel revascularizations were avoided, but 25 (95% CI 15-34) additional bleeding complications with need for blood transfusion or surgical intervention occurred. In sensitivity analysis 11 (95% CI 2-20) and 2 (95% CI -4-7) deaths were avoided per 1000 patients treated with stents rather than PTCA in trials that routinely used compared to trials that did not use glycoprotein IIb/IIIa inhibitors. Conclusion In non-acute coronary disease stents may reduce overall mortality, but this benefit seems to be limited to stents used in conjunction with glycoprotein IIb/IIIa inhibitors. Stents compared to PTCA reduce target vessel revascularizations, but increase the risk of bleeding complication