St. Charles Hospital

Abstract Background Dupuytren’s disease (DD) is a common fibrotic disorder of the hand, characterized by progressive thickening and contracture of the palmar and digital fascia. Surgical excision remains the primary treatment; however, there are currently no therapies to prevent disease progression or recurrence. This study aims to develop a 3D in vitro model to test novel antifibrotic therapies. The model is based on decellularized pathological DD tissue seeded with patient-derived fibroblasts, capturing the role of both cellular and extracellular matrix components in disease progression. Methods Fibrotic DD tissues were obtained from surgical excisions, sectioned, and decellularized. In parallel, primary fibroblasts were isolated from patient samples. The decellularized extracellular matrices (dECMs) were characterized with respect to biochemical composition, collagen structure, and mechanical properties. Fibroblasts were seeded onto the dECMs and cultured stepwise to initially promote proliferation, followed by differentiation into myofibroblasts. Secretomes of cells cultivated on the established 3D model were compared to those from conventional 2D cultivations. To evaluate the model´s relevance and effectiveness we tested the antifibrotic drug minoxidil. Results The dECMs retained the pathological architecture and mechanical properties of native DD tissue, although individual ECM components were reduced after decellularization. Fibroblasts successfully adhered, proliferated, and repopulated the scaffold. The relevance of the 3D model was demonstrated by the presence of myofibroblasts with disease–relevant secretome. The responsiveness to the drug minoxidil was significantly more complex in the 3D model than in conventional 2D cultures. Conclusion We demonstrated that dECM seeded with DD fibroblasts represents a relevant 3D in vitro model of Dupuytren’s disease. The model enables antifibrotic drug screening, as demonstrated by the testing of minoxidil. Our model provides a reproducible platform also suitable for the investigation of cells and ECM contributions to fibrotic processes.

IntroductionSexual functioning is an essential aspect of human existence. Sexual dysfunctions are prevalent and negatively affect the quality of life in the general population. Little attention has been paid to the sexual function of health workers.ObjectivesThe aim of our work was to evaluate sexual dysfunction among Tunisian doctors and to determine associated underlying factors.MethodsA cross-sectional study was conducted online, from January to March 2024, via a pre-established questionnaire. Tunisian doctors, who had finished their medical studies, working in the public or private sector and who agreed to anonymously respond to the questionnaire were included. Sociodemographic, economic, clinical data and those related to the medical profession were collected. Sexual function was evaluated with the Arizona Sexual Experience Scale (ASEX).ResultsA total of 80 individuals had fully responded to the questionnaire. The mean age of participants was 36.81 ± 7.49 years and 68,7 % (n=55) of them were male. Ninety five percent (n=76) were married and 77.5 % (n=62) had children. The mean working hours per week was 34.32 ± 5.32. A regular physical activity was practiced by 35 % (n=28) of individuals. The mean monthly income was 3592.5 ± 596 Tunisian Dinars. The results of the ASEX showed that 23,8 % (n=19) of participants, 23,6 % (n=13) of male participants and 24 % of female (n=6) participants had sexual dysfunction. Ten per cent of individuals (n=8) have previously consulted a sexologist. Longer working hours, lower monthly income, less physical exercise were significantly associated with increased risk for sexual dysfunction.ConclusionsSexual dysfunctions seem to be common among Tunisian doctors. Knowledge about their sexual functioning is important to promote their physical and mental health and to improve the care delivered.Disclosure of InterestNone Declared

IntroductionCystoscopy with retrograde ureteral indocyanine green injection (ICG-cystoscopy) and near infrared imaging during robotic surgery simplifies ureter identification and reduces risk. However, addition of a procedure increases surgical time and risk. We assessed total operating room time (OR time) and actual surgical time before and after introduction of ICG-cystoscopy to determine whether it prolonged surgical time.MethodsA retrospective review 40 cases pre- and post- intervention: cystoscopy with retrograde instillation of 10 mL ICG 2.5 mg/dL to bilateral ureters before the procedure was performed. OR time, surgical time, and patient data were tabulated. Twenty pre- and post- intervention cases were matched for procedure and difficulty. Paired t-tests were performed to assess whether a statistically significant time difference existed between the two groups.ResultsMean pre-ICG and post-ICG OR times were 260.85 (SE 18.06) min and 242.52 min (SE 12.52), respectively. Mean difference between pre- and post-ICG OR time was 18.45 min (SE 21.78). Mean pre-ICG and post-ICG surgical times were 198.15 min (SE 17.38) and 180.1 min (SE 12.20), respectively. Mean difference between pre- and post-ICG surgery time was 18.05 minutes (std error 21.05). No statistically significant difference for total OR time or surgical time was detected.Conclusion/ImplicationsWe observed no statistically significant difference in mean total OR or surgery time after ICG-cystoscopy implementation. This reduces risk of ureteral injury by improving ureter visibility. ICG-cystoscopy may be added as a risk-reduction measure for patient safety.

This research comprises of two studies examining the effect of impossible problem solving on state anger. For the first study, using 155 participants on Amazon’s MTurk, a significant difference was observed on state anger from baseline to post-intervention (p = .04). Due to the well documented concerns about using MTurk participants, a second study involving 111 participants from a small liberal arts college was conducted. Using the same design, no significant effect of time on state anger was observed (p > .05). Post-hoc analyses indicated a significant difference between MTurk and in-person participants on trait anger (p < .05), pre-test state anger (p < .05), and post-test state anger (p < .05). Implications are discussed.

Nosocomial infections are a significant concern in healthcare settings, contributing to increased morbidity, mortality, and healthcare costs. Nursing leadership plays a critical role in implementing effective infection control measures. This study aims to explore the impact of nursing leadership on the reduction of nosocomial infections and identify key strategies employed by nurse leaders in infection prevention. A systematic review of the literature was conducted, using electronic databases and relevant journals. Studies that examined the relationship between nursing leadership and the reduction of nosocomial infections were included. Data extraction and synthesis were performed to identify common themes and patterns related to nursing leadership practices and their impact on infection control. The results of the systematic review indicated that effective nursing leadership is associated with a reduction in nosocomial infections. Key leadership practices identified included fostering a culture of safety, implementing evidence-based infection control protocols, ensuring adequate staffing and resources, promoting staff education, and training, and facilitating multidisciplinary collaboration. Nurse leaders who exhibited transformational leadership qualities, such as empowering and inspiring their teams, were particularly effective in driving infection prevention efforts. Nursing leadership plays a crucial role in reducing nosocomial infections. This study highlights the importance of effective leadership practices in implementing infection control measures and creating a culture of safety in healthcare settings. By promoting evidence-based practices, providing adequate resources, and empowering healthcare teams, nurse leaders can contribute to the reduction of nosocomial infections and improve patient outcomes. Future research should further explore the specific leadership strategies that are most effective in infection prevention.

Post Trauma Stress Syndrome has two forms, acute and chronic; depending on the interval and duration of stress, since this is a typically reactive psychosocial disorder with vegetative medical symptomatology evoked by acute or chronic stress. The aim of this three cohort comparative study is to compare the position of PTSS between: victims of bombing in Yemen (air strikes only); combined war operations in Ukraine; and combined operations in Syria, and chronic military unrests in Lebanon