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We suggested a plasmonic platform based on a cubic pattern of gold spheres for surface enhanced Raman spectroscopy (SERS). In the case of linear polarization along the symmetry axes, the SERS enhancement per area is identical to hexagonally patterned surfaces. The validity of this model was tested using the simulation package of COMSOL Multiphysics® Modeling Software. We found an improved sensitivity in the near infrared and visible region of the electromagnetic spectrum. This method considered tolerance towards stacking faults and suggested a plasmonic platform for ultra-sensing applications. The design can be extended towards the molecular detection if the proposed plasmonic platform is used with SERS.

AbstractInflammatory response and oxidative stress state have been largely described in diabetes and depression separately but not in combination. We aimed to explore the involvement of diabetes and unpredictable chronic mild stress (UCMS) separately or in combination on inflammatory response and oxidative stress. Diabetes, UCMS or combined rat models were used. Proinflammatory cytokines, Interleukin 6 (IL-6) and Tumor necrosis factor alpha (TNF-α) were assessed by real time quantitative polymerase chain reaction (q-PCR) and Enzyme-Linked Immunosorbent Assay (ELISA). Superoxide dismutase (SOD) and catalase (CAT) were determined by colorimetric assays. In the diabetes group, IL-6 mRNA expression increased by 55% and 34% (p < 0.05), respectively, in liver and kidney. UCMS alone or in combination with diabetes increased the mRNA of IL-6, respectively, by 85% and 78% in the liver and by 28% and 63% in the kidney (p < 0.01 for all). ELISA showed that diabetes and UCMS act in synergy on TNF-α and IL-6 expression. Diabetes and UCMS separately or in combination inhibited significantly (p < 0.01) the activities of the two anti-oxidant enzymes when compared to controls. The malondialdehyde (MDA) level was significantly enhanced in the group with diabetes combined with UCMS compared to UCMS alone in both organs. UCMS enhances the proinflammatory cytokines release and induces oxidative stress imbalance, and diabetes comorbidity with depression aggravates the inflammatory response and lipid peroxidation. These observations can be useful to better understand depression-induced organ damage.

Luminescent complexes of earth-abundant first-row transition metals are of renewed, broad interest due to their spectroscopic and photochemical properties as well as emerging applications. New strong-field polypyridine ligands have led to six-coordinate 3d3chromium(III) complexes with intense spin-flip luminescence in solution at room temperature. The ground and emissive states both arise from the (t2)3electron configuration involving the dπlevels (O point group symmetry labels). Pseudoctahedral 3d8nickel(II) complexes with such strong ligands are a priorialso promising candidates for spin-flip luminescence. In contrast, the relevant electron configurations involve the dσorbitals and (e)2configurations. We have prepared the known nickel(II) complexes [Ni(terpy)2]2+, [Ni(phen)3]2+, and [Ni(ddpd)2]2+as well as the novel complexes [Ni(dgpy)2]2+and [Ni(tpe)2]2+forming a series with increasing ligand field strengths (terpy = 2,2′:6′,2″-terpyridine; phen = 1,10-phenanthroline; ddpd = N,N′-dimethyl-N,N′-dipyridine-2-ylpyridine-2,6-diamine; dgpy = 2,6-diguanidylpyridine; tpe = 1,1,1-tris(pyrid-2-yl)ethane). The lowest-energy singlet and triplet excited states of these nickel(II) complexes are analyzed based on absorption spectra using ligand field theory and CASSCF-NEVPT2 calculations for vertical transition energies and a model based on coupled potential energy surfaces, leading to calculated absorption spectra in good agreement with the experimental data. No photoluminescence signal was observed in the wavelength ranges identified through the analyses of the absorption spectra. The models provide insight into key differences between the nickel(II) complexes and their strongly luminescent chromium(III) analogues.

