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• A Living Lab approach offers an opportunity for shifting practices to reduce or improve energy use. • Three disruptive events (an experimental heating challenge; the COVID-19 lockdown; and a drastic increase of energy prices) are considered in terms of their character and their effects on domestic energy use. • Energy reductions are possible when routinized practices are disrupted through experimentation. • The meanings tied up with being comfortable indoors have changed due to experimentation. • Participants of a community-oriented living lab have learned more about how to connect and reach out to learn and adapt collaboratively. Household energy use relates to our socio-cultural identity, our socio-economic status and the socio-cultural and material contexts in which we live. Around the world, households experienced dramatic changes in light of the COVID-19 pandemic and the drastic increase of energy prices following the Russian invasion of Ukraine. Habits and routines were disrupted, reinterpreted, reorganized and renegotiated, albeit under constraints and in most cases involuntarily. This paper analyses how the practice of 'keeping warm' responds to disruptive events ranging from a small-scale and short-lived experiment to much more drastic and far-reaching geopolitical events. Following an initial study challenging households to reduce temperatures inside their homes during October/November 2018, the same households were revisited for follow-up questioning two and a half years after the start of the COVID-19 pandemic in Europe and six months after the attack of Russian armed forces on Ukraine. Quantitative and qualitative data were collected before, during, and three months as well as three years after the original 'heating challenge'. The final follow-up survey took place in August 2022 and turned the initial short-lived Living Lab-based experiment into a longitudinal study. The experimental exploration of possibilities to reduce household energy use through the disruption of routinized practices in Living Labs enables an analysis of the effects of disruptive events, including the role of values, social norms, habits and routines (Sahakian et al., 2021). But what happens, when experiments get serious and large-scale upheaval affecting many challenges and changes meanings, thus contributing to changes in social norms and practices? This research explores lasting-changes in energy-related household practices following voluntary disruptive experimentation and subsequent involuntary disruptions. Compared to the macro-systemic disruptions experienced during the COVID-19 pandemic and the more recent energy crisis, the disruptions induced through the initial 'heating challenge' are of a much smaller magnitude. Our findings show that reductions in energy use are possible when routinized practices are disrupted through voluntary experimentation. In addition, our results indicate that the meanings tied up with indoor comfort had changed due to the initial experiment and that participants who initially experimented in an interactive community setting had learned more about how to connect, share experiences and reflections to adapt to other, also large-scale disruptions collaboratively. [ABSTRACT FROM AUTHOR]

Taxanes are one of the most effective chemotherapies (CT) in breast cancer (BC), but the efficacy of taxanes rechallenge in early metastatic relapse has been poorly studied in patients previously treated by taxanes in the (neo)adjuvant setting. Our study aimed to analyse the efficacy of taxane rechallenge in case of early metastatic relapse in a multicentre retrospective observational study compared with other chemotherapies. We analysed the French national ESME metastatic BC (MBC) database and selected HER2- MBC patients who received CT in first-line treatment for a metastatic relapse occurring 3–24 months after previous (neo)adjuvant taxanes treatment. Of 23,501 female patients with MBC in ESME, 1057 met the selection criteria. 58.4% received a taxane-based regimen (75.4% concomitant bevacizumab) and 41.6% received other CT. In hormone-receptor positive (HR+)/HER2- MBC, multivariate analysis showed no difference in OS between taxanes without bevacizumab compared to other CT (HZR = 1.3 [0.97; 1.74], but taxanes was significantly associated with worse PFS (HZR = 1.48 [1.14; 1.93]). In TNBC, taxanes without bevacizumab and carboplatin/gemcitabine were not superior to other CT for OS (HZR = 1.07 [0.79; 1.44] and HZR = 0.81 [0.58; 1.13], respectively), while for PFS, taxanes was inferior (HZR = 1.33 [1.06–1.67]) and carboplatin plus gemcitabine was superior to other CT (HZR = 0.63 [0.46; 0.87]). For both subtypes, the worse outcome observed with paclitaxel was no longer observed with the addition of bevacizumab. With the limitation of retrospective design, taxanes rechallenge in early metastatic relapse of BC may result in a worse PFS in TNBC and HR+/HER2- MBC, which was not observed with the addition of bevacizumab. • Patients with HER2-advanced breast cancer (ABC) have often previously received taxanes in the (neo)adjuvant setting. • Current guidelines suggest a rechallenge by taxanes in ABC with DFI≥12 months, few data are available for DFI ≤24 months. • Taxane rechallenge in early metastatic relapse of BC (DFI ≤24 months) may result in a worse PFS in TNBC and HR+/HER2- ABC. • In TNBC, the addition of bevacizumab to taxanes improves PFS and OS for DFI ≤24 months. [ABSTRACT FROM AUTHOR]

• Used Practical Epistemology Analysis and Transactional Learning Theory in two Dutch water cases. • Three-year embedded action research yields a worm-eye view on resistance and inertia. • Insights on learning moments reveal diverse dynamics of incumbency at the micro-level. • Co-creation stalled when citizen concerns were not resolved, or commitment waned. • Incumbency resides not only with regime-actors, but also governments and citizens. Existing transitions literature often highlights successful experiments for changing practices through multi-actor processes but overlooks the challenges of adjusting incumbent practices and engaging actors in reflexive learning. The current article addresses this gap through two qualitative case studies of water-related co-creation processes in the Netherlands. Each case met inertia and resistance from various actors in different forms. We examine the difficulties encountered using data from semi-structured interviews and observations of micro-level interactions from embedded action research. We find that using transactional learning perspective combined with Practical Epistemology Analysis is useful for obtaining a worm-eye view of dynamics of incumbency on the actor-level, in contrast to the eagle-eye view commonly adopted in transitions studies. Our main contribution is the identification of specific barriers to change and demonstrating how a worm-eye perspective offers detailed insights into micro-level interactions that hinder sustainability transitions. [ABSTRACT FROM AUTHOR]

