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Abstract Supplier Impersonation Fraud (SIF) is a rising issue for Business-to-Business companies. The use of remote and quick digital transactions has made the task of identifying fraudsters more difficult. In this paper, we propose a data-driven fraud detection system whose goal is to provide an accurate estimation of financial transaction legitimacy by using the knowledge contained in the network of transactions created by the interaction of a company with its suppliers. We consider the real dataset collected by SIS-ID for this work.We propose to use a graph-based approach to design an Anomaly Detection System (ADS) based on a Self-Organizing Map (SOM) allowing us to label a suspicious transaction as either legitimate or fraudulent based on its similarity with frequently occurring transactions for a given company. Experiments demonstrate that our approach shows high consistency with expert knowledge on a real-life dataset, while performing faster than the expert system.

Calciphylaxis is a rare vascular disorder, characterized by a progresive systemic calcification of dermo-hypodermic arterioles. We present a case of end-stage renal disease (ESRD) patient on Hemodialysis, with calciphyilaxis, whose clinical manifestation were ulcerated lesions on the penis, treated with phosphodiesterae-5 (PDE5) inhibitors, with good clinical response. Keywords: Penile calciphyilaxis, End-stage renal disease, Tadalafil

(1) Background: The influence of food culture on eating behavior and obesity risk is poorly understood. (2) Methods: In this qualitative study, 25 adults in France with or without overweight/obesity participated in semi-structured interviews (n = 10) or focus groups (n = 15) to examine attitudes to food consumption and external pressures that influence eating behavior and weight management. Results were compared to an equivalent study conducted in the United States, thereby contrasting two countries with markedly different rates of obesity. Emerging key themes in the French data were identified through coding using a reflexive approach. (3) Results: The main themes identified were: (1) influence of commensality, social interactions, and pleasure from eating on eating behavior, (2) having a balanced and holistic approach to nutrition, (3) the role of environmental concerns in food consumption, (4) relationship with “natural” products (idealized) and food processing (demonized), (5) perceptions of weight status and management. Stress and difficulties in hunger cue discernment were viewed as important obstacles to weight management in both countries. External pressures were described as a major factor that explicitly influences food consumption in the U.S., while there was an implicit influence of external pressures through eating-related social interactions in France. In France, products considered “natural” where idealized and juxtaposed against processed and “industrial” products, whereas this was not a salient aspect in the U.S. (4) Conclusions: This first comparative qualitative study assessing aspects of food culture and eating behaviors across countries identifies both common and divergent attitudes to food and eating behavior. Further studies are needed to inform the development of effective behavioral interventions to address obesity in different populations.

The CarboEurope Regional Experiment Strategy (CERES) was designed to develop and test a range of methodologies to assess regional surface energy and mass exchange of a large study area in the South-Western part of France. This paper describes a methodology to estimate sensible and latent heat fluxes on the basis of net radiation, surface radiometric temperature measurements and information obtained from available products derived from the Meteosat Second Generation (MSG) geostationary meteorological satellite, weather stations and ground-based eddy covariance towers. It is based on a simplified bulk formulation of sensible heat flux that considers the degree of coupling between the vegetation and the atmosphere and estimates latent heat as the residual term of net radiation. Estimates of regional energy fluxes obtained in this way are validated at the regional scale by means of a comparison with direct flux measurements made by airborne eddy-covariance. The results show an overall good matching between airborne fluxes and estimates of sensible and latent heat flux obtained from radiometric surface temperatures that holds for different weather conditions and different land use types. The overall applicability of the proposed methodology to regional studies is discussed.

The current paper reviews the experimental setup of the CarboEurope Experimental Strategy (CERES) campaigns with the aim of providing an overview of the instrumentation used, the data-set and associated modelling. It then assesses progress in the field of regional observation and modelling of carbon fluxes, bringing the papers of this special issue into a somewhat broader context of analysis. Instrumental progress has been obtained in the field of remotely monitoring from tall towers and the experimental planning. Flux measurements from aircraft are now capable, within some constraints, to provide regular regional observations of fluxes of CO2, latent and sensible heat. Considerable effort still needs to be put into calibrating the surface schemes of models, as they have direct impact on the input of energy, moisture and carbon fluxes in the boundary layer. Overall, the mesoscale models appear to be capable of simulating the large scale dynamics of the region, but in the fine detail, like the precise horizontal and vertical CO2 field differences between the models still exist. These errors translate directly into transport uncertainty, when the forward simulations are used in inverse mode. Quantification of this uncertainty, including that of inadequate boundary layer height modelling, still remains a major challenge for state of the art mesoscale models. Progress in inverse models has been slow, but has shown that it is possible to estimate some of the errors involved, and that using the combination of observations. Overall, the capability to produce regional, high-resolution estimates of carbon exchange, exist in potential, but the routine application will require considerable effort, both in the experimental as in the modelling domain.

