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Neuhoff J, Berkulian O, Kramer A, Thavarajasingam S, Wengert A, Schleicher P, Pingel A, Kandziora F. Single- and Multilevel Corpectomy and Vertebral body replacement for treatment of spinal infections. A retrospective single-center study of 100 cases. Brain Spine 2023; 4:102721. [PMID: 38510622 PMCID: PMC10951701 DOI: 10.1016/j.bas.2023.102721] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/25/2023] [Indexed: 03/22/2024]
Abstract
Background The optimal operative approach for treating spinal infections remains a subject of debate. Corpectomy and Vertebral Body Replacement (VBR) have emerged as common modalities, yet data on their feasibility and complication profiles are limited. Methods This retrospective single-center study examined 100 consecutive cases (2015-2022) that underwent VBR for spinal infection treatment. A comparison between Single-level-VBR and Multi-level-VBR was performed, evaluating patient profiles, revision rates, and outcomes. Results Among 360 cases treated for spinal infections, 100 underwent VBR, located in all spinal regions. Average clinical and radiologic follow-up spanned 1.5 years. Single-level-VBR was performed in 60 cases, Two-level-VBR in 37, Three-level-VBR in 2, and Four-level-VBR in one case.Mean overall sagittal correction reached 10° (range 0-54°), varying by region. Revision surgery was required in 31 cases. Aseptic mechanical complications (8% pedicle screw loosening, 3% cage subsidence, 6% aseptic adjacent disc disease) were prominent reasons for revision. Longer posterior constructs (>4 levels) had significantly higher revision rates (p < 0.01). General complications (wound healing, hematoma) followed, along with infection relapse and adjacent disc infection (9%) and neurologic impairment (1%).Multilevel-VBR (≥2 levels) displayed no elevated cage subsidence rate compared to Single-level-VBR. Three deaths occurred (43-86 days post-op), all in the Multi-level-VBR group. Conclusion This study, reporting the largest number of VBR cases for spinal infection treatment, affirmed VBR's effectiveness in sagittal imbalance correction. The overall survival was high, while reinfection rates matched other surgical studies. Anterior procedures have minimal implant related risks, but extended dorsal instrumentation elevates revision surgery likelihood.
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Affiliation(s)
- J. Neuhoff
- BG Unfallklinik, Center for Spinal Surgery and Neurotraumatology, Frankfurt Am Main, Germany
| | - O. Berkulian
- BG Unfallklinik, Center for Spinal Surgery and Neurotraumatology, Frankfurt Am Main, Germany
| | - A. Kramer
- Department of Neurosurgery, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - S. Thavarajasingam
- Department of Neurosurgery, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Imperial Brain & Spine Initiative, Imperial College London, London, United Kingdom
| | - A. Wengert
- BG Unfallklinik, Center for Spinal Surgery and Neurotraumatology, Frankfurt Am Main, Germany
| | - P. Schleicher
- BG Unfallklinik, Center for Spinal Surgery and Neurotraumatology, Frankfurt Am Main, Germany
| | - A. Pingel
- BG Unfallklinik, Center for Spinal Surgery and Neurotraumatology, Frankfurt Am Main, Germany
| | - F. Kandziora
- BG Unfallklinik, Center for Spinal Surgery and Neurotraumatology, Frankfurt Am Main, Germany
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2
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Shah B, Hallinan B, Kramer A, Caccamese JF. Predictability of the virtual surgical plan for orthognathic surgery with the mandible surgery first sequence. Int J Oral Maxillofac Surg 2023; 52:1179-1187. [PMID: 37087313 DOI: 10.1016/j.ijom.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 04/24/2023]
Abstract
The aim of this study was to compare the virtually planned position to the postoperative position of the maxilla, having performed the maxilla-first sequence or mandible-first sequence orthognathic surgery. An audit of 64 patients who underwent bimaxillary surgery between 2017 and 2020 was performed. Thirty patients had maxilla-first surgery and 34 had mandible-first surgery. The planned and post-surgical positions were analyzed using specific skeletal landmarks. Differences were calculated and the two-sample t-test was used to compare the groups. Measured differences between the planned and postoperative results differed significantly between the mandible-first and maxillary-first surgery groups (P < 0.001). The maxillary central incisors were under-advanced in the anterior-posterior direction in both groups. Most data points showed deviation from the surgical plan ≤ 2 mm and ≤ 4°. Secondarily, maxillary under-advancement in the mandible-first cohort was evaluated; these patients were subdivided into rigid and non-rigid fixation groups. The non-rigid fixation group showed less accuracy compared to the rigid fixation group, which was statistically significant (P = 0.014). The findings of this study demonstrate that virtual surgical planning can be less accurate in predicting the maxillary incisor position when performing mandible-first surgery, but this inaccuracy is within the acceptable range and can be mitigated by rigid fixation of the mandible.
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Affiliation(s)
- B Shah
- Clinic D, Oral and Maxillofacial Surgery, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, USA.
| | - B Hallinan
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Maryland, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - A Kramer
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Maryland, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - J F Caccamese
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Maryland, University of Maryland Medical Center, Baltimore, Maryland, USA
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Zwicker P, Meng M, Friesecke S, Stein T, Herzog A, Herzer C, Kammerlander M, Gebhardt T, Kugler C, Kramer A. An interactive feedback system for increasing hand antisepsis adherence in stationary intensive care. J Hosp Infect 2023; 133:73-80. [PMID: 36646137 DOI: 10.1016/j.jhin.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/05/2022] [Accepted: 12/13/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Pathogens causing infections are in many cases transmitted via the hands of personnel. Thus, hand antisepsis has strong epidemiological evidence of infection prevention. Depending on various factors, hand antisepsis adherence ranges between 9.1% and 85.2%. AIM To evaluate a new transponder system that reminded medical staff to use an alcohol-based hand rub based on indication by giving real-time feedback, to detect hand antisepsis adherence. METHODS The monitoring system consisted of three components: a portable transponder detecting alcohol-based hand rub and able to give feedback; a beacon recognizing entries to and exits from the patient's surroundings; and a sensor placed at the hand-rub dispensers to count the number of hand rubs. With these components, the system provided feedback when hand antisepsis was not conducted although it was necessary according to moments 1, 4, and 5 of hand antisepsis. Adherence was measured in two use-cases with five phases, starting with the baseline measurement followed by intervention periods and phases without intervention to test the sustainability of the feedback. FINDINGS Using the monitoring system, hand antisepsis adherence was increased by up to 104.5% in comparison to the baseline measurement. When the intervention ceased, however, hand antisepsis adherence decreased to less than or equal to the baseline measurement. CONCLUSION A short-term intervention alone is not sufficient to lead to a long-term change in hand antisepsis adherence. Rather, permanent feedback and/or the integration in a multi-modal intervention strategy are necessary.
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Affiliation(s)
- P Zwicker
- Institute of Hygiene and Environmental Medicine, University Medicine, Greifswald, Germany; Section Antiseptic Stewardship of the German Society of Hospital Hygiene, Berlin, Germany.
| | - M Meng
- Institute of Nursing Science, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Federal Institute for Vocational Education and Training (VET), Bonn, Germany
| | - S Friesecke
- Department of Internal Medicine B, Medical Intensive Care Unit, University Medicine, Greifswald, Germany
| | - T Stein
- Neurological Rehabilitation Center gGmbH, Greifswald, Germany
| | - A Herzog
- HyHelp AG, Frankfurt am Main, Germany; United-Ventures GmbH, Frankfurt am Main, Germany
| | - C Herzer
- GWA Hygiene GmbH, Stralsund, Germany
| | - M Kammerlander
- Institute of Nursing Science, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Institute of Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany
| | | | - C Kugler
- Institute of Nursing Science, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - A Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine, Greifswald, Germany; Section Antiseptic Stewardship of the German Society of Hospital Hygiene, Berlin, Germany
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4
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Gozashti L, Roy SW, Thornlow B, Kramer A, Ares M, Corbett-Detig R. Transposable elements drive intron gain in diverse eukaryotes. Proc Natl Acad Sci U S A 2022; 119:e2209766119. [PMID: 36417430 PMCID: PMC9860276 DOI: 10.1073/pnas.2209766119] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/19/2022] [Indexed: 11/24/2022] Open
Abstract
There is massive variation in intron numbers across eukaryotic genomes, yet the major drivers of intron content during evolution remain elusive. Rapid intron loss and gain in some lineages contrast with long-term evolutionary stasis in others. Episodic intron gain could be explained by recently discovered specialized transposons called Introners, but so far Introners are only known from a handful of species. Here, we performed a systematic search across 3,325 eukaryotic genomes and identified 27,563 Introner-derived introns in 175 genomes (5.2%). Species with Introners span remarkable phylogenetic diversity, from animals to basal protists, representing lineages whose last common ancestor dates to over 1.7 billion years ago. Aquatic organisms were 6.5 times more likely to contain Introners than terrestrial organisms. Introners exhibit mechanistic diversity but most are consistent with DNA transposition, indicating that Introners have evolved convergently hundreds of times from nonautonomous transposable elements. Transposable elements and aquatic taxa are associated with high rates of horizontal gene transfer, suggesting that this combination of factors may explain the punctuated and biased diversity of species containing Introners. More generally, our data suggest that Introners may explain the episodic nature of intron gain across the eukaryotic tree of life. These results illuminate the major source of ongoing intron creation in eukaryotic genomes.
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Affiliation(s)
- Landen Gozashti
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA95064
- Genomics Institute, University of California Santa Cruz, Santa Cruz, CA95064
| | - Scott W. Roy
- Department of Biology, San Francisco State University, San Francisco, CA94117
| | - Bryan Thornlow
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA95064
- Genomics Institute, University of California Santa Cruz, Santa Cruz, CA95064
| | - Alexander Kramer
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA95064
- Genomics Institute, University of California Santa Cruz, Santa Cruz, CA95064
| | - Manuel Ares
- Department of Molecular, Cell, and Developmental Biology, University of California Santa Cruz, Santa Cruz, CA95064
| | - Russell Corbett-Detig
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA95064
- Genomics Institute, University of California Santa Cruz, Santa Cruz, CA95064
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5
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Ye C, Thornlow B, Hinrichs A, Kramer A, Mirchandani C, Torvi D, Lanfear R, Corbett-Detig R, Turakhia Y. matOptimize: a parallel tree optimization method enables online phylogenetics for SARS-CoV-2. Bioinformatics 2022; 38:3734-3740. [PMID: 35731204 PMCID: PMC9344837 DOI: 10.1093/bioinformatics/btac401] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/21/2022] [Accepted: 06/16/2022] [Indexed: 11/14/2022] Open
Abstract
MOTIVATION Phylogenetic tree optimization is necessary for precise analysis of evolutionary and transmission dynamics, but existing tools are inadequate for handling the scale and pace of data produced during the coronavirus disease 2019 (COVID-19) pandemic. One transformative approach, online phylogenetics, aims to incrementally add samples to an ever-growing phylogeny, but there are no previously existing approaches that can efficiently optimize this vast phylogeny under the time constraints of the pandemic. RESULTS Here, we present matOptimize, a fast and memory-efficient phylogenetic tree optimization tool based on parsimony that can be parallelized across multiple CPU threads and nodes, and provides orders of magnitude improvement in runtime and peak memory usage compared to existing state-of-the-art methods. We have developed this method particularly to address the pressing need during the COVID-19 pandemic for daily maintenance and optimization of a comprehensive SARS-CoV-2 phylogeny. matOptimize is currently helping refine on a daily basis possibly the largest-ever phylogenetic tree, containing millions of SARS-CoV-2 sequences. AVAILABILITY AND IMPLEMENTATION The matOptimize code is freely available as part of the UShER package (https://github.com/yatisht/usher) and can also be installed via bioconda (https://bioconda.github.io/recipes/usher/README.html). All scripts we used to perform the experiments in this manuscript are available at https://github.com/yceh/matOptimize-experiments. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Cheng Ye
- Department of Electrical and Computer Engineering, University of California, San Diego, San Diego, CA 92093, USA
| | - Bryan Thornlow
- Department of Biomolecular Engineering, University of California, Santa Cruz, Santa Cruz, CA 95064, USA
- Genomics Institute, University of California, Santa Cruz, Santa Cruz, CA 95064, USA
| | - Angie Hinrichs
- Genomics Institute, University of California, Santa Cruz, Santa Cruz, CA 95064, USA
| | - Alexander Kramer
- Department of Biomolecular Engineering, University of California, Santa Cruz, Santa Cruz, CA 95064, USA
- Genomics Institute, University of California, Santa Cruz, Santa Cruz, CA 95064, USA
| | - Cade Mirchandani
- Department of Biomolecular Engineering, University of California, Santa Cruz, Santa Cruz, CA 95064, USA
- Genomics Institute, University of California, Santa Cruz, Santa Cruz, CA 95064, USA
| | - Devika Torvi
- Department of Bioengineering, University of California, San Diego, San Diego, CA 92093, USA
| | - Robert Lanfear
- Department of Ecology and Evolution, Research School of Biology, Australian National University, Canberra, ACT 2601, Australia
| | - Russell Corbett-Detig
- Department of Biomolecular Engineering, University of California, Santa Cruz, Santa Cruz, CA 95064, USA
- Genomics Institute, University of California, Santa Cruz, Santa Cruz, CA 95064, USA
| | - Yatish Turakhia
- Department of Electrical and Computer Engineering, University of California, San Diego, San Diego, CA 92093, USA
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6
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Jabs JM, Schwabe A, Wollkopf AD, Gebel B, Stadelmaier J, Erdmann S, Radicke F, Grundmann H, Kramer A, Monsef I, Rücker G, Rupp J, Scheithauer S, Schmucker C, Simon A, Mutters NT. The role of routine SARS-CoV-2 screening of healthcare-workers in acute care hospitals in 2020: a systematic review and meta-analysis. BMC Infect Dis 2022; 22:587. [PMID: 35780088 PMCID: PMC9250183 DOI: 10.1186/s12879-022-07554-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/08/2022] [Indexed: 02/08/2023] Open
Abstract
Background Healthcare workers (HCW) are at increased risk of infection with SARS-CoV-2. Vulnerable patient populations in particular must be protected, and clinics should not become transmission hotspots to avoid delaying medical treatments independent of COVID. Because asymptomatic transmission has been described, routine screening of asymptomatic HCW would potentially be able to interrupt chains of infection through early detection. Methods A systematic search was conducted in the Cochrane COVID-19 Study Register, Web of Science and WHO COVID‐19 Global literature on coronavirus with regard to non-incident related testing of healthcare workers using polymerase chain reaction on May 4th 2021. Studies since January 2020 were included. An assessment of risk of bias and representativeness was performed. Results The search identified 39 studies with heterogeneous designs. Data collection of the included studies took place from January to August 2020. The studies were conducted worldwide and the sample size of the included HCW ranged from 70 to 9449 participants. In total, 1000 of 51,700 (1.9%) asymptomatic HCW were tested positive for SARS-CoV-2 using PCR testing. The proportion of positive test results ranged between 0 and 14.3%. No study reported on HCW-screening related reductions in infected person-days. Discussion and conclusions The heterogeneous proportions might be explained by different regional incidences, lock-downs, and pre-analytical pitfalls that reduce the sensitivity of the nasopharyngeal swab. The very high prevalence in some studies indicates that screening HCW for SARS-CoV-2 may be important particularly in geographical regions and pandemic periods with a high-incidence. With low numbers and an increasing rate of vaccinated HCW, a strict cost–benefit consideration must be made, especially in times of low incidences. Since we found no studies that reported on HCW-screening related reductions in infected person-days, re-evaluation should be done when these are available. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07554-5.
