In Vivo Degradation Behavior of Magnesium Alloy for Bone Implants with Improving Biological Activity, Mechanical Properties, and Corrosion Resistance.

This study aimed to establish a surface modification technology for ZK60 magnesium alloy implants that can degrade uniformly over time and promote bone healing. It proposes a special micro-arc oxidation (MAO) treatment on ZK60 alloy that enables the composite electrolytes to create a coating with better corrosion resistance and solve the problems of uneven and excessive degradation. A magnesium alloy bone screw made in this way was able to promote the bone healing reaction after implantation in rabbits. Additionally, it was found that the MAO-treated samples could be sustained in simulated body-fluid solution, exhibiting excellent corrosion resistance and electrochemical stability. The Ca ions deposited in the MAO coating were not cytotoxic and were beneficial in enhancing bone healing after implantation.

Preoptimized phage cocktail for use in aerosols against nosocomial transmission of carbapenem-resistant Acinetobacter baumannii: A 3-year prospective intervention study.

Using bacteriophages (phages) as environmental sanitizers has been recognized as a potential alternative method to remove bacterial contamination in vitro; however, very few studies are available on the application of phages for infection control in hospitals. Here, we performed a 3-year prospective intervention study using aerosolized phage cocktails as biocontrol agents against carbapenem-resistant Acinetobacter baumannii (CRAB) infection in the hospital. When a CRAB-infected patient was identified in an intensive care unit (ICU), their surrounding environment was chosen for phage aerosol decontamination. Before decontamination, 501 clinical specimens from the patients were subjected to antibiotic resistance analysis and phage typing. The optimal phage cocktails were a combination of different phage families or were constructed by next-evolutionary phage typing with the highest score for the host lysis zone to prevent the development of environmental CRAB phage resistance. The phage infection percentage of the antibiotic-resistant A. baumannii strains was 97.1%, whereas the infection percentage in the antibiotic-susceptible strains was 79.3%. During the phage decontamination periods from 2017 to 2019, the percentage of carbapenem-resistant A. baumannii in test ICUs decreased significantly from 65.3% to 55%. The rate of new acquisitions of CRAB infection over the three years was 4.4 per 1000 patient-days, which was significantly lower than that in the control wards (8.9 per 1000 patient-days) where phage decontamination had never been performed. In conclusion, our results support the potential of phage cocktails to decrease CRAB infection rates, and the aerosol generation process may make this approach more comprehensive and time-saving.

The Potential of Calcium/Phosphate Containing MAO Implanted in Bone Tissue Regeneration and Biological Characteristics.

Micro arc oxidation (MAO) is a prominent surface treatment to form bioceramic coating layers with beneficial physical, chemical, and biological properties on the metal substrates for biomaterial applications. In this study, MAO treatment has been performed to modify the surface characteristics of AZ31 Mg alloy to enhance the biocompatibility and corrosion resistance for implant applications by using an electrolytic mixture of Ca3(PO4)2 and C10H16N2O8 (EDTA) in the solutions. For this purpose, the calcium phosphate (Ca-P) containing thin film was successfully fabricated on the surface of the implant material. After in-vivo implantation into the rabbit bone for four weeks, the apparent growth of soft tissues and bone healing effects have been documented. The morphology, microstructure, chemical composition, and phase structures of the coating were identified by SEM, XPS, and XRD. The corrosion resistance of the coating was analyzed by polarization and salt spray test. The coatings consist of Ca-P compounds continuously have proliferation activity and show better corrosion resistance and lower roughness in comparison to mere MAO coated AZ31. The corrosion current density decreased to approximately 2.81 × 10-7 A/cm2 and roughness was reduced to 0.622 µm. Thus, based on the results, it was anticipated that the development of degradable materials and implants would be feasible using this method. This study aims to fabricate MAO coatings for orthopedic magnesium implants that can enhance bioactivity, biocompatibility, and prevent additional surgery and implant-related infections to be used in clinical applications.

Altered susceptibility to air sampling stress by filtration is related to colistin resistance development in Acinetobacter baumannii.

