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The validity of different available contact models is tested against experimental data for contact normal loading of artificially shaped granite stones. Three elastic models and two plastic models were tested with different combinations of contact shape (spherical, conical and flat) and roughnesses. It was found that the deviation from the Hertz model increased with surface roughness with a generally better representation of the data achieved by using models which consider surface roughness and the fractality of the surface. The validity of all these models seems to be limited to before excessive plastic deformations start taking place, after which the contact seems to deform under constant stiffness. [ABSTRACT FROM AUTHOR]

Contact tests on machined and natural granite showed that extensive plastic deformation which extends to the core shape is happening before the cross-over from the behaviour of an elastic rough surface to the Hertzian behaviour of an elastic smooth contact when all asperities have yielded in the surface. The plastic deformation, which was found to take place when the estimated maximum stresses at the contact reaches about 0.6 of the material hardness, affects the behaviour during normal loading as the material will start to deform at constant stiffness after reaching these stresses. The plastic deformation during lateral loading also affects the applicability of lateral loading models. The data yielded a much lower lateral stiffness which is around one order of magnitude less than that predicted by the available contact models. [ABSTRACT FROM AUTHOR]

In this paper, the evolution of nanoscale pores, covering inter-particle pores and inter-layer pores, in illite-dominant clay during consolidation is monitored using small angle X-ray scattering (SAXS) and nitrogen gas adsorption (N2GA) techniques. No obvious change observed in the characteristic peaks of SAXS intensity curves during consolidation suggests that the intra-particle structure of the clay, including interlayer spacings, is not affected by mechanical loading, at least up to 4 MPa. The N2GA test results show that the volume of inter-particle pores inside the aggregates does decrease gradually as the compression proceeds, which is accompanied by a gradual reduction in specific surface area, probably due to the rearrangement of the particles composing the aggregates. The inter-particle pores are compressed as a whole during consolidation instead of the progressive collapse in an ordered manner, from the larger to the smaller. By comparing the pore-size distributions of illite-dominant clay obtained by MIP (mercury intrusion porosimetry) and N2GA techniques, it is found that the shapes of the two distributions in the common measurement range are obviously not matched, essentially due to the sequential nature of the drying and wetting processes. While filling the research gap in the evolution of intra-aggregate pores during consolidation, this study also shows that the N2GA technique and SAXS measurement used in conjunction with each other appear as a powerful approach for clay nano-pores identification. [ABSTRACT FROM AUTHOR]

Background: Treating hypoxemia while meeting the soaring demands of oxygen can be a challenge during the COVID-19 pandemic. Objective: To determine the efficacy of the surgical facemask and the double-trunk mask on top of the low-flow oxygen nasal cannula on arterial partial pressure of oxygen (PaO2) in hypoxemic COVID-19 patients. Design: Randomized controlled trial. Participants: Hospitalized adults with COVID-19 and hypoxemia treated with the low-flow nasal cannula were enrolled between November 13, 2020, and March 05, 2021. Interventions: Patients were randomized in a 1:1:1 ratio to receive either the nasal cannula alone (control) or the nasal cannula covered by the surgical facemask or the double-trunk mask. Arterial blood gases were collected at baseline and 30 min after the use of each system. The oxygen output was adapted afterwards to retrieve the baseline pulse oxygen saturation. The final oxygen output value was recorded after another 30-min period. Main Measures: The primary outcome was the absolute change in PaO2. Secondary outcomes included changes in oxygen output, arterial partial pressure of carbon dioxide (PaCO2), vital parameters, and breathlessness. Key Results: Arterial blood samples were successfully collected in 24/27 (8 per group) randomized patients. Compared to the nasal cannula alone, PaO2 increased with the surgical facemask (mean change: 20 mmHg, 95% CI: 0.7–38.8; P =.04) and with the double-trunk mask (mean change: 40 mmHg; 95% CI: 21–59; P <.001). Oxygen output was reduced when adding the surgical facemask (median reduction: 1.5 L/min [95% CI: 0.5–4.5], P <.001) or the double-trunk mask (median reduction: 3.3 L/min [95% CI: 2–5], P <.001). The double-trunk mask was associated with a PaCO2 increase of 2.4 mmHg ([95% CI: 0–4.7], P =.049). Neither mask influenced vital parameters or breathlessness. Conclusions: The addition of the surgical facemask or the double-trunk mask above the nasal cannula improves arterial oxygenation and reduces oxygen consumption. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the safety and patient satisfaction of a fast-track procedure for cataract surgery under topical anaesthesia without perioperative anaesthesia care. This is a prospective single-centre study including all cataract procedures in the Centre Ambulatoire de la Chirurgie de la Cataracte at the Hospital of Bourges between May and August 2018. Procedures were performed under topical anaesthesia without the presence of a nurse anaesthesiologist or anaesthesiologist, the patient had not fasted, and no peripheral venous line was placed. Only heart rate and oxygen saturation were monitored intraoperatively with pulse oximetry. Incidence and nature of intraoperative adverse events and surgical complications were recorded. Patient satisfaction was assessed using the Iowa Satisfaction with Anaesthesia Scale (ISAS). In total, 651 cataract surgeries were performed among which 614 (94.3%) were uneventful. Thirty (4.6%) intraoperative adverse events and 8 (1.2%) surgical complications were recorded. All surgeries were successfully completed. No medical emergency team intervention or hospital admittance was encountered. The mean ISAS score was 5.7/6, indicating high patient satisfaction. Cataract surgery in an ambulatory cataract surgery centre without perioperative anaesthesia care is a safe procedure with high patient satisfaction for screened patients. Anaesthesia ressources are scarce and may be more beneficial to more complex ophthalmic or non-ophthalmic surgeries. [ABSTRACT FROM AUTHOR]

