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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.

Pour obtenir un aperçu spécifique des rôles que les micro-organismes pourraient jouer dans la stéatose hépatique non alcoolique (NAFLD), certaines bactéries intestinales et lactiques et une levure (Anaerostipes caccae, Bacteroides thetaiotaomicron, Bifidobacterium longum, Enterococcus fecalis, Escherichia coli, Lactobacillus acidophilus, Lactobacillus fermentum, Lactobacillus plantarum, Weissella confusa, Saccharomyces cerevisiae) ont été caractérisées par une chromatographie liquide haute performance pour la production d'éthanol lorsqu'elles sont cultivées sur différents glucides : hexoses (glucose et fructose), pentoses (arabinose et ribose), disaccharides (lactose et lactulose) et inuline. Les quantités les plus élevées d'éthanol ont été produites par S. cerevisiae, L. fermentum et W. confusa sur le glucose et par S. cerevisiae et W. confusa sur le fructose. En raison de la mannitol-déshydrogénase exprimée dans L. fermentum, la production d'éthanol sur le fructose a été significativement réduite (P < 0,05). Le pyruvate et le citrate, deux accepteurs d'électrons potentiels pour la régénération du NAD+/NADP+, ont considérablement réduit la production d'éthanol avec de l'acétate produit à la place dans L. fermentum cultivé sur glucose et W. confusa cultivé sur glucose et fructose, respectivement. Dans les boues fécales préparées à partir des matières fécales de quatre volontaires en surpoids, on a constaté que l'éthanol était produit lors de l'ajout de fructose. L'ajout d'A. caccae, L. acidophilus, L. fermentum, ainsi que de citrate et de pyruvate, respectivement, a aboli la production d'éthanol. Cependant, l'ajout de W. confusa a entraîné une augmentation significative (P < 0,05) de la production d'éthanol. Ces résultats indiquent que des micro-organismes comme W. confusa, une bactérie lactique hétéro-fermentaire, négative à la mannitol-déshydrogénase, peuvent favoriser la NAFLD par l'éthanol produit à partir de la fermentation du sucre, tandis que d'autres bactéries intestinales et des bactéries lactiques homo- et hétéro-fermentaires mais positives à la mannitol-déshydrogénase peuvent ne pas favoriser la NAFLD. En outre, nos études indiquent que les facteurs alimentaires interférant avec le microbiote gastro-intestinal et le métabolisme microbien peuvent être importants dans la prévention ou la promotion de la NAFLD. Para obtener información específica sobre los roles que podrían desempeñar los microorganismos en la enfermedad del hígado graso no alcohólico (NAFLD, por sus siglas en inglés), algunas bacterias intestinales y del ácido láctico y una levadura (Anaerostipes caccae, Bacteroides thetaiotaomicron, Bifidobacterium longum, Enterococcus fecalis, Escherichia coli, Lactobacillus acidophilus, Lactobacillus fermentum, Lactobacillus plantarum, Weissella confusa, Saccharomyces cerevisiae) se caracterizaron por cromatografía líquida de alto rendimiento para la producción de etanol cuando se cultivaron en diferentes carbohidratos: hexosas (glucosa y fructosa), pentosas (arabinosa y ribosa), disacáridos (lactosa y lactulosa) e inulina. Las cantidades más altas de etanol fueron producidas por S. cerevisiae, L. fermentum y W. confusa en glucosa y por S. cerevisiae y W. confusa en fructosa. Debido a la manitol-deshidrogenasa expresada en L. fermentum, la producción de etanol en fructosa se redujo significativamente (P < 0.05). El piruvato y el citrato, dos aceptores de electrones potenciales para la regeneración de NAD+/NADP+, redujeron drásticamente la producción de etanol con acetato producido en su lugar en L. fermentum cultivado en glucosa y W. confusa cultivado en glucosa y fructosa, respectivamente. En suspensiones fecales preparadas a partir de heces de cuatro voluntarios con sobrepeso, se encontró que el etanol se producía tras la adición de fructosa. La adición de A. caccae, L. acidophilus, L. fermentum, así como citrato y piruvato, respectivamente, abolió la producción de etanol. Sin embargo, la adición de W. confusa resultó en un aumento significativo (P < 0.05) de la producción de etanol. Estos resultados indican que microorganismos como W. confusa, una bacteria de ácido láctico hetero-fermentativa, negativa para manitol-deshidrogenasa, pueden promover