Gas Flow to Enhance the Detection of Alpha-Induced Air Radioluminescence Based on a UVTron Flame Sensor.

In many field applications where alpha-induced radioluminescence (or so-called UV fluorescence) could potentially be used for stand-off detection of alpha-emitting materials, it may not be possible to create a fully purged gas atmosphere. Hence, an alternative gas delivery method to utilise the radioluminescence enhancing properties of gases has been investigated, with the novel results from this presented herewithin. A solar blind ultraviolet C (UVC) sensor (UVTron R9533, Hamamatsu, Japan) has been used to detect changes in the signal in the UVC wavelength range (180⁻280 nm), where gases of Ar, Xe, Ne, N2, Kr, and P-10 were flowed over a 6.95 MBq 210Po source using a narrow diameter pipe close to the source. In comparison with an air atmosphere, there was an increase in signal in all instances, the greatest being the flow of Xe, which in one instance greater than doubled the average counts per second. This increase in signal could prove beneficial in the design of a stand-off alpha detector to detect the very small UVC radioluminescence signals from alpha-emitting materials found in nuclear decommissioning environments.

First Results of Using a UVTron Flame Sensor to Detect Alpha-Induced Air Fluorescence in the UVC Wavelength Range.

In this work, a robust stand-off alpha detection method using the secondary effects of alpha radiation has been sought. Alpha particles ionise the surrounding atmosphere as they travel. Fluorescence photons produced as a consequence of this can be used to detect the source of the alpha emissions. This paper details experiments carried out to detect this fluorescence, with the focus on photons in the ultraviolet C (UVC) wavelength range (180-280 nm). A detector, UVTron R9533 (Hamamatsu, 325-6, Sunayama-cho, Naka-ku, Hamamatsu City, Shizuoka Pref., 430-8587, Japan), designed to detect the UVC emissions from flames for fire alarm purposes, was tested in various gas atmospheres with a 210Po alpha source to determine if this could provide an avenue for stand-off alpha detection. The results of the experiments show that this detector is capable of detecting alpha-induced air fluorescence in normal indoor lighting conditions, as the interference from daylight and artificial lighting is less influential on this detection system which operates below the UVA and UVB wavelength ranges (280-315 nm and 315-380 nm respectively). Assuming a standard 1 r 2 drop off in signal, the limit of detection in this configuration can be calculated to be approximately 240 mm, well beyond the range of alpha-particles in air, which indicates that this approach could have potential for stand-off alpha detection. The gas atmospheres tested produced an increase in the detector count, with xenon having the greatest effect with a measured 52% increase in the detector response in comparison to the detector response in an air atmosphere. This type of alpha detection system could be operated at a distance, where it would potentially provide a more cost effective, safer, and faster solution in comparison with traditional alpha detection methods to detect and characterise alpha contamination in nuclear decommissioning and security applications.

A neo-strategic planning approach to enhance local tobacco control programs.

BACKGROUND: Research in tobacco control demonstrating best practices is widely disseminated; however, application at the local level is often difficult. Translating research into practice requires a concerted effort to develop an understanding of the evidence and how it can be applied within diverse contexts. PURPOSE: A strategic planning infrastructure was developed to support the translation of evidence-based interventions into community practice. This paper highlights the strategic process of turning "know-what" into "know-how" to facilitate the strategic planning and implementation of tobacco control best practices at the local level. DESIGN: The purpose, people, process, and product strategies of knowledge management and translation provided a framework for the strategic planning infrastructure. The knowledge translation concepts of audience, motivations, and mechanisms were synergized in the neo-strategic planning component design. SETTING/PARTICIPANTS: The participants were 20 community coalitions funded to implement local tobacco control programs. INTERVENTION: From 2004 to 2011, the strategic planners facilitated a cyclical process to translate research into practice using a trio of integrated tools, skill-building workshops on strategic planning, and grantee-driven technical assistance and consultation. MAIN OUTCOME MEASURES: In the short term, the usefulness of the strategic planning components to the programs was measured. The intermediate outcome was the successful movement of the community programs from the planning stage to the implementation stage. The achievement of community-level changes in planned tobacco control efforts was the overall outcome measure for the success of the local coalitions. RESULTS: Seventeen of 20 communities that began the planning process implemented strategic plans. All 17 of the programs implemented evidence-based practices, resulting in numerous tobacco-free policies, increased cessation, and increased support from the media and community. CONCLUSIONS: Bridging the gap between research and practice can enhance the practicality, efficiency, and effectiveness of tobacco control programs at the local level, maximizing the potential positive health impact.

