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The aim of this study is to evaluate the implementation of healthy lifestyle education in the fulfillment of child-friendly school indicators at the Surakarta institution of early childhood education. The history of this research is the responsibility of schools in the city of Surakarta to obtain the title of child-friendly schools, which in many measures of child-friendly schools implies healthy living behaviors. Efforts in the collaboration to achieve the status of child-friendly kindergarten. Education for healthier lifestyles is crucial in achieving the fulfillment of children's rights and security. This method of analysis uses descriptive qualitative studies through questionnaires, interviews, and documentation to analyze the data. In addition to fulfilling children's rights and protecting children, which are the key objectives of child-friendly schools, the conclusion of the healthy living habits investigation has been well carried out and supports the fulfillment of child-friendly school indicators. Abstrak Tujuan penelitian ini adalah untuk mengevaluasi implementasi pendidikan gaya hidup sehat dalam pemenuhan indikator sekolah ramah anak di lingkungan PAUD Surakarta. Sejarah penelitian ini adalah tanggung jawab sekolah di kota Surakarta untuk mendapatkan predikat sekolah ramah anak, yang dalam banyak ukuran sekolah ramah anak mengandung arti perilaku hidup sehat. Upaya kolaborasi untuk mencapai status taman kanak-kanak ramah anak. Pendidikan untuk gaya hidup sehat sangat penting dalam mewujudkan pemenuhan hak dan keamanan anak. Metode analisis ini menggunakan studi deskriptif kualitatif melalui angket, wawancara, dan dokumentasi untuk menganalisis data. Selain pemenuhan hak anak dan perlindungan anak yang menjadi tujuan utama sekolah ramah anak, kesimpulan dari investigasi kebiasaan hidup sehat telah dilakukan dengan baik dan mendukung pemenuhan indikator sekolah ramah anak.

Introduction Information and communication technologies (ICTs) play a major role in the current evolution of work. They are both a great tool for emancipating human beings from the most tedious and most dangerous tasks and an effective vector for intensifying work. Methods On the basis of three foresight exercises carried out in recent years and by describing concrete examples of work organizations, the authors highlight the main possible trends for the changes to come. Conclusions They conclude on a few general principles that could allow the establishment of a win–win policy.

International audience; Objective To determine long-term predictors of bronchial hyperresponsiveness (BHR) and forced expiratory volume in one second (FEV1) decline.Methods A longitudinal study in 110 bakers in 4 industrial bakeries and 38 non-exposed workers was conducted at the workplace with a mean of 3.3 visits per subject over a period of 13 years and a mean duration of follow-up of 6 years in bakers and 8 years in non-exposed subjects. A respiratory health questionnaire was administered; occupational allergen skin prick tests, spirometry and a methacholine bronchial challenge test were performed at each visit. In each bakery, full-shift dust samples of the inhalable fraction were obtained in order to assess the exposure of each job assignment. The repeated measurements of BHR and FEV1 were analyzed using mixed effects logistic and linear regression models in subjects seen at least twice.Results BHR, respiratory symptoms and their simultaneous occurrence depended on the duration of exposure. FEV1 significantly decreased with duration of exposure and BHR at a preceding visit. This result persisted when adjusting for the effect of BHR at the current visit. The measured exposure levels were not a significant predictor for any outcome. Occupational sensitization was only a predictor of a decline in FEV1 when duration of exposure was not included.Conclusion In flour-exposed industrial bakers, length of exposure and smoking are long-term determinants of BHR and of the decrease in FEV1. BHR at a preceding visit predicted lower FEV1 even when accounting for the effect of BHR at the current visit.

Ikan patin siam (Pangasianodon hypopthalamus) merupakan salah satu komoditi ikan budidaya air tawar yang potensial untuk dikembangkan karena memiliki nilai ekonomis yang tinggi. Produksi benih ikan patin sangat tergantung dari ketersediaan stok induk matang gonad dalam jumlah banyak dan berkualitas. Salah satu alternatif yang dapat dilakukan untuk memenuhi kebutuhan benih yaitu dengan melakukan pemijahan secara buatan dengan cara kawin suntik menggunakan hormon Human Chorionic Gonadotropin (HCG) dan ovaprim. Parameter utama yang diamati dalam penelitian ini adalah fekunditas telur, fertilisasi telur, hatching rate, growth rate dan survival rate. Kualitas air selama pengamatan masih berada pada batas kisaran normal yakni suhu berkisar antara 28–31.0C, pH antara 6-8 dan oksigen terlarut antara >3-4 mg/l.

