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Introduction Design Methods Results Conclusion Clinical Relevance The purpose of this study was to explore nurses' perspectives on Machine Learning Clinical Decision Support (ML CDS) design, development, implementation, and adoption.Qualitative descriptive study.Nurses (n = 17) participated in semi‐structured interviews. Data were transcribed, coded, and analyzed using Thematic analysis methods as described by Braun and Clarke.Four major themes and 14 sub‐themes highlight nurses' perspectives on autonomy in decision‐making, the influence of prior experience in shaping their preferences for use of novel CDS tools, the need for clarity in why ML CDS is useful in improving practice/outcomes, and their desire to have nursing integrated in design and implementation of these tools.This study provided insights into nurse perceptions regarding the utility and usability of ML CDS as well as the influence of previous experiences with technology and CDS, change management strategies needed at the time of implementation of ML CDS, the importance of nurse‐perceived engagement in the development process, nurse information needs at the time of ML CDS deployment, and the perceived impact of ML CDS on nurse decision making autonomy.This study contributes to the body of knowledge about the use of AI and machine learning (ML) in nursing practice. Through generation of insights drawn from nurses' perspectives, these findings can inform successful design and adoption of ML Clinical Decision Support. [ABSTRACT FROM AUTHOR]

Femtosecond lasers interacting with Kerr nonlinear optical materials, propagate in form of filaments due to the balance of beam diffraction by self-focusing induced by the Kerr nonlinearity. Femtosecond laser filamentation is a universal phenomenon that belongs to a general class of processes proper to ultrashort lasers processing systems, associated with the competition between nonlinearity and dispersion also known to promote optical solitons. The present work considers a model describing femtosecond laser inscriptions in a transparent medium with Kerr nonlinearity. Upon inscription, the laser stores energy in the optical material which induces an electron plasma. The model consists of a cubic complex Ginzburg-Landau equation, in which an additional K-order nonlinear term takes into account K-photon absorption processes. The complex Ginzburg-Landau equation is coupled to a time first-order nonlinear ordinary differential equation, accounting for time evolution of the plasma density. The main objective of the study is to examine effects of the competition between multi-photon absorptions, radiative recombination and electron diffusion processes, on temporal profiles of the laser amplitude as well as of the plasma density. From numerical simulations, it is found that when the photon number (i.e. K) contributing to multiphoton ionization is large enough, taking the electron diffusion processes into account favours periodic structures in temporal profiles both of the laser and the plasma density. The pulse repetition rate in the optical soliton train is increased with increase of the electron diffusion coefficient, while the plasma density is a train of multi-periodic anharmonic wave patterns. [ABSTRACT FROM AUTHOR]

Presents a study which gave evidence of resonant optical absorption with tungsten oxide (WO[sub3]) overcoat on thick silver films. Differential reflectance measurements for WO[sub3] overcoats; Reasons that WO[sub3] has been chosen as the discontinuous overlayer; Comparison between WO[sub3] and MgF[sub2].

Résumé: Objectif: L’utilisation de la thermofusion dans l’hystérectomie vaginale a permis une réduction significative du temps et de la douleur postopératoire, ouvrant ainsi la voie à la réalisation de cette intervention en ambulatoire. Notre objectif a consisté en l’étude de la faisabilité de l’hystérectomie vaginale ambulatoire. Patientes et méthodes: Il s’agit d’une étude prospective à propos de 30 patientes ayant bénéficié d’une hystérectomie vaginale ambulatoire selon une technique standardisée. La douleur postopératoire a été évaluée par une échelle visuelle analogique et la durée totale de consommation d’antalgiques relevée. La satisfaction des patientes a été évaluée au moment de la visite postopératoire et par le biais d’une enquête téléphonique. Résultats: La durée opératoire moyenne était de 59,3 (25–110) minutes et le poids moyen de la pièce opératoire de 170,2 (60–710) grammes. Aucune complication intra-opératoire n’est à déplorer. Trois patientes sur 30 (10 %) n’ont pas quitté le service d’hospitalisation le jour de l’intervention. À J1 et J2, les scores de douleur (EVA) étaient de 4,40 et 4,35/10. La durée moyenne de consommation d’antalgiques a été de 5jours (3–8jours). Les patientes ont déclaré être très satisfaites de la prise en charge dans 36,7 % des cas (11/30), satisfaites dans 53,3 % (16/30) et peu satisfaites dans 10,0 % (3/30). Au total, 83,3 % (25/30) auraient accepté de refaire l’intervention dans le secteur ambulatoire. Discussion et conclusion: L’hystérectomie vaginale ambulatoire a démontré sa faible morbidité et un taux de satisfaction globale élevé. Cette technique pourrait être proposée aux femmes clairement informées des risques potentiels. [ABSTRACT FROM AUTHOR]

Abstract: Actually, the choice of surgical approach for pelvic organ prolapse repair depends more on surgeon experience rather than patients characteristics. Laparoscopic sacral colpopexy seems to offer complete repair, low morbidity and satisfactory anatomic and functional results. This technique requires specially trained and experienced surgeons and optimal operative conditions. To improve feasibility of laparoscopic sacral colpopexy, we propose a simplified operative strategy to optimise this complex procedure. [Copyright &y& Elsevier]

Abstract: Electrochromic properties of porous nanostructured thin films of tungsten trioxide were investigated. Films were fabricated at normal and high vapor incidence angles with the technique of glancing angle deposition in a thermal evaporation chamber. A dry lithiation method was subsequently used to intercalate films with lithium atoms. Coloration in both visible and near-infrared regions was observed with lithium insertion. We report on the morphology, porosity, and optical properties of as-deposited and lithiated films, and discuss the role of substrate tilt in comparing the coloration efficiency of these films. [Copyright &y& Elsevier]

Abstract: The rate of incomplete uterine ruptures is unknown. These ruptures are usually asymptomatic but may cause chronic pelvic pain and/or intermenstrual bleeding. The conservative surgical repair techniques described in the literature are often practised by vaginal, combined (vaginal and laparoscopic) or hysteroscopic way. We propose an exclusive laparoscopic repair technique with satisfactory anatomical and functional short-term results. [Copyright &y& Elsevier]

