BACKGROUND

Health care-associated infections (HAIs) are a major cause of morbidity and mortality in intensive care unit (ICU) patients. Our objective was to evaluate the impact of daily bathing with chlorhexidine gluconate (CHG) on the incidence rates of HAIs, with a focus on their causative bacteria, in a French ICU.

METHODS

From March 2012-May 2013, we enrolled 325 patients with at least 1 episode of suspected sepsis in the ICU, during two 6-month periods. The intervention group was subjected daily to skin cleansing with 2% CHG-impregnated cloths, whereas the control group was bathed daily with soap and water. HAI included bloodstream infections, ventilator-associated pneumonia, and urinary tract infections. Incidence rates corresponded to the number of infections per 1,000 patient days.

RESULTS

Incidence of HAI was significantly decreased in the intervention group (29 vs 56; P = .01). After adjustment for baseline patient characteristics, the increased risk of HAI in the water and soap group was significant (odds ratio = 1.993; 95% confidence interval [CI], 1.132-3.508; P = .017). The incidence rate of clinical cultures positive for gram-negative bacteria, including Enterobacteriaceae and nonfermenting bacilli, decreased in the intervention group (risk ratio = 0.588; 95% CI, 0.346-0.978; P = .04).

CONCLUSIONS

CHG daily cleansing reduced the incidence rate of HAI caused by gram-negative bacteria, highlighting the role of the transient gram-negative bacteria skin colonization in the pathogenesis of HAI.

BACKGROUND

Removing allergen from the indoor environment should be a primary strategy for the management and treatment of allergic disease.

OBJECTIVE

The aims of this study were to characterize the distribution of dog, cat, and mite allergen on hard surfaces in homes with and without pets and to evaluate the efficiency of removing allergen from hard surfaces by wiping with a dry dust cloth and by vacuum cleaning using the dustbrush attachment.

METHODS

The amount of allergen collected from adjacent areas of two smooth floors, a wall, and finished furniture by wiping with a Pledge Grab-it dust cloth (S. C. Johnson & Son, Inc, Racine, WI) and by brush-vacuuming were compared for 24 homes with and without pets. In addition, the areas first wiped with the dust cloth were then brush-vacuumed and the amounts of allergen collected by the first and second cleaning were compared.

RESULTS

A key finding was that 23 of the 24 homes had Can f 1 allergen on one or more of the sampled areas regardless of whether a dog was present. Most homes with pets and many homes without pets had Can f 1 and Fel d 1 allergens on walls, smooth floors, and finished furniture. Carpets were the major reservoir for pet allergens in homes with pets whereas allergen was more uniformly distributed in homes without pets. Little mite allergen was found on hard surfaces even when it was present in carpets.

CONCLUSIONS

Dog and cat allergens are prevalent on walls, smooth floors, and finished furniture in homes with and without pets. Dry dusting with a Grab-it dust cloth was an effective cleaning method for removing allergen from hard smooth surfaces.

BACKGROUND

Infectious acute respiratory disease (ARD) is a significant cause of worldwide morbidity, disproportionately affecting individuals living in crowded conditions, such as found at military training centers, school dormitories, and correctional facilities. Vaccines have been used to protect against ARD; however, these are not always available or effective.

METHODS

The medical literature (1963-2004) on preventive nonvaccine ARD interventions (NOVARDIs) for infectious diseases, which addressed personal measures, administrative controls, and engineering controls, was studied during 2000 to 2004. Population-based studies in community settings (non-health care) were reviewed in detail to evaluate the effectiveness of NOVARDIs. Budgetary and logistic factors as well as acceptance were considered in formulating recommendations for implementation of NOVARDIs in military training centers.

RESULTS

Thirty-eight population-based studies contained in 35 publications were examined. Three studies contained information on multiple NOVARDIs. Nine studies supported the use of personal measures relating to hand hygiene. Ten studies supported administrative controls such as cohorting military training units to reduce contact between units (4 studies), providing adequate personal space to reduce crowding (5), and cloth barriers between beds (1); and 14 studies supported the use of engineering controls such as increased indoor air dilution and ventilation (2), dust suppression (4), and air sterilization (8).

CONCLUSIONS

Promoting hand hygiene and reducing crowding through the provision of adequate living space and cohorting of training units may offer benefits in respiratory disease control. These interventions, along with UV lights and air dilution/ventilation, deserve further evaluation in controlled studies to assess their efficacy. NOVARDIs could benefit military and other populations living in close contact.

