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Salivary carcinomas of minor salivary glands are very infrequent tumors. When located in the tongue, the therapeutic strategy may comprise upfront surgery, which may be debilitating, and/or (chemo‐)radiotherapy. The aim of this study was to identify the prognostic factors of salivary carcinomas of the tongue in a population‐based cohort. This retrospective multicentric study, based on the "Réseau d'Expertise Français sur les Cancers ORL Rares" (REFCOR), included all the patients with a salivary carcinoma of the tongue, diagnosed between January 2009 and December 2018. Dubious slides were reviewed by REFCOR expert pathologists to ensure diagnostic accuracy. Treatment was performed in accordance with national REFCOR recommendations. From 28 centers, 103 patients were included in this study. Median age at diagnosis was 63 years, and 60.2% were female. Tumors were adenoid cystic carcinomas (41.7%), mucoepidermoid carcinomas (30.1%), and other adenocarcinomas (28.2%). Primary treatment was surgical for 61.2% of them. Five‐year overall survival (OS) and event‐free survival (EFS) rates were 84.7% and 38.6%, respectively. In multivariable analysis, EFS was significantly worse in case of nonsurgical treatment, alcohol consumption, and glossotonsillar sulcus involvement. N‐positive status was the only significant prognostic factor for OS in multivariable analysis. Salivary carcinomas of the tongue represent a heterogeneous group of rare tumors, with a high risk of recurrence. In this national cohort, surgery was associated with better EFS and N‐status was the main independent prognostic factor for OS. [ABSTRACT FROM AUTHOR]

Objective: To study the efficiency of lingual tonsillectomy (LT) as part of multilevel surgery in children with complex obstructive sleep apnea (OSA). To evaluate the safety and the outcomes of LT. Study Design: Retrospective case series. Setting: Pediatric tertiary care academic center. Methods: We included all children operated for LT to treat complex OSA, from January 2018 to June 2022. All patients underwent a protocolized drug‐induced sleep endoscopy (DISE) followed by a coblation LT, associated with the treatment of all other obstructive sites. Patient demographics, medical history, surgery, and outcomes were reviewed. The efficiency of LT was analyzed exclusively in patients with a preoperative and postoperative sleep study. Results: One hundred twenty‐three patients were included. Median age was 8 years (interquartile range, IQR [3‐12]). Sixty‐five (53%) patients had Down syndrome, 22 (18%) had a craniofacial malformation, and 8 (7%) were obese. LT was associated with adenoidectomy (n = 78, 63%), partial tonsillectomy (n = 70, 57%), inferior turbinoplasty/turbinectomy (n = 59, 48%), epiglottoplasty (n = 92, 75%), and/or expansion pharyngoplasty (n = 2, 2%). Eighty‐nine patients underwent a sleep study before and after surgery. The median apnea‐hypopnea index (AHI) decreased from 18 events/h (IQR [9‐36]) before surgery to 3 events/h (IQR [1‐5]) after surgery (P <.001) (patients with a postoperative AHI <1.5 events/h, n = 31, 35%, and an AHI <5 events/h, n = 32, 36%). Seventeen out of 30 (57%) patients could be weaned from continuous positive airway pressure after surgery. Two patients had a postoperative hemorrhage and 2 patients required a transient postoperative reintubation. Conclusion: In children with complex OSA, LT as part of a DISE‐directed multilevel upper airway surgery, was a very efficient and safe procedure. [ABSTRACT FROM AUTHOR]

Not all patients on dialysis want to be registered on the kidney transplantation (KT) waiting list and undergo transplantation. The aim of this convergent mixed methods study was to determine the features of patients refusing to be registered on the KT waiting list and the reasons. Quantitative data on all 2017–2019 incident 18–85-year-old dialysis patients, eligible for KT, were extracted from the REIN registry in France. Qualitative data were collected through semi-structured interviews with patients on dialysis and nephrologists from the Bretagne, Île-de-France and Normandie French regions. The binary logistic regression method was used to identify factors/reasons associated with registration refusal and an inductive thematic analysis was performed on qualitative data. The quantitative analysis included data of 10,512 patients (mean age = 57.5 years). Among them, 860 (8.18%) refused to be registered on the KT waiting list. The multivariate analysis showed that women were 83% more likely to refuse registration compared with men. The qualitative analysis included 21 patients and 11 nephrologists. The integration of the results from the quantitative and qualitative analyses allowed identifying some factors associated with the registration refusal. Most of these factors converged across analyses. These included age, sex/gender, autonomy on dialysis and comorbidities. The integration of the results highlighted some divergence concerning sex/gender and autonomy and an area of expansion related to comorbidities. In conclusion, the patient age, sex/gender and comorbidities appear to play an important role in the refusal to be registered on the waiting list. Interventions focused on these factors might help to improve KT accessibility in France. [ABSTRACT FROM AUTHOR]

Background: Patients with central lines face an increased risk of developing bacteremia. Preventing late-onset catheter-related infections relies on implementing various measures during manipulations of the catheter hub of central lines (e.g., during connections, disconnections, blood withdrawals, pulsed rinses, or injections performed at the first connection after the central catheter). French guidelines include, among these measures, the requirement to put on sterile gloves immediately before proximal manipulation to help prevent contamination of the catheter hub during preparation. To our knowledge, no study has reported compliance with wearing sterile gloves during these manipulations, nor the impact of not wearing sterile gloves on the cleanliness of the fingers of healthcare workers (HCWs) just before manipulating the connectors. Methods: We conducted a two-part study to assess compliance with sterile gloving and to provide direct microbiological evidence of bacterial contamination on HCWs' hands immediately before the manipulation of central lines when sterile gloving is not used. First, the use of sterile gloves was observed during proximal manipulations of central lines using a standardized grid. Second, we examined the microbial flora present on the fingers of each observed HCW just before proximal manipulation. Results: A total of 260 HCWs from 35 healthcare institutions were observed during proximal manipulation. The HCWs were distributed into three groups: 188 used sterile gloves (72%), 23 used nonsterile gloves (9%), and 49 did not wear gloves (19%). The swabbing of the fingertips revealed microbial cultures from 72 samples (28%). A total of 97 microorganisms were identified, all of which are well-recognized agents responsible for catheter-related bacteremia, predominantly coagulase-negative staphylococci (n = 36) and Bacillus sp. (n = 31). Fingertip contamination was lower for HCWs wearing sterile gloves (27/188; 14%) than for those wearing nonsterile gloves (12/23; 52%) or not wearing gloves (33/49; 67%) (p < 0.001). The contaminants were similar across the three groups. Conclusions: Our data support the positive impact of sterile gloving in ensuring clean fingertips during proximal manipulation of central lines, a key measure in preventing late-onset catheter-related bacteremia. The contamination of sterile gloves in one out of seven HCWs highlights the need for a clean care environment and minimal contact with the patient's skin and surroundings during proximal manipulation. [ABSTRACT FROM AUTHOR]

