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This study aimed to investigate the impact of different types of baby wipes on the barrier recovery of compromised skin after repeated wiping. The forearm skin of adult females was compromised through repeated tape-stripping. Baby wipes with different compositions and water and cloth were used to repeatedly wipe the compromised forearm skin. The health of the skin barrier was evaluated by transepidermal water loss and erythema over the course of 5 days. Skin wiped with pH-buffered baby wipes containing emollients had better barrier health in comparison to skin wiped with baby wipes lacking these features. Additionally, one of the pH-buffered wipes with emollients was gentler on compromised skin than the other baby wipes, as well as water and cloth and performed similarly to unwiped skin. Baby wipes composition can affect the barrier health of compromised skin after wiping.

Every day patients make informal complaints directly to care professionals. Although common in care encounters, the practice remains understudied. In this study, we focus on informal complaints through an analysis of interviews with 19 patients in Sweden, many living with chronic illness. We conceptualise these complaints as 'informal complaint biographies': not merely verbal expressions, but interwoven with people's lives, identities and care trajectories. As a lens through which to examine informal complaining, this study investigates 'dirty work': work that is considered a nuisance or even humiliating. We identify three different kinds of dirty work. 'Disgusting' refers to work with physical dirt entangled with the complaint. 'Drudging' describes patients' persistence, their effort to make healthcare function. Finally, 'disrupting' characterises work that challenges expertise from a vulnerable position. Our analysis shows how informal complaining can involve various types of undignifying work that cannot be separated from the complaint itself. By including work done by others than the traditional 'worker', namely patients, this study expands scholarship on dirty work. The study calls attention to how dirty work is shaped by systemic inefficiencies in healthcare and contributes new perspectives to complaints, research and policy, which is often wiped clean from any kind of dirt.

Multidrug-resistant (MDR) gram-negative bacteria (GNB) are threatening global public health. Since colistin (COL) is the last resort antibiotic for MDR gram-negative infections, the rise in colistin-resistant ‌(COL-R) bacteria could pose risks to people. The current research investigation explored the antimicrobial, anti-biofilm, and anti-inflammatory capacities of SMAP29, a naturally generated cationic antibacterial peptide, against clinical COL-R Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii, and explored its antibacterial mechanisms. The results demonstrated that SMAP29 exhibited a very low minimum inhibitory concentration against COL-R GNB and rapidly killed bacteria within 30 min. In addition, SMAP29 inhibited biofilm growth and eliminated it. According to another study's findings, SMAP29 could lead to the membrane's integrity being wiped out, which could result in the formation of intracellular reactive oxygen species. Moreover, SMAP29 could effectively prevent RAW 264.7 macrophages in mice from generating the pro-inflammatory cytokines TNF-α, IL-6, and IL-1β. Assays for cytotoxicity and hemolysis in vitro revealed that SMAP29 proved safe at the tested concentrations. In vivo experiments further demonstrated that the amount of bacteria in the infected mice's thighs was significantly reduced through SMAP29 treatment. Collectively, our findings demonstrate that SMAP-29's efficacy stems from its dual action: rapid bactericidal activity via lipopolysaccharide-mediated membrane disruption and concurrent anti-inflammatory effects. This multifaceted potency, validated both in vitro and in vivo, positions SMAP-29 as a promising therapeutic candidate against multidrug-resistant bacterial infections. Multidrug-resistant gram-negative bacteria have emerged as critical threats to global public health, driving intractable infections with steadily rising incidence. These pathogens exhibit formidable tolerance to virtually all classes of contemporary antibiotics, translating into persistently high mortality and formidable clinical challenges. This study elucidates the antibacterial, anti-biofilm, and anti-inflammatory activities of the antimicrobial peptide SMAP-29 against colistin-resistant gram-negative organisms while dissecting its underlying mechanisms. Our findings provide a mechanistic framework and a promising therapeutic avenue for combating multidrug-resistant infections.

