Colistin serves as the last line of defense against multidrug resistant Gram-negative bacterial infections in both human and veterinary medicine. This study aimed to investigate the occurrence and ...spread of colistin-resistant Enterobacterales (ColR-E) using a One Health approach in Belgium and in the Netherlands.
In a transnational research project, a total of 998 hospitalized patients, 1430 long-term care facility (LTCF) residents, 947 children attending day care centres, 1597 pigs and 1691 broilers were sampled for the presence of ColR-E in 2017 and 2018, followed by a second round twelve months later for hospitalized patients and animals. Colistin treatment incidence in livestock farms was used to determine the association between colistin use and resistance. Selective cultures and colistin minimum inhibitory concentrations (MIC) were employed to identify ColR-E. A combination of short-read and long-read sequencing was utilized to investigate the molecular characteristics of 562 colistin-resistant isolates. Core genome multi-locus sequence typing (cgMLST) was applied to examine potential transmission events.
The presence of ColR-E was observed in all One Health sectors. In Dutch hospitalized patients, ColR-E proportions (11.3 and 11.8% in both measurements) were higher than in Belgian patients (4.4 and 7.9% in both measurements), while the occurrence of ColR-E in Belgian LTCF residents (10.2%) and children in day care centres (17.6%) was higher than in their Dutch counterparts (5.6% and 12.8%, respectively). Colistin use in pig farms was associated with the occurrence of colistin resistance. The percentage of pigs carrying ColR-E was 21.8 and 23.3% in Belgium and 14.6% and 8.9% in the Netherlands during both measurements. The proportion of broilers carrying ColR-E in the Netherlands (5.3 and 1.5%) was higher compared to Belgium (1.5 and 0.7%) in both measurements. mcr-harboring E. coli were detected in 17.4% (31/178) of the screened pigs from 7 Belgian pig farms. Concurrently, four human-related Enterobacter spp. isolates harbored mcr-9.1 and mcr-10 genes. The majority of colistin-resistant isolates (419/473, 88.6% E. coli; 126/166, 75.9% Klebsiella spp.; 50/75, 66.7% Enterobacter spp.) were susceptible to the critically important antibiotics (extended-spectrum cephalosporins, fluoroquinolones, carbapenems and aminoglycosides). Chromosomal colistin resistance mutations have been identified in globally prevalent high-risk clonal lineages, including E. coli ST131 (n = 17) and ST1193 (n = 4). Clonally related isolates were detected in different patients, healthy individuals and livestock animals of the same site suggesting local transmission. Clonal clustering of E. coli ST10 and K. pneumoniae ST45 was identified in different sites from both countries suggesting that these clones have the potential to spread colistin resistance through the human population or were acquired by exposure to a common (food) source. In pig farms, the continuous circulation of related isolates was observed over time. Inter-host transmission between humans and livestock animals was not detected.
The findings of this study contribute to a broader understanding of ColR-E prevalence and the possible pathways of transmission, offering insights valuable to both academic research and public health policy development.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Biallelic pathogenic variants in SLC5A6 resulting in sodium‐dependent multivitamin transporter (SMVT) defect have recently been described as a vitamin‐responsive inborn error of metabolism ...mimicking biotinidase deficiency. To our knowledge, only 16 patients have been reported so far with various clinical phenotypes such as neuropathy and other neurologic impairments, gastro‐intestinal dysfunction and failure to thrive, osteopenia, immunodeficiency, metabolic acidosis, hypoglycemia, and recently severe cardiac symptoms.
Methods
We describe a case report of a 5‐month‐old girl presenting two recurrent episodes of metabolic decompensation and massive cardiac failure in the course of an infectious disease. We compare clinical, biological, and genetic findings of this patient to previous literature collected from Pubmed database (keywords: Sodium‐dependent multivitamin transporter (SMVT), SMVT defect/disorder/deficiency, SLC5A6 gene/mutation).
Results
We highlight the life‐threatening presentation of this disease, the stagnation of psychomotor development, the severe and persistent hypogammaglobulinemia, and additionally, the successful clinical response on early vitamin supplementation (biotin 15 mg a day and pantothenic acid 100 mg a day). Metabolic assessment showed a persistent increase of urinary 3‐hydroxyisovaleric acid (3‐HIA) as previously reported in this disease in literature.
