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There is a pressing global need to increase the use of renewable energy sources and limit greenhouse gas emissions. Towards this goal, highly efficient and molecularly selective chemical processes that operate under mild conditions are critical. Plasmonic photocatalysis uses optically-resonant metallic nanoparticles and their resulting plasmonic, electronic, and phononic light-matter interactions to drive chemical reactions. The promise of simultaneous high-efficiency and product-selective reactions with plasmon photocatalysis provides a compelling opportunity to rethink how chemistry is achieved. Plasmonic nanoparticles serve as nanoscale ‘antennas’ that enable strong light–matter interactions, surpassing the light-harvesting capabilities one would expect purely from their size. Complex composite structures, combining engineered light harvesters with more chemically active components, are a focal point of current research endeavors. In this review, we provide an overview of recent advances in plasmonic catalysis. We start with a discussion of the relevant mechanisms in photochemical transformations and explain hot-carrier generation and distributions from several ubiquitous plasmonic antennae. Then we highlight three important types of catalytic processes for sustainable chemistry: ammonia synthesis, hydrogen production and CO2 reduction. To help elucidate the reaction mechanism, both state-of-art electromagnetic calculations and quantum mechanistic calculations are discussed. This review provides insights to better understand the mechanism of plasmonic photocatalysis with a variety of metallic and composite nanostructures toward designing and controlling improved platforms for green chemistry in the future.

Nanoparticle photocatalysts are essential to processes ranging from chemical production and water purification to air filtration and surgical instrument sterilization. Photochemical reactions are generally mediated by the illumination of metallic and/or semiconducting nanomaterials, which provide the necessary optical absorption, electronic band structure, and surface faceting to drive molecular reactions. However, with reaction efficiency and selectivity dictated by atomic and molecular interactions, imaging and controlling photochemistry at the atomic scale are necessary to both understand reaction mechanisms and to improve nanomaterials for next-generation catalysts. Here, we describe how advances in plasmonics, combined with advances in electron microscopy, particularly optically coupled transmission electron microscopy (OTEM), can be used to image and control light-induced chemical transformations at the nanoscale. We focus on our group's research investigating the interaction between hydrogen gas and Pd nanoparticles, which presents an important model system for understanding both hydrogenation catalysis and hydrogen storage. The studies described in this Account primarily rely on an environmental transmission electron microscope, a tool capable of circumventing traditional TEM's high-vacuum requirements, outfitted with optical sources and detectors to couple light into and out of the microscope. First, we describe the H2 loading kinetics of individual Pd nanoparticles. When confined to sizes of less than ∼100 nm, single-crystalline Pd nanoparticles exhibit coherent phase transformations between the hydrogen-poor α-phase and hydrogen-rich β-phase, as revealed through monitoring the bulk plasmon resonance with electron energy loss spectroscopy. Next, we describe how contrast imaging techniques, such as phase contrast STEM and displaced-aperture dark field, can be employed as real-time techniques to image phase transformations with 100 ms temporal resolution. Studies of multiply twinned Pd nanoparticles and high aspect ratio Pd nanorods demonstrate that internal strain and grain boundaries can lead to partial hydrogenation within individual nanoparticles. Finally, we describe how OTEM can be used to locally probe nanoparticle dynamics under optical excitation and in reactive chemical environments. Under illumination, multicomponent plasmonic photocatalysts consisting of a gold nanoparticle "antenna" and a Pd "reactor" show clear α-phase nucleation in regions close to electromagnetic "hot spots" when near plasmonic antennas. Importantly, these hot spots need not correspond to the traditionally active, energetically preferred sites of catalytic nanoparticles. Nonthermal effects imparted by plasmonic nanoparticles, including electromagnetic field enhancement and plasmon-derived hot carriers, are crucial to explaining the site selectivity observed in PdHx phase transformations under illumination. This Account demonstrates how light can contribute to selective chemical phenomena in plasmonic heterostructures, en route to sustainable, solar-driven chemical production.

Invasive species are a major cause of biodiversity loss worldwide, but their impact on communities and the mechanisms driving those impacts are varied and not well understood. This study employs functional diversity metrics and guilds-suites of species with similar traits-to assess the influence of an invasive tree (Tamarix spp.) on riparian plant communities in the southwestern United States. We asked: (1) What traits define riparian plant guilds in this system? (2) How do the abundances of guilds vary along gradients of Tamarix cover and abiotic conditions? (3) How does the functional diversity of the plant community respond to the gradients of Tamarix cover and abiotic conditions? We found nine distinct guilds primarily defined by reproductive strategy, as well as growth form, height, seed weight, specific leaf area, drought and anaerobic tolerance. Guild abundance varied along a covarying gradient of local and regional environmental factors and Tamarix cover. Guilds relying on sexual reproduction, in particular, those producing many light seeds over a long period of time were more strongly associated with drier sites and higher Tamarix cover. Tamarix itself appeared to facilitate more shade-tolerant species with higher specific leaf areas than would be expected in resource-poor environments. Additionally, we found a high degree of specialization (low functional diversity) in the wettest, most flood-prone, lowest Tamarix cover sites as well as in the driest, most stable, highest Tamarix cover sites. These guilds can be used to anticipate plant community response to restoration efforts and in selecting appropriate species for revegetation.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field.

