Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectra of bacterial proteins were obtained from water, lettuce and cloth samples contaminated with Shigella flexneri, Escherichia coli, and Aeromonas hydrophila. Spectra were obtained using proteins directly isolated from water (or water used for rinsing samples) without culturing the bacteria. For S. flexneri and E. coli, two marker ions for specific proteins associated with a virulence-related property (acid resistance) were easily detected. For A. hydrophila, ions from two specifically selected marker proteins, as well as ions from the larger group of proteins isolated from pure cultures, all matched spectra from a contaminated water sample, providing strong evidence that A. hydrophila was the bacterial contaminant. Rinse water from contaminated lettuce and cloth samples showed the same marker ions as the contaminated water samples.

Three types of clinical studies were carried out to better understand diaper dermatitis in a general infant population. In 'snapshot' clinical studies, skin condition under the diaper was evaluated at a given point in time across a large base of infants. Correlations were sought between diaper dermatitis incidence and severity and a number of factors, including sex, diet, maturity, type of diaper, history of allergy, contact with fecal matter, presence of Candida albicans, and diaper change frequency. Severe diaper rash correlated strongly with the presence of C. albicans, and the frequency of rash correlated with duration of contact with feces and inversely with diaper change frequency. Diaper rash peaked at ages 9-12 months and was lower for breast-fed than for formula-fed infants. Exclusive use of disposable diapers correlated with lower rash levels than when some or all cloth diapers were used. In a longitudinal study, infants were observed daily for 50 days in order to determine the frequency and duration of rash episodes. In this study, the tendency for some infants to be rash-prone was clearly indicated. In a third type of study, over 10,000 infant visits to physicians' offices were used to record skin condition. Results showed a three-to fourfold increase in diaper rash if the child had diarrhea during the previous 48 h.

Cerrado biome, the South American savannah, covers about 2 million km(2) and is very rich in endemic species but threatened by agriculture. In this report free-living tick species are presented, and their seasonal and relative distribution within the various phytophysiognomies in a small Cerrado reserve in Minas Gerais State, Brazil. Overall 2,694 free-living ticks were found during a 2 years sampling period with CO(2) traps and cloth dragging. Of these, 73.5% were Amblyomma cajennense and 0.6% Amblyomma dubitatum. All other ticks (25.9%) were retained as Amblyomma spp. Adults of A. cajennense peaked in spring, the nymphs in winter of both years. Amblyomma larval clusters were found in autumn and winter. Adult ticks (46.7%) and nymphs (39.5%) were most often found in woodlands, whereas most larval clusters were found in valley-side marshes (39%). Amblyomma cajennense, Anocentor nitens, Rhipicephalus (Boophilus) microplusand Rhipicephalus sanguineus ticks were found on domestic animals from neighboring properties. Search for Rickettsia in the hemolymph of 497 A. cajennense and one A. dubitatum ticks yielded negative results. Results confirmed earlier reports on the overwhelming prevalence of A. cajennense ticks in the Cerrado biome of Brazil and added information to habitat preferences of this tick species, a major vector in Brazil of the Rocky Mountain spotted fever.

Pudendal nerve palsy is a reported complication of hip arthroscopy. We report a technique using a deflated taped beanbag rather than a perineal post. The patient is placed in the supine or lateral position on a fracture table. The beanbag is contoured around the patient's flank and thorax. The distal aspect of the beanbag is placed no further than the iliac crest, and care is taken to avoid compression of the posterior aspect of the axillary region or the posterior humerus. The molded beanbag is deflated, a blanket is positioned over the abdomen and lower thorax, and with the use of 3-in-wide cloth tape, the patient and beanbag are secured to the operative table circumferentially. The superior margin of the deflated beanbag remains firm, preventing compression of the thorax and avoiding compromised ventilation. The arm on the operative side is placed across the chest and secured to avoid obstruction of the operative field. This patient positioning provides sufficient stability for adequate traction and good visualization while minimizing the risk of a pudendal nerve palsy.