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Affiliation(s)
- J M Jabs
- Institute for Hygiene and Public Health, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
| | - A Schwabe
- Institute for Hygiene and Public Health, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
| | - A D Wollkopf
- Institute for Hygiene and Public Health, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
| | - B Gebel
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - J Stadelmaier
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Breisacher Str. 86, 79110, Freiburg, Germany
| | - S Erdmann
- Institute for Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - F Radicke
- Institute for Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - H Grundmann
- Institute for Infection Prevention and Hospital Hygiene, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - A Kramer
- Institute for Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - I Monsef
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cochrane Haematology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - G Rücker
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Zinkmattenstraße 6a, 79108, Freiburg, Germany
| | - J Rupp
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - S Scheithauer
- Institute of Infection Control and Infectious Diseases, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - C Schmucker
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Breisacher Str. 86, 79110, Freiburg, Germany
| | - A Simon
- Clinic for Pediatric Oncology and Hematology, Saarland University Hospital, Kirrberger Straße, 66421, Homburg, Saar, Germany
| | - Nico T Mutters
- Institute for Hygiene and Public Health, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany.
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Thornlow B, Kramer A, Ye C, De Maio N, McBroome J, Hinrichs AS, Lanfear R, Turakhia Y, Corbett-Detig R. Online Phylogenetics using Parsimony Produces Slightly Better Trees and is Dramatically More Efficient for Large SARS-CoV-2 Phylogenies than de novo and Maximum-Likelihood Approaches. bioRxiv 2022:2021.12.02.471004. [PMID: 35611334 PMCID: PMC9128781 DOI: 10.1101/2021.12.02.471004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Phylogenetics has been foundational to SARS-CoV-2 research and public health policy, assisting in genomic surveillance, contact tracing, and assessing emergence and spread of new variants. However, phylogenetic analyses of SARS-CoV-2 have often relied on tools designed for de novo phylogenetic inference, in which all data are collected before any analysis is performed and the phylogeny is inferred once from scratch. SARS-CoV-2 datasets do not fit this mould. There are currently over 10 million sequenced SARS-CoV-2 genomes in online databases, with tens of thousands of new genomes added every day. Continuous data collection, combined with the public health relevance of SARS-CoV-2, invites an "online" approach to phylogenetics, in which new samples are added to existing phylogenetic trees every day. The extremely dense sampling of SARS-CoV-2 genomes also invites a comparison between likelihood and parsimony approaches to phylogenetic inference. Maximum likelihood (ML) methods are more accurate when there are multiple changes at a single site on a single branch, but this accuracy comes at a large computational cost, and the dense sampling of SARS-CoV-2 genomes means that these instances will be extremely rare because each internal branch is expected to be extremely short. Therefore, it may be that approaches based on maximum parsimony (MP) are sufficiently accurate for reconstructing phylogenies of SARS-CoV-2, and their simplicity means that they can be applied to much larger datasets. Here, we evaluate the performance of de novo and online phylogenetic approaches, and ML and MP frameworks, for inferring large and dense SARS-CoV-2 phylogenies. Overall, we find that online phylogenetics produces similar phylogenetic trees to de novo analyses for SARS-CoV-2, and that MP optimizations produce more accurate SARS-CoV-2 phylogenies than do ML optimizations. Since MP is thousands of times faster than presently available implementations of ML and online phylogenetics is faster than de novo , we therefore propose that, in the context of comprehensive genomic epidemiology of SARS-CoV-2, MP online phylogenetics approaches should be favored.
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Affiliation(s)
- Bryan Thornlow
- Department of Biomolecular Engineering, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
- Genomics Institute, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
| | - Alexander Kramer
- Department of Biomolecular Engineering, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
- Genomics Institute, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
| | - Cheng Ye
- Department of Electrical and Computer Engineering, University of California, San Diego; San Diego, CA 92093, USA
| | - Nicola De Maio
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus; Cambridge CB10 1SD, UK
| | - Jakob McBroome
- Department of Biomolecular Engineering, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
- Genomics Institute, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
| | - Angie S. Hinrichs
- Genomics Institute, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
| | - Robert Lanfear
- Department of Ecology and Evolution, Research School of Biology, Australian National University; Canberra, ACT 2601, Australia
| | - Yatish Turakhia
- Department of Electrical and Computer Engineering, University of California, San Diego; San Diego, CA 92093, USA
| | - Russell Corbett-Detig
- Department of Biomolecular Engineering, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
- Genomics Institute, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
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8
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McBroome J, Thornlow B, Hinrichs AS, Kramer A, De Maio N, Goldman N, Haussler D, Corbett-Detig R, Turakhia Y. A Daily-Updated Database and Tools for Comprehensive SARS-CoV-2 Mutation-Annotated Trees. Mol Biol Evol 2021; 38:5819-5824. [PMID: 34469548 PMCID: PMC8662617 DOI: 10.1093/molbev/msab264] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The vast scale of SARS-CoV-2 sequencing data has made it increasingly challenging to comprehensively analyze all available data using existing tools and file formats. To address this, we present a database of SARS-CoV-2 phylogenetic trees inferred with unrestricted public sequences, which we update daily to incorporate new sequences. Our database uses the recently proposed mutation-annotated tree (MAT) format to efficiently encode the tree with branches labeled with parsimony-inferred mutations, as well as Nextstrain clade and Pango lineage labels at clade roots. As of June 9, 2021, our SARS-CoV-2 MAT consists of 834,521 sequences and provides a comprehensive view of the virus' evolutionary history using public data. We also present matUtils-a command-line utility for rapidly querying, interpreting, and manipulating the MATs. Our daily-updated SARS-CoV-2 MAT database and matUtils software are available at http://hgdownload.soe.ucsc.edu/goldenPath/wuhCor1/UShER_SARS-CoV-2/ and https://github.com/yatisht/usher, respectively.
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Affiliation(s)
- Jakob McBroome
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA, USA
- Genomics Institute, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Bryan Thornlow
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA, USA
- Genomics Institute, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Angie S Hinrichs
- Genomics Institute, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Alexander Kramer
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA, USA
- Genomics Institute, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Nicola De Maio
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Cambridge, United Kingdom
| | - Nick Goldman
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Cambridge, United Kingdom
| | - David Haussler
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA, USA
- Genomics Institute, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Russell Corbett-Detig
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA, USA
- Genomics Institute, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Yatish Turakhia
- Department of Biomolecular Engineering, University of California Santa Cruz, Santa Cruz, CA, USA
- Genomics Institute, University of California Santa Cruz, Santa Cruz, CA, USA
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9
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Abstract
Phylogenetics has been central to the genomic surveillance, epidemiology and contact tracing efforts during the COVD-19 pandemic. But the massive scale of genomic sequencing has rendered the pre-pandemic tools inadequate for comprehensive phylogenetic analyses. Here, we discuss the phylogenetic package that we developed to address the needs imposed by this pandemic. The package incorporates several pandemic-specific optimization and parallelization techniques and comprises four programs: UShER, matOptimize, RIPPLES and matUtils. Using high-performance computing, UShER and matOptimize maintain and refine daily a massive mutation-annotated phylogenetic tree consisting of all SARS-CoV-2 sequences available in online repositories. With UShER and RIPPLES, individual labs - even with modest compute resources - incorporate newly-sequenced SARS-CoV-2 genomes on this phylogeny and discover evidence for recombination in real-time. With matUtils, they rapidly query and visualize massive SARS-CoV-2 phylogenies. These tools have empowered scientists worldwide to study the SARS-CoV-2 evolution and transmission at an unprecedented scale, resolution and speed.
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Affiliation(s)
- Cheng Ye
- University of California, San Diego; San Diego, CA 92093, USA
| | - Bryan Thornlow
- University of California, Santa Cruz; Santa Cruz, CA 95064, USA
- Genomics Institute, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
| | - Alexander Kramer
- University of California, Santa Cruz; Santa Cruz, CA 95064, USA
- Genomics Institute, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
| | - Jakob McBroome
- University of California, Santa Cruz; Santa Cruz, CA 95064, USA
- Genomics Institute, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
| | - Angie Hinrichs
- Genomics Institute, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
| | - Russell Corbett-Detig
- University of California, Santa Cruz; Santa Cruz, CA 95064, USA
- Genomics Institute, University of California, Santa Cruz; Santa Cruz, CA 95064, USA
| | - Yatish Turakhia
- University of California, San Diego; San Diego, CA 92093, USA
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Hallinan B, Shah B, Caccamese J, Kramer A. Accuracy of Virtual Surgical Planning with Mandible-first Surgery and Factors that may Affect It. J Oral Maxillofac Surg 2021. [DOI: 10.1016/j.joms.2021.08.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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11
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Assadian O, Golling M, Krüger CM, Leaper D, Mutters NT, Roth B, Kramer A. Surgical site infections: guidance for elective surgery during the SARS-CoV-2 pandemic - international recommendations and clinical experience. J Hosp Infect 2021; 111:189-199. [PMID: 33600892 PMCID: PMC7883712 DOI: 10.1016/j.jhin.2021.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The COVID-19 pandemic not only had an impact on public life and healthcare facilities in general, but also affected established surgical workflows for elective procedures. The strategy to protect patients and healthcare workers from infection by SARS-CoV-2 in surgical departments has needed step-by-step development. Based on the evaluation of international recommendations and guidelines, as well as personal experiences in a clinical 'hot spot' and in a 450-bed surgical clinic, an adapted surgical site infection (SSI) prevention checklist was needed to develop concise instructions, which described roles and responsibilities of healthcare professionals that could be used for wider guidance in pandemic conditions. METHOD Publications of COVID-19-related recommendations and guidelines, produced by health authorities and organizations, such as WHO, US-CDC, ECDC, the American College of Surgery and the Robert Koch Institute, were retrieved, assessed and referenced up to 31st January 2020. Additionally, clinical personal experiences in Germany were evaluated and considered. RESULTS Part 1 of this guidance summarizes the experience of a tertiary care, surgical centre which utilized redundant hospital buildings for immediate spatial separation in a 'hot spot' COVID-19 area. Part 2 outlines the successful screening and isolation strategy in a surgical clinic in a region of Germany with outbreaks in surrounding medical centres. Part 3 provides the synopsis of personal experiences and international recommendations suggested for implementation during the COVID-19 pandemic. CONCLUSION Understanding of COVID-19, and SARS-CoV-2-related epidemiology, is constantly and rapidly changing, requiring continuous adaptation and re-evaluation of recommendations. Established national and local guidelines for continuation of surgical services and prevention of SSI require ongoing scrutiny and focused implementation. This manuscript presents a core facility checklist to support medical institutions to continue their clinical and surgical work during the COVID-19 pandemic.
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Affiliation(s)
- O Assadian
- Regional Hospital Wiener Neustadt, Austria; Institute for Skin Integrity and Infection Prevention, University of Huddersfield, UK
| | - M Golling
- Surgical Clinic I, Diakonie-Klinikum Schwäbisch Hall gGmbH, Germany
| | - C M Krüger
- Immanuel Klinikum Rüdersdorf, Department of Surgery, Center for Robotics, Rüdersdorf b. Berlin, Germany
| | - D Leaper
- Department of Surgery, University of Newcastle upon Tyne, UK; Department of Clinical Sciences, ISIaIP, University of Huddersfield, Huddersfield, UK
| | - N T Mutters
- Institute for Hygiene and Public Health, Bonn University Hospital, Bonn, Germany; CEOsys Network of the National University Medicine Research Network on Covid-19 (NUM)
| | - B Roth
- Surgical Clinic, District Hospital Belp/Switzerland, FMH for General and Trauma Surgery, Wattenwil, Switzerland
| | - A Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany; CEOsys Network of the National University Medicine Research Network on Covid-19 (NUM).