Zr-Al-C was in-situ synthesized as a toughening component in ZrB 2 -SiC ceramics by spark plasma sintering (SPS) ball-milled ZrB 2 -based composite powders with SiC and graphite powders. The phase composition of Zr-Al-C toughened ZrB 2 -SiC (ZSA) composite ceramics fabricated through the two-step process (ball milling and SPS) did not change dramatically with varying content of Zr-Al-C which shows a major phase of Zr 3 Al 4 C 6 . With increasing Zr-Al-C content, the fracture toughness of the ZSA ceramics initially increased and then decreased when the content reached 40 vol%. The ZSA ceramic with 30 vol% Zr-Al-C exhibited a maximum fracture toughness value of 5.96 ± 0.31 MPa m 1/2 , about 22% higher than that of the ZSA ceramic with 10 vol% Zr-Al-C. When the Zr-Al-C content goes beyond 30 vol%, the higher open porosity and component agglomeration led to the relatively lower fracture toughness. Crack deflection and bridging resulted from the weak interface bonding between Zr-Al-C and matrix phases and the weak internal layers of Zr-Al-C crystals, leading to longer crack paths and, hence, the toughened ZSA composite ceramics. Compared to the one-step in-situ synthesis process of Zr-Al-C and the direct incorporation process of synthesized Zr-Al-C grains, the two-step in-situ synthesis process not only led to the more uniform distribution of different components but also resulted in a much larger size of Zr-Al-C grains with a large aspect ratio causing longer crack propagation path as the result of crack deflection and bridging. The larger Zr-Al-C grains combined with the more homogeneous microstructure achieve the most substantial toughening of the ZSA composite ceramics. This work points out a promising approach to control and optimize the microstructure and improve the fracture toughness of ZrB 2 -SiC composite ceramics by selecting the incorporation process of compound reinforcement components.

We report a novel approach to the instantaneous photoinitiated synthesis of mixed anatase-rutile nanocrystalline TiO2 thin films with a three-dimensional nanostructure through pulsed white light irradiation of photosensitive Ti-organic precursor films. Pulsed photoinitiated pyrolysis accompanied by instantaneous self-assembly and crystallization occurred to form graphitic oxides-coated TiO2 nanograins. Subsequent pulsed light irradiation working as in situ pulsed photothermal treatment improved the crystalline quality of TiO2 film despite its low attenuation of light. The non-radiative recombination of photogenerated electrons and holes in TiO2 nanograins, coupled with inefficient heat dissipation due to low thermal conductivity, produces enough heat to provide the thermodynamic driving force for improving the crystalline quality. The graphitic oxides were reduced by pulsed photothermal treatment and can be completely removed by oxygen plasma cleaning. This photoinitiated nanofabrication technology opens a promising way for the low-cost and high-throughput manufacturing of nanostructured metal oxides as well as TiO2 nanocrystalline thin films.

Issue Granulocyte colony-stimulating factors (G-CSF), recommended by international oncology guidelines as a prophylaxis of febrile neutropenia are expensive drugs. Despite biosimilars marketing since 2008, G-CSF spending represents a major and growing expense for health insurance. Description of the problem Between 2010 and 2013 an unsustainable increase of G-CSF spending by 20% occurred in a French area: Pays-la-Loire. An intervention based on guidelines was carried out to the oncologists involved in ambulatory cancer care to reduce G-CSF spending by improving prescription and promoting biosimilars. Hospital oncologists have been the main target. A partnership between physicians and pharmacists of the Brittany - Pays-de-la-Loire Cancer Dedicated Observatory network and the Pays de la Loire Medical Department of Health insurance composed the operational team involved in the work. Interrupted time series analysis based on the French national health data system database were chosen to assess the impact of the intervention on G-CSF spending, their prescription and biosimilars use. Results Twelve professional meetings were performed to cancer medical teams from 7 community hospitals and 5 private hospitals of the Pays-de-la-Loire region. This intervention reduced G-CSF spending by 11% and improves G-CSF local use. Lessons This type of multi-stakeholder intervention carrying common to various health actor’s messages represents a promising tool to improve the quality of care and the control of health expenditure. These results and the possible cost saving showed have encouraged the heads of French health insurance to promote this action in 2019 in the whole France. Key messages In the current context of unsustainable increases in cancer cares related costs in France the rational use of G-CSF’s seemed to be one available resources. biosimilar promotion for ensure broad access to innovative cancer therapeutic for patients and finance cancer prevention campaigns.

La prise en charge des blessés hémorragiques graves nécessite un contrôle précoce de l'hémorragie associé à une réanimation transfusionnelle. En mission extérieure, la transfusion de sang total est une option thérapeutique présentant un rapport bénéfice/risque favorable dans le cadre d'une hémorragie massive. Un des éléments de ce rapport bénéfice/risque est la majoration du risque infectieux. La sélection des donneurs est primordiale pour diminuer ce risque. Nous nous sommes intéressés à cette sélection chez les militaires du détachement air du Niger. Résultats: 34,6 % des personnels avaient reçu une information sur la transfusion de sang total avant projection et 29 ,3 % avaient rempli le questionnaire de présélection et 65,1 % des militaires étaient volontaires au don de sang total. Discussion: notre étude montre qu'une amélioration de l'information et de la sélection des donneurs est nécessaire. Durant notre mission, cette sélection a été réalisée à l'arrivée des militaires sur le théâtre.

