A global review of the impact on women from men's alcohol drinking: the need for responding with a gendered lens.

BACKGROUND: Global evidence shows that men's harmful alcohol use contributes to intimate partner violence (IPV) and other harms. Yet, interventions that target alcohol-related harms to women are scarce. Quantitative analyses demonstrate links with physical and verbal aggression; however, the specific harms to women from men's drinking have not been well articulated, particularly from an international perspective. AIM: To document the breadth and nature of harms and impact of men's drinking on women. METHODS: A narrative review, using inductive analysis, was conducted of peer-reviewed qualitative studies that: (a) focused on alcohol (men's drinking), (b) featured women as primary victims, (c) encompassed direct/indirect harms, and (d) explicitly featured alcohol in the qualitative results. Papers were selected following a non-time-limited systematic search of key scholarly databases. RESULTS: Thirty papers were included in this review. The majority of studies were conducted in low- to middle-income countries. The harms in the studies were collated and organised under three main themes: (i) harmful alcohol-related actions by men (e.g. violence, sexual coercion, economic abuse), (ii) impact on women (e.g. physical and mental health harm, relationship functioning, social harm), and (iii) how partner alcohol use was framed by women in the studies. CONCLUSION: Men's drinking results in a multitude of direct, indirect and hidden harms to women that are cumulative, intersecting and entrench women's disempowerment. An explicit gendered lens is needed in prevention efforts to target men's drinking and the impact on women, to improve health and social outcomes for women worldwide.

Main findings: Women experience a multitude of direct, indirect and hidden harms from a male intimate partner's alcohol drinking, particularly in LMIC settings.Added knowledge: This review consolidates global qualitative evidence from diverse women's lived experience and adds a broader understanding of harm from men's alcohol drinking, beyond physical and verbal abuse shown in quantitative evidence.Global health impact for policy and action: Policy and intervention efforts that take an explicit gendered and intersectional lens on men's harmful drinking have potential to greatly improve health and social outcomes for women globally.

Effect of Model Body Type and Print Angle on the Accuracy of 3D-Printed Orthodontic Models.

The assortment of low-cost 3D printers for "in-practice" use, e.g., for clear aligner therapies, is ever increasing. To address concerns about the accuracy of orthodontic models produced on such printers when cost-efficient modes of 3D printing are employed, this study examined the effect of print model body type and print angulation on accuracy. Six printing-configuration groups were included: two model types (solid or hollow shell) combined with three print angles (0°, 70°, or 90°) with 10 models/group; all models were printed with 100 µm layer thickness using a digital light processing-based three-dimensional printer. Eleven selected structures and distances were measured on the printed models with a digital microscope and compared to the same measures on a digitized master model. The clinically acceptable range was set at ±0.25 mm difference from the master model for single tooth measurements (intra-tooth) and ±0.5 mm for cross-arch measurements (inter-tooth). For individual measurements across all models, 98% fell within clinical acceptability. For mean measurements within each model group, only canine height for the shell-0° model had a mean difference (-0.26 mm ± 0.03) outside the clinically acceptable range for intra-tooth measurements. Standard deviations for all intra-tooth measurements were within 0.07 mm. While none of the mean inter-tooth measurements exceeded the acceptability range, the standard deviations were larger (0.04 to 0.30 mm). The accuracy of the orthodontic models for clear aligner therapies was not impacted beyond the clinically acceptable range when altering model body type and print angulation to improve efficiency of 3D printing. These findings suggest greater flexibility of the practitioner to alter print settings to address time and cost efficiency in various clinical scenarios and still maintain clinically acceptable model accuracy.

Resolvin T4 enhances macrophage cholesterol efflux to reduce vascular disease.

