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The presence of Pseudomonas aeruginosa biofilms in cystic fibrosis (CF) patients suffering from chronic lung infections contributes to the failure of antimicrobial therapy. Conventionally, the minimal inhibitory concentration (MIC) is determined to assess the antimicrobial susceptibility of a pathogen, however this parameter fails to predict success in treating biofilm-associated infections. In the present study we developed a high throughput method to determine the antimicrobial con-centration required to prevent P. aeruginosa biofilm formation, using a synthetic cystic fibrosis sputum medium (SCFM2). Biofilms were grown in SCFM2 for 24 h in the presence of antibiotics (tobramycin, ciprofloxacin or colistin), whereafter biofilms were disrupted and a resazurin staining was used to quantify the number of surviving metabolically active cells. In parallel, the content of all wells was plated to determine the number of colony forming units (CFU). Biofilm preventing concentrations (BPCs) were compared to MICs and minimal bactericidal concentrations (MBCs) determined according to EUCAST guidelines. Correlations between the resazurin-derived fluorescence and CFU counts were assessed with Kendall's Tau Rank tests. A significant correlation between fluorescence and CFU counts was observed for 9 out of 10 strains investigated, suggesting the fluorometric assay is a reliable alternative to plating for most P. aeruginosa isolates to determine biofilm susceptibility in relevant conditions. For all isolates a clear difference between MICs and BPCs of all three antibiotics was observed, with the BPCs being consistently higher than the MICs. Additionally, the extent of this difference appeared to be antibiotic -dependent. Our findings suggest that this high throughput assay could be a valuable addition to evaluate the antimicrobial susceptibility in P. aeruginosa biofilms in the context of CF.

Objective Urine self-sampling has gained increasing interest for cervical cancer screening. In contrast to analytical performance, little information is available regarding the clinical accuracy for high-risk Human Papillomavirus (hrHPV) testing on urine. Methods VALHUDES is a diagnostic test accuracy study comparing clinical accuracy to detect high-grade cervical precancer (CIN2+) of HPV testing on self-collected compared to clinician-collected samples ( NCT03064087 ). Disease outcome was assessed by colposcopy and histology. The Abbott RealTime High Risk HPV assay performance was evaluated on Colli-Pee collected first-void urine with cervical outcomes as comparator. Results As no assay cut-off for urine has been clinically validated, we used the predefined cut-off for cervical samples (CN ≤ 32). Using this cut-off, hrHPV testing was similarly sensitive (relative sensitivity 0.95; 95% CI: 0.88–1.01) and specific (relative specificity 1.03; 95% CI: 0.95–1.13) for detection of CIN2+ compared to testing cervical samples. In the subgroup of women of 30 years and older, similar relative sensitivity (0.97; 95% CI: 0.89–1.05) and specificity (1.02; 95% CI: 0.93–1.12) was found. Additionally, an exploratory cut-off (CN ≤ 33.86) was defined which further improved sensitivity and analytical test performance. Conclusion HrHPV-DNA based PCR testing on home-collected first-void urine has similar accuracy for detecting CIN2+ compared to cervical samples taken by a clinician.

Gender dysphoria, a discrepancy between gender identity and genetically determined sex, is encountered in approximately 0.5% of people uniformly across the world. In the case of transgender men, formerly called female-to-male transsexuals, the available gender-affirming measures, hormone therapy and possible surgical procedures, are multiple and discussed in detail in this series of articles.

