IoT-based incubator monitoring and machine learning powered alarm predictions.

BACKGROUND: Incubators, especially the ones for babies, require continuous monitoring for anomaly detection and taking action when necessary. OBJECTIVE: This study aims to introduce a system in which important information such as temperature, humidity and gas values being tracked from incubator environment continuously in real-time. METHOD: Multiple sensors, a microcontroller, a transmission module, a cloud server, a mobile application, and a Web application were integrated Data were made accessible to the duty personnel both remotely via Wi-Fi and in the range of the sensors via Bluetooth Low Energy technologies. In addition, potential emergencies were detected and alarm notifications were created utilising a machine learning algorithm. The mobile application receiving the data from the sensors via Bluetooth was designed such a way that it stores the data internally in case of Internet disruption, and transfers the data when the connection is restored. RESULTS: The obtained results reveal that a neural network structure with sensor measurements from the last hour gives the best prediction for the next hour measurement. CONCLUSION: The affordable hardware and software used in this system make it beneficial, especially in the health sector, in which the close monitoring of baby incubators is vitally important.

From garages to ecosystems: the coevolution of life science incubators and accelerators.

Incubators and accelerators catalyze the launch of life science startups and have evolved from simple facilities to vibrant ecosystems offering research infrastructure, programs, and funding. Analysis of financing activities indicates the outperformance of incubator companies relative to accelerators in fundraising, mergers and acquisitions (M&As), and initial public offerings (IPOs), attributed to extended interactions with investors and peers.

Monitoring System for Operating Variables in Incubators in the Neonatology Service of a Highly Complex Hospital through the Internet of Things (IoT).

BACKGROUND: Around 15 million premature babies are born annually, requiring specialized care. Incubators are vital for maintaining their body temperature, which is crucial for their well-being. Ensuring optimal conditions in incubators, including constant temperature, oxygen control, and comfort, is essential for improving the care and survival rates of these infants. METHODS: To address this, an IoT-based monitoring system was developed in a hospital setting. The system comprised hardware components such as sensors and a microcontroller, along with software components including a database and a web application. The microcontroller collected data from the sensors, which was then transmitted to a broker via WiFi using the MQTT protocol. The broker validated and stored the data in the database, while the web application provided real-time access, alerts, and event recording. RESULTS: Two certified devices were created, employing high quality components. The system was successfully implemented and tested in both the biomedical engineering laboratory and the neonatology service of the hospital. The results of the pilot test supported the concept of IoT-based technology, demonstrating satisfactory responses in temperature, humidity, and sound variables within the incubators. CONCLUSIONS: The monitoring system facilitated efficient record traceability, allowing access to data over various timeframes. It also captured event records (alerts) related to variable problems, providing information on duration, date, hour, and minutes. Overall, the system offered valuable insights and enhanced monitoring capabilities for neonatal care.

Enablers and inhibitors of digital startup evolution: a multi-case study of Swedish business incubators.

Global advances in digital technology are facilitating corresponding rises in digital entrepreneurship and its startup manifestation. There are many uncertainties on the road to digital startup evolution, some of which may be successfully navigated with the assistance of business incubators. While these organisations provide valuable guidance and support to the startup community, their efforts are at least partly constrained by the lack of a consistent, coherent roadmap to guide both them and their incubatees. T0 help efforts to develop such a map, this paper seeks to identify factors that influence digital startup evolution within an incubator setting through a multiple-case study focusing on digital startups under the umbrella of three business incubators in the Swedish city Umeå. Sets of enabling and inhibitory factors are identified through literature searches and the case studies. The latter may include inertia and possibly attitudes towards failure. In addition, present the Ideation Dynamics Model as a guide for both incubators and digital startups is proposed.

Innovative instrumentation to strong reduction of the noise levels inside newborn incubators used in the neonatal intensive care units.

