Antibiotic resistant bacteria/genes dissemination in lacustrine sediments highly increased following cultural eutrophication of Lake Geneva (Switzerland).

This study investigates faecal indicator bacteria (FIB), multiple antibiotic resistant (MAR), and antibiotic resistance genes (ARGs), of sediment profiles from different parts of Lake Geneva (Switzerland) over the last decades. MARs consist to expose culturable Escherichia coli (EC) and Enterococcus (ENT) to mixed five antibiotics including Ampicillin, Tetracycline, Amoxicillin, Chloramphenicol and Erythromycin. Culture-independent is performed to assess the distribution of ARGs responsible for, β-lactams (blaTEM; Amoxicillin/Ampicillin), Streptomycin/Spectinomycin (aadA), Tetracycline (tet) Chloramphenicol (cmlA) and Vancomycin (van). Bacterial cultures reveal that in the sediments deposited following eutrophication of Lake Geneva in the 1970s, the percentage of MARs to five antibiotics varied from 0.12% to 4.6% and 0.016% to 11.6% of total culturable EC and ENT, respectively. In these organic-rich bacteria-contaminated sediments, the blaTEM resistant of FIB varied from 22% to 48% and 16% to 37% for EC and ENT respectively, whereas the positive PCR assays responsible for tested ARGs were observed for EC, ENT, and total DNA from all samples. The aadA resistance gene was amplified for all the sediment samples, including those not influenced by WWTP effluent water. Our results demonstrate that bacteria MARs and ARGs highly increased in the sediments contaminated with WWTP effluent following the cultural eutrophication of Lake Geneva. Hence, the human-induced changing limnological conditions highly enhanced the sediment microbial activity, and therein the spreading of antibiotic resistant bacteria and genes in this aquatic environment used to supply drinking water in a highly populated area. Furthermore, the presence of the antibiotic resistance gene aadA in all the studied samples points out a regional dissemination of this emerging contaminant in freshwater sediments since at least the late nineteenth century.

Detailed 3D seismic imaging of a fault zone beneath Lake Geneva, Switzerland

An efficient high-resolution (HR) three-dimensional (3D) seismic reflection system for small-scale targets in lacustrine settings was developed. In Lake Geneva, near the city of Lausanne, Switzerland, the offshore extension of a complex fault zone well mapped on land was chosen for testing our system. A preliminary two-dimensional seismic survey indicated structures that include a thin (<40 m) layer of subhorizontal Quaternary sediments that unconformably overlie south-east-dipping Tertiary Molasse beds and a major fault zone (Paudeze Fault Zone) that separates Plateau and Subalpine Molasse (SM) units. A 3D survey was conducted over this test site using a newly developed three-streamer system. It provided high-quality data with a penetration to depths of 300 m below the water bottom of non-aliased signal for dips up to 30degrees and with a maximum vertical resolution of 1.1 m. The data were subjected to a conventional 3D processing sequence that included post-stack time migration. Tests with 3D pre-stack depth migration showed that such techniques can be applied to HR seismic surveys. Delineation of several horizons and fault surfaces reveals the potential for small-scale geologic and tectonic interpretation in three dimensions. Five major seismic facies and their detailed 3D geometries can be distinguished. Three fault surfaces and the top of a molasse surface were mapped in 3D. Analysis of the geometry of these surfaces and their relative orientation suggests that pre-existing structures within the Plateau Molasse (PM) unit influenced later faulting between the Plateau and SM. In particular, a change in strike of the PM bed dip may indicate a fold formed by a regional stress regime, the orientation of which was different from the one responsible for the creation of the Paudeze Fault Zone. This structure might have later influenced the local stress regime and caused the curved shape of the Paudeze Fault in our surveyed area.