Research question Is implantation impaired in patients with endometriosis undergoing IVF and intracytoplasmatic sperm injection (ICSI) cycles? Design A retrospective matched cohort study was carried out on IVF/ICSI cycles with fresh single embryo transfer at the Department of Assisted Reproductive Medicine, Ghent University Hospital, Belgium, between July 2015 and August 2017 (n = 1053). A total of 118 endometriosis cases were matched 1:1 to 118 couples diagnosed with male subfertility and stratified by embryo quality (identical ALPHA grading categories), female age (±1 year) and parity (±1 delivery). Transvaginal ultrasound, magnetic resonance imaging or laparoscopy was used to diagnosed endometriosis, and the revised American Society for Reproductive Medicine score was used to classify the endometriosis into grade I/II versus grade III/IV. Male subfertility was defined in accordance with World Health Organization criteria (fifth edition). Results Compared with endometriosis cases, control couples with male subfertility had significantly higher rates of positive HCG test on day 16 (P = 0.047, OR 2.077, CI 1.009 to 4.276), ongoing implantation (defined as a positive fetal heart rate on transvaginal ultrasound at a gestational age of at least 6.5–7 weeks) (P = 0.038, OR 2.265, CI 1.048 to 4.893), ongoing pregnancy (defined by a vital pregnancy at 11 weeks) (P = 0.046, OR 2.292, CI 1.016 to 5.173) and live birth (P = 0.043, OR 2.502, CI 1.029 to 6.087). Conclusions After matching for embryo quality, woman's age and parity, rates of positive HCG tests, ongoing implantation, ongoing pregnancy and live birth were more than twice as high in the control group compared with the endometriosis group.

New lithium-ion battery generations for electric vehicles are constantly being developed. Currently, batteries with silicon and graphite anode enter the market as third-generation batteries, with limited knowledge of their environmental impacts. This life cycle assessment study evaluates the impacts of the entire life cycle of a prototype lithium nickel manganese cobalt oxide (LiNi0.6Mn0.2Co0.2O2) battery with a silicon-rich anode using the ReCiPe 2016 method. This prototype battery is compared to a state-of-the-art graphite-based battery. A sensitivity analysis is carried out, and the uncertainty of the results is quantified using Monte Carlo analysis. The battery emits 265 gCO2eq/kWh delivered over its life cycle (95 % confidence interval = [219;322]). The energy use in the cell manufacturing phase is critical for all environmental impact categories grouped with climate change. The new silicon-based anode does not contribute more than 7 % to the environmental impact categories. The cathode paste production is the main contributor to ozone formation, human non-carcinogenic toxicity, fine particulate matter, terrestrial acidification, mineral resource scarcity and ecotoxicity (terrestrial, freshwater and marine). The results are sensitive to the carbon intensity of the electricity mix used in the manufacturing phase and during charging. Switching to an electricity mix based on renewable energy sources reduces the impact by up to 53 % (for freshwater eutrophication). The impact categories climate change and ozone formation have the lowest coefficient of variation, while water consumption and human carcinogenic toxicity have the highest. Third-generation batteries can be environmentally beneficial, as soon as their cycle life is sufficient: at least 180,000 km.

OBJECTIVE: To understand the concept of goal-oriented care (GOC) through the experiences of people with chronic conditions. METHOD: Interviews with people living with chronic conditions (n = 50) were analyzed in two ways. A deductive approach based on GOC attributes generated in a concept analysis on GOC: goal-elicitation, goal-setting, goal-evaluation, patients' context, and patients' needs and preferences. An inductive approach based on a thematic analysis using descriptive phenomenology. RESULTS: The phase of goal-elicitation was recognized by the participants, whereas goal-setting and goal-evaluation were experienced to a lesser extent. Regarding the underpinning attributes, mixed feelings were reported concerning the integration of the patient's context and the presence of their needs and preferences throughout the care process. The inductive analysis revealed specific attention to informing patients about their condition and treatment options and discussing goals in interprofessional collaboration. CONCLUSION: Goal-elicitation was already present and seems to be a good foundation for GOC. More attention should be given to goal-setting and goal-evaluation. PRACTICE IMPLICATIONS: Developing guidance by means of a workflow, tools, or questions might support people with chronic conditions and providers to underpin the entire care process with patients' personal goals.