In spite of the advent of medical technology, modern newborn incubators (NIs) do not protect them from high noise levels in the neonatal intensive care units (NICUs). Allied to bibliographical research carried out measurements were made inside the dome of a NIs and the results show that the sound pressure levels, or noises, are much more intense than the levels stipulated by the norm NBR IEC 60.601.2.19 of ABNT. These measurements revealed that the NIs air convection system motor is the main source of excess noise. In view of the above, a project was developed with the objective of significantly reducing the noise level inside the dome by modifying the air convection system. Thus, a quantitative study was developed, based on the experimental method, where a ventilation mechanism was designed, constructed and tested, which operated from the network of medical compressed air, present in the NICUs and maternity rooms. Respectively, before and after the modification of the air convection system, the data of relative humidity, air velocity, atmospheric pressure, air temperature and noise [(64.9% ur/33.1% ur); (0.27 m s-1/0.28 m s-1); (1.013.98 hPa/1.013, 60 hPa); (36.5 °C/36.3 °C); (45.9 dBA/30.2 dBA], were collected by electronic meters that registered the conditions of the external and internal environment of the dome of an NI with a passive humidification system. The noise measurements in the environment showed that there was a strong reduction of 15.7 dBA, or 34.2% of internal noise, measured after the modification of the ventilation system, showing a significative performance of the modified NI. Therefore, our results may be a good choose to improve NI acoustics to enable optimal care of the neonate in the neonatal intensive care units.

Disinfection of incubators in neonatal intensive care units: impact of steam pulverization on bacterial colonization.

BACKGROUND: In neonatal intensive care units (NICUs), neonates requiring medical care after birth, including very vulnerable preterm infants, are housed in incubators. Previous studies have reported that the standard chemical disinfection measures used to disinfect these incubators are insufficient to eradicate contaminating bacteria, leading to a worrying infectious risk for preterm neonates. This study aimed to evaluate the efficacy of a disinfection method based on steam pulverization to eradicate the persistent bacterial contamination in such incubators. METHODS: In a tertiary NICU, 20 incubators were monitored qualitatively for bacterial contamination at five different sites (the rubber grommet, the left door handles, the temperature adjustment button, the mattress and the scale) using a culture method at three times: before and after steam pulverization then 24 h after turning on and housing a new neonate. Clinical data of neonates housed in each incubator were retrieved from the medical records to identify potential occurrence of late onset sepsis (LOS). RESULTS: Just after steam pulverization, only two incubators were free from bacteria. Before disinfection 87% of all the samples were contaminated compared to 61% after disinfection. After 24 h, the proportion of contaminated samples reached 85%. Mattresses and scales were the most frequently contaminated incubator sites with respectively 90% and 80% positive samples after disinfection compared to 100% and 90% before disinfection. Coagulase-negative staphylococci, Enterococcus, Enterobacteria and Bacillus resisted disinfection and were identified on respectively 90%, 20%, 5% and 45% of incubators just after disinfection. Three preterm neonates developed LOS after being housed in a disinfected incubator but the bacterial species involved have not been identified in their incubator after disinfection. In two cases, the bacterium had been isolated from the mattress 24 h after housing the infected patient. CONCLUSION: Steam pulverization is not sufficient to eradicate bacterial contamination of incubators. These results highlight the urgent need for an effective disinfection method, especially for mattresses that are in constant contact with patients. In parallel, new incubator designs and mattress protections must be developed.

A novel method for conformity assessment testing of infant incubators for post-market surveillance purposes.