• ctDNA holds a progressively stronger impact in the management of early-stage NSCLC. • Screening, MRD measure and detection of relapse are the most promising applications. • Ongoing trials will better clarify how to integrate ctDNA in clinical practice. Liquid biopsy is a minimally invasive method for biomarkers detection in body fluids, particularly in blood, which offers an elevated and growing number of clinical applications in oncology. As a result of the improvement in the techniques for DNA analysis, above all next-generation sequencing (NGS) assays, circulating tumor DNA (ctDNA) has become the most informing tumor-derived material for most types of cancer, including non-small cell lung cancer (NSCLC). Although ctDNA concentration is higher in patients with advanced tumors, it can be detected even in patients with early-stage disease. Therefore, numerous clinical applications of ctDNA in the management of early-stage lung cancer are emerging, such as lung cancer screening, the identification of minimal residual disease (MRD), and the prediction of relapse before radiologic progression. Moreover, a high number of clinical trials are ongoing to better define the impact of ctDNA evaluation in this setting. Aim of this review is to offer a comprehensive overview of the most relevant implementations in using ctDNA for the management of early-stage lung cancer, addressing available data, technical aspects, limitations, and future perspectives. [ABSTRACT FROM AUTHOR]

The purpose was to report the short-term outcomes and survival of hemiarthroplasty with a pyrocarbon head (HA-PYC) for the treatment of shoulder osteoarthritis in patients aged ≤ 60 years. We hypothesized that HA-PYC could be an alternative to hemi-metal (avoiding the risk of rapid glenoid erosion) and total shoulder arthroplasty (TSA) (avoiding the risk of rapid glenoid loosening) in an active patient population. Sixty-four consecutive patients (mean age, 53 years) who underwent HA-PYC for glenohumeral osteoarthritis were included. The primary outcome was revision to TSA or reverse shoulder arthroplasty. Secondary outcome measures included functional outcome scores; return to work and sports; and radiographic evaluation of humeral reconstruction quality using the "circle method" of Mears, as well as glenoid erosion severity and progression using the Sperling classification. Patients were reviewed and underwent radiography at an average follow-up of 33 months (range, 24-60 months). At last follow-up, the rate of survival of the HA-PYC prosthesis was 92%. Revision was performed in 5 patients, with a mean delay of 24 months (range, 15-37 months): 1 conversion to TSA and 4 conversions to reverse shoulder arthroplasty. The Constant score and Subjective Shoulder Value increased from 36 points (range, 26-50 points) to 75 points (range, 69-81 points) and from 35% (range, 20%-50%) to 80% (range, 75%-90%), respectively (P <.001). Postoperatively, 91% of the patients (42 of 46) returned to work and 88% (15 of 17) returned to sport. The severity of preoperative and postoperative glenoid wear (Sperling grade 3 or 4) had no influence on the functional results. Patients who underwent associated concentric glenoid reaming (n = 23) had similar Constant scores and Subjective Shoulder Values (P =.95) to other patients and did not show more progression of glenoid wear. Nonanatomic reconstruction of the proximal humerus (center of rotation of the prosthesis > 3 mm from the anatomic center) occurred in 29% (18 of 62 patients) and was associated with significantly lower functional and subjective results, more complications (subscapularis insufficiency and/or symptomatic glenoid erosion), and a higher risk of revision. The additional 1.5-mm thickness of the metal disc under the pyrocarbon head was found to be the main reason for oversizing of the prosthetic head. HA-PYC is a reliable procedure to treat shoulder osteoarthritis and allows return to work and sports in a young (≤60 years) and active patient population. The severity of glenoid bone erosion or the association with glenoid reaming does not affect functional outcomes and failure risk. By contrast, nonanatomic reconstruction of the proximal humerus after HA-PYC (because of humeral head oversizing) occurred in one-third of the cases and is associated with lower functional outcomes, as well as higher risks of complications and revision. [ABSTRACT FROM AUTHOR]

Objectives: To collect information about the retinal blood flow variations and other choroidal and retinal parameters during a prolonged effort such as marathon running.Design: Non-randomized prospective cohort study.Methods: Patients were recruited through an information campaign at the Rothschild Foundation Hospital (Paris, France). A first visit (V1) was planned in the month before the marathon. All participants underwent blood pressure measurement, fundus photography, spectral domain-optical coherence tomography (SD-OCT) and OCT-angiography (OCT-A). A second visit (V2) was scheduled within one hour of crossing the finish line. The same tests were repeated, using the same equipment.Results: Of the 31 runners who were included, 29 finished the marathon and attended V2. At baseline, various ophthalmological abnormalities were found in 45.2% of the 58 eyes, among which almost a third concerned the optic nerve and a quarter the pachychoroid spectrum. A significant decrease in retinal vascular plexus density was found between V1 and V2 (p<0.01). While median macular and retinal nerve fiber layer (RNFL) thicknesses significantly increased after the marathon (p<0.01), median choroidal thickness significantly decreased (p<0.01). Both systolic and diastolic blood pressures significantly decreased (p<0.01 and p=0.021 respectively).Conclusions: Prolonged physical effort impacts the structure and vascularization of the retina and the choroid. Hypoxia and dehydration due to such an effort may induce a low ocular blood flow rate resulting in a choroidal thinning, contrasting with a transient subclinical ischemic edema of the inner retina and optic nerve head.Clinical Trial Registration Number: NCT03864380. [ABSTRACT FROM AUTHOR]

Myxoid Round cell containing myxoid liposarcomas (MRCLS) have a high propensity to metastasize to soft tissue and bone. Whole Body Magnetic Resonance Imaging (BMRI) has been reported as a critical modality to early detect disease spreading in asymptomatic patients. The purpose of this study is to describe metastatic patterns and outcomes in patients through annual BMRI surveillance after diagnosis of MRCLS of the extremities and trunk. This retrospective study included patients with histology confirmed MRCLS. Initial BMRI were done within 6 months following the first line treatment then once a year. Forty-five out of 51 consecutive MRCLS patients were included. At the last follow-up 10 patients (22.2%) had an extra-pulmonary soft-tissue or/and bone metastasis detected in a median delay of 22.7 ± 16 months [0−49] from the diagnosis of the MRCLS. Nine patients were asymptomatic. Finally, 5-years metastatic free survival was 72 ± 8%. All metastatic patients had multiple lesion within the year following the first lesion diagnosis. Systematic BMRI in MRCLS patients following treatment frequently identify extra-pulmonary metastasis in asymptomatic patients within the first 5 years of follow-up. Despite a long survival can be expected after diagnosis, extra-skeletal metastasis was a signal of disseminated disease. [ABSTRACT FROM AUTHOR]