Research question Is there a difference in blastocyst formation between fresh and vitrified-warmed sibling oocytes and can this difference be attributed to changes in embryo morphokinetics? Design Between February 2016 and December 2017, 472 metaphase II (MII) oocytes in 67 donor-recipient cycles from 27 different healthy anonymous oocyte donors were allocated for fresh transfer (FSHO) (n = 220) to a synchronous recipient (n = 36) or vitrified (VITO) (n = 252) to be warmed and transferred to another recipient (n = 31). Embryos derived from the FSHO and their sibling VITO were analysed for morphokinetic development using time-lapse imaging, blastocyst formation and clinical outcome. Results Time-lapse analysis showed an overall delay in cleavage rate from the time of pronuclei disappearance up to the time of blastulation in the VITO compared with their sibling FSHO. Twelve morphokinetic variables were significantly different between the groups. On Day 5 significantly more FSHO embryos developed to blastocyst (expansion 1-6) and reached the full blastocyst stage (expansion 3-6) compared with the VITO embryos [53.2% (84/158) versus 40.0% (64/160); P = 0.0244 and 48.1% (76/158) versus 31.3% (50/160); P = 0.0028, respectively]. The embryo utilization rate was similar in both groups at the time of cryopreservation; 51.3% (FSHO) versus 45.0% (VITO) (P = 0.3124). The pregnancy rate per cycle was 47.2% (17/36) in FSHO patients and 48.4% (15/31) in VITO patients (P = 1). Limitations in this study: non-randomized, small study size and not powered to detect differences in clinical outcomes. Conclusions Timing of development is altered and blastocyst formation is delayed in embryos derived from vitrified-warmed donor oocytes compared with their fresh sibling counterparts. Although preliminary results suggest that the clinical impact of this delay may be limited, this needs further investigation in larger randomized studies.

L’ibuprofene est l’anti-inflammatoire non steroidien le plus consomme en France. Une enquete de type client mystere a ete realisee sur l’ensemble des pharmacies de Caen afin d’evaluer l’attitude du pharmacien d’officine face a une demande d’ibuprofene sans ordonnance dans le cadre d’une douleur de gorge febrile evoluant depuis plus de trois jours. Concernant l’automedication, l’interrogatoire et les informations delivrees sont insuffisants. Afin de limiter la survenue de complications, parfois graves, il est necessaire de sensibiliser les professionnels de soins primaires et les patients, au moyen de formations et en multipliant les sources d’information.

Research question To what extent does vitrification affect the Ca2+-releasing and activation potential of mouse oocytes, which are commonly used to determine the oocyte activation potential of human spermatozoa? Design The effect of mouse oocyte vitrification on Ca2+ dynamics and developmental competence after oocyte activation was assessed and compared with fresh mouse oocytes. Moreover, the Ca2+ store content of the endoplasmic reticulum was determined at different time points during the vitrification–warming procedure. Finally, the Ca2+ pattern induced by cryoprotectant exposure was determined. Results After human sperm injection into mouse oocytes, Ca2+ dynamics but not fertilization rates were significantly altered by vitrification warming (P 0.05), whereas activation rates after ionomycin exposure were significantly lower in vitrified–warmed oocytes (P 0.05). Cryoprotectant exposure was associated with a strong drop in endoplasmic reticulum Ca2+ store content. Oocytes rapidly recovered during warming and recovery in Ca2+-containing media; a threshold area under the curve of Ca2+ dynamics to obtain activation rates above 90% was determined. Conclusions Vitrified–warmed mouse oocytes display reduced Ca2+-releasing potential upon oocyte activation, caused by cryoprotectant exposure. With adapted classification criteria, these oocytes could be used for diagnosing oocyte activation deficiencies in patients. Evaluating the Ca2+-signalling machinery in vitrified–warmed human oocytes is required.

