Moria (France)

Subfascial (SF) pocket breast augmentation (BA) has gained popularity, whereas the transaxillary approach (TAA) offers the benefit of an inconspicuous scar. Previous reports on both techniques involved limited follow-up/samples, and few clinical studies specifically address surgical technique and outcomes following primary and secondary BA. The purpose of this study was to assess outcomes from the SF TAA technique in a large series of patients who underwent primary and secondary BA. A retrospective cohort of patients who underwent BA between 1999 and 2024 was identified. The primary outcome was occurrence of incision and implant/pocket complications. Regression logistic analysis evaluated risk factors including age, body mass index, smoking, implant surface/volume, and fat grafting. The cohort contained 1015 patients (mean age, 28.5 ± 7.3 years), and the average follow-up was 77.6 ± 38.6 months. In primary BA, 212 patients (23.4%) experienced at least 1 complication, most frequently capsular contracture. More complications were seen in secondary BA ( P = 0.016). Multivariate regression identified body mass index less than 18.5 kg/m 2 as a significant risk factor for incision complications, whereas textured surface (OR, 2.70; P < 0.001) and implant volume greater than 350 cc (OR, 2.79; P < 0.001) were risk factors for implant/pocket complications. Despite extensive research on BA procedures, studies on SF TAA procedures are limited and have not analyzed long-term outcomes following primary/reoperative operations. These results demonstrate that SF TAA is a reliable technique, and the data are compatible with other studies using different BA approaches. Knowledge of the axillary and pectoralis fascia anatomy allows surgeons to safely implement the SF TAA technique and minimize risk. Therapeutic, III.

•Giant and solitary polyps evolve with anemia. •EUS is an important tool for stage and manage this disease. •Endoscopic treatment is the best treatment choice. •Supplementary video available on this case report.

Abstract Background Research shows low EBP uptake among palliative care nurses, which is a global concern because the demand for palliative care services is rising, raising the urgent need to improve healthcare quality. Promoting EBP uptake in palliative care can improve healthcare quality. This systematic review investigated nurses’ barriers to EBP implementation in palliative care. Method PubMed and Google Scholar were used to identify six articles. Articles were included for review if published within the past ten years (English-only) and investigated barriers to EBP implementation in palliative care. Results Four barriers were identified: (a) time and resource constraints, (b) lack of readiness for organisational change, (c) negative attitudes towards palliative care, and (d) process-specific difficulties. Conclusion The findings of this systematic review can be used to inform policy changes to improve the uptake of EBP in palliative care.

Abstract: This research was conducted by the author to find out and produce qualitative data regarding the development of mission insights and praxis from the 19th century to the 20th century in the context of their encounter with indigenous peoples' religions and cultures within the scope of the Mamasa Toraja Church.&#x0D; Abstrak: Penelitian ini dilakukan oleh penulis untuk mengetahui dan menghasilkan data kualitatif perihal perkembangan wawasan dan praksis misi abad ke-19 dengan abad ke-20 dalam konteks perjumpaannya dengan agama dan budaya massyarakat pribumi dalam lingkup pelayanan Gereja Toraja Mamasa.

Abstract Genetic correlations between traits can strongly impact evolutionary responses to selection, and may thus impose constraints on adaptation. Theoretical and empirical work has made it clear that, without strong linkage, genetic correlations at evolutionary equilibrium result from an interplay of correlated pleiotropic effects of mutations, and correlational selection favoring combinations of trait values. However, it is not entirely clear how the strength of stabilizing selection influences this compromise between mutation and selection effects on genetic correlations. Here, we show that the answer to this question crucially depends on the intensity of genetic drift. In large, effectively infinite populations, genetic correlations are unaffected by the strength of selection, regardless of whether the genetic architecture involves common small-effect mutations (Gaussian regime), or rare large-effect mutations (House-of-Cards regime). In contrast in finite populations, the strength of selection does affect genetic correlations, by shifting the balance from drift-dominated to selection-dominated evolutionary dynamics. The transition between these domains depends on mutation parameters to some extent, but with a similar dependence of genetic correlation on the strength of selection. Our results are particularly relevant for understanding how senescence shapes patterns of genetic correlations across ages, and genetic constraints on adaptation during colonization of novel habitats.

Geosynthetics have been extensively used in landfills as a lining system to prevent leachate infiltration into groundwater. In piggy-back landfill expansion (PBLE), consisting of building a new landfill over an existing one, a lining system is implemented between the old and new waste. In this context, interface failure (stability) and deformation (integrity) of the lining system should be considered for the design. Such stability and integrity mainly depend on the PBLE geometry and the mechanical properties of the geosynthetics. Comprehensive numerical modelling simulations were performed to show how these factors influence the shear stresses, shear displacements, translational stability and the axial strains/forces within the various geosynthetics. The numerical modelling was conducted using the finite difference code FLAC 2D, focusing on a typical PBLE and considering geosynthetic interface strain softening, the nonlinear stiffness of geosynthetics, and the differentiation between the compressive and tensile behaviours of geosynthetics. The simulations showed that the lateral length of the PBLE, the type of geomembrane (textured or smooth) and the level of the leachate table in new waste are the factors that most influenced the mechanical behaviour of the lining system and its stability. Finally, a parameter called the stability ratio was proposed as a complement to the traditional factor of safety, to analyse the progressive slippage along the geosynthetic interfaces. The numerical results indicated that interface failure concurrently begins at the rightmost part of the lower flat area of the PBLE and near the corner of the inner slope before spreading out to the left as backfilling progresses.

Abstract Ps 105,1–15 transfers the characteristics of the alliance with David of Ps 89 upon the alliance with the patriarchs. I Chr 16 puts a parallel of Ps 105,1–15 in the Davidic context of the instauration of the cult of the temple during the transfer of the ark of alliance of Yahweh Sabaoth to Jerusalem. The reaffirmation of David concerns also the staff of the temple installed by David, particularly the Levitical singers, with the Asaphites in the first place. The »servants« of Ps 105,16–46, and first Joseph, are not in the line of a glorious David. The proofs of the »servants«, like the proofs of the exile, prepare the salvation. On this point we observe also a new using from components of Ps 18, a psalm that puts back David and his dynasty. The book of Isaiah recalls the patriarchs »servants« in 41,8 and then the »servant« of 42,1 appears in the line of the servants of Ps 105,16–46.

In this research, we aim at reducing physical strain from nozzle reaction force and making the fire fighting activity more smoothly. We measured reaction forces as water is projected from a nozzle. We also conducted an analysis of physical strain for water projection angle and nozzle bending angle.