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Additional file 1: Figure S1. Peritoneal fluid culture analysis of 16 rats 16 hours after CLP

Actes du XVIIIe congrès UISPP, 4-9 juin 2018, Session XXXIV-1 : Conditions for the adoption of money, crossed contributions from weighted metal to Ancient coins; International audience; Cet article est avant tout une réflexion préliminaire sur la question de la fiduciarité des monnaies en alliages cuivreux dans le monde celtique. Le propos s’articule autour d’une approche multiscalaire. Après avoir rappelé les liens étroits qui unissent« fiduciarité » et autorité émettrice, la diversité métallique des monnaies antiques dites de « bronze » est soulignée. L’apparition de la monnaie de bronze dans le monde antique est brièvement replacée dans son contexte grec avant d’être traitée à l’échelle de la Gaule celtique. Une attention particulière est portée aux potins. L’exemple carnute, qui illustre le phénomène gaulois, est développé à l’appui des données obtenues dans le cadre du projet ATMOCE consacré à l’atelier monétaire gaulois d’Orléans et à la production, à la diffusion et à l’usage des monnaies en alliage cuivreux attribuées aux Carnutes aux IIe et Ier siècles av. J.-C.

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Les modèles numériques des caloducs capillaires deviennent aujourd'hui abondants, que ce soit par éléments ou volumes finis [1], ou par des méthodes plus récentes comme Lattice-Boltzmann [2]. Cependant, tous ces modèles sont encore assez coûteux en temps de calcul pour permettre à la fois un dimensionnement rapide du caloduc (à l'instar des modèles macroscopiques) et une estimation précise des transferts de chaleur. Ainsi, ces dernières années, un léger retour à l'utilisation de modèles analytiques a été observé [3,4]. Le travail présenté s'appuie sur l'utilisation de transformations intégrales de Fourier et, de manière originale, sur une représentation par quadripôles thermiques pour modéliser à la fois les transferts de chaleur dans l'enveloppe du caloduc et au sein de la mèche poreuse. La difficulté réside dans la gestion des conditions aux limites interne (interface liquide/vapeur) ou externe (chauffage, refroidissement et pertes), pouvant nécessiter une linéarisation des conditions thermohydrauliques, ou une discrétisation spatiale localisée sur la paroi externe. Le modèle développé permet de rendre compte des transferts de chaleur tridimensionnels par conduction au sein des deux couches, couplés aux conditions internes de saturation et de l'écoulement de vapeur. Il offre la possibilité d'évaluer la température moyenne de saturation en fonction des conditions aux limites externes dans le cas d'une connaissance des pertes thermiques. Alors que la résolution thermique (en températures et flux de chaleur) peut être directe avec des conditions de flux externes imposés, elle peut demander une démarche itérative rapide dans le cas de conditions plus complexes. Finalement, les variables hydrauliques (champs de pressions et de vitesses des écoulements de vapeur et de liquide) sont également déduites analytiquement. La présente communication expose les modèles développés en régime permanent d'un caloduc capillaire cylindrique. La démarche et le formalisme sont d'abord établis en introduisant la modélisation quadripolaire, en coordonnées cylindriques (faisant intervenir des fonctions de Bessel modifiées) et en coordonnées cartésiennes (sous l'hypothèse d'une épaisseur du système {enveloppe + poreux} faible devant le périmètre du caloduc). Après validation à partir de résultats issus de la littérature [3], plusieurs analyses sont présentées afin de discuter sur l'influence de diverses conditions et hypothèses (résolution cartésienne, condition uniforme de saturation, …). Les travaux effectués aident à généraliser la méthode de mise en œuvre de ce type de modèles analytiques, comme ceux développés précédemment [3,4]. Ils permettent également d'envisager plus facilement la modélisation analytique de caloducs plus complexes (avec plusieurs couches poreuses), ou encore une résolution en régime transitoire (par l'intermédiaire d'une transformation de Laplace supplémentaire). \footnotesize{ \noindent ~[1] N.Pooyoo et al., Numerical simulation of cylindrical heat pipe considering non-Darcian transport for liquid flow inside wick and mass flow rate at liquid–vapor interface, IJHMT 70 (2014) 965-978 \noindent ~[2] K.Grissa et al., Performance of a cylindrical wicked heat pipe used in solar collectors: Numerical approach with Lattice Boltzmann method, ECM 150 (2017) 623-636 \noindent ~[3] H.Shabgard and A.Faghri, Performance characteristics of cylindrical heat pipes with multiple heat sources, ATE 31 (2011) 3410-3419. \noindent ~[4] S.Lips and F.Lefèvre, A general analytical model for the design of conventional heat pipes, IJHMT 72 (2014) 288-298.}

