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Haemosporidian parasites are protozoans that infect many different vertebrate hosts. Re-examination of the diversity of haemosporidian parasites, using molecular tools, has generally led to rearrangements of traditional classifications. In this study, we explored the diversity of haemosporidian parasites infecting some species of reptile and birds living in the forests of Gabon, Central Africa, by analyzing a collection of 128 samples of reptiles and birds. We found that samples from 2 tortoise species (Pelusios castaneus and Kinixys erosa) and 3 bird species (Turtur afer, Ceratogymna atrata, and Agelastes niger) were infected by Haemocystidium spp. and Parahaemoproteus spp., respectively. From an ecological point of view, these lineages of parasites do not show host specificity because we have found them in several host species (2 tortoise and 3 bird species) that come from different areas of Gabon forest which are infected with these parasites. Also, our phylogenetic analyses revealed that the obtained lineages are related to isolates from other continents found in the same groups of vertebrates. Thus, our results show that haemosporidian parasites are also infecting central African vertebrates and that new lineages of these parasites are circulating in wild animals of the Gabon forest.

International audience; In 2017, the order Mononegavirales was expanded by the inclusion of a total of 69 novel species. Five new rhabdovirus genera and one new nyamivirus genus were established to harbor 41 of these species, whereas the remaining new species were assigned to already established genera. Furthermore, non-Latinized binomial species names replaced all paramyxovirus and pneumovirus species names, thereby accomplishing application of binomial species names throughout the entire order. This article presents the updated taxonomy of the order Mononegavirales as now accepted by the International Committee on Taxonomy of Viruses (ICTV).

Providing effective sedation and analgesia in infants and children admitted on a Pediatric Intensive Care Unit (PICU) is a cornerstone of daily patient care and probably one of the most challenging tasks facing PICU professionals. The wide range in age, weight and body composition, underlying medical and neurological diseases, the usually high sensory stimulatory environment, the repetitive physical stimuli related to medical therapy (e.g., physical examination, invasive procedures, and interventions) and—most importantly—the scarcity of high quality evidence applicable for daily practice may all contribute to this difficulty. A holistic comfort directed policy, including both pharmacological interventions as well as non-pharmacological strategies is promoted. For assessing comfort and/or pain several instruments are available. Particular attention should be paid to certain challenging clinical problems related to sedation, i.e. the management of refractory agitation, drug withdrawal and delirium.

International audience; Technological innovations in the food sector have been driven by high-volume production lines over the past decades. Cost-efficiency of processing and price competitiveness of final products have been major factors. The economics of up-scaling have led to new technologies that are more efficient in terms of throughput and utilization of (homogenous) resources. The question now is whether there is a future for competitive, sustainable processing at small scale. To answer that question, we address two major issues. The first deals with process efficiency and the reliability and resilience of technologies for small-scale processing to be competitive. The second deals with localization of processing and the advantages and disadvantages of technologies for small-scale processing. Novel technologies, especially those based on electro-thermo-dynamic principles, may emerge with characteristics that appear more beneficial for applications at small-scale, and so may well contribute to the competitiveness of local producers of food and biobased products valorizing renewable resources in an integrated manner for a variety of business sectors. However, these novel technologies should go hand in hand with end-to-end innovation of the local food and biobased product system in order to be competitive with international-scale enterprises.

Few studies have analyzed the gut microbiota of child in unindustrialized countries, but none during the first month of life. Stool samples were collected from healthy newborns in hospitals of Gabon (n = 6) and Republic of the Congo (n = 9) at different time points during the first month of life: meconium, day 2 (D02), day 7 (D07) and day 28 (D28). In addition, one fecal sample was collected from each mother after delivery. Metagenomic sequencing was performed to determine the bacterial communities, and multiplex real-time PCR was used to detect the presence of seven enteric viruses (rotavirus a, adenovirus, norovirus I and II, sapovirus, astrovirus, enterovirus) in these samples. Bacterial diversity was high in the first days of life, and was dominated by the genus Prevotella. Then, it rapidly decreased and remained low up to D28 when the gut flora was composed almost exclusively of strictly anaerobic bacteria. Each infant’s fecal bacterial microbiota composition was significantly closer to that of their mother than to that of any other woman in the mothers’ group, suggesting an intrauterine, placental or amniotic fluid origin of such bacteria. Moreover, bacterial communities differed according to the delivery mode. Overall, the bacterial microbiota communities displayed a similar diversification and expansion in newborns within and between countries during the first four weeks of life. Moreover, six of the fifteen infants of this study harbored enteric viruses (rotavirus, enterovirus and adenovirus) in fecal samples, but never in the meconium. A maternal source for the viruses detected at D02 and D07 can be excluded because none of them was found also in the child’s mother. These findings improve our knowledge on the gut bacterial and viral communities of infants from two Sub-Saharan countries during their first month of life.

The aim of this study was to provide information on trypanosome species infecting trypanotolerant cattle from southern Gabon. The study was conducted on 224 trypanotolerant cattle from three regions located in southern Gabon, using ITS1 primer-based PCR. Seventy-two (32%) N'dama cattle were found polymerase chain reaction (PCR) positive with trypanosomes. The overall prevalence of trypanosomosis was 57% (63/110), 4% (4/100), and 36% (5/14) in the Gala section of the Nyanga ranch, the Miyama ranch, and Ossiele, respectively. Trypanosoma congolense and Trypanosoma vivax were identified. In Gala section and Ossiele, T. congolense and T. vivax were found. In the Miyama ranch, only T. vivax was identified. Mixed infections were also found. The forest (9%) and savannah (63%) subgroups of T. congolense were identified. The presence of the two subgroups was detected in 16 out of 56 cattle (29%). T. congolense and T. vivax would appear to be the main agents responsible for bovine trypanosomosis in southern Gabon. Although trypanotolerant, N'dama cattle may serve as a reservoir, and this should be further studied. On the other hand, these trypanotolerant cattle can be reared in such tsetse infested areas, which gives them an advantage compared to other trypanosensitive breeds, and this shows that they represent a key factor in biodiversity which has to be promoted.

Examination and comparison of the current DSM-IV-TR and the proposed revisions for the forthcoming DSM-5, with regard to neuropsychiatric aspects of critical illness, identified five important issues. These remain to be addressed in order to improve the care of critically ill patients. These are 1) sickness behavior, as part of the organic reaction types of the brain; 2) delirium in children and the "Differential Diagnosis of Mental Disorders Due to a General Medical Condition" in children; 3) catatonia; 4) regressive disorders in childhood in relation to somatic disorders (e.g., anti-NMDAR encephalitis); 5) age-related diagnostic criteria in relation to neuro-psychiatric disorders.

International audience; In 2016, the order Mononegavirales was emended through the addition of two new families (Mymonaviridae and Sunviridae), the elevation of the paramyxoviral subfamily Pneumovirinae to family status (Pneumoviridae), the addition of five free-floating genera (Anphevirus, Arlivirus, Chengtivirus, Crustavirus, and Wastrivirus), and several other changes at the genus and species levels. This article presents the updated taxonomy of the order Mononegavirales as now accepted by the International Committee on Taxonomy of Viruses (ICTV).

International audience; Laboratory-acquired infections due to a variety of bacteria, viruses, parasites, and fungi have been described over the last century, and laboratory workers are at risk of exposure to these infectious agents. However, reporting laboratory-associated infections has been largely voluntary, and there is no way to determine the real number of people involved or to know the precise risks for workers. In this study, an international survey based on volunteering was conducted in biosafety level 3 and 4 laboratories to determine the number of laboratory-acquired infections and the possible underlying causes of these contaminations. The analysis of the survey reveals that laboratory-acquired infections have been infrequent and even rare in recent years, and human errors represent a very high percentage of the cases. Today, most risks from biological hazards can be reduced through the use of appropriate procedures and techniques, containment devices and facilities, and the training of personnel.

