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Background Cardiovascular disease, one of the main Non-Communicable Disease (NCD), is the first cause of death in the world representing 30% of global mortality. Their prevention, early detection, reduction of risk and progression are major daily challenges. Success depends on patient adherence which is the most enigmatic and difficult challenge for the physician to assess. Our objective was to better understand Patients' Experience, including their behavior and knowledge of the risks and benefits of their treatment, as well as their perception of therapeutic adherence and iatrogenic risk. Purpose This real-world study conducted on patients affected by cardiovascular diseases, identified their views on iatrogenic risk and compliance with their condition and treatment intake. Method An online survey was conducted on the Carenity platform among adult patients affected by cardiovascular disease (CV) between February 14th and May 15th, 2020. A multiple correspondence analysis (MCA) was performed on a dataset of French patients with CV disease using a hierarchical cluster analysis. Results 403 patients (women 54%) mean age 60,6 YO with High Blood Pressure (56,6%), diabetes (28,3%), heart attack (26%), hypercholesterolemia (22%), arrythmia (19,6%), stroke (14%). Mean number of medications per day was 5,1 and 6,1 of pills. 3 groups of patients were identified as per MCA. The group 1 “at risk” (n=168) concerns the least compliant patients, mostly women. They visit more often their doctor (83%), whom they are afraid to disappoint. 46% deliberately deviate from initial prescription even if they feel compliant (73%). They consider they are less likely to have received explanation on treatment benefits (73%). They seem to be more worried about incompatibility with daily life (33%) and frequency of administration (40%). 34% are more likely to be afraid of becoming dependent and 49% lacking efficacy. 76% discuss about constraints and risks with someone. The group 2 “tolerant” (n=90) includes patients less aware with interactions with other treatments (73%) and with alcohol (64%). They do not think it is necessary to inform their doctor about compliance issues (76%). The group 3 “reporters” (n=145) concerns patients, mostly men, who feel more compliant (90%) than others. They feel informed (84%), they use practical solutions to be compliant (63%) and they are aware of treatment interactions such as tobacco (37%). Conclusion These results from the Patient Experience, suggest new patient behaviors and profiles. They focus on coping mechanisms and solutions they develop to manage their relationship with treatment. These identified profiles should be included in the Therapeutic Patient Education approach. The objective is to improve overall management by increasing compliance and reducing the iatrogenesis risk. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Pfizer PFE France, a Viatris company

Background Omalizumab, an anti-IgE antibody, is used to treat patients with severe allergic asthma. The evolution of lung function parameters over time and the difference between omalizumab responder and nonresponder patients remain inconclusive. The objective of this real-life study was to compare the changes in forced expiratory volume in 1 second (FEV1) of omalizumab responders and nonresponders at 6 months. Methods A multicenter analysis was performed in 10 secondary and tertiary institutions. Lung function parameters (forced vital capacity (FVC), pre- and postbronchodilator FEV1, residual volume (RV), and total lung capacity (TLC) were determined at baseline and at 6 months. Omalizumab response was assessed at the 6-month visit. In the omalizumab responder patients, lung function parameters were also obtained at 12, 18, and 24 months. Results Mean prebronchodilator FEV1 showed improvement in responders at 6 months, while a decrease was observed in nonresponders (+0.2±0.4 L and −0.1±0.4 L, respectively, P

This research study examines the ageless human debate of the body versus the soul, testing leadership in the industry of building constructors. Based on Kohlbergian theory of cognitive moral development, the multidisciplinary literature review advances the proposition that moral development proceeds in waves of egoism, leading to altruism that is couched in power—“the apple of the eye.” The results from respondents of the Iowa Architects Institute of America (n = 93) indicated that, despite their higher education and aesthetic interests, the sample of architects ranked low on moral maturity level compared to the average of the Defining Issues Test data bank as a whole. Principled scores were 36.4 for architects and 39.1 for the data bank. This research also compared the moral maturity of intra-industry groups in marketing dyads consisting of architects, contractors, and suppliers using analysis of variance. Again, it was expected that architects with higher education and aesthetic interests would rank highest. Findings of post hoc comparisons revealed no significant difference in moral maturity level between architects and contractors engrossed in the same power paradigm (p = 1.00), yet a significant difference existed between architects and suppliers (p = 0.024). This implication is consistent with the teleological ethical pattern that is prevalent in research studies of salespeople.

This article presents and discusses the theory of universal human values, the universal human values of people across cultures, and how culture and values impact organizations. This article reviews the history and research into human values, culture, and behavior, followed by reviews of Hofstede’s Cultural Dimensions and Schwartz and Bilky’s Theory of Universal Human Values. A strong connection exists between these theories and their related empirical research, not only chronologically, but also theologically and methodologically. The subjects are presented in a temporal sequence. Thus, the work of Professor Gert Hofstede is presented first; the work of Schwartz, Bilsky, is more recent, but strongly linked to prior research by Hofstede on values and culture. The objective is to improve ones understanding of work-related values, culture, and the impact that values may have on individuals in different cultural environments that are found in international organizations. This study tests to see if there is a difference in individualism scores of Mexican and American engineers when compared to Hofstede’s original study in 1980. This study also looks at the Mexican and American engineer samples to see if their scores on Hofstede’s cultural dimensions show a correlation with the scores on Schwartz’s culture-level dimensions. The study attempts to determine if there is a divergence or convergence of cultural values. Findings of the study are reported.

