Surface sampling within a pediatric ward—how multiple factors affect cleaning efficacy

BACKGROUND: The objectives of this study were to assess the number of organisms present on different surfaces within a clinical environment before and after cleaning took place, and to identify the impact of cleaning. The study involved extensive 2-week microbiological environmental monitoring of an entire ward before and after cleaning; the ward was located within a pediatric hematology-oncology ward comprised of a day unit and outpatient ward. METHODS: Tryptone soya agar contact plates were used to take a total of 1,160 surface samples before and after cleaning from 55 predetermined sites. Samples were taken from representative surfaces throughout the ward representing a variety of materials, surface heights, functions, and distances from patients, as well as both high-touch and infrequently touched surfaces. RESULTS: After surface cleaning was undertaken within the ward, there was a significant difference between the amount of colony-forming units (CFUs) recovered before and after cleaning (P < .0001). Cleaning produced an average CFU reduction of 68% throughout the ward environment. The corridor was the most contaminated area within the ward. There were differences in the CFUs among the various areas within the ward, which were cleaned with varying efficiency. The surface material, who interacted with the surface, levels of initial contamination, perceived risk, and perceived cleanability were all found to have a varying impact on the cleaning effectiveness. CONCLUSIONS: To the authors' current knowledge, this is the only study to assess cleaning within a pediatric ward by taking samples directly before and after cleaning. The standard of cleaning undertaken within the ward is open for discussion, and these data highlight the need for an improved cleaning intervention and can provide insight into the multitude of factors that must be considered when designing an effective training protocol

Technical feasibility of storage on large dish stirling systems

Dish-Stirling systems have been demonstrated to provide high-efficiency solar-only electrical generation, holding the world record at 31.25%. This high efficiency results in a system with a high possibility of meeting the DOE SunShot goal of $0.06/kWh. Current dish-Stirling systems do not incorporate thermal storage. For the next generation of non-intermittent and cost-competitive solar power plants, we propose a thermal energy storage system that combines latent (phase-change) energy transport and latent energy storage in order to match the isothermal input requirements of Stirling engines while also maximizing the exergetic efficiency of the entire system. This report takes an initial look at the technical advantages of dish Stirling with storage as well as the technical challenges, in order to make a preliminary estimate as to the technical feasibility of such a system. We find that a storage system using metallic eutectic phase change storage results in a feasible physical embodiment, with mass, volume, and complexity suitable for 25kWe dish Stirling systems. The results indicate a system with 6 hours of storage and a solar multiple of 1.25 provides the optimum impact to LCOE and profit. Further, for no negative impact on LCOE, the optimal storage system may cost as much as$82/kWhth or $33k/dish, a substantial departure from the SunShot goals for tower systems. The storage system also is shown to have substantial structural benefits to the dish design. In addition, there may be benefits in terms of capacity payments or failure-to-deliver penalties. A dish storage system design must take into account the value placed on storage by the PUC or utility

Development and application of the GIM code for the Cyber 203 computer

The GIM computer code for fluid dynamics research was developed. Enhancement of the computer code, implicit algorithm development, turbulence model implementation, chemistry model development, interactive input module coding and wing/body flowfield computation are described. The GIM quasi-parabolic code development was completed, and the code used to compute a number of example cases. Turbulence models, algebraic and differential equations, were added to the basic viscous code. An equilibrium reacting chemistry model and implicit finite difference scheme were also added. Development was completed on the interactive module for generating the input data for GIM. Solutions for inviscid hypersonic flow over a wing/body configuration are also presented

New insights into North Sea deep crustal structure and extension from transdimensional ambient noise tomography