The aim of this survey was to describe the attitudes and self-reported practices of French dentists towards antibiotic use and resistance and to compare practices with national guidelines. A nationwide cross-sectional internet-based survey was conducted among the 41,800 French dentists. The online questionnaire was distributed through professional networks from April 2017 to April 2018. Seven-hundred seventy-five dentists participated but only 455 questionnaires were complete enough to be included in the analyses. Amoxicillin was the most frequently prescribed antibiotic (65.8%, 1783/2711), followed by spiramycin + metronidazole fixed-dose combination (11.6%, 312/2711) and amoxicillin–clavulanic acid (10.3%, 279/2711). The main indications for use were abscess (349/423, 82.5%), cervicofacial cellulitis (74.2%, 314/423), and pericoronitis (58.6%, 239/408). Most dentists (90.5%, 381/421) considered that antibiotic resistance is of concern but only half of them (56.3%, 238/423) felt adequately informed about antibiotic use. Many dentists did not comply with the national guidelines: the majority of them declared inappropriate antibiotic prescriptions for 11/17 clinical situations. They did not prescribe antibiotics for 5/6 clinical situations requiring prophylaxis. They reported that the publication of clinical guidelines is the main factor influencing their prescriptions (71.0%, 299/421). They wished to receive regular updates of national guidelines in the form of practical sheets (93.0%, 172/185). French dentists should urgently be targeted by antibiotic stewardship initiatives. [ABSTRACT FROM AUTHOR]

During axon pathfinding, growth cones commonly show changes in sensitivity to guidance cues that follow a cell-intrinsic timetable. The cellular timer mechanisms that regulate such changes are, however, poorly understood. Here we have investigated microRNAs (miRNAs) in the timing control of sensitivity to the semaphorin Sema3A in Xenopus laevis retinal ganglion cell (RGC) growth cones. A developmental profiling screen identified miR-124 as a candidate timer. Loss of miR-124 delayed the onset of Sema3A sensitivity and concomitant neuropilin-1 (NRP1) receptor expression and caused cell-autonomous pathfinding errors. CoREST, a cofactor of a NRP1 repressor, was newly identified as a target and mediator of miR-124 for this highly specific temporal aspect of RGC growth cone responsiveness. Our findings indicate that miR-124 is important in regulating the intrinsic temporal changes in RGC growth cone sensitivity and suggest that miRNAs may act broadly as linear timers in vertebrate neuronal development. [ABSTRACT FROM AUTHOR]

This article analyses the roots of Dutch Atlanticism. It holds that during the early Cold War, in spite of the conviction that neutrality was a thing of the past, the Atlantic orientation of the Netherlands was something that had to be 'sold' to the public. A sustained propaganda campaign aimed at selling the notion of 'Atlantic values' domestically by defining security in moral terms. The memories of the Second World War and anticommunist sentiments that stemmed from the interwar years provided a framework that government agencies could build on. [ABSTRACT FROM AUTHOR]

