"Hand hygiene perception and self-reported hand hygiene compliance among emergency medical service providers : a Danish survey"

BackgroundHand hygiene (HH), a cornerstone in infection prevention and control, lacks quality in emergency medical services (EMS). HH improvement includes both individual and institutional aspects, but little is known about EMS providers' HH perception and motivations related to HH quality. Therefore, we aimed to investigate the HH perception and assess potential factors related to self-reported HH compliance among the EMS cohort.MethodsA cross-sectional, self-administered questionnaire consisting of 24 items (developed from the WHOs Perception Survey for Health-Care Workers) provided information on demographics, HH perceptions and self-reported HH compliance among EMS providers from Denmark.ResultsOverall, 457 questionnaires were answered (response rate 52%). Most respondents were advanced-care providers, males, had >5years of experience, and had received HH trainingPeer reviewe

Upper ocean carbon fluxes in the Atlantic Ocean: The importance of the POC:PIC ratio

The mean depth distribution of the POC:PIC ratio of sinking particles, measured with particle interceptor traps deployed in the Atlantic Ocean, is fitted by an exponential function (POC:PIC = 64.3Z−0.56; r2 = 0.69) The function is successfully evaluated by comparison with (a) estimates of the POC:PIC ratio of export production, computed from seasonal changes of nitrate and alkalinity and (b) estimates of the POC:PIC ratio of remineralization on shallow isopycnals. The basin mean POC:PIC ratio of export production is 4.2–4.37. The POC:PIC-depth function is combined with empirical relationships between the flux of particulate organic matter, primary production and depth, satellite derived primary production data sets, and the regional distribution of ψ (the ratio of released CO2:precipitated carbonate during CaCO3 formation) in order to estimate the effective carbon flux (Jeff) in the Atlantic Ocean. Remineralization of organic carbon above the winter mixed layer (11–17%) and CaCO3 sequestration from the winter mixed layer (13–16%), which is the balance between CaCO3 production and shallow dissolution, are the two main processes which control the difference between export production (0.9 and 2.9 GT C yr−1) and Jeff (0.64 and 2.2 GT C yr−1) on the basin scale (65°N to 65°S). CaCO3 sequestration is the dominant process modulating effective carbon export in the tropics, while shallow POC remineralization dominates in temperate and polar waters. Observed regional patterns like polarward increases of the POC:PIC export ratio and of ψ counteract each other largely when Jeff is computed

The necessity of prehospital peripheral intravenous cannulation and its relation to triage category

Background: Prehospital peripheral intravenous cannulation (PPIC) is a procedure performed routinely and often precautionary despite evidence that it increases the risk of infection and phlebitis, prolongs scene time and increases mortality. The aim of this study was to identify to which extend PPIC was necessary before arrival to hospital, and to investigate whether the triage category of the patient had a role in the necessity of PPIC. Methods: Prehospital providers from the Capital Region of Denmark were asked to collect data on all PPIC attempts in a course of two months, during summer 2018. The questions were related to the patients’ classification into one of four available triage categories and the providers’ assessment of the necessity of the PPIC for either prehospital medical treatment or the anticipation of such. Data was exported to statistical software for analysis and descriptive statistics was performed. Results: From the available datasets (n=204) 52% (n=106) of PPIC attempts were considered necessary by the prehospital provider. In the red/immediate triage category, 37 PPIC attempts were performed, of these 70.2% (n=26) were considered necessary. In the amber/very urgent triage category, 20 PPIC attempts were performed, of these 85% (n=17) were considered necessary. In the yellow/urgent triage category, 40 PPIC attempts were performed, of these 65% (n=26) were considered necessary. In the green/non-urgent triage category, 107 PPIC attempts were performed, of these 34.6% (n=37) were considered necessary. Conclusions: Based on the findings of this study, approximately half of PPIC’s are necessary for prehospital use, and the necessity tends to correspond with an increase in triage category. However, PPIC necessity for patients in the green/non-urgent triage category should be carefully evaluated, based on a patient risk/benefit analysis

End-tidal kuldioxid monitorering af den ikke-intuberede, akutte patient giver potentiel diagnostisk og patientsikkerhedsmæssig værdi