NAFLD a través del etanol producido a partir de la fermentación de azúcar, mientras que otras bacterias intestinales y bacterias de ácido láctico homo- y hetero-fermentativas pero positivas para manitol-deshidrogenasa pueden no promover NAFLD. Además, nuestros estudios indican que los factores dietéticos que interfieren con la microbiota gastrointestinal y el metabolismo microbiano pueden ser importantes para prevenir o promover la EHGNA. To gain some specific insight into the roles microorganisms might play in non-alcoholic fatty liver disease (NAFLD), some intestinal and lactic acid bacteria and one yeast (Anaerostipes caccae, Bacteroides thetaiotaomicron, Bifidobacterium longum, Enterococcus fecalis, Escherichia coli, Lactobacillus acidophilus, Lactobacillus fermentum, Lactobacillus plantarum, Weissella confusa, Saccharomyces cerevisiae) were characterized by high performance liquid chromatography for production of ethanol when grown on different carbohydrates: hexoses (glucose and fructose), pentoses (arabinose and ribose), disaccharides (lactose and lactulose), and inulin. Highest amounts of ethanol were produced by S. cerevisiae, L. fermentum and W. confusa on glucose and by S. cerevisiae and W. confusa on fructose. Due to mannitol-dehydrogenase expressed in L. fermentum, ethanol production on fructose was significantly (P < 0.05) reduced. Pyruvate and citrate, two potential electron acceptors for regeneration of NAD+/NADP+, drastically reduced ethanol production with acetate produced instead in L. fermentum grown on glucose and W. confusa grown on glucose and fructose, respectively. In fecal slurries prepared from feces of four overweight volunteers, ethanol was found to be produced upon addition of fructose. Addition of A. caccae, L. acidophilus, L. fermentum, as well as citrate and pyruvate, respectively, abolished ethanol production. However, addition of W. confusa resulted in significantly (P < 0.05) increased production of ethanol. These results indicate that microorganisms like W. confusa, a hetero-fermentative, mannitol-dehydrogenase negative lactic acid bacterium, may promote NAFLD through ethanol produced from sugar fermentation, while other intestinal bacteria and homo- and hetero-fermentative but mannitol-dehydrogenase positive lactic acid bacteria may not promote NAFLD. Also, our studies indicate that dietary factors interfering with gastrointestinal microbiota and microbial metabolism may be important in preventing or promoting NAFLD. لاكتساب بعض الأفكار المحددة حول الأدوار التي قد تلعبها الكائنات الحية الدقيقة في مرض الكبد الدهني غير الكحولي (NAFLD)، تميزت بعض بكتيريا حمض الأمعاء واللاكتيك وخميرة واحدة (Anaerostipes caccae، Bacteroides thetaiotaomicron، Bifidobacterium longum، Enterococcus fecalis، Escherichia coli، Lactobacillus acidophilus، Lactobacillus fermentum، Lactobacillus plantarum، Weissella confusa، Saccharomyces cerevisiae) بتصوير سائل عالي الأداء لإنتاج الإيثانول عند زراعته على كربوهيدرات مختلفة: hexoses (الجلوكوز والفركتوز)، pentoses (الأرابينوز والريبوز)، disaccharides (اللاكتوز واللاكتولوز)، و inulin. تم إنتاج أعلى كميات من الإيثانول بواسطة S. cerevisiae و L. fermentum و W. confusa على الجلوكوز و S. cerevisiae و W. confusa على الفركتوز. بسبب نازعة هيدروجين المانيتول المعبر عنها في L. fermentum، انخفض إنتاج الإيثانول على الفركتوز بشكل كبير (P < 0.05). قلل البيروفات والسيترات، وهما مستقبلان محتملان للإلكترون لتجديد NAD +/NADP+، بشكل كبير من إنتاج الإيثانول مع الأسيتات المنتجة بدلاً من ذلك في L. fermentum المزروع على الجلوكوز و W. confusa المزروع على الجلوكوز والفركتوز، على التوالي. في الملاط البرازي الذي تم تحضيره من براز أربعة متطوعين يعانون من زيادة الوزن، وجد أن الإيثانول يتم إنتاجه عند إضافة الفركتوز. إضافة A. caccae، L. acidophilus، L. fermentum، وكذلك السترات والبيروفات، على التوالي، ألغت إنتاج الإيثانول. ومع ذلك، أدت إضافة W. confusa إلى زيادة كبيرة في إنتاج الإيثانول (P < 0.05). تشير هذه النتائج إلى أن الكائنات الحية الدقيقة مثل W. confusa، وهي بكتيريا حمض اللاكتيك السلبية غير المتجانسة، قد تعزز NAFLD من خلال الإيثانول المنتج من تخمير السكر، في حين أن البكتيريا المعوية الأخرى وبكتيريا حمض اللاكتيك الإيجابية غير المتجانسة ولكن غير المتجانسة قد لا تعزز NAFLD. أيضًا، تشير دراساتنا إلى أن العوامل الغذائية التي تتداخل مع الكائنات الحية الدقيقة في الجهاز الهضمي والتمثيل الغذائي الميكروبي قد تكون مهمة في منع أو تعزيز NAFLD.

