Environmental cleaning and disinfection in the operating room: a systematic scoping review through a human factors and systems engineering lens.

OBJECTIVE: To synthesize evidence and identify gaps in the literature on environmental cleaning and disinfection in the operating room based on a human factors and systems engineering approach guided by the Systems Engineering Initiative for Patient Safety (SEIPS) model. DESIGN: A systematic scoping review. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched 4 databases (ie, PubMed, EMBASE, OVID, CINAHL) for empirical studies on operating-room cleaning and disinfection. Studies were categorized based on their objectives and designs and were coded using the SEIPS model. The quality of randomized controlled trials and quasi-experimental studies with a nonequivalent groups design was assessed using version 2 of the Cochrane risk-of-bias tool for randomized trials. RESULTS: In total, 40 studies were reviewed and categorized into 3 groups: observational studies examining the effectiveness of operating-room cleaning and disinfections (11 studies), observational study assessing compliance with operating-room cleaning and disinfection (1 study), and interventional studies to improve operating-room cleaning and disinfection (28 studies). The SEIPS-based analysis only identified 3 observational studies examining individual work-system components influencing the effectiveness of operating-room cleaning and disinfection. Furthermore, most interventional studies addressed single work-system components, including tools and technologies (20 studies), tasks (3 studies), and organization (3 studies). Only 2 studies implemented interventions targeting multiple work-system components. CONCLUSIONS: The existing literature shows suboptimal compliance and inconsistent effectiveness of operating-room cleaning and disinfection. Improvement efforts have been largely focused on cleaning and disinfection tools and technologies and staff monitoring and training. Future research is needed (1) to systematically examine work-system factors influencing operating-room cleaning and disinfection and (2) to redesign the entire work system to optimize operating-room cleaning and disinfection.

Metal oxide surfaces for enhanced colorimetric response in bioassays.

Physical stability of metal nanoparticle films on planar surfaces can be increased by employing surface modification techniques and/or type of metal nanoparticles. Subsequently, the enzymatic response of colorimetric bioassays can be increased for improved dynamic range for the detection of biomolecules. Using a model bioassay b-BSA, three planar platforms (1) poly (methyl methacrylate) (PMMA) with silver thin films (STFs), (2) silver nanowires (Ag NWs) on paper and (3) indium tin oxide (ITO) on polyethylene terephthalate (PET) were evaluated to investigate the extent of increase in the colorimetric signal. Bioassays for b-BSA and Ki-67 antigen (a real-life bioassay) in buffer were performed using microwave heating (total assay time is 25-30min) and at room temperature (a control experiment, total assay time is 3h). Model bioassays showed that STFs were removed from the surface during washing steps and the extent of ITO remained unchanged. The lowest level of detection (LLOD) for b-BSA bioassays were: 10-10M for 10nm STFs on PMMA and Ag NWs on paper and 10-11M for ITO. Bioassays for Ki-67 antigen yielded a LLOD of <10-9M on ITO platforms, while STFs platforms were deemed unusable due to significant loss of STFs from the surfaces.

Metal-Assisted and Microwave-Accelerated Decrystallization: An Alternative Approach to Potential Treatment of Crystal Deposition Diseases.

Gout is a painful and prevalent crystal deposition disease caused by the overproduction of Uric Acid (UA) in the body and the atypical deposition in human synovial joints as Monosodium Urate Monohydrate (MSUM). Conventional treatments, such as NSAIDs, cyclooxygenase-2 inhibitors, and systemic glucocorticoids often present harmful side-effects and are short-lived. Long-term therapies including xanthine oxidase inhibitors and the use of uricosuric agents have been developed and aim to lower the UA serum levels in the body. As regards to post-crystals deposition, our research laboratory recently proposed and demonstrated the use of the Metal-Assisted and Microwave-Accelerated Decrystallization (MAMAD) technique for the breakdown of organic and biological crystals on planar surfaces. The MAMAD technique is based on the combined use of microwave heating and Au NPs in solution. The interactions of the Au NPs with microwave's electromagnetic field result in an increase in the kinetic energy of Au NPs, and subsequently, an increase in the collisions with target crystals placed on planar surfaces leading to rapid crystal breakdown. In this regard, our laboratory aims to develop the MAMAD technique as an alternative treatment for crystal deposition diseases, particularly gout, with minimal invasion and side-effects as compared to current treatments. In this review article, we will summarize our previous findings and provide additional data detailing the effectiveness of the MAMAD technique as a rapid and efficient method for the breakdown of gout related crystals and L-alanine crystals (a model crystal).