暂无摘要。

This study aimed to analyze the operational conditions to preserve immunobiological products in Brazil. This mixed-method study with a sequential explanatory design was developed in vaccination rooms in several Brazilian regions from 2021 to 2022. Its quantitative stage developed a descriptive cross-sectional study by applying the Immunobiological Conservation Assessment Scale to nursing professionals. Data were analyzed by descriptive statistics. Its qualitative stage developed a descriptive-exploratory study in cold chain instances with the respective technical managers and nursing professionals. The interviews were evaluated by thematic content analysis. The data were combined by connection, and joint-displays and meta-inferences were elaborated. Overall, 280 rooms were analyzed. Most were for exclusive use (79.6%), had polyurethane boxes (77.8%), and kept their equipment away from sunlight/heat (73.5%). Only 27.5% had batteries/generators and 26.5% had other temperature measuring instruments. In total, 60% had refrigerated rooms and 67.6%, air-conditioned rooms. This study found weaknesses associated with geographical conditions, infrastructure, material inputs, human and financial resources, work organization and management, turnover, and training. These findings showed the plurality of the Brazilian cold chain and identified the potentialities and weaknesses related to the structures and work processes in preserving immunobiological products, which require improvement.
Este estudo objetivou analisar as condições operacionais para conservação de imunobiológicos no Brasil. Trata-se de um estudo de método misto com delineamento explanatório sequencial, desenvolvido nas salas de vacinação de distintas regiões brasileiras entre 2021 e 2022. Na etapa quantitativa, desenvolveu-se um estudo transversal descritivo, com a aplicação da Escala de Avaliação da Conservação de Imunobiológicos aos profissionais de enfermagem. Os dados foram analisados por meio de estatística descritiva. Já na etapa qualitativa, desenvolveu-se um estudo descritivo-exploratório nas instâncias da cadeia de frio, com os respectivos responsáveis técnicos e profissionais de enfermagem. Analisou-se as entrevistas por meio da Análise de Conteúdo na Modalidade Temática. Os dados foram combinados mediante conexão, com elaboração de joint-displays e metainferências. Foram analisadas 280 salas, em que grande parte: era de uso exclusivo (79,6%); utilizava caixas de poliuretano (77,8%); e mantinha seus equipamentos distantes da incidência de luz solar/fontes de calor (73,5%). Apenas 27,5% dispunham de baterias/geradores e 26,5% de outros instrumentos de medição de temperatura. Sessenta por cento detinham câmaras refrigeradas e 67,6% ambientes climatizados. Revelaram-se fragilidades associadas a condições geográficas, infraestrutura, insumos materiais, recursos humanos e financeiros, organização e gestão do trabalho, rotatividade e capacitação. Os achados possibilitaram conhecer a pluralidade da cadeia de frio brasileira e permitiram a identificação de potencialidades e fragilidades na conservação de imunobiológicos relacionadas às estruturas e aos processos de trabalho que requerem aprimoramento.
Este estudio tuvo como objetivo analizar las condiciones operativas para la conservación de inmunobiológicos en Brasil. Estudio de método mixto con diseño explicativo secuencial, desarrollado en las salas de vacunación de las distintas regiones brasileñas, entre 2021 y 2022. En la etapa cuantitativa se desarrolló un estudio transversal descriptivo, con la aplicación de la Escala de Evaluación de la Conservación de Inmunobiológicos a los profesionales de enfermería. Los datos fueron analizados mediante estadística descriptiva. En la etapa cualitativa se desarrolló un estudio descriptivo-exploratorio en las instancias de la cadena de frío, con los respectivos responsables técnicos y profesionales de enfermería. Las entrevistas se analizaron por medio del Análisis de Contenido en la Modalidad Temática. Los datos fueron combinados mediante conexión, con elaboración de joint-displays y metainferencias. Se analizaron 280 salas. Gran parte era de uso exclusivo (79,6%); utilizaba cajas de poliuretano (77,8%) y mantenía sus equipos alejados de la incidencia de la luz solar/fuentes de calor (73,5%). Solo el 27,5% disponía de baterías/generadores y el 26,5% de otros instrumentos de medición de temperatura. El 60% tenía cámaras refrigeradas y el 67,6% ambientes climatizados. Se revelaron debilidades asociadas a las condiciones geográficas, la infraestructura, los insumos de materiales, los recursos humanos y financieros, la organización y gestión del trabajo, la rotación y la capacitación. Los hallazgos posibilitaron conocer la pluralidad de la cadena de frío brasileña y permitieron la identificación de potencialidades y debilidades de la conservación de inmunobiológicos relacionadas con las estructuras y los procesos de trabajo que requieren mejoras.

