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We study benign overfitting in the setting of nonparametric regression under mean squared risk, and on the scale of Hölder classes. We construct a local polynomial estimator of the regression function that is minimax optimal on a Hölder class with any given smoothness, and that is a continuous function interpolating the set of observations with high probability. The key element of the construction is the use of singular kernels. Moreover, we prove that adaptation to unknown smoothness is compatible with benign overfitting. Namely, we construct a continuous and interpolating local polynomial estimator attaining the minimax optimal rate in L 2 adaptively to the unknown Hölder smoothness. Our results highlight the fact that interpolation can be fundamentally decoupled from bias-variance tradeoff in the problem of nonparametric regression. [ABSTRACT FROM AUTHOR]

The theory describing the evolution of offspring size often assumes that the production cost per unit volume is the same for small and large offspring. However, this may not be true if indirect costs of reproduction (e.g. material and energetic costs of supporting offspring development) scale disproportionately with offspring size. Here we show how direct and indirect costs of reproduction can be explicitly modeled within the Smith–Fretwell framework and how observations of size-number relationships can thus be used to evaluate indirect costs. We applied this analysis to measures of egg volume and fecundity for over 300 individuals of a coastal fish species and found that the tradeoff was much stronger than the expected inverse (fecundity scaled with volume−1.843). Larger offspring were thus more expensive to produce. For our study species, an important indirect cost was that larger eggs were accompanied by disproportionately more ovarian fluid. Calorimetry and removal experiments were used to further measure both the energetic costs and fitness benefits of ovarian fluid. In addition, we show that indirect costs of reproduction can intensify size-number tradeoffs in a variety of fishes. Indirect costs of reproduction can be large and may therefore play an important role in the evolution of offspring size. [ABSTRACT FROM AUTHOR]

Hot tub lung (HTL) is a type of Hypersensitivity Pneumonitis (HP) caused by inhalation of aerosols containing non‐tuberculous mycobacteria (NTM). We report the first case of hot tub lung in Victoria, Australia. A 31‐year‐old female presented with 3 weeks of dyspnoea, fevers and malaise, despite a course of antibiotics. She had used an indoor spa frequently for the past several months. She was hypoxic saturating 86% on room air. Examination revealed fine bilateral basal crepitations without wheeze. Inflammatory markers were elevated. A high resolution CT (HRCT) chest demonstrated extensive bilateral ground glass changes and centrilobular nodular opacities involving upper and lower zones. Bronchial washings were obtained and isolated Mycobacterium Avium Complex. Clinically, the patient had excellent response to empirical corticosteroids and avoidance of hot tub. This case highlights the importance of clinical history taking and suspicion of Hot Tub Lung as a differential diagnosis in a patient with a compatible clinical history, radiology and microbiology and exposure to a hot tub. [ABSTRACT FROM AUTHOR]

Aims: The aim of this scoping review is to evaluate the current biomarkers used in the assessment of adverse cardiac remodelling in people with diabetes mellitus (DM) and in the diagnosis and prognosis of subsequent cardiovascular disease. We aim to discuss the biomarkers' pathophysiological roles as a reflection of the cardiac remodelling mechanisms in the presence of DM. Methods: We performed the literature search to include studies from 2003 to 2021 using the following databases: MEDLINE, Scopus, Web of Science, PubMed, and Cochrane library. Articles that met our inclusion criteria were screened and appraised before being included in this review. The PRISMA guidelines for Scoping Reviews were followed. Results: Our literature search identified a total of 43 eligible articles, which were included in this scoping review. We identified 15 different biomarkers, each described by at least two studies, that were used to determine signs of cardiac remodelling in cardiovascular disease (CVD) and people with DM. NT‐proBNP was identified as the most frequently employed biomarker in this context; however, we also identified emerging biomarkers including hs‐CRP, hs‐cTnT, and Galectin‐3. Conclusion: There is a complex relationship between DM and cardiovascular health, where more research is needed. Current biomarkers reflective of adverse cardiac remodelling in DM are often used to diagnose other CVDs, such as NT‐proBNP for heart failure. Hence there is a need for identification of specific biomarkers that can detect early signs of cardiac remodelling in the presence of DM. Further research into these biomarkers and mechanisms can deepen our understanding of their role in DM‐associated CVD and lead to better preventative therapies. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is a leading cause of mortality worldwide, with cigarette smoking being a major preventable risk factor. Smoking cessation can be difficult due to the addictive nature of nicotine and the withdrawal symptoms following cessation. Electronic cigarettes (e-Cigs) have emerged as an alternative smoking cessation device, which has been increasingly used by non-smokers; however, the cardiovascular effects surrounding the use of e-Cigs remains unclear. This study aimed to investigate the effects of e-Cig aerosol condensate (EAC) (0 mg and 18 mg nicotine) in vitro on human coronary artery endothelial cells (HCAEC) and in vivo on the cardiovascular system using a mouse model of 'e-vaping'. In vitro results show a decrease in cell viability of HCAEC when exposed to EAC either directly or after exposure to conditioned lung cell media (p < 0.05 vs. control). Reactive oxygen species were increased in HCAEC when exposed to EAC directly or after exposure to conditioned lung cell media (p < 0.0001 vs. control). ICAM-1 protein expression levels were increased after exposure to conditioned lung cell media (18 mg vs. control, p < 0.01). Ex vivo results show an increase in the mRNA levels of anti-angiogenic marker, FKBPL (p < 0.05 vs. sham), and endothelial cell adhesion molecule involved in barrier function, ICAM-1 (p < 0.05 vs. sham) in murine hearts following exposure to electronic cigarette aerosol treatment containing a higher amount of nicotine. Immunohistochemistry also revealed an upregulation of FKBPL and ICAM-1 protein expression levels. This study showed that despite e-Cigs being widely used for tobacco smoking cessation, these can negatively impact endothelial cell health with a potential to lead to the development of cardiovascular disease. [ABSTRACT FROM AUTHOR]

Heart failure (HF) is the leading cause of hospitalisations worldwide, with only 35% of patients surviving the first 5 years after diagnosis. The pathogenesis of HF with preserved ejection fraction (HFpEF) is still unclear, impeding the implementation of effective treatments. FK506-binding protein like (FKBPL) and its therapeutic peptide mimetic, AD-01, are critical mediators of angiogenesis and inflammation. Thus, in this study, we investigated—for the first time—FKBPL's role in the pathogenesis and as a biomarker of HFpEF. In vitro models of cardiac hypertrophy following exposure to a hypertensive stimulus, angiotensin-II (Ang-II, 100 nM), and/or AD-01 (100 nM), for 24 and 48 h were employed as well as human plasma samples from people with different forms of HFpEF and controls. Whilst the FKBPL peptide mimetic, AD-01, induced cardiomyocyte hypertrophy in a similar manner to Ang-II (p < 0.0001), when AD-01 and Ang-II were combined together, this process was abrogated (p < 0.01–0.0001). This mechanism appears to involve a negative feedback loop related to FKBPL (p < 0.05). In human plasma samples, FKBPL concentration was increased in HFpEF compared to controls (p < 0.01); however, similar to NT-proBNP and Gal-3, it was unable to stratify between different forms of HFpEF: acute HFpEF, chronic HFpEF and hypertrophic cardiomyopathy (HCM). FKBPL may be explored for its biomarker and therapeutic target potential in HFpEF. [ABSTRACT FROM AUTHOR]

