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Background Consenting patients for trauma procedures following hip fracture is a key stage in the treatment pathway from admission to the operating theatre. Errors in this process can result in delayed procedures which may negatively impact patient recovery. The aim of this project was to identify and reduce errors in our consenting process for patients with capacity. Methods Consent forms for all adult patients with capacity admitted for surgical repair of traumatic hip fracture were reviewed over a 4-week period. The baseline measurement (n = 24), identified errors in three key process measures: clarity of documentation, failure to record procedure-specific risks and not offering a copy of the consent form to the patient. Pre-printed stickers and targeted teaching were then introduced as quality improvement measures. Their impact was evaluated over subsequent 4-week review of the same patient demographic, with further refinement of these interventions being carried out and re-evaluated for a final cycle. Results Cycle 1 (n = 26) following targeted teaching demonstrated a reduction in abbreviations from 38 to 20%, while doubling the documentation of discussion of procedure-specific risks from 31 to 72%. More patients were offered a copy of their consent form, rising from 12 to 48%. Cycle 2 (n = 24) saw the introduction of pre-printed “risk of procedure” stickers. Although clarity measures continued to improve, quality of pre-procedure risk documentation remained static while the number of forms being offered to patients fell to 8%. Conclusions Our project would suggest that while pre-printed stickers can be useful memory aids, specific teaching on consenting produces the greatest benefit. The usage of such tools should therefore be limited, as adjuncts only to specific training.

International audience; The detection of Salmonella spp. in food samples is regulated by the ISO 6579:2002 standard, which requires that precise procedures are followed to ensure the reliability of the detection process. This standard requires buffered peptone water as a rich medium for the enrichment of bacteria. However, the effects of different brands of buffered peptone water on the identification of microorganisms by Raman spectroscopy are unknown. In this regard, our study evaluated the discrimination between two bacterial species, Salmonella enterica and Escherichia coli, inoculated and analyzed with six of the most commonly used buffered peptone water brands. The results showed that bacterial cells behaved differently according to the brand used in terms of biomass production and the spectral fingerprint. The identification accuracy of the analyzed strains was between 85% and 100% depending on the given brand. Several batches of two brands were studied to evaluate the classification rates between the analyzed bacterial species. The chemical analysis performed on these brands showed that the nutrient content was slightly different and probably explained the observed effects. On the basis of these results, Raman spectroscopy operators are encouraged to select an adequate culture medium and continue its use throughout the identification process to guarantee optimal recognition of the microorganism of interest.

Background In low-resource settings, the awareness level of colorectal cancer (CRC) signs and symptoms plays a crucial role in early detection and treatment. This study examined the public awareness level of CRC signs and symptoms in Palestine and investigated the factors associated with good awareness. Methods This was a national cross-sectional study conducted at hospitals, primary healthcare centers, and public spaces in 11 governorates across Palestine between July 2019 and March 2020. A translated-into-Arabic version of the validated bowel cancer awareness measure (BoCAM) was utilized to assess the awareness level of CRC signs and symptoms. For each correctly identified CRC sign/symptom, one point was given. The total score (ranging from 0 to 12) was calculated and categorized into three categories based on the number of symptoms recognized: poor (0 to 4), fair (5 to 8), and good awareness (9 to 12). Results Of 5254 approached, 4877 participants completed the questionnaire (response rate = 92.3%). A total of 4623 questionnaires were included in the analysis; 1923 were from the Gaza Strip and 2700 from the West Bank and Jerusalem (WBJ). Participants from the Gaza Strip were younger, gained lower monthly income, and had less chronic diseases than participants in the WBJ. The most frequently identified CRC sign/symptom was ‘lump in the abdomen’ while the least was ‘pain in the back passage’. Only 1849 participants (40.0%, 95% CI: 39.0%-41.0%) had a good awareness level of CRC signs/symptoms. Participants living in the WBJ were more likely to have good awareness than participants living in the Gaza Strip (42.2% vs. 37.0%; p = 0.002). Knowing someone with cancer (OR = 1.37, 95% CI: 1.21–1.55; p p p = 0.006) and following a vegetarian diet (OR = 0.59, 95% CI: 0.48–0.73; p Conclusion Less than half of the study participants had a good awareness level of CRC signs and symptoms. Future education interventions are needed to improve public awareness of CRC in Palestine.