BACKGROUND: Premature born infants or infants born sick require immediate medical attention and decreasing the stress imposed onto their body by the environment. Infant incubators provide an enclosed environment that can be controlled to fit the needs of the infant. As such, their performance must be consistent and without significant deviations. The only manner to ensure this is by post-market surveillance (PMS) focused on evaluation of both safety and performance. The new Medical Device Regulation (MDR) defines medical device post-market surveillance (PMS) as performed by independent, third-party, notified bodies more strategically in hope to improve traceability of device performance. However, there is still an apparent gap in terms of standardised conformity assessment testing methods. OBJECTIVE: This paper proposes a novel method for conformity assessment testing of infant incubators for post-market surveillance purposes. METHOD: The method was developed based on guidelines for devices providing measurements laid out by the International Organisation of Legal Metrology (OIML). The methodology was validated during a four year period in healthcare institutions of all levels. RESULTS: The developed method was validated between 2018 and 2021 in healthcare institutions of all levels. The results obtained during validation suggest that conformity assessment testing of infant incubators as a method used during PMS contributes to significant improvement in devices' accuracy and reliability. CONCLUSION: A standardized approach in conformity assessment testing of infant incubators during PMS, besides increasing reliability of the devices, is the first step in digital transformation of management of these devices in healthcare institutions opening possibility for use of artificial intelligence.

Acoustic conditioning of the neonatal incubator compartment: Improvement proposal.

The objective of this work focuses on the study of the main sources of noise associated with incubators and the acoustic effects that derive from them. The method that has been established is based on tests carried out under different operating conditions of the incubators. Noise levels are analyzed under different boundary conditions (Neonatal ICU and "Controlled environment rooms"). Under normal operating conditions, the levels inside the incubator are around 56 dB (A), values that exceed the maximum limits recommended by the American Academy of Pediatrics. The scope of this study is to evaluate the existing noise levels in the incubator and analyze possible design improvements. The study was carried out in the hospitals of Cádiz, Huelva, and Malaga.

A quasi experimental study to compare thermo-regulator blanket with conventional method (incubator) for temperature regulations in preterm, low birth weight neonates landing at emergency department of a tertiary care paediatric facility.

Objective: To compare incubator and thermal blanket for thermoregulation in preterm and low birth weight neonates. METHODS: The pilot study was conducted from January to March 2018 at the emergency department of the National Institute of Child Health, Karachi, and comprised preterm and low birth weight neonates without any co-morbidity who were randomised to control and interventional groups. Data was collected using a proforma about demographics, weight, gestational age and brief clinical history. Temperature, blood pressure and pulse were monitored along with other routine care after every 15 minutes in the incubator, and the same procedure was adopted for thermal blankets. Data was analysed using Statistical Package for Social Sciences (SPSS) Version 23. RESULTS: Of the 38 subjects, 19(50%) each were cases and controls. The mean gestational age between the groups was not significantly different (p>0.05). Temperature for the first 60 minutes remained similar in the two groups, but at 75 minutes and onwards, the incubator showed a significantly better results (p<0.05). Conclusion: Thermal blankets can sufficiently provide a hyperthermic environment to the neonates, but an incubator is a more reliable option to provide sustained temperature.

Ending Neonatal Deaths From Hypothermia in Sub-Saharan Africa: Call for Essential Technologies Tailored to the Context.

Neonatal death represents a major burden in Sub-Saharan Africa (SSA), where the main conditions triggering mortality, such as prematurity, labor complications, infections, and respiratory distress syndrome, are frequently worsened by hypothermia, which dramatically scales up the risk of death. In SSA, the lack of awareness on the procedures to prevent hypothermia and the shortage of essential infant devices to treat it are hampering the reduction of neonatal deaths associated to hypothermia. Here, we offer a snapshot on the current available medical solutions to prevent and treat hypothermia in SSA, with a focus on Kenya. We aim to provide a picture that underlines the essential need for infant incubators in SSA. Specifically, given the inappropriateness of the incubators currently on the market, we point out the need for reinterpretation of research in the field, calling for technology-based solutions tailored to the SSA context, the need, and the end-user.

Incubator humidity and temperature control in infants born at 22-23 weeks' gestation.

