"Water or not water: That is the question." Analysis of costs and consumption of the operating theaters in a greener perspective.

OBJECTIVE: To compare the amounts of water and plastic used in surgical hand washing with medicated soaps and with alcohol-based products and to compare costs and consumption in a year, based on scheduled surgical activity. METHOD: This retrospective study was carried out at Udine's Gynecology Operating Block from October to November 2022. We estimated the average amount of water with a graduated cylinder and the total cost of water usage based on euros/m3 indicated by the supplier; for each antiseptic agent we collected the data relevant to wash time, amount of water and product used per scrub, number of handscrubs made with every 500 mL bottle and cost of a single bottle. We put data into two hypothetical contexts, namely WHO guidelines and manufacturers' recommendations. Data were subjected to statistical analysis. RESULTS: The daily amount of water using povidone-iodine, chlorhexidine-gluconate and alcohol-based antiseptic agents was 187.6, 140.7 and 0 L/day (P value = 0.001), respectively; A total of 69 000 L/year of water would be saved if alcohol-based products were routinely used. A single unit of an alcohol-based product allows three times as many handscrubs as any other product (P value = 0.001) with consequent reduction in plastic packaging. CONCLUSION: Despite the cost saving being negligible, choosing alcohol-based handrub over medicated soap handrub - on equal antiseptic efficacy grounds - could lead to a significant saving of water and plastic, thus making our operating theaters more environmentally friendly.

Vegetable oil-based surfactants are adjuvants that enhance the efficacy of neonicotinoid insecticides and can bias susceptibility testing in adult mosquitoes.

BACKGROUND: The standard operating procedure for testing the susceptibility of adult mosquitoes to neonicotinoid or butenolide insecticides recommends using a vegetable oil ester (Mero) as a surfactant. However, there is growing evidence that this adjuvant contains surfactants that can enhance insecticide activity, mask resistance and bias the bioassay. METHODOLOGY/PRINCIPAL FINDINGS: Using standard bioassays, we tested the effects of commercial formulations of vegetable oil-based surfactants similar to Mero on the activity of a spectrum of active ingredients including four neonicotinoids (acetamiprid, clothianidin, imidacloprid and thiamethoxam) and two pyrethroids (permethrin and deltamethrin). We found that three different brands of linseed oil soap used as cleaning products drastically enhanced neonicotinoid activity in Anopheles mosquitoes. At 1% (v/v), the surfactant reduced the median lethal concentration, LC50, of clothianidin more than 10-fold both in susceptible and in resistant populations of Anopheles gambiae. At 1% or 0.5% (v/v), linseed oil soap restored the susceptibility of adult mosquitoes fully to clothianidin, thiamethoxam and imidacloprid and partially to acetamiprid. By contrast, adding soap to the active ingredient did not significantly affect the level of resistance to permethrin or deltamethrin suggesting that vegetable oil-based surfactants specifically enhance the potency of some classes of insecticides. CONCLUSIONS/SIGNIFICANCE: Our findings indicate that surfactants are not inert ingredients, and their use in susceptibility testing may jeopardize the ability to detect resistance. Further research is needed to evaluate the potential, the limitations and the challenges of using some surfactants as adjuvants to enhance the potency of some chemicals applied in mosquito control.

"Soap bubble" sign as an imaging marker for posterior fossa ependymoma Group B.

PURPOSE: To investigate the predictive value of the "soap bubble" sign on molecular subtypes (Group A [PFA] and Group B [PFB]) of posterior fossa ependymomas (PF-EPNs). METHODS: MRI scans of 227 PF-EPNs (internal retrospective discovery set) were evaluated by two independent neuroradiologists to assess the "soap bubble" sign, which was defined as clusters of cysts of various sizes that look like "soap bubbles" on T2-weighted images. Two independent cohorts (external validation set [n = 31] and prospective validation set [n = 27]) were collected to validate the "soap bubble" sign. RESULTS: Across three datasets, the "soap bubble" sign was observed in 21 PFB cases (7.4% [21/285] of PF-EPNs and 12.9% [21/163] of PFB); none in PFA. Analysis of the internal retrospective discovery set demonstrated substantial interrater agreement (1st Rating: κ = 0.71 [0.53-0.90], 2nd Rating: κ = 0.83 [0.68-0.98]) and intrarater agreement (Rater 1: κ = 0.73 [0.55-0.91], Rater 2: κ = 0.74 [0.55-0.92]) for the "soap bubble" sign; all 13 cases positive for the "soap bubble" sign were PFB (p = 0.002; positive predictive value [PPV] = 100%, negative predictive value [NPV] = 44%, sensitivity = 10%, specificity = 100%). The findings from the external validation set and the prospective validation set were similar, all cases positive for the "soap bubble" sign were PFB (p < 0.001; PPV = 100%). CONCLUSION: The "soap bubble" sign represents a highly specific imaging marker for the PFB molecular subtype of PF-EPNs.