The accurate quantification of antibiotic-resistant bacteria in indoor air has recently attracted increasing attention. Here, we investigated whether the susceptibility of a nosocomial infection-related microbe, Acinetobacter baumannii, to strong sampling stress caused by Nuclepore filter changes as it develops resistance to a drug called colistin. Both colistin-sensitive A. baumannii (CSAB) and colistin-resistant A. baumannii (CRAB) are generally desiccation-resistant strains that can be collected by filter sampling. However, the resistance of CRAB to the three combined stresses (aerosolization, impaction, and desiccation) caused by filter sampling was 1.8 times lower than that of CSAB (P < 0.05). The sampling stresses caused by filter sampling not only reduced the culturability of A. baumannii but also destroyed proteins to result in cellular protein leakage. CRAB released 17%-38% more extracellular protein than did CSAB when they were both subjected to desiccation stress for 240 minutes (P < 0.01). The combination of using a sampling flow rate of 20 L/min and sampling for 60 minutes with a Nuclepore filter with open-face cassettes (OFCs) is recommended for collecting airborne A. baumannii. A Nuclepore filter operated with closed-face cassettes (CFCs) significantly decreased the culturability of CRAB due to desiccation effects.

The assessment of exposure to occupational noise and hearing loss for stoneworkers in taiwan.

INTRODUCTION: Stoneworkers in Taiwan are exposed to occupational noise and suffer hearing impairment. A complete assessment of exposure and health effects is needed for a better understanding. MATERIALS AND METHODS: We accessed nine stone factories, monitored the environmental and personal doses of noise, analyzed the frequency spectra of noise from various machines, and recruited 55 stoneworkers and 25 administrative staff as controls for pure tone audiometry testing. RESULTS: The means (standard deviations) of 8-h time-weighted averages for environmental and personal monitoring were 85.0 (6.2) and 87.0 (5.5) dB(A), respectively, with seven of nine personal measurements being higher than the respective environmental results. The monitoring data suggest that occupational noise in the stonework environments should be a matter of great concern. Nearly all frequency spectra indicated peak values occurring between 2 and 4 kHz, which were within the bands for early noise-induced hearing loss (NIHL). The mean hearing threshold levels of the study participants were elevated in low and high frequencies (29.2 and 41.2 dB) compared to that of controls (∼25 dB for both bands). Linear regression analysis indicated no significance in the low frequencies (P = 0.207) but statistical significance in the high frequencies (P = 0.002) after adjustment for covariates, suggesting NIHL among the stoneworkers. CONCLUSION: Stoneworkers apparently display early signs of NIHL. Noises in the stonework factories with peaks in the high frequencies are harmful to hearing ability. Employers and workers have to comply with the regulation strictly to prevent further hearing damage.

Altered susceptibility to the bactericidal effect of photocatalytic oxidation by TiO2 is related to colistin resistance development in Acinetobacter baumannii.

Multidrug-resistant Acinetobacter baumannii is a well-documented pathogen associated with hospital-acquired infections. In addition to multidrug resistance, A. baumannii can also become resistant to colistin, the antibiotic treatment of last resort, by the loss of the lipopolysaccharide from its outer membrane. Here, we demonstrate that the development of colistin resistance also increases the resistance of A. baumannii to titanium dioxide (TiO2) photocatalysis. Both colistin-sensitive A. baumannii (CSAB) and colistin-resistant A. baumannii (CRAB) were inactivated by TiO2 when irradiated by ultraviolet A (UV-A). The resistance of CRAB to TiO2 photocatalysis was 1.5 times higher than that of CSAB, as determined by either culture assay or quantification of leaked proteins after photocatalysis (p < 0.05). The results of two-dimensional gel electrophoresis led to the speculation that the high resistance of CRAB may be associated with a lack of sensitive targets and oxidative enzymes. This hypothesis was confirmed by antimicrobial assays with 25 mM hydrogen peroxide (H2O2) and 1.07 mM sodium hypochlorite (NaClO). CRAB was significantly more resistant to H2O2 and NaClO treatment than CSAB (p < 0.01), consistent with the results of the TiO2 inactivation experiment. Therefore, the antibiotic resistance profiles of bacterial strains should be considered before the use of strains as indicators to represent sanitary quality after TiO2 photocatalysis.

