Intraocular foreign bodies in children: A retrospective case series.

INTRODUCTION: Open globe injuries are a major cause of visual impairment in children, related to the severity of the trauma or secondary to induced amblyopia. Intraocular foreign bodies (IOFB) have been reported in approximately one third of cases of open globe injuries. As clinical presentation and management may differ between adults and children, data is lacking about IOFBs in children under 18years of age. The purpose of this study was to assess the clinical characteristics and visual prognosis of ocular trauma associated with intraocular foreign bodies in children. MATERIALS AND METHODS: This single-center retrospective study included patients under 18years of age treated for ocular trauma with IOFB. Demographic characteristics, complete initial and final ophthalmological examination, imaging data and details of medical and surgical management were collected. RESULTS: Fourteen patients were included (78.6% boys), with a mean age of 10.3years (min 7months-max 17years). In 92.9% of cases, patients were found to have a single IOFB, mostly metallic (71.4%). Posterior segment IOFBs were found in 50% of cases, anterior segment IOFBs in 28.6% and orbital IOFBs in 21.4%. The clinical examination permitted detection of the IOFBs in 50% of cases, while they were visible on CT scan in all cases. The mean initial visual acuity was 20/320, and the mean final visual acuity was 20/125. Endophthalmitis occurred in 2 cases (14%). DISCUSSION: Open globe injuries associated with IOFB are severe and sight-threatening. Localization of the IOFB in the posterior segment has a worse prognosis. CT scan is mandatory, especially in children, as the trauma history is often missing. Retinal detachment and endophthalmitis appear to be the main prognostic factors requiring urgent specialized pediatric ophthalmology management.

Re-examining Geospatial Online Participatory Tools for Environmental Planning.

Geospatial online participatory tools, or geo-OPTs, are increasingly used worldwide for engaging the public in planning. Yet, despite growth in the adoption and use of geo-OPTs, and the growing scholarship to accompany it, our understanding of their ability to support public participation in environmental planning is still underdeveloped. In this paper, we investigate the application of a geo-OPT by the United States Army Corps of Engineers (USACE), a leading water management agency in the United States, in three contextually and geographically diverse cases. Through a combination of document analysis, interviews, and participant observation, we examine the processes and dynamics associated with the development and use of the geo-OPT Crowdsource Reporter. Our findings highlight the importance of managing geo-OPTs not in isolation or as a panacea but rather as part of a broader planning process that recognizes the complexity and significance of communication in geo-OPT processes. Although it may be tempting and seemingly simple to create and launch these online tools, our research reveals how a lack of intention early on may lead to underuse or misapplication of the tool. More significantly, real damage can be done, like increased public frustration and alienation, resulting in breakdown in communications or even worsening public relations for federal agencies.

A summary of the U.S. Marine Recruit Assessment Program (RAP) procedures and survey from 2003 to 2021

The Recruit Assessment Program (RAP) is a cross-sectional, baseline survey of U.S. Marine recruits administered at Marine Corps Recruit Depot, San Diego. This report presents RAP study procedures and survey content that was administered to 229,015 participants between 2003 and 2021. Self-reported data were collected on recruit demographics, physical and mental health, adverse life experiences, lifestyle and risky behaviors, and substance use. In 2013, the survey was updated to remove questions with other linkable and reliable sources and those with low completion rates and low relevance to Marine health research; the removal of these items allowed for the addition of instrument measures for major depression, post-traumatic stress disorder, anger, and resilience with no significant change to overall survey length. Average completion rates are approximately 95%. Multiple studies have shown the utility of RAP data collected thus far as a robust data repository of pre-service health and behavioral measures.

[Sex therapy and support for women and couples]. / Sexothérapie et accompagnement de la femme et du couple.

Sexuality is shaped by experience and by what has been passed down. Body image and sex influence desire and pleasure. In the case of endometriosis, suffering and pain can lead to shame and guilt. Encouraging people to talk to each other helps to create a free eroticism that resembles the couple.

Barriers to COVID-19 Vaccination in a Troop of Fleet Antiterrorism Security Team Marines: Observational Study.