Background Access to kidney transplantation (KT) remains challenging for patients with end-stage kidney disease. This study assessed women's access to KT in France by considering comorbidities and neighbourhood social deprivation. Methods All incident patients 18–85 years old starting dialysis in France between 1 January 2017 and 31 December 2019 were included. Three outcomes were assessed: access to the KT waiting list after dialysis start, KT access after waitlisting and KT access after dialysis start. Cox and Fine–Gray models were used. Gender–European Deprivation Index and gender–age interactions were tested and analyses were performed among strata if required. Results A total of 29 395 patients were included (35% of women). After adjusting for social deprivation and comorbidities, women were less likely to be waitlisted at 1 year {adjusted hazard ratio [adjHR] 0.91 [95% confidence interval (CI) 0.87–0.96]} and 3 years [adjHR 0.87 (95% CI 0.84–0.91)] after dialysis initiation. This disparity concerned mainly women ≥60 years of age [adjHR 0.76 (95% CI 0.71–0.82) at 1 year and 0.75 (0.71–0.81) at 3 years]. Access to KT after 2 years of waitlisting was similar between genders. Access to KT was similar between genders at 3 years after dialysis start but decreased for women after 4 years [adjHR 0.93 (95% CI 0.88–0.99)] and longer [adjHR 0.90 (95% CI 0.85–0.96)] follow-up. Conclusions In France, women are less likely to be waitlisted and undergo KT. This is driven by the ≥60-year-old group and is not explained by comorbidities or social deprivation level. [ABSTRACT FROM AUTHOR]

Background Campylobacteriosis in kidney transplant recipients (KTRs) is the most common identified bacterial cause of diarrhea. Risk factors in KTRs are unknown. Methods A 10-year multicentric, retrospective 1:1 case-control study was performed in France between 2010 and 2020. The main aim was to identify factors associated with Campylobacter -related infection in KTRs. The KTRs with a functional graft and campylobacteriosis (positive stool culture and/or blood culture and/or positive nucleic amplification test) and their controls matched on transplantation date within the same center were included. Results We identified 326 patients with campylobacteriosis. The estimated incidence rate of campylobacteriosis was 2.3/1000 patient-years. The infection occurred at a median of 2.4 years posttransplantation. The independent risk factors for campylobacteriosis were use of corticosteroids as maintenance regimen (75.8% vs 66%; P <.001), acute rejection (8.9% vs 4%; P =.048), low lymphocyte count (0.96 vs 1.4 giga/liter (G/L); P <.001), and low basal estimated glomerular filtration rate (eGFR) (44.2 vs 57.5 mL/minute/1.73 m2; P <.001). A fluoroquinolone was initiated in 64 (21.4%) patients, with 51.1% of antimicrobial resistance, whereas almost all strains were erythromycin sensitive. Conclusions Campylobacteriosis has a higher incidence in the 2 first years of transplantation. The factors independently associated with campylobacteriosis are corticosteroids as maintenance immunosuppressive regimen, low lymphocyte counts, low eGFR, and a history of acute rejection. Due to high antimicrobial resistance with fluoroquinolone, the first line of treatment should be azithromycin. [ABSTRACT FROM AUTHOR]

This research aims to develop an integrated approach to construction project management by integrating digital technology into monitoring and surveillance operations. Through the use of drones and image processing software, data can be updated regularly and accurately about the progress at the construction site, allowing managers and decision makers to have a clear view of the current situation and make effective decisions based on accurate. In addition, this approach contributes to improving communication and coordination among project team members, as data and images can be easily and effectively shared, reducing opportunities for error and enhancing effective interaction among different parties. Using digital twin technologies, planning and forecasting processes can also be improved, as comprehensive analysis of digital data provides a deeper understanding of project dynamics, identifies potential risks, and enables appropriate preventive measures to be taken. In conclusion, the integration of digital twins and the use of drones in construction projects represent a significant step towards achieving smarter and more efficient management, and successfully achieving the defined goals with greater effectiveness. [ABSTRACT FROM AUTHOR]

This article discusses the use of a local flap called the septal nasopharyngeal "kite flap" in the treatment of petrous apex cholesterol granuloma (PACG). PACG is a benign lesion of the temporal bone that can cause symptoms such as headache, hearing loss, and facial paresthesia. The study found that the septal nasopharyngeal "kite flap" is a reliable solution to prevent restenosis of PACG when used in conjunction with an endoscopic trans-pterygoid infra-petrous approach. The flap was found to be effective in preventing recurrence of symptoms and had no major complications. Further research is needed to validate these findings. [Extracted from the article]

A new hemicryptophane host with a ditopic molecular cavity combining a cyclotriveratrylene (CTV) unit with a tris‐urea moiety was synthesized. The complexation of halides, tetramethylammonium (TMA+) cation, and ion pairs was investigated. A positive cooperativity was observed, since halides display a higher binding constant when a TMA+ cation is already present inside the cage. When TMA+ was complexed alone, a decrease of temperature from 298 K to 230 K was required to switch from a fast to a slow exchange regime on the NMR time scale. Nevertheless, the prior complexation of a halide guest in the lower part of the host resulted in significant decrease of the exchange rate of the subsequent complexation of the TMA+ cation. Under these conditions, the 1H NMR signals characteristic of a slow exchange regime were observed at 298 K. Addition of an excess of salts, increases the ionic strength of the solution, restoring the fast exchange dynamics. This result provides insight on how the exchange rate of a cation guest can be modulated by the complexation of a co‐guest anion. [ABSTRACT FROM AUTHOR]