Characterization of fecal indicator bacteria in sediments cores from the largest freshwater lake of Western Europe (Lake Geneva, Switzerland)

This study characterized the fecal indicator bacteria (FIB), including Escherichia coli (E. coli) and Enteroccocus (ENT), disseminated over time in the Bay of Vidy, which is the most contaminated area of Lake Geneva. Sediments were collected from a site located at similar to 500 m from the present waste water treatment plant (WWTP) outlet pipe, in front of the former WWTP outlet pipe, which was located at only 300 m from the coastal recreational area (before 2001). E. coil and ENT were enumerated in sediment suspension using the membrane filter method. The FIB characterization was performed for human Enterococcus faecalis (E. faecalis) and Enterococcus faecium (E. faecium) and human specific bacteroides by PCR using specific primers and a matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Bacterial cultures revealed that maximum values of 35.2 x 10(8) and 6.6 x 10(6) CFU g(-1) dry sediment for E. coil and ENT, respectively, were found in the sediments deposited following eutrophication of Lake Geneva in the 1970s. whereas the WWTP started operating in 1964. The same tendency was observed for the presence of human fecal pollution: the percentage of PCR amplification with primers ESP-1/ESP-2 for E. faecalis and E. faecium indicated that more than 90% of these bacteria were from human origin. Interestingly, the PCR assays for specific-human bacteroides HF183/HF134 were positive for DNA extracted from all isolated strains of sediment surrounding WWPT outlet pipe discharge. The MALDI-TOF MS confirmed the presence of general E. coli and predominance E. faecium in isolated strains. Our results demonstrated that human fecal bacteria highly increased in the sediments contaminated with WWTP effluent following the eutrophication of Lake Geneva. Additionally, other FIB cultivable strains from animals or adapted environmental strains were detected in the sediment of the bay. The approaches used in this research are valuable to assess the temporal distribution and the source of the human fecal pollution in aquatic environments. (C) 2011 Elsevier Inc. All rights reserved.

Risk assessment of herbicide mixtures in a large European lake

Lake Geneva is one of the largest European lakes with a surface area of 580 km2. Its catchment area covers 7400 km2, of which approximately 20% is arable land. Monitoring campaigns have been carried out in 2004 and 2005 to determine the contamination of the lake by pesticides. The results highlight the widespread presence of herbicides in water, the measured concentrations for most substances remaining constant in 2004 and 2005. However, for some individual herbicides the concentrations increased drastically (e.g., the herbicide foramsulfuron). We assessed the environmental risk of the herbicides detected in the lake using water quality criteria recently determined for the Swiss environmental protection agency. Furthermore, we assessed the risk of herbicide mixtures, grouped based upon their mode of action. Generally, the risk estimated for all single substances is low, except for some sulfonylurea compounds. For these substances, the measured concentrations are higher than the predicted no-effect concentration. Impact on the flora of the lake can therefore not be excluded. When mixtures of pesticides with similar mode of action are taken into account, the risk remains lower than the mixture water quality criteria for all groups, but can reach as high as one third of this quality criteria. A further step would therefore be to assess the risk of the total pesticide mixture, including similar and dissimilar modes of action

A High-Resolution 2D/3D Seismic Study of a Thrust Fault Zone in Lake Geneva, Switzerland

P130 A HIGH-RESOLUTION 2D/3D SEISMIC STUDY OF A THRUST FAULT ZONE IN LAKE GENEVA SWITZERLAND M. SCHEIDHAUER M. BERES D. DUPUY and F. MARILLIER Institute of Geophysics University of Lausanne 1015 Lausanne, Switzerland Summary A high-resolution three-dimensional (3D) seismic reflection survey has been conducted in Lake Geneva near the city of Lausanne Switzerland where the faulted molasse basement (Tertiary sandstones) is overlain by complex Quaternary sedimentary structures. Using a single 48-channel streamer an area of 1200 m x 600 m was surveyed in 10 days. With a 5-m shot spacing and a receiver spacing of 2.5 m in the inline direction and 7.5 m in the crossline direction, a 12-fold data coverage was achieved. A maximum penetration depth of ~150 m was achieved with a 15 cu. in. water gun operated at 140 bars. The multi-channel data allow the determination of an accurate velocity field for 3D processing, and they show particularly clean images of the fault zone and the overlying sediments in horizontal and vertical sections. In order to compare different sources, inline 55 was repeated with a 30/30 and a 15/15 cu. in. double-chamber air gun (Mini GI) operated at 100 and 80 bars, respectively. A maximum penetration depth of ~450 m was achieved with this source.

