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Background Italy records very alarming levels antimicrobial resistance (AMR), so a National Action Plan on Antimicrobial resistance (PNCAR) was developed, adopting the AMR European Union’s recommendations based on the results of the ECDC site visit of January 2017. For achieving PNCAR objectives, it is necessary to support and harmonize the implementation of recommendations in all the different healthcare levels (regional authorities and local trusts), so the SPiNCAR project was launched to create a tool for reaching this goal. Methods We developed a framework based on a scientific literature and national and international guidelines. Firstly, we identified the major intervention areas for tackling AMR, then, for each area, we built a set of standards, both for regional authorities than for local trusts. Every standard is composed by a set of essential and additional criteria, which refer to a minimum or supplemental performance level respectively. The contents were firstly discussed by the project’s team during face-to-face kick-off meetings, then confirmed with Delphi methodology and finally validated through a pilot study. Results The final framework consists of seven different areas that reflect the PNCAR structure: Governance, Surveillance and Monitoring, Appropriate Use of antimicrobials, Healthcare-associated Infections (HAIs) control and prevention, Education and Training, Alliance among Stakeholders, Implementation. The total number of standards for the regional framework was 34 with 264 criteria and for the local version 36 criteria with 279 standards. Conclusion The ongoing use of this tool, developed on international evidences and recommendations that were tailored on the Italian specific context, allows monitoring the improvement achieved over time and plan the next steps.

It's a difficult enough job to maintain a steady medical practice in today's challenging health care environment, let alone grow and expand your business. Administrative burdens, scheduling, answering the phones, [...]

Organic solar cells (OSCs) have increased their power conversion efficiency above 18% thanks to the use of non-fullerene acceptors in binary or ternary blends or in tandem configurations. In this article, a study on the lifetime of P3HT:O-IDTBR bulk heterojunction OSCs on ITO-free flexible substrates is presented. A direct comparison of glass–glass and plastic–plastic encapsulation performance, with a special focus on its effect on the lifetime of the devices after degradation procedures, has been carried out complying with the ISOS protocols for organic photovoltaic devices. The manufactured OSCs with 1 cm2 active layer have power conversion efficiencies ranging from 1.9 to 3.4% depending on the encapsulant material, encapsulation process, and substrate. An exponential degradation rate has been found, with a similar functional behavior for glass and plastic differing in the degradation constants, which ranges from k = 0.01 to 0.002 h−1. Only in one case, the ISOS-T3 essay for plastic encapsulation, a double exponential process, was observed with degradation rates of k1 = 0.03 h−1 and a second slower process with k2 = 0.001 h−1. The longest achieved T80 lifetime is 86 h for glass-encapsulated devices under an accelerated ISOS-T3 protocol.

Only a few earlier clinical radiologic reports exist describing post-COVID-19 pulmonary fibrosis. We report a case of 74-year-old woman referred with dizziness and hypoxemic respiratory failure with chest high resolution computer tomography (HRCT) showing ground glass opacities and emphysema. The patient was tested for Sars-CoV-2 and resulted positive, she was treated with medical therapy and supported with mechanical ventilation. Despite initial clinical and radiological improvements, subsequently the respiratory failure worsened as ground glass opacities evolved, with the appearance of combined pulmonary fibrosis and emphysema and the patient eventually died. Development of pulmonary fibrosis after SARS-CoV-2 infection and the overlap with preexistent emphysema could be a fatal complication.

As the rise of nonfullerene acceptors (NFA) has allowed lab‐scale organic solar cells (OSC) to reach 20% efficiency, translating these devices into roll‐to‐roll compatible fabrication still poses many challenges for researchers. Among these are the use of green solvent solubility for large‐scale manufacture, roll‐to‐roll compatible fabrication, and, not least, information on charge carrier dynamics in each upscaling step, to further understand the gap in performance. In this work, the reproducibility of champion devices using slot‐die coating with 14% power conversion efficiency (PCE) is demonstrated, under the condition that the optimal thickness is maintained. It is further shown that for the donor:acceptor (D:A) blend PM6:Y12, the processing solvent has a more significant impact on charge carrier dynamics compared to the deposition technique. It is found that the devices processed with o‐xylene feature a 40% decrease in the bimolecular recombination coefficient compared to those processed with CB, as well as a 70% increase in effective mobility. Finally, it is highlighted that blade‐coating yields devices with similar carrier dynamics to slot‐die coating, making it the optimal choice for lab‐scale optimization with no significant loss in translation toward up‐scale. [ABSTRACT FROM AUTHOR]

Populism and institutions have been characterized as antithetical to each other by Ernesto Laclau. Yet the Latin American pink tide has offered many instances of left populism in power, with Rafael Correa's Ecuador representing a prime example of the enmeshment between populist rhetoric and technocratic construction. Some accounts have emerged to make room for the latter, while ultimately failing to capture much of the dynamics at play. One of the chief questions is that the simple enlargement of the State cannot be taken as a trustworthy indicator of the stability and regularity of the new institutions. In order to secure their sustainability, these need to be propped up by accountable governance and a broader cultural transformation. By neglecting such aspects, left populism in Ecuador has left behind a mixed record in terms of institutional legacy. From a normative viewpoint, populism is thus conceived as a transitional device which can usher in a new institutionality, but, if some of its 'vices' are excessively protracted, it may be indicative of its failure to instil a new hegemony and its institutional achievements may be subject to a swift dismantling. [ABSTRACT FROM AUTHOR]

A physician has an 88% chance of facing a malpractice lawsuit during their career, according to Hugh Francis III, M.D., chair of the board at State Volunteer Mutual Insurance Company [...]