Guinea worm infection is one of the most easily prevented parasitic diseases, but it is nevertheless a common cause of disability in rural areas of Africa, south-west Asia, and India. Infection occurs when drinking water is infested with infected Cyclops, a microcrustacean. Worms up to 70-80 cm in length develop in the subcutaneous tissues of the feet or legs and larvae are liberated to renew the cycle when an infected individual steps into a well or pond from which others draw drinking water. Infection is markedly seasonal because of (a) the influence of the climate on the types of water source used and (b) the developmental cycle of the parasite. The disability may be economically very important if the period of infection coincides with busy periods in the agricultural year. Sieving water through a cloth is sufficient to remove the Cyclops, but on a public health scale improved water supplies are required for control. Once the cycle of reinfection can be broken in any district the disease disappears. Chemical treatment of water bodies with temephos is also an effective and safe way of controlling transmission. Treatment consists of rolling out each emerging worm onto a small stick, a few centimetres each day, and certain drugs reduce the pain and pruritus and enable the worm to be removed more quickly.

The recovery operations following the 2001 attacks with Bacillus anthracis spores were complicated due to the unprecedented need for large-area surface sampling and decontamination protocols. Since this event, multiple reports have been published describing recovery efficiencies of several surface sampling materials. These materials include fibrous swabs of various compositions, cloth wipes, vacuum socks, and adhesive tapes. These materials have reported recovery efficiencies ranging from approximately 20% to 90% due to the many variations in their respective studies including sampling material, composition of surface sampled, concentration of contaminant, and even the method of deposition and sample processing. Additionally, the term recovery efficiency is crudely defined and could be better constructed to incorporate variations in contaminated surface composition and end user needs. While significant efforts in devising protocols for large-area surface sampling have been undertaken in the years since the anthrax attacks, there is still a general lack of consensus in optimal sampling materials and the methodology in which they are evaluated. Fortunately, sampling efforts are continuing to be supported, and the knowledge gaps in our procedures, methodology, and general understanding of sampling mechanisms are being investigated which will leave us better prepared for the future.

BACKGROUND

The invasive nature of surgery, with its increased exposure to blood, means that during surgery there is a high risk of transfer of pathogens. Pathogens can be transferred through contact between surgical patients and the surgical team, resulting in post-operative or blood borne infections in patients or blood borne infections in the surgical team. Both patients and the surgical team need to be protected from this risk. This risk can be reduced by implementing protective barriers such as wearing surgical gloves. Wearing two pairs of surgical gloves, as opposed to one pair, is considered to provide an additional barrier and further reduce the risk of contamination.

OBJECTIVE

The primary objective of this review was to determine if double gloving (wearing two pairs of gloves), rather than single gloving, reduces the number of post-operative or blood borne infections in surgical patients or blood borne infections in the surgical team. The secondary objective of this review was to determine if double gloving, rather than single gloving, reduces the number of perforations to the innermost pair of surgical gloves. The innermost gloves (next to skin) compared with the outermost gloves are considered to be the last barrier between the patient and the surgical team.

METHODS

The reviewers searched the Cochrane Wounds Group Specialised Trials Register, MEDLINE, CINAHL, EMBASE and the Cochrane Controlled Trials Register. Glove manufacturing companies and professional organisations were also contacted.

METHODS

Randomised controlled trials involving: single gloving, double gloving, glove liners or coloured puncture indicator systems.

METHODS

Both reviewers independently assessed the relevance and quality of each trial. Trials to be included were cross checked and authenticated by both reviewers. Data was extracted by one reviewer and cross checked for accuracy by the second reviewer.

