Care Equipment Research Articles

Management of critically ill patients in austere environments: good clinical practice by the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI).

The Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has developed a good clinical practice to address the challenges of treating critically ill patients in resource-limited austere environments, exacerbated by recent pandemics, natural disasters, and conflicts. The methodological approach was based on a literature review and a modified Delphi method, which involved blind voting and consensus evaluation using a Likert scale. This process was conducted over two rounds of online voting. The document covers six critical topics: the overall impact of austere conditions on critical care, airway management, analgesia, bleeding control, vascular access, and medical devices and equipment. In these settings, it is vital to apply basic care techniques flexibly, focusing on immediate bleeding control, airway management, and hypothermia treatment to reduce mortality. For airway management, rapid sequence intubation with ketamine for sedation and muscle relaxation is suggested. Effective pain management involves a multimodal approach, including patient-controlled analgesia by quickly acting safe drugs, with an emphasis on ethical palliative care when other options are unavailable. Regarding hemorrhage, military-derived protocols like Tactical Combat Casualty Care significantly reduced mortality and influenced the development of civilian bleeding control devices. Establishing venous access is crucial, with intraosseous access as a swift option and central venous access for complex cases, ensuring aseptic conditions. Lastly, selecting medical equipment that matches the specific logistical and medical needs is essential, maintaining monitoring standards and considering advanced diagnostic tools like point-of-care ultrasounds. Finally, effective communication tools for coordination and telemedicine are also vital.

A survey of healthcare workers on the acceptance and value of personal protective equipment for patient care.

Assess healthcare workers' (HCW) attitudes toward universal masking, and gowns and gloves used as part of transmission-based precautions. Cross-sectional survey. Academic, tertiary care medical center in Baltimore, Maryland. HCW who work in patient care areas and have contact with patients. In May 2023, a 15-question web-based survey was distributed by the hospital's communications team via email. The survey contained questions to assess HCW perceptions of universal masking policies prior to the availability of COVID-19 vaccines and at the time of the survey, and the use of gowns and gloves for transmission-based precautions. Descriptive statistics were used to summarize data. Differences in agreement with universal masking over time, level of agreement with gown and glove policies, and with all PPE types across respondent characteristics were assessed. 257 eligible respondents completed the survey. Nurses and patient care technicians (43%) and providers (17%) were the most commonly reported roles. Agreement with universal mask use decreased from 84% early in the pandemic to 55% at the time of the survey. 70% and 72% of HCW agreed masks protect themselves and others, respectively. 63% expressed any level of annoyance with mask wearing, the most often due to communication challenges or physical discomfort. 75% agreed with gown use for antibiotic-resistant bacteria compared with 90% for glove use. The majority of HCW agree with the use of PPE to prevent pathogen transmission in the healthcare setting. Agreement with universal mask use for patient care shifted during the COVID-19 pandemic.

Assessing effectiveness of cleaning and disinfection of equipment and environmental surfaces in cystic fibrosis clinics using an ATP assay.

Infection control guidelines for cystic fibrosis (CF) stress cleaning of environmental surfaces and patientcare equipment in CF clinics. This multicenter study measured cleanliness of frequently touched surfaces in CF clinics using an ATP bioluminescence assay to assess the effectiveness of cleaning/disinfection and the impact of feedback. Eight surfaces were tested across 19 clinics (10 pediatric, 9 adult) over 5 rounds of testing. Rounds 1 and 2 served as uncleaned baseline, and Round 3 occurring after routine cleaning. Rounds 4 and 5 were performed after feedback provided to staff and measured after cleaning. Pass rates defined as <250 relative light units were the primary outcome. Of the 750 tests performed, 72% of surfaces passed at baseline, and 79%, 83%, and 85% of surfaces passed in Rounds 3, 4, and 5, respectively. The overall pass-rate was significantly higher in adult compared to pediatric clinics (86% vs 71%; P < 0.001). In pediatric clinics, blood pressure equipment and computer keyboards in the pulmonary function lab consistently passed, but the exam room patient/visitor chairs consistently failed in all rounds. In adult clinics blood pressure equipment, keyboards in exam rooms and exam tables passed in all rounds and no surface consistently failed. We demonstrate the feasibility of an ATP bioluminescence assay to measure cleanliness of patient care equipment and surfaces in CF clinics. Pass rates improved after cleaning and feedback for certain surfaces. We found that surfaces are more challenging to keep clean in clinics taking care of younger patients.