Komposisi plankton pada perairan terutama pada tambak udang Vannamei dapat berperan sebagai parameter ekologi perairan selain sebagai pakan alami dan penghasil oksigen. Sistem resirkulasi merupakan salah satu cara untuk menjaga kualitas air yang nantinya mampu mendukung komposisi plankton yang seimbang sehingga budidaya udang vannamei super intensif dapat berjalan optimal. Microbubble merupakan suatu alat yang berfungsi menghasilkan gelembung udara dalam air denga ukuran diameter kurang dari 200 µm. Gelembung mikro ini mampu meningkatkan kadar oksigen terlarut sehingga dapat menurunkan kadar ammonia dalam air budidaya sampai 95%. Penelitian yang dilakukan merupakan penilitian eksperimental yang dirancang dengan menggunakan dua kolam bundar dengan diameter 3 m. Satu kolam bundar menngunakan aerator dan yang lain menggunakan Microbubble untuk sistem aerasinya. Jenis Plankton diamati menggunakan mikroskop. Dari hasil penelitian tersebut Genus plankton yang mendominasi adalah Chlorophyta dengan nilai 88,%, Cyanophyta 8,%, dan Chrysophyta 2,7%. Jenis Chlorophyta meliputi Chlorella, Nanochloropsis, dan Oocystis. Penggunaan Microbubble mampu meningkatkan kelarutan oksigen, dari hasil penelitian nilai DO yang di dapat 5,05 mg/L. kelarutan oksigen yang tinggi di perairan memberikan dampak yang positif terhadap udang dan juga biota perairan yang lain.

Mathematics is important for human life, including for early childhood development. Introducing mathematical concepts from an early age provides many opportunities for success in human development. However, introducing mathematics is not just a child who can count and recognize various geometric shapes and follow certain patterns. The purpose of this study is to explore the ability of mathematical thinking patterns in children aged 4–6 years in cognitive development in stimulating high-level cognitive development. The method used in this research is descriptive quantitative and qualitative approaches. and the results showed that children are less stimulated to think to a higher level that can stimulate children to think rationally and solve their own problems. Mathematics learning is still in a formal setting and is predominantly using children's worksheets, so that children's interest is reduced. The results of this study recommend that learning mathematics involves more early childhood and raises interest and provides stimulation so that children can develop cognitive thinking in mathematics through reasoning and problem solving.

Hepatitis C Virus (HCV) is one virus that has a high mutation rate in the world. To predict the mutation can be used fundamental analysis and technical analysis. Fundamental analysis relies on external factors such as attributes attached to the primer and the isolate. While technical analysis learns the movement of the mutation itself by relying on graphs and mathematical formulas. This study combines fundamental analysis and technical analysis in predicting HCV mutations. Application of Recurrent Neural Network (RNN) method as a form of technical analysis and fundamental analysis is applied in the form of including some fundamental factor data as training datasets. RNN is a neural network that has a feedback connection to the neuron itself, or a previous neuron. RNN is able to reactivate actual data values in the past to be re-entered with actual data values at the moment. This study used Elman network architecture with Back Propagation Through Time learning algorithm (BPTT) and used Linear normalization. The problem when predicting HCV mutations is how to determine the best learning rate value. Therefore the fundamental approach will also be incorporated into the neural network. On the backward process, to calculate the value of weight correction is to multiply the value of learning rate with hidden neuron value. We propose that each neuron has an adaptive learning rate according to the condition of the neuron. Where each input neuron from this study is the result of the HCV primer normalized in preliminary research. Each primer has attributes that can be developed as decision support. Test results show the smallest error of the prediction process by RMSE are 0.0163000, with accuracy prediction value are 99%.

Keterampilan sosial anak usia dini merupakan kemampuan anak untuk bersosialisasi atau berinteraksi dengan orang lain dalam konteks sosial dengan cara-cara khusus yang dapat diterima dan menghindari perilaku yang akan di tolak oleh lingkungan. Maka keterampilan sosial pada anak usia dini perlu dikembangkan secara optimal untuk bekal perkembangan selanjutnya, karena keterampilan sosial berpengaruh pada penerimaan siswa dalam kelompok sehingga dapat berkembang lagi dalam perkembangan selanjutnya. Aspek dari keterampilan sosial antra lain sikap empati, bekerja sama, tanggung jawab, dan persaingan sehat. Maka sangat perlunya untuk melatih keterampilan sosial tersebut. Permainan tradisional dapat menjadi sarana untuk mengembangkan dan melatih keterampilan sosial anak karena permainan adalah bagian dari anak-anak yang tidak bisa dilepaskan. Anak akan merasa senang dan larut dalam permainan sehingga tidak disadari sedang belajar untuk melatih keterampilan sosial mereka. Anak akan aktif dalam permainan yang menuntut anak untuk bermain secara kelompok dan saling berbagi. Maka permaianan tradisional adalah permainan rakyat yang biasa dimainkan bersama atau berkelompok sehingga permainan tradisional dapat meningkatkan aspek-aspek pada keterampilan sosial anak.

This research investigated (1) the implementation of Flipped Classroom for teaching English; (2) the students’ achievement; (3) the students’ opinion; and (4) the differences between the high and low achieving students’ opinion toward Flipped Classroom. There were 41 seventh grade students and one English teacher of the seventh grade investigated. In this research, interview, questionnaires and lesson plan analysis were analyzed using interactive model; meanwhile the post-test and high and low achieving students’ opinion given were statistically analyzed using SPSS 16. It was resulting that in implementing Flipped Classroom the teacher did several preparations and teaching procedures which differentiated the classroom activity and home activity; the students’ achievement was seen to be good; the students also perceived the learning positively; the differences among high and low achieving students’ opinion were not significantly seen. This research helps the teacher who wants to implement flipped classroom as a consideration in teaching.

