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Heart failure (HF) is the leading cause of hospitalisation in the elderly in France. Early rehospitalisations are common, often through an emergency department. The aim of this study was to assess the impact of a primary care-hospital coordination network, with interventions by coordination nurses (IDEC), on the rehospitalisations after a first hospitalisation for acute decompensation in frail elderly HF patients. From 01/10/2019 to 01/10/2021, 237 patients aged > 75 years with frailty criteria, hospitalised in 8 departments of 5 private or public hospitals in the Yvelines Sud health territory were followed by an IDEC (hospital visit, telephone contacts, home visit(s)) within 3 months of their return home. This prospective observational study analysed the rate of consultations to the emergency room, rehospitalisations (total and for acute HF), and the number of events avoided at 90 days after discharge. The mean age of the patients was 87 years, 54% were women, 68% had a left ventricular ejection fraction > 40%, and 70% had atrial fibrillation. Non-cardiac comorbidities were very frequent. At 3-month follow-up, mortality was 9.3% (22/237), only 27 patients (11.3%) consulted the emergency room for acute HF, and the rehospitalisation rate for HF was 19.8%, without difference according to left ventricular ejection fraction. A consultation to the emergency room or a rehospitalisation for heart failure could be avoided for 10% of patients. This study suggests that a primary care-hospital coordination network with dedicated coordination nurses is useful for the management of very elderly frail patients following hospitalisation for heart failure, limiting visits to the emergency room and rehospitalisations. [ABSTRACT FROM AUTHOR]

Outpatient treatment (OT) of patients with low-risk pulmonary embolisms (PE) is recommended. A multidisciplinary OT program including the general practitioner (GP) has been implemented at Versailles hospital in 2019. The objectives of the study were to assess the feasibility, safety and acceptability of the program. The feasibility of, and the inclusion criteria for OT were defined from a retrospective cohort study of PE patients carried out in 2018. In the prospective study, consecutive patients consulting in the emergency department between 2019 and 2021 with confirmed PE were eligible for OT if they had sPESI and HESTIA scores equal to 0, normal troponin and NT-pro-BNP levels, and no right ventricular dilation on imaging. PEs associated with COVID were excluded. The OT program included 4 appointments within 3 months, including 2 with the GP. Events (death, recurrence of PE or venous thromboembolism, bleeding, rehospitalisation) were collected at 3-month follow-up. In the retrospective study, 19% of the 138 PE patients seen in the emergency department were eligible for OT. No complication occurred at Day 90. In the prospective study, 313 consecutive patients with confirmed PE in the emergency department were included, 66 (21%) were eligible for OT. Overall, 43 patients (14%) received OT (39 eligible) and 27 patients eligible for OT were hospitalised (92% because of pulmonary infarction). At 3-month follow-up, there were no death, no recurrence of thromboembolism, and one patient has been early hospitalised for COVID; 3 female patients treated with rivaroxaban had minor bleeding (heavy menstrual bleeding). The satisfaction rate of general practitioner was 95%. This study confirms the feasibility and safety of our OT program for low-risk EP patients, centered on the general practitioner. It reduces the time spent in the emergency department, reduces hospitalisations and strengthens the city-hospital link for care. [ABSTRACT FROM AUTHOR]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.anbehav.2006.06.022 Byline: Carol E. Sparling, Jean-Yves Georges, Susan L. Gallon, Mike Fedak, Dave Thompson Abstract: Many theoretical models have been proposed to explain and predict the behaviour of air-breathing divers exploiting a food resource underwater. Many field observations of the behaviour of divers do not fit with the prediction that to maximize energetic gain divers should dive close to their aerobic diving limits. In an attempt to explain this paradox, proposed a model of diving behaviour that takes into account patchily distributed prey patches of varying quality. We tested this model experimentally in a simulated foraging set-up. We measured the diving behaviour of grey seals, Halichoerus grypus, diving to patches of varying prey density and distance from the surface. Our results were equivocal with respect to the model predictions. Seals responded to prey density, leaving low-quality patches earlier. However, this pattern was still evident at long dive distances, contrary to the prediction that during deep dives seals should stay at a patch regardless of prey density. While seals maximized dive durations at high prey densities and long distances, they did not do so at short distances. The apparent quitting strategy of the seals always produced higher net rates of energy gain than would have been achieved if they had remained at the foraging site up to their aerobic dive limit on every dive. These results indicate that seals' diving behaviour, particularly bottom duration, may indicate the relative prey availability in their environment. Author Affiliation: (a) Sea Mammal Research Unit, University of St Andrews U.K. (a ) Centre National de la Recherche Scientifique, Institut Pluridisciplinaire Hubert Curien, Departement Ecologie, Physiologie et Ethologie (DEPE) U.K. Article History: Received 1 March 2006; Revised 25 April 2006; Accepted 26 June 2006 Article Note: (miscellaneous) MS. number: 8866R