Until recently, hantaviruses (family Bunyaviridae) were believed to originate from rodent reservoirs. However, genetically distinct hantaviruses were lately found in shrews and moles, as well as in bats from Africa and Asia. Bats (order Chiroptera) are considered important reservoir hosts for emerging human pathogens. Here, we report on the identification of a novel hantavirus, provisionally named Makokou virus (MAKV), in Noack's Roundleaf Bat (Hipposideros ruber) in Gabon, Central Africa. Phylogenetic analysis of the genomic l-segment showed that MAKV was the most closely related to other bat-borne hantaviruses and shared a most recent common ancestor with the Asian hantaviruses Xuan Son and Laibin. Breakdown of the virus load in a bat animal showed that MAKV resembles rodent-borne hantaviruses in its organ distribution in that it predominantly occurred in the spleen and kidney; this provides a first insight into the infection pattern of bat-borne hantaviruses. Ancestral state reconstruction based on a tree of l gene sequences of all relevant hantavirus lineages was combined with phylogenetic fossil host hypothesis testing, leading to a statistically significant rejection of the mammalian superorder Euarchontoglires (including rodents) but not the superorder Laurasiatheria (including shrews, moles, and bats) as potential hosts of ancestral hantaviruses at most basal tree nodes. Our data supports the emerging concept of bats as previously overlooked hantavirus reservoir hosts.

Background Extracorporeal photopheresis (ECP) is an established treatment for graft-versus-host disease (GVHD). Various haematocrit thresholds have been used to trigger red blood cells transfusion prior to ECP. Moderate-to-severe GVHD is frequently complicated by anaemia; the safety and collection efficiency with a lower haematocrit for ECP is unknown. Methods We prospectively enrolled 26 consecutive adult GVHD patients with haematocrits between 25% and 28·9% who received ECP on the CELLEX system. Preprocedural transfusion was withheld. We monitored the adverse events and transfusions avoided. A complete blood cell count with differential was performed on preprocedural peripheral blood and buffy coat collected. Lymphocyte fold enrichment (LFE) was compared between this cohort and two historical control groups with haematocrits of 29% or higher. Results Red Blood Cells transfusion was avoided in the lower-haematocrit cohort without adverse events. The median LFE was 4·5 (95%CI, 3·1–5·7) in the lower-haematocrit cohort and 5·2 (95%CI, 4·1–6·5) in the higher-haematocrit CELLEX-treated control group. The median difference was 0·7 (95%CI, −0·3 to 2·0, P = 0·14). It could not be established that the lower-haematocrit cohort was non-inferior to the higher-haematocrit control group with a prespecified non-inferiority margin of 1·3. However, LFE was significantly higher in the lower-haematocrit cohort than the higher-haematocrit UVAR XTS-treated control group (P < 0·01). Conclusion Buffy coat can be collected for ECP using CELLEX in GVHD patients with a haematocrit of 25% or higher, with a collection efficiency superior to that in patients with higher haematocrits but treated using UVAR XTS. No increase in adverse events was observed at these lower haematocrits.

International audience; Background: Orf or contagious ecthyma is a zoonotic viral infection with a potential serious health threat for the small ruminants industry as well as humans. It is currently emerging in new territories.Results: Eight suspected clinical cases of pustular dermatitis in goats occurred in the rural area of Tebe, in south-eastern Gabon, in January 2013. The orf virus (ORFV) was detected by high-throughput sequencing on sera, buccal swabs and scab pool samples. It was confirmed in six out of eight sick goats by using specific PCR targeting the major envelope protein (B2L) and the orf virus interferon resistance (VIR) genes. Phylogenetic analysis revealed that the Gabonese strain and South Korean strains evolved from a common ancestor, suggesting an Asian origin of the ORFV’ Gabonese strain.Conclusions: This study provides the molecular detection of the ORFV strain involved in the cases of pustular dermatitis in goats and highlights its circulation in Gabon

Crimean Congo hemorrhagic fever virus (CCHFV) is a highly virulent tick-borne pathogen that causes hemorrhagic fever in humans. The geographic range of human CCHF cases largely reflects the presence of ticks. However, highly similar CCHFV lineages occur in geographically distant regions. Tick-infested migratory birds have been suggested, but not confirmed, to contribute to the dispersal. Bats have recently been shown to carry nairoviruses distinct from CCHFV. In order to assess the presence of CCHFV in a wide range of bat species over a wide geographic range, we analyzed 1,135 sera from 16 different bat species collected in Congo, Gabon, Ghana, Germany, and Panama. Using a CCHFV glycoprotein-based indirect immunofluorescence test (IIFT), we identified reactive antibodies in 10.0% (114/1,135) of tested bats, pertaining to 12/16 tested species. Depending on the species, 3.6%–42.9% of cave-dwelling bats and 0.6%–7.1% of foliage-living bats were seropositive (two-tailed t-test, p = 0.0447 cave versus foliage). 11/30 IIFT-reactive sera from 10 different African bat species had neutralizing activity in a virus-like particle assay. Neutralization of full CCHFV was confirmed in 5 of 7 sera. Widespread infection of cave-dwelling bats may indicate a role for bats in the life cycle and geographic dispersal of CCHFV.

Purpose of review Painful and/or stressful medical procedures mean a substantial burden for sick children. There is good evidence that procedural comfort can be optimized by a comprehensive comfort-directed policy containing the triad of non-pharmacological strategies (NPS) in all cases, timely or preventive procedural analgesia if pain is an issue, and procedural sedation. Recent findings Based both on well-established theoretical frameworks as well as an increasing body of scientific evidence NPS need to be regarded an inextricable part of procedural comfort care. Summary Procedural comfort care must always start with a child-friendly, nonthreatening environment in which well-being, confidence, and self-efficacy are optimized and maintained. This requires a reconsideration of the medical spaces where we provide care, reduction of sensory stimulation, normalized professional behavior, optimal logistics, and coordination and comfort-directed and age-Appropriate verbal and nonverbal expression by professionals. Next, age-Appropriate distraction techniques and/or hypnosis should be readily available. NPS are useful for all types of medical and dental procedures and should always precede and accompany procedural sedation. NPS should be embedded into a family-centered, care-directed policy as it has been shown that family-centered care can lead to safer, more personalized, and effective care, improved healthcare experiences and patient outcomes, and more responsive organizations.

International audience; Recent studies have revealed a large diversity of Plasmodium spp. among African great apes. Some of these species are related to Plasmodium falciparum, the most virulent agent of human malaria (subgenus Laverania), and others to Plasmodium ovale, Plasmodium malariae and Plasmodium vivax (subgenus Plasmodium), three other human malaria agents. Laverania parasites exhibit strict host specificity in their natural environment. Plasmodium reichenowi, Plasmodium billcollinsi, Plasmodium billbrayi and Plasmodium gaboni infect only chimpanzees, while Plasmodium praefalciparum, Plasmodium blacklocki and Plasmodium adleri are restricted to gorillas and Plasmodium falciparum is pandemic in humans. This host specificity may be due to genetic and/or environmental factors. Infrastructures hosting captive primates, such as sanctuaries and health centres, usually concentrate different primate species, thus favouring pathogen exchanges. Using molecular tools, we analysed blood samples from captive non-human primates living in Gabon to evaluate the risk of Plasmodium spp. transfers between host species. We also included blood samples from workers taking care of primates to assess whether primate-human parasite transfers occurred. We detected four transfers of Plasmodium from gorillas towards chimpanzees, one from chimpanzees to gorillas, three from humans towards chimpanzees and one from humans to mandrills. No simian Plasmodium was found in the blood samples from humans working with primates. These findings demonstrate that the genetic barrier that determines the apparent host specificity of Laverania is not completely impermeable and that parasite exchanges between gorillas and chimpanzees are possible in confined environments.