Pengabidan Kepada Masyarakat ini diadakan dengan tujuan untuk memberikan pendalaman kreativitas pendidik dalam pelaksanaan pembelajaan saintifik pada kurikulum 2013. Pengbdian ini sebagai tindak lanjut dari penelitian sebelumnya yang telah dilaksanakan tentang peningkatan kreatifitas guru dalam pelaksanaan kurikulum 2013. Pelaksanaan pengabdian pada masyarakat ini didahului dengan koordinasi kepada pimpinan lembaga dan melakukan perjanjian kerja sama dalam berbagai bidang salah satunya pelatihan melalui pengabdian pada masyarakat ini.Pada kegiatan pengabdian ini dilaksanakan di RA Al Islam 3 Gebang, pengabdian ini menggunakan metode kolaboratif dengan melakukan pengalian informasi untuk mengetahuai pemahaman guru tentang kreativitas pendidik dalam pembelajaran saintifik pada implementasi kurikulum 2013. Dilanjut dengan memberikan materi mengenai kreativitas pendidik dalam pembelajaran saintifik pada implementasi kurikulum 2013. Kemudian mempraktekan kegiatan pembelajaran dengan pembelajaran santifik. Tindak lanjutnya akan dilakukan monitoring oleh mahasiswa seberapa luas penyebaran IPTEK yang telah diberikanHasil dari Pengabidan ini adalah peningkatan pemahaman guru tentang perlunya peningkatan kreativitas guru dalam melaskanakan pendekatan saintifik berbasis kurikulum 2013. Sehingga guru dapat merancang dan melaksanakan pembelajaran dengan pendekatan saintifik yang kreatif, harapanya Iptek yang telah disampaikan dapat di sebarkan oleh mitra.Kata Kunci : Saintifik, Kreativitas guru.

Penelitian ini bertujuan untuk mengetahui kreativitas pendidik pada pembelajaran saintifik sesuai kurikulum PAUD 2013 di Lembaga PAUD. Melihat bagaimana pendidik dalam mengelola kelas dan bagaimana implementasi kurikulum 2013 di di Dabin III Gagak Sipat Boyolali. Penelitian ini merupakan Study Kasus, mengunakan metode pendekatan deskriptif kualitatif. Subyek dalam penelitian ini adalah Pendidik di TK Gagak Sipat Boyolali, Data diambil berdasarkan Sampel di Dabin III Gagak Sipat Boyolali. Teknik pengumpulan data mengunakan wawancara, observasi, dokumentasi dan catatan lapangan pada saat pelaksanaan pembelajaran. Keabsahan data mengunakan triangulasi teori, data yang diperoleh dianalisis secara kualitatif dengan pembahasan untuk mendapatkan gambaran mengenai peranan implementasi pembelajaran saintifik di kurikulum PAUD 2013. Prosedur penelitian meliputi tahap pralapangan, tahapan pekerjaan lapangan, tahapan analisis dan interpretasi data. Luaran dari penelitian ini adalah rekomendasi mengenai pendekatan saintifik dalam impelemntasi kurikulum 2013 disamping Artikel sebagai pertanggunganjawab hasil penelitian yang siap dimuat di jurnal ilmiah. Hasil penelitian ini menunjukan kreativitas guru dalam pembelajaran saintifik implementasi kurikulum 2013 di Lembaga TK Dabin III Gagak Sipat Boyolali. Kreativitas guru dalam pembelajaran dalam kategori sedang maka direkomendasikan untuk ditingkatkan karena terbukti dengan kreativitas guru dapat mempengaruhi aspek perkembangan anak.

Tujuan penelitian ini adalah mengetahui peningkatan perkembangan kognitif pada anak melalui pendekatan saintifik di kelompok B TK Pertiwi II Gagaksipat Boyolali Tahun Pelajaran 2018/2019.Penelitian ini dilaksanakan di TK Pertiwi II Gagaksipat Boyolali. Subjek dalam penelitian ini adalah siswa kelompok B yang berjumlah 24 siswa. Penelitian ini adalah Peneliti a n Tindakan Kelas (PTK) yang dilaksanakan dalam 2 siklus, setiap siklus terdiri dari 4 tahap yaitu, perencanaan, tindakan, observasi dan refleksi. Teknik analisis data yang digunakan adalah deskriptif kuantitatif yaitu dengan mendeskribsikan kegiatan kemudian membandingkan nilai hasil belajar kondisi awal, siklus I, dan siklus II. Teknik pengumpulan data dengan observasi, wawancara, dan dokumentasi. Hasil penelitian menunjukkan bahwa pendekatan saintifik dapat meningkatkan perkembangan kognitif anak kelompok B TK Pertiwi II Gagaksipat Boyolali. Pada siklus I perkembangan kognitif anak mengalami peningkatan sebesar 50%. Sedangkan dalam siklus II, perkembangan kognitif anak mengalami peningkatan sebesar 79,16%. Berdasarkan penelitian tersebut dapat diambil kesimpulan bahwa penerapan pendekatan saintifik dapat meningkatkan perkembangan kognitif pada anak kelompok B.

