Healthcare worker protection against mpox contamination: position paper of the French Society for Hospital Hygiene.

In the context of the recent re-emergence of mpox worldwide, the French Society for Hospital Hygiene (SF2H) performed a literature review of the transmission paths and proposed specific recommendations for healthcare workers (HCWs) caring for patients with suspected or confirmed MPXV. In developed countries, the risk of contamination among HCWs in healthcare facilities seemed to be very low, limited to contamination through needle stick injuries. Two additional contamination cases were reported and not fully explained. Beyond healthcare settings, the analysis of the literature highlighted (i) a main contamination route during sexual intercourse, mainly among men who have sex with men, and (ii) a very low secondary attack rate in other contexts, such as schools or jails. Numerous studies have reported molecular or virus identification on surfaces or in the air surrounding patients, without any association with the low secondary case incidence; moreover, the minimum infectious dose through air or mucosal exposure is still unknown. Owing to the lack of evidence of MPXV respiratory transmission in the healthcare setting, the SF2H recommends the implementation of standard and contact precautions combined with medical/surgical mask use. Owing to the lack of evidence of transcutaneous contamination, the SF2H recommends the use of gloves only if contact with cutaneous lesions or mucous membranes occurs. Regarding the risk of contamination from the environment in healthcare facilities, additional studies must be conducted to investigate this.

Radiative relaxation in isolated large carbon clusters: Vibrational emission versus recurrent fluorescence.

Recurrent fluorescence (RF) from isolated carbon clusters containing between 24 and 60 atoms is theoretically investigated as a function of internal energy, cluster size, and structural features. The vibrational relaxation kinetics and the associated IR emission spectra are determined by means of a Monte Carlo approach with vibrational density of states computed in the harmonic approximation. RF is generally found to be highly competitive with vibrational emission. The behaviors predicted for clusters of various sizes and archetypal structures indicate that the IR emission spectra are strongly influenced by RF, an energy gap law being obtained for the evolution of the RF rate constant depending on the electronic excitation state. The present results are relevant to the photophysics of the interstellar medium and could contribute to elucidating the carriers of the extended red emission bands and the continuum emission lying below the aromatic infrared bands believed to originate from mixed aromatic-aliphatic compounds.

Atomistic modeling of the infrared response of fullerenes under hydrostatic pressure.

The anharmonic infrared spectrum of individual C60 and C70 fullerenes under hydrostatic pressure was theoretically computed by means of atomistic simulations. Using a tight-binding model for the fullerenes and a simple particle-based pressure-transmitting fluid, the structural and vibrational properties were determined at room temperature and up to 20 GPa. All properties generally exhibit relative variations that are linear with increasing pressure, but whose magnitude can be comparable to pure thermal effects. The bond length contraction usually agrees with existing results, and for C70 our approach manages to reproduce the occasionally negative pressure coefficient found for some low-frequency modes in experiments.

Fighting the good fight: the fallout of fake news in infection prevention and why context matters.

Although misinformation has always existed, the scope and speed at which fake news can reach even the most remote corners of the globe is a modern phenomenon. In the field of infection prevention and control (IPC), we like to believe that our dedication to the field and the process of conducting science protects us from the ravages of 'bad buzz' and fake news. This misconception leads medical professionals to underestimate the negative effects of misinformation on public health. This paper focuses on the nexus of what is happening between the field of IPC and the public. Its aim is to examine how information gets distorted and amplified between the medical community and the public, and outline some of the issues that deserve further attention. It looks at a number of case studies which show that even one badly conducted study can have a severe negative impact on public health, and that a well-conducted study can be distorted to make people believe something fallacious. In the current system of publishing and the proliferation of online journals that publish without peer review, 'bad buzz' and fake news can quickly do a good deal of damage.

Size Effect in the Ionization Energy of PAH Clusters.

We report the first experimental measurement of the near-threshold photoionization spectra of polycyclic aromatic hydrocarbon clusters made of pyrene C16H10 and coronene C24H12, obtained using imaging photoelectron-photoion coincidence spectrometry with a VUV synchrotron beamline. The experimental results of the ionization energy are compared to calculated ones obtained from simulations using dedicated electronic structure treatment for large ionized molecular clusters. Experiment and theory consistently find a decrease of the ionization energy with cluster size. The inclusion of temperature effects in the simulations leads to a lowering of this energy and to quantitative agreement with the experiment. In the case of pyrene, both theory and experiment show a discontinuity in the IE trend for the hexamer. This work demonstrates the ability of the models to describe the electronic structure of PAH clusters and suggests that these species are ionized in astronomical environments where they are thought to be present.

Sharp Decrease of Reported Occupational Blood and Body Fluid Exposures in French Hospitals, 2003-2012: Results of the French National Network Survey, AES-RAISIN.