BACKGROUND: In 2019, the World Health Organization declared the reluctance to vaccinate despite the availability of vaccination services as one of the top 10 threats to global health. In early 2021, self-reported reluctance to vaccinate among military personnel might have been considered a significant threat to national security. Having a choice architecture that made COVID-19 vaccination optional rather than required for military personnel could have inadvertently undermined military readiness if vaccination uptake did not reach an acceptable threshold. OBJECTIVE: The purpose of this observational study was to examine Marines' self-reported reasons for planning to decline the COVID-19 vaccine to understand their barriers to vaccination. METHODS: As the vaccination became available to 1 company of Fleet Antiterrorism Security Team (FAST) Marines in early 2021, company command required those planning to decline vaccination to write an essay with up to 5 reasons for their choice. These essays provided the data for this study. Qualitative descriptive analysis with elements from grounded theory was used to thematically categorize FAST Marines' written reasons for planning to decline the COVID-19 vaccine into a codebook describing 8 key behavioral determinants. Interrater agreement among 2 qualitatively trained researchers was very good (κ=0.81). RESULTS: A troop of 47 Marines provided 235 reasons why they planned to decline the COVID-19 vaccine. The most frequent reasons were difficulty understanding health information (105/235, 45%), low estimates of risk (33/235, 14%), and fear of physical discomfort (29/235, 12%). Resulting interventions directly targeted Marines' self-reported reasons by reducing barriers (eg, normalized getting the vaccine), increasing vaccine benefits (eg, improved access to base gyms and recreational facilities), and increasing nonvaccine friction (eg, required in writing 5 reasons for declining the vaccine). CONCLUSIONS: Understanding the barriers military personnel experience toward COVID-19 vaccination remains critical as vaccine acquisition and availability continue to protect military personnel. Insights from subpopulations like FAST Marines can enhance our ability to identify barriers and appropriate intervention techniques to influence COVID-19 vaccination behaviors.

Impact of U.S. Federal Loan Repayment Programs on the Behavioral Health Workforce: Scoping Review.

OBJECTIVE: Federal loan repayment programs (LRPs) are one strategy to address the shortage of behavioral health providers. This scoping review aimed to identify and characterize the federal LRPs' impact on the U.S. behavioral health workforce. METHODS: A scoping review was conducted in accordance with JBI (formerly known as the Joanna Briggs Institute) methodology for scoping reviews. The authors searched the Ovid MEDLINE, Web of Science, APA PsycInfo, EconLit, PAIS Index, and Embase databases, and gray literature was also reviewed. Two coders screened each article's abstract and full text and extracted study data. Findings were narratively synthesized and conceptually organized. RESULTS: The full-text screening identified 17 articles that met eligibility criteria. Of these, eight were peer-reviewed studies, and all but one evaluated the National Health Service Corps (NHSC) LRP. Findings were conceptually organized into five categories: descriptive studies of NHSC behavioral health needs and the NHSC workforce (k=4); providers' perceptions of, and experiences with, the NHSC (k=2); associations between NHSC funding and the number of NHSC behavioral health providers (k=4); NHSC behavioral health workforce productivity and capacity (k=3); and federal LRP recruitment and retention (k=4). CONCLUSIONS: The literature on federal LRPs and their impact on the behavioral health workforce is relatively limited. Although federal LRPs are an important and effective tool to address the behavioral health workforce shortage, additional federal policy strategies are needed to attract and retain behavioral health providers and to diversify the behavioral health workforce.

Formerly used defense sites on Unalaska Island, Alaska: Mapping a legacy of environmental pollution.