Abstract: The placenta percreta is a rare form of anomaly of placental insertion threatening the maternal and foetal lives. The incidence of abnormal placental adhesion is correlated to frequency of caesarean sections and advanced maternal age. Patients who are at high risk should be identified during pregnancy by ultrasound examination with Color Doppler looking for characteristic features. The practice of MRI in case of echographic suspicion may be useful, particularly in posterior placentas. A late diagnosis, in an emergency context, leads generally to hysterectomy and even to partial resection of neighbour organs. Thus, we report the case of a conservative management associating uterine embolisation following an elective caesarean delivery at 36 weeks gestation. In postpartum, the placental involution was followed clinically and by imagery. In our case, a total abdominal hysterectomy was performed on the fifth postoperative week because of a severe antibiotics resistant infection. No blood transfusion was required and the postoperative period was uneventful. This clinical case aims to show, through an analysis of the recent data of the literature, the interest of modern imagery to select patients with suspected placenta percreta that would be suitable candidates for conservative management. [Copyright &y& Elsevier]

Abstract: Many surgical procedures for the repair of pelvic organ prolapse are used nowadays. Reconstructive pelvic surgery continues to evolve while surgeons continue to search the definitive surgical cure and have to choose the most appropriate procedures for their patients. Concerning the vaginal approach procedures, there is an increasing interest in the use of synthetic meshes which are at present widely used for surgical repair of pelvic organ prolapse. Prosthetic repair seems to be more reliable, especially when native tissues are of poor quality. The use of synthetic meshes may also simplify surgical procedures and reduce operative duration and morbidity. Material must be inert, permanent and resistant to infection. Based on authors'' and other researchers'' published experimental and clinical experience, polypropylene is assumed to be the most appropriate material for the vaginal repair of pelvic organ prolapse. However, since no standardized outcome measure is available, it is difficult to compare the results of surgical procedures. Only in recent studies, the subjective cure rates (patient satisfaction and outcome) have been assessed as well as the objective cure rates determined by the investigators. The subjective cure rate is probably more influenced by the functional outcome and sexual activity than by the anatomical result. Continuous evaluation is necessary to study replacement synthetic materials which should improve the rate of prolapse recurrence and reduce the risk of complications. Randomized controlled trials are required to determine which surgical procedures and type of prosthesis are most suitable. This review evaluates the properties of prosthetic materials, their complications and the most common procedures involved in the use of meshes for pelvic reconstructive surgery. [Copyright &y& Elsevier]

Objective. – To evaluate mid term results, tolerance and efficiency of interposition of a tension-free polypropylene monofilament mesh by vaginal approach for the repair of cystoceles.Patients and methods. – Fourty consecutive women underwent this new procedure between March 2001 and September 2002. After complete dissection of the cystocele, the polypropylene mesh (Gynemesh®, Gynecare, Ethicon, Johnson & Johnson, France), proper cut-out was positioned under the bladder without any fixation. The lateral extensions of the mesh where introduced in the para-vesical spaces in contact with the arcus tendinus fascia pelvis.Results. – Before surgery all patients had cystocele of more or equal than grade II according to the POP-Q classification. Eight had grade II cystocele (20%) and 32 had grade III cystocele (80%). Thirty women had associated posterior or median prolapse (82.5%). Thirty women had urinary incontinence (75%). Mean age was 63.9 years (51–78). The procedure was performed without any difficulty in all cases. Duration of a cystocele cure procedure was 20 min ± 2.2 (16–24). Mean follow-up is 16.4 months ± 4.7 (12–24). The early complication rate was 7.5% (two vaginal erosions and one complete exposition of the mesh which requires secondary ablation). There was no mesh infection. The success rate was 95%. The satisfaction index overpasses 80% in 95% of our patients 6 months after the cystocele repair.Discussion and conclusions. – The interposition of a sub-vesical transversal tension-free polypropylene mesh by the vaginal route seems to be an excellent procedure in the definitive surgical treatment of grades II and III anterior vaginal wall prolapse. This new procedure is simple, mini-invasive, reproducible and efficient with low morbidity and good tolerance. [Copyright &y& Elsevier]

We report the case of a woman, 43 years old, presenting with an ovarian choriocarcinoma. This patient, addressed for a right-side suspicious pelvic mass, had an exploratory laparotomy. Frozen section found an ovarian cancer. The patient had total hysterectomy, left annexectomy and a complete staging surgery. Histology concluded to an ovarian gestational choriocarcinoma. It is a rare germinal tumour, the treatment of which was medical, with radical exeresis and complete staging surgery associated with polychemotherapy. [ABSTRACT FROM AUTHOR]

Aim: To detect effects of desmopressin on sleep in enuretic children and to look for polysomnographical differences between responders and non-responders to desmopressin treatment.Methods: Twenty-one children with primary nocturnal enuresis were examined polysomnographically before treatment. All but one of the children then received treatment with desmopressin in standard dosage, and the response was documented. Seven of the children underwent a second polysomnographic registration while on treatment.Results: The time interval (+/- 1 SD) between sleep onset and the enuretic episode was 92 +/- 67 min without medication and 372 +/- 157 min when desmopressin was given (p = 0.003). Standard polysomnographic variables were not affected by the drug. Ten children were desmopressin responders and 10 were non-responders. The total sleep time was 455 +/- 56 min in the former and 408 +/- 31 min in the latter group (p = 0.04). The responders spent 27.4 +/- 5.5% of their total sleep time in rapid eye movement sleep, compared with 18.2 +/- 6.5% in the non-responder group (p = 0.004).Conclusion: Desmopressin has no major effects on sleep as such but does delay bladder emptying. Enuretic children responding to desmopressin treatment have more rapid eye movement sleep than therapy-resistant children. [ABSTRACT FROM AUTHOR]