While cardiovascular disease (CVD) is one of the major co-morbidities in patients with rheumatoid arthritis (RA), the mechanism(s) that contribute to CVD in patients with RA remain to be fully elucidated. Herein, we observe that plasma concentrations of 13-series resolvin (RvT)4 negatively correlate with vascular lipid load in mouse inflammatory arthritis. Administration of RvT4 to male arthritic mice fed an atherogenic diet significantly reduces atherosclerosis. Assessment of the mechanisms elicited by this mediator demonstrates that RvT4 activates cholesterol efflux in lipid laden macrophages via a Scavenger Receptor class B type 1 (SR-BI)-Neutral Cholesterol Ester Hydrolase-dependent pathway. This leads to the reprogramming of lipid laden macrophages yielding tissue protection. Pharmacological inhibition or knockdown of macrophage SR-BI reverses the vasculo-protective activities of RvT4 in vitro and in male mice in vivo. Together these findings elucidate a RvT4-SR-BI centered mechanism that orchestrates macrophage responses to limit atherosclerosis during inflammatory arthritis.

Brown Adipose Tissue Activation in Humans Increases Plasma Levels of Lipid Mediators.

CONTEXT: Activation of brown adipose tissue (BAT) thermogenesis improves insulin sensitivity and is beneficial in obesity. Emerging evidence indicates that BAT activation increases lipid mediators that play autocrine and endocrine roles to regulate metabolism and inflammation. OBJECTIVE: The goal of the study was to determine the relationship between 2 distinct approaches of BAT activation (cold exposure and mirabegron treatment) with lipid mediators in humans. METHODS: Healthy female subjects (n = 14) were treated with the ß3-adrenergic receptor agonist mirabegron (100 mg) daily for 28 days. A subset of female subjects (n = 8) was additionally exposed to cold temperatures (14-16 °C) for 2 hours using a cooling vest prior to initiating mirabegron treatment. A panel of lipid mediators was assessed in plasma using targeted liquid chromatography-tandem mass spectrometry, and their relationship to anthropometric and metabolic parameters was determined. RESULTS: Activation of BAT with cold exposure acutely increased levels of lipoxygenase and cyclooxygenase products, including 12-hydroxyeicosapentaenoic acid, 12-hydroxyeicosatetraenoic acid (HETE), 5-HETE, 14-hydroxydocosahexaenoic acid (HDHA), an isomer of maresin 2 (MaR2), 17-HDHA, protectin D1 (PD1), and prostaglandin E2. Mirabegron treatment similarly increased these products acutely, although levels of some mediators were blunted after chronic mirabegron treatment. Selected lipid mediators, including an MaR2 isomer, 17-HDHA, 5-HETE, and 15-HETE, positively correlated with nonesterified fatty acids and negatively correlated with the respiratory quotient, while PD1, 15-HETE, and 5-HETE positively correlated with adiponectin. CONCLUSION: These results indicate that selected lipid mediators may serve as biomarkers of BAT activation.

Effect of Different Crosslinkers on Denatured Dentin Collagen's Biostability, MMP Inhibition and Mechanical Properties.

OBJECTIVE: Sound, natural dentin collagen can be stabilized against enzymatic degradation through exogenous crosslinking treatment for durable bonding; however, the effect on denatured dentin (DD) collagen is unknown. Hence, the ability of different crosslinkers to enhance/restore the properties of DD collagen was assessed. METHODS: Demineralized natural and DD collagen films (7 mm × 7 mm × 7 µm) and beams (0.8 mm × 0.8 mm × 7 mm) were prepared. DD collagen was experimentally produced by heat or acid exposure, which was then assessed by various techniques. All specimens were then treated with 1 wt% of chemical crosslinker 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide/n-hydroxysuccinimide (EDC/NHS) and two structurally different flavonoids-theaflavins (TF) from black tea and type-A proanthocyanidins from cranberry juice (CR) for either 30 s or 1 h. The controls were untreated. Dentin films were assessed for chemical interaction and cross-linking effect by FTIR, biostability against exogenous collagenase by weight loss (WL) and hydroxyproline release (HYP), and endogenous matrix metalloproteinases (MMPs) activity by confocal laser microscopy. Dentin beams were evaluated for tensile properties. Data were analyzed using ANOVA and Tukey's test (α = 0.05). RESULTS: Compared with natural collagen, DD collagen showed pronounced structural changes, altered biostability and decreased mechanical properties, which were then improved to various degrees that were dependent on the crosslinkers used, with EDC/NHS being the least effective. Surprisingly, the well-known MMP inhibitor EDC/NHS showed negligible effect on or even increased MMP activity in DD collagen. As compared with control, cross-linking induced by TF and CR significantly increased collagen biostability (reduced WL and HYP release, p < 0.05), MMP inhibition (p < 0.001) and mechanical properties (p < 0.05), regardless of denaturation. CONCLUSIONS: DD collagen cannot or can only minimally be stabilized via EDC/NHS crosslinking; however, the challenging substrate of DD collagen can be enhanced or restored using the promising flavonoids TF and CR.