Baggrund End-tidal carbondioxid (etCO2) monitorering anvendes rutinemæssigt hos alle intuberede patienter. Kapnografi er ligeledes tilgængelig til den ikke-intuberede, akutte patient, hvor brugen i diagnostisk og patientsikkerhedsmæssigt øjemed er sparsomt beskrevet. Formål Formålet med denne statusartikel er at beskrive og diskutere eventuelle diagnostiske og patientsikkerhedsmæssige fordele og ulemper ved kapnografimonitorering af ikke-intuberede, akutte patienter. Metode Artiklen er baseret på resultatet af en systematisk litteratursøgning, hvor tilgængelig evidens fra 1990-2016 blev identificeret fra databaserne MEDLINE, Cinahl, Scopus, Cochrane og Academic Search Complete. Litteratur relevant for denne artikels emne blev udvalgt og gennemgået. Resultat Artiklen beskriver og diskuterer den udvalgte litteratur. Overordnet vidner denne om en diagnostisk og patientsikkerhedsmæssig fordel ved kapnografi til patienter med vejrtrækningsbesvær, til vurdering af effekt af medicinsk behandling samt til kontinuerlig monitorering. Artiklen diskuterer ligeledes anvendelsen af kapnografi præhospitalt og potentialet for brugen i Akutafdelingen. Konklusion Kapnografi findes i varierende grad at have potentiale indenfor diagnostik og kontinuerlig monitorering af akutte patienter, efter adækvat uddannelse i brugen. _________________________________________________________________________________________________________________________________ Background End-tidal carbon dioxide (etCO2) monitoring is routinely used in intubated patients. Capnography is also available for the non-intubated patient but its use as a diagnostic and patient safety tool is sparsely described. Aim The aim of this article was to describe and discuss potential diagnostic and patient safety benefits of capnography monitoring in acute, non-intubated patients. Methods The article is based on the results of a systematic literature search, where available evidence from 1990-2016 was located from the databases MEDLINE, Cinahl, Scopus, Cochrane and Academic Search Complete. Literature relevant for this article was selected and reviewed. Results The article describes and discusses the selected literature. Overall, there is evidence of a diagnostic and patient safety benefit for patients with breathing difficulties, assessment of the effect of medical treatment and capnography used as continuous monitoring. The article further discusses the prehospital use of capnography in Denmark and the possible advantages for its use in the Emergency Department. Conclusions After adequate training in its use, capnography seems to have potential in diagnostics and continuous monitoring of acute, non-intubated patients

Underwriter Reputation and Certification in the High Yield Bond Market

Limbach P, Betzer A, Andres C. Underwriter Reputation and Certification in the High Yield Bond Market . In: Fridson M, ed. High Yield Future Tense: Cracking the Code of Speculative Debt. 2015

Three-component C-H bond sulfonylation of imidazoheterocycles via visible-light organophotoredox catalysis

International audienc

Fluorescent biosensor for detection of the R248Q aggregation‐prone mutant of p53

International audienceThe p53 tumour suppressor and guardian of the genome undergoes missense mutations that lead to functional inactivation in 50 % of human cancers. These mutations occur mostly in the DNA‐binding domain of the protein, and several of these result in conformational changes that lead to amyloid‐like protein aggregation. Herein, we describe a fluorescent biosensor that reports on the R248Q mutant of p53 in vitro and in living cells, engineered through conjugation of an environmentally sensitive probe onto a peptide derived from the primary aggregation segment of p53. This biosensor was characterised both in vitro and by means of fluorescence microscopy following facilitated delivery into cultured cells. It is shown that this biosensor preferentially reports on the p53 R248Q mutant in the PC9 lung cancer cell line compared with other lung cancer cell lines harbouring either wild‐type or no p53

Ultrabright two-photon excitable red-emissive fluorogenic probes for fast and wash-free bioorthogonal labeling in live cells

Fluorogenic bioorthogonal reactions are promising tools for tracking small molecules or biomolecules in living organisms. Two-photon excitation, by shifting absorption towards the red, significantly increases the signal-to-noise ratio and decreases photodamages, while allowing to image about 10 times deeper than with a confocal. However, efficient two-photon excitable fluorogenic probes are currently lacking. We report here the design and synthesis of fluorogenic probes based on a two-photon excitable fluorophore and a tetrazine quenching moiety. These probes react with bicyclo[6.1.0]no-4-yn-9yl)methanol (BCN) with good to impressive kinetic rate constant (up to 1.1x103 M-1.s-1) and emit in the red window with moderate to high turn-on. TDDFT allowed to rationalize both the kinetic and fluorogenic performance of the different probes. The best candidate displays a turn-on of 13.8-fold measured by fluorescence intensities quantification in living cells under one-photon excitation, whereas a value of 3 is enough for live-cell imaging with high contrast. Moreover, live-cell imaging under two-photon excitation confirmed that there was no need for washing to monitor the reaction between BCN and this probe as a turn-on of 8.0-fold was measured under two-photon excitation. Finally, the high two-photon brightness of the clicked adduct (>300 GM) allows the use of a weak laser power compatible with in vivo imaging

On the road for more efficient biocompatible two-photon excitable fluorophores

International audienceRed to NIR absorption and emission wavelengths are key requirements for intravital bioimaging. One of the way to reach such excitation wavelengths is to use two-photon excitation. Unfortunately, there is still a lack of two-photon excitable fluorophores that are both efficient and biocompatible. Thus, we design a series of biocompatible quadrupolar dyes in order to study their ability to be used for live-cell imaging, and in particular for two-photon microscopy. Hence, we report the synthesis of 5 probes based on different donor cores (phenoxazine, acridane, phenazasiline and phenothiazine) and the study of their linear and non-linear photophysical properties. TD-DFT calculations were performed and were able to highlight the structure-property relationship of this series. All these studies highlight the great potential of three of these biocompatible dyes for two-Photon microscopy, as they both exhibit high two-photon cross-sections (up to 3 650 GM) and emit orange to red light. This potential was confirmed through live-cell two-photon microscopy experiments, leading to images with very high brightness and contrast