Control Guidelines Research Articles

Cyanobacterial blooms management: A simulation-based optimization method

Controlling cyanobacterial blooms is not only an engineering and technical issue but also an optimization problem in environment management. Under budget constraints, a novel simulation-based optimization model for cyanobacterial control is constructed in this study. The simulation model is used for simulating cyanobacteria growth and diffusion processes. The optimization model is utilized to determine the optimal search and treatment path. Through the interactive coupling of simulation modeling and resource allocation optimization, this research provides decision-makers with new operational guidelines for cyanobacterial control. Our test results demonstrate that the initial invasion frequency has a greater economic impact than invasion abundance. The nearby cells to the initial invasion are affected first, and then the influence radiates outward in a diffusion pattern. Using a slow search speed and a treatment frequency of every 10 days can achieve the lowest possible economic losses in most test scenarios. Moreover, we also find that the optimal search and treatment paths revolve around the initial invasion location. This study is a typical interdisciplinary research, which can assist water resource managers in making more accurate decisions regarding cyanobacteria removal paths, removal frequencies, and treatment speeds.

Prevention of solidification cracking in alloy 718 additive manufacturing by laser metal deposition method based on control guidelines for weld solidification cracking

The chemical composition of alloy 718 powder was optimized to suppress a solidification cracking in the additive manufactured part by the laser metal deposition method. The relationship between the condition of additive manufacturing and defects was evaluated. A lack of fusion was observed on the low heat input (low energy density), and the solidification cracking occurred on the high heat input (high energy density). The powder composition of alloy 718 was attempted to be optimized from a theoretical approach of the solidification cracking susceptibility. It was found that Si and B had a significant influence on the solidification cracking, therefore a preventive powder with reduced Si and B was developed. The effects of Si and B on solidification cracking were compared by reproducing the solidification conditions during additive manufacturing and evaluating the solidification brittle temperature range (BTR) using the Varestraint test. It was found that the BTR of the preventive material was smaller, and the solidification cracking susceptibility was improved. In addition, the solidification cracking did not occur in additive manufacturing using the preventive powder. In other words, it is suggested that the countermeasure for weld solidification cracking leads to the prevention of solidification cracking in additive manufacturing directly, and the effectiveness of the optimization of powder composition was verified.

Assessment of Level of Implementation of Infection Control Guidelines in Sub District Hospitals in Gadag District by using Kayakalp Assessment Tool

Infection control is one of the main tenets of the "Kayakalp" movement. Well-kept and sanitary surroundings improve the hospital's image in the eyes of both patients and visitors. They also help the healthcare facility (HCF) create an atmosphere that reduces the number of hospital-acquired infections (HAI). Patients within hospitals and other healthcare establishments are vulnerable to healthcare-associated infections, commonly referred to as "nosocomial" or "hospital" infections, which are neither present nor in an incubating stage at the moment of admission. This category also encompasses occupational ailments among healthcare personnel and diseases contracted by patients during their hospitalization, which manifest after their discharge. Globally, nosocomial (hospital-acquired) infections constitute a significant and escalating concern. In the absence of adequate preventive strategies, individuals receiving medical treatment in any healthcare establishment face the risk of acquiring an infection. Healthcare-associated infections not only result in additional suffering but also impose substantial financial burdens on patients and their families, akin to numerous other issues related to patient safety. Antibiotic resistance is a result of infections, which also lengthen hospital stays, cause chronic disability, greatly increase the financial burden on healthcare systems, raise costs for patients and their families, and result in avoidable deaths. The present study results are intended to clarify the current state of infection control practices in the Gadag district's sub-district hospitals and identify possible areas for improvement.

Comparison of a dual antibody and antigen HCV immunoassay to standard of care algorithmic testing.

