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Purpose: To evaluate four decontamination strategies utilizing enzymatic agents available in most clinical settings to determine (1) the amount of biomaterial that can be removed in a group of previously used healing abutments (uHAs) and (2) the degree to which the decontaminated HAs are capable of inducing an inflammatory response in vitro compared to new HAs. Materials and Methods: In total, 50 HAs were collected following 2 to 4 weeks of intraoral use and distributed randomly into five test groups (groups A-E; n = 10 per group). Group A used enzymatic cleaner foam and an autoclave. Group B used an ultrasonic bath with enzymatic cleaner and an autoclave. Group C used a prophy jet, enzymatic cleaner foam, and an autoclave. Group D used a prophy jet, an ultrasonic bath with enzymatic cleaner, and an autoclave. Lastly, group E used a prophy jet and an autoclave. The control group consisted of 10 new and sterile HAs. Residual protein concentration was determined by a Micro BCA protein assay (Thermo Fisher Scientific), while HAs from each group were stained with Phloxine B and macroscopically examined for the presence of debris. To examine the inflammatory potential, human primary macrophages were exposed to HAs, and supernatant levels of nine cytokine and chemokine profiles were analyzed using a multiplex bead assay. Results: All test groups showed differences in the degree of visual decontamination compared to controls. Groups D and E displayed the most effective surface debris removal and reduced protein concentration, while group A was the least effective. However, compared to controls, all test groups showed high levels of inflammatory cytokine secretion via multiplex assay for up to 5 days. Conclusions: Our study found that decontamination of uHAs utilizing enzymatic cleaners failed to reestablish inert HA surfaces and prevent an inflammatory immune response in vitro. Clinicians should not reuse HAs even after attempts to decontaminate and sterilize HA surfaces. [ABSTRACT FROM AUTHOR]

Purpose: To determine and compare the frequency of contamination on different sites of healing abutments (HAs) a=er steriliza3on with Phloxine B dye on unused and used HAs a=er steriliza3on. Materials and Methods: A total of 60 HAs were divided into two test groups: (1) used and sterilized and (2) a control group (unused). The test group was evaluated for contamina3on a=er steriliza3on; the control group did not undergo any procedure. Data were analyzed using SPSS version 22 (IBM). Descrip3ve sta3s3cs were used to determine the frequency of contamina3on in the different groups and at the different HA sites. Chi-square test was used to evaluate the association of frequency of contamination with the HA site and design. The level of significance was kept at P ≤ .01. Results: The test group showed more contamination compared to the control group. The most contaminated sites were the screw thread and the screwdriver engagement location. Conclusions: HA reuse is cost-effective, but cleaning and sterilization was not effective for these components; thus, HAs need to be reused with caution because they were heavily contaminated when compared to new HAs. Among the different sites, the screw thread and screwdriver engagement sites were more prone to contamination. HA type did not influence the frequency of contamination. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to assess the real-world experiences of cleanroom managers and specialists who have designed, installed, and maintained stick-built and/or modular cleanrooms, delineate the advantages and disadvantages of each type of cleanroom, and gather sterile compounding cleanroom design and installation advice and lessons learned. Methods This study was conducted via surveys and semistructured interviews of individuals with cleanroom experience in the previous 5 years. Qualitative analyses were conducted on participants' survey and interview responses to assess their satisfaction with each type of cleanroom and to determine what they perceive to be the pros and cons of each type based on their own experiences. Key lessons learned and advice from these individuals were also extracted from their survey and interview responses. Results Fourteen individuals from 13 US states completed the survey; 12 participated in follow-up interviews. Fifty percent of the participants (n = 7) had installed 5 or more cleanrooms in the previous 5 years and over half (n = 8; 57%) had 7 or more years of cleanroom experience. The average satisfaction scores for each type of cleanroom, on a 1 to 10 scale, was 5.3 for stick-built (n = 11) and 9.3 for modular (n = 4). The pros of stick-built cleanrooms included greater design and material flexibility and lower up-front costs. The pros of modular cleanrooms included the cleanroom experience and expertise of modular vendors, quick and easy installations, guaranteed certification, and high-quality and durable design features and materials. Additionally, modular cleanrooms had fewer long-term maintenance issues, greater long-term flexibility, and lower indirect and long-term costs than stick-built cleanrooms. Key pieces of advice from the participants included the following: do your homework before beginning a cleanroom project; make sure heating, ventilation, and air conditioning system(s) and air handlers are adequate for your needs; and remember that the ultimate purpose of a quality cleanroom is patient safety. Participants also advocated for industry-wide cleanroom standards that go beyond USP regulations. Conclusion The findings of this study confirm many of the purported pros and cons of each type of cleanroom, with further insight gained into the relative quality and costs of each type. Modular cleanrooms were considered by most participants to be a better long-term option, based on quality and lifetime costs, if feasible to install. Study participants also emphasized that designing and installing pharmacy cleanrooms is a complex and time-intensive process that often comes with a steep learning curve. While there are federal and state cleanroom standards available and consultants for hire, a comprehensive resource or manual that could provide guidance, insight, and collective lessons learned on cleanroom design and installation is needed. [ABSTRACT FROM AUTHOR]

With the rapid emergence of antibiotic‐resistant pathogens, nanomaterial‐assisted catalytic sterilization has been well developed to combat pathogenic bacteria by elevating the level of reactive oxygen species including hydroxyl radical (·OH). Although promising, the ultra‐short lifetime and limited diffusion distance of ·OH severely limit their practical antibacterial usage. Herein, the rational design and preparation of novel virus‐like copper silicate hollow spheres (CSHSs) are reported, as well as their applications as robust artificial bacteriophages for localized bacterial capture and enhanced catalytic sterilization in the treatment of oral infectious diseases. During the whole process of capture and killing, CSHSs can efficiently capture bacteria via shortening the distance between bacteria and CSHSs, produce massive ·OH around bacteria, and further iinducing the admirable effect of bacterial inhibition. By using mucosal infection and periodontitis as typical oral infectious diseases, it is easily found that the bacterial populations around lesions in animals after antibacterial treatment fall sharply, as well as the well‐developed nanosystem can decrease the inflammatory reaction and promote the hard or soft tissue repair. Together, the high Fenton‐like catalytic activity, strong bacterial affinity, excellent antibacterial activity, and overall safety of the nanoplatform promise its great therapeutic potential for further catalytic bacterial disinfection. [ABSTRACT FROM AUTHOR]

Background: The modern wound dressing is produced to absorb fluid and protect against external contamination. The choice of which wound dressing to apply after surgery is usually based on local tradition. There are various impervious dressings on the market. Even if the wound is sterile before application, there will be subsequent recolonisation of skin microbiota. Previous studies suggest that a high bacterial load on the skin hampers wound healing and might be a risk for SSI. Aim: The aim was to compare bacterial recolonisation on the shoulder under three different wound dressings, 48 h after sterile preparation of the skin as in preparation for surgery. Method: In 25 healthy volunteers, a standard pre-surgical skin disinfection for a deltopectoral incision was made on the left shoulder with 0.5% chlorhexidine solution in 70% ethanol. Three different wound dressings were then placed on the shoulder, and 48 h later the skin beneath each dressing was swabbed, subsequently cultured and bacterial density analysed using viable count. Results: The bacterial recolonisation under air-dry (gauze) dressing was significantly lower (p =.0001) compared to semipermeable and occlusive wound dressings. Conclusion: Choosing a less permeable wound dressing may lead to an increased bacterial load on the skin during the first 48 h after surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND: In pursuit of innovative wastewater treatment solutions, this study investigates the use of thermally treated palygorskite (TP) as an adsorbent to remove Escherichia coli and Enterococcus faecalis from synthetic wastewater. The goal is to explore a natural alternative to chlorine‐based disinfectants by utilizing TP's antimicrobial properties. Columns were packed with two granulometries (G1: 0.25–0.6 mm; G2: 1.40–2.36 mm) of TP and arranged in three different configurations (CA1, CA2 and CA3) to assess their bacterial removal efficiency, kinetic behavior and potential for reuse after dry heat sterilization. RESULTS: The CA3 column configuration, with its multilayer arrangement of TP, achieved the highest bacterial removal efficiency, reaching 99.1% for E. coli and 98.1% for E. faecalis. Kinetic experiments revealed that most bacterial adsorption occurred within the first 3 min, with E. coli requiring up to 10 min to reach maximum removal. TP's antibacterial effectiveness remained above 90% after two reuses. Additionally, dry heat sterilization allowed for repeated use of TP, showing stable removal efficiencies for E. faecalis and a slight decline for E. coli with each successive reuse. CONCLUSIONS: TP demonstrates significant potential as an adsorbent for wastewater disinfection, particularly in the CA3 multilayer configuration. Its rapid adsorption kinetics and resilience to heat sterilization underscore its reusability, making it a viable natural alternative to chemical disinfectants. Further research should focus on scaling this method to real wastewater treatment applications to validate its functionality in real‐world conditions. © 2024 Society of Chemical Industry (SCI). [ABSTRACT FROM AUTHOR]