RESULTS

Two trials were found which addressed the primary outcome. A total of 18 randomised controlled trials which measured glove perforations were identified and included in the review. DOUBLE GLOVING (wearing two pairs of latex gloves). Nine trials compared single latex gloves versus double latex gloves. These found no difference in the number of perforations between the single latex gloves and the outermost pair of the double latex gloves, but the number of perforations to the double latex-innermost glove was significantly reduced when two pairs of latex gloves were worn. ORTHOPAEDIC GLOVES (thicker than standard latex gloves). One trial compared single latex orthopaedic gloves with double latex gloves. This showed there was no difference in the number of perforations to the innermost gloves when wearing double latex gloves compared with a single pair of latex orthopaedic gloves. INDICATOR GLOVES (coloured latex gloves worn underneath latex gloves). Three trials compared double latex gloves versus double latex indicator gloves. These trials showed similar numbers of perforations to both the innermost and the outermost gloves for both gloving groups. Perforations to the outermost gloves were detected more easily when double latex indicator gloves were worn. Wearing double latex indicator gloves did not increase the detection of perforations to the innermost gloves. GLOVE LINERS (an insert worn between two pairs of latex gloves). Two trials compared double latex gloves versus double latex gloves with liners. These trials showed a significant reduction in the number of perforations to the innermost glove when a glove liner was worn between two pairs of latex gloves. CLOTH GLOVES (cloth gloves worn on top of latex gloves). Two trials compared double latex gloves versus latex inner with cloth outer gloves. These trials showed that wearing a cloth outer glove significantly reduced the number of perforations to the innermost latex glove. STEEL WEAVE GLOVES (steel weave gloves worn on top of latex gloves). One trial compared double latex gloves versus latex inner with steel weave outer gloves. This trial showed no reduction in the number of perforations to the innermost glove when wearing a steel weave outer glove.

CONCLUSIONS

Wearing two pairs of latex gloves significantly reduces the number of perforations to the innermost glove. This evidence comes from trials undertaken in 'low risk' surgical specialties, that is specialties which did not include orthopaedic joint surgery. Wearing two pairs of latex gloves does not cause the glove wearer to sustain more perforations to their outermost glove. Wearing double latex indicator gloves enables the glove wearer to detect perforations to the outermost glove more easily than when wearing double latex gloves. However wearing a double latex indicator system will not assist with the detection of perforations to the innermost glove, nor reduce the number of perforations to either the outermost or the innermost glove. Wearing a glove liner between two pairs of latex gloves to undertake joint replacement surgery significantly reduces the number of perforations to the innermost glove compared with double latex gloves only. Wearing cloth outer gloves to undertake joint replacement surgery significantly reduces the number of perforations to the innermost glove compared with wearing double latex gloves. Wearing steel weave outer gloves to undertake joint replacement surgery does not reduce the number of perforations to innermost gloves compared with double latex gloves.

A three-year research project was conducted on Key Island, Collier County, Florida, USA, to evaluate an innovative attractant-based mosquito management technique. In the first year, species composition, relative abundance, and spatial distribution were determined. Although 16 species were collected, the dominant species was the black salt march mosquito, Aedes taeniorhynchus, which was the primary pest species. Efficacy of a single line barrier, consisting of 52 carbon dioxide (200 cc/min) + octenol (ca. 4 mg/h) baited traps (1994) or insecticide (lambdacyhalothrin) impregnated shade cloth targets (1995), spaced ca. 16.5 m apart, to reduce mosquito abundance in a resort area, was evaluated on the northern end of the island. Success was evaluated by means of baited surveillance traps located on both sides of the barrier. Traps and targets performed equally well. Though not statistically significant (p>> 0.05), there was a reduction in mosquito abundance in the resort area when the barrier was functional. These data indicate that with refinement this mosquito management technique may be practical in certain situations.

The green stink bug, Acrosternum hilare (Say), the southern green stink bug, Nezara viridula (L), and the brown stink bug, Euschistus servus (Say), were predominant phytophagous Pentatomidae detected during 1995-1997 in cotton in South Carolina. These species occurred in similar numbers in conventional and transgenic cotton 'NuCOTN33B', containing the gene for expression of CryIA(c) delta-endotoxin of Bacillus thuringiensis Berliner variety kurstaki. Adult stink bugs moved into cotton from wild and cultivated alternate hosts during July, and reproducing populations usually were detected in cotton from late July into September. Applications of either methyl parathion (0.56 kg [AI]/ha) directed for stink bugs or lambda-cyhalothrin (0.037 kg [AI]/ha) or cyfluthrin (0.056 kg [AI]/ha) for control of cotton bollworm, Helicoverpa zea (Boddie), provided effective control of pentatomids in NuCOTN33B or conventional 'DP5415' and increased yields compared with untreated plots. Fiber quality did not differ among treated or untreated plots of NuCOTN33B. The ground-cloth technique was used to estimate populations of stink bugs, and data indicated that treatment at one bug per 2 m of row adequately protected cotton from yield loss due to stink bug damage. Observations on boll damage indicated that treatment might be necessary if >20-25% reveal internal symptoms of feeding injury during mid- to late season. More detailed damage thresholds should be developed to complement an approach based on population monitoring. This study validated current recommendations for management of pentatomids in cotton, demonstrated the necessity of threshold use for stink bugs in transgenic cultivars expressing endotoxin from B. thuringiensis, and provided insight into further development of management options for pentatomids in the crop.

