Impact of environmental hygiene interventions on healthcare-associated infections and patient colonization: a systematic review

BACKGROUND Healthcare-associated infections (HAI) are one of the gravest threats to patient safety worldwide. The importance of the hospital environment has recently been revalued in infection prevention and control. Though the literature is evolving rapidly, many institutions still do not consider healthcare environmental hygiene (HEH) very important for patient safety. The evidence for interventions in the healthcare environment on patient colonization and HAI with multidrug-resistant microorganisms (MDROs) or other epidemiologically relevant pathogens was reviewed. METHODS We performed a systematic review according to the PRISMA guidelines using the PubMed and Web of Science databases. All original studies were eligible if published before December 31, 2019, and if the effect of an HEH intervention on HAI or patient colonization was measured. Studies were not eligible if they were conducted in vitro, did not include patient colonization or HAI as an outcome, were bundled with hand hygiene interventions, included a complete structural rebuild of the healthcare facility or were implemented during an outbreak. The primary outcome was the comparison of the intervention on patient colonization or HAI compared to baseline or control. Interventions were categorized by mechanical, chemical, human factors, or bundles. Study quality was assessed using a specifically-designed tool that considered study design, sample size, control, confounders, and issues with reporting. The effect of HEH interventions on environmental bioburden was studied as a secondary outcome. FINDINGS After deduplication, 952 records were scrutinized, of which 44 were included for full text assessment. A total of 26 articles were included in the review and analyzed. Most studies demonstrated a reduction of patient colonization or HAI, and all that analyzed bioburden demonstrated a reduction following the HEH intervention. Studies tested mechanical interventions (n = 8), chemical interventions (n = 7), human factors interventions (n = 3), and bundled interventions (n = 8). The majority of studies (21/26, 81%) analyzed either S. aureus, C. difficile, and/or vancomycin-resistant enterococci. Most studies (23/26, 88%) reported a decrease of MDRO-colonization or HAI for at least one of the tested organisms, while 58% reported a significant decrease of MDRO-colonization or HAI for all tested microorganisms. Forty-two percent were of good quality according to the scoring system. The majority (21/26, 81%) of study interventions were recommended for application by the authors. Studies were often not powered adequately to measure statistically significant reductions. INTERPRETATION Improving HEH helps keep patients safe. Most studies demonstrated that interventions in the hospital environment were related with lower HAI and/or patient colonization. Most of the studies were not of high quality; additional adequately-powered, high-quality studies are needed. Systematic registration number: CRD42020204909

Blending of nanoscale and microscale in uniform large-area sculptured thin-film architectures

The combination of large thickness ($>3$ $\mu$m), large--area uniformity (75 mm diameter), high growth rate (up to 0.4 $\mu$m/min) in assemblies of complex--shaped nanowires on lithographically defined patterns has been achieved for the first time. The nanoscale and the microscale have thus been blended together in sculptured thin films with transverse architectures. SiO$_x$ ($x\approx 2$) nanowires were grown by electron--beam evaporation onto silicon substrates both with and without photoresist lines (1--D arrays) and checkerboard (2--D arrays) patterns. Atomic self--shadowing due to oblique--angle deposition enables the nanowires to grow continuously, to change direction abruptly, and to maintain constant cross--sectional diameter. The selective growth of nanowire assemblies on the top surfaces of both 1--D and 2--D arrays can be understood and predicted using simple geometrical shadowing equations.Comment: 17 pages, 9 figure

Roadmap on dynamics of molecules and clusters in the gas phase

This roadmap article highlights recent advances, challenges and future prospects in studies of the dynamics of molecules and clusters in the gas phase. It comprises nineteen contributions by scientists with leading expertise in complementary experimental and theoretical techniques to probe the dynamics on timescales spanning twenty order of magnitudes, from attoseconds to minutes and beyond, and for systems ranging in complexity from the smallest (diatomic) molecules to clusters and nanoparticles. Combining some of these techniques opens up new avenues to unravel hitherto unexplored reaction pathways and mechanisms, and to establish their significance in, e.g. radiotherapy and radiation damage on the nanoscale, astrophysics, astrochemistry and atmospheric science

Quantum calculation of vibrational states in the aniline-argon Van der Waals cluster

Contains fulltext : 6852.pdf (publisher's version ) (Open Access

Fighting the good fight: the fallout of fake news in infection prevention and why context matters

