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Bituminous geomembranes (BGM) have been used over the last 20 years in mining applications in innovative ways, to reduce the hazards of mining in the environment. BGM is a reinforced geomembrane made of a geotextile from 250 gr/m² to 400 gr/m2 impregnated by elastomeric bitumen. This gives the geomembrane unique features that enables their use in demanding weather conditions of low temperatures (– 45°C or -49°F in Northern Canada or Europe) or high temperatures (+40°C in Brazil) due to its low thermal expansion coefficient that avoids the formation of wrinkles. This allows the installation and welding at high temperatures in the countries of Latin America. This paper will describe how several unique characteristics have been used for challenging and environmentally sensitive mining projects throughout the Americas, including treatment of solid waste spoil dumps (heap leach pads, closure, and encapsulation of mining facilities) of different types of ore: gold, diamonds, lithium, copper, silver, rare earth: niobium and in hydraulic applications for tailings or clear water dams and reservoirs.

Background: At the beginning of the COVID-19 pandemic, professionals in charge of particularly vulnerable populations, such as adult congenital heart disease (ACHD) patients, were confronted with difficult decision-making. We aimed to assess changes in risk stratification and outcomes of ACHD patients suffering from COVID-19 between March 2020 and April 2021., Methods and Results: Risk stratification among ACHD experts (before and after the first outcome data were available) was assessed by means of questionnaires. In addition, COVID-19 cases and the corresponding patient characteristics were recorded among participating centres. Predictors for the outcome of interest (complicated disease course) were assessed by means of multivariable logistic regression models calculated with cluster-robust standard errors. When assessing the importance of general and ACHD specific risk factors for a complicated disease course, their overall importance and the corresponding risk perception among ACHD experts decreased over time. Overall, 638 patients (n = 168 during the first wave and n = 470 during the subsequent waves) were included (median age 34 years, 52% women). Main independent predictors for a complicated disease course were male sex, increasing age, a BMI >25 kg/m2, having ≥2 comorbidities, suffering from a cyanotic heart disease or having suffered COVID-19 in the first wave vs. subsequent waves., Conclusions: Apart from cyanotic heart disease, general risk factors for poor outcome in case of COVID-19 reported in the general population are equally important among ACHD patients. Risk perception among ACHD experts decreased during the course of the pandemic., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Professor Werner Budts reports financial support was provided by Abbott and Occlutech. Following co-authors: Dr. Pastora Gallego, Dr. Magalie Ladouceur, Dr. Massimo Chessa, Professor Werner Budts and Prof. Helmut Baumgartner are Associate Editors and, therefore, members of the Editorial Board of the International Journal of Cardiology Congenital Heart Disease., (© 2022 The Authors.)

Evaluation of right ventricular (RV) function after tricuspid valve surgery is complex. The objective was to identify the most appropriate RV function parameters for this purpose. This prospective study included 70 patients undergoing cardiac and tricuspid valve (TV) surgery. RV size and function parameters were determined at 3 months and 1-year post-surgery. Categorical variables were analyzed with the McNemar test and numerical variables with the Student's t-test for related samples or, when non-normally distributed, the Wilcoxon test. Spearman's rho was used to determine correlations between variables at 3 months and 1 year. RV diameters were reduced at 3 months post-surgery and were then unchanged at 1 year. Tricuspid annular plane systolic excursion (TAPSE) and S' wave values were worse at 3 months and then improved at 1 year (t-score-2.35, p 0.023; t-score-2.68; p 0.010). There was no significant reduction in free wall longitudinal strain (LS) or shortening fraction (SF) at 3 months (t-score 1.421 and - 1.251; p 0.218 and 0.172), and they were only slightly below pre-surgical values at 1 year. No relationship was found between RV function parameters and mortality or major complications. During the first few months after TV surgery, LS may be a more appropriate parameter to evaluate global ventricular function in comparison to TAPSE. At 1 year, good correlations are observed between TAPSE, S' wave, and LS values., (© 2022. The Author(s).)