In our search for tick repellents of plant origin, to be used as alternatives to commercial arthropod repellents, we investigated the effect of the well known plant signaling compound methyl jasmonate (MJ) using nymphs of the tick Ixodes ricinus. In laboratory tests, pieces of cloth with MJ at 0.075, 0.15, 0.30 and 0.75 mg/cm2 yielded increasing repellencies against the nymphs: 57%, 71%, 92% and 99%, respectively, of the nymphs did not cling to the cloth. Repellency of MJ was also investigated in a tick-infested woodland area in central Sweden. Cotton flannel cloths sprayed with 0.05, 0.1 or 0.2 mg/cm2 MJ dissolved in acetone were dragged over the ground vegetation. The numbers of nymphs on the treated cloths were significantly lower than those on the untreated cloth. Thus, MJ has, at the concentrations tested, significant repellent activity against I. ricinus nymphs.

A total of 148 femoropopliteal bypass procedures followed for a minimum of 2 years yielded a patency rate of 61.9 percent among survivors. Diabetes mellitus, cigarette smoking, quality of the outflow, or prior inflow procedures did not influence patency rate. Results were less satisfactory in women and when cloth grafts were used. The indications for femoropopliteal bypass require continuing careful assessment.

Since Berry and Friend developed methods to isolate hepatocytes from the liver by a collagenase digestion technique in 1969, studies in laboratory animals have demonstrated that hepatocyte transplantation could potentially be used for the treatment of liver failure and inborn errors of liver-based metabolism. Healthy human hepatocytes are an ideal source for hepatocyte transplantation; however, their relative scarcity is one of the major drawbacks, further compounded by the competing demands of liver transplantation. Notably, most of the hepatocytes are isolated from discarded livers that are not suitable for organ transplantation for a variety of reasons, including excessive fat content. Importantly, the hepatocyte isolation procedure itself exerts major stress on hepatocytes by the disruption of cell-to-cell and cell-to-matrix contacts, resulting in hepatocytic apoptosis. Prevention of apoptosis would maximize yield of healthy cells and maintain hepatocyte differentiated function in culture. In this review, we describe methods to prevent apoptosis by utilizing both antiapoptotic molecules and matrices. We also introduce a new type of liver tissue engineering, hepatocyte sheet transplantation, which utilizes unwoven cloth having a cellular adhesive property.

BACKGROUND

Sporadic influenza A virus (IAV) outbreaks in humans and swine have resulted from commingling of large numbers of people and pigs at agricultural fairs in the United States. Current antemortem IAV surveillance strategies in swine require collecting nasal swabs, which entails restraining pigs with snares. Restraint is labor-intensive for samplers, stressful for pigs, and displeasing to onlookers because pigs often resist and vocalize.

OBJECTIVE

To evaluate the utility of snout wipes in exhibition swine as a method to make IAV surveillance efforts less intrusive, less labor-intensive, and more widely accepted among pig owners and exhibition officials.

METHODS

Three materials (rayon/polyester gauze, cotton gauze, and Swiffer(®) Sweeper dry cloths) were inoculated with IAV, and viral recoveries from these materials were quantified using qRT-PCR and TCID50 assays. In a field trial, paired cotton gauze snout wipes and gold standard polyester-tipped nasal swabs were collected from 553 pigs representing 29 agricultural fairs and the qualitative results of rRT-PCR and viral isolation were compared.

CONCLUSIONS

Viral recoveries from potential snout wipe materials ranged from 0.26 to 1.59 log10 TCID50 /ml less than that of the positive control in which no substrate was included; rayon/polyester gauze performed significantly worse than the other materials. In the field, snout wipes and nasal swabs had high levels of agreement for both rRT-PCR detection and virus isolation. Although further investigation and refinement of the sampling method is needed, results indicate that snout wipes will facilitate convenient and undisruptive IAV surveillance in pigs at agricultural fairs.