Best products for skin antisepsis.

BACKGROUND: Skin antiseptics are used for several purposes before surgical procedures, for bathing high-risk patients as a means of reducing central line-associated infections and other health care associated infections. METHODS: A PubMed search was performed to update the evidence on skin antiseptic products and practices. RESULTS: Current guidelines for prevention of surgical site infections (SSIs) recommend preoperative baths or showers with a plain or antimicrobial soap prior to surgery, but do not make recommendations on the timing of baths, the total number of baths needed, or about the use of chlorhexidine gluconate (CGH)-impregnated cloths. Randomized controlled trials have demonstrated that pre-operative surgical hand antisepsis using an antimicrobial soap or alcohol-based hand rub yields similar SSI rates. Other studies have reported that using an alcohol-based hand rub caused less skin irritation, was easier to use, and required shorter scrub times than using antimicrobial soap. Current SSI prevention guidelines recommend using an alcohol-containing antiseptic for surgical site infection. Commonly used products contain isopropanol combined with either CHG or with povidone-iodine. Surgical site preparation protocols for shoulder surgery in men may need to include coverage for anaerobes. Several studies suggest the need to monitor and improve surgical site preparation techniques. Daily bathing of intensive care unit (ICU) patients with a CHG-containing soap reduces the incidence of central line-associated bloodstream infections (CLABSIs). Evidence for a similar effect in non-ICU patients is mixed. Despite widespread CHG bathing of ICU patients, numerous barriers to its effective implementation exist. Measuring CHG levels on the skin is useful for identifying gaps in coverage and suboptimal skin concentrations. Using alcohol-based products with at least 2% CHG for skin preparation prior to central line insertion reduces CLABSIs. CONCLUSIONS: Progress has been made on skin antisepsis products and protocols, but improvements in technique are still needed.

Negative formaldehyde release from textiles washed with a formaldehyde-containing laundry soap according to manufacturer instructions: An application of chromotropic acid testing.

BACKGROUND: Formaldehyde is a common preservative used to prevent microbial growth in water. It can be found in personal care products and household cleaning products, including laundry detergents. Formaldehyde has frequently been recognised as a cause of allergic contact dermatitis, but whether it remains present in textiles washed with formaldehyde-containing laundry detergents is unknown. OBJECTIVES: This study aimed to utilise the chromotropic acid method (CAM) to assess formaldehyde release from textiles washed with a laundry detergent known to contain formaldehyde. MATERIALS AND METHODS: Textiles were laundered with a detergent containing calcium formate at four concentrations (0×, 0.5×, 1× and 5× the recommended amount per manufacturer label) and kept wet or allowed to dry. Select textiles were subjected to an additional rinse cycle. Textiles were then tested utilising the CAM. A sample of the pure laundry detergent was also tested using the CAM. RESULTS: The CAM was positive only for wet textiles washed at 5× the recommended concentration of detergent and pure detergent. All dry textiles were negative. CONCLUSIONS: Formaldehyde release was not detected from any textiles washed following the manufacturer's recommendations. Once dry, it is likely safe for formaldehyde-allergic patients to wear textiles washed with formaldehyde-containing detergents.

Aluminum soap nanoparticles-lignin powder form phase-selective gelator as an efficient sorbent for oils/water separation.