Introduction: A sterile technique is a standard to reduce microorganism transmission during surgery. Gaps in knowledge and practice in sterile techniques by nurses are common causes of surgical site infections for surgical patients. Even though surgical site infection is a global problem due to lack of knowledge and practice, almost no study has been done in Ethiopia regarding nurses' knowledge and practice of sterile techniques in the operating room. Therefore, this study aimed to assess nurses' knowledge, practice, and associated factors of sterile techniques in Addis Ababa public hospitals, Ethiopia. Method: An institutional-based cross-sectional study was conducted on 423 nurses who were working in sixty-six operation rooms at seven public hospitals in Addis Ababa, Ethiopia, from May 11 to June 26/2022. A simple random sampling method was employed to select study participants. A pre-tested, self-administered questionnaire was used to collect data. Data were entered by Epi-data version 4.6 and analyzed by SPSS version 25. Descriptive statistics were presented by text, table, and figure. Multivariable analysis was used to identify the association between the dependent variable and independent variables. Variables with a P-value < 0.05 were considered statistically significant. Result: Nearly three-fifths (58.1%; 95%CI: 53.2 to 63.7) of respondents had good knowledge, and 56.1% with 95%CI (51.5 to 61.1) had good practice with respect to sterile techniques in the operation room. Training [AOR = 1.989; 95%CI (1.120 to 3.530)], availability of guidelines [AOR = 6.4; 95%CI (3.773 to 10.856)], and supervision [AOR = 2.963; 95%CI (1.693 to 5.184)] were associated with nurses' knowledge about sterile techniques in the operating room. Availability of guidelines [AOR = 1.890, 95%CI (1.123 to 3.182)], presence of supervision [AOR = 4.732; 95%CI (2.643 to 8.471)], and having good knowledge of sterile techniques [AOR = 5.419; 95%CI (3.087 to 9.512)] were associated with nurses' practice of sterile techniques in the operation room. Conclusion: Operative theater nurses' knowledge and practice of sterile techniques were found inadequate. Training, supervision, availability of guidelines, and knowledge of nurses towards sterile techniques are factors associated with sterile techniques in the operating room. So, it is better to strengthen training, equip wards with standardized guidelines, and provide supervision, which is crucial to enhancing their knowledge and practice. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Material and Methods Results Conclusions Trial Registration To evaluate the influence of the three‐dimensional (3D) printing technology, material, sterilization, and disinfection on the accuracy of guided surgical templates.Fifty printed resin surgical templates were designed and fabricated using a digital light processing 3D printer with a photopolymerizing resin, and 50 printed metal surgical templates were designed and fabricated using a selective laser melting 3D printer with a titanium alloy. Templates from both groups were randomly divided into five subgroups involving different sterilization and disinfection procedures. The group without any sterilization or disinfection procedure served as the control group, whereas the other groups were used as the study groups (hydrogen peroxide gas plasma sterilization, 5% povidone‐iodine disinfection, 75% ethyl alcohol disinfection, and steam autoclave sterilization). Implant simulations were performed on the 3D‐printed resin models, and postoperative impressions were acquired with scan bodies attached to the implants. All surgical templates were digitally scanned. The root mean square was used to determine and quantify fabrication accuracy and reproducibility, and the definitive and planned implant positions were compared.The printed resin templates exhibited lower fabrication accuracy and reproducibility, as well as higher 3D deviations, after steam autoclave sterilization (p < 0.001); however, the printed metal templates were not affected by the different sterilization or disinfection procedures (p > 0.05).Printed metal surgical templates are viable alternatives for guided implant surgery. Preoperative steam or gas plasma sterilization is recommended, especially for metal templates, as resin templates show deformation and decreased accuracy after steam sterilization.chictr.org.cn number: ChiCTR2400081334 [ABSTRACT FROM AUTHOR]

Background Environmental disinfection is essential for reducing spread of healthcare-associated infections (HAIs). Previous studies report conflicting results regarding the effects of ultraviolet (UV) light in reducing infections. This trial evaluated the impact of adding pulsed-xenon UV (PX-UV) to standard terminal cleaning in reducing environmentally implicated HAIs (eiHAIs). Methods The Lowering the Acquisition of MDROs with Pulsed-xenon (LAMP) trial was conducted in 2 hospitals (15 inpatient wards) utilizing a cluster-randomized, controlled, double-blinded, interventional crossover trial comparing standard terminal cleaning followed by either PX-UV (intervention arm) or sham (control arm) disinfection. The primary outcome was incidence of eiHAIs from clinical microbiology tests on the fourth day of stay or later or within 3 days after discharge from the study unit. EiHAIs included clinical cultures positive for vancomycin-resistant enterococci, extended-spectrum beta-lactamase–producing Escherichia coli or Klebsiella pneumonia , methicillin-resistant Staphylococcus aureus , and Acinetobacter baumannii , and stool polymerase chain reaction (PCR) positive for Clostridiodes difficile. Results Between 18 May 2017 and 7 January 2020, 25 732 patients were included, with an incidence of 601 eiHAIs and 180 954 patient-days. There was no difference in the rate of eiHAIs in the intervention and sham arms (3.49 vs 3.17 infections/1000 patient-days, respectively; RR, 1.10; 95% CI,.94–1.29; P =.23). Study results were similar when stratified by eiHAI type, hospital, and unit type. Conclusions The LAMP study failed to demonstrate an effect of the addition of UV light disinfection following terminal cleaning on reductions in rates of eiHAIs. Further investigations targeting hospital environmental surfaces and the role of no-touch technology to reduce HAIs are needed. Clinical Trials Registration. ClinicalTrials.gov identifier: NCT03349268; R01HS024709. [ABSTRACT FROM AUTHOR]

Rationale: Ethylene oxide (EO) sterilization is commonly employed for the sterilization of medical devices and has a very high market share. However, EO and its metabolite ethylene chlorohydrin (ECH) are toxic to humans. In compliance with the classification and residue limits of medical devices defined by ISO 10993‐7, our study established two extraction methods for the testing of EO and ECH. Methods: The first method involves simulated‐use extraction using water as the extraction solvent. While the second, exhaustive extraction, directly extracts sample through headspace sampling analysis. Gas chromatography–tandem mass spectrometry in multiple reaction monitoring mode was utilized, requiring only 16 min. Then, the developed method was applied to assess 10 commercially available medical devices sterilized by EO. Results: In simulated‐use extraction, calibration curves were evaluated in the range of 1–100 and 5–500 μg for EO and ECH, respectively (r > 0.999). Inter‐day recoveries ranged from 85.0% to 95.2% and from 94.8% to 102.4%. In exhaustive extraction, calibration curves spanned 0.5–50 and 2–200 μg for EO and ECH, respectively (r > 0.999). Inter‐day recoveries ranged from 101.6% to 102.1% for EO and from 98.1% to 102.2% for ECH. After analysis of the 10 commercially available medical devices, two cotton swabs were found to have ECH of 35.1 and 28.4 μg per device, and four medical devices were found to have EO with concentration below the limit of quantification. Meanwhile, we found that the EO internal standard (propylene oxide) recommended by ISO 10993‐7 had interference problems with other similar substances and was not suitable as an internal standard for EO. Conclusions: This study offers a sensitive and straightforward analytical approach to EO and ECH residues in a variety of medical devices. In addition, the results show that the EO or ECH content of these types of medical devices in our study falls below the regulatory limits, therefore instilling confidence among consumers regarding their safe use. [ABSTRACT FROM AUTHOR]