Objective To investigate the extent to which assisted oocyte activation (AOA) improves clinical outcomes in patients diagnosed with oocyte activation deficiencies (OADs). Design Retrospective cohort study comparing AOA cycles and previous intracytoplasmic sperm injection (ICSI) cycles in couples experiencing low or total failed fertilization after ICSI. Importantly, the sperm-related oocyte-activating capacity was examined in all patients before AOA with the use of the mouse oocyte activation test (MOAT). Setting Infertility center at a university hospital. Patient(s) A total of 122 couples with a history of low or total failed fertilization after ICSI. Intervention(s) ICSI, MOAT, AOA, and embryo transfer. Main Outcome Measure(s) Fertilization, pregnancy, and live birth rates. Result(s) MOAT revealed 19 patients with a sperm-related OAD (MOAT group 1), 56 patients with a diminished sperm-related oocyte-activating capacity (MOAT group 2), and 47 patients with a suspected oocyte-related OAD (MOAT group 3). AOA (191 cycles) significantly improved fertilization, pregnancy, and live birth rates in all MOAT groups compared with previous ICSI attempts (243 cycles). Fertilization rates after AOA were significantly different among MOAT groups 1 (70.1%), 2 (63.0%), and 3 (57.3%). Between MOAT group 1 and 3, significant differences in pregnancy (49.0% vs. 29.4%) and live birth (41.2% vs. 22.1%) rates were observed. In total, 225 embryo transfers resulted in 60 healthy live births following AOA. Conclusion(s) Patients undergoing diagnostic testing before AOA show a significant improvement in clinical outcomes compared with previous cycles. Our findings highlight that AOA should be reserved for patients with clear OADs.

Lightweight hybrid concrete beams are advantageous in terms of installation, but their mechanical behaviour is not easy to predict due to their heterogeneity. In the present study composite hollow beams made of Textile Reinforced Cement (TRC) reinforced with Carbon Fibre Reinforced Polymer (CFRP) strips and a concrete layer are subjected to bending. Their fracture behaviour is complicated as they exhibit multiple failure mechanisms: cracking of the cement matrix, debonding of the CFRP and delamination between successive layers of TRC. Herein, their mechanical performance is evaluated and monitored by Acoustic Emission (AE) and Digital Image Correlation (DIC). AE indices show that beams suffering from one major failure mechanism (matrix cracking) release AE signals with high frequency content while beams suffering from delaminations exhibit longer AE waveforms of lower frequency. These tendencies are obvious even at early loading stage, enabling prediction of the mode of the subsequent failure.

Research question Can oocyte-related activation deficiencies be evaluated in oocytes that failed to fertilize after intracytoplasmic sperm injection (ICSI) combined with assisted oocyte activation (AOA)? Design Evaluation of the spindle–chromosome complexes and intracellular distribution of inositol trisphosphate type 1 receptors (IP3R1) in in-vitro matured (IVM) and failed-to-fertilize oocytes from patients undergoing AOA. Assessment of the oocyte-related Ca2+ releasing capacity in response to Ca2+ ionophores and sperm microinjection in oocytes that failed to fertilize after ICSI or ICSI-AOA. Results IVM oocytes from patients undergoing conventional ICSI (control) and ICSI-AOA (study group) revealed a similar normalcy of spindle–chromosome complexes and distribution patterns of IP3R1. Failed-to-fertilize oocytes from both groups showed significant differences in proportion of normal or abnormal spindle–chromosome complex conformations. However, migration of IP3R1 was identified in a higher proportion of failed-to-fertilize oocytes after ICSI-AOA than after conventional ICSI. It was further observed that oocytes which failed to fertilize, either after ICSI or ICSI-AOA, mostly retain their capacity to respond to stimuli such as exposure to Ca2+ ionophores or to sperm microinjection. Conclusions Evaluation of spindle–chromosome normalcy and distribution of IP3R1 does not help identify the presence of Ca2+ releasing deficiencies in these oocytes. However, oocyte Ca2+ analysis adds value in identifying Ca2+ releasing incapacity of oocytes that failed to fertilize after ICSI or ICSI-AOA. Some patients experiencing fertilization failure after ICSI-AOA present with a suspected activation deficiency downstream of the Ca2+ machinery, which cannot be overcome by ICSI-AOA based on the use of Ca2+ ionophores.