SUMMARY The deep crustal structure beneath the North Sea is poorly understood since it is constrained by only a few seismic reflection and refraction profiles. However, it is widely acknowledged that the mid to lower crust plays important roles in rift initiation and evolution, particularly when large-scale sutures and/or terrane boundaries are present, since these inherited features can focus strain or act as inhibitors to extensional deformation. Ancient tectonic features are known to exist beneath the iconic failed rift system of the North Sea, making it an ideal location to investigate the complex interplay between pre-existing regional heterogeneity and rifting. To this end, we produce a 3-D shear wave velocity model from transdimensional ambient seismic noise tomography to constrain crustal properties to ∼30 km depth beneath the North Sea and its surrounding landmasses. Major North Sea sedimentary basins appear as low shear wave velocity zones that are a good match to published sediment thickness maps. We constrain relatively thin crust (13–18 km) beneath the Central Graben depocentres that contrasts with crust elsewhere at least 25–30 km thick. Significant variations in crustal structure and rift symmetry are identified along the failed rift system that appears to be related to the locations of Laurentia–Avalonia–Baltica palaeoplate boundaries. We constrain first-order differences in structure between palaeoplates; with strong lateral gradients in crustal velocity related to Laurentia–Avalonia–Baltica plate juxtaposition and reduced lower crustal velocities in the vicinity of the Thor suture, possibly representing the remnants of a Caledonian accretionary complex. Our results provide fresh insight into the pivotal roles that ancient terranes can play in the formation and failure of continental rifts and may help explain the characteristics of other similar continental rifts globally.</jats:p

Enterovirus infection and type 1 diabetes mellitus: systematic review and meta-analysis of observational molecular studies

Objective To review the association between current enterovirus infection diagnosed with molecular testing and development of autoimmunity or type 1 diabetes

Structure of the crust and upper mantle beneath Bass Strait, southeast Australia, from teleseismic body wave tomography

© 2019 Elsevier B.V. We present new constraints on the lithospheric velocity structure of Bass Strait and the adjoining landmasses of mainland Australia and Tasmania in order to better constrain their geological and tectonic relationship. This is achieved by performing teleseismic tomography using data from fifteen deployments of WOMBAT and BASS transportable arrays, which span southeastern Australia. The starting model for the teleseismic tomography includes crustal velocity structure constrained by surface waves extracted from ambient seismic noise data and a Moho surface and broad-scale variations in 3-D upper mantle velocity structure from the Australian seismological reference Earth model (AuSREM). As a consequence, we produce a model with a high level of detail in both the crust and upper mantle. Our new results strengthen the argument for a low velocity upper mantle anomaly that extends down to ~150 km depth directly beneath the Newer Volcanics Province in Victoria, which is likely related to recent intra-plate volcanism. Beneath Bass Strait, which is thought to host the entrained VanDieland microcontinent, upper mantle velocities are low relative to those typically found beneath Precambrian continental crust; it is possible that failed rifting in Bass Strait during the Cretaceous, opening of the Tasman Sea, extension of VanDieland during Rodinian break-up and recent plume activity in the past 5 Ma may have altered the seismic character of this region. The data nevertheless suggest: (1) the velocity structure of the VanDieland microcontinent lacks continuity within its lithosphere; (2) the Moyston Fault defines an area of strong velocity transition at the boundary between the Cambrian Delamerian Orogen and the Cambrian-Carboniferous Lachlan Orogen; and (3) there is a rapid decrease in mantle velocity inboard of the east coast of Australia, which is consistent with substantial thinning of the lithosphere towards the passive margin

Does size matter? The impact of a small but targeted cleaning training intervention within a paediatric ward

