Outgroup Research Articles

Efficacy of spinal anesthesia—ultrasound guided versus landmark-based, in patients undergoing spinal anesthesia: a prospective cross-sectional study

Abstract Objective: This research aims to assess the effectiveness and practical value of ultrasound imaging (US group) in minimizing the discomfort and potential hazards associated with spinal anesthesia compared to traditional landmark-based (LM group) approaches. Materials and Methods: In this prospective, randomized comparative investigation, 80 patients were enrolled to undergo spinal anesthesia using either the landmark-based or ultrasound-guided method, with an equal distribution of 40 patients in each respective group. The study recorded various parameters, including evaluation duration, count of needle insertion attempts, instances of redirection, duration of spinal anesthesia, overall procedure time (comprising assessment and administration of spinal anesthesia), and measurement of intrathecal space depth. Patient comfort was evaluated employing a visual analog scale (VAS). Results: Demographic characteristics, including age, gender, and body mass index, exhibited no notable differences. The overall procedure time was approximately 2–3 min for the LM group and 3–4 min for the US group, with a statistically significant difference (P < 0.0001). The initial successful needle insertion rate was considerably more critical in the US group (52.5%) than in the LM group (10%). The distance from the skin to the subarachnoid space was notably more remarkable in the US group, with a statistically significant distinction from the LM group (P = 0.034). The successful spinal needle placement rate was 77.5% in the US group, significantly surpassing the LM group’s rate of 25% (P < 0.05). Regarding patient comfort assessed using the VAS, the US group demonstrated significantly greater comfort levels than the LM group. In the US group, every patient reported a VAS score of <4, whereas only 27.5% achieved the same level of comfort in the LM group. Conclusion: Our study provides evidence supporting the utility of pre-procedural ultrasound evaluation of the subarachnoid space as an effective tool for achieving successful lumbar punctures in patients receiving spinal anesthesia. Compared to the traditional landmark technique, this approach reduces the number of attempts required while enhancing patient comfort.

Factors Affecting Implant Surface Roughness and Platform Alterations After Implantoplasty: An In Vitro Study Simulating Different Clinical Scenarios.

Purpose: To determine which clinical factors might affect the postimplantoplasty presence of residual threads, platform alterations, and level of surface roughness. Materials and Methods: A total of 60 implants were placed in 20 resin models (10 edentulous maxillary models and 10 partially dentate mandibular models), and 5-mm peri-implant bone defects were created. These models were then placed in simulation mannequins. A single researcher performed the implantoplasties, which were divided into the following groups: favorable situation (FS; maxillary incisors without adjacent teeth), unfavorable situation (US; mandibular molars with adjacent teeth), crown (C; mandibular premolars with a prosthetic crown and adjacent teeth), and noncrown (NC; mandibular premolars with adjacent teeth and without a prosthetic crown). The presence of residual threads, gaps in the implant-abutment interface, and silicone debris was assessed using a scanning electron microscope (SEM), and the surface roughness (Sa and Sz) was analyzed with a confocal optical microscope. A descriptive and bivariate analysis was conducted. Results: The postimplantoplasty surfaces were significantly smoother than the original implant surfaces. The surface roughness was significantly higher in the US group than in the FS group. Gaps in the implant-abutment interface were infrequent (6.67%; 95% CI = 2.62 to 15.93) and only appeared in the posterior zone. The odds ratio for the presence of residual threads and silicone debris (US group vs FS group) was 7.1 (95% CI = 4.15 to 12.14; P < .001) and 5.53 (95% CI = 3.21 to 9.53; P < .001), respectively. When a prosthetic crown was present, residual threads were 7 times more likely to be found (OR = 7.0; 95% CI = 3.5 to 13.99; P < .001). Conclusions: Implantoplasty leads to a significant reduction in the surface roughness of implants but is affected by several variables. Performing implantoplasty on posterior mandibular implants with adjacent teeth seems to be more challenging compared to implants placed in the anterior region of a fully edentulous maxilla. The presence of a prosthetic crown should also be considered as a relevant factor. Furthermore, implantoplasty can sometimes cause gaps in the implant-abutment interface and an accumulation of silicone debris, especially in areas with limited access.