We compared the efficiency of paper, cloth, and electric warm air drying in eliminating rotaviruses and Escherichia coli remaining on finger pads washed with 70% isopropanol, a medicated liquid soap, an unmedicated liquid soap, or tap water alone. The contaminated area on the finger pads of a volunteer was exposed to the hand-washing agent for 10 seconds and then rinsed in 40 degrees C tap water. The washed areas were dried for 10 seconds by one of the three methods. Irrespective of the hand-washing agent used, electric air drying produced the highest and cloth drying the lowest reduction in the numbers of both test organisms. These findings indicate the importance of selecting the right means for drying washed hands, particularly when less effective hand-washing agents are used.

A rotating fibrous-bed bioreactor (RFB) was developed for fermentation to produce L(+)-lactic acid from glucose and cornstarch by Rhizopus oryzae. Fungal mycelia were immobilized on cotton cloth in the RFB for a prolonged period to study the fermentation kinetics and process stability. The pH and dissolved oxygen concentration (DO) were found to have significant effects on lactic acid productivity and yield, with pH 6 and 90% DO being the optimal conditions. A high lactic acid yield of 90% (w/w) and productivity of 2.5 g/L.h (467 g/h.m(2)) was obtained from glucose in fed-batch fermentation. When cornstarch was used as the substrate, the lactic acid yield was close to 100% (w/w) and the productivity was 1.65 g/L.h (300 g/h.m(2)). The highest concentration of lactic acid achieved in these fed-batch fermentations was 127 g/L. The immobilized-cells fermentation in the RFB gave a virtually cell-free fermentation broth and provided many advantages over conventional fermentation processes, especially those with freely suspended fungal cells. Without immobilization with the cotton cloth, mycelia grew everywhere in the fermentor and caused serious problems in reactor control and operation and consequently the fermentation was poor in lactic acid production. Oxygen transfer in the RFB was also studied and the volumetric oxygen transfer coefficients under various aeration and agitation conditions were determined and then used to estimate the oxygen transfer rate and uptake rate during the fermentation. The results showed that the oxygen uptake rate increased with increasing DO, indicating that oxygen transfer was limited by the diffusion inside the mycelial layer.

A novel electrochemical reactor employing carbon-cloth electrodes was constructed for disinfection of drinking water. Escherichia coli K-12 (10(2) cells per cm3) was sterilized when a cell suspension was passed through the reactor at a dilution rate of 6.0 h-1, and a potential of 0.7 V versus a saturated calomel electrode was applied to an electrode. The survival ratio increased with increasing dilution rate but was less than 0.1% at dilution rates of less than 6.0 h-1. Although the survival ratio increased with increasing cell concentration above 10(3) cells per cm3, the disinfection rate also increased. The disinfection rate was 6.0 x 10(2) cells per cm3 per h at a cell concentration of 10(2) cells per cm3. Continuous sterilization of E. coli cells was carried out for 24 h. Sterilization is based on an electrochemical reaction between the electrode and the cell which is mediated by intracellular coenzyme A. Sterilization of drinking water by using this reactor was successfully performed, demonstrating the potential of such a reactor for clean and efficient water purification.

Congenital cytomegalovirus (CMV) affects ~1 of 150 births and is a leading cause of hearing loss and intellectual disability. It has been suggested that transmission may occur via contaminated surfaces. CMV AD169 in filtered human saliva, applied to environmental surfaces, was recovered at various time points. Samples were evaluated by culture and real-time polymerase chain reaction. CMV was found viable on metal and wood to 1 hour, glass and plastic to 3 hours, and rubber, cloth, and cracker to 6 hours. CMV was cultured from 83 of 90 wet and 5 of 40 dry surfaces. CMV was more likely to be isolated from wet, highly absorbent surfaces at earlier time points.