The Centers for Disease Control and Prevention (CDC) guidelines for hepatitis C virus (HCV) testing, although effective, may miss crucial diagnostic opportunities. The goal of this study was to assess the utility of an antibody (Ab) and antigen (Ag) combination immunoassay as an alternative to traditional HCV screening. Remnant specimens from 1,341 patients with concurrent third-generation serologic (Roche anti-HCV-II) and nucleic acid amplification testing (NAAT) were assessed using the HCV Duo Ab/Ag immunoassay (Roche). Patient demographics, risk factors, and standard of care (SOC) laboratory results from the medical records were recorded. Overall, 99.0% (197/199) of the HCV Duo Ab+/Ag+specimens accurately identified active infections as confirmed by NAAT, and 99.9% (670/671) Ab-/Ag- samples corresponded to those without HCV infections. Individually, the HCV Duo Ab component demonstrated a 95.6% positive percent agreement (PPA) (95% CI = 93.8-96.9) and 99.1% negative percent agreement (NPA) (98.8-99.6) compared with SOC anti-HCV II Ab assay. The HCV Duo Ag had a 73.5% PPA (67.9-78.4) and 99.8% NPA (99.3-100) with NAAT. Among RNA+ specimens, 73.4% (197/267) were HCV Duo Ag+, and 265/267 (99.3%) were successfully detected on the HCV Duo Ab component. Notably, 5/7 (71.4%) Ab-/RNA +specimens were detected by HCV Duo, which would have been missed by traditional algorithmic testing. Fourth generation HCV Duo Ab/Ag assay demonstrated comparable performance to SOC testing and shortens the diagnostic window but does not eliminate the need for NAAT in all patients. Ab/Ag testing identified several Ab-/RNA+ cases, a subgroup often undiagnosed by current algorithmic testing, demonstrating promise for improved diagnostic efficiency and accuracy in HCV detection.IMPORTANCEThis study highlights the potential of a combined hepatitis C virus (HCV) Duo antibody (Ab) and antigen (Ag) immunoassay to improve early detection of HCV infections. Traditional Ab-only screening methods recommended by the Centers for Disease Control and Prevention may miss early-stage infections. The HCV Duo assay showed high accuracy, detecting nearly all active infections confirmed by nucleic acid amplification testing. Dual detection of HCV Ab and Ag shortens the diagnostic window, enabling intervention and treatment in a single visit, which is crucial for improving patient outcomes and reducing HCV transmission, especially in areas with limited access to confirmatory molecular testing.

WHO guidelines for quality control of herbal medicines: From cultivation to consumption

WHO guidelines serve as a comprehensive framework for ensuring the safety, efficacy, and quality of herbal products throughout their lifecycle, from cultivation to consumption. Here's why adherence to these guidelines is crucial. By following WHO guidelines, manufacturers can implement practices that minimize the risks associated with herbal medicines, including contamination, adulteration, and variability in potency. This helps protect public health and ensures that consumers can use herbal products with confidence. Quality control measures recommended by WHO contribute to the consistency and reliability of herbal medicines. Standardization of production processes and the establishment of quality parameters help maintain the potency and efficacy of herbal products, leading to more predictable therapeutic outcomes. Adherence to WHO guidelines facilitates compliance with regulatory requirements established by national authorities and international bodies. Regulatory agencies often refer to WHO guidelines when developing regulations for the manufacturing, distribution, and labeling of herbal medicines. Compliance with these guidelines helps manufacturers meet regulatory standards and gain market authorization for their products. WHO guidelines provide a harmonized approach to quality control practices, promoting consistency and uniformity in the assessment of herbal medicines worldwide. This facilitates international trade and ensures that products manufactured in one country meet quality standards accepted globally, fostering trust and confidence among consumers and healthcare professionals. The systematic review highlights the ongoing efforts of WHO to review and update guidelines based on emerging scientific evidence and best practices. Adhering to these evolving guidelines encourages continuous improvement in quality control practices and fosters innovation in the herbal medicine industry.

