Relationship between endothelial nitric oxide synthase gene polymorphisms and the risk of myocardial infarction in the Algerian population

Introduction: Endothelial nitric oxide synthase (eNOS), the enzyme in charge of nitric oxide production, plays a crucial role in vascular biology. However, the impact of single nucleotide polymorphisms (SNPs) affecting the gene encoding for eNOS (eNOS) on coronary artery diseases remains under debate and no data were available at present in populations originating from Mahghreb.Aim of the Study: Our purpose was to evaluate the association between the eNOS -786T/C and +894G/T SNPs and (i) the risk of myocardial infarction (MI) and (ii) variations in systolic (SBP) and diastolic (DBP) blood pressure values.Patients and Methods: Concerning MI, the SNPs were characterised in a casecontrol study (70 cases vs 68 controls) based on the male population originating from Oran, Algeria.Results: The associations with blood pressure values were assessed in anenlarged control group including 115 male subjects. Since the -786T/CSNP could not be associated to MI, the genotype distribution of the+894G/T genotypes signifi cantly differed between MI cases and controls(p=0.025). The risk of MI (odds ratio) associated to the +894G/T SNP wasestimated to 1.2 (95%CI=[1.03;1.32]). The haplotype analysis confi rmedthis association and the absence of impact of the -786T/C SNP. On the other hand, no consistent association was shown between the two SNPs and SBP or DBP.Conclusion: As observed in other populations, the eNOS +894G/T SNPwas associated with MI in the Algerian population but the mechanismunderlying the effect could not be related to variations in blood pressure.Keywords: Endothelial nitric oxide synthase, myocardial infarction, blood pressure, genetic epidemiology

Effectiveness of saline water and lidocaine injection treatment of intractable plantar keratoma: a randomised feasibility study

Background: An intractable plantar keratoma (IPK) is a conical thickening of the epidermis' stratum corneum and a common cause of foot pain which can have a significant, detrimental impact on the mobility, quality of life and independence of individuals. Conservative treatments are currently offered to patients with IPK, but they are unsatisfactory since they do not offer a sufficient or permanent reduction of symptoms. The purpose of this study was the evaluation of the feasibility, safety and effectiveness of innovative treatments for intractable plantar keratoma (IPK). Methods: A randomized single blind trial with 40 patients divided with block randomization in four parallel groups was conducted to compare treatment combinations: conservative sharp debridement only or sharp debridement with needle insertion, physiological water injection or lidocaine injection. All patients obtained the same treatment four times at a four-week interval. At each visit, visual analog scale (VAS), Foot Function Index (FFI) and IPK size were evaluated. VAS and FFI were also completed at a six and twelve-month follow-up. Results: Our findings in regards to feasibility demonstrated recruitment challenges because of the anticipated pain that would be provoked by needle insertion may not be worth the potential pain relief compared to debridement alone from the patient's perspective. This was also the principal cause of drop out. Our preliminary results show no main effect of group for any of the clinical outcomes: pain felt on VAS, FFI score, IPK's size (p > 0.05). However, the analysis revealed a statistically significant effect of time on VAS (p 0.05). Conclusions: This study demonstrates that IPK treatment consisting of sharp debridement with needle insertion, physiological saline water injection or lidocaine injection is feasible and safe. There was a non-statistically significant trend toward diminishing pain intensity compared to scalpel debridement alone. The pain provoked by needle insertion and injection treatments must be addressed with a scientifically proven protocol to make it more comfortable for patients before these treatments could be considered in further studies. Trial registration: ClinicalTrials.gov, NCT04777227. 2 March, 2021 - Retrospectively registered (All participants were recruited prior to registration)

Justifications-on-demand as a device to promote shifts of attention associated with relational thinking in elementary arithmetic

Student responses to arithmetical questions that can be solved by using arithmetical structure can serve to reveal the extent and nature of relational, as opposed to computational thinking. Here, student responses to probes which require them to justify-on-demand are analysed using a conceptual framework which highlights distinctions between different forms of attention. We analyse a number of actions observed in students in terms of forms of attention and shifts between them: in the short-term (in the moment), medium-term (over several tasks), and long-term (over a year). The main factors conditioning students´ attention and its movement are identified and some didactical consequences are proposed

The AROME-WMED reanalyses of the first special observation period of the Hydrological cycle in the Mediterranean experiment (HyMeX)

To study key processes of the water cycle, two special observation periods (SOPs) of the Hydrological cycle in the Mediterranean experiment (HyMeX) took place during autumn 2012 and winter 2013. The first SOP aimed to study high precipitation systems and flash flooding in the Mediterranean area. The AROME-WMED (western Mediterranean) model (Fourrié et al., 2015) is a dedicated version of the mesoscale Numerical Weather Prediction (NWP) AROME-France model, which covers the western Mediterranean basin providing the HyMeX operational center with daily real-time analyses and forecasts. These products allowed for adequate decision-making for the field campaign observation deployment and the instrument operation. Shortly after the end of the campaign, a first reanalysis with more observations was performed with the first SOP operational software. An ensuing comprehensive second reanalysis of the first SOP, which included field research observations (not assimilated in real time) and some reprocessed observation datasets, was made with AROME-WMED. Moreover, a more recent version of the AROME model was used with updated background error statistics for the assimilation process. This paper depicts the main differences between the real-time version and the benefits brought by HyMeX reanalyses with AROME-WMED. The first reanalysis used 9 % additional data and the second one 24 % more compared to the real-time version. The second reanalysis is found to be closer to observations than the previous AROME-WMED analyses. The second reanalysis forecast errors of surface parameters are reduced up to the 18 and 24 h forecast range. In the middle and upper troposphere, fields are also improved up to the 48 h forecast range when compared to radiosondes. Integrated water vapor comparisons indicate a positive benefit for at least 24 h. Precipitation forecasts are found to be improved with the second reanalysis for a threshold up to 10 mm (24 h)-1. For higher thresholds, the frequency bias is degraded. Finally, improvement brought by the second reanalysis is illustrated with the Intensive Observation Period (IOP8) associated with heavy precipitation over eastern Spain and southern France