Abstract??Measuring Lagrangian velocities in a turbulent flow is of a great interest for turbulence modeling. We report measurements made in an axisymmetric turbulent air jet at Reynolds numberR????320, using acoustical Doppler scattering. Helium-filled soap bubbles are used as Lagrangian tracers. We describe an experimental setup which allows the simultaneous measurement of the full three-component Lagrangian velocity and the longitudinal Eulerian one. Lagrangian velocity probability density functions (PDF) are found Gaussian, close to Eulerian ones. Velocity correlations are analysed as well as the statistical dependence between components. [ABSTRACT FROM AUTHOR]

C6.9 rat glioma cells undergo a cell death program when exposed to 1,25-dihydroxyvitamin D3 (1,25-D3). As a global analytical approach, we have investigated gene expression in C6.9 engaged in this cell death program using differential screening of a rat brain cDNA library with probes derived from control and 1,25-D3-treated cells. Using this methodology we report the isolation of 61 differentially expressed cDNAs. Forty-seven cDNAs correspond to genes already characterized in rat cells or tissues. Seven cDNAs are homologous to yeast, mouse or human genes and seven are not related to known genes. Some of the characterized genes have been reported to be differentially expressed following induction of programmed cell death. These include PMP22/gas3, MGP and β-tubulin. For the first time, we also show a cell death program induced up-regulation of the c-myc associated primary response gene CRP, and of the proteasome RN3 subunit and TCTP/mortalin genes. Another interesting feature of this 1,25-D3 induced-cell death program is the down-regulated expression of transcripts for the microtubule motor dynein heavy chain/MAP lC and of the calcium-binding S100β protein. Finally 15 upregulated cDNAs encode ribosomal proteins suggesting a possible involvement of the translational apparatus in this cell program. Alternatively, these ribosomal protein genes could be up-regulated in response to altered rates of cellular metabolism, as has been demonstrated for most of the other isolated genes which encode proteins involved in metabolic pathways. Thus, this study presents to our knowledge the first characterization of genes which are differentially expressed during a cell death program induced by 1,25-D3. Therefore, this data provides new information on the fundamental mechanisms which participate in the antineoplastic effects of 1,25-D3 and on the machinery of a cell death program in a glioma cell line. [ABSTRACT FROM AUTHOR]

Slurry tailings storage in large impoundments has been largely used worldwide for a long time, as their cost is very competitive. However, recent disasters have brought to light the need to better comprehend the mechanics of the materials stored and to search for disposal alternatives to overcome the drawbacks. One possibility is the filtered tailings disposal (dry stacking) which requires a better understanding of the material's response in a dewatered (through filtration) and compacted condition. This paper compares two tailings from the same beneficiation (treatment) plant with different gradings and mineralogy, related to the beneficial processes they undergo. A series of triaxial tests comprising isotropic compression without shearing specimens, as well as isotropic compression followed by drained (CID) and undrained (CIU) shearing, and K-compression followed by undrained (CKU) shearing specimens were conducted over a range of confining pressures and initial compaction degrees. The experimental program allowed the evaluation of convergence for normal compression lines (NCLs) and the analysis under the light of critical state soil mechanics for the stress–strain response of the tested materials. The research outcomes show that changes in iron ore tailings gradings due to different production processes and the use of different compaction degrees had an influence on its behavior (compression and shearing) at lower stress levels, while at higher stresses levels, this difference is erased and there is a convergence for unique and parallels NCL and CSL on ν–ln p′ plane with a spacing of 2.71. On the p′–q plane both tailings showed a unique and similar CSL. [ABSTRACT FROM AUTHOR]