Addressing elementary school teachers' professional stressors: Practical suggestions for schools and adminstrators

Purpose: Given the preponderance of education reform since the No Child Left Behind Act (U.S. Department of Education, 2001), reform efforts have shaped the nature of the work and culture in schools. The emphasis on standardized testing to determine schools' status and student performance, among other factors, has generated stress, particularly for teachers. Therefore, district and school administrators are encouraged to consider the contextual factors that contribute to teacher stress to address them and to retain high-performing teachers. Research Methods/Approach: Participants were recruited from two types of schools in order to test hypotheses related to directional responding as a function of working in a more challenging (high-priority) or less challenging (non-high-priority) school environment. We employed content analysis to analyze 64 suburban elementary school teachers' free-responses to a prompt regarding their stress as teachers. We cross-analyzed our findings through external auditing to bolster trustworthiness in the data and in the procedure. Findings: Teachers reported personal and contextual stressors. Herein, we reported concrete examples of the five categories of contextual stressors teachers identified: political and educational structures, instructional factors, student factors, parent and family factors, and school climate. We found directional qualities and overlapping relationships in the data, partially confirming our hypotheses. Implications for Research and Practice: We offer specific recommendations for practical ways in which school administrators might systemically address teacher stress based on the five categories of stressors reported by participants. We also suggest means of conducting action research to measure the effects of implemented suggestions.

Stable isotopes in lake Geneva carbonate sediments and molluscs: Review and new data

New isotopic results on bulk carbonate and mollusc (gastropods and bivalves) samples from Lake Geneva (Switzerland), spanning the period from the Oldest Dryas to the present day, are compared with pre-existing stable isotope data. According to preliminary calibration of modern samples, Lake Geneva endogenic calcite precipitates at or near oxygen isotopic equilibrium with ambient water, confirming the potential of this large lake to record paleoenvironmental and paleoclimatic changes. The onset of endogenic calcite precipitation at the beginning of the Allerod biozone is clearly indicated by the oxygen isotopic signature of bulk carbonate. A large change in delta(13)C values occurs during the Preboreal. This carbon shift is likely to be due to a change in bioproductivity and/or to a `'catchment effect'', the contribution of biogenic CO2 from the catchment area to the dissolved inorganic carbon reservoir of the lake water becoming significant only during the Preboreal. Gastropods are confirmed as valuable for studies of changes in paleotemperature and in paleowater isotopic composition, despite the presence of a vital effect. Mineralogical evidence indicates an increased detrital influence upon sedimentation since the Subboreal time period. On the other hand, stable isotope measurements of Subatlantic carbonate sediments show values comparable to those of pure endogenic calcite and of gastropods (taking into account the vital effect). This apparent disagreement still remains difficult to explain.

A propos des "small area variations": opérations pour fracture de hanche dans le canton de Vaud. [Small area variations: surgery for hip fractures in the canton of Vaud].