Penelitian ini bertujuan meningkatkan rasa cinta tanah air melalui permainan ular tangga pada anak kelompok bermain strawberry. Metode pengumpulan data menggunakan observasi dan dokumentasi. Teknik analisis data menggunakan deskriptif kuantitatif. Hasil penelitian tindakan kelas menunjukkan pencapaian tingkat rasa cinta tanah air yang berkembang sangat baik. Pada siklus I rasa cinta tanah air anak mengalami peningkatan sebanyak 3 anak dari 13 anak atau 23,2% berada pada kriteria berkembang sesuai harapan. Sedangkan dalam siklus II, rasa cinta tanah air anak mengalami peningkatan sebanyak 11 anak dari 13 anak atau sebesar 84,7% berada pada kriteria berkembang sangat baik dan berkembang sesuai harapan. Penelitian dihentikan sampai siklus II karena sudah memenuhi keriteria keberhasilan indikator yaitu minimal 75% dari 13 anak.

Purpose While new strategies for the treatment of invasive breast cancer (BC) are emerging, radiotherapy (RT) modalities are still under debate. The French expert review board of Nice-Saint-Paul de Vence was asked firstly to conduct a qualitative evidence-based systematic review and then to establish clinical practice guidelines for the use of post operative RT in invasive BC. Methods and materials A search to identify eligible studies was undertaken using the Medline® database. All phase III randomized trials and systematic reviews evaluating the role and modalities of RT in invasive BC were included, together with some noncontrolled studies if no randomized trials were identified. The quality and clinical relevance of the studies were evaluated to determine the level of evidence. Results The maximum delay between surgery and RT should ≤8 weeks when chemotherapy (CT) is not indicated. This should not exceed 24 weeks when adjuvant CT is administered. Whole breast RT delivering 50 Gy in 25 fractions followed by a boost of 10–16 Gy remains the standard of care after conservative surgery (CS). In the elderly population, for certain cases presenting comorbidities associated with a limited life expectancy, RT indication (even hypofractioned) and boost delivery may be unnecessary in the light of an unfavourable risk/benefit ratio. RT technique and indications should not vary in case of neoadjuvant CT followed by CS. After total mastectomy, RT should be indicated in N+ and in N− patients with high risk of local recurrence. The experts recommend to initiate tamoxifen at the end of RT, while aromatase inhibitors could be administered either concomitantly or sequentially with RT. There is no consistent data to delay (or suspend) trastuzumab administration during RT. As for all patients, in case of concurrent RT-trastuzumab administration, reduction of cardiac tissues exposure is highly recommended. After breast reconstruction, RT should be delivered as after standard CS without boost. Conclusion Due to significant variations in practice in the treatment of patients with BC, our group aimed to provide guidelines for clinical practice. The systematic review of the literature formed the basis of our evidence-based recommendations; however expert agreements were necessary on those subjects that are still under debate. Our group will update these guidelines every 4 years, taking in consideration new advances in technology, new drugs administration, biologic tools and innovative therapeutic options.

Resume But de l’etude Les cancers de vessie sont la deuxieme localisation la plus frequente de cancer d’origine professionnelle, en relation avec une exposition ancienne a certains amines aromatiques (AA) et hydrocarbures aromatiques polycycliques (HAP). Toutefois, la mise en evidence d’une telle exposition professionnelle reste difficile. L’objet de ce travail est de proposer un questionnaire avec approche par tâches permettant un reperage des salaries exposes ou ayant ete exposes a des agents cancerogenes pour la vessie. Methodes A partir des travaux realises dans le cadre du colloque « Pour en finir avec le cancer de vessie d’origine professionnelle » organise par l’INRS en mars 2007, nous avons selectionne des situations exposantes en nous appuyant sur des criteres de frequence et d’intensite. Les niveaux des expositions, bases autant que faire se peut sur les donnees metrologiques, ont ete modules en fonction des periodes concernees et completes, pour les AA, par la probabilite d’exposition. Resultats Quarante-trois questions ont ete retenues : cinq concernent des situations de travail exposant potentiellement aux AA cancerogenes, 38 aux HAP. L’utilisation des AA cancerogenes a ete notamment rapportee dans le secteur de la plasturgie, l’industrie des colorants, la synthese de produits phytosanitaires, l’industrie du caoutchouc et le secteur de la recherche et de l’industrie pharmaceutique. Les situations d’exposition aux HAP les plus importantes sont les travaux en cokerie, a certains postes en siderurgie et a la fabrication d’aluminium, l’entretien et le ramonage des fours et des chaudieres, le travail en procede Soderberg en electrometallurgie et le decoupage, poncage ou usinage de pieces ayant beneficie d’un traitement anticorrosion. D’autres situations sont presentees. Discussion Ce questionnaire constitue un outil d’evaluation retrospective des expositions professionnelles mais pourrait egalement etre utilise dans le cadre de la mise en surveillance post exposition et post professionnelle. Il ne peut cependant etre considere comme exhaustif. Conclusion Ce questionnaire constitue un outil didactique d’aide au reperage des expositions professionnelles susceptibles d’engendrer une lesion maligne de la vessie. Il s’adresse notamment aux medecins du travail qui pourront repondre aux interrogations eventuelles des personnes questionnees portant sur leur exposition professionnelle.

