Corrigendum to "Never boring: Non-invasive palaeoproteomics of mummified human skin" [J. Archaeol. Sci. (2020) 105145]

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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

Verso un nuovo rapporto tra microclima e beni culturali nell’ambito della conservazione preventiva: il caso dell’edificio storico di Villa Blanc (Roma)

La Fisica dell’Atmosfera applicata allo studio del microclima fornisce strumenti utili per la caratterizzazione dell’ambiente di conservazione delle opere culturali, permettendo di indagare sia le cause dei meccanismi di degrado che l’efficacia degli interventi di restauro architettonico. Studiare il microclima non si limita alla raccolta dei dati e alla descrizione di quello che sta accadendo, ma consente anche di indagare le complesse interazioni tra aria, edificio e oggetti. Negli ultimi anni, il Gruppo di Meteorologia (GMET) di Sapienza Università di Roma ha intrapreso una nuova linea di ricerca in Fisica dell'Atmosfera applicata alla conservazione dei Beni Culturali, conducendo campagne di osservazioni microclimatiche in ambienti confinati per comprendere l'interazione tra i manufatti e l’aria. Il GMET, avvalendosi anche delle competenze in chimica del restauro, ha avviato alla fine del 2015 il monitoraggio delle condizioni ambientali a Villa Blanc, con lo scopo di studiare il microclima nella Hall dell’edificio prima e dopo il recente intervento di restauro. Il sistema di monitoraggio consiste di tre termo-igrometri per le misure di temperatura (T) e umidità relativa (UR) -due in interno e uno in esterno- e di un sensore per la misura della concentrazione di anidride carbonica (CO2). Le misure in interno sono state prese alle quote di 2.5 e 4.0 m per lo studio della stabilità dell'aria. Dopo il completamento del restauro, le serie termo-igrometriche mostrano una significativa riduzione delle escursioni a livello stagionale e un concomitante aumento su base giornaliera dovuto all’accensione del riscaldamento. Lo studio del profilo termico evidenzia una situazione di sostanziale stabilità dell’aria. La concentrazione di CO2 segue un ciclo annuale dipendente dagli andamenti esterni individuati nel periodo precedente all’apertura della struttura al pubblico. L’inclusione della CO2 ha permesso di evidenziare la relazione tra la fruizione e le dinamiche dei parametri termo-igrometrici in ambiente interno

Safe microclimate thresholds for photographic and cinematographic media: a new challenge in the era of climate change

Vulnerable collections such as photographic and cinematographic media can be preserved in historical buildings (which generally have poor thermal insulation, low moisture buffer, and energy demanding air conditioning systems) or in purpose-built spaces, which, differently, are more efficient. Regarding the vulnerable collections, we are focusing on films in cellulose nitrate and cellulose triacetate and on photographic media, in particular the paper prints. In general, storage in a frozen or cold environment for films is encouraged, because at lower temperature the kinetics of the chemical degradation reactions decreases. For paper prints we have to avoid the acidification of the paper support. According to the policy framework, we note heterogeneity and great variety of thresholds, but it is necessary that temperature must be lower than 15°C for films, and 20°C for paper prints. As for relative humidity the maximum suggested RH is 50% for both films and paper prints. It is very important to follow guidelines that improve the energy performance of the building, because this also allows for greater conservation of the cultural heritage preserved internally. The EN 16883:2017 concerns historical buildings and focuses the attention on the climate changes which can have an effect on hygrothermal and load risks. It is necessary to reduce the energy demand, reduce greenhouse gas emissions, and maintain indoor conditions suitable for collections

Neonatal Early Onset Sepsis: Impact of Kaiser Calculator in an Italian Tertiary Perinatal Center