Background: Clopidogrel associated with aspirin is the recommended treatment for patients undergoing elective percutaneous coronary intervention (PCI). Although severe PCI-related events are rare, evidence suggests that PCI-related myocardial infarction and myocardial injury are frequent complications that can impact the clinical prognosis of the patients. Antiplatelet therapy with a potent P2Y12 receptor inhibitor such as ticagrelor may reduce periprocedural ischemic complications while maintaining a similar safety profile as compared with conventional dual antiplatelet therapy by aspirin and clopidogrel in this setting.Methods: Assessment of Loading with the P2Y12 inhibitor ticagrelor or clopidogrel to Halt ischemic Events in patients Undergoing elective coronary Stenting (ALPHEUS) (NCT02617290) is an international, multicenter, randomized, parallel-group, open-label study in patients with stable coronary artery disease who are planned for an elective PCI. In total, 1,900 patients will be randomized before a planned PCI to a loading dose of ticagrelor 180 mg or a loading dose of clopidogrel (300 or 600 mg) in addition to aspirin. Patients will then receive a dual antiplatelet therapy with aspirin and ticagrelor 90 mg twice daily or clopidogrel 75 mg once daily for 30 days. The primary ischemic end point is PCI-related myocardial infarction (myocardial infarction type 4a or 4b) or major myocardial injury within 48 hours (or at hospital discharge if earlier) after elective PCI/stent. Safety will be evaluated by major bleeding events (Bleeding Academic Research Consortium type 3 or 5) at 48 hours (or discharge if it occurs earlier).Conclusion: ALPHEUS is the first properly sized trial comparing ticagrelor to clopidogrel in the setting of elective PCI and is especially designed to show a reduction in periprocedural events, a surrogate end point for mortality. [ABSTRACT FROM AUTHOR]

Pollution contributes to the degraded state of continental aquatic ecosystems and biodiversity. Some species appear to be tolerant to aquatic pollution, yet little is known about the effects of such pollution on population structure and dynamics. Here, we investigated how wastewater treatment plant (WWTP) effluents of the Cabestany City, in southern France, contribute to the pollution levels of the Fosseille River, and we tested how they could affect population structure and medium-term dynamics of the native freshwater turtle, the Mediterranean Pond Turtle Mauremys leprosa (Schweigger, 1812). Amongst the 68 pesticides surveyed from water samples collected along the river in 2018 and 2021, a total of 16 pesticides were detected, among which eight were found in the upstream section of the river, 15 in the river section located downstream of the WWTP, and 14 in the outfall of the WWTP, exhibiting the contribution of effluents to the river pollution. From 2013 to 2018 and in 2021, capture-mark-recapture protocols were carried out on the freshwater turtle population living in the river. Using robust design and multi-state models, we showed a stable population throughout the study period, with high year-dependent seniority, and a bidirectional transition occurring primarily from the upstream to the downstream river sections of the WWTP. The freshwater turtle population consisted mostly of adults, with a male biased sex ratio detected downstream of the WWTP neither related to sex-dependent survival, recruitment, nor transition, suggesting a male bias in the hatchlings or primary sex ratio. Also, the largest immatures and females were captured downstream of the WWTP, with females having the highest body condition, whereas no such differences were observed in males. This study highlights that population functioning of M. leprosa is driven primarily by effluents induced resources, at least over the medium-term. [Display omitted] • Monitoring of the Mediterranean Pond Turtle between 2013 and 2021 in a polluted river. • Investigation of population dynamics using robust design and multi-state models. • Detection of a male biased adult sex ratio downstream, but not upstream, of a wastewater treatment plant (WWTP). • Detection of bi-directional transitions, mainly directed towards downstream of the WWTP. • Positive covariation of immatures and adult females' body size with habitat pollution level. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Wireless sensor networks may be used for the surveillance of large systems (bridges, tunnels, etc.) or in the management of disasters such as forest fires, or oil spills. In some of these applications, the topology of the network is going to be dynamic: a connected system can evolve into a clustered system that presents a break of the global connectivity. Using a collector which will regularly visit the disjoint clusters enables to restore a discreet connectivity. A session layer protocol is proposed to reconstitute a consistent global information system. It enables the collector to reconstruct the communication context with the previously visited clusters, knowing they could have moved, merged, or have split. A node sensor model has been integrated into the Riverbed Opnet Modeler network simulation environment. Simulations show the benefits of the protocol, and particularly how it provides a better trajectory planning of the collector. [ABSTRACT FROM AUTHOR]

