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In the past years infections caused by multidrug-resistant Gram-negative bacteria have dramatically increased in all parts of the world. This consensus paper is based on presentations, subsequent discussions and an appraisal of current literature by a panel of international experts invited by the Rudolf Schülke Stiftung, Hamburg. It deals with the epidemiology and the inherent properties of Gram-negative bacteria, elucidating the patterns of the spread of antibiotic resistance, highlighting reservoirs as well as transmission pathways and risk factors for infection, mortality, treatment and prevention options as well as the consequences of their prevalence in livestock. Following a global, One Health approach and based on the evaluation of the existing knowledge about these pathogens, this paper gives recommendations for prevention and infection control measures as well as proposals for various target groups to tackle the threats posed by Gram-negative bacteria and prevent the spread and emergence of new antibiotic resistances.

BackgroundThe emergence of the Internet has increased access to health information and can facilitate active individual engagement in health care decision making. Hispanics are the fastest-growing minority group in the United States and are also the most underserved in terms of access to online health information. A growing body of literature has examined correlates of online health information seeking behaviors (HISBs), but few studies have included Hispanics. ObjectiveThe specific aim of this descriptive, correlational study was to examine factors associated with HISBs of Hispanics. MethodsThe study sample (N=4070) was recruited from five postal zip codes in northern Manhattan for the Washington Heights Inwood Informatics Infrastructure for Comparative Effectiveness Research project. Survey data were collected via interview by bilingual community health workers in a community center, households, and other community settings. Data were analyzed using bivariate analyses and logistic regression. ResultsAmong individual respondents, online HISBs were significantly associated with higher education (OR 3.03, 95% CI 2.15-4.29, P

Precision medicine envisions a future of effective diagnosis, treatment, and prevention grounded in precise understandings of the genetic and environmental determinants of disease. Given that the original genome-wide association studies represented a predominately European White population, and that diversity in genomic studies must account for genetic variation both within and across racial categories, new research studies are at a heightened risk for inadequate representation. Currently biological samples are being made available for sequencing in biobanks across the USA, but the diversity of those samples is unknown. The aims of this study were to describe the types of recruitment and enrollment materials used by US biobanks and the diversity of the samples contained within their collection. Biobank websites and brochures were evaluated for reading level, health literacy, and factors known to encourage the recruitment of minorities, such as showing pictures of diverse populations. Biobank managers were surveyed by mail on the methods and materials used for enrollment, recruitment, consent, and the self-reported race/ethnicity of biobank participants. From 51 US biobanks (68% response rate), recruitment and enrollment materials were in English only, and most of the websites and brochures exceeded a fifth-grade reading level. When compared to the 2015 US Census, self-reported race/ethnicity of participants was not significantly different for Whites (61%) and blacks (13%). The percentages were significantly lower for Hispanics and Latinos (18 vs. 7%, p = 0.00) and Hawaiian/Pacific Islanders (0.2 vs. 0.01%; p = 0.01) and higher for Asians (13 vs. 5%, p = 0.01). Materials for recruitment predominantly in English may limit participation by underrepresented populations.

: Introduction: Multiple studies have demonstrated elevated incidence and prevalence of HIV among transgender women; however, few studies have been conducted among transmasculine individuals. HIV prevalence among transgender men in the United States is estimated to be 0–4%; however, there have not been any US studies examining HIV prevalence that stratify by the gender of sexual partners. The aim of this research was to examine HIV prevalence and its association with socio‐demographic and other factors, including the gender of sexual partners and receipt of gender‐affirming care (hormones/surgery), among transmasculine individuals at the Callen‐Lorde Community Health Center in New York City. Methods: The Transgender Data Project was an Institutional Review Board‐approved retrospective chart review of all transgender and gender diverse clients at the clinic, ages 18+, between 1 January 2009 and 12 December 2010. Charts were reviewed manually. Data included birth sex, gender, race/ethnicity, education, employment, housing, insurance status, gender of sexual partners, HIV screening and status, and receipt of gender‐affirming care. Bivariate and multivariable logistic regression models were used to assess the association between HIV status and other variables. Results and discussion: Five hundred and seventy‐seven transmasculine individuals, mean age 32.1 years (18.3–70.5), were included in this analysis. A small majority were White (55% White, 13.9% Black and 11.7% Hispanic). The majority, 78.9%, had received hormones (testosterone) and 41.6% had received at least one gender‐affirming surgery. The HIV screening rate was 43.4%. HIV prevalence was 2.8%, (95% CI: 1.13%, 5.68%) among those screened, notably higher than the US population prevalence. HIV prevalence was highest among transmasculine individuals who had sex exclusively with cisgender men (11.1%). In the multivariable model (age, education and gender of sexual partners), the adjusted odds ratio of HIV for those who had sex exclusively with cisgender male partners compared to no cisgender male partners was 10.58 (95% CI: 1.33, 84.17). Conclusions: Although HIV prevalence has been estimated to be low among transgender men, the analysis found heterogeneous results when stratified by gender of sexual partners. The results underscore the need to understand sexual risk among transmasculine individuals and to disaggregate HIV data for those having sex with cisgender men, thus also allowing for better inclusion in HIV prevention efforts., INTRODUCTION There are an estimated 1 million transgender adults in the United States [1] who are heterogeneous in terms of age, race, ethnicity, socio‐economic status, gender and sexual orientation identities [...]

We sought to examine the growth of an interdisciplinary center using social network analysis techniques. Specific aims were to examine the patterns of growth and interdisciplinary connectedness of the Center and to identify the social network characteristics of its productive members. The setting for this study was The Center for Interdisciplinary Research on Antimicrobial Resistance (CIRAR) at Columbia University. Periodic surveys and social network analysis comprised the study design. The data for this study included a relational survey taken by all members of the Center at three time points over one year. Respondents confirmed whether or not they had "heard of," "met," or "know the work of," or had "worked with" each of the other Center members. Data were analyzed using the social networking software program Organizational Risk Analyzer (ORA). Over time the social network increased in size, density, centralization, and complexity. The density of connections among and between different disciplines in the Center varied from Time 1 to 2 to 3; some increased, some decreased, while others stayed the same. Finally, the total degree centrality and the betweeness centrality of Center members were highly correlated to productivity. The study shows that a number of characteristics of an interdisciplinary research center can be quantified and described using social network techniques. Data from these analyses can be used to evaluate a center's progress, identify important indicators of leadership, identify areas of strength and need for improvement, and inform decisions on strategic direction. (Contains 2 tables and 3 figures.)

Improving the informed consent process is a common theme in literature regarding biomedical human subjects research. Standards for appropriate language and required information have undergone scrutiny and evolved over time. One response to the call for improvement is the provision and use of informed consent templates (ICTs) to ensure that documents have a standardized format and quality of content. Little is known, however, about the prevalence of such ICTs or their effectiveness. This article discusses the rationale for creating and using templates, describes the prevalence of and commonalities between templates, and identifies the need for an evaluation of their effectiveness in terms of their ethical and practical implications. The websites of 144 Association of American Medical Colleges (AAMC)-accredited institutions in the United States, 21 institutes in the National Institutes of Health (NIH), and the World Health Organization (WHO) were searched for the presence of ICTs. A total of 105 (72.9%) medical schools, 3 (14.2%) NIH institutes, and the WHO had at least one ICT publicly available on their websites. The templates varied in format, length, style, language, and sections included. The prevalence of ICTs, variability in their content, and lack of published research regarding their effectiveness suggest that ICTs are available, but more research into their effectiveness and standardization of their development are needed.