Background: Iatrogenic cerebrospinal fluid leak (iCSF-L) is a major complication of endonasal surgeries whose occurrence is always a potential adverse event due to anatomical variation/asymmetry of the skull base (SB). The aim of this manuscript is to provide a topographical map of iCSF-L and to investigate the role of SB asymmetry in iCSF-L occurrence. Methods: In this retrospective study, the location of iCSF-L dural defect was studied and compared to patients affected by spontaneous and post-traumatic CSF-L. Considering only iCSF-L, after having collected the SB asymmetry data, the Keros, Gera, distance of the anterior ethmoidal artery from the SB, frontal sinus pneumatization, and Thailand–Malaysia–Singapore score classifications were compared to a control group of patients. Results: A total of 153 CSF-Ls (103 spontaneous, 37 iatrogenic, and 13 traumatic) were included. A significant association was noted (p < 0.001) between the nature of the CSF-L and the areas involved. Considering iCSF-Ls, only the Gera classification was significantly different (p < 0.05) and the most reliable in predicting the risk of dural transgression (AUC = 0.719). Conclusions: ICSF-Ls present peculiar regional SB involvement with the cribriform plate, with the ethmoidal roof being the most involved. After having assessed the asymmetry of the SB, the Gera classification was the most reliable one. [ABSTRACT FROM AUTHOR]

Frontotemporal lobar degeneration with tau (FTLD-tau) is a group of tauopathies that underlie ∼50% of FTLD cases. Identification of genetic risk variants related to innate/adaptive immunity have highlighted a role for neuroinflammation and neuroimmune interactions in FTLD. Studies have shown microglial and astrocyte activation together with T cell infiltration in the brain of THY-Tau22 tauopathy mice. However, this remains to be confirmed in FTLD-tau patients. We conducted a detailed post-mortem study of FTLD-tau cases including 45 progressive supranuclear palsy with clinical frontotemporal dementia, 33 Pick's disease, 12 FTLD-MAPT and 52 control brains to characterize the link between phosphorylated tau (pTau) epitopes and the innate and adaptive immunity. Tau pathology was assessed in the cerebral cortex using antibodies directed against: Tau-2 (phosphorylated and unphosphorylated tau), AT8 (pSer202/pThr205), AT100 (pThr212/pSer214), CP13 (pSer202), PHF1 (pSer396/pSer404), pThr181 and pSer356. The immunophenotypes of microglia and astrocytes were assessed with phenotypic markers (Iba1, CD68, HLA-DR, CD64, CD32a, CD16 for microglia and GFAP, EAAT2, glutamine synthetase and ALDH1L1 for astrocytes). The adaptive immune response was explored via CD4+ and CD8+ T cell quantification and the neuroinflammatory environment was investigated via the expression of 30 inflammatory-related proteins using V-Plex Meso Scale Discovery. As expected, all pTau markers were increased in FTLD-tau cases compared to controls. pSer356 expression was greatest in FTLD-MAPT cases versus controls (P < 0.0001), whereas the expression of other markers was highest in Pick's disease. Progressive supranuclear palsy with frontotemporal dementia consistently had a lower pTau protein load compared to Pick's disease across tau epitopes. The only microglial marker increased in FTLD-tau was CD16 (P = 0.0292) and specifically in FTLD-MAPT cases (P = 0.0150). However, several associations were detected between pTau epitopes and microglia, supporting an interplay between them. GFAP expression was increased in FTLD-tau (P = 0.0345) with the highest expression in Pick's disease (P = 0.0019), while ALDH1L1 was unchanged. Markers of astrocyte glutamate cycling function were reduced in FTLD-tau (P = 0.0075; Pick's disease: P < 0.0400) implying astrocyte reactivity associated with a decreased glutamate cycling activity, which was further associated with pTau expression. Of the inflammatory proteins assessed in the brain, five chemokines were upregulated in Pick's disease cases (P < 0.0400), consistent with the recruitment of CD4+ (P = 0.0109) and CD8+ (P = 0.0014) T cells. Of note, the CD8+ T cell infiltration was associated with pTau epitopes and microglial and astrocytic markers. Our results highlight that FTLD-tau is associated with astrocyte reactivity, remarkably little activation of microglia, but involvement of adaptive immunity in the form of chemokine-driven recruitment of T lymphocytes. [ABSTRACT FROM AUTHOR]

The persistent organic pollutant chlordecone massively contaminates water resources of the French West Indies. Hemicryptophanes are cages capable of complexing chlordecone in organic solvents. Here we demonstrate that a hemicryptophane cage is not only able to recognize this pollutant in chloroform but is also efficient for the removal of chlordecone from water. This evidences that, beyond our previously reported proof of concept, this receptor could be apply as a direct and efficient depolluting agent, making it a promising system for applied supramolecular chemistry. A simple pH switch (basic washing) enables the release of chlordecone from the host, under its deprotonated form, allowing the empty supramolecular cage to be recycled and reused. This method for recycling the receptor, is to the best of our knowledge unprecedented. [ABSTRACT FROM AUTHOR]

In brief: The causes of subfertility and recurrent pregnancy loss are often unclear. This study shows that endometrial gland cilia from women with subfertility have ultrastructural defects. Endometrial glands secrete products into the endometrium and are necessary for embryo implantation and successful pregnancy. However, structural and functional abnormalities in endometrial gland cilia from women with reproductive failure remain poorly understood. This was a cross-sectional study where endometrial biopsies were collected at days 19-23 of the menstrual cycle from women with unexplained recurrent pregnancy loss (n = 15), unexplained subfertility (n = 11) or from egg donor control participants (n = 10). Endometrial gland cilia ultrastructure was imaged by transmission electron microscopy and cilia defects assessed by an electron-microscopist from a national primary ciliary dyskinesia diagnostic centre. Endometrial glands were isolated, and the cilia beat frequency recorded by high speed video. Subfertile women have proportionately lower ultrastructurally normal cilia (P < 0.05); higher frequency of absent dynamin arms (P < 0.01) or inner arm defects (P < 0.01) and lower cilia beat frequency (P < 0.05). The mechanisms underlying these obversions have yet to be determined. Recent studies have identified cilia related gene expression changes associated with reproductive failure and this study adds to the growing body of literature revealing structural and functional changes. The observation that cilia defects occurred at a higher frequency in endometrial glands of subfertile women raises the question of its mechanistic role in implantation. [ABSTRACT FROM AUTHOR]

