Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2k guidelines of the German Sepsis Society (Deutsche Sepsis-Gesellschaft e.V. (DSG)) and the German Interdisciplinary Association of Intensive Care and Emergency Medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI))

Practice guidelines are systematically developed statements and recommendations that assist the physicians and patients in making decisions about appropriate health care measures for specific clinical circumstances taking into account specific national health care structures. The 1(st) revision of the S-2k guideline of the German Sepsis Society in collaboration with 17 German medical scientific societies and one self-help group provides state-of-the-art information (results of controlled clinical trials and expert knowledge) on the effective and appropriate medical care (prevention, diagnosis, therapy and follow-up care) of critically ill patients with severe sepsis or septic shock. The guideline had been developed according to the "German Instrument for Methodological Guideline Appraisal" of the Association of the Scientific Medical Societies (AWMF). In view of the inevitable advancements in scientific knowledge and technical expertise, revisions, updates and amendments must be periodically initiated. The guideline recommendations may not be applied under all circumstances. It rests with the clinician to decide whether a certain recommendation should be adopted or not, taking into consideration the unique set of clinical facts presented in connection with each individual patient as well as the available resources.

Sediment dynamics in the subaquatic channel of the Rhone delta (Lake Geneva, France/Switzerland)

bstract With its smaller size, well-known boundary conditions, and the availability of detailed bathymetric data, Lake Geneva’s subaquatic canyon in the Rhone Delta is an excellent analogue to understand sedimentary pro- cesses in deep-water submarine channels. A multidisciplinary research effort was undertaken to unravel the sediment dynamics in the active canyon. This approach included innovative coring using the Russian MIR sub- mersibles, in situ geotechnical tests, and geophysical, sedimentological, geochemical and radiometric analysis techniques. The canyon floor/levee complex is character- ized by a classic turbiditic system with frequent spillover events. Sedimentary evolution in the active canyon is controlled by a complex interplay between erosion and sedimentation processes. In situ profiling of sediment strength in the upper layer was tested using a dynamic penetrometer and suggests that erosion is the governing mechanism in the proximal canyon floor while sedimen- tation dominates in the levee structure. Sedimentation rates progressively decrease down-channel along the levee structure, with accumulation exceeding 2.6 cm/year in the proximal levee. A decrease in the frequency of turbidites upwards along the canyon wall suggests a progressive confinement of the flow through time. The multi-proxy methodology has also enabled a qualitative slope-stability assessment in the levee structure. The rapid sediment loading, slope undercutting and over-steepening, and increased pore pressure due to high methane concentrations hint at a potential instability of the proximal levees. Fur- thermore, discrete sandy intervals show very high methane concentrations and low shear strength and thus could cor- respond to potentially weak layers prone to scarp failures.

Contrasts, Contacts, and Interconnections — Tel Kinrot as an Early Iron Age Key Site in the Northern Jordan Rift Valley at the Dawn of the 1st Millennium BCE

Ancient Kinneret (Tēl Kinrōt [Hebrew]; Tell el-ʿOrēme [Arabic]) is located on a steep limestone hill on the northwestern shores of the Sea of Galilee (2508.7529 [NIG]). The site, whose settlement history began sometime during the Pottery-Neolithic or the early Chalcolithic period, is emerging as one of the major sites for the study of urban life in the Southern Levant during the Early Iron Age (c. 1130–950 BCE). Its size, accessibility by major trade routes, and strategic location between different spheres of cultural and political influence make Tēl Kinrōt an ideal place for studying the interaction of various cultures on urban sites, as well as to approach questions of ethnicity and regionalism during one of the most debated periods in the history of the ancient Levant. The paper will briefly discuss the settlement history of the site during the Early Iron Age. However, the main focus will lie on the material culture of the late Iron Age IB city that rapidly evolved to a regional center during the transition from the 11th to the 10th century BCE. During this period, ancient Kinneret features a multitude of cultural influences that reach from Egypt via the Central Hill Country until the Northern parts of Syria and the Amuq region. While there are indisputably close ties with the ‘Aramaean’ realm, there are also strong indications that there were – at the same time – vivid socio-economic links with the West, i.e. the Southern and Northern Mediterranean coasts and their hinterland. It will be argued that the resulting ‘cultural blend’ is a typical characteristic of the material culture of the Northern Jordan Rift Valley in the advent of the emerging regional powers of the Iron Age II.