Using 180 degrees field-of-view imaging polarimetry, we measured the reflection-polarization patterns of two artificial surfaces (water-dummies) in the red, green and blue spectral ranges under clear and partly cloudy skies at different solar elevations. The dummies consisted of a horizontal glass pane with a matt black or matt light grey cloth underneath, imitating a dark or bright water body, respectively. Assuming that polarotactic water insects interpret a surface as representing water if the degree of linear polarization of reflected light is higher than a threshold and the deviation of the direction of polarization from the horizontal is lower than a threshold, we calculated the proportion, P, of the artificial surfaces detected polarotactically as water. We found that at sunrise and sunset P is maximal for both water-dummies and their reflection-polarizational characteristics are most similar. From this, we conclude that polarotactic water detection is easiest at low solar elevations, because the risk that a polarotactic insect will be unable to recognize the surface of a dark or bright water body is minimal. This partly explains why many aquatic insect species usually fly en masse at dusk. The daily change in the reflection-polarization pattern of water surfaces is an important visual ecological factor that may contribute to the preference of the twilight period for habitat searching by polarotactic water insects. Air temperature at sunrise is generally low, so dusk is the optimal period for polarotactic aquatic insects to seek new habitats.

Microbial fuel cells (MFCs) harness the metabolism of microorganisms, converting chemical energy into electrical energy. Anode performance is an important factor limiting the power density of MFCs for practical application. Improving the anode design is thus important for enhancing the MFC performance, but only a little development has been reported. Here, we describe a biocompatible, highly conductive, two-scale porous anode fabricated from a carbon nanotube-textile (CNT-textile) composite for high-performance MFCs. The macroscale porous structure of the intertwined CNT-textile fibers creates an open 3D space for efficient substrate transport and internal colonization by a diverse microflora, resulting in a 10-fold-larger anolyte-biofilm-anode interfacial area than the projective surface area of the CNT-textile. The conformally coated microscale porous CNT layer displays strong interaction with the microbial biofilm, facilitating electron transfer from exoelectrogens to the CNT-textile anode. An MFC equipped with a CNT-textile anode has a 10-fold-lower charge-transfer resistance and achieves considerably better performance than one equipped with a traditional carbon cloth anode: the maximum current density is 157% higher, the maximum power density is 68% higher, and the energy recovery is 141% greater.

A simple technique was developed to functionalize the surface of commercial cotton cloth with bactericidal polycationic groups. The cloth was first graft copolymerized with 4-vinylpyridine (4VP) and subsequently derivatized with hexylbromide via the quaternization of the grafted pyridine groups into pyridinium groups. X-ray photoelectron spectroscopy (XPS) was used to characterize the cotton cloth after each surface functionalization step. The pyridinium groups introduced on the substrate surface exhibited a high bacterial killing efficiency as shown by airborne and waterborne Escherichia coli (E. coli) assays, as well as a test to measure the number of viable E. coli cells in suspension upon contact with the cloth. This antibacterial property is preserved even after the cloth is subjected to prolonged weathering under UV irradiation and water spray. Wild-type bacteria were also cultured from soil and used to verify the antibacterial potential of the functionalized cloth. The inhibition of biofilm formation on the functionalized cloth was observed even with the inoculation of high concentrations of microorganisms. The success of the present surface functionalization technique as applied to cloth is a promising development, as since cloth is a common material having wide applications.

1. The preparation of gram quantities of isolated epithelial-cell ;ghosts' from mucosal scrapings of rat small intestine is described. The method involves dispersing the tissue by gentle homogenization in 6% dextran in Krebs-Ringer phosphate, pH7.4, followed by filtration through nylon cloth and sedimentation by low-speed centrifuging. 2. The isolated epithelial-cell ;ghosts' contained all of the DNA, but only 52% of the protein and 53-57% of the RNA of the original homogenate. They contained most of the activity of the following enzymes found in the homogenate: aminopeptidase (71%); alkaline beta-glycerophosphatase (82%); invertase (92%); adenosine triphosphatase (93-116%); acid beta-glycerophosphatase (83%); nonspecific esterase (76%); succinate dehydrogenase (96%). Only small proportions of the total lactate-dehydrogenase (10%) and phosphoglucose-isomerase (2%) activities found in the homogenate were recovered in the isolated cell ;ghosts'. 3. The epithelial-cell ;ghost' preparation did not respire unless cofactors and substrates were added, and did not consume glucose or produce lactic acid from glucose. 4. The effect of varying the composition of the homogenization medium was studied. Concentrations of dextran (mol.wt. 15x10(4)) from 1 to 12%, solutions of dextrans (all at 6%) with mol.wt. varying between 3.6x10(4) and 2x10(6), and a solution of 8% polyethylene glycol (mol.wt. 4000) served equally well for the production of epithelial-cell ;ghosts'. Two of these solutions, however, 12% dextran (mol.wt.15x10(4)) and 6% dextran (mol.wt. 2x10(6)), were too viscous to allow the complete sedimentation of the cell ;ghosts' at low relative centrifugal forces. Omission of either Krebs-Ringer phosphate or dextran from the medium resulted in almost complete cell breakage during the homogenization. 5. The isolated cell ;ghosts' were used as a starting material for subcellular fractionation of rat intestinal mucosa by differential centrifugation. The distributions of protein and succinate-dehydrogenase activity among the fractions were compared with corresponding values in fractions isolated by differential centrifugation of mucosa homogenized in 0.3m-sucrose-5mm-EDTA, pH7.4. The method in which cell ;ghosts' were used as starting material gave a better separation and cleaner fractions than the method in which untreated mucosal scrapings were used.