A sample of dairy farms in Great Britain with a monthly bulk milk somatic cell count of less than 150,000 cells/ml was enrolled into a 12-month prospective study. At the end of the study, a questionnaire on milking practice and other farm management practices was sent to the 482 farmers who had collected data on the occurrence of mastitis throughout the 12 months. The response rate was 93 per cent. The reported mean incidence of clinical mastitis was 36.9 cases per 100 cow-years. Factors associated with an increase in the incidence of clinical mastitis were cleaning out the straw yard less frequently than every six weeks, more than 5 per cent of cows leaking milk outside the parlour, checking the foremilk, wearing gloves during milking, an average annual milk yield of more than 7000 litres per cow, dipping or spraying teats before milking and keeping milk with a high somatic cell count out of the bulk tank. Factors associated with a decrease in the incidence of clinical mastitis were using a cloth to dry the teats after washing them as part of premilking preparation, using calving boxes for less than 40 per cent of calvings, and using both cubicles and straw yards to house dry cows, as opposed to other housing.

This paper describes a health education intervention which was conducted during the 1990 dry season in 3 study villages in the Northern Region of Ghana, to reduce dracunculiasis prevalence in that area by promoting the use of cloth filters for drinking water and avoidance of water contact by sufferers. The impact of the intervention in reducing dracunculiasis prevalence was examined by comparing the period prevalence of infection in 1990 and 1991. The findings demonstrate that the intervention had a measurable but limited impact on dracunculiasis prevalence. Face-to-face health education was successful in persuading 56% of households to buy filters. Ownership of at least one filter for every 10 people in the household was associated with a reduction of at least 20% in the risk of dracunculiasis.

BACKGROUND

Bacterial reservoirs in the near-patient environment are likely vectors of healthcare-acquired infection.

OBJECTIVE

To conduct a laboratory-based study to confirm a previous clinical finding of higher numbers of bacteria on plastic than on painted steel bed rails.

METHODS

Six different surfaces were inoculated with Staphylococcus aureus suspended in a range of synthetic soils. Aerobic colony counts and ATP bioluminescence were used to assess the efficacy of cleaning with microfibre cloths and antibacterial wipes. The ease with which S. aureus was transferred between fingertips and each bed rail was also investigated.

RESULTS

Antibacterial wipes reduced bacterial numbers to below detectable levels on all rails but were less effective than microfibre cloths in removing organic debris. Surfaces that were comparatively easy to clean were more likely to transfer S. aureus on contact. If inadequately disinfected these rails could pose the greatest risk in terms of cross-transmission. In the absence of contaminating soil, bacterial transfer from fingertips to rail ranged from 38% to 64%. Transfer from rail to fingertip ranged from 22% to 38%. Surface material and rugosity were important factors in determining cleanability and transfer rate. However, the presence of organic soils affected bacterial transfer from all bed rails regardless of material or finish.

CONCLUSIONS

Bed rails can become heavily contaminated. Regular wiping with antibacterial wipes could be a cost-effective means of maintaining low numbers of bacteria near to the patient. To minimize the risk of cross-transmission, cleaning protocols should be validated to ensure effective removal of microbial and non-microbial surface contamination.

A number of preventive measures for the protection of humans against tick-borne diseases were evaluated. Measures involving the avoidance of tick bites with the use of protective clothing and insect repellents are the simplest and most effective. Repellents are applied directly to the skin or clothing and other fabrics, such as bednets, tents and anti-mosquito screens. Currently, DEET (N,N-diethyl-m-toluamide) is considered the most efficient arthropod repellent reference substance. The registered and recommended active repellent ingredients for skin and/or cloths application, among others, are: DEET, 1-methyl-propyl-2- (hydroxyethyl)-1-piperidinecarboxylate (picaridin), p-menthane-3,8-diol (PMD), ethyl butylactyloaminopropionate ( IR3535), 1S,2S-2-methylpiperidinyl-3-cyclohexene-1-carboxamide (SS220), racemic 2-methylpiperidinyl-3-cyclohexene-1-carboxamide (AI3-37220) and synthethic pyrethroid - 3-phenoxybenzyl-cis-trans-3(2,2 dichlorovinyl)-2,2-dimethylcyclopropancarboxylate (permethrin) - an acaricide with repellent properties. To achieve the protection from tick bites by avoiding attachment and/or engorgement by the arthropod, acaricides with repellent properties, such as synthetic pyrethroid-permethrin are used. This pyrethroid is an acaricide of choice used for clothing impregnation, which is effective for personal protection against all three parasitic stages of western black-legged ticks. Products based on natural compounds, e.g. eugenol from Ocimum basilicum, 2-undecanone originally derived from wild tomato, geraniol - a natural product extracted from plants, and many others, represent an interesting alternative to common synthetic repellents and/or acaricides.