Background In France, kidney diseases of undetermined origin account for 5%–20% of all causes of end-stage kidney disease. We investigated the impact of social disadvantage on the lack of aetiological diagnosis of nephropathies. Methods Data from patients who started dialysis in France between 1 January 2017 and 30 June 2018 were extracted from the French Renal Epidemiology and Information Network registry. The social deprivation of each individual was estimated by the European Deprivation Index (EDI) defined by the patient's address. Logistic regression was used to perform mediation analysis to study the potential association between social deprivation and unknown nephropathy. Results Of the 7218 patients included, 1263 (17.5%) had unknown kidney disease. A total of 394 (31.4%) patients in the unknown kidney disease belonged to the most deprived quintile of the EDI [fifth quintile (Q5)], vs 1636 (27.5%) patients in the known kidney disease group. In the multivariate analysis, unknown kidney disease was associated with Q5 (odds ratio 1.40, 95% confidence interval 1.12–1.74, P  = .003). Mediation analysis did not identify any variables (e.g. obesity, initiation of dialysis in emergency, number of visits to the general practitioner and nephrologist before initiation of dialysis, date of first nephrology consultation) that mediated the association between social deprivation and nephropathy of unknown origin. Conclusions Our results show that, compared with nondeprived subjects, individuals experiencing social deprivation have a higher risk of unknown nephropathy at dialysis initiation. However, mediation analysis did not identify any variables that explained the association between social deprivation and nephropathy of unknown origin. [ABSTRACT FROM AUTHOR]

Background This study was carried out to evaluate the association between patient sex and the proportion of nurse-assisted peritoneal dialysis (PD) at dialysis initiation and to explore whether sex disparities in nurse-assisted PD utilization was explained by predialysis care and/or by social deprivation using mediation analysis. Methods This was a retrospective study using data from the Renal Epidemiology and Information Network (REIN) registry linked to the French National Healthcare Database (SNDS) of incident patients between 1 January 2017 and 30 June 2018. A regression logistic was used for statistical analysis. A mediation analysis explored the direct effect of sex on nurse-assisted PD proportion and the indirect effect through the European Deprivation Index (EDI), and the number of general practitioner (GP) and nephrologist visits before dialysis initiation. Results Among 1706 patients on PD, there were 637 women (37.3%) and 1069 men (62.7%). Nurse-assisted PD proportion was 332/610 (54.4%) for women vs 464/1036 (44.8%) for men. In the multivariable analysis women were more likely to be treated by nurse-assisted PD {odds ratio (OR) 1.92 [95% confidence interval (CI) 1.46–2.52]}. Nurse-assisted PD was associated with the median number of GP visits [OR 1.44 (95% CI 1.11–1.86)] and with the median number of nephrologist visits [OR 0.59 (95% CI 0.46–0.76)]. The mediation analysis showed a direct effect of sex on nurse-assisted PD [OR 1.90 (95% CI 1.80–2.01)] and an indirect effect through the median number of GP visits [OR 1.05 (95% CI 1.04–1.06], the median number of nephrologist visits [OR 1.02 (95% CI 1.02–1.03)] and quintile 5 of the EDI [OR 1.03 (95% CI 1.02–1.03)]. Conclusion Women were more frequently treated by nurse-assisted PD than men. Differences between women and men in predialysis care and social deprivation could explain the greater utilization of nurse-assisted PD among women. [ABSTRACT FROM AUTHOR]

The 18kD translocator protein (TSPO) is used as a positron emission tomography (PET) target to quantify neuroinflammation in patients. In Alzheimer's disease (AD), the cerebellum is the pseudo-reference region for comparison with the cerebral cortex due to the absence of AD pathology and lower levels of TSPO. However, using the cerebellum as a pseudo-reference region is debated, with other brain regions suggested as more suitable. This paper aimed to establish the neuroinflammatory differences between the temporal cortex and cerebellar cortex, including TSPO expression. Using 60 human post-mortem samples encompassing the spectrum of Braak stages (I–VI), immunostaining for pan-Aβ, hyperphosphorylated (p)Tau, TSPO and microglial proteins Iba1, HLA–DR and MSR-A was performed in the temporal cortex and cerebellum. In the cerebellum, Aβ but not pTau, increased over the course of the disease, in contrast to the temporal cortex, where both proteins were significantly increased. TSPO increased in the temporal cortex, more than twofold in the later stages of AD compared to the early stages, but not in the cerebellum. Conversely, Iba1 increased in the cerebellum, but not in the temporal cortex. TSPO was associated with pTau in the temporal cortex, suggesting that TSPO positive microglia may be reacting to pTau itself and/or neurodegeneration at later stages of AD. Furthermore, the neuroinflammatory microenvironment was examined, using MesoScale Discovery assays, and IL15 only was significantly increased in the temporal cortex. Together this data suggests that the cerebellum maintains a more homeostatic environment compared to the temporal cortex, with a consistent TSPO expression, supporting its use as a pseudo-reference region for quantification in TSPO PET scans. [ABSTRACT FROM AUTHOR]

Background: Looking for treatment-by-subset interaction on a right-censored outcome based on observational data using propensity-score (PS) modeling is of interest. However, there are still issues regarding its implementation, notably when the subsets are very imbalanced in terms of prognostic features and treatment prevalence. Methods: We conducted a simulation study to compare two main PS estimation strategies, performed either once on the whole sample ("across subset") or in each subset separately ("within subsets"). Several PS models and estimands are also investigated. We then illustrated those approaches on the motivating example, namely, evaluating the benefits of facial nerve resection in patients with parotid cancer in contact with the nerve, according to pretreatment facial palsy. Results: Our simulation study demonstrated that both strategies provide close results in terms of bias and variance of the estimated treatment effect, with a slight advantage for the "across subsets" strategy in very small samples, provided that interaction terms between the subset variable and other covariates influencing the choice of treatment are incorporated. PS matching without replacement resulted in biased estimates and should be avoided in the case of very imbalanced subsets. Conclusions: When assessing heterogeneity in the treatment effect in small samples, the "across subsets" strategy of PS estimation is preferred. Then, either a PS matching with replacement or a weighting method must be used to estimate the average treatment effect in the treated or in the overlap population. In contrast, PS matching without replacement should be avoided in this setting. [ABSTRACT FROM AUTHOR]

Few studies investigated sex-related differences in care consumption after dialysis initiation. Therefore, the aim of this study was to compare the care trajectory in the first year after dialysis start between men and women by taking into account the context of dialysis initiation. All patients who started dialysis in France in 2015 were included. Clinical data of patients and context of dialysis initiation were extracted from the Renal Epidemiology and Information Network (REIN) registry. Data on care consumption in the first year after dialysis start came from the French national health data system (SNDS): hospital stays <24h, hospital stays to prepare or maintain vascular access, hospital stays >24h for kidney problems and hospital stays >24h for other problems, and consultations with a general practitioner. Variables were compared between men and women with the χ2 test and Student's or Welch t-test and logistic regression models were used to identify the factors associated with care consumption after dialysis start. The analysis concerned 8,856 patients (36% of women). Men were less likely to have a hospital stays >24h for kidney problems than women (OR = 0.8, 95% CI = [0.7–0.9]) and less general practitioner consultations (OR = 0.8, 95% CI = [0.8–0.9]), in the year after dialysis initiation, after adjustment on patient's characteristics. Moreover, hospital stays for vascular access preparation or maintenance were longer in women than men (median duration: 2 days [0–2] vs. 1 day [0–2], p < 0.001). In conclusion, despite greater comorbidities in men, this study found few differences in post-dialysis care trajectory between men and women. [ABSTRACT FROM AUTHOR]

