Nichtraucherschutz und Tabakentwöhnung: Ein Thema für Mitarbeitende in Einrichtungen der deutschen Kinder- und Jugendpsychiatrie?

Fragestellung: Mitarbeitende in kinder- und jugendpsychiatrischen (KJP) Einrichtungen stehen im Spannungsverhältnis zwischen der Durchsetzung von Rauchverboten für Patient_innen und dem eigenen Rauchverhalten. Bisher fehlen Daten, ob und wo Mitarbeitende rauchen und welche Entwöhnungsangebote KJP-Einrichtungen ihnen anbieten. Methodik: In einer Onlinestudie beantworteten n = 78 leitende Mitarbeitende deutscher KJP-Einrichtungen (41.9 % aller Angeschriebenen) Fragen zu stationsübergreifenden sowie stationsspezifischen Nichtraucherschutzmaßnahmen sowie zu Tabakentwöhnungsmaßnahmen. Ergebnisse: Umfassende Rauchverbote werden selten umgesetzt (< 20 % der Einrichtungen). Mitarbeitende dürfen vorrangig im Außengelände rauchen (z. B. in Raucherzonen: 69 bis 78 % je nach Stationstyp). Entwöhnungsangebote für Mitarbeitende bietet nur jede zweite KJP an (47 %). Schlussfolgerungen: Die Daten weisen auf zukünftige Handlungsfelder der Tabakkontrolle in der KJP-Pflege hin: transparente Regeln, Weiterbildungen und Ausbau betrieblicher Entwöhnungsangebote.Objective: Whereas, on the one hand, employees in child and adolescent psychiatric institutions (CAP) have to enforce smoking bans among patients, on the other hand, they have a high likelihood of being smokers themselves. Little data are available on the enforcement of smoking regulations and what cessation support is offered by CAP institutions. Method: In an online survey, n = 78 senior staff members or directors of German CAP institutions (41.9 % of all addressed CAP institutions) responded to questions on smoking regulations, exceptions, and cessation support for employees. Results: The enforcement of comprehensive smoking bans is rarely reported (<20 % of CAP institutions). Employees are exempted or allowed to smoke mostly outside of the building (e. g., in designated smoking areas: 69-78 % depending on ward type). Cessation support was offered by less than half of the CAP institutions (47%). Conclusions: The data presented point toward future areas for tobacco control in CAP care, including transparent regulations, staff training, and dissemination of support for occupational smoking cessation

Comparison of Electrical Contacting Techniques to Carbon Fiber Reinforced Plastics for Self-Strain-Sensing Applications

The electrical conductivity of carbon fibers can be used to enable the design of intrinsically smart carbon fiber reinforced plastics (CFRPs). Resistance and impedance measurements of the structural material itself can then be used to measure physical stimuli such as strain or damage without requiring a dedicated sensor to be installed. Measuring the resistance with high precision requires good electrical contact between the measurement equipment and the conductive carbon fibers. In the literature, many different combinations of surface contacting material and surface preparation procedures are used, but only seldomly compared to one another. This article aims to compare frequently used electrical contact methods by analyzing their contact resistance to a pultruded CFRP rod. Furthermore, this study explores the change of contact resistance with increasing mechanical strain. The results show that contact resistance is highly dependent on both the material used for contacting the fibers as well as the surface preparation technique. From the combinations analyzed in this article, the electrodeposition in combination with a surface treatment using concentrated sulphuric acid shows the most promising results

Comparison of Electrical Contacting Techniques to Carbon Fiber Reinforced Plastics for Self-Strain-Sensing Applications

The electrical conductivity of carbon fibers can be used to enable the design of intrinsically smart carbon fiber reinforced plastics (CFRPs). Resistance and impedance measurements of the structural material itself can then be used to measure physical stimuli such as strain or damage without requiring a dedicated sensor to be installed. Measuring the resistance with high precision requires good electrical contact between the measurement equipment and the conductive carbon fibers. In the literature, many different combinations of surface contacting material and surface preparation procedures are used, but only seldomly compared to one another. This article aims to compare frequently used electrical contact methods by analyzing their contact resistance to a pultruded CFRP rod. Furthermore, this study explores the change of contact resistance with increasing mechanical strain. The results show that contact resistance is highly dependent on both the material used for contacting the fibers as well as the surface preparation technique. From the combinations analyzed in this article, the electrodeposition in combination with a surface treatment using concentrated sulphuric acid shows the most promising results