Use of gentamicin-collagen sponges in closure of sternal wounds in cardiothoracic surgery to reduce wound infections.

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Are antibiotic implants like gentamicin-collagen implants useful in preventing sternal wound infections (SWIs)? Altogether, more than 484 papers were found using the reported search; of these, 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that most randomized controlled trials (RCTs) have been performed with gentamicin-collagen sponges for sternal closure. Two out of four RCTs showed a significant benefit of the implant in a reduction in superficial and deep SWIs in routine and emergency cardiac surgery. One RCT showed a significant reduction in superficial infections in 2005, a follow-up trial by the same group in 2009 showed a reduction in deep infections as well. Another group has shown a reduction in deep and superficial SWI with gentamicin implant, in an RCT on 800 patients, however have not published details of the complete trial. The third trial on 542 patients showed no benefit of the implant, but was not adequately powered. However, the most recent multicentre RCT conducted on 1052 patients showed no benefit of gentamicin-collagen sponges in elective surgery (coronary artery bypass grafting and/or valve surgery) in high-risk patients with diabetes, obesity or both. Concerns were raised that gentamicin sponges dipped in saline 1-2 s prior to application may have lost the gentamicin into the saline, thereby reducing their efficacy and that some surgeons may have been unfamiliar with wound closure with sponges. However, these were robustly refuted by the authors. One RCT showed that gentamicin sponges may cause increased sternal rebleeding if used in double layers. Coagulase-negative staphylococci were predominantly isolated from infected wounds in all the trials except the one from USA, where infections were polymicrobial. Gentamicin resistance among common pathogens causing SWIs can vary from 15 to 80%. Gentamicin-collagen is unlikely to reduce SWIs in high-risk patients and polymicrobial infections.

Diagnosis of metastatic pancreatic mesenchymal tumors by endoscopic ultrasound-guided fine-needle aspiration.

Involvement of the pancreas by metastatic sarcoma is rare, and can prove challenging to differentiate from sarcomatoid carcinomas which occur more commonly. The endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) technique has been successfully used for the diagnosis of pancreatic carcinomas whether primary or metastatic, and is now considered the most effective noninvasive method for the identification of pancreatic metastases. However, to date very few reports detail the diagnosis of mesenchymal neoplasms by EUS-FNA. Herein, we report a series of four patients who underwent EUS-FNA of the pancreas, where the diagnosis of metastatic sarcoma was made based on morphology and ancillary studies. The cases include metastases of leiomyosarcoma, liposarcoma, alveolar rhabdomyosarcoma, and solitary fibrous tumor. The history of a primary sarcoma of the chest wall, mediastinum, and respectively lower extremity was known for the first three of these patients while in the case of the solitary fibrous tumor a remote history of a paraspinal "hemangiopericytoma" was only elicited after the EUS-FNA diagnosis was made. We conclude that EUS-FNA is efficient and accurate in providing a diagnosis of sarcoma, even in patients without a known primary sarcoma, thus allowing institution of therapy without additional biopsies.

Importance of the environment for patient acquisition of methicillin-resistant Staphylococcus aureus in the intensive care unit: a baseline study.

OBJECTIVE: To assess the degree of environmental contamination with methicillin-resistant Staphylococcus aureus (MRSA) in critical care and the likelihood of subsequent new patient acquisition if carriers were or were not moved to single rooms. DESIGN: Randomized sequential sampling of bed areas. SETTING: Intensive care units of two teaching hospitals. PATIENTS: Medical and surgical patients requiring critical care. INTERVENTIONS: Six environmental sites around randomly selected patients plus two communal sites were sampled using contact plates during periods when patients with MRSA were physically isolated or not. Admission, weekly, and discharge screening patient swabs were taken to identify patients admitted with, or newly acquiring, MRSA. MEASUREMENTS AND MAIN RESULTS: A total of 2,436 samples were taken from environments around 114 patients, plus a further 349 samples from doctors' hands and telephones. Of the 47 bed areas where MRSA strains were identified that were not found initially on patients, only one patient subsequently acquired the same strain. Five other patients became colonized with new MRSA strains, but these were not found in their environment beforehand. Of 52 patients colonized with MRSA, 34 had a similar strain found subsequently in their environment. CONCLUSIONS: Whereas the MRSA-colonized patient frequently contaminates his or her local environment, transmission of MRSA from the environment to the patient was not commonly identified. Studies elucidating possible routes of MRSA transmission are urgently needed to inform infection control policies.