Background: It is believed that the cessation of normative cancer care services during the COVID-19 pandemic may be resulting in pathologic upstaging and higher long-term mortality rates. We aimed to understand how the pandemic has affected our patients diagnosed with non–small-cell lung cancer (NSCLC). Methods: We conducted a single-centre retrospective analysis to assess how the COVID-19 pandemic has affected patient referrals, pathologic stage of NSCLC, mortality rates and surgical procedures at our cancer care centre in Ontario, Canada. At our centre, physicians advocated for and followed recommendations that operations in cancer patients should be among the last procedures to be delayed. Patients were included if they were aged 18 years or older, were not receiving palliative care, and had been screened, diagnosed and treated for NSCLC (primary tumours). We compared outcomes between a prepandemic period (January 2019 to February 2020) and a period during the pandemic (March 2020 to February 2021). Results: A total of 695 patients were included for statistical analysis, of whom 650 underwent surgery. There was no statistically significant difference in any of the outcomes of interest between patients seen before (n = 330) and during (n = 320) the pandemic. Conclusion: Cancer care services at our centre were maintained during the COVID-19 pandemic, and potential adverse effects on prognosis and survival that have been seen in other countries were avoided. The results inform health care providers how the effects of future pandemics can be blunted by using proactive preservative strategies and surgeon advocacy. [ABSTRACT FROM AUTHOR]

We describe the first case of antisynthetase syndrome (ASS) with antibodies to anti‐glycyl tRNA synthetase (EJ‐1) with antiphospholipid syndrome (APLS). A 66‐year‐old man presented with progressive dyspnoea, fever, dry cough and proximal muscle weakness over several months on a background of cryptogenic organizing pneumonia. Examination revealed bibasal fine chest crackles, proximal muscle weakness of the upper and lower limbs, digital skin thickening and facial telangiectasias. Creatine kinase was elevated and autoimmune screening was positive for anti‐EJ‐1, anti‐beta‐2‐glycoprotein, anti‐Ro and anti‐La antibodies. Computed tomography of the chest revealed a usual interstitial pneumonia pattern and a ventilation–perfusion scan demonstrated scintigraphic evidence of bilateral pulmonary emboli. A diagnosis of ASS and APLS was made. Immunosuppressive therapy including pulsed methylprednisolone, rituximab and mycophenolate was commenced with improvement in symptoms. This case highlights the importance of evaluation for ASS in idiopathic interstitial pneumonia, and APLS in ASS patients. [ABSTRACT FROM AUTHOR]

Methods for the use of baited remote underwater video stations (BRUVS) have been tested and refined such that they are now widely used in marine research for assessing fish community structure. There is comparatively less known about the effectiveness of different bait types or bait containers for use with BRUVS in freshwater temperate environments. We conducted a field-based experiment in Lake Opinicon, located in southeastern Ontario, Canada to compare the effectiveness of three baits and two styles of bait container to unbaited systems. Species richness per deployment and the probability of detecting each species were used as measures of effectiveness. BRUVS were deployed in weedy habitats in the littoral zone of the lake (1–3 m depth) with corn, cat food, sardines, or no bait, in an accessible mesh bag, or an inaccessible perforated PVC container. The mean species richness detected was uniform across bait type and container. For Micropterus salmoides, Cyprinidae spp., and Esox lucius, there were associations between bait type and proportion of detections. BRUVS appear to be effective in observing species richness in a shallow, low-visibility freshwater environment; however, there is little evidence that use of bait improves effectiveness relative to unbaited RUVS. [ABSTRACT FROM AUTHOR]

Key message: Persistent productive cough despite appropriate treatment warrants consideration of flexible bronchoscopy to obtain bronchial specimens for culture. Endobronchial examination of airways may reveal signs of infection in the form of purulent secretions, sputum plugs or in this case, an unexpected finding of a calcified broncholithiasis secondary to Nocardia infection.Nocardia is generally regarded as an opportunistic infection, affecting immunocompromised patients but case reports have been described in immunocompetent patients. Endobronchial nocardiosis is a rare manifestation of pulmonary nocardiosis. Persistent productive cough despite appropriate treatment warrants suspicion of pulmonary nocardiosis such as in this case, which resulted in an unexpected finding of a calcified broncholithiasis secondary to Nocardia infection. [ABSTRACT FROM AUTHOR]

Animals have the innate ability to select optimal defensive behaviors with appropriate intensity within specific contexts. The vomeronasal organ (VNO) serves as a primary sensory channel for detecting predator cues by relaying signals to the medial hypothalamic nuclei, particularly the ventromedial hypothalamus (VMH), which directly controls defensive behavioral outputs. Here, we demonstrate that cat saliva contains predator cues that signal the imminence of predator threat and modulate the intensity of freezing behavior through the VNO in mice. Cat saliva activates VNO neurons expressing the V2R-A4 subfamily of sensory receptors, and the number of VNO neurons activated in response to saliva correlates with both the freshness of saliva and the intensity of freezing behavior. Moreover, the number of VMH neurons activated by fresh, but not old, saliva positively correlates with the intensity of freezing behavior. Detailed analyses of the spatial distribution of activated neurons, as well as their overlap within the same individual mice, revealed that fresh and old saliva predominantly activate distinct neuronal populations within the VMH. Collectively, this study suggests that there is an accessory olfactory circuit in mice that is specifically tuned to time-sensitive components of cat saliva, which optimizes their defensive behavior to maximize their chance of survival according to the imminence of threat. [ABSTRACT FROM AUTHOR]

We report the first case of autoimmune pulmonary alveolar proteinosis (PAP) associated with and preceding myelodysplastic syndrome. A 74-yearold female with a history of polymyalgia rheumatica presented with six months history of progressive exertional breathlessness. Examination revealed bilateral chest crackles and exertional desaturation. A diagnosis of autoimmune PAP was made based on the presence of autoantibodies to granulocyte-macrophage colony-stimulating factor and characteristic findings on chest computed tomography, bronchoalveolar lavage, and transbronchial biopsies. Bilateral whole lung lavage was performed with prompt improvement in symptoms. Fourteen months later, she presented with new breathlessness and was diagnosed with myelodysplasia on bone marrow biopsy. No recurrence of alveolar proteinosis was detected. This case highlights the importance of follow-up and screening of patients with autoimmune PAP for haematological conditions. [ABSTRACT FROM AUTHOR]