Conclusion
SMVT deficiency is a vitamin‐responsive inborn error of metabolism that can lead to a wide range of symptoms. Increased and isolated excretion of urinary 3‐hydroxyisovaleric acid may suggest, in the absence of markedly reduced biotinidase activity, a SMVT deficiency. Prompt supplementation with high doses of biotin and pantothenic acid should be initiated while awaiting results of SLC5A6 sequencing as this condition may be life‐threatening.
We highlight the life‐threatening presentation of SMVT deficiency. Increased and isolated excretion of urinary 3‐hydroxyisovaleric acid may suggest, in the absence of markedly reduced biotinidase activity, a SMVT deficiency. Prompt supplementation with high doses of biotin and pantothenic acid should be initiated while awaiting results of SLC5A6 sequencing as this condition may be life‐threatening and a high dose of these water‐soluble vitamins seems harmless.
A key issue in implementing adaptation strategies at the landscape level is that landowners take measures on their land collectively. We explored the role of information in collective decision-making ...in a landscape planning process in the Baakse Beek region, the Netherlands. Information was provided on (a) the degree to which measures contribute to multiple purposes, (b) whether they are beneficial to stakeholders representing different sectors of land use, and (c) the need for landscape-level implementation of adaptation measures. Our analysis suggests that the negotiation process resulted in collective decisions for more collaborative adaptation measures than could be expected from individual preferences previous to the planning session. Based on the results, it is plausible that the provided information enhanced integrative agreements by leading stakeholders to realize that they were mutually interdependent, both in acquiring individual benefits as well as in implementing the measures at the landscape level. Our findings are significant in the context of the emerging insight that targeted information provision for climate adaptation of landscapes can support collaboration between the relevant stakeholders.
To compare outcomes after laparoscopic versus open major liver resection (hemihepatectomy) mainly for primary or metastatic cancer. The primary outcome measure was time to functional recovery. ...Secondary outcomes included morbidity, quality of life (QoL), and for those with cancer, resection margin status and time to adjuvant systemic therapy.
This was a multicenter, randomized controlled, patient-blinded, superiority trial on adult patients undergoing hemihepatectomy. Patients were recruited from 16 hospitals in Europe between November 2013 and December 2018.
Of the 352 randomly assigned patients, 332 patients (94.3%) underwent surgery (laparoscopic, n = 166 and open, n = 166) and comprised the analysis population. The median time to functional recovery was 4 days (IQR, 3-5; range, 1-30) for laparoscopic hemihepatectomy versus 5 days (IQR, 4-6; range, 1-33) for open hemihepatectomy (difference, -17.5% 96% CI, -25.6 to -8.4;
< .001). There was no difference in major complications (laparoscopic 24/166 14.5%
open 28/166 16.9%; odds ratio OR, 0.84;
= .58). Regarding QoL, both global health status (difference, 3.2 points;
< .001) and body image (difference, 0.9 points;
< .001) scored significantly higher in the laparoscopic group. For the 281 (84.6%) patients with cancer, R0 resection margin status was similar (laparoscopic 106 77.9%
open 122 patients 84.1%, OR, 0.60;
= .14) with a shorter time to adjuvant systemic therapy in the laparoscopic group (46.5 days
62.8 days, hazard ratio, 2.20;
= .009).
Among patients undergoing hemihepatectomy, the laparoscopic approach resulted in a shorter time to functional recovery compared with open surgery. In addition, it was associated with a better QoL, and in patients with cancer, a shorter time to adjuvant systemic therapy with no adverse impact on cancer outcomes observed.
Day care centres (DCCs) are ideal settings for drug-resistant bacteria to emerge. Prevalence numbers of faecal carriage of antimicrobial resistant bacteria in these settings are rare. We aimed to ...determine the prevalence of faecal antimicrobial resistant bacteria carriage in children attending DCCs and to assess and identify infection risk factors within DCCs in The Netherlands and Belgium.
