110 research outputs found
Health-related quality of life after isolated limb perfusion compared to extended resection, or amputation for locally advanced extremity sarcoma:Is a limb salvage strategy worth the effort?
Introduction: The aim of this study was to compare long-term patient reported outcomes (PROs) in patients with locally advanced extremity soft tissue sarcoma (eSTS) after isolated limb perfusion followed by resection (IR), compared to extended resection (ER), primary amputation (A) or secondary amputation after IR (IR-A). Methods: Patients were selected from the respondents of a multi-institutional cross-sectional cohort survivorship study (SURVSARC) conducted among sarcoma survivors registered in the Netherlands Cancer Registry (NCR), 2â10 years after diagnosis. Used PROs were the EORTC QLQ-C30, the Cancer worry scale (CWS), the Hospital Anxiety and Depression Scale (HADS), and the Toronto Extremity Salvage Score (TESS). Results: We identified 97 eSTS survivors: IR = 20, ER = 49, A = 20, IR-A = 8. While there were no differences in PROs between IR and ER, results showed better functioning and functionality in both groups versus the amputation groups. The amputation groups scored significantly lower on physical functioning (A = 62.7, IR-A = 65.7 versus IR = 78.0, ER = 82.7, p = 0.001) and role functioning (A = 67.5, IR-A = 52.8 versus IR = 79.2, ER = 80.6, p = 0.039), both EORTC QLQ-C30 scales. Also for the TESS, the scores were significantly lower for the amputation groups compared to the limb sparing groups (upper extremity p = 0.007 with A = 68.9, IR-A = 71.6 versus IR = 93.3, ER = 91.1; lower extremity p < 0.001 with A = 72.2, IR-A50.9 versus IR = 84.5 and ER = 85.5). There were no significant differences between the groups on cancer worry, anxiety and depression. Conclusion: HRQoL in eSTS survivors treated with IR or ER is equal; for maintenance of physical functioning and functionality IR and ER outperform an amputation
Health-related quality of life of Adolescent and Young Adult Cancer Survivors before and during the COVID-19 pandemic::Longitudinal improvements on social functioning and fatigue
The health-related quality of life (HRQoL) among long-term Adolescent and Young Adult Cancer Survivors (AYACS) and an age- and sex-matched normative population was examined. Although the HRQoL of AYACS was worse compared to the normative population before and during the COVID-19 pandemic, the scores of AYACS improved over time in contrast to the normative population. Presumably, AYACS are used to adjusting their lives to stressful life events. Furthermore, the lockdown may have been beneficial for AYACS who face difficulties fully participating in society due to the impact of cancer. AYACS who encounter HRQoL issues could benefit from support interventions to empower them and build resilience
True substrates: The exceptional resolution and unexceptional preservation of deep time snapshots on bedding surfaces
Abstract: Rock outcrops of the sedimentaryâstratigraphic record often reveal bedding planes that can be considered to be true substrates: preserved surfaces that demonstrably existed at the sedimentâwater or sedimentâair interface at the time of deposition. These surfaces have high value as repositories of palaeoenvironmental information, revealing fossilized snapshots of microscale topography from deep time. Some true substrates are notable for their sedimentary, palaeontological and ichnological signatures that provide windows into key intervals of Earth history, but countless others occur routinely throughout the sedimentaryâstratigraphic record. They frequently reveal patterns that are strikingly familiar from modern sedimentary environments, such as ripple marks, animal trackways, raindrop impressions or mudcracks: all phenomena that are apparently ephemeral in modern settings, and which form on recognizably human timescales. This paper sets out to explain why these shortâterm, transient, smallâscale features are counterâintuitively abundant within a 3.8 billion yearâlong sedimentaryâstratigraphic record that is known