Feasibility of Monitoring Heart and Respiratory Rates Using Nonwearable Devices and Consistency of the Measured Parameters: Pilot Feasibility Study.

As Japan is the world's fastest-aging society with a declining population, it is challenging to secure human resources for care providers. Therefore, the Japanese government is promoting digital transformation and the use of nursing care equipment, including nonwearable devices that monitor heart and respiratory rates. However, the feasibility of monitoring heart and respiratory rates with nonwearable devices and the consistency of the rates measured have not been reported. In this study, we focused on a sheet-type nonwearable device (Safety Sheep Sensor) introduced in many nursing homes. We evaluated the feasibility of monitoring heart rate (HR) and respiratory rate (RR) continuously using nonwearable devices and the consistency of the HR and RR measured. A sheet-type nonwearable device that measured HR and RR every minute through body vibrations was placed under the mattress of each participant. The participants in study 1 were healthy individuals aged 20-60 years (n=21), while those in study 2 were older adults living in multidwelling houses and required nursing care (n=20). The HR was measured using standard methods by the nurse and using the wearable device (Silmee Bar-type Lite sensor), and RR was measured by the nurse. The primary outcome was the mean difference in HR and RR between nonwearable devices and standard methods. The mean difference in HR was -0.32 (SD 3.12) in study 1 and 0.04 (SD: 3.98) in study 2; both the differences were within the predefined accepted discrepancies (<5 beats/min). The mean difference in RR was -0.98 (SD 3.01) in study 1 and -0.49 (SD 2.40) in study 2; both the differences were within the predefined accepted discrepancies (3 breaths/min). HR and RR measurements obtained using the nonwearable devices and the standard method were similar. Continuous monitoring of vital signs using nonwearable devices can aid in the early detection of abnormal conditions in older people.

Analisis performa inkubator grashof dengan menggunakan lampu LED sebagai pemanas

The high infant mortality rate that occurs between the time after the baby's birth and the time when the baby is not exactly one year old is due to hypothermia/hypertermia, insufficient access to doctors and inability to pay for the use of pre-natal care equipment. Research has been conducted on the analysis of the performance of grashof incubators using LED lamps and copper fiber as heaters to determine the efficiency of LED lights when used for heating in a baby incubator (grazhof inkubator). The results of the research show that 20 watt LED lamp with the addition of fibre as a medium for the heating of air inside incubators is more efficient in tempering the air to reach a temperature of 35oC compared to a 25 watt fiber lamp that does not use a heater fiber. Temperature testing in a baby incubator is measured using a K-type thermocouple due to good accuracy and high sensitivity to temperature changes that need to be monitored in real time. From the results of the analysis of energy efficiency and heating speed (free convection) obtained results that show that with the addition of copper syrup as a heating medium in the incubator has a real influence on the speed of heating air inside the incubators.

커뮤니티 공공 공간 고령자 적합성 디자인에 관한 연구 - 커뮤니티 양로 모델으로

The problem of population aging is becoming more and more serious, especially under the mode of community-based elderly care, the demand of elderly residents for community public space is becoming more and more prominent. In this paper, through the study of representative elderly care communities in the United States, Japan, Singapore and South Korea, the design strategy of community public space for aging is discussed. The research content covers spatial structure planning, barrier-free design, intelligent elderly care equipment, green landscape proportion, public service facilities distribution and other aspects, aiming to optimize the community environment to meet the physiological and psychological needs of the elderly. Through comparative analysis, this paper puts forward the guidelines for the design of aging, expecting to provide theoretical reference for the development of community-based elderly care mode in the future, and build a more harmonious, stable and livable community.