We study the characteristics of a statistical ensemble of mesoscale simulations in order to estimate the model error in the simulation of CO2 concentrations. The ensemble consists of ten members and the reference simulation using the operationnal short range forecast PEARP, perturbed using the Singular Vector technique. We then used this ensemble of simulations as the initial and boundary conditions for the meso scale model (Méso-NH) simulations, which uses CO2 fluxes from the ISBA-A-gs land surface model. The final ensemble represents the model dependence to the boundary conditions, conserving the physical properties of the dynamical schemes, but excluding the intrinsic error of the model. First, the variance of our ensemble is estimated over the domain, with associated spatial and temporal correlations. Second, we extract the signal from noisy horizontal correlations, due to the limited size ensemble, using diffusion equation modelling. The computational cost of such ensemble limits the number of members (simulations) especially when running online the carbon flux and the atmospheric models. In the theory, 50 to 100 members would be required to explore the overall sensitivity of the ensemble. The present diffusion model allows us to extract a significant part of the noisy error, and makes this study feasable with a limited number of simulations. Finally, we compute the diagonal and non-diagonal terms of the observation error covariance matrix and introduced it into our CO2 flux matrix inversion for 18 days of the 2005 intensive campaign CERES over the South West of France. Variances are based on model-data mismatch to ensure we treat model bias as well as ensemble dispersion, whereas spatial and temporal covariances are estimated with our method. The horizontal structure of the ensemble variance manifests the discontinuities of the mesoscale structures during the day, but remains locally driven during the night. On the vertical, surface layer variance shows large correlations with the upper levels in the boundary layer (> 0.6), dropping to 0.4 with the lower levels of the free troposphere. Large temporal correlations were found during the afternoon (> 0.5 for several hours), reduced during the night. The diffusion equation model extracted relevant error covariance signals horizontally, with reduced correlations over mountain areas and during the night over the continent. The posterior error reduction on the inverted CO2 fluxes accounting for the model error correlations illustrates the predominance of the temporal over the spatial correlations when using tower-based CO2 concentration observations.

This paper describes a numerical interpretation of the April 2007, CarboEurope Regional Experiment Strategy (CERES) campaign, devoted to the study of the CO2 cycle at the regional scale. Four consecutive clear sky days with intensive observations of CO2 concentration, fluxes at the surface and in the boundary layer have been simulated with the Meso-NH mesoscale model, coupled to ISBA-A-gs land surface model. The main result of this paper is to show how aircraft observations of CO2 concentration have been used to identify surface model errors and to calibrate the CO2 driving component of the surface model. In fact, the comparisons between modelled and observed CO2 concentrations within the Atmospheric Boundary Layer (ABL) allow to calibrate and correct not only the parameterization of respired CO2 fluxes by the ecosystem but also the Leaf Area Index (LAI) of the dominating land cover. After this calibration, the paper describes systematic comparisons of the model outputs with numerous data collected during the CERES campaign, in April 2007. For instance, the originality of this paper is the spatial integration of the comparisons. In fact, the aircraft observations of CO2 concentration and fluxes and energy fluxes are used for the model validation from the local to the regional scale. As a conclusion, the CO2 budgeting approach from the mesoscale model shows that the winter croplands are assimilating more CO2 than the pine forest, at this stage of the year and this case study.

An atmospheric Lagrangian experiment for regional CO2 budgeting with aircraft measurements took place during the CarboEurope Regional Experiment Strategy campaign (CERES) in south-west France, in June 2005. The atmospheric CO2 aircraft measurements taken upstream and downstream of an active and homogeneous pine forest revealed a CO2 depletion in the same air mass, using a Lagrangian strategy. This field experiment was analyzed with a meteorological meso-scale model interactively coupled with a surface scheme, with plant assimilation, ecosystem respiration, anthropogenic CO2 emissions and sea fluxes. First, the model was carefully validated against observations made close to the surface and in the atmospheric boundary layer. Then, the carbon budget was evaluated using the numerous CERES observations, by upscaling the surface fluxes observations, and using the modeling results, in order to estimate the relative contribution of each physical process. A good agreement is found between the two methods which use the same vegetation map: the estimation of the regional CO2 surface flux by the Eulerian meso-scale model budget is close to the budget deduced from the upscaling of the observed surface fluxes, and found a budget between −9.4 and −12.1 μmol.m−2.s−1, depending on the size of the considered area. Nevertheless, the associated uncertainties are rather large for the upscaling method and reach 50%. A third method, using Lagrangian observations of CO2 estimates a regional CO2 budget a few different and more scattered, (−16.8 μmol.m−2.s−1 for the small sub-domain and −8.6 μmol.m−2.s−1 for the larger one). For this budgeting method, we estimate a mean of 31% error, mainly arising from the time of integration between the two measurements of the Lagrangian experiment. The paper describes in details the three methods to assess the regional CO2 budget and the associated errors.

We investigate the ability of a mesoscale model to reconstruct CO2 fluxes at regional scale. Formally, we estimate the reduction of error for a CO2 flux inversion at 8 km resolution in the South West of France, during four days of the CarboEurope Regional Experiment Strategy (CERES) in spring 2005. Measurements from two towers and two airplanes are available for this campaign. The lagrangian particle dispersion model LPDM was coupled to the non-hydrostatic model Meso-NH and integrated in a matrix inversion framework. Impacts of aircraft and tower measurements are quantified separately and together. We find that the configuration with both towers and aircraft is able to significantly reduce uncertainties on the 4-day averaged CO2 fluxes over about half of the 300×300 km2 domain. Most of this reduction comes from the tower measurements, even though the impact of aircraft measurements remains noticeable. Imperfect knowledge of boundary conditions does not significantly impact the error reduction for surface fluxes. We test alternative strategies to improve the impact of aircraft measurements and find that most information comes from measurements inside the boundary layer. We find that there would be a large improvement in error reduction if we could improve our ability to model nocturnal concentrations at tower sites.