OBJECTIVES: Studies of small area variations of health care utilization are more and more frequent. Such variations are often considered to be an indication of variations in the quality of medical care. The variations in the rate of operations for hip fractures are among the lowest studied to date, due to the fact that a consensus exists concerning this surgery. Our objective is to examine these variations within the context of relatively small and heterogeneous districts. METHOD: Based on anonymous computerized data on public hospital stays, this study describes the variations in population rates (crude and standardized) of operations for hip fracture among the health districts of the Canton of Vaud for the period from 1986 to 1991. District populations vary from 22,000 to 164,000. Using the extremal quotient (EQ), the importance of these variations was determined. RESULTS: The study population consists of 2363 cases, of which 78% are women. Mean age is 80.4 for women and 70.6 for men. Standardized rates of operation for hip fracture per 100,000 in the Canton Vaud for the years 1986 to 1991 are, respectively: 56; 67; 86; 91; 89 and 94. The EQ for the years 1986 to 1991 are respectively: 8.2; 4.0; 3.5; 2.7; 1.9 and 1.9. The high EQ, especially for the earlier years, are contrary to the initial premise of absence of variation. The progressive implementation in the Canton Vaud of VESKA medical statistics could play a role, as could the small size of many of the districts, with resultant instability of rates. CONCLUSIONS: Considering the wide variations shown here for an operation hardly regarded as subject to variations, it is important to exercise caution in interpreting published data of small area variations.

Prospective determination of plasma imipenem concentrations in critically ill children.

Plasma imipenem concentrations were measured in 19 critically ill children (median age, 0.8 year; range, 0.02 to 12.9 years). Wide interindividual variations (2 to 4x at peak and >10x at trough concentrations) resulted in unpredictable plasma levels in several children. To avoid subtherapeutic drug levels, we recommend treatment with at least 100 mg/kg of body weight/day of imipenem-cilastatin for critically ill children requiring such therapy.

Development of a 3D very high-resolution seismic reflection system for lacustrine settings - a case study over a thrust fault zone in Lake Geneva