Humans expend energy at rest (REE), and this major energy exchange component is now usually estimated using statistical equations that include weight and other predictor variables. While these formulas are useful in evaluating an individual's or group's REE, an important gap remains: available statistical models are inadequate for explaining underlying organ-specific and tissue-specific mechanisms accounting for resting heat production. The lack of such systems level REE prediction models leaves many research questions unanswered. A potential approach that can fill this gap began with investigators who first showed in animals and later in humans that REE reflects the summated heat production rates of individual organs and tissues. Today, using advanced imaging technologies, REE can be accurately estimated from the measured in vivo mass of 10 organ-tissue mass components combined with their respective mass-specific metabolic rates. This review examines the next frontier of energy expenditure models and discusses how organ-tissue models have the potential not only to better predict REE but also to provide insights into how perturbations in organ mass lead to structure-function changes across other interacting organ systems. The introductory ideas advanced in this review provide a framework for future human energy expenditure modelling research.

Questo contributo esamina le varie influenze greche nelle pitture - soprattutto pitture funerarie - in Etruria e in Italia meridionale fra il VI e il III sec. a.C. This contribution is dealing with the manifold Greek influences in the paintings - specially tomb paintings - in Etruria and Southern Italy from the 6th to the 3rd cent. B.C.

International audience

Nanostructured metal oxide thin films with a large specific surface area are preferable for practical device applications in energy conversion and storage. Herein, we report instantaneous (milliseconds) photonic synthesis of three-dimensional (3-D) nanostructured metal oxide thin films through the pulsed photoinitiated pyrolysis of organometallic precursor films made by chemical solution deposition. High wall-plug efficiency-pulsed photonic irradiation (xenon flash lamp, pulse width of 1.93 ms, fluence of 7.7 J/cm2 and frequency of 1.2 Hz) is used for scalable photonic processing. The photothermal effect of subsequent pulses rapidly improves the crystalline quality of nanocrystalline metal oxide thin films in minutes. The following paper highlights pulsed photonic fabrication of 3-D nanostructured TiO2, Co3O4, and Fe2O3 thin films, exemplifying a promising new method for the low-cost and high-throughput manufacturing of nanostructured metal oxide thin films for energy applications.

Exploring for underground resources using land-based electromagnetic methods can be very challenging due to the presence of strong human-generated and “geological” noise. In such context, some passive EM techniques like the Magneto-Telluric method may not be applicable at all and a dedicated toolbox of EM techniques capable of dealing with these issues is required. We focus here on the challenges encountered while exploring for geothermal resources in volcanic islands, namely a highly heterogeneous near-surface creating strong static-shifts, the presence of a sea/land transition zone and a high degree of urbanization over the area of interest. We will show that a combined airborne and land-based controlled-source EM approach provide a robust approach and illustrate these aspects with an EM dataset acquired over the Martinique Island, in the French Lesser Antilles. We believe this work sets the foundations for more robust geophysical exploration workflows in such challenging EM environments.

International audience; New insights are presented on the composition, thickness, and application of the decorating gold leaves remaining on Greek terracotta figurines, kept in the Louvre Museum. Excavated from various sites around the Mediterranean basin, the objects are dated to the Hellenistic and Roman period (4th c. BC–1st c. AD). The thickness of the gold leaves was determined using 3 MeV H+ Rutherford backscattering spectroscopy, while the gold concentration was calculated using H+-particle induced X-ray emission. On artifacts exhibiting large gilded areas, mapping permitted to define zones of interest in both well-conserved and weathered areas of the leaves for the thickness calculation. The obtained thicknesses in the different zones are in agreement within the standard deviations, thus validating the use of point measurements performed for the other objects. For the whole studied corpus, the thicknesses ranged between 160 and 710 nm for a gold concentration mostly superior to 95%, strongly suggesting an ancient purification process as well as a developed goldbeating technique during these periods in the ancient Greek world. Tin leaves were also evidenced on several figurines, but their thicknesses were not estimated due to a strong oxidation.

Aims The first seconds of ventricular fibrillation (VF) are well organized and can consist of just one to two rotating waves (rotors). New rotors are spawned when local propagation block causes wave fragmentation. We hypothesized that this process, which leads to fully developed VF, begins at a consistent anatomic site. Methods and results We initiated VF with a stimulus timed to the local T-wave in 10 isolated pig hearts. Hearts were stained with a voltage-sensitive dye and four video cameras recorded electrical propagation panoramically across the epicardium. In each VF episode, we identified the position of the first wavebreak event that produced new rotor(s) that persisted for at least one cycle. The first such wavebreak occurred along the anterior right ventricular insertion (ARVI) in 26 of 32 VF episodes. In these episodes, wavebreak sites were 6 ± 4 mm from the midline of the ARVI. In the remaining 6 episodes, wavebreak sites were 24 ± 5 mm from the midline on either the LV or RV. During rapid pacing, conduction speed was locally depressed at the ARVI when waves crossed parallel to the midline. Action potential duration (APD) was slightly longer (2.2 ± 2.1 ms) at the ARVI compared with other sites ( P < 0.01). Temporal APD alternans were small and not unique to the break site, suggesting that dynamic APD properties were not the cause of wavebreak. Conclusion The ARVI is the dominant site for wavebreak at the onset of VF in normal myocardium. This may be due to the anatomic complexity of the region.