ObjectivesTo quantify the burden of COVID-19-related sick leave during the first pandemic wave in France, accounting for sick leaves due to symptomatic COVID-19 (‘symptomatic sick leaves’) and those due to close contact with COVID-19 cases (‘contact sick leaves’).MethodsWe combined data from a national demographic database, an occupational health survey, a social behaviour survey and a dynamic SARS-CoV-2 transmission model. Sick leave incidence from 1 March 2020 to 31 May 2020 was estimated by summing daily probabilities of symptomatic and contact sick leaves, stratified by age and administrative region.ResultsThere were an estimated 1.70M COVID-19-related sick leaves among France’s 40M working-age adults during the first pandemic wave, including 0.42M due to COVID-19 symptoms and 1.28M due to COVID-19 contacts. There was great geographical variation, with peak daily sick leave incidence ranging from 230 in Corse (Corsica) to 33 000 in Île-de-France (the greater Paris region), and greatest overall burden in regions of north-eastern France. Regional sick leave burden was generally proportional to local COVID-19 prevalence, but age-adjusted employment rates and contact behaviours also contributed. For instance, 37% of symptomatic infections occurred in Île-de-France, but 45% of sick leaves. Middle-aged workers bore disproportionately high sick leave burden, owing predominantly to greater incidence of contact sick leaves.ConclusionsFrance was heavily impacted by sick leave during the first pandemic wave, with COVID-19 contacts accounting for approximately three-quarters of COVID-19-related sick leaves. In the absence of representative sick leave registry data, local demography, employment patterns, epidemiological trends and contact behaviours can be synthesised to quantify sick leave burden and, in turn, predict economic consequences of infectious disease epidemics.

What is the key clinically controllable preventive measure that may help reduce the incidence of biological complications? Implant complications are common, ineffective care, and delay in diagnosis can lead to expensive time‐consuming surgical and nonsurgical interventions. Careful selection and placement of implant allow development of adequate emergence design of the implant suprastructure. This helps achieve effective plaque control, adequate maintenance at hygiene visits, accurate follow‐up assessments of the peri‐implant tissues addressing the key underlying factor impacting biological complications. This clinically controllable preventative measure may be considered a vital strategy in averting peri‐implant disease. Surge in biological complications has led to increased patient dissatisfaction in terms of time, cost, esthetics, and maintenance. One of the factors identified in causing biological complications is the iatrogenic prosthesis‐related factor. Minimizing the impact of this factor is crucial to the overall implant success. Selection and placement of implant following meticulous planning, using careful surgical protocols, allow development of adequate suprastructure design that improves overall patient outcomes by reducing biological complications. Further research is essential to comprehensively assess the impact of these strategies in thwarting development of biological complications.

Objective: A wave of bombings struck France in 1995 and 1996, killing 12 people and injuring more than 200. The authors conducted follow-up evaluations with the victims in 1998 to determine the prevalence of and factors associated with posttraumatic stress disorder (PTSD). Method: Victims directly exposed to the bombings (N = 228) were recruited into a retrospective, cross-sectional study. Computer-assisted telephone interviews were conducted to evaluate PTSD, per DSM-IV criteria, and to assess health status before the attack, initial injury severity and perceived threat at the time of attack, and psychological symptoms, cosmetic impairment, hearing problems, and health service use at the time of the follow-up evaluation. Factors associated with PTSD were investigated with univariate logistic regression followed by multiple logistic regression analyses. Results: A total of 196 respondents (86%) participated in the study. Of these, 19% had severe initial physical injuries (hospitalization exceeding 1 week). Problems reported at the follow-up evaluation included attack-related hearing problems (51%), cosmetic impairment (33%), and PTSD (31%) (95% confidence interval= 24.5%-37.5%). Results of logistic regression analyses indicated that the risk of PTSD was significantly higher among women (odds ratio=2.54), participants age 35-54 (odds ratio=2.83), and those who had severe initial injuries (odds ratio=2.79) or cosmetic impairment (odds ratio=2.74) or who perceived substantial threat during the attack (odds ratio=3.99). Conclusions: The high prevalence of PTSD 2.6 years on average after a terrorist attack emphasizes the need for improved health services to address the intermediate and long-term consequences of terrorism.

Dans de nombreux pays, on observe une sensibilité croissante de la population pour la qualité des environnements de vie, en particulier, autour d'installations industrielles. Pour y répondre, les agences de sécurité sanitaire de plusieurs pays ont mené des études épidémiologiques, centrées sur des critères de mortalité ou de morbidité caractérisés médicalement. Pour apporter une réponse complète, ces agences ont élargi le champ à la mesure de la santé perçue. Néanmoins, ces approches ont été menées au cas par cas sans qu'il existe une conduite à tenir. Il est donc apparu nécessaire de réaliser un travail d'identification de ces outils grâce à une « scoping review ». Ce travail a pour objectif d'analyser comment la validité et la fiabilité des outils ont été appréhendées dans les articles.