Can alcohol policy prevent harms to women and children from men's alcohol consumption? An overview of existing literature and suggested ways forward.

The World Health Organization's list of cost-effective alcohol control policies is a widely-used resource that highlights strategies to address alcohol-related harms. However, there is more evidence on how recommended policies impact harms to people who drink alcohol-such as physical health problems caused by heavy alcohol use-than on secondhand harms inflicted on someone other than the person drinking alcohol, i.e., alcohol's harms to others. In this essay, we describe evidence of impacts of alcohol policy on harms to women and children resulting from men's alcohol consumption, as well as options for making policies more relevant for reducing intimate partner violence and child abuse. We begin with an overview of harms to women and children resulting from men's alcohol consumption and review cost-effective alcohol policies with potential to reduce these harms based on likely mechanisms of action. Next, we present a rapid review of reviews to describe existing evidence of impacts of these policies on the outcomes of physical violence, sexual violence, and child abuse and neglect. We found little evidence of systematic evaluation of impacts of these important alcohol policies on harms to women and children. Thus, we advocate for increased attention in evaluation research to the impacts of alcohol policies on harms experienced by women and children who are exposed to men who drink alcohol. We also argue for more consideration of a broader range of policies and interventions to reduce these specific types of harm. Finally, we present a conceptual model illustrating how alcohol policies may be supplemented with other interventions specifically tailored to reduce alcohol-related harms commonly experienced by women and children as a result of men's alcohol use.

Discordant pathologic diagnoses of myelodysplastic neoplasms and their implications for registries and therapies.

Myelodysplastic neoplasms (MDS) are a collection of hematopoietic disorders with widely variable prognoses and treatment options. Accurate pathologic diagnoses present challenges because of interobserver variability in interpreting morphology and quantifying dysplasia. We compared local clinical site diagnoses with central, adjudicated review from 918 participants enrolled in the ongoing National Heart, Lung, and Blood Institute National MDS Natural History Study, a prospective observational cohort study of participants with suspected MDS or MDS/myeloproliferative neoplasms (MPNs). Locally, 264 (29%) were diagnosed as having MDS, 15 (2%) MDS/MPN overlap, 62 (7%) idiopathic cytopenia of undetermined significance (ICUS), 0 (0%) acute myeloid leukemia (AML) with <30% blasts, and 577 (63%) as other. Approximately one-third of cases were reclassified after central review, with 266 (29%) diagnosed as MDS, 45 (5%) MDS/MPN overlap, 49 (5%) ICUS, 15 (2%) AML with <30%, and 543 (59%) as other. Site miscoding errors accounted for more than half (53%) of the local misdiagnoses, leaving a true misdiagnosis rate of 15% overall, 21% for MDS. Therapies were reported in 37% of patients, including 43% of patients with MDS, 49% of patients with MDS/MPN, and 86% of patients with AML with <30% blasts. Treatment rates were lower (25%) in cases with true discordance in diagnosis compared with those for whom local and central diagnoses agreed (40%), and receipt of inappropriate therapy occurred in 7% of misdiagnosed cases. Discordant diagnoses were frequent, which has implications for the accuracy of study-related and national registries and can lead to inappropriate therapy. This trial was registered at www.clinicaltrials.gov as #NCT05074550.