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After having endonasal medial maxillectomies pre-lacrimal with lacrimal transposition, the posterosuperior bony wall of the lacrimal pathway, which represents the anterior boundary of the retro-lacrimal recess, is evident, highlighting the feasibility of lesions involving this area. EPLA is a surgical procedure that is gaining popularity; however, the real applicability of this approach is generally related to the anatomy of the MS medial wall and lacrimal pathway. Keywords: functional endoscopic sinus surgery; inverted papilloma; lacrimal transposition; medial maxillectomy; pre-lacrimal approach EN functional endoscopic sinus surgery inverted papilloma lacrimal transposition medial maxillectomy pre-lacrimal approach 2090 2094 5 08/14/23 20230901 NES 230901 EPLA lacrimal transposition facilitates management of maxillary sinus/pterygopalatine fossa lesions and overcomes limitations such as the Simmen type I recess or IPMS pedicled on the medial wall, without increasing peri-operative morbidity. [Extracted from the article]

The 18kD translocator protein (TSPO) is used as a positron emission tomography (PET) target to quantify neuroinflammation in patients. In Alzheimer's disease (AD), the cerebellum is the pseudo-reference region for comparison with the cerebral cortex due to the absence of AD pathology and lower levels of TSPO. However, using the cerebellum as a pseudo-reference region is debated, with other brain regions suggested as more suitable. This paper aimed to establish the neuroinflammatory differences between the temporal cortex and cerebellar cortex, including TSPO expression. Using 60 human post-mortem samples encompassing the spectrum of Braak stages (I–VI), immunostaining for pan-Aβ, hyperphosphorylated (p)Tau, TSPO and microglial proteins Iba1, HLA–DR and MSR-A was performed in the temporal cortex and cerebellum. In the cerebellum, Aβ but not pTau, increased over the course of the disease, in contrast to the temporal cortex, where both proteins were significantly increased. TSPO increased in the temporal cortex, more than twofold in the later stages of AD compared to the early stages, but not in the cerebellum. Conversely, Iba1 increased in the cerebellum, but not in the temporal cortex. TSPO was associated with pTau in the temporal cortex, suggesting that TSPO positive microglia may be reacting to pTau itself and/or neurodegeneration at later stages of AD. Furthermore, the neuroinflammatory microenvironment was examined, using MesoScale Discovery assays, and IL15 only was significantly increased in the temporal cortex. Together this data suggests that the cerebellum maintains a more homeostatic environment compared to the temporal cortex, with a consistent TSPO expression, supporting its use as a pseudo-reference region for quantification in TSPO PET scans. [ABSTRACT FROM AUTHOR]

Merkel cell carcinoma from renal transplant recipients are mostly MCPyV-negative and are frequently associated with squamous cell carcinomas or precursors Briefly, patients were mostly male (M/F: 10/5), with a median age at MCC diagnosis of 63 years (range 52-84) and a median delay of 11.5 years (range 1-24 years) between transplantation and MCC diagnosis. In line with the hypothesis that MCPyV-negative tumours may derive from SCC, six patients with MCPyV-negative tumours had a prior history of SCC. [Extracted from the article]

(1) Background: In head and neck squamous cell carcinoma, tumor hypoxia has been associated with radio/chemoresistance and poor prognosis, whereas human papillomavirus (HPV)-positive status has a positive impact on treatment response and survival outcomes. The aim of this study was to evaluate the expression and the potential prognostic value of hypoxia-induced endogenous markers in patients treated for squamous cell carcinoma of the nasal cavity and paranasal sinuses (SNSCC), and their correlation with HPV status. (2) Methods: In this monocentric study, patients treated in a curative intent for a SNSCC were screened retrospectively. Protein expression of CA-IX, GLUT-1, VEGF, VEGF-R1, and HIF-1α was determined by immunohistochemical staining, scored, and then correlated with overall survival (OS) and locoregional recurrence free survival (LRRFS). HPV status was assessed and correlated with hypoxic markers. (3) Results: 40 patients were included. A strong expression of CA-IX, GLUT-1, VEGF, and VEGF-R1 was detected in 30%, 32.5%, 50%, and 37.5% of cases, respectively. HIF-1α was detected in 27.5% of cases. High CA-IX expression was associated in univariate analysis with poor OS (p = 0.035), but there was no significant association between GLUT-1, VEGF, VEGF-R1, and HIF-1α expression, and OS/LRRFS. There was no correlation found between HPV status and hypoxia-induced endogenous markers (all p > 0.05). (4) Conclusions: This study provides data on the expression of hypoxia-induced endogenous markers in patients treated for SNSCC and underlines the potential role of CA-IX as a prognostic biomarker for SNSCC. [ABSTRACT FROM AUTHOR]

In electrical power engineering, elements such as reliability analysis, modeling, and optimization for complex systems are of the utmost importance. Although there exist myriad studies regarding reliability optimization with conventional methods, researchers are still seeking to find more efficient and accurate methods to address the issue of the redundancy allocation problem. To that effect, an ideal power energy management approach is put forward for the operation of a hybrid microgrid system with different kinds of productions. In the present study, we suggest three algorithms in order to optimize the series-parallel power energy system: the Firefly (FA), Bat (BA), and Interior Search (ISA) algorithms. Moreover, the reliability estimate of the system is solved with the Ushakov algorithm (UMGF). The components may completely fail, which decreases their performance rate. Furthermore, the optimization results are achieved using objective functions that include the total cost of the system, emission gases (NOX, SO2, and CO2) of the power production from fuel cells, diesel generators, and gas turbines, and take into consideration the dependability indices. Devices used in power subsystems are characterized based on their dependabilities, performances, capital costs, and maintenance costs. Reliability hinges on a functioning system, which naturally entails meeting customer demand; as a result, it is influenced by the accumulated batch curve. This method provides an idea with regards to the economic cost optimization of microgrid systems. Finally, we present the results of numeric simulations. [ABSTRACT FROM AUTHOR]

