The synergistic antibacterial activity of ozone and surfactant mists.

The microbiological safety of medical equipment and general surfaces is paramount to both the well-being of patients and the public. The application of ozone (a potent oxidant) has been recognised and implemented for this purpose, globally. However, it has primarily been utilised in the gaseous and aqueous forms. In this study, we investigate the potency of fine ozone mists and evaluate the synergistic effect when combined with cationic, anionic and non-ionic surfactants (dodecyl trimethyl ammonium bromide - DTAB, sodium dodecyl sulfate - SDS, alkyl polyglycoside - APG) as well as polyethylene glycol (PEG). Ozone mist is generated via a nebuliser (equipped with a compressed gas stream) and the piezoelectric method; whereas fabric substrates contaminated with Escherichia coli and Staphylococcus aureus are utilised in this study. Contamination levels on the fabric swatches are evaluated using agar dipslides. Compared to gaseous ozonation and aqueous ozonation (via nanobubble generation), the produced ozone mists showed significantly inferior antimicrobial properties for the tested conditions (6 ppm, 5-15 min). However, the hybrid mist-based application of 'ozone + surfactants' and 'ozone + PEG' showed considerable improvements compared to their independent applications (ozone mist only and surfactant mist only). The 'ozone + DTAB' mist had the highest activity, with better results observed with the micron-mist nebuliser than the piezoelectric transducer. We propose a likely mechanism for this synergistic performance (micellar encapsulation) and demonstrate the necessity for continued developments of novel decontamination technologies.

Ozone Decontamination of Medical and Nonmedical Devices: An Assessment of Design and Implementation Considerations.

The control of infectious diseases can be improved via carefully designed decontamination equipment and systems. Research interest in ozone (a powerful antimicrobial agent) has significantly increased over the past decade. The COVID-19 pandemic has also instigated the development of new ozone-based technologies for the decontamination of personal protective equipment, surfaces, materials, and indoor environments. As this interest continues to grow, it is necessary to consider key factors affecting the applicability of lab-based findings to large-scale systems utilizing ozone. In this review, we present recent developments on the critical factors affecting the successful deployments of industrial ozone technologies. Some of these include the medium of application (air or water), material compatibility, efficient circulation and extraction, measurement and control, automation, scalability, and process economics. We also provide a comparative assessment of ozone relative to other decontamination methods/sterilization technologies and further substantiate the necessity for increased developments in gaseous and aqueous ozonation. Modeling methodologies, which can be applied for the design and implementation of ozone contacting systems, are also presented in this review. Key knowledge gaps and open research problems/opportunities are extensively covered including our recommendations for the development of novel solutions with industrial importance.

ScotGEM - an update on Scotland's only graduate-entry rural generalist-focused undergraduate programme, including student career intentions.

INTRODUCTION: In 2016, the Scottish Government commissioned ScotGEM, a generalist focused graduate entry medical programme. The first cohort of 55 students entered in 2018 and will graduate in 2022. Key unique features of ScotGEM include over 50% of clinical education being led by GPs, the creation of a team of dedicated Generalist Clinical Mentors (GCMs) who support this, a geographically dispersed approach to delivery, and a focus on healthcare improvement activities. This presentation will focus on the progress of our inaugural cohort in terms of progression, performance, and career intentions in comparison with the related internationally literature. METHODS: Progression and performance will be reported based upon assessment outcomes. Career intentions were assessed via an electronic questionnaire exploring career preferences, including speciality, location and reasoning distributed to the first three cohorts. We utilised questions derived from key UK and Australian studies to allow direct comparison with the existing literature. RESULTS: The response rate was 77% (126/163). ScotGEM students' progression rate was high and performance directly comparable with Dundee students. A positive attitude towards general practice and emergency medicine careers was reported. A high proportion of students intended to remain in Scotland, with half interested in working in rural or remote settings. DISCUSSION: Overall, results suggest ScotGEM is meeting the aims of its Mission, a finding of key workforce relevance in Scotland and other rural European contexts that supplements the existing international evidence base. The role of GCMs has been instrumental and may be applicable in other areas.

A qualitative perspective on what factors influence ScotGEM students' career intentions.

INTRODUCTION: ScotGEM is a novel graduate medicine programme in Scotland with a rural generalist focus. This survey-based study aimed to assess the career intentions of ScotGEM students and the various factors influencing them. METHODS: An online questionnaire was devised from existing literature that explored students' interest regarding generalist or specialty career, geographical location, and influencing factors. Free-text responses regarding their primary care career interest and their reasoning behind geographical preferences allowed for qualitative content analysis. Responses were coded inductively and categorised into themes by two independent researchers who then compared and finalised the themes. RESULTS: 126/163 (77%) completed the questionnaire. Content analysis of free-text responses in relation to a negative attitude towards a prospective GP career yielded themes: personal aptitude, emotional toll of GP and uncertainty. Themes in relation to desired geographical preference included: family factors, lifestyle issues and perceptions regarding professional and personal development opportunities. DISCUSSION: The qualitative analysis of factors influencing the career intentions of students on the graduate programme is key to understanding what is important to them. Students who have decided against primary care have realised an early aptitude for specialism due to their experiences, while also witnessing the potential emotional toll of primary care. Family needs may already be dictating where they will choose to work in the future. Lifestyle reasons were in favour of both urban and rural careers, with a sizeable number of responses still uncertain. These findings and their implications are discussed in context of existing international literature on rural medical workforce.

