The Influence of Environmental Temperature and Air Humidity on the Maintenance of Sterility of Surgical Instruments Sterilized in Different Wraps

State of Sao Paulo Research Foundation (FAPESP), Brazil

Effect of low-dose gaseous ozone on pathogenic bacteria

Background: Treatment of chronically infected wounds is a challenge, and bacterial environmental contamination is a growing issue in infection control. Ozone may have a role in these situations. The objective of this study was to determine whether a low dose of gaseous ozone/oxygen mixture eliminates pathogenic bacteria cultivated in Petri dishes. Methods: A pilot study with 6 bacterial strains was made using different concentrations of ozone in an ozone-oxygen mixture to determine a minimally effective dose that completely eliminated bacterial growth. The small and apparently bactericidal gaseous dose of 20 mu g/mL ozone/oxygen (1: 99) mixture, applied for 5min under atmospheric pressure was selected. In the 2nd phase, eight bacterial strains with well characterized resistance patterns were evaluated in vitro using agar-blood in adapted Petri dishes (10(5) bacteria/dish). The cultures were divided into 3 groups: 1-ozone-oxygen gaseous mixture containing 20 mu g of O-3/mL for 5 min; 2- 100% oxygen for 5 min; 3- baseline: no gas was used. Results: The selected ozone dose was applied to the following eight strains: Escherichia coli, oxacillin-resistant Staphylococcus aureus, oxacillin-susceptible Staphylococcus aureus, vancomycin-resistant Enterococcus faecalis, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, carbapenem-resistant Acinetobacter baumannii, Acinetobacter baumannii susceptible only to carbapenems, and Pseudomonas aeruginosa susceptible to imipenem and meropenem. All isolates were completely inhibited by the ozone-oxygen mixture while growth occurred in the other 2 groups. Conclusion: A single topical application by nebulization of a low ozone dose completely inhibited the growth of all potentially pathogenic bacterial strains with known resistance to antimicrobial agents.

Applying validated quality indicators to surgical antibiotic prophylaxis in a Brazilian hospital: Learning what should be learned

Background: Compliance with the best surgical antibiotic prophylaxis practice is usually low despite many published guidelines. Objective: This study investigated compliance with the Hospital Infection Control Committee guideline for antibiotic prophylaxis in a Brazilian hospital using quality indicators. Methods: A retrospective study was carried out from November 2009 to March 2010. Medical records from adult inpatients undergoing cardiac, neurologic, and orthopedic clean surgeries were included. The full compliance index was considered 100% when the antibiotic prophylaxis showed adequacy in all evaluated attributes. Analyses were conducted with 5% significance. Results: Medical records from 101 cardiac, 128 neurologic, and 519 orthopedic surgical patients were evaluated. The compliance index was 4.9%, and the compliance index according to specialty was 5.8%, 3.1%, and 3.0%, respectively, for orthopedic, neurologic, and cardiac surgeries. The attribute route of administration produced the best outcomes, whereas the attribute duration of antibiotic prophylaxis produced the worst. No association was identified between compliance to the attributes and patient characteristics. Conclusion: This study showed a low level of adherence to Hospital Infection Control Committee guidelines for antibiotic prophylaxis. This suggests that different strategies should be implemented to promote the best possible practice in the field of antibiotic prophylaxis with greater surgeon engagement. Copyright (C) 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Periodic sterility assessment of materials stored for up to 6 months at continuous microbial contamination risk: Laboratory study

An investigation was conducted to test the hypothesis that the storage time of packaging sterility has no effect on contamination susceptibility even under deliberate bacterial exposure (Serratia marcescens). No growth of the test microorganisms was identified in the experimental group in any of the storage intervals (7, 14, 28, 90, and 180 days). Current recommendations/guidelines suggest that contamination of packaging occurs only because of events. This study, done in vitro, supports these recommendations. Copyright (c) 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Epidemiologic surveillance of postoperative endophthalmitis in a specialized ophthalmologic center in Sao Paulo, Brazil

This article describes a postoperative endophthalmitis (POE) surveillance system in place in a specialized ophthalmologic center in Sao Paulo, Brazil. The study involved a review of medical records from 2004-2009, during which a total of 31,999 intraocular surgeries were performed. Nineteen of these cases fulfilled the criteria for POE, for an infection rate of 0.06%. The main etiologic agent causing POE was Pseudomonas aeruginosa, identified in 42.1% of the cases (8/19). Copyright (C) 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Borohydride electrooxidation on Au and Pt electrodes