Un système efficace de sismique tridimensionnelle (3-D) haute-résolution adapté à des cibles lacustres de petite échelle a été développé. Dans le Lac Léman, près de la ville de Lausanne, en Suisse, des investigations récentes en deux dimension (2-D) ont mis en évidence une zone de faille complexe qui a été choisie pour tester notre système. Les structures observées incluent une couche mince (<40 m) de sédiments quaternaires sub-horizontaux, discordants sur des couches tertiaires de molasse pentées vers le sud-est. On observe aussi la zone de faille de « La Paudèze » qui sépare les unités de la Molasse du Plateau de la Molasse Subalpine. Deux campagnes 3-D complètes, d?environ d?un kilomètre carré, ont été réalisées sur ce site de test. La campagne pilote (campagne I), effectuée en 1999 pendant 8 jours, a couvert 80 profils en utilisant une seule flûte. Pendant la campagne II (9 jours en 2001), le nouveau système trois-flûtes, bien paramétrés pour notre objectif, a permis l?acquisition de données de très haute qualité sur 180 lignes CMP. Les améliorations principales incluent un système de navigation et de déclenchement de tirs grâce à un nouveau logiciel. Celui-ci comprend un contrôle qualité de la navigation du bateau en temps réel utilisant un GPS différentiel (dGPS) à bord et une station de référence près du bord du lac. De cette façon, les tirs peuvent être déclenchés tous les 5 mètres avec une erreur maximale non-cumulative de 25 centimètres. Tandis que pour la campagne I la position des récepteurs de la flûte 48-traces a dû être déduite à partir des positions du bateau, pour la campagne II elle ont pu être calculées précisément (erreur <20 cm) grâce aux trois antennes dGPS supplémentaires placées sur des flotteurs attachés à l?extrémité de chaque flûte 24-traces. Il est maintenant possible de déterminer la dérive éventuelle de l?extrémité des flûtes (75 m) causée par des courants latéraux ou de petites variations de trajet du bateau. De plus, la construction de deux bras télescopiques maintenant les trois flûtes à une distance de 7.5 m les uns des autres, qui est la même distance que celle entre les lignes naviguées de la campagne II. En combinaison avec un espacement de récepteurs de 2.5 m, la dimension de chaque «bin» de données 3-D de la campagne II est de 1.25 m en ligne et 3.75 m latéralement. L?espacement plus grand en direction « in-line » par rapport à la direction «cross-line» est justifié par l?orientation structurale de la zone de faille perpendiculaire à la direction «in-line». L?incertitude sur la navigation et le positionnement pendant la campagne I et le «binning» imprécis qui en résulte, se retrouve dans les données sous forme d?une certaine discontinuité des réflecteurs. L?utilisation d?un canon à air à doublechambre (qui permet d?atténuer l?effet bulle) a pu réduire l?aliasing observé dans les sections migrées en 3-D. Celui-ci était dû à la combinaison du contenu relativement haute fréquence (<2000 Hz) du canon à eau (utilisé à 140 bars et à 0.3 m de profondeur) et d?un pas d?échantillonnage latéral insuffisant. Le Mini G.I 15/15 a été utilisé à 80 bars et à 1 m de profondeur, est mieux adapté à la complexité de la cible, une zone faillée ayant des réflecteurs pentés jusqu?à 30°. Bien que ses fréquences ne dépassent pas les 650 Hz, cette source combine une pénétration du signal non-aliasé jusqu?à 300 m dans le sol (par rapport au 145 m pour le canon à eau) pour une résolution verticale maximale de 1.1 m. Tandis que la campagne I a été acquise par groupes de plusieurs lignes de directions alternées, l?optimisation du temps d?acquisition du nouveau système à trois flûtes permet l?acquisition en géométrie parallèle, ce qui est préférable lorsqu?on utilise une configuration asymétrique (une source et un dispositif de récepteurs). Si on ne procède pas ainsi, les stacks sont différents selon la direction. Toutefois, la configuration de flûtes, plus courtes que pour la compagne I, a réduit la couverture nominale, la ramenant de 12 à 6. Une séquence classique de traitement 3-D a été adaptée à l?échantillonnage à haute fréquence et elle a été complétée par deux programmes qui transforment le format non-conventionnel de nos données de navigation en un format standard de l?industrie. Dans l?ordre, le traitement comprend l?incorporation de la géométrie, suivi de l?édition des traces, de l?harmonisation des «bins» (pour compenser l?inhomogénéité de la couverture due à la dérive du bateau et de la flûte), de la correction de la divergence sphérique, du filtrage passe-bande, de l?analyse de vitesse, de la correction DMO en 3-D, du stack et enfin de la migration 3-D en temps. D?analyses de vitesse détaillées ont été effectuées sur les données de couverture 12, une ligne sur deux et tous les 50 CMP, soit un nombre total de 600 spectres de semblance. Selon cette analyse, les vitesses d?intervalles varient de 1450-1650 m/s dans les sédiments non-consolidés et de 1650-3000 m/s dans les sédiments consolidés. Le fait que l?on puisse interpréter plusieurs horizons et surfaces de faille dans le cube, montre le potentiel de cette technique pour une interprétation tectonique et géologique à petite échelle en trois dimensions. On distingue cinq faciès sismiques principaux et leurs géométries 3-D détaillées sur des sections verticales et horizontales: les sédiments lacustres (Holocène), les sédiments glacio-lacustres (Pléistocène), la Molasse du Plateau, la Molasse Subalpine de la zone de faille (chevauchement) et la Molasse Subalpine au sud de cette zone. Les couches de la Molasse du Plateau et de la Molasse Subalpine ont respectivement un pendage de ~8° et ~20°. La zone de faille comprend de nombreuses structures très déformées de pendage d?environ 30°. Des tests préliminaires avec un algorithme de migration 3-D en profondeur avant sommation et à amplitudes préservées démontrent que la qualité excellente des données de la campagne II permet l?application de telles techniques à des campagnes haute-résolution. La méthode de sismique marine 3-D était utilisée jusqu?à présent quasi-exclusivement par l?industrie pétrolière. Son adaptation à une échelle plus petite géographiquement mais aussi financièrement a ouvert la voie d?appliquer cette technique à des objectifs d?environnement et du génie civil.<br/><br/>An efficient high-resolution three-dimensional (3-D) seismic reflection system for small-scale targets in lacustrine settings was developed. In Lake Geneva, near the city of Lausanne, Switzerland, past high-resolution two-dimensional (2-D) investigations revealed a complex fault zone (the Paudèze thrust zone), which was subsequently chosen for testing our system. Observed structures include a thin (<40 m) layer of subhorizontal Quaternary sediments that unconformably overlie southeast-dipping Tertiary Molasse beds and the Paudèze thrust zone, which separates Plateau and Subalpine Molasse units. Two complete 3-D surveys have been conducted over this same test site, covering an area of about 1 km2. In 1999, a pilot survey (Survey I), comprising 80 profiles, was carried out in 8 days with a single-streamer configuration. In 2001, a second survey (Survey II) used a newly developed three-streamer system with optimized design parameters, which provided an exceptionally high-quality data set of 180 common midpoint (CMP) lines in 9 days. The main improvements include a navigation and shot-triggering system with in-house navigation software that automatically fires the gun in combination with real-time control on navigation quality using differential GPS (dGPS) onboard and a reference base near the lake shore. Shots were triggered at 5-m intervals with a maximum non-cumulative error of 25 cm. Whereas the single 48-channel streamer system of Survey I requires extrapolation of receiver positions from the