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Bacterial infection contributes to the bioburden of wounds, which is an essential factor in determining whether a wound can heal. Wound dressings with antibacterial properties that can promote wound-healing are highly desired for the treatment of chronic wound infections. Herein, we fabricated a simple polysaccharide-based hydrogel dressing encapsulating tobramycin-loaded gelatine microspheres with good antibacterial activity and biocompatibility. We first synthesised long-chain quaternary ammonium salts (QAS) by the reaction of tertiary amines with epichlorohydrin. The amino groups of carboxymethyl chitosan were then conjugated with QAS through the ring-opening reaction and QAS-modified chitosan (CMCS) was obtained. The antibacterial analysis showed that both QAS and CMCS could kill E. coli and S. aureus at relatively low concentrations. QAS with 16 carbon atoms has a MIC of 16 μg/mL for E. coli and 2 μg/mL for S. aureus. A series of formulations of tobramycin-loaded gelatine microspheres (TOB-G) were generated and the best formulation was selected by comparing the characters of the microspheres. The microsphere fabricated by 0.1 mL GTA was selected as the optimal candidate. We then used CMCS, TOB-G, and sodium alginate (SA) to prepare physically crosslinking hydrogels using CaCl2 and investigated the mechanical properties, antibacterial activity, and biocompatibility of the hydrogels. In summary, the hydrogel dressing we produced can be used as an ideal alternative for the management of bacteria-infected wounds. [ABSTRACT FROM AUTHOR]

Bacterial infection contributes to the bioburden of wounds, which is an essential factor in determining whether a wound can heal. Wound dressings with antibacterial properties that can promote wound-healing are highly desired for the treatment of chronic wound infections. Herein, we fabricated a simple polysaccharide-based hydrogel dressing encapsulating tobramycin-loaded gelatine microspheres with good antibacterial activity and biocompatibility. We first synthesised long-chain quaternary ammonium salts (QAS) by the reaction of tertiary amines with epichlorohydrin. The amino groups of carboxymethyl chitosan were then conjugated with QAS through the ring-opening reaction and QAS-modified chitosan (CMCS) was obtained. The antibacterial analysis showed that both QAS and CMCS could kill E. coli and S. aureus at relatively low concentrations. QAS with 16 carbon atoms has a MIC of 16 μg/mL for E. coli and 2 μg/mL for S. aureus. A series of formulations of tobramycin-loaded gelatine microspheres (TOB-G) were generated and the best formulation was selected by comparing the characters of the microspheres. The microsphere fabricated by 0.1 mL GTA was selected as the optimal candidate. We then used CMCS, TOB-G, and sodium alginate (SA) to prepare physically crosslinking hydrogels using CaCl2 and investigated the mechanical properties, antibacterial activity, and biocompatibility of the hydrogels. In summary, the hydrogel dressing we produced can be used as an ideal alternative for the management of bacteria-infected wounds.

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This paper discusses the development and implementation of a smoking cessation training program for diabetes nurse educators. People with diabetes who smoke have a significantly higher risk of morbidity and mortality. Smoking greatly increases diabetes complications. Surveys were conducted to ascertain how frequently nurses counseled patients to quit and their interest in cessation training. Observations of nursepatient interactions and interviews with diabetes nurses facilitated the development of a culturally sensitive cessation training program. Survey results revealed that diabetes nurse educators recognized the need for training in smoking cessation, as many patients with diabetes do not consider smoking to be harmful for their health. A two-day workshop was developed for nurses on the specific harms of smoking for diabetes patients, including hands-on training in cessation counseling and motivational interviewing. Two months after training, nurses reported that the skills they acquired gave them confidence to counsel patients but identified four challenges to conducting cessation in their clinical settings. Diabetes nurse educators can play a pivotal role in delivering cessation. Training and overcoming challenges to implementation are urgently needed in the time of coronavirus disease 2019 given the dual risks of diabetes and smoking for severe complications. [ABSTRACT FROM AUTHOR]