Background and Aims GI angiectasia (GIA) is the most common small-bowel (SB) vascular lesion, with an inherent risk of bleeding. SB capsule endoscopy (SB-CE) is the currently accepted diagnostic procedure. The aim of this study was to develop a computer-assisted diagnosis tool for the detection of GIA. Methods Deidentified SB-CE still frames featuring annotated typical GIA and normal control still frames were selected from a database. A semantic segmentation images approach associated with a convolutional neural network (CNN) was used for deep-feature extractions and classification. Two datasets of still frames were created and used for machine learning and for algorithm testing. Results The GIA detection algorithm yielded a sensitivity of 100%, a specificity of 96%, a positive predictive value of 96%, and a negative predictive value of 100%. Reproducibility was optimal. The reading process for an entire SB-CE video would take 39 minutes. Conclusions The developed CNN-based algorithm had high diagnostic performances, allowing detection of GIA in SB-CE still frames. This study paves the way for future automated CNN-based SB-CE reading softwares. [ABSTRACT FROM AUTHOR]

Accurate predictions of algal productivity under nutrient-limiting conditions are needed to assess the economics of full-scale algal cultivation for the developing markets of food, feed, and at longer term, green chemistry and biofuel. In particular, predicting pigments production from micro-algae is a critical milestone in the assessments of high-value chemicals production from micro-algae. This study validates a mathematical model predicting algal biomass productivity in outdoor raceway ponds under nitrogen-limiting conditions. The model was first validated from experimental data collected during Dunaliella salina cultivation in indoor photobioreactors and accounts for the impact of light, temperature, and nitrogen concentration on algal productivity (overall accuracy on algal concentration of ±2.7 mg L −1 , N  = 48). The model was then validated against data collected in outdoor raceway ponds over a period of 2 years, representing a total of 111 days of cultivation. Biomass and extracellular nitrogen concentrations predictions were accurate within ±0.055 g L −1 ( N  = 69) and ±0.0024 g L −1 ( N  = 26), respectively. Model inaccuracies were mostly due to measurement errors and uncertainties on model inputs. Measured carotenoids concentrations were found proportional to the biomass concentrations in the outdoor raceway ponds. By coupling this linear correlation to the productivity model, predicted carotenoids concentrations were in good agreement with experimental data (accuracy within ±0.0046 g L −1 , N  = 55). The mathematical model developed in this study has therefore the potential to refine previous assessments of algal cultivation for biofuels and pigments production. [ABSTRACT FROM AUTHOR]

• In this prospective monocentric study, among 108 adult patients, 71 (65.7%) had multiple sclerosis (MS), 19 (17.6%) had idiopathic ON, 13 (12.0%) and 5 (4.6%) had myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies, respectively. • At baseline, the distribution of bilateral ON, CSF-restricted oligoclonal bands, optic perineuritis, optic nerve length lesions and positive dissemination in space and dissemination in time criteria on MRI were different between the four groups. • No significant difference in visual acuity nor inner retinal layer thickness was found between the different ON aetiologies. Previous cross-sectional studies have reported distinct clinical and radiological features among the different acute optic neuritis (ON) aetiologies. Nevertheless, these reports often included the same number of patients in each group, not taking into account the disparity in frequencies of ON aetiologies in a real-life setting and thus, it remains unclear what are the truly useful features for distinguishing the different ON causes. To determine whether clinical evaluation, ophthalmological assessment including the optical coherence tomography (OCT), CSF analysis, and MRI imaging may help to discriminate the different causes of acute ON in a real-life cohort. In this prospective monocentric study, adult patients with recent acute ON (<1 month) underwent evaluation at baseline and 1 and 12 months, including, high- and low-contrast visual acuity, visual field assessment and OCT measurements, baseline CSF analysis and MRI. Among 108 patients, 71 (65.7%) had multiple sclerosis (MS), 19 (17.6%) had idiopathic ON, 13 (12.0%) and 5 (4.6%) had myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies, at last follow up respectively.At baseline, the distribution of bilateral ON, CSF-restricted oligoclonal bands, optic perineuritis, optic nerve length lesions and positive dissemination in space and dissemination in time criteria on MRI were significantly different between the four groups (p <0.001). No significant difference in visual acuity nor inner retinal layer thickness was found between the different ON aetiologies. In this large prospective study, bilateral visual involvement, CSF and MRI results are the most useful clues in distinguishing the different aetiologies of acute ON, whereas ophthalmological assessments including OCT measurements revealed no significant difference between the aetiologies. [ABSTRACT FROM AUTHOR]

Heart Rate Variability (HRV) is a non-invasive tool for assessing the autonomic regulation of heart rate through variations in RR-intervals. It reflects the control of parasympathetic and sympathetic autonomic functions in the cardiovascular system. In humans, HRV is used to adjust exercise training for improving performance. Also, some HRV parameters have been correlated to running performance and fitness status. In horses, although HRV has been used to assess behavioral response to stress, little is known regarding its correlation with performance. This experiment aimed to investigate if resting values of HRV correlate to racing performance in Standardbred horses. Forty-eight horses (27 stallions, 4 geldings and 17 mares; 2 to 7 years old; 2 to 95 races run) from Hunter Valley stables were followed over one year. Electrocardiograms were recorded twice (6 mo apart) using heart rate monitors Equimetre (Arioneo, France) for 10 min in the early morning when horses were in individual stalls. Horses did not undergo intense exercise the day before data collection. Analysis of HRV parameters was performed on Kubios HRV software to determine Standard Deviation (SDNN), Root Mean Square of Successive Differences (RMSSD), number of successive intervals differing more than 50ms (pNN50) and Standard Deviation from Poincaré plot (SD1 and SD2). Racing performances (total earnings, earnings perrace, racing time) were collected from LeTrot database for each horse over the whole career, and close to the day of measurement (one month before to 2 mo after). Performance and HRV parameters were correlated using Pearson coefficients, and linear regressions were performed to predict racing performances. Best time in career and close to HRV measurement were negatively correlated to SDNN, RMSSD, pNN50, SD1 and SD2 (P < 0.01; −0.46 P < 0.03; 0.27 > r > 0.35). Total earnings and earnings per race during the 3 mo close to HRV measurement were correlated with RMSSD, pNN50 and SD1 (P < 0.05; 0.29 > r > 0.52). Prediction of total earnings and earnings per race from the HRV parameters within 3 mo close to the measure was modest (adjusted R2 = 0.31 and 0.24; P = 0.0004 and 0.0016 respectively). In human athletes, higher HRV parameters indicate greater parasympathetic tone, better training adaptation and increased recovery. In our study, horses with higher HRV parameters possibly also recovered better, as the trainer decided to make them race more (P < 0.01; R > 0.36). Further research focusing on inter-individual variations to accurately track the horses' training and schedule the racing program would be valuable. [ABSTRACT FROM AUTHOR]