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.

AbstractThe co‐occurrence of chronic pain and alcohol use disorders (AUDs) involves complex interactions between genetic and neurophysiological aspects, and the research has reported mixed findings when they both co‐occur. There is also an indication of a gender‐dependent effect; males are more likely to use alcohol to cope with chronic pain problems than females. Recently, a new conceptualization has emerged, proposing that the negative affective component of pain drives and maintains alcohol‐related behaviors. We studied in a longitudinal fashion alterations in alcohol drinking patterns and pain thresholds in a mouse model of chronic neuropathic pain in a sex‐dependent manner. Following partial denervation (spared nerve injury [SNI]), stimulus‐evoked pain responses were measured before chronic alcohol consumption, during drinking, during a deprivation phase, and following an episode of excessive drinking. During the course of alcohol drinking, we observed pronounced sex differences in pain thresholds. Male mice showed a strong increase in pain thresholds, suggesting an analgesic effect induced by alcohol over time, an effect that was not observed in female mice. SNI mice did not differ from sham‐operated controls in baseline alcohol consumption. However, following a deprivation phase and the reintroduction of ethanol, male SNI mice but not female mice showed more pronounced excessive drinking than controls. Finally, we observed decreased central ethanol sensitivity in male SNI mice but not in females. Together with our finding, that ethanol is able to decrease a pain‐induced negative affective memory we come to following conclusion. We propose that a lower sensitivity to the intoxicating effects of alcohol together with the ability of alcohol to reduce the negative affective component of pain may explain the higher co‐occurrence of AUD in male chronic pain patients.

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. 

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.

ABSTRACTA novel design for a high temperature SOFC, based on lamellar electrode-electrolyte segments obtained by solidification of an oxidic eutectic melt on an electrolyte substrate is presented. Such “composite” electrodes contain NiO or MnO - 8Y-ZrO2 lamellae, which after reduction / oxidation yield electrode-electrolyte lamellae with 1–2 μm width and a vertical dimension of> 100 μm, depending upon the amount of eutectic melt solidified on a polycrystalline substrate. The nucleation of the eutectic on a polycrystalline substrate followed by a semi-directional crystallization of the two phases yields a gradient of 3-phase boundaries over the height of such an electrode, with the number of 3-phase boundaries increasing towards the substrate.

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.