Introduction Smoking cessation is a key clinical intervention for reducing progressive lung destruction and lung function deterioration in patients with Chronic Obstructive Pulmonary Disease (COPD). Specialised Tobacco Cessation Guidelines for High-risk Groups (TOB-G) were developed and published in 2017 that present evidence-based recommendations to support smoking cessation in COPD patients. The purpose of this pilot study was to examine the real world effectiveness of the TOB-G guideline recommendations among a sample of COPD patients. Methods A pilot study was conducted among a sample of COPD patients who smoke and were interested in quitting. Participants were recruited from inpatient and outpatient hospital admissions between October and December 2016 in Iasi, Romania. The intervention program was designed based on the recommendations of the TOB-G guidelines for COPD patients. Patients received a total of four contacts: at baseline, 1, 2, and 6 months. The primary outcome measure was biochemically validated point prevalence smoking abstinence measured at 6 months. Results Fifty patients (74% male; age mean±SD = 60.2±7.8) with diagnosed COPD took part in the pilot study. Self-reported rates of point prevalence smoking abstinence were 30.6%, 44.9% and 64.6% at the 1-, 2-, and 6-month follow-up, respectively. Carbon monoxide testing was completed with 51.6% of the sample at 6 months. The biochemically verified abstinent rate was 33.3% at the 6-month follow-up. Conclusions This pilot testing of the TOB-G Clinical Practice Guidelines for COPD patients was associated with high rates of patient smoking abstinence, which are of clinical importance. Further research is needed to evaluate the guidelines large-scale effectiveness in clinical practice.

Introduction: The reading of antibiotic sensitivity testing goes beyond the determination of the bacterial sensitivity profile. The interpretive reading of antibiotic susceptibility tests based on different patterns observed with beta-lactam agents is proposed in this article, which will provide an understanding of the identification of unusual patterns, interpretation of possible resistance phenotypes based on existing knowledge in antibiotic resistance mechanisms. Methods: Antimicrobial susceptibility testing of 320 isolates of gram-negative bacterial pathogens isolated from clinical samples were performed using various phenotypic methods for the detection of resistance mechanisms. Interpretive reading of the antibiogram data was performed to investigate the unusual resistance mechanisms from resistance phenotype. Results: Out of 249 isolates 128 isolates (59%) were positive for cefoxitin screen. Out of these 128 isolates, 86 (67%) were extended spectrum beta-lactamase (ESBL) co-producers. Distorted patterns of antibiotic inhibition zones in the presence of beta-lactamase-inducing agent provide information which is not otherwise evident from conventional methods. Discussion: Distorted morphology of antibiotic inhibition zones in the presence of beta-lactamase-inducing agent provides information which is not otherwise evident from routine testing by conventional methods. Conclusion: The antibiotic susceptibility patterns observed on antimicrobial susceptibility testing (AST) plate for isolates harboring multiple resistance can be obscure. Hence, it is important to practice mindfulness while reporting in microbiology laboratories in this era of increased antimicrobial resistance; to promptly identify the resistant pathogens, to prevent its spread and for better patient outcomes by selecting the most suitable drug even in resource-limited settings. [ABSTRACT FROM AUTHOR]

Given a quaternionic form G of a p-adic classical group (p odd) we classify all cuspidal irreducible representations of G with coefficients in an algebraically closed field of characteristic different from p. We prove two theorems: At first: Every irreducible cuspidal representation of G is induced from a cuspidal type, i.e. from a certain irreducible representation of a compact open subgroup of G , constructed from a β -extension and a cuspidal representation of a finite group. Secondly we show that two intertwining cuspidal types of G are up to equivalence conjugate under some element of G . [ABSTRACT FROM AUTHOR]