Curt Griffith Salem, IL Dear Dirt Wheels, Here are some pics from an October day out on the trail with my buds at "Cougar Patch" here in Alberta. Wiley Russell Volant PA Dear Dirt Wheels, This is a picture of my son, Seth, 14 years ago and a picture of him now. PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR). [Extracted from the article]

AbstractContextDisorders associated with diabetes and the beneficial effects of pomegranate peel extract (PPE) were widely reported. However effect of diabetes and PPE on extracellular matrix (ECM) remodelling needs further investigation.ObjectivesThe focus of this study was to investigate the involvement of diabetes in cardiac ECM and the beneficial effects of PPE.MethodsDiabetes was induced by alloxan. PPE group was injected with 100 mg/kg of PPE. The phenolic profile of PPE was analyzed by HPLC. ECM was detected by ELISA. MMP-1, -8, -13 were determined by a colorimetric assay.ResultsCompared to control fibronectin and laminin plasma content was higher respectively by 69% and 42% (p < 0.05) in diabetes. LV content of hydroxyproline and total collagen was higher by 195% (p < 0.01) and 56% (p < 0.05) in the diabetic group compared to control and restored at a similar level to controls in the PPE group. Compared to control, collagenase activity was significantly reduced by 32% (p < 0.05) and 35% (p < 0.05) respectively in ALX and PPF groups. There is no significant difference in collagenase activities in diabetic rats after and before PPE injection.ConclusionDiabetes is involved in cardiac ECM remodelling which can be improved by PPE. These findings will be useful for more understanding diabetes-induced cardiac disorders.

It is important to evaluate whether a new treatment for heart failure with reduced ejection fraction (HFrEF) provides additive benefit to background foundational treatments. As such, we aimed to evaluate the efficacy and safety of empagliflozin in patients with HFrEF in addition to baseline treatment with specific doses and combinations of disease-modifying therapies.

La pandémie de Covid-19 a suscité une mobilisation scientifique sans précédent, notamment sur le plan épidémiologique. Malgré cela, le fardeau sanitaire est tel que l’on peut parler d’un échec de santé publique. Cet article discute les raisons d’hiatus. Il souligne l’importance du rôle des médecins du travail dans ce contexte. Il présente les leçons à tirer pour l’avenir.

Among the techniques to reveal the chemistry, structure, and dynamics of surfaces, tip-enhanced Raman spectroscopy (TERS) occupies a unique position for the investigation of nonmetallic nanomaterials: it provides a wealth of information of Raman spectroscopy even under ambient conditions with the opportunity for spatial resolution below the diffraction limit. The high sensitivity of the optical near field to surfaces has been exploited on self-assembled monolayers on multiple occasions, and yet, the potential for the investigation of crystalline surfaces remains to be unfolded. Using strontium titanate (SrTiO3) as a model system, we demonstrate that TERS does not only provide insight into surface symmetries but also activates otherwise symmetry-forbidden modes. The bulk phase of strontium titanate is Raman-inactive, and the optical far field therefore does not provide any first-order Raman signature: as a consequence, any peak in TERS configuration originates from the optical near field, confined to a few nanometers at the apex of the tip. We observe first-order Raman peaks interpreted as TO2, TO4, and LO4 phonon modes and the strong field enhancement of both infrared-active LO3 and Raman surface modes in agreement with density functional theory (DFT) calculations. The intensity enhancement of the surface modes shows the sensitivity of TERS to monitor surface relaxation effects associated with structural phase transformations into, e.g., a polar phase, and to detect surface reconstructions that are known to be crucial for photocatalytic activity.

(Ca1‐xEux)Ga2S4(x= 0.10, 0.40, 0.70, 1.0) phosphors were synthesized from CaS, EuS, and Ga2S3via a solid‐state reaction, and their crystal structures were investigated by X‐ray diffraction analysis. Cathodoluminescence (CL) spectra of these phosphors under moderate electron‐beam voltages from 4 to 10 kV were investigated to assess their applicability in carbon nanotube field‐emission displays. The wavelength at maximum intensity (λmax) of the CL spectra changed gradually from 557 to 546 nm with increasing europium‐ion mole fraction (x) in the (Ca1‐xEux)Ga2S4phosphors. These bands were attributed to the transitions from the lowest energy level of the 4f65d1excited state to the 4f7(8S7/2) ground state of the Eu2+ions. The blue shift of this wavelength was interpreted on the basis of the crystal structures of the phosphors. The color of light emitted from the (Ca1‐xEux)Ga2S4phosphors was confirmed to be tunable. Color Tuning of Light Emitted from Cathodoluminecence of (Ca1−xEux)Ga2S4Phosphors.