Determining residual gastric volume in healthy children using ultrasound.

PURPOSE: Fasting guidelines for children recommend restricting clear fluids for one or two hours before a procedure to reduce pulmonary aspiration. Gastric volumes < 1.5 mL·kg-1 do not seem to present an increased risk of pulmonary aspiration. Our aim was to quantify the time to achieve a gastric volume < 1.5 mL·kg-1 after clear fluid ingestion in children. METHODS: We conducted a prospective observational study in healthy volunteers aged 1-14 yr. Participants followed American Society of Anesthesiologists fasting guidelines prior to data collection. Gastric ultrasound (US) was performed in the right lateral decubitus (RLD) position to determine the antral cross-sectional area (CSA). Following baseline measurements, participants consumed 250 mL of a clear fluid. We then performed gastric US at four time intervals: 30, 60, 90, and 120 min. Data were collected following a predictive model for gastric volume estimation using the formula: volume (mL) = -7.8 + (3.5 × RLD CSA) + (0.127) × age (months). RESULTS: We recruited 33 healthy children aged 2-14 yr. The mean gastric volume per weight (mL·kg-1) at baseline was 0.51 mL·kg-1 (95% confidence interval [CI], 0.46 to 0.57). The mean gastric volume was 1.55 mL·kg-1 (95% CI, 1.36 to 1.75) at 30 min, 1.17 mL·kg-1 (95% CI, 1.01 to 1.33) at 60 min, 0.76 mL·kg-1 (95% CI, 0.67 to 0.85) at 90 min, and 0.58 mL·kg-1 (95% CI, 0.52 to 0.65) at 120 min. CONCLUSION: Our results show that total gastric fluid volume was < 1.5 mL·kg-1 after 60 min, suggesting that current fasting guidelines for children could be liberalized.

RéSUMé: OBJECTIF: Les directives de jeûne pour les enfants recommandent de restreindre les liquides clairs pendant une ou deux heures avant une intervention pour réduire l'aspiration pulmonaire. Des volumes gastriques < 1,5 mL·kg−1 ne semblent pas présenter un risque accru d'aspiration pulmonaire. Notre objectif était de quantifier le temps nécessaire pour atteindre un volume gastrique < 1,5 mL·kg−1 après ingestion de liquides clairs chez les enfants. MéTHODE: Nous avons mené une étude observationnelle prospective chez des volontaires en bonne santé âgé·es de 1 à 14 ans. Les participant·es ont suivi les directives de jeûne de l'American Society of Anesthesiologists avant la collecte de données. L'échographie gastrique a été réalisée en décubitus latéral droit (DLD) pour déterminer la section transversale antrale. Après les mesures initiales, les participant·es ont consommé 250 mL d'un liquide clair. Nous avons ensuite réalisé une échographie gastrique à quatre intervalles de temps : 30, 60, 90 et 120 minutes. Les données ont été recueillies selon un modèle prédictif pour l'estimation du volume gastrique à l'aide de la formule : volume (mL) = −7,8 + (3,5 × section transversale antrale en DLD) + (0,127) × âge (mois). RéSULTATS: Nous avons recruté 33 enfants en bonne santé âgé·es de 2 à 14 ans. Le volume gastrique moyen par poids (mL·kg−1) au début de l'intervention était de 0,51 mL·kg−1 (intervalle de confiance [IC] à 95 %, 0,46 à 0,57). Le volume gastrique moyen était de 1,55 mL·kg−1 (IC 95 %, 1,36 à 1,75) à 30 min, 1,17 mL·kg−1 (IC 95 %, 1,01 à 1,33) à 60 min, 0,76 mL·kg−1 (IC 95 %, 0,67 à 0,85) à 90 min, et 0,58 mL·kg−1 (IC 95 %, 0,52 à 0,65) à 120 min. CONCLUSION: Nos résultats montrent que le volume total de liquide gastrique était < 1,5 mL·kg−1 après 60 min, suggérant que les directives actuelles de jeûne pour les enfants pourraient être libéralisées.