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Adrenomedullin (ADM) regulates vascular tone and endothelial permeability during sepsis. Levels of circulating biologically active ADM (bio-ADM) show an inverse relationship with blood pressure and a direct relationship with vasopressor requirement. In the present prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock 1 (, AdrenOSS-1) study, we assessed relationships between circulating bio-ADM during the initial intensive care unit (ICU) stay and short-term outcome in order to eventually design a biomarker-guided randomized controlled trial.AdrenOSS-1 was a prospective observational multinational study. The primary outcome was 28-day mortality. Secondary outcomes included organ failure as defined by Sequential Organ Failure Assessment (SOFA) score, organ support with focus on vasopressor/inotropic use, and need for renal replacement therapy. AdrenOSS-1 included 583 patients admitted to the ICU with sepsis or septic shock.Circulating bio-ADM levels were measured upon admission and at day 2. Median bio-ADM concentration upon admission was 80.5 pg/ml [IQR 41.5-148.1 pg/ml]. Initial SOFA score was 7 [IQR 5-10], and 28-day mortality was 22%. We found marked associations between bio-ADM upon admission and 28-day mortality (unadjusted standardized HR 2.3 [CI 1.9-2.9]; adjusted HR 1.6 [CI 1.1-2.5]) and between bio-ADM levels and SOFA score (p0.0001). Need of vasopressor/inotrope, renal replacement therapy, and positive fluid balance were more prevalent in patients with a bio-ADM70 pg/ml upon admission than in those with bio-ADM ≤ 70 pg/ml. In patients with bio-ADM70 pg/ml upon admission, decrease in bio-ADM below 70 pg/ml at day 2 was associated with recovery of organ function at day 7 and better 28-day outcome (9.5% mortality). By contrast, persistently elevated bio-ADM at day 2 was associated with prolonged organ dysfunction and high 28-day mortality (38.1% mortality, HR 4.9, 95% CI 2.5-9.8).AdrenOSS-1 shows that early levels and rapid changes in bio-ADM estimate short-term outcome in sepsis and septic shock. These data are the backbone of the design of the biomarker-guided AdrenOSS-2 trial.ClinicalTrials.gov, NCT02393781 . Registered on March 19, 2015.

A thermohydraulic analytical model of a capillary cylindrical heat pipe in steady-state is proposed in this article. It is based on an original representation by thermal quadrupoles to describe heat transfer in the wall and in the porous wick, via the use of Fourier integral transforms. Thanks to a validation from literature results, this model provides two-dimensional axisymetric thermal fields and one-dimensional pressure and velocity profiles of both liquid and vapour flows. Different developments and solutions are introduced according to the kind of boundary conditions at evaporator and at condenser, and with a more or less strong thermohydraulic coupling at the liquid/vapour interface. For the simple case with imposed uniform heat fluxes, intrinsic properties of the heat pipe are originally defined. The introduced model offers a generalisation of analytical models of standard heat pipe as a design or optimisation tool. Wider developments of analytical models for more complex three-dimensional geometries of heat pipe and in transient regime can be expected.