L’étude Esspol (Etat de santé et santé perçue des populations résidant à proximité d'un site et sol potentiellement pollué en région Grand Est) vise à décrire, outre le contexte local, l’état de santé objectivée et la santé perçue de trois populations résidant à proximité de sites industriels, arrêtés, en activité ou en projet, ainsi que l’état de santé d'une population non riveraine d'un site industriel.

Depuis plusieurs années, les inquiétudes en santé environnementale induisent une sollicitation accrue des agences de sécurité sanitaire comme Santé publique France, dans un contexte général de défiance. Le centre industriel de stockage géologique (Cigéo), situé en Meuse, est destiné à recevoir des déchets nucléaires. Encore à l’état de projet, il suscite déjà des interrogations des riverains sur sa future exploitation et ses conséquences sanitaires à long terme. Le comité local d'information et de suivi (Clis) a souhaité une surveillance de la santé des riverains pérenne, adaptée à la vie du projet industriel et comportant un état de référence sanitaire. Santé publique France a le projet de construire une réponse structurée à ce type de sollicitations.

Thoracoscopic talc poudrage of the entire pleural surface constitutes successful treatment of recurrent pneumothorax in cystic fibrosis (CF); however, subsequent lung transplantation is seriously jeopardized due to the development of [...]

The dynamics of individual water molecules has a strong effect on the energetics of biochemical interactions, such as peptide–protein binding. Existing software are able to predict the location of water molecules at the interface between a macromolecule and a ligand in a single state or at a particular time point. The program described in this article compares explicit solvent molecules from two different states within a given volume of space; for example between a free protein vs. the same protein with a ligand bound. This comparison creates a unique one-to-one matching between waters from the two states utilizing the Jonker and Volgenant algorithm for linear assignment. Matchings are deterministic and minimize the sum of the distance between matched pairs. Explicit solvent ligand docking can utilize this matching to understand how ligand binding affects the energy of interface waters. This algorithm can also be used to compare predicted water molecules to those seen in X-ray crystallography, or to compare two different methods of solvent prediction. Program title: WaterAlignment Program files doi: http://dx.doi.org/10.17632/pk6fnvwgg7.1 Licensing provisions: GNU Lesser General Public License Programming language: Python Nature of problem: Comparison of the location of solvent water molecules present in the same volume under two conditions in order to 'match' waters between the two conditions; that is, to define matched waters that represent the same molecule. The algorithm was developed to compare waters present in the binding pocket of a protein with and without a bound ligand, in order to determine the effect of ligand binding on the energy of waters in the binding pocket. Solution method: The task is treated as a linear assignment problem solved by the Jonker and Volgenant algorithm. A bipartite graph is constructed with each part of the graph consisting of nodes representing one of the two set of waters. Edges facing from the first set of nodes to the second set are added with cost equal to the distance between the waters that the nodes represent. This data structure is then used to create propositional matches, with each new match able to replace prior matches when beneficial to the overall result. [ABSTRACT FROM AUTHOR]

Identifier les facteurs de maintien dans l’emploi, notamment en lien avec l’âge, chez les postiers reprenant le travail après un arrêt de travail pour raison de santé.

Une inquiétude soulevée sur un excès possible de mortalité chez les imprimeurs a motivé la réalisation d’une évaluation quantitative des risques sanitaires (EQRS) ayant pour objectif de quantifier les risques à long terme par les employés travaillant à proximité de la rotative. L’EQRS est une démarche comportant quatre étapes. L’identification des polluants présents, notamment dans les encres, a permis de recenser les différentes sources de dangers associées puis de choisir les polluants traceurs à prendre en considération. Les valeurs toxicologiques de référence (VTR) de ces traceurs ont été sélectionnées. L’analyse des données d’exposition a reposé sur une analyse du travail et des mesurages dans l’air et l’encre à partir desquels des scénarios d’exposition ont été construits. Les données ont alors été synthétisées pour caractériser les risques. Le principal résultat est un excès important de risque de cancer lié à l’exposition aux PM10. Les VTR pour les HAP sont respectés. Alors même que les valeurs limites d’exposition en vigueur pour les PM10 sont respectées, cette EQRS montre que les travailleurs à proximité des rotatives ont un niveau de risque élevé de cancer. Ce résultat appelle la mise en œuvre de mesures correctives immédiates, complétée par un suivi régulier des niveaux d’exposition.

