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This study assessed the hand hygiene performance in French nursing homes using the consumption of alcohol-based hand rubs (AHRs) as a surrogate. Nursing homes from the 17 French regions were contacted to collect their AHR consumption and occupancy in 2018 and 2019. A total of 1290 nursing homes from 15 French regions participated in the survey. The estimated median number of hand hygiene actions per resident-day was 1.48 (interquartile range: 1.04-2.03) in 2018 and 1.60 (1.10-2.26) in 2019. A significantly higher AHR consumption was observed in public nursing homes with an infection control team or link nurse.

Aims The aim of this study was to determine whether the sequential application of povidone iodine-alcohol (PVI) followed by chlorhexidine gluconate-alcohol (CHG) would reduce surgical wound contamination to a greater extent than PVI applied twice in patients undergoing spinal surgery. Patients and Methods A single-centre, interventional, two arm, parallel group randomised controlled trial was undertaken, involving 407 patients who underwent elective spinal surgery. For 203 patients, the skin was disinfected before surgery using PVI (10% [w/w (1% w/w available iodine)] in 95% industrial denatured alcohol, povidone iodine; Videne Alcoholic Tincture) twice, and for 204 patients using PVI once followed by CHG (2% [w/v] chlorhexidine gluconate in 70% [v/v] isopropyl alcohol; Chloraprep with tint). The primary outcome measure was contamination of the wound determined by aerobic and anaerobic bacterial growth from samples taken after disinfection. Results The detection of viable bacteria in any one of the samples taken after disinfection (culture-positive) was significantly lower in the group treated with both PVI and CHG than in the group treated with PVI alone (59 (29.1%) versus 85 (41.7%), p = 0.009; odds ratio 0.574; 95% confidence interval, 0.380 to 0.866). Conclusions Antisepsis of the skin with the sequential application of PVI and CHG more effectively reduces the contamination of a surgical wound than PVI alone. Cite this article: Bone Joint J 2017;99-B:1354–65.

Nearly three billion people in low- and middle-income countries (LMICs) rely on polluting fuels, resulting in millions of avoidable deaths annually. Polluting fuels also emit short-lived climate forcers and greenhouse gases (GHGs). Liquefied petroleum gas (LPG) and grid-based electricity are scalable alternatives to polluting fuels but have raised climate and health concerns. Here, we compare emissions and climate impacts of a business-as-usual household cooking fuel trajectory to four large-scale transitions to gas and/or grid electricity in 77 LMICs. We account for upstream and end-use emissions from gas and electric cooking, assuming electrical grids evolve according to the 2022 World Energy Outlook’s “Stated Policies” Scenario. We input the emissions into a reduced-complexity climate model to estimate radiative forcing and temperature changes associated with each scenario. We find full transitions to LPG and/or electricity decrease emissions from both well-mixed GHG and short-lived climate forcers, resulting in a roughly 5 millikelvin global temperature reduction by 2040. Transitions to LPG and/or electricity also reduce annual emissions of PM2.5 by over 6 Mt (99%) by 2040, which would substantially lower health risks from Household Air Pollution. Primary input data was collected from the following sources: Baseline household fuel choices - WHO household energy database (https://www.nature.com/articles/s41467-021-26036-x) End-use emissions - US EPA lifecycle assessment of household fuels (https://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=339679&Lab=NRMRL&simplesearch=0&showcriteria=2&sortby=pubDate&timstype=Published+Report&datebeginpublishedpresented) Upstream emissions - Argonne National Labs GREET Model (https://greet.es.anl.gov/index.php) Current and future population estimates - UNECA (http://data.un.org/Explorer.aspx?d=EDATA) Input data was processed by defining household fuel choice scenarios, estimating national household fuel consumption based on these scenarios, and applying fuel-specific emission factors to create country-specific emission pathways. These emission pathways were input into the FaIR model (https://zenodo.org/record/5513022#.Yt_jfHbMLb0) which generated additional data for each scenario including time series of pollution concentrations, radiative forcing, and temperature changes. All data is provided in CSV format. Nothing proprietary is required. 

Background and purpose:The contribution of endothelin‐1 (ET‐1) to vascular hyper‐reactivity associated with chronic ethanol intake, a major risk factor in several cardiovascular diseases, remains to be investigated.Experimental approach:The biphasic haemodynamic responses to ET‐1 (0.01–0.1 nmol kg−1, i.v.) or to the selective ETB agonist, IRL1620 (0.001–1.0 nmol kg−1, i.v.), with or without ETA or ETB antagonists (BQ123 (c(DTrp‐Dasp‐Pro‐Dval‐Leu)) at 1 and 2.5 mg kg−1 and BQ788 (N‐cis‐2,6‐dimethyl‐piperidinocarbonyl‐L‐γ‐methylleucyl1‐D‐1methoxycarbonyltryptophanyl‐D‐norleucine) at 0.25 mg kg−1, respectively) were tested in anaesthetized rats, after 2 weeks' chronic ethanol treatment. Hepatic parameters and ET receptor protein levels were also determined.Key results:The initial hypotensive responses to ET‐1 or IRL1620 were unaffected by chronic ethanol intake, whereas the subsequent pressor effects induced by ET‐1, but not by IRL1620, were potentiated. BQ123 at 2.5 but not 1 mg kg−1 reduced the pressor responses to ET‐1 in ethanol‐treated rats. Conversely, BQ788 (0.25 mg kg−1) potentiated ET‐1‐induced increases in mean arterial blood pressure in control as well as in ethanol‐treated rats. Interestingly, in the latter group, increases in heart rate, induced by ET‐1 at a dose of 0.025 mg kg−1 were enhanced following ETB receptor blockade. Finally, we observed higher levels of ETA receptor in the heart and mesenteric artery and a reduction of ETB receptor protein levels in the aorta and kidney from rats chronically treated with ethanol.Conclusions and implications:Increased vascular reactivity to ET‐1 and altered protein levels of ETA and ETB receptors could play a role in the pathogenesis of cardiovascular complications associated with chronic ethanol consumption.British Journal of Pharmacology (2008) 154, 971–981; doi:10.1038/bjp.2008.157; published online 12 May 2008