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Hornschuh M, Zwicker P, Kramer A, Schaufler K, Heiden SE, Bohnert JA, Becker K, Hübner NO. Extensively-drug-resistant Klebsiella pneumoniae ST307 outbreak strain from north-eastern Germany does not show increased tolerance to quaternary ammonium compounds and chlorhexidine. J Hosp Infect 2021; 113:52-58. [PMID: 33587974 DOI: 10.1016/j.jhin.2021.01.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND An outbreak of extensively-drug-resistant Klebsiella pneumoniae strain ST307 in a cluster of hospitals in north-east Germany gave rise to the assumption that the epidemiological success of the strain could be based on increased tolerance to biocides. METHODS The tolerance of the outbreak strain was compared with epidemiologically unrelated clinical isolates of K. pneumoniae, and reference strains of Pseudomonas aeruginosa (ATCC 15442) and Escherichia coli K12 (NCTC 10538). Tests were performed in a miniaturized assay based on European Standard EN 1040. The widely used biocides benzalkonium chloride (BAC) and didecyl dimethyl ammonium chloride (DDAC), their commercial formulation Descosept spezial (DS), and the antiseptic agent chlorhexidine digluconate (CHG) were selected as test substances. These biocides are used regularly in the hospitals involved in the outbreak. FINDINGS All biocides had a bactericidal effect against all tested strains in the quantitative suspension test within 5 min at typically used concentrations and dilutions. The effectiveness of BAC and DDAC alone and in combination, and CHG antisepsis were not impaired under tested conditions. CONCLUSION The outbreak strain did not show significantly increased tolerance towards biocides regarding the antiseptic. Thus, the epidemiological success of the strain has to be ascribed to other causes, such as inadequate hand hygiene of visitors.
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Affiliation(s)
- M Hornschuh
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany; Department of Paediatrics, Rostock University Medical Centre, Rostock, Germany
| | - P Zwicker
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - A Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - K Schaufler
- Institute of Pharmacy, Pharmaceutical Microbiology, University of Greifswald, Greifswald, Germany
| | - S E Heiden
- Institute of Pharmacy, Pharmaceutical Microbiology, University of Greifswald, Greifswald, Germany
| | - J A Bohnert
- Friedrich Loeffler-Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - K Becker
- Friedrich Loeffler-Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - N-O Hübner
- Central Unit for Infection Prevention and Control, University Medicine Greifswald, Greifswald, Germany.
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Veit P, Kramer A, Kanbach D, Stubner S. Revising the taxonomy of corporate accelerators: moving towards an evolutionary perspective. IJEV 2021. [DOI: 10.1504/ijev.2021.120427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Friedrich M, Kramer A, Tirilomis T, Jebran AF, Kutschka I. A New Approach to Myocardial Injury Adaptations: A Possible Solution for One of the Oldest Problems in Heart Surgery. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Veit P, Stubner S, Kanbach DK, Kramer A. Revising the Taxonomy of Corporate Accelerators: Moving towards an Evolutionary Perspective. IJEV 2021. [DOI: 10.1504/ijev.2021.10039348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kampf G, Suchomel M, Below H, Kramer A. Is ozonized water or hand washing more effective for hand hygiene than using an alcohol-based hand rub? J Hosp Infect 2020; 105:368-369. [PMID: 32298735 DOI: 10.1016/j.jhin.2020.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 10/24/2022]
Affiliation(s)
- G Kampf
- University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Greifswald, Germany.
| | - M Suchomel
- Institute of Hygiene and Applied Immunology, Medical University, Vienna, Austria
| | - H Below
- University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Greifswald, Germany
| | - A Kramer
- University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Greifswald, Germany
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DERNER O, Hruskova Z, Kramer A, Stel V, Jager K, Tesar V. SAT-389 INCIDENCE AND OUTCOME OF PATIENTS STARTING RENAL REPLACEMENT THERAPY FOR END-STAGE RENAL DISEASE DUE TO SYSTEMIC LUPUS ERYTHEMATOSUS: RESULTS FROM THE ERA-EDTA REGISTRY. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Abstract
In an ever-changing environment, crossmodal recalibration is crucial to maintain precise and coherent spatial estimates across different sensory modalities. Accordingly, it has been found that perceived auditory space is recalibrated toward vision after consistent exposure to spatially misaligned audio-visual stimuli (VS). While this so-called ventriloquism aftereffect (VAE) yields internal consistency between vision and audition, it does not necessarily lead to consistency between the perceptual representation of space and the actual environment. For this purpose, feedback about the true state of the external world might be necessary. Here, we tested whether the size of the VAE is modulated by external feedback and reward. During adaptation audio-VS with a fixed spatial discrepancy were presented. Participants had to localize the sound and received feedback about the magnitude of their localization error. In half of the sessions the feedback was based on the position of the VS and in the other half it was based on the position of the auditory stimulus. An additional monetary reward was given if the localization error fell below a certain threshold that was based on participants’ performance in the pretest. As expected, when error feedback was based on the position of the VS, auditory localization during adaptation trials shifted toward the position of the VS. Conversely, feedback based on the position of the auditory stimuli reduced the visual influence on auditory localization (i.e., the ventriloquism effect) and improved sound localization accuracy. After adaptation with error feedback based on the VS position, a typical auditory VAE (but no visual aftereffect) was observed in subsequent unimodal localization tests. By contrast, when feedback was based on the position of the auditory stimuli during adaptation, no auditory VAE was observed in subsequent unimodal auditory trials. Importantly, in this situation no visual aftereffect was found either. As feedback did not change the physical attributes of the audio-visual stimulation during adaptation, the present findings suggest that crossmodal recalibration is subject to top–down influences. Such top–down influences might help prevent miscalibration of audition toward conflicting visual stimulation in situations in which external feedback indicates that visual information is inaccurate.
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Affiliation(s)
- Alexander Kramer
- Biological Psychology and Neuropsychology, University of Hamburg, Hamburg, Germany
| | - Brigitte Röder
- Biological Psychology and Neuropsychology, University of Hamburg, Hamburg, Germany
| | - Patrick Bruns
- Biological Psychology and Neuropsychology, University of Hamburg, Hamburg, Germany
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Sauro KM, Soo A, Kramer A, Couillard P, Kromm J, Zygun D, Niven DJ, Bagshaw SM, Stelfox HT. Venous Thromboembolism Prophylaxis in Neurocritical Care Patients: Are Current Practices, Best Practices? Neurocrit Care 2020; 30:355-363. [PMID: 30276615 DOI: 10.1007/s12028-018-0614-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND/OBJECTIVES Venous thromboembolism (VTE) is a leading cause of preventable, in-hospital deaths; critically ill patients have a higher risk. Effective and efficient strategies to prevent VTE exist; however, neurocritical care patients present unique challenges due to competing risk of bleeding. The objective of this study was to examine current VTE prophylaxis practices among neurocritical care patients, concordance with guideline-recommended care, and the association with clinical outcomes. METHODS This retrospective cohort study of patients admitted to ten adult, medical-surgical and neurological intensive care units (ICUs) in nine hospitals between 2014 and 2017 using administrative and clinical data. Neurocritical care patients were classified based on the primary admission diagnosis. Concordance with guideline-recommended care was evaluated using recommendations from recent guidelines. RESULTS 20.0% of 23,191 patients were classified as neurocritical care. Among neurocritical care patients, pharmacological VTE prophylaxis was administered on 60.9% of all ICU days, mechanical VTE prophylaxis on 46.9%, and no VTE prophylaxis on 12.2% of all ICU days. Type of VTE prophylaxis was associated with sex, neurological diagnosis, and invasive neurological monitoring. Fifty-six percentage of ICU days were guideline concordant but concordance varied by recommendation (range 6-100%) and by type of VTE prophylaxis recommended (p = 0.05); among patients where guidelines recommended use of pharmacologic prophylaxis, care was concordant 26.6% of ICU days, whereas for mechanical prophylaxis it was concordant 80.5% of ICU days. There was an overall improvement in guideline concordance on 2.3% of ICU days after the publication of the Society of Neurocritical Care guideline (p = 0.005). CONCLUSIONS Neurocritical care patients commonly receive mechanical VTE prophylaxis despite guidelines recommending the use of pharmacological VTE prophylaxis. Our findings suggest uncertainty around best VTE prophylaxis practices for neurocritical care patients remains.
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Affiliation(s)
- K M Sauro
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada.
- Department of Community Health Science, O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
| | - A Soo
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
| | - A Kramer
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - P Couillard
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - J Kromm
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
| | - D Zygun
- Department of Critical Care Medicine, School of Public Health, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - D J Niven
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Science, O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - S M Bagshaw
- Department of Critical Care Medicine, School of Public Health, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - H T Stelfox
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Science, O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
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König F, Kramer A, Grab M, Mehilli J, Hagl C, Thierfelder N. Simulation of TAVI in Patient-Specific Testing Inserts at Physiologic Flow Conditions. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | - M. Grab
- Garching bei München, Germany
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21
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Khaznadar L, Dancer SJ, Petersmann A, Seifert U, Below H, Papke R, Suchomel M, Kohlmann T, Kramer A. Do pneumatic tube transport systems transmit potential pathogens? A hygienic risk assessment in a university hospital. J Hosp Infect 2019; 104:374-380. [PMID: 31759094 DOI: 10.1016/j.jhin.2019.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 11/13/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Prompted by an outbreak of vancomycin-resistant enterococci (VRE) in a medical facility, this study examined a pneumatic tube transport system (PTS) as a potential transmission channel. METHOD Samples from the receiving station and entry racks were gathered via smear technique. Sponges used for PTS decontamination were soaked with 0.89% NaCl and transported through the channel. Micro-organisms were recovered from the tubes and cleaning sponges using a wash-away technique. Air sampling was performed at the receiving station in order to detect any airborne contamination. Tubes were artificially inoculated with Escherichia coli K12 NCTC 10538 and Staphylococcus epidermidis DSM 20044 and sent through the PTS to investigate channel contamination. RESULTS No pathogens were detected in effluent air from the PTS or in tubes during routine operation. Entry racks for the test tubes were contaminated with coagulase-negative staphylococci (CNS), aerobic bacilli, moulds and vancomycin-susceptible Enterococcus faecium. E. coli proved to be unsuitable for detecting bacterial transmission by the PTS due to low persistence, but S. epidermidis was more resilient. After sending contaminated test tubes through the PTS, levels of S. epidermidis only decreased marginally. Subsequently, sponges soaked with disinfectant solution were put through the system and these eliminated S. epidermidis completely from the first attempt. DISCUSSION Routine hygienic maintenance of the PTS makes pathogen transmission highly unlikely, although entry racks should be disinfected regularly. Any involvement of the PTS in the VRE outbreak at the study institution was unlikely.
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Affiliation(s)
- L Khaznadar
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany
| | - S J Dancer
- Department of Microbiology, Hairmyres Hospital, NHS Lanarkshire, East Kilbride, UK; School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - A Petersmann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - U Seifert
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Germany
| | - H Below
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany
| | - R Papke
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany
| | - M Suchomel
- Institute for Hygiene and Applied Immunology, Medical University of Vienna, Austria
| | - T Kohlmann
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - A Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany.
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22
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Kramer A, Trinder M, Brunham L. ESTIMATING THE PREVALENCE OF FAMILIAL HYPERCHOLESTEROLEMIA IN ACUTE CORONARY SYNDROME: A SYSTEMATIC REVIEW AND META-ANALYSIS. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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23
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Harnoss JC, Dancer SJ, Kaden CF, Baguhl R, Kohlmann T, Papke R, Zygmunt M, Assadian O, Suchomel M, Pittet D, Kramer A. Hand antisepsis without decreasing efficacy by shortening the rub-in time of alcohol-based handrubs to 15 seconds. J Hosp Infect 2019; 104:419-424. [PMID: 31513881 DOI: 10.1016/j.jhin.2019.09.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 09/04/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND A previous study among neonatal intensive care unit (NICU) nurses showed that the antibacterial efficacy of alcohol-based handrubs (ABHR) can be achieved in 15 s instead of 30 s with a significant increase in the frequency of hand antisepsis. This study aimed to examine 15-s vs 30-s antisepsis performance by measuring microbial load on fingertips and compliance among nurses in a low-risk gynaecological ward. METHODS An independent trained observer monitored the frequency and compliance with hand antisepsis during shifts in a crossover design. Fingertips including thumbs were rinsed in soy broth before hand rubbing at the beginning of a shift and then hourly to determine the bacterial load. Performance activity was assigned to the contamination class of the Fulkerson scale. Immediately before the lunch break, volunteers cleaned their hands for a randomly determined application time of 15 or 30 s. RESULTS Examination of bacterial load on fingertips revealed no difference between 15 vs 30 s application time. Controlled hand antisepsis before the lunch break also showed no difference in efficacy for either test series. Participants rubbing for 15 s were more likely to perform hand antisepsis compared with those rubbing for 30 s (P=0.2). The compliance increased from 54.7% to 69.5% in the 15-s trial. DISCUSSION Shortening the duration for hand antisepsis did not decrease efficacy. Shortening the application time to 15 s should be considered within the critical components of a successful multimodal intervention strategy to improve hand-hygiene compliance in clinical practice.
