Too much ado about data: Continuous remote monitoring of water temperatures, circulation and throughput can assist in the reduction of hospital-associated waterborne infections.

BACKGROUND: National and international guidance provides advice on maintenance and management of water systems in healthcare buildings, however, healthcare-associated waterborne infections (HAWI) are increasing. This narrative review identifies parameters critical to water quality in healthcare buildings and assesses if remote sensor monitoring can deliver safe water systems thus reducing HAWI. METHOD: A narrative review was performed using the following search terms 1) consistent water temperature AND waterborne pathogen control OR nosocomial infection 2) water throughput AND waterborne pathogen control OR nosocomial infection 3) remote monitoring of in-premise water systems AND continuous surveillance for temperature OR throughput OR flow OR use. Databases employed were PubMed, CDSR (Clinical Study Data Request) and DARE (Database of Abstracts of Reviews of Effects) from Jan 2013 - Mar 2024. FINDINGS: Single ensuite-patient rooms, expansion of wash-hand basins, widespread glove use, alcohol gel and wipes have increased water system stagnancy resulting in amplification of waterborne pathogens and transmission risk of Legionella, Pseudomonas and Non-Tuberculous Mycobacteria. Manual monitoring does not represent temperatures across large complex water systems. This review deems that multiple point continuous remote sensor monitoring is effective at identifying redundant and low use outlets, hydraulic imbalance and inconsistent temperature delivery across in-premise water systems. CONCLUSION: As remote monitoring becomes more common there will be greater recognition of failures in temperature control, hydraulics and balancing in water systems and there remains much to learn as we adopt this developing technology within our hospitals.

Water free patient care, a narrative review of the literature and discussion of the pressing need for a way forward.

BACKGROUND: Florence Nightingale was the first person to recognise the link between the built environment and patient ill-health. More than 160 years later the threat of the end of the antibiotic era looms large. The AMR action plan focuses on antimicrobial stewardship and developing new therapeutic agents. The risk from the built environment has been ignored, with wastewater systems identified as major sources of antimicrobial resistance within healthcare facilities. England is undertaking the largest healthcare construction programmes globally. These facilities will be operating when antimicrobial resistance is predicted to be at its fiercest. Water free patient care is a strategy for limiting dispersal of antimicrobial resistance and preventing patient infections that need further evaluation in new hospitals. METHOD: A narrative review was undertaken using terms; waterless/waterfree units, waterless/waterfree care, sink reduction, sink removal, washing without water. Databases employed were Pubmed, CDSR,and DARE from January 2000- February 2024 for reviews and original articles. Unit type, geographical location, reasons for a waterless/waterfree approach and outcomes were recorded. FINDINGS: Seven papers were identified. Four involved adult intensive care units (ICU), one from care of the elderly settings and two involved a neonatal ICU (NICU). In five papers the aim of intervention was to reduce Gram-negative infections/colonisations. One paper was a systematic review of 'washing without water' which reviewed cost effectiveness and patient experience Of the five papers focusing on Gram-negative bacilli (GNB) all reported a reduction in infections or colonisations post intervention. CONCLUSION: More studies are highlighting the risks from water and wastewater to patient safety and the value of "waterfree" strategies in reducing infection rates.

Fabrication of Polycaprolactone-Based Polyurethanes with Enhanced Thermal Stability.

The benefit of being acquainted with thermal properties, especially the thermal stability of polyurethanes (PU), and simplified methods for their improvement is manifold. Considering this, the effect of embedding different amounts of unmodified and surface-modified TiO2 nanoparticles (NPs) within PU, based on polycaprolactone (PCL) and Boltorn® aliphatic hyperbranched polyester, on PU properties was investigated. Results obtained via scanning electron microscopy, swelling measurements, mechanical tests and thermogravimetric analysis revealed that TiO2 NPs can be primarily applied to improve the thermal performance of PU. Through surface modification of TiO2 NPs with an amphiphilic gallic acid ester containing a C12 long alkyl chain (lauryl gallate), the impact on thermal stability of PU was greater due to the better dispersion of modified TiO2 NPs in the PU matrix compared to the unmodified ones. Also, the distinct shape of DTG peaks of the composite prepared using modified TiO2 NPs indicates that applied nano-filler is mostly embedded in soft segments of PU, leading to the delay in thermal degradation of PCL, simultaneously improving the overall thermal stability of PU. In order to further explore the thermal degradation process of the prepared composites and prove the dominant role of incorporated TiO2 NPs in the course of thermal stability of PU, various iso-conversional model-free methods were applied. The evaluated apparent activation energy of the thermal degradation reaction at different conversions clearly confirmed the positive impact of TiO2 NPs on the thermal stability and aging resistance of PU.