International audience; A technique is presented for improving the structural analysis of natural fractures development in large scale fold structures. A 3D restoration of a fold provides the external displacement loading conditions to solve, by the finite element method, the forward mechanical problem of an idealized rock material with a stress-strain relationship based on the activation of pervasive fracture sets. In this elasto-plasticity constitutive law, any activated fracture set contributes to the total plastic strain by either an opening or a sliding mode of rock failure. Inherited versus syn-folding fracture sets development can be studied using this mechanical model. The workflow of this methodology was applied to the Weber sandstone formation deformed by forced folding at Split Mountain Anticline, Utah for which the different fracture sets were created and developed successively during the Sevier and the syn-folding Laramide orogenic phases. The field observations at the top stratigraphic surface of the Weber sandstone lead to classify the fracture sets into a pre-fold WNW-ESE fracture set, and a NE-SW fracture set post-dating the former. The development and relative chronology of the fracture sets are discussed based on the geomechanical modeling results. Starting with a 3D restoration of the Split Mountain Anticline, three fold-fracture development models were generated, alternately assuming that the WNW-ESE fracture set is either present or absent prior to folding process. Depending on the initial fracture configuration, the calculated fracture patterns are markedly different, showing that assuming a WNW-ESE joint set to predate the fold best correlates with field observations. This study is a first step addressing the complex problem of identification of fold-related fracturing events using an elementary concept of rock mechanics. When tight to complementary field observations, including petrography, diagenesis and burial history, the approach can be used to better constrain fractured reservoir characterization. © 2012.

The full coding sequences of two novel human enterovirus (HEV)-C serotypes 105 and 116, sampled in the Republic of the Congo in 2010 and in Russia in 2011, were identified in this study. Enterovirus (EV)-105 was closest to EV-104 in the 5′ NTR and to EV-109 in the coding genome region. It had the same unconventional 5′ NTR as EV-104 and EV-109. The non-cytopathogenic EV-116 was phylogenetically close to coxsackievirus (CV)-A1, CV-A19 and CV-A22, which also cannot be propagated in routinely used cell cultures. There were signs of recombination within this subgroup of HEV-C; however, recombination with conventional HEV-C was restricted, implying partial reproductive isolation. As there is also evidence of different permissive replication systems and distinct genetic properties of these subgroups, they may represent subspecies of the HEV-C species or different stages of speciation.

Health research programs targeting the population of Gabon and Equatorial Africa at the International Center for Medical Research in Franceville (CIRMF), Gabon, have evolved during the years since its inception in 1979 in accordance with emerging diseases. Since the reemergence of Ebola virus in Central Africa, the CIRMF "Emerging Viral Disease Unit" developed diagnostic tools and epidemiologic strategies and transfers of such technology to support the response of the National Public Health System and the World Health Organization to epidemics of Ebola virus disease. The Unit carries out a unique investigation program on the natural history of the filoviruses, emergence of epidemics, and Ebola virus pathogenesis. In addition, academic training is provided at all levels to regional and international students covering emerging conditions (host factors, molecular biology, genetics) that favor the spread of viral diseases.

Hepatitis E virus (HEV) is one of the most common causes of acute hepatitis in tropical and temperate climates. Tropical genotypes 1 and 2 are associated with food-borne and waterborne transmission. Zoonotic reservoirs (mainly pigs, wild boar, and deer) are considered for genotypes 3 and 4, which exist in temperate climates. In view of the association of several zoonotic viruses with bats, we analyzed 3,869 bat specimens from 85 different species and from five continents for hepevirus RNA. HEVs were detected in African, Central American, and European bats, forming a novel phylogenetic clade in the family Hepeviridae . Bat hepeviruses were highly diversified and comparable to human HEV in sequence variation. No evidence for the transmission of bat hepeviruses to humans was found in over 90,000 human blood donations and individual patient sera. Full-genome analysis of one representative virus confirmed formal classification within the family Hepeviridae . Sequence- and distance-based taxonomic evaluations suggested that bat hepeviruses constitute a distinct genus within the family Hepeviridae and that at least three other genera comprising human, rodent, and avian hepeviruses can be designated. This may imply that hepeviruses invaded mammalian hosts nonrecently and underwent speciation according to their host restrictions. Human HEV-related viruses in farmed and peridomestic animals might represent secondary acquisitions of human viruses, rather than animal precursors causally involved in the evolution of human HEV.

Ebolavirus and Marburgvirus, two filoviruses belonging to the Filoviridae family, are among the most virulent pathogens for humans and non-human primates, causing outbreaks of fulminant hemorrhagic fever (HF) in Central African countries with case fatality rates of up to 90%. Fruit bats are the likely reservoir, and human infection occurs through contact with bats or infected large-animal carcasses or by person-to-person contact (through body fluids, medical care, and burial practices). Schematically, clinical manifestations occur in three successive phases and include general, gastrointestinal, and mucocutaneous disorders. Death usually results from hemorrhagic complications. Cutaneous manifestations rarely make a major contribution to disease severity but can assist with the diagnosis. Rash, the main cutaneous disorder, is nonspecific and cannot guide the differential diagnosis. Immunohistochemical examination of skin biopsy or necropsy specimens can confirm the diagnosis.

Objective The aim of the study was to assess, by a review of published evidence, the safest and most effective way to provide procedural sedation (PS) in children undergoing gastrointestinal endoscopy (GIE). Methods The databases MEDLINE, Cochrane Library, and Embase were used. Search terms "endoscopy, gastrointestinal" or "endoscopy, digestive system" were combined with "sedation," "conscious sedation," "moderate sedation," "deep sedation," and "hypnotics and sedatives." The final review was restricted to studies reporting specifically on safety (incidences of adverse events) and/or effectiveness (time characteristics, need for supplemental sedation, need for restraint, procedural success, provider satisfaction, and patient comfort) of PS for GIE in children younger than 18 years. Results The search yielded 182 references and the final selection included 11 randomized controlled trials (RCTs) and 15 non-RCTs. Six sedation categories were identified: propofol, opioid/benzodiazepine, premedication, ketamine-, sevoflurane-, and midazolam-based. Only a few RCTs have compared different categories. Opioid/benzodiazepine- and propofol-based PS have a similar safety profile and a low incidence of major adverse events. Propofol-based sedation turned out to be the most effective regimen, with effectiveness comparable to general anesthesia. The addition of midazolam, fentanyl, remifentanil, and/or ketamine to propofol may increase the effectiveness without creating more adverse events. Data on midazolam-, ketamine- and sevoflurane-based sedation were generally too limited to draw conclusions. Conclusions Despite a lack of RCTs containing all aspects of effectiveness and safety, the present evidence indicates propofol-based PS to be the best practice for PS in children undergoing GIE. Propofol can be safely administered by specifically trained nonanesthesiologists.

The principal concern of this paper is with the accuracy and validity of experimental sand box models of geological structures – and of thrust faults in particular – as influenced by side wall friction. Side wall friction can produce undesirable artifacts, in particular in experiments aimed at reproducing plane deformations. The importance of such artifacts is revealed in the present study by the results of experiments that are affected in opposite ways by side wall friction. Two distinct experimental configurations have been chosen for this purpose for a set-up that comprises a body of sand placed between vertical side walls on a basal plate against a back wall and a front wall, all made of glass. In configuration M the bottom plate and attached front wall move relative to the side walls towards a fixed back wall, while in configuration F the back wall moves relative to the side walls and attached bottom plate towards a fixed front wall (‘fixed’ = ‘fixed relative to the side walls’). In both configurations, thrust traces on the top surface of the sand become curved near the side walls because of wall friction. The outcome of altogether 31 experiments in the two configurations shows that the magnitude of the experimental bias depends on the ratio S L / S B of the area of contact of the sand body with the side walls ( S L ) to its area of contact with the basal surface ( S B ). The bias is the difference in thrust locations in the two configurations. It is measured on photographs taken through the side walls during the experiments. Away from the side walls, the bias is estimated by the thrust curvatures observed in top views. For S L / S B ≤ 0.1, i.e. very little contact with side walls, there is no identifiable bias. Furthermore, a 2D theoretical solution reproduces well the results. For S L / S B increasing to 0.25, curvatures increase, yielding rather different cross-sections at the side walls, but still similar cross-sections in the central part of the sand body. For S L / S B ≥ 0.3, thrust planes occupy different regions of the box for each configuration, although their curvature is decreasing. At S L / S B = 0.9, curvatures have almost disappeared but the location of the thrusts and the length of the decollement depend strongly on the experimental configuration. Departures from the 2D theoretical solution are clearly stronger with configuration M than F. Another important conclusion is that the absence of curvature of the thrust traces is not a proof of the 2D character of the experiment. Mechanical equilibrium of the total forces recorded at both front and back walls during shortening shows that the thrust locations are controlled by the difference between basal and side wall shear forces.

