Steris (United States)

This seminar will cover utilizing a contamination control strategy with a risk-based approach to materials transfer into cleanrooms, RABS, isolators, and BSC's. There will be a focus on how to control hard to kill fungal spores such as Aspergillus and Penicillium as well as bacterial spores and viruses. Recent case studies from the past few months in ATMPF facilities and compounding pharmacies will be discussed in relation to materials transfer. Published data will also be mentioned to convey effective methods in control bioburden utilizing VHP, sporicidal chemistries, and disinfectants into the APA. This presentation will be a holistic approach to controlling bioburden from entering cleanrooms, BSC Hoods, RABS, and Isolators. New industry case studies in disinfectant field trials will also be covered and discussed in detail based on recent industry publications.

The objective: to assess awareness and use of modern contraceptive methods among female military personnel and to analyze factors influencing refusal of hormonal contraceptives (HC), considering the specific demands of military service.Materials and methods. An online survey of 431 female military personnel assessed contraceptive behavior, HC use, and reasons for refusal. Group I included women who were not in the combat zone (CZ) (n = 233); group II – women who were in CZ up to 1 month (n = 82); group III – women who were in CZ from 1 till 6 months (n = 69); group IV – women who were in CZ more than 6 months (n = 47).Results. The lowest contraceptive use rate (26.83%) was observed among women with a stay in the CZ for up to 1 month, while the highest rate (53.19%) was recorded in group IV. Barrier methods predominated in all groups (> 60%). Use of oral contraceptives (OC) increased significantly with longer stay duration in the CZ, reaching 28.00% in group IV. Overall HC use (OC and intrauterine contraceptives) increased from 7.73% in group I to 19.15% in group IV. The main reasons for refusal HC were lack of perceived need (50.00–61.86%), fear of side effects (24.14%), and insufficient awareness (13.02–18.42%).Conclusions. The level of contraceptive use among female military personnel in Ukraine remains low, and the most common method is barrier contraception (condom). Women with longer service experience more frequently use OC. Refusal of HC is mainly associated with lack of need, insufficient awareness, concerns about side effects, and contraindications. The results of the study emphasize the need for regular and structured information of female military personnel about modern, in particular long-term reversible methods of contraception, including their effectiveness and additional benefits.

Cardiovascular diseases are one of the main causes of mortality and disability among the population of the member countries of the Eurasian Association of Cardiology, which is directly related to the high prevalence of risk factors for atherosclerosis, among which dyslipidemia plays a leading role. The previous version of the Eurasian Recommendations for the Diagnosis and correction of lipid metabolism disorders for the prevention and treatment of atherosclerosis was presented in 2020. Over the past 5 years, approaches to risk stratification, diagnosis of subclinical atherosclerosis, and correction of dyslipidemia using various classes of lipid-lowering drugs have changed significantly. Among the initial updates, proposals should be highlighted for determining the blood lipid level in each adult or upon reaching the age of 18, using the SCORE and/or SCORE2 scales to stratify cardiovascular risk, and non-invasive imaging techniques to assess subclinical atherosclerosis. In the sections devoted to therapy, fixed combinations of lipid-lowering drugs, inclisiran, and bempedoic acid are presented. The section on the prevalence, significance and approaches to correction of hypertriglyceridemia, as well as the section on extracorporeal hemocorrection, has been expanded. A chapter on lipoprotein(a) is introduced. Sections on correction of dyslipidemia in cerebrovascular diseases, heart transplantation and HIV infection are presented. These recommendations will be useful to the phisicians of all specialties for the effective management of their patients.

The world is confronting numerous challenges, including global warming, health epidemics, and population growth, each presenting significant threats to the stability and sustainability of our planet’s ecosystems. Such issues have collectively contributed to a reduction in agricultural productivity, corresponding with an increase in demand and costs of essential commodities. This critical situation requires more sustainable environmental, social, and technological solutions. Molecular hydrogen (H2) has been suggested as a “green” solution for our energy needs and many health, agricultural, and food applications. H2 supplementation in agriculture may represent a novel and low-carbon biotechnological strategy applicable to the abundant production of crops, vegetables, and fruits in agri-food chains. H2 is a potential green alternative to conventional chemical fertilizers. The use of a hydrogen-rich water irrigation system may also provide other health-related advantages, i.e., decreasing the heavy metal accumulation in crops. By adopting a H2 strategy, crop producers, food processors, and decision-makers can contribute to sustainable solutions in the face of global challenges such as climate change, communicable disease epidemics, and a growing population. The versatile applications of H₂ in agriculture and the wider food industry position it as a uniquely suitable approach to address today’s significant challenges, potentially fostering better crop production and positively impacting the agri-food chain. The present review is timely in combining the latest knowledge about the potential applications of H2 in the agriculture and food industry, from farm to fork.