The global cold chain logistics market is witnessing a significant upswing, driven by the rising demand for perishable food products and increasing shipment volumes worldwide. Technological advancements are leading to a more intelligent and digitally enabled cold chain logistics system. However, the high loss rate of fresh agricultural products in China poses a significant threat to the country\'s food security. Therefore, it is imperative to explore innovative solutions, such as blockchain, to address the challenges of traditional cold chain logistics. In this paper, inspired by the prospect theory and evolutionary game theory, we propose an evolutionary game model to analyze the behavioral strategies of the tripartite of n-level cold chain participants, consumers, and government. Using MATLAB software, the numerical simulation of the game path of this tripartite theory is conducted, and the influence of variable parameters on the evolutionary process and outcomes of the system is analyzed. The results the following: (1) The development of an effective cold chain supply chain system can be divided into three stages, and blockchain technology plays a pivotal role in creating a seamless cold chain environment. The cost of blockchain adoption, government rewards, as well as penalties can significantly influence the behavioral choices of the three stakeholders. (2) The behavior of individual cold chain participants has a strong negative externality, which can impact the behavior of others. We also find that the larger the scale of the cold chain, the lower the probability of default by the participants. (3) The government\'s adoption of blockchain technology and the implementation of effective incentive policies can foster the successful development of the cold chain blockchain infrastructure. Our research contributes to the theoretical understanding of cold chain logistics decision making and policy creation for the tripartite stakeholders, including cold chain participants, consumers, and government. Our findings can serve as a valuable reference for scientific decision making and policy formulation to encourage the development of a robust cold chain supply chain system.

The rising global temperatures, attributed to the high global warming potential (GWP) of conventional refrigerants, necessitate the adoption of low-GWP alternatives in HVAC systems. However, these low-GWP refrigerants often exhibit high toxicity and flammability, limiting their usage. To address these challenges, compact heat exchangers incorporating blended refrigerants have been introduced to enhance HVAC system performance. Researchers have also made significant strides in improving HVAC system efficiency by introducing the concept of suspending nanolubricants and nanorefrigerants within the system. This review paper seeks to comprehensively assess the potential of alternative refrigerants containing suspended nanoparticles, commonly referred to as nanorefrigerants. The paper reviews various mechanisms and potential combinations of different nanorefrigerants employed to enhance refrigeration system effectiveness and efficiency. A detailed examination of key heat transfer parameters and the performance predictions of low-GWP refrigerants, including those from the hydrofluoroolefin (HFO) and hydrocarbon (HC) classes, is conducted through energy and exergy analyses. Commercial refrigerants like R-134a, R-290, R-600, R-600a, R-123, R-125, R-22, R-141b, R-152, R-11, R-113, R-404a, R-407c, R-502, R-600a, R-507a, R-1234yf, R-1234ze, 1336mzz(Z), and R-410a are evaluated in conjunction with suspended nanoparticles, considering their specific properties. The findings indicate that the utilization of nanorefrigerants leads to notable improvements in overall system performance, characterized by reduced compressor workloads and increased heat transfer rates. Consequently, the integration of blended nanoparticles into refrigerants holds significant promise for advancing the HVAC field.

