Madex Plus and Madex I12 overcome Virus Resistance of Codling Moth

Over the past three years, codling moth populations with resistance to the Mexican isolate of Cydia pomonella Granulovirus (CpGV) have been found in Germany, France, Italy, Switzerland and the Netherlands. Andermatt Biocontrol has tested two new virus isolates (Madex Plus and Madex I12) which can overcome CpGV-resistance, and compared them in the field. Both isolates proved effective against Mexican isolate resistant codling moth populations, in several locations. In Switzerland, Madex Plus has been already approved for use

Treatment of the Open Abdomen with the Commercially Available Vacuum-Assisted Closure System in Patients with Abdominal Sepsis: Low Primary Closure Rate

Background: Abdominal Vacuum-Assisted Closure (V.A.C.) systems for treatment of open abdomens have been predominantly used for trauma patients with a high primary fascial closure rate. Use of the V.A.C. technique in abdominal sepsis is less well established. Methods: All patients with abdominal sepsis and treatment with the abdominal V.A.C. system between 2004 and 2007 were prospectively assessed. End points were fascial closure, V.A.C.-related morbidity, and quality of life score (SF-36) at follow-up. Results: Thirty patients with abdominal sepsis were included in the study. Primary fascial closure was feasible in 10, partial closure in 4, and no closure in 16 patients. Median number of V.A.C. changes was 3 (range, 1-10). Nine patients died. V.A.C.-related morbidity was as follows: two fistulas, three fascial edge necroses, one skin blister, and four prolapses of small bowel between the fascia and foam. Univariate analysis showed no variables influencing primary closure rate or V.A.C.-related morbidity. Mortality was significantly influenced by age (P<0.001), respiratory failure (P=0.01), and pneumonia (P=0.03). At follow-up, V.A.C. patients scored lower in the physical health scores and similar in the mental health scores compared with the normal population. Conclusions: Treatment of the open abdomen in patients with abdominal sepsis with the abdominal V.A.C. system is safe with good long-term quality of life. Primary closure rate in these patients is substantially lower than in trauma patients. Stepwise closure of the fascia during V.A.C. changes should be attempted to avoid additional lateral retraction of fascial edges. V.A.C.-related complications may be avoided with careful surgical techniqu

Randomized controlled trial investigating the effect of music on the virtual reality laparoscopic learning performance of novice surgeons

Background: Findings have shown that music affects cognitive performance, but little is known about its influence on surgical performance. The hypothesis of this randomized controlled trial was that arousing (activating) music has a beneficial effect on the surgical performance of novice surgeons in the setting of a laparoscopic virtual reality task. Methods: For this study, 45 junior surgeons with no previous laparoscopic experience were randomly assigned to three equal groups. Group 1 listened to activating music; group 2 listened to deactivating music; and group 3 had no music (control) while each participant solved a surgical task five times on a virtual laparoscopic simulator. The assessed global task score, the total task time, the instrument travel distances, and the surgeons' heart rate were assessed. Results: All surgical performance parameters improved significantly with experience (task repetition). The global score showed a trend for a between-groups difference, suggesting that the group listening to activating music had the worst performance. This observation was supported by a significant between-groups difference for the first trial but not subsequent trials (activating music, 35 points; deactivating music, 66 points; no music, 91 points; p=0.002). The global score (p=0.056) and total task time (p=0.065) showed a trend toward improvement when participants considered the music pleasant rather than unpleasant. Conclusions: Music in the operating theater may have a distracting effect on novice surgeons performing new tasks. Surgical trainers should consider categorically switching off music during teaching procedure

Effect of bisacodyl on postoperative bowel motility in elective colorectal surgery: a prospective, randomized trial

Background: Postoperative ileus is a common condition after abdominal surgery. Many prokinetic drugs have been evaluated including osmotic laxatives. The data on colon-stimulating laxatives are scarce. This prospective, randomized, double-blind trial investigates the effect of the colon-stimulating laxative bisacodyl on postoperative ileus in elective colorectal resections. Materials and methods: Between November 2004 and February 2007, 200 consecutive patients were randomly assigned to receive either bisacodyl or placebo. Primary endpoint was time to gastrointestinal recovery (mean time to first flatus passed, first defecation, and first solid food tolerated; GI-3). Secondary endpoints were incidence and duration of nasogastric tube reinsertion, incidence of vomiting, length of hospital stay, and visual analogue scores for pain, cramps, and nausea. Results: One hundred sixty-nine patients were analyzed, and 31 patients discontinued the study. Groups were comparable in baseline demographics. Time to GI-3 was significantly shorter in the bisacodyl group (3.0 versus 3.7days, P = 0.007). Of the single parameters defining GI-3, there was a 1-day difference in time to defecation in favor to the bisacodyl group (3.0 versus 4.0days, P = 0.001), whereas no significant difference in time to first flatus or tolerance of solid food was seen. No significant difference in the secondary endpoints was seen. Morbidity and mortality did not differ between groups. Conclusion: Bisacodyl accelerated gastrointestinal recovery and might be considered as part of multimodal recovery programs after colorectal surger