The design of molecular cages with low symmetry could allow for more specific tuning of their properties and better mimic the unsymmetrical and complex environment of protein pockets. However, the added value of lowering symmetry of molecular receptors has been rarely demonstrated. Herein, C3‐ and C1‐symmetrical cages, presenting the same recognition sites, have been synthesized and investigated as hosts for carbohydrate recognition. Structurally related derivatives of glucose, galactose and mannose were found to have greater affinity to the receptor with the lowest symmetry than to their C3‐symmetrical analogue. According to the host cavity modelling, the C1 symmetry receptor exhibits a wider opening than its C3‐symmetrical counterpart, providing easier access and thus promoting guest proximity to binding sites. Moreover, our results show the high stereo‐ and substrate selectivity of the C1 symmetry cage with respect to its C3 counterpart in the recognition of sugars. [ABSTRACT FROM AUTHOR]

Recently, porous organic crystals (POC) based on macrocycles have shown exceptional sorption and separation properties. Yet, the impact of guest presence inside a macrocycle prior to adsorption has not been studied. Here we show that the inclusion of trimethoxybenzyl‐azaphosphatrane in the macrocycle cucurbit[8]uril (CB[8]) affords molecular porous host⋅guest crystals (PHGC‐1) with radically new properties. Unactivated hydrated PHGC‐1 adsorbed iodine spontaneously and selectively at room temperature and atmospheric pressure. The absence of (i) heat for material synthesis, (ii) moisture sensitivity, and (iii) energy‐intensive steps for pore activation are attractive attributes for decreasing the energy costs. 1H NMR and DOSY were instrumental for monitoring the H2O/I2 exchange. PHGC‐1 crystals are non‐centrosymmetric and I2‐doped crystals showed markedly different second harmonic generation (SHG), which suggests that iodine doping could be used to modulate the non‐linear optical properties of porous organic crystals. [ABSTRACT FROM AUTHOR]

Recently, porous organic crystals (POC) based on macrocycles have shown exceptional sorption and separation properties. Yet, the impact of guest presence inside a macrocycle prior to adsorption has not been studied. Here we show that the inclusion of trimethoxybenzyl‐azaphosphatrane in the macrocycle cucurbit[8]uril (CB[8]) affords molecular porous host⋅guest crystals (PHGC‐1) with radically new properties. Unactivated hydrated PHGC‐1 adsorbed iodine spontaneously and selectively at room temperature and atmospheric pressure. The absence of (i) heat for material synthesis, (ii) moisture sensitivity, and (iii) energy‐intensive steps for pore activation are attractive attributes for decreasing the energy costs. 1H NMR and DOSY were instrumental for monitoring the H2O/I2 exchange. PHGC‐1 crystals are non‐centrosymmetric and I2‐doped crystals showed markedly different second harmonic generation (SHG), which suggests that iodine doping could be used to modulate the non‐linear optical properties of porous organic crystals. [ABSTRACT FROM AUTHOR]

Background and Aims. If bioprotection has already been proven to limit the development of spoilage flora on musts, its effectiveness against oxidation depends on the winemaking process. To optimize its application, this study analyzed the evolution of the chemical composition of the bioprotected musts and wines, according to different settling routes. Their impacts on the organoleptic characteristics of wines were also studied. Methods and Results. A bioprotected must was subjected to 6 different maceration routes before AF (triplicates), varying the duration and temperature parameters. A temperature value ≤12°C was the main factor independently of the duration which allowed a good implantation of the bioprotectant. An increase of the maceration duration at 12°C led to browning of the must, without significant effect on the final color of the wine, which was felt as more "floral," with more length in the mouth. Conclusions. The bioprotectant implantation and its effectiveness on the sensory profile of the wine was guaranteed at maceration temperature values lower than 12°C. Significance of the Study. This study participates in the improvement of the bioprotection management in white winemaking, with the guarantee of a positive impact of the prefermentation maceration without sulphites on the organoleptic profile of the wines. [ABSTRACT FROM AUTHOR]

The globular and monocationic guest molecule trimethyl‐azaphosphatrane (AZAP, a protonated Verkade superbase) was shown to form a host:guest 1 : 1 complex with the cucurbit[10]uril (CB[10]) macrocycle in water. Molecular dynamics calculations showed that CB[10] adopts an 8‐shape with AZAP occupying the majority of the internal space, CB[10] contracting around AZAP and leaving a significant part of the cavity unoccupied. This residual space was used to co‐include planar and monocationic co‐guest (CG) molecules, affording heteroternary CB[10]⋅AZAP⋅CG complexes potentially opening new perspectives in supramolecular chemistry. [ABSTRACT FROM AUTHOR]

Background This study was conducted to estimate the direct effect of sex on the proportion of hemodialysis (HD) catheters used at dialysis initiation and to investigate whether predialysis care or socioeconomic status acted as a mediator of the sex effect. Methods Patients who started dialysis between January 1, 2017, and June 30, 2018, in France were included using the data of the Renal Epidemiology and Information Network (REIN) registry. We performed logistic regression to study the association between sex and the proportion of HD catheters used. A mediation analysis with a counterfactual approach was carried out to evaluate whether there was an indirect effect of sex through the proxies of predialysis care {hemoglobin, albumin levels, glomerular filtration rate [GFR] at dialysis initiation} and socioeconomic status. Because an interaction between sex and social deprivation has been identified, we performed a subgroup analysis on deprived and nondeprived patients. Results The study included 16 032 patients, and the sex ratio (male to female) was 10 405:5627. In the multivariable analysis, women were associated with a greater risk of starting dialysis with a catheter {odds ratio [OR], 1.32 [95% confidence interval (CI): 1.23–1.42]}. There was an indirect effect of sex on the proportion of HD catheters through proxies for predialysis care {albuminemia <30 g/L [OR, 1.08 (95% CI: 1.05–1.10)], hemoglobin <11 g/dL [OR, 1.03 (95% CI: 1.02–1.04)], glomerular filtration rate <7 mL/min [OR, 1.05 (95% CI: 1.04–1.07)]}. Among deprived patients, there was no direct effect of sex on catheter proportion. Conclusions Women were associated with a higher risk of starting dialysis through an HD catheter. The effect of sex was mediated by predialysis care, particularly for deprived patients. [ABSTRACT FROM AUTHOR]