Background. Uterine leiomyosarcomas are highly aggressive tumors with a poor prognosis. The main prognostic factors are the stage of the disease, the size of the primary tumor, and the grade of malignancy. It is well known that the clinical course and prognosis of uterine leiomyosarcoma do not correlate with the FNCLCC histological grade, based on assessment of the mitotic index and the presence and amount of necrosis in sarcomas. There is published data on a more unfavorable course of non-spindle cell uterine leiomyosarcomas.Aim. To evaluate the influence of pathological factors (histological subtype, mitotic index, necrosis and its type) on survival rates in uterine leiomyosarcoma.Materials and methods. The study included 58 patients who underwent radical surgery for uterine leiomyosarcoma. The following morphological parameters were evaluated on histological slides: histological subtype, mitotic index, the presence of necrosis in the tumor and its type. Further, the analysis of the influence of these morphological characteristics on the indicators of progression-free survival and overall survival was carried out. Statistical analysis was carried out using the IBM SPSS Statistics Professional 20.0 statistical software package. Long-term results are presented in the form of actuarial survival calculated by the Kaplan–Meier method.Results. Most cases of uterine leiomyosarcoma were of the spindle-cell variant (82.8 %), had a mitotic index >20 per 10 high power field (93.1 %) and large foci of necrosis (70.7 %), coagulation necrosis was more often detected (43.1 %). There was a significant difference in the median overall survival of patients with spindle-cell variant of uterine leiomyosarcoma and non-spindle-cell variants (epithelioid or myxoid): 77 months vs. 49 months (p = 0.05). There was no significant relationship between the mitotic index of the primary tumor, the size of necrosis foci in the tumor and survival rates. The presence of coagulative necrosis in the tumor was significantly associated with a deterioration in progression-free survival (9 months vs. 14 months, p = 0.05) and overall survival (51 months vs. 104 months, p = 0.05).Conclusion. The spindle-cell variant of leiomyosarcoma is associated with higher overall survival rates compared to other histological subtypes. The presence of coagulative necrosis in the tumor in comparison with other types of necrosis is an unfavorable prognostic factor associated with a decrease in both progression-free survival and overall survival.

Obstructive jaundice with duodenal obstruction are often encountered in patients with primary cancer or metastasis to bilipancreatoduodenal zone. Usually palliative surgery involving creation of gastroentero and liver-cholecysteneteroanas-tamosis is used. This palliative surgery carries a high risk of complications and death if performed at the height of jaundice. In this case endoscopic stenting of duodenum or EUS-guided transmural biliary drainage may be preferred method of treatment. At the same time in the majority of patients performing of ERCP in cases of duodenum obstruction is not technically feasible. In this case EUS-guided transmural biliary drainage can be implemented. This clinical case demonstrates endoscopic treatment of a patient with pancreatoduodenal cancer complicated by duodenal obstruction and obstructive jaundice using endosonography and x-ray guided endoscopy.

ABSTRACT The use of a polyimide dielectric layer in 2.5D and 3D stacked silicon packages with silicon through vias (TSV) normally requires cure temperatures in excess of 350°C. The choice of a silicon-CTE-matched polyimide offers the prospect of lowered stress and warpage and thus improved handling and yields. In this work, BPDA//PPD polyimide with a CTE of 3 ppm/°C is shown to be fully cured at only 200°C with the use of Variable Frequency Microwaves (VFM) in 60 minutes. The thermo-mechanical properties, including imidization, hardness, and elastic modulus match the properties of the conventionally cured material of 350-375°C. The CTE of BPDA//PPD coatings cured above the Tg (340°C) rises with the increased stress of crystallization but the films cured with VFM well below the Tg do not show this increased stress and warpage. Films with either 375°C oven cures or 200°C VFM cures had well less than 15μm of die-level (27mm × 19mm) warpage. Thinned wafers coated with two layers of BPDA//PPD and bonded temporarily to glass carriers were not delaminated from the glass after the 200°C VFM cure process. Wafer bow comparisons before and after cure were made with optical profilometry.

The use of true gas plasmas for the inactivation of microorganisms is an area of dynamic research. Many types of gases are used as a source of plasma, and different plasma production methods have been applied. The antimicrobial mechanisms of oxygen-based gas plasmas may be due to an etching effect on microbial structures, particularly bacterial endospores resulting in shrinkage. By contrast, the definite mechanisms of actions of other gas plasma sources, such as N(2), He, Ne, Ar and Xe gases, have not been clearly defined and indeed may be distinct. The speculated mechanisms of these gas plasmas involve the direct attack of metastable (excited molecular), UV and/or VUV to microbial structures, specifically the inner membrane and DNA in the core of bacterial endospores. According to this speculation, sterilized spore figures would remain unchanged. However, these mechanisms remain to be clarified. Future perspectives on the use of gas plasma for sterilization are of interest, as it is possible that appropriate sterility assurance levels can be obtained in parallel with material and functional compatibility. Traditional sterilization methods are often limited in these requirements. Therefore, gas plasma sterilization may prove to be an appropriate alternative sterilization procedure.