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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.

Building, bridge or wind turbine maintenance requires manual dexterity tasks by a specialist rope-access trained workforce via two principal means: harness suspension of individual workers from above, or deployment of a suspended platform or cradle from which workers access the structure to be maintained. Currently no published research compares accuracy and efficiency of simulated maintenance tasks between these modalities. This study investigated manual dexterity task performance of peg placement and shape delineation in seated, standing and suspended environments in 16 healthy controls and 26 professional rope-access trained individuals. Both seated and standing assessments were superior to those suspended, and height of suspension, total mass and years of experience had no influence on the task outcome. These findings suggest that, where feasible, cradle suspension mechanisms which permit standing maintenance are favourable in terms of task efficacy and where feasible, should be considered for deployment in wind energy and other engineering applications.

Abstract Background In the near future, the incidence of mosquito-borne diseases may expand to new sites due to changes in temperature and rainfall patterns caused by climate change. Therefore, there is a need to use recent technological advances to improve vector surveillance methodologies. Unoccupied Aerial Vehicles (UAVs), often called drones, have been used to collect high-resolution imagery to map detailed information on mosquito habitats and direct control measures to specific areas. Supervised classification approaches have been largely used to automatically detect vector habitats. However, manual data labelling for model training limits their use for rapid responses. Open-source foundation models such as the Meta AI Segment Anything Model (SAM) can facilitate the manual digitalization of high-resolution images. This pre-trained model can assist in extracting features of interest in a diverse range of images. Here, we evaluated the performance of SAM through the Samgeo package, a Python-based wrapper for geospatial data, as it has not been applied to analyse remote sensing images for epidemiological studies. Results We tested the identification of two land cover classes of interest: water bodies and human settlements, using different UAV acquired imagery across five malaria-endemic areas in Africa, South America, and Southeast Asia. We employed manually placed point prompts and text prompts associated with specific classes of interest to guide the image segmentation and assessed the performance in the different geographic contexts. An average Dice coefficient value of 0.67 was obtained for buildings segmentation and 0.73 for water bodies using point prompts. Regarding the use of text prompts, the highest Dice coefficient value reached 0.72 for buildings and 0.70 for water bodies. Nevertheless, the performance was closely dependent on each object, landscape characteristics and selected words, resulting in varying performance. Conclusions Recent models such as SAM can potentially assist manual digitalization of imagery by vector control programs, quickly identifying key features when surveying an area of interest. However, accurate segmentation still requires user-provided manual prompts and corrections to obtain precise segmentation. Further evaluations are necessary, especially for applications in rural areas.

Abstract Aims Buying and consuming no- (per cent alcohol by volume, ABV = 0.0%) and low- (ABV = >0.0% and ≤ 3.5%) alcohol beers could reduce alcohol consumption but only if they replace buying and drinking higher-strength beers. We assess whether buying new no- and low-alcohol beers increases or decreases British household purchases of same-branded higher strength beers. Methods Generalized linear models and interrupted time series analyses, using purchase data of 64,280 British households from Kantar Worldpanel’s household shopping panel, 2015–2018. We investigate the extent to which the launch of six new no- and low-alcohol beers affected the likelihood and volume of purchases of same-branded higher-strength beers. Results Households that had never previously bought a same-branded higher-strength beer but bought a new same-branded no- or low-alcohol beer were less than one-third as likely to go on and newly buy the same-branded higher-strength product. When they did later buy the higher-strength product, they bought half as much volume as households that had not bought a new same-branded no- or low-alcohol beer. For households that had previously purchased a higher-strength beer, the introduction of the new same-branded no- or low-alcohol beer was associated with decreased purchases of the volume of the higher-strength beer by, on average, one-fifth. Conclusions The increased availability of new no- and low-alcohol beers does not seem to be a gateway to purchasing same-branded higher-strength beers but rather seems to replace purchases of these higher-strength products. Thus, introduction of new no- and low-alcohol beers could contribute to reducing alcohol consumption.