Nichtraucherschutz und Tabakentwöhnung

Fragestellung: Mitarbeitende in kinder- und jugendpsychiatrischen (KJP) Einrichtungen stehen im Spannungsverhältnis zwischen der Durchsetzung von Rauchverboten für Patientinnen und Patienten und dem eigenen Rauchverhalten. Bisher fehlen Daten, ob und wo Mitarbeitende rauchen und welche Entwöhnungsangebote KJP-Einrichtungen ihnen anbieten. Methodik: In einer Onlinestudie beantworteten n = 78 leitende Mitarbeitende deutscher KJP-Einrichtungen (41.9 % aller Angeschriebenen) Fragen zu stationsübergreifenden sowie stationsspezifischen Nichtraucherschutzmaßnahmen sowie zu Tabakentwöhnungsmaßnahmen. Ergebnisse: Umfassende Rauchverbote werden selten umgesetzt (&amp;lt; 20 % der Einrichtungen). Mitarbeitende dürfen vorrangig im Außengelände rauchen (z. B. in Raucherzonen: 69 bis 78 % je nach Stationstyp). Entwöhnungsangebote für Mitarbeitende bietet nur jede zweite KJP an (47 %). Schlussfolgerungen: Die Daten weisen auf zukünftige Handlungsfelder der Tabakkontrolle in der KJP-Pflege hin: transparente Regeln, Weiterbildungen und Ausbau betrieblicher Entwöhnungsangebote

Nestin as a diagnostic and prognostic marker for combined hepatocellular-cholangiocarcinoma

info:eu-repo/semantics/publishe

Nestin as a Diagnostic and Prognostic Marker for Combined Hepatocellular-Cholangiocarcinoma.

International audienceBACKGROUND AND AIMS: Combined Hepatocellular-Cholangiocarcinoma (cHCC-CCA) is a rare primary liver cancer (PLC) associated with a poor prognosis. Given the challenges in its identification and its clinical implications, biomarkers are critically needed. We aimed to investigate the diagnostic and prognostic value of the immunohistochemical expression of Nestin, a progenitor cell marker, in a large multicentric series of PLC. METHODS: We collected 461 cHCC-CCA samples from 32 different clinical centers. Control cases included 368 hepatocellular carcinomas (HCC) and 221 intrahepatic cholangiocarcinomas (ICCA). Nestin immunohistochemistry was performed on whole tumor sections. Diagnostic and prognostic performances of Nestin expression were determined using receiver operating characteristic curves and cox regression modeling. RESULTS: Nestin was able to distinguish cHCC-CCA from HCC with AUC of 0.85 and 0.86 on surgical and biopsy samples, respectively. Performance was lower for the distinction of cHCC-CCA from ICCA (AUC of 0.59 and 0.60). Nestin, however, showed a high prognostic value, allowing identification of the subset of cHCC-CCA ("Nestin High", >30% neoplastic cells with positive staining) associated with the worst clinical outcome (shorter disease-free and overall survival) after surgical resection and liver transplantation, as well as when assessment was performed on biopsies. CONCLUSION: We show in different clinical settings that Nestin has a diagnostic value and that it is a useful biomarker to identify the subset of cHCC-CCA associated with the worst clinical outcome. Nestin immunohistochemistry may be used to refine risk stratification and improve treatment allocation for patients with this highly aggressive malignancy. LAY SUMMARY: Combined Hepatocellular-Cholangiocarcinoma (cHCC-CCA) is a rare primary liver cancer (PLC) that lacks robust tissue biomarkers. We show in different clinical settings that Nestin immunohistochemical staining has a diagnostic value and is a useful biomarker to identify the subset of cHCC-CCA associated with the worst clinical outcome. Nestin immunohistochemistry may be used to refine risk stratification and improve treatment allocation for patients with this highly aggressive malignancy

Deep learning-based phenotyping reclassifies combined hepatocellular-cholangiocarcinoma

International audienceAbstract Primary liver cancer arises either from hepatocytic or biliary lineage cells, giving rise to hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (ICCA). Combined hepatocellular- cholangiocarcinomas (cHCC-CCA) exhibit equivocal or mixed features of both, causing diagnostic uncertainty and difficulty in determining proper management. Here, we perform a comprehensive deep learning-based phenotyping of multiple cohorts of patients. We show that deep learning can reproduce the diagnosis of HCC vs. CCA with a high performance. We analyze a series of 405 cHCC-CCA patients and demonstrate that the model can reclassify the tumors as HCC or ICCA, and that the predictions are consistent with clinical outcomes, genetic alterations and in situ spatial gene expression profiling. This type of approach could improve treatment decisions and ultimately clinical outcome for patients with rare and biphenotypic cancers such as cHCC-CCA