Microbial Air Contamination in an Intensive Care Unit

Unit layout affects every aspect of intensive care services, including patient safety. A previous study has shown that patients admitted to beds adjacent to the sink and to the door of a large bayroom had the highest number of positive blood cultures and the highest blood culture incidence density, respectively. The present study measures microbial air contamination in a medical intensive care unit of a medical center in central Taiwan. Of the 17 rooms, 8 rooms with distinct physical environmental characteristics were selected. Sampling tests were conducted between December 2013 and February 2014 with a microbial air sampler (MAS-100NT). TSA was used for bacteria collection and DG18 for fungi collection. The overall average bacterial and fungal concentrations were 83CFU/m3 and 69CFU/m3, respectively. The ranges were between 8-354 CFU/m3 and 0-1468 CFU/m3, respectively. A significant difference was found in the bacterial concentration (p=.005) between different room locations. The highest concentration was found in the rooms located at the front end of the circulation (99 CFU/m3), while the lowest was found in the rooms located at the rear end of the circulation (55CFU/m3). Differences in fungal concentrations for different room locations did not reach statistical significance. In addition, differences in bacterial and fungal concentrations for rooms with different sink locations did not reach statistical significance. Even though the microbial concentrations generally complied with standards, the results may help designers and hospital administrators develop a healthier environment for patients

Set voltage distribution stabilized by constructing an oxygen reservoir in resistive random access memory

In this letter, the instability mechanism of RRAM was investigated, and a technique was developed to stabilize the distribution of high resistance state (HRS) and better concentrate the SET voltage. In previous research, we found that an interface-type switching characteristic was observed on the I-V curve beneath the filament-type switching behavior, owing to the oxygen accumulation effect. In this letter, this interface-type switching characteristic is used to fit the natural distribution of HRS for an analysis of the instability mechanism. According to the results, the reason for the HRS distribution is the accumulation of extra oxygen ions which are left over from a lower degree of oxygen and oxygen vacancy recombination during the reset process. We propose a solution which creates an extra oxygen reservoir by changing the surface topography of the electrode to store the surplus oxygen ions from the reset process, eliminating the accumulation effect, and indeed improving stability. Please click Additional Files below to see the full abstract

Prognostic Factors Influencing the Patency of Hemodialysis Vascular Access: Literature Review and Novel Therapeutic Modality by Far Infrared Therapy

In Taiwan, more than 85% of patients with end-stage renal disease undergo maintenance hemodialysis (HD). The native arteriovenous fistula (AVF) accounts for a prevalence of more than 80% of the vascular access in our patients. Some mechanical factors may affect the patency of hemodialysis vascular access, such as surgical skill, puncture technique and shear stress on the vascular endothelium. Several medical factors have also been identified to be associated with vascular access prognosis in HD patients, including stasis, hypercoagulability, endothelial cell injury, medications, red cell mass and genotype polymorphisms of transforming growth factor-β1 and methylene tetrahydrofolate reductase. According to our previous study, AVF failure was associated with a longer dinucleotide (GT)n repeat (n ≥ 30) in the promoter of the heme oxygenase-1 (HO-1) gene. Our recent study also demonstrated that far-infrared therapy, a noninvasive and convenient therapeutic modality, can improve access flow, inflammatory status and survival of the AVF in HD patients through both its thermal and non-thermal (endothelial-improving, anti-inflammatory, antiproliferative, antioxidative) effects by upregulating NF-E2-related factor-2-dependent HO-1 expression, leading to the inhibition of expression of E-selectin, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1

Understanding the Success of Software-as-a-Service (SaaS) - The Perspective of Post-Adoption Use

Understanding the antecedents and consequences of trust in an online and on-demand outsourcing context is important. This study explores the effects of service quality on trust, which in turn affects a client firm’s post-adoption use in SaaS. A research model was developed based on the dedication-constraint framework of social exchange theory to measure service quality, trust, and SaaS post-adoption as multiple dimensions. We empirically examined the model by collecting data from 246 firms (key informants) that have adopted SaaS. Results show that while all three dimensions of service quality (client orientation quality, client response quality, environment quality) positively affect trust in service quality, client orientation and environment quality have positively influence on trust in provider. Both types of trust positively influence post-adoption intention. Finally, we discuss the theoretical and practical implications

Cardiovascular Diseases and the Risk of Venous Thromboembolism: A Hospital-based Case-control Study