Thermodynamics of Dyonic Lifshitz Black Holes

Black holes with asymptotic anisotropic scaling are conjectured to be gravity duals of condensed matter system close to quantum critical points with non-trivial dynamical exponent z at finite temperature. A holographic renormalization procedure is presented that allows thermodynamic potentials to be defined for objects with both electric and magnetic charge in such a way that standard thermodynamic relations hold. Black holes in asymptotic Lifshitz spacetimes can exhibit paramagnetic behavior at low temperature limit for certain values of the critical exponent z, whereas the behavior of AdS black holes is always diamagnetic.Comment: 26 pages, 4 figure

Risk Prediction Scores for Postoperative Mortality After Esophagectomy: Validation of Different Models

Background: Different prediction models for operative mortality after esophagectomy have been developed. The aim of this study is to independently validate prediction models from Philadelphia, Rotterdam, Munich, and the ASA. Methods: The scores were validated using logistic regression models in two cohorts of patients undergoing esophagectomy for cancer from Switzerland (n = 170) and Australia (n = 176). Results: All scores except ASA were significantly higher in the Australian cohort. There was no significant difference in 30-day mortality or in-hospital death between groups. The Philadelphia and Rotterdam scores had a significant predictive value for 30-day mortality (p = 0.001) and in-hospital death (p = 0.003) in the pooled cohort, but only the Philadelphia score had a significant prediction value for 30-day mortality in both cohorts. Neither score showed any predictive value for in-hospital death in Australians but were highly significant in the Swiss cohort. ASA showed only a significant predictive value for 30-day mortality in the Swiss. For in-hospital death, ASA was a significant predictor in the pooled and Swiss cohorts. The Munich score did not have any significant predictive value whatsoever. Conclusion: None of the scores can be applied generally. A better overall predictive score or specific prediction scores for each country should be develope

The evolution of pebble size and shape in space and time

We propose a mathematical model which suggests that the two main geological observations about shingle beaches, i.e. the emergence of predominant pebble size ratios and strong segregation by size are interrelated. Our model is a based on a system of ODEs called the box equations, describing the evolution of pebble ratios. We derive these ODEs as a heuristic approximation of Bloore's PDE describing collisional abrasion. While representing a radical simplification of the latter, our system admits the inclusion of additional terms related to frictional abrasion. We show that nontrivial attractors (corresponding to predominant pebble size ratios) only exist in the presence of friction. By interpreting our equations as a Markov process, we illustrate by direct simulation that these attractors may only stabilized by the ongoing segregation process.Comment: 22 pages, 8 figure

Holographic Superconductors with Lifshitz Scaling

Black holes in asymptotically Lifshitz spacetime provide a window onto finite temperature effects in strongly coupled Lifshitz models. We add a Maxwell gauge field and charged matter to a recently proposed gravity dual of 2+1 dimensional Lifshitz theory. This gives rise to charged black holes with scalar hair, which correspond to the superconducting phase of holographic superconductors with z > 1 Lifshitz scaling. Along the way we analyze the global geometry of static, asymptotically Lifshitz black holes at arbitrary critical exponent z > 1. In all known exact solutions there is a null curvature singularity in the black hole region, and, by a general argument, the same applies to generic Lifshitz black holes.Comment: 23 pages, 4 figures; v2: added references; v3: matches published versio

Implementation research for the prevention of antimicrobial resistance and healthcare-associated infections; 2017 Geneva infection prevention and control (IPC)-think tank (part 1)

Background Around 5–15% of all hospital patients worldwide suffer from healthcare-associated infections (HAIs), and years of excessive antimicrobial use in human and animal medicine have created emerging antimicrobial resistance (AMR). A considerable amount of evidence-based measures have been published to address these challenges, but the largest challenge seems to be their implementation. Methods In June 2017, a total of 42 experts convened at the Geneva IPC-Think Tank to discuss four domains in implementation science: 1) teaching implementation skills; 2) fostering implementation of IPC and antimicrobial stewardship (AMS) by policy making; 3) national/international actions to foster implementation skills; and 4) translational research bridging social sciences and clinical research in infection prevention and control (IPC) and AMR. Results Although neglected in the past, implementation skills have become a priority in IPC and AMS. They should now be part of any curriculum in health care, and IPC career paths should be created. Guidelines and policies should be aligned with each other and evidence-based, each document providing a section on implementing elements of IPC and AMS in patient care. International organisations should be advocates for IPC and AMS, framing them as patient safety issues and emphasizing the importance of implementation skills. Healthcare authorities at the national level should adopt a similar approach and provide legal frameworks, guidelines, and resources to allow better implementation of patient safety measures in IPC and AMS. Rather than repeating effectiveness studies in every setting, we should invest in methods to improve the implementation of evidence-based measures in different healthcare contexts. For this, we need to encourage and financially support collaborations between social sciences and clinical IPC research. Conclusions Experts of the 2017 Geneva Think Tank on IPC and AMS, CDC, and WHO agreed that sustained efforts on implementation of IPC and AMS strategies are required at international, country, and hospital management levels, to provide an adequate multimodal framework that addresses (not exclusively) leadership, resources, education and training for implementing IPC and AMS. Future strategies can build on this agreement to make strategies on IPC and AMS more effective