Divide and Save: A Critical Care Air Transport Team Case With Prolonged Field Care

ABSTRACT Critical care air transport teams (CCATTs) specialize in providing intensive medical and postoperative resuscitative care during air evacuations. In a 2014 mission, a seasoned CCATT was urgently deployed to evacuate 6 American service members with gunshot wounds. Despite only having 2 hours of premission preparation and no further injury or treatment details, CCATT secured additional equipment, medications, and blood supply. Upon arrival to a foreign nonmilitary hospital, they discovered that American ground commanders had lost trust in local medical capabilities. One patient experienced prolonged extremity tourniquet time and surgical delay. This led to acute renal failure, preventing immediate evacuation without continuous renal replacement therapy (CRRT). Deviating from the standard procedure, the CCATT obtained permission to split their team. The CCATT nurse attended 5 stabilized patients during unregulated critical care air transport with plans to swiftly return with CRRT equipment for the critical sixth patient. The physician and respiratory therapist remained at the foreign hospital for 2 days to provide prolonged field care. This case demonstrates the evolving mission scope of CCATT, which may encompass ground triage, prolonged field care, unregulated movement, and atypical CCATT equipment such as CRRT, occasionally necessitating a split team construct. To adapt to these evolving needs, updated policies and training now incorporate these diverse CCATT concepts, emphasizing the importance of flexibility in en route critical care missions.

Seeking Dental Healthcare in the Context of COVID-19 Pandemic: A Study Examining the Health Belief Model

Abstract Background and Objectives The main purpose of the study was to examine the factors influencing older adults’ seeking dental care, in the context of coronavirus disease 2019 (COVID-19) pandemic, based on the Health Belief Model (HBM). Research Design and Methods Phone interviews were conducted using a structured questionnaire, among 200 older adults aged 65 and above, who are members of the Israeli largest sick fund Clalit Health Services, that were sampled through a systematic random sample. The data were collected between January 2022 and March 2022 and during September 2022. Results Our findings indicate that since the outbreak of COVID-19 in Israel, 61.5% and 55% of the participants reported visiting a dentist and a dental hygienist, respectively, and about a fifth of the participants have foregone care at both. Seeking dental care was associated with an increase in perceived threat, benefits, willingness to seek care, and with a decrease in perceived barriers. The HBM was found to be a suitable framework for illuminating older adults’ dental behavior, which explains 43% of the variance. Discussion and Implications The results of the study provided first-hand findings regarding seeking dental care during the COVID-19 pandemic. These findings emphasize the importance of providing dental services with clear recommendations about dental care and appropriate protective equipment, even under conditions of health concern, to enhance oral health services utilization.

Evaluation of ballistics euthanasia applied to stranded cetaceans using ethological and post-mortem computed tomography assessment.

Debilitated stranded cetaceans with low survival likelihood, may require euthanasia to avoid further suffering. Euthanasia can involve chemical or physical methods, including ballistics. Ballistics should cause instantaneous, permanent insensibility through brainstem disruption. Despite wide application, there is limited understanding of ballistics-related welfare outcomes. We opportunistically examined behaviour of three maternally-dependent cetaceans following shooting and the related cranial disruption post-mortem using computed tomography (PMCT). Our aim was to understand whether a 'humane death', i.e., euthanasia, was achieved. Each animal was shot using different projectile types: soft non-bonded, solid, and soft bonded. In two animals, insensibility was not immediately assessed following shooting, although both were reported as 'instantaneously insensible'. From our analysis, all animals displayed musculoskeletal responses to shooting, including peduncle stiffening and slack lower jaw, followed by musculature relaxation 24-, 10.3- and 20.8-seconds post-ballistics, respectively. The animal shot with a soft non-bonded projectile also displayed agonal convulsions and tail-lifting for 16-seconds post-shot; these were not observed for solid or soft bonded projectiles. PMCT findings indicated projectile disruption to the brainstem and/or spinal cord likely to cause near-instantaneous insensibility. However, extra-cranial wounding was also evident for the soft non-bonded projectile, highlighting potential for additional welfare compromise. Our results demonstrate that ballistics can achieve a relatively rapid death in young, stranded cetaceans, but careful equipment selection is required. To ensure a humane death, verification of insensibility must be undertaken immediately following shooting. Further studies should be undertaken to improve knowledge of appropriate procedures and equipment for euthanasia, ensuring humane deaths for compromised cetaceans.