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Affiliation(s)
- J C Harnoss
- Department of General, Visceral and Transplantation Surgery, Study Centre of the German Surgical Society (SDGC), University of Heidelberg, Heidelberg, Germany
| | - S J Dancer
- Department of Microbiology, University Hospital Hairmyres, Glasgow, UK; School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - C F Kaden
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - R Baguhl
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - T Kohlmann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - R Papke
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - M Zygmunt
- Clinic and Ambulance for Gynaecology and Obstetrics, University Medicine Greifswald, Greifswald, Germany
| | - O Assadian
- Department for Infection Control and Hospital Epidemiology, Medical University of Vienna, Vienna, Austria; Hospital Landesklinikum Neunkirchen, Neunkirchen, Austria
| | - M Suchomel
- Institute for Hygiene and Applied Immunology, Medical University of Vienna, Vienna, Austria
| | - D Pittet
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - A Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany.
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Kramer A, Conway BR, Meissner K, Scholz F, Rauch BH, Moroder A, Ehlers A, Meixner AJ, Heidecke CD, Partecke LI, Kietzmann M, Assadian O. Cold atmospheric pressure plasma for treatment of chronic wounds: drug or medical device? J Wound Care 2019; 26:470-475. [PMID: 28795892 DOI: 10.12968/jowc.2017.26.8.470] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The use of cold atmospheric pressure plasma (CAPP) as a new therapeutic option to aid the healing of chronic wounds appears promising. Currently, uncertainty exists regarding their classification as medical device or medical drug. Because the classification of CAPP has medical, legal, and economic consequences as well as implications for the level of preclinical and clinical testing, the correct classification is not an academic exercise, but an ethical need. METHOD A multidisciplinary team of physicians, surgeons, pharmacists, physicists and lawyers has analysed the physical and technical characteristics as well as legal conditions of the biological action of CAPP. RESULTS It was concluded that the mode of action of the locally generated CAPP, with its main active components being different radicals, is pharmacological and not physical in nature. CONCLUSION Depending on the intended use, CAPP should be classified as a drug, which is generated by use of a medical device directly at the point of therapeutic application.
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Affiliation(s)
- A Kramer
- Consultant Clinical Microbiology and Infection Control, Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany
| | - B R Conway
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, United Kingdom; Institute of Skin Integrity and Infection Prevention, School for Human and Health Sciences, University of Huddersfield
| | - K Meissner
- Anesthetist, Intensive Care Specialist, Department of Anesthesiology and Intensive Medicine, University Medicine, Greifswald, Germany
| | - F Scholz
- Biochemist, Institute of Biochemistry, University of Greifswald, Germany
| | - B H Rauch
- Medical Pharmacology and Toxicology, Department of Pharmacology, Center of Drug Absorption and Transport, University Medicine Greifswald, Germany
| | - A Moroder
- Lawyer, Ehlers, Ehlers & Partner Healthcare Law Firm Munich, Germany
| | - A Ehlers
- Lawyer, Ehlers, Ehlers & Partner Healthcare Law Firm Munich, Germany
| | - A J Meixner
- Physicist, Institute of Physical and Theoretical Chemistry Tübingen, Germany
| | - C-D Heidecke
- General Surgeon, Department of Surgery, University Medicine Greifswald, Germany
| | - L I Partecke
- General Surgeon, Department of Surgery, University Medicine Greifswald, Germany
| | - M Kietzmann
- Veterinary Medicine, Pharmacologist, Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - O Assadian
- Consultant Clinical Microbiology and Infection Control, Consultant Infectious Diseases and Tropical Medicine, Institute for Hospital Epidemiology and Infection Control, Medical University of Vienna, Vienna, Austria
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Choate K, Kramer A. 033 HD Real-Time Video Assessment of Catastrophic Venous Bleeding and Control from Reservoir Manipulation. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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26
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Kramer A. 219 Female Residents are as Successful as Male Counterparts in Discussions Leading to Penile Implant Surgery. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bitterman Fisher S, Steiner M, Goldman I, Hanna-Zaknun R, Davidovich S, Kramer A, Malik A, Popovits-Hadari N, Leviov M, Haddad R, Bitterman A. [INTRAOPERATIVE RADIOTHERAPY (IORT) IN EARLY BREAST CANCER - 500 PATIENTS, ONE CENTER'S EXPERIENCE]. Harefuah 2019; 158:244-247. [PMID: 31032557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIMS To present our Institute's experience with intraoperative radiotherapy in this selected population by collecting and analyzing clinical data, including long-term follow-up. BACKGROUND Breast-conserving therapy is the standard treatment for early-stage breast cancer. The treatment includes tumor resection and a whole breast irradiation. Intraoperative radiotherapy is a single dose of irradiation given to the tumor bed immediately after it is removed. This treatment is suitable for a selected population of patients with early stage breast cancer, which constitutes about 20% of all breast cancer patients and is supposed to replace the standard whole breast radiation treatment. METHODS Between the years 2006-2017, 737 women with early breast cancer were treated in Carmel Medical Center with intraoperative radiotherapy. We herein report the results of the first 500 patients who were treated until 2015. RESULTS In 13.8% of the patients, additional breast treatment was recommended due to poor pathological characteristics of the disease in final pathological examination. During a median follow-up period of 74 months (1-136), recurrence was observed in 22 patients (4.4%), and in 7 patients (1.4%) recurrence was observed in regional lymph nodes; 13 patients (2.6%) developed metastatic disease. Risk factors for regional recurrence were identified: tumor size greater than 2 cm, lack of adjuvant therapy and poor genetic profile of the disease. CONCLUSIONS Intraoperative radiotherapy is feasible and may offer an alternative to the standard whole breast radiotherapy, in low risk early breast cancer patients. The patients should be selected according to known risk factors.
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Affiliation(s)
- Sivan Bitterman Fisher
- Department of Surgery A, Carmel Medical Center, affiliated with Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - Mariana Steiner
- Department of Oncology Service, Carmel Medical Center, affiliated with Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - Iudita Goldman
- Department of Mammography- Radiology, Carmel Medical Center, affiliated with Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - Rene Hanna-Zaknun
- Department of Surgery B, Carmel Medical Center, affiliated with Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - Shirli Davidovich
- Department of Surgery A, Carmel Medical Center, affiliated with Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - Alexander Kramer
- Department of Surgery B, Carmel Medical Center, affiliated with Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - Adar Malik
- Department of Surgery A, Carmel Medical Center, affiliated with Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - Noa Popovits-Hadari
- Department of Oncology Service, Carmel Medical Center, affiliated with Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - Michelle Leviov
- Department of Oncology Service, Carmel Medical Center, affiliated with Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - Riad Haddad
- Department of Surgery B, Carmel Medical Center, affiliated with Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - Arie Bitterman
- Department of Surgery A, Carmel Medical Center, affiliated with Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
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Kramer A, Choate K. 239 Addition of Multiple Hemostatic Agents Improves Hematoma Formation and Outcomes in Penile Implant Surgery. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kramer A, Dunne M, Choate K. 179 A Strategy Guide for a Successful Urology Match: Perspective from a Resident and Program Director. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lognonné P, Banerdt WB, Giardini D, Pike WT, Christensen U, Laudet P, de Raucourt S, Zweifel P, Calcutt S, Bierwirth M, Hurst KJ, Ijpelaan F, Umland JW, Llorca-Cejudo R, Larson SA, Garcia RF, Kedar S, Knapmeyer-Endrun B, Mimoun D, Mocquet A, Panning MP, Weber RC, Sylvestre-Baron A, Pont G, Verdier N, Kerjean L, Facto LJ, Gharakanian V, Feldman JE, Hoffman TL, Klein DB, Klein K, Onufer NP, Paredes-Garcia J, Petkov MP, Willis JR, Smrekar SE, Drilleau M, Gabsi T, Nebut T, Robert O, Tillier S, Moreau C, Parise M, Aveni G, Ben Charef S, Bennour Y, Camus T, Dandonneau PA, Desfoux C, Lecomte B, Pot O, Revuz P, Mance D, tenPierick J, Bowles NE, Charalambous C, Delahunty AK, Hurley J, Irshad R, Liu H, Mukherjee AG, Standley IM, Stott AE, Temple J, Warren T, Eberhardt M, Kramer A, Kühne W, Miettinen EP, Monecke M, Aicardi C, André M, Baroukh J, Borrien A, Bouisset A, Boutte P, Brethomé K, Brysbaert C, Carlier T, Deleuze M, Desmarres JM, Dilhan D, Doucet C, Faye D, Faye-Refalo N, Gonzalez R, Imbert C, Larigauderie C, Locatelli E, Luno L, Meyer JR, Mialhe F, Mouret JM, Nonon M, Pahn Y, Paillet A, Pasquier P, Perez G, Perez R, Perrin L, Pouilloux B, Rosak A, Savin de Larclause I, Sicre J, Sodki M, Toulemont N, Vella B, Yana C, Alibay F, Avalos OM, Balzer MA, Bhandari P, Blanco E, Bone BD, Bousman JC, Bruneau P, Calef FJ, Calvet RJ, D’Agostino SA, de los Santos G, Deen RG, Denise RW, Ervin J, Ferraro NW, Gengl HE, Grinblat F, Hernandez D, Hetzel M, Johnson ME, Khachikyan L, Lin JY, Madzunkov SM, Marshall SL, Mikellides IG, Miller EA, Raff W, Singer JE, Sunday CM, Villalvazo JF, Wallace MC, Banfield D, Rodriguez-Manfredi JA, Russell CT, Trebi-Ollennu A, Maki JN, Beucler E, Böse M, Bonjour C, Berenguer JL, Ceylan S, Clinton J, Conejero V, Daubar I, Dehant V, Delage P, Euchner F, Estève I, Fayon L, Ferraioli L, Johnson CL, Gagnepain-Beyneix J, Golombek M, Khan A, Kawamura T, Kenda B, Labrot P, Murdoch N, Pardo C, Perrin C, Pou L, Sauron A, Savoie D, Stähler S, Stutzmann E, Teanby NA, Tromp J, van Driel M, Wieczorek M, Widmer-Schnidrig R, Wookey J. SEIS: Insight's Seismic Experiment for Internal Structure of Mars. Space Sci Rev 2019; 215:12. [PMID: 30880848 PMCID: PMC6394762 DOI: 10.1007/s11214-018-0574-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/29/2018] [Indexed: 05/23/2023]
Abstract
UNLABELLED By the end of 2018, 42 years after the landing of the two Viking seismometers on Mars, InSight will deploy onto Mars' surface the SEIS (Seismic Experiment for Internal Structure) instrument; a six-axes seismometer equipped with both a long-period three-axes Very Broad Band (VBB) instrument and a three-axes short-period (SP) instrument. These six sensors will cover a broad range of the seismic bandwidth, from 0.01 Hz to 50 Hz, with possible extension to longer periods. Data will be transmitted in the form of three continuous VBB components at 2 sample per second (sps), an estimation of the short period energy content from the SP at 1 sps and a continuous compound VBB/SP vertical axis at 10 sps. The continuous streams will be augmented by requested event data with sample rates from 20 to 100 sps. SEIS will improve upon the existing resolution of Viking's Mars seismic monitoring by a factor of ∼ 2500 at 1 Hz and ∼ 200 000 at 0.1 Hz. An additional major improvement is that, contrary to Viking, the seismometers will be deployed via a robotic arm directly onto Mars' surface and will be protected against temperature and wind by highly efficient thermal and wind shielding. Based on existing knowledge of Mars, it is reasonable to infer a moment magnitude detection threshold of M w ∼ 3 at 40 ∘ epicentral distance and a potential to detect several tens of quakes and about five impacts per year. In this paper, we first describe the science goals of the experiment and the rationale used to define its requirements. We then provide a detailed description of the hardware, from the sensors to the deployment system and associated performance, including transfer functions of the seismic sensors and temperature sensors. We conclude by describing the experiment ground segment, including data processing services, outreach and education networks and provide a description of the format to be used for future data distribution. ELECTRONIC SUPPLEMENTARY MATERIAL The online version of this article (10.1007/s11214-018-0574-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- P. Lognonné
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - W. B. Banerdt
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - D. Giardini
- Institut of Geophysics, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - W. T. Pike
- Department of Electrical and Electronic Engineering, Faculty of Engineering, Imperial College London, London, UK
| | - U. Christensen
- Department of Planets and Comets, Max Planck Institute for Solar System Research, Göttingen, Germany
| | - P. Laudet
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - S. de Raucourt
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - P. Zweifel
- Institut of Geophysics, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - S. Calcutt
- Atmospheric, Oceanic, & Planetary Physics, University of Oxford, Parks Road, Oxford, OX1 3PU UK
- Clarendon Laboratory, University of Oxford, Parks Road, Oxford, OX1 3PU UK
| | - M. Bierwirth
- Department of Planets and Comets, Max Planck Institute for Solar System Research, Göttingen, Germany
| | - K. J. Hurst
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - F. Ijpelaan
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - J. W. Umland
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - R. Llorca-Cejudo
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - S. A. Larson
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - R. F. Garcia
- ISAE-SUPAERO, Toulouse University, 10 Avenue E. Belin, 31400 Toulouse, France
| | - S. Kedar
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - B. Knapmeyer-Endrun
- Department of Planets and Comets, Max Planck Institute for Solar System Research, Göttingen, Germany
| | - D. Mimoun
- ISAE-SUPAERO, Toulouse University, 10 Avenue E. Belin, 31400 Toulouse, France
| | - A. Mocquet
- LPG Nantes, UMR6112, CNRS-Université de Nantes, 2 rue de la Houssinière, BP 92208, 44322 Nantes cedex 3, France
| | - M. P. Panning
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - R. C. Weber
- NASA Marshall Space Flight Center, 320 Sparkman Drive, Huntsville, AL 35805 USA
| | - A. Sylvestre-Baron
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - G. Pont
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - N. Verdier
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - L. Kerjean
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - L. J. Facto
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - V. Gharakanian
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - J. E. Feldman
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - T. L. Hoffman
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - D. B. Klein
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - K. Klein
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - N. P. Onufer
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - J. Paredes-Garcia
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - M. P. Petkov
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - J. R. Willis
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - S. E. Smrekar
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - M. Drilleau
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - T. Gabsi
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - T. Nebut
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - O. Robert
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - S. Tillier
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - C. Moreau
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - M. Parise
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - G. Aveni
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - S. Ben Charef
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - Y. Bennour
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - T. Camus