Ultrasound-guided transforaminal epidural injection with fluoroscopy confirmation for the treatment of unilateral lumbar radiculopathy: A randomized controlled non-inferiority study

BackgroundUltrasound (US)-guided injections for chronic pain has multiple advantages over traditional radiologic method. The study was performed to exam the clinical outcomes of lumbar transforaminal epidural injection (LTFEI) between US and fluoroscopy (FL) guidance for lumbar radiculopathy (LRP). MethodsA total of 164 patients with LRP were randomly assigned into US and FL group to receive LTFEI in a 1:1 ratio. Pain relief and functional disability were assessed by numeric rating scale (NRS) and Modified Oswestry Disability Questionnaire (MODQ) scores before treatment, 1 month and 3 months post-intervention. Contrast spread pattern, fluoroscopic image number and complications were also recorded. The primary outcome was accurate rate of contrast dispersing into lumbar epidural space, and non-inferiority margin was predefined at −15 %. ResultsThe accuracy of LTFEI was 90.2 % and 91.5 % in US and FL group, and the lower limit of the 95 %CI of mean difference between two modalities (−4.9 % (95 %CI: −12.8 %, 3.1 %)) was above the non-inferiority margin. Procedure time in US group (531.90 ± 67.12 s) was shorter than FL group (904.20 ± 120.20 s) (p < 0.05), while radiation dosage in the US group was lower than in the FL group (3047.20 ± 569.53 vs. 8807.50 ± 1039.10 μGy m2, p < 0.001). Both groups didn’t differ in pain reduction (F = 1.050, p = 0.306) and functional improvement (F = 0.103, p = 0.749) during follow-up period. No severe complications occurred in both groups. ConclusionsUS-guided LTFEI confirmed by FL was not inferior to conventional FL method in terms of accurate rate of lumbar epidural contrast dispersion. Effective pain relief and functional ability improvement were comparable between two modalities, and US technique had advantages of less radiation exposure and possible facilitation of avoiding critical vessels around intervertebral foramen.

A Comparison of the Efficacy of Plastic Stent Placement Above and Across the Sphincter of Oddi for Benign Biliary Hilar Stricture.

We investigated the efficacy and safety of endoscopic plastic stent (PS) placement for hilar benign biliary strictures (BBSs) and compared cases with PS placement above (inside stent, IS) and across (usual stent, US) the sphincter of Oddi. Patients who underwent initial endoscopic PS placement for hilar BBSs between August 2012 and December 2021 were retrospectively analyzed. Hilar BBSs in 88 patients were investigated. Clinical success was achieved in 81 of these cases (92.0%), including 38 patients in the IS group and 43 patients in the US group. Unexpected stent exchange (uSE) before the first scheduled PS exchange occurred in 18 cases (22.2%). The median time from first stent placement to uSE was 35 days. There was no significant difference in the rate and median time to uSE between the two groups. The rates of adverse events such as pancreatitis or cholangitis in the two groups did not significantly differ. However, the rate of difficult stent removal in the IS group (15.8%) was significantly higher than that in the US group (0%) (p=0.0019). US placement is preferable to IS placement for scheduled stent exchange, as it offers the same effectiveness and risk of adverse events with easier stent removal.

Effects of long-term administration of various dietary prebiotic supplements on the growth, immune cell activity and digestive tract histology of juvenile vimba (Vimba vimba).

The experiment was set to determine the effects of long-term (55-day) use of three commercial prebiotics including Saccharomyces cerevisiae-derived β-glucans and one including inulin on juvenile vimba (Vimba vimba) reared intensively under controlled conditions. Six-month-old fish were fed commercial feed (Control group, n = 90), or the same feed supplemented with 0.02% Leiber Beta-S (BS group, n = 90), 0.20% Biolex MB40 (MB group, n = 90), 0.30% CeFi (CE group, n = 90) or 1.00% inulin Orafti GR (IN group, n = 90) for 55 days. In the BS group, the final growth parameters were significantly lower than in the Control group, while the feed conversion ratio was significantly higher. No significant differences were found between any other group and the Control group in the respective parameters. The respiratory burst activity of the head-kidney phagocytes was significantly lower in all fish groups fed the prebiotic-supplemented diets compared to the Control group. The proliferative response of the head-kidney lymphocytes stimulated by concanavalin A was lower in the BS group than in the Control group, while in other groups this response was not affected. No significant differences were found in histopathological analyses of the digestive tract, liver or pancreas. The long-term supplementation of fish diets with prebiotics can negatively influence the growth, feed conversion, nonspecific cellular resistance and proliferative activity of the T lymphocytes of vimba juveniles.