Background Few data are available on primary percutaneous coronary intervention (pPCI) in nonagenarians. In a large prospective registry on pPCI for STEMI we compared the demographics, procedural and in-hospital outcomes between nonagenarians (age = 90 years) and patients aged < 90 years. Methods and results We included 26,157 consecutive patients with pPCI in the Greater Paris Area region between 2003 and 2011. Of these, 418 (1.6%) were = 90 years old. Nonagenarians (versus patients < 90 years) were more likely to be female (62.3% versus 22.5%, p < 0.0001), nonsmokers (81.6% versus 36.7%, p < 0.0001), in cardiogenic shock (Killip IV) upon admission (10.5% versus 4.8%, p < 0.001), and had significant co-morbidities. Over two-thirds of patients underwent procedures via the radial artery (61% versus 72.1%, p = 0.007). Both groups had high and similar angiographic success rates (98.1% versus 98.7%, p = 0.33). Drug-eluting stents were used less often in nonagenarians (4.4% versus 16.7%, p < 0.0001). Hospital mortality was significantly much higher in patients over 90 years old (24.9% versus 5.1%, p < 0.001) in univariate analysis. After adjustment for sex, cardiogenic shock, diabetes, triple vessel disease, drug-eluting stent use and glycoprotein IIb/IIIa inhibitors use, mortality remains higher in nonagenarian patients (OR: 4.31; 95% CI: 3.26-5.71, p < 0.0001). Conclusions In a real-world setting, we found important demographic differences in nonagenarian compared to younger patients. Despite achieving a high rate of reperfusion with pPCI using mainly radial access, similar to that achieved in younger patients, hospital mortality was higher in nonagenarians. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: In research on networked control systems (NCSs), the performance of the control system is assumed to be affected by network-induced parameters such as delays, jitters, packet losses and link failures. In this paper, compensation methods are studied, in the framework of NCS while considering the protocol specifications. The aim is to propose two different methods for the control over a network, adaptive Smith predictor approach and robust control based approach, which are imposed by the accessible information about the network. First, a clock synchronization protocol is implemented in each device of the network, thereby providing the possibility of end-to-end delay measurement, and a compensation strategy based on this measurement and the adaptive Smith predictor approach is applied. Secondly, the end-to-end upper bound delay estimate is calculated on the basis of the network architecture and the traffic estimation, and then subsequently used in a robust control based compensation strategy. The switched Ethernet network is used as an example of the communication network of the NCS. The efficiency of proposed approaches is evaluated with Matlab simulation as well as in the experimental prototype. [Copyright &y& Elsevier]

Abstract: Ethernet networks are based on a medium access method which is not deterministic. The use of such networks in factory environments (which are strongly time constraints) can absolutely not guarantee that the applications requirements will be respected. This paper presents a method based on genetic algorithms to minimize end-to-end delays by providing a good distribution of the devices on the network switches. The objective function is defined by using the network calculus which is a deterministic theory and enables to determine bounded delays. In this paper, a case study is described: theoretical results are verified by a real experimentation and compared with results obtained with a network simulator. [Copyright &y& Elsevier]

Abstract: This study investigates the background and evolution of requests to forgo treatment and hasten death in terminally ill cancer patients. Physicians participating in a nationwide study on end-of-life decision making were asked whether they were treating a terminally ill cancer patient whose life expectancy was longer than 1 week but no longer than 3 months and who they would continue to treat until the patient''s death. Of the 120 physicians who had a patient who met the inclusion criteria, 85 (70.8%) completed a questionnaire each month until the patient''s death. The questionnaire provided information on the patient''s symptoms, concerns, and requests involving end-of-life decisions. Most patients suffered from cancer of the gastrointestinal tract or the respiratory system, and 66% died within 2 months of the initial interview. The prevalence of requests involving end-of-life decisions increased during the last 3 months of a patient''s life. The evolution of a request was especially related to an increase in the number of severe symptoms and concerns. Requests to forgo treatment were related to general weakness, whereas loss of dignity was a major reason for requests to hasten death. Physical suffering alone appeared to lead to less drastic requests than suffering blended by concerns and psychological problems leading to requests for hastened death. The results emphasize the importance of gaining insight into the patients'' suffering to provide meaningful assistance. [Copyright &y& Elsevier]

The number of infectious pathogens to which an individual has been exposed (pathogen burden) has been linked to the development and the prognosis of coronary artery disease (CAD). The interaction among infection, genetic host susceptibility, and CAD remains unclear. This study was aimed at evaluating the modulation of the association between CAD and pathogen burden, by serum levels of inflammatory markers and polymorphisms of the interleukin (IL)-6 and tumor necrosis factor (TNF)-α genes. Immmunoglobulin (Ig) G or IgA antibodies to 8 pathogens were determined in 991 patients with CAD and 333 control subjects. Serum levels of high-sensitivity C-reactive protein, fibrinogen, IL-6, and TNF-α were also measured. All subjects were genotyped for the IL-6/G-174C, the TNF/C-851T, and the TNF/G-308A polymorphisms. Analysis of single pathogens demonstrated a positive relation to the presence of CAD for some (Chlamydia pneumoniae, cytomegalovirus, Helicobacter pylori, and herpes virus simplex type 1), but not all pathogens. A strong association between increasing pathogen burden and CAD was confirmed, even after adjustment for risk factors. The prevalence of a high pathogen burden (≥4 pathogens) was 50% in patients and 21% in controls (p <0.0001). A high pathogen burden was associated with decreased high-density lipoprotein cholesterol levels (p <0.001). The association between CAD and pathogen burden was modulated by the IL6/G-174C polymorphism, the odds ratio being higher in heterozygotes than in both types of homozygotes (p <0.05). This interaction appeared to be mediated by variations in serum IL-6 levels. No such interaction was detected with any of the 2 TNF-α polymorphisms. [Copyright &y& Elsevier]