Background: Suspected early-onset sepsis (EOS) results in antibiotic treatment and blood withdraw of a substantial number of neonates who are uninfected. We evaluated if the EOS calculator can reduce antibiotic exposure and invasive procedures for suspected EOS in term and late preterm neonates, without any significant increase in adverse outcomes. Methods: The proportion of EOS risk in neonates >= 35 weeks gestation exposed to antibiotics, intensive monitoring and blood withdrawal was compared between a baseline period (January 2018-May 2018), when Centers for Disease Control guidelines approach was used, and a post-EOS calculator-implementation period (June 2018-December 2019). Results: We included 4363 newborn infants with gestational age >= 35 weeks, respectively 824 in baseline period and 3539 in the EOS calculator period. Among them, 1021 (23.4%) infants presented risk factors for neonatal sepsis. There was a halving in empirical antibiotics exposure: 3% in the baseline and 1.4% in the post-EOS-implementation period, P < 0.05. Blood culture and laboratory evaluations had fallen from 30.6% to 15.4% (P < 0.05). Close monitoring of vital parameters decreased from 25.4% to 4.8% (P < 0.05). The number of antibiotic days per 100 live births decreased from 15.05 to 6.36 days (P <0.05). The incidence of culture-confirmed sepsis and clinical sepsis was very low in 2 periods. Only one infant identified at low-risk by Kaiser calculator at birth developed symptoms after 12 h from birth. We had no readmissions for EOS. Conclusions: Application of the EOS calculator more than halved the burden of intensive monitoring and antibiotic exposure, without compromising safety in a population with a relatively low incidence of culture-proven EOS and good access to follow-up care

Acetic acid and cellulose acetate films: artificial ageing and preliminary risk assessment of climate-induced impact

Most cellulose acetate film archives are affected by the vinegar syndrome (Bigourdan, et al., 2000). This spontaneous and self-catalytic process leads to a rapid (i.e., in a few years) deterioration of film materials, which rate increases under unfavourable thermo-hygrometric storage conditions. Therefore, the actual problem facing archives is the preservation of collections that are not yet in acetic syndrome (or in its early stage), since films in advanced stages of decay are unrecoverable and can only be handled and digitised before their definite loss. This paper presents a study in laboratory in which the ageing of films in real storages has been reproduced in a climate chamber under different conditions of temperature (T), relative humidity (RH), and acetic acid concentration. Some laboratory tests have been conducted to investigate the state of conservation and deterioration before and after different ageing experiments. Subsequently, specific dose response functions (Fenech, et al., 2013) (Menart, et al., 2014) related to archival materials have been exploited for assessing the climate-induced risk predicted specifically for cellulose acetate films in an acetic acid polluted environment. Selected samples of virgin cellulose acetate films were artificially aged in a climate chamber (i.e., with constant RH and variable T) with known concentrations of acetic acid (i.e., order of magnitude 101, 102, 103, 104 parts per billion). To qualitatively detect the presence of gaseous acidic compounds, Acid Detection (A-D) strips (developed and produced by the Image Permanence Institute - IPI) were used. Then, the state of conservation of the materials before and after the different ageing experiments was evaluated by means of non-destructive UV-visible spectrophotometry and contact surface pH measurement coupled with Fourier Transform InfraRed spectroscopy (FTIR), in order to quantify the degree of (de)polymerization of the cellulose. The impact of different acetic acid concentrations under variable thermo-hygrometric conditions was estimated. The change in colorimetric features of the cellulose acetate films was measured by UV-visible spectrophotometry, while the chemical degradation was obtained in terms of the acidification (pH) of the material associated with the appearance of characteristic peaks of aldehyde and ketone compounds in the FTIR spectra as a consequence of cellulose hydrolysis. The results are expressed in terms of the retention percentage of the capacity to handle and display the film after artificial ageing. The life expectancy calculation method was deduced from existing dose-response functions applied to the experimental data obtained. These data reproduce real archival conditions, in which films in excellent condition and films suffering acetic syndrome (i.e., contaminating the surrounding atmosphere with acetic acid) are stored in the same space. Therefore, the research outcomes are useful for estimating life expectancy of cellulose acetate films in real case studies. References - Bigourdan J.L., Reilly J.M., Effectiveness of storage conditions in controlling the vinegar syndrome: preservation strategies for acetate base motion-picture film collections, in: Aubert M., &amp; Billeaud R., Proceedings of the 5th Joint Technical Symposium - JTS, Paris (2000) 14-34. - Fenech A., Dillon C., Ntanos K., Bell N., Barrett M., Strlič M., Modelling the Lifetime of Colour Photographs in Archival Collections, Studies in Conservation, 58(2) (2013) 107-116. - Menart E., de Bruin G., Strlič M., Effects of NO2 and acetic acid on the stability of historic paper, Cellulose, 21(5) (2014) 3701-3713