Effect of Drilling Preparation on Immediately Loaded Implants: An In Vivo Study in Sheep.

To determine the biologic and biomechanical effects of two implant drilling protocols on the cortical bone around implants subjected to immediate loading. A total of 48 implants were inserted into the mandibles of six sheep following one of two drilling protocols: undersized preparation (US; n = 24) and nonundersized preparation (NUS; n = 24). Immediately after implant insertion, an abutment was placed on each implant and 36 implants were subjected to 10 sessions of dynamic vertical loads (1,500 cycles, 1 Hz) of 25 N or 50 N. Insertion torque value (ITV) was recorded at implant installation. Resonance frequency analysis (RFA) was measured at implant insertion and at each loading session. Fluorochrome was administered at day 17, and the animals were euthanized after 5 weeks. The removal torque values (RTVs) were measured, and samples underwent histomorphometric, μCT (microcomputed tomography), and fluorescence image acquisition analyses. The bone volume density (BV/TV), bone-to-implant contact (BIC), bone area fraction occupancy (BAFO), and fluorochrome stained bone surface (MS) were calculated. A linear mixed model analysis was performed, and Pearson paired correlation was calculated. Five implants from the NUS group failed, with a mean ITV of 8.8 Ncm and an RFA value of 57. The mean ITVs for US group and NUS group were 80.5 (± 14) Ncm and 45.9 (± 25) Ncm, respectively (P < .001). No differences were noted in the RFA values from the time of implant insertion until the end of the study. No differences in RTV, BV/TV, BAFO, or MS were observed between the groups. Intense new bone formation took place in the NUS group implants that were subjected to load. Undersized preparation of cortical bone ensured a greater BIC compared to a nonundersized preparation. Moreover, this study demonstrated that immediate loading did not interfere with the osseointegration process, but loading induced intense new bone formation in the NUS group. It is not recommended to immediately load the implants when the clinically perceived primary stability is lower than an ITV of 10 Ncm and an RFA value of 60. Int J Oral Maxillofac Implants 2023;38:607-618. doi: 10.11607/jomi.9949.

HR+/HER2- Breast cancer: The effect of online education on clinician knowledge, competence, and confidence in monitoring, mitigating toxicities, and developing patient-centric plans using a team-based approach.

e12522 Background: CDK4/6 inhibitors provide effective treatment options for patients with HR-positive, HER2-negative breast cancer (BC), but adherence and persistence can be challenging. To address this gap, a global educational activity was developed that consisted of a 2-hour live streaming virtual meeting with interactive workshops and a 45-minute online enduring activity. The objective of this study was to assess the educational impact of the online enduring educational activity. Methods: To assess educational impact a repeated-pairs pre-/post-assessment study design using 3 knowledge/competence questions, in which everyone served as their own control. A paired samples t-test assessed mean differences in average number of correct responses pre- to post-assessment, and a McNemar’s test assessed significance of improvement in single questions from pre- to post-assessment. P values &lt; .05 are statistically significant. Confidence was also assessed using a pre/post confidence question. The activity launched on June 4, 2021, and data was collected till March 30, 2022. Results: 80 oncologists from outside the US (OUS) and 69 oncologists from the US who answered all the assessment questions were included in the analysis. Each question assessed a learning objective. All three knowledge/competence learning objectives showed a significant improvement in the OUS oncologist group, and 2 of the 3 showed a significant improvement in the US group. Conclusions: This online enduring activity resulted in a significant improvement of oncologists’ knowledge and competence related to clinical evidence for the use of CDK4/6i, managing adverse events associated with CDK4/6i and monitoring patients on CDK4/6i. Confidence of oncologists in counselling patients on the importance of adherence to CDK 4/6 inhibitor therapy also improved in 29% of OUS oncologists and 33% of US oncologists. However, there is still a need for education in a significant percentage of both OUS and US oncologists on this topic. [Table: see text]

Effects of eutrophic water with ammonium chloride, urea, potassium dihydrogen phosphate and sodium-β-glycerophosphate on Myriophyllum verticillatum and epiphytic bacteria