Despite the renewed interest in rare earth-doped chalcogenide glasses lying mainly in mid-infrared applications, a few comprehensive studies so far have presented the photoluminescence of amorphous chalcogenide films from visible to mid-infrared. This work reports the fabrication of luminescent quaternary sulfide thin films using radio-frequency sputtering and pulsed laser deposition, and the characterization of their chemical composition, morphology, structure, refractive index and Er3+ photoluminescence. The study of Er3+ 4I13/2 level lifetimes enables developing suitable deposition parameters; the dependency of composition, structural and spectroscopic properties on deposition parameters provides a way to tailor the RE-doped thin film properties. The surface roughness is very low for both deposition methods, ensuring reasonable propagation optical losses. The effects of annealing on the sulfide films spectroscopy and lifetimes were assessed. PLD appears consistent composition-wise, and largely independent of the deposition conditions, but radiofrequency magnetron sputtering seems to be more versatile, as one may tailor the film properties through deposition parameters manipulation. The luminescence via rare earth-doped chalcogenide waveguiding micro-structures might find easy-to-use applications concerning telecommunications or on-chip optical sensors for which luminescent sources or amplifiers operating at different wavelengths are required. [ABSTRACT FROM AUTHOR]

Rainfall-induced landslides are major natural hazards that are inherently inter-disciplinary crossing various fields (from geology to hydrology) and scales (particle level to catchment scale and beyond). Comparatively, very few studies on landslides have been conducted at the particle level with most research focusing on particle breakage or the effect of particle size and shape on the macro-scale and particle contact behavior. Limited evidence suggests that soils under shear undergo changes not only of size but also of shape and surface roughness. However, the particle morphology descriptors used are frequently qualitative so that information on how the soil particles are damaged during landsliding remains incomplete. This paper uses quantitative particle morphology descriptors, namely particle size, shape, and particle surface roughness to investigate particle damage during landslide-induced shearing. A series of ring shear tests were conducted to simulate landslide movement in completely decomposed volcanic rocks (CDV), a typical soil in Hong Kong that was retrieved from a debris flow. Particle size, shape, and surface roughness were analyzed on original CDV particles and on samples subjected to ring shear testing. Owing to the crushable nature of the soil, particle breakage was the key factor controlling particle morphology, with the results revealing an intricate dependency of shape and surface roughness on particle size. Shearing enhanced the bimodal gradation of the soil, with the larger grains more rounded and smoother and the resulting fines with a more irregular shape. This may be attributed to a combination of chipping and abrasion of the coarser particles. Further research is needed to ascertain the effect of such particle morphology changes to landslide movement. [ABSTRACT FROM AUTHOR]

The article presents a case of a 68-year-old man who attended a colorectal cancer screening program. He had undergone a colonoscopy which he had a removal of four polyps, with one already having cancer. A year after, he underwent a follow-up colonoscopy prepared with polyethylene glycol solution, low volume preparation (LVP). The article discusses the efficacy of LVP compared to polyethylene glycol solution, traditional preparation (TP) for bowel cleansing before colonoscopy.

Ground improvement by cementation is a technique widely used because of the easiness of application and relatively low cost. To date, however, there is no global understanding of the behaviour of artificially cemented soil with respect to its dosage, so that in practice methodologies still rely on previous used scenarios rather than scientific facts. This paper presents results of low-to-high-pressure triaxial tests performed on pure and cemented specimens of decomposed granite where the dosage was controlled, chosen as a function of the ratio of porosity to volumetric cement content or adjusted porosity/cement index. The behaviour of the cemented soil was analysed in terms of peak strength and failure envelopes, stress dilatancy and state boundary surfaces, on which the influence of the porosity/cement index was examined. [ABSTRACT FROM AUTHOR]

Cell adhesion molecules and diffusible cues both regulate axon pathfinding, yet how these two modes of signaling interact is poorly understood. The homophilic cell adhesion molecule NF-protocadherin (NFPC) is expressed in the mid-dorsal optic tract neuroepithelium and in the axons of developing retinal ganglion cells (RGC) in Xenopus laevis. Here we report that targeted disruption of NFPC function in RGC axons or the optic tract neuroepithelium results in unexpectedly localized pathfinding defects at the caudal turn in the mid-optic tract. Semaphorin 3A (Sema3A), which lies adjacent to this turn, stimulates rapid, protein synthesis-dependent increases in growth cone NFPC and its cofactor, TAF1, in vitro. In vivo, growth cones exhibit marked increases in NFPC translation reporter activity in this mid-optic tract region that are attenuated by blocking neuropilin-1 function. Our results suggest that translation-linked coupling between regionally localized diffusible cues and cell adhesion can help axons navigate discrete segments of the pathway. [ABSTRACT FROM AUTHOR]

