BACKGROUND: Prior to September 2021, 55,000-90,000 hospital inpatients in England were identified as having a potentially nosocomial SARS-CoV-2 infection. This includes cases that were likely missed due to pauci- or asymptomatic infection. Further, high numbers of healthcare workers (HCWs) are thought to have been infected, and there is evidence that some of these cases may also have been nosocomially linked, with both HCW to HCW and patient to HCW transmission being reported. From the start of the SARS-CoV-2 pandemic interventions in hospitals such as testing patients on admission and universal mask wearing were introduced to stop spread within and between patient and HCW populations, the effectiveness of which are largely unknown.
METHODS: Using an individual-based model of within-hospital transmission, we estimated the contribution of individual interventions (together and in combination) to the effectiveness of the overall package of interventions implemented in English hospitals during the COVID-19 pandemic. A panel of experts in infection prevention and control informed intervention choice and helped ensure the model reflected implementation in practice. Model parameters and associated uncertainty were derived using national and local data, literature review and formal elicitation of expert opinion. We simulated scenarios to explore how many nosocomial infections might have been seen in patients and HCWs if interventions had not been implemented. We simulated the time period from March-2020 to July-2022 encompassing different strains and multiple doses of vaccination.
RESULTS: Modelling results suggest that in a scenario without inpatient testing, infection prevention and control measures, and reductions in occupancy and visitors, the number of patients developing a nosocomial SARS-CoV-2 infection could have been twice as high over the course of the pandemic, and over 600,000 HCWs could have been infected in the first wave alone. Isolation of symptomatic HCWs and universal masking by HCWs were the most effective interventions for preventing infections in both patient and HCW populations. Model findings suggest that collectively the interventions introduced over the SARS-CoV-2 pandemic in England averted 400,000 (240,000 - 500,000) infections in inpatients and 410,000 (370,000 - 450,000) HCW infections.
CONCLUSIONS: Interventions to reduce the spread of nosocomial infections have varying impact, but the package of interventions implemented in England significantly reduced nosocomial transmission to both patients and HCWs over the SARS-CoV-2 pandemic.

Healthcare settings have a high prevalence of infectious agents. This narrative review examines the existing evidence regarding infection prevention and control (IPC) using the WHO Infection Prevention and Control Assessment Framework (IPCAF) tool in healthcare facilities. A total of 13 full length papers from Africa, Asia and Europe were considered for this review. The findings showed that there are discrepancies in the IPCAF values from insufficient to advanced level. The current review shows an advanced IPCAF level in middle income and high income countries. Low income countries showed a lower IPCAF score. There is a need to enhance the IPC capacity building and to supply infection prevention resources to prevent healthcare associated infection (HAI) with a focus on low income countries.