OBJECTIVE

To illustrate that the attenuation formula based on monochromatic radiation in homogeneous objects may be used for dose regulation in body computed tomography (CT) based on patient circumference and using a simple cloth measuring tape.

METHODS

Based on the attenuation formula for monochromatic radiation the following Microsoft Excel equation was derived: mAs(x) = mAs(n)*EXP((0.693/ HVT)*(O(x)-O(n))/PI()), where mAs(x) (milliampere second) in a patient with circumference O(x) is calculated based on the nominal mAs(n) set for a reference patient with the circumference O(n) with regard to indication, scan protocol, and available CT scanner. The HVT = half-value thickness (object thickness change in cm affecting mAs setting by a factor of 2) resulting in the least mAs difference compared with published studies investigating the mAs needed for constant image noise in abdominal CT phantoms at 80-140 kVp was evaluated. Clinically recommended HVT values were applied to 20 patients undergoing abdominal CT using 130 effective mAs and 94 cm circumference as nominal settings, and an HVT of 9 cm.

RESULTS

The object-sized dependent mAs for constant image noise at 80-140 kVp in 10-47 cm diameter abdominal phantoms (31-148 cm in circumference) differed, with few exceptions, by no more than 10% from those obtained with our formula using an HVT of 3.2-3.8 cm. An HVT of 9 cm in the patient study resulted in the same image noise-patient circumference relation as a phantom study using a "clinically adapted mAs" resulting in an acceptable noise according to diagnostic requirements. Clinical experiences recommend an HVT of about 8 cm for abdominal CT and 12 cm in thoracic CT. Changing the kVp from 120 to 80, 100, or 140 requires a mAs change roughly by factors of 4, 2, and 0.6, respectively, for constant image noise.

CONCLUSIONS

Until fully automatic automatic exposure control systems have been introduced, applying the formula in a computer program provides the radiologist with an easy, quick, flexible, and practical instrument for reasonably good patient-sized adjusted exposure levels in clinical practice.

BACKGROUND

NICU patients are at risk of skin breakdown due to prematurity, irritant exposure, medical status and stress. There is a need to minimize damage, facilitate skin development and reduce infection risk, but the literature on the effects of skin care practices in NICU patients is limited.

OBJECTIVE

To test the hypothesis that baby diaper wipes with emollient cleansers and a soft cloth would minimize skin compromise relative to cloth and water.

METHODS

In 130 NICU infants (gestational age 23-41 weeks, at enrollment 30-51 weeks), measurements of skin condition, i.e., skin erythema, skin rash, transepidermal water loss (TEWL) and surface acidity (pH), within the diaper and at diaper and chest control sites were determined daily for 5-14 days using standardized methods. Treatments were randomly assigned based on gestational age and starting skin irritation score: wipe A, wipe B, and the current cloth and water NICU standard of care.

RESULTS

Perineal erythema and TEWL were significantly lower for wipes A and B than cloth and water beginning at day 5 for erythema (scores of 1.11 +/- 0.05, 1.2 +/- 0.05, and 1.4 +/- 0.06, respectively) and day 7 for TEWL (28.2 +/- 1.6, 28.8 +/- 1.6, and 35.2 +/- 1.6 g/m(2)/h, respectively). Wipe B produced a significantly lower skin pH (day 5, 5.47 +/- 0.03) than wipe A (5.71 +/- 0.03) and cloth and water (5.67 +/- 0.04). The starting skin condition, stool total, age and time on current standard impacted the outcomes.