We developed a new method for ratiometric optical mapping of transmembrane potential (V(m)) in cardiac preparations stained with di-4-ANEPPS. V(m)-dependent shifts of excitation and emission spectra establish two excitation bands (481 and481 nm) that produce fluorescence changes of opposite polarity within a single emission band (575-620 nm). The ratio of these positive and negative fluorescence signals (excitation ratiometry) increases V(m) sensitivity and removes artifacts common to both signals. We pulsed blue (450 ± 10 nm) and cyan (505 ± 15 nm) light emitting diodes (LEDs) at 375 Hz in alternating phase synchronized to a camera (750 frames-per-second). Fluorescence was bandpass filtered (585 ± 20 nm). This produced signals with upright (blue) and inverted (cyan) action potentials (APs) interleaved in sequential frames. In four whole swine hearts with motion chemically arrested, fractional fluorescence for blue, cyan, and ratio signals was 1.2 ± 0.3%, 1.2 ± 0.3%, and 2.4 ± 0.6%, respectively. Signal-to-noise ratios were 4.3 ± 1.4, 4.0 ± 1.2, and 5.8 ± 1.9, respectively. After washing out the electromechanical uncoupling agent, we characterized motion artifact by cross-correlating blue, cyan, and ratio signals with a signal with normal AP morphology. Ratiometry improved cross-correlation coefficients from 0.50 ± 0.48 to 0.81 ± 0.25, but did not cancel all motion artifacts. These findings demonstrate the feasibility of pulsed LED excitation ratiometry in myocardium.

This paper deals with the electrical resistivity monitoring of the Ketzin CO 2 injection pilot (CO2ReMoVe EC project) through time-lapse CSEM measurements. There, 3 boreholes about 800 m deep have been especially designed for current injection at reservoir (sandstone) depth. CO 2 is directly injected in a saline (∼240 g/l) aquifer. Prior modelling results indicated that the increase of electrical resistivity generated by the CO 2 plume (gaseous and liquid CO 2 phases) supposed to be highly resisitive, would generate measurable changes in the EM fields on the surface, when injecting current directly inside the reservoir. In order to highlight and follow these expected resistivity changes, 3 CSEM surveys were performed in August 2008 (baseline prior to injection), June 2009 and August 2010. Each time, 13 EM stations have been recorded during current injection of a square wave at 3 frequencies (0.125 Hz, 0.5 Hz and 4 Hz) in two configurations (“double mise a la masse” (2×MAM) and “mise a la masse–surface” (MAM-Surface)). This paper only presents results of the 2×MAM configuration at 0.5 Hz. In spite of a very noisy area (gas pipes, high voltage power lines), we measured signal amplitude 10 times higher than noise amplitude. We show that EM fields vectors (both inphase and quadrature components) measured on the surface are very similar to the forward modelling EM responses computed with COMSOL Multiphysics ® . Models also show that electric field spatial distribution is strongly affected by a thin and resistive layer (35 m–200 Ωm) of anhydrite above the reservoir, making E field diverging from the boreholes whereas a dipolar pattern was expected for the dipole current injection used here. Moreover, while June 2009 survey highlighted the expected strong increase of electric field (increase of resistivity), August 2010 survey showed electric field amplitudes similar to the 2008 baseline survey, revealing therefore major changes of the reservoir properties. Finally, the directional sensitivity of the 2×MAM array is tested through modelling residuals computed for five CO 2 plume spatial distributions. Results show that a north-eastward migration of the CO 2 plume is expected to fit field data.

Geophysical methods are adequate for imaging the CO2 plume in order to follow its migration within the reservoir and possible leakages through the caprock formation. In particular, changes in density, seismic velocity or electrical resistivity are associated with changes in the gas saturation and make methods such as gravity, 4D seismic and electrical resistivity tomography (ERT) or CSEM powerful tools to follow up the fate of injected CO2. Respect to the minimum amount of CO2 stored that can be quantified for verification purpose, there is an order of magnitude between 4D seismic (few 100s of Kt) and the other two methods (few Mt). Respect to the detection of leakage at the reservoir level, only 4D seismic could be considered as useful. Using downhole measurements, such as crosshole electric or downhole gravity will increase the resolution of these methods and therefore its ability to detect leakage. In case of CO2 leakage upwards and accumulation within a secondary reservoir located at a few hundreds of meters depth, the resolution of the three methods is increased by several order of magnitude and small amounts of CO2 could be detected, depending whether it is in gaseous phase or dissolved. It is expected that controlled experiments of leaking CO2 at shallow depth will help to define more precisely the conditions of use of the three methods.

