No time for handwashing!? Handwashing versus alcoholic rub: can we afford 100% compliance?

Leukocytes present in allogeneic blood components have been associated with adverse effects to the recipient. These include the development of febrile transfusion reactions, alloimmunization to human leukocyte antigens, graft-versus-host disease, and immunomodulatory effects. In addition, such leukocytes may be the vector of infectious agents such as CMV, HTLV-I/II, and EBV. It has been postulated that the use of white blood cell filters to reduce the leukocyte content in allogeneic blood products may minimize the occurrence of these biological adverse effects associated with leukocytes present in transfused blood products. However, it is still to be determined the clinical effectiveness of leukodepletion. It has been suggested that 1 log10 leukocyte reduction prevents febrile non-hemolytic transfusion reactions; that a 2 log10 reduction may prevent the transmission of viruses; and that a > or = 3 log10 reduction may be necessary to prevent platelet alloimmunization. However, because there are no data available as guidelines for the use of leukodepleted blood products for most clinical indications, the use of white cell filters should be restricted to selected patients for whom such data exist. Properly designed prospective clinical trials are necessary to provide data to help to define the cost-benefit of the clinical application of leukodepletion.     

Fingerprinting with the polymerase chain reaction: confirmation of a Enterobacter cloacae epidemic in a neonatal intensive care unit

Between end December 1993 and end January 1994 a cluster of children infected/colonized with Enterobacter cloacae was seen in the neonatal intensive care unit of the University Hospital Nijmegen. The results of the epidemiological investigation are reported, which was aimed to differentiate between a random cluster of endogenously acquired Enterobacter strains and those possibly acquired exogenously via cross-infection. 5 isolates of the 7 patients were available for fingerprinting using interrepeat PCR. According to the fingerprint pattern, 4 of these isolates were identical, thereby suggesting cross-infection among the children. 3 neonates were colonized/infected with genotypically different isolates, suggesting that the infection/colonization developed endogenously. A control strain isolated from a patient at another ward showed the same genotype as the outbreak isolates. The transmission took probably place through one of the surgeons who, among all possible health care workers, were the only professional group treating patients in both units.     

Spectral properties of fluorescein in solvent-water mixtures: applications as a probe of hydrogen bonding environments in biological systems

In a 4-year study we examined the longitudinal effects of deinstitutionalization programs on those who remain in institutions being downsized. Individual outcomes investigated were community access, social activities, community inclusion, family relationships, and choice. Effects of residential relocation on individual outcomes such as adaptive behavior were evaluated and total daily per-person expenditure on institutional services for participants was determined. Downsizing was associated with decreased community integration but no change in most other outcomes. Availability of therapy services fell over time, and individuals experienced many residential and day program moves within the institution. Per person expenditure on services increased substantially. Finally, no significant changes in adaptive behavior were associated with intrainstitutional moves.     

VALIDATION OF THE FRACTURE MECHANICS TEST METHOD EGF P1–87D (ESIS P1–90/ESIS P1–92): ANALYSIS OF AN EXPERIMENTAL ROUND ROBIN

Abstract— The elastic—plastic fracture mechanics test method EGF P1–87 D: EGF Recommendations for Determining the Fracture Resistance of Ductile Materials has been validated by an extensive round robin, covering fracture tests and their evaluation as well as scanning electron fractography. The results confirmed the suitability of the procedure, but suggested some modifications. The resulting procedure ESIS P1–90 was then further modified and its actual designation is ESIS P1–92.
The present report provides comprehensive information on the determination of crack growth resistance curves and initiation values. Particular emphasis is on single specimen techniques and on determining the stretch zone width. Beyond the validation of the ESIS procedure the information given is pertinent to elastic-plastic fracture testing in general.     

APPLICATION OF LOCAL DAMAGE MODELS TO THE NUMERICAL ANALYSIS OF DUCTILE RUPTURE

Abstract— Two damage models were implemented into the finite element program ADINA to study the correlation between microscopical damage and macroscopical material failure. In the first model, based on the Gurson yield function the nucleation, growth and the coalescence of voids were incorporated into the constitutive relations. In the second model the void growth was determined according to the Rice and Tracey model using the von Mises yield function, and material failure was simulated by eliminating the elements where the critical void growth ratio was exceeded. The numerical results for the local and global behaviour of the specimens were compared with experiments. The generality of the damage parameters was checked by investigating several specimen geometries. Both damage models deliver qualitatively consistent results with regard to the influence of the stress triaxiality on the void growth and on the beginning of the material failure. However, the Gurson model gives a more accurate numerical simulation because the damage development and the stress drop continue after the onset of void coalescence while the critical void growth model causes less convergence problems in the simulation of large crack extension. The J _n-curve was estimated on the basis of both models.