SXSW Faces Lawsuits After Fatal Car Crash

first_imgIn the wake of the tragedies that occurred at the annual South by Southwest music and interactive fest in Austin earlier this year, the victims and their families may begin to see some justice.In the wee hours of the morning on March 13, 2014, a highly intoxicated 21-year-old sped through a DUI checkpoint into oncoming traffic on a one-way street, ultimately crashing into a barricade and crowd of people outside a SXSW afterparty at The Mohawk. The terrible tragedy left four dead and nearly two dozen injured. Driver Rashad Owens has been charged with capital murder and remains in jail. Now, SXSW is seeing its first wave of victim lawsuits. One victim’s family claims that festival organizers skimped on traffic safeguards while packing thousands of people downtown.“A festival organizer or traffic design consultant of ordinary intelligence would have anticipated the danger,” the lawsuit says, according to ABC News.Meanwhile, lawyers for the festival released the following statement:“What happened on Red River was a terrible tragedy, caused by Rashad Owen’s utter disregard of human life. Our hearts continue to ache for those injured and the families of those who lost their lives. We look forward to his prosecution for his awful crimes.”last_img read more

Bombtrack Bikes Drops the Hook, Charges into Cross with Steel and Disc Brakes

first_imgAt this point, Bombtrack Bicycle Company is probably better known for their single speed and fixed gear options like the Limited Edition Adidas bike. If single speed culture or fixed gear freestyle isn’t your thing, Bombtrack’s latest project might have you taking a second look.Entering into uncharted territory, the brand has introduced their new cyclocross bike, the Hook. Details next… Bombtrack Hooks will be available in Europe starting in October and are hoping to ink a deal with one or two American distributors very soon. The bikes will be available to the US through European mail order companies, but Bombtrack wants to make it easier for consumers to find the bikes in the US. The second production batch will include the hydraulic cable guides and will be delivered in January. At this point there will also be availability of frame and fork only. For the Hook’s maiden voyage, Stefan ‘Fish’ Vis took one of the first production bikes and crashed the Bike Transalp – a 7 day adventure ride across the Alps from north to south. Not sure if the race organizers would allow him to compete on a CX bike while most of the riders were on full mountain bikes, Stefan ended up finishing well in the overall mountain stage results and 739th out of 1200 riders over all. Not bad for a guy with limited mountain biking experience on drop bars and a rigid carbon fork. The bike itself uses a Columbus “Cromor” double butted steel frame with a 44mm head tube and PF30 bottom bracket. Running QR axles front and rear, the Hook uses a carbon/alloy disc fork with a tapered steerer. Pictured with 10 speed components, the production bike will include the new 11 speed SRAM rival group and fittings that will accommodate hydraulic disc brakes (the hydraulic guides will be available starting with the second production run). Complete Hooks will include a SRAM Rival 22 drivetrain, BB7 Road S mechanical disc brakes, Mavic CrossOne wheels with Continental Cyclocross Race 700x35mm tires, and an assortment of BT Bikes parts for a combined build weight of 23.14 lbs.Hooks will be sold in S, M, L, and XL frame sizes in Matte Grey or Metallic Red.bombtrack.comlast_img read more

Exclusive! Eden Espinosa Honors South Pacific’s 70th Anniversary with a Powerful ‘Some Enchanted Evening’

first_imgLate last year, Eden Espinosa, the beloved Broadway star currently appearing as Trina in the national tour of Falsettos, lent her talent to Broadway Dreams’ gala performance of Rodgers & Hammerstein’s South Pacific to toast its 70th anniversary. In celebration of the milestone, which is this Sunday, April 7 (the same day the Broadway revival of R&H’s Oklahoma! opens), Broadway.com is exclusively sharing a video of Espinosa’s gender-swapped version of Emile de Becque’s showstopper “Some Enchanted Evening.” Listen to the fan-favorite star’s strong vocals below and cross your fingers that this Pulitzer-winning musical returns to the stage soon. View Commentslast_img