OBJECTIVE: To assess the temporal trend of reported occupational blood and body fluid exposures (BBFE) in French healthcare facilities. METHOD: Retrospective follow-up of reported BBFE in French healthcare facilities on a voluntary basis from 2003 to 2012 with a focus on those enrolled every year from 2008 to 2012 (stable cohort 2008-12). FINDINGS: Reported BBFE incidence rate per 100 beds decreased from 7.5% in 2003 to 6.3% in 2012 (minus 16%). Percutaneous injuries were the most frequent reported BBFE (84.0% in 2003 and 79.1% in 2012). Compliance with glove use (59.1% in 2003 to 67.0% in 2012) and sharps-disposal container accessibility (68.1% in 2003 to 73.4% in 2012) have both increased. A significant drop in preventable BBFE was observed (48.3% in 2003 to 30.9% in 2012). Finally, the use of safety-engineered devices increased from 2008 to 2012. CONCLUSION: Of the 415,209 hospital beds in France, 26,158 BBFE could have occurred in France in 2012, compared with 35,364 BBFE in 2003. Healthcare personnel safety has been sharply improved during the past 10 years in France.

How infection control teams can assess their own performance and enhance their prestige using activity and outcome indicators for public reporting.

In France, infection control (IC) practitioners appeared in the late 1970s. In 1995, French health authorities formally introduced the concept of IC teams, which became mandatory in November 1999. Confidential IC annual reports for each hospital became mandatory in 2000. Under pressure from consumer associations, the Ministry of Health introduced IC performance indicators for public reporting in 2004, the first being known as ICALIN. Although the annual IC report was intended to be a hospital report, in practice it was often considered to be the IC team's report, so IC teams began to be held accountable for the performance of their hospitals against IC indicators. Several IC teams thought that the report failed to reflect the volume and range of their activities, especially in terms of counselling. However, most of them recognized the benefit of public reporting, as their work was at least under scrutiny and recognized as useful. Using indicators to evaluate IC performance thus provided a real boost for IC teams in France. Indicators must be refined periodically if they are to be sustainable. Further work on core competencies for hospital hygiene professionals is needed in France to improve their performance and credibility. Should an IC team be accountable for nosocomial infection in its hospital? The answer 'no' might seem strange, but so might an unqualified 'yes'.

Low-energy vibrational spectra of flexible diphenyl molecules: biphenyl, diphenylmethane, bibenzyl and 2-, 3- and 4-phenyltoluene.

Gas phase absorption far-infrared (FIR) spectra of six flexible hydrocarbon molecules containing two phenyl groups -biphenyl, diphenylmethane, bibenzyl and 2-, 3-, 4-phenyltoluene- are reported for the first time, allowing an accurate determination of most of their active low-frequency vibrational modes. DFT calculations have been carried out at the harmonic and perturbative anharmonic levels to predict the vibrational spectra of these molecules and unambiguously assign observed vibrational modes.

Atomistic modeling of vibrational action spectra in polyatomic molecules: nuclear quantum effects.

The response of a polyatomic molecule to an infrared (IR) laser pulse of varying frequency has been simulated by classical molecular dynamics simulations and by quantum methods based on the path-integral framework (PIMD), as well as quantum thermal baths (QTBs). The outcome of the trajectories was subsequently processed to predict a dissociation spectrum, from the precalculated rate constant. Naphthalene described by a tight-binding potential energy surface was chosen as a testing ground for the present problem, possibly emitting an hydrogen atom after a 12 ps long pulse. At low field intensities, the heating efficiency of the pulse is found to vary similarly as the IR absorption spectrum for all methods considered, reflecting the validity of linear response in this regime. At fields that are sufficiently high to induce statistical dissociation over mass spectrometry timescales, marked differences appear with the spectral features exhibiting additional broadenings and redshift, especially for quantum mechanical descriptions of nuclear motion. Those excessive broadenings are mostly caused by anharmonicities but also convey the inherent approximations of the semiclassical QTB method and point at limitations of the PIMD simulations when used in such strong out-of-equilibrium conditions.

Intramolecular Processes Revealed Using UV-Laser-Induced IR-Fluorescence: A New Perspective on the "Channel Three" of Benzene.

Radiative relaxation in the infrared (IR) is common following nonradiative electronic relaxation processes, but it is rarely measured. We present ultraviolet laser-induced infrared fluorescence (UV-LIIRF) excitation spectroscopy and dispersed UV-LIIRF spectroscopy of gas phase benzene vibronically excited around the onset of channel 3, using a homemade spectrometer. We found that the vibrational IR fluorescence yield is clearly higher when benzene is excited above the onset than when it is excited below. Significant changes in dispersed IR emission profiles resulting from excitations below and above the onset of channel 3 were also observed. These results suggest that isomerization of benzene toward fulvene occurs efficiently below the opening of channel 3 and confirm that channel 3 involves a photophysical relaxation pathway that efficiently competes with isomerization.