Direct borohydride fuel cells (DBFCs) are attractive energy generators for powering portable electronic devices, mainly due to their high energy density and number of electrons per borohydride ion. However, the lack of a highly efficient electrocatalyst for the borohydride oxidation reaction limits the performance of these devices. The most commonly studied electrocatalysts for this reaction are composed of gold and platinum. Nevertheless, for these metals, the borohydride electrooxidation reaction mechanism (BOR) is not completely understood, and the total oxidation reaction, involving eight electrons per BH4- species, competes with parallel reactions, with a lower number of exchanged electrons and/or with heterogeneous chemical hydrolysis. Considering the above-mentioned issues, this work presents recent advances in the knowledge of the BOR pathways on polycrystalline (bulk) Au and Pt electrocatalysts. It presents the studies of the BOR reaction on Au and Pt electrodes using in situ Fourier Transform Infrared Spectroscopy (FUR), and on-line Differential Electrochemical Mass Spectrometry (DEMS). The spectroscopic and spectrometric data provided physical evidence of intermediate species and the formation of H-2 in the course of the BOR as a function of the electrode potential. These results enabled to advance in the knowledge about the BOR pathways on Au and Pt electrocatalysts. (C) 2012 Elsevier Ltd. All rights reserved.

Dependence of Generation-Recombination Noise With Gate Voltage in FD SOI MOSFETs

A model for computing the generation-recombination noise due to traps within the semiconductor film of fully depleted silicon-on-insulator MOSFET transistors is presented. Dependence of the corner frequency of the Lorentzian spectra on the gate voltage is addressed in this paper, which is different to the constant behavior expected for bulk transistors. The shift in the corner frequency makes the characterization process easier. It helps to identify the energy position, capture cross sections, and densities of the traps. This characterization task is carried out considering noise measurements of two different candidate structures for single-transistor dynamic random access memory devices.

Self-supported bacterial cellulose/boehmite organic-inorganic hybrid films

Self-supported organic-inorganic hybrid transparent films have been prepared from bacterial cellulose and boehmite. SEM results indicate that the BC membranes are covered by Boehmite and XRD patterns suggest structural changes on cellulose due to Boehmite addition. Thermal stability is accessed through TG curves and is dependent on Boehmite content. Transparency, as evaluated by UV-Vis absorption, increases with increasing content of boehmite suggesting application of these materials as transparent substrates for opto-electronic devices.

Photodynamic inactivation of microorganisms present on complete dentures. A clinical investigation

The aim of this study was to evaluate the effectiveness of photodynamic therapy (PDT) for the disinfection of complete dentures. Biofilm samples were collected from dentures of 60 denture users who were randomly divided into four experimental groups (n = 15 each): subjects whose maxillary dentures were sprayed with 50 and 100 mg/l of PhotogemA (R) suspension (groups P50S and P100S) and patients whose maxillary dentures were treated with 50 and 100 mg/l of PhotogemA (R) gel (groups P50G and P100G). Dentures with photosensitizers were left in the dark for 30 min (pre-irradiation time) and then irradiated with blue LED light at 37.5 J/cm(2) (26 min). Denture samples were taken with sterile cotton swab before (left side surfaces) and after (right side surfaces) PDT. All microbial material was diluted and plated on selective media for Candida spp., Staphylococcus mutans spp., streptococci and a non-selective media. After incubation (48 h/37A degrees C), the number of colony-forming units (cfu/ml) was counted. Microorganisms grown on selective media were identified using biochemical methods before and after PDT. The data were submitted to McNemar and Kruskal-Wallis tests (alpha = 0.05). No growth after PDT was observed in 60, 53, 47, and 40% of dentures from P100G, P50G, P100S, and P50S groups, respectively. When evidence of microorganisms' growth was observed, PDT regimens eliminated over 90% of microorganisms on dentures. This clinical study showed that PDT was effective for disinfecting dentures.

Candida spp. isolated from inpatients, the environment, and health practitioners in the Pediatric Unit at the Universitary Hospital of the Jundiai Medical College, State of Sao Paulo, Brazil

Introduction: This study aimed to isolate and identify Candida spp. from the environment, health practitioners, and patients with the presumptive diagnosis of candidiasis in the Pediatric Unit at the Universitary Hospital of the Jundiai Medical College, to verify the production of enzymes regarded as virulence factors, and to determine how susceptible the isolated samples from patients with candidiasis are to antifungal agents. Methods: Between March and November of 2008 a total of 283 samples were taken randomly from the environment and from the hands of health staff, and samples of all the suspected cases of Candida spp. hospital-acquired infection were collected and selected by the Infection Control Committee. The material was processed and the yeast genus Candida was isolated and identified by physiological, microscopic, and macroscopic attributes. Results: The incidence of Candida spp. in the environment and employees was 19.2%. The most frequent species were C. parapsilosis and C. tropicalis among the workers, C. guilliermondii and C. tropicalis in the air, C. lusitanae on the contact surfaces, and C. tropicalis and C. guilliermondii in the climate control equipment. The college hospital had 320 admissions, of which 13 (4%) presented Candida spp. infections; three of them died, two being victims of a C. tropicalis infection and the remaining one of C. albicans. All the Candida spp. in the isolates evidenced sensitivity to amphotericin B, nystatin, and fluconazole. Conclusions: The increase in the rate of hospital-acquired infections caused by Candida spp. indicates the need to take larger measures regarding recurrent control of the environment.

