Search

A complete low-power, low-cost and wireless solution for bridge structural health monitoring is presented. This work includes monitoring nodes with modular hardware design and low power consumption based on a control and resource management board called CoreBoard, and a specific board for sensorization called SensorBoard is presented. The firmware is presented as a design of FreeRTOS parallelised tasks that carry out the management of the hardware resources and implement the Random Decrement Technique to minimize the amount of data to be transmitted over the NB-IoT network in a secure way. The presented solution is validated through the characterization of its energy consumption, which guarantees an autonomy higher than 10 years with a daily 8 min monitoring periodicity, and two deployments in a pilot laboratory structure and the Eduardo Torroja bridge in Posadas (Córdoba, Spain). The results are compared with two different calibrated commercial systems, obtaining an error lower than 1.72% in modal analysis frequencies. The architecture and the results obtained place the presented design as a new solution in the state of the art and, thanks to its autonomy, low cost and the graphical device management interface presented, allow its deployment and integration in the current IoT paradigm.

Introduction: According to the 2018-2019 People Mobility Survey, work-related journeys (commuting and on-duty journeys) account for approximately 25% of all journeys. The use of non-motorised (nm) and motorised (m) personal mobility devices (PMDs) has steadily increased since their introduction into the French market in the last decade., Objective: This study aimed to describe the characteristics of work-related road accidents and their evolution since the introduction of new PMDs in France and the increase in the use of scooters., Materials and Methods: This was a retrospective, cross-sectional study using data from the Rhône Road Trauma Registry. Data were collected from 2015 to 2020. We included the data for the victims aged 18-70 years who were injured in work-related road accidents., Results: We identified 11 296 individuals aged 18-70 years who experienced work-related road accidents. An injury report was provided for a total of 11 277 patients. A total of 546 passengers and 78 drivers of other motorised vehicles (buses/trams, construction equipment and tractors) were excluded from the analysis. Seven patients died at the time of the accident and seven died after hospitalisation. Of the 10 653 (94.4%) victims, there were pedestrians (5.1%) or riders of bicycles (16.9%), scooters (3.8%), other PMDs (roller blades, skateboards, monowheels, gyropods and hoverboards; 0.4%) and motorised two wheelers (21.4%), or drivers of car (45.3%), and truck (1.5%). More than half of the scooter riders and 80% of other PMD riders were men. More than 60% of other PMD riders and 53% of scooter riders were under 34 years of age. Most scooter road accidents occurred during commuting (95.6%). 65% of the scooter accidents and 50% of other PMD accidents did not have opponents. Overall, one-quarter of the victims experienced accidents without opponents. Most scooter riders had injuries to their upper limbs (59.2%), lower limbs (46.8%), face (21.2%) or head (17.9%)., Discussion: This original study on work-related road accidents allowed us to characterise the increase in work-related road accidents associated with new modes of travel, particularly scooters. The results observed for users of scooters and other PMDs in this study were generally consistent with those found in the scientific literature. Despite limited data, the results suggest that accidents involving scooters or other PMDs are of low severity., Conclusion: Many head injuries could be prevented with more widespread use of helmets, among scooter and other PMD users and bicycle users., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Cyclin-dependent kinases 4/6 inhibitors (CDK 4/6i) combined with endocrine therapy have become the gold standard in hormone receptor-positive (HR +) HER2-negative (HER2-) metastatic breast cancer (MBC). However, there is a significant lack of data regarding the efficacy and safety of these treatments in elderly patients. We present the results of a real-world data (RWD) cohort stratified by age at treatment initiation (≥ 70 years compared to patients < 70 years)., Methods: Clinico-pathological data of HR + HER2- MBC patients who were candidates for CDK4/6i therapy between January 2017 and December 2020 at the Institut Català d'Oncologia (Spain) were retrospectively collected. The primary goal was to assess Progression-Free Survival (PFS), Overall Survival (OS), and safety outcomes within this patient population., Results: A total of 274 patients with MBC who received CDK4/6i treatment were included in the study. Among them, 84 patients (30.8%) were aged ≥ 70 years, with a mean age of 75, while 190 patients (69.2%) were under the age of 70, with a mean age of 55.7 years. The most frequently observed grade 3-4 toxicity was neutropenia, with similar rates in both the < 70 group (43.9%) and the ≥ 70 group (47.9%) (p = 0.728). The median Progression-Free Survival (mPFS) for the first-line CDK4/6i treatment was 22 months (95% CI, 15.4-39.8) in the < 70 group and 20.8 months (95% CI 11.2-NR) in the ≥ 70 group (p = 0.67). Similarly, the median PFS for the second-line CDK4/6i treatment was 10.4 months (95% CI, 7.4-15.1) and 7.1 months (95% CI 4.4-21.3) (p = 0.79), respectively. Median overall survival (mOS) was not reached either for the first- and second-line treatment., Conclusions: Our RWD suggests that elderly patients, when compared to those under 70, experience similar survival outcomes and exhibit comparable tolerance for CDK4/6i therapy., (© 2024. The Author(s).)

Localisation microscopy of individual molecules allows one to bypass the diffraction limit, revealing cellular organisation on a nanometric scale. This method, which relies on spatial analysis of the signal emitted by molecules, is often limited to the observation of biological objects at shallow depths, or with very few aberrations. The introduction of a temporal parameter into the localisation process through a time-modulated excitation was recently proposed to address these limitations. This method, called ModLoc, is demonstrated here with an alternative flexible strategy. In this implementation, to encode the time-modulated excitation a digital micromirror device (DMD) is used in combination with a fast demodulation approach, and provides a twofold enhancement in localisation precision. Layout: Nowadays, we can use an optical microscope to observe how proteins are organised in 3D within a cell at the nanoscale. By carefully controlling the emission of molecules in both space and time, we can overcome the limitations set by the diffraction limit. This allows us to pinpoint the exact location of molecules more precisely. However, the usual spatial analysis method limits observations to shallow depths or causing low distortion of optical waves. To overcome these restrictions, a recent approach introduces a temporal element to the localisation process. This involves changing the illumination over time to enhance the precision of localisation. This method, known as ModLoc, is showcased here using a flexible and alternative strategy. In this setup, a matrix of micrometric mirrors, working together with a fast demodulation optical module, is used to encode and decode the time-modulated information. This combination results in a twofold improvement in localisation precision., (© 2024 Royal Microscopical Society.)