BACKGROUND: Preterm infants, especially those born at ≤23 gestational weeks (GW), present with extremes in insensible water loss (IWL) and changes in water balance. AIMS: To prevent water loss from the skin and achieve skin maturation without infection, we investigated transepidermal water loss (TEWL), IWL from the skin (IWL-s), and electrolyte balance with differences in high incubator humidity and temperature control from birth to postnatal 1 month in 22-23 GW and 24-25 GW infants. STUDY DESIGN: Prospective cohort study. SUBJECTS: Extremely preterm infants born at 22-23 GW (n = 11) and 24-25 GW (n = 11), admitted to the neonatal intensive care unit between September 2018 and October 2019. OUTCOME MEASURES: Total fluid intake (TFI), fluid output volume, TEWL, IWL-s, and electrolyte balance were compared between the two groups with controlled incubator humidity and temperature, gradually decreasing the humidity and ambient temperature from 95% to 50% and from 37.0 to 34.0 °C, respectively, while maintaining the central body temperature at 36.5-37.5 °C. RESULTS: TEWL and IWL-s between the 22-23 and 24-25 GW was not significantly different for infants at postnatal age. No significant difference in electrolyte imbalance was noted between the two groups, within the first 7 days. Differences in TEWL and IWL-s were eliminated with corresponding humidity and temperature adjustments. CONCLUSIONS: Incubator humidity and temperature control should aid management of 22-23 GW infants to reduce IWL, facilitate skin maturation, and prevent infection.

Blood culture diagnostics: a Nordic multicentre survey comparison of practices in clinical microbiology laboratories.

OBJECTIVES: Accurate and rapid microbiological diagnostics are crucial to tailor treatment and improve outcomes in patients with severe infections. This study aimed to assess blood culture diagnostics in the Nordic countries and to compare them with those of a previous survey conducted in Sweden in 2013. METHODS: An online questionnaire was designed and distributed to the Nordic clinical microbiology laboratories (CMLs) (n = 76) in January 2018. RESULTS: The response rate was 64% (49/76). Around-the-clock incubation of blood cultures (BCs) was supported in 82% of the CMLs (40/49), although in six of these access to the incubators around the clock was not given to all of the cabinets in the catchment area, and 41% of the sites (20/49) did not assist with satellite incubators. Almost half (49%, 24/49) of the CMLs offered opening hours for ≥10 h during weekdays, more commonly in CMLs with an annual output ≥30 000 BCs. Still, positive BCs were left unprocessed for 60-70% of the day due to restrictive opening hours. Treatment advice was given by 23% of CMLs (11/48) in ≥75% of the phone contacts. Rapid analyses (species identification and susceptibility testing with short incubation), performed on aliquots from positive cultures, were implemented in 18% of CMLs (9/49). Compared to 2013, species identification from subcultured colonies (<6 h) had become more common. CONCLUSIONS: CMLs have taken action to improve aspects of BC diagnostics, implementing satellite incubators, rapid species identification and susceptibility testing. However, the limited opening hours and availability of clinical microbiologists are confining the advantages of these changes.

Desinfecção de incubadoras usadas em Unidades de Cuidados Intensivos Neonatais: revisão integrativa / Desinfección de incubadoras usadas en Unidades de Cuidados Intensivos Neonatales: revisión integradora / Disinfection of incubators used in Neonatal Intensive Care Units: an integrative review

Resumo Objetivo Analisar as evidências científicas de práticas de desinfecção de incubadoras usadas em Unidades de Cuidados Intensivos Neonatais. Métodos Revisão integrativa de literatura, realizada de junho a julho de 2020, nas bases de dados: LILACS, SciELO, CINAHL, SCOPUS, Web of Science e MEDLINE. Os achados foram organizados conforme o fluxograma PRISMA e discutidos de acordo com a literatura pertinente. Resultados Dos 780 artigos encontrados, apenas cinco contemplaram os critérios de inclusão. Os saneantes utilizados foram: cloreto de didecildimetilamônio, polihexametilenobiguanida e Peróxido de Hidrogênio (VHP); cloreto de didecildimetilamônio; N-(3-aminopropyl)-N-dodécylpropane-1,3-diamine; cloreto de didecildimetilamônio e limpeza a vapor; água com detergente para limpeza no balde e água sanitária (200mg/L) e desinfectante Umonium38® a 2,5%. Há diversidade de opções para desinfecção das incubadoras, com variação de métodos e frequência de limpeza. Os saneantes utilizados foram eficazes, apontando para redução da carga microbiana. Conclusão Observou-se uma variedade de procedimentos e produtos que podem ser utilizados para limpeza e desinfecção das incubadoras. Os procedimentos de desinfecção favoreceram a redução da contaminação da superfície. No entanto, a presença de micro-organismos, mesmo que reduzida, alerta sobre o risco à segurança do paciente.