UNASSIGNED: Following reports of an outbreak of HIV infection among children in Larkana District, Pakistan, an international team investigated the extent and cause of the outbreak between April and June 2019.
UNASSIGNED: To investigate the incidence of HIV among children in Larkana District, Pakistan and describe the distribution of cases by time, place and person.
UNASSIGNED: Self-referred persons were tested for HIV using the national testing protocol. Local epidemiology of HIV was reviewed to generate hypotheses. An infection prevention and control (IPC) team conducted site visits and reviewed IPC practices.
UNASSIGNED: Between 25 April and 27 June 2019, a total of 30 191 persons were tested for HIV in Larkana District, and 876 of them tested positive. Of those who tested positive, 719 (82%) were children aged <15 years. Traditional skin piercing procedures and transmission from high-risk populations to children were ruled out during the investigation. Informative interviews with parents or guardians of a convenience sample of 211 children aged <15 years showed that 99% of children had an injection or infusion for medical treatment within the past 12 months. Our investigation identified lack of HIV prevalence data for the general population including tuberculosis patients and those who attended antenatal care services.
UNASSIGNED: Investigations indicate that unsafe healthcare practices in formal and informal healthcare settings as the most likely cause of the 2019 outbreak of HIV infection in Larkana, Pakistan. Measures should be taken to improve IPC practices at the facility level, especially in pediatric and antenatal care clinics.
فاشية فيروس العوز المناعي البشري بين الأطفال في باكستان.
جمانة هرمز، مها إسماعيل، أوليفر مورجان، محمد صفدار باشا، كارل شنكل، ميج دوهرتي، محمد طيب، يتمجيتا إيايو عبد الله، محمد عاصف سيد، نافيد مسعود مأمون، رنا جواد أصغر، موسى رحيم، ثاقب شيخ، حماد علي، إليزابيث م. رابولد، روبرت فونتين، إيفان هوتين، رنا حجة.
UNASSIGNED: عقب ورود إبلاغات عن حدوث فاشية بعدوى فيروس العوز المناعي البشري بين الأطفال في منطقة لاركانا، بباكستان، استقصى فريق دولي مدى انتشار الفاشية وأسبابها في الفترة بين أبريل/ نيسان ويونيو/ حزيران 2019.
UNASSIGNED: هدفت هذه الدراسة الى استقصاء معدل الإصابة بفيروس العوز المناعي البشري بين الأطفال في منطقة لاركانا، باكستان، ووصف توزيع الحالات حسب الزمان والمكان والأشخاص.
UNASSIGNED: جرى اختبار الأشخاص الذين أحالوا أنفسهم للكشف عن فيروس العوز المناعي البشري باستخدام بروتوكول الاختبار الوطني. واستُعرضت الخصائص الوبائية المحلية لفيروس العوز المناعي البشري لإعداد فرضيات. وأجرى فريق معني بالوقاية من العدوى ومكافحتها زيارات ميدانية واستعرض ممارسات الوقاية من العدوى ومكافحتها.
UNASSIGNED: في المدة من 25 أبريل/ نيسان إلى 27 يونيو/ حزيران 2019، خضع 30,191 شخصًا لاختبار فيروس العوز المناعي البشري في منطقة لاركانا، وجاءت نتيجة فحص 876 منهم إيجابية. ومن الذين جاءت نتيجة اختبارهم إيجابية، كان 719 من الأطفال (82٪) الذين تقل أعمارهم عن 15 عامًا. واستُبعدت أثناء الاستقصاء الإجراءات التقليدية لثقب الجلد وانتقال العدوى من الفئات السكانية الشديدة التعرض للخطر إلى الأطفال. وأظهرت المقابلات الشخصية مع آباء الأطفال أو أوصيائهم، ضمن عينة عشوائية شملت 211 طفلًًا تقل أعمارهم عن 15 عامًا، أن 99٪ من الأطفال قد تلقوا حقنًا أو تسريبًا للعلاج الطبي خلال الأشهر الاثتني عشر الماضية. وكشف الاستقصاء الذي أجريناه عن نقص في بيانات انتشار فيروس العوز المناعي البشري بين عامة السكان، ومنهم مرضى السل وأولئك الذين خضعوا لخدمات الرعاية السابقة للولادة.
UNASSIGNED: تشير الاستقصاءات إلى أن ممارسات الرعاية الصحية غير المأمونة في مرافق الرعاية الصحية الرسمية وغير الرسمية هي السبب الأرجح لحدوث فاشية العدوى بفيروس العوز المناعي البشري في عام 2019 بمنطقة لاركانا، باكستان. وينبغي اتخاذ تدابير لتحسين ممارسات الوقاية من العدوى ومكافحتها على مستوى المرافق، لا سيَّما في عيادات طب الأطفال والرعاية السابقة للولادة.
Flambée épidémique de VIH chez les enfants au Pakistan.
UNASSIGNED: Suite à des rapports signalant une flambée épidémique d\'infection à VIH chez des enfants dans le district de Larkana (Pakistan), une équipe internationale a enquêté sur l\'ampleur et la cause de la flambée entre avril et juin 2019.
UNASSIGNED: Étudier l\'incidence du VIH chez les enfants dans le district de Larkana et décrire la répartition des cas en fonction du temps, du lieu et des individus.
UNASSIGNED: Les patients se présentant volontairement ont été soumis à un test de dépistage du VIH selon le protocole national de dépistage. L\'épidémiologie locale du VIH a été examinée afin de formuler des hypothèses. Une équipe pour la prévention et le contrôle des infections a réalisé des visites sur sites et a examiné les pratiques en la matière.
UNASSIGNED: Entre le 25 avril et le 27 juin 2019, un total de 30 191 personnes ont fait l\'objet d\'un test de dépistage du VIH dans le district de Larkana, et 876 d\'entre elles ont reçu un résultat positif. Parmi les personnes testées positives, 719 (82 %) étaient des enfants de moins de 15 ans. Les techniques traditionnelles de perçage de la peau et la transmission du virus aux enfants par des populations à haut risque ont été exclues au cours de l\'enquête. Des entretiens informatifs réalisés auprès des parents ou tuteurs de 211 enfants âgés de moins de 15 ans issus d\'un échantillon de commodité ont révélé que 99 % d\'entre eux avaient subi une injection ou une perfusion dans le cadre d\'un traitement médical au cours des 12 derniers mois. Notre enquête a mis en évidence un manque de données concernant la prévalence du VIH dans la population générale, y compris chez les patients atteints de tuberculose et chez ceux ayant consulté des services de soins prénatals.
UNASSIGNED: L\'enquête a démontré que des pratiques de soins de santé non sécurisées dans les établissements de santé formels et informels sont les causes les plus probables de la flambée épidémique de VIH survenue en 2019 dans le district de Larkana (Pakistan). Il est nécessaire de prendre des mesures dans le but d\'améliorer les pratiques de prévention et de contrôle des infections au niveau des établissements de santé, en particulier dans les cliniques de soins pédiatriques et prénatals.