REVITALIZING CEREAL CROP PRODUCTION: A CRITICAL REVIEW OF THE EFFECTS OF MACRO AND MICRO-NUTRIENT FOLIAR SPRAYS ON GROWTH AND YIELD

Foliar fertilizer treatment has been identified as a viable source for boosting cereal crop growth and productivity. However, some elements such as application method, nutrient supply, and timing must be taken into account to get the best results. Foliar spray is an effective and focused method of nutrient delivery since it avoids soil shortages and encourages direct absorption through leaves. This review emphasizes the significance of macronutrients for crop growth and development, including nitrogen, phosphorus, potassium, etc. It also looks at how micronutrients like zinc, iron, manganese, etc affect the quantity and quality of agricultural production. Foliar spraying can be a useful method of giving these nutrients to crops, especially during crucial growth stages. To reduce the possibility of causing harm to the crops and surrounding environment, safety precautions should be taken throughout the foliar spraying process. These safety measures include careful nozzle selection, equipment calibration, and cleaning. Overall, the application of foliar nutrients has the potential to result in the production of cereal crops that are more effective and sustainable.

Nontechnical Skills Assessment in Acute Care Trauma Simulations: A Mixed Methods Approach Using Eye Tracking and Behavioral Marker Systems.

The condition of trauma patients and the urgent need for timely resuscitation present unique challenges to trauma teams. These difficulties are exacerbated for military trauma teams in combat environments. Consequently, there is a need for continued improvement of nontechnical skills (NTS) training for trauma teams. However, current approaches to NTS assessment rely on subjective ratings, which can introduce bias. Accordingly, objective methods of NTS evaluation are needed. Eye-tracking (ET) methods have been applied to studying communication, situation awareness, and leadership in many health care settings, and could be applied to studying physicians' NTS during trauma situations. In this study, we aimed to assess the relationship between trauma team leaders' objective gaze patterns and subjective expert NTS ratings during patient care simulations. After Institutional Review Board approval, 9 trauma teams from first-year post-graduate general surgery and emergency medicine residents were recruited to participate in 1 of 2 trauma simulations (a difficult airway case and a multi-patient trauma). Each scenario lasted approximately 15 minutes. All team leaders wore a mobile ET system to evaluate gaze metrics-time to first fixation (TTFF), average fixation duration (AFD), and total percentage of the scenario (TPS) focused on Areas of Interest (AOI), which included patient, care team, diagnostic equipment, and patient care equipment. Trained faculty raters completed the Non-Technical Skills for Surgeons (NOTSS) assessment tool and the Trauma Non-Technical Skills (T-NOTECHS) scale. One-way analysis of variance, Kruskal-Wallis, and appropriate post-hoc pairwise comparison tests were run to assess differences between ET metrics across AOI groups. Spearman's Rho tests were used to assess correlations between ET and subjective NTS ratings. Compared to other NTS domains, trauma teams scored relatively poorly on communication across both T-NOTECHS (3.29$ \pm $0.61, maximum = 5) and NOTSS (2.87$ \pm $0.66, maximum = 4). We found significant differences in trauma team leaders' TTFF between teammates and the patient (Team: 1.56 vs Patient: 29.82 seconds, P < .001). TTFF on the diagnostic equipment was negatively correlated (P < .05) to multiple measures of subjective NTS assessments. There were no significant differences in AFD between AOIs, and AFD on teammates was positively correlated (P < .05) to communication and teamwork. There were significant differences in TPS across most AOI pairs (P < .05), and the average TPS fixated was highest on the patient (32%). Finally, there were several significant correlations between additional ET and NTS metrics. This study utilized a mixed methods approach to assess trauma team leaders' NTS in simulated acute care trauma simulations. Our results provide several objective insights into trauma team leaders' NTS behaviors during patient care simulations. Such objective insights provide a more comprehensive understanding of NTS behaviors and can be leveraged to guide NTS training of trauma physicians in the future. More studies are needed to apply these methods to capture NTS from a larger sample of teams in both simulated and real trauma environments.

Enhancing experimental image quality in two-phase bubbly systems with super-resolution using generative adversarial networks

Fluid Dynamics is a key scientific field to multitudes of engineering applications. Experimental work in this field requires careful set-up and expensive image-capturing equipment, particularly when considering the finer details of complex phenomena. In this work, we study the application of super-resolution Generative Adversarial Networks (GANs) to achieve high-resolution results by upscaling lower-resolution experimental images.We train GANs proposed for natural images on a bubbly flow experimental Fluid Dynamics dataset and compare common super-resolution evaluation metrics to domain expert assessments of the upscaled images. We find that these models achieve promising results, as evaluated by experts, and transfer learning from natural images translates to better performance overall. Attention mechanisms are found to be particularly useful in recreating sharper details. On the other hand, traditional super-resolution evaluation metrics are found to align poorly with expert perception of quality, signaling the need for better systematic evaluation methodologies in this domain.