Limited information is currently available on the impact of vasoactive medications in intensive care (ICU) and long-term outcomes. The main objective of our study was to describe the association between the use of inotropes and/or vasopressors and ICU mortality. Secondary objectives were to evaluate the association between the use of vasoactive drugs and in-hospital as well as 1-year all-cause mortality in ICU survivors.FROG-ICU was a prospective, observational, multi-centre cohort designed to investigate long-term mortality of critically ill adult patients. Cox proportional hazards models were used to evaluate the association between the use of inotropes and/or vasopressors and ICU mortality, as well as in-hospital and 1-year all-cause mortality in a propensity-score matched cohort.The study included 2087 patients, 939 of whom received inotropes and/or vasopressors during the initial ICU stay. Patients treated with vasoactive medications were older and had a more severe clinical presentation. In a propensity score-matched cohort of 1201 patients, ICU mortality was higher in patients who received vasoactive medications (HR of 1.40 [1.10-1.78], p = 0.007). One thousand six hundred thirty-five patients survived the index ICU hospitalisation. There was no significant difference according to the use of inotropes and/or vasopressors in the propensity-score matched cohort on in-hospital mortality (HR of 0.94 [0.60-1.49], p = 0.808) as well as one-year all-cause mortality (HR 0.94 [0.71-1.24], p = 0.643).Inotropic and/or vasopressor therapy is a strong predictor of in-ICU death. However, the use of inotropes and/or vasopressors during ICU admission was not associated with a worse prognosis after ICU discharge.

Introducción: en la actualidad, el envejecimiento de la población cubana acrecienta la demanda de atención integral de adultos mayores y emerge la importancia social del cuidador primario de adultos mayores. Objetivo: caracterizar a cuidadores primarios de ancianos del consultorio del médico de la familia no. 3 “La Punta” adscrito al Policlínico Universitario “Hermanos Martínez Tamayo”, Baracoa, Guantánamo, durante el 2018. Método: se realizó un estudio descriptivo, transversal, apoyado en la metodología cuanticualitativa. El universo se constituyó por 80 cuidadores primarios de ancianos, de los que se eligieron 21 a través de un muestreo intencional. Estos se caracterizaron según las siguientes variables: edad, sexo, escolaridad, estado civil, vínculo de parentesco. También se evaluó la autoestima y el estilo de vida. La información obtenida se presentó en tablas y se resumieron mediante frecuencias absolutas y porcentajes. Resultados: la mayor proporción de los cuidadores tenía 60 años o más en un (52,4 %), fueron mujeres (90,5 %), con estado civil casadas y unión consensual (28,6 y 19 %, respectivamente), nivel escolar preuniversitario (42,8 %) y eran hijas cuidadoras (38,0 %). Conclusiones: la caracterización de cuidadores primarios de ancianos del consultorio del médico de la familia No 3 “La Punta” adscrito al Policlínico Universitario “Hermanos Martínez Tamayo” durante el 2018 reveló la presencia de factores que presuponen su vulnerabilidad para el cumplimiento limitado de sus funciones, entre los que se distinguen: insuficiencias en su estilo de vida y en la autoestima.

Methods used to explore biomarkers for acute kidney injury (AKI) might have a major impact on the results and the use of these biomarkers. We evaluated the methods used to investigate biomarkers of AKI.A systematic review and meta-analysis were performed using a computerized search of the MEDLINE and the EMBASE databases (PROSPERO CRD42017059618). Articles reporting biomarker's performance to diagnose AKI were included. The outcome included a description of the methods used to assess the performance of biomarkers to diagnose AKI.Among the 295 included studies, assessment of biomarkers was the primary endpoint in 284 with sample size calculation in only 8% of cases. Eighty-five percent of the studies summarized the performance of biomarkers with receiver operating characteristic (ROC) curves; however, 74 studies (25%) did not provide the threshold, sensibility or specificity. A total of 176 studies evaluated more than one biomarker, and only 25% combined biomarkers to increase diagnostic performance. We determined that the definition of AKI and study design impacted the diagnostic performance using uNGAL (urinary neutrophil gelatinase-associated lipocalin) as an example. Major publication bias was identified.Most articles that reported biomarkers of AKI performance present methodological weaknesses. Basic rules should be provided to increase the quality of reporting in this area.

