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), 2–10 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 sedimentary–stratigraphic record often reveal bedding planes that can be considered to be true substrates: preserved surfaces that demonstrably existed at the sediment–water or sediment–air 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 sedimentary–stratigraphic 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 short‐term, transient, small‐scale features are counter‐intuitively abundant within a 3.8 billion year‐long sedimentary–stratigraphic record that is known to be inherently time‐incomplete. 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 time–length 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 by‐products of the accrual of the sedimentary–stratigraphic record should shift perspectives on what can be understood about Earth history from field studies of the sedimentary–stratigraphic record. They should be recognized as providing high‐definition information about the mundane day to day operation of ancient environments, and critically assuage the argument that the incomplete sedimentary–stratigraphic record is unrepresentative of the geological past

Dictionnaire de la Shoah

info:eu-repo/semantics/publishe

Procédés Réacteurs Biologiques à Membranes (BRM)

National audiencePrincipe et domaine d’application. Procédé BRM : • Technologies et performances • Procédure de dimensionnement • Aération et transfert d’oxygène • Filtration et perméabilité des membranes • Coûts d’investissement et d’exploitation • Conclusions et recommandation

Procédés Bioréacteurs à Membranes. Retour d’expériences sur la technologie BRM appliquée aux ERU (3 000 - 60 000 EH)

National audienceCes dernières années, 8 installations BRM (de 3 000 EH à 66 000 EH) équipées de fibres creuses ou de plaques ont fait l’objet de suivis approfondis sur le long terme par une équipe d’Irstea. Un bilan de ces suivis a permis de dresser un état de l’art de la technique des bioréacteurs et de son application en France pour le traitement des eaux usées urbaines. De l’expérience acquise, il ressort que cette technique entre tout à fait en concurrence avec des solutions « boues activées conventionnelles + traitement tertiaire », et ce, avec une plus grande compacité. Plusieurs points apparaissent déterminants dans le fonctionnement des BRM : •la qualité du tamisage et son dimensionnement, garants de la fiabilité du procédé et de la pérennité des membranes, •une concentration de boue établissant un bon compromis entre charge massique, production de boue et transfert d’oxygène (une concentration élevée réduit la charge volumique donc l’emprise au sol mais réduit aussi le transfert d’oxygène) •une bonne technicité des exploitants. Les concentrations en boues initialement préconisées ont été progressivement diminuées afin de réduire les coûts énergétiques. La production de boue biologique demeure proche de celle de systèmes conventionnels fonctionnant avec des âges de boue identiques (environ 0,35 kg MES/kg DCOéliminée). Le coût énergétique des BRM demeure plus élevé que celui d’une boue activée conventionnelle du fait notamment de l’air nécessaire au décolmatage des membranes, de la concentration en boue plus élevée pénalisant le transfert d’oxygène et de la recirculation entre les cellules membranaires et le bassin d’aération qui est généralement de 400 à 500 % du débit d’entrée. Les consommations énergétiques relevées sur les installations suivies par Irstea sont d’autant plus élevées que la sous-charge est importante. Une fraction de l’énergie consommée est en effet très dépendante de la surface de membrane installée et donc en partie fixe. Des réductions significatives de dépenses énergétiques sont possibles et sont actuellement testées par les concepteurs et par les exploitants de BRM. On peut agir en particulier sur les cycles d’aération dans les cellules membranaires, sur les débits d’air, et en réduisant les concentrations de boue notamment lorsque la charge organique reçue s’avère très inférieure à la charge nominale