Candida spp. isolated from inpatients, the environment, and health practitioners in the pediatric unit at the Universitary Hospital of the Jundiaí Medical College, state of São Paulo, Brazil

INTRODUCTION: This study aimed to isolate and identify Candida spp. from the environment, health practitioners, and patients with the presumptive diagnosis of candidiasis in the Pediatric Unit at the Universitary Hospital of the Jundiaí Medical College, to verify the production of enzymes regarded as virulence factors, and to determine how susceptible the isolated samples from patients with candidiasis are to antifungal agents. METHODS: Between March and November of 2008 a total of 283 samples were taken randomly from the environment and from the hands of health staff, and samples of all the suspected cases of Candida spp. hospital-acquired infection were collected and selected by the Infection Control Committee. The material was processed and the yeast genus Candida was isolated and identified by physiological, microscopic, and macroscopic attributes. RESULTS: The incidence of Candida spp. in the environment and employees was 19.2%. The most frequent species were C. parapsilosis and C. tropicalis among the workers, C. guilliermondii and C. tropicalis in the air, C. lusitanae on the contact surfaces, and C. tropicalis and C. guilliermondii in the climate control equipment. The college hospital had 320 admissions, of which 13 (4%) presented Candida spp. infections; three of them died, two being victims of a C. tropicalis infection and the remaining one of C. albicans. All the Candida spp. in the isolates evidenced sensitivity to amphotericin B, nystatin, and fluconazole. CONCLUSIONS: The increase in the rate of hospital-acquired infections caused by Candida spp. indicates the need to take larger measures regarding recurrent control of the environment.

Revisão sistemática sobre antissepsia cirúrgica das mãos com preparação alcoólica em comparação aos produtos tradicionais

A antissepsia cirúrgica das mãos visa à prevenção de infecções do sítio cirúrgico, importante causa de morbimortalidade pós-operatória e aumento dos custos hospitalares. Este estudo teve como objetivo comparar a eficácia de preparações alcoólicas com os produtos tradicionais na antissepsia cirúrgica das mãos por meio de uma revisão sistemática da literatura. Foram considerados estudos primários ou secundários, tendo como desfecho a contagem microbiana das mãos ou taxas de infecções do sítio cirúrgico. A busca foi realizada no Portal BVS, PubMed, Ask e MEDLINE. Foram selecionados 25 estudos (2 revisões sistemáticas, 19 experimentais e 4 de coorte). As preparações alcoólicas tiveram uma redução microbiana igual e/ou maior aos produtos tradicionais em 17 estudos e inferior em 4; as taxas de infecções do sítio cirúrgico foram similares. Portanto, existem evidências científicas que suportam a segurança das preparações alcoólicas para antissepsia cirúrgica das mãos.

Study of the Influence of Localized Vibrational Modes in Charge Transport Properties at Nanoscale Systems.

In molecular and atomic devices the interaction between electrons and ionic vibrations has an important role in electronic transport. The electron-phonon coupling can cause the loss of the electron's phase coherence, the opening of new conductance channels and the suppression of purely elastic ones. From the technological viewpoint phonons might restrict the efficiency of electronic devices by energy dissipation, causing heating, power loss and instability. The state of the art in electron transport calculations consists in combining ab initio calculations via Density Functional Theory (DFT) with Non-Equilibrium Green's Function formalism (NEGF). In order to include electron-phonon interactions, one needs in principle to include a self-energy scattering term in the open system Hamiltonian which takes into account the effect of the phonons over the electrons and vice versa. Nevertheless this term could be obtained approximately by perturbative methods. In the First Born Approximation one considers only the first order terms of the electronic Green's function expansion. In the Self-Consistent Born Approximation, the interaction self-energy is calculated with the perturbed electronic Green's function in a self-consistent way. In this work we describe how to incorporate the electron-phonon interaction to the SMEAGOL program (Spin and Molecular Electronics in Atomically Generated Orbital Landscapes), an ab initio code for electronic transport based on the combination of DFT + NEGF. This provides a tool for calculating the transport properties of materials' specific system, particularly in molecular electronics. Preliminary results will be presented, showing the effects produced by considering the electron-phonon interaction in nanoscale devices.