Anticorrosion Performance of Waterborne Coatings with Modified Nanoscale Titania under Subtropical Maritime Climate.

Steel structures located in subtropical marine climates face harsh conditions such as strong sunlight and heavy rain, and they are extremely corroded. In this study, a waterborne coating with excellent corrosion resistance, hydrophobic ability, high-temperature resistance and high density was successfully prepared by using modified nanoscale titania powders and grafted polymers. The effects of three modifiers on titania nanoparticles and waterborne coatings' properties were studied independently. The experimental results showed that the activation index of the modification employing methacryloxy silane reached 97.5%, which achieved the best modification effect at 64.4 °C for 43.3 min. The waterborne coating with nanoscale titania modified by methacryloxy silane exhibited the best hydrophobic effect, with a drop contact angle of 115.4° and excellent heat resistance of up to 317.2 °C. The application of the waterborne modified coating in steel structures under subtropical maritime climates showed that the waterborne titania coatings demonstrated excellent resistance to corrosion, high temperatures and harsh sunlight, with a maximum service life of up to five years. Economic analysis indicated that, considering a conservative three-year effective lifespan, this coating could save more than 50% in cost compared with conventional industrial coatings. Finally, the strengthening mechanism of the polymer coatings with modified nanoscale titania was analyzed.

Marked increase in cryptosporidiosis cases, Spain, 2023.

BackgroundBy mid-September 2023, several event notifications related to cryptosporidiosis had been identified from different regions in Spain. Therefore, a request for urgent notification of cryptosporidiosis cases to the National Surveillance Network was launched.AimWe aimed at assessing the extent of the increase in cases, the epidemiological characteristics and the transmission modes and compared to previous years.MethodsWe analysed data on case notifications, outbreak reports and genotypes focusing on June-October 2023 and compared the results to 2016-2022.ResultsIn 2023, 4,061 cryptosporidiosis cases were notified in Spain, which is an increase compared to 2016-2022. The cumulative incidence was 8.3 cases per 100,000 inhabitants in 2023, sixfold higher than the median of 1.4 cases per 100,000 inhabitants 2016-2022. Almost 80% of the cases were notified between June and October. The largest outbreaks were related to contaminated drinking water or swimming pools. Cryptosporidium hominis was the most common species in the characterised samples (115/122), and the C. hominis IfA12G1R5 subtype, previously unusual in Spain, was detected from 76 (62.3%) of the 122 characterised samples.ConclusionsA substantial increase in cryptosporidiosis cases was observed in 2023. Strengthening surveillance of Cryptosporidium is essential for prevention of cases, to better understand trends and subtypes circulating and the impact of adverse meteorological events.

Development of a "big data" groundwater microbial contamination index and spatial comparisons with enteric infection rates in southern Ontario.

Big data have become increasingly important for policymakers and scientists but have yet to be employed for the development of spatially specific groundwater contamination indices or protecting human and environmental health. The current study sought to develop a series of indices via analyses of three variables: Non-E. coli coliform (NEC) concentration, E. coli concentration, and the calculated NEC:E. coli concentration ratio. A large microbial water quality dataset comprising 1,104,094 samples collected from 292,638 Ontarian wells between 2010 and 2021 was used. Getis-Ord Gi* (Gi*), Local Moran's I (LMI), and space-time scanning were employed for index development based on identified cluster recurrence. Gi* and LMI identify hot and cold spots, i.e., spatially proximal subregions with similarly high or low contamination magnitudes. Indices were statistically compared with mapped well density and age-adjusted enteric infection rates (i.e., campylobacteriosis, cryptosporidiosis, giardiasis, verotoxigenic E. coli (VTEC) enteritis) at a subregional (N = 298) resolution for evaluation and final index selection. Findings suggest that index development via Gi* represented the most efficacious approach. Developed Gi* indices exhibited no correlation with well density, implying that indices are not biased by rural population density. Gi* indices exhibited positive correlations with mapped infection rates, and were particularly associated with higher bacterial (Campylobacter, VTEC) infection rates among younger sub-populations (p < 0.05). Conversely, no association was found between developed indices and giardiasis rates, an infection not typically associated with private groundwater contamination. Findings suggest that a notable proportion of bacterial infections are associated with groundwater and that the developed Gi* index represents an appropriate spatiotemporal reflection of long-term groundwater quality. Bacterial infection correlations with the NEC:E. coli ratio index (p < 0.001) were markedly different compared to correlations with the E. coli index, implying that the ratio may supplement E. coli monitoring as a groundwater assessment metric capable of elucidating contamination mechanisms. This study may serve as a methodological blueprint for the development of big data-based groundwater contamination indices across the globe.