boat position, for Survey II they could be accurately calculated (error <20 cm) with the aid of three additional dGPS antennas mounted on rafts attached to the end of each of the 24- channel streamers. Towed at a distance of 75 m behind the vessel, they allow the determination of feathering due to cross-line currents or small course variations. Furthermore, two retractable booms hold the three streamers at a distance of 7.5 m from each other, which is the same distance as the sail line interval for Survey I. With a receiver spacing of 2.5 m, the bin dimension of the 3-D data of Survey II is 1.25 m in in-line direction and 3.75 m in cross-line direction. The greater cross-line versus in-line spacing is justified by the known structural trend of the fault zone perpendicular to the in-line direction. The data from Survey I showed some reflection discontinuity as a result of insufficiently accurate navigation and positioning and subsequent binning errors. Observed aliasing in the 3-D migration was due to insufficient lateral sampling combined with the relatively high frequency (<2000 Hz) content of the water gun source (operated at 140 bars and 0.3 m depth). These results motivated the use of a double-chamber bubble-canceling air gun for Survey II. A 15 / 15 Mini G.I air gun operated at 80 bars and 1 m depth, proved to be better adapted for imaging the complexly faulted target area, which has reflectors dipping up to 30°. Although its frequencies do not exceed 650 Hz, this air gun combines a penetration of non-aliased signal to depths of 300 m below the water bottom (versus 145 m for the water gun) with a maximum vertical resolution of 1.1 m. While Survey I was shot in patches of alternating directions, the optimized surveying time of the new threestreamer system allowed acquisition in parallel geometry, which is preferable when using an asymmetric configuration (single source and receiver array). Otherwise, resulting stacks are different for the opposite directions. However, the shorter streamer configuration of Survey II reduced the nominal fold from 12 to 6. A 3-D conventional processing flow was adapted to the high sampling rates and was complemented by two computer programs that format the unconventional navigation data to industry standards. Processing included trace editing, geometry assignment, bin harmonization (to compensate for uneven fold due to boat/streamer drift), spherical divergence correction, bandpass filtering, velocity analysis, 3-D DMO correction, stack and 3-D time migration. A detailed semblance velocity analysis was performed on the 12-fold data set for every second in-line and every 50th CMP, i.e. on a total of 600 spectra. According to this velocity analysis, interval velocities range from 1450-1650 m/s for the unconsolidated sediments and from 1650-3000 m/s for the consolidated sediments. Delineation of several horizons and fault surfaces reveal the potential for small-scale geologic and tectonic interpretation in three dimensions. Five major seismic facies and their detailed 3-D geometries can be distinguished in vertical and horizontal sections: lacustrine sediments (Holocene) , glaciolacustrine sediments (Pleistocene), Plateau Molasse, Subalpine Molasse and its thrust fault zone. Dips of beds within Plateau and Subalpine Molasse are ~8° and ~20°, respectively. Within the fault zone, many highly deformed structures with dips around 30° are visible. Preliminary tests with 3-D preserved-amplitude prestack depth migration demonstrate that the excellent data quality of Survey II allows application of such sophisticated techniques even to high-resolution seismic surveys. In general, the adaptation of the 3-D marine seismic reflection method, which to date has almost exclusively been used by the oil exploration industry, to a smaller geographical as well as financial scale has helped pave the way for applying this technique to environmental and engineering purposes.<br/><br/>La sismique réflexion est une méthode d?investigation du sous-sol avec un très grand pouvoir de résolution. Elle consiste à envoyer des vibrations dans le sol et à recueillir les ondes qui se réfléchissent sur les discontinuités géologiques à différentes profondeurs et remontent ensuite à la surface où elles sont enregistrées. Les signaux ainsi recueillis donnent non seulement des informations sur la nature des couches en présence et leur géométrie, mais ils permettent aussi de faire une interprétation géologique du sous-sol. Par exemple, dans le cas de roches sédimentaires, les profils de sismique réflexion permettent de déterminer leur mode de dépôt, leurs éventuelles déformations ou cassures et donc leur histoire tectonique. La sismique réflexion est la méthode principale de l?exploration pétrolière. Pendant longtemps on a réalisé des profils de sismique réflexion le long de profils qui fournissent une image du sous-sol en deux dimensions. Les images ainsi obtenues ne sont que partiellement exactes, puisqu?elles ne tiennent pas compte de l?aspect tridimensionnel des structures géologiques. Depuis quelques dizaines d?années, la sismique en trois dimensions (3-D) a apporté un souffle nouveau à l?étude du sous-sol. Si elle est aujourd?hui parfaitement maîtrisée pour l?imagerie des grandes structures géologiques tant dans le domaine terrestre que le domaine océanique, son adaptation à l?échelle lacustre ou fluviale n?a encore fait l?objet que de rares études. Ce travail de thèse a consisté à développer un système d?acquisition sismique similaire à celui utilisé pour la prospection pétrolière en mer, mais adapté aux lacs. Il est donc de dimension moindre, de mise en oeuvre plus légère et surtout d?une résolution des images finales beaucoup plus élevée. Alors que l?industrie pétrolière se limite souvent à une résolution de l?ordre de la dizaine de mètres, l?instrument qui a été mis au point dans le cadre de ce travail permet de voir des détails de l?ordre du mètre. Le nouveau système repose sur la possibilité d?enregistrer simultanément les réflexions sismiques sur trois câbles sismiques (ou flûtes) de 24 traces chacun. Pour obtenir des données 3-D, il est essentiel de positionner les instruments sur l?eau (source et récepteurs des ondes sismiques) avec une grande précision. Un logiciel a été spécialement développé pour le contrôle de la navigation et le déclenchement des tirs de la source sismique en utilisant des récepteurs GPS différentiel (dGPS) sur le bateau et à l?extrémité de chaque flûte. Ceci permet de positionner les instruments avec une précision de l?ordre de 20 cm. Pour tester notre système, nous avons choisi une zone sur le Lac Léman, près de la ville de Lausanne, où passe la faille de « La Paudèze » qui sépare les unités de la Molasse du Plateau et de la Molasse Subalpine. Deux campagnes de mesures de sismique 3-D y ont été réalisées sur une zone d?environ 1 km2. Les enregistrements sismiques ont ensuite été traités pour les transformer en images interprétables. Nous avons appliqué une séquence de traitement 3-D spécialement adaptée à nos données, notamment en ce qui concerne le positionnement. Après traitement, les données font apparaître différents faciès sismiques principaux correspondant notamment aux sédiments lacustres (Holocène), aux sédiments glacio-lacustres (Pléistocène), à la Molasse du Plateau, à la Molasse Subalpine de la zone de faille et la Molasse Subalpine au sud de cette zone. La géométrie 3-D détaillée des failles est visible sur les sections sismiques verticales et horizontales. L?excellente qualité des données et l?interprétation de plusieurs horizons et surfaces de faille montrent le potentiel de cette technique pour les investigations à petite échelle en trois dimensions ce qui ouvre des voies à son application dans les domaines de l?environnement et du génie civil.