Freshwater ecosystems in the Himalayas are increasingly threatened by climate change, hydrological instability, and invasive species, yet the long-term ecological trajectories after major disturbance events remain poorly understood. This study examines post-flood environmental changes in the Assi Ganga River, a glacial tributary of the Bhagirathi, more than a decade after the catastrophic 2012-2013 flood that wiped out native and invasive fish populations, including Salmo trutta fario. From 2023 to 2024, we carried out integrated monitoring of macroinvertebrate communities, fish populations, and physicochemical parameters across three altitudinal sites (S1-S3). Water temperature increased downstream by about 1.2 °C, dissolved oxygen levels dropped accordingly, and turbidity peaked during the monsoon season. Macroinvertebrates showed signs of partial recovery, with 42 taxa recorded and a 7.3% increase in total abundance. Fish communities included seven cold-water species, with native Schizothorax spp. displaying strong numerical recovery, and invasive Salmo trutta fario reappearing across sites, likely due to recolonization from upstream refuges. Multivariate analyses revealed that temperature, DO, turbidity, and alkalinity collectively influenced both macroinvertebrate and fish communities, indicating shared environmental filters. The resurgence of S. trutta fario, potentially aided by recovering macroinvertebrate prey, raises concerns about renewed competitive pressure on native snow trout. This research highlights the importance of integrated, multi-trophic biomonitoring to understand resilience, restructuring, and invasion pathways in Himalayan river ecosystems.

Scientists still debate whether small groups of Paleolithic hunter-gatherers caused the extinction of large Ice Age animals like prehistoric elephants, giant sloths and cave lions. Beyond paleontology, this question has deep sociological implications and is relevant for how we understand the role of humankind in today's environmental crisis. A human-driven megafauna extinction has often fostered the idea of a naturalization of human environmental impacts and the belief that all people (modern or ancient, rich or poor, from any part of the world) share responsibility for the current crisis. But is that true? In the review, I discuss whether a long evolutionary history of impacts really makes us inevitably destructive, compelling humanity to accept a devastating anthropocentric dominance as the fateful destiny natural selection built for us. In contrast, I argue that, while our exceptional ability to shape environments has made us a 'hyper-keystone' species, benefiting only a few species and humans, this same ability also has the potential to help us restore balance to the world. That requires rejecting anthropocentric supremacy and placing ecosystems at the center stage of our relationship with nonhuman nature. We may have wiped out the mammoths and mastodons, but human destructiveness is not fate.

Bowhead whales were nearly wiped out by commercial whaling, but they are now generally recovering. A new study by Westbury et al. examines the impact of whaling on the genetic diversity of the Atlantic populations and its potential effect on their long-term ability to respond to future environmental changes.

Environmental services (EVS) programs may choose dilutable or ready-to-use (RTU) disinfectants. Dilutable products are generally less expensive but may have greater potential for incorrect use. We conducted a time and motion evaluation of EVS post-discharge and daily room cleaning and disinfection practices before and after a facility-wide switch from dilutable to RTU quaternary ammonium disinfectants. Observations were completed to determine the time required for tasks, appropriateness of product use, and percentage of high-touch sites wiped. Personnel were graded using a standardized compliance scale (17-20, highly compliant). We observed 40 total hours of post-discharge room cleaning and disinfection by 10 personnel before and 9 after the product substitution. After the substitution, mean compliance scores increased from 11.5 to 17.7 (P=0.003) and there was a reduction in time gathering supplies (3.8 versus 13.2 minutes; P=0.002) but not in total time per post-discharge room (50.8 versus 65.2 minutes; P=0.08). Noncompliance with dilutable disinfectants was often due to incorrect product use, including inappropriate mixing of disinfectants. For daily rooms, less than 3 minutes was spent wiping high-touch surfaces. In our facility, switching from dilutable to RTU disinfectants was associated with reduced time gathering supplies and improved compliance with recommended practices.

