Impact of drug storage systems: a quasi-experimental study with and without an automated-drug dispensing cabinet.

OBJECTIVE: To compare the costs and benefits of an automated-drug dispensing cabinet (ADC) versus traditional floor stock storage (TFSS). DESIGN: A quasi-experimental multicenter study conducted during 2015. SETTING: A teaching hospital (814 beds) equipped with 43 ADCs and a not-for-profit teaching hospital (643 beds) equipped with 38 TFSS systems, in Paris, France. PARTICIPANTS: All the wards of the two hospitals were included in the study. INTERVENTION(S): ADC versus TFSS. MAIN OUTCOME MEASURE(S): A composite outcome composed of cost and benefits. RESULTS: The total cost with payback period was substantially higher for the ADCs (574 006€ for 41 ADCs) than TFSS (190 305€ for 30 TFSS systems). The mean number of costly drugs and units were significantly higher for ADCs (P < 0.001). There was no significant difference in the mean number of overall drugs and units. There were significantly fewer urgent global deliveries with ADCs than TFSS units. Nurses' satisfaction with ADCs was high and the prevalence of medication process errors related to ADCs was low. No event due to storage errors was reported for ADCs and nine events were reported for TFSS units. On the contrary, informatic-related events increased with the use of ADCs, as expected. CONCLUSIONS: Overall, ADCs are well-established in wards and are particularly appreciated by nurses. A significant difference in the initial investment cost was confirmed, but it must be adjusted over time. This difference is offset in the long-term by gains in preparation time and fewer medication process errors, securing the medication process.

Photochemical Synthesis and Versatile Functionalization Method of a Robust Porous Poly(ethylene glycol methacrylate-co-allyl methacrylate) Monolith Dedicated to Radiochemical Separation in a Centrifugal Microfluidic Platform.

The use of a centrifugal microfluidic platform is an alternative to classical chromatographic procedures for radiochemistry. An ion-exchange support with respect to the in situ light-addressable process of elaboration is specifically designed to be incorporated as a radiochemical sample preparation module in centrifugal microsystem devices. This paper presents a systematic study of the synthesis of the polymeric porous monolith poly(ethylene glycol methacrylate-co-allyl methacrylate) used as a solid-phase support and the versatile and robust photografting process of the monolith based on thiol-ene click chemistry. The polymerization reaction is investigated, varying the formulation of the polymerisable mixture. The robustness of the stationary phase was tested in concentrated nitric acid. Thanks to their unique "easy-to-use" features, centrifugal microfluidic platforms are potential successful candidates for the downscaling of chromatographic separation of radioactive samples (automation, multiplexing, easy integration in glove-boxes environment, and low cost of maintenance).

Viable but not culturable forms of Legionella pneumophila generated after heat shock treatment are infectious for macrophage-like and alveolar epithelial cells after resuscitation on Acanthamoeba polyphaga.

Legionella pneumophila, the causative agent of legionellosis is transmitted to human through aerosols from environmental sources and invades lung's macrophages. It also can invade and replicate within various protozoan species in environmental reservoirs. Following exposures to various stresses, L. pneumophila enters a non-replicative viable but non-culturable (VBNC) state. Here, we evaluated whether VBNC forms of three L. pneumophila serogroup 1 strains (Philadelphia GFP 008, clinical 044 and environmental RNN) infect differentiated macrophage-like cell lines (U937 and HL-60), A549 alveolar cells and Acanthamoeba polyphaga. VBNC forms obtained following shocks at temperatures ranging from 50 to 70 °C for 5 to 60 min were quantified using a flow cytometric assay (FCA). Their loss of culturability was checked on BCYE agar medium. VBNC forms were systematically detected upon a 70 °C heat shock for 30 min. When testing their potential to resuscitate upon amoebal infection, VBNC forms obtained after 30 min at 70 °C were re-cultivated except for the clinical strain. No resuscitation or cell lysis was evidenced when using U937, HL-60, or A549 cells despite the use of various contact times and culture media. None of the strains tested could infect A. polyphaga, macrophage-like or alveolar epithelial cells after a 60-min treatment at 70 °C. However, heat-treated VBNC forms were able to infect macrophage-like or alveolar epithelial cells following their resuscitation on A. polyphaga. These results suggest that heat-generated VBNC forms of L. pneumophila (i) are not infectious for macrophage-like or alveolar epithelial cells in vitro although resuscitation is still possible using amoeba, and (ii) may become infectious for human cell lines following a previous interaction with A. polyphaga.

Anodic activation of iron corrosion in clay media under water-saturated conditions at 90 degrees C: characterization of the corrosion interface.

To understand the process governing iron corrosion in clay over centuries, the chemical and mineralogical properties of solids formed by free or anodically activated corrosion of iron in water-saturated clay at 90 degrees C over 4 months were probed using microscopic and spectroscopic techniques. Free corrosion led to the formation of an internal discontinuous thin (<3 microm thick) magnetite layer, an external layer of Fe-rich phyllosilicate, and a clay transformation layer containing Ca-doped siderite (Ca(0.2)Fe(0.8)CO(3)). The thickness of corroded iron equaled approximately 5-7 microm, consistent with previous studies. Anodic polarization resulted in unequally distributed corrosion, with some areas corrosion-free and others heavily corroded. Activated corrosion led to the formation of an inner magnetite layer, an intermediate Fe(2)CO(3)(OH)(2) (chukanovite) layer, an outer layer of Fe-rich 7 A-phyllosilicate, and a transformed matrix layer containing siderite (FeCO(3)). The corroded thickness was estimated to 85 microm, less than 30% of the value expected from the supplied anodic charge. The difference was accounted for by reoxidation at the anodically polarized surface of cathodically produced H(2)(g). Thus, free or anodically activated corroding conditions led to structurally similar interfaces, indicating that anodic polarization can be used to probe the long-term corrosion of iron in clay. Finally, corrosion products retained only half of Fe oxidized by anodic activation. Missing Fe probably migrated in the clay, where it could interact with radionuclides released by alteration of nuclear glass.