Measures to prevent surgical site infections: what surgeons (should) do.

BACKGROUND: The present study was designed to evaluate surgeons' strategies and adherence to preventive measures against surgical site infections (SSIs). MATERIALS AND METHODS: All surgeons participating in a prospective Swiss multicentric surveillance program for SSIs received a questionnaire developed from the 2008 National (United Kingdom) Institute for Health and Clinical Excellence (NICE) clinical guidelines on prevention and treatment of SSIs. We focused on perioperative management and surgical technique in hernia surgery, cholecystectomy, appendectomy, and colon surgery (COL). RESULTS: Forty-five of 50 surgeons contacted (90%) responded. Smoking cessation and nutritional screening are regularly propagated by 1/3 and 1/2 of surgeons, respectively. Thirty-eight percent practice bowel preparation before COL. Preoperative hair removal is routinely (90%) performed in the operating room with electric clippers. About 50% administer antibiotic prophylaxis within 30 min before incision. Intra-abdominal drains are common after COL (43%). Two thirds of respondents apply nonocclusive wound dressings that are manipulated after hand disinfection (87%). Dressings are usually changed on postoperative day (POD) 2 (75%), and wounds remain undressed on POD 2-3 or 4-5 (36% each). CONCLUSIONS: Surgeons' strategies to prevent SSIs still differ widely. The adherence to the current NICE guidelines is low for many procedures regardless of the available level of evidence. Further research should provide convincing data in order to justify standardization of perioperative management.

Multispectral remote sensing for site-specific nitrogen fertilizer management

The objective of this work was to evaluate the use of multispectral remote sensing for site-specific nitrogen fertilizer management. Satellite imagery from the advanced spaceborne thermal emission and reflection radiometer (Aster) was acquired in a 23 ha corn-planted area in Iran. For the collection of field samples, a total of 53 pixels were selected by systematic randomized sampling. The total nitrogen content in corn leaf tissues in these pixels was evaluated. To predict corn canopy nitrogen content, different vegetation indices, such as normalized difference vegetation index (NDVI), soil-adjusted vegetation index (Savi), optimized soil-adjusted vegetation index (Osavi), modified chlorophyll absorption ratio index 2 (MCARI2), and modified triangle vegetation index 2 (MTVI2), were investigated. The supervised classification technique using the spectral angle mapper classifier (SAM) was performed to generate a nitrogen fertilization map. The MTVI2 presented the highest correlation (R²=0.87) and is a good predictor of corn canopy nitrogen content in the V13 stage, at 60 days after cultivating. Aster imagery can be used to predict nitrogen status in corn canopy. Classification results indicate three levels of required nitrogen per pixel: low (0-2.5 kg), medium (2.5-3 kg), and high (3-3.3 kg).

Homing phenotypes of tumor-specific CD8 T cells are predetermined at the tumor site by crosspresenting APCs.

Expression of tissue-specific homing molecules directs antigen-experienced T cells to particular peripheral tissues. In studies using soluble antigens that focused on skin and gut, antigen-presenting cells (APCs) within regional lymphoid tissues were proposed to be responsible for imprinting homing phenotypes. Whether this occurs in other sites and after physiologic antigen processing and presentation is unknown. We define in vivo imprinting of distinct homing phenotypes on monospecific T cells responding to antigens expressed by tumors in intracerebral, subcutaneous, and intraperitoneal sites with efficient brain-tropism of CD8 T cells crossprimed in the cervical lymph nodes (LNs). Multiple imprinting programs could occur simultaneously in the same LN when tumors were present in more than one site. Thus, the identity of the LN is not paramount in determining the homing phenotype; this critical functional parameter is dictated upstream at the site of antigen capture by crosspresenting APCs.

Multi-site -sertifikaatin vaatimukset ympäristöjohtamisjärjestelmän rakentamisessa

Diplomityö muodostuu kahdesta kokonaisuudesta. Työn teoriaosa kertoo mitä ympäristöjohtaminen on, millaisia ovat multi-site -organisaatio ja multi-site -johtamisjärjestelmä sekä mitä vaatimuksia nämä asettavat yritykselle. Työssä esitetään malli, jota käyttämällä kansainvälisten johtamisjärjestelmästandardien mukaan rakennetut laatu-, ympäristö-, terveys- ja turvallisuusjärjestelmät voidaan yhdistää yhdeksi kokonaisuudeksi, multi-site - johtamisjärjestelmäksi. Malli rakentuu kolmesta tasosta, joita ovat paikallinen, maakohtainen ja konsernitaso. Esimerkkien avulla kerrotaan miteneri lähtökohdista voidaan näiden tasojen kautta edetä kohti yhtä johtamiskokonaisuutta. Esille tuodaan myös multi-site -johtamisjärjestelmän käyttöönottoa puoltavat ja vastustavat näkökohdat. Työn konkreettinen osa on johtamisjärjestelmämallin paikallisen tason toteuttaminen. Ympäristöjohtamisjärjestelmän rakentaminen standardin EN ISO 14001:2004 vaatimusten mukaiseksi Kvaerner Power Oy:n Suomen toimipaikoille sekä tämän järjestelmän yhdistäminen sertifioituun EN ISO 9001 -standardin mukaiseen laatujärjestelmään. Työssä kerrotaan miten ympäristöjohtamisjärjestelmä on rakennettu ja miten laatu- ja ympäristöjärjestelmät on liitetty yhdeksi kokonaisuudeksi. Työn tuloksena syntyi malli johtamisjärjestelmien yhdistämisestä sekä sertifioitu ympäristöjohtamisjärjestelmä, jonka yhdistäminen laatujärjestelmään toteutettiin tavoitteiden mukaisesti.