In order to characterize simian foamy retroviruses (SFVs) in wild-born nonhuman primates (NHPs) in Gabon and to investigate cross-species transmission to humans, we obtained 497 NHP samples, composed of 286 blood and 211 tissue (bush meat) samples. Anti-SFV antibodies were found in 31 of 286 plasma samples (10.5%). The integrase gene sequence was found in 38/497 samples, including both blood and tissue samples, with novel SFVs in several Cercopithecus species. Of the 78 humans, mostly hunters, who had been bitten or scratched by NHPs, 19 were SFV seropositive, with 15 cases confirmed by PCR. All but one were infected with ape SFV. We thus found novel SFV strains in NHPs in Gabon and high cross-species transmission of SFVs from gorilla bites.

It is proposed to complement the numerous geometrical constructions of fault-related folds relevant to fold-and-thrust belts by the introduction of mechanical equilibrium and of the rock limited strength to discriminate between various deformation scenarios. The theory used to support this statement is the maximum strength theorem that is related to the kinematic approach of limit analysis known in soil mechanics. The classical geometrical construction of the fault-propagation fold (FPF) is proposed for illustration of our claim. The FPF is composed of a kink fold with migrating axial surfaces ahead of the region where the ramp propagates. These surfaces are assigned frictional properties and their friction angle is found to be small compared with the usual bulk friction angle to ensure the full development of the FPF, a first scenario. For larger values of the axial surface friction angle, this development during overall shortening is arrested by the onset of fault breaking through the front limb, a second scenario. The amount of shortening at the transition from folding to break-through faulting is established.

Perovskite-type La(Ti,Nb)(O,N)3 powders with different Ti and Nb content were synthesized by a thermal ammonolysis of oxide precursors prepared via a soft chemistry route. By X-ray diffraction (XRD), a gradual increase of the unit cell volume was observed with increasing niobium content. The crystallite size calculated with the Scherrer equation displayed a minimum of about 30 nm at the intermediate composition. Scanning electron microscopy (SEM) showed morphological changes of the microstructure with increasing niobium content. Thermal re-oxidation studies with thermogravimetric analysis (TGA) revealed that a different amount of nitrogen was substituted into the La (Ti,Nb)(O,N)3 lattice. UV-visible diffuse reflectance spectroscopy (UV-vis DRS) showed that absorption edge wavelengths of the oxynitrides were in the range of 612 nm – 744 nm, corresponding to the bandgap energy of 2.02 eV – 1.67 eV. Among all La(Ti,Nb)(O,N)3, LaTiO2N showed the highest photocatalytic activity for water oxidation. One of the determining factors for the photocatalytic water oxidation with La(Ti,Nb)(O,N)3 was found to be the defects concentration.

Introduction: Weight loss amongst women with polycystic ovary syndrome (PCOS) is crucial to reduce the risk of endocrine, reproductive and metabolic complications including hirsutism, menstrual disturbances and cardiovascular disease. With approximately 50% of women with PCOS being overweight or obese, effective dietary management of weight in PCOS is essential. However, there is inconsistent evidence as to whether specifically modified diets (e.g. reduced carbohydrate diets) are more effective at achieving weight loss amongst women with PCOS than are conventional healthy hypocaloric diets. Material and Methods: A systematic review and meta-analysis of randomized controlled trials that had compared weight and BMI between women with PCOS who had undergone either a specifically modified diet or a conventional healthy hypocaloric diet were performed. Six electronic databases were searched, a manual search of the reference lists of the included studies was carried out and authors were contacted for additional information. Nine studies with a total of 395 participants (all with a body mass index [BMI] ≥30) were included in the meta-analysis. The effect size used was the mean difference in post-intervention weight and BMI between participants who had undergone a specifically modified diet and participants who had undergone a conventional healthy hypocaloric diet. Results: There were no differences between groups in post-intervention weight (mean difference 1.26, 95% confidence interval (CI) -0.92 to 3.43, p = .26; heterogeneity I2 = 50%, p = .04) or BMI (mean difference 0.15, 95% CI -0.93 to 1.23, p = 0.79; heterogeneity I2 = 44%, p = 0.10). Subgroup analyses according to the presence of a dietary run-in period (a period at the start of the study during which all participants are placed on an identical diet in order to equalize them on variables influenced by diet), intervention duration and type of diet and a sensitivity analysis according to study quality were not significant. Conclusions: Whilst the results should be interpreted in light of the moderate heterogeneity observed, they suggest that specifically modified diets offer no added benefit for weight loss in women with PCOS over conventional healthy hypocaloric diets. The findings of this meta-analysis may promote the unification of guidelines for the dietary management of PCOS and allow clinicians to be confident in prescribing conventional healthy hypocaloric diets for weight loss amongst their PCOS patients.

Tijdens magnetisch resonantie-onderzoek (MRI) hebben jonge kinderen en kinderen met een vertraagde ontwikkeling een vorm van procedurele sedatie (PS) nodig om voldoende (lang) bewegingloos te kunnen blijven liggen. In Nederland hebben zich in het afgelopen decennium ernstige ongevallen voorgedaan tijdens PS voor MRI. Het is aangetoond dat essentiele veiligheidsrichtlijnen ten aanzien van PS onvoldoende geimplementeerd zijn in de Nederlandse algemene kindergeneeskundige praktijk. Tevens bestaan er zorgen over de matige effectiviteit van vaak toegepaste PS-protocollen. Door middel van een enqueˆte onderzochten we welke PS-technieken en -medicijnen algemeen kinderartsen meestal gebruiken voor MRI bij kinderen. De gemiddelde praktijk werd vergeleken met de resultaten van een systematische review (SR) van de recente literatuur. Door middel van de SR proberen we de klinische vraag te beantwoorden wat op de kinderleeftijd de veiligste en meest effectieve techniek is voor PS tijdens MRI. Nederlandse kinderartsen doen voor MRI zelden beroep op anesthesie. Meestal wordt gebruikgemaakt van een PS op basis van chloralhydraat, midazolam en/of lytische cocktails. Deze sedativa hebben een suboptimale effectiviteit. Het is onbekend hoeveel onderzoeken hierdoor geheel of gedeeltelijk mislukken. Deze medicijnen hebben wel een reeel risico op ernstige complicaties. Het gebruik moet daarom steeds gepaard gaan met verregaande voorzorgsmaatregelen en de aanwezigheid van competente professionals. Van alle sedativa heeft propofol de hoogste effectiviteit. Propofol kan veilig worden gebruikt door competente nietanesthesiologen. Indien deze professionals niet beschikbaar zijn, verdient het aanbeveling om kinderen die gesedeerd moeten worden voor MRI, door te verwijzen naar een anesthesioloog.