Food waste is one of the main problems contributing to climate change, as its piling up in landfills produces the greenhouse gas methane. Food waste occurs at every stage of food production; however, a major source of food waste occurs at businesses that supply food to consumers. Industry 4.0 technologies have shown promise in helping to reduce food waste in food supply chains. However, more innovative technologies, such as Raman spectroscopy, hold great promise in helping to reduce food waste, although this has largely been ignored in the literature. In this context, we propose a portable Raman platform to monitor food quality during transportation. The developed system was tested in conditions mimicking those present in a refrigerated truck by analyzing chicken samples stored at temperatures of 4 °C. Raman spectra were acquired for non-packaged and packaged samples over the duration of 30 days resulting in 6000 spectra. The analysis of Raman spectra revealed that the system was able to detect noticeable changes in chicken quality starting on day six. The main Raman bands contributing to this change are amide I and tyrosine. The proposed system will offer the potential to reduce food losses during transportation by consistently checking the food quality over time.

Characterizing waste ecotoxicity is labourious because of both the undefined nature of environmental samples and the diversity of contaminants that can be present. With regard to these limitations, traditional approaches do not provide information about the nature of the pollution encountered. To improve such assessments, a fluorescent library of 1,870 transcriptomic reporters from E. coli K12 MG1655 was used to report the ecotoxic status of environmental samples. The reliability of the approach was evaluated with 6 metallic pollutants (As, Cu, Cd, Hg, Pb, Zn) used alone and in mixture in pure and complex matrices. A total of 18 synthetic samples were used to characterize the specificity of the resulting metallic contamination fingerprints. Metallic contamination impacted 4.5 to 10.2% of the whole transcriptomic fingerprint of E. coli. The analysis revealed that a subset of 175 transcriptomic reporters is sufficient to characterize metallic contamination, regardless of the nature of the sample. A statistical model distinguished patterns due to metallic contamination and provided information about the level of toxicity with 93–98% confidence. The use of the transcriptomic assessment was validated for 17 complex matrices with various toxicities and metal contaminants, such as activated sludge, wastewater effluent, soil, wood and river water. The presence of metals and their associated toxicity, which seems linked to their bioavailabilities, were thereby determined. This method constitutes a possible tool to screen unknown complex samples for their metallic status and identify those for which a deeper characterization must be achieved by the use of traditional biosensors and analytical methods.

Brachial plexus injuries usually result in significant upper limb disabilities and shoulder joint instability. Primary nerve reconstruction procedures are more effective if performed within six months from the injury. Secondary procedures, including muscle transfers, are usually indicated for delayed presentation (>6 months) or when the outcomes of primary procedures are unsatisfactory. A comprehensive systematic search of the MEDLINE, EMBASE, AMED, PubMed, and Cochrane databases was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data, including demographic information, time to surgery, the extent of brachial plexus injury, surgical techniques, follow-up duration, and functional outcomes were collected and tabulated. Meta-analysis was conducted using Review Manager (RevMan) 5.4 software ([Computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014). Seven studies were eligible to be included in this review, with a total of 218 patients. The average patient age was 28.39 ± 3 years, with a mean time to surgery of 29.87 ± 18 months. Forty-six (46) patients (21.10%) were treated as delayed presentation and 172 patients (78.89%) had muscle transfer performed as a secondary procedure. The mean time at follow-up was 18.86 ± 13.5 months. Upper trapezius muscle transfer was the most common transferred muscle (100%) either in isolation (n=159, 72.93%) or in combination with lower trapezius transfer (n=59, 27.06%). The mean preoperative and postoperative shoulder abduction were 12.22 ± 10.09 degrees and 58.36 ± 32.33 degrees, respectively (p < 0.05). Meta-analysis shows a statistically significant difference (CI at 95%, p