Objective: To develop a random forest model (RFM) to predict implantation potential of a transferred embryo and compare it with a multivariate logistic regression model (MvLRM), based on data from a large cohort including in vitro fertilization (IVF) patients treated with the use of single-embryo transfer (SET) of blastocyst-stage embryos. Design: Retrospective study of a 2-year single-center cohort of women undergoing IVF or intracytoplasmatic sperm injection (ICSI). Setting: Academic hospital. Patient(s): Data from 1,052 women who underwent fresh SET in IVF or ICSI cycles were included. Intervention(s): None. Main Outcome Measure(s): The performance of both RFM and MvLRM to predict pregnancy was quantified in terms of the area under the receiver operating characteristic (ROC) curve (AUC), classification accuracy, specificity, and sensitivity. Result(s): ROC analysis resulted in an AUC of 0.74 ± 0.03 for the proposed RFM and 0.66 ± 0.05 for the MvLRM for the prediction of ongoing pregnancies of ≥11 weeks. This RFM approach and the MvLRM yielded, respectively, sensitivities of 0.84 ± 0.07 and 0.66 ± 0.08 and specificities of 0.48 ± 0.07 and 0.58 ± 0.08. Conclusion(s): The performance to predict ongoing implantation will significantly improve with the use of an RFM approach compared with MvLRM.

Dried Blood Spots (DBS) are broadly used in SARS-CoV-2 surveillance studies, reporting either the presence or absence of SARS-CoV-2 antibodies. However, quantitative follow-up has become increasingly important to monitor humoral vaccine responses. Therefore, we aimed to evaluate the performance of DBS for the detection of anti-spike SARS-CoV-2 antibody concentrations using a commercially available assay, reporting in a standardised unitage (International Units/mL; IU/mL). To assess the sensitivity and specificity of the ImmunoDiagnostics ELISA on serum and DBS for SARS-CoV-2 antibody detection, we analysed 72 paired DBS and serum samples. The SARS-CoV-2 51 IgG ELISA kit (EUROIMMUN) on serum was used as the reference method. We performed a statistical assessment to optimise the cutoff value for DBS and serum and assessed the correlation between DBS and serum antibody concentrations. We found that anti-spike SARS-CoV-2 antibody concentrations detected in DBS are highly correlated to those detected in paired serum (Pearson correlation 0.98; p-value < 0.0001), allowing to assess serum antibody concentration using DBS. The optimal cut-off for antibody detection on DBS was found to be 26 IU/mL, with 98.1% sensitivity and 100% specificity. For serum, the optimal cut-off was 14 IU/mL, with 100% sensitivity and 100% specificity. Therefore, we conclude that the ImmunoDiagnostics ELISA kit has optimal performance in the detection of SARS-CoV-2 antibodies on both DBS and serum. This makes DBS ideal for large-scale follow-up of humoral SARS-CoV-2 immune responses, as it is an easy but valuable sampling method for quantification of SARS-CoV-2 antibodies, compared to serum.

Summary People confronted to a stressful life event may experience negative consequences on sexual intimacy (Morokoff and Gillilland, 1993; Hagemeister and Rosenblatt, 1997, Bodenmann et al., 2006). The main hypothesis of the study is that the impact of stressful events on sexuality, especially on sexual desire, will depend on the subjective reactions to this event. Fifty-two women responded to several questionnaires: the sexual desire scale, the impact of event scale-revised (IES-R) and a list of potential stressful events. The results showed a positive association between the stressful event and dyadic sexual desire. Especially, women who experienced high levels of intrusions and hyperarousal after a stressful event also exhibited a higher levels dyadic sexual desire, with no significant result for individual sexual desire.

Resume Les personnes confrontees a un evenement de vie stressant peuvent faire l’experience de consequences negatives sur leur intimite sexuelle (Morokoff et Gillilland, 1993 ; Hagemeister et Rosenblatt, 1997, Bodenmann et al., 2006). L’hypothese principale de cette etude est que l’impact des evenements stressants sur la sexualite, specialement sur le desir sexuel, dependra des reactions subjectives a cet evenement. Cinquante-deux femmes ont repondu a divers questionnaires : l’echelle du desir sexuel, l’echelle d’impact de l’evenement (revisee) et une liste d’evenements potentiellement stressant. Les resultats montrent une association positive entre l’evenement stressant et le desir sexuel dyadique. Plus specifiquement, les femmes qui ont fait l’experience de niveaux eleves d’intrusions et d’hyperactivation apres un evenement stressant ont egalement montre des niveaux eleves de desir sexuel dyadique, sans resultat significatif pour le desir sexuel individuel.