Introduction: The occupational road-accident risk on public roads and the work conditions for professional driving is still an important issue in occupational health despite lower road-accident rates. This study presents the evolution over time of the work-related constraints for these employees based on the Sumer surveys carried out in 2003, 2010 and 2017., Method: Data from the 2010 and 2017 surveys were restricted to match the scope of the 2003 survey in order to enable prevalence data to be compared in equivalent populations. The main variable of interest was "driving (car, truck, bus, and other vehicles) on public thoroughfares" for work (during the last week of work: yes/no). Work time characteristics, work rhythm, autonomy and scope for initiative, collective work group, standards and evaluations variables were completed by the occupational health physicians. A self-administered questionnaire was also provided to employees and contained the Job Content Questionnaire, which assesses decision latitude, social support and psychological demands, the reward scale of Siegrist questionnaire, the hostile behaviour with inspired questions for Leymann, sick leave and work accidents during the past 12 months and job satisfaction. Finally, prevention in the workplace was also completed by the occupational health physicians., Results: About 25% of employees in France were exposed to work-related driving in 2017, which was stable in comparison with 2003 and 2010. However, the population was older and there were more females, more often from the clerical staff/middle manager category and working in companies with fewer than 10 employees. Employees exposed to work-related driving were also more frequently exposed to sustained work schedules and physical constraints, but less exposed to psychosocial risks., Conclusions: The percentage of employees exposed to occupational road accident risk, i.e., exposure to work-related driving, remained stable at about 25% in 2017 compared with previous surveys. These employees were also more frequently exposed to sustained work schedules and physical constraints, but less exposed to psychosocial risks., Practical Applications: Prevention campaigns on work-related road accident risk should be provided to all employees in all companies since all jobs can be concerned., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Chronic pancreatitis tends to develop a number of complications that may constitute the form of presentation of the disease. Some societies have issued guidelines for diagnosis and treatment of chronic pancreatitis complications, but the level of evidence for any topic is usually low and recommendations tend to be weak. We aimed to provide defined position statements for the clinician based on updated review of published literature and on multidisciplinary expert agreement. The goal was to propose defined terminology and rational diagnostic/therapeutic circuits based on current knowledge. To this end 14 sections related to complications and special forms of chronic pancreatitis (early chronic, groove and autoimmune pancreatitis) were reviewed by 21 specialists from 6 different fields to generate 32 statements. Featured statements assert common bile duct stenosis does not require invasive treatment (endoscopic or surgical) unless cholestasis, cholangitis, lithiasis or other symptoms develop. Pancreatic duct strictures and calculi should be approached (after ruling out malignancy) if causing pain, pancreatitis, pseudocysts or other complications. Treatment of symptomatic pseudocysts must be individualized, considering associated main duct stenosis, vascular and pericystic complications. Higher risk conditions for pancreatic cancer are advance age, smoking, genetic background, recent diagnosis of chronic pancreatitis or diabetes, and appearance of new symptoms. Groove pancreatitis can initially be treated with conservative measures. Both prednisolone or rituximab can induce remission and maintenance of autoimmune pancreatitis. Internal fistula, vascular complications, bacterial overgrowth, osteoporosis and renal lithiasis require specific therapeutic approaches.

Introduction: The mental health of residents is a growing significant concern, particularly with respect to hospital and university training conditions. Our goal was to assess the professional, academic, and psychological determinants of the mental health status of all residents of the academy of Lyon, France., Materials and Methods: The Health Barometer of Lyon Subdivision Residents (BASIL) is an initiative which consists in proposing a recurrent online survey to all residents in medicine, pharmacy, and dentistry, belonging to the Lyon subdivision. The first of these surveys was conducted from May to July 2022. Participants should complete a series of validated questionnaires, including the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and the Kessler Psychological Distress Scale (K6), respectively, and ad-hoc questions assessing their global health and hospital and academic working conditions. A Directed Acyclic Graph (DAG) analysis was conducted prior to multivariable analyses, to explore the determinants associated with low wellbeing (WEMWBS <43) and high psychological distress (K6 ≥ 13)., Results: A total of 904 residents (response rate: 46.7%) participated in the survey. A low level of wellbeing was observed in 23% of participants, and was significantly associated to job strain (OR = 2.18; 95%CI = [1.32-3.60]), low social support (OR = 3.13; 95%CI = [2.05-4.78]) and the experience of very poor university teaching (OR = 2.51; 95%CI = [1.29-4.91]). A high level of psychological distress was identified for 13% of participants, and associated with low social support (OR = 2.41; 95%CI = [1.48-3.93]) and the experience of very poor university teaching (OR = 2.89, 95%CI = [1.16-7.21])., Conclusion: Hospital working conditions, social support, and the perception of teaching quality, were three major determinants of wellbeing and psychological distress among health profession residents. Demographic determinants, personal life and lifestyle habits were also associated. This supports a multilevel action in prevention programs aiming to enhance wellbeing and reduce mental distress in this specific population and local organizational specificities., 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 © 2024 Nohales, Fort, Pelloux, Coste, Leblanc, De Ternay, Wallon, Rolland, Fassier and BASIL Study Group.)

Identifying biomarkers linked to pancreatic ductal adenocarcinoma (PDAC) and chronic pancreatitis (CP) is crucial for early detection, treatment, and prevention. Methods: Association analyses of 10 serological biomarkers involved in cell signalling (IFN-γ, IL-6, IL-8, IL-10), oxidative stress (superoxide dismutase (SOD) and glutathione peroxidase (GPx) enzyme activities, total glutathione (GSH), malondialdehyde (MDA) levels), and intestinal permeability proteins (zonulin, I-FABP2) were conducted across PDAC ( n = 12), CP ( n = 21) and control subjects ( n = 23). A Mendelian randomisation (MR) approach was used to assess causality of the identified significant associations in two large genetic cohorts (FinnGen and UK Biobank). Results: Observational results showed a downregulation of SOD and GPx antioxidant enzyme activities in PDAC and CP patients, respectively, and higher MDA levels in CP patients. Logistic regression models revealed significant associations between CP and SOD activity (OR = 0.21, 95% CI [0.05, 0.89], per SD), GPx activity (OR = 0.28, 95% CI [0.10, 0.79], per SD), and MDA levels (OR = 2.05, 95% CI [1.36, 3.08], per SD). MR analyses, however, did not support causality. Conclusions: These findings would not support oxidative stress-related biomarkers as potential targets for pancreatic diseases prevention. Yet, further research is encouraged to assess their viability as non-invasive tools for early diagnosis, particularly in pre-diagnostic CP populations.

