Purchasing and consumption of over-the-counter antibiotics:a mixed-method approach to secondary data

This research explores the reasons for antibiotic purchasing and consumption at retail pharmacies in rural China. Although an increasing amount of policy recommendations are put forward, empirical studies are still lacking on antibiotic purchasing over the counter and consumption of over the counter (OTC) antibiotics in China. My research addresses this evidence gap.Firstly, a quantitative analysis was conducted on the structured observations data from the mixed-method research project Pathways to optimising antibiotic use in rural China: identifying key determinants in community and clinical settings ‘Antibiotic Pathways study’. The aim was to investigate the prevalence of OTC antibiotics dispensing and consumption and the characteristics of medical encounters in retail pharmacies. Secondly, I conducted a qualitative analysis of in-depth interviews from the same research project. The aim was to explore the purchasing and consumption of antibiotics from retail pharmacies and to provide an in-depth exploration of customers’ experience of OTC antibiotic consumption.The findings suggest that local access to antibiotics for residents remains prevalent, as a result of the lack of restrictions on purchasing antibiotics without prescription at the lower levels of the healthcare system. Customers’ perception of the ’convenient’ purchase of antibiotics over the counter, short medical encounters and easy access in the retail sector, and policy implementation contributed to the prevalent purchasing and consumption of over-the-counter antibiotics.This study provides additional support for policy recommendations on antibiotic stewardship in the retail sector. The findings suggest that addressing antibiotic stewardship in lower levels of the healthcare system requires a focus on policy implementation, and the variability of healthcare resources across regions should be taken into consideration to ensure the effective implementation of antibiotic stewardship in China

Streptococcus pneumoniae and Haemophilus influenzae type b carriage in Chinese children aged 12–18 months in Shanghai, China: a cross-sectional study

Abstract Background The bacteria Streptococcus pneumoniae (pneumococcus) and Haemophilus influenzae type b (Hib) are leading causes of childhood pneumonia and meningitis and are major contributors to worldwide mortality in children younger than 5 years of age. Asymptomatic nasopharyngeal carriage of pneumococcus and Hib was determined for healthy children in Shanghai in 2009. Methods Children from 5 immunization clinics were enrolled in this study. Specimens from the nasopharynx were collected and cultured in Columbia and chocolate agar to identify pneumococcal and Hib carriage. Pneumococcal specimens were serotyped with the Neufeld test, and antibiotic resistance for pneumococcal and Hib specimens used the E-test method. Significance of risk factors for carriage was assessed through chi-square tests. Results Among 614 children, 16.6 % had pneumococcal carriage and 8.0 % Hib carriage. The predominant serotype of pneumococcus that was isolated was 19 F (52.9 %); serotype coverage was 68.6 % for both 7-valent pneumococcal conjugate vaccine (PCV) and PCV-10, and 82.3 % for PCV-13. Household residency and father’s education were both significantly related to pneumococcal and Hib carriage. The majority of S. pneumoniae isolates were sensitive to most antimicrobials but there were high levels of resistance to azithromycin (51.0 %) and erythromycin (51.0 %). Haemophilus influenzae isolates were sensitive to almost all antimicrobials tested although 12.2 % of isolates were resistant to ampicillin. Conclusions The pneumococcal and Hib vaccines require payment, and the children with the highest burden of disease may not be receiving these vaccines. Moreover, the presence of high antibiotic susceptibility towards pneumococcus, and to a lesser extent towards Hib, underscores the need for preventive protection against these diseases. Public funding of pneumococcal and Hib vaccines would be one mechanism to increase uptake of these vaccines.http://deepblue.lib.umich.edu/bitstream/2027.42/134553/1/12879_2016_Article_1485.pd