CONCLUSIONS

Both wipes are appropriate for use on medically stable NICU patients, including both full and preterm infants, and provide more normalized skin condition and barrier function versus the cloth and water standard. Wipe B may facilitate acid mantle development and assist in colonization, infection control and barrier repair. Neonatal skin continues to change for up to 8 weeks postnatally, presumably as it adapts to the dry extra-uterine environment.

An efficient adsorption process is developed for the decontamination of trivalent chromium from tannery effluents. A low cost activated carbon (ATFAC) was prepared from coconut shell fibers (an agricultural waste), characterized and utilized for Cr(III) removal from water/wastewater. A commercially available activated carbon fabric cloth (ACF) was also studied for comparative evaluation. All the equilibrium and kinetic studies were conducted at different temperatures, particle size, pHs, and adsorbent doses in batch mode. The Langmuir and Freundlich isotherm models were applied. The Langmuir model best fit the equilibrium isotherm data. The maximum adsorption capacities of ATFAC and ACF at 25 degrees C are 12.2 and 39.56 mg/g, respectively. Cr(III) adsorption increased with an increase in temperature (10 degrees C: ATFAC--10.97 mg/g, ACF--36.05 mg/g; 40 degrees C: ATFAC--16.10 mg/g, ACF--40.29 mg/g). The kinetic studies were conducted to delineate the effect of temperature, initial adsorbate concentration, particle size of the adsorbent, and solid to liquid ratio. The adsorption of Cr(III) follows the pseudo-second-order rate kinetics. From kinetic studies various rate and thermodynamic parameters such as effective diffusion coefficient, activation energy and entropy of activation were evaluated. The sorption capacity of activated carbon (ATFAC) and activated carbon fabric cloth is comparable to many other adsorbents/carbons/biosorbents utilized for the removal of trivalent chromium from water/wastewater.

The transfer of psychiatric care from the institution to the community has presented community structures including faith-based organisations (FBOs) with an additional burden of care. In recent years there has been an increasing policy interest among government departments, public and non-statutory agencies for the inclusion of FBOs as partners in health and welfare services. However, despite their long historical involvement in healing and healthcare, clergy are seldom viewed by mental health professionals as partners in healing and restitution but with suspicion [Koenig, 1988. Handbook of Religion and Mental Health San Diego: Academic Press; Larson, Hohmann, & Kessler, 1988. The couch and the cloth: The need for linkage. Hospital and Community Psychiatry, 39, 1064-1069]. This may be compounded by ignorance about mental health care provision within FBOs in the UK and the preparedness, confidence and willingness to undertake such care. This paper is based on a study which examined clergy contact with people with mental illness. Thirty-two interviews were conducted with male clergy (Christian ministers, rabbis, and imams) most of whom were London-based. We examine barriers and dilemmas for clergy in caring for people with mental illness. We found that they play an important but often confined role the scale and impact of which is not recognised by their central organisation and training bodies. Low confidence about managing psychiatric problems, underscored by anxiety, fear and stereotyped attitudes to mental illness restrain their willingness to formalise their function. We argue that any proposed extension of clergy involvement in mental health will require further research and thorough deliberation by mental health services and religious organisations.

Contamination of food contact surfaces with pathogens is considered an important vehicle for the indirect transmission of food-borne diseases. Five different cleaning cloths were assessed for the ability to remove viruses from food contact surfaces (stainless steel surface and nonporous solid surface) and to transfer viruses back to these surfaces. Cleaning cloths evaluated include two different cellulose/cotton cloths, one microfiber cloth, one nonwoven cloth, and one cotton terry bar towel. Four viral surrogates (murine norovirus [MNV], feline calicivirus [FCV], bacteriophages PRD1 and MS2) were included. Removal of FCV from stainless steel was significantly greater (P ≤ 0.05) than that from nonporous solid surface, and overall removal of MNV from both surfaces was significantly less (P ≤ 0.05) than that of FCV and PRD1. Additionally, the terry towel removed significantly fewer total viruses (P ≤ 0.05) than the microfiber and one of the cotton/cellulose cloths. The cleaning cloth experiments were repeated with human norovirus. For transfer of viruses from cloth to surface, both cellulose/cotton cloths and microfiber transferred an average of 3.4 and 8.5 total PFU, respectively, to both surfaces, and the amounts transferred were significantly different (P ≤ 0.05) from those for the nonwoven cloth and terry towel (309 and 331 total PFU, respectively). There was no statistically significant difference (P>> 0.05) in the amount of virus transfer between surfaces. These data indicate that while the cleaning cloths assessed here can remove viruses from surfaces, some cloths may also transfer a significant amount of viruses back to food contact surfaces.