Survey: College administrators see problems as more students view marijuana as safe

first_imgVermont Business Magazine A majority of college administrators in a new survey say that more students believe marijuana to be “safe,” drawing concern that changing attitudes about marijuana might have downstream effects on college campuses. Administrators say the number of students with marijuana-related problems has either increased (37 percent) or stayed the same (32 percent), while almost none say such problems have lessened. And while they report a variety of negative impacts of marijuana use, and acknowledge the need to address the problem, they are also dealing with gaps in information and policy. A Presidents’ Panel with the associated presentation event included University of Vermont President Tom Sullivan.These are among the findings in a groundbreaking new survey of higher education officials by the Mary Christie Foundation and the Hazelden Betty Ford Institute for Recovery Advocacy in conjunction with the National Association of System Heads (NASH). The survey of 744 professionals in academic affairs, student affairs and student health was conducted by The MassINC Polling Group and released today at a national forum on college student substance use at the University of Maryland College Park.According to the survey results, administrators agree colleges should implement strategies to reduce student marijuana use, but relatively few think their own campuses are emphasizing the issue. Survey respondents said barriers to tackling the problem include lack of information about effective approaches, and limited coordination and training. Their responses also indicated more awareness of the problem among officials on the front lines of student health compared to those in academic affairs or other administrative roles.”This survey underscores what many of us have been worried about: although data show that consistent marijuana use is a serious threat to students’ wellbeing and academic performance, there is a lack of urgency to address the problem in meaningful ways,” said Robert Caret, Chancellor of the University System of Maryland, Vice Chairman of the Mary Christie Foundation, and Chairman of NASH. “While is it encouraging that administrators see a role for colleges in addressing this issue, we need more active leadership to share information and coordinate the response.” Public health experts have long warned that regular marijuana use among college students can lead to impaired memory, lack of motivation (i.e., skipped classes), and problems with information processing and executive functioning. Marijuana use also overlaps significantly with excessive drinking and other substance use, rather than being a substitute, and is associated with mental health problems and an increased risk for psychosis in vulnerable individuals, among other health risks. The survey demonstrated significant knowledge gaps on these issues among college administrators, but the need for training to learn more was clearly acknowledged.Between 2014 and 2016, the annual prevalence of marijuana use among college students increased by 14 percent. In addition, the perception of harm and risk associated with regular marijuana smoking among 18- to 22-year-olds has decreased from about 58 percent in 2000 to about 33 percent in 2015, just as more states have legalized marijuana for medical and recreational use.”Colleges find themselves on the front lines of this shift in attitudes and are playing catchup, in terms of education and training, as problems continue to grow,” said Nick Motu, Vice President of the Hazelden Betty Ford Institute for Recovery Advocacy. “We know marijuana is not benign, and we need to continue to educate our young people on the risks of marijuana use and help those who develop problems. This is a serious issue for students, their families and our wider society as schools prepare students for the demands of a rapidly changing and highly competitive workplace.”Among the key findings:Seven in 10 administrators said that the number of students with marijuana-related problems on campus had either increased (37 percent) or stayed the same (32 percent) over the past three years. A majority (54 percent) of respondents believe the number of students who perceive marijuana to be safe has increased over the past three years.A majority (55 percent) report marijuana use in college residence halls; 41 percent have observed academic problems related to marijuana use, and 36 percent have seen student mental health issues. 