Rapid and efficient recovery of oil spill is the key link for oil spill remediation, and also a great challenge. Here, the organogelator-polymerized porous matrix composed of adsorbents and organogelators can provide a new strategy for solving this problem. The gelling mechanism of aluminum 12-hydroxystearate (Al HSA) to form spherical nano micelles in solvents was investigated via UV-vis, FT-IR, and XRD. A creative method for aluminum soap-lignin gelator (OTS-AL/Al HSA) syntheses was put forward through the saponification of 12-hydroxystearic acid (HSA) and lignin via epichlorohydrin (ECH) crosslinking. By adjusting the ECH content, the growth of Al HSA nanoparticles (15-40 nm) on lignin can be realized, and the accordingly increased roughness endowed gelator with better hydrophobicity (WCA of 134.6°) before octadecyltrichlorosilane (OTS) modification. Thanks to the porous structures, the gelator powder exhibited a high sorption capacity in the range of 3.5-5.2 g g-1 for oils and organic solvents. Rheological studies demonstrated high mechanical strength of gels (>1.6 × 105 pa) and the gelator still retained 70% sorption capacity after 6 gelation-distillation cycles. The gelation characteristics of OTS-AL/Al HSA were attributed to the rapid sorption of oils by lignin and the self-assembly of Al HSA nano micelles on lignin to form an aggregated network structure trapping oils, thus realizing the synergistic effect of oil sorption-gelation.

Prevention of radiation dermatitis with skin hygiene and washing: a systematic review and meta-analysis.

PURPOSE: This systematic review and meta-analysis aims to evaluate the effects of washing in patients receiving radiotherapy (RT) on radiation dermatitis (RD) severity. METHODS: A literature search was performed using Ovid MEDLINE, Embase, and Cochrane databases between January 1, 1946, and January 31, 2023. Four randomized controlled trials (RCTs) studying the effects of washing with or without soap on RD were identified. A meta-analysis was conducted for clinician-reported outcomes using RevMan 5.4 and a narrative synthesis for patient-reported outcomes due to a lack of reported data amenable to quantitative comparison in accordance with the Synthesis Without Meta-analysis (SWiM) guidelines. The Cochrane Risk of bias (RoB2) and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria were used to assess risk of bias and certainty of evidence, respectively. RESULTS: Two RCTs met the inclusion criteria for meta-analysis. Washing with or without soap significantly reduced the incidence of severe RD (OR: 0.32, 95% CI: 0.19-0.55, p < 0.01) and moist desquamation (OR: 0.25, 95% CI: 0.12-0.52, p < 0.01). Two of four trials found an association between washing and reduced itching score (p = 0.38). Pain score was not found to be significantly different with or without washing in any of the four studies (p = 0.07). The two studies that assessed burn scores did not detect any difference between the washing group versus no washing group (p = 0.25). Washing was associated with improved quality of life (QoL) measures in one study. CONCLUSION: Washing with or without soap during RT resulted in less severe RD and less moist desquamation. Given the QoL benefits of washing, it should be advocated as part of routine skin care during RT.

Discrimination and authentication of lard blending with palm oil in cosmetic soap formulations.

BACKGROUND: The employment of Fourier transforms infrared (FT-IR) spectroscopy combined with chemometrics for determination and quantification of lard in a binary blend with palm oil in a cosmetic soap formulations. OBJECTIVE: To determine and quantify lard as an adulterant in a binary blend with palm oil in a cosmetic soap formulations by FT-IR and multivariate analysis. METHODS: Fatty acids in lard, palm oil and binary blends were extracted via liquid-liquid extraction and were subjected to FTIR spectrometry, combined with principal component analysis (PCA) and discriminant analysis (DA) for the classification of lard in cosmetic soap formulations via two DA models: Model A (percentage of lard in cosmetic soap) and Model B (porcine and non-porcine cosmetic soap). Linear regression (MLR), partial least square regression (PLS-R) and principal components regression (PCR) were used to assess the degree of adulteration of lard in the cosmetic soap. FINDINGS: The FTIR spectrum of palm oil slightly differed from that of lard at the wavenumber range of 1453 cm -1 and 1415 cm -1 in palm oil and lard, respectively, indicating the bending vibrations of CH2 and CH3 aliphatic groups and OH carboxyl group respectively. Both of the DA models could accurately classify 100% of cosmetic soap formulations. Nevertheless, less than 100% of verification value was obtained when it was further used to predict the unknown cosmetic soap sample suspected of containing lard or a different percentage of lard. The PCA for Model A and Model B explained a similar cumulative variability (CV) of 92.86% for the whole dataset. MLR and PCR showed the highest determination coefficient (R2) of 0.996, and the lowest relative standard error (RSE) and mean square error (MSE), indicating that both regression models were effective in quantifying the lard adulterant in cosmetic soap. CONCLUSION: FTIR spectroscopy coupled with chemometrics with DA, PCA and MLR or PCR can be used to analyse the presence of lard and quantify its percentage in cosmetic soap formulations.

