Dual-action hygienic coatings: Benefits of hydrophobicity and silver ion release for protection of environmental and clinical surfaces

Nanoplatforms: The future of oral cancer treatment

Background and Aims

Cytotoxicity is a key disadvantage of using chemotherapeutic drugs to treat cancer. This can be overcome by encapsulating chemotherapeutic drugs in suitable carriers for targeted delivery, allowing them to be released only at the cancerous sites. Herein, we aim to review the recent scientific developments in the utilization of nanotechnology-based drug delivery systems for treating oral malignancies that can lead to further improvements in clinical practice.

Methods

A comprehensive literature search was conducted on PubMed, Google Scholar, ScienceDirect, and other notable databases to identify recent peer-reviewed clinical trials, reviews, and research articles related to nanoplatforms and their applications in oral cancer treatment.

Results

Nanoplatforms offer a revolutionary strategy to overcome the challenges associated with conventional oral cancer treatments, such as poor drug solubility, non-specific targeting, and systemic toxicity. These nanoscale drug delivery systems encompass various formulations, including liposomes, polymeric nanoparticles, dendrimers, and hydrogels, which facilitate controlled release and targeted delivery of therapeutic agents to oral cancer sites. By exploiting the enhanced permeability and retention effect, Nanoplatforms accumulate preferentially in the tumor microenvironment, increasing drug concentration and minimizing damage to healthy tissues. Additionally, nanoplatforms can be engineered to carry multiple drugs or a combination of drugs and diagnostic agents, enabling personalized and precise treatment approaches.

Conclusion

The utilization of nanoplatforms in oral cancer treatment holds significant promise in revolutionizing therapeutic strategies. Despite the promising results in preclinical studies, further research is required to evaluate the safety, efficacy, and long-term effects of nanoformulations in clinical settings. If successfully translated into clinical practice, nanoplatform-based therapies have the potential to improve patient outcomes, reduce side effects, and pave the way for more personalized and effective oral cancer treatments.

Lean Design of the Pediatric Intensive Care Unit Patient Room for Efficient and Safe Care Delivery

BACKGROUND

The pediatric intensive care unit (PICU) is an environment where seriously ill children receive complex care, delivered mostly by specialty-trained nurses (registered nurses [RNs]) who must perform multiple high-level tasks. With stressors on healthcare systems at an all-time high, design that optimizes RN workflow has taken on a renewed imperative.

OBJECTIVES

To employ a multimodal approach (1) to identify environmental factors in the PICU patient room that contribute to caregiver workflow inefficiencies, (2) to optimize safety by identifying high-touch surfaces that cause hospital-acquired infections, (3) to develop human-centered design recommendations.

METHODS

This mixed-method case study was conducted in a 23-bed urban hospital PICU. The activities, movements, and workflows of 13 RNs were recorded using spatial movement mapping, behavioral mapping, and clinical activity mapping. Frequency of RN contact with surfaces was documented to assess relative infection transmission risk. Face-to-face interviews were conducted with RNs to elicit their views on care delivery and their physical work environment.

RESULTS

Direct patient care occupied 50% of RNs' time. Of the direct patient care workflow activities recorded, 26% were to prepare for care around the bedside, while 27% were for random travel between clean and soiled areas. The surfaces most frequently touched were (1) patient bedrails, (2) intravenous pumps and poles, (3) tubing and medical equipment, and (4) vital sign monitors.

CONCLUSION

Value-added tasks account for only about 20% of nurses' work. Combining technology and strategic interior design to streamline workflow and enhance infection prevention optimizes efficiency and empowers frontline providers to maximize their time at the bedside performing value-added tasks.

Antimicrobial coatings for environmental surfaces in hospitals: a potential new pillar for prevention strategies in hygiene

Recent reports provide evidence that contaminated healthcare environments represent major sources for the acquisition and transmission of pathogens. Antimicrobial coatings (AMC) may permanently and autonomously reduce the contamination of such environmental surfaces complementing standard hygiene procedures. This review provides an overview of the current status of AMC and the demands to enable a rational application of AMC in health care settings. Firstly, a suitable laboratory test norm is required that adequately quantifies the efficacy of AMC. In particular, the frequently used wet testing (e.g. ISO 22196) must be replaced by testing under realistic, dry surface conditions. Secondly, field studies should be mandatory to provide evidence for antimicrobial efficacy under real-life conditions. The antimicrobial efficacy should be correlated to the rate of nosocomial transmission at least. Thirdly, the respective AMC technology should not add additional bacterial resistance development induced by the biocidal agents and co- or cross-resistance with antibiotic substances. Lastly, the biocidal substances used in AMC should be safe for humans and the environment. These measures should help to achieve a broader acceptance for AMC in healthcare settings and beyond. Technologies like the photodynamic approach already fulfil most of these AMC requirements.

High-touch surfaces: microbial neighbours at hand

Despite considerable efforts, healthcare-associated infections (HAIs) continue to be globally responsible for serious morbidity, increased costs and prolonged length of stay. Among potentially preventable sources of microbial pathogens causing HAIs, patient care items and environmental surfaces frequently touched play an important role in the chain of transmission. Microorganisms contaminating such high-touch surfaces include Gram-positive and Gram-negative bacteria, viruses, yeasts and parasites, with improved cleaning and disinfection effectively decreasing the rate of HAIs. Manual and automated surface cleaning strategies used in the control of infectious outbreaks are discussed and current trends concerning the prevention of contamination by the use of antimicrobial surfaces are taken into consideration in this manuscript.

