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Abstract A systematic review was conducted on studies reporting steroid injections with ultrasound for de Quervain. From 10 studies included and 379 wrists, 73.9% reported complete resolution of symptoms, 18.2% with partial and 7.9% without resolution. When compared to the landmark‐guided technique, ultrasound guidance showed significantly higher rates of symptom resolution (P = 0.0132) and lower pain scores (P

Abstract Background Centre hospitalier de l’Université de Montréal in Canada introduced accompanying patients (APs) into the breast cancer care trajectory. APs are patients who have been treated for breast cancer and have been integrated into the clinical team to expand the services offered to people affected by cancer. This study describes the profiles of the people who received the support and explores whether one-offs vs ongoing encounters with APs influence their experience of care, on self-efficacy in coping with cancer, and on their level of psychological distress. Methods An exploratory cross-sectional study was carried out among patients to compare patients who had one encounter with an AP (G1) with those who had had several encounters (G2). Five questionnaires were administered on socio-demographic characteristics, care pathway, evaluation of the support experience, self-efficacy in coping with cancer, and level of psychological distress. Logbooks, completed by the APs, determined the number of encounters. Linear regression models were used to evaluate the associations between the number of encounters, patient characteristics, care pathway, number of topics discussed, self-efficacy measures in coping with cancer, and level of psychological distress. Results Between April 2020 and December 2021, 60% of 535 patients who were offered support from an AP accepted. Of these, one hundred and twenty-four patients participated in the study. The study aimed to recruit a minimum of 70 patients with the expectation of obtaining at least 50 participants, assuming a response rate of 70%. There were no differences between G1 and G2 in terms of sociodemographic data and care pathways. Statistical differences were found between G1 and G2 for impacts on and the return to daily life (p = 0.000), the return to the work and impacts on professional life (p = 0.044), announcement of a diagnosis to family and friends (p = 0.033), and strategies for living with treatment under the best conditions (p = 0.000). Significant differences were found on the topics of cancer (p = 0.000), genetic testing (p = 0.023), therapeutic options (p = 0.000), fatigue following treatment (p = 0.005), pain and discomfort after treatment or surgery (p = 0.000), potential emotions and their management (p = 0.000) and the decision-making processes (p = 0.011). A significant relationship was found between the two groups for patients’ ability to cope with cancer (p = 0.038), and their level of psychological distress at different stages of the care pathway (p = 0.024). Conclusions This study shows differences between one-time and ongoing support for cancer patients. It highlights the potential for APs to help patients develop self-efficacy and cope with the challenges of cancer treatment.

Background: Carotid free-floating thrombus (CFFT) is an uncommon disorder. The aim of this study was to describe a French cohort of CFFT patients. Methods: We conducted a retrospective monocentric study from a Stroke Center among patients admitted for stroke with CFFT. Results: Between January 2017 to December 2019, 2038 ischemic strokes were recorded. A total of 50 patients with CFFT were consecutively included (32 men/18 women). The mean age was 58.2 years (±11.7). Their etiologies were atheroma (46%), carotid dissection and web (20%), hypercoagulability disorders (16%) and arrhythmia (10%). Exclusive medical management was performed in 38 patients (76%): 29 (59.2%) were anticoagulated and 9 (18.4%) received antiplatelets alone in the first week. Surgical intervention was performed in the first 30 days for 11 patients (22%). The main surgical indication was a residual carotid stenosis over 70%. Only three patients had a recurrent stroke in the medical group with anticoagulants. No patients in the antiplatelet group or the surgical group had a recurrent stroke. Conclusions: Our study summarized a large cohort of 50 patients with CFFT. This diagnosis implies the need to search for a local arterial disease and to screen for hypercoagulability states. An initial medical strategy followed by a delayed carotid surgery if the follow-up imaging shows a residual stenosis appears to be safe.