Background Hip fractures are a common acute trauma presentation that if requiring surgery, should be performed within 48 hours. Consenting the patient is an important element of the pathway from admission to operating theatre and errors can lead to delayed procedures, medico-legal exposure and may represent a loss of patient autonomy. The aim of this project was to evaluate areas for improvement in our consenting process for patients with capacity and trial new strategies to determine which achieved the greatest improvement. Methods Following a baseline measurement (n=24), deficiencies were noted in three key process measures of clarity of documentation, failure to record procedure-specific risks and not offering a copy of the consent form to the patient. Two quality improvement cycles then followed using targeted teaching for doctors performing the consenting process. Results Cycle 1 (n=26) following targeted teaching demonstrated improved clarity, with a reduction in abbreviations from 38% to 20%, while more than doubling the documentation of discussion of key procedure-specific risks from 31% to 72%. More patients were offered a copy of their consent form, rising from 12% to 48%. Cycle 2 (n=24) saw the introduction of pre-printed “risk of procedure” stickers. Although clarity measures continued to improve, improvements in pre-procedure risk documentation remained broadly static while the number of forms being offered to patients starkly declined to 8%. Conclusions Our project would suggest that while pre-printed stickers can be useful memory aids, specific teaching on consenting produces the greatest benefit. The usage of such tools should therefore be limited, as adjuncts only to detailed training.

The aim of the present study was to evaluate Raman spectroscopy in determining changes that occur in the structure of gluten proteins induced during bread dough mixing. Raman spectra were measured directly within the dough. Three particular phases of mixing were studied: under-mixing, optimum mixing and over-mixing. A thiol blocking reagent, Tris(2-carboxyethyl)phosphine (TCEP) was then used to reduce disulphide bonds within proteins to confirm the important role of disulphide bridges in gluten network formation. For the control dough, the most important changes occurred during the optimum mixing phase when an increase in intermolecular disulphide bonds, anti-parallel β-sheet and α-helix structures was observed, combined with the hydrophobic burial of tryptophan and tyrosine residues. The addition of TCEP appeared to effectively reduce the formation of intermolecular disulphide bonds, anti-parallel β-sheet and α-helix structures and lead to a more disordered secondary protein structure.

Microalgal bioprocesses are increasing in multiple industrial sectors for production at large scales. Nevertheless, classical sensors are still used but are not adapted for production monitoring, leading to monoparametric, invasive and time-consuming solutions. Future approaches should eliminate those weaknesses and take advantage of optical methods to optimize the monitoring. This work is focussed on the concrete application of Raman spectroscopy to characterize the physiological kinetics of a microalgal process. The monitoring of Chlamydomonas reinhardtii growth in photobioreactors led us to build its specific Raman spectral database. The complex Raman signatures acquired showed 35 reproducible bands for each day of growth, corresponding to the spectral fingerprints of the cell metabolites, such as chlorophyll a , beta-carotene, nucleic acids and lipids. In total, 2688 spectra were compiled in a database representing the cellular chemical fingerprints in three physiological stages and showed progressive variations between the days of acquisition. New data acquisitions allowed us to build a trial for blind validation and to characterize the bioprocesses with 89.2% accuracy. To complete the study, transcriptomic experiments following the transcript expression of two different metabolic pathways of the microalgae confirmed the cell physiology attributions made by the Raman spectroscopy. This work enables us to query the bioprocess status directly from the cells by attributing a spectrum to the current cell physiology.

International audience; New methods for pathogens identification are of growing interest in clinical and food sectors. The challenge remains to develop rapid methods that are more simple, reliable, and specific. Surface-enhanced Raman spectroscopy (SERS) appears to be a promising tool to compete with current untargeted identification methods. This article presents the intensive research devoted to the use of SERS for bacterial identification, from the first to the very recent published results. Compared to normal Raman spectroscopy, the introduction of nanoparticles for SERS acquisition introduces a new degree of complexity. Bacterial Raman fingerprints, which are already subject to high spectral variability for a given strain, become then very dependent on numerous experimental parameters. To overcome these limitations, several approaches have been proposed to prepare the sample, from the microbiological culture conditions to the analysis of the spectrum including the coupling of nanoparticles on the bacterial membrane. Main strategies proposed over the last 20 years are examined here and discussed in the perspective of a protocol transfer towards industry.