Legionella-Induced Rhabdomyolysis and Acute Kidney Injury: A Case Report.

Legionella pneumonia is a severe form of pneumonia caused by the bacterium Legionella pneumophila. It often presents with atypical symptoms and can lead to complications such as rhabdomyolysis and acute kidney injury (AKI). Here, we report a case of Legionella pneumonia-induced rhabdomyolysis and AKI in a 32-year-old male. Laboratory investigations revealed elevated creatinine kinase levels and acute kidney injury. Further investigation confirmed Legionella pneumonia. The patient was promptly treated with appropriate antibiotics and supportive care, resulting in clinical improvement and resolution of rhabdomyolysis and AKI. This case underscores the importance of considering Legionella pneumonia as a potential cause of rhabdomyolysis and AKI, especially in patients with atypical pneumonia presentations.

Performance and Morphology of Waterborne Polyurethane Asphalt in the Vicinity of Phase Inversion.

Waterborne polyurethane asphalt emulsion (WPUA) is an environmentally friendly bituminous material, whose performance is highly dependent on the phase structure of the continuous phase. In this paper, WPUAs in the vicinity of phase inversion were prepared using waterborne polyurethane (WPU) and asphalt emulsion. The chemical structures, thermal stability, dynamic mechanical properties, phase-separated morphology and mechanical performance of WPUAs were studied. Fourier-transform infrared (FTIR) spectra revealed that there are no -NCO bonds in either the pure WPU or WPUAs. Moreover, the preparation of WPUA is a physical process. The addition of WPU weakens the thermal stability of asphalt emulsion. WPU improves the storage modulus of asphalt emulsion at lower and higher temperatures. The glass transition temperatures of the WPUA films are higher than that of the pure WPU film. When the WPU concentration increases from 30 wt% to 40 wt%, phase inversion occurs; that is, the continuous phase shifts from asphalt to WPU. The WPUA films have lower tensile strength and toughness than the pure WPU film. However, the elongations at break of the WPUA films are higher than that of the pure WPU film. Both the tensile strength and toughness of the WPUA films increase with the WPU concentration. Due to the occurrence of phase inversion, the elongation at break, tensile strength and toughness of the WPUA film containing 30 wt% WPU are increased by 29%, 250% and 369%, respectively, compared to the film with 40 wt% WPU.

A Novel Intumescent MCA-Modified Sodium Silicate/Acrylic Flame-Retardant Coating to Improve the Flame Retardancy of Wood.

The incompatibility between inorganic flame retardants and organic acrylic coatings represents a significant challenge that requires resolution. This work selected environmentally friendly organic aqueous acrylic coatings as the substrate, sodium silicate hydrate as the inorganic flame retardant, and melamine cyanurate (MCA) as the flame-retardant modifier and the flame-retardant co-modifier, with the objective of improving the dispersion and flame-retardant properties of sodium silicate hydrate in the aqueous acrylic coatings. Subsequently, the sodium silicate/MCA/waterborne acrylic acid flame-retardant coating was prepared. The flame-retardant treatment was then applied to poplar veneer in order to create a flame-retardant poplar veneer. The dispersion of the flame-retardant coating was characterized by scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDX), and X-ray diffractometry (XRD). Furthermore, the flame-retardant properties of the flame-retardant poplar veneer were analyzed by thermogravimetry (TG), limiting oxygen index (LOI), and cone calorimeter. The results demonstrated that the MCA-modified sodium silicate flame retardant was well dispersed in aqueous acrylic coatings. The results of the flame-retardant properties of the poplar veneer indicated that the ignition time of the 9% flame retardant-treated poplar veneer was increased by 122.7%, the limiting oxygen index value was increased by 43.0%, and the peak heat release rate (pHRR), the peak total heat release rate (pTHR), and the peak mass loss rate were decreased by 19.9%, 10.8%, and 27.2%, respectively, in comparison to the non-flame retardant-treated poplar veneer. Furthermore, the residual char mass increased by 14.4%, and the residual char exhibited enhanced thickness, density, and regularity. The results demonstrated that MCA was an effective promoter of sodium silicate dispersion in acrylic coatings. Furthermore, the sodium silicate/MCA/waterborne acrylic flame-retardant coating significantly enhance the flame retardancy of wood, and its flame retardant mechanism was consistent with the synergistic silicone-nitrogen expansion flame-retardant mechanism. This work presents a novel approach to enhancing the dispersion of inorganic flame retardants in organic coatings, offering a valuable contribution to the advancement of research and application in the domains of innovative flame retardant coatings and flame retardant wood.