Background:. Breast reconstruction after mastectomy improves patient quality of life. Independently of the type of reconstruction, ancillary procedures are sometimes necessary to improve results. Fat grafting to the breast is a safe procedure with excellent results. We report patient-reported outcomes using the BREAST-Q questionnaire after autologous fat grafting in different types of reconstructed breasts. Methods:. We performed a single-center, prospective, comparative study that compared patient-reported outcomes using the BREAST-Q in patients after different types of breast reconstruction (autologous, alloplastic, or after breast conserving) who subsequently had fat grafting. Results:. In total, 254 patients were eligible for the study, but only 54 (68 breasts) completed all the stages needed for inclusion. Patient demographic and breast characteristics are described. Median age was 52 years. The mean body mass index was 26.1 ± 3.9. The mean postoperative period at the administration of BREAST-Q questionnaires was 17.6 months. The mean preoperative BREAST-Q was 59.92 ± 17.37, and the mean postoperative score was 74.84 ± 12.48 (P < 0.0001). There was no significant difference when divided by the type of reconstruction. Conclusion:. Fat grafting is an ancillary procedure that improves the outcomes in breast reconstruction independently of the reconstruction type and heightens patient satisfaction, and it should be considered an integral part of any reconstruction algorithm.

Background:. Penile enlargement surgery is the second most desired cosmetic procedure in men worldwide. The mainstay of penile lengthening procedures is a partial release of the penile suspensory ligament system. Concerns regarding erect penis stability after this procedure have been raised by the surgical community. This study describes the anatomical features of the penile suspensory ligament system and explores the stability mechanisms of the penis. Methods:. This study is subdivided in two parts: an anatomical analysis and a clinical analysis. The anatomical part consists of a dissection of eight male cadavers to describe the anatomy and test the stability after sectioning successively the suspensory ligaments. The clinical part consists of an analysis of 30 patients with micropenis operated on for penile lengthening by a penile suspensory ligament release and lipofilling. Results:. The suspensory apparatus consists of four distinct ligamentous structures: fundiform, suspensory, dense vertical, and arcuate ligaments. These different structures are lax superficially but become firm and tense posteriorly. The section of the fundiform and suspensory ligaments did not destabilize the penis. Conclusion:. Penile lengthening by way of cautious suspensory ligament release can be performed without erection instability.

Summary:. Implant malposition remains one of the main complications of aesthetic breast augmentation and alloplastic breast reconstruction with expanders and implants. Many capsulorrhaphy techniques have been described to adjust the breast pocket and correct the malposition. In this study, we tested the efficacy of the argon beam coagulator (ABC) for lateral capsulorrhaphy on breast reconstruction patients at the time of expander replacement with a permanent implant. We also experimentally compared the effects of the ABC and the standard electrocautery on fragments of healthy breast capsule. We noted a 69.5% capsule shrinkage with the ABC versus 46.8% with the standard electrocautery. We concluded that breast capsulorrhaphy using the ABC is a safe and efficient technique for the correction of breast implant malposition in both reconstructive and aesthetic breast surgery.

Introduction: Umbrella shaped Perforated Screws (UPS) were developed for the use of orthopedic surgery to facilitate anchoring and fixation of the tissue to bone. We here present a retrospective study of Temporomandibular joint Internal derangement (ID) with fixation using this type of screws. Materials & Methods: We conducted a retrospective study including patients treated for ID using UPS to reposition the articular disc. The study included patients treated between 1998 and 2005. Patients were selected in concordance with clinical symptoms and signs of severity. All patients had an MRI (open/closed mouth) to confirm the diagnosis. Wilkes classification of temporomandibular disease (TMD) was adopted in the selection criteria. Results: Hundred and five patients were included, 92 female and 13 males with average age of 37.56. Dentists or general physicians mainly addressed these patients to our unit. The mean time from symptoms initiating to first consultation was 3.77 years, while the mean timing of surgery after initial consultation was 9.38 months. Patients have presented with various symptoms before the surgery including pain, limitation in eating habits and clicking. 77% of the patients had no or minimal pain post surgery. Hundred and one patients had good eating habits after surgery. Only 34 patients had persistent clicking despite surgery. We had neither infection nor hematoma as complication. Major complication to this technique is frontal paresis (14 patients), which was explained to all patients preoperatively. This paresis recovered in less than 2 months in all patients. We had 89.5% of the patients satisfied with their results. Conclusion: UPS are useful in the field of plastic surgery. This novel technique has the advantage of not compromising the vascular supply of the TMJ articular surface. This technique provides a simple, fast and efficient technique for posterior aponeurosis flap fixation. Our overall satisfactory rate was comparable to other studies.

