Explore the vast range of titles available.

Increased antibiotic use (AU) has been reported globally during the COVID-19 pandemic despite low rates of bacterial co-infection. We assessed changes in AU during the COVID-19 pandemic in Indonesia and the Philippines. We evaluated hospital-wide AU over 36 months in six hospitals, 3 in Indonesia and 3 in the Philippines. Intravenous antibiotics commonly used for respiratory conditions were selected and grouped for analysis. AU rates were calculated as monthly defined daily dose per 1000 patient-days or patient discharges. Median AU rates were compared from the pre-pandemic (March 2018-February 2020) and pandemic periods (March 2020-February 2021) using quantile regression to assess for statistical significance. Changes in AU during the COVID-19 pandemic were analyzed using interrupted time series analysis. Significant increases were noted in the median AU rate from the pre-pandemic to pandemic period of all antibiotics combined in 3/6 hospitals (percentage change, Δ, 12.5%-63.6%) and anti-pseudomonal antibiotics in 3/6 hospitals (Δ 51.5%-161.5%). In the interrupted time series analysis, an immediate increase (range: 125.40-1762) in the use of all included antibiotics combined was observed in 3/6 hospitals at the onset of the COVID-19 pandemic. One of these 3 hospitals experienced a statistically significant sustained increase, while another experienced a decrease over time. We observed significant increases in facility-wide inpatient AU during the COVID-19 pandemic in our participating hospitals in Indonesia and the Philippines. These findings reinforce the importance of antibiotic stewardship practices to optimize AU, especially during infectious disease pandemics.

\"When Wally West, the adolescent nephew of the Flash's fiancee accidentally gained powers of superspeed, he became the Scarlet Speedster's sidekick. Growing up as his hero's protege, Kid Flash had a childhood of amazing action and adventure. But on the day that The Flash died, Wally's carefree adolescence abruptly ended and his life as an adult began. THE FLASH BY MARK WAID BOOK ONE looks back at Wally's earliest days as the Kid Flash and explores the gamut of his emotions and experiences from his first day as a child hero to his succession of Barry Allen as the new Flash. A journey full of humor and drama, this story shows just how much Wally West loves being the fastest man alive\"-- Provided by publisher.

Background: The coronavirus disease 2019 (COVID-19) pandemic severely affected Southeast Asia, with >35 million cases and ~360,000 deaths. Despite relatively low rates of secondary bacterial infection among inpatients with COVID-19, several countries reported increased antibiotic use; raising concerns for worsening antimicrobial resistance. We assessed the impact of the COVID-19 pandemic on the use of antibiotics commonly used to treat respiratory infections in Southeast Asia. Methods: We evaluated intravenous antibiotic use among hospitalized adults in acute-care wards in 6 hospitals; 3 in Indonesia and 3 in the Philippines. We abstracted data on antibiotics that are commonly used to treat respiratory infections in these hospitals. We calculated antibiotic use rates for the 25 included antibiotics as monthly defined daily dose per 1,000 patient days (or patient discharges where patient days was unavailable) using data from pharmacy dispensing records and administrative records. Median antibiotic use rates for the prepandemic period (March 2018–February 2020) and the pandemic period (March 2020–February 2021) were compared, and percentage changes were calculated for (1) all 25 antibiotics combined; (2) ceftriaxone; (3) vancomycin and linezolid combined (anti-MRSA); and (4) broad-spectrum antibiotics with activity against Pseudomonas aeruginosa (anti-PSA). Monthly antibiotic use and COVID-19 patient discharges were graphed over the 36-month study period (March 2018–February 2021) to visualize trends (Fig. 1). The Wilcoxon rank-sum test was used to determine whether differences in median antibiotic use rates were statistically significant (2-tailed P < .05). Results: Overall, trends in antibiotic use were higher during months with increased COVID-19 patient discharges (Fig. 1). Use of all 25 antibiotics combined significantly increased in 4 of 6 hospitals (6.9%–63.6%) during the pandemic period compared to the prepandemic period. Ceftriaxone use significantly increased in 3 of 6 hospitals (37.1%–55.4%) and decreased in 3 of 6 hospitals (15.9%–31.9%). Anti-PSA antibiotic use significantly increased in 4 of 6 hospitals (16.1%–161.5%). Although anti-MRSA antibiotic use was low (comprising <2% of the overall included antibiotic use in Indonesia and <11% in the Philippines), use during the pandemic increased in 3 of 6 hospitals (59.8%–212.6%). Conclusions: We observed substantial increases in antibiotic use among hospitalized adults in Indonesia and the Philippines during the COVID-19 pandemic. The increased use of broad-spectrum antibiotics is concerning given the potential consequence of worsening antimicrobial resistance. Understanding how increases in antibiotic use compares to rates of bacterial infection, antimicrobial resistance, and antibiotic availability and accessibility during this time is important to contextualize results. These findings reinforce the importance of antibiotic stewardship practices to optimize antibiotic use, especially during pandemics. Disclosure: None

The influence of sea salt on the cloud droplet activation of sulfate particles is investigated using a size-resolving model of the aerosol activation process. The authors found that the total number concentration of activated cloud droplets increases with increasing sea salt concentration if the sulfate number concentrations are relatively low and updrafts are strong, but it decreases with higher sea salt if sulfate number concentrations are high and cloud updrafts are weak.