There has been a shift from cemented to uncemented hip arthroplasty. One popular uncemented combination is the R3 acetabular cup with Polarstem, having the lowest revision rate in the UK National Joint Registry. However, there are no medium-term clinical outcomes on this combination in the literature. The aim of this study is to review our centre’s outcomes with this combination using conventional bearings with a minimum of 7-year follow-up. Using our centre’s arthroplasty database, we identified all patients that underwent a total hip arthroplasty using these implants from August 2009 to December 2010. One hundred and forty-four procedures were performed. The primary outcome was revision rate, and the secondary outcomes were clinical and radiological evaluation. The mean cohort age at surgery was 68.3 years. There were three revisions, of which only one underwent a cup revision. The mean Oxford Hip Score at 7-year follow-up was 38. Radiological evaluation of both acetabular and stem component did not show any radiolucency at 7-year follow-up. Kaplan–Meier survivorship analysis showed an implant survival rate of 97.69% at 7 years using revision for all causes as endpoint. The risk of revision was 1.47% at 7 years. Our revision rates are comparable to the UK’s National Joint Registry, with excellent clinical and radiological outcome. Our results correlate with the allocated rating of 7A* by the Orthopaedic Data Evaluation Panel for both R3 acetabular cup and Polarstem.

An egg product is a complex matrix, mainly composed of water, proteins and lipids. It also contains carbohydrates, vitamins, minerals and many other compounds in varying concentrations. This chemical complexity makes it difficult to analyze, and most of the protocols are mainly concerned with the albumen and vitellus fractions, aside from the whole egg product. The hygienic quality and freshness of eggs can be assessed according to physico-chemical or microbiological criteria, imposed by the regulations in force. The state provides procedures and recommendations for the production and marketing of such products. Criteria and procedures vary from region to region, for example European legislation forbids the breaking of eggs by centrifugation for eggs intended for the food industry whereas American legislation allows the possibility of breaking eggs by centrifugation if they are clean, disinfected and intact and if they ultimately undergo heat treatment (baking etc.). In addition to the procedures and recommendations concerning the production process, the hygienic quality of egg products is ensured by controlling the physico-chemical and microbiological quality of the raw materials used and the finished products. European legislation thus provides maximum levels for certain compounds such as lactic acid or succinic acid at different points in the production chain.

The previous chapter focused on illustrating the potential of the latest analytical equipment to discover markers or groups of markers that are characteristic of LE spoilage. Depending on the resolving power of this chemotyping equipment, these markers would be either in the form of single molecules (in the case of high or low resolution spectrometers such as NMR or MS often coupled with chromatography), or in the form of groups of these same molecules, all of which are then identified unambiguously (NMR-HR and MS-HR, often coupled with chromatography), or in the form of a chemical signature reflecting the contribution of large chemical groups present in the sample (FTIR, NIRS, Raman).

Bioreporters are widespread in the ecotoxicological field, and they are used in concert with a range of physico-chemical methods for environmental characterization. These biological methods allow the assessment of other parameters that are not otherwise accessible. Among the broad diversity of available bioreporters, bacterial approaches are particularly interesting for their simple implementation, low cost and timeliness of their response (because of their metabolic kinetics and their growth rate). In this chapter, we are interested in the primary proposed strategies from one initial assumption: the use of one bioreporter to test one parameter. This strategy rapidly reached its limits (for lack of specificity or representativity), thus opening the way for other biological approaches that were more reliable but also more complex (implemented technology and data treatment).