Effect of fluoride varnish in combination with simulated oral environment on enamel-bracket shear bond strength.

To determine the effect of fluoride varnish application combined with a simulated oral environment prior to bracket bonding on the shear bond strength (SBS) between brackets and tooth enamel. Sixty de-identified, extracted teeth were grouped to either receive or not receive fluoride varnish and then stored for 7 days at 37 °C in phosphate-buffered saline (PBS) solution or PBS combined with three 15-min cycles/day in a demineralizing solution to simulate pH variation following meals. Subsequently, brackets were bonded and after 24-h dark cure at 37 °C, debonded using shear forces in a simulated oral environment. The maximum shear force was used to calculate SBS, and the adhesive remnant index (ARI) was determined by image analysis of photos of the bracket mesh pad after debonding. A statistically higher SBS (10.16 MPa) was observed when fluoride varnish was applied prior to storage in PBS + demineralizing solution compared to SBS (6.38 MPa) following storage in the same solution without varnish application. Based on 37% effect size, this difference is also clinically relevant. In contrast, no significant differences in SBS were observed with varnish application combined with PBS with no demineralizing solution or between storage solution alone. Moreover, there was no significant difference in ARI due to varnish combined with either storage method or storage solution only. Results suggest varnish application prior to bracket bonding in combination with simulated oral environment that included acid exposure is beneficial in maintaining higher SBS between bracket and enamel. Despite higher SBS, adhesive remaining on enamel did not increase.

Assessment of the reliability of virtual preanesthetic airway evaluation compared to traditional in-person airway evaluation: a prospective observational study.

PURPOSE: Airway evaluation is a fundamental component of the preanesthetic examination. Virtual care has increased during the COVID-19 pandemic. We aimed to assess the reliability of a virtual preanesthetic airway evaluation compared with a traditional in-person airway evaluation. METHODS: This prospective observational study compared the inter-rater agreement of an in-person airway evaluation performed by a consultant anesthesiologist with a virtual airway evaluation (VAE) performed by consultant anesthesiologists and medical students. The airway evaluation was completed using a comprehensive airway evaluation and scoring tool. The primary outcome was the inter-rater agreement of total scores between in-person anesthesiologist airway evaluations and the VAEs of both the anesthesiologists and medical students, assessed using Cohen's Kappa (CK). Secondary outcomes included the inter-rater agreement for each airway evaluation component between the in-person anesthesiologists and both the anesthesiologist and medical student VAEs, assessed using prevalence-adjusted and bias-adjusted Kappa. RESULTS: One hundred out of 111 participants completed all three evaluations. The in-person anesthesiologist airway evaluations had fair and good levels of agreement of total scores with the VAEs of the anesthesiologists (CK, 0.21; 97.5% confidence interval [CI], 0.07 to 0.34) and the medical students (CK, 0.74; 97.5% CI, 0.62 to 0.86), respectively. One participant was reported to have a difficult intubation. CONCLUSION: Virtual airway evaluations performed by anesthesiologists and medical students had fair and good inter-rater agreement, respectively, with in-person anesthesiologist airway evaluations. Further study with a focus on patients with difficult airways is required to define the predictive value of VAEs regarding difficult intubations.