Validation of the French version of the Hospital Survey on Patient Safety Culture questionnaire.

OBJECTIVE: To assess the psychometric properties of the French version of the Hospital Survey on Patient Safety Culture questionnaire (HSOPSC) and study the hierarchical structure of the measured dimensions. DESIGN: Cross-sectional survey of the safety culture. SETTING: 18 acute care units of seven hospitals in South-western France. PARTICIPANTS: Full- and part-time healthcare providers who worked in the units. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Item responses measured with 5-point agreement or frequency scales. Data analyses A principal component analysis was used to identify the emerging components. Two structural equation modeling methods [LInear Structural RELations (LISREL) and Partial Least Square (PLS)] were used to verify the model and to study the relative importance of the dimensions. Internal consistency of the retained dimensions was studied. A test-retest was performed to assess reproducibility of the items. RESULTS: Overall response rate was 77% (n = 401). A structure in 40 items grouped in 10 dimensions was proposed. The LISREL approach showed acceptable data fit of the proposed structure. The PLS approach indicated that three dimensions had the most impact on the safety culture: 'Supervisor/manager expectations & actions promoting safety' 'Organizational learning-continuous improvement' and 'Overall perceptions of safety'. Internal consistency was above 0.70 for six dimensions. Reproducibility was considered good for four items. CONCLUSIONS: The French HSOPSC questionnaire showed acceptable psychometric properties. Classification of the dimensions should guide future development of safety culture improving action plans.

Should public reporting be made for performance indicators on healthcare-associated infections?

There are still many uncertainties regarding the benefit of public reporting on indicators of healthcare-associated infections. Publishing the results of performance indicators in healthcare facilities seems to stimulate quality insurance activity, but for the moment, without any demonstrated impact on the rates of healthcare-associated infections. Furthermore, it is not proved that public reporting of these results is beneficial. The French Society for Hospital Hygiene, in this synthesis, considered the advantages and drawbacks of public reporting of healthcare-associated infections. Beyond the difficult choice of indicators, public reporting of such indicators requires taking many precautions listed in this article, including a broad dialogue between the various stakeholders involved, a test period, and mandatory control of the produced indicator validity by health authorities.

Amplification of anharmonicities in multiphoton vibrational action spectra.

The influence of one or several infrared laser pulses on the stability of bare and argon-tagged sodium chloride clusters is investigated theoretically by a combination of computational methods involving explicit molecular dynamics and properly calibrated unimolecular rate theories. The fragmentation spectra obtained by varying the laser frequency in the far-IR range is compared to the linear absorption spectrum resulting from the dipole moment autocorrelation function. Under appropriate laser field parameters, the action spectra are found to resemble the absorption spectra quite accurately in terms of positions, line widths, and even relative intensities. However, the action spectra exhibit residual and systematic redshifts of a few percent, which are partly due to the finite spectral bandwidth but are amplified by the progressive heating by the laser. A quantitative analysis suggests that these anharmonicity effects should generally arise upon multiple photon absorption.

Temperature effects on the rovibrational spectra of pyrene-based PAHs.

Absorption infrared spectra have been computed for a variety of polycyclic aromatic hydrocarbon molecules of the pyrene family, taking into account anharmonicity and temperature effects, rovibrational quantization, and couplings. The energy levels are described by a second-order perturbative expansion of the rovibrational Hamiltonian in the vibrational and rotational quantum numbers, as relevant for a symmetric-top molecule, with ingredients obtained from quantum chemistry calculations. Multicanonical Monte Carlo simulations are carried out to compute bidimensional IR intensity histograms as a function of total energy and vibrational frequency, which then provide the absorption spectrum at arbitrary temperatures via a Laplace transformation. The main spectral features analyzed for neutral, anionic, and cationic pyrene indicate a strong dependence on temperature, in agreement with existing laboratory experiments, and a significant contribution of rotational degrees of freedom to the overall broadenings. The spectral shifts and broadenings reveal some sensitivity of anharmonicities to the charge and protonation states and, in the case of protonated pyrene and pyrenyl cation, on possible isomers and between aromatic and aliphatic C-H bands. Implications of the present work to the general issue of interstellar emission features are discussed.

Antibiotic stewardship programmes: legal framework and structure and process indicator in Southwestern French hospitals, 2005-2008.