Chikungunya virus (CHIKV), an alphavirus of the Togaviridae family, is a small enveloped virus enclosing a single-stranded positive-sense RNA genome of approximately 12kb [1]. First isolated in 1953, CHIKV has since caused numerous outbreaks in Africa and Southeast Asia [1, 2]. In the last few years, CHIKV has spread to new regions of the world, including Indian Ocean islands [3–8], Central Africa [9–11] and even Europe [12]. A CHIKV outbreak in La Reunion island counted 266,000 clinical cases in 2005–2006 [3, 4], and at least 1.3 million cases were estimated in India in 2006–2007 [5–7]. Increased human mobility, spread of mosquito larvae through the international trade of used tires, and increased insecticide resistance have all contributed to the spread of CHIKV outbreaks. The very recent discovery of Aedes albopictus, a vector for CHIKV, and the first imported case of Chikungunya fever (CHIKF) in the south of France, as well as the recent outbreak in Italy in 2007, illustrate the potential for worldwide dissemination [12–14], making this virus a major threat to public health [15]. CHIKF is an acute illness. After a silent incubation period lasting 2–4 days, patients generally display an abrupt high fever, followed by skin rash and painful polyarthralgia. Symptoms may persist 3–7 days during the acute phase of the disease; however, chronic and incapacitating arthralgia can persist for months or even years [16]. Although CHIKF is not generally considered life-threatening, severe forms involving neurological and hepatological complications can occur, and fatalities were recently reported [17, 18]. Previous studies have focused mostly on the mosquito vectors [13, 17, 19–26], the genotyping and molecular characterization of CHIKV isolates, and outbreak epidemiology [1, 4–6, 27]. Few studies have focused on CHIKF pathogenesis. Three studies have attempted to correlate cytokine and chemokine profiles with CHIKF disease characteristics [28–30]. For instance, severe CHIKF has been linked to increased plasma levels of proinflammatory interleukins IL-12 and IL-6, as well as decreased levels of proinflammatory chemokine RANTES [28, 30]. A few other cytokines and chemokines have also been found to be upregulated during CHIKV infection (IL-7, IL-12, IP-10, MCP-1, IFN-α, and IFN-γ), although only a limited number of patients have been studied and at a unique time point during the acute phase [28–31]. Somewhat contradictory results have been published regarding the cytokines IL-1β and IL-10 [28, 30]. Virtually nothing is known about the mounting of adaptive immune responses to CHIKV infection. T and B lymphocytes and monocyte-derived dendritic cells are not susceptible to CHIKV infection [32] but their role in the clearance of infected cells or possibly in the pathogenesis of the disease remains completely unestablished. Furthermore, although CHIKV is known to induce apoptosis in vitro [16], the expression of markers of apoptosis ex vivo is still undocumented. Although the human immune response to CHIKV infection is poorly documented [28, 29, 32], the much more studied other members of the alphavirus genera bring some indications as to the possible interactions between CHIKV and the host's immune system. These studies show that the capacity of many alphaviruses to induce a severe disease is directly dependant on its ability to avoid or subvert the hosts' innate immunity. Type I Interferons (essentially IFN-α/β) are produced by most cell types and constitute the first line of defense against viral infections. Sindbis virus and Eastern equine encephalitis virus replication are strongly inhibited by IFN (types I and II) treatment [33–35], and in the absence of type I IFNs, the severity of Sindbis-induced disease is highly increased in animal models [33, 36]. A prominent role for type I IFNs in CHIKV clearance has also been suggested by both in vitro and animal models [32, 37]. Although the increasing impact of CHIKF in public health greatly exceeds that of other alphaviruses, immune responses to CHIKV infection have been neglected in comparison. Here, we conducted a large ex vivo study based on multiplex analysis of cytokine, chemokine, and growth factor plasmatic profiles of 69 CHIKF patients from the Gabonese outbreak of 2007. This is the largest cohort of CHIKF patients ever studied in this matter. Furthermore, we present phenotypic data on the T lymphocyte immune responses that occur during acute CHIKV infection in humans.

Two young girls without a notable medical history except for asthma presented with an acute toxic encephalopathy with very low serine concentrations both in plasma and cerebrospinal fluid (CSF) comparable to patients with 3-phosphoglycerate dehydrogenase (3-PGDH) deficiency. Clinical symptoms and enzyme measurement (in one patient) excluded 3-PGDH deficiency. Deficiencies in other serine biosynthesis enzymes were highly unlikely on clinical grounds. On basis of the fasting state, ketone bodies and lactate in plasma, urine and CSF, we speculate that reduced serine levels were due to its use as gluconeogenic substrate, conversion to pyruvate by brain serine racemase or decreased L-serine production because of a lack of glucose. These are the first strikingly similar cases of patients with a clear secondary serine deficiency associated with a toxic encephalopathy.

Objectives Following two fatal accidents during paediatric procedural sedation (PS), the authors investigated the level of adherence to established safety standards on PS in a nationwide cohort of fully trained general paediatricians, entrusted with PS. Study design and methods: Sample survey Safety guidelines on PS were split into four domains (“Presedation Assessment”, “Monitoring during PS”, “Recovery after PS” and “Facilities and Competences for Emergencies and Rescue”). Each domain was operationalised into sub-domains and items. Items were presented within a questionnaire list as procedural points of attention on which respondents could give their personal adherence score. Percentages of full adherence were calculated. Non-adherence was defined as gradual deviation from full adherence. After factor and reliability analysis, observed scores were summed up to scales, and results were transformed to a 0–10 report mark (RM). An RM of ≥9 is considered as a satisfactory level of adherence while an RM Results Full adherence was rare. For most (sub) domains, only a minority of respondents achieved a satisfactory level of adherence. Large numbers of respondents had scores below 6. Conclusions Potentially unsafe PS practices are common under Dutch general paediatricians, despite the availability of guidelines. The design of guidelines should include a goal-directed plan for implementation including training, initiatives for continuous quality assurance and improvement and repeated measurements of adherence to guidelines.

Hiv-besmetting heeft wereldwijd een prevalentie van 0,8%, een jaarlijkse incidentie en een sterfte van respectievelijk 2,7 miljoen en 2,0 miljoen mensen. Ongeacht ras en socio-economische status gaat hiv-besmetting gepaard met stigmatisering en discriminatie. Deze casus beschrijft een minderjarige patiente wier ouders bij opname niet vertelden dat ze hiv-positief was. Wij bespreken het medisch-ethisch dilemma met betrekking tot het verzwijgen van een hiv-positieve status en de culturele verschillen die bij deze beslissing een rol spelen. De stigmatisering en discriminatie van de hiv-geinfecteerde heeft verscheidene gevolgen. Zo kan dit leiden tot schending van de mensenrechten, voornamelijk die gerelateerd zijn aan toegang tot de gezondheidszorg en geschikte medische behandeling. Dit kan een reden zijn om ernstige ziekten zoals hiv-besmetting te verzwijgen voor zowel familieleden als gezondheidszorgmedewerkers. In Nederland heeft zowel de arts als de patient een informatieplicht volgens de Wet op de geneeskundige behandelingsovereenkomst (WGBO). Het verzwijgen van een positieve hiv-status kan meerdere nadelige gevolgen hebben, zowel voor de patient als voor hulpverleners

Les tumeurs intracrâniennes, tous types confondus, sont frequentes en neurologie. Leur incidence suit celle des accidents vasculaires cerebraux et des demences. Leur prise en charge implique un partenariat multidisciplinaire. Ainsi, a l’heure de la preservation de la qualite de vie en oncologie, la neuropsychologie prend une place croissante dans la preparation de la prise en charge des patients presentant ces tumeurs. En effet, tant dans son optique evaluative/diagnostique que du point de vue de la mise en place d’une reeducation cognitive ou d’une prise en charge comportementale, le neuropsychologue s’allie aux neuro-oncologue, neuroradiologue, anatomopathologiste, neurochirurgien, radiotherapeute… Cet article expose les grandes lignes de l’evaluation neuropsychologique, propose des pistes pour un « bilan type » base sur l’experience de l’auteur dans les tumeurs cerebrales primitives que sont les gliomes de bas grade et suggere une reduction de ce bilan au fur et a mesure de l’evolution et de l’aggravation de la pathologie pour preconiser en cas de metastases cerebrales un bilan minimaliste adapte.