Datasets of various geotechnical surveys in several arrays in the Taipei Basin.

The standard penetration test (SPT), seismic cone penetration test (SCPT), and various in-situ seismic tests are commonly utilized for geotechnical site investigations. The investigated data via these tests are widely adopted to capture site characteristics for geotechnical engineering design. However, site characterizations vary in the above in-situ tests, which leads to uncertainties in the corresponding engineering analysis and design. To address these variabilities, this paper meticulously carried out the above-mentioned geotechnical in-situ tests with rigorous supervision at 13 selected sites in the Taipei Basin, yielding several valuable datasets. The datasets consist of digital investigation data including SPT-N, soil classification, CPT-qc and -fs, and the shear wave velocities (Vs) obtained from different measurements. We believe that these datasets will be beneficial for conducting various calibration studies for different geotechnical investigation methods and the corresponding geotechnical parameters.

Biocompatibility and corrosion resistance of drug coatings with different polymers for magnesium alloy cardiovascular stents.

Recently, advances in enhancing corrosion properties through various techniques, and the clinical application of biodegradable cardiovascular stents made from magnesium (Mg) alloys face challenges to corrosion resistance, blood compatibility, and biocompatibility. Drug-eluting stents (DES) offer a solution to enhance the corrosion resistance of Mg alloys while simultaneously reducing the occurrence of restenosis. In this study, WE43 Mg alloy was pretreated using electropolishing technology, and different polymers (PEG and PLLA) were used as drug-polymer coatings for the Mg alloy. At the same time, PTX, an anticoagulant, was incorporated to achieve drug coating of different polymers on WE43 Mg alloy. The corrosion resistance of different polymer-drug coatings was assessed using a plasma solution. Furthermore, in vitro and in vivo tests were used to evaluate the blood biocompatibility of these coatings. The results indicated the PTX-PEG-coated WE43 Mg alloy exhibited the highest corrosion resistance and the most stable drug release profile among the tested coatings. Its hemolysis rate of 0.6 % was within the clinical requirements (<5 %). The incorporation of PEG prevents non-specific protein adsorption and nanoparticle aggregation, enhancing the surface hemocompatibility of WE43 Mg alloy. Therefore, the PTX-PEG coating shows promising potential for application in the development of drug-coated Mg alloy.

Novel artificial tricalcium phosphate and magnesium composite graft facilitates angiogenesis in bone healing.

BACKGROUND: Bone grafting is the standard treatment for critical bone defects, but autologous grafts have limitations like donor site morbidity and limited availability, while commercial artificial grafts may have poor integration with surrounding bone tissue, leading to delayed healing. Magnesium deficiency negatively impacts angiogenesis and bone repair. Therefore, incorporating magnesium into a synthetic biomaterial could provide an excellent bone substitute. This study aims to evaluate the morphological, mechanical, and biological properties of a calcium phosphate cement (CPC) sponge composed of tetracalcium phosphate (TTCP) and monocalcium phosphate monohydrate (MCPM), which could serve as an excellent bone substitute by incorporating magnesium. METHODS: This study aims to develop biomedical materials composed mainly of TTCP and MCPM powder, magnesium powder, and collagen. The materials were prepared using a wet-stirred mill and freeze-dryer methods. The particle size, composition, and microstructure of the materials were investigated. Finally, the biological properties of these materials, including 3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide (MTT) assay for biocompatibility, effects on bone cell differentiation by alkaline phosphatase (ALP) activity assay and tartrate-resistant acid phosphatase (TRAP) activity assay, and endothelial cell tube formation assay for angiogenesis, were evaluated as well. RESULTS: The data showed that the sub-micron CPC powder, composed of TTCP/MCPM in a 3.5:1 ratio, had a setting time shorter than 15 minutes and a compressive strength of 4.39±0.96 MPa. This reveals that the sub-micron CPC powder had an adequate setting time and mechanical strength. We found that the sub-micron CPC sponge containing magnesium had better biocompatibility, including increased proliferation and osteogenic induction effects without cytotoxicity. The CPC sponge containing magnesium also promoted angiogenesis. CONCLUSION: In summary, we introduced a novel CPC sponge, which had a similar property to human bone promoted the biological functions of bone cells, and could serve as a promising material used in bone regeneration for critical bone defects.