Although misinformation has always existed, the scope and speed at which fake news can reach even the most remote corners of the globe is a modern phenomenon. In the field of infection prevention and control (IPC), we like to believe that our dedication to the field and the process of conducting science protects us from the ravages of 'bad buzz' and fake news. This misconception leads medical professionals to underestimate the negative effects of misinformation on public health. This paper focuses on the nexus of what is happening between the field of IPC and the public. Its aim is to examine how information gets distorted and amplified between the medical community and the public, and outline some of the issues that deserve further attention. It looks at a number of case studies which show that even one badly conducted study can have a severe negative impact on public health, and that a well-conducted study can be distorted to make people believe something fallacious. In the current system of publishing and the proliferation of online journals that publish without peer review, 'bad buzz' and fake news can quickly do a good deal of damage

Préparation d’alliages à base de PVC/poly(p-phénylène-1,3,5-hexatriénylène) : propriétés électromagnétiques et structure

Des composites conducteurs ont été réalisés après synthèse d’oligomères conjugués à base de poly(p-phénylène-1,3,5-hexatriénylène), dispersion dans une matrice polymère PVC isolante, et dopage à l’acide sulfurique du film obtenu. Des mesures effectuées en hyperfréquence de 10 kHz à 10 GHz ont permis de mettre en évidence des valeurs de conductivité de l’ordre de 10-3 à 10-1 Scm-1, et ont également servi de support à des travaux de modélisation de la permittivité diélectrique selon la théorie du Milieu Effectif Généralisé(GEM) proposée par McLachlan; des informations sur la forme des particules et la microstructure des composites ont pu en être déduites

Results of an international pilot survey on healthcare environmental hygiene at the facility level

Background: Healthcare-associated infections (HAIs) are a major threat to patient safety worldwide. The importance of the healthcare environment in patient care is not always adequately addressed. Currently, no overview exists of how healthcare environmental hygiene (HEH) is performed around the world. Methods: Our pilot survey tested a preliminary version of a framework for HEH self-assessment. It aimed to gather data to improve the framework as well as evaluate the strengths and challenges in HEH programs around the world, and across resource levels. The survey was developed by a group of experts, and based on the hand hygiene multimodal improvement strategy. The online survey was sent to 743 healthcare facilities (HCFs) from all of the World Bank income levels, aiming for at least four participants from each level. Overall responses were analyzed as a group as well as stratified per income level using OpenEpi. Results: Overall, 51 HCFs from 35 countries participated. Almost all HCFs surveyed (50/51, 98%) were found lacking in some or all of the five components of the WHO multimodal strategy independent of income level. The results demonstrate the widespread challenges in HEH institutions are facing around the world. Conclusion: The feedback from survey participants allowed for the improvement of the self-assessment tool. There is a clear need for more focus on and investment in HEH programs in HCFs worldwide.</p

Experimental characterisation of the wake behind paired vertical-axis wind turbines

Two vertical-axis wind turbines (VAWTs) benefit from a power increase when placed side by side in close proximity. To study the potential of paired VAWTs for integration in wind farms, wind tunnel wake measurements of lift-driven VAWTs are compared for isolated and three counter-rotating configurations. Because the wake of an isolated VAWT is deflected, the direction of rotation significantly influences the wake of paired VAWTs. The wake of counter-rotating VAWTs where the adjacent blades move downwind, exhibits a similar length, width and replenishment as the wake of an isolated VAWT. The wake of counter-rotating VAWTs with adjacent upwind moving blades, however, significantly differs from an isolated VAWT wake. While its wake length is similar to an isolated VAWT wake, its width and replenishment are not. Because of appealing wake characteristics, paired VAWTs exhibit unique advantages for wind farm applications, and especially for offshore floating wind farms