Blood acetate originates from fiber degradation by the hindgut microbiota. In addition to glucose and fat, acetate represents an energy substrate for muscles during exercise. Compared with horses fed high-starch diets, it has been reported that high-fiber diets lead to higher plasma acetate concentrations prior and post-exercise, lower lactatemia during exercise, and lower glycogen depletion post-exercise. Fibrolytic efficiency of the hindgut microbiota could thus play a crucial role in energy metabolism during exercise by enhancing acetate availability, which could modulate performance. This study aimed at investigating the relationships between fibrolytic efficiency, energy metabolism, and exercise performance in Standardbred horses. Twenty-one elite 2-years old Standardbred horses (12 stallions, 9 mares) from Ecurie Hunter Valley with similar feeding (hay ad libitum + 6.8kg concentrates/day) and training regimen (3 very heavy works/week) were included in this experiment. An individual in vitro fermentation test was performed from fecal samples with hay as substrate. Gas production (GP) in the bottles was monitored during 48h and fitted to a generalized model using nonlinear regression. Dry matter (DM), cellulose, and hemicellulose were analyzed in substrate residues, and their disappearance was calculated. Two weeks after, horses performed an incremental exercise including 3 steps of 3 min duration at35km/h, 40km/h, and maximal velocity. Steps were separated by 1 min walking. Maximal speed was defined as the maximal velocity sustained for 1 min during the last step. Blood samples were collected before (T0), 5 min (T5), and 20 min (T20) after the incremental exercise to measure glucose, lactate, NEFA, and acetate concentrations. Maximal speed, blood parameters, and fermentation parameters were correlated with Pearson coefficients. No significant correlation was found between maximal speed and glycemia, lactatemia, or NEFA concentration. Maximal speed was correlated with asymptotic GP (P = 0.04; r = 0.46), DM (P = 0.01; r = 0.53) and cellulose (P = 0.02; r = 0.52) disappearance, and with acetate concentration measured at T5 (P = 0.03; r = 0.48). Higher in vitro fibrolytic activity of the hindgut ecosystem was associated with better performance, although resting acetate did not correlate significantly with maximal speed. These results suggest that the extra source of energy provided by fiber digestion could benefit muscle activity during high-intensity exercise in horses. Further work should monitor blood metabolites during exercise to evaluate acetate absorption from the hindgut and utilization by muscles. [ABSTRACT FROM AUTHOR]

Firstly, this paper presents new criteria for fatigue life prediction of spot weld. It starts with the presentation of the database used for this study. Then, two criteria for spot weld life prediction, based respectively on mechanical damage and fracture mechanics, are developed through a nonlinear multiple regression method of optimization. These criteria considerably improve the correlation between numerical and test results. Finally, an application of this study is led on a fatigue test of a full body-in-white with about 4000 spot welds. Secondly, this paper presents new fatigue data editing techniques. Existing fatigue data editing techniques are tested on a full body-in-white fatigue lifetime calculation. The load applied to the biw is complex, with several load application locations and directions. All the critical point have to be detected with the new strength signal. Existing fatigue data editing techniques are adapted and tested on a full body-in-white fatigue calculation. Since the time discretization point number of the new load signal obtained from the literature techniques is too high, two new fatigue data editing technique are developed and tested on a full body-in-white durability calculation. The damage values damages at both spot weld and sheet metal, predicted with these new simplified load signals, are close to the damages values calculated with the full load signal. In addition, the number of time discretization points is low, at least 4.2 inferior to the time discretization point number obtained with existing techniques. [ABSTRACT FROM AUTHOR]

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Background The detection of circulating DNA is considered a promising strategy in cancer patients. Digital PCR has emerged as a sensitive method able to quantify both circulating free and tumour DNA. Aim The aim of this study was to prospectively evaluate the clinical value of a chip-based digital PCR for the detection of circulating DNA. Methods Digital PCR was used in 34 metastatic colorectal cancer patients to detect and quantify circulating free and tumour DNA based on K-ras mutational status. Clinical outcomes were analyzed according to circulating DNA measurements. Results Digital PCR yielded a detection rate of 69% for circulating tumour DNA. The median concentrations of circulating free and tumour DNA were 20 and 6.8 ng/mL, respectively, with significant correlation between both biomarkers ( p < 0.001). Median overall survival was 4.8 months in patients with high circulating free DNA (>75% quartile) versus not reached in patients with a low level (<25% quartile) ( p = 0.029). Moreover, median overall survival was significantly decreased in patients with detectable circulating tumour DNA compared to those without (respectively 11.8 months versus not reached, p = 0.04). Conclusions Chip-based digital PCR is a simple and non-invasive method allowing the efficient detection of circulating DNA. Our results highlight that levels of these circulating markers may have a potential prognostic value. [ABSTRACT FROM AUTHOR]