A novel selective synthesis of the unsymmetrically substituted tetrathiafulvalene dimethyltrimethylene-tetrathiafulvalene (DMtTTF) is described together with its electrocrystallization to the known conducting mixed-valence ClO4– and ReO4– salts. Infrared (IR) and Raman spectra of the two isostructural quasi-one-dimensional cation radical salts (DMtTTF)2X (X = ReO4–, ClO4–) are investigated as a function of temperature (T = 5–300 K). At ambient temperature, these salts show metallic-like properties and below Tρ = 100–150 K, they undergo a smeared transition to semiconducting state. To study this charge localization, we measured temperature dependence of polarized IR reflectance spectra (700–16 000 cm–1) and Raman spectra (150–3500 cm–1, excitation λ = 632.8 nm) of single crystals. For both compounds, the Raman data and especially the bands related to the C=C stretching vibration of the DMtTTF molecule show that the charge distribution on molecules is uniform down to the lowest temperatures. Similarly, IR data confirm that down to the lowest temperatures, there is neither charge ordering nor important modification of the electronic structure. However, the temperature dependence of Raman spectra of both salts reveals a regime change at about 150 K. Additionally, using Density Functional Theory (DFT) methods, the normal vibrational modes of the neutral DMtTTF0 and cationic DMtTTF+ species and also their theoretical IR and Raman spectra were calculated. The theoretical data were compared with the experimental IR and Raman spectra of neutral DMtTTF0 molecule. Copyright © 2013 John Wiley & Sons, Ltd.

International audience

International audience; Defining a theory, such as arithmetic, geometry, or set theory, in predicate logic just requires to chose function and predicate symbols and axioms, that express the meaning of these symbols. Using, this way, a single logical framework, to define all these theories, has many advantages. First, it requires less efforts, as the logical connectives, ∧, ∨, ∀... and their associated deduction rules are defined once and for all, in the framework and need not be redefined for each theory. Similarly, the notions of proof, model... are defined once and for all. And general theorems, such as the soundness and the completeness theorems, can be proved once and for all. Another advantage of using such a logical framework is that this induces a partial order between theories. For instance, Zermelo-Fraenkel set theory with the axiom of choice (ZFC) is an extension of Zermelo-Fraenkel set theory (ZF), as it contains the same axioms, plus the axiom of choice. It is thus obvious that any theorem of ZF is provable in ZFC, and for each theorem of ZFC, we can ask the question of its provability in ZF. Several theorems of ZFC, that are provable in ZF have been identified, and these theorems can be used in extensions of ZF that are inconsistent with the axiom of choice. Finally, using such a common framework permits to combine, in a proof, lemmas proved in different theories: if T is a theory expressed in a language L and T a theory expressed in a language L , if A is expressed in L ∩ L , A ⇒ B is provable in T , and A is provable in T , then B is provable in T ∪ T. Despite these advantages, several logical systems have been defined, not as theories in predicate logic, but as independent systems: Simple type theory, also known as Higher-order logic, is defined as an independent system—although it is also possible to express it as a theory in predicate logic. Similarly, Intuitionistic type theory, the Calculus of constructions, the Calculus of inductive constructions... are defined as independent systems. As a consequence, it is difficult to reuse a formal proof developed in an automated or interactive theorem prover based on one of these formalisms in another, without redeveloping it. It is also difficult to combine lemmas proved in different systems: the realm of formal proofs is today a tower of Babel, just like the realm of theories was, before the design of predicate logic. The reason why these formalisms have not been defined as theories in predicate logic is that predicate logic, as a logical framework, has several limitations, that make it difficult to express modern logical systems.

International audience; The scratch test was used to determine the coating-substrate adhesion of d.c. magnetron-sputtered films on substrates. Several systems are discussed, including Cu, Al, AlN/XC70 steel; Cu, Au/Al2O3; and Cu/Ni. Furthermore, the following effects of deposition conditions on adhesion are also discussed: the effect of heating the sample during or after deposition; the effect of applying a bias voltage on the substrate during deposition; the effect of ion bombardment etching of the substrate surface; the effect of ageing treatment after deposition; the effect of chemical etching treatment before deposition. The scratch track was observed by scanning electron microscopy (SEM), and some energy-dispersive X-ray spectra were recorded to reveal whether the coating was completely removed from its substrate or not. The adhesion failure probability was estimated for each load (Q) by optically inspecting the channels. A correlation between the thermal contact resistance and the adhesion, as determined by the scratch test, is found. To understand the origin of the mean critical load and interface evolution, observations were made using SEM, Auger electron spectroscopy (AES) and X-ray photoelectron spectroscopy (XPS). The results show that the structural change of the film and formation of a complex interface appear to be the main reasons for interface evolution. In most cases, the widening of the interfacial region offers a better film anchorage to its substrate, which requires a notably high stylus load to produce an adhesion failure.