Background : Though multidisciplinary pain treatment (MPT) is considered the gold standard for managing chronic pain, it is unclear which patients benefit most from this high-cost treatment approach. Aims : The goals were to identify subgroups of patients sharing similar pain severity trajectories over time and predictors of MPT responsiveness. Methods : Participants were 1894 patients (mean age = 53.18 years [SD = 14.0]; female = 60.3%) enrolled in the Quebec Pain Registry with moderate to severe baseline pain severity. Patients completed validated questionnaires on pain and related constructs before initiating treatment and 6, 12, and 24 months later. Results : Trajectory analyses of pain severity (intensity and interference) showed that a three-class model best fit the data. Two of the trajectories, which included 24.5% of patients, showed significant improvement in pain severity levels over time (improvers). Compared to patients in the nonimproving trajectory (non-improvers), improvers were younger and more likely to suffer from neuropathic pain and had pain of shorter duration, lower worst pain intensity, lower sleep disturbances and depression scores at baseline, a lower tendency to catastrophize, and better physical health-related quality of life (QOL). This predictive model had a specificity of 96.2% and a sensitivity of 23.6%. Conclusions : Only a minority of patients exhibited an improvement in their pain severity with MPT. Several patients' characteristics were significantly associated with pain trajectory membership. Early identification of nonimprovers, through examination of baseline characteristics and rates of change in pain scores, can provide valuable information about prognosis and open the doors for evaluation of different cost-effective treatment approaches. Abbreviations : CP = chronic pain; MPT = multidisciplinary pain treatment; QPR = Quebec Pain Registry; QOL = quality of life., (© 2017 M. Gabrielle Pagé, E. Manolo Romero Escobar, Mark A. Ware, and and Manon Choinière. Published with license by Taylor & Francis.)

Purpose: The aim of this study was to explore acute movement-evoked postoperative pain intensity trajectories over the first 5 days after total hip arthroplasty (THA) and to examine how these pain trajectories are associated with pain-related outcomes 6 weeks and 6 months later., Methods: A total of 150 adult patients [72 women (48.0 %); mean age 60.0 ± 9.2 (standard deviation) years] completed pain questionnaires preoperatively, several times daily postoperatively until hospital discharge, and 6 weeks and 6 months after surgery., Results: Results showed that the best model had four different acute postoperative pain trajectories and a significant quadratic term. The trajectories varied in terms of initial pain intensity levels and rates of decline/increase in pain over the first 4 postoperative days. Significant predictors of pain trajectory membership were preoperative pain disability and anxiety as well as cumulative morphine consumption 24 h following surgery. Pain trajectories were significantly associated with levels of pain intensity and anxiety at 6 weeks but not at 6 months postoperatively., Conclusion: This study showed that during the postoperative period patients differed in terms of pain intensity profiles and that these differences were associated with outcomes for up to 6 weeks following surgery. Pain trajectories were not predictive of persistent postoperative pain status at 6 months. Nonetheless, these results highlight the importance of patient heterogeneity in acute postoperative pain and pain-related outcomes months after THA.

It has been demonstrated that the human biomonitoring of susceptible populations is a valuable method for the identification of critical contaminants. Therefore, the purpose of this study was to assess the exposure profile for arsenic (As), lead (Pb), mercury (Hg), 1-hydroxypyrene (1-OHP), 1,1-bis(p-chlorophenyl)-2,2,2-trichloroethane (DDT), 1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene (DDE), polybrominated diphenyl ethers (PBDEs), and polychlorinated biphenyls (PCBs) in children living in Ciudad Juarez, Chihuahua, Mexico (a major manufacturing center in Mexico). In 2012, we evaluated a total of 135 healthy children living in Ciudad Juarez since birth. The total PBDEs levels ranged from nondetectable (< LOD) to 215 ng/g lipid, with a mean total PBDEs level of 29.5 ± 53.0 ng/g lipid (geometric mean ± standard deviation). The mean total PCBs level in the study participants was 29.0 ± 10.5 ng/g lipid (range 4.50-50.0 ng/g lipid). The mean concentration of total DDT (DDT + DDE) was 11.9 ± 6.70 ng/g lipid (range 3.00-26.0 ng/g lipid). The mean 1-OHP levels was 1.2 ± 1.1 µmol/mol creatinine (range