Background: Apolipoprotein E (apo E) is a protein associated with plasma lipoproteins. Apo E polymorphism has been related to significant modifications of lipoprotein profile, as well as to the incidence of different pathologies including cardiovascular disease, Alzheimer's disease, and vascular dementia. Furthermore, it was proposed that apo E polymorphism might be involved in the aging selection process.Objective: The purposes of the present study were the following: (1) to evaluate apo E polymorphism in 'successful' and 'unsuccessful' aging, defined as the absence or presence of disability and severe chronic diseases (mainly cardiovascular disease and dementia), respectively; (2) to evaluate the impact of apo E polymorphism on plasma lipids in very old individuals free of or affected by disability.Methods: 253 Italian subjects including 100 free-living healthy octo- and nonagenarians, 62 disabled octo- and nonagenarians, and 91 healthy adult controls, all matched for origin were studied. Apo E phenotypes were determined by PhastSystem (Pharmacia). Lipoprotein parameters (total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, lipoprotein (a), and apoprotein A-I and B) were measured by standardized methods. ADL were evaluated by the Katz index.Results: The frequency of sigma2, sigma3, and sigma4 alleles was 0.062, 0.887, and 0.051 respectively in the entire sample; no differences in alleles distribution were found between the three groups. When the subjects were divided according to the E type (E2 type: E2/E2 and E2/E3; E3 type: E3/E3; E4 type: E3/E4 and E4/E4), no differences in lipoprotein parameters emerged, but a trend toward higher total and LDL-cholesterol from the E2 to the E4 type was observed. The sigma4 allele had a raising effect, while sigma2 had a lowering effect on total cholesterol levels, but these effects were much less profound in the disabled octo- and nonagenarians.Conclusions: We conclude that (1) the frequency of the sigma4 allele is very low in this sample of subjects from central Italy; (2) no differences emerged in sigma4 distribution between healthy and disabled octo- and nonagenarians, and adult controls; the very low frequency of sigma4 allele might contribute to this finding; (3) our data do not support the hypothesis of a possible association between apo E polymorphism and longevity or disability in this population. [ABSTRACT FROM AUTHOR]

An automatic goniometer has been built in order to simultaneously measure the reflectance and transmittance of films at different angles of incidence of the incoming light. The angle can be varied from 7° to 83° and the incident light can be either s or p polarized. Following a minimization procedure, optical constants for the deposited films can be accurately determined. Results for Nb2O5, WO3, LiBO2 are presented and the precision of the method is discussed. [ABSTRACT FROM AUTHOR]

Presents a study which investigated the electrochromic coloration characteristics of thin WO[sub3] films. Factor which limits the reversible electrochromic performance of such types of thin films; Background on the potential applications of electrochromism; Observations on the changes in the optical density of the thin films.

• Cu-Ni/ceria/Al 2 O 3 -spheres catalysts are suitable for a scaling-up process. • Impregnation over Al 2 O 3 spheres improved the redox and textural properties of samples. • For the Water Gas Shift reaction conditions used, internal diffusion is rate limiting. • Cu addition to Ni catalysts enhanced the selectivity towards Water Gas Shift reaction. • Bimetallic catalysts showed a great performance in comparison with literature samples. Water Gas Shift (WGS) reaction recently gained attraction as a purifying method to remove CO in H 2 stream produced from bio-alcohols reforming for fuel cells applications. In previous works, we tested Cu-Ni samples supported on Pr promoted ceria as catalysts for WGS reaction. However, powder samples are not recommended for a scale-up process and ceria samples lack of cohesive forces to obtain a pellet. Then, supported catalysts can be an interesting alternative to study. In the present work, alumina spheres were impregnated in order to replicate the same chemical formulation of powder-state samples. It was studied the influence in catalytic performance of several textural and catalytic features such as: pellet size, active phase content and distribution, Cu:Ni ratio in bimetallic samples, and contact time. The Cu samples showed a moderate activity and the Ni ones a better performance, but tendency to generate CH 4. For all catalysts, the decrease in the pellet size induced a higher CO conversion, indicating strong mass diffusion effects. Besides, it was observed that small addition of Cu to Ni samples significantly moderated the methanation reaction, but maintaining the activity. The change in active metal content slightly modified the activity and changed the selectivity, in agreement with the characterization techniques results (H 2 -TPR and OSC). In summary, the sample with Cu:Ni ratio equal to 1:2 with 1.5 wt%, presented a great performance, by removing 8 to 2 %v/v of CO with an acceptable contact time and high selectivity, being the most promissory catalyst for higher scale tests. [ABSTRACT FROM AUTHOR]

Presents information on a study which determined the electrical and optical properties of lithium (Li)-doped LiBO[sub2] and LiNbO[sub3] films. Effect of doping the ionic conductivity of the films; Degree of transmission exhibited by the films in the spectral region; Impact of Li doping of Li niobate and Li borate films on film ionic conductivies.

Examines the electrical and optical properties of thermally evaporated lithium borate films. Application of the films as lithium ion conductors in electrochromic devices; Representation of the general configuration in thin film form; Details of a complex impedance diagram of a thermally evaporated lithium borate film.

Muscle diseases share common pathological features suggesting common underlying mechanisms. We hypothesized there is a common set of genes dysregulated across muscle diseases compared to healthy muscle and that these genes correlate with severity of muscle disease. We performed meta-analysis of transcriptional profiles of muscle biopsies from human muscle diseases and healthy controls. Studies obtained from public microarray repositories fulfilling quality criteria were divided into six categories: (i) immobility, (ii) inflammatory myopathies, (iii) intensive care unit (ICU) acquired weakness (ICUAW), (iv) congenital muscle diseases, (v) chronic systemic diseases, (vi) motor neuron disease. Patient cohorts were separated in discovery and validation cohorts retaining roughly equal proportions of samples for the disease categories. To remove bias towards a specific muscle disease category we repeated the meta-analysis five times by removing data sets corresponding to one muscle disease class at a time in a "leave-one-disease-out" analysis. We used 636 muscle tissue samples from 30 independent cohorts to identify a 52 gene signature (36 up-regulated and 16 down-regulated genes). We validated the discriminatory power of this signature in 657 muscle biopsies from 12 additional patient cohorts encompassing five categories of muscle diseases with an area under the receiver operating characteristic curve of 0.91, 83% sensitivity, and 85.3% specificity. The expression score of the gene signature inversely correlated with quadriceps muscle mass (r = −0.50, p-value = 0.011) in ICUAW and shoulder abduction strength (r = −0.77, p-value = 0.014) in amyotrophic lateral sclerosis (ALS). The signature also positively correlated with histologic assessment of muscle atrophy in ALS (r = 0.88, p-value = 1.62 × 10–3) and fibrosis in muscular dystrophy (Jonckheere trend test p-value = 4.45 × 10–9). Our results identify a conserved transcriptional signature associated with clinical and histologic muscle disease severity. Several genes in this conserved signature have not been previously associated with muscle disease severity. [ABSTRACT FROM AUTHOR]

The article focuses on the post hoc analysis from an observational study of the patients of type 2 diabetes mellitus in Germany that would provide insights into effectiveness of vildagliptin compared with sulfonylurea in combination with metformin. It mentions that the association of vildagliptin reduces glycated hemoglobin HbA1c and less hypoglycemia while with sulfonylurea the patients shows weight gain problem but no evidence of hypoglycemia.