Thirdhand smoke (THS) is a mixture of chemicals that remain on indoor surfaces after smoking has ceased. These chemicals can be inhaled, ingested, or absorbed dermally, and thus could impact human health. We evaluated the cytotoxicity and mode of action of fresh and aged THS, the toxicity of volatile organic chemicals (VOCs) in THS, and the molecular targets of acrolein, a VOC in THS. Experiments were done using mouse neural stem cells (mNSC), human pulmonary fibroblasts (hPF), and lung A549 epithelial cells. THS-exposed cotton cloth was extracted in Dulbecco's Eagle Medium and caused cytotoxicity in the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. THS extracts induced blebbing, immotility, vacuolization, cell fragmentation, severing of microfilaments and depolymerization of microtubules in mNSC. Cytotoxicity was inversely related to headspace volume in the extraction container and was lost upon aging, suggesting that VOCs in THS were cytotoxic. Phenol, 2',5'-dimethyl furan and acrolein were identified as the most cytotoxic VOCs in THS, and in combination, their cytotoxicity increased. Acrolein inhibited proliferation of mNSC and hPF and altered expression of cell cycle regulatory genes. Twenty-four hours of treatment with acrolein decreased expression of transcription factor Dp-1, a factor needed for the G1 to S transition in the cell cycle. At 48 h, WEE1 expression increased, while ANACP1 expression decreased consistent with blocking entry into and completion of the M phase of the cell cycle. This study identified acrolein as a highly cytotoxic VOC in THS which killed cells at high doses and inhibited cell proliferation at low doses.

Metal oxides have attracted renewed interest as promising electrode materials for high energy density supercapacitors. However, the electrochemical performance of metal oxide materials deteriorates significantly with the increase of mass loading due to their moderate electronic and ionic conductivities. This limits their practical energy. Herein, we perform a morphology and phase-controlled electrodeposition of MnO2 with ultrahigh mass loading of 10 mg cm-2 on a carbon cloth substrate to achieve high overall capacitance without sacrificing the electrochemical performance. Under optimum conditions, a hierarchical nanostructured architecture was constructed by interconnection of primary two-dimensional ε-MnO2 nanosheets and secondary one-dimensional α-MnO2 nanorod arrays. The specific hetero-nanostructures ensure facile ionic and electric transport in the entire electrode and maintain the structure stability during cycling. The hierarchically structured MnO2 electrode with high mass loading yields an outstanding areal capacitance of 3.04 F cm-2 (or a specific capacitance of 304 F g-1) at 3 mA cm-2 and an excellent rate capability comparable to those of low mass loading MnO2 electrodes. Finally, the aqueous and all-solid asymmetric supercapacitors (ASCs) assembled with our MnO2 cathode exhibit extremely high volumetric energy densities (8.3 mWh cm-3 at the power density of 0.28 W cm-3 for aqueous ASC and 8.0 mWh cm-3 at 0.65 W cm-3 for all-solid ASC), superior to most state-of-the-art supercapacitors.

Layered systems of commonly available fabric materials can be used by the public and healthcare providers in face masks to reduce the risk of inhaling viruses with protection that is about equivalent to or better than the filtration and adsorption offered by 5-layer N95 respirators. Over 70 different common fabric combinations and masks were evaluated under steady-state, forced convection air flux with pulsed aerosols that simulate forceful respiration. The aerosols contain fluorescent virus-like nanoparticles to track transmission through materials that greatly assist the accuracy of detection, thus avoiding artifacts including pore flooding and the loss of aerosol due to evaporation and droplet breakup. Effective materials comprise both absorbent, hydrophilic layers and barrier, hydrophobic layers. Although the hydrophobic layers can adhere virus-like nanoparticles, they may also repel droplets from adjacent absorbent layers and prevent wicking transport across the fabric system. Effective designs are noted with absorbent layers comprising terry cloth towel, quilting cotton, and flannel. Effective designs are noted with barrier layers comprising nonwoven polypropylene, polyester, and polyaramid.

Keywords: COVID-19; face mask; filtration efficiency; nanoparticles; personal protective equipment.