Customizable 3D‐printed biopolymer hydrogels, highly sought after for diabetic wound management, face challenges in clinical application due to weak physical crosslinking within their constituent inks. In this study, a novel chitosan‐based hydrogel ink with a dense yet reversible physical crosslinking network is subtly designed for the rapid in situ fabrication of personalized diabetic wound dressing. This robust network is established through multiple electrostatic and hydrogen bonding interactions between unique carboxymethyl chitosan and nanoclay, further reinforced by the introduction of amide bonds, which act as double hydrogen bond donors/acceptors. Benefiting from this network, the ink with low nanoclay content exhibits remarkable self‐supporting properties, enabling high‐fidelity, large‐scale, and complex 3D printability without additional processing, while substantially retaining its inherent rheological properties after autoclave sterilization and the incorporation of active components. Given these advantages, this multifunctional 3D printable hydrogel can be rapidly in situ constructed on diabetic wounds. Simultaneously, the 3D‐printed hydrogel demonstrates biodegradability, anti‐swelling, and appropriate mechanical properties, along with remarkable in vitro antibacterial and pro‐angiogenic capabilities, leading to effective diabetic wound healing in vivo. This work offers a new strategy for creating highly self‐supporting biopolymer inks and paves the way for developing advanced personalized wound dressings. [ABSTRACT FROM AUTHOR]

Introduction: Exposure of healthcare workers to hazardous drugs can lead to adverse health effects supporting the importance of a continuous monitoring program, for example, by taking surface wipe samples. The objective was to describe the results of repeated monitoring of contamination with hazardous drugs on multiple surfaces in a hospital pharmacy and at two wards using standardized preparation techniques and cleaning procedures. Methods: Twelve surfaces in the hospital pharmacy and at two wards were sampled and analyzed for contamination with the hazardous drugs cyclophosphamide, doxorubicin, 5-fluorouracil, gemcitabine, methotrexate, and paclitaxel. The drugs were prepared with a closed-system drug transfer device (CSTD). Sampling of the drugs was performed in four trials during eight months. Liquid chromatography tandem mass spectrometry was used for the analysis of the drugs. Results: During the four trials, contamination with five of the six hazardous drugs was found on half of the surfaces in the pharmacy and in a ward. Seventeen out of 288 possible outcomes were positive (6%), with the biological safety cabinet grate (n = 6) and scanner (n = 5) most frequently contaminated. The highest level of contamination was observed on the pass-thru window (cyclophosphamide: 2.90 ng/cm2) and the touch screen of the Diana device (5-fluorouracil: 2.38 ng/cm2). Both levels were below the action level of 10 ng/cm2. Conclusions: The long-term use of a CSTD in combination with appropriate cleaning has proven effective in achieving low levels of surface contamination with hazardous drugs. [ABSTRACT FROM AUTHOR]

Background/Aim. The most important moment in modern endodontics is the inclusion of rotating instruments made of nickel-titanium alloy in daily clinical work, which have supplanted stainless steel instruments due to their superior properties. The aim of this study was to investigate the influence of autoclave sterilization on cyclic fatigue (CF) in two types of rotating instruments produced by M-wire technology with different types of rotation. Methods. This research included two types of M-wire rotary instruments -- 48 ProTaper Next® instruments with full rotation and 48 WaveOne® Gold instruments with reciprocating rotation. Each of the two groups of instruments was divided into four additional groups of 12 instruments depending on the number of cycles of sterilization in the autoclave. The instruments were tested in an artificial canal with a 2 and 5 mm radius of curvature. Results. Statistically significantly higher resistance to CF was observed with WaveOne® Gold compared to ProTaper Next® (p < 0.001) instruments, both in the non-sterilized group and after their exposure to the first, third, and fifth cycle of sterilization. The third and fifth cycle of sterilization significantly reduced resistance to CF in the WaveOne® Gold (p < 0.001) group. There was no statistically significant difference in CF resistance between sterilized and non-sterilized instruments of the ProTaper Next® group. Conclusion. Sterilization in an autoclave for instruments based on M-wire technology did not increase resistance to CF. [ABSTRACT FROM AUTHOR]

The study aimed to explore the antimicrobial efficacy of grape seed extract (GSE) and cold atmospheric plasma (CAP) individually or in combination against L. monocytogenes and E. coli wild type (WT) and their isogenic mutants in environmental stress genes. More specifically, we examined the effects of 1% (wt/vol) GSE, 4 min of CAP treatment, and their combined effect on L. monocytogenes 10403S WT and its isogenic mutants sigB, gadD1, gadD2, gadD3, as well as E. coli K12 and its isogenic mutants rpoS, oxyR, and dnaK. In addition, the sequence of the combined treatments was tested. A synergistic effect was achieved for all L. monocytogenes strains when exposure to GSE was followed by CAP treatment. However, the same effect was observed against E. coli strains, only for the reversed treatment sequence. Additionally, L. monocytogenes sigB was more sensitive to the individual GSE and the combined GSE/CAP treatment, whereas gadD2 was more sensitive to CAP, as compared to the rest of the mutants under study. Individual GSE exposure was unable to inhibit E. coli strains, and individual CAP treatment resulted in higher inactivation of E. coli in comparison to L. monocytogenes with the strain rpoS appearing the most sensitive among all studied strains. Our findings provide a step toward a better understanding of the mechanisms playing a role in the tolerance/sensitivity of our model Gram-positive and Gram-negative bacteria toward GSE, CAP, and their combination. Therefore, our results contribute to the development of more effective and targeted antimicrobial strategies for sustainable decontamination. IMPORTANCE Alternative approaches to conventional sterilization are gaining interest from the food industry, driven by (i) the consumer demand for minimally processed products and (ii) the need for sustainable, environmentally friendly processing interventions. However, as such alternative approaches are milder than conventional heat sterilization, bacterial pathogens might not be entirely killed by them, which means that they could survive and grow, causing food contamination and health hazards. In this manuscript, we performed a systematic study of the impact of antimicrobials derived from fruit industry waste (grape seed extract) and cold atmospheric plasma on the inactivation/killing as well as the damage of bacterial pathogens and their genetically modified counterparts, for genes linked to the response to environmental stress. Our work provides insights into genes that could be responsible for the bacterial capability to resist/survive those novel treatments, therefore, contributing to the development of more effective and targeted antimicrobial strategies for sustainable decontamination. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate microbiological cultures of cataract surgical devices and products that were reused for multiple cases. Setting: Aravind Eye Hospital, Pondicherry, Tamil Nadu, India. Design: Prospective cohort study. Methods: Samples from multiple surgical instruments and products that were reused for consecutive cataract surgeries underwent bacterial and fungal cultures and were monitored alongside positive controls for 7 days. This included instruments that were processed using immediate use steam sterilization (IUSS) between cases (eg, surgical cannulas, syringes, phacoemulsification and coaxial/bimanual irrigation/aspiration [I/A] tips, phacoemulsification and I/A sleeves) (Group 1), instruments that were used without sterilization between cases (eg, phacoemulsification tubing/handpieces, coaxial I/A handpieces) (Group 2), and the residual (unused) fluid from balanced salt solution bags after being used for multiple patients (Group 3). Results: 3333 discrete samples were collected from all 3 product groups that were reused across multiple patients. In all collected samples, no bacterial or fungal growth was observed. Of the 3241 cataract surgeries that used reused and IUSS-sterilized instruments alongside instrument sets cultured on the same day and balanced salt solution bags shared across multiple patients, no eyes developed endophthalmitis over a 6-week follow-up period. Conclusions: Bacterial or fungal growth was not found in extensive microbiological cultures of IUSS-sterilized ophthalmic surgical instruments and cataract surgical products that were reused in multiple patients. This microbiological data complements clinical endophthalmitis data from 2 million consecutive cases at the Aravind Eye Hospital, suggesting that their instrument and surgical supply processing practices may allow for safe and sustainable ophthalmic care. [ABSTRACT FROM AUTHOR]