- Institut de Recherche en Astrophysique et Planétologie, UMR5277 CNRS - Université Toulouse III Paul Sabatier, 14, avenue Edouard Belin, 31400 Toulouse, France
| | - P. A. Dandonneau
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - C. Desfoux
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - B. Lecomte
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
- Present Address: Institut d’Astrophysique Spatiale, Université Paris-Sud, Bâtiment 121, 91405 Orsay Cedex, France
| | - O. Pot
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
- Present Address: Laboratoire de Mécanique et d’Acoustique, LMA - UMR 7031 AMU - CNRS - Centrale Marseille, 4 impasse Nikola Tesla, CS 40006, 13453 Marseille Cedex 13, France
| | - P. Revuz
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - D. Mance
- Institut of Geophysics, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - J. tenPierick
- Institut of Geophysics, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - N. E. Bowles
- Atmospheric, Oceanic, & Planetary Physics, University of Oxford, Parks Road, Oxford, OX1 3PU UK
- Clarendon Laboratory, University of Oxford, Parks Road, Oxford, OX1 3PU UK
| | - C. Charalambous
- Department of Electrical and Electronic Engineering, Faculty of Engineering, Imperial College London, London, UK
| | - A. K. Delahunty
- Department of Electrical and Electronic Engineering, Faculty of Engineering, Imperial College London, London, UK
- Present Address: Advanced Technology and Research, Arup, 13 Fitzroy Street, London, W1T 4BQ UK
| | - J. Hurley
- Atmospheric, Oceanic, & Planetary Physics, University of Oxford, Parks Road, Oxford, OX1 3PU UK
- Clarendon Laboratory, University of Oxford, Parks Road, Oxford, OX1 3PU UK
- RAL Space, STFC Rutherford Appleton Laboratory, Harwell Science and Innovation Campus, Didcot, OX11 0QX UK
| | - R. Irshad
- RAL Space, STFC Rutherford Appleton Laboratory, Harwell Science and Innovation Campus, Didcot, OX11 0QX UK
| | - Huafeng Liu
- Department of Electrical and Electronic Engineering, Faculty of Engineering, Imperial College London, London, UK
- Present Address: Center for Gravitational Experiments, Huazhong University of Science and Technology, 1037 Luoyu Rd, Wuhan, 430074 P.R. China
| | - A. G. Mukherjee
- Department of Electrical and Electronic Engineering, Faculty of Engineering, Imperial College London, London, UK
| | | | - A. E. Stott
- Department of Electrical and Electronic Engineering, Faculty of Engineering, Imperial College London, London, UK
| | - J. Temple
- Atmospheric, Oceanic, & Planetary Physics, University of Oxford, Parks Road, Oxford, OX1 3PU UK
- Clarendon Laboratory, University of Oxford, Parks Road, Oxford, OX1 3PU UK
| | - T. Warren
- Atmospheric, Oceanic, & Planetary Physics, University of Oxford, Parks Road, Oxford, OX1 3PU UK
- Clarendon Laboratory, University of Oxford, Parks Road, Oxford, OX1 3PU UK
| | - M. Eberhardt
- Department of Planets and Comets, Max Planck Institute for Solar System Research, Göttingen, Germany
| | - A. Kramer
- Department of Planets and Comets, Max Planck Institute for Solar System Research, Göttingen, Germany
| | - W. Kühne
- Department of Planets and Comets, Max Planck Institute for Solar System Research, Göttingen, Germany
| | - E.-P. Miettinen
- Department of Planets and Comets, Max Planck Institute for Solar System Research, Göttingen, Germany
| | - M. Monecke
- Department of Planets and Comets, Max Planck Institute for Solar System Research, Göttingen, Germany
| | - C. Aicardi
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - M. André
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - J. Baroukh
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - A. Borrien
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - A. Bouisset
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - P. Boutte
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - K. Brethomé
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - C. Brysbaert
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - T. Carlier
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - M. Deleuze
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - J. M. Desmarres
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - D. Dilhan
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - C. Doucet
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - D. Faye
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - N. Faye-Refalo
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - R. Gonzalez
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - C. Imbert
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - C. Larigauderie
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - E. Locatelli
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - L. Luno
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - J.-R. Meyer
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - F. Mialhe
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - J. M. Mouret
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - M. Nonon
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - Y. Pahn
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - A. Paillet
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - P. Pasquier
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - G. Perez
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - R. Perez
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - L. Perrin
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - B. Pouilloux
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - A. Rosak
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - I. Savin de Larclause
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - J. Sicre
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - M. Sodki
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - N. Toulemont
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - B. Vella
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - C. Yana
- Centre National d’Etudes Spatiales, 18 av. Edouard Belin, 31401 Toulouse Cedex 9, France
| | - F. Alibay
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - O. M. Avalos
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - M. A. Balzer
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - P. Bhandari
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - E. Blanco
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - B. D. Bone
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - J. C. Bousman
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - P. Bruneau
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - F. J. Calef
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - R. J. Calvet
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - S. A. D’Agostino
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - G. de los Santos
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - R. G. Deen
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - R. W. Denise
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - J. Ervin
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - N. W. Ferraro
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - H. E. Gengl
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - F. Grinblat
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - D. Hernandez
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - M. Hetzel
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - M. E. Johnson
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - L. Khachikyan
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - J. Y. Lin
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - S. M. Madzunkov
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - S. L. Marshall
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - I. G. Mikellides
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - E. A. Miller
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - W. Raff
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - J. E. Singer
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - C. M. Sunday
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - J. F. Villalvazo
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - M. C. Wallace
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - D. Banfield
- Cornell Center for Astrophysics and Planetary Science, Cornell University, Ithaca, NY USA
| | | | - C. T. Russell
- Earth, Planetary and Space Sciences, University of California, Los Angeles, Los Angeles, USA
| | - A. Trebi-Ollennu
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - J. N. Maki
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - E. Beucler
- LPG Nantes, UMR6112, CNRS-Université de Nantes, 2 rue de la Houssinière, BP 92208, 44322 Nantes cedex 3, France
| | - M. Böse
- Swiss Seismological Service, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - C. Bonjour
- Institut of Geophysics, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - J. L. Berenguer
- Geoazur, University Cote d’Azur, 250 rue Einstein, 06560 Valbonne, France
| | - S. Ceylan
- Institut of Geophysics, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - J. Clinton
- Swiss Seismological Service, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - V. Conejero
- Département de Sismologie, Institut de Physique du Globe de Paris-Sorbonne Paris Cité, UMR 7154 CNRS - Université Paris Diderot, 1 Rue Jussieu, Paris Cedex, 75238 France
| | - I. Daubar
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - V. Dehant
- Royal Observatory of Belgium, 3 avenue Circulaire, 1180 Brussels, Belgium
| | - P. Delage
- Laboratoire Navier (CERMES), Ecole des Ponts ParisTech, Marne la Vallée, France
| | - F. Euchner
- Institut of Geophysics, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - I. Estève
- Institut de Minéralogie et de Physique des Matériaux et de Cosmochimie, Case courrier 115, 4 Place Jussieu, 75252 Paris Cedex 05, France
| | - L. Fayon
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - L. Ferraioli
- Institut of Geophysics, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - C. L. Johnson
- University of British Columbia, Vancouver, BC Canada
- Planetary Science Institute, Tucson, AZ USA
| | - J. Gagnepain-Beyneix
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - M. Golombek
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - A. Khan
- Institut of Geophysics, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - T. Kawamura
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - B. Kenda
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - P. Labrot
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - N. Murdoch
- ISAE-SUPAERO, Toulouse University, 10 Avenue E. Belin, 31400 Toulouse, France
| | - C. Pardo
- Département de Sismologie, Institut de Physique du Globe de Paris-Sorbonne Paris Cité, UMR 7154 CNRS - Université Paris Diderot, 1 Rue Jussieu, Paris Cedex, 75238 France
| | - C. Perrin
- Institut de Physique du Globe de Paris-Sorbonne Paris Cité, Université Paris Diderot (UMR 7154 CNRS), Planetology et Space Science Team, 35 Rue Hélène Brion, Paris, 75013 France
| | - L. Pou
- ISAE-SUPAERO, Toulouse University, 10 Avenue E. Belin, 31400 Toulouse, France
| | - A. Sauron
- Institut of Geophysics, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - D. Savoie
- SYRTE, Observatoire de Paris, Université PSL, CNRS, Sorbonne Université, LNE, 61 avenue de l’Observatoire, 75014 Paris, France
| | - S. Stähler
- Institut of Geophysics, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - E. Stutzmann
- Département de Sismologie, Institut de Physique du Globe de Paris-Sorbonne Paris Cité, UMR 7154 CNRS - Université Paris Diderot, 1 Rue Jussieu, Paris Cedex, 75238 France
| | - N. A. Teanby
- School of Earth Sciences, University of Bristol, Wills Memorial Building, Queens Road, Bristol, BS8 1RJ UK
| | - J. Tromp
- Department of Geosciences, Princeton University, Guyot Hall, Princeton, NJ 08544 USA
| | - M. van Driel
- Institut of Geophysics, ETHZ, Sonneggstrasse 5, 8092 Zurich, Switzerland
| | - M. Wieczorek
- Observatoire de la Côte d’Azur, Boulevard de l’Observatoire, CS 34229, 06304 Nice Cedex 4, France
| | - R. Widmer-Schnidrig
- Black Forest Observatory, Karlsruhe Institute of Technology and Stuttgart University, Heubach 206, 77709 Wolfach, Germany
| | - J. Wookey
- School of Earth Sciences, University of Bristol, Wills Memorial Building, Queens Road, Bristol, BS8 1RJ UK
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Abstract
BACKGROUND Now that cleaning and decontamination are recognized as integral to infection control, it is timely to examine the process in more detail. This is because cleaning practices vary widely within healthcare districts, and it is likely that both time and energy are needlessly wasted with ill-defined duties. Furthermore, inadequate cleaning will not reduce the risk of infection but may even enhance it. The process would benefit from a systematic appraisal, with each component placed within an evidence-based and ordered protocol. METHODS A literary search was performed on 'hospital cleaning', focusing on manual aspects of cleaning, pathogen reservoirs and transmission, hand hygiene, staff responsibilities and patient comfort. RESULTS No articles providing an evidence-based practical approach to systematic cleaning in hospitals were identified. This review therefore proposes a simple four-step guide for daily cleaning of the occupied bed space. Step 1 (LOOK) describes a visual assessment of the area to be cleaned; Step 2 (PLAN) argues why the bed space needs preparation before cleaning; Step 3 (CLEAN) covers surface cleaning/decontamination; and Step 4 (DRY) is the final stage whereby surfaces are allowed to dry. CONCLUSION Given the lack of articles providing practical cleaning guidance, this review proposes a four-step protocol based on evidence if available, or justified where not. Each step is presented, discussed and risk-assessed. It is likely that a systematic cleaning process would reduce the risk of healthcare-associated infection for everyone, including outbreaks, in addition to heightened confidence in overall quality of care.
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Affiliation(s)
- S J Dancer
- Department of Laboratory Sciences, Hairmyres Hospital, NHS Lanarkshire, East Kilbride, UK; School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK.
| | - A Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
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Jiao Y, Ganster D, Nicholson R, O’Connor D, McAuley E, Kramer A, Burzynska A. MIDLIFE STRESSFUL OCCUPATIONAL EXPOSURES AND HIPPOCAMPAL SIZE IN HEALTHY OLDER ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y Jiao
- Colorado State University
| | | | | | | | - E McAuley
- University of Illinois at Urbana-Champaign
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33
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Kramer A, Pochhammer J, Walger P, Seifert U, Ruhnke M, Harnoss JC. [Spectrum of pathogens in postoperative complications of visceral surgery : The problem of multidrug resistance]. Chirurg 2018; 88:369-376. [PMID: 28229205 DOI: 10.1007/s00104-017-0382-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
In general surgery the etiology of surgical site infections has not significantly changed over the last 30 years. Gram-positive bacteria, e.g. coagulase negative staphylococci (CNS), Staphylococcus aureus and Enterococcus spp. as well as Gram-negative bacteria, e.g. Escherichia coli, Enterobacter spp., Klebsiella spp. and Pseudomonas aeruginosa, are the most common findings. Although in general surgery 10% of the S. aureus causing postoperative wound infections were methicillin resistant (MRSA), no cases of multidrug-resistant Gram-negative (MRGN) bacteria were reported. Yeasts (particularly Candida spp.) are rarely the pathogen causing surgical site infections (≤3%) and concomitant risk factors are typical (e.g. diabetes, chemotherapy, immunosuppression and malnutrition). Viruses are rarely the cause of surgical site infections. Transmission can occur by HBV, HCV or HIV positive surgical staff or in organ transplantations and postoperative reactivation of persistent infections is possible (especially for HBV, HCV, CMV, EBV and HIV). The principles for prevention of surgical site infections are dealt with as consequences of preoperative colonization by MRSA, methicillin-sensitive S. aureus (MSSA) and MRGN and reviewed with respect to screening, perioperative antibiotic prophylaxis and decolonization. In nosocomial peritonitis, the selection of antibiotics should consider previous antibiotic treatment. A single intra-abdominal detection of Candida spp. usually does not require antimycotic treatment in postoperatively stable and immunocompetent patients but is recommended in severe community-acquired or nosocomial peritonitis. Viral infections can be avoided by screening of organ donors and serological surveillance of surgery personnel.
