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Role of Antimicrobial Stewardship Programs in Decreasing Hospital-Associated clostridium difficile Infections

cURRENT TREATMENT OPTIONS IN INFEcTIOUS DISEASES 2018年第2期10卷 270-280页

作者： Aljefri, Doaa M. christensen, Alyssa B. Gibson, Amanda K. Postelnick, Michael Northwestern Mem Hosp Dept Pharm 251 E HuronFeinberg LC-700 Chicago IL 60611 USA King Abdul Aziz Med City Jeddah Saudi Arabia Univ Illinois Coll Pharm Chicago IL USA OSF St Anthony Med Ctr Dept Pharm Rockford IL USA Univ Utah Hlth Salt Lake City UT USA

Opinion statementPurpose of review To provide a review of literature that discusses some of the most successful antimicrobial stewardship interventions reported across institutions worldwide in response to increased clostridium difficile infection (cDI) rates. Recent findings Although many different types of antimicrobial reduction practices have been proven effective, differences in resources across varying sizes of institutions may make some interventions more attainable than other. Regardless of available resources, an initial assessment of the correlation of positive laboratory tests to clinical disease is necessary to quantify the true burden of hospital-onset cDIs (HO-cDI). Infection prevention programs, in conjunction with antimicrobial reduction interventions, and the appropriate identification of patients to undergo laboratory testing, are key components of a HO-cDI reduction program. clostridium difficile is an important cause of serious healthcare-associated infections (HAIs), causing adverse consequences for patients including, but not limited to, increased length of hospital stay, healthcare costs, and mortality. Since the early 2000s, there has been a notable increase in cDI. Antimicrobial stewardship programs (ASPs) have responded to this public health threat with a number of different strategies including antimicrobial use reduction, education, appropriate testing, and multiple other interventions. Along with providing a literature review on ASP interventions to address the cDI threat, we describe our experience in successfully reducing HO-cDI at Northwestern Memorial Hospital with the use of multiple interventions.

关键词： c difficile clostridium difficile infection Hospital-onset clostridium difficile infection Antimicrobial stewardship

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Impact of direct acting antivirals on occurrence and recurrence of hepatocellular carcinoma: Biologically plausible or an epiphenomenon?

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World Journal of Hepatology 2018年第2期10卷 267-276页

作者： Amna Subhan Butt Fatima Sharif Shahab Abid Section of Gastroenterology Department of Medicine Aga Khan University Hospital

Hepatocellular carcinoma(Hcc) is a major cause of morbidity and mortality worldwide. chronic hepatitis c virus infection(HcV) is the most common cause of Hcc in many European countries, Japan and Pakistan. Introduction of the new direct acting antivirals(DAAs) has revolutionized the management of HcV worldwide, with high rates of sustained virologic response in patients who could not have tolerated the previous interferon based treatments. However, recently there have been reports raising caution about the long term effects of DAAs, particularly a possible increased risk of Hcc. Therefore this review explores the current molecular studies as well as clinical data that investigate the impact of DAAs on occurrence and recurrence of Hcc.

关键词： Hepatocellular carcinoma Direct acting antivirals Hepatitis c

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Performance Optimisation of a Non-disposable Brake Pad Sensor

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Journal of Mechanics Engineering and Automation 2018年第5期8卷 226-231页

作者： A.A.Adeseko B.Kareem Industrial and Production Engineering Faculty of EngineeringThe Federal University of TechnologyAkure 340252Nigeria

Road accidents in the world are re-occurring *** accidents are attributed to vehicular brake pad *** safety can be sought through the use of sensors to alert the drivers before the occurrence of any failure due to worn-out brake pad;Hence brake pad sensor serves as an effective way to enhance vehicle *** this study,a non-disposable brake pad sensor was designed and fabricated to enable imminent failure alert in order to reduce the risk of road *** research approach involved the development of a software component of the *** software includes a Mikro c Pro(to write the program and compile into machine language)using a *** control aspect of the system(sensor)was developed by using Proteus Design *** designed circuitry was fabricated and tested in simulated *** test results indicated that,during normal operating condition,the tri-colour LED emits green colour signifying that the brake pad is in good condition(the integrity of the sensor connection is maintained)also the amber appearance signifying that the pad should be replaced.