INTRODUCTION Tobacco smoking poses a significant threat to the health of individuals living with diabetes. Intensive stand-alone smoking cessation interventions, such as multiple or long (>20 minutes) behavioral support sessions focused solely on smoking cessation, with or without the use of pharmacotherapy, increase abstinence when compared to brief advice or usual care in the general population. However, there is limited evidence so far for recommending the use of such interventions amongst individuals with diabetes. This study aimed to assess the effectiveness of intensive stand-alone smoking cessation interventions for individuals living with diabetes and to identify their critical features. METHODS A systematic review design with the addition of a pragmatic intervention component analysis using narrative methods was adopted. The key terms 'diabetes mellitus' and 'smoking cessation' and their synonyms were searched in 15 databases in May 2022. Randomized controlled trials which assessed the effectiveness of intensive stand-alone smoking cessation interventions by comparing them to controls, specifically amongst individuals with diabetes, were included. RESULTS A total of 15 articles met the inclusion criteria. Generally, the identified studies reported on the delivery of a multi-component behavioral support smoking cessation intervention for individuals with type I and type II diabetes, providing biochemically verified smoking abstinence rates at follow-up at six months. The overall risk-of-bias of most studies was judged to be of some concern. Despite observing inconsistent findings across the identified studies, interventions consisting of three to four sessions, lasting more than 20 min each, were found to be more likely to be associated with smoking cessation success. The additional use of visual aids depicting diabetes-related complications may also be useful. CONCLUSIONS This review provides evidence-based smoking cessation recommendations for use by individuals with diabetes. Nonetheless, given that the findings of some studies were found to be possibly at risk-of-bias, further research to establish the validity of the provided recommendations is suggested. [ABSTRACT FROM AUTHOR]

This study aims to assess the environmental impacts and the energy efficiency of organic and conventional vegetable production in Palas Basin, Kayseri, Turkey. Three organic and three conventional farmers representing the vegetable production in the region participated in face‐to‐face questionnaires. Life cycle assessment (LCA) was implemented to assess the global warming potential (GWP), eutrophication potential (EP), acidification potential (AP), and energy use, which were selected as environmental impact potentials. Additionally, the environmental risk assessment was conducted to understand the impact of pesticide use in the region. Six farmers were investigated individually, and it was found that all of the farmers had a common cultivation calendar, but there were differences in the application. Particularly, mineral fertilizer use and irrigation were excessive in some agricultural practices. Although the use of N‐ and P‐based mineral fertilizers was one of the main differences between organic and conventional farming, irrigation was a common practice. Irrigation, the most influential practice, elevated not only water consumption but also EP, AP, and GWP as a result of electricity consumption by electrical pumps. Electricity consumption from irrigation contributed to the GWP most, and this value was in the range of 45%–95%. Mineral fertilizer use covered up to 40% of the EP, 31% of the GWP, and 37% of the AP for conventional farmers. Three different scenarios were developed to reduce the environmental impacts of the use of excessive mineral fertilizer and irrigation. The developed scenarios recommended the reductions by 38%, 44%, 25%, and 60% in GWP, EP, AP, and total energy inputs, respectively. This study demonstrates that LCA is beneficial in determining the environmental impact of hotspots in vegetable production and allows the development of different solutions to mitigate environmental impacts for agricultural sustainability. Integr Environ Assess Manag 2022;18:1733–1746. © 2022 SETAC KEY POINTS: The main difference between organic and conventional farming was determined as inorganic mineral fertilizers that mostly affected eutrophication potential and the indirect energy.Among all agricultural inputs, electricity was detected as an environmental impact hotspot contributing to the global warming potential from 45% to 95% and the direct energy up to 83.21% regardless of organic or conventional farming.It can be concluded that the prohibition of synthetic inputs for organic farming reduces environmental impacts and contributes to higher energy efficiency.The LCA approach used in the study could be used to determine the environmental impacts of mixed vegetable production and develop the different scenarios for reducing these environmental impacts by energy savings and less greenhouse gas emissions for environmental sustainability. [ABSTRACT FROM AUTHOR]

Extra virgin olive oil (EVOO) from Olea europaea L. drupes, a cornerstone in the Mediterranean diet, is well known for its nutritional and health properties, especially for prevention of cardiovascular diseases and metabolic disorders. Traditionally, beneficial health effects have been largely attributed to the high concentration of monounsaturated fatty acids, and in recent years, these have also been related to other components including oleacein and oleocanthal. Here, we evaluated, for the first time, the antimicrobial activity of different green extra virgin olive oil-based formulations in natural deep eutectic solvents (NaDESs) emerging as powerful and biocompatible solvents. Specifically, the antimicrobial activity of the EVOO extract, as well as purified oleocanthal and oleacein in two NaDESs (choline/glycerol and choline/propylene glycol), against several drug-resistant clinical isolates and standard microbial strains has been evaluated. The main result was the inhibitory activity of the EVOO extract in choline/glycerol as well as oleacein in choline/propylene glycol toward drug-resistant Gram-positive and -negative strains. Specifically, the EVOO extract in choline/glycerol showed the highest antibacterial activity against several clinical strains of Staphylococcus aureus , whereas oleacein in choline/propylene glycol was the most effective toward various clinical strains of Escherichia coli , Pseudomonas aeruginosa , and Klebsiella pneumoniae. In addition, all the formulations tested were effective against Candida spp. In conclusion, our results suggest EVOO-based formulations in NaDESs as an interesting strategy that may help in reducing the risk of development of drug resistance. Under this perspective, the usage of NaDESs for the preparation of new antimicrobial formulations may represent a promising approach. [ABSTRACT FROM AUTHOR]