Atmospheric CO2 modeling in interaction with the surface fluxes, at the regional scale is developed within the frame of the European project CarboEurope-IP and its Regional Experiment component. In this context, five meso-scale meteorological models at 2 km resolution participate in an intercomparison exercise. Using a common experimental protocol that imposes a large number of rules, two days of the CarboEurope Regional Experiment Strategy (CERES) campaign are simulated. A systematic evaluation of the models is done in confrontation with the observations, using statistical tools and direct comparisons. Thus, temperature and relative humidity at 2 m, wind direction, surface energy and CO2 fluxes, vertical profiles of potential temperature as well as in-situ CO2 concentrations comparisons between observations and simulations are examined. These comparisons reveal a cold bias in the simulated temperature at 2 m, the latent heat flux is often underestimated. Nevertheless, the CO2 concentrations heterogeneities are well captured by most of the models. This intercomparison exercise shows also the models ability to represent the meteorology and carbon cycling at the synoptic and regional scale in the boundary layer, but also points out some of the major shortcomings of the models.

The PAES (French acronym for synoptic scale atmospheric pollution) network focuses on the chemical composition (ozone, CO, NOx/y and aerosols) of the lower troposphere (0–3000 m). Its high-altitude surface stations located in different mountainous areas in France complete the low-altitude rural MERA stations (the French contribution to the european program EMEP, European Monitoring and Evaluation Program). They are representative of pollution at the scale of the French territory because they are away from any major source of pollution. This study deals with ozone observations between 2001 and 2004 at 11 stations from PAES and MERA, in addition to 16 elevated stations located in mountainous areas of Switzerland, Germany, Austria, Italy and Spain. The set of stations covers a range of altitudes between 115 and 3550 m. The comparison between recent ozone mixing ratios to those of the last decade at Pic du Midi (2877 m), as well as trends calculated over 14-year data series at three high-altitude sites in the Alps (Jungfraujoch, Sonnblick and Zugspitze) reveal that ozone is still increasing but at a slower rate than in the 1980s and 1990s. The 2001–2004 mean levels of ozone from surface stations capture the ozone stratification revealed by climatological profiles from the airborne observation system MOZAIC (Measurement of OZone and water vapour by Airbus In-service airCraft) and from ozone soundings above Payerne (Switzerland). In particular all data evidence a clear transition at about 1000–1200 m a.s.l. between a sharp gradient below (of the order of +30 ppb/km) and a gentler gradient (+3 ppb/km) above. The same altitude (1200 m) is also found to be a threshold regarding how well the ozone levels at the surface stations agree with the free-tropospheric reference (MOZAIC or soundings). Below the departure can be as large as 40%, but suddenly drops within 15% above. For stations above 2000 m, the departure is even less than 8%. Ozone variability also reveals a clear transition between boundary-layer and free-tropospheric regimes around 1000 m a.s.l. Below, diurnal photochemistry accounts for about the third of the variability in summer, but less than 20% above – and at all levels in winter – where ozone variability is mostly due to day-to-day changes (linked to weather conditions or synoptic transport). In summary, the altitude range 1000–1200 m clearly turns out in our study to be an upper limit below which specific surface effects dominate the ozone content. Monthly-mean ozone mixing-ratios show at all levels a minimum in winter and the classical summer broad maximum in spring and summer – which is actually the superposition of the tropospheric spring maximum (April–May) and regional pollution episodes linked to persistent anticyclonic conditions that may occur from June to September. To complement this classical result it is shown that summer maxima are associated with considerably more variability than the spring maximum. This ensemble of findings support the relevance of mountain station networks such as PAES for the long-term observation of free-tropospheric ozone over Europe.

Research during the past decades has outlined the importance of biogenic isoprene emission in tropospheric chemistry and regional ozone photo-oxidant pollution. The first part of this article focuses on the development and validation of a simple biogenic emission scheme designed for regional studies. Experimental data sets relative to Boreal, Tropical, Temperate and Mediterranean ecosystems are used to estimate the robustness of the scheme at the canopy scale, and over contrasted climatic and ecological conditions. A good agreement is generally found when comparing field measurements and simulated emission fluxes, encouraging us to consider the model suitable for regional application. Limitations of the scheme are nevertheless outlined as well as further on-going improvements. In the second part of the article, the emission scheme is used on line in the broader context of a meso-scale atmospheric chemistry model. Dynamically idealized simulations are carried out to study the chemical interactions of pollutant plumes with realistic isoprene emissions coming from a Mediterranean oak forest. Two types of anthropogenic sources, respectively representative of the Marseille (urban) and Martigues (industrial) French Mediterranean sites, and both characterized by different VOC/NOx are considered. For the Marseille scenario, the impact of biogenic emission on ozone production is larger when the forest is situated in a sub-urban configuration (i.e. downwind distance TOWN-FOREST -1). In this case the enhancement of ozone production due to isoprene can reach +37% in term of maximum surface concentrations and +11% in term of total ozone production. The impact of biogenic emission decreases quite rapidly when the TOWN-FOREST distance increases. For the Martigues scenario, the biogenic impact on the plume is significant up to TOWN-FOREST distance of 90km where the ozone maximum surface concentration enhancement can still reach +30%. For both cases, the importance of the VOC/NOx ratio in the anthropogenic plume and its evolution when interacting with the forest emission are outlined. In complement to real case studies, this idealized approach can be particularly useful for process and sensitivity studies and constitutes a valuable tool to build regional ozone control strategies.