Twenty-minute neighbourhoods highlight the importance of well-connected and mixed-used neighbourhoods and communities with proximate access to employment, essential services, public transport, and open spaces. Shorter distances together with re-prioritised public spaces encourage more active transport choices, resulting in public health benefits and reduced environmental pollution. Higher liveability brought about by mixed-use developments enables people to have equitable access to local facilities, amenities, and employment opportunities, promoting vibrancy, social cohesion, and intergenerational connections. The attributes of 20-minute neighbourhoods also combine to create places, that are acknowledged as friendly for all ages, address changing needs across the life course, and provide better support for the ageing population. Furthermore, there are indications that 20-minute neighbourhoods may be more resilient against many of the negative impacts of stringent public health protocols such as those implemented in periods of lockdown during the Covid-19 pandemic. In this article, we evaluate and compare planning policies and practices aimed at establishing 20-minute neighbourhoods in Melbourne (Australia) and Scotland (the UK). Using case studies, we discuss similarities and differences involved in using place-based approaches of 20-minute neighbourhoods to address 21st-century challenges in key areas of health and wellbeing, equity, environmental sustainability, and community resilience.

Abstract As the part of a study to develop buparvaquone (BPQ) formulations for the treatment of cutaneous leishmaniasis, the topical delivery of BPQ and one of its prodrugs from a range of formulations was evaluated. In previous studies, BPQ and its prodrugs were shown to be potent antileishmanials in-vitro, with ED50 values in the nanomolar range. 3-Phosphono-oxymethyl-buparvaquone (3-POM-BPQ) was the most potent antileishmanial and was chosen, together with the parent drug, for further investigation. The ability of the parent and prodrug formulations to cross human and murine skin was tested in-vitro using the Franz diffusion cells. Formulations intended for topical application containing either BPQ or 3-POM-BPQ were developed using excipients that were either acceptable for topical use (GRAS or FDA inactive ingredients) or currently going through the regulatory process. BPQ was shown to penetrate both human epidermal membranes and full thickness BALB/c skin from a range of formulations (gels, emulsions). Similarly, 3-POM-BPQ penetrated full-thickness BALB/c skin from several gel formulations. In-vitro binding studies showed that BPQ bound melanin in a dose-dependent manner and preferably bound to delipidized skin over untreated BALB/c skin (on a weight to weight basis). The results confirm that BPQ and its prodrug 3-POM-BPQ can penetrate the skin from several formulations, making them potentially interesting candidates for further investigation of topical formulations using in-vivo models of cutaneous leishmaniasis.

Environmental factors may operate differently when relations are measured across different geographical locations, a phenomenon known as spatial non-stationarity. This study investigates the spatial non-stationarity effect of unhealthy food environments and green spaces on the T2DM prevalence rate at the neighborhood level in Toronto. This study also compares how the results vary between age groups, classified as all adults (20 and above), young adults (from 20 to 44), middle adulthood (from 45 to 64), and seniors (65 and above). The geographically weighted regression model is utilized to explore the impacts of spatial non-stationarity effects on the research results, which may lead to biased conclusions, which have often been ignored in past studies. The results from this study reveal that environmental variables dissimilarly affect T2DM prevalence rates among different age groups and neighborhoods in Toronto after controlling for socioeconomic factors. For example, the green space density yields positive associations with diabetes prevalence rates for elder generations but negative relationships for younger age groups in twenty-two and four neighborhoods, respectively, around Toronto East. The observed associations will provide beneficial suggestions to support government and public health authorities in designing education, prevention, and intervention programs targeting different neighborhoods to control the burden of diabetes.

COVID-19, caused by a member of the coronavirus family of viruses, has spread to most countries around the world since it was first recorded in humans in China in late 2019. Closing universities and cancelling all face-to-face activities have become a COVID-19 inevitable reality in many parts of the world. Its impact on university programs, particularly to maintain academic standards and quality assurance procedures, has become significantly more challenging and complex. New ways of working digitally, to minimize disruption to daily operations, have also led to enormous anxiety and uncertainty within the student population, and meeting students’ expectations has also become significantly more difficult. This paper reviews actions taken by universities to safeguard high academic standards and quality assurance procedures during this time and appraise the challenges and impacts on students’ academic performance.