Better Operating Room Ventilation as Determined by a Novel Ventilation Index is Associated with Lower Rates of Surgical Site Infections.

OBJECTIVE To assess the impact of operating room (OR) ventilation quality on surgical site infections (SSI) using a novel ventilation index. SUMMARY BACKGROUND DATA Previous studies compared laminar air flow with conventional ventilation, thereby ignoring many parameters that influence air flow properties. METHODS In this cohort study, we surveyed hospitals participating in the Swiss SSI surveillance and calculated a ventilation index for their ORs, with higher values reflecting less turbulent air displacement. For procedures captured between 01/2017-12/2019, we studied the association between ventilation index and SSI rates using linear regression (hospital-level analysis) and with the individual SSI risk using generalized linear mixed-effects models (patient-level analysis). RESULTS We included 47 hospitals (182 ORs). Among the 163'740 included procedures, 6791 SSIs were identified. In hospital-level analyses, a 5-unit increase in the ventilation index was associated with lower SSI rates for knee and hip arthroplasty (-0.41 infections per 100 procedures, CI -0.69 to -0.13), cardiac (-0.89, -1.91 to 0.12), and spine surgeries (-1.15, -2.56 to 0.26). Similarly, patient-level analyses showed a lower SSI risk with each 5-unit increase in ventilation index (adjusted odds ratio 0.71, CI 0.58 to 0.87 for knee and hip; 0.72, 0.49 to 1.06 for spine; 0.82, 0.69 to 0.98 for cardiac surgery). Higher index values were mainly associated with a lower risk for superficial and deep incisional SSIs. CONCLUSIONS Better ventilation properties, assessed with our ventilation index, are associated with lower rates of superficial and deep incisional SSIs in orthopedic and cardiac procedures. OR ventilation quality appeared to be less relevant for other surgery types

Better operating room ventilation as determined by a novel ventilation index is associated with lower rates of surgical site infections

OBJECTIVE: The aim was to assess the impact of operating room (OR) ventilation quality on surgical site infections (SSIs) using a novel ventilation index. BACKGROUND: Previous studies compared laminar air flow with conventional ventilation, thereby ignoring many parameters that influence air flow properties. METHODS: In this cohort study, we surveyed hospitals participating in the Swiss SSI surveillance and calculated a ventilation index for their ORs, with higher values reflecting less turbulent air displacement. For procedures captured between January 2017 and December 2019, we studied the association between ventilation index and SSI rates using linear regression (hospital-level analysis) and with the individual SSI risk using generalized linear mixed-effects models (patient-level analysis). RESULTS: We included 47 hospitals (182 ORs). Among the 163,740 included procedures, 6791 SSIs were identified. In hospital-level analyses, a 5-unit increase in the ventilation index was associated with lower SSI rates for knee and hip arthroplasty (-0.41 infections per 100 procedures, 95% confidence interval: -0.69 to -0.13), cardiac (-0.89, -1.91 to 0.12), and spine surgeries (-1.15, -2.56 to 0.26). Similarly, patient-level analyses showed a lower SSI risk with each 5-unit increase in ventilation index (adjusted odds ratio 0.71, confidence interval: 0.58-0.87 for knee and hip; 0.72, 0.49-1.06 for spine; 0.82, 0.69-0.98 for cardiac surgery). Higher index values were mainly associated with a lower risk for superficial and deep incisional SSIs. CONCLUSIONS: Better ventilation properties, assessed with our ventilation index, are associated with lower rates of superficial and deep incisional SSIs in orthopedic and cardiac procedures. OR ventilation quality appeared to be less relevant for other surgery types

Maize and sunflower biomass estimation in southwest France using high spatial and temporal resolution remote sensing data

