Researching effective approaches to cleaning in hospitals: Protocol of the REACH study, a multi-site stepped-wedge randomised trial

Background The Researching Effective Approaches to Cleaning in Hospitals (REACH) study will generate evidence about the effectiveness and cost-effectiveness of a novel cleaning initiative that aims to improve the environmental cleanliness of hospitals. The initiative is an environmental cleaning bundle, with five interdependent, evidence-based components (training, technique, product, audit and communication) implemented with environmental services staff to enhance hospital cleaning practices. Methods/design The REACH study will use a stepped-wedge randomised controlled design to test the study intervention, an environmental cleaning bundle, in 11 Australian hospitals. All trial hospitals will receive the intervention and act as their own control, with analysis undertaken of the change within each hospital based on data collected in the control and intervention periods. Each site will be randomised to one of the 11 intervention timings with staggered commencement dates in 2016 and an intervention period between 20 and 50 weeks. All sites complete the trial at the same time in 2017. The inclusion criteria allow for a purposive sample of both public and private hospitals that have higher-risk patient populations for healthcare-associated infections (HAIs). The primary outcome (objective one) is the monthly number of Staphylococcus aureus bacteraemias (SABs), Clostridium difficile infections (CDIs) and vancomycin resistant enterococci (VRE) infections, per 10,000 bed days. Secondary outcomes for objective one include the thoroughness of hospital cleaning assessed using fluorescent marker technology, the bio-burden of frequent touch surfaces post cleaning and changes in staff knowledge and attitudes about environmental cleaning. A cost-effectiveness analysis will determine the second key outcome (objective two): the incremental cost-effectiveness ratio from implementation of the cleaning bundle. The study uses the integrated Promoting Action on Research Implementation in Health Services (iPARIHS) framework to support the tailored implementation of the environmental cleaning bundle in each hospital. Discussion Evidence from the REACH trial will contribute to future policy and practice guidelines about hospital environmental cleaning. It will be used by healthcare leaders and clinicians to inform decision-making and implementation of best-practice infection prevention strategies to reduce HAIs in hospitals. Trial registration Australia New Zealand Clinical Trial Registry ACTRN12615000325​505

Using multi-label classification for acoustic pattern detection and assisting bird species surveys

Acoustics is a rich source of environmental information that can reflect the ecological dynamics. To deal with the escalating acoustic data, a variety of automated classification techniques have been used for acoustic patterns or scene recognition, including urban soundscapes such as streets and restaurants; and natural soundscapes such as raining and thundering. It is common to classify acoustic patterns under the assumption that a single type of soundscapes present in an audio clip. This assumption is reasonable for some carefully selected audios. However, only few experiments have been focused on classifying simultaneous acoustic patterns in long-duration recordings. This paper proposes a binary relevance based multi-label classification approach to recognise simultaneous acoustic patterns in one-minute audio clips. By utilising acoustic indices as global features and multilayer perceptron as a base classifier, we achieve good classification performance on in-the-field data. Compared with single-label classification, multi-label classification approach provides more detailed information about the distributions of various acoustic patterns in long-duration recordings. These results will merit further biodiversity investigations, such as bird species surveys.

Multi-resistance states in the electrical switching behavior of amorphous Si15Te75Ge10 thin films: Possibility of multi-bit storage

Electrical switching studies on amorphous Si15Te75Ge10 thin film devices reveal the existence of two distinct, stable low-resistance, SET states, achieved by varying the electrical input to the device. The multiple resistance levels can be attributed to multi-stage crystallization, as observed from temperature dependant resistance studies. The devices are tested for their ability to be RESET with minimal resistance degradation; further, they exhibit a minimal drift in the SET resistance value even after several months of switching. (c) 2013 Elsevier B.V. All rights reserved.

Multi Label Classification of Discrete Data

The paper describes an algorithm for multi-label classification. Since a pattern can belong to more than one class, the task of classifying a test pattern is a challenging one. We propose a new algorithm to carry out multi-label classification which works for discrete data. We have implemented the algorithm and presented the results for different multi-label data sets. The results have been compared with the algorithm multi-label KNN or ML-KNN and found to give good results.

Multi-colour switching of polymer stabilized chiral nematic liquid crystal devices

We have fabricated a series of polymer stabilized chiral nematic test cells for use as flexoelectro-optic devices. The devices fabricated were based on commercial chiral nematic mixtures which were polymer stabilized so as to enhance the uniformity and stability of the uniform lying helix texture in the cells. During fabrication and test procedures a series of unusual scattering states have been observed within the devices at different viewing angles. The observations made so far indicate that the properties of the scattering state lies somewhere between the focal conic texture and the Grandjean or planar texture and that the devices exhibit both a helical pitch selective reflection and scattering effect. What is even more dramatic is that the wavelength selectivity of the scattering effect can be tuned by an applied field. In addition, we show that it is possible to achieve good uniform lying helix textures from such devices. Moreover, we show that in certain cases the spontaneous alignment of the helix in the plane of the device opens up the possibility of a new mode of switching. Flexoelectric, Redshift, Coloured scattering, Liquid crystal, Polymer-stabilized liquid-crystal;.