Summary Background & aims Screening for malnutrition is not often done in the management of hospitalized patients. An original computer tool was developed at the Dunkerque hospital to detect readmissions of patients with malnutrition during a previous stay and generate e-mail alerts to the nutrition department. The aim of the study was to describe and evaluate this tool and the activity of the nutrition department in connection with the alerts sent. Methods The number of alerts sent, dietary consultations conducted, assessments of the nutritional status and the number of malnourished patients diagnosed were collected from September 1st to November 30th 2012. The positive predictive value (PPV) of the malnutrition screening tool was estimated. The evolution of the nutritional status between the last and the current hospitalization was also evaluated. Results A total of 531 e-mail alerts were sent (mean of 8.2 per working day), leading to 205 dietary consultations but only 144 recorded assessments of the nutritional status (lack of information in medical records). Of the latter, 128 diagnoses of malnutrition were made, i.e. a PPV of 88.9%, 95% Confidence Interval = [83.8%, 94%]. Overall, only one quarter of readmitted patients had improved nutritional status. Conclusions The automatic e-mail alert system is operational and useful to effectively detect patients at risk of malnutrition and make follow up possible. In addition, an unfavorable evolution of the nutritional status of malnourished patients was observed. [ABSTRACT FROM AUTHOR]

Purpose A surgical gastrostomy is mandatory in cases where a PEG is not feasible. Various minimally invasive techniques have been described, but many involve unusable materials in small children and/or have risk of disunion. We describe a technique for true Stamm gastrostomy performed by laparoscopy (LSG) with a purse string suture and four points of attachment onto the wall. Method We reviewed 20 children who underwent an LSG from 2010 to 2013. After incision of the skin at the location planned for the gastrostomy, using three 3-5 mm ports the stomach is fixed to the wall by three suspension stitches, which are entered and then emerged subcutaneously. A fourth stitch of attachment is used to make an award on the stomach and tie around the gastrostomy tube. Results Mean age was 4.2 years, with 70% aged < 2 years. All children were malnourished, most often severely. All but two underwent a concomitant fundoplication. Feeding through the gastrostomy started on D0 or D1. Total feeding by gastrostomy was achieved in a mean duration of 2.9 day. Mean hospital stay was 4.5 days. There was no perioperative complication. Mean follow-up was 14 months. Once, the balloon was accidently deflated and reinflated in the wall leading to its necrosis. Five peristomial granulomas were noticed. It was always possible to replace the tube by a gastrostomy device at least 6 weeks after surgery. Conclusion This new technique for true Stamm gastrostomy by laparoscopy reproduces exactly the one done by laparotomy, without special equipment. It can be made since the neonatal period, in all the circumstances when a laparoscopy is possible. [ABSTRACT FROM AUTHOR]

This paper reports a numerical study of natural convection in a vertical enclosure filled with a non-Newtonian fluid. Thermal boundary conditions of the Neumann type are applied on the vertical walls of the enclosure while the horizontal ones are assumed adiabatic. A Carreau–Yasuda model, adequate for many non-Newtonian fluids, is used to characterize the behavior of the shear thinning fluids. The governing parameters for the problem are the thermal Rayleigh number Ra , Prandtl number Pr , power-law index n , aspect ratio A and parameters of non–Newtonian fluid model. A semi-analytical solution, valid for an infinite layer ( A ≫ 1), is derived on the basis of the parallel flow approximation. The influence of the constitutive Carreau–Yasuda equation parameters on the fluid flow, temperature field and heat transfer is discussed in detail. A good agreement is found between the predictions of the parallel flow approximation and the numerical results obtained by solving the full governing equations. The results reveal the strong influence of the pseudoplastic behavior of a non-Newtonian fluid on its natural convection heat transfer within the enclosure. Results are also obtained by considering the same phenomenon on the basis of the power law model. A comparison is made between the predictions of the two rheological models. [ABSTRACT FROM AUTHOR]

In this paper, the classical debate on suitability of proactive versus reactive routing approaches is revisited, however in the context of their application in Low-Power Lossy Networks (LLNs) as opposed to pure Mobile Ad Hoc Networks (MANETs). We argue that LLNs differ from traditional ad hoc networks not only due to node capacity, but also in the nature of traffic generation and routing requirements. This study aims at a fair comparison between two protocols proposed at the IETF, namely RPL (IPv6 Routing Protocol for Low-Power and Lossy Networks) - the proactive candidate, and LOADng (LLN On-demand Ad-hoc Distance vector routing protocol - next generation) - the reactive candidate, making use of real traffic scenarios and topology deployments of varied size, as well as random topologies in the particular case of metrics relating to scalability. Several metrics of interest are investigated, including metrics that have not been paid much attention in the existing MANET literature. In the course of this investigation, we also uncovered non-optimal protocol behavior for the case of large networks and proposed new mechanisms that are shown to improve control plane congestion, as a result improving network lifetime for large scale LLNs. We also derive bounds on control overhead for the two protocols, which indicate that RPL incurs an overhead that is lower than O(N2) and reduces to Θ(Nlog(N)) for a balanced tree structure, whereas LOADng has a total control overhead of Θ(N2), irrespective of topology. [ABSTRACT FROM AUTHOR]

The scattering of elastic waves in a one dimensional phononic (PnC) crystal composed of alternate collagen and hydroxy-apatite constituent layers is studied. These superlattices are metaphors for mineralized tissues present in bones and teeth. The collagen is treated as an open system elastic medium with water content which can vary depending on the level of stress applied. The open system nature of the collagen-water system leads to a non-linear stress-strain response. The finite difference time domain method is employed to investigate the propagation of non-linear mechanical waves through the superlattice. The spectral energy density method enables the calculation of the non-linear vibrational wave band structure. The non-linearity in the mechanical response of the collagen-water system enables a variety of multi-phonon scattering processes resulting in an increase in the number of channels for the dissipation of elastic waves and therefore for the dissipation of mechanical energy. These results provide an explanation for the relationship between bone fragility and decreased hydration. [ABSTRACT FROM AUTHOR]

Highlights: [•] We review the biological and ecological traits, damage and impact of O. acuta. [•] We summarize the eradication, containment and management for O. acuta in China. [•] We examine the risk of wider spread in China and neighboring countries of Asia. [•] We present strategies for better containment and management of O. acuta. [Copyright &y& Elsevier]