Objective: To compare the effectiveness and safety of laparoscopic sacropexy (LS) and transvaginal mesh (TVM) at 4 years. Design: Extended follow up of a randomised trial. Setting: Eleven centres. Population: Women with cystocele stage ≥2 (pelvic organ prolapse quantification [POP‐Q], aged 45–75 years without previous prolapse surgery. Methods: Synthetic non‐absorbable mesh placed in the vesicovaginal space and sutured to the promontory (LS) or maintained by arms through pelvic ligaments and/or muscles (TVM). Main outcome measures: Functional outcomes (pelvic floor distress inventory [PFDI‐20] as primary outcome); anatomical assessment (POP‐Q), composite outcome of success; re‐interventions for complications. Results: A total of 220 out of 262 randomised patients have been followed at 4 years. PFDI‐20 significantly improved in both groups and was better (but below the minimal clinically important difference) after LS (mean difference −7.2 points; 95% CI −14.0 to −0.05; P = 0.029). The improvement in quality of life and the success rate (LS 70%, 61–81% versus TVM 71%, 62–81%; hazard ratio 0.92, 95% CI 0.55–1.54; P = 0.75) were similar. POP‐Q measurements did not differ, except for point C (LS −57 mm versus TVM −48 mm, P = 0.0093). The grade III or higher complication rate was lower after LS (2%, 0–4.7%) than after TVM (8.7%, 3.4–13.7%; hazard ratio 4.6, 95% CI 1.007–21.0, P = 0.049)). Conclusions: Both techniques provided improvement and similar success rates. LS had a better benefit–harm balance with fewer re‐interventions due to complications. TVM remains an option when LS is not feasible. At 4 years, Laparoscopic Sacropexy (LS) had a better benefit–harm balance with fewer re‐interventions due to complications than Trans‐Vaginal Mesh (TVM). At 4 years LS had a better benefit–harm balance with fewer re‐interventions due to complications than TVM. [ABSTRACT FROM AUTHOR]

Abstract: Transvaginal ultrasound is the first line imaging investigation in gynaecology. It was thus introduced for the exploration of female stress urinary incontinence at the beginning of the 1980s. Various techniques and parameters of ultrasound examination have been used for the assessment of bladder neck mobility. The aim of this literature review was to suggest the adequate ultrasound technique to study bladder neck mobility. We reviewed articles indexed in MEDLINE dealing with urogenital ultrasound and published between 1998 and 2008. The bladder-symphysis distance measured by transperineal ultrasound is a reliable and reproductive tool to study female stress urinary incontinence. Despite a lack of standardization of Valsalva manoeuvre, normal bladder neck mobility is estimated between 15 and 20mm. Furthermore, in case of complications from stress urinary incontinence surgery, ultrasound is considered as the first line imaging test. Perineal ultrasound is an interesting investigation for preoperative assesment of stress urinary incontinence or in case of surgery failure or complications. This suggests the need for wider diffusion of this technique in urogynecology teams. [ABSTRACT FROM AUTHOR]

Obesity is a growing public health problem because of the morbimortality factors linked to it. In obstetrics and gynecology, consequences on fertility and contraception are notable: infertility, low assisted reproductive technologies (ART) results, miscarriages, congenital abnormalities, obstetrical and neonatal complications, low hormonal contraception efficacy. These effects are partially corrected by weight loss which can be achieved by behavioural, medical or surgical treatment. Gynaecologists should always participate in a multidisciplinary management of obesity before hormonal contraception or ART. [Copyright &y& Elsevier]

Objective: To compare infracoccygeal sacropexy (IS) and sacrospinous suspension (SS) for the treatment of uterine or vault prolapse.Methods: A randomized trial of 49 women assigned to either the IS group using IVS tape (n=24) or SS group (n=25). Concomitant hysterectomy and repairs were performed as appropriate. Evaluations included prolapse staging using the POP-Q system and validated questionnaires for symptoms (PFDI), quality of life (PFIQ), and sexuality (PISQ-12). The primary outcome measure was postoperative pain.Results: Patients' characteristics were similar in both groups. IS was quicker, easier, and less painful than SS (P<0.01). Hemorrhage or hematoma rates were similar. Neither rectal injury nor vaginal erosion occurred. Mean follow-up was 16.8 months. Prolapse cure rates, symptom scores, and quality of life were similar. Postoperative cystocele occurred in 4.8% of women after IS and 25% after SS (P>0.05).Conclusion: Infracoccygeal sacropexy is equivalent to sacrospinous suspension, with a decreased rate of postoperative pain and cystocele recurrence. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The purpose of the study was to compare the postoperative pain of patients who had a hysterectomy through vaginal route according to the process of binding: wire or electrosurgical bipolar vessel sealing. Patients and methods: Retrospective study carried out in the 60 last patients who underwent a hysterectomy by vaginal route for a benign pathology in the gynaecological service of surgery of the CHI Poissy–Saint-Germain-en-Laye until March 2006. Among these patients, 32 had profited from a binding by wire and 28 of the electrosurgical bipolar vessel sealing. The studied criteria were the post-operative pain, total morphine consumption and the durations of the analgesic treatment, the hospitalisation and intervention time. Results: The postoperative pain in the first 24 hours was twice lower using thermofusion; it was valid in immediate post-operative period and after 24 hours. In addition, total morphine consumption was also significantly lower using thermofusion. Discussion and conclusion: This pilot study shows that the electrosurgical bipolar vessel sealing allows a reduction in the pain into the immediate postoperative period. Other prospective and randomised studies would allow it and conclude on the duration of hospitalisation, the quality of life from the patients and the cost in terms of public health. [Copyright &y& Elsevier]

