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The purpose of surgical hand antisepsis before surgical or invasive procedures is to suppress microbial flora on the hands. This study aimed to evaluate the effect of a modified surgical hand antisepsis technique on recolonization of microbial flora on surgeons’ hands over time.
Methods:
Participating surgeons were randomly assigned to one of two study groups. In both groups, surgical hand antisepsis was performed using 10% povidone-iodine followed by rinsing of the hands and forearms. In Group 1, surgeons dried their hands after rinsing according to the conventional method. In Group 2, surgeons applied an additional layer of 10% povidone-iodine to the still-wet hands and forearms after rinsing and then allowed the solution to dry without further rinsing. Hand cultures were obtained immediately after antisepsis (0 hour) and at 1 and 2 hours thereafter. Colony-forming units (CFUs) were counted and compared between groups and sampling periods.
Results:
Fourteen surgeons participated in the study, with seven surgeons allocated to each group. No significant difference in bacterial growth was observed between the groups at 0 hour (Group 1: mean CFU 41.59 ± 72.53 vs Group 2: 18.63 ± 24.27, P = .27). At 1 hour, bacterial growth was significantly lower in Group 2 compared with Group 1 (8.43 ± 20.65 vs 25.44 ± 53.62 CFU, P = .001). Similarly, at 2 hours, Group 2 demonstrated significantly lower bacterial growth than Group 1 (16.37 ± 34.25 vs 32.88 ± 52.55 CFU, P = .022).
Conclusion:
Compared with the conventional surgical handwashing technique, reapplication of povidone-iodine without a final rinse resulted in significantly reduced bacterial recolonization on surgeons’ hands at 1 and 2 hours after hand antisepsis. These findings suggest that this modified technique may provide prolonged antimicrobial activity during surgical procedures. Further large-scale studies are warranted to confirm its clinical utility.
Let C be a smooth projective curve defined over ${\overline {\mathbb Q}}$, let $\pi :\mathcal {E}\longrightarrow C$ be an elliptic surface and let $\sigma _{P_1},\sigma _{P_2},\sigma _{Q}$ be sections of $\pi $ (corresponding to points $P_1,P_2, Q$ of the generic fibre E of $\mathcal {E}$). We obtain a precise characterisation, expressed solely in terms of the dynamical relations between the points $P_1,P_2,Q$ with respect to the endomorphism ring of E, so that there exist infinitely many $\lambda \in C({\overline {\mathbb Q}})$ with the property that $[m_{i,\lambda }](\sigma _{{P_{i}}}(\lambda ))=\sigma _{Q}(\lambda )$ (for $i=1,2$) for some nonzero integers $m_{1,\lambda },m_{2,\lambda }$, on the smooth fibre $E_\lambda $ of $\mathcal {E}$.
This study discusses the archaeometry (radiometric dating and metallography) of two Iron-Age axes, one from Kazakhstan (Kyzylzhartas Axe-Adze) and one from Northern Germany (Högersdorf Axe). To understand their age and production, 14C dating of metallic bound carbon and metallographic analysiswere performed. The Kyzylzhartas Axe-Adze dates to 357–166 BCE and shows an advanced production technique with a careful selection of carburized and non-carburized iron. The Högersdorf Axe dates to 480–211 BCE and is made of poorly carburized, phosphoric-rich ferritic iron. The study compares the material composition and smelting efficiency of both axes, revealing differences in iron ore sources and smelting processes between the two regions. The Kyzylzhartas Axe-Adze indicates a more efficient smelting process compared to the Högersdorf Axe, which may have utilized local resources.
Using data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database, we evaluated paediatric cardiovascular mortality across the United States from 2003 to 2023. The overall paediatric cardiovascular mortality declined from 4.73 to 3.17 per 100,000. There were reductions in mortality among large metropolitan, medium/small metropolitan, and nonmetropolitan counties with no rural–urban disparities. In addition, there were declines in mortality by age, sex, and racial/ethnic groups, highlighting geographic equity in paediatric cardiovascular outcomes.
We construct a relative version of the $A_{ {\mathrm {inf}}}$-cohomology theory developed by Bhatt-Morrow-Scholze and relate it to the prismatic theory of Bhatt-Scholze. The construction relies on the fiber product of topoi. As an application we show that there is an étale comparison of the q-crystalline pushforward after inverting $\mu \in A_{ {\mathrm {inf}}}$.