Impact of the introduction of real-time therapeutic drug monitoring on empirical doses of carbapenems in critically ill burn patients.

PURPOSE: Adequate empirical antibiotic dose selection for critically ill burn patients is difficult due to extreme variability in drug pharmacokinetics. Therapeutic drug monitoring (TDM) may aid antibiotic prescription and implementation of initial empirical antimicrobial dosage recommendations. This study evaluated how gradual TDM introduction altered empirical dosages of meropenem and imipenem/cilastatin in our burn ICU. METHODS: Imipenem/cilastatin and meropenem use and daily empirical dosage at a five-bed burn ICU were analyzed retrospectively. Data for all burn admissions between 2001 and 2011 were extracted from the hospital's computerized information system. For each patient receiving a carbapenem, episodes of infection were reviewed and scored according to predefined criteria. Carbapenem trough serum levels were characterized. Prior to May 2007, TDM was available only by special request. Real-time carbapenem TDM was introduced in June 2007; it was initially available weekly and has been available 4 days a week since 2010. RESULTS: Of 365 patients, 229 (63%) received antibiotics (109 received carbapenems). Of 23 TDM determinations for imipenem/cilastatin, none exceeded the predefined upper limit and 11 (47.8%) were insufficient; the number of TDM requests was correlated with daily dose (r=0.7). Similar numbers of inappropriate meropenem trough levels (30.4%) were below and above the upper limit. Real-time TDM introduction increased the empirical dose of imipenem/cilastatin, but not meropenem. CONCLUSIONS: Real-time carbapenem TDM availability significantly altered the empirical daily dosage of imipenem/cilastatin at our burn ICU. Further studies are needed to evaluate the individual impact of TDM-based antibiotic adjustment on infection outcomes in these patients.