Cette étude vise à évaluer la distribution spatio-temporelle des troubles musculosquelettiques (TMS) de 1990 à 2019 à l’aide des données du Global Burden of Disease(GBD).

« Comment réaliser une évaluation fiable de l’exposition journalière aux vibrations corps entier A(8) sans mesure métrologique ? ». L’Association interprofessionnelle des centres médicaux sociaux de santé au travail de la région Île-de-France (ACMS) a vu augmenter pour ce risque les demandes de ces adhérents. Les objectifs de cette étude sont les suivants : optimiser les ressources du service et des adhérents en minimisant les mesurages ; établir une méthodologie pour évaluer ce risque ; accompagner les entreprises dans leur démarche de prévention.

The features of Saab's new sports coupe Aero-X exhibited at Geneva Motor Show are discussed.

The $13 billion Public Employees' Retirement System of Nevada has awarded Western Asset Management a $400 million active U.S. bond mandate, PERSN CFO Ken Lambert said. While he wouldn't name […]

Les troubles musculosquelettiques (TMS) affectaient environ 1,71 milliard de personnes en 2020, soit plus de 22 % de la population mondiale. Ces pathologies peuvent avoir des conséquences considérables sur la qualité de vie, mais aussi sur la productivité et les coûts de santé. Or, à ce jour, les variations géographiques mondiales et les tendances temporelles dans la survenue de ces maladies ont été peu étudiées de manière systématique.

The retention and displacement of water molecules during formation of ligand–protein interfaces play a major role in determining ligand binding. Understanding these effects requires a method for positioning of water molecules in the bound and unbound proteins and for defining water displacement upon ligand binding. We describe an algorithm for water placement and a calculation of ligand-driven water displacement in >9000 protein–ligand complexes. The algorithm predicts approximately 38% of experimental water positions within 1.0 Å and about 83% within 1.5 Å. We further show that the predicted water molecules can complete water networks not detected in crystallographic structures of the protein–ligand complexes. The algorithm was also applied to solvation of the corresponding unbound proteins, and this allowed calculation of water displacement upon ligand binding based on differences in the water network between the bound and unbound structures. We illustrate use of this approach through comparison of water displacement by structurally related ligands at the same binding site. This method for evaluation of water displacement upon ligand binding may be of value for prediction of the effects of ligand modification in drug design.

Aims. The importance of disc-disc major mergers in galaxy evolution remains uncertain. We study the major merger fraction in a SPITZER/IRAC-selected catalogue in the GOODS-S field up to z ~ 1 for luminosity- and mass-limited samples.Methods. We select disc-disc merger remnants on the basis of morphological asymmetries/distortions, and address three main sources of systematic errors: (i) we explicitly apply morphological K-corrections; (ii) we measure asymmetries in galaxies artificially redshifted to zd= 1.0 to deal with loss of morphological information with redshift; and (iii) we take into account the observational errors in z and A, which tend to overestimate the merger fraction, though use of maximum likelihood techniques.Results. We obtain morphological merger fractions (fmmph) below 0.06 up to z ~ 1. Parameterizing the merger fraction evolution with redshift as fmmph(z) = fmmph(0) (1+z)m, we find that m = 1.8 ? 0.5 for MB? -20 galaxies, while m = 5.4 ? 0.4 for M*? 1010M?galaxies. When we translate our merger fractions to merger rates (Remmph), their evolution, parameterized as Remmph(z) = Remmph(0) (1+z)n, is quite similar in both cases: n = 3.3 ? 0.8 for MB? -20 galaxies, and n = 3.5 ? 0.4 for M*? 1010M?galaxies.Conclusions. Our results imply that only ~8% of today's M*? 1010M?galaxies have undergone a disc-disc major merger since z ~ 1. In addition, ~21% of M*? 1010M?galaxies at z ~ 1 have undergone one of these mergers since z ~ 1.5. This suggests that disc-disc major mergers are not the dominant process in the evolution of M*? 1010M?galaxies since z ~ 1, with only 0.2 disc-disc major mergers per galaxy, but may be an important process at z > 1, with ?1 merger per galaxy at 1 < z < 3.