CONTEXTE: Combinée à la chimiométrie, la spectroscopie infrarouge à transformée de Fourier (SI-TF) permet de déterminer et de quantifier la présence du saindoux dans un mélange binaire avec de l'huile de palme parmi des formulations de savon cosmétique. OBJECTIF: Déterminer et quantifier le saindoux comme adultérant dans un mélange binaire avec de l'huile de palme parmi des formulations de savon cosmétique par SI-TF et analyse multivariée. MÉTHODES: Les acides gras dans le saindoux, l'huile de palme et les mélanges binaires ont été extraits par extraction liquide-liquide, puis ont été soumis à une SI-TF. Ils ont également fait l'objet d'une analyse en composantes principales (ACP) et d'une analyse discriminante (AD) pour la classification du saindoux dans les formulations de savons cosmétiques via deux modèles d'AD : le modèle A (pourcentage de saindoux dans le savon cosmétique) et le modèle B (savon cosmétique de porc et non de porc). Le degré d'altération du saindoux dans le savon cosmétique a été évalué selon une régression linéaire (régression L), une régression des moindres carrés partiels (régression PLS) et une régression sur composantes principales (régression CP). RÉSULTATS: Le spectre SI-TF de l'huile de palme différait légèrement de celui du saindoux sur la plage de nombre d'ondes de 1 453 cm −1 et 1 415 cm −1 dans l'huile de palme et le saindoux, respectivement, et indiquait les vibrations de flexion des groupes aliphatiques CH2 et CH3, et du groupe carboxyle OH, respectivement. Les deux modèles d'AD ont permis de classer avec précision 100 % des formulations de savon cosmétique. Néanmoins, la valeur de vérification obtenue s'est avérée inférieure à 100 % une fois les modèles utilisés pour prédire l'échantillon de savon cosmétique inconnu suspecté de contenir du saindoux ou un pourcentage de saindoux différent. L'ACP du modèle A et du modèle B expliquait une variabilité cumulée (VC) similaire de 92,86 % pour l'ensemble de l'ensemble des données. La régression L et la régression PLS ont montré le coefficient de détermination le plus élevé (R2), soit 0,996, ainsi que l'erreur type relative (ETR) et l'erreur carrée moyenne (EMM) les plus faibles, indiquant que les deux modèles de régression ont été efficaces pour quantifier le saindoux adultérant dans le savon cosmétique. CONCLUSION: Couplée à la chimiométrie avec une AD, une ACP et une régression L ou une régression PLS, la SI-TF permet d'analyser la présence de saindoux et de quantifier son pourcentage dans les formulations de savon cosmétique.

Extended skin cleaning on the shoulder with chlorhexidine reduces the cutaneous bacterial load but fails to decrease suture contamination in patients undergoing arthroscopy rotator cuff repair.