Theresa Marteau and colleagues argue for rapid, radical changes to the infrastructure and pricing systems that currently support unhealthy unsustainable behaviour

Spatiotemporal monitoring of urban CO2 emissions is crucial for developing strategies and actions to mitigate climate change. However, most spatiotemporal inventories do not adopt urban form data and have a coarse resolution of over 1 km, which limits their implications in intra-city planning. This study aims to model the spatiotemporal carbon emissions of the two largest mega-urban regions in China, the Yangtze River Delta and the Pearl River Delta, using urban form data from the Local Climate Zone scheme and landscape metrics, nighttime light images, and a year-fixed effects model at a fine resolution from 2012 to 2016. The panel data model has an R2 value of 0.98. This study identifies an overall fall in carbon emissions in both regions since 2012 and a slight elevation of emissions from 2015 to 2016. In addition, urban compaction and integrated natural landscapes are found to be related to low emissions, whereas scattered low-rise buildings are associated with rising carbon emissions. Furthermore, this study more accurately extracts urban areas and can more clearly identify intra-urban variations in carbon emissions than other datasets. The open data supported methodology, regression models, and results can provide accurate and quantifiable evidence at the community level for achieving a carbon-neutral built environment.

The Pan-African Consortium for the Evaluation of Anti-Tuberculosis Antibiotics (PanACEA) was designed to build tuberculosis (TB) trial capacity whilst conducting clinical trials on novel and existing agents to shorten and simplify TB treatment. PanACEA has now established a dynamic network of 11 sub-Saharan clinical trial sites and four European research institutions.In 2011, a capacity development program, funded by the European & Developing Countries Clinical Trials Partnership (EDCTP), was launched with four objectives, aiming at strengthening collaborating TB research sites to reach the ultimate goal of becoming self-sustainable institutions: networking; training; conducting clinical trials; and infrastructure scaling-up of sites.Assessment in six sub-Saharan TB-endemic countries (Gabon, Kenya, South Africa, Tanzania, Uganda and Zambia) were performed through a structured questionnaire, site visits, discussion with the PanACEA consortium, setting of milestones and identification of priorities and followed-up with evaluations of each site. The results of this needs-based assessment was then translated into capacity development measures.In the initial phase, over a four-year period (March 2011 - June 2014), the programme scaled-up six sites; conducted a monitoring training program for 11 participants; funded five MSc and four PhD students, fostering gender balance; conducted four epidemiological studies; supported sites to conduct five Phase II studies and formed a sustainable platform for TB research (panacea-tb.net).Our experience of conducting TB clinical trials within the PanACEA programme environment of mentoring, networking and training has provided a sound platform for establishing future sustainable research centres. Our goal of facilitating emergent clinical TB trial sites to better initiate and lead research activities has been mostly successful.

Abstract Aims Minimum unit price (MUP) of 50 pence per unit of alcohol was introduced in Scotland on the 1 May 2018. We assessed alcohol-related liver disease (ArLD) discharges from Glasgow Royal Infirmary (GRI) before and after the introduction of MUP. Methods Medical records of all patients discharged from Gastroenterology wards at GRI in the fourth quarter (Q4) of the years 2015–2019 were reviewed. All patients with ArLD were identified, and detailed hospitalization data were collected retrospectively. Active drinking, severity scores, presence of alcoholic hepatitis (AH) and 90-day mortality and readmission rates were assessed. Results There were fewer ArLD discharges per quarter after MUP than before (mean 80.3 pre-MUP; mean 68 post-MUP), and the proportion of active drinkers was lower post-MUP (64.7 vs. 70.5%). There was a significant fall in the mean number of weekly discharges of individual patients who were actively drinking (4.0 ± 2.0 pre-MUP, 2.8 ± 1.5 post-MUP, P = 0.01). There were no differences in the proportion of patients presenting with ascites, encephalopathy or AH; however, there was a reduction in presentations with acute upper gastrointestinal bleeding from 15.8% pre-MUP to 7.4% post-MUP (P = 0.02; odds ratio 0.42). Severity of liver disease remained unchanged. The 90-day mortality and readmission rates were not significantly different. Conclusion Since the introduction of MUP there has been a reduction in the absolute numbers of patients discharged with ArLD and the number of individual patients involved at GRI. The pattern of clinical presentation was largely unaffected with overall ArLD severity, readmission rates and 90-day mortality similar pre- and post-MUP.