RéSUMé: OBJECTIF: L'évaluation des voies aériennes constitue un élément fondamental de l'examen préanesthésique. Les soins prodigués virtuellement ont augmenté pendant la pandémie de COVID-19. Nous avons tenté d'évaluer la fiabilité d'une évaluation préanesthésique virtuelle des voies aériennes par rapport à une évaluation traditionnelle en personne. MéTHODE: Cette étude observationnelle prospective a comparé la concordance inter-observateurs d'une évaluation des voies aériennes en personne effectuée par un anesthésiologiste avec une évaluation virtuelle des voies aériennes (EVVA) réalisée par des anesthésiologistes et des étudiants en médecine. L'évaluation des voies aériennes a été réalisée à l'aide d'un outil d'évaluation et de notation des voies aériennes. Le critère d'évaluation principal était la concordance inter-observateurs des scores totaux entre les évaluations des voies aériennes réalisées par des anesthésiologistes en personne et les EVVA effectuées par des anesthésiologistes et des étudiants en médecine, évaluée à l'aide du coefficient Kappa de Cohen (CK). Les critères d'évaluation secondaires comprenaient la concordance inter-observateurs pour chaque composante de l'évaluation des voies aériennes entre les anesthésiologistes en personne et les anesthésiologistes et étudiants en médecine ayant réalisé les EVVA, évaluée à l'aide d'un coefficient de Kappa ajusté pour la prévalence et les biais. RéSULTATS: Cent des 111 participants ont complété les trois évaluations. Les évaluations des voies aériennes par des anesthésiologistes en personne présentaient des niveaux de concordance des scores totaux fidèles et bons par rapport aux EVVA réalisées par les anesthésiologistes (CK, 0,21; intervalle de confiance [IC] à 97,5 %, 0,07 à 0,34) et les étudiants en médecine (CK, 0,74; IC 97,5 %, 0,62 à 0,86), respectivement. Une intubation difficile a été rapportée pour un participant. CONCLUSION: Les évaluations virtuelles des voies aériennes réalisées par des anesthésiologistes et des étudiants en médecine avaient une concordance inter-observateurs fidèle et bonne avec les évaluations des voies aériennes réalisées en personne par des anesthésiologistes. Des recherches plus approfondies axées sur les patients présentant une prise en charge difficile des voies aériennes sont nécessaires pour définir la valeur prédictive des EVVA dans un contexte d'intubations difficiles.

The Quality of Assessment for Learning score for evaluating written feedback in anesthesiology postgraduate medical education: a generalizability and decision study.

Background: Competency based residency programs depend on high quality feedback from the assessment of entrustable professional activities (EPA). The Quality of Assessment for Learning (QuAL) score is a tool developed to rate the quality of narrative comments in workplace-based assessments; it has validity evidence for scoring the quality of narrative feedback provided to emergency medicine residents, but it is unknown whether the QuAL score is reliable in the assessment of narrative feedback in other postgraduate programs. Methods: Fifty sets of EPA narratives from a single academic year at our competency based medical education post-graduate anesthesia program were selected by stratified sampling within defined parameters [e.g. resident gender and stage of training, assessor gender, Competency By Design training level, and word count (≥17 or <17 words)]. Two competency committee members and two medical students rated the quality of narrative feedback using a utility score and QuAL score. We used Kendall's tau-b co-efficient to compare the perceived utility of the written feedback to the quality assessed with the QuAL score. The authors used generalizability and decision studies to estimate the reliability and generalizability coefficients. Results: Both the faculty's utility scores and QuAL scores (r = 0.646, p < 0.001) and the trainees' utility scores and QuAL scores (r = 0.667, p < 0.001) were moderately correlated. Results from the generalizability studies showed that utility scores were reliable with two raters for both faculty (Epsilon=0.87, Phi=0.86) and trainees (Epsilon=0.88, Phi=0.88). Conclusions: The QuAL score is correlated with faculty- and trainee-rated utility of anesthesia EPA feedback. Both faculty and trainees can reliability apply the QuAL score to anesthesia EPA narrative feedback. This tool has the potential to be used for faculty development and program evaluation in Competency Based Medical Education. Other programs could consider replicating our study in their specialty.