Gastroenteritis Outbreaks after Contamination of Water Supply Systems: Public Health Response Gaps and Challenges, Greece, 2004-2023.

BACKGROUND: waterborne disease outbreaks (WGDOs) following the contamination of drinking water remain a public health concern. METHODS: The current study aims to assess the occurrence and identify gaps in the notification and investigation of WGDOs in Greece. Data for 2004-2023 were retrieved and summarized. RESULTS: Thirty-five outbreaks with 6128 recorded cases were identified. The median time from the date of onset in the first cases to reporting was 7 days (range: 1-26 days). Authorities were informed by health care services in thirty (85.7%) outbreaks and by the media in five (14.3%). The investigation methods used varied. An analytical study was conducted in nine (25.7%) outbreaks and the testing of clinical samples in twenty-seven (77.1%). In three (11.1%) outbreaks, clinical samples were simultaneously tested for multiple bacteria, viruses, and parasites. Water samples were collected in nineteen (54.3%) outbreaks (in three after chlorination) with a mean time lag of 5 days (range: 1-20 days) from the first cases. A pathogen in clinical samples was identified in 20 (57.1%) outbreaks and, in 1 (6.25%), the same microorganism was isolated in both clinical and water samples. CONCLUSIONS: delays in reporting and the heterogeneity of investigations depict that the surveillance of WGDOs and response practices should be strengthened, and operational procedures should be standardised.

Simultaneous SERS-decoding detection of multiple pathogens in drinking water with home-made portable double-layer filtration and concentration device.

The engineering of a home-made portable double-layer filtration and concentration device with the common syringe for rapid analysis of water samples is reported. The core elements of the device were two installed filtration membranes with different pore sizes for respective functions. The upper filtration membrane was used for preliminary intercepting large interfering impurities (interception membrane), while the lower filtration membrane was used for collecting multiple target pathogens (enrichment membrane) for determination. This combination can make the contaminated environmental water, exemplified by surface water, filtrated quickly through the device and just retained the target bacteria of Escherichia coli O157:H7, Staphylococcus aureus, and Listeria monocytogenes on the lower enrichment membrane. Integrating with surface-enhanced Raman spectra (SERS) platform to decode the SERS-Tags (SERS-TagCVa, SERS-TagR6G, and SERS-TagMB) already labeled on each of the enriched bacteria based the antibody-mediated immuno-recognition effect, fast separation, concentration, and detection of multiple pathogenic bacteria from the bulk of contaminated environmental water were realized. Results show that within 30 min, all target bacteria in the lake water can be simultaneously and accurately measured in the range from 101 to 106 CFU mL-1 with detection limit of 10.0 CFU mL-1 without any pre-culture procedures. This work highlights the simplicity, rapidness, cheapness, selectivity, and the robustness of the constructed method for simultaneous detecting multiple pathogens in aqueous samples. This protocol opens a new avenue for facilitating the development of versatile analytical tools for drinking water and food safety monitoring in underdeveloped or developing countries.

Water-Based Continuous Fabrication of Highly Elastic Electromagnetic Fibers.