Abstract: Background: Esophageal replacement for caustic stenosis in children poses a challenging surgical problem. Blind removal of the injured esophagus without thoracotomy through a left cervical and transhiatal approach followed by an orthotopic esophageal replacement using either the colon or the stomach is a difficult procedure and can be dangerous in children. We performed our first total laparoscopic transhiatal esophagectomy in February 2007. We aim to compare this new technique to the previously applied method of blind closed-chest esophagectomy through a cervicotomy and laparotomy. Methods: We analyzed the surgery and follow-up of 40 children operated upon for extensive irreversible caustic burns of the esophagus. The first 20 esophageal replacements were performed following a blind dissection of the mediastinum through a cervical incision and a laparotomy for esophagectomy (Group I). The last 20 esophageal replacements were performed after laparoscopic transhiatal dissection in the mediastinum and cervicotomy in the neck for esophagectomy (Group II). All operations were performed under the supervision of the same senior surgeon. Results: Average age at the time of surgery was the same in both groups. Total esophagectomy was achieved in 45.0% of cases in Group I versus in 90.0% of cases in Group II. Colon was used in 80.0% of cases in Group I and in 90.0% in Group II. The mean duration of surgery was one hour longer in the laparoscopy group. One vascular injury was reported in the blind laparotomy group. Pneumothorax was more frequent in Group II without significant consequences besides drainage. Average time of extubation was about the same in both groups (1.8days). Conclusion: Laparoscopic transhiatal esophagectomy for caustic burns before esophageal replacement in children is safe and effective. It could avoid vascular and bronchial mediastinal injuries as the dissection is performed under direct visual control. The routine use of laparoscopic assistance by a senior surgeon improves the safety of esophageal dissection and reduces life-threatening complications. [Copyright &y& Elsevier]

Abstract: The Marangoni flows in a shallow cavity subject to uniform heat fluxes on all sides are investigated. A power law model is used to characterize the non-Newtonian fluid behavior of the fluid. The system with an underformable free upper surface is assumed to be under a zero gravity environment. The governing parameters for the problem are the thermal Marangoni number Ma, power-law index n, Prandtl number Pr and cavity aspect ratio aspect ratio A. An analytical solution, valid for an infinite layer (A ≫1), is derived on the basis of the parallel flow approximation. For the case of a layer heated from the bottom it is demonstrated that, for shear-thinning fluids (n <1), the onset of convection is subcritical. For shear thickening fluids (n >1), convection is found to occur at a supercritical Rayleigh equal to zero. For the case of a layer heated from all sides it is shown that multiple steady state solutions are possible, some of which are unstable. The effects of the non-Newtonian behavior on the fluid flow, temperature field and heat transfer are discussed. A good agreement is found between the analytical predictions and the numerical results obtained by solving the full governing equations. [Copyright &y& Elsevier]

Abstract: Most data regarding the natural history of inflammatory bowel diseases and their therapeutic management are from tertiary referral-centres. However, the patients followed in these centres represent a selected sample and extrapolation of these data to the general population is disputable. The EPIMAD Registry covers a large area of Northern France with almost 6 million inhabitants representing 9.3% of the entire French population. From 1988 to 2008, 18,170 incident patients were recorded in the registry including 8071 incident Crohn''s disease, 5113 incident ulcerative colitis and 591 unclassified inflammatory bowel disease cases. The aim of this study was to review some of the most recent information obtained from this large population-based registry since its launch in 1988. [Copyright &y& Elsevier]

Abstract: The frequent outbreaks of rice planthoppers, especially brown planthopper Nilaparvata lugens (Stål), in the last ten years in China and other Asian countries have caused serious rice (Oryza sativa L.) yield losses. The key problem is possibly due to biodiversity loss in rice ecosystems. We examined the potential of intercrops of soybean (Glycine max L.) and corn (Zea mays L.), both of which are more profitable than rice and mostly planted in levees, to diversify rice ecosystems and enhance insect pest management. We studied the impacts of such intercrops on planthopper populations and their natural enemies. The results showed significantly lower numbers of rice planthoppers in rice fields with intercrops of corn than in rice monocultures and rice fields with intercrops of soybean. Rice fields with corn intercrops had 26–48% fewer planthoppers than rice monoculture. Rice fields with soybean intercrops had lower rice planthopper abundance compared to rice monoculture in 2008 but higher in 2009. However, neither parasitoid nor predator numbers were significantly affected by intercropping. There were no significant differences in directional movements of planthoppers or natural enemies between crop subplots in the different cropping systems. Moreover, movement of planthoppers was very limited. Our study indicated that soybean and corn intercrops do not greatly enhance the ability of natural enemies to suppress planthoppers. However, rice fields with intercrops of corn had lower abundance of planthoppers and this strategy may be useful as part of an integrated pest management strategy for the sustainable rice production. [Copyright &y& Elsevier]

Abstract: Carbohydrate and glycoconjugates play a major role in key biological events such as cell-cell recognition, pathogenesis and inflammation. As a consequence, there is a need to understand the structural parameters governing the recognition of carbohydrate by their receptors. Technologies for rapid monitoring and evaluating such interactions are of great importance to provide deep insights relevant to carbohydrate involving biological events. However, most conventional approaches are cumbersome and material and time consuming. Carbohydrate microarray technology is a promising approach for probing carbohydrate/protein interactions because it permits the simultaneous screening of a number of biological interactions with only minute amounts of material. Herein, we develop a strategy to probe different glycoconjugates (different spatial configuration, linker, geometry…) toward proteins in one time on a DNA Directed Immobilization (DDI) oligosaccharide biochip. [Copyright &y& Elsevier]

Abstract: We present a label-free biosensor capable to map local potential by photogenerating charge carriers in a field effect device. It consists in an amplitude-modulated laser beam scanning through an electrolyte/insulator/semiconductor structure at very low illumination around the equilibrium state of semiconductor. A proof of principle is demonstrated by depositing a self-assembled monolayer on the dielectric and by showing a clear photopotential change between naked and covered areas. [Copyright &y& Elsevier]