Turbulent transport of material inclusions plays an important role in many natural and industrial situations. Being able to accurately model and predict the dynamics of dispersed particles transported by a turbulent carrier flow, remains a challenge. One critical and difficult point is to develop models which correctly describe the dynamics of particles over a wide range of sizes and densities. Our measurements show that acceleration statistics of particles dispersed in a turbulent flow do exhibit specific, and so far unpredicted, size and density effects and that they preserve an extremely robust turbulent signature with lognormal fluctuations, regardless of particles size and density. This has important consequences in terms of modeling for the turbulent transport of dispersed inclusions. [ABSTRACT FROM AUTHOR]

To the Editor, The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for coronavirus disease 2019 (COVID-19), has resulted in a global pandemic. COVID-19 occurring in patients with CVID has been reported in 5 patients and seems to confer an increased risk of severe COVID-19 [[2]]. In addition, for patient 2, mitogen-stimulated T cell proliferation was normal and SARS-CoV-2-specific T cell response evaluated by enzyme-linked immunoSpot (ELISPOT) was positive (Table 1) and similar to what is usually seen in non-ID patients with COVID-19 (data not shown). We describe the first two cases of severe COVID-19 in patients with hypogammaglobulinemia and absence of B lymphocytes and of efficacy of convalescent plasma in one patient with prolonged SARS-CoV-2 infection. [Extracted from the article]

Nephrotic patients are at risk of developing venous and arterial thrombotic complications. Pulmonary embolism due to affected deep leg veins is by far the most common event. Renal or cerebral vein thromboses have been described. Thrombosis of arterial vessels is less frequent. Mesenteric infarction is a rare but severe complication in patients with nephrotic syndrome (NS). We report a 7-year-old boy with a steroid-dependent (SD) NS and a homozygous mutation of methylenetetrahydrofolate reductase, increasing the risk of thromboembolic events. He developed a thrombosis of his superior mesenteric artery during his ninth relapse, which was responsible for a necrosis of 240 cm of his small bowel, necessitating resection of necrotic parts and double external ostomy diversion. Remission was achieved with pulse prednisolone therapy. Corticoids were reduced over 4 months progressively. Oral cyclosporin A (CyA) was initiated for long-term treatment. Due to a short bowel syndrome with severe malabsorption, even oral administration of 22.5 mg/kg per day CyA did not lead to sufficient plasma levels. Intravenous cyclophosphamide pulse therapy over 6 months led to a complete remission. No relapse occurred over a period of more than 5 months after the last cyclophosphamide pulse. Anticoagulation and screening for increased susceptibility for thrombotic events are necessary in every nephrotic patient. Intravenous cyclophosphamide pulse therapy is a useful alternative in SDNS with impaired intestinal absorption of applied immunosuppressive drugs. [ABSTRACT FROM AUTHOR]

Objectives: This prospective study examined the relationship between resting blood pressure (BP; primary outcome), demographic features of patients, anatomical characteristics of the extracted teeth, surgery variables (secondary outcomes), and acute postsurgical pain in patients undergoing tooth extraction. Materials and methods: Standardized surgery was performed under local anesthesia. A composite numerical index, referred to as 'postoperative pain/analgesia score' (PPAS), was built out of two intermediate ones, indicating (i) the degree of spontaneous pain reported by the patient (postoperative pain score) and (ii) the amount of analgesic drug intake (postoperative analgesia score). Results: A total of 293 patients with complete data sets were included in the analysis. Univariate analysis reveals that the intensity of postoperative pain is related to age, history of hypertension and previous oral surgery, number of extracted teeth, duration of surgery, and extraction of the third molar. On the other hand, there is no relationship with gender, anxiety, and operation duration. Multivariate analysis reveals that the intensity of acute postoperative pain is only associated with the location (upper/lower jaw, P = 0.004) and deepness of implantation of the extracted tooth ( P < 0.0001), and mean resting BP ( P = 0.031). Conclusions: This large prospective study shows that patients with high resting BP had a lower oral postsurgical pain than those with low resting BP. This suggests that high resting BP is a protective factor against oral postsurgical pain. Clinical relevance: The measurement of resting BP before surgery may be used in clinical practice to identify patients at risk of developing severe oral postsurgical pain. [ABSTRACT FROM AUTHOR]