Summary: LysR‐type transcriptional regulators (LTTRs) generally bind to target promoters in two conformations, depending on the availability of inducing ligands. OccR is an LTTR that regulates the octopine catabolism operon of Agrobacterium tumefaciens. OccR binds to a site located between the divergent occQ and occR promoters. Octopine triggers a conformational change that activates the occQ promoter, and does not affect autorepression. This change shortens the length of bound DNA and relaxes a high‐angle DNA bend. Here, we describe the crystal structure of the ligand‐binding domain (LBD) of OccR apoprotein and holoprotein. Pairs of LBDs form dimers with extensive hydrogen bonding, while pairs of dimers interact via a single helix, creating a tetramer interface. Octopine causes a 70° rotation of each dimer with respect to the opposite dimer, precisely at the tetramer interface. We modeled the DNA binding domain (DBD), linker helix and bound DNA onto the apoprotein and holoprotein. The two DBDs of the modeled apoprotein lie far apart and the bound DNA between them has a high‐angle DNA bend. In contrast, the two DBDs of the holoprotein lie closer to each other, with a low DNA bend angle. This inter‐dimer pivot fully explains earlier studies of this LTTR. Gene expression is often regulated by regulatory proteins that bind to promoter DNA. These proteins are themselves regulated by particular small molecules. We describe a molecular mechanism used by one such a protein to detect its cognate regulatory molecule. [ABSTRACT FROM AUTHOR]

We describe the preparation of mixed metal oxide nanoparticles of a desirable composition and their transformation to the crystalline solids ZrxTi1−xO2 (0.0 ≤x≤ 1.0) after heat treatment. The correlation analysis between the size of the nucleus, the crystalline phase and the elemental composition of the solid is presented. Mixed metal oxide zirconium–titanium-oxo-alkoxy (ZTOA) nanoparticles of different elemental compositions 0 ≤x = CZr/(CZr + CTi) ≤ 1 were prepared via the sol–gel method in a reactor by rapid micromixing of n-propanol fluids containing the precursors and water. The structural transformation of the nanoparticles takes place in two temperature ranges, 210–250 °C and 380–680 °C, which sensitively depends on the elemental composition. In the range 0.3 ≤x≤ 0.6, stable ZTOA nanoparticles with a radius of 2.1 ± 0.05 nm appeared at the hydrolysis ratio H≤ 1.5. The heat treatment results in a single orthorhombic ZrxTi1−xO2 phase. The crystallisation onset temperature was the highest in this range of x, attaining 680 °C at x = 0.5. In the range 0 ≤x≤ 0.2, the particle radius decreased to 1.6 nm for pure titanium-oxo-alkoxy nuclei (TOA, x = 0); their heat treatment resulted in a single TiO2 anatase phase. In the range 0.7 ≤x≤ 1, the particle radius decreased to 1.8 nm for pure zirconium-oxo-alkoxy nuclei (ZOA, x = 1); their heat treatment resulted in mixed monoclinic and tetragonal ZrO2 phases. The crystalline cell parameters of the observed phases underwent a continuous variation with x. TEM images evidenced the nanoporous structure of submicronic orthorhombic ZrxTi1−xO2 monocrystals with a mean pore size of about that of the ZTOA nanoparticles. [ABSTRACT FROM AUTHOR]

The cognitive and behavioural deficits caused by traumatic brain injury (TBI) to the immature brain are more severe and persistent than TBI in the mature brain. Understanding this developmental sensitivity is critical as children under four years of age sustain TBI more frequently than any other age group. Microglia (MG), resident immune cells of the brain that mediate neuroinflammation, are activated following TBI in the immature brain. However, the type and temporal profile of this activation and the consequences of altering it are still largely unknown. In a mouse model of closed head weight drop paediatric brain trauma, we characterized i) the temporal course of total cortical neuroinflammation and the phenotype of ex vivo isolated CD11B-positive microglia/macrophage (MG/MΦ) using a battery of 32 markers, and ii) neuropathological outcome 1 and 5 days post-injury. We also assessed the effects of targeting MG/MΦ activation directly, using minocycline a prototypical microglial activation antagonist, on these processes and outcome. TBI induced a moderate increase in both pro- and anti-inflammatory cytokines/chemokines in the ipsilateral hemisphere. Isolated cortical MG/MΦ expressed increased levels of markers of endogenous reparatory/regenerative and immunomodulatory phenotypes compared with shams. Blocking MG/MΦ activation with minocycline at the time of injury and 1 and 2 days post-injury had only transient protective effects, reducing ventricular dilatation and cell death 1 day post-injury but having no effect on injury severity at 5 days. This study demonstrates that, unlike in adults, the role of MG/MΦ in injury mechanisms following TBI in the immature brain may not be negative. An improved understanding of MG/MΦ function in paediatric TBI could support translational efforts to design therapeutic interventions. [ABSTRACT FROM AUTHOR]

The nucleation-growth of titanium oxo-alkoxy (TOA) nanoparticles was studied in n-propanol and isopropanol solvents. A common feature is quasi-instantaneous appearance of stable clusters with the hydrodynamic radius 1.6 nm, which form nanoparticles aggregated during the induction period. In contrast to clusters, the nanoparticle size and growth kinetics were affected by solvent: their size was 3.8 nm in n-propanol and 5.2 nm in isopropanol and the growth kinetics in isopropanol was significantly faster. The results suggest that the stability of the growing TOA units decreases with an increase of size, supporting the hierarchical model of the sol-gel growth. [ABSTRACT FROM AUTHOR]

Fish captured and released by recreational anglers are often exposed to air to enable hook removal and for admiration (e.g., photography). It is necessary to identify thresholds for air exposure that minimize sublethal alterations to inform best practice guidelines yet doing so in ecological-relevant field settings is challenging. We developed a novel attachment method for tri-axial accelerometer and depth biologgers to quantify short-term post-release behaviour in recreationally angled northern pike (Esox lucius), smallmouth bass (Micropterus dolomieu), and walleye (Sander vitreus) following a range of air exposure treatments (i.e., 0, 15, 30, 60, and 180 s). The biologgers were attached to the fish using a quick-release Velcro® harnesses that facilitated easy retrieval of the device from free-swimming fish without the need to recapture the individual. For this study, biologgers were retrieved after a 10 min observational period. Overall dynamic body acceleration (ODBA) was calculated from accelerometric data to estimate post-release swimming activity. Clustering of ODBA via k-means was used to classify distinct movement patterns: resting, steady-state swimming, and high intensity swimming occurrences. In northern pike, ODBA in the first minute after release was significantly higher in the 0 s air exposure treatment compared to the 15 s, 30 s, 60 s, and 180 s treatments, however the same patterns were not observed for smallmouth bass or walleye. We did not observe differences in the time spent resting, time spent steady-state swimming, or the number of high intensity swimming occurrences among air exposure treatments across all study species. This proof-of-concept study demonstrated the utility of this non-invasive bio-logger approach for the short-term study of catch-and-release and also revealed that for the species and context (e.g., water temperatures of 17–25 º C) studied here, air exposure had relatively little negative short-term impact on behaviour or reflex impairment. Nonetheless, we encourage air exposure to be minimized as longer fight times or higher water temperatures may interact with air exposure to increase behaviour impairments and negatively impact survival. [ABSTRACT FROM AUTHOR]