Strategie di campionamento di microplastiche in ambienti acquatici e metodi di pretrattamento

Le microplastiche rappresentano contaminanti ambientali “emergenti” ampiamente diffusi negli ambienti acquatici e da tempo studiati per i possibili effetti sulla salute umana e animale. Possono appartenere a polimeri molto diversi tra loro e presentano una eterogeneità dimensionale, come sottolineato dalla definizione che l’ECHA ha nel 2019, “dimensioni comprese tra 1 nm ≤ x ≤ 5 mm o per fibre di lunghezza compresa tra 3 nm ≤ x ≤ 15 mm, con rapporto lunghezza/ diametro &gt; 3”. I metodi per il loro campionamento e il pretrattamento necessario per la loro corretta identificazione e quantificazione riflettono questa eterogeneità dimensionale. In relazione alla tipologia e alla destinazione d’uso delle acque, il campionamento può essere effettuato raccogliendo direttamente l’acqua in contenitori adatti o filtrando l’acqua in situ. Quest’ultima soluzione, la più impiegata per la possibilità di filtrare volumi d’acqua elevati, soprattutto per acque destinate al consumo umano, prevede l’utilizzo di specifiche reti per il campionamento o sistemi di filtrazione specifici attraverso i quali l’acqua viene convogliata tramite una pompa o mediante un tubo collegato al rubinetto. I metodi di pretrattamento più comuni prevedono ulteriori filtrazioni, un’estrazione per separare le microplastiche dagli interferenti e una digestione per rimuovere il contenuto organico e biologico presente nel campione.Microplastics can be considered environmental “emerging” contaminants. Extremely widespread in water bodies, microplastics have been studied for some time due to the possible effects on human and animal health. One of the main problems related to microplastics analysis in environmental matrices is due to the size range. Their definition, according to ECHA (2019), is particles have (i) all dimensions 1 nm ≤ x ≤ 5 mm, or (ii), for fibres, a length of 3 nm ≤ x ≤ 15 mm and length to diameter ratio of &gt;3). Sampling and pre-treatment methods for identifying and quantifying microplastics reflect this issue. In relation to their type and destination of use, water sampling can be done simply collecting water or by in situ filtration. The latter method is the most used, especially for water intended for human consumption, because high volumes can be filtered. This can be achieved with a specific sampling net or through a filtration system where water is usually conveyed with a pump or with a hose connected to the tap. Pre-treatment methods include additional filtrations, a digestion step necessary for organic matter removal and an extraction procedure to remove interferers

Nitrogen compounds in buildings housing collections: a preliminary review

Indoor climate and air pollutants are environmental stressors that can directly/indirectly affect the natural progressive ageing of materials constituting cultural heritage and be also responsible for accelerating or triggering degradation mechanisms. This preliminary literature review is based on a three‐step procedure through the PRISMA (Preferred Reporting Items for Systematic reviews and Meta‐Analyses) flow diagram, leading to the inclusion of 42 articles from two databases (Scopus and Web of Science), over the period 1966-2020. The review concerns nitrogen compounds in confined conservation spaces. The topic is mainly published in journal concerning the “environmental sciences” and by a first author affiliated to an Italian institution. Moreover, 40% of the sites are equipped with HVAC (Heating, Ventilation and Air Conditioning) systems, coupled or not with filters. Finally, the NO2 concentration is heterogeneous among sites located in Europe, considering both the sampling site and the presence of HVAC systems, with a minimum concentration value of 0.2 μg/m3 and a maximum of 99.7 μg/m3

Continuous Glucose Monitoring Linked to an Artificial Intelligence Risk Index: Early Footprints of Intraventricular Hemorrhage in Preterm Neonates

To develop and validate a new risk score for intraventricular hemorrhage (IVH) in preterm neonates based on continuous glucose monitoring (CGM)