Chlorhexidine and the prevention of surgical site infection

Surgical site infections (SSI) are a prevalent health care-associated infection (HAl). Prior to the mid-19th century, surgical sites commonly developed postoperative wound complications. It was in the 1860's, after Joseph Lister introduced carbolic acid and the principles of antisepsis that postoperative wound infection significantly decreased. Today, patient preoperative skin preparation with an antiseptic agent prior to surgery is a standard of practice. Povidone-iodine and chlorhexidine gluconate are currently the most commonly used antimicrobial agents used to prep the patient's skin. In this current study, the epidemiology, diagnosis, surveillance and prevention of SSI with chlorhexidine were investigated. The antimicrobial activity of chlorhexidine was assessed. In in-vitro and in-vivo studies the antimicrobial efficacy of 2% (w/v) chlorhexidine gluconate (CHG) in 70% isopropyl alcohol (IPA) and 10% povidoneiodine (PVP-I) in the presence of 0.9% normal saline or blood were examined. The 2% CHG in 70% IPA solutions antimicrobial activity was not diminished in the presence of 0.9% normal saline or blood. In comparison, the traditional patient preoperative skin preparation, 10% PVP-I antimicrobial activity was not diminished in the presence of 0.9% normal saline, but was diminished in the presence of blood. In an in-vivo human volunteer study the potential for reduction of the antimicrobial efficacy of aqueous patient preoperative skin preparations compromised by mechanical removal of wet product from the application site (blot) was assessed. In this evaluation, 2% CHG and 10% povidone-iodine (PVP-I) were blotted from the patient's skin after application to the test site. The blotting, or mechanical removal, of the wet antiseptic from the application site did not produce a significant difference in product efficacy. In a clinical trial to compare 2% CHG in 70% IPA and PVP-! scrub and paint patient preoperative skin preparation for the prevention of SSI, there were 849 patients randomly assigned to the study groups (409 in the chlorhexidine-alcohol and 440 in the povidone-iodine group) in the intention-to-treat analysis. The overall surgical site infection was significantly lower in the 2% CHG in 70% IPA group than in the PVP-I group (9.5% versus 16.1 %, p=0.004; relative risk, 0.59 with 95% confidence interval of 0.41 to 0.85). Preoperative cleansing of the patient's skin with chlorhexidine-alcohol is superior to povidone-iodine in preventing surgical site infection after clean-contaminated surgery.

Controlled RAFT polymerization and zinc binding performance of catechol-inspired homopolymers

Incorporation of catechols into polymers has long been of interest due to their ability to chelate heavy metals and their use in the design of adhesives, metal-polymer nanocomposites, antifouling coatings, and so on. This paper reports, for the first time, the reversible addition-fragmentation chain transfer (RAFT) polymerization of a protected catechol-inspired monomer, 3,4-dimethoxystyrene (DMS), using commercially available trithiocarbonate, 2-(dodecylthiocarbonothioylthio)-2-methylpropionic acid (DDMAT), as a chain transfer agent. Our identified RAFT system produces well-defined polymers across a range of molecular weights (5-50 kg/mol) with low molar mass dispersities (Mw/Mn < 1.3). Subsequent facile demethylation of poly(3,4-dimethoxystyrene) (PDMS) yields poly(3,4-dihydroxystyrene) (PDHS), a catechol-bearing polymer, in quantitative yields. Semiquantitative zinc binding capacity analysis of both polymers using SEM/EDXA has demonstrated that both PDMS and PDHS have considerable surface binding (65% and 87%, respectively), although the films deposited from PDMS are of a better quality and processability due to solubility and lower processing temperatures. © 2014 American Chemical Society.

Digital Art and Design

The desire to create unique things and give free rain to one's imagination served as a powerful impetus to the development of digital art and design software. The commoner was the use of computers the wider variety of professional software was developed. Nowadays the creators and computer designers are receiving more and more new and advanced programs that allow their ideas becoming virtual reality. This research paper looks at the history of the development of graphic editors from the simplest to the most modern and advanced. This brief survey includes the history of different graphic editors’ creation, their features and abilities. This paper highlights the two basic branches of graphic editors – these that are in free use and commercial graphic editors design software. The researcher selected the most powerful and influential graphic editors design software brands like Paint.NET and GIMP among free software and commercial Adobe Photoshop. This paper also dwells upon the way digital art transferred from the exclusively professional business into the hobby for ordinary users. This research paper bears implications for those who are interested in features and potentiality of most popular graphic editors design software.