The article focuses on a study on risk factors of percutaneous cannulation failure by intensivists for veno‑arterial extracorporeal life support for refractory cardiac arrest. It mentions predictive factors for unsuccessful percutaneous ECLS cannulation. It also mentions feasibility of ultrasound-guided percutaneous femoral cannulation by intensivists.

Burkholderia cepacia complex is a set of closely related bacterial species that are notorious pathogens of cystic fibrosis patients, responsible for life-threatening lung infections. Expression of several virulence factors of Burkholderia cepacia complex is controlled by a mechanism known as quorum sensing (QS). QS is a means of bacterial communication used to coordinate gene expression in a cell-density-dependent manner. The system involves the production of diffusible signaling molecules (N-acyl-L-homoserine lactones, AHLs), that bind to cognate transcriptional regulators and influence their ability to regulate gene expression. One such system that is highly conserved in Burkholderia cepacia complex consists of CepI and CepR. CepI is AHL synthase, whereas CepR is an AHL-dependent transcription factor. In most members of the Burkholderia cepacia complex group, the cepI and cepR genes are divergently transcribed and separated by additional genes. One of them, bcam1869, encodes the BcRsaM protein, which was recently postulated to modulate the abundance or activity of CepI or CepR. Here, we show the crystal structure of BcRsaM from B. cenocepacia J2315. It is a single-domain protein with unique topology and presents a novel fold. The protein is a dimer in the crystal and in solution. This regulator has no known DNA-binding motifs and direct binding of BcRsaM to the cepI promoter could not be detected in in vitro assays. Therefore, we propose that the modulatory action of RsaM might result from interactions with other components of the QS machinery rather than from direct association with the DNA promoter. [ABSTRACT FROM AUTHOR]

The overproduction of polysaccharide alginate is responsible for the formation of mucus in the lungs of cystic fibrosis patients. Histidine kinase KinB of the KinB-AlgB two-component system in Pseudomonas aeruginosa acts as a negative regulator of alginate biosynthesis. The modular architecture of KinB is similar to other histidine kinases. However, its periplasmic signal sensor domain is unique and is found only in the Pseudomonas genus. Here, we present the first crystal structures of the KinB sensor domain. The domain is a dimer in solution, and in the crystal it shows an atypical dimer of a helix-swapped four-helix bundle. A positively charged cavity is formed on the dimer interface and involves several strictly conserved residues, including Arg-60. A phosphate anion is bound asymmetrically in one of the structures. In silico docking identified several monophosphorylated sugars, including β-D-fructose 6-phosphate and β-D-mannose 6-phosphate, a precursor and an intermediate of alginate synthesis, respectively, as potential KinB ligands. Ligand binding was confirmed experimentally. Conformational transition from a symmetric to an asymmetric structure and decreasing dimer stability caused by ligand binding may be a part of the signal transduction mechanism of the KinB-AlgB two-component system. [ABSTRACT FROM AUTHOR]

Résumé: L’ischémie cérébrale est un des dénominateurs communs à l’ensemble des lésions cérébrales aiguës, qu’elles soient d’origine vasculaire ou traumatique. L’oxygénothérapie hyperbare (OHB) permettrait de suppléer cette carence en oxygène et d’inverser un processus théoriquement réversible d’ischémie avant la constitution de lésions définitives. En effet, dans les modèles expérimentaux de traumatisme crânien ou d’ischémie cérébrale, l’OHB a un effet neuroprotecteur lié à différents mécanismes comme la modulation du stress oxydatif, de l’inflammation et du métabolisme cérébral en particulier mitochondrial. Toutefois, les résultats des essais cliniques se sont avérés décevants pour l’ischémie cérébrale et incertains pour le traumatisme crânien. La possibilité de combiner des gaz inertes à la séance d’OHB, en particulier l’argon ou le xénon qui ont fait la preuve expérimentale de leurs effets neuroprotecteurs, pourrait apporter un bénéfice supplémentaire dans l’amélioration des lésions cérébrales. Néanmoins, des études mieux ciblées, multicentriques et de bonne qualité sont nécessaires avant de statuer définitivement sur l’efficacité de l’OHB et de l’ajout d’un gaz inerte dans la neuroprotection des lésions cérébrales aiguës. [ABSTRACT FROM AUTHOR]

Abstract: Microglia mediate multiple facets of neuroinflammation, including cytotoxicity, repair, regeneration, and immunosuppression due to their ability to acquire diverse activation states, or phenotypes. Modulation of microglial phenotype is an appealing neurotherapeutic strategy but a comprehensive study of classical and more novel microglial phenotypic markers in vitro is lacking. The aim of this study was to outline the temporal expression of a battery of phenotype markers from polarised microglia to generate an in vitro tool for screening the immunomodulatory potential of novel compounds. We characterised expression of thirty-one macrophage/microglial phenotype markers in primary microglia over time (4, 12, 36, and 72h), using RT-qPCR or multiplex protein assay. Firstly, we selected Interleukin-4 (IL-4) and lipopolysaccharide (LPS) as the strongest M1–M2 polarising stimuli, from six stimuli tested. At each time point, markers useful to identify that microglia were M1 included iNOS, Cox-2 and IL-6 and a loss of M2a markers. Markers useful for quantifying M2b-immunomodulatory microglia included, increased IL-1RA and SOCS3 and for M2a-repair and regeneration, included increased arginase-1, and a loss of the M1 and M2b markers were discriminatory. Additional markers were regulated at fewer time points, but are still likely important to monitor when assessing the immunomodulatory potential of novel therapies. Further, to facilitate identification of how novel immunomodulatory treatments alter the functional affects of microglia, we characterised how the soluble products from polarised microglia affected the type and rate of neuronal death; M1/2b induced increasing and M2a-induced decreasing neuronal loss. We also assessed any effects of prior activation state, to provide a way to identify how a novel compound may alter phenotype depending on the stage of injury/insult progression. We identified generally that a prior M1/2b reduced the ability of microglia to switch to M2a. Altogether, we have characterised a profile of phenotype markers and a mechanism of assessing functional outcome that we can use as a reference guide for first-line screening of novel immunomodulatory therapies in vitro in the search for viable neuroprotectants. [Copyright &y& Elsevier]