It has become a tradition for the BAMP (Bacteriocins and Antimicrobial Peptides) symposium to be a part of the IPC (International Probiotic Conference). In 2024, IPC/BAMP will be held on the 18th-20th of June in Prague, Czech Republic ( www.probiotic-conference.net ) and will reunite scientists, students, and representatives from industry and regulations agencies from all around the world. The meeting will serve as a platform for the exchange of knowledge and ideas regarding the past, present, and future of beneficial microbes, probiotics, antimicrobials, and proteins, and their influence on a prosperous and healthier future.

UNASSIGNED: Insufficient infection prevention and control (IPC) practices in healthcare settings increase the SARS-CoV-2 infection risk among health workers. This study aimed to examine the level of preparedness for future outbreaks.
UNASSIGNED: We modelled the experience from the COVID-19 pandemic and assessed the return on investment on a global scale of three IPC interventions to prevent SARS-CoV-2 infections among health workers: enhancing hand hygiene; increasing access to personal protective equipment (PPE); and combining PPE, with a scale-up of IPC training and education (PPE+). Our analysis covered seven geographic regions, representing a combination of World Health Organization (WHO) regions and the Organisation for Economic Co-operation and Development (OECD) countries. Across all regions, we focused on the first 180 days of the pandemic in 2020 between January 1st and June 30th. We used an extended version of a susceptible-infectious-recovered compartmental model to measure the level of IPC preparedness. Data were sourced from the WHO COVID-19 Detailed Surveillance Database.
UNASSIGNED: In all regions, the PPE + intervention would have averted the highest number of new SARS-CoV-2 infections compared to the other two interventions, ranging from 6562 (95% CI 4873-8779) to 38,170 (95% CI 33,853-41,901) new infections per 100,000 health workers in OECD countries and in the South-East Asia region, respectively. Countries in the South-East Asia region and non-OECD countries in the Western Pacific region were poised to achieve the highest level of savings by scaling up the PPE + intervention.
UNASSIGNED: Our results not only support efforts to make an economic case for continuing investments in IPC interventions to halt the COVID-19 pandemic and protect health workers, but could also contribute to efforts to improve preparedness for future outbreaks.
UNASSIGNED: This work was funded by WHO, with support by the German Federal Ministry of Health for the WHOResearch and Development Blueprint for COVID-19.

Antibiotic resistance (ABR) is increasing the mortality and morbidity associated with infectious diseases, besides increasing the cost of healthcare, saturating health system capacity, and adversely affecting food security. Framing an appropriate narrative and engaging local communities through the \'One Health\' approach is essential to complement top-down measures. However, the absence of objective criteria to measure the performance of ABR interventions in community settings makes it difficult to mobilize interest and investment for such interventions. An exercise was therefore carried out to develop an indicator framework for this purpose. A comprehensive list of indicators was developed from experiences gathered through community engagement work in a local panchayat (small administrative area) in Kerala, India and a consultative process with health, veterinary, environment, and development experts. A prioritization exercise was carried out by global experts on ABR, looking at appropriateness, feasibility, and validity. A 15-point indicator framework was designed based on the prioritization process. The final set of indicators covers human health, animal health, environment management, and Water Sanitation and Hygiene (WASH) domains. The indicator framework was piloted in the panchayat (located in Kerala), which attained a score of 34 (maximum 45). The score increased when interventions were implemented to mitigate the ABR drives, indicating that the framework is sensitive to change. The indicator framework was tested in four sites from three other Indian states with different socioeconomic and health profiles, yielding different scores. Those collecting the field data were able to use the framework with minimal training. It is hoped that, this indicator framework can help policymakers broadly understand the factors contributing to ABR and measure the performance of interventions they choose to implement in the community as part of National Action Plan on AMR.

