Background/Objectives: Hand hygiene is a cornerstone of infection prevention, yet the extent to which multimodal institutional hand hygiene interventions translate into measurable reductions in healthcare-associated infections (HAIs) remains uncertain. This systematic review aimed to evaluate the association between hospital-wide or multi-ward multimodal hand hygiene interventions and clinical HAI outcomes in acute care hospitals. Methods: A structured literature search was conducted in PubMed, Scopus, Embase, and Google Scholar using a combination of Medical Subject Headings (MeSH) and free-text terms related to hand hygiene, healthcare-associated infections, hospital settings, and intervention strategies. Eligible studies were quasi-experimental designs, including before–after, controlled before–after, and interrupted time-series studies, evaluating multimodal hand hygiene interventions implemented at hospital-wide or multi-ward level and reporting clinical HAI outcomes. Two reviewers independently assessed risk of bias using the ROBINS-I tool, and certainty of evidence across major outcome categories was summarized using GRADE. Results: twelve studies met the inclusion criteria. Overall, multimodal hand hygiene interventions were generally associated with favorable directional trends in clinical outcomes. Reductions were most consistent for broader institutional HAI measures and some device-associated infections, particularly central line-associated bloodstream infections. In contrast, organism-specific outcomes, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Clostridioides difficile, were more heterogeneous across studies and settings. All included studies were judged to be at serious or critical overall risk of bias, primarily because of confounding, lack of contemporaneous controls, co-interventions, and phased implementation. Conclusions: Multimodal hand hygiene programs in acute care hospitals may be associated with improvement in selected clinically relevant HAI outcomes, particularly at the institutional level. However, the overall certainty of evidence remains low to very low, and the strength of inference is limited by the non-randomized nature of the available studies and the difficulty of isolating the independent effect of hand hygiene within complex infection-prevention strategies.

Background and Objectives: p16 immunohistochemistry (IHC) is widely used as a surrogate marker for high-risk human papillomavirus (HPV)-driven carcinogenesis in oropharyngeal squamous cell carcinoma. Diagnostic reliability in laryngeal squamous cell carcinoma (LSCC) is still up for debate, particularly because HPV DNA detection, p16 overexpression, and transcriptionally active HPV infection may be discordant at this anatomical site. This systematic review aimed to assess the diagnostic performance of p16 IHC as a surrogate marker for high-risk HPV status in primary invasive LSCC. Materials and Methods: A systematic review was conducted in accordance with PRISMA principles and prospectively registered in PROSPERO. PubMed, Scopus, and Web of Science, and citation searches were used to identify studies reporting paired p16 IHC and tumour-based molecular HPV testing in invasive LSCC. Eligible HPV reference standards included HPV DNA PCR/genotyping, DNA in situ hybridization, RNA in situ hybridization, and E6/E7 mRNA detection. Data were synthesized narratively because of substantial heterogeneity in p16 thresholds, HPV assays, and study populations. Results: Fourteen studies were included. p16 positivity thresholds varied widely, ranging from ≥30% moderate/strong staining to ≥70–75% diffuse nuclear and cytoplasmic staining. HPV reference standards also differed substantially across studies. Overall, p16 IHC showed inconsistent concordance with molecular HPV testing. Studies using RNA-based reference standards showed that transcriptionally active HPV was uncommon in LSCC and that p16-positive tumours often lacked evidence of active HPV transcription. Conclusions: p16 IHC should not be used as a standalone surrogate marker for high-risk HPV-driven carcinogenesis in invasive LSCC. When HPV attribution is clinically or analytically important, p16-positive cases should be confirmed using HPV-specific molecular testing, preferably RNA-based assays. Future prospective studies using standardized p16 protocols and transcriptionally active HPV reference standards are needed.

Background: Medically relevant biofilms are difficult to detect, characterize, and eradicate because their behavior depends on microbial species, biofilm maturity, extracellular matrix, surface properties, and environmental conditions. Physicochemical approaches provide complementary strategies for monitoring biofilm development and for preventing or disrupting established communities. This structured narrative review examines electrical and electrochemical methods, ultrasound, light-based and photodynamic treatments, plasma and thermal approaches, nanomaterials and photocatalysis, surface modification, and physicochemical detection methods, with particular emphasis on magnetic-field-based strategies. Contemporary primary studies published from January 2025 to July 2026 were considered together with selected earlier studies providing methodological or comparative context. Findings: Physicochemical approaches produced substantial effects across bacterial and fungal biofilm models, but outcomes were strongly dependent on experimental conditions and assessment methods. Cultivability, biomass, metabolic activity, adhesion, detachment, architecture, and physicochemical signals represent distinct aspects of biofilm behavior and should not be interpreted interchangeably. Real-time monitoring methods provide valuable temporal information but require validation against biological endpoints. Magnetic approaches particularly illustrate this methodological heterogeneity. Direct magnetic-field exposure produced variable and incompletely standardized responses, whereas magnetothermal, magnetomechanical, and magnetically guided systems generally showed more consistently quantified antibiofilm effects. Further progress requires standardized physicochemical characterization, appropriate mechanistic controls, clinically representative models, and complementary assessment of biofilm viability, biomass, structure, and regrowth.