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Biosecurity is the cornerstone of prevention strategies to limit infectious pathogen spread between poultry farms. However, poor compliance of biosecurity measures is often observed when entering or exiting barns. The lack of knowledge, understanding, risk perception or technical skill are often described for anteroom-related biosecurity errors (i.e., not respecting anteroom zoning in relation to changing boots, clothing, and hand sanitation). In this study, we designed and assessed the efficacy of an intervention aiming at improving biosecurity compliance in anterooms, using substances glowing under ultraviolet light, which mimic microbiological contamination. Training exercises offered in a single session were proposed to 145 participants with an interest in animal farming (veterinary students, agricultural students, poultry farmers and poultry farm advisors). The exercises' efficacy was assessed by measuring the change in attitude and intentions of participants about specific biosecurity measures. The participants' attitudes and intentions were quantified using a questionnaire before and after training. The change in score was assessed in a multivariate linear regression model to measure the effect of various parameters on this change. The attitudes and intentions of participants were statistically improved (p < 0.05) and were affected by the initial attitude and intention score, the gender of the participants and the status of the participant (type of student or activity in the poultry industry). The use of this exercise material, perceived as playful and engaging, could be included in the framework of biosecurity training for all stakeholders of the poultry industry., Competing Interests: Declaration of Competing Interest The author whose names are listed immediately below certify that they have no affiliation or involvement in any organization or entity with financial interest (such as honoraria, educational grants, participation in speakers’ bureaus, membership, employment, consultancies, stock ownership, or equity interest, and expert testimony of patent-licensing arrangements), or non-financial interest (such as personal of professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript., (Copyright © 2024. Published by Elsevier B.V.)

Introduction: Despite extensive research on the effect of supervised exercise therapy on walking performance in patients with symptomatic peripheral arterial disease (PAD), it remains unclear which training modality provides the greatest improvement in walking capacity. The objective of this study was to compare the effect of different types of supervised exercise therapy on walking capacity in individuals with symptomatic PAD., Methods: A random-effect network meta-analysis was performed. The following databases were searched from January 1966 to April 2021: SPORTDiscus, CINAHL, MEDLINE, AMED, Academic Search Complete and, Scopus. Trials had to include at least one type of supervised exercise therapy for patients with symptomatic PAD, with an intervention lasting ≥2 wk with ≥5 training sessions, and an objective measure of walking capacity., Results: Eighteen studies were included for a total sample of 1135 participants. Interventions duration ranged from 6-24 wk and included aerobic exercise (treadmill walking, ergometer, and Nordic walking), resistance training (lower and/or upper body), a combination of both, and underwater exercise. Results showed that combined training improved treadmill walking capacity to a comparable extent to aerobic walking (+122.0 [24.2-219.8] m vs +106.8 [34.2-179.4] m), but with a larger effect size (1.20 [0.50-1.90] vs 0.67 [0.22-1.11]). Similar results were observed for the 6-min walk distance, with combined training being the most promising modality (+57.3 [16.2-98.5] m), followed by underwater training (+56.5 [22.4-90.5] m) and aerobic walking (+39.0 [12.8-65.1] m)., Conclusion: While not statistically superior to aerobic walking, combined exercise seems to be the most promising training modality. Aerobic walking and underwater training also improved walking capacity for patients with symptomatic PAD., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To assess the perception of Advanced Nurse Practitioners (ANP) by physicians and nurses in vascular medicine. As the status of ANP in France was recently enacted by law in 2018, we aimed to investigate physicians and nurses working with patients suffering from Peripheral Artery Disease (PAD) to gather their opinions and draw the cooperation outlines these practitioners could have with an ANP., Methods: A qualitative study based on in-depth interviews was conducted among healthcare practitioners taking care of patients with PAD: 10 physicians working either in a private practice settings or hospital settings or both, and eight nurses working within a hospital inpatients vascular unit. Verbatim responses were extracted and coded according to a continuous thematization method., Results: Three main features emerged from participants' responses. Vascular medicine has a specific organization with a significant lack of time and staff to fulfill the mission regarding patients' severity of illness. Second, the ANP is wanted to fill part of this gap. The expected benefits include a smoother care pathway and increased capacity for cardiovascular education and prevention, especially during consultations. Lastly, some clarification is required to integrate such new practitioners within vascular teams already in place., Conclusion: Advanced nurse practitioners could be the missing link in a "Vascular team" by creating a continuum in the care of patients with PAD, ensuring clinical assessment, nursing supervision, adverse event screening, and renewing drug prescriptions with the required adaptations while ensuring essential part of therapeutic education adapted to each patient., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kubiak, Sitruk, Durivage, Khider, Mohamedi, Détriché, Messas, Mirault and Goudot.)