Local air quality is a major concern for the population regularly exposed to high levels of air pollution. Due mainly to its aircraft engine activities during taxiing and take-off, the airport is often submitted to heterogeneous but important concentrations of NO x and Particulate Matter (PM). The study suggests an innovative approach to determining the air traffic impact on air quality at the scale of the airport, its runways, and its terminals, to be able to locate the persistent high-concentration spots, for example. The pollutant concentrations at 10 m resolution and 1 s time step are calculated in order to identify the most affected areas of an airport platform and their contributors. A real day of air traffic on a regional airport is simulated, using observations and aircraft trajectories data from radar streams. In order to estimate the aircraft emissions, the Air Transport Systems Evaluation Infrastructure (IESTA) is used. Regarding local air quality, IESTA relies on the non-hydrostatic meso-scale atmospheric model Meso-NH using its grid-nesting capabilities with three domains. The detailed cartography of the airport distinguishes between grassland, parking, and terminals, allowing the computation of exchanges of heat, water, and momentum between the different types of surfaces and the atmosphere as well as the interactions with the building using a drag force. The dynamic parameters like wind, temperature, turbulent kinetic energy, and pollutants concentration are computed at 10 m resolution over the 2 km × 4 km airport domain. The pollutants are considered in this preliminary study as passive tracers, without chemical reactions. This study aims at proving the feasibility of high-scale modelling over an airport with state-of-the-art physical models in order to better understand the repartition of pollutants over an airport, taking into account advection and turbulence in interactions with buildings and regional trends, emissions, Auxiliary Power Units (APU), taxiing, parking, take off. All these processes drive the model at each time step and are not averaged over one hour or more like in Gaussian or Lagrangian ones. This study is investigating the feasibility of high spatio-temporal air quality modelling for research purposes but not for operational forecasting.

Erosion of soils affects both natural landscapes and engineering constructions as embankment dams or levees. Improving the safety of such earthen structures requires in particular finding out more about the elementary mechanisms involved in soil erosion. Towards this end, an experimental work was undertaken in three steps. First, several model materials were developed, made of grains (mostly glass beads) with solid bridges at particle contacts whose mechanical yield strength can be continuously varied. Furthermore, for most of them, we succeeded in obtaining a translucent system for the purpose of direct visualization. Second, these materials were tested against surface erosion by an impinging jet to determine a critical shear stress and a kinetic coefficient [2, 3]. Note that an adapted device based on optical techniques (combination of Refractive Index Matching and Planar Laser Induced Fluorescence [3]) was used specifically for the transparent media. Third, some specifically developed mechanical tests, and particularly traction tests, were implemented to estimate the mechanical strength of the solid bridges both at micro-scale (single contact) and at macro-scale (sample) and to investigate a supposed relationship with soil resistance to erosion.

Les examens biologiques d'allergie contribuent de façon importante au diagnostic et au suivi des maladies allergiques. L'augmentation de la prévalence de ces maladies dans la population française durant les dernières décennies et le recours de plus en plus fréquent au diagnostic biologique nécessite l'optimisation de l'utilisation de cet outil. Son utilisation rationnelle selon les données actualisées de la science et une démarche privilégiant le rapport coût/bénéfice sont à même de garantir l'efficience diagnostique. Consciente de cet enjeu, la Société française d'allergologie (SFA) a mis en place un groupe de travail multidisciplinaire pour l'actualisation des recommandations de biologie de l'allergie, les précédentes recommandations élaborées en 2005 par la Haute autorité de santé (HAS) étant devenues en partie obsolètes en raison de l'évolution des techniques et concepts. La méthodologie utilisée est celle des recommandations pour la pratique clinique (RPC) élaborée par la HAS, même si le texte n'a pas été labellisé par celle institution. Le groupe de travail a rédigé 73 recommandations gradées et un préambule comportant 6 questions d'ordre général. Bien que non exhaustives, ces 79 questions répondent aux préoccupations les plus courantes des prescripteurs qu'ils soient allergologues ou non pour la prise en charge des patients allergiques ou ayant une suspicion d'allergie, tout en tenant compte du contexte réglementaire français. Ce texte court résume ces 79 questions sans revenir sur le rationnel ni la discussion. Allergy laboratory tests make an important contribution to the diagnosis and monitoring of allergic diseases. The increase in the prevalence of these diseases in the French population in recent decades and the increasingly frequent use of biological diagnostics requires the optimization of the use of this tool. Its rational use according to updated scientific data and an approach favoring the cost/benefit ratio can guarantee diagnostic efficiency. Aware of this issue, the French Society of Allergology (SFA) has set up a multidisciplinary task force to update allergy biology recommendations, the previous recommendations drawn up in 2005 by the High Authority for Health (HAS) having become partly obsolete due to the evolution of techniques and concepts. The methodology used is that of the recommendations for clinical practice (RPC) developed by the HAS, even if the text has not been labeled by that institution. The working group drafted 73 graded recommendations and a preamble with 6 general questions. Although not exhaustive, these 79 questions answer the most common concerns of prescribers whether they are allergists or not for the management of patients with allergies or with suspected allergies, while taking into account the French regulatory context. This short text sums up these 79 questions without going back to the rational or the discussion. [ABSTRACT FROM AUTHOR]

