Prevalence and Antimicrobial Susceptibility Status of Gram-Negative and Gram-Positive Bacteria on Handheld Shopping Trolleys and Baskets in Supermarkets in Ndola, Zambia

Background: Supermarkets are a place visited by individuals with different health conditions daily where microbiological contaminants through touch onto fomites such as trolleys and baskets can be passed on to other people hence potentially spreading infectious diseases. This study aimed to investigate the presence of Gram-negative and Gram-positive bacteria on handheld shopping trolleys and baskets and their antimicrobial susceptibility status against commonly used antibiotics in Zambia. Methods: A cross-sectional study was conducted. Trolleys and basket handles were swabbed and standard microbiological methods were used to identify the bacteria and disc diffusion to determine their antimicrobial susceptibility status. Data was collected from December 2021 to April 2022. Data was analysed using IBM Statistical Package for Social Sciences (SPSS) Version 22. Results: Twenty-eight percent of the 200 total samples were found to be culture-positive and predominant isolates were Staphylococcus aureus (17.3%), Pseudomonas species (4.5%), Escherichia coli (2%), Corynebacterium species (2%), Staphylococcus species (1.5%) and Enterobacter aerogenes (0.5%). Staphylococcus aureus showed the most resistance to azithromycin (17%) followed by ciprofloxacin (2.8%), nitrofurantoin (2.8%) and chloramphenicol (2.8%). Escherichia coli showed 100% resistance to amoxicillin, cloxacillin and ampicillin, 75% resistance to ciprofloxacin and the least resistance to azithromycin (25%) while it was susceptible to nitrofurantoin. Staphylococcus species, Corynebacterium species, Enterobacter aerogenes and Pseudomonas species showed no resistance to any antibiotics. Conclusion: The study showed the presence of microorganisms with considerable antimicrobial resistance to antibiotics in Zambia on trolley and basket handles indicating the need for more initiatives to address proper hygiene in public environmental sites for better infection prevention and control.

Bamboo Baskets From Eastern Zhejiang

Among Chinese woven products, bamboo baskets have the widest of uses. They are light and durable and graceful. Bamboo baskets have been indispensable for hundreds of years in South China. there are large varieties of bamboo baskets in China, but the best are those made by the local people in eastern Zhejiang Province, especially in Shengxian and Dongyang. These places have a long history in bamboo basket making and work is well-known nationwide. The baskets from there

Measurement of Stone Diameter with Three Sizes of Automatically Fixating Stone Baskets

Background: Complications after endoscopic retrieval of kidney and ureter stones are obviously related to the size of the stones as well as the experience of the surgeon and other factors. During the procedure it is sometimes difficult for surgeons to estimate stone size and therefore give prognostic advises. The visual perception of the stone size depends on the shape, colour, distance to the renoscope and dilatation of the ureter. This is the so-called binding problem, because shape, color and direction of motion are processed separately by different population of optical neurons. In order to establish a better prognostic rational especially for less experienced surgeons, we established an intra operative semi-quantitative measurement of the stone size supported by a stone basket. Materials and Methods: We modified the tipped, nitinol stone baskets from the company Urotech with diameters of 2.5, 3.0 and 4 FR. The handle of this basket has a spring mechanism, which automatically closes the basket and provides a predefined fixation force of the stones within the basket. On the handle we established a non-linear scale in mm by grabbing standardized balls or standardized screws. Result: The scales are nonlinear because of the nonlinear relation between the diameter of the stone and the distance of the slider. Also the scales differ in between the basket size, because of the different strain conditions due to the different wire sizes and materials or the spring and basket. Conclusion: This scale could be an important orientation for a surgeon during endourological procedures to estimate stone sizes. After further clinical experience a semi-quantitative visualization like green, yellow and red colors could help to predict potential complications due to large stone sizes. Finally it could bevery interesting for other disciplines like gastroenterology.

Picturing the Times

On September 25,locals and tourists pose for photos with a giant decorative flower basket on Tiananmen Square in Beijing to celebrate the forthcoming National Day.The four Chinese characters adorning the basket mean"blessing the motherland."(IC PHOTO)

Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results

Objective:To evaluate the long-term stone-free rate(SFR)of retrograde intrarenal surgery(RIRS)in the treatment of lower pole renal calculi using only basket relocation and identify independent predictors of stone-free status.Methods:All consecutive patients undergoing RIRS lower pole renal calculi at a single highvolume tertiary center were analyzed retrospectively.Lower pole stones were relocated to the upper pole,where laser lithotripsy was performed.All patients were followed up in the clinic following the surgery and yearly thereafter.The stone-free status was assessed with a combination of an abdominal ultrasound and abdominal X-ray,or an abdominal non-contrast computed tomography if the stones were known to be radiolucent.Results:A total of 480 consecutive patients who underwent RIRS for treatment of lower pole renal calculi,between January 2012 and December 2018,were analyzed from a prospectively maintained database of 3000 ureteroscopies.With a median follow-up time of 18.6 months,the mean SFR was 94.8%.The procedures were unsuccessful in 26(5.4%)patients due to unreachable stones.The median stone size of the unreachable stones was 12 mm(range 10e30 mm).Multivariable logistic regression analysis revealed two predictors of SFR for lower pole stones:a small cumulative stone burden(odds ratio[OR]:0.903,95%confidence interval[CI]:0.867e0.941,p<0.0001)and preoperative ureteral stent insertion(OR:0.515,95%CI:0.318e0.835,pZ0.007).Conclusion:The long-term SFR of RIRS for the treatment of lower pole stones with basket displacement with appropriate patient selection is high.

Impact of Dialysis Coverage on the Provision of Universal Health Insurance in the Republic of the Congo

Introduction: The launch of health insurance in the Republic of the Congo took place against a backdrop of extremely high costs for dialysis, which was not one of the services financed within this framework. The aim of this study is to assess the impact of including dialysis in the health insurance package in Congo. Methodology: This is a descriptive cross-sectional study with an evaluative aim, analyzing the impact of dialysis on the financing capacity of health insurance and health facilities to provide this type of care. Results: The results show that including dialysis in the universal health insurance package will require an additional financial effort of 6.20% of the current total financing capacity of the care basket. Most dialysis sessions are provided by the private health sector (87.5%), whose health facilities are unevenly distributed across the country, and concentrated in the country’s two major cities. This problem is the dual consequence of the very high cost of a dialysis session (average cost 140,234,375 FCFA or 229 US Dollars) and the number of patients under care, which will increase in the absence of effective and ongoing prevention efforts against chronic diseases in general and end-stage renal failure in particular. Conclusion: Dialysis is a high-impact public health intervention. The impact of its inclusion in the universal health insurance care package is difficult to bear financially. For dialysis to be covered by universal health insurance, additional funding and improved technical facilities are needed.

STEMI患者直接PCI应避免植入DES

自从1年前BASKET—LATE研究公布后，药物涂层支架和晚期血栓形成的问题经历了去年ESC会议的争论和随后FDA连续两天的听证会，近期ACC等多家权威学术团体又先后发表了两项重要的建议性文件，但很多问题仍然没有完全解决。

Intracellular transport of hepatitis B virus

For genome mulUplication hepadnaviruses use the transcriptional machinery of the cell that is found within the nucleus. Thus the viral genome has to be transported through the cytoplasm and nuclear pore. The intracytosolic translocation is facilitated by the viral capsid that surrounds the genome and that interacts with cellular microtubules. The subsequent passage through the nuclear pore complexes （NPC） is mediated by the nuclear transport receptors importin α andβ. Importin α binds to the C-terminus of the capsid protein that comprises a nuclear localization signal （NLS）. The exposure of the NLS is regulated and depends upon genome maturation and/or phosphorylation of the capsid protein. As for other karyophilic cargos using this pathway importin α interacts with importin β that facilitates docking of the import complex to the NPC and the passage through the pore. Being a unique strategy, the import of the viral capsid is incomplete in that it becomes arrested inside the nuclear basket, which is a cage-like structure on the karyoplasmic face of the NPC. Presumably only this compartment provides the factors that are required for capsid disassembly and genome release that is restricted to those capsids comprising a mature viral DNA genome.

Giant choledocholithiasis treated by mechanical lithotripsy using a gastric bezoar basket

Mechanical lithotripsy （ML） is usually considered as a standard treatment option for large bile duct stones. However, it is impossible to retrieve oversized stones because the conventional lithotripsy basket may not be able to grasp the stone. However, there is no es- tablished endoscopic extraction method for such gi- ant stone removal. We describe a case of successful extraction of a 4-cm large stone using a gastric bezoar basket. A 78-year-old woman had suffered from upper abdominal pain for 20 d. Contrast-enhanced computed tomogram revealed a 4-cm single stone in the distal common bile duct （CBD）. Endoscopic stone retraction was decided upon and endoscopic papillary balloon dilation was performed using a large balloon. An at- tempt to capture the stone using a standard lithotripsy basket failed due to the large stone size. Subsequently, we used a gastric bezoar basket to successfully capturethe stone. The stone was fragmented into small pieces and extracted. The stone was completely removed after two sessions of endoscopic retrograde cholangio- pancreatography; each of which took 30 rain. No com- plications occurred during or after the procedure. The patient was fully recovered and discharged on day 11 of hospitalization. ML using a gastric bezoar basket is a safe and effective retrieval method in select cases, and is considered as an alternative nonoperative option for the management of difficult CBD stones.