Aims Adrenomedullin (ADM) is an important regulator of endothelial barrier function and vascular tone, and may represent a novel treatment target in sepsis. The non-neutralizing ADM antibody adrecizumab has shown promising results in preclinical sepsis models. In the present study, we investigated the safety, tolerability and pharmacokinetics (PK)/pharmacodynamics of adrecizumab in a first-in-man study and in a second study during experimental human endotoxaemia. Methods Forty-eight healthy male volunteers were enrolled in two randomized, double-blind, placebo-controlled phase I studies. In both studies, subjects received placebo or one of three doses of adrecizumab (n = 6 per group). In the second study, a bolus of 1 ng kg-1 endotoxin was followed by infusion of 1 ng kg-1 h-1 endotoxin for 3 h to induce systemic inflammation, and the study medication infusion started 1 h after endotoxin bolus administration. Results Adrecizumab showed an excellent safety profile in both studies. PK analyses showed proportional increases in the maximum plasma concentration of adrecizumab with increasing doses, a small volume of distribution, a low clearance rate and a terminal half-life of ~14 days. adrecizumab elicited a pronounced increase in plasma ADM levels, whereas levels of mid-regional pro-adrenomedullin remained unchanged, indicating that de novo synthesis of ADM was not influenced. In the second study, no effects of adrecizumab on cytokine clearance were observed, whereas endotoxin-induced flu-like symptoms resolved more rapidly. Conclusions Administration of adrecizumab is safe and well tolerated in humans, both in the absence and presence of systemic inflammation. These findings pave the way for further investigation of adrecizumab in sepsis patients.

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Critical care clinicians are trained to analyze simultaneously multiple physiological parameters to predict critical conditions such as hemodynamic instability. We developed the Multi-task Learning Physiological Deep Learner (MTL-PDL), a deep learning algorithm that predicts simultaneously the mean arterial pressure (MAP) and the heart rate (HR). In an external validation dataset, our model exhibited very good calibration: R2 of 0.747 (95% confidence interval, 0.692 to 0.794) and 0.850 (0.815 to 0.879) for respectively, MAP and HR prediction 60-minutes ahead of time. For acute hypotensive episodes defined as a MAP below 65 mmHg for 5 min, our MTL-PDL reached a predictive value of 90% for patients at very high risk (predicted MAP ≤ 60 mmHg) and 2‰ for patients at low risk (predicted MAP >70 mmHg). Based on its excellent prediction performance, the Physiological Deep Learner has the potential to help the clinician proactively adjust the treatment in order to avoid hypotensive episodes and end-organ hypoperfusion.

Introduction Postoperative ileus(POI) and anastomotic leakage(AL) are highly associated but the direction of this link is unknown. Indeed, it has traditionally been stated that AL leads to POI(secondary POI). The objective was to statistically determine the best model of link between POI and AL by comparing different Structural Equation Models(SEM). Methods This is a retrospective analysis of a prospective multicentric database from the Francophone Group for Enhanced Recovery after surgery(GRACE) including patients undergoing colorectal resection or Hartmann reversal between 2014 and 2017. The main outcome measure was the occurrence of postoperative ileus defined by the absence of Gastrointestinal (GI)-3 recovery in or after postoperative day 4 and the occurrence of AL. Results Among the 2227 patients included, 223 patients experienced POI (10 %) and 72 patients experienced anastomotic leakage (3.2 %). In all the models, POI was significantly increased in case of male gender, older age, opioids consumption, right colectomy, chronic obstructive bronchopneumopathy disease and performance of a stoma, and reduced by Enhanced Recovery Programs (ERP) compliance ≥ 70 % and intake of Non-Steroidal Anti-Inflammatory Drugs. Open surgery was not significantly associated with POI in all the models. In contrast, the male gender was the only factor increasing AL in the model drawn with ERP risk factors for AL. In all the models, POI was highly associated with AL and statistical analyses advocate for POI leading to AL. Conclusion The findings of the present large study suggest that the more statistically probable model is the one in which POI come first before AL.

