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Objectives The magnitude of impact caused by low blood culture utilization on estimates of the proportions and incidence rates of antimicrobial-resistant (AMR) bacterial infections is largely unknown. Methods We used routine electronic databases of microbiology, hospital admission and drug prescription at Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand, from 2011 to 2015, and bootstrap simulations. Results The proportions of Escherichia coli and Klebsiella pneumoniae bacteraemias caused by 3rd generation cephalosporin resistant isolates (3GCREC and 3GCRKP) were estimated to increase by 13 and 24 percentage points (from 44% to 57% and from 51% to 75%), respectively, if blood culture utilization rate was reduced from 82 to 26 blood culture specimens per 1,000 patient-days. Among patients with hospital-origin bloodstream infections, the proportion of 3GCREC and 3GCRKP whose first positive blood culture was taken within ±1 calendar day of the start of a parenteral antibiotic at the study hospital was substantially lower than those whose first positive blood culture was taken later into parenteral antibiotic treatment (30% versus 79%, p

Artemisinin Combination Therapies (ACT) are first-line treatments for malaria. The Tracking Resistance to Artemisinin Collaboration (TRAC) mapped the spread of artemisinin resistance in 10 countries in Asia (7) and Africa (3) and described artemisinin resistance in Southeast Asia (SEA). In Cambodia, Thailand, and Vietnam, artemisinin resistance is compounded by partner drug resistance resulting in dihydroartemisininpiperaquine (DHA-PPQ) treatment failure rates of >60%. The TRACII study conducted in 8 countries in Asia (7) and Africa (1) explored the concept of combining an ACT with a third antimalarial drug and assessed efficacy, safety and tolerability of two Triple ACT (TACT): DHA-PPQ+mefloquine (DHA-PPQ+MQ) and artemether-lumefantrine+amodiaquine (AL+AQ). Both TACT were safe, well tolerated and highly efficacious against ACTresistant parasites in SEA. TACT could become standard treatment for malaria worldwide as part of strategies to prevent or delay emergence of drug resistant malaria in regions outside of SEA. A new project titled Development of Triple Artemisinin Combination Therapies (DeTACT) will take a multifaceted approach to assess potential benefits and disadvantages of deploying TACT as first-line antimalarial treatments. In a randomized, controlled, non-inferiority trial, we will compare safety, tolerability and efficacy of dose-optimised artesunate-PPQ+MQ and AL+AQ TACT in blistered co-packages versus ACT+placebo in 13 countries in Asia (5) and Africa (8). The potential of TACT to delay emergence and spread of antimalarial resistance and cost-effectiveness of deploying TACT will be assessed through mathematical modelling. We will address ethical issues such as balancing individual and community disadvantages versus public benefits of introducing TACT in regions where ACT are still efficacious. Market and demand related issues involved in development, implementation and deployment of TACT will be studied to guide future introduction in the global marketplace and communicated to stakeholders via a strategic engagement plan. Development of the project and progress to date will be presented.

Since 2000, considerable progress has been made in health research in Iran. An example of this progress has been the Gastro- Esophageal Malignancies in Northern Iran (GEMINI). The original aim of this project was to identify etiologic factors and prevention measures for upper gastrointestinal cancers in Northern provinces of Iran, but its achievements have gone much beyond the initial goal. This project is one of the largest studies in the Middle East and North African region, has helped build and strengthen research capacity at both individual and institutional levels in Iran, and has provided international credibility to research institutes and the wider research system in Iran. The success of GEMINI reveals the feasibility of large-scale studies in developing countries and serves as a successful model not only for health research institutes within Iran, but also for research systems in other developing countries. The outcomes of the project are numerous, including establishment of research networks, development of efficient methods for planning and implementation of research projects, and introduction of methodologies for project management, data management and usage of health technology. Finally and perhaps most importantly, GEMINI is among the few projects that has had a significant impact on the attitudes and concerns of decision makers in the health sector in Iran. It signifies the importance of investment in human resources and has proved that health policies should be health-based rather than patient-based. Here we review the impact of GEMINI on the health research system and the broader health care system of Iran and put these into a more global perspective.