Analysis of interhospital emergency referrals despite safety concerns on the roads: Emergency referrals in Northwest Syria intraregional borders

Objectives This study aims to assess emergency patient referrals between hospitals in the northwestern region of Syria. In this way, determining the patient profiles referred in the region can help shed light on the reasons for avoidable referrals, reduce referrals, and reduce the risks associated with referrals. Methods This retrospective study investigated the patients who were referred to AAA Hospital, BBB Hospital, and CCC Hospital and from these facilities within the borders of the northwestern region of Syria between 01/01/2020-01/01/2021. Referral records of patients transferred between hospitals and ambulance stations were searched in files and computer records. Because there was no automation system in the healthcare facilities involved in the study, data were recorded manually on the data collection form and processed for statistical analysis. Statistical analyzes of the study were performed as descriptive statistics of variables are reported as mean∓standard deviation, median (min-max), and n(%). Statistical analyzes of categorical variables were performed using the chi-square test and Fisher Freeman Halton Exact test. Results The mean age of the patients of 899 patients included in the study was 33.68∓26.80 years, 530(59.0%) were male and 369(41.0%) were female. 27.3% of patients were trauma patients and of both sexes. Male trauma patients were approximately 2.5 times more common than female trauma patients. Among pediatric referrals, trauma was present in one out of every three patients. Patients were most frequently referred in February, March, and June and least frequently in January (p &lt; 0.05). It was found that the need for adult, newborn, and pediatric intensive care, the need for medical material and equipment, the need for further examination/treatment, followed by the need for treatment under the supervision neurosurgeon, obstetric and gynecologist, cardiology specialist, or pediatrician. It was also noted that referrals for COVID -19 (SARS-CoV-2 Coronavirus Disease 2019) service needs due to the impact of the COVID -19 outbreak during the study period were among the most common reasons. COVID -19, falls, respiratory distress, traffic accidents, and acute MI were the most common diagnoses in all referred age groups. Conclusion In northwestern Syria, emergency patients are most often referred from one hospital to another because they require all types of intensive care units, medical materials and equipment, advanced diagnostic treatment, and specialists in neurosurgery, obstetrics and gynecology, cardiology, and pediatrics. Increasing hospital capacity and qualifications of hospitals within the humanitarian response and increasing the number of specialists, may be considered to reduce inter-hospital referrals of emergency patients.

The significance of quadratic thermal radiative scrutinization of a nanofluid flow across a microchannel with thermophoretic particle deposition effects

Abstract The investigation of thermal radiation and thermophoretic impacts on nano-based liquid circulation in a microchannel has a significant impact on the cooling of microscale equipment, microliquid devices, and many more. These miniature systems can benefit from the improved heat transfer efficiency made possible by the use of nanofluids, which are designed to consist of colloidal dispersion of nanoparticles in a carrier liquid. Understanding and precisely modeling the thermophoretic deposition (TPD) of nanoparticles on the channel surfaces is of utmost importance since it can greatly affect the heat transmission properties. This work examines the complex interaction between quadratic thermal radiation, magnetohydrodynamics, and TPD in a permeable microchannel. It aims to solve a significant knowledge gap in microfluidics and thermal and mass transport. The governing equations are simplified by applying suitable similarity restrictions, and computing solutions to the resulting equations is done using the Runge‒Kutta Fehlberg fourth‒fifth-order scheme. The results are shown using graphs, and significant engineering metrics are analyzed. The outcomes show that increased Eckert number, magnetic, and porous factors will improve the thermal distribution. Quadratic thermal radiation shows the greater thermal distribution in the presence of these parameters, while Linear thermal radiation shows the least thermal distribution. The rate of thermal distribution is higher in the linear thermal distribution case and least in the nonlinear thermal radiation case in the presence of radiation and solid fraction factors. The outcomes of the present research are helpful in improving the thermal performance in microscale devices, electronic devices cooling, health care equipment, and other microfluidic applications.