Epidemic Risk Assessment by a Novel Communication Station Based Method

The COVID-19 pandemic has caused serious consequences in the last few months and trying to control it has been the most important objective. With effective prevention and control methods, the epidemic has been gradually under control in some countries and it is essential to ensure safe work resumption in the future. Although some approaches are proposed to measure people's healthy conditions, such as filling health information forms or evaluating people's travel records, they cannot provide a fine-grained assessment of the epidemic risk. In this paper, we propose a novel epidemic risk assessment method based on the granular data collected by the communication stations. We first compute the epidemic risk of these stations in different intervals by combining the number of infected persons and the way they pass through the station. Then, we calculate the personnel risk in different intervals according to the station trajectory of the queried person. This method could assess people's epidemic risk accurately and efficiently. We also conduct extensive simulations and the results verify the effectiveness of the proposed method

Calf muscle pump tensing as a novel maneuver to improve the diagnostic performance of detecting patent foramen ovale during transesophageal echocardiography

ObjectiveThe Valsalva maneuver is the most sensitive provocative maneuver for patent foramen ovale detection. However, nearly half of patients are unable to perform the Valsalva maneuver well. The aim of this study was to investigate the mechanism of action of calf muscle pump tensing (TENSE) as a novel patent foramen ovale (PFO) provocative maneuver and to evaluate the diagnostic value for PFO and the effect on right-to-left shunt volume compared with the Valsalva maneuver.MethodsThis study prospectively investigated 171 patients who were highly suspected to have PFO clinically. Five patients with atrial septal defects newly diagnosed on transesophageal echocardiography (TEE) were excluded. 166 patients were injected with agitated saline under three provocative maneuvers: Valsalva maneuver, TENSE, and Valsalva + TENSE combined maneuver. The patients were divided into the effective Valsalva group (n = 93) and ineffective Valsalva group (n = 73) according to whether they could perform an effective Valsalva maneuver. TENSE consisted of the straightening of both lower limbs, and when the right atrium was filled with microbubbles, the patient performed instantaneous ankle dorsiflexion movements while maintaining dorsiflexion for 3–5 s.ResultsOverall, the PFO detection rate of the Valsalva + TENSE combined maneuver (78 [50.1%]) was significantly higher than that of the Valsalva maneuver (51 [30.7%]) and TENSE maneuver (57 [34.3%]) (P < 0.001). In the patients who were able to perform an effective Valsalva maneuver, the PFO detection rate by TENSE was not significantly different from that by the Valsalva maneuver (Valsalva 37/93 [39.8%] vs. TENSE 31/93 [33.3%], P > 0.05), while for the patients who performed an ineffective Valsalva maneuver, the PFO detection rate by the TENSE maneuver was higher than that by the Valsalva maneuver (TENSE 26/73 [35.6%] vs. Valsalva14/73[19.2%], P = 0.017).ConclusionTENSE is a simple and effective provocative maneuver in the diagnosis of PFO using TEE and can assist the Valsalva maneuver. For patients who cannot perform an effective Valsalva maneuver, TENSE can be an alternative to the Valsalva maneuver to some extent

Neglected intrapulmonary arteriovenous anastomoses: A comparative study of pulmonary right-to-left shunts in patients with patent foramen ovale