关键词： Microcontroller Mikro c proteus sensor tri-LED

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Autoantibodies in chronic hepatitis c: A clinical perspective

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World Journal of Hepatology 2015年第8期7卷 1074-1085页

作者： Janaína Luz Narciso-Schiavon Leonardo de Lucca Schiavon Department of Internal Medicine Gastroenterology Division Federal University of Santa Catarina

Non-organ-specific autoantibodies and thyroid autoantibodies have been frequently found in chronic carriers of hepatitis c virus(HcV). With respect to endomysial antibodies and tissue transglutaminase, it is controversial whether the prevalence of glutenrelated seromarkers is higher in patients with HcV. In such cases, in addition to acknowledging any currently existing autoimmune disease, recognizing the risk of the patient developing an autoimmune disease during interferon(IFN)-based treatment must be a principle concern. From a clinical point-of-view, the presence of autoantibodies arouses suspicion that an autoimmunedisease may be present or may be precipitated by IFNbased HcV treatment. In this paper, we review the prevalence of autoantibodies in individuals with hepatitis c, the clinical significance of these autoantibodies, and the approach recommended for such situations.

关键词： Hepatitis c Autoimmunity Antibodies Antinuclear Hepatitis Autoimmune Thyroid diseases Hashimoto disease Thyroglobulin celiac disease Transglutaminases Diarrhea Interferon-alpha

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clinical applications of squamous cell carcinoma antigenimmunoglobulins M to monitor chronic hepatitis c

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World Journal of Hepatology 2015年第29期7卷 2913-2919页

作者： Andrea Martini Andrea Gallotta Patrizia Pontisso Giorgio Fassina Department of Medicine University of Padua Xeptagen S.p.A. VEGA Science Park

Hepatitis c virus(HcV) is the main cause of chronic liver disease and cirrhosis in Western countries. Over time, the majority of cirrhotic patients develop hepatocellular carcinoma(Hcc), one of the most common fatal cancers worldwide- fourth for incidence rate. A high public health priority need is the development of biomarkers to screen for liver disease progression and for early diagnosis of Hcc development, particularly in the high risk population represented by HcV-positive patients with cirrhosis. Several studies have shown that serological determination of a novel biomarker, squamous cell carcinoma antigen-immunoglobulins M(SccA-Ig M), might be useful to identify patients with progressive liver disease. In the initial part of this review we summarize the main clinical studies that have investigated this new circulating biomarker on HcV-infected patients, providing evidence that in chronic hepatitis c SccA-Ig M may be used to monitor progression of liver disease, and also to assess the virological response to antiviral treatment. In the last part of this review we address other, not less important, clinical applications of this biomarker in hepatology.

关键词： Hepatitis c virus Treatment Prognosis Squamous cell carcinoma antigen-immunoglobulins M cirrhosis

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Oxidative stress modulation in hepatitis c virus infected cells

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World Journal of Hepatology 2015年第29期7卷 2880-2889页

作者： Sonia A Lozano-Sepulveda Owen L Bryan-Marrugo carlos cordova-Fletes Maria c Gutierrez-Ruiz Ana M Rivas-Estilla Department of Biochemistry and Molecular Medicine School of MedicineUniversidad Autonoma de Nuevo LeonMonterreyNuevo Leon 64460Mexico Department of Health Sciences Biological Sciences and Health DivisionSchool of Biological SciencesUniversidad Autonoma Metropolitana