Most patients with idiopathic nephrotic syndrome are steroid-responsive, but about 50% relapse and often become steroid-dependent and exposed to long-term steroid complications. The aim of this study was to determine predictive risk factors for steroid and/or cyclosporine A (CyA) dependence. In France, steroid responsiveness is defined as remission after 1 month of oral prednisone (60 mg/m2 per day) and—in the case of persistent proteinuria on day 30—three methylprednisolone pulses (MPP; 1 g/1.73 m2 on days 1, 3, and 5). Thirty-five steroid-responsive children, followed between 1999 and 2006, were included in this study. Median age at diagnosis was 4.9 years. All patients initially received prednisone 60 mg/m2 per day. Twenty-four of the 35 patients were steroid-dependent, with 12 requiring MPP. Of the latter 12 patients, 83.3% were treated with CyA during follow-up; in comparison, only 16.7% of the patients who did not receive MPP required CyA during follow-up (chi-square test, P = 0.001). T risk for steroid dependence was 100% in our cohort if remission was achieved after day 20. Patients who need MPP are at high risk to require CyA to achieve disease control. By identifying these children, we could use adequate immunosuppressive drugs earlier and reduce morbidity related to steroids and multiple relapses. [ABSTRACT FROM AUTHOR]

We present the results of an experimental study of the spatial Fourier modes of the vorticity in a turbulent jet flow. By means of an acoustic scattering setup we have recorded the evolution in time of Fourier modes of the vorticity field, characterized by well defined wavevectors k. By computing the auto-correlation of the amplitude of the Fourier modes we evidence that, whatever the length scale (or equivalently k), the dynamic evolution of the vorticity field involves two well separated time scales. We have also performed the simultaneous acquisitions of pairs of Fourier modes with two wavevectors k and k'. Whatever the spectral gap k- k', any pair of Fourier modes exhibits a significant cross-correlation over long time delays, indicating a strong statistical dependence between scales. [ABSTRACT FROM AUTHOR]

The vascularization of the posterolateral area of the arm is supplied by the terminal branches of the deep brachial artery [middle collateral artery (MCA) and posterior radial collateral artery]. Their anatomy has been a field of confusion for a long time. An extended lateral arm flap, named the “extreme” lateral arm flap, supplied by these branches and dissected as a retrograde island flap has been proposed as an alternative for large compound defects of the distal forearm. We carried out an extensive anatomic study of the “extreme” lateral arm flap on 69 upper limbs: 54 fresh injected with colored latex, 10 embalmed and 5 radiographed after Micropaque injection. Two origin levels of the MCA were found: a proximal one (37%) above the radial groove, and a distal one (63%) at the level of the groove. The deep brachial artery always bifurcated after the origin of the MCA into a posterior radial collateral artery (PRCA) and anterior radial collateral artery (ARCA). Indeed in our dissections, after the origin of the MCA from the deep brachial artery, there was always a common trunk named the radial collateral artery (RCA) which bifurcated into the ARCA and PRCA. In all dissected arms we always found the MCA anastomosed in a transverse pattern with the inferior ulnar collateral artery (IUCA), contributing to the anastomotic circle of the elbow. This circle represents the unique vascularization source of the reverse “extreme” lateral arm flap. [ABSTRACT FROM AUTHOR]

It is well known that a cutaneous artery is constantly located near a cutaneous peripheral nerve, forming a vascular plexus around it. This vascular axis can be either a true artery or an interlacing network, ensuring the vascularization of the nerve and giving off several neurocutaneous perforators to the skin. The anatomy of the accompanying arteries of the dorsal branch of the ulnar nerve (DBUN) and their relationships with the dorsal branch of the ulnar artery (DBUA) were investigated in 22 fresh upper limbs injected with colored neoprene latex. A constant perineural vascularization of the terminal branch of the DBUN was observed in the fourth web space, connected distally with the corresponding dorsal metacarpal or palmar digital arteries. Our findings therefore provide anatomical bases for a new neurocutaneous island flap. Moreover, they allow us to describe a precise surgical technique in order to raise this flap over the larger branch of the DBUN, in the fourth intermetacarpal space. The flap is harvested on the medial aspect of the dorsum of the hand, and its point of rotation is located in the fourth web space, 1 cm proximal to the metacarpophalangeal joint. It is supplied by a reversed flow originating from distal anastomoses of the perineural vessel with the dorsal metacarpal and digital palmar arteries in the fourth web space. This flap does not involve in its pedicle the distal course of the DBUA. It represents a pure neurocutaneous flap. [ABSTRACT FROM AUTHOR]