Unalaska Island, Alaska, served as a US military base during World War II. The military installed bases on Unalaska and nearby islands, many of which were built adjacent to Unangan communities. The military used toxic compounds in its operations and left a legacy of pollution that may pose health risks to residents and local wildlife. The goals of this study were to identify hotspots of contamination remaining at Unalaska formerly used defense (FUD) sites, evaluate the risk posed by arsenic, and examine "no US Department of Defense action indicated" (NDAI) status determinations for FUD sites near communities. We compiled soil chemistry data from remediation reports prepared by the US Army Corps of Engineers at 18 FUD sites on and near Unalaska. Nine had past and/or active remediation projects and on-site sampling data. Eight sites did not have sampling data and were characterized as NDAI. One site was listed as closed. For the nine sites with sampling data, we compiled data for 22 contaminants of concern (COC) and compared concentrations to soil cleanup levels for human health (18 AAC 75.341). We mapped contaminant concentrations exceeding these levels to identify hotspots of contamination. We found that concentrations of some of the 22 COC exceeded Alaska cleanup levels despite remediation efforts, including diesel range organics, arsenic, and lead. The highest COC concentrations were at the FUD site adjacent to the City of Unalaska. A quantitative risk assessment for arsenic found that the risk of exposure through drinking water is low. We highlight concerns with NDAI designations and current remedial practices at remote FUD sites located adjacent to communities. Our data suggest the need for further remediation and monitoring efforts on Unalaska for certain contaminants and research to examine potential threats to human and animal health associated with these sites. Integr Environ Assess Manag 2024;00:1-12. © 2024 SETAC.

[Anorexia nervosa and the perinatal period]. / Anorexie mentale et période périnatale.

As a complex pathology, anorexia nervosa interacts with the psychological challenges of pregnancy, and raises questions about how to support the women concerned. As part of a multidisciplinary approach, support groups are particularly important, offering both individual and social support. Child-parent drop-in centers can also provide a supportive space for the psychological work of parenting.

Field catering in the operational and training activities of the Carabinieri Corps.

The Armed Force's victualling sector, and field catering, in particular, were brought up to date following Publication No. C-19, Compendium of Logistic Provisions of the Carabinieri Force. Previously, there was no specific regulation in the defense sector, except for the operational reality of military contingents deployed abroad. The aim of this discussion is the military field catering regulatory adaptation to the procedures of the Certified Notification of Commencement of Activities, pursuant to Law 241/90. To this end, the Ministry of Defense has adopted a specific notification model for its food businesses (Interministerial Decree 06/03/2020). Presidential Decree 327/1980 also applies in the Arma with regard to refrigerated shelters intended for the storage of foodstuffs at a controlled temperature. The authorization, issued by the Veterinary Service of the Arma General Headquarters, is valid for 2 years and is renewable subject to verification of the specific requirements. The procedures to submit the certified activity start notice (SCIA) are functional for the type of service operation. The Veterinary Service issues a specific technical opinion on the relative hygiene and health requirements, while the plant-infrastructure part is assessed by the competent Directorate of Works of the Corps of Engineers of the aforementioned General Command. Failure to submit the SCIA is punishable under Legislative Decree No. 193/2007; however, if the conditions are met, recourse to the administrative institution of the warning is preferred. In the verification phase of the shelters in question, compliance with the regulations concerning the Agreement on the Transport of Perishable Goods must be ascertained. The new regulations allow the Armed Force to guarantee food safety in military operations involving the use of field modules for catering purposes.

Non-traditional HIIT-style ROTC training elicits positive bone quality and performance adaptations.

Military personnel experience elevated bone injury incidence, partly due to arduous and repetitive training. Non-traditional High-Intensity Interval Training-style (HIIT) may benefit pre-enlisted Reserve Officer Training Corps (ROTC) cadet's musculoskeletal health and performance prior to military service. This study investigated 16 ROTC (n = 12 males; n = 4 females) and 15 physically active sex-, age-, and body mass-matched Controls' musculoskeletal health and performance from November to April. Total body, lumbar spine, and dual- hip dual-energy X-ray absorptiometry scans and 4%, 38%, 66% tibial peripheral quantitative computed tomography scans, blood draws (serum sclerostin and parathyroid hormone), and maximal muscle strength and aerobic capacity testing were completed. From November to April, ROTC improved bone density (DXA) of the dominant total hip and greater trochanter and non-dominant greater trochanter and 38% and 66% tibial total volumetric and cortical bone density (pQCT) similarly or more than Controls (all p ≤ 0.049). From November to April, ROTC also improved bench and leg press, and peak aerobic capacity (all p ≤ 0.013). From November to January, serum sclerostin increased (p ≤ 0.007) and remained elevated through April, while parathyroid hormone was unchanged. HIIT-style training induced positive musculoskeletal adaptations, suggesting it may be an excellent pre-service training modality for this injury prone group.

