SysMART Indoor Services: A System of Smart and Connected Supermarkets

Smart gadgets are being embedded almost in every aspect of our lives. From smart cities to smart watches, modern industries are increasingly supporting the Internet of Things (IoT). SysMART aims at making supermarkets smart, productive, and with a touch of modern lifestyle. While similar implementations to improve the shopping experience exists, they tend mainly to replace the shopping activity at the store with online shopping. Although online shopping reduces time and effort, it deprives customers from enjoying the experience. SysMART relies on cutting-edge devices and technology to simplify and reduce the time required during grocery shopping inside the supermarket. In addition, the system monitors and maintains perishable products in good condition suitable for human consumption. SysMART is built using state-of-the-art technologies that support rapid prototyping and precision data acquisition. The selected development environment is LabVIEW with its world-class interfacing libraries. The paper comprises a detailed system description, development strategy, interface design, software engineering, and a thorough analysis and evaluation.Comment: 7 pages, 11 figur

Rhodococcus Bacteremia in Cancer Patients Is Mostly Catheter Related and Associated with Biofilm Formation

Rhodococcus is an emerging cause of opportunistic infection in immunocompromised patients, most commonly causing cavitary pneumonia. It has rarely been reported as a cause of isolated bacteremia. However, the relationship between bacteremia and central venous catheter is unknown. Between 2002 and 2010, the characteristics and outcomes of seventeen cancer patients with Rhodococcus bacteremia and indwelling central venous catheters were evaluated. Rhodococcus bacteremias were for the most part (94%) central line-associated bloodstream infection (CLABSI). Most of the bacteremia isolates were Rhodococcus equi (82%). Rhodococcus isolates formed heavy microbial biofilm on the surface of polyurethane catheters, which was reduced completely or partially by antimicrobial lock solution. All CLABSI patients had successful response to catheter removal and antimicrobial therapy. Rhodococcus species should be added to the list of biofilm forming organisms in immunocompromised hosts and most of the Rhodococcus bacteremias in cancer patients are central line associated

Effect of Algorithm-Based Therapy vs Usual Care on Clinical Success and Serious Adverse Events in Patients with Staphylococcal Bacteremia: A Randomized Clinical Trial

Importance: The appropriate duration of antibiotics for staphylococcal bacteremia is unknown. Objective: To test whether an algorithm that defines treatment duration for staphylococcal bacteremia vs standard of care provides noninferior efficacy without increasing severe adverse events. Design, Setting, and Participants: A randomized trial involving adults with staphylococcal bacteremia was conducted at 16 academic medical centers in the United States (n = 15) and Spain (n = 1) from April 2011 to March 2017. Patients were followed up for 42 days beyond end of therapy for those with Staphylococcus aureus and 28 days for those with coagulase-negative staphylococcal bacteremia. Eligible patients were 18 years or older and had 1 or more blood cultures positive for S aureus or coagulase-negative staphylococci. Patients were excluded if they had known or suspected complicated infection at the time of randomization. Interventions: Patients were randomized to algorithm-based therapy (n = 255) or usual practice (n = 254). Diagnostic evaluation, antibiotic selection, and duration of therapy were predefined for the algorithm group, whereas clinicians caring for patients in the usual practice group had unrestricted choice of antibiotics, duration, and other aspects of clinical care. Main Outcomes and Measures: Coprimary outcomes were (1) clinical success, as determined by a blinded adjudication committee and tested for noninferiority within a 15% margin; and (2) serious adverse event rates in the intention-to-treat population, tested for superiority. The prespecified secondary outcome measure, tested for superiority, was antibiotic days among per-protocol patients with simple or uncomplicated bacteremia. Results: Among the 509 patients randomized (mean age, 56.6 [SD, 16.8] years; 226 [44.4%] women), 480 (94.3%) completed the trial. Clinical success was documented in 209 of 255 patients assigned to algorithm-based therapy and 207 of 254 randomized to usual practice (82.0% vs 81.5%; difference, 0.5% [1-sided 97.5% CI, -6.2% to ∞]). Serious adverse events were reported in 32.5% of algorithm-based therapy patients and 28.3% of usual practice patients (difference, 4.2% [95% CI, -3.8% to 12.2%]). Among per-protocol patients with simple or uncomplicated bacteremia, mean duration of therapy was 4.4 days for algorithm-based therapy vs 6.2 days for usual practice (difference, -1.8 days [95% CI, -3.1 to -0.6]). Conclusions and Relevance: Among patients with staphylococcal bacteremia, the use of an algorithm to guide testing and treatment compared with usual care resulted in a noninferior rate of clinical success. Rates of serious adverse events were not significantly different, but interpretation is limited by wide confidence intervals. Further research is needed to assess the utility of the algorithm. Trial Registration: ClinicalTrials.gov Identifier: NCT01191840

Comparative Effectiveness and Persistence of Antimicrobial Durability in Dry and Wet States of a Novel Antimicrobial Surface Disinfectant

Aims: We evaluated a novel disinfectant (VR) and seven comparators (disinfectants A–G) against resistant pathogens common in healthcare settings. Methods and Results: VR at different dilutions, along with commercial disinfectants A–G, was tested against surrogate viruses, and resistant bacterial and fungal pathogens. Surrogate viruses had an initial concentration of ~1 × 108 mL−1, and bacterial and fungal isolates had an initial concentration of ~1 × 106 mL−1 on Siliconee surfaces. After the application of VR or a comparator disinfectant, surfaces were tested for the reduction in microbial loads after 30 s and 5 min wet exposures, and after a 24 h dry residue exposure. Sterile deionized water was used as a control. The VR at a concentration of 4.68% was superior to all comparator disinfectants against most pathogens in wet and dry testing. The VR at 7.8% concentration showed the highest pathogen-reduction rate among all comparator disinfectants when tested against all pathogens. Conclusions: Overall, the novel VR disinfectant was the most effective disinfectant in both wet and dry residue states against the range of tested pathogens. Significance and Impact of the Study: VR is a broadly effective disinfectant combination for use in high-risk settings, particularly those in which intervals between applications of disinfectant can be lengthy or inconsistent

Insights on the Role of Antimicrobial Cuffed Endotracheal Tubes in Preventing Transtracheal Transmission of VAP Pathogens from an In Vitro Model of Microaspiration and Microbial Proliferation

We developed an in vitro model to evaluate the effect of different cuffed endotracheal tubes (ETTs) on transtracheal transmission of ventilator-associated pneumonia (VAP) pathogens along external surfaces of ETTs. The model independently assessed the relative contributions of microbial proliferation to the distal tip and microaspiration of contaminated secretions past the cuff by testing in three modes: microaspiration only, microbial proliferation only, and simultaneous microaspiration and microbial proliferation. We evaluated transmission of methicillin resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa (PA) in the presence of a standard ETT; a soft, tapered cuff ETT with subglottic suctioning; and a novel antimicrobial gendine (combination of gentian violet and chlorhexidine) ETT in the model. In the microaspiration only mode, when leakage past the cuff occurred quickly, no ETT prevented transmission. When microaspiration was delayed, the gendine ETT was able to completely disinfect the fluid above the cuff and thereby prevent transmission of pathogens. In microbial proliferation only mode, the gendine ETT was the sole ETT that prevented transmission. With both mechanisms simultaneously available, transmission was dependent on how long microaspiration was delayed. Potent antimicrobial ETTs, such as a gendine ETT, can make unique contributions to prevent VAP when microaspiration is gradual