Selenide-based electrocatalysts and scaffolds on carbon cloth are successfully fabricated and demonstrated for enhanced water oxidation applications. A max-imum current density of 97.5 mA cm(-2) at an overpotential of a mere 300 mV and a small Tafel slope of 77 mV dec(-1) are achieved, suggesting the potential of these materials to serve as advanced oxygen evolution reaction catalysts.

Designing highly efficient electrocatalysts for oxygen evolution reaction (OER) plays a key role in the development of various renewable energy storage and conversion devices. In this work, we developed metallic Co4N porous nanowire arrays directly grown on flexible substrates as highly active OER electrocatalysts for the first time. Benefiting from the collaborative advantages of metallic character, 1D porous nanowire arrays, and unique 3D electrode configuration, surface oxidation activated Co4N porous nanowire arrays/carbon cloth achieved an extremely small overpotential of 257 mV at a current density of 10 mA cm(-2), and a low Tafel slope of 44 mV dec(-1) in an alkaline medium, which is the best OER performance among reported Co-based electrocatalysts to date. Moreover, in-depth mechanistic investigations demonstrate the active phases are the metallic Co4N core inside with a thin cobalt oxides/hydroxides shell during the OER process. Our finding introduces a new concept to explore the design of high-efficiency OER electrocatalysts.

A housing and tether system was designed to permit sampling of body fluids, chronic monitoring of physiologic parameters (e.g. blood pressure, heart rate), performance of species typical behavioral interactions (aggression, affiliation, reproduction, etc), physical exercise (work on a motorized treadmill), assessment of water and diet consumption, as well as feces and urine collection. The system provided primates with the opportunity to engage in species typical social behavior and thereby minimized conditions which have been identified as contributing to the development of abnormal behaviors associated with individual housing. The system consisted of two parts: (a) a specialized cage system for housing small social groups of primates and (b) a tether and indwelling catheter system. Each modular system permitted four adult baboons (Papio cynocephalus anubis) to be tethered and housed in a social group. Each cage was 2.44 x 2.44 x 1.22 m (L x W x H) and could be subdivided by means of woven wire wall partitions. The tether system consisted of a backpack, a cloth jacket, a stainless-steel flexible cable containing electrical cables and catheters, and a saline infusion pump mounted on top of the cage. The system provides laboratory primates with the ability to socially interact with other nonhuman primates. The social cage tether system represents an example of a housing environment which could conform to both the letter and spirit of the new animal welfare legislation and still remain compatible with the objective of obtaining scientific data.

The topical agents used in burn care today, although beneficial, do have limitations, the most important of which is the failure to prevent or treat burn wound infections in patients with extensive injuries. Therefore, we evaluated the antimicrobial activity of two silver nylon fabrics (SN and HRS) on the growth of S. aureus, P. aeruginosa, and C. albicans. The theoretical advantages of these nylon fabrics over presently available silver compounds is their ability to continuously release silver ions into the burn wound as long as the material is in contact with the wound. Additionally, the release of silver from these fabrics can be augmented electrolytically. The results of these experiments indicated that both materials were microbicidal in vitro for all three test organisms. Furthermore, the antimicrobial activity could be significantly augmented by passing a weak DC current through the material, which increased the rate of release of silver ions from the fabrics. In vivo, HRS was as effective as silver sulfadiazine in preventing colonization of the burn wound. The use of silver nylon fabrics thus appears to be a promising way of delivering large quantities of silver ions into the burn wound without the potential side effects of a carrier molecule or cream.

OBJECTIVE

Cleansing the skin of intensive care unit (ICU) patients daily with chlorhexidine gluconate (CHG) has been associated with beneficial effects, including a reduction in central-line-associated bacteremias (CLABSIs). Most studies have been done in medical ICUs. In this study, we evaluated the effectiveness of daily chlorhexidine skin cleansing on CLABSI rates in a surgical ICU.

METHODS

In Fall 2005, the 30-bed surgical ICU at Rush University Medical Center discontinued daily soap-and-water bathing of patients and substituted skin cleansing with no-rinse, 2% CHG-impregnated cloths. This change was made without research investigator input or oversight. Using administrative, microbiological and infection control practitioner databases, we compared rates of CLABSIs and blood culture contamination during soap-and-water bathing (September 2004-October 2005) and CHG cleansing (November 2005-October 2006) periods. Rates of other nosocomial infections that were not expected to be affected by CHG bathing (secondary bacteremia, Clostridium difficile-associated diarrhea, ventilator-associated pneumonia, urinary tract infection) were included as control variables.