L’appareil respiratoire constitue une voie d’exposition privilégiée pour les aérocontaminants, qu’il s’agisse de gaz ou de particules qui peuvent avoir des effets nocifs à court ou long terme. En moyenne, l’homme respire 15 m3d’air par jour et, en milieu urbain, passe plus de 80 % de son temps à l’intérieur des locaux. La diversité des méthodes épidémiologiques utilisées par plusieurs équipes dans des lieux différents et la cohérence générale de ces observations montrent que les effets à court ou long terme de l’exposition aux polluants de l’intérieur et de l’extérieur des locaux, bien que faibles, restent décelables.

Diffuse optical tomography (DOT) is a new and effective technique for functional brain imaging. It can detect local changes in both oxygenated and deoxygenated haemoglobin concentrations in tissue based on differential absorption at multiple wavelengths. Traditional methods in spatio-temporal analysis of haemoglobin concentrations in diffuse optical tomography first reconstruct the spatial distribution at different time instants independently, then look at the temporal dynamics on each pixel, without incorporating any temporal information as a prior in the image reconstruction. In this work, we present a temporal haemodynamic response function model described by a basis function expansion, in a joint spatio-temporal DOT reconstruction of haemoglobin concentration changes during simulated brain activation. In this joint framework, we simultaneously employ spatial regularization, spectral information and temporal assumptions. We also present an efficient algorithm for solving the associated large-scale systems. The expected improvements in spatial resolution and contrast-to-noise ratio are illustrated with simulations of human brain activation.

Spectroscopic diffuse optical tomography (DOT) can directly image the concentrations of physiologically significant chromophores in the body. This information may be of importance in characterizing breast tumours and distinguishing them from benign structures. This paper studies the accuracy with which lesions can be characterized given a physiologically realistic situation in which the background architecture of the breast is heterogeneous yet highly structured. Specifically, in simulation studies, we assume that the breast is segmented into distinct glandular and adipose regions. Imaging with a high-resolution imaging modality, such as magnetic resonance imaging, in conjunction with a segmentation by a clinical expert, allows the glandular/adipose boundary to be determined. We then apply a two-step approach in which the background chromophore concentrations of each region are estimated in a nonlinear fashion, and a more localized lesion is subsequently estimated using a linear perturbational approach. In addition, we examine the consequences which errors in the breast segmentation have on estimating both the background and inhomogeneity chromophore concentrations.

Details a boat test of the Pershing 50 along the Adriatic Coast of Italy. Design features of the boat; Amenities of the boat for guests.

ABSTRACTWilliam Dab (M.D., Ph.D.) was responsible for the project as the general representative of the APPA. Claire Ségala (M.D., MPH, SEPIA) was the main researcher. The other members of the working group are Frédéric Dor (Ph.D., Institut de Veille Sanitaire), Bernard Festy (president of the APPA), Philippe Lameloise (AIRPARIF), Yvon Le Moullec (Laboratoire d'Hygiène de la Ville de Paris), Alain Le Tertre (MSc, Institut de Veille Sanitaire), Sylvia Médina (M.D., MSc, Institut de Veille Sanitaire), Philippe Quénel (M.D., Ph.D., Institut de Veille Sanitaire), Benoît Wallaert (PU-PH, Faculté de Médecine de Lille) and Denis Zmirou (M.D., Ph.D., MCU-PH Faculté de Médecine de Grenoble).Many epidemiologic studies have observed, in different contexts, a slight short-term relationship between particles in air and cardiopulmonary mortality, even when air quality standards were respected. The causality of this relationship is important to public health because of the number of people exposed. Our aim was to make a critical assessment of the arguments used in 15 reviews of published studies.We explain the importance of distinguishing validity from causality, and we systematically analyze the various criteria of judgment within the context of ecologic time studies. Our conclusion is that the observed relationship is valid and that most of the causality criteria are respected. It is hoped that the level of exposure of populations to these particles be reduced. In Europe, acting at the root of the problem, in particular on diesel emissions, will also enable the reduction of levels of other pollutants that can have an impact on health. In the United States, the situation is more complicated, as particles are mainly secondary. It is also essential to continue with research to become better acquainted with the determinants of personal global exposures and to better understand the toxic role of the various physicochemical factors of the particles.