INTRODUCTION:: Among patients with indolent form of B-cell chronic lymphocytic leukemia, some of them will progress into more advanced stages. To better define this subpopulation of patients, we attempted to define some parameters capable of predicting a pejorative clinical outcome. MATERIALS AND METHODS:: Eighty-eight previously untreated patients with B-cell chronic lymphocytic leukemia in Binet stage A were analysed to study the prognostic value of simple serological variables: soluble CD23 (sCD23), β2 microglobulin (β2m), lactate-dehydrogenase activities and albumin level. Results were compared to other conventional clinical and biological parameters by univariate and multivariate statistical analysis. RESULTS:: Our data show that: (1) among those studied, sCD23 >50 u/ml was the only serological significant parameter clearly correlated with disease progression and (2) stage A′′ patients (hemoglobin level between 100 and 120 g/l and/or lymphocytosis >30.109/l), axillary lymph nodes and hypogammaglobulinemia were found to be other variables associated with a pejorative outcome. These four variables enabled the establishment of a scoring system, capable of predicting disease progression since 66% of the patients with a score 2 are going to evolve into advanced stages vs 12% with a score <2. Furthermore, the time to progression is shortened when the score is increasing. CONCLUSION:: Our findings show the prognostic relevance of a scoring system including sCD23 level. This score could be taken into account in the treatment strategy of B-cell chronic lymphocytic leukemia.The Hematology Journal (2000) 1, 301–306 [ABSTRACT FROM AUTHOR]

The aim of the study was to design and test a new, easy to use, assessment tool, the Migraine Assessment of Current Therapy (Migraine-ACT), for identifying patients who require a change in their acute treatment. A 27-item questionnaire was developed by an international advisory board including questions formulated in four domains: headache impact, global assessment of relief, consistency of response and emotional response. Migraine patients entered a multinational, prospective study to investigate the test-retest reliability and construct validity of the tool, which was completed by the patients on two occasions. Test-retest reliability was assessed by Pearson’s and by Spearman correlation coefficients. Construct validity was assessed by correlating patients’ answers to the 27-item questionnaire with those of well-reported measures: SF-36, MIDAS and Migraine Therapy Assessment Questionnaire (MTAQ). The test-retest reliability of the 27 initial questions ranged from good to excellent. Correlations of all items with SF-36, MIDAS and MTAQ scores-assessed by discriminatoryt-tests-indicated that the following 4 were the most discriminating items: Does your migraine medication work consistently, in the majority of your attacks? Does the headache pain disappear within 2 hours? Are you able to function normally within 2 hours? Are you comfortable enough with your medication to be able to plan your daily activities? The 4-item Migraine-ACT is a brief, simple, and reliable assessment tool to identify patients who require a change in their acute migraine treatment, and can be recommended for primary care physicians, neurologists and headache clinicians. [ABSTRACT FROM AUTHOR]

Knowing which geodynamic regimes characterised the early Earth is a fundamental question. This implies to determine when and how modern plate tectonics began. Today, the tectonic regime is dominated by mobile-lid tectonics including deep and cold subduction. However, in the early Earth (4.5 to 2 Ga) stagnant-lid tectonics may also have occurred. The study of high pressure-low temperature (HP-LT) metamorphic rocks is important, because these rocks are only produced in present-day subduction settings. Here, we characterize the oldest known HP-LT eclogite worldwide (2089 ± 13 Ma; 17-23 kbar/500-550 °C), discovered in the Democratic Republic of the Congo. We provide evidence that the mafic protolith of the eclogite formed at 2216 ± 26 Ma in a rift-type basin, and was then subducted to mantle depths (>55 km) before being exhumed during a complete Wilson cycle lasting ca. 130 Ma. Our results indicate the operation of modern mobile-lid plate tectonics at 2.2-2.1 Ga. [ABSTRACT FROM AUTHOR]