청소년의 건강행태와 먹방⋅쿡방 시청이 비만에 미치는 영향: 제18차 청소년건강행태조사 자료를 활용하여

Objectives The purpose of this study was to determine the relationship between adolescents' health behaviors and obesity and their viewing of mukbangs and cooking shows. Methods This study used data from the 18th Youth Health Behavior Survey conducted in 2022, and a total of 51,850 participants were analyzed by reflecting stratification variables, clustering variables, and weights according to the Korean Centers for Disease Control and Prevention's guidelines for composite sample analysis. Composite frequency analysis and composite crosstabulation analysis(Rao-Scott χ2-test) were conducted, and composite logistic regression analysis was performed to analyze the influencing factors. Results The results showed that adolescents' gender, grade level, subjective economic status, breakfast skipping, fruit consumption, fast food consumption, vegetable consumption, late-night snacking, days of physical activity of 60 minutes or more per day during the week, days of strength training during the week, and frequency of watching mukbangs and cooking shows were significantly associated with obesity. Conclusions In order to prevent obesity in teenagers, it is necessary to provide appropriate education and various programs so that people can enjoy watching mukbang and cooking show videos and manage the effects on their own.

Occurrence and Antimicrobial Susceptibility Profile of Vancomycin Resistance among Clinical Isolates of Staphylococcus aureus in Enugu Metropolis, Nigeria

Introduction: Staphylococcus aureus is a significant cause of community-acquired and healthcare-acquired infections worldwide. Methicillin-resistant Staphylococcus aureus infections have been treated with vancomycin, a last-resort antibiotic. This study aimed to investigate the occurrence of vancomycin resistance among Staphylococcus aureus isolates obtained from different clinical samples. Materials and Methods: The study was conducted from February to August 2022 in the Microbiology Laboratory of the University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu. A total of 150 Staphylococcus aureus isolates from different clinical samples were used for the study. The antimicrobial susceptibility profile was done using the Kirby-Bauer disc diffusion procedure. Methicillin resistance was detected using the cefoxitin disc diffusion technique. VRSA was confirmed using the broth dilution method. Results: Isolates showed high resistance to cephalosporins; 100% resistance to cefixime, to cefotaxime 98.7%, to cefuroxime 93.3%, and to ceftriaxone 80%. There was also high resistance of isolates to imipenem 98.7%, Augmentin 92.2%, erythromycin, and azithromycin 81.3% and 80.0% respectively. Of the 150 isolates, 51(34.0%) were methicillin-sensitive Staphylococcus aureus (MSSA) and 99(66.0%) were MRSA. Of the 99 MRSA strains, 9 (9.1%) were vancomycin-resistant (VRSA), 24 (24.2%) were vancomycin intermediate (VISA) and 66 (66.7%) were vancomycin-sensitive (VSSA). The overall prevalence of VRSA was 6%. Conclusion: The isolates had a high resistance to the antibiotics used in our study. The proportion of MRSA was high. A high percentage of VRSA/VISA was also detected. To prevent the further spread of VRSA, rigorous monitoring of vancomycin treatment, response, and the development of appropriate control guidelines are strongly recommended and required.

A Study to Assess the Effectiveness of Informative Booklet Regarding Knowledge, Attitude and Practice Among Intensive Care Unit (ICU) Staff Nurses Regarding Prevention of Central Line Associated Blood Stream Infection (CLABSI)

Background: Nurses in Intensive Care Units (ICU) have a vital role in reducing Central line associated blood stream infections (CLABSI) if they are well educated to use strategies to decrease Central line associated blood stream infections (CLABSI) rate which are based on the center for disease control and prevention guidelines (CDC) to improve patient’s outcomes. Health-care-associated infections are a huge concern in the intensive care units (ICUs) across the globe. Nearly 90% of catheter-related bloodstream infections are caused by central venous catheters (CVCs). Central venous catheters (CVC) are commonly inserted in critically ill patients and play an important role for hemodynamic monitoring and delivery of crucial treatments. Central line-associated bloodstream infection (CLABSI) is a laboratory confirmed bloodstream infection occurring in a patient with a CVC in place for >48 hours that is not related to an infection at any other site. Preventing nosocomial infections pose a great challenge in ICU, because of the multi-drug resistant organisms treated with broad-spectrum antibiotics. Clinical practice guidelines from various organizations are available for prevention of vascular catheter related infections. The Institute for Healthcare Improvement has introduced a “central line bundle” that includes the five best evidence-based practices to prevent CLABSI. This bundle includes hand hygiene, maximal barrier precautions during catheter insertion, skin antisepsis with chlorhexidine, optimal selection of the catheter site, with avoidance of the femoral vein and a daily assessment of line necessity, including the removal of an unnecessary line. Of these components, “hand hygiene” (HH) is the most convenient and cost effective to follow. “Hand Hygiene” HH prevents the transmission of pathogens and is a universal strategy to prevent all nosocomial infections. The World Health Organization has proposed a multimodal strategy; which includes five elements called the “Five Moments for Hand Hygiene”, as an evidence-based approach to prevent hospital-acquired infections. The five moments include, before touching the patient, before performing any a clean/aseptic procedure, after exposure/risk of body fluid, after touching the patient and after touching the patient surroundings. Therefore, the researcher was curious to know the effectiveness of informative booklet regarding knowledge, attitude and practice of intensive care unit staff nurses regarding prevention of central line associated blood stream infection (CLABSI).