63 percent agreed that students who use marijuana are more academically disengaged than non-users.Eight in ten (79 percent) believe college campuses should implement policies and programs to effectively reduce marijuana among college students, but only a third think their campus is putting a great deal (5 percent) or a fair amount (28 percent) of emphasis on preventing marijuana use right now.Majorities think that a lack of resources, coordination and information are barriers to successful marijuana prevention and enforcement on campus. Student opposition is also seen as a concern. There is a large gap in knowledge and perception of the issue between administrators on the frontlines of combatting substance abuse (health and wellness, prevention, residential life, and campus safety) and those a step removed (academic and student affairs). Majorities of the first group think that marijuana use is a serious problem on their campuses, while majorities of the latter group think it is not.One way to address this gap could be to improve training and information sharing. Majorities of all types of administrators are interested in receiving training on how to handle various aspects of marijuana use among students, including impacts on student health and well-being and academic success.Administrators say marijuana is not treated as seriously as alcohol. Screening for marijuana use is less common than screening for alcohol, and administrators are not fully aware of research that shows marijuana is associated with as many academic problems as drinking and that a majority of marijuana users also drink to excess. Experts are urging colleges to collect more regular data regarding the scope and consequences of student marijuana use and to utilize evidence-based public health approaches to intervention. They are also calling for better coordination among college departments and top-down communication that puts all those who support students on the same page.”The primary mission of every institution of higher education is to promote student success,” said Dr. Amelia Arria, Director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health. “These new data from the unique vantage point of college administrators indicate that marijuana use is a barrier to student achievement. Therefore, leaders of these institutions should intensify their efforts to develop comprehensive, scientifically-informed solutions to reduce student substance use.”The new survey was released at today’s national forum entitled, “College Substance Use: New Solutions to a Perennial Problem,” at the University of Maryland College Park. National leaders in higher education, policymaking and substance use prevention and treatment convened to discuss the latest trends, challenges and innovations in preventing and addressing substance use on America’s college campuses.Hosted by the Mary Christie Foundation, the Hazelden Betty Ford Institute for Recovery Advocacy and the University of Maryland School of Public Health, the event featured a panel of five university presidents, and several notable speakers. The Presidents’ Panel consisted of:Marty Meehan (President of the University of Massachusetts)Kim Schatzel (President of Towson University)Wayne Frederick (President of Howard University)Gregory Crawford (President of Miami University)Tom Sullivan (President of the University of Vermont)Video of the entire event can be viewed at www.wirestream.tv/customer/studiobdc/2017/10-17/(link is external), and the full survey results are available at marychristiefoundation.org/reports/(link is external).About the PollThese results are based on a national survey of college campus officials conducted online between September 4 and 25, 2017. Seven-hundred forty-four officials began the survey, and 523 completed it. Respondents were contacted via an email distributed by the National Association of System Heads (NASH) to its members, to be shared with relevant administrators on campuses. The survey was also distributed to members of the American College Health Association (ACHA) via their listserv. The final data were weighted to better match the distribution of higher education institutions across census regions, using data from the National Center for Education Statistics. The poll was conducted by The MassINC Polling Group for the Mary Christie Foundation and the Hazelden Betty Ford Institute for Recovery Advocacy in conjunction with NASH.About the Mary Christie FoundationThe Mary Christie Foundation is a thought leadership and philanthropic organization dedicated to the health and wellness of teens and young adults. With world-renowned experts in health care policy, public health, behavioral health and higher education, the Foundation contributes to the examination and resolution of the most pressing, and often overlooked, health issues facing young people. Learn more at www.marychristiefoundation.org(link is external).About the Hazelden Betty Ford Institute for Recovery AdvocacyOur mission is to provide a trusted national voice on all issues related to addiction prevention, treatment and recovery and to facilitate conversation among those in recovery, those still suffering and society at large. We are committed to smashing stigma, shaping public policy and educating people everywhere about the problems of addiction and the promise of recovery. The Hazelden Betty Ford Institute for Recovery Advocacy is part of the Hazelden Betty Ford Foundation, the nation’s largest nonprofit treatment provider. Learn more at www.HBFinstitute.org(link is external) and on Twitter @hbfinstitute(link is external).SOURCE COLLEGE PARK, Md., Oct. 17, 2017 /PRNewswire-USNewswire/ — Hazelden Betty Ford Foundation www.HBFinstitute.org(link is external)last_img read more