With the rapid development of industry and agriculture, excessive nitrogen and phosphorus released into natural surface water have caused eutrophication. Applying submerged plants to manage eutrophic water has attracted widespread attention. However, there are limited studies on the effects of different nitrogen and phosphorus in the water environment on submerged plants and their epiphytic biofilm. Therefore, this paper investigated the effects of eutrophic water with ammonium chloride (IN), urea (ON), potassium dihydrogen phosphate (IP), and sodium-β-glycerophosphate (OP) on Myriophyllum verticillatum and epiphytic biofilms. The results showed that Myriophyllum verticillatum exhibited a good purification effect on the eutrophic water with inorganic phosphorus, the removal rates of IP were 68.0%, and the plants grew best in this condition. The fresh weight of the IN group and ON group increased by 12.24% and 7.12%, and the shoot length of the IN group and the ON group increased by 17.71% and 8.33%; the fresh weight of the IP group and OP group increased by 19.19% and 10.83%, the shoot length of the IP group and the OP group increased by 21.09% and 18.23%. In addition, the enzyme activities of superoxide dismutase, catalase, nitrate reductase, and acid phosphatase in plant leaves were significantly changed in eutrophic water with different forms of nitrogen and phosphorus. Finally, the analysis of the epiphytic bacteria showed that different forms of nitrogen and phosphorus nutrients could significantly alter the abundance and structure of microorganisms and microbial metabolism also had significant changes. This study provides a new theoretical basis for evaluating the removal of different forms of nitrogen and phosphorus by Myriophyllum verticillatum, and it also provides new insights for the subsequent engineering of epiphytic microorganisms to improve the capability of submerged plants to treat eutrophic water.

0335 Persistence of Sleep Duration Phenotypes Across Nights of Laboratory and Home Sleep Recording

Abstract Introduction Vgontzas and colleagues have proposed dividing the population of persons with insomnia disorder into short (&amp;lt; 6 hours/night) and normal (&amp;gt; 6 hours/night) sleep duration phenotypes based on their objective sleep duration as measured by one or more nights of polysomnography (PSG). However, first night effects, homeostatic recovery mechanisms and the site where PSG is conducted may all affect the sleep duration observed on individual PSG nights. The current study evaluated the stability of objective sleep duration phenotyping across multiple laboratory and home-based PSG recordings. Methods Seventy-six adults (Mage = 51.8±16.5 yrs.; 50% women) with an insomnia disorder underwent a series of three PSG recordings in the sleep lab and three in their homes in a counterbalanced order. Participants chose their own bed and rising times each night to produce results representative of their usual sleep patterns. Participants were classified into short (ISS: TST &amp;lt; 6 hours) and normal (INS: TST &amp;gt; 6 hours) duration phenotypes using the mean sleep times across all nights. Results Twenty-eight participants were classified as the ISS phenotype and 48 were classified as the INS phenotype with equal numbers of men and women in each group. A linear mixed models analysis showed only significant main effects for phenotype classification (F = 119.72; p &amp;lt; .0001) and recording night (F = 4.29; p &amp;lt; .025). The ISS mean TST was 326.8 minutes whereas the INS mean TST was 396.8 minutes. Mean TST across both groups was significantly shorter on the first PSG night (Mean = 353.0 min.) across settings than on night 2 (Mean = 372.4 min.). The majority of the ISS group (78.6%) and INS group (77.1%) had TST &amp;lt; 6 hours and TST &amp;gt; 6 hours, respectively, on 4 or more nights of sleep recordings. Conclusion ISS and INS sleep duration phenotypes have relative stability in their objective sleep times across nights and recording sites. These findings support the growing literature suggesting the distinctiveness of these subtypes of insomnia disorder. Support (if any) Funding support from the Department of Veterans Affairs Merit Review Grant Program

HEMORHEOLOGICAL MODELS APPLIED TO DATA ANALYSIS IN GROUPS OF PATIENTS AND IN HEALTHY SUBJECTS

An overview of some mathematical models describing the rheological behavior of blood is done. Several known models were used to describe the non-Newtonian rheological properties of blood. The parameters of two of the simplest models — the power law and the Herschel–Bulkley law were used to analyze the differences between the microrheological and micromechanical characteristics of blood in a group of patients with diabetes mellitus type 2 (T2DM) and in healthy subjects. The experiments were carried out with Low Shear 30 (LS 30) Contraves viscometer in a wide range of shear rates. All experimental data were statistically processed using the Mann–Whitney U-test for intergroup comparison of independent variables, as well as the t-test. The Statistica program was used for statistical processing. The results obtained are compared with the hemorheological models from other disease states.

Urbanization led to the abundance of Gram-negative, chemo-organo-heterotrophs, and antibiotic resistance genes in the downstream regions of the Ganga River water of India.

