The Canadian Bandaging Trial: Evidence-informed leg ulcer care and the effectiveness of two compression technologies

Background: Objective: To determine the relative effectiveness of evidence-informed practice using two high compression systems: four-layer (4LB) and short-stretch bandaging (SSB) in community care of venous leg ulcers. Design and Setting: Pragmatic, multi-centre, parallel-group, open-label, randomized controlled trial conducted in 10 centres. Cognitively intact adults (≥18 years) referred for community care (home or clinic) with a venous ulceration measuring ≥0.7cm and present for ≥1 week, with an ankle brachial pressure index (ABPI) ≥0.8, without medication-controlled Diabetes Mellitus or a previous failure to improve with either system, were eligible to participate.Methods: Consenting individuals were randomly allocated (computer-generated blocked randomization schedule) to receive either 4LB or SSB following an evidence-informed protocol. Primary endpoint: time-to- healing of the reference ulcer. Secondary outcomes: recurrence rates, health-related quality of life (HRQL), pain, and expenditures.Results: 424 individuals were randomized (4LB n = 215; SSB n = 209) and followed until their reference ulcer was healed (or maximum 30 months). An intent-to-treat analysis was conducted on all participants. Median time to ulcer healing in the 4LB group was 62 days [95% confidence interval (CI) 51 to 73], compared with 77 days (95% CI 63 to 91) in the SSB group. The unadjusted Kaplan-Meier curves revealed the difference in the distribution of cumulative healing times was not significantly different between group (log rank χ2 = 0.001, P = 0.98) nor ulcers recurrence (4LB, 10.1%; SSB, 13.3%; p = 0.345). Multivariable Cox Proportional Hazard Modeling also showed no significant between-bandage differences in healing time after controlling for significant covariates (p = 0.77). At 3-months post-baseline there were no differences in pain (no pain: 4LB, 22.7%; SSB, 26.7%; p = 0.335), or HRQL (SF-12 Mental Component Score: 4LB, 55.1; SSB, 55.8; p = 0.615; SF-12 Physical Component Score: 4LB, 39.0; SSB, 39.6; p = 0.675). The most common adverse events experienced by both groups included infection, skin breakdown and ulcer deterioration.Conclusions: The Canadian Bandaging Trial revealed that in the practice context of trained RNs using an evidence-informed protocol, the choice of bandage system (4LB and SSB) does not materially affect healing times, recurrence rates, HRQL, or pain. From a community practice perspective, this is positive news for patient-centred care allowing individual/family and practitioner choice in selecting compression technologies based on circumstances and context.Trial registration: clinicaltrials.gov Identifier: NCT00202267

Climate patterns during former periods of mountain glaciation in Britain and Ireland: Inferences from the cirque record

We map glacial cirques, and analyse spatial variability in their altitude and aspect to derive a long-term, time-integrated, perspective on climate patterns during former periods of mountain glaciation (likely spanning multiple Quaternary glaciations) in Britain and Ireland. The data reveal that, although air temperatures were important, exposure to moisture-bearing air masses was the key factor in regulating sites of former mountain glacier formation, and indicate that during such periods, moisture supply was largely controlled by North Atlantic westerlies, with notable inland precipitation gradients (precipitation decreasing inland), similar to present day. In places, trends in cirque altitude may also reflect regional differences in the extent of cirque deepening, controlled by the dimensions and dynamics of the glaciers that came to occupy them. Specifically, comparatively deep cirques in coastal locations may reflect the former presence of dynamic (fed by moisture from the North Atlantic), but comparatively small, glaciers (largely confined to their cirques). By contrast, decreasing cirque depth further inland, may reflect the former presence of larger and/or less dynamic ice masses, occupying comparatively continental climatic conditions

Surface exposure dating of Lateglacial ice fluctuations in the upper Ariège catchment (France): inferences concerning paleoclimate and implications for Upper Paleolithic human dispersals through the Pyrenees. Session PP4-L10

International audienc

Ca(2+)-activated K+ channels of human and rabbit erythrocytes display distinctive patterns of inhibition by venom peptide toxins

Despite recent progress in the molecular characterization of high-conductance Ca(2+)-activated K+ (maxi-K) channels, the molecular identities of intermediate conductance Ca(2+)-activated K+ channels, including that of mature erythrocytes, remains unknown. We have used various peptide toxins to characterize the intermediate conductance Ca(2+)-activated K+ channels (Gardos pathway) of human and rabbit red cells. With studies on K+ transport and on binding of 125I-charybdotoxin (ChTX) and 125I-kaliotoxin (KTX) binding in red cells, we provide evidence for the distinct nature of the red cell Gardos channel among described Ca(2+)-activated K+ channels based on (i) the characteristic inhibition and binding patterns produced by ChTX analogues, iberiotoxin (IbTX) and IbTX-like ChTX mutants, and KTX (1-37 and 1-38 variants); (ii) the presence of some properties heretofore attributed only to voltage-gated channels, including inhibition of K transport by margatoxin (MgTX) and by stichodactyla toxin (StK); (iii) and the ability of scyllatoxin (ScyTX) and apamin to displace bound 125I-charybdotoxin, a novel property for K+ channels. These unusual pharmacological characteristics suggest a unique structure for the red cell Gardos channel

Traitement d’effluents industriels par Oxydation Voie humide Catalytique en présence de catalyseurs métalliques supportés : succès et limites

SSCI-VIDE+CARE:CDFA+CDS:MBENational audienceNon

Understanding the effects of the origin, occurrence, monitoring, control, fate and removal of siloxanes on the energetic valorization of sewage biogas - A review

This paper reviews the effects of the origin, occurrence, monitoring, control, fate and removal of siloxanes on the energetic valorization of sewage biogas, which can be severely compromised by its volatile organic silicon compound (VOSiC) content. Almost 25 years after identifying silicon dioxide in the exhaust gases from engines powered using sewage and landfill gas, a wide range of studies have been conducted addressing the different stages of the siloxane life cycle. The cycle starts with the production and use of polydimethylsiloxane polymers in a wide range of industrial and domestic applications and its further dispersal into environmental compartments. Siloxanes are subsequently introduced into wastewater treatment plants, where as a result of their low biodegradability and high affinity to dissolved and particulate matter, they are first transferred from wastewater into sludge and later volatilized in biogas in anaerobic digesters. Biogas treatment technologies can reduce siloxane concentrations to less than 0.1 mg/m3; adsorbent materials with micro- and mesoporous structures appear to be the most relevant technology in technical and economic terms. The state-of-the-art on siloxanes is vast and extensive, but there are still some knowledge gaps to be addressed in the future, such as the standardization of the methodology for off-line analysis, the development of on-line monitoring equipment, better understanding the fates of siloxanes in wastewater treatment processes to operate at specific conditions to avoid siloxanes-related problems, the development of more selective and regenerative removal technologies from biogas to reduce operating costs and even to recover silicon, and better understand the detrimental effects on energy recovery technologies to determine the inlet concentration limits. This work compiles the most relevant results available in the literature for each stage of the siloxane life cycl