Objective: Coronavirus disease 19 is a well-established cause of rare arterial thrombosis. Nevertheless, the exact mechanism of arterial thrombosis remains to be elucidated. We herein report the case of a large floating thrombus of the aortic arch, its surgical management and histological analysis. Case: A 65-year-old patient presented to the emergency department with a suspected stroke. He was non-smoker, but presented cardiovascular risk factors, namely hypertension, type 2 diabetes and hyperlipidaemia. A computed tomography of the aorta revealed a large floating thrombus of the aortic arch, at the base of the brachiocephalic trunk, suspected to be the etiology of stroke. Therapeutic anticoagulation was immediately started. The decision was made to perform an open aortic replacement surgery because of the symptomatic thromboembolic event with recent cerebral infarction and the potential harmfulness of the thrombus due to its size. A mobile thrombus was observed at the base of the brachiocephalic trunk by echocardiography. It was attached to a small area of the upper aortic wall and had an irregular surface. Histology revealed a platelet-rich thrombus lying on an aortic atherosclerotic plaque without pronounced inflammation. No plaque ulceration was present but endothelial cell desquamation was observed consistent with plaque erosion. Conclusion: In our case, there was a thrombus lying on an atherosclerotic plaque with intact thick fibrous cap, but associated with a plaque erosion mechanism. The thrombus formation appeared more likely to relate to a very localized endothelial injury., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Goudot, Amrane, El Ayoubi, Bel, Gendron, Khider, Durivage, Smadja, Messas, Achouh and Mirault.)

Acute limb ischemia induced by arterial vasospasm remains an exceptional situation, favoured by the use of arterial vasoconstrictors. The risk of these substances is largely underestimated in the general population, especially with the co-administration of strong cytochrome inhibitors like human immunodeficiency virus (HIV) protease inhibitors. A 33-year-old woman, who used to take dihydroergotamine for orthostatic hypotension, was prescribed a post-exposure HIV prophylaxis including lopinavir and ritonavir. One day later, she presented an acute bilateral limb ischemia with a sudden pain in both calves, initially while walking and then at rest with bilateral ischemic toes. Angiography confirmed diffuse arterial vasospasm of the lower limb arteries. A first-line therapy with isosorbide dinitrate and amlodipine was ineffective, with rapid clinical worsening. A combination of intra-arterial injections and intra-venous infusions of vasodilators, transluminal balloon angioplasty and bilateral 4-Compartment fasciotomies permitted rapid improvement and finally resulted in both lower limbs rescue. This case and literature review illustrate ergotism due to ergotamine overdose after taking HIV protease inhibitors. It also demonstrates the benefit of an interventional procedure besides medical therapy with vasodilators in severe arterial vasospasm. All along the lower limb arterial tree, transluminal balloon angioplasty restored the blood flow, without vasospasm recurrence. CONCLUSION: In case of ergotism with acute lower limbs ischemia, combining medical vasodilator therapy with interventional procedure can restore the arterial blood flow, thus allowing to save lower limbs., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Biosecurity is crucial for infectious disease prevention, more importantly in the absence of vaccination. The need for improving the implementation of biosecurity practices was highlighted in French duck farms following the 2016-2017 H5N8 Highly Pathogenic Avian Influenza (HPAI) epidemic. Farmers have multiple reasons for not implementing biosecurity practices: external (time, money) and internal (socio-psychological). The purpose of this study was to determine how sets of socio-psychological factors (i.e. knowledge on biosecurity and avian influenza transmission, attitudes, personality traits, social background) affect the adoption of on-farm biosecurity practices. Biosecurity practices and socio-psychological determinants were assessed during 127 duck farm visits, in South West France, using both questionnaires and on-farm observations. Factorial analysis of mixed data (FAMD) and hierarchical clustering analysis (HCA) identified three groups of farmers with different socio-psychological profiles: the first group was characterized by minimal knowledge, negative attitudes towards biosecurity, little social pressure and a low level of conscientiousness. The second group was characterized by more extensive experience in poultry production, higher stress and social pressure. The third group was characterized by less experience in poultry production, better knowledge and positive attitudes towards biosecurity, increased self-confidence and orientation towards action. The first group had a significantly lower adoption of biosecurity measures than the two other groups. A better understanding of the factors involved in farmers' decision-making could improve the efficiency of interventions aiming at improving and maintaining the level of on-farm biosecurity in the duck industry., (© 2020 Blackwell Verlag GmbH.)

