Contributing Risk Factors to Self-Contamination During the Process of Donning and Doffing Personal Protective Equipment.

OBJECTIVE: The goal of this study is to explore the risk factors associated with self-contamination points during personal protective equipment (PPE) donning and doffing among health care workers (HCWs). METHODS: In total, 116 HCWs were randomly sampled and trained to don and doff the whole PPE set. We smeared the whole PPE set with the fluorescent powder. After each participant finished PPE doffing, the whole body was irradiated with ultraviolet light in order to detect contamination points and record the position and quantity. Sociodemographic characteristics and previous infection prevention control (IPC) training experience, among others, were collected by using electronic questionnaires. Poisson regression was used in identifying risk factors that are associated with the number of contamination points, and the relative risk (RR) and its 95% confidence interval (CI) were calculated. RESULTS: About 78.5% of participants were contaminated. Ever training experience (RR = 0.37; 0.26, 0.52), clinical departments (RR = 0.67; 0.49, 0.93), body mass index (BMI) (RR = 1.09; 1.01, 1.18), and shoulder width (RR = 1.07; 1.01, 1.13) were associated with the number of contamination points. CONCLUSIONS: Previous IPC training experience, department types, BMI, and shoulder width were associated with self-contamination points after the PPE was removed.

Multidrug-Resistant Organism Infections of Inpatients in a Hospital in Eastern China from 2015 to 2021.

Background: The prevalence of multidrug-resistant organisms (MDRO) is gradually increasing in the global scope, causing serious burden to patients and society, which is an important public health problem. Objective: To analyze the distribution and trend of MDROs and provide a reference for hospital infection control. Methods: Collected data on MDROs infections among inpatients in a Grade III Level A hospital in Suzhou from 2015 to 2021, including drug-resistant bacteria strains and specimen sources, etc. Mantel-Haenszel χ2 test was used to evaluate the trend of infection rates over the years and SPSS version 26.0 was used for statistics analysis. Results: The hospital infection rate showed an overall downward trend across the seven-year period, ranging from 1.53% to 2.10%. According to the analysis of change of drug-resistant bacteria strains, the highest infection rate was carbapenem-resistant Acinetobacter baumannii (CRABA) (63.74%), followed by methicillin-resistant Staphylococcus aureus (MRSA) (46.37%), carbapenem-resistant Pseudomonas aeruginosa (CRPAE) (24.87%), carbapenem-resistant Enterobacteriaceae (CRE) (13.14%) and vancomycin-resistant Enterococcus (VRE) (0.42%). The results of Mantel-Haenszel χ2 test showed that there was a linear relationship between the detection rate of CRE and CRPAE and the time (P<0.001), but the correlation was not strong (R = 0.136; R = 0.139). The overall detection rate of the five pathogens also increased (P<0.001). The majority of the specimens, mainly from sputum, airway secretions, and midstream urine, had a detection rate of over 70%. Conclusion: Our data showed that the detection rate of MDROs generally increased from 2015 to 2021, although the hospital infection rate displayed a declining trend. Among the detection rate MDROs, the highest was CRABA, and the lowest was VRE. It is necessary to enhance the prevention, control, and management of MDROs infections in the clinical practice.

Prognostic Factors and Nomograms for Overall and Cancer-Specific Survival of Patients with Uveal Melanoma without Metastases: A SEER Analysis of 4119 Cases.

Purpose: To determine prognostic factors for patients with uveal melanoma without metastases and to construct nomograms to predict their 3- and 5-year overall survival (OS) and cancer-specific survival (CSS). Methods: We included 4119 patients who were registered from 2004 to 2015 in the Surveillance, Epidemiology, and End Results database. The median follow-up time was 5.8 years. Independent risk factors affecting OS and CSS were identified with univariate and multivariate Cox regression analyses and used to construct nomograms. Internal and external validation were carried out by using the bootstrap method to calculate the concordance indices (C-indices) and plot the calibration curves. Results: Age, primary site, histological type, T-stage, and treatment were independent risk factors for OS and CSS; marital status and sequence number were factors only for OS. The C-indices for internal validation of OS and CSS were 0.713 (95% CI, 0.697-0.729) and 0.708 (95% CI, 0.688-0.728), respectively, and for external validation they were 0.729 (95% CI, 0.705-0.753) and 0.731 (95% CI, 0.700-0.762), respectively. The calibration curves also revealed good agreement between the predicted and actual survival rates. Conclusions: We constructed nomograms to predict the 3- and 5-year OS and CSS of patients with uveal melanoma without metastases. Our nomograms may improve prognostication and assist with the development of individualized treatment strategies.

Characterization of key aroma compounds in flat peach juice based on gas chromatography-mass spectrometry-olfactometry (GC-MS-O), odor activity value (OAV), aroma recombination, and omission experiments.

The aroma profiles of fresh flat peach juice (FPJ) samples obtained from four different cultivars (RP1), (ZLP), (RP18), and (ZP) were characterized by gas chromatography-Mass spectrometry-olfactometry (GC-MS-O). Totally, 32 aroma-active compounds in FPJs were identified by GC-MS-O and further quantified. Of these, 14 aroma-active compounds presented odor activity values (OAVs) greater than 1, with several lactones and aldehydes contributing as key aroma-active components of FPJs. Partial least-squares regression (PLSR) revealed that RP18 was greatly related to "fruity", "sweet" and "peach-like" attributes, while ZLP was highly correlated with "floral" and "green and grassy" attributes, confirming the quantitative describe analysis (QDA) results. In addition, an aroma recombination experiment was conducted to mimic the aroma profile of flat peach juice based on the actual concentrations of RP18. Omission experiments indicated that lactones were very highly significant for the characteristic aroma of FPJ.

