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Infection control and antimicrobial stewardship programs (ICASPs) are essential to reduce the emergence and spread of antimicrobial resistance. The primary objective of this study was to assess the feasibility of extending a commercial off-the-shelf (COTS) software for ICASPs in low- and middle-income countries (LMICs). This project involved three hospitals in Colombia, including Centro Médico Imbanaco, Clínica San Francisco, and DIME Clínica Neurocardiovascular. A COTS platform (ILÚM Health Solutions ™ Kenilworth, NJ) was extended to function in a range of technology settings, and translatable to almost any language. ICASP features were added, including clinical practice guidelines, hand hygiene (HH) documentation, and isolation precaution (IP) documentation. The platform was delivered as a smartphone mobile application ("app") for both iOS and Android. The app was successfully implemented at all sites, however, full back-end data integration was not feasible at any site. In contrast to the United States, a suite of surveillance tools and physician-focused decision support without patient data proved to be valuable. Language translation processing occurred quickly and incurred minimal costs. HH and IP compliance tracking were the most used features among ICASP staff; treatment guidelines were most often used by physicians. Use of the app streamlined activities and reduced the time spent on ICASP tasks. Users consistently reported positive impressions including simplicity of design, ease of navigation, and improved efficiency. This ICASP app was feasible in limited-resource settings, highly acceptable to users, and represents an innovative approach to antimicrobial resistance prevention., Competing Interests: Conflicts of Interest WJS, JBFO, LNH and JMM are all employed by ILÚM Health Solutions, LLC, the developer of the mobile application. No conflicts of interest are reported by other authors.

With current national emphasis on translational research, data exchange systems are needed that bridge basic science and clinical research. To meet this challenge, an electronic system was developed by the Biomedical Informatics Unit (BMIU) of the University of Tennessee Clinical Translation Science Institute (UT CTSI). This integrated data system collects, processes, archives, and distributes basic, clinical, and translational research data. The system provides information via web-based applications in a secure and Health Insurance Portability and Accountability Act (HIPAA)-compliant manner to facilitate data sharing and analysis across domains. The system is currently in use by a number of studies and has proven to be an effective tool for data collection and processing in clinical studies.

We studied three cases of primitive neuroectodermal tumors surgically removed from the cauda equina region of adults. There was no clinical or radiological evidence of cerebellar medulloblastoma, other intracranial tumor or paraspinal sympathetic neuroblastoma. Two patients died: autopsies revealed no primary intracranial neoplasm. One patient is alive 3 years after surgery with no detectable intracranial tumor. The tumors had the light and electron microscopic features of primitive neuroectodermal tumors as described earlier in the literature. In addition, in all three cases many tumor cells could be stained for cytoplasmic neurofilament antigen.