Resume Jusqu’a aujourd’hui, a l’exception de l’etude de Wiedeman et Hurst en 1998, aucune recherche n’a ete faite quant a la relation entre l’estime de soi sexuelle des femmes, le BMI, la satisfaction physique et l’image corporelle. A travers deux etudes menees aupres de femmes adultes, notre objectif etait de mieux comprendre l’impact de la satisfaction physique sur l’estime de soi sexuelle des femmes aussi bien que les elements sur lesquels celle-ci se fonde. Les donnees issues de la premiere etude semblent indiquer que le BMI pourrait etre correle negativement et de maniere moderee a l’estime de soi sexuelle des femmes. Une relation plus claire, cependant, est observee entre l’estime de soi sexuelle et la satisfaction corporelle/physique. Les resultats de la deuxieme etude n’indiquent pas de relation entre le BMI et l’estime de soi sexuelle, mais ils en indiquent par contre bien une entre l’estime de soi sexuelle et l’image corporelle (estime corporelle). De plus, les traits qui se detachent le plus de l’attractivite/de la seduction sont lies au visage (les yeux, les levres, le sourire). Au final, les resultats de la recherche semblent suggerer que « la relation au corps » peut etre centrale dans la conceptualisation de l’estime de soi sexuelle des femmes.

CONTEXTE Outre le fait que la solitude soit un facteur de risque pour la santé de l’individu, de nombreux patients expriment leur difficulté à engager une relation amoureuse. La création d’un lien affectif passe nécessairement par une phase de séduction. Cet article a donc pour objectif de présenter un état des lieux des recherches menées sur la séduction afin de relever les habiletés qui peuvent être travaillées et ainsi améliorer les interventions thérapeutiques des professionnels. MATÉRIEL ET MÉTHODE Analyse de la littérature de 1967 et 2017 dans les bases de données Scopus, PsycInfo et SciencesDirect en utilisant les mots clefs suivants : seduction, human, courtship, female, male et pheromone. RÉSULTATS La séduction est composée d’aspects physiologiques, a priori immuables, mais également d’aspects psychologiques sur lesquelles il est possible d’agir. Cependant, si les premiers aspects font l’objet d’une littérature abondante, les seconds sont quant à eux encore peu approfondis. CONCLUSION Actuellement, il existe encore peu d’article portant sur le versant psychologique et modulable de la séduction. Malgré tout, la littérature existante nous offre des pistes intéressantes sur les habiletés de séduction qui peuvent être travaillées afin de favoriser la rencontre amoureuse. [Can we improve our seduction skills?] PURPOSE Solitude and social isolation are correlated with most risk of suicide, depression and alcoholism. Affective link is a protective factor for human well being. To create an affective link, people have to initiate a courtship phase. However, many patients seem to be showing difficulty to seduce a partner. The purpose of this article is to investigate seduction characteristics in order to highlight what skills should be improved to facilitate the seduction phase. The initial section gives the definition of seduction and a brief history of his evolution. The influence of culture shall be also discussed. The second section gives information about biological and physiological aspects of seduction. Finally, the third section is focused on psychological aspects. SOURCES AND METHODOLOGY A review of the literature about seduction will be presented. We investigate studies from 1967 to 2017 using Scopus and SciencesDirect and PsycInfo data base with the keywords seduction, human, courtship, female, male and pheromone. RESULTS Seduction includes biological and psychological aspects. Most studies are focused on biological aspect. Nevertheless, these factors cannot be modified because they are part of our human genetic inheritance. But psychological aspects give keys to improve seduction skills. Psychological aspects are composed of cognitive, emotional and behavioral dimensions. These dimensions can be improved with patients during therapy. CONCLUSION Studies might be more focused on psychological aspects of seduction because they can be improved and worked with patients.