Elastic electromagnetic fibers are promising building blocks for next-generation flexible electronics. However, fabrication of elastic fibers is still difficult and usually requires organic solvents or high temperatures, restricting their widespread applications. Furthermore, the continuous production of electromagnetic fibers has not been realized previously. In this study, we propose an ionic chelation strategy to continuously produce electromagnetic fibers with a magnetic liquid metal (MLM) as the core and elastic polyurethane as the sheath in water at room temperature. Sodium alginate (SA) has been introduced to rapidly chelate with calcium ions (Ca2+) in a coagulation bath to support the continuous spinning of waterborne polyurethane (WPU) as a sheath. Meanwhile, WPU-encapsulated MLM microparticles efficiently suppress the fluid instability of MLM for continuous extrusion as the core. The resultant fiber exhibits excellent mechanical performances (tensile strength and toughness up to 32 MPa and 124 MJ/m3, respectively), high conductive stability in large deformations (high conductivity of 7.6 × 104 S/m at 580% strain), and magnetoactive properties. The applications of this electromagnetic fiber have been demonstrated by conductance-stable wires, sensors, actuation, and electromagnetic interference shielding. This work offers a water-based molecular principle for efficient and green fabrication of multifunctional fibers and will inspire a series of applications.

Polymerization-Induced Hierarchical Hybrid Particles from Siloxane Emulsification Endowing Polyurethane Composite Coating with Superhydrophobicity, Thermal Insulation, and Fluorescence.

Hierarchically structural particles (HSPs) are highly regarded as favorable nanomaterials for superhydrophobic coating due to their special multiscale structure and surface physicochemical properties. However, most of the superhydrophobic coatings constructed from HSPs are monofunctional, constraining their broader applications. Moreover, traditional methods for constructing HSPs mostly rely on complicated chemical routes and template removal. Herein, we propose an innovative strategy (one-pot method) for producing multifunctional hierarchical hybrid particles (HHPs). Polysilsesquioxane (PSQ), generated from hydrolysis condensation of methyltriethoxylsilane, is used as the sole stabilizer to anchor on the surface of styrene and short fluoroalkyl compound tridecafluorooctyl acrylate comonomers droplets, forming a mesoporous PSQ shell. Subsequently, the comonomers inside of the shell perform restricted polymerization to generate the HHP due to the driving of the mesoporous capillary force. The HHP is then mixed with waterborne polyurethane (WPU) to develop a robust nanocomposite coating (WPU-HHP). Through the deliberate design of the HHP components, the WPU-HHP coating has thermal insulation, photoluminescence properties, and the ability to achieve a wettability transition during abrasion. Our research has achieved the integration of multifunctionality in one waterborne hybrid system, broadening the application areas of nanocomposite coatings.

Outbreak of waterborne acute diarrheal disease in a South District village of Tripura: A public health emergency in the Northeast region of India.

Food and waterborne outbreaks are a neglected public health problem in India. However, it is important to identify the source of infection and the causative pathogen to curb the outbreak quickly and minimize mortality and morbidity. A retrospective descriptive study was conducted with a line list of 130 diarrheal cases. Epidemiological investigation and laboratory investigation were done. Data were collected from hospital case report forms as well as interviewed affected cases. A case of acute diarrheal disease was reported among the people in the village with abdominal pain, vomiting, and diarrhea from December 31, 2022 to January 3, 2023. Out of a total of 130 recorded cases, 33 stool samples were collected and were positive for Enteroaggregative Escherichia coli, Shigella flexneri 3a, and Shigella sonnei by cultural and molecular tests. The presumptive fecal pollution indicator assay indicated high coliform counts in the water samples (most probable number [MPN]-05) and the presence of Escherichia coli. The identified pathogens showed susceptibility to gentamicin and meropenem. People who used public drinking water were found to be infected with acute diarrheal disease (ADD). Quick identification of the causative pathogens and their antimicrobial resistance pattern helped correct antibiotic prescriptions and quick recovery of the patients without any deaths. Thus, a timely implementation of food and waterborne outbreak investigation is crucial to saving lives and preventing the spread of infection.

Current and potential future impacts of food- and water-borne parasites in a changing world: A Norwegian perspective.

In 2021, the Norwegian Scientific Committee for Food and Environment published a multi-criteria risk ranking of 20 potentially food-borne pathogens in Norway. The pathogens ranked included five parasite taxa (3 species, one genus, one family): Toxoplasma gondii, Echinococcus multilocularis, Giardia duodenalis, Cryptosporidium spp., and Anisakidae. Two of these, T. gondii and E. multilocularis, scored very highly (1st and 3rd place, respectively), Cryptosporidium was about midway (9th place), and G. duodenalis and Anisakidae ranked relatively low (15th and 20th place, respectively). Parasites were found, on average, more likely to present an increasing food-borne disease burden in the future than the other pathogens. Here, we review the current impact of these five potentially food-borne parasites in Norway, and factors of potential importance in increasing their future food-borne disease burden. Climate change may affect the contamination of water and fresh produce with transmission stages of the first four parasites, potentially leading to increased infection risk. Alterations in host distribution (potentially due to climate change, but also other factors) may affect the occurrence and distribution of Toxoplasma, Echinococcus, and Anisakidae, and these, coupled with changes in food consumption patterns, could also affect infection likelihood. Transmission of food-borne pathogens is complex, and the relative importance of different pathogens is affected by many factors and will not remain static. Further investigation in, for example, ten-years' time, could provide a different picture of the relative importance of different pathogens. Nevertheless, there is clearly the potential for parasites to exert a greater risk to public health in Norway than currently occurs.