Resumen Objetivo Analizar las evidencias científicas de prácticas de desinfección de incubadoras usadas en Unidades de Cuidados Intensivos Neonatales. Métodos Revisión integradora de literatura, realizada de junio a julio de 2020, en las bases de datos: LILACS, SciELO, CINAHL, SCOPUS, Web of Science y MEDLINE. Los resultados fueron organizados de acuerdo con el diagrama de flujo PRISMA y discutidos de acuerdo con la literatura pertinente. Resultados De los 780 artículos encontrados, solamente cinco contemplaron los criterios de inclusión. Los desinfectantes utilizados fueron: cloruro de didecildimetilamonio, polihexametilen biguanida y peróxido de hidrógeno (VHP); cloruro de didecildimetilamonio; N-(3-aminopropil)-N-dodecilpropano-1,3-diamina; cloruro de didecildimetilamonio y limpieza a vapor; agua con detergente para limpieza en el balde y cloro (200mg/L) y desinfectante Umonium38® al 2,5 %. Existe una diversidad de opciones para la desinfección de las incubadoras, con variación de métodos y frecuencia de limpieza. Los desinfectantes utilizados fueron eficaces, lo que indica una reducción de la carga microbiana. Conclusión Se observó una variedad de procedimientos y de productos que se pueden utilizar para la limpieza y la desinfección de las incubadoras. Los procedimientos de desinfección favorecieron la reducción de la contaminación de la superficie. Sin embargo, la presencia de microorganismos, aunque reducida, alerta respecto al riesgo a la seguridad del paciente.

Abstract Objective To analyze the scientific evidence of incubator disinfection practices used in Neonatal Intensive Care Units. Methods This is an integrative literature review, conducted from June to July 2020, in the LILACS, SciELO, CINAHL, Scopus, Web of Science and MEDLINE databases. The findings were organized according to the PRISMA flowchart and discussed according to pertinent literature. Results Of the 780 articles found, only five met the inclusion criteria. The sanitizers used were: didecyldimethylammonium chloride, PHMB and vaporized hydrogen peroxide (VHP); didecyldimethylammonium chloride; N-(3-aminopropyl)-N-dodecylpropane-1,3-diamine; didecyldimethylammonium chloride and steam cleaning; water with detergent for cleaning in the bucket and bleach (200 mg/L) and 2.5% Umonium38® disinfectant. There is a diversity of options for disinfection of incubators, with variation of methods and frequency of cleaning. The sanitants used were effective, pointing to reduction of microbial load. Conclusion A variety of procedures and products were observed that can be used for cleaning and disinfection of incubators. Disinfection procedures favored the reduction of surface contamination. However, the presence of microorganisms, even if reduced, alerts about the risk to patient safety.

Newborn Incubators Do Not Protect from High Noise Levels in the Neonatal Intensive Care Unit and Are Relevant Noise Sources by Themselves.