Owing to the unique quantum size effect and surface effect, gold-based nanomaterials (GNMs) are promising for pathogen detection and broad-spectrum antimicrobial activity. This review summarizes recent research on GNMs as sensors for detecting pathogens and as tools for their elimination. Firstly, the need for pathogen detection is briefly introduced with an overview of the physicochemical properties of gold nanomaterials. And then strategies for the application of GNMs in pathogen detection are discussed. Colorimetric, fluorescence, surface-enhanced Raman scattering (SERS) techniques, dark-field microscopy detection and electrochemical methods can enable efficient, sensitive, and specific pathogen detection. The third section describes the antimicrobial applications of GNMs. They can be used for antimicrobial agent delivery and photothermal conversion and can act synergistically with photosensitizers to achieve the precise killing of pathogens. In addition, GNMs are promising for integrated pathogen detection and treatment; for example, combinations of colorimetric or SERS detection with photothermal sterilization have been demonstrated. Finally, future outlooks for the applications of GNMs in pathogen detection and treatment are summarized. [ABSTRACT FROM AUTHOR]

Introduction: Surgical guides are commonly used to assist with dental implant placement. This study investigated the effects of five sterilization and disinfection methods on the accuracy of implant guides. Methods: Thirty surgical guides (five in each group) were designed and printed (with digital light processing technology) using different sterilization or disinfection methods categorized into six groups: hydrogen peroxide sterilization (group one); glutaraldehyde sterilization (group two); autoclaving (group three); plasma sterilization (group four); iodophor disinfection (group five); and blank group (group six). Verification was determined using three methods: distance and angle between the cross‐shaped marks, deformation after superimposing the guides, and displacement and axial changes in the virtual implant. Results: After disinfection and sterilization, the guides in the autoclaving and iodophor groups showed a more pronounced color change and the guide in the autoclaving group had visible cracks. More significant changes were observed in the H2O2, glutaraldehyde, autoclaving, and iodophor groups regarding deformation after superimposing the guides and the distance and angle between the cross‐shaped marks. The average labial deformation values (mm) of the first through fifth groups of guides were 0.283, 0.172, 0.289, 0.153, and 0.188, respectively. All groups were statistically different from the blank group for displacement and axial changes of the virtual implant (p < 0.05). Conclusion: The sizes of almost all surgical guides changed after sterilization and disinfection treatments, with between‐group differences. Plasma sterilization was more suitable for surgical guide sterilization because of the smaller deformations after treatment. [ABSTRACT FROM AUTHOR]

This work aims at improving the proven protocol for doubled haploid production in wheat. This procedure has some deficits, for example, microbial infection of ears as well as of the nutrient culture medium. In the present study, the potential effect of sterilization by detached tiller culture fungicides of ears as well as of nutrient medium to control microbial infection, and its effect on the formation of caryopses and embryos (CFF, EFF) was studied. In a further experiment, the UV‐light was used as physical sterilant for the nutrient medium. All of the fungicides and their concentrations studied were found to be effective to control infection on ears except the concentration 0.05% tilt. 0.1% tilt gave the highest CFF (79.5%) followed by 0.1% Bayleton (78.0%). The lowest CFF was recorded in control treatment (48.8%). Among Bavistin treatments, the 0.2% Bavistin gave maximum CFF (68.5%) as well as EFF (29.1%) followed by 0.1% Bavistin (64.9%, 23.7%). The higher concentration of tilt (0.2%) showed detrimental effects on EFF (17.5%). Bavistin in tiller culture nutrient medium reduced infection in medium and was shown to improve CFF and EFF (67.4%, 29.8%). [ABSTRACT FROM AUTHOR]

OBJECTIVE The objective of this study was to determine the effects of repeated steam sterilization cycles on the biomechanical properties of surgical screws. METHODS 42 3.5-mm and 42 2.0-mm self-tapping, cortical screws were divided into 3 groups per size and underwent autoclave sterilization for 1 (G1), 50 (G50), or 100 (G100) cycles and testing from August 2018 through June 2021. Sixty screws were then inserted into canine cadaver femurs, and biomechanical properties were measured, including peak insertional torque, torque to failure, and pullout strength, each normalized to cortical thickness. Scanning electron micrographs were taken from 24 screws, and images were blindly analyzed by 5 trained examiners. RESULTS The mean normalized insertion torque for 3.5-mm screws was significantly different between G1 and both G50 and G100. The mean normalized torque to failure for 3.5-mm screws was significantly different between G1 and both G50 and G100. Axial pullout testing was found to be significantly different for 2.0-mm screws between G1 and G100. Scanning electron micrographs surface scoring identified a significant difference in 3.5-mm screws at the screw tip. CONCLUSIONS The results indicate that biomechanical changes occur with repeated steam sterilizations. Specifically, peak insertional torque and torque to failure are decreased with increased sterilizations for 3.5-mm screws, whereas 2.0-mm screws were altered in pullout testing after 100 sterilizations. It is suspected that numerous sterilizations negatively alter the physical-mechanical properties of certain screw sizes. CLINICAL RELEVANCE The biomechanical properties of the bone-implant interface could negatively be affected by multiple steam sterilizations during clinical setting. [ABSTRACT FROM AUTHOR]

Decentralized water systems (DWS) distribute water in remote African areas. Throughout an intervention in Maniema, Congo, the influence of a DWS performing chlorination in the community's water quality was measured. Additionally, a socio-economic and WASH practices survey was conducted in the communities. Free residual chlorine (FRC) and microbiological contamination were measured; at the borehole, treatment site, distribution points, and households's water containers. In Big Five, water was collected from unimproved sources before DWS construction. Despite that, only 16,6% of households used efficient water treatment methods, resulting in 73% of water stored unsafe for consumption. After construction, household water quality drastically improved, regardless of FRC fluctuations; 93% of samples were classified as low health risk (safe). The renovation guaranteed continuous supply through electro-chlorinators in RVA, where chlorination was intermittent. Water from DWS with adequate chlorine levels prevented microbiological contamination in households for 12 hours. Although economically attractive, the system's sustainability will require future evaluation. [ABSTRACT FROM AUTHOR]

Clinical guidelines for infectious keratitis treatment require that anti-inflammatory drugs can only be used after infection elimination, which causes irreversible inflammatory damage to the cornea. In this work, photodynamic metal organic frameworks (PCN-224) were used as drug carrier to load Pt NPs with catalase-like activity and anti-inflammatory drug (Dexamethasone, DXMS) for endogenous oxygen generation and reduced corneal damage, respectively. The photodynamic therapy (PDT) effect was greatly enhanced in bacteria elimination and bacterial biofilms removal through catalysis of overexpressed hydrogen peroxide (H 2 O 2 , ∼8.0 and 31.0 μM in bacterial solution and biofilms, respectively) into oxygen by Pt NPs. More importantly, the cationic liposome modified PCN-224@Pt@DXMS@Liposomes (PPDL NPs) greatly enhanced the adhesion to negatively charged ocular surface and penetration into corneal barrier and bacterial biofilms. Both in vitro cell viability test and in vivo eye irritation tests proved good biocompatibility of PPDL NPs under 660 nm laser irradiation. Furthermore, PDT of PPDL NPs in rapid bacteria killing was verified through infectious keratitis animal model. The superior bactericidal effect of antibacterial materials could largely replace the bactericidal effect of the immune system. It is worth mentioning that this simultaneous sterilization and anti-inflammation treatment mode is a new exploration against the clinical treatment guidelines. [Display omitted] [ABSTRACT FROM AUTHOR]

In this work, a nine level (9-L) asymmetrical switched-capacitor multilevel inverter (ASCMLI) based induction heated (IH) autoclave for sterilization in medical applications is proposed. Due to the several benefits of multilevel inverter such as controlling of voltage magnitude and hence uniformity of heat is maintained at the load side as compared to conventional heating of autoclave. It has two common ground-connected dc voltage sources, which makes it ideal for usage in medical applications. Moreover, the development of a compact autoclave is carried out in this work that has a much reduced running time without sacrificing the quality of its sterilization. Further, the sterilization schedule for conventional and IH autoclave is presented in different temperature and pressure condition. The distributions of magnetic flux density and induced eddy current density in the multilevel inverter based IH autoclave were also exhibited. Finally, the performance of the proposed system are validated by simulation and experimental results obtained from a laboratory prototype setup. [ABSTRACT FROM AUTHOR]