RESULTS

There was no significant difference in the CLABSI rate between soap-and-water and CHG bathing periods (3.81/1,000 central line days vs. 4.6/1,000 central line days; p = 0.57). Blood culture contamination declined during CHG bathing (5.97/1,000 to 2.41/1,000 patient days; p = 0.003). Rates of other nosocomial infections did not change significantly.

CONCLUSIONS

In this real-world effectiveness trial, daily cleansing of surgical ICU patients' skin with CHG had no effect on CLABSI rates, but was associated with half the rate of blood culture contamination. Controlled trials in surgical ICUs are needed to determine whether CHG bathing can prevent infections in this setting.

BACKGROUND

The application of single-incision laparoscopic surgery (SILS) to splenectomy is still challenging with much room for technical improvement. The purpose of this study was to describe the tug-exposure technique, an innovative technique for performing safe single-incision laparoscopic splenectomy (SILS-Sp).

METHODS

We performed SILS-Sp in ten consecutive adult patients with a variety of pathology requiring total splenectomy. A SILS™ Port with three 5-mm trocars was placed in the umbilicus as a single-access site. A flexible 5-mm laparoscope and an articulating grasper were used in addition to standard laparoscopic equipment. A cloth tape was introduced intraperitoneally to encircle and tug the splenic hilum. Both ends of the tape were extracted through an extra needle hole in the skin. Pulling the tape in appropriate directions provided excellent exposure of the splenic hilum (the tug-exposure technique). Under sufficient tension and exposure by tugging the spleen, a linear stapler was introduced for stapling and dividing the splenic hilum and the splenic artery and vein. The spleen was extracted through the umbilical wound within a retrieval bag. The umbilical wound was closed with subcutaneous sutures.

RESULTS

The tug-exposure technique was successfully used in all patients and markedly improved the exposure of the splenic hilum during SILS-Sp. The median intraoperative blood loss was 15 (range 0-1,000) ml. Only one patient (10%) required conversion to open surgery. Median operative time was 230 (range, 150-378) min, the median extracted spleen weight was 260 (range, 100-580) g, and the median postoperative hospital stay was 7 (range, 4-9) days. All patients were discharged uneventfully. The umbilical incision was nearly invisible at the 1-month follow-up.

CONCLUSIONS

The tug-exposure technique is an innovative technique that enables easy and safe SILS splenectomy by experienced surgeons.

BACKGROUND

Clostridium difficile spores can survive in the environment for months or years, and contaminated environmental surfaces are important sources of nosocomial C. difficile transmission.

OBJECTIVE

To compare the clinical and cost effectiveness of eight C. difficile environmental disinfection methods for the terminal cleaning of hospital rooms contaminated with C. difficile spores.

METHODS

This was a novel randomized prospective study undertaken in three phases. Each empty hospital room was disinfected, then contaminated with C. difficile spores and disinfected with one of eight disinfection products: hydrogen peroxide vapour (HPV; Bioquell Q10) 350-700 parts per million (ppm); dry ozone at 25 ppm (Meditrox); 1000 ppm chlorine-releasing agent (Actichlor Plus); microfibre cloths (Vermop) used in combination with and without a chlorine-releasing agent; high temperature over heated dry atomized steam cleaning (Polti steam) in combination with a sanitizing solution (HPMed); steam cleaning (Osprey steam); and peracetic acid wipes (Clinell). Swabs were inoculated on to C. difficile-selective agar and colony counts were performed pre and post disinfection for each method. A cost-effectiveness analysis was also undertaken comparing all methods to the current method of 1000 ppm chlorine-releasing agent (Actichlor Plus).

RESULTS

Products were ranked according to the log(10) reduction in colony count from contamination phase to disinfection. The three statistically significant most effective products were hydrogen peroxide (2.303); 1000 ppm chlorine-releasing agent (2.223) and peracetic acid wipes (2.134).

CONCLUSIONS

The cheaper traditional method of using a chlorine-releasing agent for disinfection was as effective as modern methods.