Analysis of the Distributions of Color Characteristics in Art Painting Images

In this paper we study some of the characteristics of the art painting image color semantics. We analyze the color features of differ- ent artists and art movements. The analysis includes exploration of hue, saturation and luminance. We also use quartile’s analysis to obtain the dis- tribution of the dispersion of defined groups of paintings and measure the degree of purity for these groups. A special software system “Art Paint- ing Image Color Semantics” (APICSS) for image analysis and retrieval was created. The obtained result can be used for automatic classification of art paintings in image retrieval systems, where the indexing is based on color characteristics.

Out of credit: Evaluating the impact of the EU structural funds on Hungarian small business growth and access to finance

Totaling EUR 29 billion, Hungary is in the midst of implementing its largest economic development program in its young democratic history. At the center of the European Union led development program is an effort to revitalize and reequip Hungary’s languishing small and medium sized enterprises (SME), long the country's heart of employment. This paper examines the efficiency and impact of two Structural Fund's instruments to enhance SME development – ECOP 2.1.1 and JEREMIE. A survey of 1275 SME and interviews with dozens of top policy-makers paint a flawed development program in dire need of reform. Despite this, empirical analysis suggests JEREMIE funds may have dampened the effects of the financial crisis and are crucial for the continued liquidity of SME, who have been particularly hit hard by the world financial crisis.

Az európai vállalkozó karaktere (The characters of the European entrepreneur and the European manager)

Miben különböznek motivációjukat, értékeit, habitusukat tekintve a vállalkozók, illetve a menedzserek a társadalom többi tagjától és egymástól? Egy 29 európai országra kiterjedő reprezentatív lakossági kérdőíves felmérés (European Social Survey) alapján keresik a szerzők a választ e kérdésre. A Schwartz-értéktesztet használják, amelynek segítségével meghatározhatók az általános célok, elvek, amelyek követését egy személy fontosnak tartja az életében. Így felrajzolható a személy karaktere. Hozzájárulásuk az irodalomhoz kettős. Bár készültek európai szinten elemzések a vállalkozók által vallott sajátos értékekről, a Schwartz-teszt átfogóbb, árnyaltabb és megbízhatóbb elemzést tesz lehetővé. Továbbá, az említett elemzések csak az önfoglalkoztatókat vizsgálták, amely kategória magában foglalja ugyan a vállalkozókat, ám tágabb annál. Az alkalmazott menedzserekről pedig tudomásuk szerint egyáltalán nem készült hasonló elemzés. / === / What distinguishes entrepreneurs and managers from the rest of society and from each other in terms of motivation and values? The authors attempt to answer these questions by analysing data from the European Social Survey covering the populations of 29 countries. They use the Schwartz value-test to identify the general goals and principles people choose to follow in their lives. The test enables them to paint the typical personal characters of entrepreneurs and managers. Their contribution to the literature is threefold. First, although the values held by European entrepreneurs have been investigated before, the Schwartz test provides for a more comprehensive and nuanced analysis. Second, prior statistical analyses have focussed on self-employed, which is a much broader category than entrepreneurs. Third, the distinguishing values of employed managers have not been analysed so far in a similar way.

Blood Lead Levels in Children and Environmental Lead Contamination in Miami Inner City, Florida

Studies have shown that the environmental conditions of the home are important predictors of health, especially in low-income communities. Understanding the relationship between the environment and health is crucial in the management of certain diseases. One health outcome related to the home environment among urban, minority, and low-income children is childhood lead poisoning. The most common sources of lead exposure for children are lead paint in older, dilapidated housing and contaminated dust and soil produced by accumulated residue of leaded gasoline. Blood lead levels (BLL) as low as 10 μg/dL in children are associated with impaired cognitive function, behavior difficulties, and reduced intelligence. Recently, it is suggested that the standard for intervention be lowered to BLL of 5 μg /dl. The objectives of our report were to assess the prevalence of lead poisoning among children under six years of age and to quantify and test the correlations between BLL in children and lead exposure levels in their environment. This cross-sectional analysis was restricted to 75 children under six years of age who lived in 6 zip code areas of inner city Miami. These locations exhibited unacceptably high levels of lead dust and soil in areas where children live and play. Using the 5 μg/dL as the cutoff point, the prevalence of lead poisoning among the study sample was 13.33%. The study revealed that lead levels in floor dust and window sill samples were positively and significantly correlated with BLL among children (p < 0.05). However, the correlations between BLL and the soil, air, and water samples were not significant. Based on this pilot study, a more comprehensive environmental study in surrounding inner city areas is warranted. Parental education on proper housecleaning techniques may also benefit those living in the high lead-exposed communities of inner city Miami.