Ozone application in different industries: A review of recent developments.

Ozone - a powerful antimicrobial agent, has been extensively applied for decontamination purposes in several industries (including food, water treatment, pharmaceuticals, textiles, healthcare, and the medical sectors). The advent of the COVID-19 pandemic has led to recent developments in the deployment of different ozone-based technologies for the decontamination of surfaces, materials and indoor environments. The pandemic has also highlighted the therapeutic potential of ozone for the treatment of COVID-19 patients, with astonishing results observed. The key objective of this review is to summarize recent advances in the utilisation of ozone for decontamination applications in the above-listed industries while emphasising the impact of key parameters affecting microbial reduction efficiency and ozone stability for prolonged action. We realise that aqueous ozonation has received higher research attention, compared to the gaseous application of ozone. This can be attributed to the fact that water treatment represents one of its earliest applications. Furthermore, the application of gaseous ozone for personal protective equipment (PPE) and medical device disinfection has not received a significant number of contributions compared to other applications. This presents a challenge for which the correct application of ozonation can mitigate. In this review, a critical discussion of these challenges is presented, as well as key knowledge gaps and open research problems/opportunities.

Application of Ultraviolet-C Radiation and Gaseous Ozone for Microbial Inactivation on Different Materials.

With the advent of the COVID-19 pandemic, there has been a global incentive for applying environmentally sustainable and rapid sterilization methods, such as ultraviolet-C radiation (UVC) and ozonation. Material sterilization is a requirement for a variety of industries, including food, water treatment, clothing, healthcare, medical equipment, and pharmaceuticals. It becomes inevitable when devices and items like protective equipment are to be reused on/by different persons. This study presents novel findings on the performance of these sterilization methods using four microorganisms (Escherichia coli , Staphylococcus aureus , Candida albicans , and Aspergillus fumigatus) and six material substrates (stainless steel, polymethyl methacrylate, copper, surgical facemask, denim, and a cotton-polyester fabric). The combination of both ozone and UVC generally yields improved performance compared to their respective applications for the range of materials and microorganisms considered. Furthermore, the effectiveness of both UVC and ozone was higher when the fungi utilized were smeared onto the nonabsorbent materials than when 10 µL droplets were placed on the material surfaces. This dependence on the contaminating liquid surface area was not exhibited by the bacteria. This study highlights the necessity of adequate UVC and ozone dosage control as well as their synergistic and multifunctional attributes when sterilizing different materials contaminated with a wide range of microorganisms.

Microbial Inactivation: Gaseous or Aqueous Ozonation?

For decades, ozone has been known to have antimicrobial properties when dissolved or generated in water and when utilized in its gaseous form on different substrates. This property (the ability to be used in air and water) makes it versatile and applicable to different industries. Although the medium of ozonation depends on the specific process requirements, some industries have the inherent flexibility of medium selection. Thus, it is important to evaluate the antimicrobial efficacy in both media at similar concentrations, an endeavor hardly reported in the literature. This study provides insights into ozone's efficacy in air and water using two Gram-negative bacteria (Escherichia coli NTCC1290 and Pseudomonas aeruginosa NCTC10332), two Gram-positive bacteria (Staphylococcus aureus ATCC25923 and Streptococcus mutans), and two fungi (Candida albicans and Aspergillus fumigatus). For gaseous ozonation, we utilized a custom-made ozone chamber (equipped with ultraviolet lamps), whereas an electrolysis oxygen radical generator was applied for ozone generation in water. During gaseous ozonation, the contaminated substrates (fabric swatches inoculated with bacterial and fungal suspensions) were suspended in the chamber, whereas the swatches were immersed in ozonated water for aqueous ozone treatment. The stability of ozone nanobubbles and their resulting impact on the aqueous disinfection efficiency were studied via dynamic light scattering measurements. It was observed that ozone is more effective in air than in water on all tested organisms except Staphylococcus aureus. The presented findings allow for the adjustment of the treatment conditions (exposure time and concentration) for optimal decontamination, particularly when a certain medium is preferred for ozonation.

Bacterial and fungal disinfection via ozonation in air.

Ozone treatment is an eco-friendly and cost-effective approach to achieve material disinfection, and this disinfection method is of utmost importance in the present global pandemic. The efficacy of ozone's oxidative potential on common microorganisms has been extensively studied, particularly in the food and water treatment industries. However, little is still understood regarding its antimicrobial capabilities for the treatment of textile substrates in air. In this study, fabric swatches inoculated with bacterial and fungal suspensions are exposed to ozone for different durations and at different ozone concentrations. Pathogenic bacteria (Escherichia coli, Staphylococcus aureus), and fungi (Aspergillus fumigatus, and Candida albicans), are the microbes utilised in this study. The efficacy of ozone is demonstrated by the complete removal of microbiota on the tested swatches when a concentration and exposure duration of 20 ppm and 4 mins are respectively maintained in a test ozone chamber. We expect the insights from this work to guide the development of new ozonation techniques capable of rapid sterilisation in industrial & public settings.