Prognostication of Mortality in Critically Ill Patients With Severe Infections.

BACKGROUND: The purpose of this study was to confirm the prognostic value of pancreatic stone protein (PSP) in patients with severe infections requiring ICU management and to develop and validate a model to enhance mortality prediction by combining severity scores with biomarkers. METHODS: We enrolled prospectively patients with severe sepsis or septic shock in mixed tertiary ICUs in Switzerland (derivation cohort) and Brazil (validation cohort). Severity scores (APACHE [Acute Physiology and Chronic Health Evaluation] II or Simplified Acute Physiology Score [SAPS] II) were combined with biomarkers obtained at the time of diagnosis of sepsis, including C-reactive-protein, procalcitonin (PCT), and PSP. Logistic regression models with the lowest prediction errors were selected to predict in-hospital mortality. RESULTS: Mortality rates of patients with septic shock enrolled in the derivation cohort (103 out of 158) and the validation cohort (53 out of 91) were 37% and 57%, respectively. APACHE II and PSP were significantly higher in dying patients. In the derivation cohort, the models combining either APACHE II, PCT, and PSP (area under the receiver operating characteristic curve [AUC], 0.721; 95% CI, 0.632-0.812) or SAPS II, PCT, and PSP (AUC, 0.710; 95% CI, 0.617-0.802) performed better than each individual biomarker (AUC PCT, 0.534; 95% CI, 0.433-0.636; AUC PSP, 0.665; 95% CI, 0.572-0.758) or severity score (AUC APACHE II, 0.638; 95% CI, 0.543-0.733; AUC SAPS II, 0.598; 95% CI, 0.499-0.698). These models were externally confirmed in the independent validation cohort. CONCLUSIONS: We confirmed the prognostic value of PSP in patients with severe sepsis and septic shock requiring ICU management. A model combining severity scores with PCT and PSP improves mortality prediction in these patients.