NEWS SCAN: Global flu update, H5N1 in Japan, Salmonella sprout suspects, public health info network, disease reporting rates

first_img GAO: HHS falls short on planning for public health information networkThe Government Accountability Office (GAO) reports that the Department of Health and Human Services (HHS) has not developed a strategic plan for establishing an electronic public health situational awareness network, a step required by Congress in a 2006 preparedness law. Under the Pandemic and All-Hazards Preparedness Act of 2006, HHS is supposed to work with state, local, and tribal officials to prepare such a plan and present it to Congress, the GAO said in a report released last week. Several offices within HHS have developed related strategies that could contribute to such a strategic plan, but they created them for other purposes, the GAO said. For example, HHS has developed systems to share information for disease and syndromic surveillance, but did not do so as part of a comprehensive strategy as required by the law. HHS also has awarded funds to states and localities to improve the ability to detect public health threats, the report notes. In written comments on a draft, HHS said that a complete strategy would be developed, according to the report.GAO page with report summary and links Sprouts suspected in Illinois Salmonella casesHealth officials in Illinois are investigating a Salmonella serotype I4,5,12,i- outbreak that they suspect is linked to alfalfa sprouts that has sickened 46 people in nine counties. The Illinois Department of Public Health (IDPH) said in a Dec 17 statement that many of the people who became ill ate at Jimmy John’s restaurants. The state has been receiving reports of illnesses matching the Salmonella serotype since Nov 1. State authorities are testing produce for Salmonella and investigating alfalfa sprout producers.Dec 17 IDPH press release Dec 20, 2010 Japan finds H5N1 in swanAnimal health officials in Japan have detected the H5N1 avian influenza virus in a dead tundra swan found on the balcony of a home in Tottori prefecture, located in the western part of the country, Kyodo news service reported today. The house is 4 miles from a poultry farm in Shimane prefecture that reported a recent H5N1 outbreak. Specialists conducting surveillance in the areas around the house and farm found 23 dead birds, which will be tested for the virus. Scientists said examination revealed the virus found in the swan samples is “partially identical” to the strain found on the poultry farm, Kyodo reported. In other developments, South Korean authorities reported a low pathogenic H7N2 outbreak at a poultry farm in Southern Chungcheong province, according to a Dec 17 report from the World Organization for Animal Health (OIE). The virus turned up during surveillance activities. One bird on the poultry farm was sick and all of the 110 birds were culled to control the spread of the virus.Dec 17 OIE reportcenter_img WHO: Flu season under way in Northern HemisphereThe World Health Organization (WHO) said in its latest flu update that the season is starting in some Northern Hemisphere locations such as the East Asia, North America, and most notably the United Kingdom. England is seeing co-circulation of 2009 H1N1 and influenza B viruses. with an increasing number of severe flu cases. The latest data show the 2009 H1N1 strain is epidemiologically and virologically similar to last year’s strain. A genetic analysis of H1N1 samples from England shows several genetic substitutions compared with the vaccine virus, but the WHO said they don’t affect the antigenicity of the virus and are similar to changes that have already been detected in other parts of the world. Small to moderate increases in flu-like illnesses have been noted in 14 European countries, especially in children, with activity rising above baselines in the Russian Federation and the Ukraine. In East Asia, flu activity has recently increased in Mongolia and South Korea, and to a lesser extent, northern China. In tropical countries flu activity is low, except for Sri Lanka, where 2009 H1N1 activity recently peaked. Little flu activity has been reported in sub-Saharan Africa, except for Cameroon, which reported a recent surge in 2009 H1N1 infections.Dec 17 WHO influenza update Study: Reporting of notifiable diseases improving but still limitedResearchers in North Carolina found that the rate of reporting of notifiable infectious diseases in the state improved over more than a decade but remained low, according to an article published online today by Emerging Infectious Diseases. The researchers, from the University of North Carolina at Chapel Hill and the North Carolina Department of Health, studied the reporting of 53 notifiable diseases by eight healthcare systems from 1995-97 and 2000-06. They examined healthcare system records to identify all patients who were assigned a diagnostic code for a reportable communicable disease and then compared the resulting data with the number of cases reported to the North Carolina Department of Health and Human Services. They found that the completeness of reporting varied from 2% to 30% among the eight health systems and improved with time. Reporting rates for specific diseases ranged from 0% to 82%, “but were generally low even for diseases with great public health importance and opportunity for interventions,” the report says. They suggest that the combination of electronic health records and automated case-finding and data collection will be the key to substantially improving disease reporting.Dec 20 Emerg Infect Dis studylast_img read more