Summary: Perinatal inflammation can lead to fetal/neonatal inflammatory syndrome, a risk factor for brain lesions, especially in the white matter. Perinatal inflammation is associated with increased incidence of cerebral palsy in humans and animal models and there is a strong relationship with increased incidence of autism and schizophrenia in humans. Perinatal inflammation causes acute microglial and astroglial activation, blood–brain barrier dysfunction, and disrupts oligodendrocyte maturation leading to hypomyelination. Inflammation also sensitizes the brain to additional perinatal insults, including hypoxia-ischemia. Furthermore, long after the primary cause of inflammation has resolved, gliosis may also persist and predispose to neurodegenerative diseases including Alzheimer''s and Parkinson''s disease, but this relation is still hypothetical. Finding of acute and chronic changes in brain structure and function due to perinatal inflammation highlights the need for treatments. As gliosis appears to be involved in the acute and chronic effects of perinatal inflammation, modulating the glial phenotype may be an effective strategy to prevent damage to the brain. [Copyright &y& Elsevier]

We elaborated a new electrolyte composition, based on butyronitrile solvent, that exhibits low volatility for use in dye-sensitized solar cells. The strong point of this new class of electrolyte is that it combines high efficiency and excellent stability properties, while having all the physical characteristics needed to pass the IEC 61646 stability test protocol. In this work, we also reveal a successftil approach to control, in a sub-Nernstian way, the energetics of the distribution of the trap states without harming cell stability by means of incorporating Nal in the electrolyte, which shows good compatibility with butyronitrile. These excellent features, in conjunction with the recently developed thiophene-based C106 sensitizer, have enabled us to achieve a champion cell exhibiting 10.0% and even 10.2% power conversion efficiency (PCE) under 100 and 51.2 mW·cm-2 incident solar radiation intensity, respectively. We reached >95% retention of PCE while displaying as high as 9.1% PCE after 1000 h of 100 mW·cm-2 light-soaking exposure at 60 °C. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The purpose of this review is to draw up a statement on current knowledge available on perioperative management of Parkinson''s disease patients. Study design: Review. Data synthesis: In France, approximately 150,000 persons suffer from Parkinson''s disease, a neurodegenerative disorder of central nervous system. Parkinson''s disease results in selective and irreversible loss of dopaminergic neurons in the substantia nigra pars compacta. Medications based on dopaminergic drugs are used to control motor symptoms and improve motor function. Development of surgical approach, especially deep brain stimulation, has revolutionized the medical management of many patients with Parkinson''s disease. Anesthesia of these patients remains a challenge for the clinician. The aim of this review is to describe anaesthetic considerations of patients with Parkinson''s disease and to discuss management of antiparkinsonians medications during the perioperative period. [Copyright &y& Elsevier]

Abstract: Thin nanocoatings prepared by chemical deposition of 6.0-nm titanium oxide oxo-particles on glass supports show an increased photocatalytic activity, which can be as high as that of the best commercial crystalline powders and even higher. In the present Letter, we report on original method of nanocoatings preparation and on effect of the coating mass on its photocatalytic activity. We show that internal efficiency of this photocatalyst increases with a decrease of its mass. Moreover, the very first layer of oxo-particles possesses both high mechanically stability and the maximum efficiency. No photocatalyst deactivation has been observed. [Copyright &y& Elsevier]

Porous TiO2 and mixed mesoporous (SiO2:TiO2 95:5 in molar ratio) have been synthesized by a sol–gel method followed by a supercritical i-PrOH treatment (300 °C, 80 bar) and using a template molecule. They have been characterized by X-ray diffraction, scanning electron microscopy and specific surface area measurements. A photocatalytic degradation of phenol and salicylic acid investigated as a function of calcination temperature allows to obtain a best sample at 450 °C (SD450 TiO2). The surface hydroxyl amount of the lab-made photocatalyst and that of the commercial powders (Degussa P25, Sachtleben Hombikat UV100 and Acros TiO2) have been compared. This factor is found to strongly modify the O2 adsorption. The commercial Hombikat and Acros TiO2 have been found to be less active than SD450 and P25 TiO2 under identical condition confirming in this way the dominant role of surface OH groups. In addition, for Acros TiO2 the phenol photodegradation shows a formation of numerous oxidative intermediate products. Their identification permits to indicate that the photolysis significantly occurs because of a low concentration of OH⋅ radicals whereas for SD450 or Degussa P25 TiO2, these behaviours appear negligible. [Copyright &y& Elsevier]

A series of 1,4-naphthoquinone derivatives were synthesized and tested for antifungal and antitumor activity against a number of fungal disease causative species and Walker 256 carcinoma cell lines. The results show that the compounds 8a,e and 11b possess pronounced antifungal proifile where as 7b and f were found to be active against Walker 256 carcinoma cell lines. Moreover 7c and 11a showed inhibitory effect against reverse transcriptase enzyme from Rauscher Murine Leukemia Virus. [Copyright &y& Elsevier]

The synthesis of E-isomer of 4-Hydroxystilbene and its derivatives 3 by reductive elimination of the carbonyl function in 2-phenyl-1-(4-hydroxyphenyl)ethan-1-one and its derivatives 2 and the X-ray structure of 2a are described. [ABSTRACT FROM AUTHOR]

Various 1,3,4-oxadiazoles have been synthesized in excellent yields by BF3ċEt2O promoted cyclodehydration of 1,2-diacyl and diaroyl hydrazines prepared in situ from corresponding acid chlorides and hydrazine. [ABSTRACT FROM AUTHOR]

Numerous studies have investigated the impacts of catch-and-release on the post-release behaviour of fish during periods characterized by warm air and water temperatures. Comparatively little is known about the post-release behaviour of fish caught while ice fishing. Largemouth bass (LMB), a popular sportfish in North America, is sometimes encountered during ice fishing and is often released due to angler conservation ethic or to comply with regulations. To examine the impacts of ice angling on the post-release behaviour of LMB, we exposed them to a range of handling practices and assessed their skin temperatures prior to release, as well as short-term post-release swimming activity using biologgers equipped with a tri-axial accelerometer, temperature and pressure sensors. Skin temperature of LMB had a significant positive relationship with windchill temperature. Generally, the longer that LMB were exposed to air or placed on the ice, the colder their skin became. Overall, water depth and water temperature selected by LMB increased with time during the post-release period. Overall dynamic body acceleration (ODBA), a proxy for locomotory activity, decreased as time progressed in the release period, while ODBA decreased with increasing depth and water temperatures. LMB with warmer skin temperatures had lower locomotory activity compared to those with colder skin temperatures. Further, the effect of skin temperature on locomotory activity became more amplified with increasing depth and warming water temperatures selected by LMB post-release. Anglers practicing catch-and-release angling during the winter should adopt best handling practices by reducing the time fish are removed from the water when windchill temperatures are sub-freezing to avoid alteration in post-release behaviour. [ABSTRACT FROM AUTHOR]