BACKGROUND: It remains unclear whether preoperative skin cleaning of the chin, neck, and chest with chlorhexidine soap can reduce suture contamination by Cutibacterium acnes in patients undergoing arthroscopic rotator cuff repair. METHODS: This study included patients who underwent primary arthroscopic rotator cuff repair. Exclusion criteria included age <18 years, previous shoulder surgery, history of shoulder infection, and allergy to chlorhexidine. Patients were randomized into 3 groups. Patients in the control group cleaned their skin with soap and water, as usual. Patients in the shoulder group cleaned their shoulders with chlorhexidine soap 3 days before surgery, whereas patients in the extended shoulder group additionally cleaned their chest, back, neck, and face with chlorhexidine soap. On the day of surgery, skin swab samples were obtained from the shoulder after surgical draping. After rotator cuff repair, sutures were cut from the anchor ends. Both traditional culture methods and polymerase chain reaction (PCR) were used. RESULTS: Ninety patients were enrolled (32 in the control group, 29 in the shoulder group, and 29 in the extended shoulder group) in the present study. The culture-positive rate from the posterior shoulder skin samples in the extended shoulder group (17.2%) was significantly lower than that in the control (40.6%) and shoulder (48.3%) groups (P = .036), whereas the culture-positive rates were not different among the 3 groups in other skin samples as well as the suture samples. The detection rates of C acnes in suture samples were 12.5%, 13.8%, and 17.2% in the control, shoulder, and extended shoulder groups, respectively (P = .603). CONCLUSION: Extensive skin cleaning of the shoulder region with chlorhexidine helps reduce the shoulder cutaneous bacterial load, but the detection of C acnes suture contamination in patients undergoing arthroscopic rotator cuff repair remained untouched regardless of the use of chlorhexidine soap in skin cleaning on the preoperative days.

Rheo-SAXS characterization of lead-treated oils: Understanding the influence of lead driers on artistic oil paint's flow properties.

From the 15th century onwards, painters began to treat their oils with lead compounds before grinding them with pigments. Such a treatment induces the partial hydrolysis of the oil triglycerides and the formation of lead soaps, which significantly modify the rheological properties of the oil paint. Organization at the supramolecular scale is thus expected to explain these macroscopic changes. Synchrotron Rheo-SAXS (Small Angle X-ray Scattering) measurements were carried out on lead-treated oils, with different lead contents. We can now propose a full picture of the relationship between structure and rheological properties of historical saponified oils. At rest, lead soaps in oil are organized as lamellar phases with a characteristic period of 50 Å. Under shear, the loss of viscoelastic properties can be linked to the modification of this organization. Continuous shear resulted in a preferential and reversible orientation of the lamellar domains which increased with the concentration of lead soaps. The parallel orientation predominates over the entire shear range (0-1000 s-1). Conversely, oscillatory shear coiled the lamellae into cylinders that oriented themselves vertically in the rheometer cell. This is the first report of such a vertical cylindrical structure obtained under shear from lamellae.

A randomised control trial using soap in the prevention of surgical site infection in Tanzania.

BACKGROUND: Surgical site infections (SSIs) are common and serious complications of surgery. Guidelines on preventing SSIs have been developed, but the role of preoperative bathing with plain soap among paediatric population is unclear. We aimed to assess the effectiveness of pre-operative bathing using plain soap in preventing SSIs among paediatric surgical patients. MATERIALS AND METHODS: An open-label, randomised trial was conducted at Muhimbili National Hospital in Tanzania. Preoperatively, patients in the intervention group washed their body using plain soap, while those in the control group did not. The primary outcome was SSI postoperatively. Statistical tests included χ2, Wilcoxon rank sum, and univariate and multivariable logistic regression. RESULTS: Of the 252 patients recruited,114 were randomised to the intervention arm. In the control arm, 40.6% (56/138) of participants developed SSIs compared to 11.4% (13/114) in the intervention arm (p < 0.01). After adjusting for confounding factors in multivariable analysis, the intervention reduced the odds of an SSI by 80% (OR: 0.20 [95% CI: 0.10, 0.41]; p < 0.01). Preoperative antibiotics were deemed to be an effect modifier of the association between the intervention and SSI (p = 0.05). The intervention significantly reduced the odds of an SSI by 88% among participants not given preoperative antibiotics (OR: 0.12 [95% CI: 0.05, 0.30]; p < 0.01). CONCLUSION: This study has shown that preoperative bathing with soap significantly reduces SSIs in paediatric surgical patients. It is a simple, cost effective and sustainable intervention. LEVEL OF EVIDENCE: Level II.

Investigation of used cooking oil on the formation of FOG deposits in sewer line clogging.