Preparation of Waterborne Silicone-Modified Polyurethane Nanofibers and the Effect of Crosslinking Agents on Physical Properties.

Silicone-modified polyurethane (PUSX) refers to the introduction of a silicone short chain into the polyurethane chain to make it have the dual properties of silicone and polyurethane (PU). It can be used in many fields, such as coatings, films, molding products, adhesives, and so on. The use of organic solvents to achieve the fiberization of silicone-modified polyurethane has been reported. However, it is challenging to achieve the fiberization of silicone-modified polyurethane based on an environmentally friendly water solvent. Herein, we report a simple and powerful strategy to fabricate environmentally friendly waterborne silicone-modified polyurethane nanofiber membranes through the addition of polyethylene glycol (PEG) with different molecular weights using electrospinning technology and in situ doping with three crosslinking agents with different functional groups (a polyoxazoline crosslinking agent, a polycarbodiimide crosslinking agent, and a polyisocyanate crosslinking agent) combined with various heating treatment conditions. The influence of PEG molecular weight on fiber formation was explored. The morphology, structure, water resistance, and mechanical properties were analyzed regarding the effect of the introduction of silicone into PU. The effects of the type and content of crosslinking agent on the morphology and physical properties of PUSX nanofiber membranes are discussed. These results show that the introduction of silicone can improve the water resistance and high temperature resistance of waterborne PU, and the addition of a crosslinking agent can further improve the water resistance of the sample, so that the sample can maintain good morphology after immersion. Crosslinking agents with different functional groups had different effects on the mechanical properties of PUSX nanofiber membranes due to different reactions. Among them, the oxazoline crosslinking agent had a significant effect on improving tensile strength, while the isocyanate crosslinking agent had a significant effect on improving the elongation at break. The PUSX nanofiber membrane prepared in this work did not use organic solvents that were harmful to humans and the environment, and it can be used in outdoor textiles, oil-water separation, medical health, and other fields.

Fabrication of Waterborne Silicone-Modified Polyurethane Nanofibers for Nonfluorine Elastic Waterproof and Breathable Membranes.

Waterproof and breathable membranes have a huge market demand in areas, such as textiles and medical protection. However, existing fluorinated nanofibrous membranes, while possessing good waterproof and breathable properties, pose health and environmental hazards. Consequently, fabricating fluorine-free, eco-friendly waterborne membranes by integrating outstanding waterproofing, breathability, and robust mechanical performance remains a significant challenge. Herein, we successfully prepared waterborne silicone-modified polyurethane nanofibrous membranes with excellent elasticity, waterproofing, and breathability properties through waterborne electrospinning, using a small quantity of poly(ethylene oxide) as a template polymer and in situ doping of the poly(carbodiimide) crosslinking agent, followed by a simple hot-pressing treatment. The silicone imparted the nanofibrous membrane with high hydrophobicity, and the crosslinking agent enabled its stable porous structure. The hot-pressing treatment (120 °C) further reduced the pore size and improved the water resistance. This environmentally friendly nanofibrous membrane showed a high elongation at break of 428%, an ultra-high elasticity of 67.5% (160 cycles under 400% tensile strain), an air transmission of 13.2 mm s-1, a water vapor transmission rate of 5476 g m-2 d-1, a hydrostatic pressure of 51.5 kPa, and a static water contact angle of 137.9°. The successful fabrication of these environmentally friendly, highly elastic membranes provides an important reference for applications in healthcare, protective textiles, and water purification.

Freshwater sports and infectious diseases: A narrative review.