BackgroundThe effects of various cardiovascular diseases on the risk of venous thromboembolism (VTE) are not well defined. To gather more information, we performed a hospital-based case-control study to evaluate the effects of major cardiovascular diseases on the risk of VTE.MethodsWe identified all incident cases of VTE needing hospitalization and anticoagulant therapy between January 1990 and December 2002 in a large tertiary hospital. Each case was matched with up to 4 controls, randomly selected from inpatients who were not hospitalized due to any of the exposures, on age, sex, calendar time and veteran/nonveteran status.ResultsThis study comprised 173 cases of VTE and 546 matched controls. The adjusted odds ratio (OR) of VTE was significant among patients with peripheral atherosclerotic diseases (OR 7.1, 95% confidence interval [CI] 1.4-34.4), and nondebilitating cerebrovascular diseases (OR 2.5, 95% CI 1.4-4.7). Other independent risk factors for VTE included a body mass index ≥ 25.0kg/m2 current estrogen use, a history of hyperlipidemia and varicose veins.ConclusionPeripheral atherosclerotic disease and nondebilitating cerebrovascular disease are important risk factors for VTE. Patients with these diseases should therefore be frequently evaluated for the possible coexistence of VTE and, if appropriate, should be given prophylaxis. Failure to take into account the potential confounding effects of these diseases may also result in an erroneous estimate of the effect of drug exposures on the risk of idiopathic VTE

Local Activities of the Membranes Associated with Glycosaminoglycan-Chitosan Complexes in Bone Cells

Chitosan is a cationic polysaccharide derived from the partial deacetylation of chitin. Hyaluronic acid (HA), chondroitin sulfate (CS) and heparin (HP) are anionic glycosaminoglycans (GCGs) which can regulate osteogenic activity. In this study, chitosan membranes were prepared by glutaraldehyde crosslinking reaction and then complexed with three different types of GCGs. 7F2 osteoblasts-like cells and macrophages Raw264.7 were used as models to study the influence of chitosan membranes on osteometabolism. Although chitosan membranes are highly hydrophilic, the membranes associated with GCG-chitosan complexes showed about 60-70% cell attachment. Furthermore, the membranes associated with HP-chitosan complexes could increase ALP activity in comparison with chitosan films only. Three types of the membranes associated with GCG-chitosan complexes could significantly inhibit LPS induced-nitric oxide expression. In addition, chitosan membranes associated with HP and HA can down-regulate tartrate-resistant acid phosphatase (TRAP) activity but not CS-chitosan complexes. Based on these results, we conclude that chitosan membranes associated with HP can increase ALP activity in osteoblasts and chitosan membranes associated with HP and HA reduce TRAP activity in osteoclasts

Microbial Air Contamination in an Intensive Care Unit

Unit layout affects every aspect of intensive care services, including patient safety. A previous study has shown that patients admitted to beds adjacent to the sink and to the door of a large bayroom had the highest number of positive blood cultures and the highest blood culture incidence density, respectively. The present study measures microbial air contamination in a medical intensive care unit of a medical center in central Taiwan. Of the 17 rooms, 8 rooms with distinct physical environmental characteristics were selected. Sampling tests were conducted between December 2013 and February 2014 with a microbial air sampler (MAS-100NT). TSA was used for bacteria collection and DG18 for fungi collection. The overall average bacterial and fungal concentrations were 83CFU/m3 and 69CFU/m3, respectively. The ranges were between 8-354 CFU/m3 and 0-1468 CFU/m3, respectively. A significant difference was found in the bacterial concentration (p=.005) between different room locations. The highest concentration was found in the rooms located at the front end of the circulation (99 CFU/m3), while the lowest was found in the rooms located at the rear end of the circulation (55CFU/m3). Differences in fungal concentrations for different room locations did not reach statistical significance. In addition, differences in bacterial and fungal concentrations for rooms with different sink locations did not reach statistical significance. Even though the microbial concentrations generally complied with standards, the results may help designers and hospital administrators develop a healthier environment for patients

Participant Network Patterns in Enhancing Online Community Interactivity

Social media is having an increasing impact on businesses. In particular, the explosive growth of online brand communities has attracted organizations and marketers’ attentions. However, despite the increasing importance of online community for marketing, it is noticed that relatively few of them are successful in attracting community members and enhancing interactivity. In this study, we argue that it is necessary to have a comprehensive understanding regarding how the community members participate in the communal context and interact with each other, and thereby the community interactivity can be continued. To this end, we collected a large amount of data from an online discussion forum where we found that the participants were highly interactive across the discussion topics, thus forming robust communities. Currently, the data analysis pertaining to this study is work in progress, but we will be in a position to offer more in-depth analysis of the rich findings that the research has generated by the time of the conference