Fat, oil, and grease (FOG) deposits, resulting from saponification reaction, have been identified as the primary source of blockage of sewer pipes. This mainly emanates from the adhesion of these deposits on pipe walls, culminating in the sanitary sewer overflows (SSOs). This undesired phenomenon poses several challenges for municipalities, including environmental issues, health-related hazards, and an increase in incurred costs. Unlike the previous literature, the present study, for the first time, attempts to characterize the effect of used cooking oils (a mixture of different oils) as a perceived crux, triggering the genesis of deposits. The experimental results revealed that there exists a host of physical and chemical disparities between fresh oil calcium soaps (FOCSs) and used oil calcium soaps (UOCSs). Notably, when mixed with water, FOCSs produced non-miscible layers, whereas a homogenous, sticky, and viscous solution observed for UOCSs. Fourier transform infrared (FTIR) analysis casts light on the fact that the heating process would greatly influence the oil chemical structure and its resultant calcium soaps. In comparison with calcium chloride, as time elapsed, the optical microscope images illustrated that the calcium sulfate clots formation proceeded at an accelerated rate, delivering particles with larger sizes. Viscosity and adhesion are two prominent distinctions between soaps. In sharp contrast to soap produced from oil with a higher palmitic acid content, it was discerned that the oil containing less palmitic acid generates UOCSs with higher viscosity and adhesion than FOCSs. It can therefore be inferred that the distinct chemical structures driven by high temperature during the cooking process produce soaps with different characteristics as compared with fresh oil. This phenomenon would have a profound impact on the formation of the deposits in sewer lines.

Synthesis and characterization of selenium nanoparticles stabilized with cocamidopropyl betaine.

In this work, selenium nanoparticles (Se NPs) stabilized with cocamidopropyl betaine were synthesized for the first time. It was observed that Se NPs synthesized in excess of selenic acid had a negative charge with ζ-potential of -21.86 mV, and in excess of cocamidopropyl betaine-a positive charge with ξ = + 22.71 mV. The resulting Se NPs with positive and negative charges had a spherical shape with an average size of about 20-30 nm and 40-50 nm, respectively. According to the data of TEM, HAADF-TEM using EDS, IR spectroscopy and quantum chemical modeling, positively charged selenium nanoparticles have a cocamidopropylbetaine shell while the potential- forming layer of negatively charged selenium nanoparticles is formed by SeO32- ions. The influence of various ions on the sol stability of Se NPs showed that SO42- and PO43- ions had an effect on the positive Se NPs, and Ba2+ and Fe3+ ions had an effect on negative Se NPs, which corresponded with the Schulze-Hardy rule. The mechanism of coagulating action of various ions on positive and negative Se NPs was also presented. Also, influence of the active acidity of the medium on the stability of Se NPs solutions was investigated. Positive and negative sols of Se NPs had high levels of stability in the considered range of active acidity of the medium in the range of 1.21-11.98. Stability of synthesized Se NPs stability has been confirmed in real system (liquid soap). An experiment with the addition of Se NPs stabilized with cocamidopropyl betaine to liquid soap showed that the particles of dispersed phases retain their initial distributions, which revealed the stability of synthesized Se NPs.

The Use of Waterless Alcohol-based Antiseptic for Surgical Skin Preparation in Rhesus Macaques (Macaca mulatta).

Ensuring asepsis of the surgical site before surgery is an essential component of safe surgical practices to reduce the incidence of surgical site infections in veterinary medicine. The current accepted method of skin preparation is a multistep process that alternates either a povidone-iodine or chlorhexidine soap scrub with a 70% alcohol rinse. After cleansing, the site is left to dry before draping. The goal of this study was to assess the effectiveness of a waterless alcohol-based (WAB) antiseptic as part of a 2-step procedure after the soap scrub. WAB antiseptics are commonly used as a presurgical hand scrub for the surgeon as they evaporate quickly and provide effective antisepsis. Previous studies have examined the WAB antiseptics in small animal surgeries. We tested this approach in large animal surgery. Twenty-four rhesus macaques were divided into 4 groups that received one of the following treatments: saline and alcohol, iodine-alcohol-iodine, soap scrub/WAB, and chlorhexidine-alcohol-chlorhexidine. The surgical site was swabbed before and after treatment and plated to assess sterility. Overall, no colonies were recovered from skin treated with WAB antiseptic, establishing it as an effective alternative to the current standard protocol. This method will simplify the current 3-step procedure and reduce animal handling, the use of materials, and the time necessary for surgical preparation.