It has been suggested that solvent exposure may have a role in the progression of glomerulonephritis (GN) to end-stage renal failure (ESRD), but this has never been tested with an appropriate cohort study design. We included 338 nonESRD patients with a first biopsy for primary GN between 1994 and 2001: 194 IgA nephropathies (IgAN), 75 membranous nephropathies (MN) and 69 focal and segmental glomerulosclerosis (FSGS). ESRD, defined as an estimated glomerular filtration rate < 15 mL/min/1.73m2 or dialysis, was registered over a mean follow-up period of 5 years. Patients’ lifelong solvent exposures before and after diagnosis were recorded by interview and assessed by industrial hygienist experts. We used Cox models to estimate adjusted hazard ratios (HR) of ESRD related to exposures. Overall, 15% of the patients had been exposed at a low level before diagnosis and 14% at a high level. Forty-two with IgA N reached ESRD, 12 with MN, and 22 with FSGS. A graded relationship was observed for MN: age- and gender-adjusted HR [95% confidence interval] for low exposure vs none 3.1 [0.5–18.2], and for high exposure vs none 8.2 [1.9–34.7], as well as for IgA N: 1.6 [0.7–3.9] and 2.2 [1.0–4.8], respectively, but not for FSGS. Solvent risk was only partly mediated by baseline proteinuria: adjusted HR for high exposure vs none = 5.5 [1.3 – 23.9] for MN and 1.8 [0.8 – 3.9] for IgA N. In patients with IgA N, there was a trend in increasing HR with exposure duration before and its persistence after diagnosis. These findings support the hypothesized association of solvent exposure with the progression of GN to ESRD. They should prompt clinicians to give greater attention to patients’ occupational exposures and possibly to consider professional reclassification.

Tujuan dari penelitian ini adalah untuk mengetahui proses peningkatan keterampila sosial kelas II melalui metode pembalajaran team game tournament (TGT) dan mengetahui sejauh mana hasil peningkatan keterampilan sosial siswa kelas II SD Negeri Mangkubumen Kulon No.83 Surakarta. Metode yang digunakan dalam penelitian ini adalah Penelitian Tindakan yang mengacu pada model Penelitian Tindakan Kelas dari Kemmis dan Mc. Taggart yang meliputi empat tahap yaitu perencanaan, tindakan, pengamatan, refleksi. Penelitian ini terdiri dari dua siklus, masing-masing siklus terdiri dari 6 kali pertemuan/ tindakan. Analisis data menggunakan data kuantitatif dan kualitatif. Analisis data kuantitatif dengan statistik deskriptif yaitu membandingkan hasil yang diperoleh dari siklus pertama dan siklus kedua. Sedangkan analisis data kualitatif dengan cara menganalisis data dari hasil catatan lapangan dan wawancara selama penelitian dengan langkah-langkah reduksi data, display data dan verifikasi data. Hasil penelitian menunjukkan adanya peningkatan keterampilan sosial melalui penerapan metode pembelajaran team games tournament (TGT), dapat dibuktikan rata-rata skor Keterampilan sosial pra penelitian besar 63,35%. Kemudian mengalami peningkatan pada siklus I sebesar 15,23% sehingga menjadi 78,58%. Selanjutnya dari siklus I ke siklus II kecerdasan kinestetik anak mengalami peningkatan sebesar 11,80% dari 78,58% menjadi 90,37%. Sehingga total peningkatan kecerdasan kinestetik anak mulai dari pra tindakan, siklus I sampai siklus II 27,02% yaitu 63,35% menjadi 90,37%.

Purpose We reviewed follow-up of patients treated in 19 randomized trials of adjuvant epirubicin in early breast cancer to determine incidence, risk, and risk factors for subsequent acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Patients and Methods The patients (N = 9,796) were observed from the start of adjuvant treatment (53,080 patient-years). Cases of AML or MDS (AML/MDS) were reported, with disease characteristics. Incidence and cumulative risk were compared for possible risk factors, for assigned regimens, and for administered cumulative doses of epirubicin and cyclophosphamide. Results In 7,110 patients treated with epirubicin-containing regimens (92% of whom also received cyclophosphamide), 8-year cumulative probability of AML/MDS was 0.55% (95% CI, 0.33% to 0.78%). The risk of developing AML/MDS increased in relation to planned epirubicin dose per cycle, planned epirubicin dose-intensity, and administered cumulative doses of epirubicin and cyclophosphamide. Patients with administered cumulative doses of both epirubicin and cyclophosphamide not exceeding those used in standard regimens (≤ 720 mg/m2 and ≤ 6,300 mg/m2, respectively) had an 8-year cumulative probability of developing AML/MDS of 0.37% (95% CI, 0.13% to 0.61%) compared with 4.97% (95% CI, 2.06% to 7.87%) for patients administered higher cumulative doses of both epirubicin and cyclophosphamide. Conclusion Patients treated with standard cumulative doses of adjuvant epirubicin (≤ 720 mg/m2) and cyclophosphamide (≤ 6,300 mg/m2) for early breast cancer have a lower probability of secondary leukemia than patients treated with higher cumulative doses. Increased risk of secondary leukemia must be considered when assessing the potential benefit to risk ratio of higher than standard doses.