Abstract: Investigation of adverse outcomes in obstetrics and gynaecology requires a systematic and systemically oriented approach. The main objective of these assessments is to decrease their incidence. Lethal complications in obstetrics and gynaecological surgery have become so rare in developed countries that we have to grapple mainly with severe morbidities. A model for such investigation is presented, based on answers to 3 questions: What? How? and Why? These questions correspond to 3 components of quality assurance: Outcome, Process, and Structure, respectively. Aspects of Reason''s model of accidents are also included, in the form of "active failures" and "latent conditions." The latter are divided into basic contributory factors, 4 of which are derived from a model of human factors influencing behaviour in anaesthesia or flight-crew environments. To illustrate its basic nature, the model is applied to anonymized cases of surgical complications. Application of the model to the reactive investigation of close calls is discussed, as is application to the proactive interrogation of the care system for the presence and nature of hazards that pose threats to safety. [Copyright &y& Elsevier]

We studied the relationship between sleep quality and bed surface firmness. Nine men were investigated, sleeping in their homes for at least 5 consecutive nights on a soft and a more firm mattress using a sensor pad placed under the mattress and a solid-state recording device. The subjective feeling of sleep quality did not always agree with the recorded sleep data. The difference was most marked when changing from the subject's own to one of the test mattresses. For the same subject the results were reproducible between nights provided there were no external disturbing factors. Four of the 9 subjects slept significantly better on the softer of the two mattresses and 2 on the hard mattress. The difference in sleep quality observed among the subjects tested makes it necessary to relate the results to the same person rather than considering a whole group as an entity. The adaptation period for a new sleep surface extended to many days. [ABSTRACT FROM AUTHOR]

1‐(6‐Bromohexyloxy)‐4‐propargyloxybenzene upon quaternization with 3‐dimethylamino‐1‐propanol and N,N‐dimethyldodecylamine produced two new inhibitor molecules: N‐[6‐(4‐Propargyloxyphenoxy)hexyl]‐N,N‐dimethyl‐N‐(3‐hydroxypropyl)ammonium bromide (PHAB) and N‐[6‐(4‐Propargyloxyphenoxy)hexyl]‐N,N‐dimethyl‐N‐dodecylammonium bromide (PDAB), respectively, in excellent yields. The inhibitor molecules were characterized by elemental analysis, Fourier transform infrared spectroscopy, 1H NMR, and 13C NMR spectroscopy. The inhibitors were evaluated for X‐60 mild steel corrosion in 15 wt.% HCl using different electrochemical and gravimetric techniques. The potentiodynamic polarization confirms both the inhibitors as mixed‐type corrosion inhibitors. A low concentration (15 ppm) of PDAB has demonstrated excellent corrosion inhibition efficiencies of 97%, 98%, and 86% at 25 °C, 50 °C, and 70 °C, respectively, for 24 h exposure time. SEM and EDX spectra reveal that the adsorptions of corrosion inhibitors on X‐60 mild steel create a protective film that serves as a barrier to mitigate the corrosion process. The X‐ray photoelectron spectroscopy confirmed the chemical interaction between the corrosion inhibitors and mild steel, which was predicted by the Langmuir adsorption model. Assembly of inhibitive motifs of the alkyne, π‐electron‐rich aromatic, quaternary ammonium and C12 alkyl chain hydrophobe in PDAB has augmented its inhibiting action. [ABSTRACT FROM AUTHOR]

Signs and symptoms of craniomandibular dysfunction (CMD) and social medical history were reported in 29 subjects, aged 23-68 years, with longstanding (5 years or more) bruxing behaviour. The subjects were selected from answers to an advertisement in the local newspaper. The subjects presented many symptoms of a general character including somatic and psycho-social problems, sleep disorders (72%). and pain (86%). More than half of the subjects (55%) had symptoms every day. Frequent aches in the neck, back, throat or shoulders. were reported by 69% and frequent headache by 48% of the subjects. The most common symptoms of CMD were pain in the face or jaws (48%), stiffness in the jaws in the morning (44%), temporomandibular joint (TMJ) sounds (34%) and fatigue in the jaws during chewing (38%) and the most common clinical signs were more than three muscles tender on palpation (76%), TMJ-sounds (55%) and tenderness of TMJ on lateral palpation (66%). There was a statistically significant correlation between frequent tooth clenching and headache, pain in the neck, back, throat or shoulders, sleep disorders and high scores of the clinical dysfunction index (Di). The frequent clenchers had higher score values than the `non-clenchers' for pain in the face and the jaws; headache; pain in the neck, back, throat or shoulders and the clinical dysfunction index (Di). These findings indicate a causal relationship between frequent tooth clenching and signs and symptoms of CMD, including headache and pain in the neck, back, throat or shoulders and high pathogenicity for frequent clenching. However, the material in this study is small and some precaution must be taken prior to generalized conclusions. More studies are required, especially sleep laboratory investigations, which could perhaps give answers to some of the numerous questions in this unexplored field of odontology. [ABSTRACT FROM AUTHOR]

The personality pattern of 29 subjects, 10 men and 19 women, with a mean age of 371 years (range 23-68) was studied by means of a personality inventory (KSP) and compared with the personality traits of a `normal population'. The bruxers had significantly higher scores in the somatic anxiety and muscular tension scales and lower scores in the socialization scale; that is, the bruxers were more anxiety-prone, had higher vulnerability for psycho- somatic disorders and were less socialized. The frequent clenchers (once to twice a week) comprised a special subgroup within he material with higher values in the somatic anxiety, psychic anxiety and muscular tension scales. A strong correlation was found between high values in the muscular tension scale and headache; aching neck, back, throat or shoulders; tooth clenching; number of muscles tender at palpation and the clinical dysfunction index (Di). The results of this study indicate a possible aetiological relationship between personality tooth clenching and cranio mandibular dysfunction (CM D), However, the material was small and some precaution must he taken prior to generalization of the results. Studies on larger material are needed and especially more studies in sleep laboratories. [ABSTRACT FROM AUTHOR]