A point-prevalence study was conducted in 28 Dutch (499 children) and 18 Belgian (448 children) DCCs. Stool samples were taken from the children's diapers and a questionnaire was filled in by their parents. Hygiene related to stool and toilet use, hygiene related to food, environmental contamination, hand hygiene and hygiene guidelines were assessed conform a standardized questionnaire by the infection prevention and control expert visiting the DCC. Multilevel logistical regression analyses were used to define which characteristics predicted the presence of extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E), carbapenemase-producing Enterobacterales (CPE), vancomycin-resistant enterococci (VRE), and ciprofloxacin-resistant Enterobacterales (CipR-E).
The ESBL-E prevalence was 16% (n = 71) in Belgium and 6% (n = 30) in the Netherlands. The CipR-E prevalence was 17% (n = 78) in Belgium and 8% (n = 38) in the Netherlands. Antimicrobial use (RR: 0.30; 95% CI: 0.33-0.48) and hospital admissions (RR: 0.37; 95% CI: 0.25-0.54) were lower in the Netherlands. Children travelling to Asia were at higher risk of being an ESBL-E carrier. Children using antimicrobials were at higher risk of being a CipR-E carrier. Cleaning the changing mat after each use was found as a protective factor for CipR-E carriage.
We established a significant difference in ESBL-E and CipR-E carriage and antimicrobial use and hospital admissions between the Netherlands and Belgium among children attending DCCs. The differences between both countries should be further studied to improve the policy on anti-microbial use and hospital admissions in children.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The European Commission is pursuing a circular bioeconomy to tackle pressing sustainability challenges, such as climate change and fossil dependency. Previous bioeconomy policy studies demonstrated ...the existence of competing bioeconomy discourses in the European Union. However, it remains nebulous how such discursive conflicts emerge and change, particularly in online settings. In this paper, we provide a more in-depth analysis of how argumentative changes of actors alter the network of online dynamic discourse coalitions. We base our findings on interviews and a qualitative discourse network analysis of 9983 tweets about European Union bioeconomy policies from the period 2008–2021. Our results indicate that initially, expert debates centred around storylines on bioeconomy advantages. After the 2012 Bioeconomy Strategy, the debate diversified with the entry of new actors and storylines. Two discourse coalitions, ‘Green future’ and ‘Planetary boundaries’, emerged around conflicting storyline clusters. In the aftermath of the 2018 Bioeconomy Strategy update, the debate simplified into core argumentations of few, highly conflicting storylines, leading to a polarization of the two discourse coalitions. Storyline hijacking further added to polarization and conflict. Understanding the evolution of online dynamic discourse coalitions provides new opportunities for practitioners to open up discourses towards storylines from other parts of the discourse network. This can help to prevent locking-in the limited range of solutions in congruence with the dominant ‘Green future’ discourse.
Display omitted
•The future of the bioeconomy in the EU is discussed controversially on X/Twitter.•Storyline diversification and simplification dynamics led to polarization.•The EU Commission is almost exclusively part of one side of the discourse network.•EU bioeconomy debates head towards a problematic discursive lock-in.•To open up the debate, include ideas of other parts of the discourse network.
•The collective dimensions of socio-ecological management challenges are often not acknowledged.•Whether diseases (‘public bads’) require a public good response depends on specific social and ...agro-ecological factors.•Local management challenges cannot be addressed only at the community level.•Combining environmental monitoring and citizen science may foster systemic learning.•More attention is needed for the responsible design of digital citizen science platforms.
Rural communities in Africa are facing numerous challenges related to human health, agricultural production, water scarcity and service delivery. Addressing such challenges requires effective collective action and coordination among stakeholders, which often prove difficult to achieve. Against the background of the increased availability of information and communication technologies (ICTs), this article synthesizes the lessons from six case-studies reported in this Special Issue. The cases investigate the possible role of digital citizen science platforms (labelled EVOCAs: Environmental Virtual Observatories for Connective Action) in overcoming the challenges of integrating heterogeneous actors in collective management of common resources and/or the provision of public goods. Inspired by the seminal work of Elinor Ostrom, our expectation was that such platforms could help operationalize communication and information-related design principles and community conditions that are known to enhance the capacity to address environmental challenges.