Endoscopic retrieval of 28 foreign bodies in a 100-year-old female after attempted suicide

Foreign body ingestion is a common emergency situation in children with one or a few objects having been ingested. Here we report our experience using endo-scopic retrieval in a female centenarian with dyspnea and foreign bodies in the esophagus. She attempted suicide by swallowing 26 coins and two other foreign bodies. A gastroscope was used to remove all foreign bodies in the lower esophagus. In total, 26 coins, one ferrous ring and one cylindrical plastic object were retrieved. To our knowledge, this is the first clinical report on retrieval of so many foreign bodies in a single case.

Comparison of brush and basket cytology in differential diagnosis of bile duct stricture at endoscopic retrograde cholangiopancreatography

BACKGROUND： A previous report has identified a significantly higher sensitivity of cancer detection for dedicated grasping basket than brushing at endoscopic retrograde cholangiopancreato- graphy （ERCP）. This study aimed to compare the diagnostic accuracy of Geenen brush and Dormia basket cytology in the differential diagnosis of bile duct stricture. METHOD： The current study enrolled one hundred and fourteen patients who underwent ERCP with both Geenen brush and Dormia basket cytology for the differential diagnosis of bile duct stricture at our institution between January 2008 and December 2012. RESULTS： We adopted sequential performances of cytologic samplings by using initial Geenen brush and subsequent Dormia basket cytology in 59 patients and initial Dormia basket and subsequent Geenen brush cytology in 55 patients. Presampling balloon dilatations and biliary stentings for the stricture were performed in 17 （14.9%） and 107 patients （93.9%）, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Geenen brush cytology for the diagnosis of malignant bile duct stricture were 75.0%, 100.0%, 100.0%, 66.7% and 83.3%, respectively, and those of Dormia basket cytology were 64.5%, 100.0%, 100.0%, 58.5% and 76.3%, respectively （P=0.347 and 0.827 for sensitivity and accuracy, respectively）. The good and excellent cellular yields （≥grade 2） were obtained by Geenen brush and Dormia basket cytology in 88 （77.2%） and 79 （69.3%） patients, respectively.CONCLUSION： The sensitivity, specificity and accuracy of biliary sampling with a Dormia basket are comparable to those with conventional Geenen brush cytology in the detection of malignant bile duct stricture.

Impaction of a lithotripsy basket during endoscopic lithotomy of a common bile duct stone

The treatments for common bile duct (CBD) stones are being continually developed. Impaction of the lithotripsy basket during endoscopic removal of CBD stones was seen in 5.9% patients. We report the case of a 66-yearold woman who underwent surgery for the removal of an impacted biliary basket. She was admitted to our hospital with a complaint of right upper abdominal pain. Magnetic resonance cholangiopancreatography revealed a CBD stone (20 mm × 15 mm). We diagnosed her with choledocholithiasis and performed endoscopic retrograde cholangiopancreatography to remove the stone. However, unfortunately, the retrievable basket around the stone became impacted. An endotriptor along with forceps could not be used owing to the entrapment of the basket, and thus we performed urgent surgery. The basket containing the stone was removed through a longitudinal choledochotomy. The wires leading to the basket were cut, and the basket containing the stone was removed via the incision. A T-tube was inserted,and the choledochotomy was closed. The postoperative course was uneventful. In conclusion, if the diameter of a CBD stone is more than 20 mm, then the risk of basket impaction increases, and surgery may be necessary as the initial treatment of the CBD stone.

电子海图ADC选图软件的使用

使用ADC选图软件选用海图是电子海图(ECDIS)使用过程中必不可缺少的部分。文章介绍了ADC选图软件的基本操作,有助于船舶驾驶人员在实际工作中简化操作,腾出更多精力用于其他工作。

CO2 capture over molecular basket sorbents:Effects of SiO2 supports and PEG additive

The objective of this work is to study the influences of silica supports and PEG additive on the sorption performance of molecular basket sorbent（MBS） for COcapture consisting of polyethylenimine and one of the following supports: SBA-15（2-D structure）, TUD-1（3-D sponge-like structure） and fumed silica HS-5（3-D disordered structure）. Effects of the supports regarding pore structures and pore properties, the PEI loading amount as well as the sorption temperature were examined. Furthermore, polyethylene glycol（PEG） was introduced as an additive into the sorbents and its effect was investigated at different PEI loadings and sorption temperatures. The results suggest that the pore properties of MBS（after PEI loading） play a more important role in the COsorption capacity, rather than those of the supports alone.MBS with 3D pore structure exhibits higher COsorption capacity and amine efficiency than those with 2D-structured support. Among the sorbents studied, fumed silica（HS-5） based MBS showed the highest COsorption capacity in the temperature range of 30-95 °C, probably due to its unique interstitial pores formed by the aggregation of polymer-loaded SiOparticles. It was found that the temperature dependence is directly related to the PEI surface coverage layers. The more PEI surface coverage layers, the higher diffusion barrier for COand the stronger temperature dependence of COcapacity. 3D MBS exceeds 2D MBS at the same PEI coverage layers due to lower diffusion barrier. Adding PEG can significantly enhance the COsorption capacity and improve amine efficiency of all MBS, most likely by alleviating the diffusion barrier within PEI bulk layers through the inter-molecular interaction between PEI and PEG.