[Beneficial effects of ketogenic diet for Alzheimer's disease management]. / Intérêt du régime cétogène dans la prise en charge de la maladie d'Alzheimer.

Alzheimer's disease (AD) is a neurodegenerative disease that affects almost 1 million people in France and 55 million in the world. This pathology is a global health preoccupation because of the lack of efficient curative treatment and the increase of its prevalence. During the last decade, the comprehension of pathophysiological mechanisms involved in AD have been improved. Amyloid plaques and neurofibrillary tangles accumulation are characteristic of Alzheimer's brain patients, accompanied by increased brain inflammation and oxidative stress, impaired cerebral metabolism of glucose and mitochondrial function. Treatment of AD includes different approaches, as pharmacology, psychology support, physiotherapy, and speech therapy. However, these interventions do not have a curative effect, but only compensatory on the disease. Ketogenic diet (KD), a low-carbohydrates and high-fat diet, associated with a medium-chain triglycerides intake (MCTs) might induce benefices for Alzheimer disease patients. Carbohydrate restriction and MCTs promotes the production of ketone bodies from fatty acid degradation. These metabolites replacing glucose, serve the brain as energetic substrates, and induce neuroprotective effects. Such a nutritional support might slow down the disease progression and improve cognitive abilities of patients. This review aims to examine the neuroprotective mechanisms of KD in AD progression and describes the advantages and limitations of KD as a therapeutic strategy.

Title: Intérêt du régime cétogène dans la prise en charge de la maladie d'Alzheimer. Abstract: La maladie d'Alzheimer (MA), pathologie neurodégénérative en expansion, devient une préoccupation importante de santé publique, en raison d'une absence de traitement curatif efficace. Les mécanismes mis en œuvre dans la physiopathologie de la MA sont de mieux en mieux connus, et incluent l'accumulation de plaques amyloïdes et de dégénérescences neurofibrillaires. L'augmentation de l'inflammation et du stress oxydant et l'altération du métabolisme cérébral du glucose aggravent la pathologie en réduisant l'activité neuronale en perturbant la fonction mitochondriale. À l'heure actuelle, le traitement de cette pathologie regroupe différentes approches bien que ces interventions n'aient pas un effet curatif, mais uniquement compensatoire. L'alimentation cétogène, pauvre en glucides et enrichie en lipides, couplée à une prise de triglycérides à chaîne moyenne (MCT), favorise la production de corps cétoniques, substrats énergétiques qui pourraient présenter des effets neuroprotecteurs bénéfiques pour les personnes atteintes de la MA. Une telle prise en charge nutritionnelle pourrait limiter la progression de la maladie et améliorer les capacités cognitives des patients. Cette revue vise à examiner le rôle éventuel et les mécanismes neuroprotecteurs de l'alimentation cétogène dans la progression de la MA, et décrit les avantages et les limites de son utilisation comme stratégie thérapeutique.

[The body that takes care of us]. / Ce corps qui prend soin de nous.

The body takes care of us in the sense that it ensures our biological existence while incorporating the information necessary for motor activity and emotional life. Through contact with the world and others, it awakens our self-awareness. These interactions produce an incorporation of information that enables us to adapt our bodies to our environment, and our attitudes to interactions with others. This incorporation enriches the plasticity of our abilities and body awareness.

[Touching and being touched, the bodily experience of osteopathic touch]. / Toucher et être touché, expérience corporelle du toucher ostéopathique.

The theme of touch is present in many contemporary issues. During the Covid-19 pandemic, the introduction of barrier gestures had an impact on touch, to the point of prohibiting it. Touch is essential to health care, and retains a fundamental place in the healing professions, particularly osteopathy.