This work reports a new technique for scalable and low-temperature processing of nanostructured TiO2 thin films, allowing for practical manufacturing of TiO2-based devices such as perovskite solar cells at low-temperature or on flexible substrates. Dual layers of dense and mesoporous TiO2/graphitic oxide nanocomposite films are synthesized simultaneously using inkjet printing and pulsed photonic irradiation. Investigation of process parameters including precursor concentration (10-20 wt%) and exposure fluence (4.5-8.5 J cm-2) reveals control over crystalline quality, graphitic oxide phase, film thickness, dendrite density, and optical properties. Raman spectroscopy shows the E g peak, characteristic of anatase phase titania, increases in intensity with higher photonic irradiation fluence, suggesting increased crystallinity through higher fluence processing. Film thickness and dendrite density is shown to increase with precursor concentration in the printed ink. The dense base layer thickness was controlled between 20 and 80 nm. The refractive index of the films is determined by ellipsometry to be 1.92 ± 0.08 at 650 nm. Films exhibit an energy weighted optical transparency of 91.1%, in comparison to 91.3% of a thermally processed film, when in situ carbon materials were removed. Transmission and diffuse reflectance are used to determine optical band gaps of the films ranging from 2.98 to 3.38 eV in accordance with the photonic irradiation fluence and suggests tunability of TiO2 phase composition. The sheet resistance of the synthesized films is measured to be 14.54 ± 1.11 Ω/□ and 28.90 ± 2.24 Ω/□ for films as-processed and after carbon removal, respectively, which is comparable to high temperature processed TiO2 thin films. The studied electrical and optical properties of the light processed films show comparable results to traditionally processed TiO2 while offering the distinct advantages of scalable manufacturing, low-temperature processing, simultaneous bilayer fabrication, and in situ formation of removable carbon nanocomposites.

Stories have long been used in various cultures and settings to help make meaning and enhance awareness. The authors describe how reflection on and discussion of myths and fairy tales in supervision may help transcend cultural boundaries and increase multicultural understanding. Las historias se han utilizado durante mucho tiempo en diversas culturas y escenarios para facilitar la comprension de significado y aumentar el nivel de conciencia. Los autores describen como la reflexion y la discusion de mitos y cuentos en la supervision pueden ayudar a trascender barreras culturales y elevar el entendimiento multicultural.

Computer modeling of cardiac propagation suggests that curvature of muscle fibers modulates conduction velocity (CV). The effect could be involved in arrhythmogenesis by altering the dynamics of reentrant wavefronts or by causing propagation block. To verify the existence of this effect experimentally, we measured CV in anisotropic neonatal rat ventricular myocyte monolayers. The orientation of the cells was directed by scratches machined into plastic coverslips. Each substrate contained a region in which scratch radius of curvature varied from 0.25 to 1.0 cm. The CV anisotropy ratio (longitudinal CV/transverse CV in straight fiber regions) was 2.3 plusmn 0.3 (n = 38 ). We initiated wavefronts transverse to fibers with the fibers either curving toward or away from the wavefronts. Action potentials were recorded using a potentiometric dye and a video camera. Propagation was faster ( p = 0.0003) when fibers curved toward wavefronts than when fibers curved in the opposite direction. The mean CV difference was 0.38 plusmn 0.44 cm/s (n = 24), which is 3.5% of nominal straight fiber transverse CV (11.0 plusmn 3.2 cm/s). The effect was also present (p = 0.07) when pacing was slowed from 350 to 500 ms (n = 6). In a control group ( n = 8) with uncurved fibers, CV was the same in both directions (p = NS). We conclude that fiber curvature is a factor in modulating cardiac propagation.

To analyze data on inpatient insulin pump use and examine staff compliance with hospital procedures, glycemic control, and safety.We conducted a retrospective review of charts and bedside glucose data for patients who had been receiving outpatient insulin pump therapy and were admitted to our teaching hospital between November 1, 2005, and February 8, 2008.During the study period, there were 50 hospitalizations involving 35 patients who had been receiving outpatient insulin pump therapy. The mean age and duration of diabetes of the 35 patients was 55 years and 32 years, respectively. Sixty-six percent were women, and 91% had type 1 diabetes. Patients in 31 of the hospitalizations (62%) were deemed candidates for continued insulin pump therapy during their stay. Of the 31 hospitalizations, 80% had the presence of the pump documented at admission; 100% had an admission glucose value; 77% had documentation of signed patient consent; 81% had evidence of completed preprinted insulin pump orders; 77% received an endocrine consultation; and 68% had a completed bedside flow sheet. Patients continuing insulin pump therapy had mean bedside glucose levels similar to those whose pump therapy was discontinued (P = .11); however, the proportion of hypoglycemic events was lower among insulin pump users (P.01) than among nonusers.Insulin pump therapy is safe for select inpatients. Overall, staff compliance with procedures was high, although we identified areas for improvement. Continued study is needed on the effectiveness of insulin pump therapy in controlling inpatient hyperglycemia.

This article reviews the performance of our hospital's inpatient insulin pump policy.Twenty-five hospital admissions of 21 unique patients receiving outpatient insulin pump therapy were reviewed.Between November 1, 2005, and November 30, 2006, there were 25 hospital admissions involving 21 patients receiving outpatient insulin pump therapy. The average age and duration of diabetes among these 21 patients was 50 and 29 years, respectively; 67% were women, 90% had type 1 diabetes, and all were white. The mean length of hospital stay was 4 days, and the average reported length of insulin pump therapy was 4 years. Patients in 16 of the admissions were identified as candidates for continued use of the insulin pump during the hospital stay. Over 90% of patients remaining on the insulin pump had documentation by nursing of the presence of the pump at the time of admission; 100% of the patients had an admission glucose recorded; 88% had a record of signed patient consent; 81% had evidence of completed preprinted insulin pump orders; 75% received a required endocrine consultation; and 75% of cases had documentation of completed bedside flow sheet. A high frequency of both hypoglycemic and hyperglycemic events occurred in the patients; however, no adverse events were related directly to the insulin pump.Insulin pump therapy can be safely continued in the hospital setting. While staff compliance with required procedures was high, there was still room for improvement. More data are needed, however, on whether this method of insulin delivery is effective for controlling hyperglycemia in hospitalized patients.

