To compare the administration of neuropsychological tests by teleneuropsychology (TeleNP) and face to face (F-F) in order to determine the feasibility and reliability of TeleNP.
At the inclusion ...visit, all participants underwent a traditional F-F neuropsychological assessment as part of their standard care. Four months after inclusion, they were randomized to undergo an additional neuropsychological assessment either by F-F administration or by TeleNP.
A total of 150 adults with cognitive complaints, but with no major cognitive or sensorial impairment were included. At 4 months, 69 participants were randomized in the F-F arm and 71 in TeleNP arm (10 lost in the follow-up). The overall satisfaction was high: 87.1% in the TeleNP arm were "very satisfied", and 82.9% indicated no preference between F-F and TeleNP. In agreement with previous data from the literature, neuropsychological assessments gave similar results across both administration conditions for a large majority of tests Mini-Mental State Examination (MMSE), Free and Cued Selective Reminding Test (FCSRT) French version, Mahieux gestural praxis battery, Frontal Assessment Battery (FAB), time of completion of the Trail making Test (TMT) A and B, number of errors of the TMT B, Rey complex figure test, categorical et phonological verbal fluency tests and minor differences for others 80-picture naming test (DO-80), FAB, Digit Span forward and backward and number of errors in the TMT A.
TeleNP is a promising method to be able to test patients as an alternative to F-F condition. Before this procedure can be generalized, it is now necessary to standardize the adaptation of certain tests and to test them in populations with more significant cognitive disorders.
To evaluate the effect of the fetal head station at attempted operative vaginal delivery (aOVD), and specifically midpelvic or low aOVD, on urinary incontinence (UI), anal incontinence (AI), and ...perineal pain at 6 months.
Prospective cohort study.
1941 women with singleton term fetuses in vertex presentation with midpelvic or low aOVD between 2008 and 2013 in a tertiary care university hospital.
Symptoms of urinary incontinence (UI) using the Bristol Female Lower Urinary Tract Symptoms questionnaire, and symptoms of anal incontinence (AI) severity using Fecal Incontinence Severity Index (FISI) were assessed 6 months after aOVD. We measured the association between midpelvic or low aOVD and symptoms of UI, AI, and perineal pain at 6 months using multiple regression and adjusting for demographics, and risk factors of UI and AI, with adjusted odds ratios (aORs) and 95% confidence intervals (95% CI).
The study included 907 women (46.7%) who responded to the questionnaire; 18.4% (167/907) had midpelvic aOVD, and 81.6% (740/907) low; and none of women with symptoms of UI (26.6%, and 22.4%, respectively; p = 0.31), AI (15.9%, and 21.8%; p = 0.09), the FISI score, and perineal pain (17.2%, and 12.7%; p = 0.14) differed significantly between groups. The same was true for stress, urge, and mixed-type UI, severe UI and difficulty voiding. Compared with low pelvic aOVD, the aORs for symptoms of UI in midpelvic aOVD were 0.70 (0.46-1.05) and AI 1.42 (0.85-2.39). Third- and fourth-degree tears were a major risk factor of symptoms of UI (aOR 3.08, 95% CI 1.35-7.00) and AI (aOR 3.47, 95% CI 1.43-8.39).
Neither symptoms of urinary nor anal incontinence differed at 6 months among women who had midpelvic and low pelvic aOVD. These findings are reassuring and need further studies at long-term to confirm these short-term data.
This research examines levels of objective and perceived control held by incumbents and successors in 100 Canadian family businesses approaching succession. Although results suggest that control ...remains largely with incumbents, indicators of succession readiness were more reliably correlated with the successors' levels of control. Generational differences in the association between succession indicators and actual levels of control are highlighted. Implications of these generational differences and the association between succession readiness indicators and control outcomes are discussed.
Due to its biological properties, human amniotic membrane (hAM) is widely studied in the field of tissue engineering and regenerative medicine. hAM is already very attractive for wound healing and it ...may be helpful as a support for bone regeneration. However, few studies assessed its potential for guided bone regeneration (GBR). The purpose of the present study was to assess the potential of the hAM as a membrane for GBR.
In vitro
, cell viability in fresh and cryopreserved hAM was assessed.
In vivo
, we evaluated the impact of fresh versus cryopreserved hAM, using both the epithelial or the mesenchymal layer facing the defect, on bone regeneration in a critical calvarial bone defect in mice. Then, the efficacy of cryopreserved hAM associated with a bone substitute was compared to a collagen membrane currently used for GBR.
In vitro
, no statistical difference was observed between the conditions concerning cell viability. Without graft material, cryopreserved hAM induced more bone formation when the mesenchymal layer covered the defect compared to the defect left empty. When associated with a bone substitute, such improved bone repair was not observed. These preliminary results suggest that cryopreserved hAM has a limited potential for GBR.
Because of its low immunogenicity, biological properties, and high availability, the Human Amniotic Membrane (HAM) is widely used in the clinic and in tissue engineering research. However, while its ...biological characteristics are well described, its mechanical properties remain understudied especially in terms of inter- and intra-HAM variability. To guide bioengineers in the use of this natural biomaterial, a detailed cartography of the HAM’s mechanical properties was performed. Maximal force (Fmax) and strain at break (Smax) were identified as the relevant mechanical criteria for this study after a combined analysis of histological sections, thickness measurements after dehydration, and uniaxial tensile tests. Eight HAMs were studied by mechanical cartography using a standardized cutting protocol and sampling pattern. On average, 103 ± 10 samples were retrieved and tested per HAM. Intra-tissue variability highlighted the fact that there were two mechanically distinct areas (placental and peripheral) in each HAM. For all HAMs, placental HAM was significantly stronger by 82 ± 45% and more stretchable by 19 ± 6% than their peripheral counterparts. Our results also demonstrated that placental, but not peripheral, HAM presented isotropic mechanical properties. Thus, placental HAM can be a raw material of choice that could be favored especially in the development of tissue engineering products where mechanical properties play a key role.
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•Placental HAM was stronger and more stretchable than peripheral.•Placental HAM presented isotropic mechanical properties.•Intra-tissue variability was higher than inter-tissue variability.
Objective: Postpartum hemorrhage (PPH) is one of the most common causes of mortality in obstetrics worldwide. Accuracy in the estimated blood loss is a priority in determining appropriate treatment. ...The aim of this study was to evaluate the accuracy of estimating blood loss by obstetrics care providers during simulated training sessions.
Method: A prospective study occurred in 2013 in a maternity ward at a teaching hospital. Simulation training sessions recreated a vaginal delivery in which six different scenarios were presented and proposed to each participant for them to estimate the blood loss (from 350 ml to 2500 ml) while using a collector bag graduated every 100 ml from 0 ml to 1500 ml. The primary endpoint was to determine if participants could accurately evaluate blood loss within a 20% error margin.
Results: About 90.7% of the medical staff participated. Ninety-three to 98% of the participants were accurate in their answer depending on which volume they had to estimate. For the lowest volume (350 ml), there was 11.1% overestimation between the estimated volume of blood loss (EBV) and the real volume of blood loss (RBV). However, there was an 8.8% underestimation found for the highest volume.
Conclusion: The accuracy of the estimated blood loss for the obstetrical medical staff, using the collector bag, is more than 96%.
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