Abstract: The present work is concerned with the effect of a uniform magnetic field on the onset of convection in an electrically conducting micropolar fluid. A flat fluid layer bounded by horizontal rigid boundaries, subjected to thermal boundary conditions of the Neumann type, is considered. The parallel flow approximation is used to predict analytically the critical Rayleigh number for the onset of convection. The onset of motion is found to depend on the Hartmann number Ha, materials parameters K, B, , and the micro-rotation boundary condition n. A linear stability analysis is carried out to study numerically the onset of convection. The predictions of the analytical model are found to be in good agreement with the numerical solution. The above results are also compared with those obtained numerically for the case of a system subject to Dirichlet thermal boundary conditions. [Copyright &y& Elsevier]

Abstract: This investigation reports on a stability analysis of the quiescent state within a horizontal layer of a micropolar fluid. The horizontal boundaries are considered rigid–rigid, rigid–free or free–free. Thermal boundary conditions of the Neumann type are applied on the boundaries of the system. The critical Rayleigh and Marangoni numbers for the onset of supercritical convection of micropolar are predicted analytically on the basis of the parallel flow approximation. The onset of motion is found to depend on the materials parameters K, B, and the micro-rotation boundary condition n. Furthermore, a linear stability analysis is conducted yielding numerically the critical Rayleigh and Marangoni numbers for the onset of motion from the rest state. A good agreement is observed between the analytical model and the numerical simulations. [Copyright &y& Elsevier]

Abstract: This paper reports an analytical and numerical study of natural convection in a shallow rectangular cavity filled with nanofluids. Neumann boundary conditions for temperature are applied to the horizontal walls of the enclosure, while the two vertical ones are assumed insulated. The governing parameters for the problem are the thermal Rayleigh number, Ra, the Prandtl number Pr, the aspect ratio of the cavity, A and the solid volume fraction of nanoparticles, . For convection in an infinite layer , analytical solutions for the stream function and temperature are obtained using a parallel flow approximation in the core region of the cavity and an integral form of the energy equation. The critical Rayleigh number for the onset of supercritical convection of nanofluids is predicted explicitly by the present model. Furthermore, a linear stability analysis of the parallel flow solution is studied and the threshold for Hopf bifurcation is determined. Also, results are obtained from the analytical model for finite amplitude convection for which the flow and heat transfer is presented in terms of the governing parameters of the problem. Numerical solutions of the full governing equations are obtained for a wide range of the governing parameters. A good agreement is observed between the analytical model and the numerical simulations. [ABSTRACT FROM AUTHOR]

Abstract: Background: In 1989, we introduced a 1-stage procedure with orthotopic colonic transplants for esophageal stenosis. A pitfall of this procedure is frequent reflux and/or stasis in the transplants from the cologastric anastomosis. Since 1993, we have used a new antireflux wrap (ARW) using an anterior wrap technique similar to the Dor procedure but fixed to the right crus of the diaphragm. Purpose: The purpose of the study was to evaluate ARWs. Method: From 1993 to 2008, the records of 67 patients with an ARW were compared with 27 without ARW (either operated on before 1993 or ARW was not appropriate) after colonic transplant for caustic esophageal stenosis. Both groups otherwise underwent the same surgical procedure. Postoperative esophagograms done on postoperative day 10 were reviewed for the presence of gastrocolonic reflux and stasis in the transplant. Results: The reflux rate on the initial esophagogram was reduced from 48.1% to 7.5% using ARW. The incidence of reflux on later esophagograms was 40.0% with no ARW and 21.4% with ARW. The 25% long-term rate of stasis in the colonic transplant was not increased with ARW. Conclusions: A loose ARW in patients with colonic esophageal replacements reduces gastrocolic reflux without increasing the rate of stasis. In the long term, children adapt better to stasis than to reflux and are thus protected from occult inflammation. [Copyright &y& Elsevier]

Abstract: Objective: A potential issue with the Walking Impairment Questionnaire (WIQ) is that it is relatively complex. We estimated the number of errors made by patients when self-completing the WIQ, and assessed the benefit of correcting missing, duplicate or paradoxical (i.e., reported lower difficulty for a higher-intensity task) answers. Design: Prospective non-interventional study. Materials: All consecutive new patients with claudication over a 3-month period. Methods: The WIQ was self-completed before patients performed a constant-load treadmill walking test (maximised to 750 m). Main outcome measure: We analysed the coefficient of determination of the linear relationship between overall WIQ score (mean of the available subscales when at least two subscales are available) and treadmill maximal walking distance (MWD), before and after correction of errors. Results: We studied 73 patients. Thirty-seven questionnaires had to be corrected for one or more errors. The coefficient of determination between the overall WIQ score and MWD was R 2 = 0.391 (n = 56) and R 2 = 0.426 (n = 73) before and after correction, respectively. Conclusion: Supervision of self-completed WIQs detects errors in almost half of the questionnaires, resulting in a missing overall WIQ score in 23% of cases among uncorrected questionnaires. The overall WIQ score correlates only moderately with MWD, even after correction. Clinical Trial Registration: NIH database: NCT01114178. [ABSTRACT FROM AUTHOR]

Abstract: This paper reports an analytical and numerical study of natural convection in a shallow rectangular cavity filled with a micropolar fluid. Neumann boundary conditions for temperature are applied to the horizontal walls of the enclosure, while the two vertical ones are assumed insulated. The governing parameters for the problem are the thermal Rayleigh number, Ra, the Prandtl number, Pr, the aspect ratio of the cavity, A and various material parameter of the fluid. For convection in an infinite layer (), analytical solutions for the stream function temperature and angular velocity are obtained using a parallel flow approximation in the core region of the cavity and an integral form of the energy equation. The critical Rayleigh numbers for the onset of supercritical convection are predicted explicitly by the present model. Furthermore, a linear stability analysis is conducted yielding numerically the critical Rayleigh numbers for the onset of motion. Also, results are obtained from the analytical model for finite-amplitude convection for which the flow and heat transfer are presented in terms of the governing parameters of the problem. Numerical solutions of the full governing equations are obtained for a wide range of the governing parameters. A good agreement is observed between the analytical model and the numerical simulations. The influence of the material parameters on the flow and heat transfer is demonstrated to be significant. [Copyright &y& Elsevier]

