Many People Are Afraid of White Coats. They Should Be

The concept of “do no harm” is not a figure of speech. It is a pledge to our patients to insert ourselves between them and anything that can harm them physically or emotionally. “Do lab coats harbor microbes that are detrimental to our clients’ health?” was the question that drove this systematic review. Using a search to cover articles regarding the microbial integrity of the coat, several studies were found to include culture and sensitivity reports along with participants’ surveys that increase the data to include demographics, handling habits of the coat along with laundering habits of the owners of the coats. Eight studies were reviewed, seven of the eight did provide survey information, to extract data and conclusions for the summarization of the integrity of the coat. The microbial compromise of the garment was confirmed, and solutions were uncovered as the eight studies were examined. All studies referred to the garment as a source or a potential source of cross contamination. Using education guided by a multidisciplinary team, nurse practitioners can lead an effective approach to aid in the safe handling of the white coat. Standards for the handling of the coat along with monitoring of the compliance of healthcare workers can lead to a safer environment and better patient outcomes

Mid‐Holocene site formation, diagenesis and human activity at the foothills of Serra da Estrela (Portugal)

UIDB/00749/2020 UIDP/00749/2020The Neolithic occupation of Penedo dos Mouros in the foothills of Serra da Estrela, Portugalʼs highest mountain, dates to the 5th to 4th millennia cal B.C. The siteʼs faunal assemblage is extremely rare in the regional prehistoric archaeological record, due to the acidity of the granitic geology. This underlines Penedo dos Mouros importance as a reference site for understanding early pastoralism in the region. Due to the insufficient survival of bone collagen for radiocarbon dating and the homogeneity of the stratigraphy, where most visible contacts are due to postdepositional processes, we chose micromorphology to address the reasons behind the bone preservation and to assess the stratigraphic integrity of the prehistoric deposit. Reworking of eroding saprolitic soils was a major factor in the sediment accumulation, with remains of short human occupation events. Possible evidence for clearance fires linked to the first occurrences of pastoralism practised in the region, creating open spaces for grazing, was identified. Post‐depositional carbonate cementation derived from ashes, identifiable at the microscopic scale, enabled bone preservation. Carbonate and spodic‐like features document water saturation once the sedimentation ceased. This sedimentary dynamic has broader geomorphological implications, such as an inferred post‐Neolithic incision of the stream valley adjacent to the site.publishersversionpublishe

Blue-gray plaque of the penis.

We report the case of a 66-year-old white man with a 6-month history of a blue-gray plaque of the glans. The patient was heterosexual, with 2 sexual partners in the last 6 months, and denied condom use. There was no personal or family history of melanoma. Physical examination of the uncircumcised penis found a round, well-demarcated, smooth, blue-gray plaque measuring 8 7 10 mm, arising within an erythematous background plaque of the glans (Fig 1). The remaining physical examination was unremarkable, including the oral cavity

Many People Are Afraid of White Coats. They Should Be

The concept of “do no harm” is not a figure of speech. It is a pledge to our patients to insert ourselves between them and anything that can harm them physically or emotionally. “Do lab coats harbor microbes that are detrimental to our clients’ health?” was the question that drove this systematic review. Using a search to cover articles regarding the microbial integrity of the coat, several studies were found to include culture and sensitivity reports along with participants’ surveys that increase the data to include demographics, handling habits of the coat along with laundering habits of the owners of the coats. Eight studies were reviewed, seven of the eight did provide survey information, to extract data and conclusions for the summarization of the integrity of the coat. The microbial compromise of the garment was confirmed, and solutions were uncovered as the eight studies were examined. All studies referred to the garment as a source or a potential source of cross contamination. Using education guided by a multidisciplinary team, nurse practitioners can lead an effective approach to aid in the safe handling of the white coat. Standards for the handling of the coat along with monitoring of the compliance of healthcare workers can lead to a safer environment and better patient outcomes

Variation of Loranthaceae impact on

Introduction. Shea tree (V. paradoxa C.F. Gaertn.), a species endemic to the Sudanian savanna woodlands, is dominant in the parklands of West Africa where it is of great socioeconomic importance. However, shea tree has been reported in recent decades to be threatened by plant parasites, Loranthaceae. Our study aimed to assess possible variation of the impact of these parasites on shea tree fruit yield in two contrasting habitats. Materials and methods. We selected 41 weakly and 41 heavily infected shea tree individuals, of similar size, in a protected area as well as in its adjacent parklands. Shea tree traits such as diameter at breast height, canopy diameter, tree height, canopy height, number of fruit yielded, number of parasite stumps per tree and an impact index ratio were assessed on each shea tree individual. Two-way ANOVA was performed to compare parasite impact on shea tree fruit yield in relation to habitat. Hierarchical cluster, canonical discriminant and one-way ANOVA analyses were used to show quantitative traits that characterize shea tree groups from habitats. Results. Loranthaceae did not reduce fruit yield significantly either in the parklands or in the protected area. Quantitative traits tended to discriminate all pooled shea trees in relation to habitats. Shea tree individuals in parklands were characterized mostly by the highest value of number of infected stumps per tree and of the impact index ratio, suggesting that many shea tree individuals in parklands were sensitive to Loranthaceae impact on their fruit yield. Conclusion. These findings were helpful for implementing some shea tree conservation plans