Environmental lead contamination in Miami inner-city area

The purpose of the study was to evaluate the magnitude of environmental lead contamination in the downtown area of Miami. Lead inspections took place at 121 homes in Little Haiti and Liberty City and involved the collection ofrepresentative samples from floors, window wells, tap water, soil and air. Community health workers (CHWs) trained in interview and safety techniques went from door to door to enlist participation. On-site investigations were tailored to areas most utilized by children underthe age of6 years. The presence of lead-containing paint was also investigated in situ via X-ray fluorescence (XRF) analysis. Results: Of the sampling areas, the window wells area had the most abundant occurrence of lead. On analysis, 24% of sites returned window well samples with lead levels above Department of Housing and Urban Development (HUD) guidelines. Of the soil samples, the playgrounds around the house had the highest concentration of lead. Soil sampling demonstrated that 27.5% of sites returned samples with lead levels (400 to 1600 ppm) inexcess of HUD/Environmental Protection Agency (EPA) standards. Positive XRF readings in one or more components were returned by 18% of sites. Conclusions: More than half of the houses in these two neighborhoods exhibited unacceptably high levels of lead dust and soil in areas where children live and play. Limitations of this study did not allow the assessment of how many children in this area are affected. A more comprehensive study including other areas of Miami-Dade County with older housing stock is recommended.

An Analysis of Stock Market Performance:The Dow Jones Industrial Average and the Three Top Performing Lodging Firma: 1982-1988

In their dialogue - An Analysis of Stock Market Performance: The Dow Jones Industrial Average and the Three Top Performing Lodging Firms 1982 – 1988 - by N. H. Ringstrom, Professor and Elisa S. Moncarz, Associate Professor, School of Hospitality Management at Florida International University, Professors Ringstrom and Moncarz state at the outset: “An interesting comparison can be made between the Dow Jones lndustrial Average and the three top performing, publicly held lodging firms which had $100 million or more in annual lodging revenues. The authors provide that analytical comparison with Prime Motor Inns Inc., the Marriott Corporation, and Hilton Hotels Corporation.” “Based on a criterion of size, only those with $100 million in annual lodging revenues or more resulted in the inclusion of the following six major hotel firms: Prime Motor Inns, Inc., Marriott Corporation, Hilton Hotels Corporation, Ramada Inc., Holiday Corporation and La Quinta Motor Inns, Inc.,” say Professors Ringstrom and Moncarz in framing this discussion with its underpinnings in the years 1982 to 1988. The article looks at each company’s fiscal and Dow Jones performance for the years in question, and presents a detailed analysis of said performance. Graphic analysis is included. It helps to have a fairly vigorous knowledge of stock market and fiscal examination criteria to digest this material. The Ringstrom and Moncarz analysis of Prime Motor Inns Incorporated occupies the first 7 pages of this article in and of itself. Marriot Corporation also occupies a prominent position in this discussion. “Marriott, a giant in the hospitality industry, is huge and continuing to grow. Its 1987 sales were more than $6.5 billion, and its employees numbered over 200,000 individuals, which place Marriott among the 10 largest private employers in the country,” Ringstrom and Moncarz parse Marriott’s influence as a significant financial player. “The firm has a fantastic history of growth over the past 60 years, starting in May 1927 with a nine-seat A & W Root Beer stand in Washington, D.C.,” offer the authors in initialing Marriot’s portion of the discussion with a brief history lesson. The Marriot firm was officially incorporated as Hot Shoppes Inc. in 1929. As the thesis statement for the discussion suggests the performance of these huge, hospitality giants is compared and contrasted directly to the Dow Jones Industrial Average performance. Reasons and empirical data are offered by the authors to explain the distinctions. It would be difficult to explain those distinctions without delving deeply into corporate financial history and the authors willingly do so in an effort to help you understand the growth, as well as some of the setbacks of these hospitality based juggernauts. Ringstrom and Moncarz conclude the article with an extensive overview and analysis of the Hilton Hotels Corporation performance for the period outlined. It may well be the most fiscally dynamic of the firms presented for your perusal. “It is interesting to note that Hilton Hotels Corporation maintained a very strong financial position with relatively little debt during the years 1982-1988…the highest among all companies in the study,” the authors paint.

Otimização de parâmetros mecânicos e microestruturais dos moldes em areia de sílica ligados quimicamente pelo processo de cura a frio em fundição de aço

