Nous présentons dans cet article original une étude histologique de résidus cutanés opératoires.
Cette étude a été réalisée dans le but de montrer de manière objective la diversité qu’il existe au ...niveau de la peau saine en fonction de la zone anatomique, du sexe et de l’âge, d’expliciter des principes chirurgicaux admis désormais de tous, mais souvent mal illustrés ou encore d’apporter un raffinement cosmétique supplémentaire à nos indications.
Sur une période de deux ans, 141 patients ont été sélectionnés, il s’agissait de 69 hommes et 72 femmes. Les prélèvements ont intéressé 54 fois la région tête et cou (38,3 %), 34 fois le tronc (24,1 %) et 53 fois les membres (37,6 %). Au niveau de ces trois grandes régions, nous avions préalablement défini 35 zones d’intérêt, qui ont toutes été étudiées à l’exception du menton et de la région cervicale antérieure. L’étude a consisté en l’analyse de résidus cutanés opératoires et de peau périphérique saine de lésions bénignes. Chaque prélèvement après son acheminement au laboratoire d’anatomopathologie a bénéficié de la réalisation de lames suivant quatre techniques différentes. Ainsi, une étude histologique complète a alors pu être menée. Elle a consisté en une étude purement quantitative avec mesure des différentes couches cutanées, évaluation de la densité pigmentaire et mesure objective de la densité en fibres élastiques. Enfin, une analyse descriptive a été menée zone par zone.
Les résultats de l’analyse quantitative nous ont permis d’établir des hiérarchies entre les différentes zones et ce pour tous les paramètres considérés. Ces résultats sont globalement en accord avec les données disponibles dans la littérature. Les résultats de l’analyse descriptive nous ont eux, permis de révéler les spécificités régionales, avec illustration visuelle de l’existence au niveau de la face, notamment d’une véritable mosaïque cutanée. Enfin, le croisement des deux analyses nous a permis d’énoncer des principes de bonne pratique en chirurgie reconstructrice quant au choix de la couverture cutanée la mieux adaptée en fonction des critères étudiés et de la zone considérée.
Cette étude qui représente l’ébauche d’une cartographie dynamique adaptée à la chirurgie plastique, n’a aucune prétention d’exhaustivité. Mais si modeste soit-elle, elle nous a fourni des résultats conformes aux données de la littérature et nous a conforté dans nos pratiques chirurgicales. Enfin, elle nous a permis de confirmer notre postulat de départ, à savoir qu’il n’existe non pas une mais des peaux.
We present in this original article a histological study of surgical skin residues.
This study was realized in order to show, in objective way, skin diversity according to sex, age and area, and to illustrate some current surgical practices of our speciality.
Two years along, 141 patients was selected, 69 Men and 72 women. Fifty-four biopsies were realized on the upper extremity, 34 on the trunk and 53 on legs and arms. The histological study was based on two steps; the first one was a classic quantitative study, with measurement of each cutaneous layer, and objective evaluation of elastic density in superficial dermis. The second one was a descriptive histological analysis of each cutaneous area.
The results coming from the quantitative analysis, allowed us to establish a classification of all the areas, according to each parameter. These results are globally compliant to the literature. The results of the descriptive analysis, lead us to conclude that it exists a lot of different skins with regional specificities. Then the crossover of the two analyses allowed us to define good practices tricks, in order to choose the best reconstruction technique for each area.
This study is just a rough draft of a dynamic skin cartography adapted to our surgery. But it allowed us to confirm our basic premise: it doesn’t exist only one skin but many skins.