Extra-hepatic portal vein thrombosis (EHPVO) represents the obstruction of the portal vein outside the liver and is not related to chronic liver disease or neoplasia. In chronic EHPVO, collateral veins and portal hypertension develop, resulting in splenomegaly and variceal formation. Myeloproliferative neoplasms (MPN) are the most frequent acquired etiology of EHPVO. These conditions put pregnant women at increased risk of vascular complications, including venous thrombosis, occlusion of the placental circulation, and variceal bleeding. In this report, we present a 36-year-old pregnant woman with chronic, anticoagulated EHPVO secondary to latent MPN who developed severe intrauterine growth restriction and had cesarean section at 32+1 weeks for increased umbilical doppler resistance and breech presentation. The article will emphasize outcome and management of pregnancies complicated by chronic EHPVO, portal hypertension, and MPN.

Biosecurity compliance is generally poor in all types of animal production systems around the world. Therefore, it is essential to define strategies to improve the implementation of biosecurity measures. This study evaluated the value of audits and visible cameras on compliance with biosecurity measures required when entering and exiting poultry barns on 24 poultry farms in Québec, Canada. Short term (first two weeks) and medium term (six months later) compliance were determined. Application of biosecurity measures was evaluated using hidden cameras. Video viewing revealed a total of 2748 visits by 259 different individuals. Results showed that bimonthly audits did not have any impact on medium term compliance. Visible cameras had a significant impact on changing boots (OR=9.6; 1.9-48.4) and respecting areas (contaminated vs. clean) during the visit (OR=14.5; 1.2-175.1) for the short term period. However, six months later, compliance declined and was no longer significantly different from controls. Duration and moment of the visit, presence of the grower or an observer, barn entrance design, number of barns, number of biosecurity measures requested, type of boots worn, gender and being a member of a grower's family were significantly associated with biosecurity compliance., (Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.)

Biosecurity compliance is an issue in all types of animal production. Poor compliance is frequently related to lack of knowledge or comprehension. Human dimensions, such as personality and attitudes were also suggested as being related to compliance. As part of a larger study, personality traits, experience, education and training of employees, visitors and growers were evaluated to assess their relationship with their compliance with biosecurity measures when entering and exiting poultry barns. Biosecurity compliance was evaluated using hidden cameras. One hundred fourteen individuals involved in a total of 2379 visits on 23 poultry farms responded to a personality test. Results demonstrated that several determinants of compliance exist, and some are related to personality, experience and education. Three personality traits were significantly associated with compliance: responsibility, complexity and action-oriented. Such information has important implications for the selection of job applicants or task attribution and to enhance effectiveness of training programs., (Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.)