Freshwater sports involve a wide range of practices leading to contact with soil and water that can entail exposure to agents of potential infectious diseases. The pathogens can be multiple (bacteria, parasites, viruses, fungi), and be either well-known or more unfamiliar and exotic. We conducted a literature review to describe various infections contracted following exposure to water and mud during freshwater sport activities. Out of the 1011 articles identified, 50 were finally included. Our findings encompassed bacterial infections (leptospirosis and gastrointestinal infections); parasitic infections (schistosomiasis, cercarial dermatitis); viral infections (norovirus and other gastrointestinal viruses; seaweed contamination; and fungal infections. These infections were reported in various countries worldwide among diverse freshwater sport activities, including swimming, surfing, kayaking, as well as extreme sports such as adventure races and mud runs. Water sports in freshwater can expose participants to infectious risks according to geographical location and type of sport. Because regular sport practice is beneficial for health, freshwater sports should not be avoided due to potential exposure to pathogens; that much said, certain precautions should be taken. In addition to adoption of preventive measures, participants should be informed about infectious risks and seek medical advice if symptoms appear after exposure. Current guidelines for assessment of bathing water quality do not suffice to ensure comprehensive evaluation of freshwater quality. Event organizers are called upon to pay close attention to environmental factors and meteorological events, to conduct timely sensitization campaigns, and to enforce appropriate safety measures.

Quantitative microbial risk assessment for Escherichia Coli O157: H7 via drinking water in the Gaza Strip, Palestine.

Introduction: Microbial contamination of drinking water, particularly by pathogens such as Escherichia coli O157: H7, is a significant public health concern worldwide, especially in regions with limited access to clean water like the Gaza Strip. However, few studies have quantified the disease burden associated with E. coli O157: H7 contamination in such challenging water management contexts. Objective: This study aimed to conduct a comprehensive Quantitative Microbial Risk Assessment to estimate the annual infection risk and disease burden attributed to E. coli O157: H7 in Gaza's drinking water. Methods: Applying the typical four steps of the Quantitative Microbial Risk Assessment technique-hazard identification, exposure assessment, dose-response analysis, and risk characterization-the study assessed the microbial risk associated with E. coli O157: H7 contamination in Gaza's drinking water supply. A total of 1317 water samples from various sources across Gaza were collected and analyzed for the presence of E. coli O157: H7. Using Microsoft ExcelTM and @RISKTM software, a Quantitative Microbial Risk Assessment model was constructed to quantify the risk of infection associated with E. coli O157: H7 contamination. Monte Carlo simulation techniques were employed to assess uncertainty surrounding input variables and generate probabilistic estimates of infection risk and disease burden. Results: Analysis of the water samples revealed the presence of E. coli O157: H7 in 6.9% of samples, with mean, standard deviation, and maximum values of 1.97, 9.74, and 112 MPN/100 ml, respectively. The risk model estimated a median infection risk of 3.21 × 10-01 per person per year and a median disease burden of 3.21 × 10-01 Disability-Adjusted Life Years per person per year, significantly exceeding acceptable thresholds set by the WHO. Conclusion: These findings emphasize the urgent need for proactive strategies to mitigate public health risks associated with waterborne pathogens in Gaza.

Clostridium and Cryptosporidium outbreak linked to a splash pad.

BACKGROUND: . Splash pads for recreational purposes are widespread. Using these pads can pose a health risk if they lack installation regulation and water quality supervision. Our aim was to describe a waterborne disease outbreak caused by Clostridium perfringens and Cryptosporidium spp. in a Barcelona district and the measures taken for its control. METHODS: . On August 2018, 71 cases of acute gastroenteritis were detected, affecting people who used a splash pad or were in contact with a user. Microbiological and environmental investigations were carried out. A descriptive analysis of the sample and Poisson regression models adjusted for age and sex were performed, obtaining frequencies, median values, and adjusted prevalence ratios with their 95% confidence intervals. RESULTS: The median age of the cases was 6.7 years, 27 (38%) required medical care, and three (4.2%) were hospitalized. The greater the number of times a person entered the area, the greater the number of symptoms and their severity. Nineteen (76%) of the 25 stool samples collected from cases showed the presence of one or both pathogens. Environmental investigations showed deficiencies in the facilities and identified the presence of both species in the splash pad. Health education and hygiene measures were carried out, and 14 days after the closure of the facilities, no more cases related to the pad were recorded. CONCLUSIONS: . Specific regulations are needed on the use of splash pads for recreational purposes. Until these regulations are in place, these types of facility should comply with the regulations that apply to swimming pools and spas, including those related to the design of the tanks, water recirculation systems, and adequate disinfection systems.