Catch-and-release is practiced in recreational fisheries under the premise that released fish will survive with negligible injury and stress. However, hooking injuries may prevent that outcome from being realized. One way to potentially minimize injuries and maximize survival in angled fish is to replace treble hooks on hard plastic lures with single hooks, but the effectiveness of this tactic has yet to be tested. Our study investigated if replacing treble hooks with single hooks on hard plastic lures reduced injuries and handling for angled Northern Pike (Esox lucius), Smallmouth Bass (Micropterus dolomieu) and Largemouth Bass (Micropterus salmoides). Furthermore, we compared fish handling (i.e., need for use of hook removal gear) and injuries between fish that were captured with barbed and barbless hooks. Fish were angled using three types of conventional hard plastic lures (i.e., crankbaits, jerkbaits, and lipless crankbaits). Upon landing, total length of the fish, an array of hooking characteristics (i.e., number of hook points in the fish, anatomical hooking location(s)), and reflex impairment were recorded. Analyses revealed that using barbless J hooks on all lures yielded the shortest unhooking times for all species. For Smallmouth Bass caught on both crank and jerk baits, J hooks tended to result in more shallow hooking than treble hooks. Barbless treble hooks were more likely to be embedded in a sensitive location (e.g., foul hooked, gullet, gills, and/or eyes) compared to barbless J hooks in Smallmouth Bass. No other significant differences in hook types and anatomical locations were found for other species. Hook type and lure type did not influence reflex impairment or survival for any of the species. Using J hooks, especially barbless ones, on lures that traditionally have treble hooks should be considered when encouraging best angling practices for the freshwater gamefish studied here to expedite release, although the extent to which this influences mortality remains unclear. [ABSTRACT FROM AUTHOR]

Introduction: Extracorporeal shockwave lithotripsy (ESWL) is a useful technique for the treatment of kidney and urinary tract stones but appears also to cause some extrarenal complications. Case Presentation: We report the case of a 33-year-old Caucasian man with a history of Crohn’s disease who presented septic shock due to a jejunum perforation 6 h following an ESWL for a right ureteral stone. The perforation, which occurred at the exact site of a previous surgical anastomosis, was revealed on a CT scan which found an unusual aspect probably due to cavitation and bubbles formation induced by ESWL. Conclusion: This case emphasizes the particular aspect of CT scan and the extrarenal potential danger of the ESWL procedure. Some precautions and dedicated patient information must be taken when used in patients with chronic inflammation of the digestive tract or history of intestinal surgery. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: We report a case of meningoencephalitis following influenza vaccine revealed by status epilepticus. The patient, an 82-year-old man who had been vaccinated against influenza two days before, had a favourable outcome after intensive care admission including mechanical ventilation. Neurologic side effects have been previously described after influenza vaccination. Although confirmation''s exams do not exist, diagnosis is based on imputability criteria, with a complete aetiologic check-up in particular microbiologic check-up. This case, illustrated by modern techniques of biology and imaging, completes the rare and old cases already described in the literature. [Copyright &y& Elsevier]

Shoreline erosion in lakes is a pressing issue for many landowners, yet common erosion mitigation practices that involve armoring can alter littoral habitat and potentially diminish near-shore biodiversity. We studied the effects of two armoring methods (i.e., riprap, retaining walls) on habitat, taxonomic richness, relative abundance, and total abundance of fishes and benthic macroinvertebrates at shorelines on Big Rideau Lake in eastern Ontario, Canada. Snorkel surveys were conducted to assess aquatic habitat characteristics and fish diversity, and benthic infauna were sampled using kick-nets. Submergent and emergent macrophytes were more abundant at natural rocky shorelines compared to shorelines modified with riprap or retaining walls. Coarse woody debris was also more abundant at natural shorelines compared to riprap and retaining wall shorelines. Relative abundances of some fish species varied between shoreline types, but overall species richness and total abundance did not. Largemouth Bass (Micropterus salmoides) were more abundant at natural sites than armored sites. Conversely, Rock Bass (Ambloplites rupestris), Pumpkinseed (Lepomis gibbosus), Bluegill (Lepomis macrochirus), Yellow Perch (Perca flavescens), and baitfish from the family Cyprinidae were more abundant at both types of armored sites compared to natural sites. Taxonomic richness of benthic macroinvertebrates did not vary among shoreline types, however abundance of Amphipoda, Isopoda, Ephemeroptera, and Cladocera was greater at armored shorelines. These results suggest that human modification of shorelines is altering littoral ecosystems and potentially leading to shifts in the community structure of littoral nekton. More study is needed to fully understand the community level effects of shoreline erosion mitigation involving armoring in freshwater lakes and determine the effectiveness of alternative mitigation strategies that preserve natural habitat features. [ABSTRACT FROM AUTHOR]

Contrast-enhanced magnetic resonance angiography (MRA) has demonstrated the potential for detecting gastrointestinal bleeding in animal studies. We report a case of active lower gastrointestinal bleed diagnosed with MRA in an elderly patient. Clinical, radiologic, and surgical findings are described. [ABSTRACT FROM AUTHOR]

In recent years, distributed generation (DG) is becoming an interesting topic for researchers and engineers for improving the distribution system performance by reducing power loss and enhancing the voltage profile. Meanwhile, DG integration in the system requires a technical solution to get maximum benefits and avoid any negative impacts in terms of location and size of DG presence. In this paper, a meta- heuristic optimization method called Grey Wolf Optimizer (GWO) which is a novel optimization algorithm is applied to find the optimal location and size of DG in radial distribution systems. Moreover, the real power loss minimization and voltage profile improvement are the objective functions in this paper considering DG which injects only real power. The proposed algorithm is compared with other three well-known optimization methods including the genetic algorithm (GA), Artificial Bee Colony (ABC), and Particle Swarm Optimization (PSO). Also, the algorithm performance is evaluated with 33 and 69 bus radial distribution systems. The obtained results show the proposed method provided better performance with less computation time when compared with the other three algorithms. [ABSTRACT FROM AUTHOR]