Abstract: Today the use of nanoparticles based on magnetite Fe3O4 or maghemite γ-Fe2O3 for magnetic fluid hyperthermia (MFH) application is preferred for evident reasons as biocompatibility and easy synthesis. However, they only show moderate heating capacities because their magnetic properties cannot be simply adjusted to a suitable level. A possible improvement of the MFH technique consists in using more complex magnetic oxides such as: (i) cobalt ferrite and derived phases whose magnetic properties depend on the composition and coercivity is essentially controlled by the magnetocrystalline and/or shape anisotropy, (ii) La1−x SrxMnO3 perovskites whose magnetic properties are influenced by the composition and crystallite size, and (iii) SrFe12O19/γ-Fe2O3 composites whose magnetic properties are mainly controlled by the ratio of the respective magnetic phases. Our main results concerning the synthesis of these compounds in the form of submicronic particles, their magnetic properties and their heating abilities are summarized, compared and discussed in this paper. [Copyright &y& Elsevier]

Abstract: We study theoretically, by means of layer-multiple scattering techniques, the propagation of elastic waves through finite slabs of phononic crystals consisting of metallic spheres in polyester matrix, embedded in air. We focus on the study of modes localized on the surfaces of the structure, investigating the physical parameters which influence and determine their appearance. Our results reveal the existence of absolute phononic frequency gaps in these finite structures, and point out the possibility, under an appropriate choice of the parameters, of tunable regions of frequency free of propagating and/or surface-localized modes. This could be very useful in the design of devices related to frequency filtering, waveguiding, etc. [Copyright &y& Elsevier]

Abstract: Using the finite element method (FEM), we investigate the existence of absolute band gaps and localized modes associated with a guide in thin films of phononic crystals. Two different structures based on two-dimensional (2D) phononic crystals are considered, namely a free standing plate and a plate deposited on a silicon substrate. The 2D phononic crystal is constituted by a square array of cylindrical holes drilled in an active piezoelectric PZT5A matrix. We demonstrate the existence of absolute band gap in the band structure of the phononic crystal plate and, then, the possibility of guided modes inside a linear defect created by removing one row of air holes. In the case of the supported plate, we show the existence of an absolute forbidden band in the plate modes when the thickness of the substrate significantly exceeds the plate thickness. [Copyright &y& Elsevier]

Abstract: We report numerical simulations, based on a finite difference time domain (FDTD) method, of light propagation in two-dimensional semiconductor micro-optical waveguides coupled to one or several lateral stubs. It is shown that when the stub is covered with a perfectly metallic thin layer, the transmission spectrum contains several narrow dips. Such simulation of the metallic coating can be used in the far infrared frequency domain, far from the optical regime. We propose a selective filtering device based on the interaction between several stubs. Inserting an appropriate defect stub between a set of periodical stubs leads to a tunnelling transmission, with a narrow peak inside the gap. This filtering phenomenon is used to propose a demultiplexer based on a Y-shaped waveguide for separating signals with different frequencies. Finally, we show that the filtering effect of a stub can also be reproduced when the metal is described in the frame of a Drude model instead of being perfect, which makes plausible the realization of the above devices in the near optical regime. [Copyright &y& Elsevier]

Abstract: Purpose: The objective of this study is to describe a prognostic classification for prenatally diagnosed sacrococcygeal teratoma (SCT). Methods: Charts from 44 fetuses were reviewed. Three groups were defined as follows: group A—tumor diameter less than 10 cm, absent or mild vascularity and slow growth; group B—diameter 10 cm or greater, pronounced vascularity or high-output cardiac failure and fast growth; group C—diameter 10 cm or greater, predominantly cystic lesion with absent or mild vascularity and slow growth. Results: Size at diagnosis, growth rate, and vascularity were higher in group B. Gestational age at delivery was lower in group B. Eleven of 21 died in the perinatal period in group B and none in groups A and C. In group C, drainage or shunting of the SCT has been performed in 6 of 10 cases. Conclusions: Group A is associated to good maternal and perinatal outcome, as well as group C, although shunting or drainage of the SCT could be necessary. Large fast-growing SCT with rich vascularity is associated with a higher perinatal mortality and morbidity than smaller lesions with mild vascularity. [Copyright &y& Elsevier]

Abstract: This paper reports an analytical and numerical study of the natural convection in a horizontal shallow cavity filled with a binary fluid. Neumann boundary conditions for temperature and solute concentration are applied to the two vertical walls of the enclosure. The governing parameters of the problem are the thermal Rayleigh number , the aspect ratio A, the buoyancy ratio φ, the Lewis number Le and parameter a. Both double diffusive convection () and Soret induced convection () are considered. An analytical model, based on the parallel flow approximation, is proposed for the case of a shallow layer (). The particular case where the buoyancy forces induced by the thermal and solutal effects are opposing each other and of equal intensity () is considered. For this situation the critical Rayleigh number for the onset of supercritical and subcritical convection is predicted. The study is completed by a numerical solution of the full governing equations. [Copyright &y& Elsevier]

Abstract: Magnetic nanoparticles have attracted attention because of their current and potential usefulness as contrast agents for magnetic resonance imaging (MRI) or colloidal mediators for cancer magnetic hyperthermia. This contribution examines these in vivo applications through an understanding of the involved problems and the current and future possibilities for resolving them. A special emphasis is made on magnetic nanoparticle requirements from a physical viewpoint (e.g. relaxivity for MRI and specific absorption rate for hyperthermia), the factors affecting their biodistribution and the solutions envisaged for enhancing their half-life in the blood compartment and targeting tumour cells. Then, the synthesis strategies developed in our group are presented and focused on covalent platforms capable to be tailor-derivatised by surface molecular chemistry. The opportunity of using more complex oxides than conventional magnetite for controlling the in vivo temperature is also discussed. [Copyright &y& Elsevier]

Abstract: This paper presents an analytical and numerical study of natural convection of a binary mixture confined in a tall enclosure, slightly inclined about the gravity field. The cavity is heated from the bottom by a constant heat flux while the long side walls are impermeable and adiabatic. Both double-diffusive convection and Soret-induced convection are considered. The basis of the analytical approximation is an assumption of parallel flow over a large portion of the layer. The existence of multiple steady states, for small enough inclinations around the vertical plane, is demonstrated. Numerical confirmation of the stable analytical results is also presented. [Copyright &y& Elsevier]