Introduction: Few studies are available on the health status of doctoral students. This position at the border between university studies and a professional activity presents specific risk factors, especially in terms of psychosocial constraints. The lockdowns implemented worldwide to control the COVID-19 pandemic are potentially worsening factors., Methods: At Lyon 1 University, a systematic medical follow-up of first year PhD students had been set up by the occupational health service in 2019. In the context of the lockdown during the COVID-19 pandemic, a telephonic interview was proposed to the same PhD students in order to assess the impact of the lockdown on working conditions and health and to provide possible assistance. During this interview, a standardized questionnaire was used to collect information about the conditions during the lockdown, doctoral work during this period and the consequences on research progress, as well as possible financial difficulties due to the lockdown. In addition, questions were asked about the perceived general health conditions and consultation with a health practitioner during this period. The Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) were used to assess depression and anxiety. Questions on lifestyle during lockdown, changes in diet during the period, weight change, and changes in the quantity and quality of their sleep were also asked. Comparisons of perceived health status, the prevalence of anxiety and depression symptoms at baseline and during the follow-up survey were made by MacNemar Chi 2 tests, as the data were repeated ones. The students were informed orally and in writing that their data would be entered anonymously into a computer and that they could have access to their data in accordance with the General Data Protection Regulation (GDPR). They were all informed by e-mail about the study results at the end of the study. The data collection process was registered with the National Institute for Health Data (INDS) and with the university's register under reference no. 2020/002 by the university's data protection officer in compliance with the French data protection laws (CNIL). The protocol was approved by the ethics committee of the Lyon University College of General Medicine (notification number: 2020-10-29-02)., Results: Of the 161 PhD students initially interviewed, 149 underwent a second interview. In total, 89.2% of the students assessed their health as good or very good. Regarding the answers to the GAD-7 questionnaire, 8.1% had a score equal to or higher than 10, corresponding to moderate to severe anxiety. Regarding the answers to PHQ-9, 19.6% of the PhD students had a score equal to or higher than 9 corresponding to moderate to severe depressive syndromes. The prevalence of an anxiety disorder was significantly associated with the absence of an outside private access in the place of residence during lockdown (75% vs. 37%), an increase in coffee consumption (33% vs. 5%), an increase in the quantity of food consumed (50% vs. 12%), weight gain (50% vs. 19%) and a deterioration in sleep quality (75% vs. 28%). The prevalence of a depressive symptom was significantly associated with lockdown in an urban area (89% vs. 70%), the occurrence of financial difficulties (7% vs. 1%), the consultation of a health professional during the period (34% vs. 15%), smoking cessation (14% vs. 1%), changes in the quantity (31% vs. 9%) and deterioration (59% vs. 25%) of the quality of sleep, and diet changes (66% vs. 43%). GAD-7 scores were unchanged for 90% of participants between the two surveys, but they were higher for 6.8% of doctoral students and lower for 2.7 % (P=0.1). A deterioration of the PHQ-9 scores, i.e. higher scores in the second survey compared to the first, was observed for 15.5% of the PhD students while an improvement of the scores was observed for 1.4% (P=0.0001)., Discussion: A number of studies have been published on the impact of lockdown on mental health, but few of them focused specifically on PhD students and even fewer were prospective studies. Their results are therefore difficult to compare with ours; they generally show GAD-7 and PHQ-9 scores that are similar to those of our population, or even higher. The impact of lockdown on the mental health of doctoral students highlighted in our study therefore justifies an appropriate follow-up of this population, particularly in the case of former psychiatric disorders., (Copyright © 2022 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Background: The endocrine-disrupting effects of phytopharmaceutical active substances (PAS) on human health are a public health concern. The CIPATOX-PE database, created in 2018, listed the PAS authorized in France between 1961 and 2014 presenting endocrine-disrupting effects for humans according to data from official international organizations. Since the creation of CIPATOX-PE, European regulations have changed, and new initiatives identifying substances with endocrine-disrupting effects have been implemented and new PAS have been licensed., Objectives: The study aimed to update the CIPATOX-PE database by considering new 2018 European endocrine-disrupting effect identification criteria as well as the new PAS authorized on the market in France since 2015., Methods: The endocrine-disrupting effect assessment of PAS from five international governmental and non-governmental initiatives was reviewed, and levels of evidence were retained by these initiatives for eighteen endocrine target organs., Results: The synthesis of the identified endocrine-disrupting effects allowed to assign an endocrine-disrupting effect level of concern for 241 PAS among 980 authorized in France between 1961 and 2021. Thus, according to the updated CIPATOX-PE data, 44 PAS (18.3%) had an endocrine-disrupting effect classified as "high concern," 133 PAS (55.2%) "concern," and 64 PAS (26.6%) "unknown effect" in the current state of knowledge. In the study, 42 PAS with an endocrine-disrupting effect of "high concern" are similarly classified in CIPATOX-PE-2018 and 2021, and 2 new PAS were identified as having an endocrine-disrupting effect of "high concern" in the update, and both were previously classified with an endocrine-disrupting effect of "concern" in CIPATOX-PE-2018. Finally, a PAS was identified as having an endocrine-disrupting effect of "high concern" in CIPATOX-PE-2018 but is now classified as a PAS not investigated for endocrine-disrupting effects in CIPATOX-PE-2021. The endocrine target organs associated with the largest number of PAS with an endocrine-disrupting effect of "high concern" is the reproductive system with 31 PAS. This is followed by the thyroid with 25 PAS and the hypothalamic-pituitary axis (excluding the gonadotropic axis) with 5 PAS., Discussion: The proposed endocrine-disrupting effect indicator, which is not a regulatory classification, can be used as an epidemiological tool for occupational risks and surveillance., 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. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Roger, Paul, Fort, Lamouroux, Samal, Spinosi and Charbotel.)

Objective: Approximately 20% of established malignant bowel obstruction (MBO) patients do not respond to pharmacological treatment. In these cases, venting percutaneous radiologic gastrostomy (VPRG) may be useful. Existing evidence is based on retrospective studies with methodological limitations. The purpose of this study is to describe safety and effectiveness for symptom control after VPRG placement in a prospective cohort of MBO patients., Methods: Complications of VPRG placement, symptom control, destination on discharge and survival were analysed., Results: Twenty-one patients were included, 13 (61.9%) of whom were women. Mean age was 62.7 years (36-85). Local pain (n=8, 38.1%) and peristomal leakage (n=4, 19%) were the most frequent minor complications. No major complications occurred. Nausea and vomiting were relieved in most patients (n=20, 95.2%) after VPRG, and small quantities of liquid diet were introduced to these patients. Median time to death after VPRG was 13 days (IQR 8.6-17.4). Thirteen patients (61.9%) were discharged, with seven of them (33.3%) returning home., Conclusions: When pharmacological treatment fails, the use of VPRG in MBO patients may be feasible, safe and effective., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: In a working environment that is predominantly male, very tough physically, with a difficult working environment, occupational exposures and working, verbal and physical aggression can be more frequent than in other sectors. Fishing, merchant shipping and yachting are all sectors where fitness to sail is reassessed every year by doctors in the Seafarers' Health Service. Seafarers are increasingly reporting insulting, violent or sexist behaviour. The main types of abuse seen on board can be verbal and/or physical aggression, humiliation, whether in private or in front of others. Sexual harassment of women is a very worrying subject., Materials and Methods: It was a retrospective observational study which is part of the professional monitoring of seafarers. The target population was adult seafarers coming for a fitness to sail visit. The group was recruited from seafarers aged over 18 who were being monitored by one of the seafarers' health services (or local centres). The inclusion period was 4 months between January and April 2023. All the information was collected using a self-questionnaire developed from the questionnaires of the Surveillance Médicale des Expositions des Salariés au Risques Professionnels (SUMER) for health status, job satisfaction and the European mini-module, verbal and physical aggression and psychological violence at work (based on the Leymann questionnaire), sexual violence and aggression based on the sexual harassment questionnaire and the PCLS-5 scale validated and translated into French to assess post-traumatic stress. The population studied was therefore 788 sailors., Results: The study population was predominantly male (82.3%). The average age was 41.4 years (standard deviation = 11.7). 46.7% of seafarers estimate being in very good health. During the past 12 months, overall, 24.5% of seafarers disclaimed having been victim in work-related context of a verbal aggression, with a significant difference according to the gender (21.1% for men and 41.0% for women). During the last 12 months, overall, 3.2% of seafarers have been victim in work-related context of a physical aggression (2.6% for men and 5.8% for women, NS), whereas 10.9% of seafarers reported hostile behaviour at present. Twenty per cent of seafarers reported sexual harassment in the last 12 months. During the entire working life of seafarers, 65.5% of women and 38.2% of men reported sexual harassment, and 38.8% of seafarers stated that they had experienced at least one traumatic event in the last 12 months., Discussion: A quarter of seafarers say they have been the victim of verbal or physical aggression at work in the last twelve months. These figures are high, and higher than those of the global survey on violence and harassment at work carried out by the International Labour Organization. One of the most alarming results of our study is the overexposure of women working in the maritime industry to the risk of physical, verbal or sexual assault of any kind. Indeed, in all the questions concerning the experience of verbal and physical aggression, the number of women victims is twice as high as that of their male colleagues, and this difference is statistically significant. As far as prevention is concerned, it seems that an effort is needed in terms of information, since only one seafarer in two knows the procedure to follow in the event of aggression within their shipyard. Communication between shipowners and seafarers needs to be stepped up to ensure that everyone is familiar with the procedures.

Cardiovascular disease is a common problem in cancer patients that is becoming more widely recognized. This may be a consequence of prior cardiovascular risk factors but could also be secondary to the anticancer treatments. With the goal of offering a multidisciplinary approach to guaranteeing optimal cancer therapy and the early detection of related cardiac diseases, and in light of the recent ESC Cardio-Oncology Guideline recommendations, we developed a Cardio-Oncology unit devoted to the prevention and management of these specific complications. This document brings together important aspects to consider for the development and organization of a Cardio-Oncology program through our own experience and the current evidence.