[Conversion disorder, caring for body, mind]. / Le trouble de conversion, prendre soin du corps et de l'esprit.

Conversion disorder is a psychiatric disorder whose clinic and management lie at the crossroads between body and mind. It challenges healthcare professionals in terms of diagnosis, further investigation, referral and care. A number of questions arise, such as how caregivers perceive the relationship between body and mind, the place of the psychiatric hypothesis among the initial diagnostic hypotheses, and the temporality of care.

[Sophrology, an experience of corporality for student nurses]. / La sophrologie, une expérience de la corporalité des étudiants infirmiers.

The body approach is a real challenge in nursing training. It is part of the relationship between the caregiver and the cared-for. Through their bodies, students experience all their sensations and perceptions. Questioning nursing students through the phenomenological approach of sophrology means enabling them to achieve body-mind harmonization, a fundamental pillar of this mind-body technique. The regular practice of sophrology teaches them to act autonomously on themselves, developing their personal resources for a better body-mind and/or mind-body well-being.

[Contribution of whole-body MRI to the initial assessment of myxoid liposarcoma]. / Apport de l'IRM corps entier au bilan initial du liposarcome myxoïde.

INTRODUCTION: Myxoid liposarcoma is a soft tissue sarcoma associated with multifocal metastases at diagnosis. These metastases are asymptomatic and occult on CT and FDG-PET and can alter the therapeutic management and prognosis. In this context, we evaluated the contribution of whole-body MRI to the initial workup of patients with myxoid liposarcoma. METHOD: This retrospective study was conducted between January 2015 and December 2020 at the Oscar Lambret Center. We enrolled 22 patients who were diagnosed with myxoid liposarcoma and underwent whole-body MRI at diagnosis. The number of metastases at diagnosis, their location, and the visibility of these lesions on CT were evaluated. Associations between clinical features, presence of metastasis, and their impact on management were assessed. RESULTS: Sixteen patients (72.7%) had non-metastatic disease at the initial diagnosis, and 15 of these patients were managed using local treatment. Six patients (27.3%) had metastases at multiple locations and received chemotherapy. The main locations were the bones (n=5) and lungs (n=3). In five patients with metastases, whole-body MRI demonstrated additional lesions that were not visible on CT (bone and soft tissue lesions). Only the presence of a round cell contingent (P=0.009) was found as a criterion associated with the presence of metastases. CONCLUSION: The patients' young age, absence of reliable prognostic factors at diagnosis, asymptomatic nature of the lesions, and the benefits of early and targeted therapeutic management encourage the use of whole-body MRI as part of the initial work-up as it seems to provide a better initial staging compared with conventional imaging.

[Animal models of trauma and post-traumatic stress disorder]. / Les modèles animaux du traumatisme et du trouble de stress post-traumatique.

Initially believed to be specific to humans emerging from life-threatening events, Post-traumatic stress disorder (PTSD) has been found to occur in wild animals and can also be experimentally induced in laboratory rodents. This article aims to highlight and discuss the evolution and relevance of animal models in PTSD research. Studies by LeDoux, Davis, and McGaugh have made significant contributions to our understanding of PTSD. By focusing on fear responses in rodents and aversive Pavlovian conditioning, they suggested that PTSD could result from excessively efficient aversive learning processes, with a significant role played by amygdala. However, numerous studies have shown that this explanation fails to account for the complexity of processes involved in PTSD. Current hypotheses focus on deficits in extinction retention, perception of safety signals, or emotional regulation. This review will specifically address the animal models that closely resemble human PTSD and explore reasons for their limited utilization, as a majority of animal studies continues to employ classical Pavlovian conditioning protocols. Furthermore, this review will present cutting-edge experimental studies that tackle previously challenging questions in animal research. Specifically, we will examine the relationship between respiration and the maintenance of fear states, offering a potential explanation for the efficacy of meditation and breath control techniques in emotion regulation. We will also shed light on recent findings on decoding neural activity related to internal representations in animals, thus enabling now the exploration of rumination, a characteristic symptom of PTSD previously inaccessible to animal studies.