Les examens biologiques d'allergie contribuent de façon importante au diagnostic et au suivi des allergies respiratoires. L'augmentation de la prévalence de ces maladies dans la population française durant les dernières décennies et le recours de plus en plus fréquent au diagnostic biologique nécessite l'optimisation de l'utilisation de cet outil. Son utilisation rationnelle selon les données actualisées de la science et une démarche privilégiant le rapport coût/bénéfice sont à même de garantir l'efficience diagnostique. Consciente de cet enjeu, la Société française d'allergologie (SFA) a mis en place un groupe de travail multidisciplinaire pour l'actualisation des recommandations de biologie de l'allergie, les précédentes recommandations élaborées en 2005 par la Haute Autorité de santé (HAS) étant devenues en partie obsolètes en raison de l'évolution des techniques et concepts. La méthodologie utilisée est celle des recommandations pour la pratique clinique (RPC) élaborée par la HAS, même si le texte n'a pas été labellisé par celle institution. Le groupe de travail a rédigé 11 recommandations gradées sur l'allergie respiratoire. Bien que non exhaustives, ces 11 questions répondent aux préoccupations les plus courantes des prescripteurs qu'ils soient allergologues ou non pour la prise en charge des patients ayant une suspicion d'allergie respiratoire, tout en tenant compte du contexte réglementaire français. Allergy laboratory tests provide an important contribution to the diagnosis and monitoring of respiratory allergies. The increase in the prevalence of these diseases in the French population during the last decades and the increasingly frequent use of biological diagnosis requires the optimization of the use of this tool. Its rational use according to updated scientific data and an approach favoring the cost/benefit ratio can guarantee diagnostic efficiency. Aware of this issue, the French Society of Allergology (SFA) has set up a multidisciplinary task force to update allergy biology recommendations, the previous recommendations drawn up in 2005 by the High Authority for Health (HAS) having become partly obsolete due to the evolution of techniques and concepts. The methodology used is that of the recommendations for clinical practice (RPC) developed by the HAS, even if the text has not been labeled by that institution. The working group drafted 11 graded recommendations for the management of respiratory allergy. Although not exhaustive, these 11 questions respond to the most common concerns of prescribers whether or not they are allergists for the management of patients with allergies or with a suspected respiratory allergy, while taking into account the French regulatory context. [ABSTRACT FROM AUTHOR]

Les examens biologiques d'allergie contribuent de façon importante au diagnostic et au suivi des maladies allergiques. L'augmentation de la prévalence de ces maladies dans la population française durant les dernières décennies et le recours de plus en plus fréquent au diagnostic biologique nécessite l'optimisation de l'utilisation de cet outil. Son utilisation rationnelle selon les données actualisées de la science et une démarche privilégiant le rapport coût/bénéfice sont à même de garantir l'efficience diagnostique. Consciente de cet enjeu, la Société française d'allergologie (SFA) a mis en place un groupe de travail multidisciplinaire pour l'actualisation des recommandations de biologie de l'allergie, les précédentes recommandations élaborées en 2005 par la Haute Autorité de santé (HAS) étant devenues en partie obsolètes en raison de l'évolution des techniques et concepts. La méthodologie utilisée est celle des recommandations pour la pratique clinique (RPC) élaborée par la HAS, même si le texte n'a pas été labellisé par celle institution. Le groupe de travail a rédigé 73 recommandations gradées et un préambule comportant 6 questions d'ordre général. Bien que non exhaustives, ces 79 questions répondent aux préoccupations les plus courantes des prescripteurs qu'ils soient allergologues ou non pour la prise en charge des patients allergiques ou ayant une suspicion d'allergie, tout en tenant compte du contexte réglementaire français. Allergy laboratory tests make an important contribution to the diagnosis and monitoring of allergic diseases. The increase in the prevalence of these diseases in the French population in recent decades and the increasingly frequent use of biological diagnostics requires the optimisation of the use of this tool. Its rational use according to updated scientific data and an approach favoring the cost/benefit ratio can guarantee diagnostic efficiency. Aware of this issue, the French society of allergology (SFA) has set up a multidisciplinary task force to update allergy biology recommendations, the previous recommendations drawn up in 2005 by the High authority for health (HAS) having become partly obsolete due to the evolution of techniques and concepts. The methodology used is that of the recommendations for clinical practice (RPC) developed by the HAS, even if the text has not been labelled by that institution. The working group drafted 73 graded recommendations and a preamble with 6 general questions. Although not exhaustive, these 79 questions answer the most common concerns of prescribers whether they are allergists or not for the management of patients with allergies or with suspected allergies, while taking into account the French regulatory context. [ABSTRACT FROM AUTHOR]

Les examens biologiques d'allergie contribuent de façon importante au diagnostic et au suivi des allergies alimentaires. L'augmentation de la prévalence des allergies alimentaires dans la population française durant les dernières décennies et le recours de plus en plus fréquent au diagnostic biologique nécessite l'optimisation de l'utilisation de cet outil. Son utilisation rationnelle selon les données actualisées de la science et une démarche privilégiant le rapport coût/bénéfice sont à même de garantir l'efficience diagnostique. Le mésusage de la biologie de l'allergie et/ou son interprétation erronée risque d'aboutir à des attitudes thérapeutiques inadaptées voire dangereuses. Consciente de cet enjeu, la Société française d'allergologie (SFA) a mis en place un groupe de travail multidisciplinaire pour l'actualisation des recommandations de biologie de l'allergie, les précédentes recommandations élaborées en 2005 par la Haute autorité de santé (HAS) étant devenues en partie obsolètes en raison de l'évolution des techniques et concepts. La méthodologie utilisée est celle des recommandations pour la pratique clinique (RPC) élaborée par la HAS, même si le texte n'a pas été labellisé par celle institution. Le groupe de travail a rédigé 28 recommandations gradées sur l'allergie alimentaire. Bien que non exhaustives, ces 28 questions répondent aux préoccupations les plus courantes des prescripteurs qu'ils soient allergologues ou non pour la prise en charge des allergies alimentaires avérées ou suspectées, tout en tenant compte du contexte réglementaire français. Allergy laboratory tests provide an important contribution to the diagnosis and monitoring of food allergies. The increase in the prevalence of food allergies in the French population during the last decades and the increasingly frequent use of biological diagnosis requires the optimization of the use of this tool. Its rational use according to updated scientific data and an approach favoring the cost/benefit ratio can guarantee diagnostic efficiency. The misuse of allergy biology and/or its misinterpretation may lead to inappropriate or even dangerous therapeutic attitudes. Aware of this issue, the French Society of Allergology (SFA) has set up a multidisciplinary task force to update allergy biology recommendations, the previous recommendations drawn up in 2005 by the High Authority for Health (HAS) having become partly obsolete due to the evolution of techniques and concepts. The methodology used is that of the recommendations for clinical practice (RPC) developed by the HAS, even if the text has not been labeled by that institution. The working group drafted 28 graded recommendations for the management of food allergy. Although not exhaustive, these 28 questions respond to the most common concerns of prescribers whether or not they are allergists for the care of known or suspected food allergies, while taking into account the French regulatory context. [ABSTRACT FROM AUTHOR]