Polyethylene terephthalate (PET) recycling is one of the most important environmental issues, assuring a cleaner environment and reducing the carbon footprint of technological products, taking into account the quantities used year by year. The recycling possibilities depend on the quality of the collected material and on the targeted product. Current research aims to increase recycling quantities by putting together recycled PET in an innovative way as a filler for the additive manufactured metallic lattice structure. Starting from the structures mentioned above, a new range of composite materials was created: IPC (interpenetrating phase composites), materials with a complex architecture in which a solid phase, the reinforcement, is uniquely combined with the other phase, heated to the temperature of melting. The lattice structure was modeled by the intersection of two rings using Solid Works, which generates the lattice structure, which was further produced by an additive manufacturing technique from 316L stainless steel. The compressive strength shows low values for recycled PET, of about 26 MPa, while the stainless-steel lattice structure has about 47 MPa. Recycled PET molding into the lattice structure increases its compressive strength at 53 MPa. The Young\'s moduli are influenced by the recycled PET reinforcement by an increase from about 1400 MPa for the bare lattice structure to about 1750 MPa for the reinforced structure. This sustains the idea that recycled PET improves the composite elastic behavior due to its superior Young\'s modulus of about 1570 MPa, acting synergically with the stainless-steel lattice structure. The morphology was investigated with SEM microscopy, revealing the binding ability of recycled PET to the 316L surface, assuring a coherent composite. The failure was also investigated using SEM microscopy, revealing that the microstructural unevenness may act as a local tensor, which promotes the interfacial failure within local de-laminations that weakens the composite, which finally breaks.

BACKGROUND: Infection prevention and control (IPC) is a critical component of delivering safe, effective and high-quality healthcare services, and eliminating avoidable healthcare-associated infections (HAIs) in health facilities, predominantly in population-dense settings such as Bangladesh.
OBJECTIVE: Our study aimed to assess the effect of an integrated intervention package in improving the IPC level of the health facilities in Bangladesh.
METHODS: We conducted a pre-post intervention study in six district hospitals (DHs) and 13 Upazila Health Complexes (UHCs) in the six districts of Bangladesh. Baseline and endline assessments were conducted between March and December 2021 using the adapted World Health Organization Infection Prevention and Control Assessment Framework (WHO-IPCAF) tool. The IPCAF score, ranging from 0-800, was calculated by adding the scores of eight components, and the IPC promotion and practice level was categorized as Inadequate (0-200), Basic (201-400), Intermediate (401-600) and Advanced (601-800). The integrated intervention package including IPC committee formation, healthcare provider training, logistics provision, necessary guidelines distribution, triage/flu corners establishment, and infrastructure development was implemented in all facilities.
RESULTS: The average IPCAF score across all the facilities showed a significant increase from 16% (95% CI: 11.5-20.65%) to 54% (95% CI: 51.4-57.1%). Overall, the IPCAF score increased by 34 percentage points (P<0.001) in DHs and 40 percentage points (P<0.001) in UHCs. Following the intervention, 12 (three DHs, nine UHCs) of 19 facilities progressed from inadequate to intermediate, and another three DHs upgraded from basic to intermediate in terms of IPC level.
CONCLUSIONS: The integrated intervention package improved IPCAF score in all facilities.

Mammalian cells remain the mainstay of biological production host. In industry, cultivating and harvest strategies are sorted in batch mode (e.g., batch, fed-batch, concentrated fed-batch and intensified fed-batch) and continuous mode (e.g., perfusion). To retrieve greater productivity and better product quality, especially for the sensitive products prone to fragmentation, culture modes with various modifications are innovated (e.g., intensified perfusion culture [IPC]). In our study, we demonstrated that the fragmentation of Fc-fusion product (Molecule A) is time-dependent in traditional fed-batch (TFB) culture. The fragmentation proportion increased from 3.8% to 12.4% for Clone A, 0.8% to 1.7% for Clone B and 0.9% to 2.0% for Clone C from Day 10 to Day 14. By applying a novel bioprocess, IPC, which allows continuous feeding of the fresh medium and constant removal of the spent medium without bleeding cells to maintain a defined constant viable cell density, the fragmentation was reduced to 0.3% while the productivity was increased from 2.96 g/L to 15.51 g/L for Clone A. To validate whether the fragmentation reduction is product-sensitive, plasmids carrying the DNA sequences of two other Fc-fusion molecules (Molecule B and Molecule C) were transfected into the host. The results showed consistent fragmentation reducing effect by using IPC. Furthermore, the cultivation scale was expanded to 50 L and 1000 L. A minimum fragmentation level below 0.1% was observed for Molecule C. Our study revealed the capability of IPC in reducing Fc-fusion protein fragmentation and the reproducibility when scaling up while maintaining high productivity.

Although the Paralympic Games have been around for over 60 years, women remain underrepresented in almost all aspects of the Paralympic Movement. It has been suggested that a way to increase women\'s involvement is through the implementation of mixed-gender events. On paper, this approach makes sense. However, when it comes to the implementation of mixed-gender opportunities for women, it is less clear how effective these events are in increasing participation by women in Para sport. Through document analysis and interviews with athletes and organizers of mixed-gender Paralympic sport, we explore the various strategies that four mixed-gender sports have used to address the issue of gender parity. Using critical feminist theories, we illustrate how larger social, political, and cultural ideas about gender influence women\'s experiences within these events and discuss the potential of using mixed-gender initiatives to address gender parity within the Paralympic Movement.