Summary Aim: Immediate adjuvant tamoxifen reduces disease recurrence and improves survival in patients with early breast cancer. However, is it too late to administer tamoxifen to patients who have already undergone treatment, but were unable to benefit from this adjuvant therapy? The French National Cancer Centers (FNCLCC) have investigated the efficacy of delayed tamoxifen administration in a randomized controlled trial. Patients and methods: From September 1986 to October 1989, women with primary breast cancer, who had undergone surgery, radiotherapy, and/or received adjuvant chemotherapy but not hormone therapy more than two years earlier, were randomized to receive either 30 mg/day tamoxifen or no treatment. The 10-year disease-free and overall survival rates of the two groups of patients and of various subgroups were determined according to the Kaplan-Meyer method and compared by the log-rank test. Results: This intention-to-treat analysis comprised 250 women in the tamoxifen group and 244 in the control group. Patient characteristics (age, T stage, number of positive nodes, receptor status, and interval since tumor treatment) were comparable in both groups. Delayed adjuvant tamoxifen significantly improved overall survival only in node-positive patients and in patients with estrogen receptor-positive (ER+) or progesterone receptor-positive (PR+) tumors. Disease-free survival, however, was significantly improved in the global population and in several patient subgroups (node-positive, ER+, PR+). Patients in whom the interval between primary treatment and delayed adjuvant tamoxifen was greater than five years also had significantly improved disease-free survival. Conclusions: Overall and disease-free survival results indicate that delayed adjuvant tamoxifen administration (30 mg/day) is justified in women with early breast cancer, even if this treatment is initiated two or more years after primary treatment.

The current methods of sampling hydrogen peroxide, based on bubbling in acid solutions (titanium tetrachloride or titanium oxysulfate), are unsuitable for personal sampling. An alternative medium has been developed: silica gel coated with titanium oxysulfate. Sample tubes of this new sampling medium are suitable for personal sampling. The sampling performance is the same as that of the methods based on bubbling, but the tubes must be desorbed as soon as possible, even if the spectrophotometric analysis can be postponed. Special emphasis has been placed on the possible interference by peracetic acid, which is currently used in conjunction with hydrogen peroxide in the food industry.

The main objective of the present work was to determine the nutritional value and the strategies of using green banana meal (BM) in growing pigs. Two trials involving a total of 96 growing pigs were designed to study the effect of the harvest stage on the nutritional and energy values of BM (trial 1) and to evaluate the consequence of feeding gradual levels of BM on growth performance and feeding behavior in growing pigs (trial 2). In trial 1, the digestive utilization of three diets including 40% BM were compared with a control (C) soybean meal-corn diet in two batches of 12 pigs. BM was obtained from fruits harvested at 750 degrees-days (DD; early harvesting stage), 900 DD (normal harvesting stage) and 1150 DD (late harvesting stage). In trial 2, 72 Large White pigs were grouped in pens of nine animals and were given ad libitum access to one of the four dietary treatments (two pens/diet) differing from the rate of inclusion of 900 DD BM (0%, 20%, 40%, 60%). The estimated energy apparent digestibility coefficients of BM increased with the harvest stage (75.5%, 80.7% and 83.2% for BM at 750, 900 and 1150 DD, respectively). Digestible energy and metabolizable energy values were higher for BM at 1150 DD (13.56 and 13.05 MJ/kg DM, respectively) than at 900 DD (13.11 and 12.75 MJ/kg DM, respectively) or at 750 DD (12.00 and 11.75 MJ/kg DM, respectively). In trial 2, average daily gain and feed conversion ratio were not affected (P>0.05) by the rate of BM inclusion (822 g/day and 2.75 kg/kg on average, respectively). Feed intake and feeding behavior parameters were not significantly influenced by the dietary treatments except for the rate of feed ingestion with a lower value for the diet with 40% of BM (27.4 v. 32.2 g/min on average; P

The exposure of employees of different contracting firms to chemical pollutants was assessed during the five-week biennial maintenance shut-down of an isocyanate (TDI) synthesis plant. This assessment was mainly based on personal sampling, but work-related constraints occasionally required that area samples be used instead. Many tasks were carried out during the shut-down procedure (dismantling of reactors, installation of insulation, refection of kilns, cleaning, painting, electricity, etc.), thereby causing the employees of the contracting firms to be exposed to different kinds of pollutants, including products used or manufactured in the process (solvents, TDI and its synthesis intermediates), and products specific to the contractors' activity (welding fumes, crystalline silica, mineral fibers of heat insulation). The highest level of exposure (mainly to TDI) was found for the mechanical engineering activities undertaken during the dismantling of reactors and for cleaning activities. It was demonstrated that there was much variability in day-to-day exposure levels, and occasionally in the exposure levels encountered during a given shift. Cases of concomitant exposure to TDI (mainly short-term exposures) and other pollutants due to simultaneous activities from different tasks in the same area (co-activity) were also observed. Both the need for, and limitations of personal protective equipment (mainly respiratory) are stressed. Special emphasis is put on the responsibility of the owner of the facilities in helping the contractors in the organization of a health and safety policy.