This paper presents the design of an academic level simulation for an industrial plant and the current status of practice activities proposed for an undergraduate course on industrial automation for electronic engineering students. Strongly focused on professional processes and methods, in particular, it deals with the specific activities developed by electronic engineers at the lower levels of the automation pyramid.

This article is a thorough study of a scarce sub-type of the C. L. CAESARES denarii, RIC (2nd edition) Augustus 208, currently known from 26 specimens. These coins bear the well-known Augustan types and legends, but metallurgical analyses as well as observations on typological details make it clear that we are in fact dealing with an unsigned restoration issue, for which an attribution to the reign of Hadrian is proposed., Cet article livre une étude complète d’un rare sous-type de deniers C. L. CAESARES, l’émission RIC (2e édition) Auguste 208, dont 26 exemplaires sont actuellement connus. Ces monnaies portent les types et les légendes augustéens bien connus mais des analyses métallurgiques ainsi que certains détails typologiques révèlent qu’il s’agit en fait d’une émission de restauration non signée que nous proposons d’attribuer au règne d’Hadrien., Woytek Bernhard, Blet-Lemarquand Maryse. The C. L. CAESARES denarii RIC I² Augustus 208. A pseudo-Augustan unsigned restoration issue. Corpus, die study, metallurgical analyses. In: Revue numismatique, 6e série - Tome 174, année 2017 pp. 183-248.

Introduction Les epidermolyses bulleuses hereditaires (EBH) sont des maladies genetiques tres rares, caracterisees par une fragilite cutaneomuqueuse. Les actes chirurgicaux, relies ou non a l’EBH, exposent les patients a de nouvelles bulles. La gestion des voies aeriennes superieures, du monitorage et de la douleur peuvent etre particulierement difficiles. Afin d’optimiser la prise en charge multidisciplinaire peri-operatoire de ces patients au sein d’un centre de reference national EBH adulte, une procedure specifique, mise en place en 2007 a ete evaluee 10 ans plus tard. Materiel et methodes Cette etude observationnelle monocentrique retrospective incluait tous les patients EBH pris en charge pour une chirurgie depuis 2007 et evaluables en 2016. Les donnees medico-demographiques et de surveillance d’anesthesie etaient recueillies. A partir d’octobre 2016, les patients repondaient a un questionnaire en post-operatoire sur leur vecu et l’eventuel retentissement cutaneo-muqueux de l’anesthesie. L’objectif principal etait de decrire la prise en charge anesthesique des patients EBH et les objectifs secondaires l’identification des dysfonctionnements. Resultats Au total, 48 anesthesies chez 21 patients atteints d’EBH etaient repertoriees : 62 % de femmes, d’âge median 37 ans [26–43], dont 76 % avaient une EBH dystrophique recessive severe, de score ASA 2 pour 43 % et 3 pour 57 %. Parmi les 48 actes chirurgicaux (90 % programmes), 50 % concernaient l’exerese d’un carcinome epidermoide cutane, 29 % des soins dentaires, 4 % des dilatations œsophagiennes, 17 % d’autres chirurgies. Les modalites anesthesiques etaient : 60 % d’anesthesies generales avec intubation tracheale, dont 86 % par fibroscopie vigile (IFV) d’emblee, 17 % de sedations et 21 % d’anesthesie locoregionale (ALR). Sur les 21 questionnaires completes par 14 patients, la satisfaction etait de 7,6/10 [7–10] et l’echelle numerique de la douleur maximale de 4,2/10 [1–7,3]. Les principaux facteurs associes a la douleur etaient l’intubation vigile par fibroscopie (19 %), la realisation d’ALR (19 %), et les gestes chirurgicaux (33 %). Sept patients sur 21 (33 %) avaient de nouvelles lesions bulleuses. Discussion Cette etude est une des plus grandes cohortes de patients EBH operes, et la seule comportant une auto-evaluation. La majorite des chirurgies sont en lien avec l’EBH. La procedure d’intubation par fibroscopie vigile, rendue obligatoire chez la majorite des patients du fait des stenoses des voies aeriennes superieures etait mal vecue, la gestion de la douleur insuffisante et de nouvelles bulles apparaissaient. Une nouvelle procedure a ete redigee et devra etre evaluee. Conclusion La prise en charge des patients atteints d’EBH represente un defi pour l’equipe d’anesthesie-reanimation. Le suivi de ces patients a permis l’amelioration des procedures existantes ainsi qu’une meilleure information des patients lors de la consultation d’anesthesie.