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Affiliation(s)
- A Kramer
- Institut für Hygiene und Umweltmedizin, Universitätsmedizin Greifswald, Walther-Rathenau-Str. 49a, 17495, Greifswald, Deutschland.
| | - J Pochhammer
- Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, Marienhospital Stuttgart, Vinzenz von Paul Kliniken, Stuttgart, Deutschland
| | - P Walger
- Internistische Intensivmedizin und Infektiologie, Johanniterkrankenhaus, Johanniterkliniken Bonn, Bonn, Deutschland
| | - U Seifert
- Friedrich-Loeffler-Institut für Medizinische Mikrobiologie, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - M Ruhnke
- Paracelsus-Klinik Osnabrück, Osnabrück, Deutschland
| | - J C Harnoss
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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34
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Abstract
BACKGROUND The role of enterococci in the context of peritonitis and surgical site infections (SSI) has not yet been definitively clarified but enterococci are being detected more frequently. Numerous resistances reduce the available antibiotic options. OBJECTIVE This article gives an overview of the pathogenic importance of enterococci and of current recommendations for therapy and prophylaxis. On the basis of our own data we discuss the relevance of enterococci for SSI. MATERIAL AND METHODS All colorectal resections carried out between January 2008 and September 2016 were retrospectively documented. Revision surgery, SSI and intra-abdominally or subcutaneously detected pathogens were recorded. RESULTS A total of 2713 interventions were evaluated with 28.3% having primary peritonitis. In 587 patients (21.6%) SSI followed, and pathogen determination was possible in 431 cases (73.4%). Enterococci were frequently found in re-operations (58.4%) and SSI (46.1%), with E. faecalis and E. faecium in approximately equal proportions. If intra-abdominal enterococci were detectable in patients with primary peritonitis, it was more common to develop SSI and enterococci were more frequently detected subcutaneously. Enterococci in SSI were found to be significantly more frequent in left hemicolectomies as well as in pre-existing renal insufficiency. CONCLUSION It can be inferred that enterococci are not adequately covered by commonly used perioperative antibiotic therapy or preoperative prophylaxis, which increases the risk for SSI by enterococci. This could be favored by selection of these pathogens due to the use of antibiotics without enterococcal efficacy (e. g. cephalosporins). The consideration in the choice of perioperative antibiotic prophylaxis by the additional administration of ampicillin or vancomycin could be advantageous.
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Affiliation(s)
- J Pochhammer
- Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, Marienhospital Stuttgart, Vinzenz von Paul Kliniken, Böheimstr. 39, 70199, Stuttgart, Deutschland.
| | - A Kramer
- Institut für Hygiene und Umweltmedizin, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - M Schäffer
- Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, Marienhospital Stuttgart, Vinzenz von Paul Kliniken, Böheimstr. 39, 70199, Stuttgart, Deutschland
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Affiliation(s)
- A Kramer
- 1 Technion, Israel Institute of Technology School of Medicine, Haifa, Israel
| | - A Peleg
- 1 Technion, Israel Institute of Technology School of Medicine, Haifa, Israel
| | - R Wollstein
- 2 New York University, School of Medicine, New York, NY, USA.,3 University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
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Pivovarova O, Kessler K, Jürchott K, Hornemann S, Sticht C, Kemper M, Gretz N, Rudovich N, Kramer A, Pfeiffer AFH. Effects of the diurnal distribution of carbohydrates and fat on the adipose tissue transcriptome in humans. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- O Pivovarova
- German Institute of Human Nutrition Potsdam-Rehbruecke, Dept. of Clinical Nutrition, Nuthetal, Germany
- Charité University Medicine, Dept. of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Berlin, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - K Kessler
- German Institute of Human Nutrition Potsdam-Rehbruecke, Dept. of Clinical Nutrition, Nuthetal, Germany
- Charité University Medicine, Dept. of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Berlin, Germany
| | - K Jürchott
- Charité University Medicine, Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Berlin, Germany
| | - S Hornemann
- German Institute of Human Nutrition Potsdam-Rehbruecke, Dept. of Clinical Nutrition, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - C Sticht
- Faculty of Medicine Mannheim at Heidelberg University, Center for medical research (ZMF), Mannheim, Germany
| | - M Kemper
- German Institute of Human Nutrition Potsdam-Rehbruecke, Dept. of Clinical Nutrition, Nuthetal, Germany
- Charité University Medicine, Dept. of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Berlin, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - N Gretz
- Faculty of Medicine Mannheim at Heidelberg University, Center for Medical Research (ZMF), Mannheim, Germany
| | - N Rudovich
- German Institute of Human Nutrition Potsdam-Rehbruecke, Dept. of Clinical Nutrition, Nuthetal, Germany
- Charité University Medicine, Dept. of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Berlin, Germany
- Spital Bülach, Division of Endocrinology and Diabetes, Department of Internal Medicine, Bülach, Switzerland
| | - A Kramer
- Charité University Medicine, Laboratory of Chronobiology, Institute for Medical Immunology, Berlin, Germany
| | - AFH Pfeiffer
- German Institute of Human Nutrition Potsdam-Rehbruecke, Dept. of Clinical Nutrition, Nuthetal, Germany
- Charité University Medicine, Dept. of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Berlin, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
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37
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Kiss A, Santer D, Kramer A, Hallstrom S, Fallouh H, Hackl M, Skalicky S, Chambers D, Podesser BK. P97Cardioprotection during cardiac surgery: impact of temperature of cardioplegic solution on microRNA profile in a pig model of cardiopulmonary bypass. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Kiss
- Medical University of Vienna, Center for Biomedical Research, Vienna, Austria
| | - D Santer
- Medical University of Vienna, Center for Biomedical Research, Vienna, Austria
| | - A Kramer
- Medical University of Vienna, Center for Biomedical Research, Vienna, Austria
| | - S Hallstrom
- Medical University of Graz, Institute of Physiological Chemistry, Center for Physiological Medicine, Graz, Austria
| | - H Fallouh
- St Thomas' Hospital, Cardiac Surgical Research, The Rayne Institute (King’s College London), Guy’s and St Thomas’ NHS Fou, London, United Kingdom
| | - M Hackl
- TAmiRNA GmbH, Vienna, Vienna, Austria
| | | | - D Chambers
- St Thomas' Hospital, Cardiac Surgical Research, The Rayne Institute (King’s College London), Guy’s and St Thomas’ NHS Fou, London, United Kingdom
| | - B K Podesser
- Medical University of Vienna, Center for Biomedical Research, Vienna, Austria
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38
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Harnoss JC, Assadian O, Kramer A, Probst P, Müller-Lantzsch C, Scheerer L, Bruckner T, Diener MK, Büchler MW, Ulrich AB. Comparison of chlorhexidine–isopropanol with isopropanol skin antisepsis for prevention of surgical-site infection after abdominal surgery. Br J Surg 2018; 105:893-899. [DOI: 10.1002/bjs.10793] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/11/2017] [Accepted: 11/17/2017] [Indexed: 11/06/2022]
Abstract
Abstract
Background
Prevention of surgical-site infection (SSI) has received increasing attention. Clinical trials have focused on the role of skin antisepsis in preventing SSI. The benefit of combining antiseptic chlorhexidine with alcohol has not been compared with alcohol-based skin preparation alone in a prospective controlled clinical trial.
Methods
Between August and October 2014, patients undergoing abdominal surgery received preoperative skin antisepsis with 70 per cent isopropanol (PA). Those treated between November 2014 and January 2015 received 2 per cent chlorhexidine with 70 per cent isopropanol (CA). The primary endpoint was SSI on postoperative day (POD) 10, which was evaluated using univariable analysis, and a multivariable logistic regression model correcting for known independent risk factors for SSI. The study protocol was published in the German Registry of Clinical Studies (DRKS00011174).
Results
In total, 500 patients undergoing elective midline laparotomy were included (CA 221, PA 279). The incidence of superficial and deep SSIs was significantly different on POD 10: 14 of 212 (6·6 per cent) among those treated with CA and 32 of 260 (12·3 per cent) in those who received PA (P = 0·038). In the multivariable analysis, skin antisepsis with CA was an independent factor for reduced incidence of SSI on POD 10 (P = 0·034).
Conclusion
This study showed a benefit of adding chlorhexidine to alcohol for skin antisepsis in reducing early SSI compared with alcohol alone.
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Affiliation(s)
- J C Harnoss
- Department of General, Visceral and Transplantation Surgery and Study Centre of the German Surgical Society, University Hospital Heidelberg, Heidelberg, Germany
| | - O Assadian
- Department for Hospital Epidemiology and Infection Control, Medical University of Vienna, Vienna, Austria
| | - A Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - P Probst
- Department of General, Visceral and Transplantation Surgery and Study Centre of the German Surgical Society, University Hospital Heidelberg, Heidelberg, Germany
| | - C Müller-Lantzsch
- Department of General, Visceral and Transplantation Surgery and Study Centre of the German Surgical Society, University Hospital Heidelberg, Heidelberg, Germany
| | - L Scheerer
- Department of General, Visceral and Transplantation Surgery and Study Centre of the German Surgical Society, University Hospital Heidelberg, Heidelberg, Germany
| | - T Bruckner
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - M K Diener
- Department of General, Visceral and Transplantation Surgery and Study Centre of the German Surgical Society, University Hospital Heidelberg, Heidelberg, Germany
| | - M W Büchler
- Department of General, Visceral and Transplantation Surgery and Study Centre of the German Surgical Society, University Hospital Heidelberg, Heidelberg, Germany
| | - A B Ulrich
- Department of General, Visceral and Transplantation Surgery and Study Centre of the German Surgical Society, University Hospital Heidelberg, Heidelberg, Germany
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Felten M, Teixeira Alves LG, Chaput C, Letsiou E, Suttorp N, Kramer A, Maier B, Witzenrath M. The circadian clock modulates susceptibility of mice to ventilator-induced lung injury. Pneumologie 2018. [DOI: 10.1055/s-0037-1619144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Felten
- Med. Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin
| | - LG Teixeira Alves
- Med. Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin
| | - C Chaput
- Med. Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin
| | | | - N Suttorp
- Med. Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin; Capnetz Stiftung, Hannover
| | - A Kramer
- Institut für Medizinische Immunologie-Chronobiologie, Charité Universitätsmedizin Berlin
| | - B Maier
- Institut für Medizinische Immunologie-Chronobiologie, Charité Universitätsmedizin Berlin
| | - M Witzenrath
- Med. Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin
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40
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Hübner N, Dittmann K, Begunk R, Kramer A. Infection control measures and prevalence of multidrug-resistant organisms in non-hospital care settings in northeastern Germany: results from a one-day point prevalence study. J Hosp Infect 2017. [DOI: 10.1016/j.jhin.2017.08.002 epub 2017 aug 8.2015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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41
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Walk A, Chojnacki M, Drollette E, Raine L, Balbinot A, Biggan J, Kramer A, Cohen N, Holscher H, Hillman C, Khan N. Influence of Birth-weight-for-gestational-age on Neuroelectric Function in Preadolescence. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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42
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Balbinot A, Chojnacki M, Drollette E, Raine L, Walk A, Biggan J, Kramer A, Cohen N, Holscher H, Hillman C, Khan N. Differences In Timing of Developmental Milestones Across Vaginally vs. Cesarean-section Delivered Infants: A Retrospective Study. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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43
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Roth B, Neuenschwander R, Brill F, Wurmitzer F, Wegner C, Assadian O, Kramer A. Effect of antiseptic irrigation on infection rates of traumatic soft tissue wounds: a longitudinal cohort study. J Wound Care 2017; 26:79-87. [PMID: 28277997 DOI: 10.12968/jowc.2017.26.3.79] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Acute traumatic wounds are contaminated with bacteria and therefore an infection risk. Antiseptic wound irrigation before surgical intervention is routinely performed for contaminated wounds. However, a broad variety of different irrigation solutions are in use. The aim of this retrospective, non-randomised, controlled longitudinal cohort study was to assess the preventive effect of four different irrigation solutions before surgical treatment, on wound infection in traumatic soft tissue wounds. METHOD Over a period of three decades, the prophylactic application of wound irrigation was studied in patients with contaminated traumatic wounds requiring surgical treatment, with or without primary wound closure. The main outcome measure was development of wound infection. From 1974-1983, either 0.04 % polihexanide (PHMB), 1 % povidone-iodine (PVP-I), 4 % hydrogen peroxide, or undiluted Ringer's solution were concurrently in use. From 1984-1996, only 0.04 % PHMB or 1 % PVP-I were applied. From 1997, 0.04 % PHMB was used until the end of the study period in 2005. RESULTS The combined rate for superficial and deep wound infection was 1.7 % in the 0.04 % PHMB group (n=3264), 4.8 % in the 1 % PVP-I group (n=2552), 5.9 % in the Ringer's group (n=645), and 11.7 % in the 4 % hydrogen peroxide group (n=643). Compared with all other treatment arms, PHMB showed the highest efficacy in preventing infection in traumatic soft tissue wounds (p<0.001). However, compared with PVP-I, the difference was only significant for superficial infections. CONCLUSION The large patient numbers in this study demonstrated a robust superiority of 0.04 % PHMB to prevent infection in traumatic soft tissue wounds. These retrospective results may further provide important information as the basis for power calculations for the urgently needed prospective clinical trials in the evolving field of wound antisepsis.