Zoonotic abortive diseases represent a significant health and economic risk for national public health. This cross-sectional survey was conducted from April to October 2021 among 200 selected small ruminant farmers in the three northern regions of Cameroon. Data collection was done through questionnaires administered by exchange with the herder, and responses were coded and recorded on an Excel spreadsheet. The data were then analyzed with R software, version 2.13.0. An ANOVA test was used to assess significant differences in mean of Knowledge, Attitudes, Practices, and Perception of zoonotic risks (KAPP) scores between regions. Pearson correlations were used to calculate the association between KAPP scores within regions. Small ruminant farmers surveyed had low mean scores for knowledge of abortive toxoplasmosis and chlamydophilosis (0.1 ± 0.2), desirable attitude (0.32 ± 0.07), appropriate practice (0.36 ± 0.13) in managing abortion, and positive perception of zoonotic risks of toxoplasmosis and chlamydophilosis in small ruminants (0.12 ± 0.33), respectively. KAPP was significantly (P < 0.01) and positively associated with knowledge (r = 0.98) and risk perception (r = 0.99). However, attitudes (r = 0.06), practices (r = 0.05), and risk perception of toxoplasmosis (r = 0.07) and chlamydophilosis (r = 0.08) were not associated with farmers' knowledge. This study revealed significant knowledge gaps, low levels of desired attitudes, and high-risk behavioral practices. These results therefore call for capacity building of health professionals and farmers to better integrate the One Health concept in the management of neglected zoonotic diseases. [ABSTRACT FROM AUTHOR]

Background Breast implants have always been composed of a silicone elastomer envelope filled with either silicone gel or saline. Breast implant illness (BII) is a set of symptoms that has previously been linked to the leakage of silicone particles from the implants into the body. Objectives Our research aimed to quantify the number of silicone particles present in the capsules of breast implants available in North America. Methods Thirty-five periprosthetic capsules were sampled and analyzed, and silicone particles were counted and measured. The capsule surface area was then measured and utilized to calculate particle density and total number of silicone particles. Results Eighty-five percent of capsules analyzed from silicone gel implants contained silicone, with an average of 62 particles per mm3 of capsular tissue. These implants had approximately 1 million silicone particles per capsule. In contrast, none of the saline implant capsules contained silicone. Capsules from macrotextured tissue expanders contained fewer and larger silicone particles. Conclusions Silicone gel implants presented silicone particle bleeding into the periprosthetic capsule, totaling on average 1 million silicone particles per capsule. On the other hand, no silicone particle bleeding was observed from saline breast implants. These data suggest that particle bleeding comes from the inner silicone gel, and not from the smooth outer silicone shell. Previous studies have reported the presence of breast implant illness in patients with both silicone- and saline-filled implants. Therefore, our data suggest that silicone migration is not the sole cause of BII. Level of Evidence: 4 [ABSTRACT FROM AUTHOR]

The international comparative studies on students' outcomes have initiated analyses that have had a growing influence on national and sub-national education policies in industrialised and developing countries. It is particularly the case of the OECD's Programme for International Student Assessment (PISA) which started in 2000 and has organised surveys every 3 years, so that the 2015 survey was the 6th. Its influence has been particularly important for several reasons: 1) it assesses the basic competences in reading literacy, maths and science of 15 year-olds students, i.e. around the end of compulsory education in many countries; 2) the assessment is based on a reliable methodology and the tests are completed by qualitative surveys and studies; 3) and the results lead to recommendations and are amplified by the media in most countries. However, it is not easy to evaluate the real impact of PISA because of the existence of other international studies such as IEA's TIMSS and, particularly in Europe, the influence of the recommendations and benchmarks of the EU that has been growing steadily in the last 25 years. Our analysis of the impact of PISA and EU policy focuses on the evolution of the education policy in France, but also studies its evolution in a few other European countries. Finally, we underline the limits of the influence of PISA and international standards in education towards a convergence of education systems because of the importance of their specific historic and cultural contexts.

The theories and approaches of steering/monitoring a process of change within education systems have evolved over the last 20 years or so as a result of many factors such as globalisation and decentralisation, a faster pace of change, increasing expectations and demands from various stakeholders (parents, employers, teacher unions, etc.) and the growing influence of OECD and of the EU in the field of education because of some more or less explicit standards and policy recommendations. All these evolutions contributed to increase the complexity of the education systems and of the instruments and procedures required to establish some coherence between the initiatives of a large number of more autonomous stakeholders. Our main objective here is to describe how the previous notions and concepts used in analysing the conditions for steering education systems have been gradually integrated within a larger paradigm: the "governance of multi-level complex education systems".