A significant proportion of the world's agricultural production is lost to pests and diseases. To mitigate this problem, an AIoT system for the early detection of pest and disease risks in crops is proposed. It presents a system based on low-power and low-cost sensor nodes that collect environmental data and transmit it once a day to a server via a NB-IoT network. In addition, the sensor nodes use individual, retrainable and updatable machine learning algorithms to assess the risk level in the crop every 30 min. If a risk is detected, environmental data and the risk level are immediately sent. Additionally, the system enables two types of notification: email and flashing LED, providing online and offline risk notifications. As a result, the system was deployed in a real-world environment and the power consumption of the sensor nodes was characterized, validating their longevity and the correct functioning of the risk detection algorithms. This allows the farmer to know the status of their crop and to take early action to address these threats.

The structural and magnetic properties of a drop-cast film of flat C 54 H 34 Br 4 CuO 4 , a β-diketonato complex functionalized with bromine atoms, on a graphite surface are investigated using scanning tunneling microscopy, synchrotron X-ray absorption spectroscopy, and X-ray magnetic circular dichroism. Experimental measurements reveal that the Cu-complexes preferentially lay flat on the graphite surface. The magnetic hysteresis loops show that the organic thin film remains paramagnetic at 2 K with an easy axis of magnetization perpendicular to the graphite surface and is therefore perpendicular to the plane of the Cu-complex skeleton.

The complete simulation model of an existing 1 kW high-temperature proton exchange membrane (HT-PEM) fuel cell-based residential micro-combined heat-and-power process, including a compact intensified heat-exchanger-reactor, is developed in the simulation software ProSimPlus v3.6.16. Detailed simulation models of the heat-exchanger-reactor, a mathematical model of the HT-PEM fuel cell, and other components are presented. The results obtained by the simulation model and by the experimental micro-cogenerator are compared and discussed. To fully understand the behavior of the integrated system and assess its flexibility, a parametric study is performed considering fuel partialization and important operating parameters. The values of the air-to-fuel ratio = [30, 7.5] and steam-to-carbon ratio = 3.5 (corresponding to net electrical and thermal efficiencies of 21.5 and 71.4%) are chosen for the analysis of inlet/outlet component temperatures. Finally, the exchange network analysis of the full process proves that the process efficiencies can still be increased by further improving the process internal heat integration., Competing Interests: The authors declare the following competing financial interest(s): Jean-Marc COMMENGE reports financial support was provided by BPI France. Di WU reports financial support was provided by National Association for Research in Technology., (© 2023 The Authors. Published by American Chemical Society.)

An industrial wireless monitoring and control system, capable of supporting energy-harvesting devices through smart sensing and network management, designed for improving electro-refinery performance by applying predictive maintenance, is presented. The system is self-powered from bus bars, and features wireless communication and easy-to-access information and alarms. With cell voltage and electrolyte temperature measurements, the system enables real-time cell performance discovery and early reaction to critical production or quality disturbances such as short-circuiting, flow blockages, or electrolyte temperature excursions. Field validation shows an increase in operational performance of 30% (reaching 97%) in the detection of short circuits, which, thanks to a neural network deployed, are detected, on average, 10.5 h earlier compared to the traditional methodology. The developed system is a sustainable IoT solution, being easy to maintain after its deployment, and providing benefits of improved control and operation, increased current efficiency, and decreased maintenance costs.

Damping is usually associated with irreversibility. Here, we present a counterintuitive concept to achieve time reversal of waves propagating in a lossless medium using a transitory dissipation pulse. Applying a sudden and strong damping in a limited time generates a time-reversed wave. In the limit of a high damping shock, this amounts to "freezing" the initial wave by maintaining the wave amplitude while canceling its time derivative. The initial wave then splits in two counterpropagating waves with half of its amplitude and time evolutions in opposite directions. We implement this damping-based time reversal using phonon waves propagating in a lattice of interacting magnets placed on an air cushion. We show with computer simulations that this concept also applies to broadband time reversal in complex disordered systems.

The control of wave propagation based on refraction principles offers unparalleled possibilities as shown by the striking example of optics. This approach is unfortunately limited for water waves as it relies mainly on variations of the liquid depth which, while controlling the wave velocity, also trigger nonlinearities and damping. In this article, we show experimentally that electrostriction allows to implement extensive refraction-based control of water waves in a precise and contactless manner. The setup consists of an electrode under high voltage placed above the grounded conductive water. The waves propagating under the electrode can be slowed down up to approximately half their speed compared to free propagation. We characterize the Snell-Descartes laws of refraction and the total internal reflection for the water waves. We implement emblematic refraction-based devices such as electrically tunable focusing lenses, waveguides without obstacles, and beam splitters based on frustrated internal reflection to perform interference experiments.

Background: Traffic road crashes are the leading cause of fatal crashes at work. The circumstances of work-related road accidents have been a regular focus of study, but there is still a lack of knowledge about commuting accidents., Objective: The aims of this study were to estimate the overall incidence of commuting accidents for non-physician professionals in a major French university hospital, by gender and different professional categories, and to assess its evolution over a 5-year period., Methods: A descriptive analysis was performed on 390 commuting accidents from 2012 to 2016 extracted from the university hospital's occupational health service. Incidences of commuting accidents were calculated according to gender, occupational categories, and years. Crude relative risk (RR) for the association of commuting accidents with gender, occupational categories, and year of the accident was also estimated using log-binomial regressions., Results: The annual incidence ranged from 354 to 581 accidents per 100,000 employees. Compared with administrative staff, the relative risk (RR) for commuting accidents for service agents was 1.6 (95% confidence interval (CI): 1.1-2.4) and for auxiliary nurses and childcare assistants was 1.3 (95% CI: 1.0-1.9). Nursing executives had a non-significantly lower RR of 0.6 (95% CI: 0.3-1.5)., Conclusion: The increased risk observed for the auxiliary nurses and childcare assistants and for the service agents may be related in part to the fatigue caused by work schedules, long commuting distances, physical work, and psychological burden.

Tropical vines and lianas have evolved mechanisms to avoid mechanical damage during their climbing life histories. We explore the mechanical properties and stem development of a tropical climber that develops trellises in tropical rain forest canopies. We measured the young stems of Condylocarpon guianensis (Apocynaceae) that construct complex trellises via self-supporting shoots, attached stems, and unattached pendulous stems. The results suggest that, in this species, there is a size (stem diameter) and developmental threshold at which plant shoots will make the developmental transition from stiff young shoots to later flexible stem properties. Shoots that do not find a support remain stiff, becoming pendulous and retaining numerous leaves. The formation of a second TYPE II (lianoid) wood is triggered by attachment, guaranteeing increased flexibility of light-structured shoots that transition from self-supporting searchers to inter-connected net-like trellis components. The results suggest that this species shows a "hard-wired" development that limits self-supporting growth among the slender stems that make up a liana trellis. The strategy is linked to a stem-twining climbing mode and promotes a rapid transition to flexible trellis elements in cluttered densely branched tropical forest habitats. These are situations that are prone to mechanical perturbation via wind action, tree falls, and branch movements. The findings suggest that some twining lianas are mechanically fine-tuned to produce trellises in specific habitats. Trellis building is carried out by young shoots that can perform very different functions via subtle development changes to ensure a safe space occupation of the liana canopy., 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 © 2022 Soffiatti, Fort, Heinz and Rowe.)