Effects of an educational intervention to strengthen humanistic practice on haemodialysis nurses' caring attitudes and behaviours and quality of working life: a cluster randomised controlled trial.

Nurses are trained to establish a trusting relationship with patients to create an environment promoting patients' quality of life. However, in tech-heavy care settings, such as haemodialysis units, dehumanising practices may emerge and take root for various reasons to the potential detriment of both patients and nurses. For patients, this may lead to a deterioration of quality of life and, ultimately, of health status. For nurses, it may cause a deterioration of the work environment and, in turn, of quality of working life. Based on Watson's Theory of Human Caring, we developed a brief educational intervention for haemodialysis nurses to strengthen their humanistic practice in the aim of improving the nurse-patient relationship and nurse quality of working life.. The intervention was tested by way of an experimental design. One hundred and one haemodialysis nurses, recruited in ten hospitals in French-speaking Switzerland, were randomised into an experimental group that received the intervention and a control group. The nurse-patient relationship was measured with the Caring Nurse-Patient Interaction Scale (EIIP-70) and nurse quality of life at work was measured with the Quality of Work Life Questionnaire at four time points: pre-intervention, intervention completion, and six-month and one-year follow-ups. Random intercept regression analysis was used to evaluate change over time in the two variables under study. The intervention appeared to reinforce nurse attitudes and behaviours geared to a more humanistic practice. The effect seemed to fade over time but, 1 year post-intervention, six dimensions of the nurse-patient relationship (hope, sensibility, helping relationship, expression of emotions, problem solving, teaching) scored above baseline. Nurse quality of working life, too, seemed positively impacted. The cultural dimension of nurse quality of working life, that is, the degree to which everyday work activities attune with personal and cultural values, seemed positively impacted, as well, with improvement stable throughout the year following the intervention. Results support a positive effect of the intervention over both the short term and the medium-to-long term. A brief intervention of the sort may constitute an effective means to improve the nurse-patient relationship by preventing or reducing dehumanising practices. NCT03283891

Development and experimental validation of an analytical model to predict the demoulding force in hot embossing

During the demoulding stage of the hot embossing process, the force required to separate a polymer part from the mould should be minimized to avoid the generation of structural defects for the produced micro structures. However, the demoulding force is dependent on a number of process factors, which include the material properties, the demoulding temperature, the polymer pressure history and the design of the mould structures. In particular, these factors affect the chemical, physical and mechanical interactions between a polymer and the replication master during demoulding. The focus of the reported research is on the development and validation of an analytical model that takes into account the adhesion, friction and deformation phenomena to predict the required demoulding force in hot embossing under different processing conditions. The results indicate that the model predictions agree well with the experimental data obtained and confirm that the design of the mould affects the resulting demoulding force. In addition, the applied embossing load was observed to have a significant effect on demoulding. More specifically, the increase in pressure within the polymer raises the adhesion force while it also reduces the friction force due to the decrease in the thermal stress

Recovery characteristics of three anaesthetic techniques for outpatient orthopaedic surgery

The goals of this study are to observe prospectively the perioperative recovery characteristics associated with general anaesthesia (GA), spinal anaesthesia (SAB), and epidural anaesthesia (EPID) in 200 patients scheduled for outpatient knee arthroscopy. Patients were observed from the time they entered the recovery room until they were discharged. Patients were contacted on postoperative days (POD) 1, 3, and 5. The EPID group had the quickest recovery times (125 +/- 37 min, mean +/- SD, ANOVA P < 0.01) compared with the GA group (165 +/- 57 min) and SAB group (167 +/- 51 min). Comparing the side effects of the three anaesthetic techniques, GA was associated with the highest incidence of nausea (27%) and vomiting (16%) on the day of surgery that persisted into the first postoperative day (nausea 41 % and vomiting 22%). There was no difference in the incidence of headache overall; however, SAB was associated with a 13% incidence of postdural puncture (PDP) headache that became apparent on POD 3. All the PDP headaches resolved with conservative therapy by the first postoperative week, except for two patients who required an epidural blood patch. The EPID group followed by the SAB and GA groups, had the highest incidence of backaches on POD 1 (respectively, 63%, 41% and 17%). By POD 3, the incidence of backache was not statistically different between groups. No specific treatment for backache was required. The ideal anaesthetic has not been developed, but our data suggests that an epidural technique is advantageous for knee arthroscopy in terms of a quick recovery and minimal adverse effects.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30913/1/0000582.pd