CDC expert reports some anomalies in Jordan MERS cases

first_imgEditor’s note: This story was revised on Jun 20 to correct information about the detection of an asymptomatic infection. The previous version stated erroneously that the person who had an asymptomatic infection was a household contact of one of the confirmed case-patients.Eight Jordanians who had MERS-CoV (Middle East respiratory syndrome coronavirus) infections in a hospital outbreak more than a year ago, as determined by recent blood tests, didn’t quite match the profile of more recent cases, according to a CDC expert.Most of the eight people did not have preexisting diseases, and one of them had no symptoms, said Mark Pallansch, PhD, director of the CDC’s Division of Viral Diseases.The majority of MERS-CoV cases reported in recent months involved patients who had preexisting health problems such as diabetes or heart disease. And the asymptomatic case appears to be the first one reported.The eight cases were associated with a hospital outbreak in Zarqa, Jordan, in April 2012. The cause of the outbreak was a mystery at the time, because MERS-CoV was not discovered until June of last year, when a Saudi man died of his infection.The Jordan outbreak involved 11 cases, 2 of them fatal. Samples from the patients were stored, and later analysis led to confirmation of the virus in the two fatal cases. The WHO said the other cases probably were MERS, but that couldn’t be confirmed.Earlier this week a Canadian Press report revealed that serologic (antibody) tests of 124 people related to the Jordan cluster had turned up 8 more cases, raising the number of confirmed cases in the outbreak to 10. The testing was done by the CDC in collaboration with Jordanian health officials.Pallansch provided more details on the study in an interview. He cautioned that the findings are preliminary, because the CDC has had few serum samples from MERS-CoV patients with which to validate the two new serologic tests that were used.”There’s always a caveat that we could have subsequent testing change some of the results,” he said.Six of the eight cases were in healthcare workers and were part of the hospital illness cluster, Pallansch said.One of the other two, the asymptomatic case, was in a healthcare worker who worked at the same hospital as the others. The other case involved a household contact of one of the confirmed cases, he reported. That person “by recall did have an illness, but was not considered part of the cluster at the time,” he said.Among the other six case-patients, “there was a range of illness, but all were hospitalized, so it was reasonably severe,” Pallansch said.He said he is not aware of any other asymptomatic MERS-CoV cases. Such cases are considered important because they suggest that people who aren’t sick can unknowingly spread the virus. Asymptomatic cases are likely to be discovered only through serologic tests, which for MERS-CoV have become available only recently.Pallansch said he couldn’t give any information about how the first case-patient in the Jordanian cluster might have caught the virus or about the patients’ possible animal exposures. Officials are still working on their report, he explained.”This is a report that will go back to the Jordanian Ministry of Health, and they’ll make decisions about how it will be disseminated or published,” he said.See also:Related Jun 17 CIDRAP News storyNov 30, 2012, CIDRAP News storylast_img read more

Guinea goes a week with no new Ebola detections

first_imgGuinea reported no Ebola cases last week, a period of high alert, given that the most recent cluster of family-linked cases generated several risky exposures, the World Health Organization (WHO) said today.Looking at the bigger picture, the number of cases in Guinea has stayed at four or fewer for the past 16 weeks, the WHO noted in its weekly snapshot of the outbreak. Guinea’s lull in cases came in the wake of its neighbor Sierra Leone being declared free of the disease on Nov 7, becoming the second of the three outbreak countries to reach that status.Still following high-risk contactsAll of the 69 contacts still being monitored are from the Forecariah district village where the family members were infected, the WHO said. They included a 25-year-old woman who died from Ebola after delivering a baby, who also tested positive for the virus and whose illness was announced last week. The two other patients in the cluster are the woman’s two other young children.The illnesses had links to the last known transmission chain that began in Conakry’s Ratoma area. Sixty of the contact are considered high risk, and one contact from the district has been lost to follow-up, the WHO said in its weekly update.”Therefore, there remains a near-term risk of further cases among both registered and untraced contacts,” it said. Guinea’s contacts will complete their 21-day follow-up period on Nov 14.Response objectivesThe WHO said Liberia and Sierra Leone have both reached the first objective in phase 3 of the response framework: ending Ebola transmission. Now they are working on the second objective, which is to manage and respond to residual risks of the disease.All three countries have put systems in place that allow members of the public to report any illness or death that they think might be linked to Ebola. Guinea recorded 24,634 such alerts last week from all of its districts. For comparison, Sierra Leone logged 1,690 alerts from 12 of 24 districts through the week ending Oct 25. Similar data weren’t available for Liberia.Liberia and Sierra Leone are both in a 90-day enhanced surveillance period.Overall, the total for the outbreak—which began in early 2014—is at 28,599 confirmed, probable, or suspected cases. So far 11,299 deaths have been reported.A call to end Canada’s visa banIn related news, an Ottawa law professor today called for Canada’s new Prime Minister Justin Trudeau to end the country’s ban on issuing visas to people from the three affected outbreak countries.Writing in the journal Policy Options, Steven Hoffman, with the University of Ottawa’s Centre for Health Law, Policy, and Ethics, said it’s been a year since Canada took the step, which he said was an overreaction that, among a host of problems, hurt the outbreak response and went against the International Health Regulations. The journal is published by the Montreal-based Institute for Research on Public Policy, a nonpartisan public policy think tank.Hoffman said the restrictions are still in effect for two of the countries, even though the outbreak has been contained and public health experts have said the bans don’t work and can impair the outbreak response. “Canada ending its visa restrictions would have the added benefit of bringing our country into compliance with its international legal obligations. Such a move would also be in line with evidence-based public health guidance,” he wrote.Model finds missed control opportunitiesA statistical model that includes data from Sierra Leone’s health ministry mapped the spread of the virus during the outbreak, highlighting two critical opportunities health responders had to curb the outbreak.The analysis was conducted by a research team based at Columbia University’s Mailman School of Public Health and was published today in the Journal of the Royal Society Interface. The model includes the patient’s home district, population of the district, and distance between districts.The team found that the first window to control Sierra Leone’s outbreak was before the virus reached Kenema, a period that lasted 1 month. The second was before it reached Port Loko, a much shorter interval. The authors said Kenema and Port Loko were critical junctions during the outbreak, due to their many connections to other districts.Jeffrey Shaman, PhD, senior author of the study and associate professor at the Mailman school, said in a Columbia University press release, “While this analysis is too late to be used for application to and intervention in the Ebola epidemic, the method we used could be useful for future disease outbreaks, and not just for Ebola.”See also:Nov 11 WHO Ebola situation updateNov 11 Policy Options editorialNov 11  J R Soc Interface abstractNov 11 Columbia University press releaselast_img read more