Background: Diffuse interstitial lung diseases (ILD) constitute a heterogeneous group of conditions with complex etiological diagnoses requiring a multidisciplinary approach. Much is still unknown about them, particularly their relationship with occupational exposures. The primary objective of this study was to investigate the distribution of occupational exposures according to type of ILD. The secondary objectives were to estimate the proportion of ILDs possibly related to occupational exposure and to evaluate the added value of the participation of an occupational disease consultant in ILD multidisciplinary discussions (MDD)., Methods: From May to December 2020, all consecutive patients with ILD whose cases were reviewed during a MDD in a referral centre for ILD were prospectively offered a consultation with an occupational disease consultant., Results: Of the 156 patients with ILD whose cases were reviewed in MDD during the study period, 141 patients attended an occupational exposure consultation. Occupational exposure was identified in 97 patients. Occupational exposure to asbestos was found in 12/31 (38.7%) patients with idiopathic pulmonary fibrosis (IPF) and in 9/18 (50.0%) patients with unclassifiable fibrosis. Occupational exposure to metal dust was found in 13/31 (41.9%) patients with IPFs and 10/18 (55.6%) patients with unclassifiable fibrosis. Silica exposure was found in 12/50 (24.0%) patients with autoimmune ILD. The link between occupational exposure and ILD was confirmed for 41 patients after the specialist occupational consultation. The occupational origin had not been considered (n = 9) or had been excluded or neglected (n = 4) by the MDD before the specialised consultation. A total of 24 (17%) patients were advised to apply for occupational disease compensation, including 22 (15.6%) following the consultation. In addition, a diagnosis different from the one proposed by the MDD was proposed for 18/141 (12.8%) patients., Conclusions: In our study, we found a high prevalence of occupational respiratory exposure with a potential causal link in patients with ILD. We suggest that a systematic specialised consultation in occupational medicine could be beneficial in the ILD diagnostic approach., (© 2022. The Author(s).)

Nearly localized moiré flat bands in momentum space, arising at particular twist angles, are the key to achieve correlated effects in transition-metal dichalcogenides. Here, we use angle-resolved photoemission spectroscopy (ARPES) to visualize the presence of a flat band near the Fermi level of van der Waals WSe 2 /MoSe 2 heterobilayer grown by molecular beam epitaxy. This flat band is localized near the Fermi level and has a width of several hundred meVs. By combining ARPES measurements with density functional theory calculations, we confirm the coexistence of different domains, namely the reference 2H stacking without layer misorientation and regions with arbitrary twist angles. For the 2H-stacked heterobilayer, our ARPES results show strong interlayer hybridization effects, further confirmed by complementary micro- Raman spectroscopy measurements. The spin-splitting of the valence band at K is determined to be 470 meV. The valence band maximum (VBM) position of the heterobilayer is located at the Γ point. The energy difference between the VBM at Γ and the K point is of -60 meV, which is a stark difference compared to individual single monolayer WSe 2 and monolayer WSe 2 , showing both a VBM at K ., (© 2022 IOP Publishing Ltd.)

Currently, there are no reliable biomarkers for the diagnosis of pancreatic cancer (PaC). Glycoproteomic approaches that analyze the glycan determinants on specific glycoproteins have proven useful to develop more specific cancer biomarkers than the corresponding protein levels. In PaC, mesothelin (MSLN) is a neo-expressed glycoprotein. MSLN glycosylation has not been described and could be altered in PaC. In this work, we aimed to characterize MSLN glycans from PaC cells and serum samples to assess their potential usefulness as PaC biomarkers. First, we analyzed MSLN glycans from PaC cell lines and then we developed an enzyme-linked lectin assay to measure core fucosylated-MSLN (Cf-MSLN) glycoforms. MSLN glycans from PaC cells were analyzed by glycan sequencing and through Western blotting with lectins. All of the cell lines secreted MSLN, with its three N -glycosylation sites occupied by complex-type N -glycans, which were mainly α2,3-sialylated, core fucosylated and highly branched. The Cf-MSLN glycoforms were quantified on PaC serum samples, and compared with MSLN protein levels. The Cf-MSLN was significantly decreased in PaC patients compared to control sera, while no differences were detected by using MSLN protein levels. In conclusion, Cf-MSLN glycoforms were differently expressed in PaC, which opens the way to further investigate their usefulness as PaC biomarkers.

Objectives: To assess the mental health and working constraints perception of first-year PhD in France., Design: It is a cross-sectional study., Setting: The study was conducted by the team of the Lyon 1 University's Occupational Health and Medical Service for Staff, from October 2019 to February 2020. First-year PhD students employed by the university were seen during the routine occupational health medical check-up., Participants: A total of 161 PhD students in science from the 2019 intake were included in the study (participation rate 98%)., Outcome Measures: Data were collected using a self-questionnaire on psychosocial constraints at work (Job Content Questionnaire), the quality of the professional relationship with the supervisor (Advisory Working Alliance Inventory, Student perspective (AWAI-S)), medical conditions, anxiety (Generalized Anxiety Disorder-7) and depressive symptoms (Patient Health Questionnaire-9)., Results: A total of 161 PhD students from the 2019 intake were included in the study (participation rate 98%). Most of the PhD students reported high psychological demands (58%), high decision latitude (53%), high social support (55%) and good professional relationships with their supervisor (mean of global score of AWAI-S=114.5). However, 34% showed signs of at least mild depression, 19% showed signs of anxiety and 20% were referred to a mental health professional after the survey. Bivariate analyses showed that history of psychiatric disorders, their relationship with their supervisor, having complementary teaching activities and stressful working conditions contributed to anxiety and depression., Conclusions: Even in the first year of their PhD, some students had mental health issues. It seems relevant to generalise the medical follow-up of all PhD students as soon as they enter the doctoral programme in order to detect and treat their health problems and psychological disorders at an early stage., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The International Agency for Research on Cancer established a causal link between asbestos exposure and ovarian cancer. However, the exposure frequency and histological characteristics of asbestos-associated ovarian cancers remain to be investigated in detail. This multicenter case-case study assessed the asbestos exposure in ovarian carcinoma (OC) patients, alongside its association with histological subtype. Women were recruited in four hospitals in Lyon, France. Histological reports were reviewed by a pathologist. Patient and family members' data were collected by phone-based questionnaires. Asbestos exposure was defined as direct (occupational and environmental) and indirect (via parents, partners, and children). An industrial hygienist assessed the probability and level of exposure. The 254 enrolled patients (mean age 60 years) reported having an average of 2.3 different jobs (mean working duration 29 years). The prevalence of direct and indirect asbestos exposure was 13% (mean exposure duration 11 years) and 46%, respectively. High-grade serous carcinoma accounted for 73% of all OCs and 82% of histological subtypes in women with direct exposure. After adjustment on a familial history of OC, no significant associations between asbestos exposure (direct and/or indirect) and high-grade serous carcinoma were found. Women with OC had a high prevalence of asbestos exposure. Establishing risk profiles, as reported here, is important in facilitating compensation for asbestos-related OCs and for the surveillance of women at risk.

Structured illumination in single-molecule localization microscopy provides new information on the position of molecules and thus improves the localization precision compared to standard localization methods. Here, we used a time-shifted sinusoidal excitation pattern to modulate the fluorescence signal of the molecules whose position information is carried by the phase and recovered by synchronous demodulation. We designed two flexible fast demodulation systems located upstream of the camera, allowing us to overcome the limiting camera acquisition frequency and thus to maximize the collection of photons in the demodulation process. The temporally modulated fluorescence signal was then sampled synchronously on the same image, repeatedly during acquisition. This microscopy, called ModLoc, allows us to experimentally improve the localization precision by a factor of 2.4 in one direction, compared to classical Gaussian fitting methods. A temporal study and an experimental demonstration both show that the short lifetimes of the molecules in blinking regimes impose a modulation frequency in the kilohertz range, which is beyond the reach of current cameras. A demodulation system operating at these frequencies would thus be necessary to take full advantage of this new localization approach. This article is part of the Theo Murphy meeting issue 'Super-resolution structured illumination microscopy (part 2)'.