*Hydrophobic tails emerging from NP layers compress the NPs because of the hydrophilic heads present in the water and hydrophobic tails suspended from CO 2. **Viscoelastic surfactant (VS) molecules get entangled to confer stability to the foam. [Display omitted] • CO 2 utilization for EOR to achieve net-zero carbon emissions. • Factors affecting the stability of CO 2 foam in reservoir conditions. • Choice of surfactants and commercial nanoparticles for the generation of stable CO 2 foam. • Usage of functionalized nanoparticles for prolonged stability of CO 2 foam. • Basic requirements for an advanced setup to investigate the stability of CO 2 foam. Modern technology must meet the urgent need for net-zero global carbon emissions to mitigate the deleterious effects of fossil fuel consumption. CO 2 utilization in fields such as oil extraction not only prevents global warming, but also has universal benefits. CO 2 flooding is a well-established and promising technology for enhancing residual oil recovery. Enhanced oil recovery (EOR) from fractured reservoirs is difficult because the injected fluids cannot displace crude oil from the matrix. This may be attributed to the (i) lighter weight and lower viscosity of CO 2 than those of the crude oil in the reservoir and (ii) highly permeable layers in the reservoirs, which provide a "path of least resistance" for CO 2 flow. The injection of large amounts of foam into the matrix can be achieved using a strong and stable foam, which generates high pressure in the fractures by blocking the highly permeable layers and directing the CO 2 towards less permeable zones. Extensive efforts have been devoted to improving the long-term stability of CO 2 foams. Such approaches include the use of surfactants (cationic, anionic, non-ionic, and zwitterionic), viscoelastic surfactants (VES), polymers, and nanoparticles (NPs). This article provides a brief overview of the basic principles underlying CO 2 foam stabilization, selection of surfactants, choice of NPs, the role of surface functionalization of the particles, and various factors affecting CO 2 foam stabilization, reported during 2016–2023. Furthermore, this review highlights the need for experimental protocols to investigate NP-stabilized CO 2 foams. [ABSTRACT FROM AUTHOR]

*Hydrophobic tails emerging from NP layers compress the NPs because of the hydrophilic heads present in the water and hydrophobic tails suspended from CO 2. **Viscoelastic surfactant (VS) molecules get entangled to confer stability to the foam. [Display omitted] • CO 2 utilization for EOR to achieve net-zero carbon emissions. • Factors affecting the stability of CO 2 foam in reservoir conditions. • Choice of surfactants and commercial nanoparticles for the generation of stable CO 2 foam. • Usage of functionalized nanoparticles for prolonged stability of CO 2 foam. • Basic requirements for an advanced setup to investigate the stability of CO 2 foam. Modern technology must meet the urgent need for net-zero global carbon emissions to mitigate the deleterious effects of fossil fuel consumption. CO 2 utilization in fields such as oil extraction not only prevents global warming, but also has universal benefits. CO 2 flooding is a well-established and promising technology for enhancing residual oil recovery. Enhanced oil recovery (EOR) from fractured reservoirs is difficult because the injected fluids cannot displace crude oil from the matrix. This may be attributed to the (i) lighter weight and lower viscosity of CO 2 than those of the crude oil in the reservoir and (ii) highly permeable layers in the reservoirs, which provide a "path of least resistance" for CO 2 flow. The injection of large amounts of foam into the matrix can be achieved using a strong and stable foam, which generates high pressure in the fractures by blocking the highly permeable layers and directing the CO 2 towards less permeable zones. Extensive efforts have been devoted to improving the long-term stability of CO 2 foams. Such approaches include the use of surfactants (cationic, anionic, non-ionic, and zwitterionic), viscoelastic surfactants (VES), polymers, and nanoparticles (NPs). This article provides a brief overview of the basic principles underlying CO 2 foam stabilization, selection of surfactants, choice of NPs, the role of surface functionalization of the particles, and various factors affecting CO 2 foam stabilization, reported during 2016–2023. Furthermore, this review highlights the need for experimental protocols to investigate NP-stabilized CO 2 foams. [ABSTRACT FROM AUTHOR]

Examines resonant optical absorption in discontinuous MgF[sub2] film by deposited on gold surfaces. Consequences of the optical absorption; Applications of enhanced optical absorption in metal films; Description of an ellipsoidal particle model for the explanation of the observed resonant absorption.

Résumé Objectif Évaluer l’effet de l’utilisation d’une colle synthétique sur la durée globale de la promontofixation laparosocpique (PFL) et analyser les résultats fonctionnels, la morbidité et la satisfaction globale des patientes à court terme. Patientes et méthodes Il s’agit d’une étude de type quasi expérimentale, prospective, à propos de 32 patientes ayant bénéficié d’une PFL au CHI Poissy Saint-Germain. Les patientes ont été opérées soit exclusivement par sutures laparoscopiques (Groupe S), soit par colle chirurgicale synthétique en complément des sutures utilisées sur les sites subissant des contraintes mécaniques (Groupe combiné C). Les patientes ont été appariées sur le nombre de prothèses utilisées et les chirurgies associées. L’évaluation de la satisfaction globale a été réalisée par le questionnaire validé PGI-I. Résultats La durée moyenne d’intervention (173,1 [Groupe C] vs 178,7 minutes [Groupe S]) et la durée moyenne de séjour (3,31 [Groupe C] vs 3,94 jours [Groupe S]) n’étaient pas significativement différentes. Trois récidives ont été constatées dans le groupe S dont une réopérée à 7 mois. Le score de satisfaction moyen évalué par le questionnaire PGI-I était de 1,30 dans le Groupe C vs 1,67 dans le Groupe S. Discussion et conclusion L’utilisation de la colle chirurgicale synthétique en complément des sutures n’a pas significativement diminué la durée opératoire de la PFL. Cette pratique a cependant montré son innocuité par rapport à la technique conventionnelle avec une morbidité et des résultats anatomiques et fonctionnels identiques à court terme. Une étude prospective incluant des effectifs plus importants et un suivi plus long restent à réaliser. Aim To study the impact of the use of glue instead of some laparoscopic sutures, on the operative time, the morbidity, and the short-term anatomical and functional results in the laparoscopic sacrocolpopexy (LSCP). Patients and methods Thirty-two patients underwent a LSCP at Poissy-St-Germain-en-Laye University Hospital. The fixation of prostheses was made either exclusively by sutures (Group S), or by associating sutures (on traction sites) and biological glue (Group C). Comparison was made after pairing on the number of prostheses associated surgery. Patients’ satisfaction was assessed thanks to the validated PGI-I questionnaire. Results The mean operative time (178.7 [Group S] vs 173.1 minutes [Group C]) and the mean hospital stay (3.94 [Group S] vs 3.31 days [Group C]) were not significantly different. Anatomical results (POP-Q) and the mean satisfaction rate in the short-term were similar in both groups (1.67 [Group S] vs 1.30 [Group C]. Morbidity was also similar in both groups; no serious complications have been experienced. Discussion and conclusion The use of the glue in the LSCP did not significantly reduce the operative time. However, the use of glue for the adhesion of prostheses in addition to sutures has shown its safety and efficacy compared to the conventional technique (sutures exclusively) since the morbidity, the anatomical results and satisfaction rate are identical in the short-term. A study involving a larger number of patients with a longer follow-up seems necessary. [ABSTRACT FROM AUTHOR]