OBJECTIVES: Adrenomedullin has vascular properties and elevated plasma adrenomedullin levels were detected in sepsis. We assessed, in septic and nonseptic ICU patients, the relation between circulating adrenomedullin, the need for organ support and mortality, using an assay of bioactive adrenomedullin. DESIGN: Prospective multicenter observational cohort study. SETTING: Data from the French and euRopean Outcome reGistry in ICUs study. PATIENTS: Consecutive patients admitted to intensive care with a requirement for invasive mechanical ventilation and/or vasoactive drug support for more than 24 hours following ICU admission and discharged from ICU were included. INTERVENTIONS: Clinical and biological parameters were collected at baseline, including bioactive-adrenomedullin. Status of ICU survivors was assess until 1 year after discharge. The main outcome was the need for organ support, including renal replacement therapy and/or for inotrope(s) and/or vasopressor(s). Secondary endpoints were the ICU length of stay and the 28-day all-cause mortality. MEASUREMENTS AND MAIN RESULTS: Median plasma bioactive adrenomedullin (n = 2,003) was 66.6 pg/mL (34.6-136.4 pg/mL) and the median Simplified Acute Physiology Score II score 49 (36-63). Renal replacement therapy was needed in 23% and inotropes(s) and/or vasopressor(s) in 77% of studied patients. ICU length of stay was 13 days (7-21 d) and mortality at 28 days was 22 %. Elevated bioactive adrenomedullin independently predicted 1) the need for organ support (odds ratio, 4.02; 95% CI, 3.08-5.25) in ICU patients whether admitted for septic or nonseptic causes and 2) the need for renal replacement therapy (odds ratio, 4.89; 3.83-6.28), and for inotrope(s) and/or vasopressor(s) (odds ratio, 3.64; 2.84-4.69), even in patients who were not on those supports at baseline. Elevated bioactive adrenomedullin was also associated with a prolonged length of stay (odds ratio, 1.85; 1.49-2.29) and, after adjustment for Simplified Acute Physiology Score II, with mortality (odds ratio, 2.31; 1.83-2.92). CONCLUSIONS: Early measurement of bioactive adrenomedullin is a strong predictor of the need of organ support and of short-term mortality in critically ill patients

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International audience; À la mosaïque de peuples « barbares » qui formaient la Gaule, les Romains comme les Grecs attribuaient un point commun : le goût de l’or. Les sources antiques décrivent à l’excès leur inextinguible soif pour ce métal précieux et leurs immenses richesses en or. La Gaule, présentée comme un « eldorado », aiguisa ainsi les appétits de conquêtes commerciales puis militaires. Mais qu’en était-il réellement ? Aujourd’hui, l’archéologie permet d’examiner sous un autre jour les rapports complexes qu’entretenaient les Gaulois et les Celtes avec l’or, et offre le recul nécessaire à l’examen critique des témoignages antiques.

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