A novel biodegradable magnesium skin staple: A safety and functional evaluation.

BACKGROUND: The potential of biodegradable magnesium (Mg) skin staple has recently garnered widespread attention due to their biodegradability and biocompatibility rather than traditional stainless steel staples, the most commonly used in current clinical practice. The aim of this study is to evaluate the safety and mechanical properties of a novel biodegradable Mg skin staple. METHODS: A prototype of Mg skin staple was designed using a novel ZK60 Mg alloy. The mechanical properties of the staple were evaluated using a universal testing machine. The cytotoxicity of the staple was examined in vitro and the efficacy of the staple in wound closure was assessed in New Zealand rabbits for one and three weeks, respectively. RESULTS: The tensile strength of this Mg alloy is 258.4 MPa with 6.9% elongation. The treatment of HaCaT and L929 cells with the staple extract resulted in over 95% cell viability, indicating no cytotoxicity. In vivo, no tissue irritation was observed. No difference was found in wound healing between the Mg skin staple and the stainless steel staple after one and three weeks in the cutting wound on the back of rabbits. Some Mg skin staples spontaneously dislodged from the skin within three weeks, while others were easily removed. CONCLUSION: Our results confirm the safety, biocompatibility, and functionality of the novel Mg skin staple in wound closure. The efficacy of the staple in wound closure was demonstrated to be as effectively as conventional staples, with the added benefit of decreased long-term retention of skin staples in the wounds.

Potential of bacteriophage ΦAB2 as an environmental biocontrol agent for the control of multidrug-resistant Acinetobacter baumannii.

BACKGROUND: Multidrug-resistant Acinetobacter baumannii (MDRAB) is associated with nosocomial infections worldwide. To date, the use of a phage to prevent infections caused by MDRAB has not been demonstrated. RESULTS: The MDRAB-specific phage ϕAB2 was stable at 4°C and pH 7 in 0.5% chloroform solution, and showed a slight decrease in plaque-forming units (PFU)/ml of 0.3-0.9 log after 330 days of storage. The addition of ϕAB2 at a concentration of at least 105 PFU/ml to an A. baumannii M3237 suspension killed >99.9% of A. baumannii M3237 after 5 min, regardless of A. baumannii M3237 concentration (104, 105, or 106 colony-forming units (CFU)/ml). The addition of ϕAB2 at a concentration of 108 PFU/slide (>107 PFU/cm²) to glass slides containing A. baumannii M3237 at 104, 105, or 106 CFU/slide, significantly reduced bacterial numbers by 93%, 97%, and 99%, respectively. Thus, this concentration is recommended for decontamination of glass surfaces. Moreover, infusion of ϕAB2 into 10% glycerol exhibited strong anti-MDRAB activity (99.9% reduction), even after 90 days of storage. Treatment of a 10% paraffin oil-based lotion with ϕAB2 significantly reduced (99%) A. baumannii M3237 after 1 day of storage. However, ϕAB2 had no activity in the lotion after 1 month of storage. CONCLUSIONS: Phages may be useful for reducing MDRAB contamination in liquid suspensions or on hard surfaces. Phages may also be inoculated into a solution to produce an antiseptic hand wash. However, the phage concentration and incubation time (the duration of phage contact with bacteria) should be carefully considered to reduce the risk of MDRAB contamination.

Using cluster algorithms with a machine learning technique and PMF models to quantify local-specific origins of PM2.5 and associated metals in Taiwan.