The effectiveness of biosecurity measures depends largely on the consistency of their applications by all those involved in poultry production. Unfortunately, poor biosecurity compliance has been reported repeatedly in poultry, as well in all other major animal productions. As part of a larger study, we conducted an investigation on eight poultry farms in Quebec, Canada, to evaluate compliance of existing biosecurity measures using hidden cameras. The objectives were to evaluate and describe the application of biosecurity measures when entering and exiting poultry barns. A total of 44 different mistakes were observed from 883 visits done by 102 different individuals. On average, four errors were recorded per visit. The maximum number of errors made by one individual during one visit was 14. People observed over several visits made on average six different errors. Twenty-seven out of the 44 errors (61.4%) were related to area delimitation (clean versus contaminated), six to boots (13.6%), five to hand washing (11.4%), three to coveralls (6.8%) and three to logbooks (6.8%). The nature and frequency of errors suggest a lack of understanding of biosecurity principles. There is thus a need to improve biosecurity training by making educational material available to all poultry personnel demonstrating why and how to apply biosecurity measures., (© 2011 Elsevier B.V. All rights reserved.)

All therapists working in psychiatry will have to deal orte day with an aggressive patient. Besides, the probability of such an encounter is more and more to be expected in view of the increase of violence in psychiatry. Witnessing this, the author set about researching the subject. He presents in this article a review of literature on this theme (aetiologic hypothesis, statistics, etc.) and illustrates his ideas with specific examples. He ends his article by wishing that a better understanding of this problem may help the therapists to improve treatment of these patients and to prevent their act of violence.

HLA antigen typing was carried out in a family with an autosomal dominant form of spinocerebellar degeneration [possibly olivoponto cerebellar atrophy (O.P.C.A.)--Type 1]. Eleven ataxic patients, three possibly ataxic subjects, two unrelated spouses and 13 clinically normal at risk siblings were typed for ABO and Rh blood groups, HLA-A and HLA-B antigens, C4 component of the complement and a number of other serum proteins (Clq, beta-1A, beta-1C, C5, beta-lipoproteins). No solid evidence for linkage between the ataxia gene and the HLA or C4 loci could be demonstrated in this family. Certain serum proteins, and particularly beta-lipoproteins were found to be significantly reduced in some sub-groups of subjects.

We report a clinical and biochemical survey of 23 patients with Friedreich's ataxia from southern Italy. They were studied clinically and by means of a clinical rating scale devised by us (Inherited Ataxias Clinical Rating Scale). Laboratory tests, based on the Quebec Cooperative Study, were also performed on our patients. No major clinical or biochemical differences were found between Italian and Canadian patients. Investigation of CSF monoamine metabolites showed that HVA decreased after probenecid and metoclopramide loading.

This paper reviews risk factors associated with assaultive behaviour. The author will look at specific risk factors to evaluate when assessing patients with an aggressive potential and he will examine patient-staff relationships that might trigger assaultive behaviour. The author believes that a better knowledge of risk factors allows us to develop preventive attitudes, and these will be discussed in the latter part of this paper.

The purpose of this research was to determine whether brain stimulation reward and exploration are induced by activation of the same set of neurons along the medial forebrain bundle. The behavioral version of the collision test was utilized with electrodes in the lateral hypothalamus (LH) and the ventral tegmental area (VTA). A collision effect obtained between LH and VTA in one behavior at the exclusion of the other was treated as evidence of the involvement of two different sets of fibers. In 4 rats, a collision effect was observed only in self-stimulation, whereas in 1 rat, a collision was obtained in exploration at the exclusion of self-stimulation. Three animals showed no collision in either behavior. These data suggest that coexistence of self-stimulation and exploration following medial forebrain bundle stimulation can be explained by current spread on two different sets of fibers.

With the use of moveable electrodes, 28 rat mesencephalic sites were examined for self-stimulation behavior (SS). The relative importance of each site in SS was established according to (1) a traditional method which consists of comparing sites based on the rates of responding (2) a psychophysical procedure based on the pulse frequency required at each site in order for the stimulation to elicit a criterion behavioral performance. It was shown that anatomical conclusions reached by the use of behavioral output procedures depend purely on the arbitrary choice of stimulation parameters. It was also demonstrated that the combination of moveable electrodes with psychophysical measurements results in enhanced mapping resolution and enables one to trace the boundaries of behaviorally relevant structures and pathways with significantly better confidence.