On-call pharmacy services: a perspective from the Royal Alexandra Hospital (NHS Greater Glasgow & Clyde) and comparison with NHS Tayside, Scotland.

OBJECTIVE: To quantify the number and types of calls received by on-call pharmacists at the Royal Alexandra Hospital from January 2016 to February 2018. METHOD: A retrospective analysis of the on-call log in an Excel spreadsheet was conducted. Excel was used to analyse the data recorded by on-call pharmacists during the out-of-hours period. RESULTS: A total of 871 calls were made over 26 months, averaging 33.5 calls per month or 1.1 calls per day. The busiest day of the week was Saturday (21.7%, 189/871) with the weekend accounting for 38.3% (334/871) of calls. Between 17:00 and 18:00, 26.5% (225/850) of calls occurred, with 48.2% (410/850) of calls starting between 17:00 and 20:00. The largest users of the service were nurses (51.0%, 374/734). The most common calls were medicine supply (36.5%, 314/860) and 'Finishing the days work' (18.3%, 157/860). The majority of calls were resolved within 30 min (59.8%, 502/840). The average length of a call was 37.5 min, with the most junior pharmacists resolving calls quicker than the most senior with averages of 28.1 min and 32.7 min, respectively. There were 109 occasions where compensatory rest was triggered, accounting for the equivalent of 63.1 working days of rest being taken by on-call pharmacists with an approximate cost of £14 617 over 26 months. CONCLUSIONS: The supply of medication was the primary use of the on-call pharmacy service, with increased demand immediately following department closure. With approximately 30 working days of compensatory rest per year being accrued as part of on-call work at one hospital, this is an area of on-call that needs to be further understood. Extending the hours of hospital pharmacy service may bring long-term savings in avoiding both paying a premium for an on-call pharmacist or losing them to compensatory rest the following day.

Estimating the Relative Sociolinguistic Salience of Segmental Variables in a Dialect Boundary Zone.

One way of evaluating the salience of a linguistic feature is by assessing the extent to which listeners associate the feature with a social category such as a particular socioeconomic class, gender, or nationality. Such 'top-down' associations will inevitably differ somewhat from listener to listener, as a linguistic feature - the pronunciation of a vowel or consonant, for instance - can evoke multiple social category associations, depending upon the dialect in which the feature is embedded and the context in which it is heard. In a given speech community it is reasonable to expect, as a consequence of the salience of the linguistic form in question, a certain level of intersubjective agreement on social category associations. Two metrics we can use to quantify the salience of a linguistic feature are (a) the speed with which the association is made, and (b) the degree to which members of a speech community appear to share the association. Through the use of a new technique, designed as an adaptation of the Implicit Association Test, this paper examines levels of agreement among 40 informants from the Scottish/English border region with respect to the associations they make between four key phonetic variables and the social categories of 'Scotland' and 'England.' Our findings reveal that the participants exhibit differential agreement patterns across the set of phonetic variables, and that listeners' responses vary in line with whether participants are members of the Scottish or the English listener groups. These results demonstrate the importance of community-level agreement with respect to the associations that listeners make between social categories and linguistic forms, and as a means of ranking the forms' relative salience.

Exercise-induced stress inhibits both the induction and elicitation phases of in vivo T-cell-mediated immune responses in humans.

Little is known about the influence of exercise on induction and elicitation phases of in vivo immunity in humans. We used experimental contact-hypersensitivity, a clinically relevant in vivo measure of T cell-mediated immunity, to investigate the effects of exercise on induction and elicitation phases of immune responses to a novel antigen. The effects of 2 h-moderate-intensity-exercise upon the induction (Study One) and elicitation of in vivo immune memory (Study Two) to diphenylcyclopropenone (DPCP) were examined. Study One: matched, healthy males were randomly-assigned to exercise (N=16) or control (N=16) and received a primary DPCP exposure (sensitization), 20 min after either 2 h running at 60% V O(2peak) (EX) or 2 h seated rest (CON). Four weeks later, participants received a low, dose-series DPCP challenge (elicitation) on their upper inner arm, which was read at 24 and 48 h as clinical score, oedema (skinfold thickness) and redness (erythema). Study Two: pilot; 13 healthy males were sensitized to DPCP. Elicitation challenges were repeated every 4 weeks until responses reached a reproducible plateau. Then, N=9 from the pilot study completed both EX and CON trials in a randomized order. Elicitation challenges were applied and evaluated as in Study One. Results demonstrate that exercise-induced stress significantly impairs both the induction (oedema -53% at 48 h; P<0.001) and elicitation (oedema -19% at 48 h; P<0.05) phases of the in vivo T-cell-mediated immune response. These findings demonstrate that prolonged moderate-intensity exercise impairs the induction and elicitation phases of in vivo T-cell-mediated immunity. Moreover, the induction component of new immune responses appears more sensitive to systemic-stress-induced modulation than the elicitation component.