Microcrystalline collagen is a recently developed material possessing remarkable topical hemostatic properties. The potential utility of this substance for cardiovascular surgery was evaluated in a canine arterial bleeding model. A hemostatic protocol allowed comparison of initial and final hemostasis rates as well as the time required to accomplish hemostasis. The results of these studies revealed that microcrystalline collagen, or MCC, achieved hemostasis more frequently and rapidly than either pressure alone or oxidized cellulose cloth. MCC also was highly effective initially after large doses of heparin and in the presence of platelets with function rendered deficient by acetyl salicylate. Only in the presence of profound thrombocytopenia was any loss of initial effectiveness observed. Some delayed hemorrhage occurred in the heparin-treated groups leading to a lessened incidence of final hemostasis, a result intimately related to MCC's probable mechanism of action. However, even under the extreme conditions imposed by this severe experimental model, MCC remained effective in greater than 70 percent of the trials. On this basis MCC seems to possess great potential as a useful adjunct during cardiovascular surgical procedures.

Handlebar hernia is a rare type of blunt traumatic abdominal wall hernia (TAWH). It involves a disruption of the abdominal wall muscles, with bowel loop herniation through the defect in the abdominal wall. We report a case of bicycle-handlebar hernia in a 9-year-old boy who had all layers of his abdominal wall disrupted after falling from his bicycle. He was brought to our hospital with lower abdominal pain and bulging. A physical examination revealed left lower quadrant bulging in a standing posture, and a palpable fascial defect, 3 cm in diameter. Computed tomography showed a disruption of the abdominal rectal muscle layer, but his skin and intra-abdominal organs were completely intact. The patient was treated conservatively with abdominal wall compression using a cotton cloth corset. Within 3 weeks, his abdominal wall hernia had healed without the need for any surgical intervention.

A trial to compare the effect of military clothing treated by high-pressure spray with permethrin or placebo on the incidence of malaria in Royal Thai Army troops was conducted in northeastern Thailand. Bioassays of treated clothing using laboratory-reared Anopheles dirus females showed permethrin remained in the treated fabric for up to 90 days. Both permethrin- and placebo-treated uniform shirts provided>> 84% protection from biting An. dirus in laboratory bioassays for the duration of the study. In laboratory tests, knockdown of An. dirus exposed to permethrin-treated cloth fell to < 20% after 3 hand washes, despite the presence of 28.7-59.9% of the original dose of permethrin. The use of permethrin-treated uniforms without adjunct application of topical repellents did not reduce malaria in Thai troops in an operational setting where incidence during 6 months was as high as 412 cases/1,000 in spite of chemoprophylaxis and use of untreated bednets.

One of the main challenges to malaria elimination is the resilience of vectors, such as Anopheles arabiensis, that evade lethal exposure to insecticidal control measures or express resistance to their active ingredients. This study investigated a novel technology for population control that sterilizes mosquitoes using pyriproxyfen, a juvenile hormone analogue. Females of An. arabiensis were released in a semifield system divided into four equal sections, and each section had a mud hut sheltering a tethered cow providing a blood source for mosquitoes. In all sections, the inner mud hut walls and roofs were lined with black cotton cloth. In one-half of the sections, the cloth was dusted with pyriproxyfen. An overwhelming 96% reduction in adult production was achieved in pyriproxyfen-treated sections compared with control sections. This unprecedented level of control can be exploited to design new vector control strategies that particularly target existing behaviorally resilient and insecticide-resistant populations.

The main objective of this study was to compare the trapping efficiency of two Alsynite sticky traps (modified Williams and modified Broce) and two phtalogen blue cloth traps (Vavoua and Nzi) to be used in an integrated control programme of Stomoxys spp. (Diptera: Muscidae) on Reunion Island. Mean daily catches of these flies on two dairy farms differed significantly between the four types of trap. The Broce trap was the least efficient and had the lowest specificity for Stomoxys spp. The Vavoua, Nzi and Williams traps performed significantly better but could not be ranked on the basis of the numbers of Stomoxys caught because their respective performances differed between farms. Given the various practical criteria, it is concluded that, as control tools, blue cloth traps (Vavoua and Nzi) have practical advantages over the Williams trap. The Vavoua trap, which is less expensive and easier to use for farmers, seems adequate to complement other methods of fly control on Reunion Island.