The present investigation assesses the bacterial microbiome and antibiotic resistance genes (ARGs) of the river Ganga from Uttarakhand (upstream region; US group) and Uttar Pradesh (downstream region; DS group) regions using a 16S rRNA amplicon-based metagenomic approach. Gram-negative, aerobic, and chemo-organotrophic bacteria made up the majority of the bacterial genera during the overall analysis. Physicochemical analysis revealed a higher concentration of nitrate and phosphate in the downstream sites of the Ganga River. The prevalence of Gemmatimonas, Flavobacterium, Arenimonas, and Verrucomicrobia in the water of the DS region indicates a high organic load. Pseudomonas and Flavobacterium emerged as the most prevalent genera among the 35 significantly different shared genera (p-value < 0.05) in the US and DS regions, respectively. Overall antibiotic resistance analysis of the samples showed the dominance of β-lactam resistance (33.92%) followed by CAMP (cationic antimicrobial peptide) resistance (27.75%), and multidrug resistance (19.17%), vancomycin resistance (17.84%), and tetracycline resistance (0.77%). While comparing, the DS group exhibited a higher abundance of ARGs over the US group, where the CAMP resistance and β-lactam ARGs were dominant in the respective regions. The correlation (p-value < 0.05) analysis showed that most bacteria exhibit a significant correlation with tetracycline resistance followed by the phenicol antibiotic. The present findings draw attention to the need for regulated disposal of multiform human-derived wastes into the Ganga River to reduce the irrepressible ARGs dissemination.

Powerlifting Balance Of SBD Disciplines (Squat, Bench Press And Deadlift) Ratio To Total Score

This research studied the powerlifting balance of squat, bench press and deadlift (SBD) disciplines ratio to the total score. The data set was from Powerlifting Championships recognized by the International Powerlifting Federation, compiled by the Open Powerlifting project. The records were 65,867 men’s and 35,679 women’s samples from classic powerlifting and 19,295 men’s and 7,426 women’s samples from equipped powerlifting, all with ages from 24 to 39 years from 2012 to November 2022. For each record, the SBD ratios were calculated by the mean of the formula (SBD discipline / Total score) by one hundred. Dispersion plots of Good Lift Points (GLP) score versus the SBD ratios and Bar plots of mean and variance of SBD ratios were done, highlighted by quantiles of GLP score. The Mean and Standard Deviation from Elite Powerlifters (90-100th quantiles) of each weight class were used to calculate the SBD ratio ranges. An algorithm with twenty-six permutations, where the addition and subtraction from 0.5 to 3 standard deviation to the mean marked the ranges' Upper and Lower borders. The best permutation by each weight class was selected when the athletes' group inside the optimal ratio ranges (ORR) showed the highest Impact Factor (GLP mean by frequency) and the shortest ORR. To evaluate the effectiveness of the ORR for each weight class in sexes and events were analyzed lower levels of Powerlifters, inside 0-50th and 50th-90th quantiles of GLP score. For these sets, was applied One Way ANOVA to evaluate the meaning differences between IN and OUT groups from ORR, using post-hoc test of Tukey's HSD or Games-Howell. From sixty-four evaluations, forty-eight were higher in GLP mean score for the IN group, meaning differences regarding the OUT group. At the same time, fifteen were only the highest but not statistically different, and only one was rejected for both. Regardless of the quantile level, for Classic Powerlifting, four Women’s (57, 63, 69 and +84) and five Men’s (66, 74, 93, 105 and +120) classes presented ORR supported; while for Equipped Powerlifting were four Men’s (74, 83, 93 and 105) and six Women’s (57, 63, 69, 76, 84 and +84) classes. These findings support the theory of Powerlifting balance in SBD disciplines, which influences performance.

Ultrasound versus Fluoroscopic-Guided Superior Hypogastric Plexus Block in Cancer Bladder: A Randomized Controlled Trial