A full-day workshop organised by Simon Coles (Chair) and Mike Hursthouse (University of Southampton, UK), John Huffman (Indiana University, USA), Peter Strickland (IUCr), Frank Allen (CCDC) and John Westbrook (PDB).This event is aimed at initiating a wide-ranging debate on new routes for the effective and efficient dissemination of the ever-increasing volume of crystallographic raw and results data, as a complementary approach to the conventional route of publication of scientific journal articles. The workshop is concerned with: a) raising awareness of innovative procedures under development for data dissemination and the new opportunities they can provide for publication, b) enabling groups working in the area to compare approaches and develop a unified strategy for data management, including publication and preservation and c) inviting participation in this topic from interested parties. The methods and approaches to publishing scientific research output (i.e. making it available to the public domain) are currently undergoing a seed-change. New initiatives include such processes as author self deposition of reprints in Institutional Repositories, author-pays open access journals and open discussion of results in Wiki’s or Blogs, and these are gathering momentum. On one hand this movement has been slow to appear in some disciplines (eg Chemistry), yet is widely accepted and routine in others (eg Physics and Biology). The field of crystallography is a data-rich subject that supports a vast number of conventional journal articles across a very broad range of disciplines, and seeds of change are very much evident here. Recent developments include: 1. The IUCr prepared an extensive report to the Science and Technology Committee in 2004 regarding electronic publishing, data and open access (http://www.iucr.org/iucr/stcttee04.html) and a position paper (http://www.iucr.org/iucr/gicsi/positionpaper.html). 2. IUCr were awarded three rounds of funding to enable the content of their journals provided by UK authors to be made publicly available through Open Access (JISC funded) and examine the culture changes and impact on their business model. 3. From Jan 2008 Acta Cryst Section E will become Open Access (Author pays). 4. Numerous successful projects aimed at authors self-publishing data (eCrystals, ReciprocalNet, Crystallography Open Database) have been created. The indications are therefore that the time is now right to explore these new routes to publishing, with a particular emphasis on the crystallographic raw and results data, as an alternative to conventional journal articles. This is especially relevant in the light of a recognised data deluge (F.H. Allen, Crystallogr. Reviews, 2004, 10, 3-15), where it is commonly recognised that approximately only 20% of small-molecule crystal structures determined as a result of publicly funded research reach the public domain. This is a direct consequence of the way in which data is traditionally published. The principal contributions to this workshop would be from those responsible for recent developments and innovations in the area and are outlined below. The primary aims of the workshop will be to: 1. Raise awareness in the crystallographic community of these new innovations and the opportunities they offer for data publication, and invite participation. 2. Enable projects and interested parties working in the area to compare approaches and develop a unified way forward for the future of data publication. The topics to be covered as sessions of the workshop include: 1. Self publication by an author: Institutional data repositories (eg eCrystals project), Open databases (e.g. COD) and consortia (eg ReciprocalNet) 2. Author pays Open Access (eg Acta Cryst E, Chemistry Central) 3. Interoperability and linking between data sources 4. Interactions between data sources and data centres, publishers & learned societies 5. Data discovery and linking to journal articles and other sources of electronic information openly available 6. Support, training, raising awareness and advocacy for data publication 7. Future sustainability and preservation of openly available data, -policy and finance. 8. Ownership of data Workshop Program 10:00 - 10:05 Introduction: Housekeeping & Purpose of Workshop Session 1: Data Archival and Availability * 10:05 - 10:20 Brian McMahon: The IUCr perspective * 10:20 - 10:35 Rick McMullen: The ReciprocalNet consortium * 10:35 - 10:50 Simon Coles: The eCrystals Federation * 10:50 - 11:05 Ashley Buckle : The TARDIS project * 11:05 - 11:20 Rick McMullen & Simon Coles: The outcomes of the CGF2007 workshop Session 2: Data Publication, Databases and Reuse * 11:45 - 12:00 Bill Clegg: Acta E's Adventures in Journal-land * 12:00 - 12:15 Howard Einspahr: Data Publication in Acta F * 12:15 - 12:30 Frank Allen: Publishing and the CSD * 12:30 - 12:45 John Westbrook: The Protein Databank in an Open Data Community * 12:45 - 13:00 Nick Day: The CrystalEye Open Data aggregator Session 3: Open Forum * 13:45 - Close: Structured Q&A Debate on Future Direction

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