French hospitals are required to implement antibiotic stewardship programmes (ABS) to improve antibiotic use. We analysed the legal framework on ABS and assessed its impact on hospitals' ABS development in Southwestern France. For each official text, required measures, date of issue, means of control and incentives were analysed. Annual retrospective surveys were conducted in 84 hospitals from 2005 to 2008 to monitor implementation of ABS components: organisation, resources and actions. Evolution of individual measures and of a structure and process indicator (SPI) reflecting ABS was described for each hospital. From 2002, official texts issued by health authorities set out requirements on ABS, based on previous professional guidelines. Incentives and means of control were reinforced in 2006 and in 2007 with mandatory reporting of SPI for public disclosure. ABS implementation improved during the course of the study period. In 2008, at least 98% of hospitals had implemented formularies, antibiotic committees, surgical prophylaxis guidelines, and monitored antibiotic use; antibiotic advisors were appointed in 85% of hospitals. Little progress was made regarding time dedicated by pharmacists to antibiotic management and restrictive dispensation using stop-orders. Computerised tools, continuing education and audits remained under-used. SPI values were higher in private hospitals and rehabilitation centres than in others. Official texts and the SPI public disclosure increased professionals' and hospital managers' commitment to develop ABS, resulting in improvements. However, some actions still need to be reinforced. It appears crucial to monitor practical implementation to better approach ABS effectiveness and to adapt requirements.

Finite-temperature infrared spectroscopy of polycyclic aromatic hydrocarbon molecules. II. Principal mode analysis and self-consistent phonons.

Following previous work [F. Calvo et al. J. Chem. Phys. 132, 124308 (2010)], infrared spectra of several polycyclic aromatic hydrocarbon molecules are simulated with classical and quantum molecular dynamics trajectories. The interactions are modeled using a tight-binding potential energy surface and quantum delocalization is accounted for using the partially adiabatic centroid and ring-polymer molecular dynamics frameworks, both built upon the path-integral representation. The spectra obtained directly by Fourier transformation of the dipole moment autocorrelation function are here compared with several quasiharmonic approximations that provide additional information about the vibrational modes. A principal mode analysis (PMA) is carried out from the covariance matrix of atomic displacements in classical and quantum trajectories. The method systematically overestimates the line shifts due to anharmonicities, except in the power spectra of atomic displacements, and is not robust in predicting IR intensities for such large molecules. Alternatively, effective normal modes have also been determined by adapting the self-consistent phonon (SCP) theory of condensed matter physics to the present tight-binding model, in both classical and quantum mechanical descriptions. The SCP approximation turns out as semiquantitative in estimating the redshift of tight stretching modes, and performs better for classical systems. More problematic, it predicts that many low- or medium-frequency modes should be blueshifted, in contradiction with the molecular dynamics results. The sets of anharmonic normal modes extracted from the PMA and SCP approaches reveal important mixings within the tightest C-H and C-C stretching modes, which are also manifested on the corresponding power spectra.

Finite temperature infrared spectroscopy of polycyclic aromatic hydrocarbon molecules: path-integral molecular dynamics.

The vibrational spectra of the naphthalene, pyrene, and coronene molecules have been computed in the 0-3500 cm(-1) infrared range using classical and quantum molecular dynamics simulations based on a dedicated tight-binding potential energy surface. The ring-polymer molecular dynamics (RPMD) and partially adiabatic centroid molecular dynamics (CMD) methods have been employed to account for quantum nuclear effects. The contributions of quantum delocalization to the line shift and broadening are significant in the entire spectral range and of comparable magnitude as pure thermal effects. While the two methods generally produce similar results, the CMD method may converge slower at low temperature with increasing Trotter discretization number. However, and contrary to the CMD method, the RPMD approach suffers from serious resonance problems at high frequencies and low temperatures.

Finite-temperature IR spectroscopy of polyatomic molecules: a theoretical assessment of scaling factors.

With a recently developed simulation method (Basire, M.; et al. J. Phys. Chem. A 2009, 113, 6947), the infrared vibrational spectra of several polyatomic molecules are calculated over a broad range of temperature, taking into account quantum, anharmonic, and couplings effects. Anharmonic force fields, generated from static first-principle calculations, are sampled in the microcanonical ensemble to provide energy-resolved absorption intensities and their finite temperature analogues after Laplace transformation. Effective anharmonic frequencies are characterized as a continuous function of temperature for vinyl fluoride, the N-acetyl-Phe-NH(2) peptide, and protonated naphthalene. These frequencies generally deviate increasingly from the harmonic value with increasing temperature, although the overestimation due to the harmonic approximation is particularly salient for high-frequency modes. Anharmonicities may also be sufficient to alter structural assignment of experimental spectra with respect to empirically scaled harmonic bands. These results emphasize some possible limitations and inaccuracies inherent to using such static scaling factors for correcting harmonic IR spectra.