La patologia medica de las glandulas salivales constituye un campo amplio y su tratamiento requiere una cierta experiencia y, en ocasiones, la colaboracion de distintos especialistas. Numerosos farmacos son responsables de modificaciones de la produccion salival, ya que compiten con los neurotransmisores del sistema nervioso autonomo. Las sialoadenitis virales y supuradas pertenecen al ambito del medico general y se benefician de un tratamiento sintomatico, e incluso a veces especifico. Las sialolitiasis representan el trastorno medico mas frecuente. Su tratamiento mediante sialoendoscopia y litotricia intra o extracorporea aparece como una alternativa a las tecnicas quirurgicas convencionales. Las sialoadenitis cronicas y las sialoadenosis (entre ellas el sindrome de Sjogren) requieren un tratamiento medico y a menudo un seguimiento clinico prolongado.

Purpose Individuals whose diabetes is being treated in the outpatient setting via an insulin pump often wish to maintain this therapy during hospitalization. The authors propose guidelines for management of patients on insulin pumps who require a hospital admission. Methods A collaborative interinstitutional task force reviewed current available information regarding the use of insulin pumps in the hospital. Results There was little information in the medical literature on how to manage individuals on established insulin pump therapy during a hospital stay. The task force believed that a policy that promotes patient independence through continuation of insulin pump therapy while ensuring patient safety was possible. A set of contraindications for continued use of pump therapy in the hospital are proposed. A sample patient consent form and order set are presented. Finally, measures that can be used to assess effectiveness of an inpatient insulin pump policy are outlined. Conclusions Patients on established insulin pump therapy do not necessarily have to discontinue treatment while hospitalized. However, clear policies and procedures should be established at the institutional level to guide continued use of the technology in the acute care setting.

Initialement decrites dans le cadre de la chirurgie de l’etrier, les fistules perilymphatiques surviennent plus rarement dans les suites de traumatismes accidentels. Objectifs Les signes cliniques et les resultats therapeutiques sont decrits et analyses chez les patients operes d’exploration chirurgicale d’oreille pour FPL post-traumatique. Materiel et methodes Une etude retrospective a ete realisee a partir de 97 explorations d’oreille realisees entre 1995 et 1999 au CHU de Nantes, chez 90 patients presentant des signes cliniques evocateurs d’une FPL dans un contexte post-traumatique. Les principaux criteres cliniques pre-operatoires ont ete compares aux donnees de l’exploration afin de determiner leur valeur diagnostique. De meme ont ete compares les resultats post-operatoires avec les donnees de l’exploration chirurgicale. Resultats Cette etude a montre la valeur diagnostique de deux symptomes : la sensation de plenitude auriculaire et les troubles de l’equilibre. Lors de chaque exploration chirurgicale, un colmatage systematique des fenetres a ete realise, meme en l’absence de fistule chirurgicalement patente. L’amelioration clinique a concerne essentiellement les signes fonctionnels vestibulaires et l’amelioration de la surdite restant exceptionnelle. L’identification formelle de la fistule a ete sans influence sur l’evolution post-operatoire des symptomes. Conclusion Ce constat nous conduit a preconiser un colmatage systematique des fenetres lors de toute intervention decidee pour suspicion de fistule perilymphatique.

Objective: To assess the evidence demonstrating efficacy, tolerability, and safety of seven new antiepileptic drugs (AEDs) (gabapentin, lamotrigine, topiramate, tiagabine, oxcarbazepine, levetiracetam, and zonisamide) in the treatment of children and adults with refractory partial and generalized epilepsies.Methods: A 23-member committee including general neurologists, pediatric neurologists, epileptologists, and doctors in pharmacy evaluated the available evidence based on a structured literature review including MEDLINE, Current Contents, and Cochrane library for relevant articles from 1987 until March 2003.Results: All of the new AEDs were found to be appropriate for adjunctive treatment of refractory partial seizures in adults. Gabapentin can be effective for the treatment of mixed seizure disorders, and gabapentin, lamotrigine, oxcarbazepine, and topiramate for the treatment of refractory partial seizures in children. Limited evidence suggests that lamotrigine and topiramate are also effective for adjunctive treatment of idiopathic generalized epilepsy in adults and children, as well as treatment of the Lennox Gastaut syndrome.Conclusions: The choice of AED depends upon seizure and/or syndrome type, patient age, concomitant medications, AED tolerability, safety, and efficacy. The results of this evidence-based assessment provide guidelines for the prescription of AEDs for patients with refractory epilepsy and identify those seizure types and syndromes where more evidence is necessary.

Coronary vasospasm is infrequent during anaphylaxis reaction. The authors describe a severe coronary spasm following iodine allergic reaction and then should to explain the physiopathology of this complication.