The goal of this study was to follow a cohort of patients undergoing total knee arthroplasty over time to: (1) identify and describe the various pain trajectories beginning preoperatively and for up to 12 months after surgery, (2) identify baseline predictors of trajectory group membership, and (3) identify trajectory groups associated with poor psychosocial outcomes 12 months after surgery. One hundred seventy-three participants (female = 85 [49%]; mean age [years] = 62.9, SD = 6.8) completed pain and psychological questionnaires and functional performance tests preoperatively and 4 days, 6 weeks, and 3 and 12 months after total knee arthroplasty. Using growth mixture modeling, results showed that a 4-group model, with a quadratic slope and baseline pain data predicting trajectory group membership, best fit the data (Akaike information criterion = 2772.27). The first 3 pain trajectories represent various rates of recovery ending with relatively low levels of pain 12 months after surgery. Group 4, the constant high pain group, comprises patients who have a neutral or positive pain slope and do not show improvement in their pain experience over the first year after surgery. This model suggests that preoperative pain levels are predictive of pain trajectory group membership and moderate preoperative pain, as opposed to low or high pain, is a risk factor for a neutral or positive pain trajectory postoperatively. Consistent with previous studies, these results show that postoperative pain is not a homogeneous condition and point to the importance of examining intraindividual pain fluctuations as they relate to pain interventions and prevention strategies.

Objective: To determine the validity (construct, concurrent) of the Reintegration to Normal Living (RNL) Index for measurement of community participation in adults with chronic spinal cord injury (SCI)., Design: Cross-sectional telephone survey., Setting: Rehabilitation institute., Participants: Community-dwelling adult men and women (N=617) with SCI who were at least 1 year postinjury., Interventions: Not applicable., Main Outcome Measures: RNL Index and Satisfaction With Life Scale (SWLS)., Results: Reliability of the RNL Index was determined by using Cronbach α, and construct validity was established through confirmatory factor analysis (CFA). In addition, general linear models to predict RNL Index scores were conducted to establish concurrent validity. The RNL Index is a reliable measure of community participation (α=.87). CFA analyses suggested that the RNL Index loads onto a 2-factor solution and is distinct from the SWLS. Significant predictors of RNL Index score included years post-injury, impairment, ambulatory status, employment, and poor health, which yielded R(2)=.26 (P<.001)., Conclusions: The RNL Index is a valid and reliable measure of community participation for persons with chronic SCI of traumatic cause., (Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: To develop, and provide initial validation of, a 20-item Child Pain Anxiety Symptoms Scale (CPASS), a modified version of the adult 20-item Pain Anxiety Symptoms Scale., Methods: A community sample of children and adolescents (N = 959) aged 8-18 years completed the CPASS and measures of pain catastrophizing, anxiety sensitivity, and general anxiety. Factor structure was assessed using exploratory and confirmatory factor analyses (EFA and CFA)., Results: EFA yielded a one- and a three-factor solution using 17 items of the CPASS. CFA supported a hierarchical model for both a 20-item four-factor solution (based on the adult literature) and a 20-item slightly modified four-factor solution. The CPASS showed excellent internal consistency (Cronbach's alpha = .903) and good construct, discriminant, and concurrent validity., Conclusions: This study provides support for the relevance of pain anxiety in a community sample of children and adolescents and offers preliminary validity and reliability for the CPASS.

The shared management put into effect by the "Ações Integradas de Saúde" (Integrated Health Actions) in the State of S. Paulo (Brazil), in the early 80s is analysed. The relevant data were collected from the minutes of the meetings of the "Comissão Interinstitutional de Saúde" (Interinstitutional Health Committee). The data collected show the most frequent subjects discussed by the members at the meetings, the number of members related to each of the different government levels, in addition to the kind of resolutions taken at the meetings. The data analysis has demonstrated that important changes took place in public health management in the State of S. Paulo in the decade in question. The shared management process was replaced by one in which government powers were clearly divided a towards the end of the 80s. Those changes have led the public health members from each level of governmental administration to give up the common goals and the shared negotiations among them.

Povidone-iodine instillation into the lymphatic cavity is a simple method for lymphocele treatment in renal transplantation. We describe 2 cases successfully treated with this procedure.