In this paper, we consider a model of social coordination and network formation, where players of two groups play a 2 × 2 coordination game when they are connected. Players in one group actively decide on whom they play with and on the action in the game, while players in the other group decide on the action in the game only and passively accept all the connections from the active group. The players in the active group can connect to a limited number of opponents in the other group. We find that the selection of long-run outcomes is determined by the population size of each group, not the overall population size of them. If either group's population size is small in comparison to the number of maximally allowed links, all players will choose the risk-dominant equilibrium, while when both groups are sufficiently large with respect to the number of maximally allowed links, the players of the two groups will coordinate on the payoff-dominant action. [ABSTRACT FROM AUTHOR]

INTRODUCTION In 2018, the European Network for Smoking Cessation and Prevention (ENSP) released an update to its Tobacco Treatment Guidelines for healthcare professionals, which was the scientific base for the development of an accredited eLearning curriculum to train healthcare professionals, available in 14 languages. The aim of this study was to evaluate the effectiveness of ENSP eLearning curriculum in increasing healthcare professionals' knowledge, attitudes, self-efficacy (perceived behavioral control) and intentions in delivering tobacco treatment interventions in their daily clinical routines. METHODS We conducted a quasi-experimental pre-post design study with 444 healthcare professionals, invited by 20 collaborating institutions from 15 countries (Albania, Armenia, Belgium, Italy, France, Georgia, Greece, Kosovo, Romania, North Macedonia, Russia, Serbia, Slovenia, Spain, Ukraine), which completed the eLearning course between December 2018 and July 2019. RESULTS Healthcare professionals' self-reported knowledge improved after the completion of each module of the eLearning program. Increases in healthcare professionals' self-efficacy in delivering tobacco treatment interventions (p<0.001) were also documented. Significant improvements were documented in intentions to address tobacco use as a priority, document tobacco use, offer support, provide brief counselling, give written material, discuss available medication, prescribe medication, schedule dedicated appointment to develop a quit plan, and be persistent in addressing tobacco use with the patients (all p<0.001). CONCLUSIONS An evidence-based digital intervention can be effective in improving knowledge, attitudes, self-efficacy and intentions on future delivery of tobacco-treatment interventions. [ABSTRACT FROM AUTHOR]

INTRODUCTION This paper provides an up-to-date summary of the effects of smoking in pregnancy as well as challenges and best practices for supporting smoking cessation in maternity care settings. METHODS We conducted a qualitative review of published peer reviewed and grey literature. RESULTS There is strong evidence of the effects of maternal tobacco use and secondhand smoke exposure on adverse pregnancy outcomes. Tobacco use is the leading preventable cause of miscarriage, stillbirth and neonatal deaths, and evidence has shown that health effects extend into childhood. Women who smoke should be supported with quitting as early as possible in pregnancy and there are benefits of quitting before the 15th week of pregnancy. There are a variety of factors that are associated with tobacco use in pregnancy (socioeconomic status, nicotine addiction, unsupportive partner, stress, mental health illness etc.). Clinical-trial evidence has found counseling, when delivered in sufficient intensity, significantly increases cessation rates among pregnant women. There is evidence that the use of nicotine replacement therapy (NRT) may increase cessation rates, and, relative to continued smoking, the use of NRT is considered safer than continued smoking. The majority of women who smoke during pregnancy will require support throughout their pregnancy, delivered either by a trained maternity care provider or via referral to a specialized hospital or community quitsmoking service. The 5As (Ask, Advise, Assess, Assist, Arrange) approach is recommended for organizing screening and treatment in maternity care settings. Additionally, supporting smoking cessation in the postpartum period should also be a priority as relapse rates are high. CONCLUSIONS There have been several recent updates to clinical practice regarding the treatment of tobacco use in pregnancy. It is important for the latest guidance to be put into practice, in all maternity care settings, in order to decrease rates of smoking in pregnancy and improve pregnancy outcomes. [ABSTRACT FROM AUTHOR]