Activated charcoal is widely used in the medical management of acute intoxications, yet its gross appearance at autopsy is poorly described and may represent a diagnostic pitfall. We report a case highlighting this issue. An elderly man with a history of cardiovascular disease, diabetes mellitus, and prostate cancer was found unresponsive in his closed residential garage after making suicidal statements. Open bottles of amlodipine and glimepiride were found on his person. He was hospitalized, where routine toxicology screening was negative, and he died in the intensive care unit less than 24 h after admission. At autopsy, the stomach contained an abundant amount of dense, black, odorless, thick material adherent to the gastric mucosa which wiped off after gentle cleaning. After removal, the underlying mucosa was intact, without hemorrhage or ulceration. Review of medical records indicated that activated charcoal had been administered during hospitalization due to concern for intentional medication ingestion. Subsequent expanded toxicology testing demonstrated a markedly elevated amlodipine concentration, consistent with acute toxicity. The cause of death was certified as amlodipine toxicity, and the manner of death as suicide. This case illustrates the characteristic gross appearance of activated charcoal in the stomach and discusses its potential to mimic other causes of black gastric contents, including gastrointestinal hemorrhage, caustic ingestion, Wischnewsky spots, hydrocarbons, black esophagus, and iron deposition. Awareness of this finding and careful correlation of gross autopsy findings with medical history and toxicologic results are essential to avoid misinterpretation and diagnostic error in forensic practice.

Clostridioides difficile spores remain viable in the environment for months to years. To detect C. difficile spores in the environment, many studies have used Polywipe™ sponges to wipe surfaces and subsequently extract and culture C. difficile. This study aimed to evaluate a new simpler, cheaper method utilising an alcohol wipe, suitable for low-resource settings. From February to March 2022, Polywipe™ sponges and alcohol wipes were used to swab surfaces in a microbiology laboratory that specialised in working on C. difficile. Culture in Robertson's cooked meat broth (CMB) and supplemented brain heart infusion broth (BHIB-S), both incubated aerobically to mimic conditions in low resource settings where neither anaerobe jars nor chambers were available, was compared. The overall prevalence of C. difficile contamination in the anaerobe laboratory was 3.4% (17/500). Recovery for alcohol wipes and Polywipe™ sponges was 3.2% and 3.6%, respectively, not significantly different. Alcohol wipes inoculated into CMB recovered 80% of C. difficile when there was ∼100 CFU inoculated, and recovery was 100% with a 300 CFU inoculum. BHIB-S recovered only 40% of C. difficile with a 300 CFU inoculum. While BHIB-S successfully recovered C. difficile from all known positive human stool samples (100%, 10/10), outperforming CMB which recovered 80% (8/10), the observed difference was not statistically significant (p = 0.143). Alcohol wipes could be used in low resource settings to recover C. difficile spores from the environment. CMB is a good enrichment medium to use with alcohol wipes as it is transportable around the world at ambient temperature with little impact.

A Burkholderia stabilis (ST480) outbreak associated with skin cleansing wipes has comprised 59 confirmed cases in the United Kingdom 2018-2026. Cases included patients with co-morbidities and clinically relevant infections. There was one associated death. Burkholderia stabilis was recovered from non-sterile alcohol-free cleansing wipes which did not have the relevant medicines authorisation. Products were suspended from sale though not recalled, and the outbreak continued following public health intervention. We highlight risks of potential relevance to other countries.