The Farmers' Market Nutrition Program (FMNP) in the U.S. provides coupons for the purchase of fruit and vegetables (FV) to pregnant women and children enrolled in the Special Supplemental Nutrition ...Program for Women, Infants and Children (WIC), and to income-eligible adults 60+ years of age. The New York State FMNP Education Event Guide was developed to support cooperative extension educators in providing information, food tastings, and cooking demonstrations at farmers' markets (FM) to encourage consumption of FV. This paper describes implementation at seven FM in New York City, and shopping and eating behaviors in a cross-sectional survey of FM shoppers (
= 377). Three of nine lessons were implemented more than once, typically with food sampling (78.9%). FM shoppers were primarily women (81.5%), racially diverse (30.5% Black, 23.1% White), frequent shoppers (2.4 times/month), and had high FV consumption (2.24 cups fruit; 2.44 cups vegetables daily). Most FM shoppers participated in the FM education event (84%), and participants and non-participants had equivalent shopping and eating behaviors. More than 70% of FM education participants believed that the event positively impacted their knowledge, self-efficacy, and behavioral intentions. FMNP education events at FM were broadly accepted by FM shoppers of all characteristics, and may improve knowledge, self-efficacy, and behavioral intention.
Prior studies demonstrate associations between risk factors for obesity and related chronic diseases (e.g., cardiovascular disease) and features of the built environment. This is particularly true ...for rural populations, who have higher rates of obesity, cancer, and other chronic diseases than urban residents. There is also evidence linking health behaviors and outcomes to social factors such as social support, opposition, and norms. Thus, overlapping social networks that have a high degree of social capital and community cohesion, such as those found in rural communities, may be effective targets for introducing and maintaining healthy behaviors.
This study will evaluate the effectiveness of the Change Club (CC) intervention, a civic engagement intervention for built environment change to improve health behaviors and outcomes for residents of rural communities. The CC intervention provides small groups of community residents (approximately 10-14 people) with nutrition and physical activity lessons and stepwise built environment change planning workshops delivered by trained extension educators via in-person, virtual, or hybrid methods. We will conduct process, multilevel outcome, and cost evaluations of implementation of the CC intervention in a cluster randomized controlled trial in 10 communities across two states using a two-arm parallel design. Change in the primary outcome, American Heart Association's Life's Simple 7 composite cardiovascular health score, will be evaluated among CC members, their friends and family members, and other community residents and compared to comparable samples in control communities. We will also evaluate changes at the social/collective level (e.g., social cohesion, social trust) and examine costs as well as barriers and facilitators to implementation.
Our central hypothesis is the CC intervention will improve health behaviors and outcomes among engaged citizens and their family and friends within 24 months. Furthermore, we hypothesize that positive changes will catalyze critical steps in the pathway to improving longer-term health among community residents through improved healthy eating and physical activity opportunities. This study also represents a unique opportunity to evaluate process and cost-related data, which will provide key insights into the viability of this approach for widespread dissemination.
ClinicalTrials.gov: NCT05002660 , Registered 12 August 2021.
We explore the possibility of performing nuclear structure studies using low-energy neutrino beams. In particular, low-energy beta-beams and conventional sources (muon decay-at-rest) are considered. ...We present results on the total charged-current as well as flux-averaged cross sections associated to electron (anti-)neutrino scattering on oxygen, iron, molybdenum and lead, as typical examples. It is shown that by using neutrinos from low-energy beta-beams, information on forbidden states, in particular the spin-dipole, could be extracted.
Background and Aims:
Primary aldosteronism is a common cause of secondary hypertension. Primary aldosteronism is caused by an aldosterone-producing adenoma or bilateral hyperplasia that in some cases ...is asymmetrical with one adrenal dominating aldosterone secretion. Most patients with aldosterone-producing adenoma are biochemically cured by unilateral adrenalectomy, but patients with bilateral hyperplasia have a significant risk of residual or recurrent disease. Here, immunohistochemistry of CYP11B1 and B2 was used to investigate whether these markers could aid in the diagnostic workup of primary aldosteronism patients.