The influence of long-range transport (LRT) of air pollutants on neighboring regions and countries has been documented. The magnitude of LRT aerosols and related constituents can misdirect control strategies for local air quality management. In this study, we aimed to quantify PM2.5 (diameter less than 2.5 µm, PM2.5) and associated metals derived from local sources and LRT in different geographic locations in Taiwan using advanced receptor models. We collected daily PM2.5 samples (n = âˆ¼1000) and analyzed 28 metals every three days from 2016 to 2018 in the northern, central-south, eastern, and southern areas of Taiwan. We first used a machine learning technique with a cluster algorithm coupled with a backward trajectory to classify local, regional, and LRT-related aerosols. We then quantified the source contributions with a positive matrix factorization (PMF) model for Taiwan weighted by region-specific populations. The northern and eastern regions were found to be more vulnerable to LRT-related PM2.5 and metals than the central-south and southern regions in Taiwan. The LRT increased Pb and As concentrations by 90-200% and ∼40% in the northern and central-south regions. Ambient PM2.5-metals mainly originated from local traffic-related emissions in the northern, central-south, and southern regions, whereas oil combustion was the primary source of PM2.5-metals in the eastern region. By subtracting the influence from the LRT, the contributions of domestic emission sources to ambient PM2.5 metals in Taiwan were 35% from traffic-related emission, 17% from non-ferrous metallurgy, 13% from iron ore and steel factories, 12% from coal combustion, 12% from oil combustion, 10% from incinerator emissions, and <1% from cement manufacturing emissions. This study proposed an advanced method for refining local source contributions to ambient PM2.5 metals in Taiwan, which provides useful information on regional control strategies.

A Novel Method for the Fabrication of Antibacterial Stainless Steel with Uniform Silver Dispersions by Silver Nanoparticle/Polyethyleneimine Composites.

Only a few studies have so far focused on the addition of silver to SS316L alloys by conventional sintering methods. Unfortunately, the metallurgical process of silver-containing antimicrobial SS is greatly limited due to the extremely low solubility of silver in iron and its tendency to precipitate at the grain boundaries, resulting in an inhomogeneous distribution of the antimicrobial phase and loss of antimicrobial properties. In this work, we present a novel approach to fabricate antibacterial stainless steel 316L by functional polyethyleneimine-glutaraldehyde copolymer (PEI-co-GA/Ag catalyst) composites. PEI is a highly branched cationic polymer, which makes it exhibit very good adhesion on the surface of the substrate. Unlike the effect of the conventional silver mirror reaction, the introduction of functional polymers can effectively improve the adhesion and distribution of Ag particles on the surface of 316LSS. It can be seen from the SEM images that a large number of silver particles are retained and well dispersed in 316LSS after sintering. PEI-co-GA/Ag 316LSS exhibits excellent antimicrobial properties and does not release free silver ions to affect the surrounding environment. Furthermore, the probable mechanism for the influence of the functional composites on the enhancement of adhesion is also proposed. The formation of a large number of hydrogen bonds and van der Waals forces, as well as the negative zeta potential of the 316LSS surface, can effectively enable the formation of a tight attraction between the Cu layer and the surface of 316LSS. These results meet our expectations of designing passive antimicrobial properties on the contact surface of medical devices.

Status of resource recycling stations in Taiwan and recycling work-related health effects.

Resource recycling has become an integral part of environmental protection efforts. At present, the development of Taiwan's resource recovery and related works are quite mature. However, laborers or volunteers working in resource recycling stations may be exposed to different types of hazards during the recycling process. These hazards can be divided into biological, chemical, and musculoskeletal problems. These hazards are usually related to the work environment and work habits; therefore, a related control strategy is needed. Tzu Chi's recycling business has been running for over 30 years. In addition to leading the trend of resource recycling in Taiwan, many elderly people have also participated in Tzu Chi recycling stations as volunteers. These older volunteers may be more sensitive to exposure to hazards, and thus the focus of this review is to illustrate the possible hazards and health impacts of resource recovery work and to recommend relevant interventions to improve occupational health during resource recovery work.

Visible light-responsive core-shell structured In2O3@CaIn2O4 photocatalyst with superior bactericidal properties and biocompatibility.