Despite being rare within paediatric patients, emerging evidence shows that low QRS voltage may be a risk factor for increased mortality even in formerly healthy patients. The prognostic value of low-voltage electrocardiography in a paediatric population has yet to be defined. Here, we present a case of an adolescent experiencing sudden cardiac arrest after Parvo B19-associated myocarditis. A striking finding was a marked low-voltage electrocardiography throughout the following years.
In this article, we examine nominal modal auxiliary phrases (NMAPs) in French. More specifically, we study NMAPs where the nominal base consists of the nouns obligation (‘obligation’), nécessité (‘necessity’) and probabilité (‘probability’). At first glance, these appear to correspond to the deontic interpretation of “obligation”, the alethic interpretation of “necessity”, and the epistemic interpretation of “high probability” associated with the modal verb devoir. We demonstrate that, from a syntactic perspective, these NMAPs can be introduced by the verbs avoir (‘to have’), être (‘to be’), se trouver (‘to find oneself’), se voir (‘to see oneself/be/’), and /se/ mettre (‘to put/set /oneself/’), with the exception of probability constructions with the noun probabilité, which can only be introduced by the verb avoir. From a semantic perspective, we show that the noun in “deontic” NMAPs is not exclusively obligation, but often nécessité as well. Similarly, while the noun in “alethic” NMAPs is most frequently nécessité, the noun obligation is not entirely excluded. Regarding NMAPs involving probabilité, the modal interpretation is almost always “alethic possibility” and not the “epistemic” interpretation of “high probability.”
Floods are increasing with climate change, and evacuating medically vulnerable people receiving home healthcare remains challenging. Patients dependent on medical devices and long-term care face complex challenges throughout the evacuation process. However, key factors influencing successful evacuation and effective support strategies remain underexamined. This study aimed to identify such factors and essential support measures across evacuation phases.
Methods
Semi-structured interviews were conducted with 13 participants—family caregivers, healthcare providers, and municipal officials—from July 2022 to March 2023 in 3 Japanese regions. Snowball sampling was used via medical administrative institutions. Thematic analysis followed COREQ guidelines, focusing on three phases: preparation, evacuation, and post-evacuation. Ethics approval was obtained (MG2022-01).
Results
Preparation showed heterogeneous readiness: some services had hazard maps and manuals/BCPs, whereas household engagement was limited and operationalization was constrained by resources. During evacuation, participants described transport and staffing limitations, difficulty in moving medical equipment, and uncertainty about feasible options, with occasional consideration of vertical evacuation. Post-evacuation challenges centered on shelter sanitation and supplies, continuity of medical support, and coordination of support systems.
Conclusions
A three-phase, multi-stakeholder perspective clarifies how constraints accumulate and informs coordinated planning among municipalities, home-care teams, and families. Limitations include a small, region-specific sample and no direct patient interviews.
Forest succession has been described to involve first a building phase followed by a thinning phase. How quickly tropical forests return to pre-disturbance levels is still unclear. We investigated changes in forest structure and tree community composition in a tropical forest in Singapore impacted by an unusually strong wind event in 2011, focusing on a hypothesised thinning phase. Stem densities of affected areas had declined by more than 50% from 2015 to 2023, while tree total basal area continued to increase slightly. Stem densities and basal area were not significantly different between affected and unaffected areas in 2023. Plot-level tree diversity also reduced between 2015 and 2023 in tandem with the loss of stems, but diversity in affected plots were still higher than that of unaffected plots in 2023. There was some evidence of a trajectory towards convergence in species composition between affected and unaffected plots, although species compositions were still different from the pre-disturbance state. Our findings provide insights on the legacies of wind disturbance on forests that endure beyond 12 years for the hurricane-free, equatorial tropics.
This paper presents a rectenna with a pentagonal-shaped circularly polarized (CP) antenna and a rectifier for radio frequency (RF) energy harvesting in the industrial, scientific and medical (ISM) (2.4 GHz) band. The antenna gain is increased by incorporating a frequency selective surface (FSS) over the patch of the antenna. A rectifier with a series topology and a T-matching network is used to translate RF energy received via the CP antenna to direct current power. The rectifier employs a Schottky diode (HSMS-2860) for rectification, achieving a peak conversion efficiency of 56.5% and delivering an output voltage of 238 mV at an input power of −10 dBm across a 1 kΩ load. Also, a unique 3D pentagonal array structure is presented, which consists of five FSS-based antenna elements, each with a 72° coverage angle. The 3D pentagonal antenna array allows for 360° collection of ambient signals, with the CP antenna sensing RF signals in the full azimuth plane, making it suitable for efficient RF energy harvesting.