Design and Performance Evaluation of Network-on-Chip Communication Protocols and Architectures

The scale down of transistor technology allows microelectronics manufacturers such as Intel and IBM to build always more sophisticated systems on a single microchip. The classical interconnection solutions based on shared buses or direct connections between the modules of the chip are becoming obsolete as they struggle to sustain the increasing tight bandwidth and latency constraints that these systems demand. The most promising solution for the future chip interconnects are the Networks on Chip (NoC). NoCs are network composed by routers and channels used to inter- connect the different components installed on the single microchip. Examples of advanced processors based on NoC interconnects are the IBM Cell processor, composed by eight CPUs that is installed on the Sony Playstation III and the Intel Teraflops pro ject composed by 80 independent (simple) microprocessors. On chip integration is becoming popular not only in the Chip Multi Processor (CMP) research area but also in the wider and more heterogeneous world of Systems on Chip (SoC). SoC comprehend all the electronic devices that surround us such as cell-phones, smart-phones, house embedded systems, automotive systems, set-top boxes etc... SoC manufacturers such as ST Microelectronics , Samsung, Philips and also Universities such as Bologna University, M.I.T., Berkeley and more are all proposing proprietary frameworks based on NoC interconnects. These frameworks help engineers in the switch of design methodology and speed up the development of new NoC-based systems on chip. In this Thesis we propose an introduction of CMP and SoC interconnection networks. Then focusing on SoC systems we propose: • a detailed analysis based on simulation of the Spidergon NoC, a ST Microelectronics solution for SoC interconnects. The Spidergon NoC differs from many classical solutions inherited from the parallel computing world. Here we propose a detailed analysis of this NoC topology and routing algorithms. Furthermore we propose aEqualized a new routing algorithm designed to optimize the use of the resources of the network while also increasing its performance; • a methodology flow based on modified publicly available tools that combined can be used to design, model and analyze any kind of System on Chip; • a detailed analysis of a ST Microelectronics-proprietary transport-level protocol that the author of this Thesis helped developing; • a simulation-based comprehensive comparison of different network interface designs proposed by the author and the researchers at AST lab, in order to integrate shared-memory and message-passing based components on a single System on Chip; • a powerful and flexible solution to address the time closure exception issue in the design of synchronous Networks on Chip. Our solution is based on relay stations repeaters and allows to reduce the power and area demands of NoC interconnects while also reducing its buffer needs; • a solution to simplify the design of the NoC by also increasing their performance and reducing their power and area consumption. We propose to replace complex and slow virtual channel-based routers with multiple and flexible small Multi Plane ones. This solution allows us to reduce the area and power dissipation of any NoC while also increasing its performance especially when the resources are reduced. This Thesis has been written in collaboration with the Advanced System Technology laboratory in Grenoble France, and the Computer Science Department at Columbia University in the city of New York.

Modelli Digitali e Archivi di Progetto. Sistemi integrati di documentazione per l'architettura.

Le tecniche dell'informazione e i metodi della comunicazione hanno modificato il modo di redigere documenti destinati a trasmettere la conoscenza, in un processo che è a tutt'oggi in corso di evoluzione. Anche l'attività progettuale in ingegneria ed architettura, pure in un settore caratterizzato da una notevole inerzia metodologica e restio all'innovazione quale è quello dell'industria edilizia, ha conosciuto profonde trasformazioni in ragione delle nuove espressioni tecnologiche. Da tempo l'informazione necessaria per realizzare un edificio, dai disegni che lo rappresentano sino ai documenti che ne indicano le modalità costruttive, può essere gestita in maniera centralizzata mediante un unico archivio di progetto denominato IPDB (Integrated Project DataBase) pur essendone stata recentemente introdotta sul mercato una variante più operativa chiamata BIM (Building Information Modelling). Tuttavia l'industrializzazione del progetto che questi strumenti esplicano non rende conto appieno di tutti gli aspetti che vedono la realizzazione dell'opera architettonica come collettore di conoscenze proprie di una cultura progettuale che, particolarmente in Italia, è radicata nel tempo. La semantica della rappresentazione digitale è volta alla perequazione degli elementi costitutivi del progetto con l'obiettivo di catalogarne le sole caratteristiche fabbricative. L'analisi della letteratura scientifica pertinente alla materia mostra come non sia possibile attribuire ai metodi ed ai software presenti sul mercato la valenza di raccoglitori omnicomprensivi di informazione: questo approccio olistico costituisce invece il fondamento della modellazione integrata intesa come originale processo di rappresentazione della conoscenza, ordinata secondo il paradigma delle "scatole cinesi", modello evolvente che unifica linguaggi appartenenti ai differenti attori compartecipanti nei settori impiantistici, strutturali e della visualizzazione avanzata. Evidenziando criticamente i pregi e i limiti operativi derivanti dalla modellazione integrata, la componente sperimentale della ricerca è stata articolata con l'approfondimento di esperienze condotte in contesti accademici e professionali. Il risultato conseguito ha coniugato le tecniche di rilevamento alle potenzialità di "modelli tridimensionali intelligenti", dotati cioè di criteri discriminanti per la valutazione del relazionamento topologico dei componenti con l'insieme globale.