BACKGROUND: While meaningful sound exposure has been shown to be important for newborn development, an excess of noise can delay the proper development of the auditory cortex. AIM: The aim of this study was to assess the acoustic environment of a preterm baby in an incubator on a newborn intensive care unit (NICU). METHODS: An empty but running incubator (Giraffe Omnibed, GE Healthcare) was used to evaluate the incubator frequency response with 60 measurements. In addition, a full day and night period outside and inside the incubator at the NICU of the University Hospital Zurich was acoustically analyzed. RESULTS: The fan construction inside the incubator generates noise in the frequency range of 1.3-1.5 kHz with a weighted sound pressure level (SPL) of 40.5 dB(A). The construction of the incubator narrows the transmitted frequency spectrum of sound entering the incubator to lower frequencies, but it does not attenuate transient noises such as alarms or opening and closing of cabinet doors substantially. Alarms, as generated by the monitors, the incubator, and additional devices, still pass to the newborn. CONCLUSIONS: The incubator does protect only insufficiently from noise coming from the NICUThe transmitted frequency spectrum is changed, limiting the impact of NICU noise on the neonate, but also limiting the neonate's perception of voices. The incubator, in particular its fan, as well as alarms from patient monitors are major sources of noise. Further optimizations with regard to the sound exposure in the NICU, as well as studies on the role of the incubator as a source and modulator, are needed to meet the preterm infants' multi-sensory needs.

Toward a predictive theoretical model for osmolality rise with non-humidified incubation: a randomized, multivariate response-surface study.

STUDY QUESTION: What factors associated with embryo culture techniques contribute to the rate of medium osmolality change over time in an embryo culture incubator without added humidity? SUMMARY ANSWER: The surface area-to-volume ratio of culture medium (surface area of the medium exposed to an oil overlay), as well as the density and height of the overlaying oil, all interact in a quantitative way to affect the osmolality rise over time. WHAT IS KNOWN ALREADY: Factors such as medium volume, different oil types, and associated properties, individually, can affect osmolality change during non-humidified incubation. STUDY DESIGN, SIZE, DURATION: Several experimental designs were used, including simple single-factor completely randomized designs, as well as a multi-factor response surface design. Randomization was performed at one or more levels for each experiment. Osmolality measurements were performed over 7 days, with up to 8 independent osmolality measurements performed per treatment group over that time. For the multi-factor study, 107 independent combinations of factor levels were assessed to develop the mathematical model. PARTICIPANTS/MATERIALS, SETTING, METHODS: This study was conducted in a research laboratory setting. Commercially available embryo culture medium and oil was used. A MINC incubator without water for humidification was used for the incubation. Osmolality was measured with a vapor pressure osmometer after calibration. Viscometry and density were conducted using a rheometer, and volumetric flasks with an analytical balance, respectively. Data analyses were conducted with several commercially available software programs. MAIN RESULTS AND THE ROLE OF CHANCE: Preliminary experiments showed that the surface area-to-volume ratio of the culture medium, oil density, and oil thickness above the medium all contributed significantly (P < 0.05) to the rise in osmolality. A multi-factor experiment showed that a combination of these variables, in the form of a truncated cubic polynomial, was able to predict the rise in osmolality, with these three variables interacting in the model (P < 0.05). Repeatability, as measured by the response of identical treatments performed independently, was high, with osmolality values being ± 2 of the average in most instances. In the final mathematical model, the terms of the equation were significant predictors of the outcome, with all P-values being significant, and only one P-value > 0.0001. LIMITATIONS, REASONS FOR CAUTION: Although the range of values for the variables were selected to encompass values that are expected to be encountered in usual embryo culture conditions, variables outside of the range used may not result in accurate model predictions. Although the use of a single incubator type and medium type is not expected to affect the conclusions, that remains an uncertainty. WIDER IMPLICATIONS OF THE FINDINGS: Using this predictive model will help to determine if one should be cautious in using a specific system and will provide guidance on how a system may be modified to provide improved stability during embryo culture. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by Cook Medical. The author is a Team Lead and Senior Scientist at Cook Medical. The author has no other conflicts of interest to declare. TRIAL REGISTRATION NUMBER: N/A.

Induced Pluripotent Stem Cells on a Chip: A Self-Contained, Accessible, Pipette-less iPSC Culturing and Differentiation Kit.