Identification and Safety Evaluation of Ochratoxin A Transformation Product in Rapeseed Oil Refining Process.

Ochratoxin A (OTA) is an important mycotoxin detected in edible oil, and it can be effectively removed by classical edible oil refining processes. However, the fate of OTA in the refining process has not been reported. In this study, we systematically tracked the OTA changes during the oil refining process by fortifying 100 µg/kg OTA in crude rapeseed oil. Results showed that about 10.57%, 88.85%, and 0.58% of OTA were removed during the degumming, deacidification, and decolorization processes. Among them, 16.25% OTA was transferred to the byproducts, including 9.85% in degumming wastewater, 5.68% in soap stock, 0.14% in deacidification wastewater, and 0.58% in the decolorizer; 83.75% OTA was found to transform into the lactone ring opened OTA (OP-OTA) during the deacidification stage, which is attributed to the hydrolysis of the lactone ring of OTA in the alkali refining. The OP-OTA was verified to distribute in the soap stock, and small amounts of OP-OTA could be transferred to deacidified wastewater when the OTA pollution level reached 500 µg/kg in crude rapeseed oil. The OP-OTA exhibited strong toxicity, especially nephrotoxicity, as reflected by the cell viability assay and in silico toxicity. Therefore, the safety of the soap stock processing products from OTA-contaminated rapeseed deserves attention.

Dispose with dish soap: A simple and convenient method to increase proper opioid disposal in postoperative pediatric patients.

BACKGROUND: The opioid abuse crisis is rampant in the United States. Children and adolescents are unique risk groups in this crisis; age-specific concerns include accidental ingestion and association with high-risk behaviors. Studies aimed at disposal are limited in pediatric patients. Our study aimed to determine whether an educational brochure detailing a simple opioid disposal method using dish soap could enhance disposal in postoperative pediatric patients. METHODS: A prospective survey study of pediatric plastic surgery patients at the St. Louis Children's Hospital was performed from January to December 2020. Patients were assigned into two groups: those who received the educational brochure at the time of surgery and those who did not. In clinic, patient caretakers completed anonymous preoperative and/or postoperative surveys regarding opioid use and disposal. RESULTS: Surveys of 326 patients were analyzed (188 preoperative, 120 pre/postoperative, and 18 postoperative). Prescribed opioids were all consumed in 19% of patients. Receiving the educational brochure significantly increased the opioid disposal of leftover medications: 78% versus 35% (OR 6.52, 95% CI [2.03, 21.37], p < 0.001). Although not statistically significant owing to small sample size (p = 0.09), 71.4% of families with excess opioids in the home preoperatively retained unused postoperative opioids versus 31.6% without preoperative opioids. CONCLUSIONS: Postoperative opioids are overprescribed for most pediatric plastic surgery patients. A simple brochure significantly increases proper postoperative opioid disposal, representing a cost-effective, convenient, risk-free method to decrease opioid misuse and accumulation in our communities.

The association between vaginal hygiene practices and spontaneous preterm birth: A case-control study.

BACKGROUND: Spontaneous preterm birth (SPTB) is a major cause of neonatal morbidity and mortality worldwide and defining its risk factors is necessary to reduce its prevalence. Recent studies have pointed out that bacterial vaginosis, a disturbance in the vaginal microbiome, is associated with SPTB. It is hypothesized that vaginal hygiene practices can alter the vaginal microbiome and are therefore associated with SPTB, but there are no studies investigating this matter. METHODS AND FINDINGS: A case-control study was conducted between August 2018 and July 2021 in two affiliated university medical centers in Amsterdam, the Netherlands. We included a total of 79 women with a SPTB and compared them with 156 women with a term birth. Women with uterine anomalies, a history of cervical surgery or major congenital anomalies of the fetus were excluded. All participants filled in a questionnaire about vaginal washing with water, soap or gel, the use of intravaginal douches and vaginal steaming, both before and during pregnancy. Most women washed vaginally with water, 144 (61.3%) women before pregnancy and 135 (57.4%) women during pregnancy. A total of 43 (18.3%) washed with soap before and 36 (15.3%) during pregnancy. Before pregnancy, 40 (17.0%) women washed with vaginal gel and 27 (11.5%) during pregnancy. We found that the use of vaginal gel before pregnancy (aOR 2.29, 95% CI: 1.08-4.84) and even more during pregnancy, was associated with SPTB (aOR 3.45, 95% CI: 1.37-8.67). No association was found between washing with water or soap, intravaginal douching, or vaginal steaming and SPTB. CONCLUSIONS: Our findings suggest that the use of vaginal gel is associated with SPTB. Women should be informed that vaginal use of gels might not be safe.