Following the recent observation of bacterial deposits on dry surfaces referred to as dry-surface biofilms (DSBs), a number of studies were conducted in vitro on bacterial culturability, sensitivity to cleaning and disinfection protocols, and bacterial transfer via gloves or wipes to culture media or inert surfaces. Our study aimed to reproduce in vitro the cross-transmission of bacteria from dry surfaces to invasive medical devices via healthcare professional's gloves. Monobacterial DSBs were produced using an automated model with five different bacterial isolates involved in healthcare-associated infections. Bacteria from dried or rehydrated DSBs were first transferred to sterile gloves, then to central venous catheters, urinary catheters or endotracheal tubes. The presence of culturable bacteria and the formation of traditional hydrated biofilms inside the devices were investigated. Methicillin-resistant Staphylococcus aureus was the only species to be transferred from both dry and rehydrated DSBs to each invasive device, while the other isolates were only transferred from rehydrated DSBs on mainly central catheters and endotracheal tubes. Despite the non-culturability of Pseudomonas aeruginosa in all the DSBs produced, rehydration enabled its transfer to endotracheal tubes and urinary catheters, suggesting residual viability as evidenced by Live/Dead staining. A possible link appears to be emerging between DSB rehydration, bacterial culturability and transferability. Rehydration may promote bacterial adhesion to gloved fingers and/or the 'resuscitation' of non-culturable bacteria. This viable but non-culturable state of bacteria in DSBs needs to be studied in depth and considered in infection prevention strategies.

Catheter-associated urinary tract infections (CAUTI) lead to higher health care costs and adverse patient outcomes. A Midwestern acute care hospital saw an increase in CAUTI rates from July to December 2022. Plan-Do-Study-Act cycles guided this quality improvement project. Staff education and coaching facilitated a change from daily bathing and urinary catheter care using soap and water to using chlorhexidine gluconate wipes for all adult patients with indwelling urinary catheters. This change led to a substantial 81.1% reduction in the CAUTI rate, sustained over 24 months, decreasing from an average rate of 2.12 to 0.40. Implementing a standardized chlorhexidine gluconate bathing and catheter care protocol significantly reduced CAUTI rates, suggesting it is an effective strategy for minimizing CAUTI risk in acute care settings.

To present a concise and comprehensive review of the lateralizing and localizing value of postictal signs in focal epilepsy and to provide guidance in the interpretation of the signs for presurgical evaluation of drug-resistant epilepsy. We performed a systematic literature review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to identify the various postictal manifestations of seizures (paresis, psychosis, nose-wiping, automatisms, language deficits, headache, autonomic disturbances, visual impairment, palinacousis, and memory disturbances). We specifically investigated its evidence in the lateralization and localization of the seizure focus by searching three databases (PubMed, Embase, Scopus) until January 03, 2024. We then assessed the possibility of selection and assessment bias and evaluated the confidence in the epileptogenic zone based on brain neuroimaging, intracranial electroencephalography, and surgical outcomes. Studies were classified as high quality if the potential for bias was low and the confidence in the epileptogenic zone was high. The majority of patients with postictal signs had temporal lobe epilepsy (TLE). Signs with the highest incidence of TLE were postictal automatisms (93%), postictal nose-wiping (89%), postictal psychosis (84.9%), postictal language impairment (84.2%), and postictal autonomic signs (83.7%). Language dysfunction had a high occurrence in left TLE (96.4%); nose-wiping had a high occurrence in ipsilateral TLE (82.1%). Paresis was always seen contralaterally to the epileptic focus and was more likely to occur in patients with frontal lobe epilepsy than other anatomical localizations (Odds = 1.5). Finally, patients with occipital lobe epilepsy had a significantly higher incidence of postictal headache (Odds = 8.3) compared to other lobar localizations. Even though occurring after seizure termination, postictal signs can have high lateralizing and localizing value in presurgical planning, along with other ancillary information.