Materials and Methods:
A total of 39 patients with primary aldosteronism who underwent unilateral adrenalectomy for a presumed adenoma during 2013–2016 were included. Immunohistochemistry using monoclonal antibodies identifying the enzymes CYP11B1 and B2 was part of routine histopathological workup in 6 cases; in 33 cases, it was applied retrospectively. The hyperplasia diagnosis was suggested when there was no dominating nodule but immunoreactivity for CYP11B2 was seen in several nodules, which were also seen on routine sections. To distinguish between adenoma and hyperplasia, a ratio between the largest and second largest CYP11B2-positive nodules was calculated.
Results:
In all, 22 patients had an aldosterone-producing adenoma, while 13 patients were judged to have hyperplasia. In four cases, a final diagnosis could not be established, thus these were judged equivocal. Among the 33 cases investigated retrospectively, the primary histopathological diagnosis was altered from hyperplasia to aldosterone-producing adenoma in 9 cases (27%) after immunohistochemistry, and the immunohistochemically rectified adenoma group displayed improved clinical cure rates compared to the routine H&E-diagnosed cohort. Moreover, the B2 ratio was significantly higher in adenoma than in hyperplasia and equivocal cases.
Conclusion:
Immunohistochemistry detecting CYP11B1 and B2 expression is of great help in establishing a final histopathological diagnosis in patients with primary aldosteronism. This procedure should be part of the histopathological routine in all operated primary aldosteronism patients.
This paper considers the correctness of the application of Good–van Oss theory (vOGT) to the calculation of acid–base components of solid surface free energies. Theory equations are written in a ...matrix form, and their application is analyzed particularly from a mathematical point of view. A calculation procedure similar to the approach used for other scales of acid–base strength is suggested to obtain in a straightforward manner the necessary material coefficients. The chemical consequences of these considerations are also discussed. The acceptability of current experimental literature data and the validity of the calculations obtained from them by the proposed method are considered, showing the origin of some inconsistencies in current results. Some general considerations regarding the difficulties commonly encountered in the application of vOGT are also discussed, and it is shown that they can be rationalized or eliminated with more acid solvents being included in the solvent set and the properties of the reference solvent being correctly chosen. The difficulties encountered in correctly expressing the acid properties of some polymers are closely examined. Finally, some indications are given of the future possible developments of vOGT.
Community-supported agriculture (CSA) participation has been associated with high fruit and vegetable (FV) consumption, which may be due to better access to FV for CSA purchasers, or to positive ...knowledge, attitudes, and beliefs (KAB) regarding healthy eating among CSA applicants. The objective of this study was to examine KAB and consumption, in association with application to a cost-offset CSA (CO-CSA) program, and with CO-CSA purchase among applicants. We conducted a cross-sectional survey of CO-CSA applicants and a comparison sample in August 2017. All respondents were English-reading adults with a child 2-12 years old and household income of <185% of the federal poverty level. Among CO-CSA applicants, some were CO-CSA purchasers (
= 46) and some were not (
= 18). An online comparison sample met equivalent eligibility criteria, but had not participated in CSA for three years (
= 105). We compared CO-CSA applicants to the comparison sample, and compared purchasers and non-purchaser sub-groups, using Mann-Whitney
tests and chi-square analysis. CO-CSA applicants reported better knowledge, self-efficacy, home habits, and diet than the comparison sample. Among applicants, CO-CSA purchasers and non-purchasers had equivalent KAB, but children in purchaser households had higher FV consumption than in non-purchaser households (4.14 vs. 1.83 cups,
= 0.001). Future research should explore associations between CO-CSA participation and diet using experimental methods.
We study CP-violation effects when neutrinos are present in dense matter, such as outside the proto-neutron star formed in a core-collapse supernova. Using general arguments based on the Standard ...Model, we confirm that there are no CP-violating effects at the tree level on the electron neutrino and anti-neutrino fluxes in a core-collapse supernova. On the other hand significant effects can be obtained for muon and tau neutrinos even at the tree level. We show that CP-violating effects can be present in the supernova electron (anti-)neutrino fluxes as well, if muon and tau neutrinos have different fluxes at the neutrinosphere. Such differences could arise due to physics beyond the Standard Model, such as the presence of flavor-changing interactions.
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