BACKGROUND

The aim of this study was to investigate the decontamination capacity of 4 different types of cleaning cloths (microfiber cleaning cloth, cotton cloth, sponge cloth, and disposable paper towels) commonly used in hospital in their ability to reduce microbial loads from a surface used dry or wet in new condition. All of the cloths except disposable paper towels were also compared after 10 and 20 times of reprocessing, respectively, at 90 degrees C for 5 minutes in a washing machine.

METHODS

Staphylococcus aureus (ATCC 6538) and Escherichia coli (ATCC 8739) were used as test organisms. Test organisms were then added to a test soil (6% bovine serum albumin and 0.6% sheep erythrocytes) resulting in a controlled concentration of 5 x 10(7) colony-forming units per milliliter in the final test suspension. Standardized tiles measuring 5 x 5 cm were used as test surface.

RESULTS

Microfiber cloths showed the best results when being used in new condition. However, after multiple reprocessing, cotton cloth showed the best overall efficacy.

CONCLUSIONS

We therefore suggest that the choice of the cleaning utilities should be based on their decontamination efficacy after several reprocessings and recommend the establishment of strict and well-defined cleaning and disinfection protocols.

Shedding of herpesvirus by adults with herpes labialis and survival of the virus in the environment were examined. In nine adults with virus-positive herpes labialis, herpesvirus was detected in the anterior oral pool of seven (78%) and on the hands of six (67%). Herpesviruses isolated from patients with oral lesions were found to survive for as long as two hours on skin, three hours on cloth, and four hours on plastic. These findings support earlier recommendations for the protection of neonates from adults with "fever blisters." In addition, environmental surfaces may be a source of transmission of herpesvirus to the neonate.

In 2000, 22,000 French military personnel were deployed overseas. The French military health service implemented a vector control strategy including personal protection by the use of permethrin preimpregnated battlefield uniforms (BFUs) and the application on the skin of a topical repellent (50% DEET). In 2000, French forces used an industrial process to impregnate cloth with permethrin by soaking it before cut-out of the BFU. A study was implemented in four experimental huts in Côte d'Ivoire to assess the field efficacy of the impregnated BFUs and their resistance to washing. Taking into account the systematic variations in each variable in the field and using a modeling based on logistic regression and discriminant analysis, this study showed that after 6 h without reapplication, the protective effects of the use of DEET as skin repellent was not significant, perhaps due to the high density of Anopheles mosquitoes during the night catching sessions and an average time of effective repellency of < 2 or 3 h in the field. The analysis also showed that the French process of industrial impregnation of permethrin of the BFU offered in 2000 some protection from mosquito bites but not enough to reduce significantly the incidence of malaria among nonimmune troops. No positive or negative interaction was noted when DEET and the impregnated BFUs were used together.

Adult Ixodes scapularis Say were collected weekly during two fall-winter-spring seasons from 1989 to 1991 to assess their temporal and spatial distribution as well as the effects of several meteorologic parameters on questing activity. Collections were made in three 0.4-ha sites in central Mississippi by flagging vegetation with a white flannel cloth. Adult I. scapularis were collected from 25 October through 11 April during the 1989-1990 season and 24 October-1 April in the 1990-1991 season. Peak I. scapularis questing activity occurred on 5 February and 4 February during the two seasons, respectively. Ticks were collected most often at approximately 20 degrees C but seven were collected on a day when the temperature was 6.9 degrees C. Ticks were clustered within the study sites and not evenly distributed. Most I. scapularis were collected from Ligustrum sinense and Chasmanthium sessiliflorum at a height of 31-40 cm. Statistical analyses of the meteorologic factors that affect questing activity are presented and discussed.