Contexte: La qualité de la rétroaction à la suite de l'évaluation d'activités professionnelles confiables (APC) est d'une importance capitale dans les programmes de résidence fondés sur les compétences. Le score QuAL (Quality of Assessment for Learning) est un outil développé pour évaluer la qualité de la rétroaction narrative dans les évaluations en milieu de travail. Sa validité a été démontrée dans le cas des commentaires narratifs fournis aux résidents en médecine d'urgence, mais sa fiabilité n'a pas été évaluée dans d'autres programmes de formation postdoctorale. Méthodes: Cinquante ensembles de commentaires portant sur des APC d'une seule année universitaire dans notre programme postdoctoral en anesthésiologie ­ un programme fondé sur les compétences ­ ont été sélectionnés par échantillonnage stratifié selon des paramètres préétablis [par exemple, le sexe du résident et son niveau de formation, le sexe de l'évaluateur, le niveau de formation en Compétence par conception, et le nombre de mots (≥17 ou <17 mots)]. Deux membres du comité de compétence et deux étudiants en médecine ont évalué la qualité de la rétroaction narrative à l'aide d'un score d'utilité et d'un score QuAL. Nous avons utilisé le coefficient tau-b de Kendall pour comparer l'utilité perçue de la rétroaction écrite et sa qualité évaluée à l'aide du score QuAL. Les auteurs ont utilisé des études de généralisabilité et de décision pour estimer les coefficients de fiabilité et de généralisabilité. Résultats: Les scores d'utilité et les scores QuAL des enseignants (r = 0,646, p < 0,001) et ceux des étudiants (r = 0,667, p < 0,001) étaient modérément corrélés. Les résultats des études de généralisabilité ont montré qu'avec deux évaluateurs les scores d'utilité étaient fiables tant pour les enseignants (Epsilon=0,87, Phi=0,86) que pour les étudiants (Epsilon=0,88, Phi=0,88). Conclusions: Le score QuAL est en corrélation avec l'utilité de la rétroaction sur les APC en anesthésiologie évaluée par les enseignants et les étudiants. Les uns et les autres peuvent appliquer de manière fiable le score QuAL aux commentaires narratifs sur les APC en anesthésiologie. Cet outil pourrait être utilisé pour le perfectionnement professoral et l'évaluation des programmes dans le cadre d'une formation médicale fondée sur les compétences. D'autres programmes pourraient envisager de reproduire notre étude dans leur spécialité.

Mechanical strain induces ex vivo expansion of periosteum.

Segmental bone defects present complex clinical challenges. Nonunion, malunion, and infection are common sequalae of autogenous bone grafts, allografts, and synthetic bone implants due to poor incorporation with the patient's bone. The current project explores the osteogenic properties of periosteum to facilitate graft incorporation. As tissue area is a natural limitation of autografting, mechanical strain was implemented to expand the periosteum. Freshly harvested, porcine periosteum was strained at 5 and 10% per day for 10 days with non-strained and free-floating samples serving as controls. Total tissue size, viability and histologic examination revealed that strain increased area to a maximum of 1.6-fold in the 10% daily strain. No change in tissue anatomy or viability via MTT or Ki67 staining and quantification was observed among groups. The osteogenic potential of the mechanical expanded periosteum was then examined in vivo. Human cancellous allografts were wrapped with 10% per day strained, fresh, free-floating, or no porcine periosteum and implanted subcutaneously into female, athymic mice. Tissue was collected at 8- and 16-weeks. Gene expression analysis revealed a significant increase in alkaline phosphatase and osteocalcin in the fresh periosteum group at 8-weeks post implantation compared to all other groups. Values among all groups were similar at week 16. Additionally, histological assessment with H&E and Masson-Goldner Trichrome staining showed that all periosteal groups outperformed the non-periosteal allograft, with fresh periosteum demonstrating the highest levels of new tissue mineralization at the periosteum-bone interface. Overall, mechanical expansion of the periosteum can provide increased area for segmental healing via autograft strategies, though further studies are needed to explore culture methodology to optimize osteogenic potential.

