Synthesis of active electrocatalysts using glycine–nitrate chemistry

Due to sluggish oxygen reduction reactions, development in the solid oxide fuel cell (SOFC) field is stagnant. Two solutions, increasing the active surface or use of precious materials, can stimulate the oxygen reduction kinetics on electrodes. Thus, to gain both these benefits, the present article addressed the synthesis of high surface-area mixed oxide ionic–electronic conductor La0.6Sr0.4Co0.8Fe0.2O3-δ (LSCF) using chemistry of the propellant glycine–nitrate reaction. In this study, different fuel to oxidant ratios (ψ), 2.0, 2.6, and 3.0 were used to control the exothermicity of reaction and powder properties. The maximum reaction temperature of 1337 K at ψ = 3.0 resulted in coarsened powder. In contrast, comparatively less exothermicity of reaction at ψ = 2.0 resulted in powder with substantial Brunauer–Emmett–Teller surface area of 10.97 m2 g−1, with maximum powder compaction achieved at sintering of 1273 K. With optimal direct current in-plane electrical conductivity of 341 S cm−1, H2-temperature-programmed reduction showed excellent catalytic activity for the sample obtained at ψ = 2.0. The electrochemical performance comparisons of electrodes in two different cell geometries – with and without a gold catalytic current collecting layer (Au–CCCL) – revealed the least polarization and cell resistance in the cell with Au–CCCL. The electrode area specific resistance and cell conductivity using Au–CCCL were 0.097 Ω cm−2 and 0.15 S cm−1, respectively.publishe

The impact of the International Nosocomial Infection Control Consortium (INICC) multicenter, multidimensional hand hygiene approach in two cities of India

The fundamental tool for preventing and controlling healthcare-acquired infections is hand hygiene (HH). Nonetheless, adherence to HH guidelines is often low. Our goal was to assess the effect of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach (IMHHA) in three intensive care units of three INICC member hospitals in two cities of India and to analyze the predictors of compliance with HH. From August 2004 to July 2011, we carried out an observational, prospective, interventional study to evaluate the implementation of the IMHHA, which included the following elements: (1) administrative support, (2) supplies availability, (3) education and training, (4) reminders in the workplace, (5) process surveillance and (6) performance feedback. The practices of health care workers were monitored during randomly selected 30-min periods. We observed 3612 opportunities for HH. Overall adherence to HH increased from 36.9% to 82% (95% CI 79.3–84.5; P=0.0001). Multivariate analysis indicated that certain variables were significantly associated with poor HH adherence: nurses vs. physicians (70.5% vs. 74%; 95% CI 0.62–0.96; P=0.018), ancillary staff vs. physicians (43.6% vs. 74.0%; 95% CI 0.48–0.72; P<0.001), ancillary staff vs. nurses (43.6% vs. 70.5%; 95% CI 0.51–0.75; P<0.001) and private vs. academic hospitals (74.2% vs. 66.3%; 95% CI 0.83–0.97; P<0.001). It is worth noticing that in India, the HH compliance of physicians is higher than in nurses. Adherence to HH was significantly increased by implementing the IMHHA. Programs targeted at improving HH are warranted to identify predictors of poor compliance

Time-dependent analysis of extra length of stay and mortality due to ventilator-associated pneumonia in intensive-care units of ten limited-resources countries: findings of the International Nosocomial Infection Control Consortium (INICC)

Ventilator-associated pneumonias (VAPs) are a worldwide problem that significantly increases patient morbidity, mortality, and length of stay (LoS), and their effects should be estimated to account for the timing of infection. The purpose of the study was to estimate extra LoS and mortality in an intensive-care unit (ICU) due to a VAP in a cohort of 69 248 admissions followed for 283 069 days in ICUs from 10 countries. Data were arranged according to the multi-state format. Extra LoS and increased risk of death were estimated independently in each country, and their results were combined using a random-effects meta-analysis. VAP prolonged LoS by an average of 2.03 days (95% CI 1.52-2.54 days), and increased the risk of death by 14% (95% CI 2-27). The increased risk of death due to VAP was explained by confounding with patient morbidity