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Affiliation(s)
- B Roth
- Department for Surgery, Regional Hospital Belp, Switzerland
| | | | - F Brill
- Dr. Brill + Partner GmbH, Institute for Hygiene and Mikrobiologie, Hamburg, Germany
| | - F Wurmitzer
- Timaru Hospital, South Canterbury, DHB, New Zealand
| | - C Wegner
- University Medicine Greifswald, Institute of Hygiene and Environmental Medicine, Greifswald, Germany
| | - O Assadian
- Institute of Skin Integrity and Infection Prevention, School of Human & Health Sciences, University of Huddersfield, UK
| | - A Kramer
- University Medicine Greifswald, Institute of Hygiene and Environmental Medicine, Greifswald, Germany
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Hübner NO, Krafczyk-Korth J, Dittmann K, Klempien I, Poldrack R, Meinck K, Fleßa S, Kramer A, Hallauer JF. KOMPASS e.V. – MRE-Netzwerk Mecklenburg-Vorpommern. Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1602103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- NO Hübner
- Universitätsmedizin Greifswald, Institut für Hygiene und Umweltmedizin, Greifswald
| | - J Krafczyk-Korth
- Universitätsmedizin Greifswald, Institut für Hygiene und Umweltmedizin, Greifswald
| | - K Dittmann
- Universitätsmedizin Greifswald, Institut für Hygiene und Umweltmedizin, Greifswald
| | - I Klempien
- HELIOS Hanseklinikum Stralsund, Abteilung für Klinische Hygiene & Infektiologie, Stralsund
| | - R Poldrack
- Landesamt für Gesundheit und Soziales Mecklenburg-Vorpommern (LAGuS), Greifswald
| | - K Meinck
- IMD Labor Greifswald MVZ GmbH, Greifswald
| | - S Fleßa
- Ernst-Moritz-Arndt-Universität Greifswald, Lehrstuhl für Allgemeine Betriebswirtschaftslehre und Gesundheitsmanagement, Greifswald
| | - A Kramer
- Universitätsmedizin Greifswald, Institut für Hygiene und Umweltmedizin, Greifswald
| | - JF Hallauer
- Dietrich-Bonhoeffer-Klinikum, Neubrandenburg
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Willy C, Stichling M, Müller M, Gatzer R, Kramer A, Back DA, Vogt D. [Acute therapeutic measures for limb salvage Part 2 : Debridement, lavage techniques and anti-infectious strategies]. Unfallchirurg 2017; 119:388-99. [PMID: 27160730 DOI: 10.1007/s00113-016-0178-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The quality of the primary care of Gustilo-Anderson (GA) type IIIB and IIIC extremity injuries is crucial to the success of the limb salvage procedure. This article provides a compilation of consistent, but often controversially discussed aspects of initial debridement, modern techniques of lavage and wound closure, in addition to current issues on the application of antibiotics and antiseptics, based on our own experiences and the latest literature. The following points should be stressed. Severe extremity injuries with gross contamination (GA IIIA, B, and C) will still be associated with an infection rate of up to 60 %. The initial debridement should be performed as soon as an experienced trauma surgeon is available. Tissue that is definitely avital will have to be removed, whereas traumatized but potentially surviving tissue will have to be re-evaluated during a second-look operation after 36-48 h. Given a high enough level of contamination, biofilms will form after as few as 6 h. The perioperative antibiotic prophylaxis has to be initiated early and should be continued for at least 24 h (GA I/II) or up to 5 days (GA III). In cases of bacterial contamination, wound irrigation will be useful with additives such as polyhexanide, octenidine or superoxidized water. Rinsing of the wound should be performed with 3-9 L and only slight manual pressure (no jet lavage). The definitive primary closure of a wound should be achieved in the initial operation, but only in the case of certain "decontamination" and overall vitality of the wound (GA I and II). In the presence of high-grade injuries, a temporary vacuum sealing technique can be used until the earliest possible definitive plastic surgical wound closure.
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Affiliation(s)
- C Willy
- Abteilung Unfallchirurgie und Orthopädie, Septisch-Rekonstruktive Chirurgie, Forschungs- und Behandlungszentrum Rekonstruktion von Defektwunden, Exzellenz-Zentrum zur Versorgung von Verwundeten aus Kriegs- und Krisengebieten, Bundeswehrkrankenhaus Berlin, Scharnhorststr. 13, 10115, Berlin, Deutschland.
| | - M Stichling
- Sektion Gefäß- und Thoraxchirurgie der Abteilung Unfallchirurgie und Orthopädie, Septisch-Rekonstruktive Chirurgie, Bundeswehrkrankenhaus Berlin, Scharnhorststr. 13, 10115, Berlin, Deutschland
| | - M Müller
- Abteilung I/Laborgruppe Med. Mikrobiologie, Zentrales Institut des Sanitätsdienstes, der Bundeswehr Kiel/Berlin, Berlin, Deutschland
| | - R Gatzer
- Abteilung I/Laborgruppe Med. Mikrobiologie, Zentrales Institut des Sanitätsdienstes, der Bundeswehr Kiel/Berlin, Berlin, Deutschland
| | - A Kramer
- Institut für Hygiene und Umweltmedizin, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - D A Back
- Abteilung Allgemein- und Viszeralchirurgie, Bundeswehrkrankenhaus Berlin, Scharnhorststr. 13, 10115, Berlin, Deutschland
| | - D Vogt
- Abteilung Unfallchirurgie und Orthopädie, Septisch-Rekonstruktive Chirurgie, Forschungs- und Behandlungszentrum Rekonstruktion von Defektwunden, Exzellenz-Zentrum zur Versorgung von Verwundeten aus Kriegs- und Krisengebieten, Bundeswehrkrankenhaus Berlin, Scharnhorststr. 13, 10115, Berlin, Deutschland
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Kümmel J, Cronin NJ, Kramer A, Avela J, Gruber M. Conditioning hops increase triceps surae muscle force and Achilles tendon strain energy in the stretch-shortening cycle. Scand J Med Sci Sports 2017; 28:126-137. [PMID: 28263394 DOI: 10.1111/sms.12870] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 11/29/2022]
Abstract
Postactivation potentiation can improve athletic performance, but the underlying mechanisms are poorly understood. This study investigated the effect of conditioning hops on triceps surae muscle force and tendon strain and its contribution to potentiated stretch-shortening cycle (SSC) performance. Thirty-two subjects participated in two experiments. In both experiments, subjects performed three drop jumps (DJs) after prior conditioning with 10 maximal hops, three unconditioned DJs served as control. Ground reaction forces, kinematics, and triceps surae electromyographic activity were recorded. Ultrasound imaging was used to determine fascicle lengths (FASC) of the gastrocnemius (GM) and soleus muscles (experiment 1) and the length of the Achilles tendon (experiment 2) during the DJs. DJ height after the conditioning hops was significantly higher compared to control DJs (experiment 1: +12% and experiment 2: +19%). A significantly shorter GM FASC during the DJs performed after the conditioning hops coincided with an increased force acting on the triceps surae muscle. Moreover, the triceps surae muscle-tendon unit (MTU) showed increased energy absorption during the eccentric phase of the DJs and increased energy release during the concentric phase. The second experiment revealed a higher Achilles tendon strain in DJs performed after the conditioning hops compared to control DJs. No significant differences in muscle activities were observed. The shorter FASC in GM and the larger Achilles tendon strain facilitated MTU energy transfer from the eccentric to the concentric phase during the DJ. Thereby, conditioning hops improved SSC efficacy and DJ performance.
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Affiliation(s)
- J Kümmel
- Sensorimotor Performance Lab, Department of Sport Science, University of Konstanz, Konstanz, Germany
| | - N J Cronin
- Faculty of Sport and Health Sciences, NeuroMuscular Research Center, Unit of Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland
| | - A Kramer
- Sensorimotor Performance Lab, Department of Sport Science, University of Konstanz, Konstanz, Germany
| | - J Avela
- Faculty of Sport and Health Sciences, NeuroMuscular Research Center, Unit of Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland
| | - M Gruber
- Sensorimotor Performance Lab, Department of Sport Science, University of Konstanz, Konstanz, Germany
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Rob D, Špunda R, Lindner J, Šmalcová J, Šmíd O, Kovárník T, Linhart A, Bìlohlávek J, Marinoni MM, Cianchi G, Trapani S, Migliaccio ML, Gucci L, Bonizzoli M, Cramaro A, Cozzolino M, Valente S, Peris A, Grins E, Kort E, Weiland M, Shresta NM, Davidson P, Algotsson L, Fitch S, Marco G, Sturgill J, Lee S, Dickinson M, Boeve T, Khaghani A, Wilton P, Jovinge S, Ahmad AN, Loveridge R, Vlachos S, Patel S, Gelandt E, Morgan L, Butt S, Whitehorne M, Kakar V, Park C, Hayes M, Willars C, Hurst T, Best T, Vercueil A, Auzinger G, Adibelli B, Akovali N, Torgay A, Zeyneloglu P, Pirat A, Kayhan Z, Schmidbauer SS, Herlitz J, Karlsson T, Friberg H, Knafelj R, Radsel P, Duprez F, Bonus T, Cuvelier G, Mashayekhi S, Maka M, Ollieuz S, Reychler G, Mosaddegh R, Abbasi S, Talaee S, Zotzmann VZ, Staudacher DS, Wengenmayer TW, Dürschmied DD, Bode CB, Nelskylä A, Nurmi J, Jousi M, Schramko A, Mervaala E, Ristagno G, Skrifvars M, Ozsoy G, Kendirli T, Azapagasi E, Perk O, Gadirova U, Ozcinar E, Cakici M, Baran C, Durdu S, Uysalel A, Dogan M, Ramoglu M, Ucar T, Tutar E, Atalay S, Akar R, Kamps M, Leeuwerink G, Hofmeijer J, Hoiting O, Van der Hoeven J, Hoedemaekers C, Konkayev A, Kuklin V, Kondratyev T, Konkayeva M, Akhatov N, Sovershaev M, Tveita T, Dahl V, Wihersaari L, Skrifvars MB, Bendel S, Kaukonen KM, Vaahersalo J, Romppanen J, Pettilä V, Reinikainen M, Lybeck A, Cronberg T, Nielsen N, Friberg H, Rauber M, Steblovnik K, Jazbec A, Noc M, Kalasbail P, Garrett F, Kulstad E, Bergström DJ, Olsson HR, Schmidbauer S, Friberg H, Mandel I, Mikheev S, Podoxenov Y, Suhodolo I, Podoxenov A, Svirko J, Sementsov A, Maslov L, Shipulin V, Vammen LV, Rahbek SR, Secher NS, Povlsen JP, Jessen NJ, Løfgren BL, Granfeldt AG, Grossestreuer A, Perman S, Patel P, Ganley S, Portmann J, Cocchi M, Donnino M, Nassar Y, Fathy S, Gaber A, Mokhtar S, Chia YC, Lewis-Cuthbertson R, Mustafa K, Sabra A, Evans A, Bennett P, Eertmans W, Genbrugge C, Boer W, Dens J, De Deyne C, Jans F, Skorko A, Thomas M, Casadio M, Coppo A, Vargiolu A, Villa J, Rota M, Avalli L, Citerio G, Moon JB, Cho JH, Park CW, Ohk TG, Shin MC, Won MH, Papamichalis P, Zisopoulou V, Dardiotis E, Karagiannis S, Papadopoulos D, Zafeiridis T, Babalis D, Skoura A, Staikos I, Komnos A, Passos SS, Maeda F, Souza LS, Filho AA, Granjeia TAG, Schweller M, Franci D, De Carvalho Filho M, Santos TM, De Azevedo P, Wall R, Welters I, Tansuwannarat P, Sanguanwit P, Langer T, Carbonara M, Caccioppola A, Fusarini CF, Carlesso E, Paradiso E, Battistini M, Cattaneo E, Zadek F, Maiavacca R, Stocchetti N, Pesenti A, Ramos A, Acharta F, Toledo J, Perezlindo M, Lovesio L, Dogliotti A, Lovesio C, Schroten N, Van der Veen B, De Vries MC, Veenstra J, Abulhasan YB, Rachel S, Châtillon-Angle M, Alabdulraheem N, Schiller I, Dendukuri N, Angle M, Frenette C, Lahiri S, Schlick K, Mayer SA, Lyden P, Akatsuka M, Arakawa J, Yamakage M, Rubio J, Mateo-Sidron JAR, Sierra R, Celaya M, Benitez L, Alvarez-Ossorio S, Rubio J, Mateo-Sidron JAR, Sierra R, Fernandez A, Gonzalez O, Engquist H, Rostami E, Enblad P, Toledo J, Ramos A, Acharta F, Canullo L, Nallino J, Dogliotti A, Lovesio C, Perreault M, Talic J, Frenette AJ, Burry L, Bernard F, Williamson DR, Adukauskiene D, Cyziute J, Adukauskaite A, Malciene L, Luca L, Rogobete A, Bedreag O, Papurica M, Sarandan M, Cradigati C, Popovici S, Vernic