Application of the behaviour-centred design to understand facilitators and deterrents of hand hygiene among healthcare providers: findings from a formative phase of a cluster randomised trial in the Kampala Metropolitan area

BackgroundHand hygiene is known to reduce healthcare-associated infections. However, it remains suboptimal among healthcare providers. In this study, we used the Behaviour-centered Design approach to explore the facilitators and deterrents to hand hygiene among healthcare providers in the Kampala Metropolitan area, Uganda.MethodsWe conducted a formative qualitative study as part of a cluster randomised trial in 19 healthcare facilities (HCFs). The study used 19 semi-structured and 18 key informant interviews to collect data on hand hygiene status and facilitators and deterrents of hand hygiene. Research assistants transcribed verbatim and used a thematic framework aided by Nvivo 14.0. to undertake analysis. We used thick descriptions and illustrative quotes to enhance the credibility and trustworthiness of our findings.ResultsAbout 47.4% of the HCFs had sufficient hand hygiene infrastructure, and 57.9% did not report total compliance with hand hygiene during patient care. The physical facilitator for hand hygiene was the presence of constant reminders such as nudges, while the biological included the frequency of patient contact and the nature of clinical work. The only biological deterrent was the heavy workload in HCFs. The executive brain facilitators included knowledge of workplace health risks, infection prevention and control (IPC) guidelines, and a positive attitude. A negative attitude was the executive brain deterrent to hand hygiene. Recognition, rewards, and fear of infections were the only motivated brain facilitators. Behavioural setting facilitators included proximity to functional hand hygiene infrastructure, the existence of active IPC committees, good leadership, and the availability of a budget for hand hygiene supplies. Behavioural setting deterrents included the non-functionality and non-proximity to hand hygiene infrastructure and inadequate supplies.ConclusionsThe study revealed low compliance with hand hygiene during the critical moments of patient care and inadequacy of hand hygiene infrastructure. The deterrents to hand hygiene included a heavy workload, negative attitude, inadequate supplies, non-functionality, and long distance to hand washing stations. Facilitators included constant reminders, fear of infections, frequency of patient contact and nature of clinical work, positive attitude, knowledge of IPC guidelines, recognition and reward, good leadership, availability of budgets for hand hygiene supplies, availability and proximity to hand hygiene supplies and infrastructure and active IPC committees.Trial registrationISRCTN Registry with number ISRCTN98148144. The trial was registered on 23/11/2020.

Foodservice strategies for reducing athlete illness at the Olympic and Paralympic Games.