• Pediatric TBI induces tertiary neuroinflammatory processes associated with white matter lesions and altered behaviors. • This study specifically highlights the vulnerability of the immature, developing brain to TBI. • There is probably a close communication between astrocytes, microglia, and oligodendrocytes in tertiary post-TBI lesions. Despite improved management of traumatic brain injury (TBI), it still leads to lifelong sequelae and disability, particularly in children. Chronic neuroinflammation (the so-called tertiary phase), in particular, microglia/macrophage and astrocyte reactivity, is among the main mechanisms suspected of playing a role in the generation of lesions associated with TBI. The role of acute neuroinflammation is now well understood, but its persistent effect and impact on the brain, particularly during development, are not. Here, we investigated the long-term effects of pediatric TBI on the brain in a mouse model. Pediatric TBI was induced in mice on postnatal day (P) 7 by weight-drop trauma. The time course of neuroinflammation and myelination was examined in the TBI mice. They were also assessed by magnetic resonance, functional ultrasound, and behavioral tests at P45. TBI induced robust neuroinflammation, characterized by acute microglia/macrophage and astrocyte reactivity. The long-term consequences of pediatric TBI studied on P45 involved localized scarring astrogliosis, persistent microgliosis associated with a specific transcriptomic signature, and a long-lasting myelination defect consisting of the loss of myelinated axons, a decreased level of myelin binding protein, and severe thinning of the corpus callosum. These results were confirmed by reduced fractional anisotropy, measured by diffusion tensor imaging, and altered inter- and intra-hemispheric connectivity, measured by functional ultrasound imaging. In addition, adolescent mice with pediatric TBI showed persistent social interaction deficits and signs of anxiety and depressive behaviors. We show that pediatric TBI induces tertiary neuroinflammatory processes associated with white matter lesions and altered behavior. These results support our model as a model for preclinical studies for tertiary lesions following TBI. [ABSTRACT FROM AUTHOR]

• Model predictive control enable fast current control and transient response. • Active LCL resonance damping is achieved through PI state feedback controller. • Automatic transition between reactive power and voltage control mode. • Experimental results validate the proposed automatic voltage regulation scheme. Predominant power generation by renewable energy sources poses an increasing challenge regarding the maintenance of a stable, reliable, but also affordable electricity supply. Power converters are the key system component to interface distributed generation systems to the electrical power grid and are increasingly required to provide grid supporting measures to an extent comparable to classical centralized power stations. Thus, improving the control performance of power converters in microgrids is becoming more significant. This work proposes an optimal voltage control strategy for a grid-feeding active-front-end power converter, which inherently regulates its bus voltage within a defined tolerance band while simultaneously keeping the provided reactive power at a specified optimal level. The focus is put on the proposed multi-loop control which incorporates a fast model predictive based current controller. Simulations and experiments on a power converter test bench are presented to validate the performance of the proposed voltage regulation scheme. The controller implementation is carried out for a three-level neutral-point-clamped voltage source inverter with an LCL output filter. Based on the results of the experimental validation, a simulation-based case study demonstrates its performance for multiple grid-tied power converters in an AC microgrid. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Apnea test during brain death assessment in mechanically ventilated and ECMO patients," by M. Giani and colleagues in the 2016 issue.

Background: Preeclampsia is a dangerous cardiovascular disorder of pregnancy that leads to an increased risk of future cardiovascular and metabolic disorders. Much of the pathogenesis and mechanisms involved in cardiac health in preeclampsia are unknown. A novel anti-angiogenic protein, FKBPL, is emerging as having a potential role in both preeclampsia and cardiovascular disease (CVD). Therefore, in this study we aimed to characterise cardiac health and FKBPL regulation in the rat reduced uterine perfusion pressure (RUPP) and a 3D cardiac spheroid model of preeclampsia. Methods: The RUPP model was induced in pregnant rats and histological analysis performed on the heart, kidney, liver and placenta (n ≥ 6). Picrosirius red staining was performed to quantify collagen I and III deposition in rat hearts, placentae and livers as an indicator of fibrosis. RT-qPCR was used to determine changes in Fkbpl, Icam1, Vcam1, Flt1 and Vegfa mRNA in hearts and/or placentae and ELISA to evaluate cardiac brain natriuretic peptide (BNP45) and FKBPL secretion. Immunofluorescent staining was also conducted to analyse the expression of cardiac FKBPL. Cardiac spheroids were generated using human cardiac fibroblasts and human coronary artery endothelial cells and treated with patient plasma from normotensive controls, early-onset preeclampsia (EOPE) and late-onset preeclampsia (LOPE); n = 3. FKBPL and CD31 expression was quantified by immunofluorescent labelling. Results: The RUPP procedure induced significant increases in blood pressure (p < 0.001), collagen deposition (p < 0.001) and cardiac BNP45 (p < 0.05). It also induced a significant increase in cardiac FKBPL mRNA (p < 0.05) and protein expression (p < 0.01). RUPP placentae also exhibited increased collagen deposition and decreased Flt1 mRNA expression (p < 0.05). RUPP kidneys revealed an increase in average glomerular size (p < 0.05). Cardiac spheroids showed a significant increase in FKBPL expression when treated with LOPE plasma (p < 0.05) and a trend towards increased FKBPL expression following treatment with EOPE plasma (p = 0.06). Conclusions: The rat RUPP model induced cardiac, renal and placental features reflective of preeclampsia. FKBPL was increased in the hearts of RUPP rats and cardiac spheroids treated with plasma from women with preeclampsia, perhaps reflective of restricted angiogenesis and inflammation in this disorder. Elucidation of these novel FKBPL mechanisms in cardiac health in preeclampsia could be key in preventing future CVD. [ABSTRACT FROM AUTHOR]

Acclimating residents to radiology residency requires attention to new responsibilities, educational material, and social cohesion. To this end, we instituted a structured orientation week for incoming residents and assessed its impact. During the first weeks of July 2016 and 2017, first year residents attended a five day orientation free of clinical duties, consisting of didactics, hands-on training sessions, and social events. After two orientation cohorts, residents who completed orientation week, and two cohorts who had not, were given a voluntary, anonymous survey using Likert scale questions (1 [worst] to 5 [best]) regarding preparedness for responsibilities, learning, and social cohesion. Residents were asked which components were or would have been helpful. Independent samples t -tests were performed to evaluate differences between the two groups (two-tailed p < 0.05). 21/37 (57%) residents participated. Higher percentages of residents who participated in the orientation week gave scores ≥4 when asked about preparedness for rotations (70% vs. 36%), learning new material (80% vs. 36%), and class cohesiveness (90% vs. 70%). Mean scores on these questions were also higher for these residents with regards to: preparedness for new responsibilities (3.7 vs. 2.9), learning new material (3.8 vs. 2.9), and class cohesiveness (4.5 vs. 3.8), with differences approaching significance (p = 0.09–0.15). Individual components receiving most votes of ≥4 were social outings, resident lunches, didactic lectures, and PACS training. A weeklong orientation program free of clinical duties was valued by residents and contributed to acclimation to new responsibilities, education, and social cohesion. • An extended orientation week free of clinical duties was valued by radiology residents. • A weeklong orientation helped acclimate residents to new responsibilities, educational content, and social adjustment. • Implementation of a longer orientation week may be a valuable tool for early radiology resident training. [ABSTRACT FROM AUTHOR]

