Towards an Antimicrobial Stewardship Program in a Young Tertiary Hospital in Southern Nigeria: A Point Prevalence Survey of Antimicrobial Usage

Background: Antimicrobial resistance (AMR) is one of the top 10 global public health threats facing humanity and this burden is borne largely by low and middle-income countries. As part of efforts to combat AMR, the World Health Organization has identified Antimicrobial Stewardship as one of the strategic objectives of its global action plan on antimicrobial resistance. This survey aimed to observe antimicrobial prescribing and usage patterns in the Rivers State University Teaching Hospital with the purpose of identifying gaps to inform the specific antimicrobial stewardship interventions necessary to address our specific needs. Methodology: A point prevalence survey was conducted using the protocol and web-based automated data management system designed by the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance, University of Antwerp, Belgium, in November 2021. Results: A total of 69 adult medical and surgical patients were surveyed;27 males and 18 females. Antimicrobial prevalence was 65.2%. Third generation cephalosporins (24.4%;33.3%), fluoroquinolones (17.8%;22.2%) and imidazole derivatives (20%;36.1%) were most prescribed on the medical and surgical wards. Antimicrobial guidelines were completely unavailable, most antimicrobials (93.8%) were prescribed empirically and 64.4% of these remained empirical after 72 hours of commencement. Conclusion: Antimicrobial stewardship interventions are necessary to minimize sub-optimal antimicrobial prescribing practices in our facility. Most critical are education on appropriate use of antimicrobials, support for development of antimicrobial guidelines, diagnostic stewardship, and the drive for improved use of the laboratory to guide antimicrobial prescriptions. The antimicrobial stewardship committee and team must drive this, having the requisite support from the management and prescribers, with the primary outcomes being reduced antimicrobial prevalence and improved antimicrobial prescription patterns.

Performance analysis of real-time and post-mission kinematic precise point positioning in marine environments

This article focuses on the performance analysis of both real-time and post-mission kinematic precise point positioning(PPP)in challenging marine environments.For this purpose,a real dynamic experiment lasting 6 h was carried out on a lake dam in?orum City of Turkey.While the kinematic test was continuing,the real-time PPP coordinates were obtained for each measurement epoch with a commercial real-time PPP(RT-PPP)service,namely the Trimble Center Point RTX.Then the post-mission PPP(PM-PPP)coordinates were calculated by using Multi-GNSS data and the Multi-GNSS Experiment(MGEX)precise products.The kinematic RT-PPP and PM-PPP results showed that the PPP coordinates were consistent with the relative solution at centimetre and decimetre level in horizontal and height components,respectively.This study implies that PPP technique is a powerful tool for highly accurate positioning in both real-time and post-mission modes,even for dynamic applications in harsh environments.

Survey concerning internal medicine physicians and prolonged QT interval:Knowledge and treatment practices

Prolongation of the QT interval is associated with adverse cardiac events specifically Torsades de pointes(TdP).There are multiple mediations that have a known,possible,or conditional risk for prolonged QT interval,but general practitioners’knowledge of these medications is unknown.We conducted a survey to assess internal medicine(IM)providers’knowledge of risk factors and medications associated with prolonged QT as well as provider experience and comfort when treating patients with prolonged QT.A 17-question,anonymous survey was constructed in 2019 and distributed to IM providers and residents at a tertiary care center.Questions included demographic information,6 Likert-scale questions gauging provider experience with prolonged QT,and 10 multiple choice clinical vignettes to assess clinical knowledge.Data was analyzed descriptively.Knowledge was assessed via clinical vignettes and compared by level of training.Forty-one responses were received out of a total of 87 possible respondents(47.1%response rate).About 70%of respondents see patients with acquired prolonged QT once monthly or more.95%rarely see congenital prolonged QT.When presented with QTc drug issues,73%of providers seldom or sometimes consulted pharmacy,but about half used online resources.The average correct score on the clinical vignettes was 5.59/10,with the highest scores seen in attending physicians in their first five years of practice(6.96/10).Our survey suggests that IM providers commonly encounter QT prolonging drugs.Educational efforts to improve knowledge of drug and patient risk factors for TdP may be needed.

The Program Construction Method of Navigation Format Files GPX and KML Based on Geological Exploration Point Information

GPX and KML are open and multi-purpose,which are widely used in many fields such as basic geological survey,geochemical survey,geophysical survey,engineering survey and so on.Based on the analysis of the syntax features,basic structure and expression of GPX and KML files,this paper discussed the construction methods of GPX and KML files by taking the construction of navigation files of point information as an example.According to the specifications of GPX and KML files,an automatic construction program of GPX and KML files is designed and compiled,which realizes the automatic generation of batch point navigation files and supports in related software,and shows good effects of holding and displaying,which is helpful to simplify work flow and improve work efficiency.