The objective of this work is to evaluate the effects of ozone combined with ultrasound (ozone+US), pasteurization (PT), and high-temperature short-time sterilization (HTST) on antimicrobial capacity, antioxidant activity, carotenoid distribution and in vitro bioaccessibility of carotenoids in high-sugar concentrated orange juice. The enhancement of cellular membrane permeability and the leakage of cytoplasmic contents in Penicillium citrinum and Saccharomyces cerevisiae induced by ozone+US treatment were confirmed by fluorescence and FTIR spectrum. Ozone+US treatment exhibited higher antimicrobial activity than PT, and ozone+US treatment could decrease 4.22 ± 0.08 log CFU/mL of P. citrinum and 4.49 ± 0.10 log CFU/mL of S. cerevisiae. Additionally, ozone+US treated samples showed significantly lower peroxidase and polyphenoloxidase residual activity, higher bioactive compounds, and antioxidant capacity of orange juice as compared to thermal treatment. Among these treatments, ozone+US-treated orange juice showed the highest retention rates of carotenoid content and carotenoid bioavailability of 3.76 ± 0.05 mg/L and 24.53 ± 1.37%, respectively. Interestingly, particle size reduction and uniform distribution of carotenoids in ozone+US-treated samples enhanced the bioaccessibility of carotenoids. Compared with those thermal treatments, ozone+US treatment would be an alternative to improve microbial safety and decrease the degradation of antioxidant components in high-sugar concentrated orange juice. [ABSTRACT FROM AUTHOR]

Hydroponic wastewater recovery provides a green alternative to chemical fertilizers by recycling nutrients, yet transitioning to closed systems introduces problems such as pathogen proliferation and high sterilization costs. These challenges, along with the need for regular water analysis to correct nutrient imbalances, can hinder crop growth and increase expenses. However, hydroponic wastewater is also beneficial for capturing harmful emissions like CO2, NOx, and NH3, thanks to its rich mineral content. As it reacts with air pollutants, it produces compounds like Ca(NO3)2 and NH4NO3, turning pollutants into useful fertilizers. This study designed a novel hydroponic wastewater recovery process for CO2, NOx, and NH3 utilization from crop residue burning gas. through the following procedures: (1) ion separation of hydroponic wastewater, (2) NOx capture and utilization using precipitated Ca(OH)2, (3) NH3 capture and utilization using separated NO3− and SO42−, and (4) CO2 capture and utilization using KOH, Ca(OH)2 and Mg(OH)2. A process model was developed, and the economic feasibility of the proposed system was determined by calculating the total annualized cost. The result shows that approximately 85% of NOx, 99% of CO2, and 99% of NH3 were captured and utilized. Importantly, the total annualized cost of the system could decrease by 70% compared with that of the base process. [ABSTRACT FROM AUTHOR]

The integration of autoclaves in podiatry is new and has been tested against two other bactericidal methods with a control. The methods were similarly sampled, and a microbiology department independently undertook bacterial counts. The difference between methods was not significant. While the autoclave remains the preferred method, operative error can arise, and an ultrasonic cleaner is recommended. Chlorhexidine gluconate (Hibitane) remains the choice for liquid disinfection but with attention to concentration and frequent fluid changes to provide an effective kill rate. Special attention is required to any jointed instruments and those with asperitous surfaces. Using an autoclave requires multiple instruments to meet the needs of a podiatry treatment session. [ABSTRACT FROM AUTHOR]

The machining of implants and parts for dental prostheses to eliminate biofilm in the implantoplasty process causes a loss of mechanical properties and also characteristics of the surfaces, making tissue regeneration difficult. In the present work, treatments consisting of elements that can reduce infection, such as citric acid and magnesium, together with elements that can improve cell adhesion and proliferation, such as collagen, are proposed for implant–crown assembly. Titanium, zirconia, composite (PMMA + feldspar) and cobalt–chromium discs were immersed in four different solutions: 25% citric acid, 25% citric acid with the addition of collagen 0.25 g/L, 25% citric acid with the addition of 0.50 g/L and the latter with the addition of 1% Mg (NO3)2. After immersion was applied for 2 and 10 min, the roughness was determined by interferometric microscopy and the contact angle (CA) was evaluated. Human fibroblastic and osteoblastic line cells (HFFs and SaOS-2) were used to determine cell viability and proliferation capacity. Cell binding and cytotoxicity were determined by resazurin sodium salt assay (Alamar Blue) and cell morphology by confocal assay (immunofluorescence F-actin (phalloidin)) after 3 days of incubation. For the evaluation of bacterial activity, the bacterial strains Sptreptococcus gordonii (Gram+) and Pseudomonas aeruginosa (Gram−) were used. The antibacterial properties of the proposed treatments were determined by means of the resazurin sodium salt (Alamar Blue) assay after 1 day of incubation. The treatments considerably decreased the contact angle of the treated samples with respect to the control samples. The treatments endowed the surfaces of the samples with a hydrophilic/super-hydrophilic character. The combination of elements proposed for this study provided cell viability greater than 70%; considering the absence of cytotoxicity, it therefore promotes the adhesion and proliferation of fibroblasts and osteoblasts. In addition, it also endows the surface with antibacterial characteristics against from Gram+ and Gram− bacteria without damaging the cells. These results show that this mouthwash can be useful in oral applications to produce a new passivation layer that favors the hydrophilicity of the surface and promotes cellular activity for the formation of fibroblasts and osteoblasts, as well as showing bactericidal activity. [ABSTRACT FROM AUTHOR]

[Objective] Laboratory animal centers in colleges and universities are crucial for production, teaching, experimentation, and technical services involving laboratory animals. Biosafety management is an important part of their standardized operation and safety management. The Biosafety Law has highlighted the importance of biosafety and introduced new requirements for managing laboratory animals in universities. Establishing a systematic biosafety risk management framework is essential to prevent public health impacts related to biosafety and ensure effective management and operation. Comprehensive and systematic implementation of biosafety management in university laboratory animal centers is vital for the standardized management of facilities, the health and safety of staff and students, and the advancement of scientific research. [Methods] We evaluated the major biosafety hazards, classified as "internal factors" and "external factors", throughout the whole experimental process. Corresponding solutions were proposed. Considering the complexity of hazards within laboratory animal facilities, we clearly identified the biosafety hazards one by one and summarized them to obtain more effective and distinct measures. [Results] Using the Institute of Laboratory Animal Science of Jinan University as a case study, we explored effective strategies for managing biosafety in animal public service platforms, such as qualified animal experimental design, standardized facility management, strict environmental and animal monitoring, frequently disinfecting facilities, periodic waste disposal, effective pest control, and veterinary supervision. Specifically, they include: 1 Ensuring research projects are reviewed and approved by the Institutional Animal Care and Use Committee of Jinan University, adhering to the welfare and ethical principles of laboratory animals. 2 Implementing rigorous regulations for material types and delivery methods to maintain sterility. 3 Establishing different entry requirements and admission procedures for various personnel, with comprehensive training for experimental staff. 4 Daily checks of physical parameters of environmental facilities to ensure stable conditions. 5 Following the Biological Safety Law for treating wastewater, exhaust gas, and other waste materials. 6 Using at least two types of disinfectants to ensure effectiveness and prevent drug resistance, with clear guidelines for disinfection scope and methods. 7 Preventing and controlling biological vectors such as mosquitoes, flies, mice, and cockroaches through disinfection and sterilization. 8 Implementing isolation and quarantine, observation and treatment, anatomical sampling, and ensuring animal safety within the facility. [Conclusions] Universities should strictly implement the safety management responsibility system, investigate biological safety hazards, and determine effective responses to ensure the safe and effective operation of animal centers. [ABSTRACT FROM AUTHOR]