In 2021, infection control guidelines, including those specific to feeding environments, were introduced by the International Olympic and Paralympic Committees to reduce virus transmission at the Tokyo 2020 Summer and Beijing 2022 Winter games. This observational cross-sectional study aimed to investigate caterers' compliance to these guidelines which included measures for personal hygiene, sanitisation, and physical distancing at these events. Expert sport dietitians attending Tokyo (n = 15) and Beijing (n = 7) games were surveyed to rate 11 COVID-19 countermeasures as fully (100%), partially or non-compliant at nine dining locations across both events. Descriptive analysis of each countermeasure based on observed compliance and location was conducted and reported as a proportion of the total responses. To better understand participant perspectives of the factors influencing compliance, open responses were systematically coded into themes and sub-themes by researchers through content analysis. Themes generated from participant comments were categorised based on their relevance to specific countermeasures and locations to identify commonalities and disparities in participant experiences, perceptions, and observations. All main dining halls at both events were observed as 100% compliant to countermeasures on more occasions compared with Tokyo's venues and satellite villages. However, Beijing's three main dining halls, showed a greater compliance compared with Tokyo's main dining hall, likely due to overcrowding in Tokyo. Comments suggested that smaller dining spaces, with overcrowding, may have contributed to reduced compliance to physical distancing measures. Food safety concerns were raised about gastrointestinal distress in Beijing due to food cross-contamination. Findings suggest that the food service environment may influence caterers' abilities to comply with foodservice safety and infection control guidelines. In the post-pandemic era, enhanced quality control and standardised risk mitigation strategies are needed to improve athletes' health at international sporting events.

Reducing single-use plastics in dental practice: a quality improvement project.

Introduction Climate change is a major issue facing the global population. Healthcare services, including dentistry, have an obligation to examine current practice and reduce the carbon footprint of their services. Single-use plastics, for example, those used to cover dental equipment, are not necessarily essential for cross-infection purposes.Materials and methods This quality improvement project was carried out in 2023 across 12 dental practices in the North London dental foundation training scheme. Baseline financial and environmental costs were estimated for the weekly single-use barrier plastics used in each practice. This was communicated to each practice. Practices using single-use plastics were contacted three months later to see if they had made any changes.Results In total, 10 out of 12 practices were using one or more of the single-use plastics at baseline, with an estimated carbon footprint ranging from 0.07-27.02 kg carbon dioxide equivalent (CO2e) per week. Three practices reduced or eliminated their single-use plastics as a result of this quality improvement project, which resulted in an equivalent saving of 46.87 kg CO2e per week.Discussion and conclusion The use of single-use plastic barriers varies widely between dental practices and is associated with a financial and environmental cost. Infection control guidelines are unclear with their recommendations. The authors urge dental services to reduce their single-use plastic barriers and would encourage infection control guidelines to consider the environmental impact when making recommendations.

ESKAPE Pathogens: Antimicrobial Resistance Patterns, Risk Factors, and Outcomes a Retrospective Cross-Sectional Study of Hospitalized Patients in Palestine.

Antimicrobial resistance to ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp). remains a major challenge in hospital settings. This study aimed to determine the ESKAPE antimicrobial resistance patterns and associated factors with multi-drug resistance strains among hospitalized patients in a single tertiary care medical hospital in Palestine. A single-center retrospective cross-sectional study was conducted by reviewing patients' electronic medical records and laboratory results from November 1, 2021, to November 30, 2022, at the Palestine Medical Complex in Palestine. The study included patients aged > 18 years who had been infected with ESKAPE pathogens 48 hours after hospital admission. This study included 231 patients, of whom 90.5% had MDR infections. In total, 331 clinical samples of ESKAPE pathogens were identified. A. baumannii was the most prevalent MDR pathogen (95.6%) with Carbapenem-resistant exceeding 95%, followed by K. pneumoniae (83.8%) with extended-spectrum cephalosporin resistance exceeding 90%, S. aureus (68.2) with 85% oxacillin-resistance, E. faecium (40%) with 20% vancomycin resistance, P. aeruginosa (22.6%) with 30% carbapenem resistance. Furthermore, emergent colistin resistance has been observed in A. baumannii, K. pneumoniae, and P. aerogenesis. Risk factors for MDR infection included age (p< 0.035), department (p< 0.001), and invasive procedures such as IUC (p< 0.001), CVC (p< 0.000), and MV (p< 0.008). Patients diagnosed with MDR bacteria had increased 30-day mortality (p< 0.001). The findings of this study show alarming MDR among hospitalized patients infected with ESKAPE pathogens, with resistance to first-line antimicrobial agents and emerging resistance to colistin, minimizing treatment options. Healthcare providers and the Ministry of Health must take steps, adopt policies to prevent antimicrobial resistance, adhere to infection control guidelines, implement antimicrobial stewardship programs to prevent and limit the growing health crisis, and support research to discover new treatment options.