This study was conducted in October 1998 and November 1999 in the Emas National Park (131,868 ha), a savanna-type cerrado region situated in the far south of Goias State, Brazil, near the geographic center of South America (15 degrees -23 degrees S; 45 degrees -55 degrees W). Animals were captured with the aid of nets and anesthetized (15 mg/kg ketamine + 1 mg/kg xylasine) in order to collect ticks for identification and to establish laboratory colonies. They included giant anteaters (Myrmecophaga tridactyla) (n = 4) and yellow armadillos (Euphractus sexcinctus) (n = 6). Free-living ticks (larvae, nymphs, and adults) were collected from the field by using a 1 x 2-m flannel cloth. Free-living ticks were identified as Amblyomma sp., A. cajennense, and A. triste. Adult ticks collected from anteaters were identified as Amblyomma cajennense and A. nodosum and from armadillos as A. pseudoconcolor and A. nodosum. The relevance of these host-tick relationships to possible mechanisms underlying emergence of tick-borne pathogens of importance to public health is discussed.

BACKGROUND

Here we set out to standardize long-lasting, visually-attractive devices for Glossina swynnertoni, a vector of both human and animal trypanosomiasis in open savannah in Tanzania and Kenya, and in neighbouring conservation areas used by pastoralists. The goal was to determine the most practical device/material that would induce the strongest landing response in G. swynnertoni for use in area-wide population suppression of this fly with insecticide-impregnated devices.

RESULTS

Trials were conducted in wet and dry seasons in the Serengeti and Maasai Mara to measure the performance of traps and targets of different sizes and colours, with and without chemical baits, at different population densities and under different environmental conditions. Adhesive film was used as a simple enumerator at these remote locations to compare trapping efficiencies of devices. Independent of season or presence of chemical baits, targets in phthalogen blue or turquoise blue cloth with adhesive film were the best devices for capturing G. swynnertoni in all situations, catching up to 19 times more flies than pyramidal traps. Baiting with chemicals did not affect the relative performance of devices. Fly landings were two times higher on 1 m(2) blue-black targets as on pyramidal traps when equivalent areas of both were covered with adhesive film. Landings on 1 m(2) blue-black targets were compared to those on smaller phthalogen blue 0.5 m(2) all-blue or blue-black-blue cloth targets, and to landings on all-blue plastic 0.32-0.47 m(2) leg panels painted in phthalogen blue. These smaller targets and leg panels captured equivalent numbers of G. swynnertoni per unit area as bigger targets.

CONCLUSIONS

Leg panels and 0.5 m(2) cloth targets show promise as cost effective devices for management of G. swynnertoni as they can be used for both control (insecticide-impregnated cloth) and for sampling (rigid plastic with insect glue or adhesive film) of populations.

BACKGROUND

While the amount of blood loss during laparoscopic hepatectomy tends to be smaller than that during open hepatectomy, intermittent vascular occlusion to control hepatic inflow can diminish blood loss during laparoscopic hepatectomy. Described herein is a useful and convenient method for intermittent vascular occlusion, which was standardized for laparoscopic hepatectomy.

METHODS

A tourniquet system consisting of cloth tape and a 20-cm catheter was used for intermittent vascular occlusion. This was placed through a hole in the abdominal wall from which a 5-mm trocar had been extracted. By operating this tourniquet system outside the patient's body, we were easily able to repeat intermittent vascular occlusion. Twenty-three patients underwent laparoscopic hepatectomy using this system.