LRCW.NET: A web site with a virtual laboratory for the study of coarse and cooking wares in the Late Antique Mediterranean

This contribution presents the LRCW.net a website with a virtual laboratory intranet devoted to the study of coarse and cooking wares in the late Antique Mediterranean. It is designed as a public website with a virtual laboratory intranet. There, all institutions and researchers interested in the subject can work together towards a specific purpose such as the creation of an on-line ‘encyclopedia’ for these categories of ceramics. The LRCW.net website and the associated virtual laboratory are just a small part of a wider initiative that aims to create an on-line Encyclopedia for Ancient Ceramics in the Mediterranean.

Detection of Body Dump Sites and Clandestine Burials: a GIS-Based Landscape Approach

Forensic archaeology has been of inestimable help in the location and excavation of clandestine burials (Hunter 1996a:16-17, 1996b; Killam 2004; Levine et al. 1984). Landscape archaeology techniques have been adapted and widely applied for such purposes. In this article, an adaptation of one of the most common applications of archaeological GIS, that is predictive site location, is applied to the detection of body dump sites and clandestine burial sites, bringing together in the process the fields of landscape archaeology, forensic sciences, and GIS.

1,2,3,4-Tetrahydrobenzo[h][1,6]naphthyridines as a new family of potent peripheral-to-midgorge-site inhibitors of acetylcholinesterase: synthesis, pharmacological evaluation and mechanistic studies

A series of 1,2,3,4-tetrahydrobenzo[h][1,6]naphthyridines differently substituted at positions 1, 5, and 9 have been designed from the pyrano[3,2-c]quinoline derivative 1, a weak inhibitor of acetylcholinesterase (AChE) with predicted ability to bind to the AChE peripheral anionic site (PAS), at the entrance of the catalytic gorge. Fourteen novel benzonaphthyridines have been synthesized through synthetic sequences involving as the key step a multicomponent Povarov reaction between an aldehyde, an aniline and an enamine or an enamide as the activated alkene. The novel compounds have been tested against Electrophorus electricus AChE (EeAChE), human recombinant AChE (hAChE), and human serum butyrylcholinesterase (hBChE), and their brain penetration has been assessed using the PAMPA-BBB assay. Also, the mechanism of AChE inhibition of the most potent compounds has been thoroughly studied by kinetic studies, a propidium displacement assay, and molecular modelling. We have found that a seemingly small structural change such as a double O → NH bioisosteric replacement from the hit 1 to 16a results in a dramatic increase of EeAChE and hAChE inhibitory activities (>217- and >154-fold, respectively), and in a notable increase in hBChE inhibitory activity (> 11-fold), as well. An optimized binding at the PAS besides additional interactions with AChE midgorge residues seem to account for the high hAChE inhibitory potency of 16a (IC50 = 65 nM), which emerges as an interesting anti-Alzheimer lead compound with potent dual AChE and BChE inhibitory activities.

1,2,3,4-Tetrahydrobenzo[h][1,6]naphthyridines as a new family of potent peripheral-to-midgorge-site inhibitors of acetylcholinesterase: synthesis, pharmacological evaluation and mechanistic studies

A series of 1,2,3,4-tetrahydrobenzo[h][1,6]naphthyridines differently substituted at positions 1, 5, and 9 have been designed from the pyrano[3,2-c]quinoline derivative 1, a weak inhibitor of acetylcholinesterase (AChE) with predicted ability to bind to the AChE peripheral anionic site (PAS), at the entrance of the catalytic gorge. Fourteen novel benzonaphthyridines have been synthesized through synthetic sequences involving as the key step a multicomponent Povarov reaction between an aldehyde, an aniline and an enamine or an enamide as the activated alkene. The novel compounds have been tested against Electrophorus electricus AChE (EeAChE), human recombinant AChE (hAChE), and human serum butyrylcholinesterase (hBChE), and their brain penetration has been assessed using the PAMPA-BBB assay. Also, the mechanism of AChE inhibition of the most potent compounds has been thoroughly studied by kinetic studies, a propidium displacement assay, and molecular modelling. We have found that a seemingly small structural change such as a double O → NH bioisosteric replacement from the hit 1 to 16a results in a dramatic increase of EeAChE and hAChE inhibitory activities (>217- and >154-fold, respectively), and in a notable increase in hBChE inhibitory activity (> 11-fold), as well. An optimized binding at the PAS besides additional interactions with AChE midgorge residues seem to account for the high hAChE inhibitory potency of 16a (IC50 = 65 nM), which emerges as an interesting anti-Alzheimer lead compound with potent dual AChE and BChE inhibitory activities.

Hector Heusghem [coureur cycliste belge] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58738