RMS roughness-independent tuning of surface wettability by tailoring silver nanoparticles with a fluorocarbon plasma polymer

A layer of 14 nm-sized Ag nanoparticles undergoes complex transformation when overcoated by thin films of a fluorocarbon plasma polymer. Two regimes of surface evolution are identified, both with invariable RMS roughness. In the early regime, the plasma polymer penetrates between and beneath the nanoparticles, raising them above the substrate and maintaining the multivalued character of the surface roughness. The growth (β) and the dynamic (1/z) exponents are close to zero and the interface bears the features of self-affinity. The presence of inter-particle voids leads to heterogeneous wetting with an apparent water contact angle θ_a = 135°. The multivalued nanotopography results in two possible positions for the water droplet meniscus, yet strong water adhesion indicates that the meniscus is located at the lower part of the spherical nanofeatures. In the late regime, the inter-particle voids become filled and the interface acquires a single valued character. The plasma polymer proceeds to grow on the thus-roughened surface whereas the nanoparticles keep emerging away from the substrate. The RMS roughness remains invariable and lateral correlations propagate with 1/z = 0.27. The surface features multiaffinity which is given by different evolution of length scales associated with the nanoparticles and with the plasma polymer. The wettability turns to the homogeneous wetting state.

On the long term antibacterial features of silver-doped diamondlike carbon coatings deposited via a hybrid plasma process

Environmental surfaces are increasingly recognized as important sources of transmission of hospital-acquired infections. The use of antibacterial surface coatings may constitute an effective solution to reduce the spread of contamination in healthcare settings, provided that they exhibit sufficient stability and a long-term antibacterial effect. In this study, silver-incorporated diamondlike carbon films (Ag-DLC) were prepared in a continuous, single-step plasma process using a hybrid, inductively coupled plasma reactor combined with a very-low-frequency sputtering setup. The average Ag concentration in the films, ranging from 0 to 2.4 at. %, was controlled by varying the sputtering bias on the silver target. The authors found that the activity of Escherichia coli was reduced by 2.5 orders of magnitude, compared with the control surface, after a 4-h contact with a 2.4 at. % Ag-DLC coating. The coatings displayed slow release kinetics, with a total silver ion release in the sub-ppb range after 4 h in solution, as measured by graphite furnace-atomic absorption spectroscopy. This was confirmed by Kirby-Bauer diffusion tests, which showed limited diffusion of biocidal silver with a localized antibacterial effect. As a slow and continuous release is mandatory to ensure a lasting antibacterial effect, the newly developed Ag-DLC coatings appears as promising materials for environmental hospital surfaces.

Controlling hospital-acquired infection: focus on the role of the environment and new technologies for decontamination

There is increasing interest in the role of cleaning for managing hospital-acquired infections (HAI). Pathogens such as vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), multiresistant Gram-negative bacilli, norovirus, and Clostridium difficile persist in the health care environment for days. Both detergent- and disinfectant-based cleaning can help control these pathogens, although difficulties with measuring cleanliness have compromised the quality of published evidence. Traditional cleaning methods are notoriously inefficient for decontamination, and new approaches have been proposed, including disinfectants, steam, automated dispersal systems, and antimicrobial surfaces. These methods are difficult to evaluate for cost-effectiveness because environmental data are not usually modeled against patient outcome. Recent studies have reported the value of physically removing soil using detergent, compared with more expensive (and toxic) disinfectants. Simple cleaning methods should be evaluated against nonmanual disinfection using standardized sampling and surveillance. Given worldwide concern over escalating antimicrobial resistance, it is clear that more studies on health care decontamination are required. Cleaning schedules should be adapted to reflect clinical risk, location, type of site, and hand touch frequency and should be evaluated for cost versus benefit for both routine and outbreak situations. Forthcoming evidence on the role of antimicrobial surfaces could supplement infection prevention strategies for health care environments, including those targeting multidrug-resistant pathogens.

Preparation and rapid analysis of antibacterial silver, copper and zinc doped sol-gel surfaces

The colonisation of clinical and industrial surfaces with microorganisms, including antibiotic-resistant strains, has promoted increased research into the development of effective antibacterial and antifouling coatings. This study describes the preparation of metal nitrate (Ag, Cu, Zn) doped methyltriethoxysilane (MTEOS) coatings and the rapid assessment of their antibacterial activity using polyproylene microtitre plates. Microtitre plate wells were coated with different volumes of liquid sol-gel and cured under various conditions. Curing parameters were analysed by thermogravimetric analysis (TGA) and visual examination. The optimum curing conditions were determined to be 50-70°C using a volume of 200 μl. The coated wells were challenged with Gram-positive and Gram-negative bacterial cultures, including biofilm-forming and antibiotic-resistant strains. The antibacterial activities of the metal doped sol-gel, at equivalent concentrations, were found to have the following order: silver>zinc>copper. The order is due to several factors, including the increased presence of silver nanoparticles at the sol-gel coating surface, as determined by X-ray photoelectron spectroscopy, leading to higher elution rates as measured by inductively coupled plasma atomic emission spectroscopy (ICP-AES). The use of microtitre plates enabled a variety of sol-gel coatings to be screened for their antibacterial activity against a wide range of bacteria in a relatively short time. The broad-spectrum antibacterial activity of the silver doped sol-gel showed its potential for use as a coating for biomaterials.