Surgical site infection after caesarean section. Space for post-discharge surveillance improvements and reliable comparisons

Surgical site infections (SSI) after caesarean section (CS) represent a substantial health system concern. Surveying SSI has been associated with a reduction in SSI incidence. We report the findings of three (2008, 2011 and 2013) regional active SSI surveillances after CS in community hospital of the Latium region determining the incidence of SSI. Each CS was surveyed for SSI occurrence by trained staff up to 30 post-operative days, and association of SSI with relevant characteristics was assessed using binomial logistic regression. A total of 3,685 CS were included in the study. A complete 30 day post-operation follow-up was achieved in over 94% of procedures. Overall 145 SSI were observed (3.9% cumulative incidence) of which 131 (90.3%) were superficial and 14 (9.7%) complex (deep or organ/space) SSI; overall 129 SSI (of which 89.9% superficial) were diagnosed post-discharge. Only higher NNIS score was significantly associated with SSI occurrence in the regression analysis. Our work provides the first regional data on CS-associated SSI incidence, highlighting the need for a post-discharge surveillance which should assure 30 days post-operation to not miss data on complex SSI, as well as being less labour intensive

Evaluation of formal IDEs for human-machine interface design and analysis: the case of CIRCUS and PVSio-web

Critical human-machine interfaces are present in many systems including avionics systems and medical devices. Use error is a concern in these systems both in terms of hardware panels and input devices, and the software that drives the interfaces. Guaranteeing safe usability, in terms of buttons, knobs and displays is now a key element in the overall safety of the system. New integrated development environments (IDEs) based on formal methods technologies have been developed by the research community to support the design and analysis of high-confidence human-machine interfaces. To date, little work has focused on the comparison of these particular types of formal IDEs. This paper compares and evaluates two state-of-the-art toolkits: CIRCUS, a model-based development and analysis tool based on Petri net extensions, and PVSio-web, a prototyping toolkit based on the PVS theorem proving system.This work is partially supported by: Project NORTE-01-0145-FEDER-000016, financed by the North Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, and through the European Regional Development Fund (ERDF); Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) PhD scholarship

Competences for democratic culture: An empirical study of an intercultural citizenship project in language pedagogy

This article reports on a pedagogical intervention in foreign language teaching in higher education. It analizes the competences developed by Argentinian and UK-based students as they used Skype to design a leaflet that addressed a real world issue: the Argentinian military dictatorship and its manipulation of the 1978 Football World Cup. The data consists of students’ discussions of this highly disturbing human rights issue. A first level of analysis focused on identifying evidence of competences using the Council of Europe’s conceptual model of ‘competences for democratic culture’ (2016). In a second level of analysis, the data was categorized within the framework of Article 2.2 of the United Nations Declaration on Human Rights Education and Training (2011). This research study provides an empirical test of these two frameworks in the field of language education, an aspect that has not been investigated before. It also contributes to our understanding of the potential of intercultural citizenship projects in achieving the goals of human rights education in foreign language teaching. Results indicate the development of substantial competences for democratic culture defined in the Council of Europe’s model

Competences for democratic culture: An empirical study of an intercultural citizenship project in language pedagogy

This article reports on a pedagogical intervention in foreign language teaching in higher education. It analizes the competences developed by Argentinian and UK-based students as they used Skype to design a leaflet that addressed a real world issue: the Argentinian military dictatorship and its manipulation of the 1978 Football World Cup. The data consists of students’ discussions of this highly disturbing human rights issue. A first level of analysis focused on identifying evidence of competences using the Council of Europe’s conceptual model of ‘competences for democratic culture’ (2016). In a second level of analysis, the data was categorized within the framework of Article 2.2 of the United Nations Declaration on Human Rights Education and Training (2011). This research study provides an empirical test of these two frameworks in the field of language education, an aspect that has not been investigated before. It also contributes to our understanding of the potential of intercultural citizenship projects in achieving the goals of human rights education in foreign language teaching. Results indicate the development of substantial competences for democratic culture defined in the Council of Europe’s model