Diffusion-driven transport in clayrock formations

Clay mineral-rich sedimentary formations are currently under investigation to evaluate their potential use as host formations for installation of deep underground disposal facilities for radioactive waste (e.g. Boom Clay (BE), Opalinus Clay (CH), Callovo-Oxfordian argillite (FR)). The ultimate safety of the corresponding repository concepts depends largely on the capacity of the host formation to limit the flux towards the biosphere of radionuclides (RN) contained in the waste to acceptably low levels. Data for diffusion-driven transfer in these formations shows extreme differences in the measured or modelled behaviour for various radionuclides, e. g. between halogen RN (Cl-36, I-129) and actinides (U-238,U-235, Np-237, Th-232, etc.), which result from major differences between RN of the effects on transport of two phenomena: diffusion and sorption. This paper describes recent research aimed at improving understanding of these two phenomena, focusing on the results of studies carried out during the EC Funmig IP on clayrocks from the above three formations and from the Boda formation (HU). Project results regarding phenomena governing water, cation and anion distribution and mobility in the pore volumes influenced by the negatively-charged surfaces of clay minerals show a convergence of the modelling results for behaviour at the molecular scale and descriptions based on electrical double layer models. Transport models exist which couple ion distribution relative to the clay-solution interface and differentiated diffusive characteristics. These codes are able to reproduce the main trends in behaviour observed experimentally, e.g. D-e(anion) < D-e(HTO) < D-e(cation) and D-e(anion) variations as a function of ionic strength and material density. These trends are also well-explained by models of transport through ideal porous matrices made up of a charged surface material. Experimental validation of these models is good as regards monovalent alkaline cations, in progress for divalent electrostatically-interacting cations (e.g. Sr2+) and still relatively poor for 'strongly sorbing', high K-d cations. Funmig results have clarified understanding of how clayrock mineral composition, and the corresponding organisation of mineral grain assemblages and their associated porosity, can affect mobile solute (anions, HTO) diffusion at different scales (mm to geological formation). In particular, advances made in the capacity to map clayrock mineral grain-porosity organisation at high resolution provide additional elements for understanding diffusion anisotropy and for relating diffusion characteristics measured at different scales. On the other hand, the results of studies focusing on evaluating the potential effects of heterogeneity on mobile species diffusion at the formation scale tend to show that there is a minimal effect when compared to a homogeneous property model. Finally, the results of a natural tracer-based study carried out on the Opalinus Clay formation increase confidence in the use of diffusion parameters measured on laboratory scale samples for predicting diffusion over geological time-space scales. Much effort was placed on improving understanding of coupled sorption-diffusion phenomena for sorbing cations in clayrocks. Results regarding sorption equilibrium in dispersed and compacted materials for weakly to moderately sorbing cations (Sr2+, Cs+, Co2+) tend to show that the same sorption model probably holds in both systems. It was not possible to demonstrate this for highly sorbing elements such as Eu(III) because of the extremely long times needed to reach equilibrium conditions, but there does not seem to be any clear reason why such elements should not have similar behaviour. Diffusion experiments carried out with Sr2+, Cs+ and Eu(III) on all of the clayrocks gave mixed results and tend to show that coupled diffusion-sorption migration is much more complex than expected, leading generally to greater mobility than that predicted by coupling a batch-determined K-d and Ficks law based on the diffusion behaviour of HTO. If the K-d measured on equivalent dispersed systems holds as was shown to be the case for Sr, Cs (and probably Co) for Opalinus Clay, these results indicate that these cations have a D-e value higher than HTO (up to a factor of 10 for Cs+). Results are as yet very limited for very moderate to strongly sorbing species (e.g. Co(II), Eu(III), Cu(II)) because of their very slow transfer characteristics. (C) 2011 Elsevier Ltd. All rights reserved

Correlation between the Indium Tin Oxide morphology and the performances of polymer light-emitting diodes

This paper reports on performance enhancement of polymer light-emitting diodes (PLEDs) based on poly(2,5-bis(3′,7′-dimethyl-octyloxy)1,4-phenylene-vinylene) (BDMO-PPV) after Indium Tin Oxide (ITO) pre-treatment. Diluted aqua regia surface treatments of ITO substrates were investigated before PLEDs manufacturing. The correlation between ITO surface morphology and the properties of devices were discussed. The residual roughness, the global ITO thickness and developed anodic active area were found extremely dependent on treatment time. The performances of the ITO/BDMO-PPV/Ca/Al diodes were improved. With long treatments, the roughness was dramatically increased and poor PLEDs performances were achieved. The incorporation of a conducting polymer layer, poly(3,4-ethylene dioxythiophene) doped with polystyrene sulfonate, between the ITO layer and the emissive polymer, was also studied. With this buffer layer, no effect of the acidic treatment was observed on luminance–voltage characteristics and low turn-on voltage devices were made