To measure the effects of dietary n-3 polyunsaturated fatty acid (PUFA) supplementation on the reproductive capacity of adult male turkeys in industrial flocks, the males of 22 commercial farms were fed either a standard diet or a fish oil diet enriched in n-3 PUFAs. The fatty acid composition of the spermatozoa and reproductive performance were measured throughout the reproductive period. The fish oil diet very effectively increased the percentage of n-3 fatty acids (FA) (22:5n-3 and 22:6n-3) in spermatozoa and correspondingly decreased the percentage of n-6 PUFAs (20:4-6 and 22:4n-6): the n-3/n-6 ratio in spermatozoa fatty acids were 0.04-0.07 with the standard diet and 0.32-0.4 with the fish oil diet. These changes did not affect the spermatozoa content of n-9 PUFAs, particularly of 22:3n-9 which is abundant in turkey spermatozoa (9-12% of the total fatty acids). The supplementation was effective in the middle as at the end of the reproductive period. The reproductive capacity of males was modified by the diet and the positive effect of the n-3 supplemented diet increased with age (increase in hatching rates of nearly 2 points at 48-58 weeks for males fed fish oil diet). These results indicate that an increase in the dietary ratio of n-3/n-6 PUFAs is valuable to sustain the reproductive capacity of male turkeys especially when they are getting older.

Une paroi experimentale renforcee par clouage a ete realisee dans le cadre d'un chantier autoroutier. Cet ouvrage, de 10m de hauteur, a ete instrumente de maniere a suivre l'evolution des deplacements et des efforts mobilises dans les clous au cours de sa realisation. Les resultats indiquent que les deplacements sont concentres dans une zone proche du parement et que les efforts, nettement inferieurs a la resistance des barres, varient en fonction de la nature des terrains traverses. Des calculs effectues par elements finis montrent que l'on peut raisonnablement predire le comportement de l'ouvrage. (A). (Titre en anglais : Mechanical behaviour of an experimental wall reinforced by nailing).

It is well known that cuffs of endotracheal tubes can induce ischemic injuries on tracheal epithelium, as a result of mechanical hyperpressure caused by the cuff on the airway tissue. Whether or not material components are leached out and may provoke a direct toxic effect on the respiratory epithelium is much less clear. To study the cytocompatibility of such materials, we have developed an in vitro cell system using human tracheal epithelial cells, arising from trachea superficial biopsies. In culture, cells have been characterized by morphological and immunocytochemical criteria. Ultrastructural observations suggest that our culture conditions are permissive for the expression of both squamous and secretory phenotypes. We have assessed the cytocompatibility of a cuff towards epithelial cells, first, by an indirect test, and second by a direct test. By the indirect test, using material extracts, we did not find any toxic effect towards human airway epithelial cells of the cuff components. By a direct test, we found a slight cell lysis after a 24 h incubation. Our study shows that this human tracheal epithelial cell system is a useful and relevant model which could be used in a quality control procedure for testing the cytocompatibility of materials for endotracheal use.

The population of Kosovo had suffered years of abuse, ethnic cleansing, turmoil, human atrocities, and constant conflict - the results of which plunged Kosovo into costly war. Following the war Kosovo was placed under the protection of the United Nations in 1999. Kosovo received many years of support and developmental assistance from the international community and became a sovereign nation in February 2008. It was very important for Kosovo’s government to serve the needs of the people without continued oversight and intervention by the United Nations. Public institutions are vital to the success of the government. There is no institution more important to the successful development of a sovereign nation and their economy than the ethical administration of a tax authority. In the spring of 2008, after Kosovo’s declaration of independence, this study was initiated to determine the moral maturity of the members of the Tax Authority of Kosovo. This study provides a review of the current situation in Kosovo and discusses ethical considerations in tax administration. The paper further provides a comprehensive discussion of ethical concerns and discusses the importance of moral development in the tax administration of Kosovo. Recommendations for managers and future research are presented.

Le comportement de l'ecran de soutenement d'une tranchee experimentale etroite a ete etudie au moyen de la methode des elements finis et de la methode des modules de reaction. La confrontation des resultats numeriques aux mesures de deplacements realisees in situ a permis de comparer les performances de chacune des methodes et de preciser leurs limites. L'importance d'une determination representative des modules de deformation est demontree en s'appuyant notamment sur l'evolution des modules pressiometriques observee en fin d'excavation dans la zone du fond de fouille. (Titre en anglais : Behaviour of the retaining structure for a narrow experimental trench).