Les examens biologiques d'allergie contribuent de façon significative au diagnostic et au suivi des allergies aux piqûres et morsures d'arthropodes. Les dosages d'IgE spécifiques apportent la preuve d'un mécanisme allergique IgE-dépendant. L'utilisation rationnelle des outils biologiques disponibles selon les données actualisées de la science est à même de garantir l'efficience diagnostique. Le mésusage de la biologie de l'allergie et/ou leur interprétation erronée risque d'aboutir à des attitudes thérapeutiques inadaptées. Consciente de cet enjeu, la Société française d'allergologie (SFA) a mis en place un groupe de travail multidisciplinaire pour l'actualisation des recommandations de biologie de l'allergie, les précédentes recommandations élaborées en 2005 par la Haute autorité de santé (HAS) étant devenues en partie obsolètes en raison de l'évolution des techniques et concepts. La méthodologie utilisée est celle des recommandations pour la pratique clinique (RPC) élaborée par la HAS, même si le texte n'a pas été labellisé par celle institution. Le groupe de travail a rédigé 8 recommandations gradées sur l'allergie aux piqûres et morsures d'arthropodes et 5 recommandations gradées sur d'autres pathologies immuno-allergiques ou frontière. Bien que non exhaustives, ces 13 questions répondent aux préoccupations les plus courantes des prescripteurs qu'ils soient allergologues ou non, tout en tenant compte du contexte réglementaire français. Allergy laboratory tests provide a significant contribution to the diagnosis and monitoring of allergies to arthropods sting or bite. Specific IgE assays provide evidence of an IgE-dependent allergic mechanism. The rational use of the biological tools available according to updated scientific data can guarantee diagnostic efficiency. The misuse of the biology of allergy and/or their misinterpretation may lead to inappropriate therapeutic attitudes. Aware of this issue, the French Society of Allergology (SFA) has set up a multidisciplinary task force to update allergy biology recommendations, the previous recommendations drawn up in 2005 by the French High Authority for Health (HAS) having become partly obsolete due to the evolution of techniques and concepts. The methodology used is that of the recommendations for clinical practice (RPC) developed by the HAS, even if the text has not been labeled by that institution. The working group drafted 8 graded recommendations for the management of allergy to arthropods sting or bite, and 5 graded recommendations on other immuno-allergic or frontier diseases. Although not exhaustive, these 13 questions respond to the most common concerns of prescribers whether or not they are allergists, while taking into account the French regulatory context. [ABSTRACT FROM AUTHOR]

Contrairement aux allergies respiratoires, alimentaires et aux venins d'hyménoptères qui concernent des allergènes protéiques, la prise en charge des allergies aux médicaments nécessite rarement le recours aux examens biologiques pour obtenir la preuve d'un mécanisme allergique IgE-dépendant. Un nombre très restreint de dosages d'IgE spécifiques de médicaments est disponible car la grande majorité des médicaments sont des haptènes. L'utilisation rationnelle des outils biologiques disponibles selon les données actualisées de la science est à même de garantir l'efficience diagnostique. Le mésusage de la biologie de l'allergie et/ou leur interprétation erronée risque d'aboutir à des attitudes thérapeutiques inadaptées voire dangereuses. Consciente de cet enjeu, la Société française d'allergologie (SFA) a mis en place un groupe de travail multidisciplinaire pour l'actualisation des recommandations de biologie de l'allergie, les précédentes recommandations élaborées en 2005 par la Haute autorité de santé (HAS) étant devenues en partie obsolètes en raison de l'évolution des techniques et concepts. La méthodologie utilisée est celle des recommandations pour la pratique clinique (RPC) élaborée par la HAS, même si le texte n'a pas été labellisé par celle institution. Le groupe de travail a rédigé 11 recommandations gradées sur l'allergie aux médicaments. Bien que non exhaustives, ces 11 questions répondent aux préoccupations les plus courantes des prescripteurs qu'ils soient allergologues ou non pour la prise en charge des patients ayant une suspicion d'allergie aux médicaments, tout en tenant compte du contexte réglementaire français. Unlike respiratory allergies, food allergies and hymenopteran venoms which involve protein allergens, the management of drug allergies rarely requires the use of laboratory tests to obtain evidence of an IgE-dependent allergic mechanism. A very small number of drug specific IgE assays are available because drugs are mostly haptens. The rational use of the biological tools available according to updated scientific data can guarantee diagnostic efficiency. The misuse of the biology of allergy and/or their misinterpretation may lead to inappropriate or even dangerous therapeutic attitudes. Aware of this issue, the French Society of Allergology (SFA) has set up a multidisciplinary task force to update allergy biology recommendations, the previous recommendations drawn up in 2005 by the High Authority for Health (HAS) having become partly obsolete due to the evolution of techniques and concepts. The methodology used is that of the recommendations for clinical practice (RPC) developed by the HAS, even if the text has not been labeled by that institution. The working group drafted 11 graded recommendations for the management of drug allergy. Although not exhaustive, these 11 questions respond to the most common concerns of prescribers whether or not they are allergists for the management of patients with suspected drug allergy, while taking into account the French regulatory context. [ABSTRACT FROM AUTHOR]