Ethical and regulatory issues of stem cell-derived 3-dimensional organoid and tissue therapy for personalised regenerative medicine.

BACKGROUND: Regenerative medicine has the potential to treat genetic disorders and replace damaged or missing tissue. The use of donor or animal tissue raises many well-known issues, including limited tissue availability, the possibility of rejection and patient infection. Stem cell therapy raised hope of overcoming these issues, but created new risks including tumour formation and limited benefit if the desired target tissue does not form. The recent development of 3-dimensional tissues, including organoids, allows the creation of more complex tissues for personalised regenerative medicine. METHODS: This article details the potential health risks of 3-dimensional organoid and tissue therapy versus dissociated stem cell therapy. The current ethical and regulatory issues surrounding 3-dimensional organoid and tissue therapy are presented with a focus on the highly influential FDA and International Society of Stem Cell Research (ISSCR) guidelines. CONCLUSIONS: The potential use of 3-dimensional organoid and tissue therapy may deliver greater patient benefits than other regenerative medicine approaches, but raises new health and ethical risks. Preclinical testing of these therapies will not mitigate some of their risks; they may only be understood after first-in-human trials. The potential irreversibility and high risk of these therapies affects how clinical trials should be structured, including post-trial care for participants.

Comparison of Floor Cleaning and Disinfection Processes in a Research Animal Facility.

Floor cleaning and disinfection are essential components of maintaining animal health status and meeting regulatory requirements in research vivaria. However, best practices for method, frequency, and evaluation techniques have not been established. Reuse of cotton string mop and bucket systems has been implicated in spreading contamination in the human hospital setting. We evaluated 4 different combinations of disinfectant and mop systems commonly used in rodent vivaria. Eight housing rooms were mopped a total of 4 times using one of the following methods: quaternary ammonium compound (QUAT) and cotton string mop (QC), QUAT and microfiber mop (QM), hydrogen peroxide disinfectant (HPD) and cotton string mop (HC), or HPD and microfiber mop (HM). ATP and RODAC samples of the floor were taken before and after mopping. The time to mop each room, floor drying time, and the amount of disinfectant used were recorded. The QC method was associated with significantly more bacterial contamination while all other methods significantly reduced bacterial contamination. The QC method performed significantly worse in reducing bacterial contamination as compared with all other methods when cotton mop heads were reused. All methods except QC significantly reduced ATP levels, with the HC and HM methods being significantly more effective at reducing ATP levels than the QC and QM methods. Costs were similar for the QC, QM, and HM methods. The results of this study indicate that reuse of cotton string mop heads with QUAT increases floor contamination while HPD is effective for up to 3 reuses. Single use microfiber mops were effective with both QUAT and HPD but did not result in more effective cleaning or disinfection than cotton string mops.

Vision Therapy Interventions to Support Occupational Performance for People With Traumatic Brain Injury With Visual Symptoms (June 2013-October 2020).

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from the systematic review on the effectiveness of interventions that address visual impairments and visual perception to improve occupational performance for adults with traumatic brain injury.

Binasal Occlusion Intervention to Support Occupational Performance for People With Traumatic Brain Injury With Visual Symptoms (June 2013-October 2020).

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from the systematic review on the effectiveness of binasal occlusion interventions that address visual impairments and visual perception to improve occupational performance for adults with traumatic brain injury.

Vestibulo-Ocular Interventions to Support Occupational Performance for People With Traumatic Brain Injury With Visual Symptoms (June 2013-October 2020).

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from the systematic review on the effectiveness of vestibulo-ocular interventions that address visual impairments and visual perception to improve occupational performance for adults with traumatic brain injury.