Hepatitis c virus(HcV) replication is associated with the endoplasmic reticulum, where the virus can induce cellular stress. Oxidative cell damage plays an important role in HcV physiopathology. Oxidative stress is triggered when the concentration of oxygen species in the extracellular or intracellular environment exceeds antioxidant defenses. cells are protected and modulate oxidative stress through the interplay of intracellular antioxidant agents, mainly glutathione system(GSH) and thioredoxin; and antioxidant enzyme systems such as superoxide dismutase, catalase, GSH peroxidase, and heme oxygenase-1. Also, the use of natural and synthetic antioxidants(vitamin c and E, N-acetylcysteine, glycyrrhizin, polyenylphosphatidyl choline, mitoquinone, quercetin, S-adenosylmethionine and silymarin) has already shown promising results as co-adjuvants in HcV therapy. Despite all the available information, it is not known how different agents with antiviral activity can interfere with the modulation of the cell redox state induced by HcV and decrease viral replication. This review describes an evidence-based consensus on molecular mechanisms involved in HcV replication and their relationship with cell damage induced by oxidative stress generated by the virus itself and cell antiviral machinery. It also describes some molecules that modify the levels of oxidative stress in HcV-infected cells.

关键词： Hepatitis c virus Oxidative stress Reactiveoxygen species Vitamin E Antioxidants Glycyrrhizin S-adenosylmethionine N-acetylcysteine Silymarin

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conformation and electronic structure of DNA in carbon nanotubes: a molecular dynamics and first-principles study

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MIcRO & NANO LETTERS 2017年第7期12卷 490-493页

作者： Zha Goujun Zhang Fayun Xinyu Univ Xinyu Peoples R China

The conformation and electronic structure of DNA in single-walled carbon nanotubes (SWcNT) were studied by combining molecular dynamics and first-principles methods. It was found that the orbital of the SWcNT inner wall induces a conformational change in single stranded DNA (ssDNA) and promotes the adsorption of general-sequence oligonucleotides on the inner walls of the SWcNTs due to - stacking interactions. Moreover, they found that the adsorbed oligonucleotides form a helix because of electrostatic and torsional interactions within the sugar-phosphate backbone.

关键词： DNA molecular biophysics molecular configurations electronic structure carbon nanotubes molecular dynamics method ab initio calculations nanobiotechnology DNA conformation electronic structure carbon nanotubes molecular dynamics method first principles study single-walled carbon nanotubes SWcNT orbital conformational change ssDNA general-sequence oligonucleotide adsorption - stacking interactions electrostatic interactions torsional interactions sugar-phosphate backbone c

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Dynamic Air-Brush Deposition Method for the New Generation of Graphene Based Supercapacitors

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MRS ADVANcES 2018年第1-2期3卷 79-84页

作者： Hondavalli, Paolo Pognon, Gregory Koumoulos, Elias charitidis, costas Natl Technol Univ Athens Thales Res & Technol Chem & Multifonct Mat Lab Athens Greece Natl Technol Univ Athens Sch Chem Engn Dept Mat Sci & Engn Athens Greece

This contribution deals with the fabrication of a new generation of supercapacitors for harsh environment (avionics) based on nanostructures layers fabricated by spray-gun deposition method. Thanks to the fabrication of electrodes using spray-gun and the utilization of specific ionic liquids developed at Thales, we were able to achieve a capacitance of 20F/g (for a whole cell) and a power of 40kW/kg using carbon nanofibres (cNFs) mixed with reduced graphene oxide (RGO). These results are not the higher values obtained in literature but they are extremely interesting considering that the final device needs to stand temperature between -55 degrees c and +105 degrees c for avionics applications and that no commercial supercaps in the world are able to work in this interval. Only using these ionic liquids and the specific electrodes, it is possible. These supercapacitors were fabricated using spray-gun deposition method which is an extremely interesting technique from an industrial point of view considering that it can be easily implemented in roll-to-roll fabrication.