Let $(-A,B,C)$ be a linear system in continuous time $t \gt 0$ with input and output space ${\mathbb C}$ and state space $H$. The scattering (or impulse response) functions $\phi_{(x)}(t)=Ce^{-(t+2x)A}B$ determines a Hankel integral operator $\Gamma_{\phi_{(x)}}$; if $\Gamma_{\phi_{(x)}}$ is trace class, then the Fredholm determinant $\tau (x)=\det (I+\Gamma_{\phi_{(x)}})$ determines the tau function of $(-A,B,C)$. The paper establishes properties of algebras including $R_x = \int_x^\infty e^{-tA}BCe^{-tA}\,dt$ on $H$, and obtains solutions of the Kadomtsev–Petviashvili PDE. Pöppe’s semi-additive operators are identified with orbits of a shift action on integral kernels, and Pöppe’s bracket operation is expressed in terms of the Fedosov product. The paper shows that the Fredholm determinant $\det (I+R_x)$ gives an effective method for numerical computation of solutions of $KP$.
This article looks at how the Czech national identity is constructed in the print media, covering the November 17, 1989, anniversary commemorating the end of the communist rule in Czechoslovakia. It examines front-page articles published in the four most circulated nationwide dailies on November 18, 1999, and front-page articles published in the four most circulated nationwide dailies on November 18, 2019. It pays closer attention to two speeches repeatedly referred to in these articles — a speech by Václav Havel from 1999 and Andrej Babiš from 2019. The underlying research questions are whether the discourse of the 2019 coverage of the November 17 events is different and, more specifically, whether and how the construction of the Czech national identity in the media has changed. It draws theoretically on the work of Michel Foucault, Stuart Hall, Pierre Bourdieu, and Norman Fairclough in relation to concepts of power, discourse, and symbolic power. It adopts the constructionist approach to national identity, which it links to modernity and industrialization and draws on the works of Ernest Gellner, Benedict Anderson, and Eric Hobsbawm in this regard. The research uses critical discourse analysis as its methodological tool, and briefly explains its use.
Critical examination of artistic embellishment on maps is useful for understanding values, fears, and political leanings of the past. The 1750 “Porcupine Map” by Moses Harris, published in The Gentleman’s Magazine (London, United Kingdom), depicted Halifax Harbour to encourage British emigration to Nova Scotia. Compared to earlier regional maps, changes reflected in the Porcupine Map, such as removing depictions of Indigenous Mi’kmaq, suggest efforts to make the colony feel more familiar to British readers of the time. Although the titular porcupine illustration has received significant interest, the map also features three prominent insects labelled as “The White Admirable,” “The Orange Underwing Tyger,” and “The Musk Beetle.” These common names refer to species occurring in Britain but not in Nova Scotia. We posit that “The White Admirable” depicts the American white admiral, Limenitis arthemis Drury (Lepidoptera: Nymphalidae), and “The Orange Underwing Tyger” represents the St. Lawrence tiger moth, Arctia parthenos Harris (Lepidoptera: Erebidae). Although less detailed, “The Musk Beetle” illustration resembles the brown prionid, Orthosoma brunneum Forster (Coleoptera: Cerambycidae), a conspicuous long-horned beetle native to North America. Including these detailed depictions of insects but mislabelling them as European species may be due to human error, artistic licence, or an overlooked expression of imperialistic propaganda.
Hospital mass casualty incident (MCI) plans must be able to remain operational during wartime. This study examined the impact of the October 7, 2023, attacks on the activation and execution of an MCI protocol in a hospital in southern Israel.
Methods
This qualitative study employed thematic analysis of semi-structured interviews conducted with 19 Emergency Department (ED) staff members who worked on October 7, 2023. Interview questions were developed by the authors, based on their professional experiences as physicians, with input from personnel involved in the October 7, 2023, response. Thematic saturation was considered achieved when consecutive interviews yielded no new themes.
Results
Three themes were identified. Threats to staff safety affected staff mobilization and prevented evacuation of patients from the ED. The prolonged and evolving nature of the attacks created unpredictability. Limited official information was partially compensated for through alternative information sources. Finally, a culture of frequent MCI drills contributed to maintaining patient flow and standards of care.
Conclusions
During wartime, MCI plans can remain effective by prioritizing staff safety and mitigating burnout. Information should be collected from multiple sources to compensate for uncertainty and limited situational awareness. Frequent, realistic drills help to maintain operational performance under the extreme stress of war.