Title: Les modèles animaux du traumatisme et du trouble de stress post-traumatique. Abstract: Le trouble de stress post-traumatique (TSPT) est généralement associé à menace vitale et est parfois considéré comme une condition spécifiquement humaine. Cependant de nombreuses études ont montré qu'il pouvait être observé chez des animaux en milieu sauvage et pouvait être induit en laboratoire chez des rongeurs. Cet article vise à présenter et discuter l'évolution et la pertinence des modèles animaux dans l'étude du TSPT. Les études de LeDoux, Davis et McGaugh sur la peur et le conditionnement aversif pavlovien chez le rongeur ont apporté une immense contribution à la compréhension du TSPT. Initialement, il a été proposé que le TSPT résulterait d'un apprentissage aversif trop efficace, impliquant en particulier l'amygdale. Néanmoins, de nombreuses études ont révélé que cette hypothèse n'était pas suffisante pour expliquer la complexité des processus mis en jeu dans le TSPT. Les théories actuelles suggèrent plutôt des déficits dans la capacité à maintenir l'extinction, la perception des signaux de sécurité ou la régulation émotionnelle. Nous examinerons plus précisément les modèles animaux qui se rapprochent le plus du TSPT humain et nous discuterons des raisons pour lesquelles leur utilisation reste limitée. En effet, la plupart des études chez l'animal continuent de s'appuyer majoritairement sur des protocoles classiques de conditionnement pavlovien. Enfin, cette revue mettra en lumière de nouvelles études expérimentales permettant d'aborder des questions auparavant difficiles à étudier chez l'animal. Nous examinerons notamment les liens entre respiration et maintien des états de peur, offrant une explication potentielle à l'efficacité des techniques de méditation et de contrôle de la respiration dans la régulation des émotions. De plus, nous présenterons des résultats récents sur le décodage de l'activité neuronale liée aux représentations internes chez l'animal, offrant ainsi la possibilité d'étudier les ruminations, symptômes caractéristiques du TSPT qui étaient auparavant inaccessibles à l'expérimentation animale.

Neurofibromatosis tipo 1 en Mali: a propósito de un caso de colaboración CIMIC / Type 1 Neurofibromatosis in Mali: a case report complying with CIMIC

Un niño de cuatro años atendido en el Centro de Salud «Santa Clara» de Koulikoro en Mali, por el personal del Cuerpo Militar de Sanidad de la European Union Training Mission Mali XIX, por presentar tumoración facial que condiciona proptosis ocular izquierda, provocando asimetría a nivel ocular izquierdo. En la exploración se observan manchas ligeramente marrones, efélide axilar y nódulos de Lisch en ambos ojos. Se sospecha de neurofibromatosis tipo I y se decide trasladar a territorio nacional, cumpliendo con los procedimientos de cooperación cívico-militar, imprescindibles en las nuevas formas de conflicto asimétrico, donde dicha relación es una herramienta fundamental para poder coordinar todas las operaciones en zona de operaciones. En el Hospital Universitario Miguel Servet, asociado al Hospital General de la Defensa de Zaragoza, se confirma el diagnóstico de neurofibroma plexiforme del trigémino izquierdo mediante estudio genético y pruebas complementarias de imagen. Se decide tratamiento con selumetinib. (AU)

A 4-year-old boy who was treated at the Santa Clara Health Center in Koulikoro by the medical team of the European Union Training Mission Mali XIX for a facial tumor that developed left ocular proptosis, causing a significant facial asymmetry at the level of the left eye. Medical examination revealed light brown stains, axillary ephelid and Lisch nodules in both eyes. Because of the suspicion of neurofibromatosis type 1 and following civil-military cooperation procedures, he is transferred to Spain. Civil-military cooperation is essential in the new forms of conflict, where these relationships are a fundamental tool in the coordination of all operations in the area. At the Miguel Servet University Hospital, in association with the General Defense Hospital of Zaragoza, the earlier diagnosis is confirmed (left trigeminal plexiform neurofibroma) with a genetic study and complementary imaging tests. It is decided to start treatment with selumetinib. (AU)