Studies the time course concentrations of creatine kinase isoenzyme MB mass and cardiac troponin I after electrical cardioversion. Assessment of accuracy for the diagnosis of chest pain; Identification of source of enzyme release; Relationship between electrical cardioversion and creatine kinase; Diagnosis of myocardial infarction.

Background There are limited data on outcomes following primary percutaneous coronary intervention (PCI) for ST-segment elevation acute myocardial infarction (STEMI) in nonagenarian patients. Methods and Results We conducted a multicentre retrospective study between 2006 and 2013 in 5 international high-volume centers and included 145 nonagenarians treated with primary PCI for STEMI. Cardiogenic shock was present at admission in 21%. Mean delay between symptom onset and balloon was 5,8±7,6 hours and 60% of procedures were performed through the transradial approach. Successful revascularization of the culprit vessel was obtained in 86% of the cases (TIMI flow of 2 or 3). Major or clinically-relevant bleeding was observed in 4% of patients. Mean cardiac troponin Ic was 65±79 ng/ml and mean LVEF post-PCI was 42±13%. The in-hospital mortality was 24% with 6 months and 1 year survival of 58% and 49% respectively. Conclusions In our study, primary PCI in nonagenarians with STEMI was successful and feasible through a transradial approach. It is associated with a high rate of successful reperfusion of the infarct-related artery and nearly 50% survival at one year. These results suggest that primary PCI should be offered in selected nonagenarians with acute myocardial infarction (table next page). Abstract 0443 – Table Procedural Findings Time from symtoms to PCI (h) 5.8±7.6 Catheterizzation access (%) Radial 60 Single Vessel Coronary Disease (%) 53 Single Vessel Coronary PCI (%) 74 Infarct-related coronary artery (%) Left main 4 Left anterior descending 41 Circumflex 14 Right 45 CABG 3 Thrombus aspiration (%) 14 TMI flow grade after procedure (%) 0 12 1 1 2 6 3 81 Coronary stenting (%) BMS 75 DES 9 POBA 10 Procedure success (%) Successful PCI 86 Failed PCI 11 Complicated PCI 3 Use of protection device (%) 2 IABP (%) 0 Use of inotropes during procedure (%) 26 [ABSTRACT FROM AUTHOR]

Data centers are estimated to have the fastest growing carbon footprint from across the whole information and communication technology (ICT) sector. Evaluating the performance of data centers in terms of energy efficiency and sustainability is becoming an increasingly important matter for organizations and governments (e.g., for regulation or reputation purposes). It nonetheless remains difficult to achieve such evaluation, as data centers imply to take into consideration a wide range of dimensions and stakeholders. Even though a wide range of sustainability performance indicators exist in the literature, there is still a lack of frameworks to help data center stakeholders (spanning from data center owners, governmental regulators to engineers/field operators) to evaluate and understand how a data center performs in terms of sustainable development/behavior. Our research work proposes such a framework, whose originality lies in the combination of state-of-the-art sustainability metrics with the biomimicry commandments of eco-mature system, which enables holistic sustainability assessment of data centres. From a theoretical perspective, the proposed model is designed based on a benefit-cost analysis using the Analytic Hierarchy Process (AHP) technique. This approach allows data center stakeholders for specifying their own preferences and/or expertise in the comparison process, whose practicability is demonstrated in this paper considering three data center candidates, which are respectively located in France, Germany and Sweden. • A new model for comparing data center sustainability performance is proposed. • The model makes use of state-of-the-art sustainability metrics together with biomimicry lessons. • The model is designed based on a benefit-cost approach using the AHP technique. • A comparison study is carried out with three distinct data center candidates. [ABSTRACT FROM AUTHOR]