International audience; The objective is to capture the 3D spatial variation in the failure mode occurring in accretionary wedges and their analog experiments in the laboratory from the sole knowledge of the material strength and the structure geometry. The proposed methodology relies on the maximum strength theorem which is in- herited from the kinematic approach of the classical limit analysis. It selects the optimum virtual velocity field which minimizes the tectonic force. These velocity fields are constructed by interpolation thanks to the spatial discretization conducted with ten-noded tetra- hedra in 3D and six-noded triangles in 2D. The re- sulting, discrete optimization problem is first presented emphasizing the dual formalism found most appropri- ate in the presence of nonlinear strength criteria, such as the Drucker-Prager criterion used in all reported examples. The numerical scheme is first applied to a perfectly triangular 2D wedge. It is known that fail- ure occurs to the back for topographic slope smaller than and to the front for slope larger than a critical slope, defining subcritical and supercritical slope stabil- ity conditions, respectively. The failure mode is char- acterized by the activation of a ramp, its conjugate back thrust, and the partial or complete activation of the décollement. It is shown that the critical slope is captured precisely by the proposed numerical scheme, the ramp, and the back thrust corresponding to regions of localized virtual strain. The influence of the back- wall friction on this critical slope is explored. It is found that the failure mechanism reduces to a thrust rooting at the base of the back wall and the absence of back thrust, for small enough values of the friction angle. This influence is well explained by the Mohr construction and further validated with experimental results with sand, considered as an analog material. 3D applications of the same methodology are presented in a companion paper.

Resume L’enclouage centromedullaire de l’humerus s’est impose comme un des traitements de reference des fractures cephalotuberositaires a deux, trois ou quatre fragments. Nous avons pu revoir 38 patients âges en moyenne de 64,2 ans, avec un recul moyen de 18 mois. Les scores fonctionnels utilises etaient le score de Constant et Murley ainsi que l’auto-questionnaire de qualite de vie DASH. Des criteres radiologiques ont ete analyses, a savoir l’angle cephalique note αF et la presence d’une eventuelle osteolyse trochiterienne. Les patients ont ete regroupes en fonction du type de fracture, selon la classification de Neer, avec neuf cas dans le groupe Neer 2, 19 dans le groupe Neer 3 et dix dans le groupe Neer 4. Le score de Constant brut etait en moyenne de 53,4 points, pondere a 71,6 %. Les mobilites articulaires retrouvaient une elevation anterieure moyenne a 108°, une abduction a 100° et une rotation externe a 27°. Ces scores etaient d’autant plus mauvais que la fracture etait comminutive. Il n’a pas ete retrouve de correlation radioclinique entre la valeur de l’angle αF et l’evolution clinique, mais la presence d’osteolyse du trochiter etait significativement liee a de mauvais resultats fonctionnels tardifs. Cinq cas d’osteonecrose ont ete denombres, repartis en 10,5 % dans le stade Neer 3 et 30 % dans le stade Neer 4. Le score de Constant brut moyen chez ces patients etait de 38,5 points et pondere a 57,7 %. L’enclouage centromedullaire permet ainsi d’osteosyntheser les fractures comminutives a trois ou quatre fragments mais le controle de la fixation et la solidite du montage n’est pas toujours de rigueur. Chez les sujets jeunes ou la consolidation des tuberosites est essentielle, les plaques vissees semblent en etre une alternative favorable. Par ailleurs, la prothese totale inversee semble avoir de plus en plus d’arguments, pour s’imposer comme le traitement de choix vis-a-vis des fractures a quatre fragments chez les personnes âgees de plus de 75 ans.

Resume Introduction Bien que les troubles cognitifs dans la sclerose en plaques soient bien etablis, meme au debut de la maladie, aucune prise en charge n’est pour autant proposee. L’objectif de cette etude etait d’elaborer et d’evaluer l’efficacite d’un programme de remediation cognitive (PROCOG-SEP) en proposant divers exercices se referant aux theories actuelles de remediation dont le principe se base sur la stimulation des fonctions preservees. Methode Le programme PROCOG-SEP est base sur le principe des techniques de facilitation. Vingt-quatre patients presentant une SEP peu invalidante (Expanded Disability Status Scale [EDSS] Resultats Une amelioration des capacites en memoire episodique verbale et memoire episodique visuelle, d’autogeneration et de flexibilite motrice a ete mise en evidence. En revanche, ce programme n’a pas permis de montrer une amelioration des capacites d’attention soutenue (PASAT), de la memoire de travail verbale et de la vitesse de traitement. Conclusion La remediation cognitive pourrait ameliorer le fonctionnement quotidien dans la SEP et diminuer le cout global de la maladie pour la societe.

International audience; Twelve years after the Kikwit Ebola outbreak in 1995, Ebola virus reemerged in the Occidental Kasaï province of the Democratic Republic of Congo (DRC) between May and November 2007, affecting more than 260 humans and causing 186 deaths. During this latter outbreak we conducted several epidemiological investigations to identify the underlying ecological conditions and animal sources. Qualitative social and environmental data were collected through interviews with villagers and by direct observation. The local populations reported no unusual morbidity or mortality among wild or domestic animals, but they described a massive annual fruit bat migration toward the southeast, up the Lulua River. Migrating bats settled in the outbreak area for several weeks, between April and May, nestling in the numerous fruit trees in Ndongo and Koumelele islands as well as in palm trees of a largely abandoned plantation. They were massively hunted by villagers, for whom they represented a major source of protein. By tracing back the initial human-human transmission events, we were able to show that, in May, the putative first human victim bought freshly killed bats from hunters to eat. We were able to reconstruct the likely initial human-human transmission events that preceded the outbreak. This study provides the most likely sequence of events linking a human Ebola outbreak to exposure to fruit bats, a putative virus reservoir. These findings support the suspected role of bats in the natural cycle of Ebola virus and indicate that the massive seasonal fruit bat migrations should be taken into account in operational Ebola risk maps and seasonal alerts in the DRC.

This paper discusses the development of a 14-inch ID high-pressure hybrid riser (10 000 psi) for surface BOP drilling in ultra-deep water (10 000 ft). The high-pressure hybrid riser system is obtained by adapting and combining two existing technologies, previously developed by the IFP for other applications: – the Clip connector, a double breech-block type connector to provide a quick and safe connection for riser joints; – hybrid pipe technology, a steel pipe hoop-wound with tapes of carbon fibers impregnated with polyamide thermoplastic resin. IFP has developed a new 14-inch ID HP Clip connector for the hybrid riser application. The connector is capable of withstanding a 2.8 million pound tension and a 10 000 psi operating pressure. In addition, a 16-inch nominal OD hybrid riser pipe has been designed to replace the steel riser pipe with a thinnerwalled hoop-wound steel pipe. The significant weight savings that can be achieved with the hybrid riser pipe make it possible to design an effective riser architecture to withstand the high pressure and deep water requirements. Pursuant to design studies, a 14-inch ID prototype assembly consisting of two hybrid riser pipe sections with a high-pressure Clip connector was manufactured. A test program, including burst and collapse tests as well as cyclic fatigue testing, was formulated and carried out to qualify the performance of the Clip connector and hybrid riser pipe system. Completion of hybrid pipe additional fatigue testing and realization of a scale-one field testing of the hybrid riser are considered as the next steps of the project. To date, the main test results (burst, collapse, fatigue resistance) confirm that the Clip connector and the hybrid pipe technologies are well suited for ultra-deep sea drilling with a surface BOP. However, the fatigue resistance of hybrid riser pipes still needs to be better characterized.