Physicians are hardworking professionals. But did you know that many of your colleagues work multiple jobs? In our 202 Medical Economics[R] Physician Report, nearly one out of three physicians told [...]

Abstract Identification of small open reading frames (smORFs) encoding small proteins (≤ 100 amino acids; SEPs) is a challenge in the fields of genome annotation and protein discovery. Here, by combining a novel bioinformatics tool (RanSEPs) with “‐omics” approaches, we were able to describe 109 bacterial small ORFomes. Predictions were first validated by performing an exhaustive search of SEPs present in Mycoplasma pneumoniae proteome via mass spectrometry, which illustrated the limitations of shotgun approaches. Then, RanSEPs predictions were validated and compared with other tools using proteomic datasets from different bacterial species and SEPs from the literature. We found that up to 16 ± 9% of proteins in an organism could be classified as SEPs. Integration of RanSEPs predictions with transcriptomics data showed that some annotated non‐coding RNAs could in fact encode for SEPs. A functional study of SEPs highlighted an enrichment in the membrane, translation, metabolism, and nucleotide‐binding categories. Additionally, 9.7% of the SEPs included a N‐terminus predicted signal peptide. We envision RanSEPs as a tool to unmask the hidden universe of small bacterial proteins.

Sources of suboxides, providing several advantages over metal sources for the molecular beam epitaxy (MBE) of oxides, are conventionally realized by decomposing the corresponding oxide charge at extreme temperatures. By quadrupole mass spectrometry of the direct flux from an effusion cell, we compare this conventional approach to the reaction of a mixed oxide + metal charge as a source for suboxides with the examples of SnO2 + Sn → 2 SnO and Ga2O3 + 4 Ga → 3 Ga2O. The high decomposition temperatures of the pure oxide charge were found to produce a high parasitic oxygen background. In contrast, the mixed charges reacted at significantly lower temperatures, providing high suboxide fluxes without additional parasitic oxygen. For the SnO source, we found a significant fraction of Sn2O2 in the flux from the mixed charge that was basically absent in the flux from the pure oxide charge. We demonstrate the plasma-assisted MBE growth of SnO2 using the mixed Sn + SnO2 charge to require less activated oxygen and a significantly lower source temperature than the corresponding growth from a pure Sn charge. Thus, the sublimation of mixed metal + oxide charges provides an efficient suboxide source for the growth of oxides by MBE. Thermodynamic calculations predict this advantage for further oxides as well, e.g., SiO2, GeO2, Al2O3, In2O3, La2O3, and Pr2O3.

Abstract This paper summarizes the presentations submitted for publication of the 12th AIST National Congress (Associazione Italiana Studio Tosse/Italian Association for Cough Study) entitled “The thousand facets of cough. A clinical and therapeutic update”, which occurred last February 2nd-3rd, 2018 in Bologna (Italy). It summarizes the contributions from leading experts of the sector, who, as in the previous editions, also this year have analyzed a problem too often underestimated which still has many dark sides as regards both the diagnosis and the therapy of cough. The Scientific Committee has chosen topics that had less space in previous editions and these are topical subjects representing a concrete opportunity for learning and comparison of opinions, as well as indispensable elements for the correct management of the symptoms. Hereby we report the abstracts of the works submitted for publication in this Meeting report. The main topics have covered Cough relationship with nerve vagus, ATP, air pollution, GERD, imaging, COPD, pediatric and therapy. Of particular interest it is the preliminary data on cough hydration ratio that shows a highly significant correlation between dehydration and cough.

It remains to be seen how the COVID-19 pandemic will affect medical liability, as so many aspects of health care are changing rapidly as a result of this world-shaking event. [...]

Primary care is in the midst of a crisis. Many practices face the possibility of closure as they deal with fallout from the COVID-19 pandemic. So what can physicians do [...]

Physicians need telehealth to ensure they can treat their patients during this unprecedented COVID-19 pandemic. They also need to secure the necessary revenue to keep their practices functioning through accurate [...]

Physicians crave autonomy. They are independent thinkers who wants to use their expertise to treat their patients the best way they know how, but this disposition often comes into conflict [...]

Primary care is in a bad place. Physicians feel undervalued. Cumbersome technology, administrative burdens and payer hassles mean physicians are unable to spend the time they want with their patients. [...]