Les dosages d'IgG et de leurs sous-classes sont des examens courants de biologie médicale. Les IgG sériques totales trouvent leur place en première intention dans les diagnostics des déficits immunitaires primitifs ; mais aussi dans leur suivi et celui des traitements par immunoglobulines polyvalentes. Pour les sous-classes d'IgG sériques, elles sont recommandées en deuxième ligne ou pour la maladie associée aux IgG4. Dans le liquide céphalorachidien, l'intérêt porte aujourd'hui sur les IgG qui permettent la distinction entre un transsudat et une synthèse intrathécale. La technique de dosage est quantitative en milieu liquide (néphélémétrie/turbidimétrie). Parmi les difficultés rencontrées, nous retrouvons l'absence de standard international pour les réactifs des sous-classes d'IgG, les discordances entre le dosage des IgG totales et celui des sous-classes dosées individuellement et la mauvaise évaluation des concentrations des IgG4. Dans cette revue actualisée de la littérature nous revenons sur ces difficultés mais aussi sur les améliorations proposées par les fournisseurs. Nous apportons également quelques pistes sur d'autres améliorations encore possibles pour pallier les difficultés qui persistent. Total IgG and IgG subclasses measurements are common lab acts in medical biology. The main indications are primary immunodeficiency's diagnosis and follow-up treatment with multivalent immunoglobulins. IgG subclass measurement plays a key role in IgG4-Related Disease but is also useful for second-line diagnosis in humoral immune deficiencies. In the cerebrospinal fluid, an index is used as an indicator of the relative amount of CSF IgG compared to serum. Any increase in the index is a reflection of IgG production in the central nervous system. There is no reference material allowing standardization of IgG subclass assays, discrepancies between total IgG and sum of IgG subclasses are quite frequent and IgG4 seem to be underestimated and lead to cross reactivity. In this review, we show that the manufacturers along the difficulties encountered during lab routine have made some improvements. In addition, we are making some suggestions for further improvements that can be done to reduce the difficulties that remain. [ABSTRACT FROM AUTHOR]

Le réseau AllergoBioNet est constitué de biologistes hospitaliers spécialistes des analyses contribuant au diagnostic et au suivi des maladies allergiques. Initialement constitué d'une dizaine de membres, il comporte actuellement soixante-dix-neuf biologistes français exerçant dans 29 CHU et 15 CH, ainsi qu'un biologiste belge. Parmi ces laboratoires, 10 ont été labellisés « laboratoires de biologie médicale de référence » (LBMR) du fait de leur expertise des explorations biologiques des maladies allergiques, des autres causes d'hypersensibilité, des pathologies mastocytaires et du complément. Les objectifs principaux des biologistes du réseau sont de tester et mettre en oeuvre des techniques robustes et fiables accréditées par le COFRAC, d'être un outil de formation médicale continue pour maintenir et actualiser les connaissances et compétences et de promouvoir des projets de recherche dont les résultats sont présentés dans les congrès nationaux et internationaux et sous forme d'articles publiés dans des revues spécialisées. Cet article est un appel auprès des biologistes hospitaliers à s'impliquer dans le domaine de l'allergologie via le réseau AllergoBioNet, mais aussi auprès des allergologues qui peuvent solliciter la collaboration de ces biologistes spécialisés pour répondre à leurs questions pratiques (conditions pré-analytiques, conservation des échantillons), de discuter des qualités analytiques des méthodes utilisées pour comprendre leurs limites techniques, de savoir où adresser le patient nécessitant une analyse très spécialisée et d'échanger autour de l'interprétation des résultats. Ce partenariat permet d'enrichir mutuellement les savoirs et les pratiques dans le but d'optimiser la prise en charge des patients. AllergoBioNet is a French association of clinical laboratory specialists of allergic and mast-cell-related diseases and their differential diagnoses. Its 79 members are working in clinical laboratories in 29 Universitary Hospitals and 15 General Hospitals in France and another one in Belgium. Ten of these laboratories have recently been certified as « laboratoires de biologie médicale de référence » (Reference Clinical Laboratories, LBMR) to valorize the expertise in hypersensitivity, mast-cell and complement laboratory investigations. The first mission of these laboratory professionals is to ensure that results are accurate and reliable. Thus, they deal with all the process of continuous quality improvement and are able to minimize errors of the sample's workflow (pre-analytic, analytic and post-analytic phases). Since years, they are certified by the French Organization for Quality (COFRAC). Moreover, they evaluate newer diagnostic tests, ensure continuous medical formation to actualize competences and knowledge, participate in research protocols and publish in national and international specialized reviews. The aims of this article are (1) to encourage all medical laboratory specialists working in the field of allergic diseases (diagnosis, monitoring patients and responses to therapy) to join the AllergoBioNet network; (2) to encourage physicians to collaborate with these laboratory professionals, so that they could answer to practical questions (ie: pre-analytical needs and conservation samples), receive updates for state-of-the-art laboratory methods and devices, refer patients needing highly specialized analyses and ensure interdisciplinary interpretation of clinical and laboratory results. This partnership should improve mutual competences and contribute to patient care. [ABSTRACT FROM AUTHOR]