This article presents some cross-cutting insights and reflections regarding the nature of the challenges identified by the diagnostic studies, and on the relevance and significance of Ostrom’s framework and analysis. It also reflects on the plausibility of our original ideas and assumptions by assessing what the various studies tell us about the significance and potential of key components of an EVOCA-type intervention: i.e. environmental monitoring, ICT, connective action, citizen science and responsible design. At the same time, we draw lessons for follow-up research and action in our research program and beyond by identifying several issues and themes that merit further investigation.
Based on the case-studies, we conclude that many collective action challenges are of a more complex nature than originally anticipated, and often cannot be resolved within clearly demarcated communities. While this complicates the realization of Ostrom’s communication and information-related design principles and community features, there may still be a meaningful role for digital citizen science platforms. To help address complex challenges, they must be oriented towards fostering adaptive and systemic learning across interdependent stakeholder communities, rather than focusing on the self-betterment of the communities alone. Such digital platforms need to be developed in a responsible manner that ensures complementarity with already existing patterns of communication and ICT-use, that anticipates dynamics of trust and distrust among interdependent stakeholders, and that prevents typical problems associated with the sharing of information such as privacy infringement and undesirable control over information by outsiders.
Muon track reconstruction and data selection techniques in AMANDA Ahrens, J.; Bai, X.; Bay, R. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
05/2004, Letnik:
524, Številka:
1
Journal Article
Recenzirano
Odprti dostop
The Antarctic Muon And Neutrino Detector
Array (AMANDA) is a high-energy neutrino telescope operating at the geographic South Pole. It is a lattice of photo-multiplier tubes buried deep in the polar ...ice between 1500 and
2000
m
. The primary goal of this detector is to discover astrophysical sources of high-energy neutrinos. A high-energy muon neutrino coming through the earth from the Northern Hemisphere can be identified by the secondary muon moving upward through the detector.
The muon tracks are reconstructed with a maximum likelihood method. It models the arrival times and amplitudes of Cherenkov photons registered by the photo-multipliers. This paper describes the different methods of reconstruction, which have been successfully implemented within
AMANDA. Strategies for optimizing the reconstruction performance and rejecting background are presented. For a typical analysis procedure the direction of tracks are reconstructed with about 2° accuracy.
Solid waste treatment options (recycling, incineration, and landfilling; the two latter processes both with co-generation of heat and electricity) have been studied for cardboard, newspaper, ...polyethylene, poly(ethylene terephthalate), polypropylene, polystyrene, and poly(vinyl chloride) waste. The conversion processes have been analyzed in terms of the second law of thermodynamics. The analysis allows calculating the exergy (useful energy) embodied in conversion products that can be obtained from the required inputs for the treatment processes. Taking into account the waste materials and the resources to convert them, it proved that recycling is the most efficient option for polyethylene with an efficiency of 62.5% versus 43.6% for incineration and 0.9% for landfilling. Next, waste treatment has been put into the broader perspective of industrial ecology. Exergetic efficiencies of industrial metabolic options have been calculated. Here resources for manufacturing and converting solid products have been considered. Furthermore, selection of one type of conversion excludes the generation of other potential conversion products. Therefore, it has to be taken into account that these latter products still have to be produced starting from virgin resources. Recycling proved to be the most efficient strategy: the ratio η between exergy embodied in all delivered products on one hand, and all exergy withdrawn from the ecosphere or from waste materials on the other hand, is the highest. For polyethylene, η proved to be 0.568, whereas η is 0.503 and 0.329 for incineration and landfilling, respectively. On the other hand, if R the ratio between exergy of delivered products on one hand and exergy of virgin materials on the other hand is calculated, the differences between the industrial metabolic options are larger. Recycling polyethylene showed a ratio R of 0.936, whereas ratios of 0.772 and 0.531 were found for incineration and landfilling, respectively. It has been shown that the exergy concept allows a quantitative comparison of different industrial metabolic options, contributing to a better assessment of sustainability of technology with respect to resource management.
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