Infection prevention and control in ultrasound - best practice recommendations from the European Society of Radiology Ultrasound Working Group

Abstract Objectives The objective of these recommendations is to highlight the importance of infection prevention and control in ultrasound (US), including diagnostic and interventional settings. Methods Review of available publications and discussion within a multidisciplinary group consistent of radiologists and microbiologists, in consultation with European patient and industry representatives. Recommendations Good basic hygiene standards are essential. All US equipment must be approved prior to first use, including hand held devices. Any equipment in direct patient contact must be cleaned and disinfected prior to first use and after every examination. Regular deep cleaning of the entire US machine and environment should be undertaken. Faulty transducers should not be used. As outlined in presented flowcharts, low level disinfection is sufficient for standard US on intact skin. For all other minor and major interventional procedures as well as all endo-cavity US, high level disinfection is mandatory. Dedicated transducer covers must be used when transducers are in contact with mucous membranes or body fluids and sterile gel should be used inside and outside covers. Conclusions Good standards of basic hygiene and thorough decontamination of all US equipment as well as appropriate use of US gel and transducer covers are essential to keep patients safe. Main messages • Transducers must be cleaned/disinfected before first use and after every examination. • Low level disinfection is sufficient for standard US on intact skin. • High level disinfection is mandatory for endo-cavity US and all interventions. • Dedicated transducer covers must be used for endo-cavity US and all interventions. • Sterile gel should be used for all endo-cavity US and all interventions

Richness, not evenness, varies across water availability gradients in grassy biomes on five continents

We sought to understand the role that water availability (expressed as an aridity index) plays in determining regional and global patterns of richness and evenness, and in turn how these water availability–diversity relationships may result in different richness–evenness relationships at regional and global scales. We examined relationships between water availability, richness and evenness for eight grassy biomes spanning broad water availability gradients on five continents. Our study found that relationships between richness and water availability switched from positive for drier (South Africa, Tibet and USA) vs. negative for wetter (India) biomes, though were not significant for the remaining biomes. In contrast, only the India biome showed a significant relationship between water availability and evenness, which was negative. Globally, the richness–water availability relationship was hump-shaped, however, not significant for evenness. At the regional scale, a positive richness–evenness relationship was found for grassy biomes in India and Inner Mongolia, China. In contrast, this relationship was weakly concave-up globally. These results suggest that different, independent factors are determining patterns of species richness and evenness in grassy biomes, resulting in differing richness–evenness relationships at regional and global scales. As a consequence, richness and evenness may respond very differently across spatial gradients to anthropogenic changes, such as climate change.Fil: Smith, Melinda D.. State University of Colorado - Fort Collins; Estados UnidosFil: Koerner, Sally E.. North Carolina State University; Estados UnidosFil: Avolio, Meghan L.. University Johns Hopkins; Estados UnidosFil: Komatsu, Kimberly J.. SMITHSONIAN ENVIRONMENTAL RESEARCH CENTER (SERC);Fil: Eby, Stephanie. Northeastern University; Estados UnidosFil: Forrestel, Elisabeth J.. University Northeastern; Estados UnidosFil: Collins, Scott L.. University of California at Davis; Estados UnidosFil: Wilcox, Kevin R.. University of New Mexico; Estados UnidosFil: Ahumada, Rodrigo José. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Buenos Aires; ArgentinaFil: Morgan, John W.. La Trobe University; AustraliaFil: Oliva, Gabriel. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Buenos Aires; ArgentinaFil: Oñatibia, Gastón Rafael. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura. Universidad de Buenos Aires. Facultad de Agronomía. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura; ArgentinaFil: Overbeck, Gerhard E.. Universidade Federal do Rio Grande do Sul; BrasilFil: Peter, Guadalupe. Universidad Nacional de Río Negro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Quiroga, Raul Emiliano. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Catamarca-La Rioja. Estación Experimental Agropecuaria Catamarca; ArgentinaFil: Sankaran, Mahesh. No especifíca;Fil: Wu, Jianshuang. No especifíca;Fil: Yahdjian, María Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura. Universidad de Buenos Aires. Facultad de Agronomía. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura; ArgentinaFil: Yu, Qiang. Beijing Forestry University; Chin