Over the past decade, induced pluripotent stem cells (iPSCs) have become a major focus of stem cell and developmental biology research, offering researchers a clinically relevant source of cells that are amenable to genetic engineering approaches. Though stem cells are promising for both research and commercial endeavors, iPSC-based assays require tedious protocols that include complex treatments, expensive reagents, and specialized equipment that limit their integration into academic curricula and cell biology research groups. Expanding on existing Kit-On-A-Lid-Assay (KOALA) technologies, we have developed a self-contained, injection molded, pipette-less iPSC culture and differentiation platform that significantly reduces associated costs and labor of stem cell maintenance and differentiation. The KOALA kit offers users the full range of iPSC culture necessities, including cell cryopreservation, media exchanges, differentiation, endpoint analysis, and a new capability, cell passaging. Using the KOALA kit, we were able to culture ~20,000 iPSCs per microchannel for at least 7 days, while maintaining stable expression of stemness markers (SSEA4 and Oct4) and normal iPSC phenotype. We also adapted protocols for differentiating iPSCs into neuroepithelial cells, cardiomyocytes, and definitive endodermal cells, a cell type from each germ layer of human development.

[Discussion on the On-site Inspection Scheme of Using Infant Incubator].

The standard terms of infant incubators with high clinical risk and high incidence of adverse events has been tested through the introduction of YY/T 0841-2011 standard, an on-site inspection scheme for using infant incubators has been proposed, the problems existing in the inspection are analyzed and reasonable suggestions are put forward, this paper provides a certain technical reference for the whole life cycle management of the infant incubator.

'There is only one thing that is truly important in an IVF laboratory: everything' Cairo Consensus Guidelines on IVF Culture Conditions.

This proceedings report presents the outcomes from an international expert meeting to establish consensus guidelines on IVF culture conditions. Topics reviewed and discussed were: embryo culture - basic principles and interactions; temperature in the IVF laboratory; humidity in culture; carbon dioxide control and medium pH; oxygen tension for embryo culture; workstations - design and engineering; incubators - maintaining the culture environment; micromanipulation - maintaining a steady physcochemical environment; handling practices; assessment practices; culture media - buffering and pH, general composition and protein supplementation, sequential or single-step media for human embryo culture; use and management - cold chain and storage; test equipment - calibration and certification; and laboratory equipment and real-time monitoring. More than 50 consensus guideline points were established under these general headings.

Discussion on the On-site Inspection Scheme of Using Infant Incubator / 中国医疗器械杂志

The standard terms of infant incubators with high clinical risk and high incidence of adverse events has been tested through the introduction of YY/T 0841-2011 standard, an on-site inspection scheme for using infant incubators has been proposed, the problems existing in the inspection are analyzed and reasonable suggestions are put forward, this paper provides a certain technical reference for the whole life cycle management of the infant incubator.

Sources and reservoirs of Staphylococcus capitis NRCS-A inside a NICU.

Background: The methicillin-resistant clone Staphylococcus capitis NRCS-A, involved in sepsis in neonatal intensive care units (NICUs) worldwide, is able to persist and spread in NICUs, suggesting the presence of reservoirs inside each setting. The purpose of the present study was to identify these reservoirs and to investigate the cycle of transmission of NRCS-A in one NICU. Methods: In a single institution study, NRCS-A was sought in 106 consecutive vaginal samples of pregnant women to identify a potential source of NRCS-A importation into the NICU. Additionally NICU caregivers and environmental including incubators were tested to identify putative secondary reservoirs. Finally, the efficacy of disinfection procedure in the elimination of NRCS-A from incubators was evaluated. Results: No S. capitis was isolated from vaginal samples of pregnant women. Three of the 21 tested caregivers (14%) carried S. capitis on their hands, but none remain positive after a five-day wash-out period outside NICU. Moreover, the clone NRCS-A persisted during six consecutive weeks in the NICU environment, but none of the sampled sites was constantly contaminated. Finally in our before/after disinfection study, all of 16 incubators were colonized before disinfection and 10 (62%) incubators remained colonized with NRCS-A after the disinfection procedure. Conclusions: The partial ineffectiveness of incubators' disinfection procedures is responsible for persistence of NRCS-A inside a NICU, and the passive hand contamination of caregivers could be involved in the inter-patient transmission of S. capitis.