to be inherently timeâincomplete. True substrates are fundamentally related to a state of stasis in ancient sedimentation systems, and distinguishable from other types of bedding surfaces that formed from a dominance of states of deposition or erosion. Stasis is shown to play a key role in both their formation and preservation, rendering them faithful and valuable archives of palaeoenvironmental and temporal information. Further, the intersection between the timeâlength scale of their formative processes and outcrop expressions can be used to explain why they are so frequently encountered in outcrop investigations. Explaining true substrates as inevitable and unexceptional byâproducts of the accrual of the sedimentaryâstratigraphic record should shift perspectives on what can be understood about Earth history from field studies of the sedimentaryâstratigraphic record. They should be recognized as providing highâdefinition information about the mundane day to day operation of ancient environments, and critically assuage the argument that the incomplete sedimentaryâstratigraphic record is unrepresentative of the geological past
Procédés Réacteurs Biologiques à Membranes (BRM)
National audiencePrincipe et domaine dâapplication. ProcĂ©dĂ© BRM : âą Technologies et performances âą ProcĂ©dure de dimensionnement âą AĂ©ration et transfert dâoxygĂšne âą Filtration et permĂ©abilitĂ© des membranes âą CoĂ»ts dâinvestissement et dâexploitation âą Conclusions et recommandation
ProcĂ©dĂ©s BiorĂ©acteurs Ă Membranes. Retour dâexpĂ©riences sur la technologie BRM appliquĂ©e aux ERU (3 000 - 60 000 EH)
National audienceCes derniĂšres annĂ©es, 8 installations BRM (de 3 000 EH Ă 66 000 EH) Ă©quipĂ©es de fibres creuses ou de plaques ont fait lâobjet de suivis approfondis sur le long terme par une Ă©quipe dâIrstea. Un bilan de ces suivis a permis de dresser un Ă©tat de lâart de la technique des biorĂ©acteurs et de son application en France pour le traitement des eaux usĂ©es urbaines. De lâexpĂ©rience acquise, il ressort que cette technique entre tout Ă fait en concurrence avec des solutions « boues activĂ©es conventionnelles + traitement tertiaire », et ce, avec une plus grande compacitĂ©. Plusieurs points apparaissent dĂ©terminants dans le fonctionnement des BRM : âąla qualitĂ© du tamisage et son dimensionnement, garants de la fiabilitĂ© du procĂ©dĂ© et de la pĂ©rennitĂ© des membranes, âąune concentration de boue Ă©tablissant un bon compromis entre charge massique, production de boue et transfert dâoxygĂšne (une concentration Ă©levĂ©e rĂ©duit la charge volumique donc lâemprise au sol mais rĂ©duit aussi le transfert dâoxygĂšne) âąune bonne technicitĂ© des exploitants. Les concentrations en boues initialement prĂ©conisĂ©es ont Ă©tĂ© progressivement diminuĂ©es afin de rĂ©duire les coĂ»ts Ă©nergĂ©tiques. La production de boue biologique demeure proche de celle de systĂšmes conventionnels fonctionnant avec des Ăąges de boue identiques (environ 0,35 kg MES/kg DCOĂ©liminĂ©e). Le coĂ»t Ă©nergĂ©tique des BRM demeure plus Ă©levĂ© que celui dâune boue activĂ©e conventionnelle du fait notamment de lâair nĂ©cessaire au dĂ©colmatage des membranes, de la concentration en boue plus Ă©levĂ©e pĂ©nalisant le transfert dâoxygĂšne et de la recirculation entre les cellules membranaires et le bassin dâaĂ©ration qui est gĂ©nĂ©ralement de 400 Ă 500 % du dĂ©bit dâentrĂ©e. Les consommations Ă©nergĂ©tiques relevĂ©es sur les installations suivies par Irstea sont dâautant plus Ă©levĂ©es que la sous-charge est importante. Une fraction de lâĂ©nergie consommĂ©e est en effet trĂšs dĂ©pendante de la surface de membrane installĂ©e et donc en partie fixe. Des rĂ©ductions significatives de dĂ©penses Ă©nergĂ©tiques sont possibles et sont actuellement testĂ©es par les concepteurs et par les exploitants de BRM. On peut agir en particulier sur les cycles dâaĂ©ration dans les cellules membranaires, sur les dĂ©bits dâair, et en rĂ©duisant les concentrations de boue notamment lorsque la charge organique reçue sâavĂšre trĂšs infĂ©rieure Ă la charge nominale
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