Aims To assess incidence rates ( IRs) of and identify risk factors for incident severe hypoglycaemia in patients with type 2 diabetes newly treated with antidiabetic drugs. Methods Using the UK-based General Practice Research Database, we performed a retrospective cohort study between 1994 and 2011 and a nested case-control analysis. Ten controls from the population at risk were matched to each case with a recorded severe hypoglycaemia during follow-up on general practice, years of history in the database and calendar time. Using multivariate conditional logistic regression analyses, we adjusted for potential confounders. Results Of 130 761 patients with newly treated type 2 diabetes (mean age 61.7 ± 13.0 years), 690 (0.5%) had an incident episode of severe hypoglycaemia recorded [estimated IR 11.97 (95% confidence interval, CI, 11.11-12.90) per 10 000 person-years ( PYs)]. The IR was markedly higher in insulin users [49.64 (95% CI, 44.08-55.89) per 10 000 PYs] than in patients not using insulin [8.03 (95% CI, 7.30-8.84) per 10 000 PYs]. Based on results of the nested case-control analysis increasing age [≥75 vs. 20-59 years; adjusted odds ratio ( OR), 2.27; 95% CI, 1.65-3.12], cognitive impairment/dementia (adjusted OR, 2.00; 95% CI, 1.37-2.91), renal failure (adjusted OR, 1.34; 95% CI, 1.04-1.71), current use of sulphonylureas (adjusted OR, 4.45; 95% CI, 3.53-5.60) and current insulin use (adjusted OR, 11.83; 95% CI, 9.00-15.54) were all associated with an increased risk of severe hypoglycaemia. Conclusions Severe hypoglycaemia was recorded in 12 cases per 10 000 PYs. Risk factors for severe hypoglycaemia included increasing age, renal failure, cognitive impairment/dementia, and current use of insulin or sulphonylureas. [ABSTRACT FROM AUTHOR]

Résumé: Le prolapsus des organes pelviens est un trouble fréquent de la statique pelvienne de la femme ménopausée. Concernant la gestion du prolapsus de la femme jeune pendant la grossesse, la littérature est particulièrement pauvre. Nous rapportons le cas d’une patiente multipare de 39ans adressée pour la prise en charge d’un prolapsus utérin extériorisé dès 13 semaines d’aménorrhée. La prise en charge de ce type de prolapsus dépend du stade clinique, de l’évolution et du terme de la grossesse. Elle associe le repos et les antiseptiques locaux à la réintégration manuelle ou par pessaire du prolapsus afin de prévenir l’ulcération et la surinfection du col utérin. En cas de prolapsus de stade IV (POP-Q), l’obstacle mécanique par extériorisation permanente du col utérin peut compromettre l’accouchement vaginal et motiver une césarienne, ce qui fut le cas chez cette patiente. S’agissant du mode d’accouchement, aucune recommandation n’est disponible dans la littérature actuelle. Celui-ci doit être clairement discuté en fonction du risque de dystocie cervicale et des risques potentiels de la césarienne. La réparation chirurgicale du prolapsus après l’accouchement devra être discutée en fonction de la gêne fonctionnelle occasionnée et du désir de grossesse ultérieur. [ABSTRACT FROM AUTHOR]

Aims To investigate therapy persistence, frequency of hypoglycaemia and macrovascular outcomes among type 2 diabetes patients with dipeptidyl peptidase-4 ( DPP-4) inhibitors ( DPP-4) and sulphonylureas ( SU). Methods Data from 19 184 DPP-4 (mean age: 64 years; 56% males) and 31 110 SU users (69 years; 51%) with new prescriptions (index date), without additional antidiabetics except metformin, in 1201 general practises in Germany were analysed. Therapy discontinuation (prescription gap >90 days), hypoglycaemia [International Classification of Diseases (ICD-10)] and macrovascular outcomes ( ICD-10) (2-year follow-up) were compared adjusting for age, sex, diabetes duration, metformin, previous hypoglycaemia, health insurance, hypertension, hyperlipidaemia, antihypertensives, lipid-lowering and antithrombotic drugs, microvascular complications and Charlson co-morbidity score using logistic or Cox regression models. Results Two years after index date, DDP-4 (non-persistence: 39%) were associated with a lower risk of discontinuation compared to SU (49%) [adjusted hazard ratio ( HR): 0.74; 95% confidence interval (CI): 0.71-0.76]. Hypoglycaemias (≥1) were documented in 0.18% patients with DPP-4 and in 1.00% with SU [odds ratio (OR): 0.21; 95% CI: 0.08-0.57]. Hypoglycaemias were significantly associated with incident macrovascular complications ( HR: 1.6; 95% CI: 1.1-2.2). Risk of macrovascular events was 26% lower in DPP-4 than in SU users. Conclusions Lack of persistence with antidiabetic therapy is frequently found in primary care patients. DPP-4 was associated with lower therapy discontinuation and a fivefold reduced frequency of patients with hypoglycaemia compared to SU. The low absolute numbers of hypoglycaemias are most likely due to the fact that only severe events were documented. DPP-4 treatment was associated with reduced incidence of macrovascular events relative to SU in type 2 diabetes patients in primary care practises. [ABSTRACT FROM AUTHOR]