In this paper, we tackle the problem of joint angle and delays estimation (JADE) of multiple reflections of a known signal impinging on multiple receiving antennae. Based on the importance sampling (IS) concept, we propose a new non-iterative maximum likelihood (ML) estimator that enjoys guaranteed global optimality and enhanced high-resolution capabilities for both single- and multi-carrier models. The new ML approach succeeds in transforming the original multi-dimensional optimization problem into multiple two-dimensional ones thereby resulting in huge computational savings. Moreover, it does not suffer from the off-grid problems that are inherent to most existing JADE techniques. By exploiting the sparsity feature of a carefully designed pseudo-pdf that is intrinsic to the new estimator, we also propose a novel approach that enables the accurate detection of the unknown number of paths over a wide range of practical signal-to-noise ratios (SNRs). Computer simulations show the distinct advantage of the new ML estimator over state-of-the art JADE techniques both in the single- and multi-carrier scenarios. Most remarkably, they suggest that the proposed IS-based ML JADE is statistically efficient as it almost reaches the Camér-Rao lower bound (CRLB) even in the adverse conditions of low SNR levels. Using real-world channel measurements collected from four access points (APs) with IEEE 802.11ac standard’s setup parameters in an indoor environment, we also show that the proposed ML estimator achieves a localization performance below 15 cm accuracy. [ABSTRACT FROM AUTHOR]

Two-dimensional linear waves at a contaminated interface separating two infinitely deep fluids of arbitrary densities and viscosities are investigated. The contamination is modeled as a massless monolayer, which may result from insoluble surfactants, and introduces interfacial elasticity. Thus, the interface supports two wave modes: transverse, capillary-gravity waves (CG-waves) and longitudinal, Marangoni waves (M-waves). A comprehensive dispersion relation is derived; it can be solved numerically to obtain the complex-valued frequency as a function of the irrotational wavenumber for the CG-waves and for the M-waves. The CG-waves are analyzed in this paper; the M-waves are analyzed in a separate work. The main result here is the derivation of an operational approximate formula for the temporal decay rate of the CG-waves. Its predictions are compared to the available measurements of (laboratory) gravity waves, ocean swell, and (laboratory) capillary waves. It is shown that the previously published decay rate models, which include either the effects due to an upper fluid or those due to interfacial contamination (but not both), are limiting cases of the present model. A parametric study of decay rate predictions shows that there are systems including ocean swell for which the influence of both the dynamics of the upper fluid and of the contamination are significant. [ABSTRACT FROM AUTHOR]

Background: Many pregnant women smoke despite the extensive data available on the detrimental perinatal outcomes. The aim of this study was to estimate the prevalence of smoking during pregnancy and to identify the factors associated with smoking among pregnant women in Northern Greece. Methods: A sample of pregnant women (mean gestational age: 12.6weeks) participated in a cross-sectional study assessing the prevalence of smoking. Univariate and multivariate logistic regression analyses were used to examine the factors associated with their smoking behavior. Results: A total of 3688 pregnant women (mean age: 31.1 ± 5.0years) completed the survey. On the basis of their answers, 36.1% (n = 1330) were smokers before pregnancy and 13.2% (n =487) were still smoking at the end of the first trimester. Eight hundred and forty-three women (63.4%) gave up smoking, apparently motivated by their pregnancy. A multivariate analysis showed an independent positive association of nulliparity, Greek ethnicity, age>35years and a BMI>30 with smoking before pregnancy. Smoking during pregnancy was more common among naturally conceived pregnancies and women with a BMI >30.Cessation rates were lower for naturally conceived pregnancies, immigrants and multiparous women. Conclusion: About one third of women who smoked before pregnancy continued to smoke during pregnancy. Naturally conceiving, multiparous and immigrant women are less likely to quit smoking when pregnant. Tailored smoking cessation interventions should target women early in their pregnancy. [ABSTRACT FROM AUTHOR]