Copyright of Misr Journal of Agricultural Engineering is the property of Egyptian National Agricultural Library (ENAL) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The clinical application of collagen-based biomaterials is expanding rapidly, especially in tissue engineering and cosmetics. While oral supplements and injectable skin boosters are popular for enhancing skin health, clinical evidence supporting their effectiveness remains limited. Injectable products show potential in revitalizing skin, but safety concerns persist due to challenges in sterilization and the risk of biological contamination. Traditional methods of sterilization (heat and irradiation) can denature collagen. This study addresses these issues by introducing a novel technique: the double filtration and low-temperature steam sterilization of a collagen gel. In vitro tests documented the sterility and confirmed that the collagen did not show cytotoxicity, degradation, integrity, and viscosity characteristics changes after the processing and sterilization. The collagen gel induced new collagen expression and the proliferation of human dermal fibroblasts when the cells were cultured with the collagen gel. An in vivo study found no adverse effects in rats or significant lesions at the implantation site over 13 weeks. These results suggest that this novel method to process collagen gels is a safe and effective skin booster. Advanced processing methods are likely to mitigate the safety risks associated with injectable collagen products, though further research is needed to validate their biological effectiveness and clinical benefits. [ABSTRACT FROM AUTHOR]

Health and environmental protection are the development trend of household appliances, coupled with the impact of the COVID-19 epidemic in the past few years. Consumers have unprecedented concerns and expectations about the sterilization and disinfection functions of household appliances. As a washing and nursing equipment for household clothes, the anti-bacterial technology of washing machine has developed rapidly. The new models of washing machines in the market have basically added the function of sterilization. In order to thoroughly solve the problem of sterilization and bacteriostasis of washing machines from the source, the distribution of microbial contamination in washing machines should be fully investigated. At present, there is almost no systematic study on the microbial community structure in washing machines in China. Therefore, the purpose of this study is to analyze the bacterial community structure in Chinese household washing machines. To explore the key factors affecting the bacterial community structure of washing machines. Bacterial communities were comprehensively analyzed by high throughput sequencing. Using chao and shannon indexes as indicators, one-way ANOVA was used to explore the key factors affecting the bacterial community structure of washing machines. A total of 2,882,778 tags and 21,265 OTUs from 522 genera were sequenced from 56 washing machine samples. Genus Mycobacterium, Pseudomonas, Brevundimonas, Sphingomonas, Sphingobium, Enhydrobacter, Methylobacterium, Pseudoxanthomonas, Stenotrophomonas and Sphingopyxis were the top ten bacteria genera in abundance. The effects of sources, types, frequency of utilization, sampling locations and service life of washing machines on bacterial diversity in washing machine were systematically analyzed. The statistical analysis showed that service life was an important factor affecting bacterial diversity in washing machine. Our study lays a foundation for directional screening of characteristic microorganisms with targeted characters including malodor-producing, fouling, pathogenic and stress-resistance, the antibacterial evaluation, metabolic mechanism of key characteristic microorganisms as well as antibacterial materials development. At present, the sterilization technology of washing machines has not been fully in combination with the distribution survey of microorganisms in washing machines. According to the specific microorganism distribution condition of the washing machine, the key distribution positions and the types of specific microorganisms contained in different positions, conduct more targeted sterilization treatment. This will help to completely solve the problem of microbial growth in washing machines from the source. [ABSTRACT FROM AUTHOR]

The paper presents the 'progressive review' for high pressure preservation/processing (HPP) (cold pasteurization) of foods and the next-generation high-pressure and high temperature (HPHT, HPT) food sterilization technologies. It recalls the basics of HPP and HPT, showing their key features and advantages. It does not repeat detailed results regarding HPP and HPT implementations for specific foods, available in numerous excellent review papers. This report focuses on HPP and HPT-related issues that remain challenging and can hinder further progress. For HPP implementations, the reliable modeling of microorganisms' number decay after different times of high pressure treatment or product storage is essential. This report indicates significant problems with model equations standard nonlinear fitting paradigm and introduces the distortion-sensitive routine enabling the ultimate validation. An innovative concept based on the barocaloric effect is proposed for the new generation of HPT technology. The required high temperature appears only for a strictly defined short time period controlled by the maximal pressure value. Results of the feasibility test using neopentyl glycol as the barocaloric medium are presented. Attention is also paid to feedback interactions between socioeconomic and technological issues in the ongoing Industrial Revolution epoch. It indicates economic constraints for HPP and HPT developments and emerging business possibilities. The discussion recalls the inherent feedback interactions between technological and socioeconomic innovations as the driving force for the Industrial Revolution epoch. [ABSTRACT FROM AUTHOR]

Aim: This study aims to evaluate the effectiveness of various cleaning methods in reducing airborne endotoxin and microbial aerosols during oral cleaning procedures. Method: Forty patients undergoing oral cleaning procedures were randomly assigned to one of four groups (n = 10 per group). Group A received strong suction alone; Group B received strong suction combined with an air disinfection machine; Group C received strong suction combined with a dental electric suction machine; Group D received strong suction in conjunction with both an air disinfection machine and a dental electric suction machine. Airborne aerosol concentrations were assessed at four-time points: before treatment, 30 min into treatment, immediately after treatment, and 60 min after treatment ended. Samples were collected at distances of 20 cm, 60 cm, and 1 m from the patient's oral cavity using the natural sedimentation method. T-test was used to evaluate the difference among tested groups. Results: Airborne endotoxins and microbial aerosols levels increased significantly during treatment, with the highest levels observed at 20 cm from the patient's mouth. During treatment, groups with additional cleaning methods (Groups B, C, and D) exhibited higher levels of airborne endotoxins and microbial aerosols compared to Group A (strong suction alone). However, post-treatment analysis revealed that Group D demonstrated the lowest level of airborne endotoxins and microbial aerosols, while Group A exhibited the highest. Conclusions: Implementing effective aerosol management strategies can significantly reduce aerosol dispersion in the oral clinical environment. Continuous monitoring aerosol concentrations and the application of appropriate control measures are essential for minimizing infection risks for both patients and healthcare providers during oral cleaning procedures. [ABSTRACT FROM AUTHOR]

Infection prevention and control (IPC) is essential in nursing practice to safeguard patient health and reduce healthcare-associated infections. This article explores IPC strategies, including hand hygiene, the use of personal protective equipment, environmental cleaning, safe injection practices, and antimicrobial stewardship. It discusses the implementation challenges and solutions, such as ensuring compliance through education, monitoring and strong leadership. IPC measures are crucial in preventing infections such as catheter-associated urinary tract infections, central line-associated bloodstream infections, surgical site infections, and ventilator-associated pneumonia. By integrating personalised IPC strategies into nursing practice, healthcare providers can significantly improve infection control outcomes and enhance overall patient safety and quality of care. [ABSTRACT FROM AUTHOR]

Background: SARS-CoV-2 (COVID-19) has disrupted lives worldwide, affecting individuals from all walks of life. Individuals who have a spinal cord injury (SCI) are also affected by this phenomenon. This survey compares the quality of life (QOL), depression, and anxiety of SCI patients before and during COVID-19 in Wuhan City, China. Methods: A cross-sectional survey utilized an online questionnaire to assess the QOL, levels of anxiety, and depression among 189 SCI patients admitted to Wuhan Tongji Hospital during pandemic from November 2020 to April 2021. Data before COVID-19 outbreak from November to December 2019 was retrieved from hospital records with the same assessment previously performed in-person or during a follow up visit. However, some participants were excluded for various reasons, such as declining to participate, not being admitted to a rehabilitation program due to the pandemic, or being under 18 years old. The World Health Organization's (WHO) QOL-Brief Version (BREF) and disability (DIS) modules, which focus on disability-related QOL, were used to assess the participants' QOL. Results: SCI patients had lower QOL scores during the pandemic compared to pre-pandemic times. Mean scores on the 12-item DIS module significantly differed before and during the COVID-19 period. Participants showed higher adherence to self-isolation and quarantine measures for high-risk encounters (64.94%), but lower compliance with home disinfection and proper rest practices (23.38%). Conclusions: The COVID-19 pandemic has had a detrimental effect on the QOL of SCI patients in China, highlighting the urgent requirement for telehealth-based rehabilitation to mitigate its impact. It is crucial to provide essential. [ABSTRACT FROM AUTHOR]