ObjectivePulmonary right-to-left shunt (P-RLS) and patent foramen ovale right-to-left shunt (PFO-RLS) often appear in combination, and there are often differences and connections between them. Intrapulmonary arteriovenous anastomoses (IPAVAs), as part of P-RLS, are often overlooked because there are no technologies to detect and identify them. This study aimed to further clarify the incidence and characteristics of P-RLS with the help of contrast transesophageal echocardiography (c-TEE) and contrast transthoracic echocardiography (c-TTE), providing a reference for clinically relevant research and patent foramen ovale (PFO) management disposal decisions.MethodsWe retrospectively investigated 414 subjects who came to our hospital for c-TEE from October 2021 to July 2022, and all subjects completed c-TTE simultaneously. 7 Patients who were newly diagnosed with an atrial septal defect were excluded. Eventually, 407 patients were included in this study. Among them, 157 patients with PFO (58 patients were treated with PFO closure subsequently) and 250 patients without PFO confirmed by c-TEE were finally enrolled. In the process, we observed and analysed the presence of P-RLS.ResultsA total of 407 patients were included in the final analysis and divided into PFO group (N = 157) and non-PFO group (N = 250) according to the results of c-TEE. Whether at rest or after Valsalva maneuver, the incidence of P-RLS was significantly higher under c-TEE than under c-TTE in the two groups (P < 0.001). For both c-TTE and c-TEE, the incidence of P-RLS was slightly higher after Valsalva maneuver than at rest, but the difference was not significant (c-TTE: rest vs. Valsalva maneuver, P = 0.214; c-TEE: rest vs. Valsalva maneuver, P = 0.076). The Valsalva maneuver increased the incidence of P-RLS in the group without PFO, which was more significant in c-TEE (c-TTE: rest vs. Valsalva maneuver, P = 0.591; c-TEE: rest vs. Valsalva maneuver, P = 0.008). In both groups, the P-RLS semiquantitative grading was statistical significance under different states and examinations (P < 0.001).ConclusionThe vast majority of P-RLS are grade 1–2 and are derived from physiological IPAVAs. Even so, attention should be given to the differentiation between P-RLS and PFO-RLS. c-TEE is an effective method to detect P-RLS; however, the recruitments of c-TEE and Valsalva maneuver to P-RLS should be noted

Macrophage-mediated trogocytosis contributes to destroying human schistosomes in a non-susceptible rodent host, Microtus fortis

Schistosoma parasites, causing schistosomiasis, exhibit typical host specificity in host preference. Many mammals, including humans, are susceptible to infection, while the widely distributed rodent, Microtus fortis, exhibits natural anti-schistosome characteristics. The mechanisms of host susceptibility remain poorly understood. Comparison of schistosome infection in M. fortis with the infection in laboratory mice (highly sensitive to infection) offers a good model system to investigate these mechanisms and to gain an insight into host specificity. In this study, we showed that large numbers of leukocytes attach to the surface of human schistosomes in M. fortis but not in mice. Single-cell RNA-sequencing analyses revealed that macrophages might be involved in the cell adhesion, and we further demonstrated that M. fortis macrophages could be mediated to attach and kill schistosomula with dependence on Complement component 3 (C3) and Complement receptor 3 (CR3). Importantly, we provided direct evidence that M. fortis macrophages could destroy schistosomula by trogocytosis, a previously undescribed mode for killing helminths. This process was regulated by Ca2+/NFAT signaling. These findings not only elucidate a novel anti-schistosome mechanism in M. fortis but also provide a better understanding of host parasite interactions, host specificity and the potential generation of novel strategies for schistosomiasis control

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Image Zooming Based on Two Classes of C1-Continuous Coons Patches Construction with Shape Parameters over Triangular Domain

Image interpolation is important in image zooming. To improve the quality of image zooming, in this work, we proposed a class of rational quadratic trigonometric Hermite functions with two shape parameters and two classes of C 1 -continuous Coons patches constructions over a triangular domain by improved side–side method and side–vertex method. Altering the values of shape parameters can adjust the interior shape of the triangular Coons patch without influencing the function values and partial derivatives of the boundaries. In order to deal with the problem of well-posedness in image zooming, we discussed symmetrical sufficient conditions for region control of shape parameters in the improved side–side method and side–vertex method. Some examples demonstrate the proposed methods are effective in surface design and digital image zooming. C 1 -continuous Coons patches constructed by the proposed methods can interpolate to scattered 3D data. By up-sampling to the constructed interpolation surface, high-resolution images can be obtained. Image zooming experiment and analysis show that compared to bilinear, bicubic, iterative curvature-based interpolation (ICBI), novel edge orientation adaptive interpolation scheme for resolution enhancement of still images (NEDI), super-resolution using iterative Wiener filter based on nonlocal means (SR-NLM) and rational ball cubic B-spline (RBC), the proposed method can improve peak signal to noise ratio (PSNR) and structural similarity index (SSIM). Edge detection using Prewitt operator shows that the proposed method can better preserve sharp edges and textures in image zooming. The proposed methods can also improve the visual effect of the image, therefore it is efficient in computation for image zooming