190 research outputs found
Is the meiofauna a good indicator for climate change and anthropogenic impacts?
Our planet is changing, and one of the most pressing challenges facing the scientific community revolves around understanding how ecological communities respond to global changes. From coastal to deep-sea ecosystems, ecologists are exploring new areas of research to find model organisms that help predict the future of life on our planet. Among the different categories of organisms, meiofauna offer several advantages for the study of marine benthic ecosystems. This paper reviews the advances in the study of meiofauna with regard to climate change and anthropogenic impacts. Four taxonomic groups are valuable for predicting global changes: foraminifers (especially calcareous forms), nematodes, copepods and ostracods. Environmental variables are fundamental in the interpretation of meiofaunal patterns and multistressor experiments are more informative than single stressor ones, revealing complex ecological and biological interactions. Global change has a general negative effect on meiofauna, with important consequences on benthic food webs. However, some meiofaunal species can be favoured by the extreme conditions induced by global change, as they can exhibit remarkable physiological adaptations. This review highlights the need to incorporate studies on taxonomy, genetics and function of meiofaunal taxa into global change impact research
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Evaluation des pratiques professionnelles dans la prise en charge des lésions méniscales médiales du patient de plus de 45 ans (d'après une étude non randomisée, prospective et multicentrique de 174 cas)
BREST-BU Médecine-Odontologie (290192102) / SudocSudocFranceF
Non-linear boundary condition for non-ideal electrokinetic equations in porous media *
International audienceThis paper studies the partial differential equation describing the charge distribution of an electrolyte in a porous medium.Realistic non-ideal effects are incorporated through the mean spherical approximation(MSA) model which takes into account finite size ions and screening effects. The main novelty is the consideration of a non-constant surface charge density on the pore walls. Indeed, a chemical equilibrium reaction is considered on the boundary to represent the dissociation of ionizable sites on the solid walls. The surface charge density is thus given as a non-linear function of the electrostatic potential. Even in the ideal case, the resulting system is a new variant of the famous Poisson-Boltzmann equation, which still has a monotone structure under quantitative assumptions on the physical parameters. In the non-ideal case, the MSA model brings in additional non-linearities which break down the monotone structure of the system. We prove existence, and sometimes uniqueness, of the solution. Some numerical experiments are performed in 2-d to compare this model with that for a constant surface charge
Post-traumatic total wrist arthrodesis: Satisfaction study of 42 cases at a mean 97 months’ follow-upArthrodèse totale de poignet post-traumatique : étude de satisfaction à propos de 42 cas avec un recul moyen de 97 mois
International audienceIntroductionTotal wrist arthrodesis is effective in reducing pain in osteoarthritic wrist, but at the cost of range of motion. The aim of the present study was to assess patient satisfaction after post-traumatic total wrist arthrodesis, complications and risk factors.HypothesisPost-traumatic total wrist arthrodesis provides a high rate of satisfaction.Patients and methodsA single-center retrospective observational satisfaction survey was carried out for the period 2005–2020 by telephone interview.ResultsForty-two post-traumatic dorsal plate total wrist arthrodeses were included. Mean follow-up was 97 months. Total arthrodesis achieved a mean 75% reduction in pain, with good functional results (QuickDASH: 23 ± 9.1 [11–42]) and satisfaction (83% of patients very satisfied or satisfied). Seventy-two percent of patients continued in their previous work. The complications rate was 48%. Twenty patients had complications, including 14 (33%) requiring surgical revision. Thirteen patients (31%) had hardware removed due to plaque discomfort and 1 due to bone and joint infection. Seven patients showed CRPS.ConclusionTotal wrist arthrodesis provided good results in terms of pain relief and satisfaction, at the cost of loss of motion. It is a reliable surgical technique, with an essential place in the therapeutic algorithm for post-traumatic osteoarthritic wrist, particularly in manual workers
Post-traumatic total wrist arthrodesis: Satisfaction study of 42 cases at a mean 97 months’ follow-upArthrodèse totale de poignet post-traumatique : étude de satisfaction à propos de 42 cas avec un recul moyen de 97 mois
International audienceIntroductionTotal wrist arthrodesis is effective in reducing pain in osteoarthritic wrist, but at the cost of range of motion. The aim of the present study was to assess patient satisfaction after post-traumatic total wrist arthrodesis, complications and risk factors.HypothesisPost-traumatic total wrist arthrodesis provides a high rate of satisfaction.Patients and methodsA single-center retrospective observational satisfaction survey was carried out for the period 2005–2020 by telephone interview.ResultsForty-two post-traumatic dorsal plate total wrist arthrodeses were included. Mean follow-up was 97 months. Total arthrodesis achieved a mean 75% reduction in pain, with good functional results (QuickDASH: 23 ± 9.1 [11–42]) and satisfaction (83% of patients very satisfied or satisfied). Seventy-two percent of patients continued in their previous work. The complications rate was 48%. Twenty patients had complications, including 14 (33%) requiring surgical revision. Thirteen patients (31%) had hardware removed due to plaque discomfort and 1 due to bone and joint infection. Seven patients showed CRPS.ConclusionTotal wrist arthrodesis provided good results in terms of pain relief and satisfaction, at the cost of loss of motion. It is a reliable surgical technique, with an essential place in the therapeutic algorithm for post-traumatic osteoarthritic wrist, particularly in manual workers
The hamstrings are more impacted than the quadriceps after severe ankle sprain