Antibacterial activity of photocatalytic substrates is primarily induced by ultraviolet light irradiation. Visible light-responsive photocatalysts were recently discovered, offering greater opportunity to use photocatalysts as disinfectants in our living environment. The development of antibacterial photocatalysts, however, has mainly focused on titanium oxide (TiO(2))-related materials with antibacterial properties not comparable with conventional chemical disinfectants. This study demonstrated that a core-shell structured In(2)O(3)@CaIn(2)O(4) substrate has superior visible light-induced bactericidal properties, as compared with several commercially available and laboratory-prepared visible light-responsive photocatalysts. The high performance is enhanced by more easily photoexcited electron transfer between the interfaces of In(2)O(3) and CaIn(2)O(4) to minimize the electron-hole recombination during photocatalysis. Additionally, when compared with TiO(2)-based photocatalysts, In(2)O(3)@CaIn(2)O(4) treatments did not induce significant cell death and tissue damage, implying a superior biocompatibility. These findings suggest that In(2)O(3)@CaIn(2)O(4) may have potential application in the development of a safer and highly bactericidal photocatalyst. FROM THE CLINICAL EDITOR: A photocatalytic susbstrate is described that functions in visible light, possesses bactericidal properties and better biocompatibility than the standard TiO(2) based methods.

Contribution of Visible Surface Mold to Airborne Fungal Concentration as Assessed by Digital Image Quantification.

The rapid monitoring of total fungi, including air and surface fungal profiling, is an important issue. Here, we applied air and surface sampling, combined with digital image quantification of surface mold spots, to evaluate the contribution of surface fungi to airborne fungal concentrations. Cladosporium, Penicillium, Aspergillus, and yeast often appeared in the air or on wall surfaces during sampling. The indoor/outdoor concentration ratios (I/O ratios) demonstrated that the airborne concentrations of commonly found fungal genera outdoors were higher than those indoors (median I/O ratio = 0.65-0.91), excluding those of Penicillium and yeast. Additionally, the surface density (fungal concentration/area) of individual fungi showed no significant correlation with the airborne concentration, excluding that of Geotrichum. However, if a higher surface ratio (>0.00031) of mold spots appeared in the total area of an indoor environment, then the concentrations of Aspergillus and Geotrichum in the air increased significantly. Our results demonstrated that the airborne concentration of indoor fungi is significantly correlated with the outdoor concentration. A higher density of surface fungi does not necessarily contribute to a high fungal concentration in the air. In contrast to fungal density, quantification of the surface fungal area is recommended to assess the risk of surface fungi propelling into the air.

Ambient viral and bacterial distribution during long-range transport in Northern Taiwan.

Long-range transport (LRT) reportedly carries air pollutants and microorganisms to downwind areas. LRT can be of various types, such as dust storm (DS) and frontal pollution (FP); however, studies comparing their effects on bioaerosols are lacking. This study evaluated the effect of LRT on viral and bacterial concentrations in Northern Taiwan. When LRT occurred and possibly affected Taiwan from August 2013 to April 2014, air samples (before, during, and after LRT) were collected in Cape Fugui (CF, Taiwan's northernmost point) and National Taiwan University (NTU). Reverse-transcription quantitative polymerase chain reaction (RT-qPCR) was applied to quantify influenza A virus. qPCR and qPCR coupled with propidium monoazide were, respectively, used to quantify total and viable bacteria. Types and occurrence of LRT were confirmed according to the changing patterns of meteorological factors and air pollution, air mass sources (HYSPLIT model), and satellite images. Two Asian DS and three FP cases were included in this study. Influenza A virus was detected only on days before and during FP occurred on January 3-5, 2014, with concentrations of 0.87 and 10.19 copies/m3, respectively. For bacteria, the increase in concentrations of total and viable cells during Asian DSs (17-19 and 25-29 November 2013) was found at CF only (from 3.13 to 3.40 and from 2.62 to 2.85 log copies/m3, respectively). However, bacterial levels at NTU and CF both increased during FP and lasted for 2 days after FP. In conclusion, LRT increased the levels of influenza A virus and bacteria in the ambient air of Northern Taiwan, particularly at CF. During and 2 days (at least) after LRT, people should avoid outdoor activities, especially in case of FP.

Integrated analysis of source-specific risks for PM2.5-bound metals in urban, suburban, rural, and industrial areas.