Résumé Quatre-vingts pour cent des hommes qui présentent des troubles de l’éjaculation sont en âge de procréer, mais seul 5 à 10 % en sont spontanément capables. Du sperme antérograde et/ou rétrograde peut être recueilli par éjaculation assistée en association à des traitements pharmacologiques (chlorhydrate de minodrine-vibroéjaculation). En cas d’échecs de recueil de sperme et d’azoospermie, l’extraction chirurgicale des spermatozoïdes épididymaires ou testiculaires permet d’obtenir des spermatozoïdes, en quantité généralement moins importante que les techniques d’éjaculation assistée, mais non infectés et dépourvus de plasma séminal (souvent délétère dans les troubles de l’éjaculation). Même en cas d’éjaculation antérograde, il est impératif de recueillir les urines systématiquement à la recherche d’une éjaculation rétrograde, fréquente dans les troubles de l’éjaculation. Au laboratoire, l’analyse du sperme et de l’urine s’effectue par les méthodes de routine standardisées. La plupart des hommes présentant des troubles de l’éjaculation ont un sperme de mauvaise qualité (asthénospermie, nécrospermie, leucospermie). Les étiologies de la dégradation des paramètres du sperme sont multifactorielles, d’origine centrale et périphérique (testiculaire et extratesticulaire). Optimiser la qualité du sperme et des spermatozoïdes reste un challenge d’actualité dans les troubles de l’éjaculation. Si la cryopréservation doit être systématique, l’utilisation du sperme frais optimisé a généralement la préférence. Réussir à obtenir du sperme offre au couple une chance de grossesse naturelle (rarement) grâce à une éjaculation coïtale, par auto-insémination, par insémination intra-utérine, par fécondation in vitro conventionnelle (FIVc) ou injection intracytoplasmique de spermatozoïdes (ICSI) dans l’ovocyte. Dans les troubles de l’éjaculation, la prise en charge de la fécondité de l’homme doit être la plus rapide possible. Elle s’effectue conjointement à celle de la femme par une équipe coordonnant l’andrologue, le biologiste et le gynécologue.

Zusammenfassung 1 Die Auswertung von 337 Energieumsatz-Versuchen, die von 12 Gruppen amerikanischer, deutscher, englischer, franzosischer und skandinavischer Forscher an Tieren sechs verschiedener Arten durchgefuhrt wurden, last erkennen, das der im Laufe von 24 Stunden eintretende Warmeverlust eines normal ernahrten, sich im energetischen Gleichgewichtszustand befindlichen Tieres dem Erhaltungsaufwand entspricht, der sich um so viele in kcal ausgedruckte k-Einheiten erhoht, wie die aufgenommene Nahrung g Trockensubstanz enthalt. 2 Der Wert dieses Koeffizienten k, der das Mas fur die spezifisch-dynamische Wirkung der Futtermittel darstellt, schwankt bei allen untersuchten Tierarten um 1 kcal je g Trockensubstanz. Die Messungen, deren Einzelheiten in vorliegender Abhandlung dargestellt wurden, haben nachstehende Werte ergeben: 3 Bei Wiederkauern und Schweinen hat der Wert dieses Koeffizienten steigende Tendenz, wenn das Verhaltnis Gesamt-Nettoenergie (E + L) zu Erhaltungsenergie E die gleiche Tendenz erkennen last. Der Korrelations-Koeffizient zwischen dem Wert k und dem Verhaltnis E + L/E betragt bei Rindern + 0,22 und bei Schweinen + 0,39. 4 Letztere Erscheinung durfte z. T. damit zu erklaren sein, das der Erhaltungsaufwand um so hoher wird, je merklicher der Gesamt-Nettoenergiewert der Ration (E + L) sich von dem Wert fur E entfernt. 5 Die bei verschiedenen Einzeltieren der gleichen Art ermittelten Koeffizienten k lassen beachtliche Schwankungen erkennen, was zu der Vermutung Anlas gibt, das unter den Tieren einer und derselben Herde gute und schlechte Futterver-werter vorhanden sein konnen. 6 Der Wert des Koeffizienten k fur das Einzeltier schwankt je nach der Gesamtdauer der Futteraufnahme je Tag. Je schneller das Tier, und zwar innerhalb der vom Viehhalter beliebig begrenzten Futterzeiten, seine Ration verzehrt, um so mehr neigt der Wert k zur Verminderung. 7 Durch Ermittlung der in einer bestimmten Ration enthaltenen Menge umsetzbarer Energie und auf Grund der Kenntnis des Gehaltes der verzehrten Futtermittel an Trockensubstanz, ist man in der Lage, festzustellen, ob ein Tier, dessen Gesamt-Nettoenergiebedarf (E + L) bekannt ist, sich im Zustand des energetischen Gleichgewichts befindet oder nicht. Rationsberechnungen nach diesem Verfahren haben zu ausgezeichneten praktischen Ergebnissen gefuhrt. 8 Es ware zweckmasig, systematische Versuche mit verschiedenen Futterarten (Heu, Silofutter, Hackfruchten, verschiedenen Kraftfutterarten), die einzeln oder in gemischten Rationen zu verabfolgen waren, durchzufuhren, um den Einflus ihrer physikalischen und chemischen Zusammensetzung auf den schnelleren oder langsameren Verzehr eines g Trockensubstanz zu ermitteln. Die Messungen waren am Anfang, in der Mitte und am Schlus jeder Futteraufnahme vorzunehmen, um feststellen zu konnen, inwieweit das Mas der Fullung des Magens die Dauer der fur die Trockensubstanzabsorption benotigten Zeit beeinflust.

International audience; The objective of this study was to investigate, under circumstances of routine care, the impact of paediatric delirium (PD) on length of stay in the paediatric intensive care unit (PICU) as well as on direct financial costs. A five-year prospective observational study (2002–2007) was carried out in a tertiary eight-bed PICU in the Netherlands. Critically ill children aged 1 to 18 years who were acutely, non-electively and consecutively admitted to the PICU and detected as having PD in routine care were compared to critically ill children aged 1 to 18 years without signs of PD. PD, population characteristics and severity of illness at admission were used as predictors for length of PICU stay. Differences in length of stay yielded short-term, direct medical costs associated with PD. Forty-nine children with and 98 children without PD were included. PD prolonged length of PICU stay with 2.39 days, independent of severity of illness, age, gender, mechanical ventilation and medical indication for admission ( = 0.38

The first objective is to study the influence of the burial depth and of an imperfection, in the form of a tilt in the inclination of the otherwise straight, laminated beam, on the conditions for the initiation and the development of kink folds. The beam, typical of sedimentary rocks, is layered with weak interfaces between the competent beds, promoting the onset of kinking by their slip. The results are analytical and based on the upper bound approach of the classical limit analysis, referred to as the maximum strength theorem in the absence of any discussion of plasticity. The weak interface strength is described by the Coulomb criterion, whereas the bulk material is also cohesive and frictional but with an additional closure in the compressive stress domain to depict the action of compacting deformation mechanisms. The new twist to the methodology is to extend its application to the development of the failure mode beyond the onset, assuming that the structure finite response is well described by the least upper bound solution. The second objective is to compare in terms of upper bounds three different failure mechanisms which are the compaction band, the reverse fault and the kink fold. Their respective domain of dominance is constructed in failure-mechanism maps in the space spanned by the imperfection angle and the burial depth. Compaction bands are predicted at the deepest end of the beam and the reverse fault and the kink fold at the shallower end. These depth differences are resulting from the geometrical imperfection. It is found that the kink-band mode at its onset, with compaction band dominant conditions, resembles to a slip-enhanced compaction band due to the weak interface activation and the compaction along the two parallel hinges. This hybrid mode migrates suddenly through the competent beam from the deepest towards the shallowest region and develops as a kink fold, after a negligible amount of shortening. The kink fold development, beyond the onset, occurs in two phases, the first corresponding to the rotation of the kink band and the second, to its widening. The associated least upper bound is first decreasing during the development and then increasing, the minimum being controlled more by the increase in the potential energy of the system than by the most favorable orientation of the frictional weak interfaces. It is finally found that the continuous activation of slip over the weak interfaces and the widening of the kink band prevent the rotation of the kink towards the large angles which are necessary to induce its locking. It is proposed that the introduction of damage along the hinges could palliate these two effects and prompt the locking observed experimentally and in the field.