El uso de la técnica de perfilación criminológica como herramienta de investigación criminal, en los últimos años ha sido objeto de revisiones en cuanto a su fundamentación científica, aplicabilidad rigurosa y funcionalidad para el aparato judicial. En consecuencia, esta investigación tuvo como principal objetivo brindar información actualizada sobre la conceptualización de perfilación criminológica, su utilidad y las críticas que ha recibido en el contexto Colombiano. Se realizó análisis del contenido en 34 documentos relacionados con perfilación criminológica, los cuales corresponden a producciones académicas realizadas durante los años 1998 y 2012 en la ciudad de Bogotá por cinco universidades, la Escuela Penitenciaria Nacional y la Escuela de Investigación Criminal de la Policía Nacional, en las cuales se imparte formación en psicología jurídica e investigación criminal. Los resultados y conclusiones de la revisión documental indican que, a) el uso de la técnica en la investigación judicial ha sido limitado, b) es utilizada para comprender el actuar de quienes realizan comportamientos criminosos, c) la mayor parte del conocimiento en perfilación criminológica se origina en la academia, especialmente en el área de psicología jurídica, haciendo análisis y construcciones conceptuales, sin muchos ejercicios de aplicación de la técnica en hechos delictuales, d) es necesario utilizar la técnica con mayor frecuencia dentro del contexto judicial y académico de la capital colombiana.

This study sheds light on previously unexplored changes in host cell metabolism induced by T. gondii infection using noninvasive, label-free autofluorescence imaging. In this study, we use optical metabolic imaging (OMI) to measure the optical redox ratio (ORR) in conjunction with fluorescence lifetime imaging microscopy (FLIM) to noninvasively monitor single host cell response to T. gondii infection over 48 hours. Collectively, our results affirm the value of using autofluorescence lifetime imaging to noninvasively monitor metabolic changes in host cells over the time course of a microbial infection. Understanding this metabolic relationship between the host cell and the parasite could uncover new treatment and prevention options for T. gondii infections worldwide.

In recent years, measles cases have soared in the United States, with 1282 cases in 2019.1 The majority of these cases occur in unvaccinated individuals, which has brought immunization school exemption laws to the forefront ofmany state legislature discussions. Beyond the issue of exemptions, little attention has been paid to the exact wording of regulations and whether that language is scientifically based. As measles outbreaks continue, physicians and public health officials are receiving more questions about accelerated measles vaccine schedules and whether early vaccination will lead to extra doses upon kindergarten entry. These questions are directly related to state-specific school immunization laws, which vary widely across the United States and often cause confusion among clinicians and families. Despite the overwhelming evidence demonstrating vaccine safety and efficacy, an increasing number of parents are hesitant to immunize their children as recommended by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (ACIP)2 and the American Academy of Pediatrics.3 In addition, a subset of these parents voice concern that school entry laws demonstrate excessive governmental control over personal health care decisions. To dispel concerns about governmental overreach while encouraging immunization, state laws should be consistent with guidelines set forth by the ACIP and American Academy of Pediatrics. These recommendations specify that individuals should receive two doses of measles-containing vaccine, with the first dose on or after aged 12 months and the second dose recommended at aged four to six years. However, the second dose can be given earlier, as long as at least 28 days pass between the doses (commonly referred to as an \"accelerated vaccination schedule\"). Additionally, vaccine doses given within four days of the minimum interval are considered valid in most cases (there are certain restrictions on this related to the timing of different live vaccines). Thus, for children who complete an accelerated two-dose measles vaccination schedule, there is no scientific evidence to support a third measles-containing vaccine dose upon kindergarten entry.

This paper calculates the expected cost of uncertainty in solar and wind energy using the uncertainty cost function (UCF), with a primary focus on computational processing time. The comparison of processing time for the uncertainty cost quantification (UCQ) is conducted through three methods: the Monte Carlo simulation method (MC), numerical integration method, and analytical method. The MC simulation relies on random simulations, while numerical integration employs established numerical formulations. These methods are commonly used for solving cost optimization problems in power systems. However, the analytical method is a less conventional approach. The analytical method for calculating uncertainty costs is closely related to the UCF, as it relies on a mathematical representation of the impact of uncertainty on costs, which is modeled through the UCF. A multi-objective approach was employed for scheduling an energy management system, that is to say, thermal–wind–solar energy systems, proposing a simplified method for modeling controllable renewable generation through UCF with an analytical method, instead of the complex probability distributions typically used in traditional methods. This simplification reduces complexity and computational processing time in optimization problems, offering greater accuracy in approximating real distributions and adaptability to various scenarios. The simulations performed yielded positive results in improving cost estimation and computational efficiency, making it a promising tool for enhancing economic distribution and grid operability.