De nombreuses études épidémiologiques ont observé dans des contextes différents une faible relation à court terme entre les particules et la mortalité cardio-pulmonaire, même quand les normes de qualité de l'air n'étaient pas dépassées. La causalité de cette relation est un enjeu de santé publique en raison de l'importance de la population exposée. Notre objectif est de faire l'inventaire critique des arguments utilisés dans 15 revues de la littérature publiées.Nous expliquons l'importance de distinguer la validité de la causalité et analysons de façon systématique les différents critères de jugement dans le contexte des études écologiques temporelles. Notre conclusion est que la relation observée est valide et que la plupart des critères de causalité sont respectés. Diminuer le niveau d'exposition des populations aux particules est souhaitable. En Europe, en agissant à la source, notamment sur les émissions Diesel, on diminuera aussi d'autres polluants qui peuvent jouer un rôle sanitaire. Aux États-Unis, la situation est plus complexe car les particules sont surtout secondaires.Il est également indispensable de poursuivre les recherches pour mieux connaître les déterminants des expositions globales des individus et mieux comprendre le rôle toxique des différents facteurs physico-chimiques des particules.

From May 1970 to September 1983, 1714 children with different forms of primary tuberculosis were referred to the paediatric home care centre (Enfants soignés au Foyer, E.S.F.) of the Brussels University Hospital St.-Pierre. They were subdivided in five groups: asymptomatic (33%), symptomatic (28%), dubious tuberculous infections (35%), high-risk contacts (3%) and unestablished diagnosis (1%). They were aged from 10 days to 19 years, and 82% of them were migrants of low socio-economic level. Fifty percent of the symptomatic infections, mainly pulmonary, appeared in children under 3 years of age. An adult source of contamination was identified in 33% of the case (48% of the symptomatic children). Diagnosis was based on tuberculin screening with a 2IU intradermal test. Gastric aspirates yieldedMycobacterium tuberculosis in 15% of our patients, 11% of them showing resistance to one or more tuberculostatic drugs. Treatment was given to 1359 patients with excellent results. Therapy was shortened during the last 2 years of the study from 12 to 6 months for the asymptomatic patients and from 12 to 9 months for the symptomatic infections. Few complications were observed. Tuberculosis remains a serious cause of morbidity particularly in migrant children. Correct diagnosis and treatment of the disease is very important.

A study was carried out in order to investigate whether the abnormal in vitroturnover of fatty acids in the phospholipids of the red blood cell membranes of cystic fibrosis patients is intrinsic to the membrane, or whether it is induced by extrinsic serum factors. Red blood cells of cystic fibrosis patients and healthy subjects were labeled in vitrowith [14C]linoleic acid, bound to albumin. The labeled cells were reincubated in autologous and homologous serum. The radioactivity present in the serum lipids and in the major phospholipid fractions of the red cell membranes was measured.

In our previous work it was found that in cystic fibrosis patients with and without pancreatic insufficiency, the fatty acid pattern of the plasma long chain, non-esterified fatty acid fraction is strikingly abnormal in comparison with the corresponding pattern of healthy subjects. However, other investigators have shown abnormal fatty acid patterns only in patients with pancreatic insufficiency. Therefore, we studied the plasma cholesterol ester fraction in cystic fibrosis patients of both types by gas liquid chromatography. It was found that the absolute total concentration of the plasma cholesterol esters in cystic fibrosis patients with and also without pancreatic insufficiency is significantly lower than in healthy subjects.

In 76 children, 102 unilateral bronchograms were compared with the results of chest radiography and Tc-99m perfusion scintigraphy to assess the presence of bronchiectasis. Additional Kr-81m ventilation lung scintigraphy was obtained in 16 patients. For the chest radiograph the sensitivity was 73% and the specificity was 76%. For lung scintigraphy the sensitivity was 92% and the specificity 60%. When both chest radiography and lung scintigraphy were considered, sensitivity reached 96% and specificity fell to 53%. Forty per cent of the bronchograms which were performed might have been avoided on the basis of the normal chest radiograph and lung scintigraphy. The combination of lung scintigraphy and chest radiography is an excellent screening method when a decision on the advisability of bronchography is being taken in children.

From December 1982 to June 1985, we diagnosed LAV/HTLV-III infection in 16 children of African origin living in Belgium or referred to one of the hospitals participating in this study. Diagnosis was proven in seven of them by isolation of virus of the LAV/HTLV-III group. In the nine others, LAV/HTLV-III infection was highly probable because of the presence of antibodies against the virus (seven subjects) or clinical and immunological evidence of immune deficiency associated with a parental history of LAV/HTLV-III infection (two subjects). Five of these children had a severe illness starting in the first months of life (range 20 days-4 months) and died within 4 months (range 19 days-10 months). Eight children presented later in life (mean age 35 months, range 2–66 months) with a milder and more chronic disease characterized by the presence of generalized lymphadenopathy (6/8), hepatomegaly (5/8), splenomegaly (5/8), interstitial pulmonary infiltration (4/8), parotid swelling (3/8), CSF lymphocytosis (3/5), diarrhoea without pathogen isolated (1/8) and fever (1/8).