The prevalence of hepatitis B virus (HBV) surface antigen was significantly higher in urban (12.9%) than in rural (7.6%) populations ( P = 0.003), but no difference was found in the prevalence of hepatitis delta virus (HDV), which was high in both populations. Phylogenetic analysis showed the circulation of HBV-A3 and -E genotypes and the presence of HDV-1, HDV-7, and HDV-8 clades.

Our aim was to evaluate a type 3 portable simplified device as a screening tool for obstructive sleep apnoea (OSA) in coronary patients.In 50 patients selected independently from sleep complaints, we compared the number of respiratory events per hour of valid recording time counted automatically by the device and the number counted manually per hour of sleep on polysomnography performed at home during the same night.Five patients were excluded because of technical failures. Estimated OSA prevalences (95% confidence interval) for apnoea/hypopnoea index (AHI) cut-offsor = 5,or = 15, andor = 30 by polysomnography were 0.93 (0.81-0.98), 0.69 (0.53-0.81), and 0.27 (0.15-0.42), respectively. The device would have correctly diagnosed 75% of patients with severe OSA (AHIor = 30 by polysomnography) and would have classified the remaining 25% as having moderate OSA.This ambulatory device may prove valuable in reducing the costs of diagnosing and managing OSA in coronary patients.

Kinderen met chronische respiratoire insufficientie kunnen in aanmerking komen voor thuisbeademing. Bij voorkeur wordt een dergelijke behandeling in electieve, niet-acute omstandigheden opgestart, nadat zorgvuldig afgewogen is of de patient ervoor in aanmerking komt. Als eenmaal besloten is dat de patient in aanmerking komt voor thuisbeademing, moet door middel van systematische screening en follow-up bepaald worden wanneer het beste hiermee gestart kan worden. Dit artikel formuleert praktische aanbevelingen hiervoor bij patienten met (1) een neuromusculaire aandoening, (2) centrale hypoventilatie, (3) het obstructief slaapapneusyndroom of (4) cystische fibrose.

The Ba8ZnxGe46−x−y◻y (4 ≤ x ≤ 8, ◻ = Ge vacancy) solid solution crystallizes in the clathrate type I structure as indicated by X-ray powder diffraction and transmission electron microscopy. The fraction of vacancies (y) derived from electron probe microanalysis varies like y = 3.3 − 0.54x for 0 ≤ x ≤ 6 and y = 0 for 6 < x ≤ 8. A simplified band picture can explain how the ratio (2−)/(4−) of formal oxidation numbers of zinc and of vacancy leads to the ∼1/2 slope of the y = f(x) relation. Hall effect measurements indicate that the Ba8ZnxGe46−x−y◻y definitely deviate from the Zintl rule when 0 ≤ x < 4, weakly deviate from the the Zintl rule when 4 ≤ x ≤ 6, and fulfill the Zintl rule when 6 < x ≤ 8. Resistivity versus temperature data for 4 ≤ x ≤ 8 are in line with a “bad metal” behavior (x ∼ 4) evolving toward a degenerate semiconducting behavior (x ∼ 8). The Seebeck coefficient increases with x in agreement with the charge carrier concentration variation and reaches −67.1 μV/K in Ba7.95Zn7.83Ge38.17 which a...

INTRODUCTION: Reduced concentrations of glucose-6-phospate dehydrogenase (G6PD) render erythrocytes susceptible to hemolysis under conditions of oxidative stress. In favism, the ingestion of fava beans induces an oxidative stress to erythrocytes, leading to acute hemolysis. DISCUSSION: The simultaneous occurrence of methemoglobinemia has been reported only scarcely, despite the fact that both phenomena are the consequence of a common pathophysiologic mechanism. The presence of methemoglobinemia has important diagnostic and therapeutic consequences. We report a previously healthy boy who presented with combined severe hemolytic anemia and cyanosis due to methemoglobinemia, following the ingestion of fava beans. His condition was complicated by the development of transient acute renal failure. A G6PD-deficiency was diagnosed. We review the literature on the combination of acute hemolysis and methemoglobinemia in favism. Pathophysiologic, diagnostic, and therapeutic aspects of this disorder are discussed.

International audience; We developed a mouse model of allergy to wheat flour gliadins, a protein fraction containing major wheat allergens. We compared the antibody responses (i.e., specific IgE and IgG1) and the profiles of cytokines secreted by reactivated splenocytes induced after intraperitoneal injections of gliadins in three strains of mice, namely, Balb/cJ, B10.A, and C3H/HeJ. The intensities of the allergic reactions elicited by intranasal challenge were also compared. Both the sensitization and elicitation were the highest in Balb/cJ mice, whereas weak or no reaction was observed in the others strains. Interestingly, the specificity of the mouse IgE against the different gliadins (i.e., alpha-, beta-, gamma-, omega 1,2-, and omega 5-gliadin) was similar to that observed in children allergic to wheat flour. Balb/cJ mice may thus provide a relevant model for the study of sensitization and elicitation by wheat gliadins and for improving our understanding of the specific role and mechanisms of action of the different classes of gliadins.

Resume Introduction Les allergenes responsables de l’allergie alimentaire a la farine de ble (AAFB) commencent a etre bien caracterises. Cependant, des modeles animaux produisant des IgE de specificite fine et des symptomes cliniques comparables a ceux observes chez les patients allergiques sont d’un grand interet pour l’etude precise des allergenes et des mecanismes impliques dans l’AAFB. L’objectif de nos travaux est de developper, dans un premier temps, un modele souris d’allergie a un extrait total de gliadines, puis de l’appliquer a deux allergenes majeurs du ble impliques dans l’AAFB chez l’enfant et l’adulte, respectivement, la proteine de transfert de lipide (LTP) et les ω5-gliadines. Methodes Dans un premier temps, nous avons determine la souche de souris et la dose d’allergene necessaire pour induire une reaction allergique au ble optimale. Trois souches de souris (Balb/cJ, B10.A et C3H/HeJ) recoivent quatre injections intraperitoneales successives d’un extrait total de gliadines (10 ou 20 μg) adsorbe sur de l’alum. Les niveaux de sensibilisation sont evalues par dosages des IgE et IgG1 specifiques des gliadines et des cytokines secretees par les splenocytes reactives ex-vivo par les gliadines. Des tests de degranulation in vitro de basophiles (RBL) sont egalement effectues. L’intensite de la reaction allergique est, de plus, comparee in vivo, par l’analyse de la production de cytokines de type Th2 et l’influx cellulaire d’eosinophiles dans le liquide bronchoalveolaire (LBA) apres un test de provocation intranasal par l’extrait gliadines. Des sensibilisations et des tests de provocation par la LTP ou les ω5-gliadines sont ensuite realises. Resultats La plus forte sensibilisation est observee chez la souris Balb/cJ, quel que soit la dose de gliadines consideree. Apres le test de provocation, ces souris developpent une reaction allergique intense comme le demontrent la forte production de cytokines de type Th2 et l’influx d’eosinophiles dans les LBA. A l’oppose, une reaction faible, voire nulle etait observee chez les souris B10.A et C3H/HeJ. Tandis que les sensibilisations des souris Balb/c par les ω5-gliadines se sont revelees peu efficaces, les administrations de LTP ont conduit a une production significative d’IgE et IgG1 specifiques et une degranulation specifique de la lignee RBL, mais peu ou pas de secretion de cytokines de type Th2 par les splenocytes reactives. L’induction de la reponse allergique apres exposition intranasale a la LTP s’est revelee peu efficace, malgre un influx cellulaire dans les LBA. Conclusion La souris Balb/cJ, sensibilisee par voie intraperitoneale avec un extrait total de gliadines, semble reproduire une partie des marqueurs de l’AAFB, mais l’etude de la sensibilisation par les allergenes purifiee semble plus complexe.