Purpose Patient exposure to radiation from interventional coronary procedures (ICPs) is high. Dose optimization is in part based on comparison with reference levels (RLs). Current RLs, however, have been deduced from small or old multicentre studies. The purpose of this study was to evaluate current practices for patient radiation protection (RP) in French non-university public hospitals, which represent >30% of the national activity for ICPs, and 60% of the emergency cases. Methods RAY'ACT was a nationwide, multicentre survey. RP parameters from 35,257 coronary angiographies (CAs) and 28,604 percutaneous coronary interventions (PCIs) performed at 48 centres during 2010 and routinely registered in professional software were extracted and analysed retrospectively. Dose-area product (DAP), fluoroscopy time (FT), number of acquired frames (NF) and runs (NR), and cumulative dose to interventional reference point (CD-IRP) were analysed separately for CAs and PCIs (elective and ad hoc pooled). Emergency and complex procedures, associated with a high level of radiation, were not excluded. Results The table shows the new RLs, based on the 75th percentiles of the values for CA and PCI, and comparison with previous RLs. Conclusions The RAY'ACT survey has allowed the definition of new RLs for DAP, FT, NF and CD-IRP for CA and PCI, based on a large study population. It confirms the trend toward a decrease in radiation doses and FT during CA. The lack of decrease in DAP and FT during PCI should be interpreted according to the likely increase in procedure complexity. [ABSTRACT FROM AUTHOR]

Purpose The RAY’ACT project is a nationwide, multicentre survey program aimed at evaluating patient radiation protection (RP) during coronary angiography (CA) and percutaneous coronary interventions (PCI) in French non-university public hospitals, which represent >30% of the national activity for PCIs, and 60% of the emergency cases. We present the updated reference levels based on the results of the second survey conducted in 2013 (RAY’ACT2). Methods RP parameters from 48,547 CAs and 40,026 PCIs performed at 61 centres during 2013 and routinely registered in professional software were extracted and analysed retrospectively. Kerma-area product (KAP), fluoroscopy time (FT), number of acquired frames (Nb F) and runs (NR), and total Air Kerma at interventional reference point (KA, r) were analysed separately for CAs and PCIs (elective and ad hoc pooled). All procedures of the year were included. Results The table shows the medians (Q1-Q3) of the RP parameters, updated RLs based on the 75th percentiles of the values for CA and PCI (bold), and previous RLs (RAY’ACT1, 2010). Conclusions Between 2010 and 2013, a 20 to 30% decrease was observed in medians and Reference Levels (Q3) for main RP parameters, including KAP and total Air Kerma. Abstract 0254 – Table: Results 2013 (RAY’ACT2) 61 centres 2010 (RAY’ACT1) 44 centres CA N=48,547 N=31,066 KAP (Gy.cm ² ) 20.9 (11.8- 35.7 ) 27.2 (15.5- 45.2 ) FT (min) 3.3 (2.1- 5.7 ) 3.7 (2.3- 6.3 ) Nb Frames 404 (284- 566 ) 553 (388- 769 ) KA,r (mGy) 294 (164- 498 ) 421 (240- 695 ) PCI N=40,026 N=25,356 KAP (Gy.cm ² ) 45.2 (25.6- 77.6 ) 56.8 (32.8- 94.6 ) FT (min) 9.8 (6.3- 15.4 ) 10.3 (6.7- 16.2 ) Nb Frames 676 (465- 960 ) 837 (578- 1193 ) KA,r (mGy) 747 (421- 1285 ) 1052 (589- 1788 ) [ABSTRACT FROM AUTHOR]

Background Percutaneous coronary interventions (PCIs) use significant doses of ionizing radiation, especially when treating complex lesions. Ionizing radiation may lead to adverse acute or delayed skin lesions in this setting, for which the incidence is not well known. Purpose To assess the incidence of radiation-induced skin lesions following PCI. Methods We conducted a prospective, observational, single-centre study on the incidence of radiation-induced skin lesions at 3-5 days (acute) and at 6 months (subacute) after PCI with a dose-area product (DAP) ≥200Gy.cm 2 , between 1 January and 31 December 2013. Patients consenting to participate were given information on potential skin lesions and were interviewed at 5-7 days and at 6 months after the PCI. Results 1168 PCIs were performed; the radiation dose was available for 937 patients. Of these, 102 underwent PCI with DAP≥200Gy.cm 2 . High body mass index (BMI; OR 6.2, 95% CI 2.8-13.9) and elective (vs emergency) procedures (OR 2.0, 95% CI 1.1-3.4) were independently associated with DAP ≥200Gy.cm 2 . Three patients (3%, 95% CI 0.6-8.4) were diagnosed with acute lesions (DAP of 485Gy.cm 2 , 205Gy.cm 2 , and 201Gy.cm 2 ), two of whom also presented with subacute lesions following PCI with DAP of 485Gy.cm2 (Fig.) and 205Gy.cm 2 . One patient presented with a subacute lesion (DAP 280Gy.cm 2 ) only. Four patients presented with a skin lesion, which represents 4% (95% CI 1.1-9.7) of patients with DAP ≥200Gy.cm 2 and 0.4% (95% CI 0.1-1.1) of all the patients who underwent PCI, irrespective of DAP dose. Conclusions The incidence of radiation-induced acute and subacute skin lesions developing after PCI in this single-centre study was 4% in patients with DAP ≥200Gy.cm 2 , with a total incidence of 0.4%. These data may suggest the need for systematic assessment of skin lesions after high-dose radiation PCI. [ABSTRACT FROM AUTHOR]