Summary: The in vitro incorporation and transport of plasma nonesterified fatty acids into phospholipids of red cell membranes have been studied in cystic fibrosis and healthy children.Red blood cells were labeled in vitro by an active “acyltransferase”-dependent incorporation of radioactively labeled nonesterified fatty acids. [3H]-Palmitic and [14C]-linoleic acid, bound to albumin, have been studied simultaneously because it has been shown before that the concentration of palmitic acid increases and the concentration of linoleic acid decreases both in the plasma nonesterified fatty acid fraction and in the various phospholipids of the erythrocyte membranes of cystic fibrosis patients.The labeled cells were reincubated in autologous serum and the radioactivity present in the serum lipids and in the major phospholipid fractions of the erythrocyte membranes was measured.A general conclusion is that the in vitro turnover of labeled palmitic and linoleic acids in the phospholipids of the erythrocyte membranes is higher for cystic fibrosis patients than for healthy children. No difference is detectable between the in vitro behaviour of [14C]-linoleic versus [3H]-palmitic acid in cystic fibrosis patients compared with healthy children.Speculation: It is possible that the primary defect in cystic fibrosis is caused by an alteration in membrane structure and function. Perhaps the increased turnover of erythrocyte fatty acids in cystic fibrosis patients is related to this membrane defect.

Summary: The absolute and the percentage plasma NEFA pattern of healthy children, Cystic Fibrosis (C.F.) patients and their parents have been determined (table I, III, V) and compared with those of age and sex matched control subjects (table II, IV, V).There is a striking difference in the percentage plasma NEFA pattern of C.F. patients with pancreatic insufficiency: palmitic, palmitoleic and oleic acid are significantly increased while linoleic, linolenic and stearic acid are decreased (table IV). Four C.F. children without pancreatic involvement have the same abnormal NEFA pattern (fig. 3).The overlapping areas of the distributions of both palmitoleic and linoleic acid (as shown in fig. 2a and ß) are small for healthy and C.F. subjects. About 90% of the C.F. subjects examined show an abnormal palmitoleic and/or linoleic acid concentration. Tested individually, recognition of this typical C.F. pattern involves a possible error of 15% (fig. 3).A correlation exists between the abnormality of the plasma NEFA pattern in C.F. patients and the severity of pulmonary disease.The percentage plasma NEFA pattern of C.F. parents is modified by an increase of linoleic acid and a decrease of saturated fatty acids (table V, fig. 1a,ß). This is possibly due to an higher dietary intake of polyunsaturated fatty acids.Speculation: It has not been convincingly demonstrated yet that the abnormal plasma NEFA pattern in Cystic Fibrosis is entirely due to malabsorption of dietary essential fatty acids. Rather, a primary defect in fatty acid metabolism also remains possible.

Extract: A simple algebraic manipulation of known formulas leads to a direct expression for the specific airway resistance (SRaw) which precludes separate measurements of the airway resistance (Raw) and the thoracic gas volume (TGV). The equation is: SRaw= tg ß (PBar– PH2O) e2, in which tg ß stands for the relation between the plethysmographic box volume and pneumotachograph flow fluctuations; PBar– PH2Ois the barometric pressure corrected for water vapor pressure at body temperature, and e2is a calibration for graphical units. Thanks to this new formula SRawcan now be easily measured with great precision and quickly calculated, even in the case of those children (Table 1) with whom this was not previously possible. No further cooperation is needed than breathing at a normal rate through mouthpiece into a whole-body plethysmograph. The intraindividual coefficient of variation (CV) for SRawis about 8% and never exceeds 15% (Table 1).Speculation: Because of our proposed simplification of the measurement of SRaw, the accumulation of data on bronchial obstruction and hence statistical analysis will be greatly facilitated in pediatrics. Further developments of this method should permit a comparison with previous studies in sedated children and answer the question of whether alteration in specific airway resistance is the consequence either of sedation or of some change associated with growth during the first 5 years life.