Sustainable product engineering is becoming increasingly important. This includes the development of environmentally friendly products and the design for recycling. In this paper a holistic method for the assessment of solution alternatives is presented, in which the stakeholder perspectives along the generic product lifecycle are taken into account. Finally, a new visualization is presented. By visualizing the results in the integrated sustainability triangle, decision-makers in product development can holistically assess the sustainability of the solution alternatives.

The use of an electronic hand hygiene monitoring system (EHHMS) decreased due to the coronavirus disease 2019 (COVID-19) pandemic. We analyzed dispenser use, hand hygiene (HH) badge use, and HH compliance to determine the effect of COVID-19 on EHHMS use and HH compliance. HH product shortages and other pandemic-induced challenges influenced EHHMS use.

The learning hospital is distinguished by ceaseless evolution of erudition, enhancement, and implementation of clinical best practices. We describe a model for the learning hospital within the framework of a hospital infection prevention program and argue that a critical assessment of safety practices is possible without significant grant funding. We reviewed 121 peer-reviewed manuscripts published by the VCU Hospital Infection Prevention Program over 16 years. Publications included quasi-experimental studies, observational studies, surveys, interrupted time series analyses, and editorials. We summarized the articles based on their infection prevention focus, and we provide a brief summary of the findings. We also summarized the involvement of nonfaculty learners in these manuscripts as well as the contributions of grant funding. Despite the absence of significant grant funding, infection prevention programs can critically assess safety strategies under the learning hospital framework by leveraging a diverse collaboration of motivated nonfaculty learners. This model is a valuable adjunct to traditional grant-funded efforts in infection prevention science and is part of a successful horizontal infection control program.

Some studies found that providing micronutrient powder (MNP) causes adverse health outcomes, but modifying factors are unknown. We aimed to investigate whether Fe status and inherited Hb disorders (IHbD) modify the impact of MNP on growth and diarrhoea among young Lao children. In a double-blind controlled trial, 1704 children of age 6–23 months were randomised to daily MNP (with 6 mg Fe plus fourteen micronutrients) or placebo for about 36 weeks. IHbD, and baseline and final Hb, Fe status and anthropometrics were assessed. Caregivers provided weekly morbidity reports. At enrolment, 55·6 % were anaemic; only 39·3 % had no sign of clinically significant IHbD. MNP had no overall impact on growth and longitudinal diarrhoea prevalence. Baseline Hb modified the effect of MNP on length-for-age (LAZ) (P for interaction = 0·082). Among children who were initially non-anaemic, the final mean LAZ in the MNP group was slightly lower (–1·93 (95 % CI –1·88, –1·97)) v. placebo (–1·88 (95 % CI –1·83, –1·92)), and the opposite occurred among initially anaemic children (final mean LAZ –1·90 (95 % CI –1·86, –1·94) in MNP v. –1·92 (95 % CI –1·88, –1·96) in placebo). IHbD modified the effect on diarrhoea prevalence (P = 0·095). Among children with IHbD, the MNP group had higher diarrhoea prevalence (1·37 (95 % CI 1·17, 1·59) v. 1·21 (95 % CI 1·04, 1·41)), while it was lower among children without IHbD who received MNP (1·15 (95 % CI 0·95, 1·39) v. 1·37 (95 % CI 1·13, 1·64)). In conclusion, there was a small adverse effect of MNP on growth among non-anaemic children and on diarrhoea prevalence among children with IHbD.

We assessed the impact of an embedded electronic medical record decision-support matrix (Cerner software system) for the reduction of hospital-onset Clostridioides difficile. A critical review of 3,124 patients highlighted excessive testing frequency in an academic medical center and demonstrated the impact of decision support following a testing fidelity algorithm.

The spatial-intensity profile of light reflected during the interaction of an intense laser pulse with a microstructured target is investigated experimentally and the potential to apply this as a diagnostic of the interaction physics is explored numerically. Diffraction and speckle patterns are measured in the specularly reflected light in the cases of targets with regular groove and needle-like structures, respectively, highlighting the potential to use this as a diagnostic of the evolving plasma surface. It is shown, via ray-tracing and numerical modelling, that for a laser focal spot diameter smaller than the periodicity of the target structure, the reflected light patterns can potentially be used to diagnose the degree of plasma expansion, and by extension the local plasma temperature, at the focus of the intense laser light. The reflected patterns could also be used to diagnose the size of the laser focal spot during a high-intensity interaction when using a regular structure with known spacing.