Purpose Patients presenting with out of hospital cardiac arrest (OHCA) and no evidence of extra-cardiac cause have a poor short term outcome. This study sought to identify which post-cardiac arrest patients may or may not benefit from emergency coronary angiography (ECA) and primary percutaneous coronary intervention (PCI). Methods Observational study in consecutive patients treated for OHCA from 2006 to 2012. Retrospective analysis of clinical, electrocardiographic, and angiographic factors associated with usefulness of PCI and in-hospital survival. Results Between 2006 and 2012, 121 consecutive pts surviving OHCA with no evidence of extra-cardiac cause were admitted in our centre and underwent ECA (median age 61 years, 85% males). Mild hypothermia was used in 105 (87%) of the pts. Survival at hospital discharge was 41%. Prehospital defibrillation with AED was used in 92 (76%) of pts, and was associated with a decrease in hospital mortality (49% vs 90%; p<.0001). In the group of pts who received at least one AED shock, survival rates considerably varied according to the first rhythm registered on 12-lead ECG: 74% (35/47) in case of Sinus Rhythm or Atrial Fibrillation, 43% (12/28) in case of persistent Ventricular Tachycardia or Fibrillation, and 0% (0/17) in case of secondary asystole (p<.0001) (Figure). Conclusion ECA and/or PCI should be restricted to OHCA survivors without either primary asytole (no AED shock) or secondary asystole (after at least 1 AED shock), although the prevalence of significant coronary disease is high in this latter subgroup. Abstract 0066 – Figure: Mortality according to the 1st ECG after AED shock [ABSTRACT FROM AUTHOR]

Background We report on the management of and processes of care in consecutive patients with Takotsubo syndrome using data from a French registry (OFSETT). Methods Between November 2010 and December 2011, 15 non-academic hospitals included consecutive patients diagnosed with Takotsubo syndrome according to the Mayo clinic diagnostic criteria. Results A total of 121 patients were enrolled: 89% were women and the mean age was 72±12 years. Most of the women (89%) were >50 years’ old; 8% of patients had diabetes, 30% were current smokers and 52% had hypertension. Symptoms of Takotsubo syndrome were chest pain (81%), dyspnoea (27%) and/ or syncope (5%). The mean maximum troponin level was 7.8 ng/mL and the mean maximum B-type natriuretic peptide level was 1013 pg/mL. ECG showed a negative T wave in 73%, ST elevation in 42% and/or a new Q wave in 29% of patients. One patient was treated with fibrinolysis. Coronary angiography was performed in all patients. Coronary arteries were angiographically normal in 78% of patients and showed <50% stenosis in 22%. Left ventricle (LV) angiography showed apical ballooning in 35% of patients. The mean LV ejection fraction was 42±13% on echocardiography and 46±10% on angiography. The target event was identified in 55% of the patients: mental stress in 61% and physical stress in 29%. In-hospital treatment included nitrates (11% of patients), unfractionated heparin (25%), low-molecular-weight heparin (79%), aspirin (91%), antiplatelets (82%), and angiotensin-converting enzyme inhibitors/angiotensin receptor inhibitors (ACE/ARB) (75%). None of the patients died during hospitalization. At discharge, patients were treated with aspirin (59%), statins (46%), beta-blockers (75%), ACE/ARB (79%) and/or neurotropic agents (26%). Conclusion These observational data from 15 non-academic French hospitals provide insights into the characteristics of patients with Takotsubo syndrome and current processes of care for this population. [ABSTRACT FROM AUTHOR]

Abstract: The switched Ethernet networks are more and more deployed in industry. The Spanning Tree Protocol implemented in the switches enables management of the link connectivity. But the reconfiguration time of the Spanning Tree Protocol (STP) when link failure occurs is not adapted to satisfy industrial constraints. The objective of this paper is to propose a method based only on standard, mitigating the probability of disconnection between nodes having hard real-time properties. The approach developed in this paper consists of duplicating frames and of forwarding them on different paths. These paths are optimized and specified by using genetic algorithms. OPNET simulations show the interest of this proposal on a particular Networked Control System. [Copyright &y& Elsevier]