Artificial intelligence–enabled care equipment

Abstract With the aging of China’s population and changes in the disease spectrum of older adults, China will face a multitude of age-related health issues and, in turn, demand for medical care services. Artificial Intelligence (AI) care equipment has become an effective means of addressing imbalances between the supply of and demand for medical care services. AI care equipment can provide intelligent, precise and personalized care services for the elderly, the core of which is to analyze the data generated during the use of care equipment and provide real-time feedback. Common AI care equipment includes mobility aid devices, bathing aid devices, smart wearable devices, and care robots. AI care equipment can not only help older adults and other users with daily living assistance and rehabilitation, but also disease prevention, environmental risk factor screening as well as emotional communication and psychological support. The technical, social and market dilemmas faced by AI care equipment will be solved through the establishment of industry standards, the formulation of laws and regulations, and the strengthening of talent training. Our goal is to promote the popularity and development of AI care equipment, and to address the shortage of care resources brought about by the aging population.

SOLAR GRASS CUTTER: HARNESSING RENEWABLE ENERGY FOR SUSTAINABLE LAWN MAINTENANCE

In the realm of sustainable landscape management, the imperative to reduce environmental impact while enhancing efficiency is paramount. This paper presents a pioneering approach to address these challenges through the development of the Solar Grass Cutter. Grounded in the fusion of renewable energy technology and innovative design, our objective is to revolutionize traditional lawn maintenance practices by introducing a comprehensive system that harnesses solar power to trim grass effectively and sustainably. At its core, the Solar Grass Cutter represents the convergence of modern engineering with environmental concern. This device provides a disruptive solution by combining solar panels with precision cutting mechanisms, reducing reliance on fossil fuels and the carbon emissions associated with traditional lawn care equipment. Key features of the Solar Grass Cutter include: 1.Renewable energy utilization: Leveraging solar power, the system operates autonomously, reducing dependence on non-renewable energy sources and mitigating environmental impact. 2.Efficient grass cutting: Through innovative design and engineering, the Solar Grass Cutter ensures precise and efficient grass trimming, optimizing resource utilization and minimizing waste. 3.Environmental stewardship: By adopting sustainable practices, the Solar Grass Cutter promotes environmental stewardship, contributing to the preservation of ecosystems and biodiversity. In essence, the Solar Grass Cutter represents an evolutionary leap in lawn maintenance, bringing technological innovation together with environmental responsibility. It represents a dedication to sustainable behaviours as well as a vision for a greener future in which human inventiveness and environmental consciousness combine to improve our planet’s health. Key Words: Solar Grass Cutter, Renewable Energy, Sustainable Lawn Maintenance, Precision Cutting, Environmental Stewardship, Technological Innovation.

OVERVIEW OF MECHANIZED CARE EQUIPMENT BY THE HOOVES OF CATTLE

The current conditions of keeping cattle in specialized industrial complexes and large farms often lead to traumatism of the hooves, which can ultimately lead to pathology of the limbs. This negatively affects the productivity of animals and, as a result, causes significant economic losses in the livestock sector. Several reasons have been identified that cause trauma to cattle limbs and lead to their pathology. Yes, hard surfaces, slotted floors, and conveyor-type conveyors for removing manure have a negative effect on the animals' hooves. Up to 40% of animals suffer from limb diseases when cows are tethered, while up to 90% in monoblock cowsheds of the untethered type. In dairy enterprises, among all mechanical injuries to cows, from 60% to 80% are limb diseases caused by trauma to the hooves and toes. In order to prevent and successfully treat horn diseases in cattle on specialized farms and dairy complexes, it is necessary to improve treatment methods, animal care rules, and methods of cleaning and trimming horn growth of hooves. Trimming and cleaning of hooves are quite time-consuming operations, which are among the mandatory measures for the prevention of diseases of the limbs of animals. This operation is performed 2-3 times a year. At the same time, the excess layer of horny growth is cut off, and the legs are given an optimal shape. This ensures uniform distribution of the load over the entire support surface of the limb. The used mechanical means for trimming hooves have some disadvantages. Such a large mass and the lack of regulation of cutting modes depending on the physical and mechanical properties of the horn growth do not contribute to high-quality processing of hooves. The review of systems and equipment for cutting hoof horn growth in cattle, especially cows, shows that this direction of research is relevant and promising. To increase the productivity of trimming hooves and ensure their natural geometric shape and the necessary roughness of the treated surface, it is advisable to conduct further research on the justification of structural and technological parameters and modes of operation of mechanical equipment for effective care of cattle hooves.