EnglishIn 2016, INRS (the French reference body for occupational risk prevention) carried out a large-scale foresight exercise on possible futures for productive industry in France to the year 2040. To this end, it brought together seven partner organizations (including Futuribles) with the ultimate aim of identifying the new health-and-safety-atwork issues. Michel Hery and Catherine Levert, who coordinated the exercise, set out the main lessons from it here. After reminding us of the context — automation and the risks and opportunities it opens up in terms of production and employment — the authors make an initial assessment of the existing situation. This shows a high increase in prescriptiveness (more procedures to be respected and less latitude left to workers) and an intensification of the pace of work in recent decades. They then stress that these and future developments (particularly relating to new tech nologies, artificial intelligence etc.) are not systematically synonymous with a deterioration in working conditions: it all depends on the decisions made by the companies introducing the automation (productivity above all or liberation from routine tasks enabling greater creativity). Lastly, Michel Hery and Catherine Levert out line the five hypotheses selected in this foresight study and their impacts on health and safety at work: intensification of work; robotization with distributed advantages; privatization of the profits of robotization; the rise of freedom-form companies; and relocation. Quite clearly, the attention paid to human resources differs greatly between these five hypotheses. The question will be, then, particularly for the public authorities, to encourage employers to make the right choices so that automation can be a winwin operation. francaisEn 2016, l’INRS a mene un vaste exercice de prospective sur les futurs possibles de la production en France a l’horizon 2040. Il a reuni, dans ce cadre, sept organismes partenaires (dont Futuribles), avec pour objectif final d’identifier les enjeux nouveaux pour la sante et la securite au travail. Michel Hery et Catherine Levert, qui ont coordonne cet exercice, en presentent ici les principaux enseignements. Apres avoir rappele le contexte — celui de l’automatisation et des risques et opportunites qu’elle ouvre en matiere de production et d’emploi —, les auteurs dressent un premier bilan de l’existant, a savoir une forte augmentation de la prescription (plus de procedures a respecter et moins de latitude laissee aux travailleurs) et une intensification des rythmes de travail au cours des dernieres decennies. Ils soulignent ensuite que ces evolutions et celles qui suivront (notamment en lien avec les nouvelles technologies, l’intelligence artificielle…) ne sont pas systematiquement synonymes de degradation des conditions de travail : tout depend des choix effectues par les entreprises recourant a l’automatisation (priorite absolue a la productivite ou liberation des tâches routinieres permettant plus de creativite). Michel Hery et Catherine Levert presentent enfin les cinq hypotheses retenues dans cette etude prospective, et leurs impacts sur la sante et la securite au travail : intensification du travail ; robotisation aux benefices distribues ; privatisation des profits de la robotisation ; essor des entreprises liberees ; et relocalisation. Bien evidemment, l’attention pretee a la ressource humaine differe fortement de l’une a l’autre de ces cinq hypotheses ; il s’agira donc — notamment pour les pouvoirs publics — d’inciter les employeurs a effectuer les bons choix, de sorte que l’automatisation soit une operation gagnant-gagnant.

Specific sampling and analytical methods were developed to assess the concentration of chloramines in the atmosphere of indoor swimming pools because swimming instructors had complained of irritation (mainly eye and lung). The sampling method is based upon the reduction of chloramines to chlorides which are then analysed by ion chromatography. The chloramine concentration in the atmosphere of 13 swimming pools (including five recreational centres and one reeducation centre) was measured, showing that the concentrations were higher in the recreational centres. The influence of slides, bubbling baths, waves and other activities were demonstrated. A correlation was made between the level of pollutants and the complaints registered, leading to the proposal of a ‘comfort’ limit value.

International audience; Cleaning products may cause work-related asthma, but information regarding the specific exposures involved is scarce. We aimed to determine the associations between asthma and occupational exposure to cleaning agents in hospital workers. Analyses were conducted in 179 (136 women) hospital workers and a reference population of 545 subjects (18-79 years) from the French case-control and familial Epidemiological study on the Genetics and Environment of Asthma (2003-2007). Exposures to cleaning agents were estimated using three methods: self-report, expert assessment and an asthma-specific job-exposure matrix (JEM). Associations between cleaning products and current asthma were evaluated by logistic regressions, stratified by sex and adjusted for age and smoking status. According to expert assessment, 55% of male and 81% of female hospital workers were exposed to cleaning/disinfecting tasks weekly (p

Le traitement conservateur (TC) repose sur une chirurgie d’exerese glandulaire permettant une exerese totale de la tumeur, laissant un sein d’aspect normal et un risque de recidive locale faible, sans qu’il y ait un sur-risque de metastase par rapport a une mastectomie. Dans la quasi-totalite des cas, le TC repose sur une association radiochirurgicale.