Stewardship / Resistance Scan for Jan 31, 2017

first_imgStudy finds resistance genes are abundant in Chinese estuariesA team of researchers has detected a high abundance and diversity of antibiotic resistance genes in Chinese coastal estuaries, according to a study yesterday in Nature Microbiology.For the study, researchers tested sediment from 18 estuaries over 4,000 km of coastal China and examined their relationship with bacterial communities, antibiotic residues, and socioeconomic factors. They found a total of 259 resistance genes in the estuary samples, with an average of 118 in each estuary at levels around 1 million resistance genes per gram of sediment. The detected genes conferred resistance to almost all major classes of antibiotics used in humans and animals, the authors said, and represented all major resistance mechanisms, including antibiotic deactivation, efflux pumps, and cellular protection.The most common resistance genes found at each estuary were multidrug and beta-lactam resistance genes, followed by aminoglycoside and tetracycline resistance genes. Vancomycin resistance genes were found at all estuaries.        When the researchers analyzed antibiotic residues in estuary samples, they found five major antibiotic classes: diaminopyrimidines, tetracyclines, sulfonamides, fluoroquinolones, and macrolides. The concentrations of tetracyclines and macrolides were positively correlated with the total abundance of resistance genes.Analysis of the relationship between socioeconomic factors and resistance-gene abundance showed that total population, gross domestic product, sewage, and aquaculture production were correlated with the abundance of aminoglycoside, multidrug, and sulfonamide resistance genes.The authors conclude that anthropogenic activity “appears to be the major driver of abundance and diversity” of resistance genes found in estuaries, and that wastewater streams from municipal sewage treatment and aquaculture are a likely contributor. Jan 30 Nat Microbiol abstract Antibiotic use in travelers linked to colonization with MDR bacteriaA new study from researchers in Sweden and Finland has found that antibiotics taken during travel to subtropical regions can predispose travelers to colonization by drug-resistant bacteria with a high rate of co-resistance to other antibiotics.In the study, which appeared yesterday in Travelers Medicine and Infectious Disease, the researchers analyzed the isolates of 90 people who had contracted extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) while traveling abroad. The 90 participants were part of an earlier investigation, in which the researchers found that taking antibiotics for traveler’s diarrhea (TD) increased the risk of colonization by ESBL-PE, particularly when traveling to regions with poor hygiene and weak antibiotic policy (such as South and Southeast Asia). One of the main takeaways of that study was that travelers should be advised against taking antibiotics for mild or moderate TD.For this study, the researchers were trying to determine what percentage of those isolates were also co-resistant to non-beta-lactam antibiotics, as co-resistance can complicate treatment of ESBL-PE infections. They considered four major risk factors of colonization, including destination, age, TD, and antibiotic use.Of the ESBL-PE isolates, 53%, 52%, 73%, and 2% were co-resistant to ciprofloxacin, tobramycin, co-trimoxazole, and nitrofurantoin, respectively. The rates were similar among those with TD and without TD. But when they compared the isolates of the travelers who had taken fluoroquinolones (FQs) to those who had taken no antibiotics, they found co-resistance rates for ciprofloxacin were 95% versus 37%, for tobramycin were 85% versus 43%, for co-trimoxazole were 85% versus 68%, and for nitrofurantoin were 5% versus 2%.”Thus, use of FQs predisposes not only to contracting ESBL-PE strains but, indeed, also to selecting ESBL-PE strains co-resistant to certain clinically important non-beta-lactam antibiotics,” the authors write.”The data reveal that the perils of antibiotic use during travel are even greater than hitherto recognized.”Jan 30 Travel Med Infect Dis studylast_img read more