L'évolution des connaissances, des techniques et la mise à disposition en routine d'un nombre important d'allergènes moléculaires, ainsi que les évolutions réglementaires qui ont fait disparaître certains extraits allergéniques pour prick tests, ont eu des répercussions sur le diagnostic biologique de l'allergie. La ociété française d'allergologie a constitué un groupe de travail, dont l'objectif était d'actualiser les recommandations de biologie de l'allergie initialement élaborées par la HAS 2 2 Haute Autorité de santé. en 2005. La méthodologie utilisée pour la rédaction est celle de la « Recommandation de bonne pratique », selon la méthode « Recommandation pour la pratique clinique » de la HAS. Elle a permis d'élaborer 73 recommandations gradées selon le niveau de preuves, destinées à tous les prescripteurs, dont les principales sont décrites ici. The evolution of knowledge, techniques and the routine availability of a large number of molecular allergens, as well as regulatory developments which have eliminated certain allergenic extracts for prick tests, have had repercussions on the biological diagnosis of allergy. The French Allergology Society has set up a working group whose objective was to update the allergy biology recommendations initially developed by HAS2 in 2005. The methodology used for the drafting is that of the "Good recommendation practice", according to the HAS method "Recommendation for clinical practice". It produced 73 recommendations graded according to the level of evidence, intended for all prescribers, the main ones of which are described here. [ABSTRACT FROM AUTHOR]

La vérification d'une méthode de dosage selon la norme NF/EN/ISO 15189 requiert l'analyse des performances de la technique (répétabilité, fidélité intermédiaire, exactitude et incertitude de mesure) avant toute utilisation en routine. Les coefficients de variation (CV) des résultats de précision intra-essai et inter-essais obtenus doivent être comparés à ceux des pairs et à ceux qui pratiquent ces mêmes dosages quelle que soit la technique. En l'absence de publications nationales ou internationales pour les IgE spécifiques et la tryptase, le réseau des biologistes des centres hospitaliers AllergoBioNet a analysé les résultats fournis par 24 centres pour proposer des limites acceptables des critères de performance pour le dosage des IgE totales et spécifiques et de la tryptase. Checking a dosing method according to NF/EN/ISO 15189 standard requires analysis of the performance of the technique (repeatability, intermediate fidelity, accuracy and measurement uncertainty) before routine use and follow-up annually. The coefficients of variation (CV) of the intra-assay and inter-assays accuracy results obtained must be compared with those of peers and those who perform the same determination regardless of the technique. In the absence of national or international guidelines for monitoring the performance of specific IgE and tryptase assay, the French network of hospital laboratories AllergoBioNet analysed the results provided by 24 centers and propose recommendations for total IgE, specific IgE and tryptase assays. [ABSTRACT FROM AUTHOR]

Une enquête portant sur 646 chiroptères porteurs sains, prélevés principalement dans les environs de Dakar (Sénégal), est effectuée. Elle intéresse 264 individus appartenant à des espèces frugivores (Eidolon, Roussettus, Epomophora), 382 exemplaires d'espèces insectivores (Tadarida, Nycteris, Hipposideros) et 106 prélèvements de guano (Tadarida). A partir des coprocultures, 83 souches de Salmonella sont isolées chez les chiroptères, ce qui correspond à un taux d'infestation moyen de 12,8 p. 100. Les ensemencements de guano fournissent 48 souches. 64 sérotypes différents sont mis en évidence au cours de cette étude (4 souches sont encore en cours d'examen). 3 sérotypes nouveaux sont découverts: S. taset, S. bambylor, S. sangalkam, et 11 sérotypes rapportés pour la première fois au Sénégal: S. vom, S. goma, S. umhlali, S. angers, S. miami, S. bolombo, S. uzaramo, S. blukwa, S. doorn, S. windermere, S. gokul. Les chiroptères constituent donc un réservoir animal de Salmonella dont l'incidence sur les risques de contamination humaine et animale est discutée.

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Due to operational and institutional constraints, humanitarian actors have found it difficult to adopt quality approaches and principles developed for the sector. Having previously explored the links between adopting a quality approach and information management, Groupe URD now wants to share more widely the insight it has gained about the adoption of quality approaches from the Sigmah project, which aims to improve the shared management of humanitarian projects. [ABSTRACT FROM AUTHOR]

A qualitative, phenomenological approach was used to explore the experiences of six occupational therapists who made career transitions. Results showed the necessity of support systems, on-the-job training, and education to make a smooth transition as well as the need for professional guidelines. [ABSTRACT FROM AUTHOR]

Atypical hemolytic uremic syndrome (aHUS) is a rare thrombotic microangiopathic disorder that may be familial or sporadic. Complement factor H (CFH), factor I, and membrane cofactor protein (MCP; CD46), 3 regulators of the alternative pathway of the complement system activation, have been implicated in this pathological state. To date, 29 different mutations of CD46 have been reported, with incomplete penetrance and better clinical outcome compared with CFH mutations. Of those mutations, only 6 were found to be homozygous (accounting for 8 patients), and 5 resulted in a lack of or dramatically decreased cell-surface CD46 expression. We report here the seventh patient with a null mutation associated with recurrent aHUS. This mutation, a guanine to cytosine substitution in the first nucleotide of intron 2, disrupts a splice donor site. Interestingly, the patient's disease-free sister showed the same homozygous mutation. Extensive analysis of other complement regulatory protein- and polymorphism-associated risk factors did not uncover a difference between the patient and his sister. In conclusion, we describe for the first time a disease-free individual with complete CD46 deficiency, confirming the extremely variable penetrance and genetic complexity of aHUS. Copyright © 2008 National Kidney Foundation, Inc. [ABSTRACT FROM AUTHOR]

The authors compare three diagnostic-imaging methods (two-dimensional-echography, heart scans and indium-111 platelet scintigraphy) used in the detection of intracardiac thrombi in 82 patients. They attempt to define their respective diagnostic values in the presence of left ventricular and atrial thrombi.