Selective serotonin reuptake inhibitors (SSRIs) are well-documented for their impact on memory. Fluoxetine has both positive and negative effects on memory depending on the dose used, the length of administration, and the specific memory context. Conversely, escitalopram has been shown to enhance memory parameters. However, both compounds have the ability to modulate synaptic plasticity and neurogenesis. We selected compounds with these specific mechanisms of action to test our hypothesis. We postulate that changes in memory parameters induced by SSRIs may result from changes in lipid composition, which affect the physicochemical properties of cell membranes and, consequently, the functional dynamics of memory. Memory tests were conducted using modified Barnes maze (MBM) following chronic SSRI administration to evaluate our hypothesis. Subsequently, brain tissue samples were analyzed using Fourier Transform Infrared Spectroscopy (FT-IR) measurement for lipid changes detection, and atomic force microscopy to measure cell membranes' elastic modulus. Chronic treatment with fluoxetine (10 mg/kg i.p.) possesses a negative impact on the general learning possibilities of mice and a positive impact on spatial learning in MBM. Influences wiping memory traces and working memory. Escitalopram (2 mg/kg i.p.) has a positive impact on memory parameters in MBM. Simultaneously, the prefrontal cortex (pFCx), hippocampus (Hc) and amygdala (Am) tissue revealed under the influence of chronic administration of SSRIs showed differences in lipid composition, which correspond with elastic modulus modifications. Our findings indicate that chronic administration of SSRIs induces region-specific alterations in lipid composition and membrane elasticity, which parallel changes in memory performance. These results support the hypothesis that SSRI-related modulation of memory may be mediated, at least in part, by lipid-dependent regulation of neuronal membrane properties and synaptic plasticity.

Bed baths are commonly used to maintain skin hygiene in older hospitalized patients whose skin may be affected by disease, treatment, and aging. The effects of bed baths on the skin barrier function, particularly in the lower limbs, in older patients with heart disease who may have fragile skin remain unclear. This quasi-experimental (crossover) study investigated the effects of bed baths with weak wiping pressure using cotton and disposable towels on the skin barrier function of the lower limbs and forearms in older hospitalized patients with heart disease. Thirty-three older hospitalized patients with heart disease were evaluated. Participants received two randomly ordered wipes (AB or BA): (A) bed baths of the lower limbs and forearms using disposable towels; and (B) bed baths of the lower limbs and forearms using cotton towels. Weak wiping pressure was used (10-20 mmHg). Skin barrier function was measured before, 15 min after, and the day after bed bath using transepidermal water loss (TEWL), stratum corneum hydration (SCH), and overall dry skin score (ODS). Mixed-effects models for repeated measures were used to compare the changes over time between the two types of bed baths. SCH and TEWL were lower in the lower limbs than in the forearms, while ODS was higher. An interaction for TEWL was observed in the lower limbs (F [2,25] = 4.0, P = 0.030); however, TEWL did not differ significantly across time points or towel types. No interaction or main effects of time or towel type on lower limb SCH and forearm TEWL were noted. Only the main effect of time on forearm SCH was observed, which was significantly lower 15 min after the cotton towel bed bath than before (t = 3.2, P = 0.004, MD [95% CI]:  - 3.5, - 0.8). ODS at baseline and the following day demonstrated no difference. Changes in TEWL and SCH over time revealed that a single bed bath with weak wiping pressure did not cause sustained impairment of skin barrier function by the following day. However, transient SCH decreases, and limited intervention periods require further mechanistic investigation. UMIN R000061354 (date of registration: March 3, 2024).

Durable optical coatings using pulsed DC sputtered hydrogenated amorphous carbon (a-C:H) were deposited on chalcogenide glasses for the longwave infrared (LWIR-8-12 µm) spectral band. Carbon layers were deposited with a novel, to the best of our knowledge, multilayer, consisting of a bulk layer of high hydrogen content and a thin capping layer of low hydrogen content. This produces a layer that combines low stress with high hardness and durability and good adhesion on chalcogenide glasses. Two- and four-layer a-C:H/germanium multilayer anti-reflection coatings are demonstrated with average LWIR transmittances (reflectance) of 92.4% (2.2%) and 94.4% (1.1%), respectively. Using the novel layered hydrogenation approach during carbon deposition achieved optimal optical performance, coating stress, and hardness resulting in durable LWIR anti-reflection coatings that pass both MIL-C-48497A durability requirements and MIL-C-675C (para 4.5.9) salt spray. In addition, the antireflection coatings pass 10,000 wipes of the TS1888 para 5.4.3 sand slurry wiper test. The paper also describes stress, hardness, Young's modulus, Raman, and electron paramagnetic resonance characterization of the a-C:H material, their relevance to optimizing optical and durability performance and variation with hydrogen content.