Ultralow-temperature refrigeration faces significant issues linked to the security of the cold chain for the production, storage, transportation, and distribution of COVID-19 vaccines. The use of environmentally friendly refrigerants in cascade refrigeration systems (CRS) to provide low-temperature range is motivated by the high demand for ultralow-temperature refrigeration units. In the current study, a CRS is built to generate a low temperature of -86 °C for the storage of COVID-19 vaccines. In the CRS, the natural refrigerant combination R290-R170 is used as high-temperature and low-temperature fluids. The pull-down performance of the -86 °C freezer is explored experimentally, and the stable operating performance is determined at two different dry bulb and wet bulb temperatures. Various status monitors are set up to analyze the CRS\'s operation features, and several temperature monitors are put in the freezer to analyze temperature variations. The power consumption of the CRS is examined and evaluated. Finally, several key findings are summarized. The current work is the first to involve experimental measurements on -86 °C temperature generated by a CRS, which can substantially enhance experiment data in ultralow-temperature refrigeration and contribute to a more in-depth understanding of the operation performance of a -86 °C ultralow-temperature freezer.

Vaccines are vital health commodities that need an appropriate supply chain system. They could be transported, stored, and used at appropriate temperatures. The purpose of this study was to assess vaccine cold chain management practices in primary health centers offering an expanded program of immunization (EPI) in Bahir Dar, Northwest Ethiopia.
A self-reported and actual practice observational cross-sectional study was conducted at primary public health centers in the Bahir Dar city administration from August 15 to 30, 2021. A simple random sampling method was used to select study participants. An interview-administered questionnaire and direct actual practice observation were used to collect data. The data was entered into the Epi-data 4.6 program and analyzed using SPSS version 25. Participants\' knowledge, storage and transport conditions, IPLS management, and vaccine cold chain management practices were examined using independent samples t-tests and one-way ANOVA tests.
A total of 50 respondents from ten health centers were enrolled in the study. Most of the EPI service providers had good knowledge (60%) and good practice in vaccine storage and transport (74%). However, more than two-thirds (68%) of EPI service providers had poor integrated pharmaceutical logistics system (IPLS) management. Only half (50%) of the health centers had good actual vaccine cold chain management practices. Higher educational background, longer work experience, and receiving training and supervision in EPI services, IPLS management, and vaccine inventory management resulted in higher knowledge, storage and transport management, IPLS management, and vaccine cold chain management practices.
Although most EPI service providers in an interview assessment reported having good knowledge and good vaccine storage and transport management, only half of the health facilities followed the standard. Stakeholders are recommended to play a vital role in improving practices related to EPI services.

There is little information on the optimal storage conditions for recovery of nontuberculous Mycobacterium spp. (NTM) from refrigerated sputum.
We investigated the storage duration that could increase the culture-positive rate of NTM isolates.
In this prospective study, we collected NTM isolates and clinical data from patients with repeated culture-positive NTM pulmonary disease (NTM-PD).
From June 2020 to July 2021, the participants were instructed to randomly collect six sputum samples and immediately store them in a refrigerator at 4°C until the date of their clinic visit. At the outpatient visits, expectorated spot sputum samples were collected.
A total of 226 sputum samples were collected from 35 patients. The median duration of refrigeration was 6 days (maximum duration: 36 days). The overall culture-positive rate was 81.6%. While there was a trend for a higher culture positivity rate when stored for ⩽3 weeks, this was not significant compared with those stored for >3 weeks (p = 0.610). According to sputum microscopy, smear-positive sputum was 100% isolated, but smear-negative samples had a culture-positive rate of 77.5%. Similarly, there was no significant association between sputum storage duration and culture positivity (p = 0.511). In addition, the recovery rate of the refrigerated sputum was comparable with the collected spot expectorated sputum (82.6% versus 80.6%, p = 0.795), which is suggestive of the long-term viability of NTM in refrigerated sputum.
Our data demonstrated the long-term viability of refrigerated NTM, and the culture positivity rate of these samples was comparable with the spot expectorated sputum. These results suggest that implementing sputum refrigeration would enhance convenience in diagnosing and following patients with NTM-PD.
Easy way to diagnose NTM lung diseasesUnder usual circumstances, most patients with suspected NTM submit spontaneously expectorated sputum rather than induced sputum for the purpose of testing the causative organism. By collecting and storing sputum specimens for a longer period than before, it is expected that more sufficient and adequate collection of sputum specimens will be possible.