BACKGROUND: Patients with advanced bladder cancer may suffer severe pelvic pain unresponsive to standard pharmacological therapy. AIM: This study assessed the feasibility, efficacy of ultrasoundguided (USG) versus fluoroscopy-guided (FG) superior hypogastric plexus block (SHPB) in bladder cancer pain management. METHODS: This randomized controlled study included 60 patients undergoing SHPB to manage pain in stages 3 and 4 bladder cancer patients from December 2020 to June 2021. They were randomly divided into two groups. Group Fluoro (n = 30) underwent FG-SHPB, while Group US (n = 30) underwent US-SHPB. The patients were assessed after 1 day and 1 and 3 months regarding pain intensity using visual analog score (VAS), daily morphine consumption, functional capacity, and quality of life (QoL) using the Short Form Health Survey-36. RESULTS: The procedure failed in 2 patients in each group. The procedure was significantly lengthier in the Fluor group than the US group (p &lt; 0.001). VAS scores decreased significantly in the two groups after 1 and 3 months and were significantly in US-SHBP after 3 months. Morphine consumption decreased significantly, and functional capacity and QoL improved significantly in both groups up to 3 months. The two groups were comparable in morphine consumption, functional capacity, and QoL. Position discomfort and back pain were more common in Fluor Group. CONCLUSION: USG SHPB is a feasible, safe, and effective analgesic procedure in patients with advanced bladder cancer suffering from severe pelvic pain. It is superior to the FG transdiscal approach regarding the duration of pain relief and improvement of functional capacity in addition to avoidance of position discomfort and back pain. REGISTRATION: Clinical Trials.gov (ID NCT05083702).

Ultrasonic irradiation enhanced the efficacy of antimicrobial photodynamic therapy against methicillin-resistant Staphylococcus aureus biofilm

Antimicrobial photodynamic therapy (aPDT) is a non-pharmacological antimicrobial regimen based on light, photosensitizer and oxygen. It has become a potential method to inactivate multidrug-resistant bacteria. However, limited by the delivery of photosensitizer (PS) in biofilm, eradicating biofilm-associated infections by aPDT remains challenging. This study aimed to explore the feasibility of combining ultrasonic irradiation with aPDT to enhance the efficacy of aPDT against methicillin-resistant staphylococcus aureus (MRSA) biofilm. A cationic benzylidene cyclopentanone photosensitizer with much higher selectivity to bacterial cells than mammalian cells were applied at the concentration of 10 μM. 532 nm laser (40 mW/cm2, 10 min) and 1 MHz ultrasound (500 mW/cm2, 10 min, simultaneously with aPDT) were employed against MRSA biofilms in vitro. In addition to combined with ultrasonic irradiation and aPDT, MRSA biofilms were treated with laser irradiation only, photosensitizer only, ultrasonic irradiation only, ultrasonic irradiation and photosensitizer, and aPDT respectively. The antibacterial efficacy was determined by XTT assay, and the penetration depth of PS in biofilm was observed using a photoluminescence spectrometer and a confocal laser scanning microscopy (CLSM). In addition, the viability of human dermal fibroblasts (WS-1 cells) after the same treatments mentioned above and the uptake of P3 by WS-1 cells after ultrasonic irradiation were detected by CCK-8 and CLSM in vitro. Results showed that the percent decrease in metabolic activity resulting from the US + aPDT group (75.76%) was higher than the sum of the aPDT group (44.14%) and the US group (9.88%), suggesting synergistic effects. Meanwhile, the diffusion of PS in the biofilm of MRSA was significantly increased by 1 MHz ultrasonic irradiation. Ultrasonic irradiation neither induced the PS uptake by WS-1 cells nor reduced the viability of WS-1 cells. These results suggested that 1 MHz ultrasonic irradiation significantly enhanced the efficacy of aPDT against MRSA biofilm by increasing the penetration depth of PS. In addition, the antibacterial efficacy of aPDT can be enhanced by ultrasonic irradiation, the US + aPDT treatment demonstrated encouraging in vivo antibacterial efficacy (1.73 log10 CFU/mL reduction). In conclusion, the combination of aPDT and 1 MHz ultrasound is a potential and promising strategy to eradicate biofilm-associated infections of MRSA.

Pluralisme juridique, sécurité industrielle et globalisation : une étude de cas dans la chimie

Cet article vise à mettre en évidence les nombreuses frontières au sein desquelles ou par-delà lesquelles s’organise la gouvernance de la sécurité industrielle dans une entreprise de chimie fine. Les acteurs de cette filiale française d’un groupe américain sont soumis à plusieurs réglementations et normes au niveau national, mais aussi supranational, notamment européen. Ils doivent les mettre en œuvre dans un contexte sociotechnique particulier impliquant des adaptations. Ces ajustements sont souvent l’objet de négociations variées entre les acteurs de l’usine considérée, avec les acteurs du groupe et les autorités de contrôle. Les acteurs de l’usine doivent aussi composer avec l’approche de gestion des risques développée aux États-Unis et traduite dans des standards de production et de sécurité (procédures, outils) pour réguler de manière de plus en plus homogène la sécurité dans les divers sites répartis autour du monde. Ce texte invite donc à une présentation empirique du pluralisme juridique.