The Romanian Society of Pneumologists (RSP) has developed its first guideline, "the Smoking Cessation and Smoker's Assistance Guidelines" (GREFA), in 2008, along with the pocket version as a quick work tool for nurses and practitioners from clinical settings, but also with an introductory supplement, meant to initiate specialists who assist smoking patients in the basic notions of approaching tobacco use and dependence. The GREFA Guideline was updated and revised in 2010 and later served as the background for the European Smoking Cessation guideline developed in 2012, in collaboration with experts from Greece, Turkey, Sweden, Ireland, France and Russia, from the European Network for Smoking And Tobacco Prevention (ENSP). The ENSP 2012 Guideline was translated into Romanian, and this version was launched at the Conference of the Tabacology Section of the RSP in November 2013, in Pitesti. In the next years, under ENSP umbrella, educational projects have been possible and have allowed the ENSP 2012 Guideline to be upgraded in a newer and more accessible version in several European countries benefiting from these projects with the support of ENSP and Global Bridges USA. From these educational projects (EPACTT 1 and EPACTT 2), the 2015 and 2017 editions of the ENSP smoking cessation guidelines were published on the ENSP website (www.ensp.org) in English, Romanian, Armenian, Russian, Ukrainian, Turkish, Georgian, etc. The collaboration between the members of the tabacology section of RSP and ENSP on the development of guidelines in this field has moved into a new phase through the ongoing European projects. We refer here to the TOB G project dedicated to guidelines for high risk patients: pregnancy, adolescents, cardiovascular disease, type 2 diabetes, COPD, and to the international tobacco control project in 6 European countries (EUREST PLUS). [ABSTRACT FROM AUTHOR]

Let S be a smooth affine algebraic curve, and let S˚ be the Riemann surface obtained by removing a point from S. We provide evidence for the congruence subgroup property of mapping class groups by showing that the congruence kernel ker (Mod(S˚) → Out(π1(S˚))) lies in the centralizer of every braid in Mod(S˚) As a corollary, we obtain a new proof of Asada's theorem that the congruence subgroup property holds in genus one. We also obtain simple-connectivity of Boggi's procongruence curve complex ĕ (S˚) when S is affine, and a new proof of Matsumoto's theorem that the congruence kernel depends only on the genus in the affine case. [ABSTRACT FROM AUTHOR]

Bacterial biofilm formation has been implicated in the high incidence of persistent otorrhoea after tympanostomy tube insertion. The aim of the study was to investigate whether biofilm formation on tympanostomy tubes depends on the genetic profile of methicillin-resistant Staphylococcus aureus (MRSA) strains. Capacity of biofilm formation on fluoroplastic tympanostomy tubes (TTs) was tested on 30 MRSA strains. Identification and methicillin resistance were confirmed by PCR for nuc and mecA genes. Strains were genotypically characterised (SCC mec, agr and spa typing). Biofilm formation was tested in microtiter plate and on TTs. Tested MRSA strains were classified into SCC mec type I (36.7 %), III (23.3 %), IV (26.7 %) and V (13.3 %), agr type I (50 %), II (36.7 %) and III (13.3 %), and 5 clonal complexes (CCs). All tested MRSA strains showed ability to form biofilm on microtiter plate. Capacity of biofilm formation on TTs was as following: 13.3 % of strains belonged to the category of no biofilm producers, 50 % to the category of weak biofilm producers and 36.7 % to moderate biofilm producers. There was a statistically significant difference between CC, SCC mec and agr types and the category of biofilm production on TTs tubes ( p < 0.001): CC5, SCC mecI type and agrII type with a moderate amount of biofilm, and CC8 and agrI type with a low amount of biofilm. Biofilm formation by MRSA on TTs is highly dependent on genetic characteristics of the strains. Therefore, MRSA genotyping may aid the determination of the possibility of biofilm-related post-tympanostomy tube otorrhea. [ABSTRACT FROM AUTHOR]