Palaeochannels of lowland rivers provide a means of investigating the sensitivity of river response to climate-driven hydrologic change. About 80 palaeochannels of the lower Macquarie River of southeastern Australia record the evolution of this distributive fluvial system. Six Macquarie palaeochannels were dated by single-grain optically stimulated luminescence. The largest of the palaeochannels (Quombothoo, median age 54 ka) was on average 284 m wide, 12 times wider than the modern river (24 m) and with 21 times greater meander wavelength. Palaeo-discharge then declined, resulting in a younger, narrower, group of palaeochannels, Bibbijibbery (125 m wide, 34 ka), Billybingbone (92 m, 20 ka), Milmiland (112 m, 22 ka), and Mundadoo (86 m, 5.6 ka). Yet these channels were still much larger than the modern river and were continuous downstream to the confluence with the Barwon-Darling River. At 5.5 ka, a further decrease in river discharge led to the formation of the narrow modern river, the ecologically important Macquarie Marshes, and Marra Creek palaeochannel (31 m, 2.1 ka) and diminished sediment delivery to the Barwon-Darling River as palaeo-discharge fell further. The hydrologic changes suggest precipitation was a driving forcing on catchment discharge in addition to a temperature-driven runoff response.

Dust transported by Southern Hemisphere mid-latitude westerly winds from Australia and deposited in the Tasman Sea shows no evidence for stronger winds during the last glacial maximum (LGM), compared to the Holocene. Features of the particle-size distributions of the dust do, however, indicate enhanced dry deposition of dust in the LGM changing to rainfall scavenging during deglaciation and the early Holocene as climate ameliorated. From these results it appears that activation of desert dunefields over 40% of Australia during the LGM was the result of a reduction in stabilizing vegetation and more frequent episodes of sand movement rather than of increased wind strength. The LGM climate of inland Australia must have been considerably more stressful for plants as a result of lower precipitation and/or carbon dioxide stress to achieve the implied levels of surface destabilization. Enhanced atmospheric dust loads in the Southern Hemisphere and deposition over Antarctica were most likely the result of greatly expanded source areas in the mid-latitude southern continents and a weaker hydrological cycle rather than greater entrainment or more efficient transport by stronger winds. During the LGM wind strength appears to have varied regionally, and predominantly in high latitudes, rather than uniformly for all zonal winds.

Pharmacogenetic/pharmacogenomic (PGx) testing is currently available for a wide range of health problems including cardiovascular disease, cancer, diabetes, autoimmune disorders, mental health disorders and infectious diseases. PGx contributes important information to the field of precision medicine by clarifying appropriate treatments for specific disease subtypes. Tangible benefits to patients including improved outcomes and reduced total health care costs have been observed. However, PGx-guided therapy faces many barriers to full integration into clinical practice and acceptance by stakeholders, whether practitioner, patient or payer. Each stakeholder has a unique perspective on the role of PGx testing, although all are similarly challenged with demonstrating or appraising its cost-to-benefit value. Coverage by insurers is a critical step in achieving widespread adoption of PGx testing. The acceleration of adoption of precision medicine in general and for PGx testing in particular will be determined by how quickly robust evidence can be accumulated that shows a return on investment for payers in terms of real dollars, for clinicians in terms of patient clinical responses, and for patients in terms of economic, health and quality of life outcomes. Trends in PGx testing utilization and uptake by payers in real-world practice are discussed; the role of pharmacoeconomics in assessing cost-effectiveness is highlighted using a case study in psychiatric care, and several issues that will affect adoption of PGx testing in the United States (US) over the next few years are reviewed.

We report a systematic study of polarization and magnetic field effects on the optical response of Fe3O4-silicone elastomer composite. The Fe3O4 particles were aligned in a silicone elastomer matrix with an external static magnetic field. Films of composites containing 5wt% of 20nm ≤ d ≤ 30nm Fe3O4 particles aligned in- and out-of-plane in the elastomer host were prepared. The optical spectra of the films were measured with the Perkin-Elmer Lambda 950 UV/vis/NIR spectrometer. We observed a systematic redshift in the optical response of the outof-plane composite films with increasing static magnetic field strength, which saturated near 600 Gauss. We obtained a maximum redshift of ∼46 nm at 600 Gauss. The observed redshift in the optical response of the out-of-plane composite film is attributed to the effect of the magnetic field. This facilitated the formation of the highly aligned particles that induced strong electric dipole in the aligned particles. Interestingly, there were no observable shifts with increasing magnetic field strength in the in-plane films, suggesting that the orientation (polarization) of the magnetic dipole and the induced electric dipole play a crucial role in the optical response.