Effectiveness of public health measures in reducing the incidence and lethality of cancer: A systematic review and meta-analysis

Cancer constitutes a real public health problem, and its burden is expected to increase national health systems. The future burden is likely to be much greater due to the increasing prevalence of factors that increase risk, such as smoking, alcoholism, unhealthy diet, physical inactivity, sedentary lifestyle, etc. The objective of this work is to evaluate, through a systematic review, the impact of public health measures on the incidence and lethality of cancers. 51 studies met the inclusion criteria in this review. High adherence to established public health cancer control guidelines for nutrition and physical activity was consistently and significantly associated with reductions of 10% to 61% in overall cancer incidence colorectal cancer in men and women (27%-52%), the incidence of breast cancer (19-60%) and prostate cancer (5 -10%), Significant reductions in the incidence and lung cancer mortality after tobacco control measures. The human papilloma vaccine has shown excellent safety and close to 100% effectiveness in preventing persistent infections and precancerous lesions of the cervix due to types 16 and 18. Through this study, we were able to know the influence of public health measures on the incidence and lethality of cancers.

Nationwide upsurge in invasive disease in the context of longitudinal surveillance of carriage and invasive Streptococcus pyogenes 2009-2023, the Netherlands: a molecular epidemiological study.

Since 2022, many countries have reported an upsurge in invasive group A streptococcal (iGAS) infections. We explored whether changes in Streptococcus pyogenes carriage rates or emergence of strains with potentially altered virulence, such as emm1 variants M1UK and M1DK, contributed to the 2022/2023 surge in the Netherlands. We determined emm (sub)type distribution for 2,698 invasive and 351 S. pyogenes carriage isolates collected between January 2009 and March 2023. Genetic evolution of emm1 was analyzed by whole-genome sequencing of 497 emm1 isolates. The nationwide iGAS upsurge coincided with a sharp increase of emm1.0 from 18% (18/100) of invasive isolates in Q1 2022 to 58% (388/670) in Q1 2023 (Fisher's exact test, P < 0.0001). M1UK became dominant among invasive emm1 isolates in 2016 and further expanded from 72% in Q1 2022 to 96% in Q1 2023. Phylogenetic comparison revealed evolution and clonal expansion of four new M1UK clades in 2022/2023. DNase Spd1 and superantigen SpeC were acquired in 9% (46/497) of emm1 isolates. S. pyogenes carriage rates and emm1 proportions in carriage isolates remained stable during this surge, and the expansion of M1UK in iGAS was not reflected in carriage isolates. During the 2022/2023 iGAS surge in the Netherlands, expansion of four new M1UK clades was observed among invasive isolates, but not carriage isolates, suggesting increased virulence and fitness of M1UK compared to contemporary M1 strains. The emergence of more virulent clades has important implications for public health strategies such as antibiotic prophylaxis for close contacts of iGAS patients.IMPORTANCEThis study describes the molecular epidemiology of invasive group A streptococcal (iGAS) infections in the Netherlands based on >3,000 Streptococcus pyogenes isolates from both asymptomatic carriers and iGAS patients collected before, during, and after the COVID-19 pandemic period (2009-2023) and is the first to assess whether changes in carriage rates or carried emm types contributed to the alarming post-COVID-19 upsurge in iGAS infections. We show that the 2022/2023 iGAS surge coincided with a sharp increase of emm1, particularly the toxicogenic M1UK variant, in invasive isolates, but not in carriage isolates. These findings suggest that increased virulence and fitness of M1UK likely contributes to an increased dissemination between hosts. The emergence of a more virulent and fit lineage has important implications for iGAS control interventions such as antibiotic prophylaxis for close contacts of iGAS patients and calls for a reappraisal of iGAS control interventions and guidelines.