Summary Background The role of exposure to substances in the workplace in new-onset asthma is not well characterised in population-based studies. We therefore aimed to estimate the relative and attributable risks of new-onset asthma in relation to occupations, work-related exposures, and inhalation accidents. Methods We studied prospectively 6837 participants from 13 countries who previously took part in the European Community Respiratory Health Survey (1990–95) and did not report respiratory symptoms or a history of asthma at the time of the fi rst study. Asthma was assessed by methacholine challenge test and by questionnaire data on asthma symptoms. Exposures were defi ned by high-risk occupations, an asthma-specifi c job exposure matrix with additional expert judgment, and through self-report of acute inhalation events. Relative risks for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking, and study centre. Findings A signifi cant excess asthma risk was seen after exposure to substances known to cause occupational asthma (Relative risk=1·6, 95% CI 1·1–2·3, p=0·017). Risks were highest for asthma defi ned by bronchial hyper-reactivity in addition to symptoms (2·4, 1·3–4·6, p=0·008). Of common occupations, a signifi cant excess risk of asthma was seen for nursing (2·2, 1·3–4·0, p=0·007). Asthma risk was also increased in participants who reported an acute symptomatic inhalation event such as fi re, mixing cleaning products, or chemical spills (RR=3·3, 95% CI 1·0–11·1, p=0·051). The population-attributable risk for adult asthma due to occupational exposures ranged from 10% to 25%, equivalent to an incidence of new-onset occupational asthma of 250–300 cases per million people per year. Interpretation Occupational exposures account for a substantial proportion of adult asthma incidence. The increased risk of asthma after inhalation accidents suggests that workers who have such accidents should be monitored closely.

The use of a direct reading photoionization detector (PID) to determine short-term solvent exposures is described in the present paper. To assess the relevance of such a total exposure evaluation it was necessary to compare it with the real concentration of pollutants. This comparison was made by measuring in parallel with the PID determination the concentration of each pollutant using a standard technique, i.e. sampling on charcoal tubes and subsequent analysis by gas chromatography. Laboratory tests showed that the linearity of the answer of the PID is good for many compounds and for a mixture of these compounds. Similar tests were carried out for painters in workplaces with the same good correlations (determination coefficient r 2 close to 1) between the PID response and the real concentration of the pollutants measured on the sampling tubes. The use of PID also allowed determination of the exposure profile of the workers and comparison of the short-term exposure to the corresponding limit values. Many cases of the short-term limit values being exceeded were revealed by use of the PID, although very few cases of the long-term limit values have been found by the usual sampling (charcoal tube) and analytical (gas chromatography) methods.

Given the physical properties of peroxyacetic acid, which decomposes into acetic acid and hydrogen peroxide, the generation and analysis of controlled atmospheres used to test the irritant potency of this peracid in mice require specific developments. The sampling and analytical method was based on the simultaneous sampling on a titanyl sulphate-impregnated silica gel tube (allowing the determination of total peroxides, peroxyacetic acid and hydrogen peroxide) and in an impinger containing a methyl-p-tolyl sulphide solution (of which the analysis yields the concentration of total acids, peroxyacetic acid and acetic acid, and peroxyacetic alone). From these results the concentrations of the different products can be inferred without interference. A special device composed of inert materials was designed for the generation of the controlled atmosphere. Buffering the peroxyacetic solution at pH 7 with a phosphate buffer allowed the generation of peroxyacetic acid atmospheres with negligible concentrations of acetic acid and hydrogen peroxide.

Characterizing the mechanisms by which endogenous factors stimulate neurogenesis is of special interest in view of the possible implication of newly generated cells in hippocampal functions or disorders. The aim of this study was to determine whether serotonin (5-HT) and oestradiol (E2) act through a common pathway to increase cell proliferation in the adult dentate gyrus (DG). We also investigated the effects of long-lasting changes in oestrogen levels on cell proliferation. Combining ovariectomy with inhibition of 5-HT synthesis using p-chlorophenylalanine (PCPA) treatment produced approximately the same decreases in the number of bromodeoxyuridine (BrdU) and PSA-NCAM immunolabelled cells in the subgranular layer as ovariectomy alone. Administration of 5-hydroxytryptophan (5-HTP) restored cell proliferation primarily decreased by ovariectomy, whereas oestradiol was unable to reverse this change in ovariectomized rats treated with PCPA. These findings demonstrate that 5-HT mediates oestrogen stimulation of cell proliferation in adult dentate gyrus. However, increase in ovarian hormones during pregnancy has no effect on dentate cell proliferation. This finding suggests that concomitant changes in other factors, such as glucocorticoids, may counterbalance the positive regulation of cell proliferation by 5-HT and oestradiol. Finally, oestrogen may regulate structural plasticity by stimulating PSA-NCAM expression independently of neurogenesis, as shown for instance by the increases in the number of PSA-NCAM labelled cells in pregnants. As 5-HT and oestrogen are involved in mood disorders, our data suggest that the positive regulation of cell proliferation and neuroplasticity by these two factors may contribute to restore hippocampal connectivity in depressive patients.