Responses of host-seeking nymphs of the blacklegged tick, Ixodes scapularis Say and lone star tick, Amblyomma americanum (Linnaeus) (Acari: Ixodidae) to the repellents N,N-diethyl-3-methylbenzamide (deet) and (1S, 2'S)-2-methylpiperidinyl-3-cyclohexene-1-carboxamide (SS220) were studied using fingertip laboratory bioassays. Ethanol solutions of both compounds applied to the skin strongly repelled both species of ticks at 0.8 and 1.6 micromole of compound/cm2 skin. The ticks were also repelled when two layers of organdie cloth covered the portion of a finger treated with either deet or SS220. Gas chromatographic analyses of the outer layer of cloth that had covered skin treated with 1.6 micromole compound/cm2 skin revealed only 0.1 nmole SS220/cm2 cloth and 2.8 nmole deet/cm2 cloth. However, in bioassays in which a single layer of cloth was treated with a dose of deet or SS220 equivalent to the amount found in the outer layer of cloth, ticks were not repelled. Results unequivocally demonstrated that these ticks responded to the repellents in the vapour phase when repellent treated skin was covered with cloth to obviate tactile contact with them, and made it clear that the ticks detect the repellents by olfactory sensing. Heretofore, the mode of action of deet and SS220 was unclear.

A model was developed using 167 carboxamide derivatives, from the United States Department of Agriculture archival database, that were tested as arthropod repellents over the past 60 yr. An artificial neural network employing CODESSA PRO descriptors was used to construct a quantitative structure-activity relationship model for prediction of novel mosquito repellents. By correlating the structure of these carboxamides with complete protection time, a measure of repellency based on duration, 34 carboxamides were predicted as candidate mosquito repellents. There were four additional compounds selected on the basis of their structural similarity to those predicted. The compounds were synthesized either by reaction of 1-acylbenzotriazoles with secondary amines or by reaction of acid chlorides with secondary amines in the presence of sodium hydride. The biological efficacy was assessed by duration of repellency on cloth at two dosages (25 and 2.5 micromol/cm2) and by the minimum effective dosage to prevent Aedes aegypti (L.) (Diptera: Culicidae) bites. One compound, (E)-N-cyclohexyl-N-ethyl-2-hexenamide, was superior to N,N-diethyl-3-methylbenzamide (deet) at both the high dosage (22 d versus 7 d for deet) and low dosage (5 d versus 2.5 d for deet). Only one of the carboxamides, hexahydro-1-(l-oxohexyl)-1H-azepine, had a minimum effective dosage that was equivalent or slightly better than that of deet (0.033 micromol/cm2 versus 0.047 micromol/cm2).

Exposure of rodents to cats or certain cat odors results in long-term behavioral effects reminiscent of enhanced anxiety that have been considered to model post-traumatic stress disorder. However, other severe stressors such as tail-shock or immobilization in wooden boards (IMO) appear to induce shorter lasting changes in anxiety. In addition, there are controversial results regarding the effects of urine/feces odors. In the present work, we studied in two experiments the relationship between the degree of stress experienced by the animals during exposure to IMO, urine odors or fur odors (as assessed by hypothalamic-pituitary-adrenal activation and plasma glucose) and the short- and long-term behavioral consequences. In the first experiment, rats were individually exposed for 15 min to a novel environment (white large cages) containing either clean cat litter (controls) or litter soiled by cats (urine odors). Half of the rats in each condition were left to freely explore the environment whereas the others were subjected to immobilization (IMO) within the cages. Although ACTH, corticosterone and glucose responses to IMO were much stronger than those to the white cages with clean litter or urine odors (which did not differ from each other), no effect of treatments on anxiety-like behavior in the elevated plus-maze (EPM) were found one week later. However, previous IMO exposure did cause sensitization of the ACTH response to the EPM. In the second experiment, the response to white large cages containing either no odor (controls), litter soiled by cats (urine odor) or a cloth impregnated with cat odor (fur odor) was compared. Urine and fur odors elicited similar ACTH and corticosterone responses that were higher than those of controls, but plasma glucose levels were slightly higher in rats exposed to fur odor. When compared to controls, activity was only diminished in the novel cages containing fur odor. Similarly, fur odor-exposed rats, but not those exposed to urine odor, showed signs of enhanced anxiety in the EPM seven days later, although the ACTH response to the EPM was similar in the three groups. The present data demonstrate: (a) a marked dissociation between the degree of ACTH, corticosterone and glucose responses to stressors and their long-term anxiety-like effects; (b) that the type of cat odor is critical in determining the short-term and long-term physiological and behavioral consequences of exposure; and (c) that plasma ACTH released during brief exposure to the EPM does not appear to reflect anxiety-like behavior.