International audienceAnkle sprains (AS) are common in the military population, with a prevalence 5 to 8 times higher than that for civilians. The aim of this study was to evaluate in patients with severe AS the impact of disuse on thigh muscle induced by unloading and immobilization due to care. This study focused on muscle trophicity and dynamometric strength. In this observational prospective study, assessments were repeated at 3 visits: close to injury, 15 and 30 days following the sprain. The injured limb was compared to the contralateral limb. A dynamometer assessment was used to monitor changes in strength and fatigue of the thigh muscles of both limbs. Isometric and isokinetic concentric evaluation of peak torque (PTiso and PTdyn), total work (Wt), and peak torque time integral (IPT) of thigh muscles. Full follow-up was obtained in 30 subjects. The injured limbs showed significant deficits in the mean (SD). The quadriceps PTiso and IPT deficits were −12.6% ± 1.9% ( P < .0001) and −13.27% ± 1.8% ( P < .0001), respectively. The quadriceps PTdyn showed a significant deficit since V2 (−12.2.5% ± 2.0). The quadriceps Wt presented a significant deficit of −4.2% ± 2.4 ( P < .0007) at 1 month. The hamstring PTdyn deficit presented a mean loss of −16.5% ± 2.4% ( P < .0001). The hamstring Wt deficit was −13.7% ± 2.3% ( P < .001). The analysis of variance showed that the grade of the sprain had a significant effect on the quadriceps PTq deficit ( P < .016) but not the type of discharge. Our study showed that disuse leads to a significant deficit in the strength of knee muscles within 1 month. It is noteworthy that the hamstrings are more affected than the quadriceps. The rehabilitation protocol to prevent the risk of iterative ankle injuries and secondary knee injuries should incorporate early training of both quadriceps and hamstrings
Dickeya dadantii pectic enzymes necessary for virulence are also responsible for activation of the Arabidopsis thaliana innate immune system
International audienceSoft-rot diseases of plants attributed to Dickeya dadantii result from lysis of the plant cell wall caused by pectic enzymes released by the bacterial cell by a type II secretion system (T2SS). Arabidopsis thaliana can express several lines of defence against this bacterium. We employed bacterial mutants with defective envelope structures or secreted proteins to examine early plant defence reactions. We focused on the production of AtrbohD-dependent reactive oxygen species (ROS), callose deposition and cell death as indicators of these reactions. We observed a significant reduction in ROS and callose formation with a bacterial mutant in which genes encoding five pectate lyases (Pels) were disrupted. Treatment of plant leaves with bacterial culture filtrates containing Pels resulted in ROS and callose production, and both reactions were dependent on a functional AtrbohD gene. ROS and callose were produced in response to treatment with a cellular fraction of a T2SS-negative mutant grown in a Pels-inducing medium. Finally, ROS and callose were produced in leaves treated with purified Pels that had also been shown to induce the expression of jasmonic acid-dependent defence genes. Pel catalytic activity is required for the induction of ROS accumulation. In contrast, cell death observed in leaves infected with the wild-type strain appeared to be independent of a functional AtrbohD gene. It was also independent of the bacterial production of pectic enzymes and the type III secretion system (T3SS). In conclusion, the work presented here shows that D. dadantii is recognized by the A. thaliana innate immune system through the action of pectic enzymes secreted by bacteria at the site of infection. This recognition leads to AtrbohD-dependent ROS and callose accumulation, but not cell death
Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID) : a retrospective, international, multicentre, cross-sectional study
Background: Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic; and to evaluate whether delays in surgery led to an increased occurrence of aggressive tumours.
Methods: In this retrospective, international, cross-sectional study, centres were invited to participate in June 22, 2022; each centre joining the study was asked to provide data from medical records on all surgical thyroidectomies consecutively performed from Jan 1, 2019, to Dec 31, 2021. Patients with indeterminate thyroid nodules were divided into three groups according to when they underwent surgery: from Jan 1, 2019, to Feb 29, 2020 (global prepandemic phase), from March 1, 2020, to May 31, 2021 (pandemic escalation phase), and from June 1 to Dec 31, 2021 (pandemic decrease phase). The main outcomes were, for each phase, the number of surgeries for indeterminate thyroid nodules, and in patients with a postoperative diagnosis of thyroid cancers, the occurrence of tumours larger than 10 mm, extrathyroidal extension, lymph node metastases, vascular invasion, distant metastases, and tumours at high risk of structural disease recurrence. Univariate analysis was used to compare the probability of aggressive thyroid features between the first and third study phases. The study was registered on ClinicalTrials.gov, NCT05178186.
Findings: Data from 157 centres (n=49 countries) on 87 467 patients who underwent surgery for benign and malignant thyroid disease were collected, of whom 22 974 patients (18 052 [78·6%] female patients and 4922 [21·4%] male patients) received surgery for indeterminate thyroid nodules. We observed a significant reduction in surgery for indeterminate thyroid nodules during the pandemic escalation phase (median monthly surgeries per centre, 1·4 [IQR 0·6-3·4]) compared with the prepandemic phase (2·0 [0·9-3·7]; p<0·0001) and pandemic decrease phase (2·3 [1·0-5·0]; p<0·0001). Compared with the prepandemic phase, in the pandemic decrease phase we observed an increased occurrence of thyroid tumours larger than 10 mm (2554 [69·0%] of 3704 vs 1515 [71·5%] of 2119; OR 1·1 [95% CI 1·0-1·3]; p=0·042), lymph node metastases (343 [9·3%] vs 264 [12·5%]; OR 1·4 [1·2-1·7]; p=0·0001), and tumours at high risk of structural disease recurrence (203 [5·7%] of 3584 vs 155 [7·7%] of 2006; OR 1·4 [1·1-1·7]; p=0·0039).
Interpretation: Our study suggests that the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic period could have led to an increased occurrence of aggressive thyroid tumours. However, other compelling hypotheses, including increased selection of patients with aggressive malignancies during this period, should be considered. We suggest that surgery for indeterminate thyroid nodules should no longer be postponed even in future instances of pandemic escalation.</p
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