Die Leistungsfähigkeit der Aufbereitungseinheit für Medizinprodukte (AEMP) ist essenziell für die Gesundheitsversorgung. Herausforderungen wie Fachkräftemangel und zunehmend komplexere Medizinprodukte machen kontinuierliche Prozessverbesserungen in der AEMP erforderlich. Ein datenbasierter Vergleich zwischen AEMPs kann Schwachstellen aufdecken, durch Handlungsempfehlungen Zeit und Kosten bei der Prozessverbesserung sparen und somit die Patientenversorgung verbessern. Der Lehrstuhl für Medizintechnik der RWTH Aachen entwickelt mit der DGSV e.V. eine AEMP-Benchmark zur Erfassung und Analyse von AEMP-Prozessen in Deutschland. Aufbauend auf in Vorarbeiten erhobenen Anforderungen und potenziellen Vergleichsgrößen wurde 2023 mittels einer Online-Umfrage eine Pilot-Datenerhebung für das Benchmarking durchgeführt. Die 48 erhobenen Datensätze von unterschiedlichen AEMP wurden zunächst bereinigt. Die Vergleichsgrößen wurden in Schlüssel-Leistungsindikatoren (engl.: Key Performance Indicators, KPI) und Leistungsbestimmende Faktoren (engl.: Performance Shaping Factors, PSF) unterteilt. Anschließend wurde eine statistische Analyse des Einflusses der PSFs auf die KPIs mit einem Signifikanzniveau von 0,05 durchgeführt. Die KPIs zeigten eine weite Streuung bei Qualität und Sicherheit. Für die Qualität waren das Sterilisator-Nutzvolumen und die gemeinsame Auswertung von Reklamationen mit den Kunden besonders starke Einflüsse. Für die Sicherheit der Beschäftigten waren vorhandene Einarbeitungskonzepte und häufige externe Fortbildungen besonders positive Einflüsse. Weitere signifikante Faktoren wurden identifiziert und in den praktischen Kontext eingeordnet. Insgesamt wurde damit das Ziel des Benchmarkings erreicht, Unterschiede in der Leistungsfähigkeit aufzudecken und PSF mit einem besonders starken Einfluss zu identifizieren. Eine Weiterführung des Benchmarkings erscheint sinnvoll, da zeitliche Veränderungen sichtbar gemacht werden können und durch eine größere Datenbasis eine Verbesserung der statistischen Auswertung und die Identifikation weiterer signifikanter PSF möglich ist. [ABSTRACT FROM AUTHOR]

Objectives The emergence of "green endoscopy" arises from the increasing global need to reform environmental sustainability due to climate change. Our review aimed to provide current evidence surrounding green endoscopy on sustainable issues including environmental impact, innovations, guidelines, policies, future directions, and recommendations. Materials and Methods A scoping review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews guidelines. Full-text English articles from established databases were screened for eligibility criteria and analyzed. Results Out of 7,892 identified articles, 28 met all the eligibility criteria. Key findings include (1) the significant environmental impact of single-use items in current endoscopic practices; (2) there are emerging green innovations in endoscopy, such as reusable instruments, eco-friendly sterilization methods, and energy-efficient technologies; (3) guidelines and green policies are increasingly available to provide clinical guidance and framework for health care facilities; (4) model institutions can provide case studies and examples of implementing green endoscopy; and (5) unified efforts from all stakeholders are needed to address challenges, including cost-effectiveness. Conclusion A paradigm shift toward green endoscopy is clearly in place and should be driven by the need to reduce environmental impact, be cost-effective, and not sacrifice patient safety. [ABSTRACT FROM AUTHOR]

Background: The presence of contamination and microorganisms at any stage of processing renders a method unsafe, leading to a high risk of cross-transmission and cross-infection. Objective: The objective of this study was to assess the cleaning quality of aspirator instruments used in neurosurgical procedures. Methods: The experimental study was conducted at the materials and sterilization center, as well as the microbiology laboratory, of a philanthropic hospital in Brazil. A study protocol was implemented, which involved the analysis of 10 samples of Yasargil aspirators with varying dimensions. The samples were subjected to protein tests to detect the presence of organic matter and microbiological analysis. Descriptive statistics were used to analyze the data. Results: The results indicated that 40% of the instruments tested positive for protein after manual cleaning. Furthermore, after automated cleaning, samples showed an increased microbiological load, with Escherichia coli accounting for 20% and Klebsiella aerogenes for 10% of the identified microorganisms. Conclusion: This study provides evidence of failures in the cleaning process of healthcare products and highlights the presence of biofilm in the pipes, thereby compromising the drinking water quality standard. [ABSTRACT FROM AUTHOR]

• The operational characteristics and virus risk levels of different work areas in the first level cold storage, as well as the disinfection process of personnel and cold chain goods from entering to leaving the cold storage. • The characteristics of virus aerosol transmission during the unloading process of imported cold chain goods. • The five-in-one method and the closed-loop cold storage disinfection system of "Human-Cargo-Apparatus-Waste" are proposed for the imported cold chain. During the period of COVID-19, the health problems caused by the contamination of imported cold chain food by pathogenic microorganisms attracted widespread attention, which brought new risks and challenges to cold chain products. The traditional liquid disinfection method has obviously been unable to meet the existing disinfection and sterilization needs, and establishing a complete set of cold chain product disinfection system has become the focus of research. This paper takes the process of importing cold chain food from Tianjin's primary cold storage as an example, and proposes the closed-loop cold storage disinfection system of "Human-Cargo-Apparatus-Waste". The establishment of the disinfection system determined the working characteristics of different areas of the primary cold storage and the risk level of virus transmission through on-site analysis and simulated aerosol diffusion experiments. According to the characteristics of different working areas in the cold storage, targeted sealing measures and disinfection techniques are adopted. It can effectively ensure the complete disinfection of cold chain products and avoid the negative impact of disinfection and sterilization methods. The expected research results provide certain technical support for the development and application of safe virus elimination throughout the entire process of imported cold chain. [ABSTRACT FROM AUTHOR]

Introduction Point of use (POU) treatment is a critical first step of medical device reprocessing. Reusable instruments and flexible endoscopes require a minimum of terminal sterilization or high-level disinfection, neither of which can be guaranteed if POU is performed incorrectly. Compliance considerations for POU include hospital accreditation readiness, unique austere surgical mission requirements, and the transition of future conflict towards Large Scale Combat Operations. This integrative review aims to describe POU for reusable instruments and endoscopes, and extrapolate implications for Military Health System policies and future considerations. Materials and methods The authors performed an integrative review and comprehensive literature search in PubMed and CINAHL with the keywords "point of use," "point of use cleaning," "POU," "instrument," "high-level disinfection," "endoscope," and "clean." Articles were limited to "English" and "human" from 2017 to 2023. The authors also performed a thorough review of the Defense Health Agency and service-specific doctrine, as well as national guidelines regarding POU adherence. Results The literature review yielded 18 articles that discussed the transport and reprocessing of reusable medical devices. Regulatory standards and national guidelines were used to supplement the literature. Seventeen evidence-based criteria were extrapolated from the literature to generate two step-by-step guides for the POU treatment of endoscopes and reusable instruments (Tables I and II). Despite increased morbidity and mortality rates linked to inadequate device reprocessing, compliance with POU procedures remains low. Barriers to practice included complex POU processes, intricately designed surgical instruments and endoscopes, lack of healthcare worker (HCW) knowledge and competency, and inadequate or ambiguously written policies. Training, competency assessments, and clearly written policies and procedures can be cost-effective, evidence-based, and feasible solutions. Conclusion Completing POU treatment is critical to a successful surgical mission in both the hospital and austere environment. Implications to practice include implementing evidence-based POU programs that improve patient outcomes and readiness while decreasing costs. [ABSTRACT FROM AUTHOR]

