Randomised clinical trial:2% taurolidine versus 0.9% saline locking in patients on home parenteral nutrition

Background: The catheter lock solutions 2% taurolidine and 0.9% saline are both used to prevent catheter-related bloodstream infections (CRBSIs) in home parenteral nutrition patients. Aims: To compare the effectiveness and safety of taurolidine and saline. Methods: This multicentre double-blinded trial randomly assigned home parenteral nutrition patients to use either 2% taurolidine or 0.9% saline for 1 year. Patients were stratified in a new catheter group and a pre-existing catheter group. Primary outcome was the rate of CRBSIs/1000 catheter days in the new catheter group and pre-existing catheter group, separately. Results: We randomised 105 patients, of which 102 were analysed as modified intention-to-treat population. In the new catheter group, rates of CRBSIs/1000 catheter days were 0.29 and 1.49 in the taurolidine and saline arm respectively (relative risk, 0.20; 95% CI, 0.04-0.71; P = 0.009). In the pre-existing catheter group, rates of CRBSIs/1000 catheter days were 0.39 and 1.32 in the taurolidine and saline arm respectively (relative risk, 0.30; 95% CI, 0.03-1.82; P = 0.25). Excluding one outlier patient in the taurolidine arm, mean costs per patient were $1865 for taurolidine and$4454 for saline (P = 0.03). Drug-related adverse events were rare and generally mild. Conclusions: In the new catheter group, taurolidine showed a clear decrease in CRBSI rate. In the pre-existing catheter group, no superiority of taurolidine could be demonstrated, most likely due to underpowering. Overall, taurolidine reduced the risk for CRBSIs by more than four times. Given its favourable safety and cost profile, taurolidine locking should be considered as an additional strategy to prevent CRBSIs. Trial registration: Clinicaltrials.gov, identifier: NCT01826526

Relational Capital and Individual Exploration: Unravelling the influence of goal alignment and knowledge acquisition

We investigate how the relational capital of a person within an organization affects the extent to which she or he conducts exploration activities. Our theory separates out a negative effect that comes from aligning goals with other organizational members from a positive effect that stems from acquiring knowledge from them. Our data from 150 members of the R&D teams of three leading R&D-intensive firms support the theoretical model. By developing and testing this theory, we contribute to the literature on exploration, which lacks understanding of the antecedents of individual exploration in organizations. We also contribute to relational capital literature which has focused on organizational and group level exploration activities but which has shown inconsistent findings regarding the relationship between relational capital and exploration. A reason for this may be that this body of research has emphasized positive effects for exploration only, and has not accounted for the different mechanisms that mediate the effects of relational capital on individual exploration. Our theory offers a more comprehensive view by explaining how relational capital may provide both benefits and liabilities to individual exploration activities.status: publishe

Source strength as a measurement to define the ability of clean air suits to reduce airborne contamination in operating rooms

Background: Surgical site infections after total hip and knee replacement are linked to the quality of the operating room (OR) air. Applying tight occlusive clothing, effective ventilation and correct working methods are key concepts to obtain low bacterial concentrations in the OR air. The dry penetration test referred to in European standard EN 13795-2:2019 is a screening method for materials used in surgical clothing. Source strength, defined as the dispersal of bacteria-carrying particles from persons during activity, is a functional test of clothing systems and has been calculated in a dispersal chamber and in ORs. Results from both tests can be used when comparing surgical clothing systems. Aim: This study relates results of dry penetration tests to source strength values for five surgical clothing systems available on the Swedish market. Methods: Experimental data are reported on the function of these products, expressed as source strength calculated from results in a dispersal chamber and in ORs during orthopaedic operations. Findings: All materials tested with dry penetration <= 50 colony-forming units (cfu) had source strength values <3 cfu/s for one person in the dispersal chamber, whereas the material of one product when laundered >50 times had source strength in the dispersal chamber of up to 8 cfu/s. Conclusion: The dry penetration test could predict the performance of clean air suits of the same design, but more studies are needed to obtain a more valid correlation. Requirements of source strength should be included in standards. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society

Investigation of characteristics and transformation processes of megacity emission plumes using a mobile laboratory in the Paris metropolitan area

A growing fraction of the world's population is living in urban agglomerations of increasing size. Currently, 20 cities worldwide qualify as so-called megacities, having more than 10 million inhabitants. These intense pollution hot-spots cause a number of scientific questions concerning their influence on local and regional air quality, which is connected with human health, flora and fauna. In the framework of the European Union FP7 MEGAPOLI project (Megacities : Emissions, urban, regional and Global Atmospheric POLlution and climate effects, and Integrated tools for assessment and mitigation) two major field campaigns were carried out in the greater Paris region in July 2009 and January/February 2010. This work presents results from mobile particulate and gas phase measurements with focus on the characteristics of the Paris emission plume and its impact on the regional air quality and on aerosol transformation processes within this plume as it travels away from its source. In addition differences between summer and winter conditions are discussed. The mobile laboratory was equipped with high time resolution instrumentation to measure particle number concentrations (dP > 2.5 nm), size distributions (dP ~ 5 nm - 32 µm), sub-micron chemical composition (non-refractory species using Aerodyne HR-ToF-AMS, PAH and black carbon) as well as major trace gases (CO2, SO2, O3, NOx) and standard meteorological parameters. On-board webcam and GPS allow detailed monitoring of traffic situation and vehicle track. In a total of 29 mobile and 25 stationary measurements with the mobile laboratory the Paris emission plume as well as the atmospheric background was characterized under various meteorological conditions. This allows investigating the influence of external factors like temperature, solar radiation or precipitation on the plume characteristics. Three measurement strategies were applied to investigate the emission plume. First, circular mobile measurements around Paris provide cross sections through plume air masses as well as local background variation measurements. Second, radial measurement trips beginning near the outer area of the agglomeration extending up to ~200 km distance from Paris along the direction of the emission plume provide insight into the extension of the plume and transformation processes. Third, stationary measurements at different locations provide background as well as pollution measurements, especially if the wind direction is shifting, causing the plume to pass over the measurement site. During radial measurement trips the decrease in the concentrations of primary pollution marker species as hydrocarbon-like organic aerosol, black carbon, PAH and NOx with increasing distance from Paris is clearly observed. This decrease is mainly caused by dilution processes, but additional aging effects are also detectable. While entering the emission plume on cross section measurements a significant increase in such marker species compared to background values can be seen. On the other hand, overall statistics of both campaigns shows that day-to-day background variations influenced mainly by long range transported pollution (i.e. air mass origin) are stronger than variations between background and plume on specific days. A description of the methods developed for analysing the mobile data will complete this presentation