Background: Cleaning is a critical tool for infection prevention and control, and is a key intervention for preventing healthcare associated infections (HCAIs) and controlling intermediate transmission routes between patient and environment. This study sought to identify potential areas of weakness in clinical surface cleaning, and assess the effectiveness of a staff group specific training intervention. Observations: One-hundred hours of audit observations in a paediatric cardiac intensive care unit (CICU) assessed surface cleaning technique of healthcare staff within bedspaces. Cleaning was assessed with a 5-component bundle, with each cleaning opportunity scored out of five. Training Intervention: Fifty hours of audit observations before and after a training intervention tested the efficacy of a staff group specific education intervention. The intervention was developed and implemented for 69% of nurses and 100% of cleaners. Results: One hundred and eighteen cleaning opportunities were observed before training, and scored an average of 2.4. One hundred and twenty-one cleaning opportunities were observed after training and scored an average 3.0. On average, before training, each cleaning opportunity by nurses and cleaners fulfilled 2.4 and 2.5, respectively, of the 5 bundle components. Following training, this improved to 3.3 and 2.9 respectively. There was a statistically significant improvement in bundle scores for nurses (P=.004) and cleaners (P=.0003). Conclusions: Surface wipe methods were inconsistent between all staff groups. The education based intervention resulted in a small improvement in most of the cleaning components. This study has identified how a small but targeted cleaning training intervention can have a significant (P= <.0001) impact on cleaning bundle compliance for both nurses and cleaners

Seismic tomography of the North Anatolian Fault: New insights into structural heterogeneity along a continental strike-slip fault

Knowledge of the structure of continental strike-slip faults within the lithosphere is essential to understand where the deformation occurs and how strain localizes with depth. With the aim to improve the constraints on the lower crust and upper mantle structure of a major continental strike-slip fault, we present a high-resolution teleseismic tomography of the North Anatolian Fault Zone (NAFZ) in Turkey. Our results highlight the presence of a relatively high velocity body between the two branches of the fault and significant along-strike variations in the NAFZ velocity structure over distances of ~20 km. We interpret these findings as evidence of laterally variable strain focussing caused by preexisting heterogeneity. Low velocities observed in the crust and upper mantle beneath the NAFZ support the presence of a narrow shear zone widening in the upper mantle, where we constrain its width to be ~50 km.Major funding was provided by the UK Natural Environment Research Council (NERC) under grant NE/I028017/1. Equipment was provided and supported by the NERC Geophysical Equipment Facility (SEIS-UK). This project is also supported by Bogaziçi University Scientific ˘ Research Projects (BAP) under grant 6922 and Turkish State Planning Organization (DPT) under the TAM project, number 2007K120610

Total Angular Momentum Conservation in Ab Initio Born-Oppenheimer Molecular Dynamics

We prove both analytically and numerically that the total angular momentum of a molecular system undergoing adiabatic Born-Oppenheimer dynamics is conserved only when pseudo-magnetic Berry forces are taken into account. This finding sheds light on the nature of Berry forces for molecular systems with spin-orbit coupling and highlights how ab initio Born-Oppenheimer molecular dynamics simulations can successfully capture the entanglement of spin and nuclear degrees of freedom as modulated by electronic interactions

Buried treasure—marine turtles do not ‘disguise’ or ‘camouflage’ their nests but avoid them and create a decoy trail

After laying their eggs and refilling the egg chamber, sea turtles scatter sand extensively around the nest site. This is presumed to camouflage the nest, or optimize local conditions for egg development, but a consensus on its function is lacking. We quantified activity and mapped the movements of hawksbill (Eretmochelys imbricata) and leatherback (Dermochelys coriacea) turtles during sand-scattering. For leatherbacks, we also recorded activity at each sand-scattering position. For hawksbills, we recorded breathing rates during nesting as an indicator of metabolic investment and compared with published values for leatherbacks. Temporal and inferred metabolic investment in sand-scattering was substantial for both species. Neither species remained near the nest while sand-scattering, instead moving to several other positions to scatter sand, changing direction each time, progressively displacing themselves from the nest site. Movement patterns were highly diverse between individuals, but activity at each sand-scattering position changed little between completion of egg chamber refilling and return to the sea. Our findings are inconsistent with sand-scattering being to directly camouflage the nest, or primarily for modifying the nest-proximal environment. Instead, they are consistent with the construction of a series of dispersed decoy nests that may reduce the discovery of nests by predators