Methodology for Definition of the Three-Dimensional Geodesic Structures in the Olinda＇s Historical Site

It is shown to be a relevant study involving terrestrial methods of measurement, such as： forward and backward intersections, geometric leveling, trigonometric leveling with short distance targeted and spatial positioning GNSS methods, for the definition of field reference points and field-object points located in rough terrain. The geodesic structures were implemented in the Historic Site of Olinda employing GNSS （global navigation satellite system） receivers, total stations and digital level. The historical site of Olinda was recorded by UNESCO as Historical and Cultural Heritage of Humanity. The study area is located in the center of the busiest site with a quite roughly relief. This area has been studied since 2007 involving Research of Scientific Initiation and Pos-Graduation Course. This paper aims to present the realized experiments for the implementation and definition of geodesic structures in environments with very rough relief, including large old houses and historic monuments.

Feasibility and acceptability of using Wi-Fi access points to provide smoking cessation help at 17 airports and 38 railway stations across China

Background: The use of mobile phone significantly improved the outcomes of tobacco cessation. However, its feasibility and acceptability were unclear in the Chinese population. This study was to explore the feasibility of using Wi-Fi access points (APs) as a platform to provide smoking cessation help at 17 airports and 38 railway stations across China. Methods: This study was divided into two stages: platform development and population survey. In the first stage, a survey platform was developed and incorporated into Wi-Fi service at airports and railway stations, which could provide survey content as a pop-up window when participants tried to access the Wi-Fi service. In the second stage, a population survey was conducted to explore the intention to receive tobacco cessation support. Results: A total of 20,199 users participated and 13,628 users submitted the survey, with a response rate of 67.47%. The smoking rate was 30.9%. A total of 86.58% of smoking participants and 2.44% of non-smoking participants wished to receive tobacco cessation support, respectively. The multivariate analysis showed intention to receive support did not differ in age, gender, and heaviness of smoking (P > 0.05). Conclusion: Providing tobacco cessation support via Wi-Fi APs is feasible and efficient, and smokers have high intention to receive tobacco cessation support. It is suggested hospitals, academia, information technology industries, and government agencies must work together to provide tobacco cessation support via mHealth.

rherapeutic efficacy observation on acupuncture for persistent allergic rhinitis

Objective： To observe the clinical effect of acupuncture for persistent allergic rhinitis （PAR）. Methods： A total of 154 PAR patients were randomized into a treatment group and a control group, 78 cases in the treatment group received acupuncture at meridian points, while 76 cases in the control group received acupuncture at non-meridian points. The treatment was done every other day, 3 times a week for a total 4 weeks. The total nasal symptom score （TNSS）, the total non-nasal symptom score （TNNSS） and the rhinoconjunctivitis quality of life questionnaire （RO, LQ） were measured before the treatment and after 2 weeks and 4 weeks of treatment, as well as 1 month and 3 months after the treatment to compare the clinical effect between the two groups. Results： After 4 weeks of treatment, the total effective rate in the treatment group was 92.3%, versus 76.3% in the control group, showing a statistically significant difference （P〈0.05）. Intra-group comparisons of TNSS, TNNSS and R0.L0. scores after 4 weeks of treatment showed statistically significant differences （all P〈0.05）. Between-group comparisons of TNSS, TNNSS and RQLQ score after 4 weeks of treatment and in follow-up visits showed statistically significant differences （all P〈0.05）. Conclusion： Acupuncture is effective for PAR, and acupuncture at meridian points can produce a better effect than acupuncture at non-meridian points.

Control method exploration of nosocomial bloodstream infection and its effect evaluation

Background Currently, slightly more than 50% of bloodstream infections （BSIs） are hospital acquired. When these infections occur in patients in intensive care units, they are associated with a high mortality rate, additional hospital days and excess hospital costs. Because of multifactor of nosocomial BSIs, measurements of control nosocomial BSIs are wide variety and lead to some confusion in practice. The aim of this study was to explore special way in accordance with self-hospital base on common principle. Methods In one ward of the Intensive Care Unit, Peking Union Medical College Hospital, at first, we divided the all operation about bloodstream way into three sections used as keypoints. By surveying keypoints respectively, some operation faults of blood way were discovered. For decreasing the mobidity of nosocomial BSIs, some intervention measurements were executed. The rate of nosocomial BSIs was analyzed by chi-square test. Results According to the statistics from January to June, we received and cured 618 patients in total; among them, there were 13 cases of nosocomial BSI and the average occurrence was 2.3 cases/month. After intervention measurements from July to December 2011, we received and cured 639 patients in total with seven cases of nosocomial BSI, and the average occurrence was 1.2 cases/month （P 〈0.05）. From January to April 2012, no nosocomial BSI occurred in the investigated ward. Conclusion Removing the operation faults of bloodstream way might decrease the nosocomial BSI rapidly and efficiently by utilizing a key point survey.