C, Sandesc D, Avakov V, Shakhova I, Trimmel H, Majdan M, Herzer GH, Sokoloff CS, Albert M, Williamson D, Odier C, Giguère J, Charbonney E, Bernard F, Husti Z, Kaptás T, Fülep Z, Gaál Z, Tusa M, Donnelly J, Aries M, Czosnyka M, Robba C, Liu M, Ercole A, Menon D, Hutchinson P, Smielewski P, López R, Graf J, Montes JM, Kenawi M, Kandil A, Husein K, Samir A, Heijneman J, Huijben J, Abid-Ali F, Stolk M, Van Bommel J, Lingsma H, Van der Jagt M, Cihlar RC, Mancino G, Bertini P, Forfori F, Guarracino F, Pavelescu D, Grintescu I, Mirea L, Alamri S, Tharwat M, Kono N, Okamoto H, Uchino H, Ikegami T, Fukuoka T, Simoes M, Trigo E, Coutinho P, Pimentel J, Franci A, Basagni D, Boddi M, Cozzolino M, Anichini V, Cecchi A, Peris A, Markopoulou D, Venetsanou K, Papanikolaou I, Barkouri T, Chroni D, Alamanos I, Cingolani E, Bocci MG, Pisapia L, Tersali A, Cutuli SL, Fiore V, Palma A, Nardi G, Antonelli M, Coke R, Kwong A, Dwivedi DJ, Xu M, McDonald E, Marshall JC, Fox-Robichaud AE, Charbonney E, Liaw PC, Kuchynska I, Malysh IR, Zgrzheblovska LV, Mestdagh L, Verhoeven EF, Hubloue I, Ruel-laliberte J, Zarychanski R, Lauzier F, Bonaventure PL, Green R, Griesdale D, Fowler R, Kramer A, Zygun D, Walsh T, Stanworth S, Léger C, Turgeon AF, Baron DM, Baron-Stefaniak J, Leitner GC, Ullrich R, Tarabrin O, Mazurenko A, Potapchuk Y, Sazhyn D, Tarabrin P, Tarabrin O, Mazurenko A, Potapchuk Y, Sazhyn D, Tarabrin P, Pérez AG, Silva J, Artemenko V, Bugaev A, Tokar I, Konashevskaya S, Kolesnikova IM, Roitman EV, Kiss TR, Máthé Z, Piros L, Dinya E, Tihanyi E, Smudla A, Fazakas J, Ubbink R, Boekhorst te P, Mik E, Caneva L, Ticozzelli G, Pirrelli S, Passador D, Riccardi F, Ferrari F, Roldi EM, Di Matteo M, Bianchi I, Iotti GA, Zurauskaite G, Voegeli A, Meier M, Koch D, Haubitz S, Kutz A, Bargetzi M, Mueller B, Schuetz P, Von Meijenfeldt G, Van der Laan M, Zeebregts C, Christopher KB, Vernikos P, Melissopoulou T, Kanellopoulou G, Panoutsopoulou M, Xanthis D, Kolovou K, Kypraiou T, Floros J, Broady H, Pritchett C, Marshman M, Jannaway N, Ralph C, Lehane CL, Keyl CK, Zimmer EZ, Trenk DT, Ducloy-Bouthors AS, Jonard MJ, Fourrier F, Piza F, Correa T, Marra A, Guerra J, Rodrigues R, Vilarinho A, Aranda V, Shiramizo S, Lima MR, Kallas E, Cavalcanti AB, Donoso M, Vargas P, Graf J, McCartney J, Ramsay S, McDowall K, Novitzky-Basso I, Wright C, Medic MG, Bielen L, Radonic V, Zlopasa O, Vrdoljak NG, Gasparovic V, Radonic R, Narváez G, Cabestrero D, Rey L, Aroca M, Gallego S, Higuera J, De Pablo R, González LR, Chávez GN, Lucas JH, Alonso DC, Ruiz MA, Valarezo LJ, De Pablo Sánchez R, Real AQ, Wigmore TW, Bendavid I, Cohen J, Avisar I, Serov I, Kagan I, Singer P, Hanison J, Mirza U, Conway D, Takasu A, Tanaka H, Otani N, Ohde S, Ishimatsu S, Coffey F, Dissmann P, Mirza K, Lomax M, Dissmann P, Coffey F, Mirza K, Lomax M, Miner JR, Leto R, Markota AM, Gradišek PG, Aleksejev VA, Sinkovič AS, Romagnoli S, Chelazzi C, Zagli G, Benvenuti F, Mancinelli P, Boninsegni P, Paparella L, Bos AT, Thomas O, Goslar T, Knafelj R, Perreault M, Martone A, Sandu PR, Rosu VA, Capilnean A, Murgoi P, Frenette AJ, Lecavalier A, Jayaraman D, Rico P, Bellemare P, Gelinas C, Williamson D, Nishida T, Kinoshita T, Iwata N, Yamakawa K, Fujimi S, Maggi L, Sposato F, Citterio G, Bonarrigo C, Rocco M, Zani V, De Blasi RA, Alcorn D, Barry L, Riedijk MA, Milstein DM, Caldas J, Panerai R, Camara L, Ferreira G, Bor-Seng-Shu E, Lima M, Galas F, Mian N, Nogueira R, de Oliveira GQ, Almeida J, Jardim J, Robinson TG, Gaioto F, Hajjar LA, Zabolotskikh I, Musaeva T, Saasouh W, Freeman J, Turan A, Saseedharan S, Pathrose E, Poojary S, Messika J, Martin Y, Maquigneau N, Henry-Lagarrigue M, Puechberty C, Stoclin A, Martin-Lefevre L, Blot F, Dreyfuss D, Dechanet A, Hajage D, Ricard J, Almeida E, Almeida J, Landoni G, Galas F, Fukushima J, Fominskiy E, De Brito C, Cavichio L, Almeida L, Ribeiro U, Osawa E, Boltes R, Battistella L, Hajjar L, Fontela P, Lisboa T, Junior LF, Friedman GF, Abruzzi F, Primo JAP, Filho PM, de Andrade JS, Brenner KM, boeira MS, Leães C, Rodrigues C, Vessozi A, Machado AS, Weiler M, Bryce H, Hudson A, Law T, Reece-Anthony R, Molokhia A, Abtahinezhadmoghaddam F, Cumber E, Channon L, Wong A, Groome R, Gearon D, Varley J, Wilson A, Reading J, Wong A, Zampieri FG, Bozza FA, Ferez M, Fernandes H, Japiassú A, Verdeal J, Carvalho AC, Knibel M, Salluh JI, Soares M, Gao J, Ahmadnia E, Patel B, McCartney J, MacKay A, Binning S, Wright C, Pugh RJ, Battle C, Hancock C, Harrison W, Szakmany T, Mulders F, Vandenbrande J, Dubois J, Stessel B, Siborgs K, Ramaekers D, Soares M, Silva UV, Homena WS, Fernandes GC, Moraes AP, Brauer L, Lima MF, De Marco F, Bozza FA, Salluh JI, Maric N, Mackovic M, Udiljak N, Bosso CE, Caetano RD, Cardoso AP, Souza OA, Pena R, Mescolotte MM, Souza IA, Mescolotte GM, Bangalore H, Borrows E, Barnes D, Ferreira V, Azevedo L, Alencar G, Andrade A, Bierrenbach A, Buoninsegni LT, Bonizzoli M, Cecci L, Cozzolino M, Peris A, Lindskog J, Rowland K, Sturgess P, Ankuli A, Molokhia A, Rosa R, Tonietto T, Ascoli A, Madeira L, Rutzen W, Falavigna M, Robinson C, Salluh J, Cavalcanti A, Azevedo L, Cremonese R, Da Silva D, Dornelles A, Skrobik Y, Teles J, Ribeiro T, Eugênio C, Teixeira C, Zarei M, Hashemizadeh H, Eriksson M, Strandberg G, Lipcsey M, Larsson A, Lignos M, Crissanthopoulou E, Flevari K, Dimopoulos P, Armaganidis A, Golub JG, Markota AM, Stožer AS, Sinkovič AS, Rüddel H, Ehrlich C, Burghold CM, Hohenstein C, Winning J, Sellami W, Hajjej Z, Bousselmi M, Gharsallah H, Labbene I, Ferjani M, Sattler J, Steinbrunner D, Poppert H, Schneider G, Blobner M, Kanz KG, Schaller SJ, Apap K, Xuereb G, Xuereb G, Apap K, Massa L, Xuereb G, Apap K, Massa L, Delvau N, Penaloza A, Liistro G, Thys F, Delattre IK, Hantson P, Roy PM, Gianello P, Hadîrcă L, Ghidirimschi A, Catanoi N, Scurtov N, Bagrinovschi M, Sohn YS, Cho YC, Golovin B, Creciun O, Ghidirimschi A, Bagrinovschi M, Tabbara R, Whitgift JZ, Ishimaru A, Yaguchi A, Akiduki N, Namiki M, Takeda M, Tamminen JN, Reinikainen M, Uusaro A, Taylor CG, Mills ED, Mackay AD, Ponzoni C, Rabello R, Serpa A, Assunção M, Pardini A, Shettino G, Corrêa T, Vidal-Cortés PV, Álvarez-Rocha L, Fernández-Ugidos P, Virgós-Pedreira A, Pérez-Veloso MA, Suárez-Paul IM, Del Río-Carbajo L, Fernández SP, Castro-Iglesias A, Butt A, Alghabban AA, Khurshid SK, Ali ZA, Nizami IN, Salahuddin NS, Alshahrani M, Alsubaie AW, Alshamsy AS, Alkhiliwi BA, Alshammari HK, Alshammari MB, Telmesani NK, Alshammari RB, Asonto LP, Zampieri FG, Damiani LP, Bozza F, Salluh JI, Cavalcanti AB, El Khattate A, Bizrane M, Madani N, Belayachi J, Abouqal R, Ramnarain D, Gouw-Donders B, Benstoem C, Moza A, Meybohm P, Stoppe C, Autschbach R, Devane D, Goetzenich A, Taniguchi LU, Araujo L, Salgado G, Vieira JM, Viana J, Ziviani N, Pessach I, Lipsky A, Nimrod A, O´Connor M, Matot I, Segal E, Kluzik A, Gradys A, Smuszkiewicz P, Trojanowska I, Cybulski M, De Jong A, Sebbane M, Chanques G, Jaber S, Rosa R, Robinson C, Bessel M, Cavalheiro L, Madeira L, Rutzen W, Oliveira R, Maccari J, Falavigna M, Sanchez E, Dutra F, Dietrich C, Balzano P, Rezende J, Teixeira C, Sinha S, Majhi K, Gorlicki JG, Pousset FP, Kelly J, Aron J, Gilbert AC, Urankar NP, Knafelj R, Irazabal M, Bosque M, Manciño J, Kotsopoulos A, Jansen N, Abdo W, Casey ÚM, O’Brien B, Plant R, Doyle B. 37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3). Crit Care 2017. [PMCID: PMC5374552 DOI: 10.1186/s13054-017-1630-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Weiss M, Daeschlein G, Kramer A, Burchardt M, Brucker S, Wallwiener D, Stope MB. Virucide properties of cold atmospheric plasma for future clinical applications. J Med Virol 2017; 89:952-959. [DOI: 10.1002/jmv.24701] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2016] [Indexed: 12/30/2022]
Affiliation(s)
- M. Weiss
- Department of Gynecology and Obstetrics; University Medicine Tübingen; Tübingen Germany
- Department of Urology; University Medicine Greifswald; Greifswald Germany
| | - G. Daeschlein
- Department of Dermatology; University Medicine Greifswald; Greifswald Germany
| | - A. Kramer
- Department of Hygiene and Environmental Medicine; University Medicine Greifswald; Greifswald Germany
| | - M. Burchardt
- Department of Urology; University Medicine Greifswald; Greifswald Germany
| | - S. Brucker
- Department of Gynecology and Obstetrics; University Medicine Tübingen; Tübingen Germany
| | - D. Wallwiener
- Department of Gynecology and Obstetrics; University Medicine Tübingen; Tübingen Germany
| | - M. B. Stope
- Department of Urology; University Medicine Greifswald; Greifswald Germany
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Kampf G, Kramer A, Suchomel M. Lack of sustained efficacy for alcohol-based surgical hand rubs containing ‘residual active ingredients’ according to EN 12791. J Hosp Infect 2017; 95:163-168. [DOI: 10.1016/j.jhin.2016.11.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022]
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Kümmel J, Kramer A, Cronin NJ, Gruber M. Postactivation potentiation can counteract declines in force and power that occur after stretching. Scand J Med Sci Sports 2016; 27:1750-1760. [PMID: 27935646 DOI: 10.1111/sms.12817] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2016] [Indexed: 11/30/2022]
Abstract
Stretching can decrease a muscle's maximal force, whereas short but intense muscle contractions can increase it. We hypothesized that when combined, postactivation potentiation induced by reactive jumps would counteract stretch-induced decrements in drop jump (DJ) performance. Moreover, we measured changes in muscle twitch forces and ankle joint stiffness (KAnkle ) to examine underlying mechanisms. Twenty subjects completed three DJs and 10 electrically evoked muscle twitches of the triceps surae subsequent to four different conditioning activities and control. The conditioning activities were 10 hops, 20s of static stretching of the triceps surae muscle, 20s of stretching followed by 10 hops, and vice versa. After 10 hops, twitch peak torque (TPT) was 20% and jump height 5% higher compared with control with no differences in KAnkle . After stretching, TPT and jump height were both 9% and KAnkle 6% lower. When hops and stretching were combined as conditioning activities, jump height was not different compared with control but significantly higher (11% and 8%) compared with stretching. TPTs were 16% higher compared with control when the hops were performed after stretching and 9% higher compared with the reverse order. KAnkle was significantly lower when stretching was performed after the hops (6%) compared with control, but no significant difference was observed when hops were performed after stretching. These results demonstrate that conditioning hops can counteract stretch-related declines in DJ performance. Furthermore, the differences in TPTs and KAnkle between combined conditioning protocols indicate that the order of conditioning tasks might play an important role at the muscle-tendon level.
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Affiliation(s)
- J Kümmel
- Sensorimotor Performance Lab, Department of Sport Science, University of Konstanz, Konstanz, Germany
| | - A Kramer
- Sensorimotor Performance Lab, Department of Sport Science, University of Konstanz, Konstanz, Germany
| | - N J Cronin
- Neuromuscular Research Center, Department of Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland
| | - M Gruber
- Sensorimotor Performance Lab, Department of Sport Science, University of Konstanz, Konstanz, Germany
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