Trace amounts of explosives on solid surfaces were detected by mass spectrometry at ambient conditions with a new technique termed dielectric barrier discharge ionization (DBDI). By the needle-plate discharge mode, a plasma discharge with energetic electrons was generated, which could launch the desorption and ionization of the explosives from solid surfaces. Hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX), 2,4,6-trinitrotoluene (TNT), and pentaerythritol tetranitrate (PETN) were desorbed directly from the explosives-contaminated surface by DBDI, forming the typical anions of [TNT](-), [TNT - H](-), [RDX + NO(2)](-), [PETN + ONO(2)](-), and [RDX + ONO(2)](-). The ions were transferred into the MS instrument for analysis in the negative ion mode. The detection limit of present method was 10 pg for TNT (m/z 197, S/N 8 : 1), 0.1 ng for RDX (m/z 284, S/N 10 : 1), and 1 ng for PETN (m/z 260, S/N 12 : 1). The present method allowed the detection of trace explosives on various matrices, including paper, cloth, chemical fiber, glass, paints, and soil. A relative standard deviation of 5.57% was achieved by depositing 100 pg of TNT on these matrices. The analysis of A-5, a mixture of RDX and additives, has been carried out and the results were consistent with the reference values. The DBDI-MS method represents a simple and rapid way for the detection of explosives with high sensitivity and specificity, which is especially useful when they are present in trace amounts on ordinary environmental surfaces.

We compared the ability of ultramicrofibre-woven cloths with conventional cloths moistened with water only, for their ability to remove several types of organisms relevant to hospital-acquired infections from a variety of surfaces in hospitals. We showed that ultramicrofibre cloths consistently outperformed conventional cloths in their decontamination ability, across all surfaces, and irrespective of whether the bacteria were coated on to the surfaces with phosphate-buffered saline (PBS) or PBS containing horse serum to simulate real-life soiling. The ability of the cloths to remove bacteria from surfaces was assessed by contact plating and colony formation, and by swabbing and measurement of ATP bioluminescence. The results suggest potential for use of ultramicrofibre in healthcare environments. Further studies are required, however, to define accurately how these cloths, which are designed to be used without detergent or biocides, might be capable of safe and effective deployment and recycling in the healthcare environment.

A microbial evaluation was made of adhesive plastic surgical drapes and cloth surgical drapes. These studies were done both during surgery and in the laboratory. The plastic drape does not allow bacterial penetration, lateral migration does not occur, skin bacteria do not multiply under the drape within the time periods studied and the patient drapes are held in place with their use. When wet, cloth drapes showed profuse bacterial penetration. Dry cloth showed less bacterial penetration as compared to wet cloth. Lateral migration under cloth drapes was not possible to assess due to a high level of penetration. The surface of cloth showed a higher level of bacterial contamination during the surgical procedures. Deep wound cultures collected just prior to closing showed 60% contamination when cloth was used compared to 6% when plastic was employed. The micro-organisms recovered from the various sites sampled were identified. Finally, in addition to the positive aseptic benefits afforded by plastic adhesive drapes, aesthetic features such as a more delineated operative field and elimination of towel clips make this product a useful adjunct to the surgeon's armamentarium.

Seasonal and annual changes in the abundance of Amblyomma americanum (L.) larvae, nymphs, and adults were monitored over a 5-yr period in the Piedmont physiographic region of Georgia. Tick abundance was monitored with cloth drags (all life stages) and CO2-baited cloth panels (nymphs and adults) monthly during March through September from 1987 through 1991. Larvae appeared in substantial numbers in July and were most numerous in August and September. Small numbers of unfed larvae apparently overwintered each year based on their presence during March, April, or May. Nymphs were most numerous from April through June and declined to much lower numbers by August and September. Adults were most numerous from March through May and virtually disappeared by August. These seasonal patterns were similar to those reported for A. americanum at other southeastern locations. Each life stage exhibited similar trends of annual abundance with an increase in 1988 followed by a relatively steady decline to levels equivalent to or below initial 1987 values by 1991. Major environmental variables that potentially could have influenced annual abundance were identified from Haile & Mount's (1987) computerized model of A. americanum population dynamics. Habitat type, host density, and day length were constants and rationally could be excluded as causes of annual variations in abundance; weather and host-finding rate were presumed to have been primarily responsible for these annual differences.