About 99.8 % of the land sustaining biodiversity in Chile is rural and regulated by legislation, which has been qualified as disperse, too specific or inorganic. Even though modern legislation like (Chilean Law of Environmental Basis) tends to be more holistic in nature, serious imperfections connected with applicability, interpretation and, mainly enforcement still prevails. We argue here that any search for, or application of, ecological models as a support for conservation biology could be strongly complemented by a measurement of the land surface (amount and spatial distribution) effectively affected by present environmental protection legislation. Our study attempts to answer to the question of how much land will be effectively under protection if law is enforced. To answer this question we designed and tested a methodology to express, in cartographic form, legal dispositions related with Chilean native forest protection. We analyzed its complexity and the effects of its application. We show that it is enough to enforce the law to get to assure a minimum of land, which in addition of increasing the currently protected are also increases connectivity while changing fragmentation patterns. Our SIG based methodology has advantages in terms of its application to environmental monitoring, planning and control of social initiatives.

An industry-wide mortality study on the association between lung cancer and occupational exposure to cobalt and tungsten carbide was carried out in the French hard-metal industry. This case-control study was nested in the historical cohort of workers ever employed in this industry's 10 facilities, most of which are located in eastern France. Workers were followed up from 1968 to 1991. Occupational exposure was assessed using a job-exposure matrix that provided semiquantitative scores for 320 job periods. These scores were significantly correlated with the levels of cobalt measured in 744 historical air samples. In this cohort, which comprised 5,777 males and 1,682 females, the death rate from lung cancer was significant (63 deaths, standardized mortality ratio=1.30, 95% confidence interval (CI) 1.00-1.66) when compared with national death rates. Sixty-one cases and 180 controls were included in the study. When the exposures during the last 10 years were ignored, a twofold lung cancer risk was observed among workers simultaneously exposed to cobalt and tungsten carbide (odds ratio (OR)=1.93, 95% CI 1.03-3.62) adjusted for other cobalt exposure (OR=2.21, 95% CI 0.99-4.90). The odds ratios increased with cumulative exposure (first quartile, OR=1.00; second quartile, OR=2.64; third quartile, OR=2.59; fourth quartile, OR=4.13) and, to a lesser degree, with duration of exposure (one decade, OR=1.00; two decades, OR=1.61; three decades, OR=2.77; four decades, OR=2.03). Adjustments for smoking and for exposures to known or suspected carcinogens did not change the results, yet the odds ratio for smoking (3.38) was lower than expected, suggesting the possibility of some misclassification. Occupational risk was highest among smokers. This study supports the hypothesis that workers who manufacture hard metals have an increased mortality from lung cancer due to simultaneous exposure to cobalt and tungsten carbide.

A job exposure matrix (JEM) was developed by a committee of experts using the DELPHI method, in the French hard metal industry, in order to assess occupational exposures to cobalt along with tungsten carbide resulting from the industrial process. This JEM is part of a nested case-control study, carried out within the historical cohort of workers ever employed in these factories, aimed at assessing lung cancer risk. The committee included 8 experts: hygienists, chemical engineers, occupational physicians and epidemiologists. The JEM was developed in four stages: (i) visit of factories, (ii) definition of lines (job-periods) and columns (exposures) of the JEM, (iii) definition of coding procedures, (iv) coding the cells of the JEM. This last stage used a method derived from the DELPHI method. Throughout the study period 1945-1994. 320 job-periods and 21 agents were defined. A quantitative assignment (level 0 to level 9) along with a frequency code (1 to 3) was attempted for 4 agents, whereas only a qualitative assignment (non exposed/exposed, i.e. 0/l) was done for the other agents. An additional probability code (1 to 3) was assigned to all agents. This procedure led to 46 columns and 14,720 cells in the JEM. When applying the DELPHI method, the consensus of the committee was obtained for 85% of all cells after the first individual assignment of experts, 88% after the second individual assignment and 100% after the third assignment by the experts all together. In order to validate the JEM, these expert assignments will be brought together with the results of exposure measurements that were performed in some workplaces of these factories. The JEM will also be linked with the data base of the case-control study for the exposure assessment of cases and controls.

Cobalt urinary excretion should be a good way to know the level of exposition of subjects submitted to hard metals. The study is done on 28 workers of 3 different workrooms. Sunday 24 hours diuresis is retained. For 5 workers, the urinary cobalt measurements are done from samples made at the beginning and the end of work during 5 days. Atmospheric dust measurements are realized in different points of the 3 workrooms (individual and general samples). For measures atomic absorption spectrometry is used. The results show a good correlation between cobalt exposure and urinary concentrations. Friday evening urinary cobalt is a good expression of week exposure. The results obtained well correlate with those of others authors. Cobalt urinary measures are proposed for supervision of workers exposed to hard metals.

The frequency of bronchial symptoms and the alteration of respiratory function parameters were studied in a group of 63 workers of an industrial flour-mill, and in a control group matched according to age, social class, and tobacco intake. In the exposed group the answers to a questionnaire indicated a greater incidence of cough (p less than 0.01) and chronic expectoration (p less than 0.01) as well as clinical airway hyperreactivity (p less than 0.01). No differences were noted for either asthma or allergy. The respiratory function parameters did not differ between the two groups studied. These results suggest that workers exposed to the vegetable dust found in fluor-mills are subject to develop chronic bronchial irritation.