We propose the method of calculating time-domain chargeability on multi current transmission using Code-Division Multiple-Access technique. The multi current transmission technique is proposed for highly efficient resistivity surveys aiming at lowering costs in large number of measurements or improving time resolution in monitoring applications for example. In the purpose of expanding multi current transmission technique to time-domain IP survey, we developed the method for calculating time-domain chargeability using measured potential data obtained by multi-transmission resistivity measurement. We conducted a simple numerical experiment and a field experiment of multi-transmission measurement for confirming our method. We showed it is possible to obtain time-domain chargeability from multi-transmission data. Currently, it is needed to be improved for adapting practical situation such like instability of current injection.

Voltage-sensitive dye imaging (VSDI) can simultaneously monitor the spatiotemporal electrical dynamics of thousands of neurons and is often used to identify functional differences in models of neurological disease. While the chief advantage of VSDI is the ability to record spatiotemporal activity, there are no tools available to visualize and statistically compare activity across the full spatiotemporal range of the VSDI dataset. Investigators commonly analyze only a subset of the data, and a majority of the dataset is routinely excluded from analysis. We have developed a software toolbox that simplifies visual inspection of VSDI data, and permits unaided statistical comparison across spatial and temporal dimensions. First, the three-dimensional VSDI dataset (x,y,time) is geometrically transformed into a two-dimensional spatiotemporal map of activity. Second, statistical comparison between groups is performed using a non-parametric permutation test. The result is a 2D map of all significant differences in both space and time. Here, we used the toolbox to identify functional differences in activity in VSDI data from acute hippocampal slices obtained from epileptic Arx conditional knock-out and control mice. Maps of spatiotemporal activity were produced and analyzed to identify differences in the activity evoked by stimulation of each of two axonal inputs to the hippocampus: the perforant pathway and the temporoammonic pathway. In mutant hippocampal slices, the toolbox identified a widespread decrease in spatiotemporal activity evoked by the temporoammonic pathway. No significant differences were observed in the activity evoked by the perforant pathway. The VSDI toolbox permitted us to visualize and statistically compare activity across the spatiotemporal scope of the VSDI dataset. Sampling error was minimized because the representation of the data is standardized by the toolbox. Statistical comparisons were conducted quickly, across the spatiotemporal scope of the data, without a priori knowledge of the character of the responses or the likely differences between them.

International audience; Electromagnetic three-component magnetic probes at diffusion frequencies are now available for use in slim mineral-exploration boreholes. When a source is operated at or below the surface of the Earth in the vicinity of a conductive orebody, these probes provide, after appropriate processing, the secondary vector magnetic field attributed to this body. Proper inversion of the resulting datasets requires as a first step a clear understanding of the electromagnetic interaction of model signals with model bodies. In this paper, the response of a conductive ellipsoid buried at shallow depth in a half-space Earth is investigate by a novel hybrid approach combining the localized nonlinear approximation and the low frequency scattering theory. The ellipsoidal shape indeed fits a large class of scatterers and yet is amenable to analytical calculations in the intricate world of ellipsoidal harmonics, while the localized nonlinear approximation is known to provide fairly accurate results at least for low contrasts of conductivity between a scattering body and its host medium. In addition, weak coupling of the body to the interface is assumed. The primary field accounts for the presence of the interface, but multiple reflection of the secondary field on this interface is neglected. After analyzing the theoretical bases of the approach, numerical simulations in several geometrical and electrical configurations illustrate how estimators of the secondary magnetic field along a nearby borehole behave with respect to a general-purpose method-of-moments (MoM) code. Perspectives of the investigation and extensions, in particular, to two-body systems, strong coupling to the interface, and high contrast cases, are discussed

A chronically depressed 44-year-old man was rescued by the French medicalised ambulance service four hours after the ingestion of Nerium oleander leaves in a suicide attempt. Cardiotoxicity was evidenced by the presence of bradycardia with mental confusion and vomiting. The patient was empirically treated in the prehospital phase with a single dose of digoxin-specific Fab antibody fragments (Digidot). In spite of this treatment, the patient presented a new episode of important bradycardia (25 b/minute). Thereafter, the patient's rhythm stabilized and neurological signs and vomiting resolved. The patient recovered uneventfully and was discharged from the intensive care unit two days later.

Publisher Summary The chapter discusses the possibilities for incorporating TES within each structure and assesses the impact of TES with respect to energy savings, and economic, social and environmental implications. With rising energy prices, all the energy structures—such as residential, commercial, industrial, urban, thermal energy transport, and electrical utilities—will try to reduce energy costs through the successful implementation of thermal energy storage (TES). There are many opportunities for the economic incorporation of TES in each of the areas considered, and with proper consideration for each group's interests, TES installations can be mutually beneficial. TES can have a large impact on future design of buildings and heating, ventilation, and air-conditioning (HVAC) systems. Detailed technical and cost analysis are required to show cost effectiveness and areas where knowledge is lacking. The largest single use of energy is for space heating, and energy savings could be made by using TES to allow more continuous operation of boilers and furnaces. This could also lead to much desired improvements in efficiency.