Surface defects on steel parts borne costs of smelting industries due to the need of rework. Sand molds are frequently used in foundry industries and largely responsible for providing surface defects. This study aims to optimize the levels of the molding process variables to minimize the occurrence of surface defects in steel castings in silica sand molds chemically linked by cold cure process. The methodology used the experimental design with split plot, being considered in the study the resin percentage factors in the mold formulation, addition of iron oxide, type of paint, the paint application method, amount of ink layers, use of hot air along the lines and waiting time of the mold before casting. They were analyzed as response variables erosion defects, sand inclusion, penetration, porosity and surface finish. Tensile strength tests were performed to evaluate the influence of factors on mechanical parameters and the microstructural parameters were carried out the analysis of X-ray diffraction, scanning electron microscopy (SEM) and thermal analysis (TG / DSC / dilatometry). The results elucidate that for the faulty erosion, the only significant factor with a 95% confidence level was the type of ink and the ink alumina-based superior results obtained. For the sand inclusion of defect, there were three significant factors, with best results obtained with alumina-based paint and spray applied using hot air in the mold before casting the metal. For the defect penetration, there were four significant factors, the best results being achieved with 0.8% of resin and addition of iron oxide in the molding formulation, the paint being applied by brush and standby time of 24 hours before leak. For the defect porosity with a 95% confidence level, no significant factors. For the defect surface finish, the best results were achieved with the 0.8% formulation of the resin in the mold and application of the paint brush. To obtain the levels of the factors that optimize all defects simultaneously, we performed a weighted average of the results of each type of fault, concluding that the best levels of the factors were: 0.8% resin and addition of iron oxide in the formulation of the template, application of two coats of paint applied with a brush or spray, using hot air in the mold before casting and 24 hours of waiting ready the mold before casting. These levels of the optimized factors were used in an experiment to confirm that ratified the results, helping to reduce rework and consequently reducing costs of cast steel parts.

Modificação do eletrodo AWS E7018 com adição de filmes finos externos de PVC e Al, para soldagem de aço C-Mn

This paper suggests modifications in coating of electrodes providing an alternative for execution of welding with low hydrogen electrode AWS E7018 without having to dry it, reducing thus the cost and time of manufacturing of high resistance welds. The welds in this research were developed with basic coated electrodes (hygroscopic) – SMAW process – externally painted with aluminum spray paint for high temperatures or wrapped with thin plastic films (PVC) and aluminum foil films used commonly for food protection. The basic premise is that establishing a barrier between the atmosphere and the electrode coating could reduce the effects of high hygroscopicity presented by coatings of low hydrogen, minimizing this way the main source of supply of hydrogen to the fusion pool during welding. It is also expected that the addition of new materials from the electrode coating to the fusion pool would induce metallurgical changes in the deposited metal and, as a consequence, modifications in its mechanical properties. This research dealt with measuring the dissolved hydrogen in the deposited metal after welding with modified electrodes, evaluating the influence of these changes in the produced microstructures and in the mechanical properties of the resulting weld, and comparing the obtained results with the standard welding procedures and with the recently developed waterproof electrodes. The results obtained in most samples welded with modified electrodes showed increased mechanical resistance and increased tenacity due to the increased percentage of acicular ferrite in metal deposited without significant elevation of hardness, when compared with the traditional welding with AWS E7018 electrode and with ELBRÁS BRH4R waterproof electrode. The diffusing hydrogen measured in the modified electrodes was kept inside the parameters defined by international codes.

Modificação do eletrodo AWS E7018 com adição de filmes finos externos de PVC e Al, para soldagem de aço C-Mn

This paper suggests modifications in coating of electrodes providing an alternative for execution of welding with low hydrogen electrode AWS E7018 without having to dry it, reducing thus the cost and time of manufacturing of high resistance welds. The welds in this research were developed with basic coated electrodes (hygroscopic) – SMAW process – externally painted with aluminum spray paint for high temperatures or wrapped with thin plastic films (PVC) and aluminum foil films used commonly for food protection. The basic premise is that establishing a barrier between the atmosphere and the electrode coating could reduce the effects of high hygroscopicity presented by coatings of low hydrogen, minimizing this way the main source of supply of hydrogen to the fusion pool during welding. It is also expected that the addition of new materials from the electrode coating to the fusion pool would induce metallurgical changes in the deposited metal and, as a consequence, modifications in its mechanical properties. This research dealt with measuring the dissolved hydrogen in the deposited metal after welding with modified electrodes, evaluating the influence of these changes in the produced microstructures and in the mechanical properties of the resulting weld, and comparing the obtained results with the standard welding procedures and with the recently developed waterproof electrodes. The results obtained in most samples welded with modified electrodes showed increased mechanical resistance and increased tenacity due to the increased percentage of acicular ferrite in metal deposited without significant elevation of hardness, when compared with the traditional welding with AWS E7018 electrode and with ELBRÁS BRH4R waterproof electrode. The diffusing hydrogen measured in the modified electrodes was kept inside the parameters defined by international codes.

Análise sequencial de criação de situações de finalização no basquetebol

Relatório de Estágio apresentado para a obtenção do grau de Mestre em Desporto com especialização em Treino Desportivo

Musical commonplace book : manuscript, [approximately 1790-approximately 1810]

Contains songs, partly from English operas, and instrumental music.