Background: Nursing homes were particularly affected by the COVID-19 pandemic. The purpose of this study was to evaluate qualitatively and quantitatively with the use of a self-reported questionnaire as a tool for screening for mental disorders in nursing home staff. Methods: A multicenter epidemiological study was conducted in 12 nursing homes in France with 1117 nursing home staff eligible. Socio-demographic, occupational, and medical data were collected by anonymous self-reported questionnaire using validated scales to assess anxiety/depressive symptoms (HAD scale) and post-traumatic stress disorder (PCL-5). A total of 12 semi-structured interviews were conducted to assess acceptance and expectations for the use of the questionnaire. Results: The participation rate was 34.5%. Data from 373 questionnaires were included in the analysis. The questionnaire was well accepted by the participants and met their wishes for prevention action. The sample was 82% female. More than half reported a feeling of powerlessness and lack of time or staffing. The prevalence of anxiety symptoms was 22%, depressive symptoms 10%, and post-traumatic stress 7%. Conclusions: This study underlines the interest in screening for mental disorders by self-reported questionnaire and deploying preventive actions in the workplace to reduce stress and facilitate the reconciliation of family and working life in this context of the pandemic.

Here, we study and implement the temporal analog in time disordered sytems. A spatially homogeneous medium is endowed with a time structure composed of randomly distributed temporal interfaces. This is achieved through electrostriction between water surface and an electrode. The wave field observed is the result of the interferences between reflected and refracted waves on the interfaces. Although no eigenmode can be associated with the wave field, several common features between space and time emerge. The waves grow exponentially depending on the disorder level in agreement with a 2D matrix evolution model such as in the spatial case. The relative position of the momentum gap appearing in the time modulated systems plays a central role in the wave field evolution. When tuning the excitation to compensate for the damping, transient waves, localized in time, appear on the liquid surface. They result from a particular history of the multiple interferences produced by a specific sequence of time boundaries.

Chronic pancreatitis is a chronic fibroinflammatory disease of the pancreas with prevalence around 50 cases per 100,000 inhabitants. It appears to originate from diverse and yet mixed etiological factors. It shows highly variable presenting features, complication types and disease progression rates. Treatment options are as wide as the multiple personalized scenarios the disease might exhibit at a given time point. Some medical societies have developed guidelines for diagnosis and treatment based on scientific evidence. Although these efforts are to be acknowledged, the gathered level of evidence for any topic is usually low and, therefore, recommendations tend to be vague or weak. In the present series of position papers on chronic pancreatitis from the Societat Catalana de Digestologia and the Societat Catalana de Pàncrees we aimed at providing defined position statements for the clinician based on updated review of published literature and on interdisciplinary expert agreement. The final goal is to propose the use of common terminology and rational diagnostic/therapeutic circuits based on current knowledge. To this end 51 sections related to chronic pancreatitis were reviewed by 21 specialists from 6 different fields to generate 88 statements altogether. Statements were designed to harmonize concepts or delineate recommendations. Part 1 of this paper series discusses topics on aetiology and diagnosis of chronic pancreatitis. Main clinical features are abdominal pain, exocrine and endocrine insufficiency and symptoms derived from complications. Some patients remain symptom-free. Diagnosis (definitive, probable or uncertain) should be based on objective data obtained from imaging, histology, or functional tests., (Copyright © 2021 Elsevier España, S.L.U. All rights reserved.)

Time varying media recently emerged as promising candidates to fulfill the dream of controlling the wave frequency without nonlinear effects. However, frequency conversion remains limited by the dynamics of the variations of the propagation properties. Here we propose a new concept of space-time cascade to achieve arbitrary large frequency shifts by iterated elementary transformation steps. These steps use an intermediate medium in which wave packets enter and exit through noncommutative space and time interfaces. This concept avoids high frequency or subwavelength demanding metamaterials. Upward and downward frequency conversions are performed. The transmitted energy yield is given by the frequency ratio, regardless of impedence mismatch. We implement this concept with water waves controlled by electrostriction and achieve frequency conversion over 4 octaves.

Background: Occupational blood and body fluid exposures (OBBFEs) are one of the biological risks run by health professionals, especially in hospitals., Objective: The objectives of this study were to assess the occurrence and reporting of occupational blood and body fluid exposures (OBBFEs) in university hospital medical staff and to investigate factors associated to declared OBBFE and factors associated to reported OBBFE., Methods: A self-administered questionnaire has been e-mailed to all junior and senior medical staff in four university hospital centers in one administrative region of France in 2017., Results: 292 of the 1,228 respondents declared at least one OBBFE. More than two-thirds (70.2%) were under-reporters and more than half (53.8%) non-reporters. Younger subjects, surgical specialties and other associated work accidents were risk factors for OBBFE. Considering the reporting procedure too complex was a risk factor for underreporting., Conclusions: Underreporting by hospital medical staff was a persistent phenomenon, with a high rate. The OBBFE reporting procedure needs rethinking.

Currently, the concept of Industry 4.0 is well known; however, it is extremely complex, as it is constantly evolving and innovating. It includes the participation of many disciplines and areas of knowledge as well as the integration of many technologies, both mature and emerging, but working in collaboration and relying on their study and implementation under the novel criteria of Cyber-Physical Systems. This study starts with an exhaustive search for updated scientific information of which a bibliometric analysis is carried out with results presented in different tables and graphs. Subsequently, based on the qualitative analysis of the references, we present two proposals for the schematic analysis of Industry 4.0 that will help academia and companies to support digital transformation studies. The results will allow us to perform a simple alternative analysis of Industry 4.0 to understand the functions and scope of the integrating technologies to achieve a better collaboration of each area of knowledge and each professional, considering the potential and limitations of each one, supporting the planning of an appropriate strategy, especially in the management of human resources, for the successful execution of the digital transformation of the industry.

Gravity shapes liquids and plays a crucial role in their internal balance. Creating new equilibrium configurations irrespective of the presence of a gravitational field is challenging with applications on Earth as well as in zero-gravity environments. Vibrations are known to alter the shape of liquid interfaces and also to change internal dynamics and stability in depth. Here, we show that vibrations can also create an "artificial gravity" in any direction. We demonstrate that a liquid can maintain an inclined interface when shaken in an arbitrary direction. A necessary condition for the equilibrium to occur is the existence of a velocity gradient determined by dynamical boundary conditions. However, the no-slip boundary condition and incompressibility can perturb the required velocity profile, leading to a destabilization of the equilibrium. We show that liquid layers provide a solution, and liquid walls of several centimeters in height can thus be stabilized. We show that the buoyancy equilibrium is not affected by the forcing., Competing Interests: The authors declare no competing interest.

Background: Whereas an increased risk of road traffic crashes has been highlighted as linked to some medicine consumptions, there is no available data on this risk according to the type of journey (private, commuting or mission). Drivers on occupational journey (commuting or mission) are likely to have different coping behaviors related to the use of medicines than drivers on private journey. The aim of our study was to investigate the association between exposure to ten classes of medicines and the risk of being responsible for a road traffic crash according to the type of journey (private, commuting or mission)., Methods: The data used came from three French national databases: the national police database of injurious crashes, the police reports and the national health care insurance database. A total of 179,269 drivers aged between 18 and 65 years old involved in an injurious crash in France between July 2005 and December 2015 were included in the analyses. Logistic regression models stratified by journey were used to estimate the Odds Ratios (OR) and 95 % confidence intervals (95 % CI), adjusted for potential confounding factors., Results: Medicines exposure levels were generally lower for drivers during occupational journeys, the risk of being responsible for a road traffic crash seems to be higher on commuting or mission journeys than on private journeys for four medicines. Indeed, for antiepileptics the OR was 1.59 [1.01-2.51] for mission journeys, 1.63 [1.24-2.15] for commuting journeys, and 1.47 [1.25-1.73] for private journey. For psycholeptics the OR was 1.02 [0.80-1.28] for mission journey, 1.19 [1.03-1.39] for commuting and 1.17 [1.08-1.26] for private journey. For psychoanaleptics OR was 1.35 [1.02-1.78] for mission journeys, 1.37 [1.17-1.60] for commuting journeys and 1.26 [1.14-1.40] for private journeys. Finally, for other nervous system drugs OR reached 2.04 [1.35-3.07] for mission journeys compared to 1.43 [1.21-1.70] for private journeys., Conclusion: Our results encourage the implementation of preventive measures about some treatments and diseases in the context of occupational journeys., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Histoplasmosis is an endemic mycosis in some areas of North and South America. This disease is usually asymptomatic, but it can result in severe and disseminated infection involving gastrointestinal tract, especially in immunocompromised individuals. We report a case of a 33-years-old Ecuadorian male treated with infliximab who developed disseminated histoplasmosis with gastrointestinal affection. Due to the non-specific presentation of gastrointestinal histoplasmosis, the diagnosis is often delayed and it causes poor outcomes. It is important to consider this diagnosis in immunocompromised patients with compatible symptoms, like patients on TNF inhibitors.