关键词： energy storage nanostructure c

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Epidemiology of hepatitis c virus exposure in Egypt: Opportunities for prevention and evaluation

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World Journal of Hepatology 2015年第28期7卷 2849-2858页

作者： F DeWolfe Miller Mahmoud S Elzalabany Sara Hassani Diego F cuadros Department of Tropical Medicine Medical Microbiology and Pharmacology John A. Burns School of edicine University of Hawaii Department of Internal Medicine Ahmed Maher Teaching Hospital School of Medicine Boston University Weill Cornell Medical College-Qatar Qatar Foundation-Education City

AIM: To critically evaluate the current epidemiology data on exposures, rather than infection, to hepatitis c virus(HcV) transmission and recommend epidemiologic strategies to fill gaps. METHODS: Standard methods for identifying and evaluating relevant epidemiologic literature and available data were used. RESULTS: There is a large body of literature on the epidemiology of HcV transmission in Egypt that collectively identifies ongoing iatrogenic exposures as the major driver for HcV transmission due to short comings in infection control and standard procedures. Additional epidemiologic studies on HcV transmission that requires the participation of human subject is unwarranted. Alternatively, very little literature was found on the epidemiology of exposure to HcV, infection control, and safe injection practices. The information that is available on patterns of HcV exposure shows high frequencies of inadequate infection control, problems in sterilization in health care facilities, low rates of hand washing, untrained personnel, lack of stated policies in facilities, HcV contamination of instruments and very large injection frequencies with low but very significant syringe and needle reuse. There is an important need to increase the number, size, and diversity of epidemiologic studies on HcV exposures, patterns of risk factors for infection, infection control, and safe injection practices. In addition to health care facilities evaluation, relevant knowledge attitude and practice studies are recommended. cONcLUSION: Epidemiologic methods on HcV ex-posure can be used to characterize the magnitude of exposures to HcV infection, target interventions to reduce exposures, and provide the best method for evaluating interventions by demonstrating the reduction of exposure to HcV infection.

关键词： Epidemiology Hepatitis c virus Egypt Exposure Prevention Epidemic

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Self-Driven Graphene Tearing and Peeling: A Fully Atomistic Molecular Dynamics Investigation

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MRS ADVANcES 2018年第8-9期3卷 460-465页

作者： Fonseca, Alexandre F. Galvao, Douglas S. Univ Campinas UNICAMP Inst Phys Gleb Wataghin Appl Phys Dept BR-13083859 Sao Paulo Brazil Univ Estadual Campinas Ctr Computat Engn & Sci Sao Paulo Brazil

In spite of years of intense research, graphene continues to produce surprising results. Recently, it was experimentally observed that under certain conditions graphene can self-drive its tearing and peeling from substrates. This process can generate long, micrometer sized, folded nanoribbons without the action of any external forces. Also, during this cracking-like propagation process, the width of the graphene folded ribbon continuously decreases and the process only stops when the width reaches about few hundreds nanometers in size. It is believed that interplay between the strain energy of folded regions, breaking of carbon-carbon covalent bonds, and adhesion of graphene-graphene and graphene-substrate are the most fundamental features of this process, although the detailed mechanisms at atomic scale remain unclear. In order to gain further insights on these processes we carried out fully atomistic reactive molecular dynamics simulations using the AIREBO potential as available in the LAMMPS computational package. Although the reported tearing/peeling experimental observations were only to micrometer sized structures, our results showed that they could also occur at nanometer scale. Our preliminary results suggest that the graphene tearing/peeling process originates from thermal energy fluctuations that results in broken bonds, followed by strain release that creates a local elastic wave that can either reinforce the process, similar to a whip cracking propagation, or undermine it by producing carbon dangling bonds that evolve to the formation of bonds between the two layers of graphene. As the process continues in time and the folded graphene decreases in width, the carbon-carbon bonds at the ribbon edge and interlayer bonds get less stressed, thermal fluctuations become unable to break them and the process stops.

关键词： simulation c nanoscale

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