Background We aimed to evaluate sex differences in peritoneal dialysis (PD) outcomes and to explore direct and indirect effects of nurse-assisted PD on outcomes. Methods This was a retrospective study using data from the Registre de Dialyse Péritonéale de Langue Française of incident PD patients between 2005 and 2016. Cox proportional hazards modelling was used to analyse transfer to haemodialysis (HD), death, PD failure, peritonitis and renal transplantation. Mediation analyses with a counterfactual approach were carried out to evaluate natural direct and indirect effects of sex on transfer to HD and peritonitis, with nurse-assisted PD as a mediator a priori. Results Of the 14 659 patients included, there were 5970 females (41%) and 8689 males (59%). Women were more frequently treated by nurse-assisted PD than men [2926/5970 (49.1%) versus 3357/8689 (38.7%)]. In the multivariable analysis, women had a lower risk of transfer to HD [cause-specific hazard ratio {cs-HR} 0.82 {95% confidence interval (CI) 0.77–0.88}], death [cs-HR 0.90 (95% CI 0.85–0.95)], peritonitis [cs-HR 0.82 (95% CI 0.78–0.87)], PD failure [cs-HR 0.86 (95% CI 0.83–0.90)] and a lower chance of undergoing transplant [cs-HR 0.83 (95% CI 0.77–0.90)] than men. There was a direct effect of sex on the risk of transfer to HD [cs-HR 0.82 (95% CI 0.82–0.83)], with an indirect effect of nurse-assisted PD [cs-HR 0.97 (95% CI 0.96–0.99)]. Nurse-assisted PD had no indirect effect on the risk of peritonitis. Conclusions Our results suggest that compared with men, women have a lower risk of both transfer to HD and peritonitis. Mediation analysis showed that nurse assistance was a potential mediator in the causal pathway between sex and transfer to HD. [ABSTRACT FROM AUTHOR]

Haloazaphosphatranes are the halogenated parents of proazaphosphatranes, also known as Verkade's superbase. While the synthesis of iodo‐, bromo‐ and chloroazaphosphatranes was reported more than thirty years ago by J. G. Verkade, the first synthesis of fluoroazaphosphatranes was only described in 2018 by Stephan et al. Currently, no common and versatile procedure exists to access fluoroazaphosphatranes platform with different structural characteristics. In this report, a new and simple synthesis of this class of compounds was developed based on the nucleophilic attack of the fluoride anion on chloroazaphosphatrane derivatives with good to high isolated yields for the corresponding fluoroazaphosphatranes (70–92%). The scope of the reaction was widened to fluoroazaphosphatranes bearing various substituents and X‐ray molecular structures of two of them are reported. The stability of fluoroazaphosphatranes toward nucleophilic solvents like water has been investigated. As they revealed much more robust cations than their chloroazaphosphatrane parents, their chloride salts were tested as organocatalysts for the formation of cyclic carbonates from epoxides and CO2. Fluoroazaphosphatranes proved to be both efficient and stable catalytic systems for CO2 conversion with catalytic activities similar to those of azaphosphatranes, and no decomposition of the cation was observed at the end of reaction. [ABSTRACT FROM AUTHOR]

Viruses and virus-like organisms are a major problem in viticulture worldwide. They cannot be controlled by standard plant protection measures, and once infected, plants remain infected throughout their life; therefore, the propagation of healthy vegetative material is crucial. In vivo thermotherapy at 36–38 °C for at least six weeks, followed by meristem tip micrografting (0.1–0.2 mm) onto in vitro-growing seedling rootstocks of Vialla (Vitis labrusca × Vitis riparia), was successfully used to eliminate eight viruses (grapevine rupestris stem pitting-associated virus (GRSPaV), grapevine Pinot gris virus (GPGV), grapevine fanleaf virus (GFLV), grapevine leafroll-associated virus 3 (GLRaV-3), grapevine fleck virus (GFkV), grapevine rupestris vein feathering virus (GRVFV), grapevine Syrah virus-1 (GSyV-1), and raspberry bushy dwarf virus (RBDV)), as well as two viroids (hop stunt viroid (HSVd) and grapevine yellow speckle viroid 1 (GYSVd-1)) from preclonal candidates of six grapevine varieties (Vitis vinifera L.). A half-strength MS medium including vitamins supplemented with 30 g/L of sucrose and solidified with 8 g/L of agar, without plant growth regulators, was used for the growth and root development of micrografts and the subsequently micropropagated plants; no callus formation, hyperhydricity, or necrosis of shoot tips was observed. Although the overall regeneration was low (higher in white than in red varieties), a 100% elimination was achieved for all eight viruses, whereas the elimination level for viroids was lower, reaching only 39.2% of HSVd-free and 42.6% GYSVd-1-free vines. To the best of our knowledge, this is the first report of GPGV, GRVFV, GSyV-1, HSVd, and GYSVd-1 elimination through combining in vivo thermotherapy and in vitro meristem tip micrografting, and the first report of RBDV elimination from grapevines. The virus-free vines were successfully acclimatized in rockwool plugs and then transferred to soil. [ABSTRACT FROM AUTHOR]

Cryptophane cages can adopt either an anti or syn configuration that present different recognition properties. While the synthesis of anti-cryptophanes is well reported, the synthesis of syn-cryptophanes remains a challenge. Herein, we demonstrate that the use of HFIP as a co-solvent during the second ring closure reaction significantly affects the regioselectivity, providing easier access to the syn-cryptophane stereomers. [ABSTRACT FROM AUTHOR]

This study focused on an industrial area, i.e., Champagne-Ardenne, France, containing 25 wind turbines with a lifespan of 25 years. We assessed the economic situation from the beginning of the operation of this plant to the end of its lifetime using the levelized cost of energy (LCOE) indicator, which assesses the average cost of energy production during a project. We also considered the environmental cost associated with the wind sector. The objective of this study was to explore the effects of all parameters, including the calculation of the LCOE indicator, to provide decision-makers and local authorities with optimization solutions. We also developed an optimization algorithm to provide the best combination of all LCOE parameters for producing sustainable energy at the lowest cost. [ABSTRACT FROM AUTHOR]