Introduction: Biosimilars of granulocyte colony-stimulating factors (G-CSF) have shown similar efficacy to originator filgrastim (Neupogen® [NEU]; Amgen Inc.) as prophylaxis in neutropenia and in the mobilization of stem cells in patients receiving combination chemotherapy with G-CSF., Methods: This was a retrospective study in which the characteristics of stem cell mobilization treated with a G-CSF alone were compared in 216 patients and 56 donors. The two G-CSF compared were NEU and the biosimilar filgrastim Zarzio® (Sandoz GmbH) (referred to hereafter as BIO). Primary objectives were mobilization rate (minimum of 10 × 10 3 /ml CD34+ on day 4 of treatment [day +4]) and use of the immunostimulant plerixafor (PLEX) in each group., Results: The general characteristics of the patients receiving NEU (n = 138) and those receiving BIO (n = 78) did not differ significantly. PLEX was used in 24% of BIO patients and in 25.7% of NEU patients. The median CD34+ cell count on day +4 was significantly lower in BIO patients who needed PLEX than in those who did not (2.4 vs. 4.8 × 10 3 /ml; p = 0.002), as was the final CD34+ cell count (2.5 vs. 3.3 × 10 6 /kg; p 0.03). Mobilization failure rate was higher in the BIO group than in the NEU group (20 vs. 0%; p = 0.01). With respect to donors, more than one apheresis was needed in three BIO donors, one of them with PLEX. The use of BIO was the only risk factor for mobilization failure in patients who needed PLEX (hazard ratio 10.3; 95% confidence interval 1.3-77.8)., Conclusion: The study revealed that BIO had a lower efficacy for stem cell mobilization when the only treatment was G-CSF, especially in poor mobilizers needing PLEX.

When placed over a less dense medium, a liquid layer will typically collapse downwards if it exceeds a certain size, as gravity acting on the lower liquid interface triggers a destabilizing effect called a Rayleigh-Taylor instability 1,2 . Of the many methods that have been developed to prevent the liquid from falling 3-6 , vertical shaking has proved to be efficient and has therefore been studied in detail 7-13 . Stabilization is the result of the dynamical averaging effect of the oscillating effective gravity. Vibrations of liquids also induce other paradoxical phenomena such as the sinking of air bubbles 14-19 or the stabilization of heavy objects in columns of fluid at unexpected heights 20 . Here we take advantage of the excitation resonance of the supporting air layer to perform experiments with large levitating liquid layers of up to half a litre in volume and up to 20 centimetres in width. Moreover, we predict theoretically and show experimentally that vertical shaking also creates stable buoyancy positions on the lower interface of the liquid, which behave as though the gravitational force were inverted. Bodies can thus float upside down on the lower interface of levitating liquid layers. We use our model to predict the minimum excitation needed to withstand falling of such an inverted floater, which depends on its mass. Experimental observations confirm the possibility of selective falling of heavy bodies. Our findings invite us to rethink all interfacial phenomena in this exotic and counter-intuitive stable configuration.

Background: There is convincing evidence demonstrating that body size characteristics such as adiposity and height are associated with breast cancer in westernized countries. However, little is known about this relationship in North African countries currently undergoing nutritional transition and industrialization. The aim of this study was to explore associations between various body size characteristics, silhouette trajectories and the risk of breast cancer among Moroccan women., Methods: In this case-control study conducted in the Fez region (2016-2017), detailed measures of body size were collected for 300 cases of breast cancer and 300 matched controls. Unconditional logistic regression was used to assess the association between body size and breast cancer risk adjusting for confounding factors., Results: Higher waist circumference and hip circumference were positively associated with breast cancer risk in pre- (highest [T3] vs. lowest tertile [T1]: OR = 2.92, 95% confidence intervals [CI]: 1.33-6.42; OR = 3.00, 95% CI: 1.42-6.33, respectively) and post-menopausal women (T3 vs. T1: OR = 4.46, 95% CI: 1.86-10.66; OR = 4.08, 95% CI: 1.76-9.42, respectively). Body shape at younger ages (6-11 years) was inversely associated with the risk of breast cancer in premenopausal women (large vs. lean silhouette: OR = 0.31, 95% CI: 0.12-0.80). Women with the greatest increase in body shape trajectory had higher risk for both pre- and post-menopausal breast cancer (T3 vs. T1: OR = 2.74, 95% CI: 1.03-7.26; OR = 3.56, 95% CI: 1.34-9.44, respectively)., Conclusion: Our findings suggest that adiposity, body shape at younger ages, and silhouette trajectory may play a role in the development of pre- and post-menopausal breast cancer among Moroccan women. Larger-scale prospective studies are needed to confirm our findings and to explore these associations with breast cancer subtypes.

Road risks (commuting and on-duty accidents) have been responsible for 44% of work-related fatalities compensated by the French system of Social Security in 2012 and still represented 37% in 2018. Our objective was to assess risk factors for commuting accidents among the non-physician staff in a French university hospital. We conducted a case-control study of commuting accidents from 2012 to 2016. Cases were identified and controls were randomly selected from the hospital's personnel file with matches by year of the accident, gender and age. Risk factors were assessed using conditional logistic regression analysis. An increased risk was observed for 2 × 8 hour shifts, crude OR = 1.40 (95% CI = 1.05-1.86) compared to daytime schedules, but not confirmed in the multiple model. Being a duty officer and not working the day before the accident were associated with increased risk of accidents with adjusted OR = 1.9 (95% CI = 1.1; 3.3) and OR = 1.5, (95% CI = 1.1; 2.1), respectively. The risk increased as the distance between home and work increased, such as adjusted OR = 2.2 (95% CI = 1.4; 3.4) for a distance of >3.6 to 9 km, OR = 2.6, (95% CI = 1.7; 4.0) for a distance of >9 km to 19 km, and OR = 4.2, (95% CI = 2.8; 6.2) for >19 km vs. <3.6 km. The distance between home and work, not working the day before the accident, and certain categories of personnel were related to commuting accidents.

Purpose: Psychosocial consequences of road accidents are a major clinical problem that incurs significant social, occupational, and economic costs. The purpose of our study was to assess medical and socio-occupational factors of psychological distress in the severely injured 5 years after a road accident., Methods: A total of 691 of the 1168 subjects enrolled in a prospective cohort of road accident casualties (ESPARR cohort) responded to both standardized follow-up questionnaires at 1 and 5 years, assessing socio-occupational characteristics, physical and psychological sequelae, pain and perceived quality of life., Results: One quarter of participants exhibited psychological distress 5 years after the road accident; most of whom are women, with low educational level, and suffering from spinal lesions. After adjusting for several factors, psychological distress at 5 years was predicted by female gender and low educational level, and by several other factors observed 1 year after the road accident: poor self-reported quality of life, attention deficit and symptoms of anxiety., Conclusions: Early-stage improvement in the screening and care of mental disorders in road accident casualties should help to reduce long-term psychological distress.