Early formation of the Moon 4.51 billion years ago

Establishing the age of the Moon is critical to understanding solar system evolution and the formation of rocky planets, including Earth. However, despite its importance, the age of the Moon has never been accurately determined. We present uranium-lead dating of Apollo 14 zircon fragments that yield highly precise, concordant ages, demonstrating that they are robust against postcrystallization isotopic disturbances. Hafnium isotopic analyses of the same fragments show extremely low initial 176Hf/177Hf ratios corrected for cosmic ray exposure that are near the solar system initial value. Our data indicate differentiation of the lunar crust by 4.51 billion years, indicating the formation of the Moon within the first ~60 million years after the birth of the solar system

High-precision U-Pb zircon dating identifies a major magmatic event on the Moon at 4.338 Ga

The Moon has had a complex history, with evidence of its primary crust formation obscured by later impacts. Existing U-Pb dates of >500 zircons from several locations on the lunar nearside reveal a pronounced age peak at 4.33 billion years (Ga), suggesting a major, potentially global magmatic event. However, the precision of existing geochronology is insufficient to determine whether this peak represents a brief event or a more protracted period of magmatism occurring over tens of millions of years. To improve the temporal resolution, we have analyzed Apollo 14, 15, and 17 zircons that were previously dated by ion microprobe at ~4.33 Ga using isotope dilution thermal ionization mass spectrometry. Concordant dates with sub-million-year uncertainty span ~4 million years from 4.338 to 4.334 Ga. Combined with Hf isotopic ratios and trace element concentrations, the data suggest zircon formation in a large impact melt sheet, possibly linked to the South Pole–Aitken basin

Completion of lunar magma ocean solidification at 4.43 Ga

Crystallization of the lunar magma ocean yielded a chemically unique liquid residuum named KREEP. This component is expressed as a large patch on the near side of the Moon and a possible smaller patch in the northwest portion of the Moon’s South Pole-Aitken basin on the far side. Thermal models estimate that the crystallization of the lunar magma ocean (LMO) could have spanned from 10 and 200 My, while studies of radioactive decay systems have yielded inconsistent ages for the completion of LMO crystallization covering over 160 My. Here, we show that the Moon achieved >99% crystallization at 4,429 ± 76 Ma, indicating a lunar formation age of ~4,450 Ma or possibly older. Using the 176Lu–176Hf decay system (t1/2 = 37 Gy), we found that the initial 176Hf/177Hf ratios of lunar zircons with varied U–Pb ages are consistent with their crystallization from a KREEP-rich reservoir with a consistently low 176Lu/177Hf ratio of 0.0167 that emerged ~140 My after solar system formation. The previously proposed younger model age of ~4.33 Ga for the source of mare basalts (240 My after solar system formation) might reflect the timing of a large impact. Our results demonstrate that lunar magma ocean crystallization took place while the Moon was still battered by planetary embryos and planetesimals leftover from the main stage of planetary accretion. The study of Lu–Hf model ages for samples brought back from the South Pole-Aitken basin will help to assess the lateral continuity of KREEP and further understand its significance in the early history of the Moon

Genotype of Immunologically Hot or Cold Tumors Determines the Antitumor Immune Response and Efficacy by Fully Virulent Retargeted oHSV

We report on the efficacy of the non-attenuated HER2-retargeted oHSV named R-337 against the immunologically hot CT26-HER2 tumor, and an insight into the basis of the immune protection. Preliminarily, we conducted an RNA immune profiling and immune cell content characterization of CT26-HER2 tumor in comparison to the immunologically cold LLC1-HER2 tumor. CT26-HER2 tumor was implanted into HER2-transgenic BALB/c mice. Hallmarks of R-337 effects were the protection from primary tumor, long-term adaptive vaccination directed to both HER2 and CT26-wt cell neoantigens. The latter effect differentiated R-337 from OncoVEXGM-CSF. As to the basis of the immune protection, R-337 orchestrated several changes to the tumor immune profile, which cumulatively reversed the immunosuppression typical of this tumor (graphical abstract). Thus, Ido1 (inhibitor of T cell anticancer immunity) levels and T regulatory cell infiltration were decreased; Cd40 and Cd27 co-immunostimulatory markers were increased; the IFNγ cascade was activated. Of note was the dampening of IFN-I response, which we attribute to the fact that R-337 is fully equipped with genes that contrast the host innate response. The IFN-I shut-down likely favored viral replication and the expression of the mIL-12 payload, which, in turn, boosted the antitumor response. The results call for a characterization of tumor immune markers to employ oncolytic herpesviruses more precisely