Results of the open surgery after endoscopic basket impaction during ERCP procedure

AIM:To report the results of open surgery for patients with basket impaction during endoscopic retrograde cholangiopancreatography(ERCP) procedure.METHODS: Basket impaction of either classical Dormia basket or mechanical lithotripter basket with an entrapped stone occurred in six patients.These patients were immediately operated for removal of stone(s) and impacted basket.The postoperative course,length of hospital stay,diameter of the stone,complication and the surgical procedure of the patients were reported retrospectively.RESULTS: Six patients(M/F,0/6) were operated due to impacted basket during ERCP procedure.The mean age of the patients was 64.33 ± 14.41 years.In all cases the surgery was performed immediately after the failed ERCP procedure by making a rightsubcostal incision.The baskets containing the stone were removed through longitudinal choledochotomy with the stone.The choledochotomy incisions were closed by primary closure in four patients and T tube placement in two patients.All patients were also performed cholecystectomy additionally since they had cholelithiasis.In patients with T-tube placement it was removed on the 13 th day after a normal T-tube cholangiogram.The patients remained stable at postoperative period and discharged without any complication at median 7 d.CONCLUSION: Open surgical procedures can be applied in patients with basket impaction during ERCP procedure in selected cases.

基于超市购物篮分析的布局研究及营销设计

本文所研究的问题是如何通过超市购物篮分析来实现对超市布局及营销活动设计,超市购物篮分析是在行业内是一个比较热的话题,许多零售企业都在业务系统或者ERP之中都有所设计,但是其应用更多停留在数据分析及顾客购买行为分析方面,本文则通过企业的实战案例,摒除繁琐、高深的数据分析,提供一个简单并具有良好的直观意义分析。

Basketing a basket:A novel emergency rescue technique

Fracture of the central lead wire of an impacted basket during a mechanical lithotripsy for large common bile duct(CBD) stones poses a special challenge.Different maneuvers have been described to resolve this problem.Most techniques require equipment or facilities which may not be readily available in small community hospitals.We present here a similar situation in a patient with a large stone at the level of the cystic duct.Through the duodenoscope,a smaller Dormia basket was introduced into the CBD along the side of the impacted broken basket.The tip of the impacted basket was grasped and,by pulling downwards,the basket was disengaged from the stone.The two baskets were then removed successfully.We suggest this simple technique should be tried initially,before resorting to more advanced procedures.

Thiacrown Molecular Basket with High Extracting Selectivity towards Ag^+

By bridging 1,3：4,6-bis（3,6-dihydroxy-1,2-xylylene）tetrahydro-3a,6a-diphenyl imidazo- [4,5]-imidazole-2,5（IH,3H）-dione I with S（CH2CH2OCOCHECl）2, thiacrown molecular basket 2c was prepared for the first time. It was found that the compound exhibited very poor affinity towards alkali metal ions but high extracting selectivity towards silver ion.

IN SITU OBSERVATION ON FORMATION OF BASKET DURING BAINITIC TRANSFORMATION

By means of riM-190 hot-stage microscopy,the in situ observation of α-β transformation in 12Cr2MoWVTiB steel has been carried out.The sequence of the growth of ferritic needles composing bainitic basket has also been determined.According to the crystallographic analy- sis a multislip system transform model concerning the formation of basket has been proposed.

Price Paradox and Strategic Choice of "Vegetable Basket" in China

By using the analysis method of game theory,this paper analyzes the phenomenon of price paradox of "vegetable basket" in China and its reason as follows:the price paradox of "vegetable basket" in China is that if the vegetable is cheap,it will harm farmers,and if the vegetable is expensive,it will harm people;high-cost logistics,low negotiation status of vegetable growers and cooperation predicament are responsible for price paradox.Based on the theoretical basis of strategic choice-theory of intermediaries,it indicates that the intermediaries can realize effective transaction and save transaction cost.The strategic choice of solving price paradox of "vegetable basket" is put forward as follows:support vegetable growers' cooperatives,reduce transaction cost and raise the negotiation status of vegetable growers;develop the model of connection of agricultural products and supermarkets,and reduce the cost of transport and distribution;innovate upon intermediaries and develop the third-party logistics.