Uji Kelayakan Alat Pelindung diri Lead Apron di Instalasi Radiologi Rumah Sakit Daerah Mangusada Badung

Lead apron is a type of personal protective equipment in the form of an apron and made of lead which is designed to protect the body from the dangers of radiation. Menurut Keputusan Menteri Kesehatan Republik Indonesia Nomor 1250/MENKES/SK/XII/2009 regarding Quality Control Guidelines to protect the density and physical condition of the lead apron, testing is required once a year and may be carried out before one year if necessary. To maintain the quality of the lead apron, it needs to be stored in a good manner and avoid stacking and folding it. Because it can cause damage which will reduce its function as radiation protection equipment. Lead apron storage should be stored flat without folds or on a special shelf. The aim of this research is to test lead aprons in the Radiology Installation of Regional Hospitals Mangusada Badung to determine the feasibility of the lead apron. The type of research used is descriptive quantitative research with a survey approach, observation, namely by carrying out testing, measurement and documentation. This research was conducted in July. The results of this study indicate that lead apron testing in the Radiology Installation of Regional Hospitals Mangusada Badung What has been done is that the four lead aprons are still in good condition and still suitable for use.

Association between Hand Hygiene Knowledge and Self-Efficacy in Nursing Students: A Multicenter Cross-Sectional Study within the Framework of the Erasmus Project.

Adherence to hand hygiene procedures is crucial for all populations, and the World Health Organization (WHO) has implemented specific guidelines for infection control. Frequent and correct hand hygiene can prevent infections, but non-compliance with hand hygiene is pervasive. Nursing students address this issue from the beginning of their training. In nursing training, self-efficacy is crucial in enhancing students' competence, motivation, and clinical performance. We performed a cross-sectional multicenter study in five European countries, with a cross-sectional design with an online application of an instrument measuring hand hygiene knowledge based on WHO guidelines and general self-efficacy and specific self-efficacy for infection control. A total of 638 first-year nursing students participated in this study. The mean percentage of correct answers was 67.9%, with a considerable difference depending on the items. The worst results were obtained for questions related to sources of infection and types of hand hygiene methods in different situations. Finnish students displayed significantly (p < 0.001) higher scores in HH knowledge, whereas Estonian students had significantly (p < 0.001) higher levels of self-efficacy. There were significant correlations between the hand hygiene knowledge score and the self-efficacy score (p < 0.001). A multivariate analysis by linear regression analysis showed significant associations between the hand hygiene knowledge survey score and the students' age (p < 0.001, OR = 0.18, 95% CI 0.04-0.10), as well as their country of origin (p = 0.01, OR = 0.09, 95% CI 0.03-0.34). HH knowledge is quite low among nursing students, and is correlated with self-efficacy, although the strongest predictors are age and country of origin. Different nursing curricula must favor HH knowledge, with varying degrees of emphasis depending on the country.

Foam detection in a stirred tank using deep learning neural networks

A deep learning method based on the Convolutional Neural Network (CNN) U-Net architecture has been explored as an image analysis tool for the detection and automated quantification of foam generated in a stirred tank. Multiple datasets of different sizes and with different types of foam were obtained experimentally and processed with data augmentation techniques in order to train the deep learning networks. The impact of adding attention and residual gates to the U-Net model to improve its performance, as well as the size of the dataset used to train the model have been assessed. The main factor influencing the accuracy of the models to detect the foam in the stirred tank is the size and quality of the dataset use to train the U-Net models; it must be sufficiently large and varied in terms of foam type/structure. The addition of attention gates and residual blocks to the U-Net model slightly improves the accuracy of foam detection, particularly for images that contain additional objects or obstructions, however the training time is 30 % longer than the standard U-Net model. In all cases, this image analysis method based on the U-Net model largely out performs conventional image analysis, which was not able to automatically differentiate between foam, additional objects in the tank and bubbles in the liquid. Two methods for the measurement of foam quantity (maximum foam height and foam volume) have also been developed based on the foam regions detected by the models. This is important for the application of the tool, which is to be used to understand the impact of operating conditions on foam formation in lab-/pilot-scale stirred tanks and then develop scale-up guidelines for foam control in industrial tanks.

