A Computer Prescribing Order Entry-Clinical Decision Support system designed for neonatal care: results of the 'preselected prescription' concept at the bedside.

WHAT IS KNOWN: The neonatal intensive care units (NICUs) are at the highest risk of drug dose error of all hospital wards. NICUs also have the most complicated prescription modalities. The computerization of the prescription process is currently recommended to decrease the risk of preventable adverse drug effects (pADEs) in NICUs. However, Computer Prescribing Order Entry-Clinical Decision Support (C.P.O.E./C.D.S.) systems have been poorly studied in NICUs, and their technical compatibility with neonatal specificities has been limited. OBJECTIVES: We set up a performance study of the preselected prescription of drugs for neonates, which limited the role of the prescriber to choosing the drugs and their indications. METHODS: A single 29 bed neonatal ward used this neonatal C.P.O.E./C.D.S. system for all prescriptions of all hospitalized newborns over an 18-month period. The preselected prescription of drugs was based on the indication, gestational age, body weight and post-natal age. The therapeutic protocols were provided by a formulary reference (330 drugs) that had been specifically designed for newborns. The preselected prescription also gave complete information about preparation and administration of drugs by nurses. The prescriber was allowed to modify the preselected prescription but alarms provided warning when the prescription was outside the recommended range. The main clinical characteristics and all items of each line of prescription were stored in a data warehouse, thus enabling this study to take place. RESULTS: Seven hundred and sixty successive newborns (from 24 to 42 weeks' gestation) were prescribed 52 392 lines of prescription corresponding to 65 drugs; About 30·4% of neonates had at least one out of licensed prescription; A prescription out of the recommended range for daily dose was recorded for 1·0% of all drug prescriptions. WHAT IS NEW?: The C.P.O.E./C.D.S. systems can currently provide a complete preselected prescription in NICUs according to dose rules, which are specific to newborns and also comply with local specificities (therapeutic protocols and formulation of drugs). The role of the prescriber is limited to the choice of drugs and their indications. The prescriber still retains the possibility of modifying each item of the prescription, with all other prescription items being calculated by the C.P.O.E. system. In these conditions, the prescribers rarely modified the preselected prescription and the rate of out of range prescription was low. A multicentric study is required to confirm and extend these observations. CONCLUSIONS: This study showed the feasibility of preselected prescription in NICUs and a low rate of out of range prescriptions. The preselected prescription could play a key role in lowering the dose error rate in NICUs.

Persistent Mercury Contamination in Shooting Range Soils: The Legacy from Former Primers.

Mercury (Hg) compounds were used in the past in primers for rifle and handgun ammunition. Despite its toxicity, little is known about the contamination of shooting-range soils with this metal. We present new data about the Hg contamination of surface soils from numerous shooting ranges of Switzerland. Our study demonstrates that Hg is measurable at high levels in surface soils from the shooting ranges. In three of the investigated ranges, concentrations above the maximum Swiss guidance value of Hg in soil of 500 µg kg-1 were measured. Since the use of mercury-containing ammunition was stopped in the 1960s, our results demonstrate the high persistence of Hg in soils and their slow recovery by natural mechanisms.

Note: Controlling the length of plasmonic tips obtained by pulsed electrochemical etching.

We present a method to control the length of plasmonic gold tips through pulsed electrochemical etching. This method uses a cut-off circuit to interrupt the etching when the desired length is achieved, paving the way to tune the plasmonic properties of these tips through their shape. The control of the tip length by monitoring the cell voltage is the result of a study of the etching dynamics. The resulting tips possess a low apex radius and a small opening angle, allowing for high spatial resolution both in topography and in near-field imaging. The plasmonic behavior was confirmed in tip-enhanced Raman spectroscopy.

Multiferroic properties-structure relationships in epitaxial Bi(2)FeCrO(6) thin films: recent developments.

We report recent developments in the growth and characterization of epitaxial Bi(2)FeCrO(6) (BFCO) thin films. The body of experimental data stemming mostly from our investigations, and also considering the few available reports from other groups, allows us to explain the origin(s) of the thickness dependence of the multiferroic properties observed. A drastic reduction of the films' magnetization is observed for film thicknesses larger than 80 nm. This decrease in magnetization is attributed to the formation of defects, such as antisites and antiphase boundaries, in the BFCO films. The change in magnetization is accompanied by a BFCO cell expansion, a consequence of the volume increase of the oxygen octahedra surrounding the Fe cations induced by the defects. BFCO films are ferroelectric for all the thicknesses investigated, ferroelectricity being only moderately affected by the film thickness.

Coexistence of antiferromagnetic and ferromagnetic orders at remanent state in epitaxial multiferroic Bi2FeCrO6 nanostructures.

We report the local electronic and magnetic properties of Bi(2)FeCrO(6) nanostructures by element-specific polarized x-ray techniques. Sizable magnetic ordering in the remanent state is observed at room temperature for both Fe and Cr ions. The Bi(2)FeCrO(6) system offers an example of d(5)-d(3) magnetic superexchange interaction with a magnetic order for both Fe and Cr, which are both formally in the  + 3 valence state. The results suggest a coexistence of antiferromagnetic and ferromagnetic superexchange interaction between Fe and Cr spins in the nanostructures at the remanent state and at room temperature.

Polarization proximity effect in isolator crystal pairs.

We experimentally study the polarization dynamics (orientation and ellipticity) of near-infrared light transmitted through magneto-optical yttrium iron garnet isolator crystal pairs using a modified balanced detection scheme. When the pair separation is in the submillimeter range, we observed a proximity effect in which the saturation field is reduced by up to 20%. One-dimensional calculations suggest that the proximity effect originates from magnetostatic interactions between the dipole moments of the isolator crystals.