Evaluation de la toxicité de l’arsenic par spectroscopie Raman et analyse en composantes indépendantes (ICA) : vers un nouveau biocapteur

Halide salts of the unsymmetrically substituted o-DMTTF, formulated as (o-DMTTF)2X, X¼Cl, Br, I, are organized into uniform chains in a tetragonal structure with space group I-42d, providing a rare example of non-dimerized 3/4 filled system. Solid solutions formulated as (o-DMTTF)(Br)x(Cl)1-x and (o-DMTTF)2(Br)x(I)1-x have been prepared and structurally characterized. A systematic preferential bromide insertion is observed together with a lateral expansion of the structure with increasing anion size.

This paper presents a detailed study of a unique groundstone (henceforth-stone) tool — the flaked stone disc. The study presents the result of an attribute analysis conducted on 703 flaked discs found in stratified contexts during excavations and as surface finds, all from sites in northern Israel. The discs are described in detail and some provisional suggestions regarding their function are discussed., Cette étude détaillée présente un outil de pierre particulier : le disque retouché. L’analyse porte sur 703 disques retouchés, provenant aussi bien de contextes stratifiés que de ramassages de surface, tous les sites étant situés dans le nord d’Israël. Ces artefacts sont décrits en détail et des suggestions relatives à leur fonction sont discutées., Rosenberg Danny, Assaf Ali Abou, Getzov Nimrod, Gopher Avi. Flaked Stone Discs of the Neolithic and Chalcolithic Periods in the Southern Levant. In: Paléorient, 2008, vol. 34, n°2. pp. 137-151.

The scarcity of clean water affecting many parts of the world encourages efforts to improve water reclamation processes, which rely on their capability to remove diverse types of water pollutants and contaminants. Thus, this study reports the application of bamboo fiber powders as potential low-cost sorbent for removal of noxious organic compounds in aqueous solution. Bisphenol A, a biorefractory endocrine disruptor compound, was chosen as model compound in order to easily follow the separation process. Principal component analysis of the FTIR spectra and BET surface area measurements were performed on treated bamboo fiber powders. Treatment of the raw powders with alkali, ionic and non-ionic surfactants appeared to improve the bisphenol A removal performance of the bamboo fiber powders with the best removal efficiency reached at 39 % for a sorbent dosage of 4 g L−1 gained after a bamboo treatment using the cationic surfactant. Effects of contact time, sorbent dosage, and particle sizes (55, 300, and 1000 μm) of cationic surfactant-treated bamboo fiber powders towards removal of bisphenol A were further assessed in a batch system with an optimum removal observed for 55 μm in particle size. Accepted version

International audience; In the field of toxicological bioassays, the latest progress in Raman spectroscopy opens new research perspectives on a fast method of observing metabolic responses against toxic agents. This technique offers a multiparametric approach, providing an overview of the physiological changes that are caused by pollutants. However, physiological spectral fingerprints require complex chemometric methods for proper analysis. In this study, particular attention has been given to the elaboration of an "aberrant spectra" detection strategy to highlight the effects of arsenic on the bacteria Escherichia coli. This strategy significantly improved spectra classification, consistent with a dose response effect of the four tested concentrations of the metal. Indeed, the correct classification score of the spectra increased from 88 to more than 99%. The exposure time effect has also been investigated. The fine analysis of Raman spectroscopy fingerprints enabled the design of different "spectral signatures", highlighting early and late effects of arsenic on bacteria. The observed variations are in agreement with the expected toxicity and encourage the use of Raman spectroscopy for toxic element detection.