RESULTS

The mean time of operation and vascular occlusion were 311.6 and 83.6 min, respectively. The mean blood loss was 215.0 mL. There were no intraoperative blood transfusions or critical postoperative complications. The average length of postoperative hospital stay was 6.5 days. The mean time to place this system was 354 s, and there were no complications caused by this system.

CONCLUSIONS

During totally laparoscopic hepatectomy, surgeons can perform intermittent vascular occlusion safely by using this method.

A case of primary cutaneous aspergillosis in a 3-week-old premature infant is reported. The lesion, which presented as a solitary nodule surmounted by three pustules, occurred following the use of elasticized and cloth adhesive tape and was cured by surgical excision. Factors predisposing to this infection included maceration, antibiotic usage, and prematurity.

Microbial electrolysis cells (MECs) are an efficient technology for generating hydrogen gas from organic matter, but alternatives to precious metals are needed for cathode catalysts. We show here that high surface area stainless steel brush cathodes produce hydrogen at rates and efficiencies similar to those achieved with platinum-catalyzed carbon cloth cathodes in single-chamber MECs. Using a stainless steel brush cathode with a specific surface area of 810 m2/m3, hydrogen was produced at a rate of 1.7 +/- 0.1 m3-H2/m3-d (current density of 188 +/- 10 A/m3) at an applied voltage of 0.6 V. The energy efficiency relative to the electrical energy input was 221 +/- 8%, and the overall energy efficiency was 78 +/- 5% based on both electrical energy and substrate utilization. These values compare well to previous results obtained using platinum on flat carbon cathodes in a similar system. Reducing the cathode surface area by 75% decreased performance from 91 +/- 3 A/m3 to 78 +/- 4 A/m3. A brush cathode with graphite instead of stainless steel and a specific surface area of 4600 m2/m3 generated substantially less current (1.7 +/- 0.0 A/m3), and a flat stainless steel cathode (25 m2/m3) produced 64 +/- 1 A/m3, demonstrating that both the stainless steel and the large surface area contributed to high current densities. Linear sweep voltammetry showed that the stainless steel brush cathodes both reduced the overpotential needed for hydrogen evolution and exhibited a decrease in overpotential over time as a result of activation. These results demonstrate for the first time that hydrogen production can be achieved at rates comparable to those with precious metal catalysts in MECs without the need for expensive cathodes.

Seasonal and daily variation in basal plasma concentrations of corticosterone and the effect of short-term confinement on plasma corticosterone concentration were examined in wild adult male and female tuatara (Sphenodon punctatus) on Stephens Island, New Zealand. Males and females sampled immediately upon capture at night (active period) showed significant variation in basal plasma corticosterone among four seasons of the year, and females also showed variation in concentration between reproductive states sampled at the same time. Highest basal concentrations in females were seen in November, when the level in gravid females about to nest (4.45 +/- 0.66 ng/ml; mean +/- SE) was almost twice that in nonnesting females at the same time (2.48 +/- 0.30 ng/ml). Plasma samples collected from tuatara at dusk, middle of the night, dawn, and middle of the day showed no significant daily variation in corticosterone concentration in either summer or winter. In these samples, significant positive correlations between body temperature and log plasma corticosterone were observed in males in summer and winter, but not in females in either season. Mean corticosterone concentrations in tuatara held in cloth bags for 3 h were significantly higher than in free-roaming controls (P < 0.01), with mean concentrations in males about 23 times, and vitellogenic females 9 times, those of their respective controls. Plasma corticosterone concentrations measured in this stress study were compared with previously published concentrations for plasma sex steroids in the same individuals. Corticosterone was positively correlated with progesterone (both sexes), but not with testosterone (both sexes) or estradiol (measured in females only). In summary, wild adult tuatara have low basal levels of plasma corticosterone that vary seasonally, but not diurnally. As in other reptiles, corticosterone concentration shows a significant elevation in response to short-term confinement.