We have conducted field experiments for evaluating practicality of a multiple transmission DC resistivity profiling using Code Division Multiple Access (CDMA) technique. In a multi-transmission resistivity profiling, it is possible to inject current at multiple points simultaneously by using coded current waveforms among which covariance between mutual waveforms equal to zero. Multi-transmission resistivity profiling technique has the potential to enable very rapid measurement compared to mono-transmission conventional resistivity profiling. In this paper, we have conducted experiments for evaluating workability and noise-robustness. The results of field experiments show that the efficiency of a multi-transmission resistivity measurement is quite high regarding to current duration time. We have found that erratic low-frequency noise badly affects the measurement result but it was possible to improve this result by post-processing the measured potential waveform.

A 70-year-old patient who had been fitted with a pacemaker for 27 years consulted his cardiologist to check the latest device, which had been changed in 1998. During the examination there was a sudden malfunction of the pacemaker, which became uncontrollable, resulting in an escape rhythm of 15 beats/min and circulatory insufficiency. Attempted treatment by isoprenaline and external transcutaneous systolic stimulation failed, and an intraventricular catheter was therefore positioned successfully as an emergency prehospital manoeuvre. This produced good haemodynamic stability, allowing the transfer of the patient to hospital where his pacemaker was changed.

Within the framework of hydrogeological studies for additional water supply to the main towns of Botswana, the BRGM company has carried out a multimethod geophysical survey of a large sedimentary basin in the Kalahari desert, for the purpose of assessing its water resources. On a regional scale, gravimetry, magnetometry and audio-magnetotellurics (AMT) were used to determine the structure of the basin, which is intensely faulted into horsts and grabens. Next, a number of favourable areas were selected for detailed profiling with horizontal portable loop EM (HLEM) and DC electrical arrays to locate accurately the fractured zones at the edges of grabens, the targets for exploratory drillholes. The AMT method proved to be the most effective for mapping the basement of the basin, thanks to the good resistivity contrast between the resistive basement and its conductive cover, and to the regional constancy of sedimentary organisation of the cover. The presence of the uniformly resistive Kalahari Sands at the top of the cover was also very favourable, protecting AMT data from troublesome “static” effects. These good conditions enabled a fast and innovative quantitative interpretation of AMT soundings, determined by borehole calibration and based on the reading of the apparent resistivity at a single frequency (10 Hz).

Optical mapping of cardiac propagation has traditionally been hampered by motion artifact, chiefly due to changes in photodetector-to-tissue registration as the heart moves. We have developed an optical mapping technique to simultaneously record electrical waves and mechanical contraction in isolated hearts. This allows removal of motion artifact from transmembrane potential (V(m)) recordings without the use of electromechanical uncoupling agents and allows the interplay of electrical and mechanical events to be studied at the whole organ level. Hearts are stained with the voltage-sensitive dye di-4-ANEPPS and ring-shaped markers are attached to the epicardium. Fluorescence, elicited on alternate frames by 450 and 505 nm light-emitting diodes, is recorded at 700 frames∕ per second by a camera fitted with a 605 ± 25 nm emission filter. Marker positions are tracked in software. A signal, consisting of the temporally interlaced 450 and 505 nm fluorescence, is collected from the pixels enclosed by each moving ring. After deinterlacing, the 505 nm signal consists of V(m) with motion artifact, while the 450 nm signal is minimally voltage-sensitive and contains primarily artifacts. The ratio of the two signals estimates V(m). Deformation of the tissue enclosed by each set of 3 rings is quantified using homogeneous finite strain.

Background: Insulin pump therapy is a complex technology prone to errors when employed in the hospital setting. When patients on insulin pump therapy require hospitalization, practitioners caring for them must decide whether to allow continued pump use. We provide the largest review regarding transitioning insulin pump therapy from the outpatient to inpatient setting. Method: Records of inpatient insulin pump users were retrospectively analyzed at a metropolitan Phoenix hospital between January 2006 and December 2009. Adherence to institutional procedures on insulin pump use was assessed, glycemic control was determined, and adverse events were examined. Results: We examined records on 65 patients with insulin pumps, totaling 125 hospitalizations. Mean (standard deviation) patient age was 55 (17) years, diabetes duration was 27 (14) years, pump duration was 6 (5) years, length of hospital stay was 4.7 (6.3) days, hemoglobin A1c was 7.3 (1.3)%, 85% had type 1 diabetes mellitus, 57% were women, and 97% were white. Admissions involving insulin pumps increased (23 in 2006, 17 in 2007, 40 in 2008, and 45 in 2009). Insulin pump therapy was continued in 83 (66%) hospitalizations. Among these hospitalizations, endocrinology consultations were obtained in 89%, consent agreements were found in 83%, insulin pump order sets were completed in 89%, admission glucose was checked in 100%, and nursing assessments of pump insertion sites were documented in 89%, but bedside insulin pump flow sheets were found in only 55%. Mean glucose of 175 (57) mg/dl was not significantly different than that in hospitalizations where insulin pumps were discontinued [175 (42) mg/dl] or used intermittently [177 (7) mg/dl]. There was one instance of a pump catheter kinking; however, no other adverse events (pump site infections, mechanical pump failure, diabetic ketoacidosis) were observed, and there were no use-related fatalities. Conclusions: Most patients using insulin pumps can safely have their therapy transitioned when hospitalized. A policy on inpatient continuous subcutaneous insulin infusion use can be successfully implemented. Compliance with required procedures can be achieved, although there was room to improve adherence with some process measures. Further study is needed to determine how to optimize glycemic control when pumps are allowed during hospitalization.