A standardized image processing and data quality platform for rodent fMRI

Functional magnetic resonance imaging in rodents holds great potential for advancing our understanding of brain networks. Unlike the human community, there remains no standardized resource in rodents for image processing, analysis and quality control, posing significant reproducibility limitations. Our software platform, Rodent Automated Bold Improvement of EPI Sequences, is a pipeline designed to address these limitations for preprocessing, quality control, and confound correction, along with best practices for reproducibility and transparency. We demonstrate the robustness of the preprocessing workflow by validating performance across multiple acquisition sites and both mouse and rat data. Building upon a thorough investigation into data quality metrics across acquisition sites, we introduce guidelines for the quality control of network analysis and offer recommendations for addressing issues. Taken together, this software platform will allow the emerging community to adopt reproducible practices and foster progress in translational neuroscience.

Comparative growth kinetics of Listeria monocytogenes and Salmonella enterica on dehydrated enoki and wood ear mushrooms during rehydration and storage.

Specialty mushrooms have been implicated in foodborne illness outbreaks in the U.S. in recent years. These mushrooms are available to consumers in both their fresh and dried states. Dehydrating mushrooms is a convenient way to increase shelf life. The dehydration process results in a lowered water activity (aw) of the commodity, creating an environment where both spoilage and pathogenic bacteria cannot proliferate. Prior to food preparation and consumption, these mushrooms are typically rehydrated and possibly stored for later use which could lead to increased levels of pathogens. This study examined the survival and growth of Listeria monocytogenes and Salmonella enterica on dehydrated enoki and wood ear mushrooms during rehydration and subsequent storage. Mushrooms were heat dehydrated, inoculated at 3 log CFU/g, and rehydrated at either 5 or 25°C for 2 h. Rehydrated mushrooms were stored at 5, 10, or 25°C for up to 14 d. L. monocytogenes and S. enterica survived on enoki and wood ear mushroom types during rehydration at 5 and 25°C, with populations often <2.39 log CFU/g. During subsequent storage, no growth was observed on wood ear mushrooms, regardless of the rehydration or storage temperature, with populations remaining <2.39 log CFU/g for both pathogens. When stored at 5°C, no growth was observed for either pathogen on enoki mushrooms. During storage at 10 and 25°C, pathogen growth rates and populations after 14 d were generally significantly higher on the enoki mushrooms rehydrated at 25°C; the highest growth rate (3.56 ± 0.75 log CFU/g/d) and population (9.48 ± 0.62 log CFU/g) after 14 d for either pathogen was observed by S. enterica at 25°C storage temperature. Results indicate a marked difference in pathogen survival and proliferation on the two specialty mushrooms examined in this study and highlight the need for individual product assessments. Data can be used to assist in informing guidelines for time and temperature control for the safety of rehydrated mushrooms.

Evaluation of the acute hepatitis B surveillance system in the Republic of Korea following the transition to mandatory surveillance.

The prevalence of hepatitis B in the Republic of Korea has declined, yet the disease burden persists. After various changes in targets and methods, the national hepatitis B surveillance system now exclusively monitors acute cases. We aimed to assess the alignment of this system with its intended purpose and to recommend improvements supporting the national strategic plan for viral hepatitis management. This study assessed acute hepatitis B cases reported to the Korean Disease Control and Prevention Agency's mandatory surveillance system over a 10-year period (2013-2022). It evaluated 5 factors from the Centers for Disease Control and Prevention's Updated Guidelines for Evaluating Public Health Surveillance Systems: simplicity, positive predictive value, data quality, timeliness, and usefulness. The nonspecific nature of acute hepatitis B symptoms, along with the complexity of diagnostic criteria, indicated a high potential for misreporting. The surveillance system demonstrated a high positive predictive value (94.4%), with data quality and timeliness also rated high. However, data following the onset of the coronavirus disease 2019 pandemic indicate the need for improvement. Moreover, given the relative importance of specific characteristics of chronic infectious diseases, only limited interventions are implementable through the current surveillance system. The evaluation of the Republic of Korea's acute hepatitis B surveillance system revealed high positive predictive value, data quality, and timeliness. However, improvements can be made in the misreporting of chronic cases and the system's usefulness. More accurate reflection of the characteristics of acute hepatitis B cases is essential for better management of viral hepatitis.