Conventional MRI Criteria to Differentiate Progressive Disease From Treatment-Induced Effects in High-Grade (WHO Grade 3-4) Gliomas.

BACKGROUND AND OBJECTIVES: Posttreatment radiologic deterioration of an irradiated high-grade (WHO grade 3-4) glioma (HGG) may be the result of true progressive disease or treatment-induced effects (TIE). Differentiation between these entities is of great importance but remains a diagnostic challenge. This study assesses the diagnostic value of conventional MRI characteristics to differentiate progressive disease from TIE in HGGs. METHODS: In this single-center, retrospective, consecutive cohort study, we included adults with a HGG who were treated with (chemo-)radiotherapy and subsequently developed a new or increasing contrast-enhancing lesion on conventional follow-up MRI. TIE and progressive disease were defined radiologically as stable/decreased for ≥6 weeks or Response Assessment in Neuro-Oncology progression and histologically as TIE without viable tumor or progressive disease. Two neuroradiologists assessed 21 preselected MRI characteristics of the progressive lesions. The statistical analysis included logistic regression to develop a full multivariable model, a diagnostic model with model reduction, and a Cohen kappa interrater reliability (IRR) coefficient. RESULTS: A total of 210 patients (median age 61 years, interquartile range 54-68, 189 male) with 284 lesions were included, of whom 141 (50%) had progressive disease. Median time to progressive disease was 2 (0.7-6.1) and to TIE 0.9 (0.7-3.5) months after radiotherapy. After multivariable modeling and model reduction, the following determinants prevailed: radiation dose (odds ratio [OR] 0.68, 95% CI 0.49-0.93), longer time to progression (TTP; OR 3.56, 95% CI 1.84-6.88), marginal enhancement (OR 2.04, 95% CI 1.09-3.83), soap bubble enhancement (OR 2.63, 95% CI 1.39-4.98), and isointense apparent diffusion coefficient (ADC) signal (OR 2.11, 95% CI 1.05-4.24). ORs >1 indicate higher odds of progressive disease. The Hosmer & Lemeshow test showed good calibration (p = 0.947) and the area under the receiver operating characteristic curve was 0.722 (95% CI 0.66-0.78). In the glioblastoma subgroup, TTP, marginal enhancement, and ADC signal were significant. IRR analysis between neuroradiologists revealed moderate to near perfect agreement for the predictive items but poor agreement for others. DISCUSSION: Several characteristics from conventional MRI are significant predictors for the discrimination between progressive disease and TIE. However, IRR was variable. Conventional MRI characteristics from this study should be incorporated into a multimodal diagnostic model with advanced imaging techniques. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that in patients with irradiated HGGs, radiation dose, longer TTP, marginal enhancement, soap bubble enhancement, and isointense ADC signal distinguish progressive disease from TIE.

Economic evaluation of pre-operative shower with antiseptic soap to prevent surgical site infections.

BACKGROUND: A pre-operative shower is recommended before surgery to prevent surgical site infections (SSIs). METHODS: We modelled the occurrence of SSIs and the potential savings for patients undergoing an antimicrobial soap (AS) shower prior to surgery at a French University Hospital level. RESULTS: AS shower prevented 209 SSIs, generating a potential saving of €632,210 per year. Results grouped by type of surgery showed annual savings of €26,537, €20,520 and €14,377 for orthopaedic, gynaecologic and obstetric, and digestive surgery, respectively. CONCLUSIONS: Despite the lack of published data surrounding the efficacy of AS in preventing SSIs, we demonstrated the potential savings and benefits of generalizing AS before surgical interventions.