The mouse preimplantation embryo is sensitive to its environment, including maternal dietary protein restriction, which can alter the developmental programme and affect lifetime health. Previously, we have shown maternal low-protein diet (LPD) causes a reduction in blastocyst mTORC1 signalling coinciding with reduced availability of branched-chain amino acids (BCAAs) in surrounding uterine fluid. BCAA deficiency leads to increased endocytosis and lysosome biogenesis in blastocyst trophectoderm (TE), a response to promote compensatory histotrophic nutrition. Here, we first investigated the induction mechanism by individual variation in BCAA deficiency in an in vitro quantitative model of TE responsiveness. We found isoleucine (ILE) deficiency as the most effective activator of TE endocytosis and lysosome biogenesis, with less potent roles for other BCAAs and insulin; cell volume was also influential. TE response to low ILE included upregulation of vesicles comprising megalin receptor and cathepsin-B, and the response was activated from blastocyst formation. Secondly, we identified the transcription factor TFEB as mediating the histotrophic response by translocation from cytoplasm to nucleus during ILE deficiency and in response to mTORC1 inhibition. Lastly, we investigated whether a similar mechanism responsive to maternal nutritional status was found in human blastocysts. Blastocysts from women with high body-mass index, but not the method of fertilisation, revealed stimulated lysosome biogenesis and TFEB nuclear migration. We propose TE lysosomal phenotype as an early biomarker of environmental nutrient stress that may associate with long-term health outcomes. [ABSTRACT FROM AUTHOR]

Microglia are the brain immune cells and their function is highly dependent on cell motility. It was hypothesised that morphological variability leads to differences in motility, ultimately impacting on the microglial function. Here, we assessed microglial morphology in 32 controls, 44 Alzheimer's disease (AD) cases and 16 AD cases from patients immunised against Aβ42 (iAD) using 2D and 3D approaches. Our 2D assessment showed an increased number of microglia in iAD vs. AD (P = 0.032) and controls (P = 0.018). Ramified microglia were fewer in AD vs. controls (P = 0.041) but increased in iAD compared to AD (P < 0.001) and controls (P = 0.006). 3D reconstructions highlighted larger cell bodies in AD vs. controls (P = 0.049) and increased total process length in iAD vs. AD (P = 0.032), with negative correlations detected for pan-Aβ load with total process length (P < 0.001) in AD and number of primary processes (P = 0.043) in iAD. In summary, reactive/amoeboid microglia are the most represented population in the aged human brain. AD does not affect the number of microglia, but the ramified population is decreased adopting a more reactive morphology. Aβ removal by immunotherapy leads to increased ramified microglia, implying that the cells retain plasticity in an aged disease brain meriting further investigation. [ABSTRACT FROM AUTHOR]

In the framework of ESS, a vacuum furnace dedicated to High Temperature Heat Treatment under Vacuum (VH2T2) of SRF bulk niobium (Nb) cavities was developed and commissioned in May 2016. This furnace is mainly used for the reduction of interstitial hydrogen in niobium. VH2T2 is an effective process for curing SRF cavities from the so-called Q0-deases phenomenon, which is due to Nb hydrid formation on the RF surface during the cool down of the resonator to cryogenic temperatures. IJCLab VH2T2 process is done at 650 °C during 10h00. The main differences between IJCLab recipe and the standard VH2T2 (SVH2T2) are 2 folds: 1) SVH2T2 is performed at 800 °C during 3h00, 2) IJCLab recipe is applied to spoke resonators equipped with Ti LHe tank. This process, will be applied to the whole series (26 cavities) of ESS 352 MHz Double-Spoke resonators. More than 28 cavities of various type (ESS Double-Spoke resonators, MYRRHA single spoke, ESS elliptical medium and high β cavities) were successfully heat treated according to our recipe and the last results are reported. Moreover, since 2 years we have launched the R&D program HELOISE with the financial support of IN2P3/CNRS. HELOISE is dedicated to Heat Treatment of SRF niobium cavities: it includes Low Temperature Baking, VH2T2, Nitrogen Infusion and Nitrogen Doping processes. HELOISE main objectives are: 1) understand the complex mechanisms of the physical phenomena involved in heat treatment processes, 2) investigate the effect of the parameters impacting the process, 3) develop and master, at large scale and with good reliability, heat treatment processes in order to produce low RF losses and high gradient SRF bulk niobium cavities. Finally, we will focus on the first experimental data on Nitrogen Infusion we obtained: the corresponding results are reported and discussed. [ABSTRACT FROM AUTHOR]

In this paper, two metaheuristics, namely the Bat algorithm (BAT) and a recent hybridization of bat algorithm with generalized walk evolutionary algorithm are presented. The bat algorithm and the Bat algorithm with generalized flight (BAG) are used to solve the problem of optimal redundancy design of series-parallel electrical systems. In order to assess the reliability of the heterogeneous system of multi-state series-parallel, the Ushakov method a universal moment generating function (UMGF) is used to allow fast estimation. The design objective is to maximize the reliability of the bulk power generation system from wind farm. The components of each electrical subsystem are characterized by their performance (capacity), cost and reliability. Reliability is defined as the ability to satisfy consumer demand that is given by a cumulative load curve. By comparing three algorithms cited in this study, the results show that the hybridization of Bat and Generalized Evolutionary Walk Algorithm (BAG) are effective in solving the reliability redundancy optimization problem (RROP). Two illustrative examples are presented. [ABSTRACT FROM AUTHOR]

FILtering by COHerence (FILCOH) is a novel technique for mitigating ground clutter echoes of weather radar, particularly those transmitting in multiple pulse repetition time (PRT) schemes. FILCOH takes advantage of the differences in correlation time for separating rain and ground echoes. In short, the longest time-lag coefficients of the autocorrelation function are used to estimate the ground clutter contribution which is then subtracted from the shortest lag coefficients before the extraction of the meteorological parameters using the conventional estimators. The initial results are obtained for uniform PRT data provided by the Degreane Horizon wind profiler radar. The analysis illustrates the behavior of FILCOH filtering and its high performance in such cases. The simulation results are then presented for 2- and 3-PRT pulse schemes using standard PRT ratios. For the 2-PRT scheme, FILCOH filters out the ground clutter echoes up to a clutter to signal ratio (CSR) of 65 dB for the received power and up to 45 and 60 dB for the radial velocity and spectrum width, respectively. For the 3-PRT scheme, ground clutter filtering is effective up to $CSR = 45$ dB for the received power and up to $CSR = 35$ dB for radial velocity and spectrum width. These results are confirmed by 3-PRT real data issued from the French X- and C-band radars. The observed performances are, however, a little less than those of the simulation since we observed a maximum 40-dB attenuation of the ground clutter echoes of the studied rain events. [ABSTRACT FROM AUTHOR]

Umbilical cord prolapse is an acute obstetric emergency associated with high fetal morbidity and mortality. To avoid poor outcomes, rapid diagnosis with immediate intervention is required, especially in the prehospital setting where resources are limited. In this case report, we describe a 38-year-old woman with umbilical cord prolapse, with a review of appropriate prehospital maneuvers and treatment. [ABSTRACT FROM AUTHOR]