Physicians' compliance for hand hygiene in medical outpatient clinics: automated hand-hygiene monitoring with touch sensor and wireless internet.

BACKGROUND: Outpatient clinics are reservoirs for significant pathogens. Hand hygiene with alcohol-based hand rubs are measures currently in use to prevent horizontal transmission of infections. The extent of compliance with hand hygiene regulations is unclear and difficult to monitor. METHODS: We built an automated monitoring system with a pressure sensor attached to the alcohol-based hand rubs containers. Wireless fidelity (WIFI)-assisted data collection took place over 9 weeks. Interventions included posters, email reminders and newsletters. Hand hygiene compliance before and after these interventions was evaluated. RESULTS: Overall compliance with hand hygiene regulations was 6.48%; half of the physicians participating in our study performed hand hygiene at only 3.08% of patient visits. Twenty-four (17.9%) physicians performed hand hygiene with high compliance (≥10%), while 11.2% performed no hand hygiene at all. Physicians in academic positions and those with ≥20 years of experience performed hand hygiene less frequently than did other physicians. Compliance with hand hygiene regulations improved from 6.08% to 6.73% (P < .001) after intervention. DISCUSSION: Compliance with hand hygiene among physicians in our outpatient clinics was very low and needs to improve. CONCLUSIONS: Interventions improved the compliance somewhat, although additional interventions including education, training and feedback were suggested.

The transcription factor E2A activates multiple enhancers that drive Rag expression in developing T and B cells.

Cell type-specific gene expression is driven by the interplay between lineage-specific transcription factors and cis-regulatory elements to which they bind. Adaptive immunity relies on RAG-mediated assembly of T cell receptor (TCR) and immunoglobulin (Ig) genes. Although Rag1 and Rag2 expression is largely restricted to adaptive lymphoid lineage cells, it remains unclear how Rag gene expression is regulated in a cell lineage-specific manner. Here, we identified three distinct cis-regulatory elements, a T cell lineage-specific enhancer (R-TEn) and the two B cell-specific elements, R1B and R2B By generating mice lacking either R-TEn or R1B and R2B, we demonstrate that these distinct sets of regulatory elements drive the expression of Rag genes in developing T and B cells. What these elements have in common is their ability to bind the transcription factor E2A. By generating a mouse strain that carries a mutation within the E2A binding site of R-TEn, we demonstrate that recruitment of E2A to this site is essential for orchestrating changes in chromatin conformation that drive expression of Rag genes in T cells. By mapping cis-regulatory elements and generating multiple mouse strains lacking distinct enhancer elements, we demonstrate expression of Rag genes in developing T and B cells to be driven by distinct sets of E2A-dependent cis-regulatory modules.

Modulation of Prins Cyclization by Vibrational Strong Coupling.

Light-molecule strong coupling has emerged within the last decade as a new method to control chemical reactions. A few years ago it was discovered that chemical reactivity could be altered by vibrational strong coupling (VSC). Only a limited number of reactions have been investigated under VSC to date, including solvolysis and deprotection reactions. Here the effect of VSC on a series of aldehydes and ketones undergoing Prins cyclization, an important synthetic step in pharmaceutical chemistry, is investigated. A decrease of the second-order rate constant with VSC of the reactant carbonyl stretching groups is observed. We also observe an increased activation energy due to VSC, but proportional changes in activation enthalpy and entropy, suggesting no substantive change in reaction pathway. The addition of common cycloaddition reactions to the stable of VSC-modified chemical reactions is another step towards establishing VSC as a genuine tool for synthetic chemistry.

Lipid raft dynamics linked to sperm competency for fertilization in mice.

It is well known that mammalian sperm acquires fertilization ability after several maturation processes, particularly within the female reproductive tract. In a previous study, we found that both glycosylphosphatidylinositol (GPI)-anchored protein (GPI-AP) release and lipid raft movement occur during the sperm maturation process. In several genetic studies, release of GPI-AP is a crucial step for sperm fertilization ability in the mouse. Here, we show that lipid raft movement is also fundamental for sperm to be competent for fertilization by comparing the sperm maturation process of two mouse inbred strains, C57BL/6 and BALB/c. We found that ganglioside GM1 movement was exclusively reduced in BALB/c compared with C57BL/6 among other examined sperm maturation parameters, such as GPI-AP release, sperm migration to the oviduct, cholesterol efflux, protein tyrosine phosphorylation and acrosome reaction, and was strongly linked to sperm fertility phenotype. The relationship between GM1 movement and in vitro fertilization ability was confirmed in other mouse strains, suggesting that lipid raft movement is one of the important steps for completing the sperm maturation process.

New layered copper 1,3,5-benzenetriphosphonates pillared with N-donor ligands: their synthesis, crystal structures, and adsorption properties.

The synthesis, crystal structures, and adsorption properties of a series of pillared layered copper phosphonates are reported herein. A hydrothermal reaction of copper oxide, 1,3,5-benzenetriphosphonic acid (BTP = H6bpt), and N-donor ligands with different lengths gives three new and one previously reported copper organophosphonates. X-ray crystal structural analyses revealed that compound 1, [Cu2(H4btp)2(pyr)] (pyr = pyrazine), forms a dense 3D network structure without open pores, and on the other hand, compounds 2-4, [Cu2(H2btp)(H2O)2(L)] (L = bipyridine for 2, 1,2-bis(4-pyridyl)ethylene for 3, and 1,3-bis(4-pyridyl)propane for 4), show topologically identical pillared layered frameworks with micropores. The framework structures are composed of copper phosphonate layers and N-donor ligands expanding the interlayer distances. Guest water molecules occupy the pores and are removable by drying treatment. Compounds 2-4 adsorb and desorb water vapor reversibly with structural transformation. Interestingly, compounds 2-4 adsorb ethanol vapor in spite of no adsorption of N2 molecules, indicating selective adsorption properties based not on the molecular size but on the molecular affinities to the surfaces.

Cooperation between MyD88 and TRIF pathways in TLR synergy via IRF5 activation.

Signaling by Toll-like receptors (TLRs) is central to evoking innate immunity, wherein each TLR is activated by distinct pathogen-derived agonists. It has been shown previously that TLR signaling occurs in synergy when certain TLR agonist combinations simultaneously activate immune cells. This synergism may constitute a mechanism critical to ensuring the effective activation of the immune system by multiple TLR activating molecules associated with a given pathogen; however, its underlying mechanism(s) remain unclarified. Here, we provide evidence that TLRs utilizing the MyD88 adaptor selectively cooperate with those utilizing the TRIF adaptor for synergistic induction of a set of target genes, and that this synergism is abrogated in cells lacking either MyD88 or TRIF. Moreover, we also provide evidence that this TLR synergy is mediated, at least in part, by activation of the transcription factor interferon regulatory factor 5 (IRF5). Thus, our findings offer a mechanistic insight into TLR synergy, revealing the hitherto unknown cross talk between the MyD88 and TRIF pathways for a robust TLR-mediated activation of the immune system.