A field study was conducted on 39 male workers exposed to styrene at concentrations below 40 ppm (time weighted average, TWA). Analyses were carried out on environmental air, exhaled air, blood, urine, and two major urinary metabolites of styrene: mandelic acid (MA) and phenylglycoxylic acid (PGA). Head space gas chromatography (GC) with a flame ionization detector (FID) was used for determination of styrene in blood and urine. Postexposure exhaled air was analyzed using capillary GC. Environmental styrene exposure was measured by personal sampling using carbon cloth personal samplers. Urinary metabolites of styrene were determined by high pressure liquid chromatograph (HPLC). When the end-of-shift breath, blood, and urine styrene levels were compared with environmental TWA values, blood styrene correlated best with styrene in air (r = 0.87), followed by breath styrene (r = 0.76). Poor correlation (r = 0.24) was observed between environmental styrene exposure and urine styrene. When styrene metabolites were compared with environmental styrene, the sum of urinary MA and PGA correlated better with styrene in air than MA or PGA alone. The correlations between urinary metabolites and environmental styrene improved when corrected for the specific gravity of urine. Even better correlations were observed when the urinary metabolites were corrected for creatinine. The correlation coefficients for environmental styrene and end-of-shift MA, PGA, and MA+PGA were 0.83, 0.84, and 0.86, respectively. The correlation coefficients between environmental styrene and next morning urinary metabolites fell to 0.47, 0.61, and 0.65 for MA, PGA, and MA+PGA, respectively. These results suggest that determination of the total MA and PGA in urine samples is preferred than separate measurements of MA or PGA. The good correlation between environmental exposure and styrene in the exhaled air also suggests that breath styrene level can be a useful indicator for low level styrene exposure, as the method is specific, noninvasive, and rapid. Urinary styrene seems to be a less reliable indicator for low level styrene exposure.

This study was conducted at Carimagua Research Centre in a well-drained savanna area in the eastern plains of Colombia. The objectives were to note the effect of ecological factors on tick burdens, principally the effect of the environment given by four grasses on the seasonal variations of tick populations. Adult female tick counts were carried out on heifers grazing four pastures and tick larvae on the grass detected by cloth dragging. Tick counts were significantly higher on animals grazing Brachiaria decumbens than those grazing Andropogon gayanus, Melinis minutiflora or native pastures. Tick larvae counts on the grass showed a similar tendency. Introduced grasses and intensification of production will require greater care to control tick infestations since increases in stocking rate and ground coverage could augment tick populations.

BACKGROUND

Jugular vein phlebectasia (JVP) is a cervical mass that occurs relatively infrequently and usually presents in children as a soft cystic swelling in the neck during straining. It is liable to be misdiagnosed or managed inappropriately. This report elucidates the clinical presentation, diagnosis, treatment choices, and postoperative complications of JVP, and diagnostic methods and treatment choices are recommended.

METHODS

Fifty-one cases of JVP were reviewed (right vein in 38 patients, left in 7 patients, and bilateral in 6 patients). The internal jugular vein was involved the most frequently. The main complaint was a soft and compressible mass in the neck, becoming more prominent with the Valsalva maneuver. All of the children except 2 had an ultrasound or color Doppler flow imaging (CDFI) performed in combination with the Valsalva's breathing test. Surgical intervention was performed in 46 patients and the other 5 patients were followed-up conservatively for 2 to 15 years.

RESULTS

Ultrasound or CDFI showed local dilatation of unilateral or bilateral veins in all patients except 2, and confirmed the diagnosis in combination with the Valsalva's breathing test. Surgical intervention included ligation of the involved jugular vein in 32 patients, and longitudinal constriction suture venoplasty plus encapsulation with medical Dacron cloth or PTFE in 14 patients. All of the children who had surgery recovered uneventfully, except 3 patients undergoing ligation of the right internal jugular vein.