The recent availability of high spatial and temporal resolution (HSTR) remote sensing data (Formosat-2, and future missions of Venμs and Sentinel-2) offers new opportunities for crop monitoring. In this context, we investigated the perspective offered by coupling a simple algorithmfor yield estimate (SAFY)with the Formosat-2 data to estimate crop production over large areas. With a limited number of input parameters, the SAFY model enables the simulation of time series of green area index (GAI) and dry aboveground biomass (DAM). From2006 to 2009, 95 Formosat-2 images (8 m, 1 day revisit) were acquired for a 24×24 km² area southwest of Toulouse, France. This study focused on two summer crops: irrigatedmaize (Zea mays) and sunflower (Helianthus annuus). Green area index (GAI) time serieswere deduced fromFormosat-2NDVI time series andwere used to calibrate six major parameters of the SAFY model. Four of those parameters (partition-to-leaf and senescence function parameters) were calibrated per crop type based on the very dense 2006 Formosat-2 data set. The retrieved values of these parameterswere consistentwith the in situ observations and a literature review. Two of themajor parameters of the SAFYmodel (emergence day and effective light-use efficiency)were calibrated per field relative to crop management practices. The estimated effective light-use efficiency values highlighted the distinction between the C4 (maize) and C3 (sunflower) plants, and were linked to the reduction of the photosynthesis rate due to water stress. The model was able to reproduce a large set of GAI temporal shapes, which were related to various phenological behaviours and to crop type. The biomass was well estimated (relative error of 28%), especially considering that biomass measurements were not used for the calibration. The grain yields were also simulated using harvest index coefficients and were compared with grain yield statistics from the French Agricultural Statistics for the department of Haute-Garonne. The inter-annual variation in the simulated grain yields of sunflowerwas consistentwith the reported variation. Formaize, significant discrepancieswere observed with the reported statistics

Biodiversités et paysages : de la connaissance et de la représentation des paysages à leur aménagement durable

Ce Hors-série, issu d’un colloque organisé en 2010 à Fort-de-France en Martinique, propose des réponses et pose un certain nombre de questions à propos des concepts biodiversité et paysages, dans l'esprit des disciplines propres aux différents auteurs mais également selon leur manière personnelle d'aborder ces deux thèmes de réflexion. Cette publication vise à dégager une vision pragmatique des problèmes afin de définir des solutions qui concilieraient nature et culture, de forger des clés pour une organisation spatiale raisonnée et raisonnable assurant un avenir serein et tranquille aux générations futures. La réhabilitation des milieux ravagés, la protection et la restauration de la biodiversité, les alertes contre certaines pratiques détestables sont également abordées. Enfin, une analyse critique est faite sur les conservatoires, les réserves biologiques et naturellement sur les avancées du droit de l'environnement et son efficacité dans le règlement des différends. Néanmoins, de nombreuses questions demeurent. Que doit-on conserver pour demain ? Une espèce, une communauté, un paysage ? Quel stade des formations doit-on privilégier ? Quel sacrifice, la société d'aujourd'hui, est-elle disposée à consentir pour promouvoir une économie de développement durable ? Quels seront les besoins des hommes de demain ? Enfin, et c'est peut-être la question essentielle, par quels moyens la recherche peut-elle aider les élus, les aménageurs à prendre des décisions et par quelle voie les résultats et les recommandations des travaux scientifiques peuvent-ils parvenir jusqu'aux politiques

The Mediterranean region under climate change

This book has been published by Allenvi (French National Alliance for Environmental Research) to coincide with the 22nd Conference of Parties to the United Nations Framework Convention on Climate Change (COP22) in Marrakesh. It is the outcome of work by academic researchers on both sides of the Mediterranean and provides a remarkable scientific review of the mechanisms of climate change and its impacts on the environment, the economy, health and Mediterranean societies. It will also be valuable in developing responses that draw on “scientific evidence” to address the issues of adaptation, resource conservation, solutions and risk prevention. Reflecting the full complexity of the Mediterranean environment, the book is a major scientific contribution to the climate issue, where various scientific considerations converge to break down the boundaries between disciplines