The levels and characteristics of atmospheric metals vary in time and location, can result in various health impacts, which increases the challenge of air quality management. We aimed to investigate PM2.5-bound metals in multiple locations and propose a methodology for comparing metal elements across study regions and prioritizing source contributions through integrated health risk assessments. PM2.5-bound metals were collected in the urban, suburban, rural, and industrial regions of Taiwan between 2016 and 2018. We incorporated the positive matrix factorization (PMF) with health risk assessments (considering estimates of the margin of exposure (MOE) and excess cancer risk (ECR)) to prioritize sources for control. We found that the concentrations of Fe, Zn, V, Cu, and Mn (industry-related metals) were higher at the industrial site (Kaohsiung) and Ba, Cr, Ni, Mo, and Co (traffic-related metals) were higher at the urban site (Taipei). The rural site (Hualian) had good air quality, with low PM2.5 and metal concentrations. Most metal concentrations were higher during the cold season for all study sites, except for the rural. Ambient concentrations of Mn, Cr, and Pb obtained from all study sites presents a higher health risk of concern. In Kaohsiung, south Taiwan, PM2.5-bound metals from the iron ore and steel factory is suggested as the first target for control based on the calculated health risks (MOE < 1 and ECR > 10-6). Overall, we proposed an integrated strategy for initiating the source management prioritization of PM2.5-bound metals, which can aid an effort for policymaking.

Detection of airborne viruses in a pediatrics department measured using real-time qPCR coupled to an air-sampling filter method.

Children are vulnerable to viral infections. The study discussed in this article investigates the possibility of aerosol transmission of viruses in children under age 18 in the pediatrics department of a medical center in Taipei, Taiwan. After first using the filtration method to collect viral aerosols, the authors combined it with real-time quantitative polymerase chain reaction (qPCR) to detect influenza A virus (INFAV), human adenovirus (HAdV), and enterovirus. Of 33 aerosol samples collected from the emergency room of the pediatrics department, 8 (24%) were positive for INFAV, 12 (36%) for HAdV, and 5 (15%) for enterovirus. HAdV was detected from the aerosol of 26 samples, but INFAV and enteroviruses were not. The filter and real-time qPCR can be used to detect and quantify the viral load in aerosols, in which enteroviruses had the highest viral titer. In summary, a well-established filter/real-time qPCR assay was successfully applied to measure viral aerosols in the occupational environment. Environmental monitoring of airborne viruses could provide an early indicator of dangerous viruses in the air of hospitals.

Size distribution and antibiotic-resistant characteristics of bacterial bioaerosol in intensive care unit before and during visits to patients.

Airborne bacteria in hospitals have been implicated in nosocomial infections. This investigation studied the characteristics of airborne bacteria and the effect of patient visitation on the bacteria profile in intensive care units (ICUs). Air at a medical ICU and surgical ICU was sampled for one year. Airborne bacteria before and during visits to patients in ICUs were collected using a Six-Stage Viable Andersen Cascade Impactor to analyze the concentration and size distribution of airborne bacteria and the percentage thereof that were antibiotic-resistant. During patient visitation in the ICUs in this study, the number of visitors was 20-80. Airborne bacteria concentration during visiting hours (total averaging 168.5 CFU/m3) was three to four times than before visiting hours (p = 0.043). With increasing the visitors, most of the airborne human-associated bacteria (HAB) concentrations during visitations were higher than before visitations in each season. The two-way ANOVA of HAB concentration before and during visitation (p = 0.028) of combining MICU and SICU in various season (p = 0.007) all revealed statistical agreement. The proportion of particles, from 1.1 to 4.7 µm, during the visits was almost 1-2.4 times that before the visits in most sampling periods (p = 0.028). In addition, the opportunistic pathogens such as Micrococcus spp., Staphylococcus spp. and Acinetobacter spp. were found in the air during visiting times. Small proportions of some environmental strains with a high antibiotic-resistance percentage (42-78%), including Brevundimonas spp., Elizabethkingia spp. and others, were detected during patient visitation. Patient visitation activities affect the bacterial profile in air in ICUs. During the visitation, visitors might bring or generate bacteria into ICUs. Limiting the number of patient visitors to ICUs, wearing respirators and gowns or increasing ventilation rate during and after patient visitation is required to maintain indoor air quality and probably decrease the risk of patient infection.