Aim: To investigate the efficacy and tolerability of vildagliptin as add-on therapy to metformin in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled with metformin. Methods: This was a 24-week, randomized, double-blind, placebo-controlled study. Patients with T2DM (N = 438) with haemoglobin A1c (HbA1c) of 7.0-10.0% and fasting plasma glucose (FPG) <15 mmol/l (<270 mg/dl) were randomized (1 : 1 : 1) to vildagliptin 50 mg bid, vildagliptin 50 mg qd or placebo in addition to metformin. Results: The treatment groups were well balanced at baseline [mean HbA1c, 8.0%, FPG, 8.8 mmol/l (158 mg/dl); body mass index, 25.5 kg/m2]. The adjusted mean change (AMΔ) in HbA1c at endpoint was −1.05 ± 0.08%, −0.92 ± 0.08% and −0.54 ± 0.08% in patients receiving vildagliptin 50 mg bid, 50 mg qd and placebo, respectively. The between-treatment difference (vildagliptin 50 mg bid-placebo) was −0.51 ± 0.11%, p < 0.001. A greater proportion of vildagliptin-treated patients met at least one responder criterion (82.1 and 70.7%) compared to placebo-treated patients (60.4%). The AMΔ at endpoint for FPG with vildagliptin 50 mg bid, −0.95 mmol/l (−17.1 mg/dl); 50 mg qd, −0.84 mmol/l (−15.1 mg/dl) was significantly different compared with the placebo −0.26 mmol/l (−4.68 mg/dl) (p ≤ 0.001). Adverse events (AEs) were reported as 34.2, 36.5 and 37.5% for patients receiving vildagliptin 50 mg bid, 50 mg qd or placebo, respectively. Two patients in the vildagliptin 50 mg qd and one in the placebo group reported serious AEs, which were not considered to be related to the study drug; one incidence of hypoglycaemic event was reported in the vildagliptin 50 mg bid group. Conclusion: Vildagliptin as add-on therapy to metformin improved glycaemic control and was well tolerated in Chinese patients who were inadequately controlled by metformin only. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To study twin pregnancy and delivery as a risk factor for developing postpartum stress urinary incontinence (SUI). Patients and methods: Retrospective single centre study comparing 117 patients who have delivered twins to 117 patients who have given birth to singletons, between January 2003 and December 2005 in a tertiary maternal-foetal medicine unit. The risk factors associated with the onset of postpartum SUI, its severity, and its impact on the quality of life were studied. Results: Sixty patients in the twin pregnancy group and 59 in the singleton pregnancy group have answered an auto-questionnaire and were included in the study. The medium-term follow-up of the patient was 20.2 months±10.1. The prevalence of SUI in the total population was 30%. The rate was significantly higher in the “twin” group (40%) than in the “singleton” group (20%) (p =0.03). Twin gestation was significantly associated with postpartum SUI for more than 20 months after delivery (OR=2.6 [1.1–5.9]). The univariate analysis found six other risk factors: prenatal urinary incontinence (OR=4.2 [1.7–10.4]), BMI greater than 30 (OR=6.3 [1.2–34.1]), labour duration greater than 8h (OR=4.8 [1.6–14.5]), fundal uterine pressure (OR=4.5 [1.1–18.3]), total intrauterine foetal weight (p =0.003), and immediate postpartum urinary incontinence (OR=12.9 [5–33.5]). Discussion and conclusion: The vaginal delivery of two successive foetuses does not seem more purveyor of SUI than caesarean. In twin pregnancies, the high rate of postpartum SUI appears to be related to total intrauterine weight. [Copyright &y& Elsevier]

This observational retrospective study analysed the association of adherence to statins with the achievement of a target total cholesterol level (CL, <200mg/dl), and any association of adherence with the time to first hospital admission for coronary event in hypercholesterolemic patients treated with statins, in one Italian Local Health Authority between 1998 and 2003. The study population consisted of 3516 patients who were prescribed statins and for whom full cholesterol results were available. After three months of treatment, there were significant reductions in CL (p <0.001) in the three treatment groups stratified by adherence (good adherents −24%, poor adherents −22%, and nonadherents −14%). Patients more likely to achieve the target CL were older, male and more adherent to the statins. The risk of first hospitalization was associated positively with increased age and male gender. Patients with co-treatments were more likely to be hospitalized. Surprisingly, better adherence to statin treatment increased the risk of hospitalization. [Copyright &y& Elsevier]

Abstract: Objectives: Recommendations for clinical practice (RPC) edited by the College of French gynecologists and obstetricians (CNGOF) claim for a more restrictive use of episiotomy. The aims of this study were to assess the impact of these recommendations on episiotomy practice and to evaluate maternal and neonatal outcomes of a more restrictive approach. Patients and methods: We compared in a retrospective analysis episiotomy practice, maternal and neonatal consequences of a restrictive episiotomy policy between 2004 and 2006 (before and after recommendations publication) in a level III maternity unit. Identification of risks factors for episiotomy practice in our population was based on a multivariate analysis. Results: Two thousand and five hundred and 2909 patients who delivered vaginally respectively in 2004 and 2006 were included. In 2006, fewer episiotomies were performed (43.48% vs 32.32%, p <0.0001) and more grade I and II perineal tears occurred (27.56% vs 36.61%, p =0.0001) whereas the anal sphincter tear rate remained constant (0.48% vs 0.69%, p =0.376). Neonatal condition assessed by the Apgar score was also stable. In multivariate analysis, risk factors for episiotomy already described in the literature were significant in our study and year 2006 was associated with less use of episiotomy in comparison with year 2004 (OR: 0.499; IC: 0.44–0.57; p <0.0001). Discussion and conclusion: In our institution, French guidelines were followed by a reduction in the use of episiotomy practice without increasing the risk for severe perineal tear or neonatal distress. [Copyright &y& Elsevier]

Objective To evaluate the risk of vascular injury during transobturator approach of cystocele repair. Design Dissection of the obturator area by perineal approach was performed after placement of mesh needles used for cystocele mesh repair. Setting Surgery school of Paris. Population or sample Twenty obturator regions in ten fresh female cadavers. Methods Transperineal dissection of the obturator area was conducted in ten fresh female anatomic subjects after inserting anterior Prolift® needles. Main outcome measures The vascular anatomy of the obturator region was mapped. Distances between needles and vascular structures of the obturator area were measured three times and averaged for each side. Results The anterior cannula-equipped needle perforated the gracilis and the adductor brevis muscles. The mean (SD) distance to the anterior obturator vessels was 21.2 (1.6) mm on the right side and 20.4 (1.5) mm on the left. The posterior needle perforated the adductor magnus. Its distance to the posterior division of the obturator vessels was 1.8 (1.0) mm on the right side and 1.1 (0.9) mm on the left. Conclusions During mesh cystocele repair by transobturator approach, the posterior obturator vessels division seems at risk of injury during the posterior needle insertion. [ABSTRACT FROM AUTHOR]

The article presents a case study of a postmenopausal woman who experienced a hemorrhage complication during transvaginal repair of cystocele using the transobturator method, a minimally invasive procedure. It states that the accidental puncturing of the internal hypogastric vein following a posterior left needle insertion causes the hemorrhage. Embolization of the area affected temporarily confines the condition.