To identify the primary pathway and source of human exposure to organophosphate and brominated flame retardants (OPFRs and BFRs), skin wipes (N = 336) and air samples (N = 60) were collected under controlled conditions from a residence in Xinxiang, China. In air, geometric mean concentrations of ∑9OPFRs exceeded those of ∑9BFRs by 2 orders of magnitude, with the air FR profile dominated by high-volatility compounds. On skin, however, ∑9OPFRs levels were 1-4 times those of ∑9BFRs. The skin FR profile was dominated by low-volatility compounds, with no significant gender differences. Furthermore, environmental interface contact contributed more significantly to dermal exposure for BFRs than for OPFRs. Principal component and correlation analyses indicated that flame retardants (FRs) on skin correlated more closely with gaseous air, but differed considerably from those in airborne particles. This indicates that gaseous air is the primary source of dermal exposure and that low-volatility FRs may transfer to skin lipids more readily. Finally, dermal uptake was identified as the major exposure pathway for both ∑9OPFRs and ∑9BFRs compared to inhalation and oral ingestion pathways, accounting for more than 99% of the total exposure. Notably, current air-to-skin transfer models considerably underestimated the actual dermal uptake of FRs.

As sebum offers transient exposure snapshots, we systematically characterized the performance of stratum corneum (SC) as a bioindicator of long-term panoramic exposure for assessing human dermal exposure to 20 organophosphate esters (OPEs) and developed an SC-based exposure assessment methodology under controlled conditions. During 12-h exposure, median ∑20OPE concentrations of arm and back sebum (n = 15, collected by skin wiping) increased remarkably from nondetectable to 5280 ng m-2 and 2280 ng m-2, respectively, whereas SC samples (collected by tape stripping) remained stable [arm (1230-1410 ng m-2) and back (1020-1240 ng m-2)]. Similar results were also obtained after 28-d exposure (n = 8). After 6-h exposure, median ∑20OPE across forehead, arm, calf, and back were 1420, 1420, 986, and 369 ng m-2 (sebum, n = 13), and 1830, 1580, 1090, and 1550 ng m-2 (SC), respectively, with higher sebum variation in different locations. A considerably uneven vertical gradient of OPEs in forehead sebum-SC (stratified into 5 layers by tape stripping, n = 12) revealed high concentrations in the outermost layer. Lipophilic OPEs (log KOW > 4.7) accumulated in sebum, while hydrophilic OPEs penetrated the sebum and SC with high interlayer uniformity. The SC-based method circumvented the inconsistency arising from time, location, and wiping force in the sebum-based method, enabling a convenient, stable, representative, and accurate whole-body dermal exposure assessment.

Burn injury induces pain and is frequently accompanied by persistent itch during wound healing. However, the underlying neural mechanisms remain poorly understood. Here, we developed a mouse model of post-burn pain and itch and examined changes in primary sensory neuron activity using in vivocalcium imaging of trigeminal ganglion (TG) neurons. To induce scald burn injury, anesthetized mice were exposed to boiling water on the cheek skin. Following injury, mice exhibited both spontaneous pain-related behaviors (wiping) and itch-related behaviors (scratching). Pain-related behaviors peaked on day 1 and returned to baseline within 5 days, whereas itch-related behaviors peaked on day 7 and persisted for up to 28 days. In vivo calcium imaging revealed a significant increase in the number of TG neurons exhibiting spontaneous activity on days 1 and 7 post-injury compared to baseline. While the proportion of capsaicin-sensitive neurons remained unchanged after scald burn, the proportion of chloroquine-sensitive neurons was reduced on day 1 and partially recovered on day 7. These findings suggest that enhanced spontaneous activity in primary sensory neurons may contribute to post-burn pain and itch. This model appears to be useful to investigate the neural mechanisms underlying sensory dysfunction following burn injury.