Caractérisation Spatiale Des Crevettes penaeidae Dans Le Lac Nokoué A So-Ava (Bénin)

Dans le lac Nokoué, premier pourvoyeur de crevettes marines au Bénin, les crevettes du genre Penaeidae sont les plus représentées. Le but de la présente étude est d’établir la cartographie de la répartition spatio-temporelle des populations de crevettes Penaeidae dans le lac Nokoué à Sô-Ava en vue de promouvoir la gestion durable de l’exploitation de l’écosystème des crevettes Penaeidae. Pour la préservation et la bonne gestion des biomasses de ces espèces de crevettes, il faut connaître leurs habitations puis la manière dont elles se répartissent dans le lac. La première partie de cette étude se focalise sur leur répartition géo-spatiale. A cet effet, nous avons fait recours à un outil intégrateur et interdisciplinaire que constituent les SIG. Un modèle conceptuel de base de données géohalieutiques a été proposé à partir des espèces de crevettes Penaeidae pêchées de janvier à avril 2012 et une analyse géostatistique à travers le krigeage a été réalisée. Le modèle de variogramme résultant de cette analyse présente un patron de distribution à tendance exponentielle sans effet de pépite. Les cartes de distribution des espèces de crevettes obtenues présentent de façon générale, un accroissement puis une décroissance des captures au cours de la période d’étude. Le pic est obtenu en avril 2012 où l’on observe jusqu’à 2,4 tonnes de crevettes pêchées. Pendant toute la période d’étude, nous avons noté des zones de concentration telles que Gbègodo (Houédo-Aguékon), Ganvié 2 (à l’ouest de Tohokomey) et Dakomey qui sont proches des berges (moins de 100 m). L’espèce Farfantepenaeus notialis concentre à elle seule en moyenne plus de 50 % des captures dans les différentes zones de concentration. L’exploitation du model conceptuel des données permettra en perspective, d’élaborer et de proposer des schémas et les normes de gestion durable des différentes espèces halieutiques en général, les crevettes du genre Penaeidae du lac Nokoué en particulier.mots-clés : Crevette Penaeidae, Lac Nokoué, variogramme, géostatistique, krigeageIn the lake Nokoué, first provider of marine prawns in Benin, the prawns of the Penaeidae are represented. The goal of this study is to understand the space time distribution of the genus Penaeidae prawn population in the lake Nokoué in Sô-Ava. For the safeguarding and the good management of the biomass of these watery species, it is necessary to know the pastern of their distribution in the lake. This first part of our study is focused on their géospace distribution. For this purpose, we used SIG recourse to an integrating and interdisciplinary tool. A geohalieutic database was built for Penaeidae prawn species caught from January to April 2012 that database allowed to carry out and a geo-statistics analysis through the krigeage was carried out. The model of variogramme resulting from this analysis showed exponential trend without effect of nugget. The distribution map of prawn species showed an increase then a decrease in the captures during the period. The peak was obtained in April 2012 at 2.4 tons of prawns. For all the study period we had noticed some zones of concentration which were close to the banks (less than 100 m). The species Farfantepenaeus notialis was found dominance with more than 50 % in all zones of concentration. The exploitation of the conceptual model of data will result in perspective, to develop and propose diagrams and the standards of sustainable management of the different fish species in general, the shrimps of the genus Penaeidae of Nokoué Lake in particular.Keywords : Penaeidae shrimps, Nokoué Lake, variogram, geostatistic, kriging

Endobronchial ultrasound-guided transbronchial needle aspiration for nodal staging in non-small cell lung carcinoma

Introduction: Lung cancer staging has recently evolved to include endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for nodal assessment. Aim: Evaluate the performance and safety of EBUS-TBNA as a key component of a staging algorithm for non-small cell lung carcinoma (NSCLC) and as a single investigation technique for diagnosis and staging of NSCLC. Methods: Patients undergoing EBUS-TBNA for NSCLC staging at our institution between April 1, 2010 and December 31, 2014 were consecutively included with prospective data collection. EBUS-TBNA was performed under general anesthesia through a rigid scope. Results: A total of 122 patients, 84.4% males, mean age 64.2 years. Histological type: 78 (63.9%) adenocarcinoma, 33 (27.0%) squamous cell carcinoma, 11 (8.9%) undifferentiated/other NSCLC. A total of 435 lymph node stations were punctured. Median number of nodes per patient was 4. EBUS-TBNA nodal staging: 63 (51.6%) N0; 8 (6.5%) N1; 34 (27.9%) N2, and 17 (13.9%) N3. EBUS-TBNA was the primary diagnostic procedure in 27 (22.1%) patients. EBUS-TBNA NSCLC staging had a sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy rate of 83.3, 100, 100, 86.1, and 91.8%, respectively. No complications were attributable to the procedure. Conclusion: A comprehensive lung cancer staging strategy that includes EBUS-TBNA seems to be safe and effective. Our EBUS-TBNA performance and safety in this particular setting was in line with previously published reports. Additionally, our study showed that, in selected patients, lung cancer diagnosis and staging are achievable with a single endoscopic technique. Keywords: EBUS-TBNA, Non-small cell lung carcinoma, Nodal stagin