Background: Carotid free-floating thrombus (CFFT) is an uncommon disorder. The aim of this study was to describe a French cohort of CFFT patients. Methods: We conducted a retrospective monocentric study from a Stroke Center among patients admitted for stroke with CFFT. Results: Between January 2017 to December 2019, 2038 ischemic strokes were recorded. A total of 50 patients with CFFT were consecutively included (32 men/18 women). The mean age was 58.2 years (±11.7). Their etiologies were atheroma (46%), carotid dissection and web (20%), hypercoagulability disorders (16%) and arrhythmia (10%). Exclusive medical management was performed in 38 patients (76%): 29 (59.2%) were anticoagulated and 9 (18.4%) received antiplatelets alone in the first week. Surgical intervention was performed in the first 30 days for 11 patients (22%). The main surgical indication was a residual carotid stenosis over 70%. Only three patients had a recurrent stroke in the medical group with anticoagulants. No patients in the antiplatelet group or the surgical group had a recurrent stroke. Conclusions: Our study summarized a large cohort of 50 patients with CFFT. This diagnosis implies the need to search for a local arterial disease and to screen for hypercoagulability states. An initial medical strategy followed by a delayed carotid surgery if the follow-up imaging shows a residual stenosis appears to be safe. [ABSTRACT FROM AUTHOR]

A systematic review was conducted on studies reporting steroid injections with ultrasound for de Quervain. From 10 studies included and 379 wrists, 73.9% reported complete resolution of symptoms, 18.2% with partial and 7.9% without resolution. When compared to the landmark‐guided technique, ultrasound guidance showed significantly higher rates of symptom resolution (P = 0.0132) and lower pain scores (P < 0.0001). Twenty‐nine patients out of 163 who initially showed complete resolution of symptoms reported subsequent recurrence. We conclude that steroid injections guided by ultrasound present high rates of symptomatic relief through precise needle insertion, especially in cases of anatomic variability with subcompartments. [ABSTRACT FROM AUTHOR]

Banana is one of the most consumed fruits in the world. Musa cavendish and Musa paradisiaca cultivars differential nutrition-health properties and more specifically their antioxidant and antiinflammatory potential are poorly known. The objective of the present study was to compare the hydroalcoholic dry extracts nutrition-health properties of these two types of Guinea bananas. Total polyphenols contents were evaluated by Folin Ciocalteu method, antioxidant capacity by DPPH, ORAC and Mito-tracker assays. Anti-inflammatory activity was evaluated in vitro on inflammatory macrophages. NO scavenging, NO and cytokines production (TNF-a and IL-6) were assessed. At 1 mg/mL, the extracts showed moderate total polyphenol content. Antioxidant activity potential was depended on the type of extracts. Banana pulps anti-inflammatory effects were demonstrated by the inhibition of NO cell production and NO scavenging suggesting that pulps have moderate antiinflammatory effect as a function of doses (100, 50 and 25 µg/mL). However, none of the extracts inhibited the production of cytokines (TNF-a and IL-6). The present study indicates that Guinea bananas may be considered as an interesting food source of antioxidants associated to a moderate anti-inflammatory potential on specific inflammation markers. [ABSTRACT FROM AUTHOR]

The Left Right Judgement Task (LRJT) involves determining if an image of the body part is of the left or right side. The LRJT has been utilized as part of rehabilitation treatment programs for persons with pain associated with musculoskeletal injuries and conditions. Although studies often attribute changes and improvement in LRJT performance to an altered body schema, imaging studies suggest that the LRJT implicates other cortical regions. We hypothesized that cognitive factors would be related to LRJT performance of hands and feet and that sensory, motor, and pain related factors would be related to LRJT in the affected hand of participants with wrist/hand pain. In an observational cross-sectional study, sixty-one participants with wrist/hand pain participated in a study assessing motor imagery ability, cognitive (Stroop test), sensory (Two-Point Orientation Discrimination, pressure pain thresholds), motor (grip strength, Purdue Pegboard Test), and pain related measures (West Haven Yale Multidimensional Pain Inventory) as well as disability (Disability of the Arm, Shoulder and Hand). Multiple linear regression found Stroop test time and motor imagery ability to be related to LRJT performance. Tactile acuity, motor performance, participation in general activities, and the taking of pain medications were predictors of LRJT accuracy in the affected hand. Participants who took pain medications performed poorly in both LRJT accuracy (p=0.001) and reaction time of the affected hand (p=0.009). These participants had poorer cognitive (p=0.013) and motor function (p=0.002), and higher pain severity scores (p=0.010). The results suggest that the LRJT is a complex mental task that involves cognitive, sensory, motor, and behavioural processes. Differences between persons with and without pain and improvement in LRJT performance may be attributed to any of these factors and should be considered in rehabilitation research and practice utilizing this task.