E-Agriculture, or Smart Farming, refers to the design, development, and application of innovative methods to use modern information and communication technologies (ICTs), such as the Internet of Things (IoT) and machine learning, to move towards more sustainable agricultural and farming practices. The integration of blockchain technology in farming is gaining attention for its potential to migrate from the centralized and monopolistic model that shapes today's food value chain. This paper highlights the fact that most of today's blockchain-based farming frameworks focus on food tracking and traceability. Only rarely does research focus on the design of digital marketplaces to support the trading of agricultural goods between farmers and potentially interested third party stakeholders; equally rarely are performance evaluations performed for the proposed frameworks. The latter is where this paper contributes the most by, not only proposing a novel blockchain-based farming marketplace platform (called "FarMarketplace"), but also a comprehensive methodology to help software solution integrators to better understand and measure how a given configuration setting of such a platform can influence the overall quality of service performance in the long run. • It is evidenced that there is a lack of digital marketplaces for trading of agricultural goods. • A novel blockchain-based farming marketplace called "FarMarketplace" is introduced. • A set of trading (smart) contract templates are specified and integrates to FarMarketplace. • A methodology to properly evaluate blockchain-based system performance limits is introduced. • Implementation and experimental performance evaluation of FarMarketplace are achieved. [ABSTRACT FROM AUTHOR]

Sarcoidosis is an inflammatory disease whose diagnosis is suggested by clinical and paraclinical signs and confirmed by histological evidence showing granulomatosis without caseous necrosis. The clinical presentation is sometimes misleading and the diagnosis difficult to confirm. We report here the case of a young woman with cardiac sarcoidosis of difficult diagnosis, revealed by a myocardial infarction with normal coronary angiography and recurrent ventricular tachycardia. Multimodal imaging, combined with left ventricular endomyocardial biopsies guided by electrophysiological analysis and endocavitary mapping, finally confirmed the diagnosis, and allowed effective medical treatment. [ABSTRACT FROM AUTHOR]

Blockchain technologies, also known as Distributed Ledger Technologies (DLT), are increasingly being explored in many applications, especially in the presence of (potential) dis-/mis-/un-trust among organizations and individuals. Today, there exists a plethora of DLT platforms on the market, which makes it challenging for system designers to decide what platform they should adopt and implement. Although a few DLT comparison frameworks have been proposed in the literature, they often fail in covering all performance and functional aspects, adding that they too rarely build upon standardized criteria and recommendations. Given this state of affairs, the present paper considers a recent and exhaustive set of assessment criteria recommended by the ITU (International Telecommunication Union). Those criteria (about fifty) are nonetheless mostly defined in a textual form, which may pose interpretation problems during the implementation process. To avoid this, a systematic literature review regarding each ITU criterion is conducted with a twofold objective: (i) to understand to what extent a given criterion is considered/evaluated by the literature; (ii) to come up with 'formal' metric definition (i.e., on a mathematical or experimental ground) based, whenever possible, on the current literature. Following this formalization stage, a decision support tool called CREDO-DLT, which stands for "multiCRiteria-basEd ranking Of Distributed Ledger Technology platforms" , is developed using AHP and TOPSIS, which is publicly made available to help decision-maker to select the most suitable DLT platform alternative (i.e., that best suits their needs and requirements). A use case scenario in the context of energy communities is proposed to show the practicality of CREDO-DLT. • Blockchain (DLT) standardization initiatives are reviewed. • To what extent ITU's DLT assessment criteria are covered in literature is studied. • A mathematical formalizations of the ITU recommendations are proposed. • A decision support tool (CREDO-DLT) is designed for DLT platform selection. • An energy community use case is developed to show the practicality of CREDO-DLT. [ABSTRACT FROM AUTHOR]

Electricity produced and used in the residential sector is responsible for approximately 30% of the greenhouse gas emissions (GHGE). Insulating houses and integrating renewable energy and storage resources are key for reducing such emissions. However, it is not only a matter of installing renewable energy technologies but also of optimizing the charging/discharging of the storage units. A number of optimization models have been proposed lately to address this problem. However, they are often limited in several respects: (i) they often focus only on electricity bill reduction, placing GHGE reduction on the backburner; (ii) they rarely propose hybrid-energy storage optimization strategies considering thermal and storage heater units; (iii) they are often designed using Linear Programming (LP) or metaheuristic techniques that are computational intensive, hampering their deployment on edge devices; and (iv) they rarely evaluate how the model impacts on the battery lifespan. Given this state-of-affairs, the present article compares two approaches, the first one proposing an innovative sliding grid carbon intensity threshold algorithm developed as part of a European project named RED WoLF, the second one proposing an algorithm designed based on LP. The comparison analysis is carried out based on two distinct real-life scenarios in France and UK. Results show that both algorithms contribute to reduce GHGE compared to a solution without optimization logic (between 10 to 25%), with a slight advantage for the LP algorithm. However, RED WoLF makes it possible to reduce significantly the computational time (≈ 25 min for LP against ≈ 1 ms for RED WoLF) and to extend the battery lifespan (4 years for LP against 12 years for RED WoLF). [ABSTRACT FROM AUTHOR]