Fisheries and Oceans Canada, "Recovery strategy for the Northern and Southern Resident killer whales (Orcinus orca) in Canada", Species at Risk Act Recovery Strategy Series (2018). Canada cannot ignore its biodiversity commitments to pursue growth at the expense of ecosystems. [Extracted from the article]

Introduction Les mastocytes sont impliqués dans la pathogénie des lésions cérébrales comme le traumatisme crânien ou l’ischémie cérébrale. L’accumulation intracérébrale de l’histamine, un des produits de dégranulation mastocytaire, a déjà été mise en évidence à la suite de ces lésions [1] . Le blocage de cette dégranulation par le cromoglycate s’est également révélé neuroprotecteur [2] . Nous avons donc étudié l’effet de l’histamine sur l’activation des populations gliales (astrocytes, microglies) et sur la toxicité neuronale in vitro . Matériel et méthodes À partir de cultures primaires des différents types cellulaires étudiés, nous avons tout d’abord contrôlé la présence de récepteurs à l’histamine (H1 à 4) sur les cellules gliales et neuronales par PCR quantitative. Sur des cultures primaires de microglies et d’astrocytes, nous avons étudié l’effet de l’histamine (1, 10, 100 μM) sur les marqueurs d’activation microgliale et astrocytaire par PCR quantitative. Sur des cultures primaires de neurones, nous avons déposé l’histamine en présence ou non de NMDA, agoniste glutamatergique activant les récepteurs impliqués dans l’excitotoxicité. Nous avons ensuite étudié la viabilité neuronale à l’aide d’une quantification de l’activité mitochondriale par du MTT. Résultats Nous avons retrouvé des récepteurs à l’histamine sur les trois populations cellulaires étudiées, majoritairement le récepteur H2. En s’intéressant à différents marqueurs d’activation microgliale pro- et anti-inflammatoire, l’application d’histamine sur des cultures primaires de microglie n’a pas modifié leur profil d’activation. Les mêmes concentrations d’histamine n’ont pas induit la synthèse de marqueurs d’activation astrocytaire ou de cytokines pro-inflammatoires sur des cultures primaires d’astrocytes. L’application isolée d’histamine sur des cultures primaires de neurones n’entraîne pas de mort neuronale. Par contre, le NMDA est responsable d’une mort neuronale, potentialisée par l’histamine proportionnellement à sa concentration. Discussion Alors que l’histamine n’a pas d’effets évidents sur les microglies et les astrocytes, elle pourrait potentialiser la neurotoxicité en présence d’un stimulus excitotoxique. Le blocage de ce médiateur, peut-être via son récepteur H2, pourrait être une voie de recherche intéressante pour de nouvelles stratégies neuroprotectrices. [ABSTRACT FROM AUTHOR]

Introduction L’estimation de la pression systémique moyenne (PSM, valeur attendue en physiologie : 7 mmHg) pourrait aider à guider le remplissage vasculaire. Une estimation peut être obtenue en mesurant le volume d’éjection systolique (VES) à différents niveaux de POD (obtenus en faisant varier les pressions intra-thoraciques (PIT)) [1] . Or l’influence de la PIT sur la POD dépend de la transmission des pressions ventilatoires aux pressions intravasculaires [2] . Nous proposons d’utiliser une nouvelle version de l’estimation de la PSM, corrigée par un index de transmission (It) [2] . Matériel et méthodes Après soumission au comité d’éthique, nous avons inclus des patients ventilés ayant une indication de remplissage vasculaire et monitorés par un Doppler œsophagien. Deux méthodes pour mesurer la PSM ont été réalisées. La valeur de référence (PSM1) est estimée par un calcul reposant sur une mesure statique de la POD, de la pression artérielle et du débit cardiaque et sur l’âge, le poids, la taille [3] . La seconde (PSM2) est basée sur la régression linéaire de valeurs mesurées de VES et de POD lors d’une pause télé-inspiratoire et télé-expiratoire à 2 niveaux de pression expiratoire positive (PEP à 5 cmH 2 O et PEP réglée pour une pression de plateau à 30 cmH 2 O) [1] . La POD corrigée est calculée avant et après remplissage par le calcul suivant : POD corrigée = POD * It avec It = DPOD/(Pplateau-PEP)) [2] . Nous avons comparé les résultats de PSM2 à la valeur de la PSM1 avant et après correction par l’It à l’aide d’une représentation de Bland et Altman. Résultats Six patients ont été inclus à ce jour. L’estimation non corrigée de la PSM2 fournit des valeurs non compatibles avec la physiologie (médianes [IQR] : 26,8 [17,4–34,6]), à l’inverse de celles obtenues après correction par l’It (7,8 [6,8–8,8]). L’agrément entre la PSM2 et la PSM1 est substantiellement amélioré en corrigeant par l’It ( Fig. 1 ). Le biais moyen est de 13,1 [IC95 % : –10,8 ; 37,0] avant correction et de 3,0 [IC95 % : –5,7 ; 11,8] après correction par l’It. Discussion Dans cette étude de faisabilité, l’estimation de la PSM par la méthode de régression linéaire semble nécessiter une correction par l’index de transmission des PIT. [ABSTRACT FROM AUTHOR]

Background: There is a need for better allocation of medical resources in polytrauma, by optimizing both the over and undertriage rates. The goal of this study is to provide a new working definition for polytrauma based on the prediction of the need for specialized trauma care.Methods: This is a prospective, observational study, performed in a specialized trauma center in Paris. All consecutive patients admitted for a trauma at a major trauma center in Paris were included in the study. The primary outcome was the need for specialized trauma care as defined by the North American consensus. The explanatory variables included basic variables collected on scene. The modeling approach relied on recursive partitioning based decision trees. Its prediction performance was evaluated both internally and externally on a validation cohort, and compared to the MGAP (Mechanism, Glasgow coma scale, Age and Arterial pressure) score.Measurements and Main Results: 1160 patients were included in the analysis over a 3-year period (2012-2014), out of which 41% needed specialized trauma care as defined by the recent US guidelines. The decision tree outperformed the MGAP and reached an area under the receiver operating characteristic curve of 0.82 [0.79-0.84]. This optimal decision rule was associated with a sensitivity of 0.94 [0.92-0.96], a specificity of 0.48 [0.44-0.52]. A conservative decision rule (refer to a trauma center all patient with a predicted probability ≥0.34) would result in an undertriage rate of 5.7% and an overtriage of 52.3% (respectively 7% and 64% in the validation cohort).Conclusions: Our tree-based decision algorithm is a user-friendly and reliable alternative to the preexisting scores, which offers good performance to predict the need for specialized trauma care. [ABSTRACT FROM AUTHOR]