Controversy over data in hydroxychloroquine COVID-19 study grows

first_imgThe editors of The Lancet yesterday issued a statement acknowledging the criticism of a recent study that concluded that the antimalaria drugs hydroxychloroquine and chloroquine did not benefit COVID-19 patients and were associated with higher risk of death and serious heart rhythm complications.The statement comes in response to a letter signed by more than 100 scientists and clinicians worldwide that raised questions about the data behind the large observational study.The Lancet said in its statement that important scientific questions had been raised about the data reported in the paper, and that an independent audit of the data commissioned by the authors is ongoing.The study, published in The Lancet on May 22, compared outcomes in patients treated with hydroxychloroquine and chloroquine (with or without macrolide antibiotics) with those who received neither drug, and was the largest to date on the use of hydroxychloroquine and chloroquine in COVID-19 patients. But in the days following publication, several scientists took to social media to express skepticism about the study and the data on which it was based, and that criticism has continued.In an open letter to Lancet Editor Richard Horton late last week, critics raised concerns about the methodology of the study, asked that a group convened by the World Health Organization (WHO) perform an independent validation of the analysis, and requested that the journal make peer review comments on the study openly available.Concerns about bias and confoundingAmong the concerns laid out in the letter are that there was inadequate adjustment for known and measured confounders, such as severity of illness.That’s been a common criticism of several of the observational studies on use of hydroxychloroquine and chloroquine for COVID-19: that many of the patients treated with the drugs in these studies have been sicker. Experts say that the inability to fully account for more severe disease among patients treated with the drug skews the results.”Because it is an observational study, we know that bias and confounding can really affect the results,” said Ruanne Barnabas, MBChB, DPhil, a physician and associate professor of global health at the University of Washington who signed the letter. “My concern about it being observational was that it [hydroxychloroquine] was used compassionately for people who were more sick and likely to do worse anyway…so we would not be able to assess the impact using the study design.”That criticism is one of the main reasons why there is a consensus among experts that randomized controlled trials (RCTs)—the gold standard for evaluating whether a drug is truly safe and effective against a disease—are needed to determine whether the drugs can help COVID-19 patients.The letter also argued that the authors of the study have not released their code or data, that no ethics review was performed, and that some of the mean daily doses of hydroxychloroquine given to patients in the study are higher than US Food and Drug Administration recommendations. And it raised specific questions about some of the data points.In particular, the critics note that data from Australia are not compatible with country reports on COVID-19 cases, with too many cases for just five hospitals and more in-hospital deaths than had occurred in the entire country during the study period. In addition, data from Africa indicated that 25% of COVID-19 cases and 40% of deaths on the continent occurred in Surgisphere-associated hospitals, a claim that the letter said seems unlikely.In a correction published in The Lancet on May 30, the authors of the study provided revised numbers on participants from Asia and Australia, and said that a hospital self-designated as belonging to the Australasia continental designation should have been assigned to the Asian continental designation. But there were no changes to the findings of the paper.Data origins, validity questionedIn addition, the critics raised red flags about the origins of the data used in the study. The analysis of 96,032 patients from 671 hospitals on six continents used data from the Surgical Outcomes Collaborative, a database that collects de-identified patient information from electronic health records, supply chain databases, and financial records. The database is owned by Surgisphere, a company founded by study co-author Sapan Desai, MD, PhD.”There was no mention of the countries or hospitals that contributed to the data source and no acknowledgments of their contributions,” the letter states. “A request to the authors for information on the contributing centers was denied.””You can understand that individual patients don’t want to share their data, but at a minimum, knowing which hospitals contributed would be important,” Barnabas said, noting that in most observational studies, you know the hospitals where the data came from, and investigators from those hospitals are often co-authors.”Although an independent audit of the provenance and validity of the data has been commissioned by the authors not affiliated with Surgisphere and is ongoing, with results expected very shortly, we are issuing an Expression of Concern to alert readers to the fact that serious scientific questions have been brought to our attention,” The Lancet said.An emailed statement sent to CIDRAP News on behalf of lead study author Mandeep Mehra, MD, medical director of the Brigham and Women’s Hospital Heart and Vascular Center, said the goal of the independent third-party auditor is to verify the source data and assess the accuracy of the database and the authors’ findings.”Upon completion of the reviews, the auditor will simultaneously provide its findings directly to the editors of the journal and to the co-authors, independent of Surgisphere,” the statement said. “I eagerly await word from the independent audits, the results of which will inform any further action.”In a statement on its website, Surgisphere said the company’s data use agreements with hospitals prevent it from sharing customer names.”Our strong privacy standards are a major reason that hospitals trust Surgisphere and we have been able to collect data from over 1,200 institutions across 46 countries,” the company said. “While our data use agreements with these institutions prevents us from sharing patient level data or customer names, we are able to complete appropriate analyses and share aggregate findings to the wider scientific community.”The company also said it stands behind the integrity of its studies, scientific researchers, clinical partners, and data analysts.Surgisphere data were also used in another COVID-19 study, published in the New England Journal of Medicine on May 1, that has come into question. NEJM Editor-in-Chief Eric Rubin, MD, PhD, yesterday issued an Expression of Concern about that study, saying the journal has asked the authors to provide evidence that the data are reliable.     Study results, media coverage affecting clinical trialsAnother issue raised in the letter from the 100-plus scientists and clinicians is that the findings of The Lancet study, and subsequent media attention, have caused concern among those currently participating in RCTs. Barnabas, who is the principal investigator in an RCT looking at whether hydroxychloroquine can prevent illness in those who’ve been exposed to people with a confirmed or pending COVID-19 diagnosis, said the findings have affected recruitment.”Certainly our trial has seen a decrease in recruitment and enrollment with every news story that comes out,” Barnabas said. “When you talk to participants and you present all the information, they understand the impact of observational studies and they are willing to participate, but then a family member or a friend will encourage them not to participate, and we have had people withdraw.”Barnabas said an independent data safety and monitoring board has reviewed and analyzed all the unblinded safety data from the trial, along with data from other ongoing RCTs studying the use of hydroxychloroquine in COVID-19 patients, and recommended continuing the study. “They had no safety concerns,” she said.The WHO, meanwhile, after announcing last week that it was pausing recruitment to the hydroxychloroquine arm of its SOLIDARITY trial, said today that its data safety monitoring board had not found a safety signal, and that the study will resume.Barnabas said data from RCTs are “absolutely essential” for determining whether hydroxychloroquine can help prevent or treat COVID-19.”We definitely need those trials to go forward,” she said. “And we don’t need just one trial, we need several trials, in different populations, asking the question in slightly different ways, so that we can understand whether there is a role here for hydroxychloroquine.”last_img read more