CONCLUSIONS

The Valsalva maneuver was most important for establishing the diagnosis. Ultrasound or CDFI, or in combination with the Valsalva's breathing test, was the diagnostic procedure of choice to confirm the diagnosis of JVP because of its clarity, safety, and low cost. Surgical intervention was recommended for cosmetic and psychologic purposes. Ligation or excision of the involved jugular vein was very safe, simple, and effective for most patients. However, in cases of lesions of the right and bilateral internal jugular veins, longitudinal constriction suture venoplasty plus encapsulation might be more preferable and safer, and should be recommended. Otherwise, treatment should be conservative (follow-up evaluation).

To investigate the effect of universal decolonization with octenidine on the incidence of ICU-acquired bloodstream infections (BSI) and MDR organisms (MDRO).

A system-wide change in practice was performed in the ICUs of a university hospital with three campuses (eight medical ICUs and nine surgical ICUs). All ICUs had a general admission screening strategy for MRSA with subsequent isolation in the 12 month baseline period, which was stopped. After a wash-in period of 1 month, decolonization of the nose with octenidine nasal gel and octenidine wash cloths was introduced. The endpoints were ICU-acquired BSI and ICU-acquired MDRO isolates from clinical cultures. Segmented regression analysis of interrupted time series was used to assess the effect of intervention.

A total of 29 532 ICU patients (16 677 surgical and 12 855 medical) were included in the study. The baseline incidence density of ICU-acquired BSI was 5.1 per 1000 patient days and the baseline ICU-acquired MRSA rate was 0.97 per 1000 patient days. Whereas no significant effect on either outcome was found in surgical ICUs, we identified a significant effect on ICU-acquired BSI for the intervention in medical ICUs by means of multivariate analysis (incidence rate ratio 0.78; 95% CI 0.65-0.94). In addition, the intervention was also effective in decreasing ICU-acquired MRSA in medical ICUs (incidence rate ratio 0.58; 95% CI 0.41-0.82). No effect on ICU-acquired VRE and Gram-negative MDRO was found.

System change was successful by decreasing infection rates in medical ICUs and improving the management in all ICUs.

Recently, layered transition-metal dichalcogenides (TMDs) have gained great attention for their analogous graphite structure and high theoretical capacity. However, it has suffered from rapid capacity fading. Herein, we present the crumpled reduced graphene oxide (RGO) decorated MoS2 nanoflowers on carbon fiber cloth. The three-dimensional framework of interconnected crumpled RGO and carbon fibers provides good electronic conductivity and facile strain release during electrochemical reaction, which is in favor of the cycling stability of MoS2. The crumpled RGO decorated MoS2 nanoflowers anode exhibits high specific capacity (1225 mAh/g) and excellent cycling performance (680 mAh/g after 250 cycles). Our results demonstrate that the three-dimensional crumpled RGO/MoS2 nanoflowers anode is one of the attractive anodes for lithium-ion batteries.

We present the fabrication and use of plastic Photonic Band Gap Bragg fibers in photonic textiles for applications in interactive cloths, sensing fabrics, signage and art. In their cross section Bragg fibers feature periodic sequence of layers of two distinct plastics. Under ambient illumination the fibers appear colored due to optical interference in their microstructure. Importantly, no dyes or colorants are used in fabrication of such fibers, thus making the fibers resistant to color fading. Additionally, Bragg fibers guide light in the low refractive index core by photonic bandgap effect, while uniformly emitting a portion of guided color without the need of mechanical perturbations such as surface corrugation or microbending, thus making such fibers mechanically superior to the standard light emitting fibers. Intensity of side emission is controlled by varying the number of layers in a Bragg reflector. Under white light illumination, emitted color is very stable over time as it is defined by the fiber geometry rather than by spectral content of the light source. Moreover, Bragg fibers can be designed to reflect one color when side illuminated, and to emit another color while transmitting the light. By controlling the relative intensities of the ambient and guided light the overall fiber color can be varied, thus enabling passive color changing textiles. Additionally, by stretching a PBG Bragg fiber, its guided and reflected colors change proportionally to the amount of stretching, thus enabling visually interactive and sensing textiles responsive to the mechanical influence. Finally, we argue that plastic Bragg fibers offer economical solution demanded by textile applications.