The evolution in Europe towards more competence-based curricula in the last ten years or so is the result of several exogenous factors and a determined European policy. The Reference Framework of Key Competences for Lifelong Learning, a Recommendation approved by the European Parliament and the Council in 2006, and the work carried out within the Open Method of Coordination as well as by European research bodies have had a significant impact on Member States' curriculum reforms. This article shows that some terminology issues, both conceptual and practical, may explain, together with other causes, the diverse formulations of key competences and the way in which they are being integrated into the compulsory education curricula by the Member States or at intra-national levels. The focus of the article is on cross-curricular competences because these are the key competences which require the most significant innovations in teaching and learning practices, on assessment tools and procedures, and school organisation. The analysis illustrates the main differences and convergences in policy formulation and implementation strategies among the EU Member States. It also identifies key obstacles that must be overcome for an effective implementation before suggesting some policy recommendations.

(1) Background: Manihot esculenta, cassava, is an essential food crop for human consumption in many parts of the world. Besides the wide use of its roots, cassava leaves have been used locally as green vegetables and for medicinal purposes. However, nutritional health data regarding cassava leaves is limited, therefore we investigated its composition and associated potential bioactivity interest for human health. (2) Methods: Cassava leaf bioactivity investigations focused on antioxidant properties (free radical scavenging) in association with immunomodulatory activities on inflammatory murine macrophages to measure the impact of cassava extract on the production of pro-inflammatory cytokines such as Interleukin-6, Tumor Necrosis Factor alpha, Monocyte Chemoattractant Protein-1, Prostaglandin-E2 and mediators such as nitric oxide. (3) Results: Antioxidant and immunomodulatory bioactivities were significant, with a concentration-dependent inhibition of cytokines production by inflammatory macrophages; (4) Conclusions: Taken together, our results tend to suggest that Manihot esculenta leaves might be underrated regarding the potential nutrition-health interest of this vegetal matrix for both human nutrition and prophylaxis of metabolic disease with underlying low grade inflammation status. [ABSTRACT FROM AUTHOR]

Near infrared spectroscopy has developed in the polymer industry as a tool for in-line monitoring of processes, particularly extrusion. However, little work is dedicated to the monitoring of chemical reactions involving polymer melts. In this paper, we examine the suitability of NIR spectroscopy for monitoring the chemical modification (catalyzed esterification) of a molten ethylene-vinyl alcohol copolymer by octanoic acid in a twin screw extruder. Extrusion samples are characterized off-line, for calibration purposes, for the three species of interest (i.e. unreacted acid, OH groups, and ester functions formed on the polymer backbone) by means of two techniques: [.sup.1.H] NMR, allowing all three species to be quantified, and residual (free) acid titration. However, the mass balance of free acid is not straightforward, due to loss of mass by volatilization at the vent. Therefore, [.sup.1.H] NMR analysis and acid titration have to be combined to allow for determination of all concentrations. Multivariate calibration is implemented here to quantify and subsequently predict the analyte concentrations by using the NIR spectroscopic data. Our calibration, based on a partial least squares regression software, provides satisfactory results in terms of correlation between actual and predicted concentrations. This work demonstrates the potential of in-line NIR spectroscopy for monitoring chemical reactions with polymer melts in extrusion. POLYM. ENG. SCI., 46:1613-1624, 2006. © 2006 Society of Plastics Engineers, INTRODUCTION Spectroscopic techniques have the potential to meet the demand from the industry for rapid, reliable, and noninvasive analytical methods for process control. Their implementation to obtain real-time information has [...]