Diffusion tensor imaging mapping of brain white matter pathology in mitochondrial optic neuropathies

BACKGROUND AND PURPOSE: Brain white matter is frequently affected in mitochondrial diseases; optic atrophy gene 1-autosomal dominant optic atrophy and Leber hereditary optic neuropathy are the most frequent mitochondrial monosymptomatic optic neuropathies. In this observational study, brain white matter microstructure was characterized by DTI in patients with optic atrophy gene 1-autosomal dominant optic atrophy and Leber hereditary optic neuropathy, in relation to clinical and genetic features. MATERIALS AND METHODS: Nineteen patients with optic atrophy gene 1-autosomal dominant optic atrophy and 17 with Leber hereditary optic neuropathy older than 18 years of age, all genetically diagnosed, and 19 healthy volunteers underwent DTI by using a 1.5T MR imaging scanner and neurologic and ophthalmologic assessments. Brain white matter DTI metrics were calculated for all participants, and, in patients, their correlations with genetics and clinical findings were calculated. RESULTS: Compared with controls, patients with optic atrophy gene 1-autosomal dominant optic atrophy had an increased mean diffusivity in 29.2% of voxels analyzed within major white matter tracts distributed throughout the brain, while fractional anisotropy was reduced in 30.3% of voxels. For patients with Leber hereditary optic neuropathy, the proportion of altered voxels was only 0.5% and 5.5%, respectively, of which half was found within the optic radiation and 3.5%, in the smaller acoustic radiation. In almost all regions, fractional anisotropy diminished with age in patients with optic atrophy gene 1-autosomal dominant optic atrophy and correlated with average retinal nerve fiber layer thickness in several areas. Mean diffusivity increased in those with a missense mutation. Patients with Leber hereditary optic neuropathy taking idebenone had slightly milder changes. CONCLUSIONS: Patients with Leber hereditary optic neuropathy had preferential involvement of the optic and acoustic radiations, consistent with trans-synaptic degeneration, whereas patients with optic atrophy gene 1-autosomal dominant optic atrophy presented with widespread involvement suggestive of a multisystemic, possibly a congenital/developmental, disorder. White matter changes in Leber hereditary optic neuropathy and optic atrophy gene 1-autosomal dominant optic atrophy may be exploitable as biomarkers. ABBREVIATIONS: DOA autosomal dominant optic atrophy; FA fractional anisotropy; LHON Leber hereditary optic neuropathy; MD mean diffusivity; OPA1 optic atrophy gene 1 ;O R optic radiation; RNFL retinal nerve fiber layer; TBSS tract-based spatial statistic

A surge in obsidian exploitation more than 1.2 million years ago at Simbiro III (Melka Kunture, Upper Awash, Ethiopia)

Pleistocene archaeology records the changing behaviour and capacities of early hominins. These behavioural changes, for example, to stone tools, are commonly linked to environmental constraints. It has been argued that, in earlier times, multiple activities of everyday life were all uniformly conducted at the same spot. The separation of focused activities across different localities, which indicates a degree of planning, according to this mindset characterizes later hominins since only 500,000 years ago. Simbiro III level C, in the upper Awash valley of Ethiopia, allows us to test this assumption in its assemblage of stone tools made only with obsidian, dated to more than 1.2 million years (Myr) old. Here we first reconstruct the palaeoenvironment, showing that the landscape was seasonally flooded. Following the deposition of an accumulation of obsidian cobbles by a meandering river, hominins began to exploit these in new ways, producing large tools with sharp cutting edges. We show through statistical analysis that this was a focused activity, that very standardized handaxes were produced and that this was a stone-tool workshop. We argue that at Simbiro III, hominins were doing much more than simply reacting to environmental changes; they were taking advantage of new opportunities, and developing new techniques and new skills according to them