Sterilization Method for Borosilicate Glass Vials and Chlorobutyl, Bromobutyl Rubbers for Medical Purposes

For surgical and medical tools to prevent the spreading of infectious microorganisms to patients, disinfection and sterilization must be achieved by the use of disinfectants and sterilization procedures. Health care regulations must determine whether cleaning, disinfection, or sterilization is essential based largely on the item’s intended use because sterilizing all patient care equipment is unnecessary. In this work, successful sterilization of vials and rubbers used for medical purposes has been implemented. It can be claimed that the sequence of moist and dry heat is more practical for sterilizing primary packaging materials used in diagnostic or treatment facilities, especially for borosilicate vials and chlorobutyl, bromobutyl rubbers. It has been shown that the suggested sterilization method provides sterile and endotoxin-free vials and rubbers that can be used for medical purposes. Endotoxins and sterility tests have been implemented for microbiological analysis of borosilicate vials and chlorobutyl, and bromobutyl rubbers. Endotoxin levels in all vials and rubbers tested were within acceptable limits, and no microbial growth was observed in test specimens based on sterility tests. The suggested sterilization method was effective in producing sterile and endotoxin-free vials and rubbers suitable for medical use.

Colonisation of hospital surfaces from low- and middle-income countries by extended spectrum β-lactamase- and carbapenemase-producing bacteria

Hospital surfaces can harbour bacterial pathogens, which may disseminate and cause nosocomial infections, contributing towards mortality in low- and middle-income countries (LMICs). During the BARNARDS study, hospital surfaces from neonatal wards were sampled to assess the degree of environmental surface and patient care equipment colonisation by Gram-negative bacteria (GNB) carrying antibiotic resistance genes (ARGs). Here, we perform PCR screening for extended-spectrum β-lactamases (blaCTX-M-15) and carbapenemases (blaNDM, blaOXA-48-like and blaKPC), MALDI-TOF MS identification of GNB carrying ARGs, and further analysis by whole genome sequencing of bacterial isolates. We determine presence of consistently dominant clones and their relatedness to strains causing neonatal sepsis. Higher prevalence of carbapenemases is observed in Pakistan, Bangladesh, and Ethiopia, compared to other countries, and are mostly found in surfaces near the sink drain. Klebsiella pneumoniae, Enterobacter hormaechei, Acinetobacter baumannii, Serratia marcescens and Leclercia adecarboxylata are dominant; ST15 K. pneumoniae is identified from the same ward on multiple occasions suggesting clonal persistence within the same environment, and is found to be identical to isolates causing neonatal sepsis in Pakistan over similar time periods. Our data suggests persistence of dominant clones across multiple time points, highlighting the need for assessment of Infection Prevention and Control guidelines.

Sustainable equipment donation in otolaryngology in low-resource settings.

The purpose of this review is to examine current practices in surgical equipment donation to lower- and middle-income countries (LMICs) with a particular focus on otolaryngology-head and neck surgery (OHNS). This is designed as a pragmatic review to guide potential donor communities to implement sustainable OHNS equipment donation in LMICs. LMICs are increasingly reliant on international equipment donation. In terms of OHNS services, global OHNS have compiled a list of essential equipment for baseline care in LMICs. Especially in terms of audiology, OHNS equipment donation has the potential to have a significant impact on populational health. However, there is a scarcity of research on donated equipment in OHNS. A suggested blueprint for sustainable equipment donation follows these steps: establish partnerships, assess needs, source equipment, and follow-up and evaluate the intervention. Key further considerations for sustainability include remanufacturing and repurposing methods, maintenance, and contextual understanding. Sustainable equipment donation in otolaryngology is an important part of global health equity and healthcare delivery in low-resource settings. Despite the good intentions behind medical equipment donations, there are many challenges; donors and recipients should engage in collaborative, needs-based planning processes that result in long-term sustainability, local capacity building, and community participation.