Global Indigenous gender concepts, gender-based violence and resilience: A scoping review

Background & objectiveThe legacy of colonialism includes ongoing trauma and disruption of traditional teachings on relationality, which has contributed to Indigenous populations being disproportionately exposed to gender-based violence (GBV). GBV in Indigenous populations is explored to consider gender-specific findings and points of resilience in relational networks. Participants & settingIncluded articles sampled Indigenous groups in Canada, US, Mexico, Guatemala, and Israel. All participants self-identified as Indigenous, and were either GBV survivors or service providers working in GBV contexts. MethodsA scoping review was conducted in OVID Medline, Embase, APA Psycinfo, and Informit Indigenous Collection, using keywords for Indigenous peoples, gender concepts, and GBV. Articles were screened and extracted by two reviewers; a third reviewer resolved conflicts. ResultsOur search yielded one mixed-method study and seven qualitative studies, all published since 2016. North American studies identified colonial, patriarchal disruptions (e.g. residential schools) to positive pre-contact gender norms (e.g. non-hierarchical roles) that contribute to emerging GBV. Studies conducted in Guatemala and Israel also described local patriarchal cultures contributing to GBV. Lack of understanding of the Two-Spirit identity (i.e. supra-binary gender identity used by Indigenous persons) led to harmful attitudes and stigma. Interpersonal support and return to traditional matriarchal practices were identified as key resilience processes. ConclusionsThere is limited literature on Indigenous gender concepts and GBV, particularly regarding GBV against males and Two-Spirit persons. Colonization-related violence and/or patriarchal gender norms were identified as precursors for GBV. Decolonization processes should be further explored to address GBV in Indigenous populations.

Effects of dietary dandelion (Taraxacum mongolicum Hand.-Mazz.) polysaccharides on the performance and gut microbiota of laying hens

This experiment was designed to evaluate the influences of dietary dandelion polysaccharides (DP) on the performance and cecum microbiota of laying hens. Three hundred laying hens were assigned to five treatment groups: the basal diet group (CK group), three DP groups (basal diets supplemented with 0.5, 1.0, and 1.5 % DP), and the inulin group (IN group, basal diet supplemented with 1.5 % inulin). Increased daily egg weight and a decreased feed conversion rate were observed when the diets were supplemented with inulin or DP. The calcium metabolism rate in the 0.5 % and 1.0 % DP groups was greater than that in the CK group. The DP groups increased the short-chain fatty acid concentration, decreased pH, and enhanced the relative abundances of Parabacteroides, Alloprevotella, and Romboutsia in the cecum. These results showed that DP supplementation in the diets of laying hens can improve their performance, which might be associated with the regulation of the cecal microbiota.

Abstract 4638: Integrative spatial analysis of paired IHC and H&amp;E images identifies Foxp3 enriched tumor-infiltrating lymphocytes associated with disease-free survival in human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma

Abstract Background: Recent studies support that high levels of tumor-infiltrating lymphocytes (TILs) were associated with better prognosis in HPV(+) oropharyngeal squamous cell carcinoma (OPSCC). While these studies provide a potential role for TILs as a prognostic biomarker, the analyses were relied on manual quantification performed by pathologists, resulting in inter-observer variability. Deep Learning (DL)-based whole slide hematoxylin and eosin (H&amp;E) image analyses may overcome these challenges. However, this analysis only provides the presence of cell types without consideration for the functional roles of each cell within the tumor immune microenvironment (TME). In this work, we develop a computational pipeline to integrate paired H&amp;E and immunohistochemistry (IHC) images to functionally characterize TILs and investigate their prognostic utility. Methods: We analyzed 88 patients: 42 stage I, 39 stage II, and 7 stage III. Our data contain both H&amp;E and IHCs examining FoxP3, CD3, PD-L1, CD20, etc. on serial sections of the tissue. In-house DL-based H&amp;E analysis used to identify TILs, tumors, and stroma in each tumor, then performed registration between adjacent H&amp;E and IHC images from the same tissue. The patients were then classified into three basic immune phenotypes: immune inflamed (IN; high TILs in the tumor region), immune excluded (EX; TILs are mostly localized in stroma), and immune desert (ID; few/no TILs) based on TIL enrichment in the TME. To functionally characterize TILs, we quantified protein expression from the adjacent IHCs. For example, we further classified each patient into different subtypes based on enriched protein expression (e.g., FoxP3 high IN, FoxP3 low IN). We used the Kaplan-Meier method and multivariate Cox analysis to evaluate the prognostic value of different subtypes enriched with different proteins to predict disease-free survival (DFS). Results: The IN group with 43 patients was significantly associated with good prognosis. Interestingly, further stratification of the IN subgroup based on Foxp3 quantification on TIL regions (i.e., high FoxP3 IN and low FoxP3 IN) showed that high protein expression of FoxP3 in TILs in the IN subgroup is significantly associated with a better prognosis compared to other immune subgroups (HR, 0.16; p-value, 0.003). Multivariate analysis, including other clinical covariates showed that the immune subtypes associated with high FoxP3 are independently associated with DFS. These results demonstrate that DL-based integrative IHC and H&amp;E image analysis could be used to identify subgroups with distinct clinical outcomes. Furthermore, our results reveal unknown roles for Foxp3 expression in the TILs in HPV(+) OPSCC as a prognostic biomarker, a finding which should be evaluated in a larger cohort. Citation Format: Sumanth Reddy Nakkireddy, Inyeop Jang, Minji Kim, Linda X. Yin, Michael Rivera, Joaquin J. Garcia MD, Kathleen R. Bartemes, David M. Routman, Eric J. Moore, Daniel J. Ma, Kathryn M. Van Abel, Tae Hyun Hwang. Integrative spatial analysis of paired IHC and H&amp;E images identifies Foxp3 enriched tumor-infiltrating lymphocytes associated with disease-free survival in human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4638.

Effects of pre-service teachers’ cultural competence on their social justice and self-efficacy beliefs: a cross-cultural comparison between Turkey, South Korea and the United States

ABSTRACT This study is a comparative research investigating whether cultural competence of preservice teachers is causally related to their social justice and self-efficacy beliefs in Turkey, South Korea and the United States. The study group involved pre-service teachers from Turkey (n = 560), South Korea (n = 790) and the United States (n = 352). The model was developed in the study to discern pattern of relationships among cultural competence acting on social justice and self-efficacy beliefs via multiple causal pathways. Multisample structural equation model was performed to test the equivalence of relationships among variables in the three samples by estimating the model separately for Turkish, S. Korean, and US groups. The study results revealed that cultural competence of pre-service teachers has positive effect on their social justice and self-efficacy beliefs in all three samples. The results indicated that there is a strongest effect of pre-service teachers’ cultural competence on their social justice beliefs in S. Korea. There was a strongest effect of pre-service teachers’ cultural competence on their self-efficacy beliefs in Turkey. The implications for academic research and teacher training are discussed.

Ultrasonic Microbubble Cavitation Deliver Gal-3 shRNA to Inhibit Myocardial Fibrosis after Myocardial Infarction

Galectin-3 (Gal-3) participates in myocardial fibrosis (MF) in a variety of ways. Inhibiting the expression of Gal-3 can effectively interfere with MF. This study aimed to explore the value of Gal-3 short hairpin RNA (shRNA) transfection mediated by ultrasound-targeted microbubble destruction (UTMD) in anti-myocardial fibrosis and its mechanism. A rat model of myocardial infarction (MI) was established and randomly divided into control and Gal-3 shRNA/cationic microbubbles + ultrasound (Gal-3 shRNA/CMBs + US) groups. Echocardiography measured the left ventricular ejection fraction (LVEF) weekly, and the heart was harvested to analyze fibrosis, Gal-3, and collagen expression. LVEF in the Gal-3 shRNA/CMB + US group was improved compared with the control group. On day 21, the myocardial Gal-3 expression decreased in the Gal-3 shRNA/CMBs + US group. Furthermore, the proportion of the myocardial fibrosis area in the Gal-3 shRNA/CMBs + US group was 6.9 ± 0.41% lower than in the control group. After inhibition of Gal-3, there was a downregulation in collagen production (collagen I and III), and the ratio of Col I/Col III decreased. In conclusion, UTMD-mediated Gal-3 shRNA transfection can effectively silence the expression of Gal-3 in myocardial tissue, reduce myocardial fibrosis, and protect the cardiac ejection function.