The purpose of this study was to evaluate the survival rates and fermentation performance of three freeze-dried lactic acid bacterial cultures previously isolated from Ghanaian traditional fermented milk. LAB cultures, i.e., Lactobacillus delbrueckii, Lactococcus lactis and Leuconostoc mesenteroides, were frozen in the chamber of a Telstar (Lyoquest) laboratory freeze dryer for 10 h at -55 °C (as single and combined cultures) using skimmed milk and cassava flour as cryoprotectants held in plastic or glass cryovials. For viability during storage, freeze-dried LAB cultures were stored in a refrigerator (4 °C) and at room temperature (25 °C) for 4 weeks. The survival of freeze-dried cultures was determined by growth kinetics at 600 nm (OD600). The performance of freeze-dried LAB cultures after 4 weeks of storage was determined by their growth, acidification of milk during yogurt fermentation and consumer sensory evaluation of fermented milk using a nine-point hedonic scale. The survival rates for LAB ranged between 60.11% and 95.4% following freeze-drying. For single cultures, the highest survival was recorded for Lactobacillus delbrueckii (L12), whereas for combined cultures, the highest survival was observed for Lactococcus lactis (L3) combined with Lactobacillus delbrueckii (L12). The consumer acceptability results showed that yogurts produced from a combined starter culture of Lactococcus lactis and Lactobacillus delbrueckii or from a single culture of Lactococcus lactis were the most preferred products with Lactococcus lactis and Lactobacillus delbrueckii possessing high survival rates and high consumer acceptability in yogurt production. These findings are crucial and can be adopted for large-scale production and commercialization of yogurt.

The development of world trade and fresh-keeping technology has led to the rapid development of international cold chain logistics. However, the novel coronavirus epidemic continues to spread around the world at the present stage, which challenges disease transmission control and safety supervision of international cold chain logistics. Constructing an Import Cold Chain Logistics Safety Supervision System (ICCL-SSS) is helpful for detecting and controlling disease import risk. This paper constructs an evaluation index system of ICCL safety that comprehensively considers the potential risk factors of three ICCL processes: the logistics process in port, the customs clearance process, and the logistics process from port to door. The risk level of ICCL-SSS is evaluated by combining the Extension Decision-making Model and the Entropy Weight Method. The case study of Shanghai, China, the world\'s largest city of ICCL, shows that the overall risk level of ICCL-SSS in Shanghai is at a moderate level. However, the processes of loading and unloading, inspection and quarantine, disinfection and sterilization, and cargo storage are at high risk specifically. The construction and risk assessment of ICCL-SSS can provide theoretical support and practical guidance for improving the safety supervision ability of ICCL regulation in the post-epidemic era, and helps the local government to scientifically formulate ICCL safety administration policies and accelerate the development of world cold chain trade.

The frequent occurrence of ammonia-related refrigeration accidents (ArRAs) restricts the safety and sustainable development of cold storage. As an essential tool for safety management, accident statistical analysis can provide a crucial decision-making basis for accident prevention and control. The present study combined descriptive statistics and comparative analysis methods to explore the characteristics and regularities of 82 ArRAs in China from 2010 to 2020. The results showed that the annual evolution of ArRAs presents a bimodal \"M\" mode in which 2013 and 2016 were the peaking years of accidents. The monthly distribution has an agglomeration effect, and the period from June to September had a high incidence period of accidents. The ArRAs mainly occurred in East China and Central China in the spatial dimension. Zhejiang, Shandong, Hubei, and Sichuan are the pivotal provinces for preventing and controlling ArRAs. Human factors and equipment failure are the leading causes of ArRAs. Accident numbers and casualties have inconsistent trends due to the uncertainty and variability of ArRAs\' consequences. The safety situation of ammonia-related refrigeration enterprises has improved but still needs to strive to prevent and control major accidents. This study draws valuable references for safety decision-making by ammonia-related refrigeration enterprises and safety regulators.