Light-To-Moderate Raw Garlic Consumption Frequency Is Inversely Associated With Thickened Carotid Intima-Media Thickness: A Population-Based Study.

Background: Previous animal and clinical studies have reported beneficial effects of garlic preparations on carotid intima-media thickness (cIMT). However, no epidemiological study has yet investigated the association between dietary raw garlic consumption and cIMT in the general population. The objective of this study was investigating the association between dietary raw garlic consumption and thickened cIMT in Chinese adults. Methods: This cross-sectional study used data from the Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. A total of 4,329 general adults from 2015 to 2017 were included in this study. Frequency of consumption of raw garlic was summarized as four categories for analysis: < 1 time/week, 1 time/week, 2-3 times/week, ≥4 times/week with a validated food frequency questionnaire. The thickened cIMT was defined as common carotid artery IMT ≥ 1.0 mm or a carotid bifurcation IMT ≥ 1.2 mm by ultrasonography. Multivariable logistic regression analysis was used to examine the association between frequency of raw garlic consumption and thickened cIMT. Results: The prevalence of thickened cIMT is 22.9% among these participants. The adjusted odds ratios (95% confidence intervals) associated with the different frequencies were 1.00 (reference) for < 1 time/week, 0.74 (0.59, 0.94) for 1 time/week, 0.71 (0.55, 0.92) for 2-3 times/week, and 0.94 (0.71, 1.25) for ≥ 4 times/week. Conclusions: Light-to-moderate raw garlic consumption was inversely associated with thickened cIMT, whereas greater raw garlic consumption (i.e., ≥4 times/week) was not associated with thickened cIMT. Future longitudinal studies should be conducted to test these findings.

Efficient biorefinery of whole cassava for citrate production using Aspergillus niger mutated by atmospheric and room temperature plasma and enhanced co-saccharification strategy.

BACKGROUND: The non-grain crop cassava has attracted intense attention in the biorefinery process. However, efficient biorefinery of whole cassava is faced with some challenges due to the existence of strain inhibition and refractory cellulose during the citrate production process. RESULTS: Here, a novel breeding method - atmospheric and room temperature plasma (ARTP) - was applied for strain improvement of citrate-producing strain Aspergillus niger from whole cassava. The citrate yield of the mutant obtained using ARTP mutagenesis increased by 36.5% in comparison with the original strain. Moreover, citric acid fermentation was further improved on the basis of an enhanced co-saccharification strategy by supplementing glucoamylase and cellulase. The fermentation efficiency increased by 35.8% with a 17.0 g L-1 reduction in residual sugar on a pilot scale. CONCLUSIONS: All these results confirmed that a combination of the novel breeding method and enhanced co-saccharification strategy could be used to efficiently refine whole cassava. The results also provide inspiration for the production of value-added products and waste disposal in agro-based industries. © 2021 Society of Chemical Industry.

Fine regulation of the starch liquefaction process and its application in the production of citric acid.

Citric acid (CA), generally fermented from the starchy material, has attracted intense attention because of its wide applications in many aspects. However, the traditional starchy-liquefaction process based on the dextrose equivalent value and iodine-testing method is inappropriate as it hinders the subsequent CA fermentations. Here, a novel method of evaluating the starch liquefaction in the CA production process was established. Firstly, dextrin samples with the molecular weight (Mw) narrow distribution were prepared by alcohol fractional precipitation. Glucoamylase (GM) from the culture of CA-producing strain Aspergillus niger was purified. Then, the structure-activity relationship between the dextrin and GM was analyzed. Results demonstrated that the Mw of liquefied components aggregated in the range of 1.4-1.9 kDa could improve the efficiency of simultaneous saccharification and fermentation process. CA production rate and total sugar uptake rate were evidently improved with residual total sugar decreasing by 10.8% and fermentation efficiency enhanced by 21.1% in 9 h shorter fermentation time. All these results confirmed that fine regulation of the starch liquefaction based on the Mw characteristics was feasible and effective to improve the CA fermentation. Our proposed strategy could also be useful for other fermentations and sugar industry involving the starchy material.

High-efficient production of citric acid by Aspergillus niger from high concentration of substrate based on the staged-addition glucoamylase strategy.

Citric acid (CA), an important platform-compound, has attracted much attention because of its broad applications and huge market demand. To solve high residual sugar at the fermentation end, we put forwarded strategy of pre-saccharification and then fermentation. Results showed that the residual total sugar decreased by 10.4% and the productivity increased by 4.0% and initially high glucose inhibited cell growth. Furthermore, commercial glucoamylase with high low-pH stability was proposed to staged-add in the fermentation process, which timely compensated enzyme loss, ensuring the glucose supply rate. The fermentation productivity was evidently enhanced by 13.3% with residual total sugar decreasing by 31.3%, simplifying the subsequent product separation and extraction process. Our results confirmed that staged-addition glucoamylase strategy was feasible to effective production of CA.