Abstract: Understanding environmental cues determining behaviour and habitat use of species of conservation concern is crucial if one aims at implementing sustainable management of these natural resources. In this way, here, we investigate the thermal and trophic conditions encountered by the critically endangered leatherback sea turtle Dermochelys coriacea during its nesting season in French Guiana where high bycatch rates have been reported. Mean sea water temperatures obtained in situ by animal-borne recorders were 26.6±0.7 °C in the water column, with all but one turtle remaining in water >25 °C during the inter-nesting interval. In terms of prey availability, regular jellyfish stranding events were recorded during the nesting season, on a 1.25-km long section of the nesting beach. The occurrence of jellyfish was supported by benthic trawls performed on the continental shelf, with a total of 45.4 kg of jellyfish collected in 3.5 h exclusively in coastal waters 10 to 20 m deep where water transparency was between 0.8 and 3 m. This is consistent with the at sea distribution area of gravid leatherbacks during their inter-nesting intervals, as they spent almost 70% of their time diving in shallow (<20 m deep) waters in front of the Maroni River estuary. In French Guiana, leatherback''s gelatinous prey are thus present in very shallow water close to the nesting site and may be easily exploited by active gravid leatherbacks. This suggests that French Guiana female leatherbacks may be influenced by local trophic conditions and actively prospect productive areas overlapping with local fisheries ground. [Copyright &y& Elsevier]

Abstract: The Atlantic Ocean hosts a major part of the world''s leatherback population, with the largest rookeries being located in the northern part of South America (Suriname/French Guiana) and in western Central Africa (Gabon). In contrast with the dramatic decline of nesting populations in the Pacific Ocean, some Atlantic leatherback rookeries have recently been reported to be stable or even to increase. This raises the question, which particular research and conservation initiatives, past and present, may have led to such development. Here we present an overview of the historical and present research and conservation efforts in French Guiana, Suriname and Gabon and highlight current gaps in knowledge and required improvements to maintain protection for the major rookeries of this critically endangered species. [Copyright &y& Elsevier]

The residential sector accounts for 30 % of the total green house gas emissions in Europe, which can be reduced either by switching to low-carbon technologies or reducing the amount of fossil fuel energy consumed. In this work, a new greenhouse gas emission (GHGE) reduction system at the house (nanogrid) level is investigated. The originality of the proposed system and underlying algorithm lies in the fact that it acts in a proactive manner, by continuously controlling and optimizing energy flows between on-site local power production systems (photovoltaics - PV - array in our case), loads, and storage units (combining battery and thermal storage reservoirs). This system/algorithm is evaluated based on real-life input datasets from the United Kingdom (UK) and France, and compared with traditional house energy infrastructures, namely (i) a house not fitted with battery, and (ii) a house fitted with battery but without additional "smart" software layer. Results show that it performs better in terms of CO 2 (capacity of the algorithm to reduce the amount of non carbon-free energy consumed from the grid), Power to Grid (capacity to maximize the use of local green energy), and financial cost (capacity to reduce the overall electricity bill), respectively improving performance by up to 8 % , 10 % and 37 %. [ABSTRACT FROM AUTHOR]

Introduction La revascularisation myocardique chirurgicale reste fréquente (20 000 pontage/an en France), l’espérance de vie des coronariens pontés augmente, ainsi que les indications de contrôle chez des patients pontés, souvent âgés ou polyvasculaires, multi-explorés. Le choix de la voie d’abord artérielle optimale pour le contrôle angiographique des PAC est déterminant, surtout si les deux artères mammaires internes ont été utilisées. Cas clinique Dans le cas présenté, une double voie ulnaire a été utilisée pour opacifier une double mammaire chez une femme n’ayant aucun autre abord artériel possible et chez qui le coroscanner n’a pas été contributif. Il nous permet de discuter les intérêts et limites des différentes voies d’abord, et les techniques qui permettent un examen complet des deux greffons mammaires et du réseau coronaire natif en limitant au maximum le nombre d’abords artériels, le risque hémorragique, le temps d’examen et d’exposition aux rayons X. L’opacification des deux pédicules mammaires internes peut se faire par voie fémorale, avec un risque hémorragique, par double abord radial, mais également un abord radial droit unique avec quelques astuces techniques (utilisation d’une sonde à forte courbure et d’un long guide d’échange). La voie ulnaire constitue une bonne alternative à la voie radiale. Conclusion La présence d’un pontage aorto-coronarien mammaire interne gauche, ou double mammaire pédiculé, ne doit pas faire exclure un abord radial droit. L’étude du pontage controlatéral est possible avec de l’expérience et quelques astuces techniques. La voie ulnaire est aussi fiable et sure que la voie radiale, y compris pour les procédures d’angioplastie complexe, mais nécessite une courbe d’apprentissage plus longue. [ABSTRACT FROM AUTHOR]