We investigate the spin relaxation of Ho single atom magnets on MgO/Ag(100) as a function of temperature and magnetic field. We find that the spin relaxation is thermally activated at low field, while it remains larger than 1000 s up to 30 K and 8 T. This behavior contrasts with that of single molecule magnets and bulk paramagnetic impurities, which relax faster at high field. Combining our results with density functional theory, we rationalize this unconventional behavior by showing that local vibrations activate a two-phonon Raman process with a relaxation rate that peaks near zero field and is suppressed at high field. Our work shows the importance of these excitations in the relaxation of axially coordinated magnetic atoms.

Objective/background: To study educational and professional pathways of narcoleptic patients and examine demographic, disease-related and environmental factors associated with a better academic and professional prognosis., Patients/methods: In sum, 69 narcoleptic patients (51 narcolepsy type 1 and 18 narcolepsy type 2, age 42.5 ± 18.2 years) were enrolled in this pilot monocentric cross-sectional study with a comparison group (80 age- and sex-matched controls) between October 2017 and July 2018 in Lyon Center for Sleep Medicine. They completed questionnaires about their academic and professional trajectories and specific scales of quality of life (EuroQol quality of life scale EQ-5D-3L), depression (beck depression inventory, BDI), sleepiness (Epworth Sleepiness Scale, ESS) and narcoleptic symptoms severity (narcolepsy severity scale, NSS)., Results: No difference in grade repetition or final obtained diploma was observed between patients and controls, but patients evaluated their academic curricula as more difficult (45.5% vs 16.9%, p = 0.0007), complained for more attentional deficits (75% vs 22.1%, p < 0.0001), and had needed more educational reorientation (28.6% vs 9.9%, p = 0.01). Even if no difference was observed in occupational category and professional status, patients expressed significantly less satisfaction about their work. Patients had more signs of depression [OR severe depression = 4.4 (1.6-12.6), p = 0.02] and their quality of life was significantly decreased (67.3 ± 18.4 vs 80.6 ± 13.2, p = 0.0007) as compared to controls. Multivariate analysis showed that a more favorable professional career was associated with a better quality of life., Conclusions: Educational and professional pathways do not seem to be significantly impaired in narcoleptic patients, but their experience and quality of life are affected. These findings may allow to reassure patients and should lead to a more comprehensive management of the disease., Clinical Trial Registration: Narcowork, https://clinicaltrials.gov/ct2/show/NCT03173378, N° NCT03173378., (Copyright © 2019 Elsevier B.V. All rights reserved.)

We perform on-surface synthesis of single-ion molecular magnets on an Ag(111) surface and characterize their morphology, chemistry, and magnetism. The first molecule we synthesize is TbPc 2 to enable comparison with chemically synthesized and subsequently surface adsorbed species. We demonstrate the formation of TbPc 2 with a yield close to 100% and show that on-surface synthesis leads to identical magnetic and morphological properties compared to the previously studied chemically synthesized species. Moreover, exposure of the surface adsorbed TbPc 2 molecules to air does not modify their magnetic and morphological properties. To demonstrate the versatility of our approach, we synthesize novel Tb double deckers using tert -butyl-substituted phthalocyanine (tbu-2H-Pc). The Tb(tbu-Pc) 2 molecules exhibit magnetic hysteresis and therefore are the first purely on-surface synthesized single ion magnet., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Introduction: Several studies of the working conditions of drivers, and in particular on their pace of work, have enabled a better understanding of the risk factors for road accidents that occur during work. However, few studies are available on the risk exposure and working conditions of employees whose occupations involve driving. The purpose of this paper is to identify the different groups of employees occupationally exposed to road risk and to classify them according to working conditions., Methodology: A Multiple Correspondence Analysis (MCA) was implemented on the 41,727 individuals from the SUMER 2010 survey (Medical Monitoring of Occupational Risk Exposure: SUrveillance Médicale des Expositions aux Risques professionnels) and for 45 variables about working conditions. The analysis used 5 categories of weekly driving exposure as a supplementary variable (variable which is not used to perform the MCA): Non-exposure; Exposed <2 h; Exposed 2-10 hours; Exposed 10-20 hours; and Exposed >20 h. The results of the MCA were used to construct an ascending hierarchical classification., Results: The first factorial axis differentiates between conventional and unconventional work schedules. Axis 2 differentiates modalities corresponding to the working hours of the most recent working week. The third axis chiefly contrasts persons who have rules to follow with those who have none. An ascending hierarchical classification distinguishes 10 clusters of individuals according to working conditions. Four clusters of employees were excessively exposed to occupational driving. Clusters also have distinct demographic, occupational and psychosocial characteristics., Conclusion: Analysis of data from the SUMER survey confirms that employees exposed to road risk are particularly affected by atypical work time characteristics, but can be found in all activity sectors and in all types of job., (Copyright © 2019. Published by Elsevier Ltd.)

Background: Breast cancer is the most frequent cancer among Moroccan women. Environmental and occupational factors may play a role in breast cancer etiology. This study aimed to investigate the association between occupation, industry, and breast cancer risk among Moroccan women., Methods: A total of 300 breast cancer cases and 300 controls (matched by age and area of residence) were included in this study. Full occupational history was collected, with a detailed description of each job held for at least 6 months. Occupations were coded according to the International Standard Classification of Occupations (ISCO 08) and the Moroccan Analytical Classification of Professions (2001). Industries were coded according to the Statistical Classification of Economic Activities in the European Community (2008). Odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for potential confounders were estimated by using conditional logistic regression., Results: An overall decreased risk of breast cancer was observed among women doing only household work (OR = 0.32; 95% CI = 0.18-0.55). An increased risk of breast cancer was observed among women in agricultural occupations, particularly those employed as agricultural laborers (ISCO 08 code: 921; OR = 2.91; 95% CI = 1.51-5.60) and the risk increased with duration of employment (P trend = .01). Analyses by industry corroborated these findings., Conclusions: Our findings suggest that occupational exposures may be associated with increased risk of breast cancer among female agricultural workers in this population. Further investigations, with advanced methods of occupational exposure assessment, are warranted to clarify the role of chemicals involved in this high-risk occupation and to suggest preventive actions and screening., (© 2019 Wiley Periodicals, Inc.)

Background: The objective of this prospective study was to assess the effect of CPAP therapy on job productivity and work quality for patients with severe obstructive sleep apnea (OSA)., Methods: A convenience sample of patients diagnosed with severe OSA using polysomnography or polygraphy and with a therapeutic indication for CPAP was enrolled in our study. Patients completed two self-administered questionnaires: the first before CPAP therapy and the second during the first 6 months after CPAP treatment. OSA symptoms were evaluated through self-administered questionnaires assessing potential effects on occupational activity: excessive daytime sleepiness was rated by the Epworth Sleepiness Scale (ESS), emotional status was rated by the Hospital Anxiety and Depression (HAD) scale, work quality was rated by the Work Role Functioning Questionnaire (WRFQ)., Results: Forty patients (30 men, mean age 47.3 ± 8.3, mean BMI 31.6 ± 7.4, mean apnea-hypopnea index 51.8 ± 16.3) showed a beneficial effect of CPAP therapy on ESS score (mean 11.6 to 8.2, p < 0.0001), the anxiety dimension (mean 57.5% to 20%, p = 0.0002), and the overall anxiety-depressive score (mean 50% to 22.5%, p = 0.0006). Mean WRFQ scores were significantly improved in the second questionnaire for the dimensions of timetable requirements (69.3% to 83.5%, p < 0.0001), productivity requirements (71.4% to 82.2%, p < 0.0001), mental requirements (72.0% to 84.3%, p < 0.0001), and social requirements (82.6% to 91.4%, p < 0.003)., Conclusions: We observed that adherence to CPAP therapy for patients with severe OSA mitigates the impact of symptoms on work including excessive daytime sleepiness, impairment of work ability, and anxiety and depressive disorders.