Improving Operating Room Efficiency After each surgery in a hospital, every reusable instrument that has entered the operating room must be sterilized before it can be used again. Hospitals spend several million dollars a year on this sterilization process, instrument tray assembly, and instrument repurchase costs. However, 70%–80% of instruments that enter the operating room are not used at a large majority of hospitals resulting in wastage of millions of dollars. For a medium-sized hospital, approximately $4–$7 million are spent on the sterilization process. Across more than 5,000 hospitals in the United States, several billion dollars per year are wasted on unnecessary sterilization. Researchers at UNC Kenan-Flagler Business School, with partners from healthcare technology firm Operative Flow Technologies, have developed an algorithm that uses detailed data of instruments used to create optimized instrument tray configuration. The algorithm creates trays informed by historical usage of instruments to reduce unused instruments in trays significantly. This algorithm scales for hundreds of trays, thousands of instruments, and thousands of surgeries and can be applied to major healthcare systems. At one implementation, the number of unused instruments was reduced by 54%. Their solution has subsequently been implemented at multiple healthcare systems leading to several million dollars of cost savings for the hospitals. Surgical procedures account for over 60% of the operating cost of a hospital. About 15% of these costs are related to surgical instruments and supplies. Hospitals spend several million dollars annually on instrument sterilization, instrument tray assembly, and instrument repurchase costs. However, in a large majority of hospitals, less than 20%–30% of reusable instruments supplied to a surgery are used on average. Prior implementations of surgical tray rationalizations have typically been expert driven. This is a labor-intensive effort typically focused on a small set of trays. On the other hand, past mathematical programming model-based studies have typically tested models with simulated data because of the difficulty in obtaining actual instrument-level usage data. We obtained actual surgical instrument usage at a large multispecialty hospital in partnership with OpFlow, a healthcare software company. We formulate a data-driven mathematical optimization model for surgical tray configuration and assignment with the goal of reducing costs of unused instruments, such as sterilization, instrument purchase, and tray assembly costs. We develop a solution methodology that scales to thousands of surgeries, thousands of instruments, and hundreds of surgical trays. This methodology decomposes the problem into a tray rationalization and an add-on tray creation step. At each step, we solve a restricted version of the full problem. We perform extensive out-of-sample testing of our solution. Our model-based approach identifies improvements in tray configuration and assignment, which would lead to a 54% reduction in unused instruments per surgery compared with the current tray configuration used at this hospital. We also validated our model with an expert-recommended solution for a subset of trays. We find that our model-based solution leads to 20% lower overage and 21% lower underage than the expert-recommended solution. We estimate projected annual cost savings of 35% in instrument sterilization, tray assembly costs, and instrument repurchase costs from using the recommendations of our model. Our solution was implemented at the UNC Rex Hospital, and we report on the results of our implementation. This analysis has quantified the value of collecting point-of-usage data to be at least $1.39 million per year from using the model-recommended solution at the hospital. Supplemental Material: The electronic companion is available at https://doi.org/10.1287/opre.2022.2426. [ABSTRACT FROM AUTHOR]

Objectives: Furosemide (FSM), a potent loop diuretic, is used to treat edema due to hypertension, congestive heart failure, and liver and renal failures. FSM applications are limited by its low bioavailability. Our aim is to use different nanoencapsulation strategies to control the release of FSM and enhance its pharmacokinetic properties. Methods: Two types of FSM-loaded nanocapsules, namely FSM-loaded lipid nanocapsules (LNCs) and polymeric nanocapsules (PNCs), were developed, physicochemically characterized, and subjected to pharmacokinetic and pharmacodynamic studies. Lipid nanocapsules were prepared by the simple phase inversion method using LabrafacTM lipid, while the polymeric nanocapsules were prepared by nanoprecipitation method using polycaprolactone polymer. Results: Transmission electron microscopy ascertains spherical structures, corroborating the nanometric diameter of both types of nanocapsules. The particle size of the optimized FSM-loaded LNCs and FSM-loaded PNCs was 32.19 ± 0.72 nm and 230.7 ± 5.13 nm, respectively. The percent entrapment efficiency was 63.56 ± 1.40% of FSM for the optimized PNCs. The in vitro release study indicated prolonged drug release compared to drug solutions. The two loaded nanocapsules systems succeeded in enhancing the pharmacokinetic parameters in comparison to the marketed FSM solution with superior diuretic activity (p < 0.05). The results of the stability study and the terminal sterilization by autoclave indicated the superiority of LNCs over PNCs in maintaining the physical parameters under storage conditions and the drastic conditions of sterilization. Conclusions: LNCs and PNCs are considered promising nanosysems for improving the diuretic effect of FSM. [ABSTRACT FROM AUTHOR]

We present a comprehensive review of the various challenges that individuals with visual impairment (VI) face during the COVID-19 pandemic. A structured review was done using online databases PubMed, EMBASE, and grey literature databases between 19 April 2021 and 4 August 2021, using search terms 'COVID-19', 'SARS-CoV-2', 'Coronavirus', or 'pandemic' combined with 'visually impaired', 'visual impairment', or 'Blind'. Studies included were written in English, published after the World Health Organization (WHO) declaration of the COVID-19 Pandemic (11 March 2020), and focused on the VI population during the pandemic. The initial search yielded 702 publications, of which 20 met our inclusion criteria and were included in analysis. Emotional distress from deteriorating mental health and social isolation were considerably higher in the VI population. For a community that relies on spatial awareness and touch, regulations related to social distancing and avoiding contact were considerable barriers. Further challenges were noted in accessing healthcare, care, receiving timely health information and changes in regulations, adequately sanitizing, using technology, and completing activities of daily living. In the unprecedented times of the COVID-19 pandemic, the VI community has faced unique challenges. A more holistic and inclusive approach needs to be adopted to ensure that more vulnerable populations are adequately cared for. [ABSTRACT FROM AUTHOR]

(1) Background. A definition of healthcare-associated infections is essential also for the attribution of the restorative burden to healthcare facilities in case of harm and for clinical risk management strategies. Regarding M. chimaera infections, there remains several issues on the ecosystem and pathogenesis. We aim to review the scientific evidence on M. chimaera beyond cardiac surgery, and thus discuss its relationship with healthcare facilities. (2) Methods. A systematic review was conducted on PubMed and Web of Science on 7 May 2024 according to PRISMA 2020 guidelines for reporting systematic reviews, including databases searches with the keyword "Mycobacterium chimaera". Article screening was conducted by tree authors independently. The criterion for inclusion was cases that were not, or were improperly, consistent with the in-situ deposition of aerosolised M. chimaera. (3) Results. The search yielded 290 eligible articles. After screening, 34 articles (377 patients) were included. In five articles, patients had undergone cardiac surgery and showed musculoskeletal involvement or disseminated infection without cardiac manifestations. In 11 articles, respiratory specimen reanalyses showed M. chimaera. Moreover, 10 articles reported lung involvement, 1 reported meninges involvement, 1 reported skin involvement, 1 reported kidney involvement after transplantation, 1 reported tendon involvement, and 1 reported the involvement of a central venous catheter; 3 articles reported disseminated cases with one concomitant spinal osteomyelitis. (4) Conclusions. The scarce data on environmental prevalence, the recent studies on M. chimaera ecology, and the medicalised sample selection bias, as well as the infrequent use of robust ascertainment of sub-species, need to be weighed up. The in-house aerosolization, inhalation, and haematogenous spread deserve experimental study, as M. chimaera cardiac localisation could depend to transient bacteraemia. Each case deserves specific ascertainment before tracing back to the facility, even if M. chimaera represents a core area for healthcare facilities within a framework of infection prevention and control policies. [ABSTRACT FROM AUTHOR]

Background/Objectives: Sterilization in dental practice is crucial for infection prevention. The aim of this study was to identify the presence and causes of bacterial growth using biological indicators in dental sterilization equipment in San Luis Potosí, S.L.P., Mexico, with different consecutive measurements over a year. Methods: This longitudinal cohort, conducted from January 2022 to January 2024 in San Luis Potosí, Mexico, aimed to identify the presence and causes of bacterial growth in dental sterilization equipment using biological indicators. A total of 207 dental offices were approached, and 175 participated, providing data through questionnaires and monitoring sterilization cycles with BIs. The checks were bimonthly for one year, with a total of six checks. Results: (a) An 11% (n = 1188) incidence of bacterial growth was observed, with a higher percentage in dry heat equipment (13%). (b) Upon analyzing the six consecutive verifications over a year, no statistically significant differences were observed in the failures of the sterilization cycles when comparing the two pieces of equipment. (c) Error in temperature and time of the equipment (OR = 4.0, 95% CI = 1.6–3.9, p = 0.0001) was significantly associated with the presence of bacterial growth during the one-year period. Conclusions: Monitoring sterilization cycles and identifying the causes of bacterial growth with different consecutive verifications decreased the presence of bacterial growth (failures) during the one-year period. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)