Topper Volleyball Undefeated In District Play

first_imgLAHS Girls Topper Volleyball finished the season Saturday night with a 9-0 record and a 3-2 victory in the District Tournament Championship. Photo by John McHale/ladailypost.com SPORTS News:Los Alamos completed a clean sweep of District opponents and finished the season with a 9-0 record and a 3-2 victory in the District Tournament Championship game played Saturday night in Griffith Gymnasium.The Toppers kept things interesting dropping the first two sets before taking control in the last three. The first two sets were plagued with 9 hitting errors, 4 serving errors and 17 serve / receive errors. Once the Toppers shored this up they set sail for a dominating three sets.Natalie Gallegos wrecked the Pintos with 37 kills followed by Nadia Gallegos with 8 kills. Edkin, Gonzales and Schmierer combined for 14 kills. The Bigs combined for 23 Solo Blocks for Kills led by Natalie Gallegos with 10. Gracie Swensen led the way from the service line with 3 Aces and 14 points off serve.The Toppers mitigated service errors with 7 in 5 sets. Swensen and Maestas settled in for the last 3 sets and delivered spot on passing to Olivas. Olivas extended the Toppers leads with 4 (3 point runs) and 17 points on serve to help seal the last three sets. Next up is State!The Toppers were awarded the number 4 seed in the State Tournament and will play the Pojoaque Elkettes in the opening round at 9:45 a.m. Thursday on court 4 played at the Santa Ana Star Center in Rio Rancho.last_img read more