Assuntos
Diagnóstico por Computador/métodos , Informática Médica/métodos , Assistência ao Paciente/normas , Processamento de Sinais Assistido por Computador , Algoritmos , Registros Eletrônicos de Saúde , Parada Cardíaca/diagnóstico , Parada Cardíaca/prevenção & controle , Humanos , Modelos Estatísticos , Segurança do Paciente/normas , Respiração Artificial/efeitos adversosAssuntos
Unidades Hospitalares/organização & administração , Hospitais Pediátricos/organização & administração , Monitorização Fisiológica , Isolamento de Pacientes/organização & administração , Criança , Processamento Eletrônico de Dados/organização & administração , Processamento Eletrônico de Dados/normas , Arquitetura de Instituições de Saúde/normas , Número de Leitos em Hospital , Unidades Hospitalares/normas , Hospitais Pediátricos/normas , Humanos , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Monitorização Fisiológica/normas , Estudos de Casos Organizacionais , Isolamento de Pacientes/normas , Isoladores de Pacientes/normas , Consulta Remota/instrumentação , Consulta Remota/organização & administração , Telemetria/métodos , Telemetria/normas , TexasRESUMO
The capping layer stabilizing silver nanoparticles (AgNPs) affects its aggregation, dissolution, and net disinfection action, especially under conditions of varying water composition, such as, pH, ionic strength and organic matter content. Herein, we correlate the silver ion (Ag(+)) release and reactive oxygen species (ROS) generation rates for AgNPs of varying functionalization to their net disinfection coefficient on Escherichia coli, under conditions of differing water chemistries. For electrostatically stabilized citrate-capped AgNPs, the rate of ROS generation, as measured using a fluorescent dye, is found to dominate over that of Ag(+) release, especially for smaller sized AgNP suspensions (~10nm) at low pH (~6.2). For these AgNPs, the ROS disinfection mechanism is confirmed to dominate net disinfection action, as measured by the live/dead assay, especially at low levels of organic matter. Steric stabilization of AgNPs by protein or starch-capped layers enables disinfection through reducing AgNP aggregation and promoting silver dissolution over ROS generation. We suggest the involvement of protons and dissolved oxygen in causing the independent formation of Ag(+) and ROS, regardless of the AgNP capping layer. While protein-capping layers effectively stabilize AgNPs, the generated ROS is likely dissipated by interference with the bulky capping layer, whereas the interference is lower with citrate-capping layers. Steric stabilization of AgNPs enables disinfection within a wide range of water chemistries, whereas effective disinfection can occur under electrostatic stabilization, only at low NaCl (<1 mmol/L) and organic matter (<5 mg/L) levels.
Assuntos
Desinfecção/métodos , Nanopartículas Metálicas/química , Prata/química , Água/química , Escherichia coli/efeitos dos fármacos , Espécies Reativas de Oxigênio/química , Prata/farmacologia , Eletricidade EstáticaRESUMO
This article introduces a method to identify risks through expert elicitation, using silver nanotechnology as a case study. Unique features of the method include supplying experts with a list of silver nanotechnology products, and conducting the elicitation in an extended interview format that captures the experts' reasoning. The end result is a series of graphical representations of expert thinking from which high-risk scenarios and knowledge gaps can be reliably inferred. This methodology, combined with other approaches to expert elicitation, can help identify knowledge and oversight gaps, and can be used as part of an adaptive management strategy.