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In case of transtibial amputation, the deficit resulting from the loss of the lower limb can be partly compensated with a prosthetic foot and adapted rehabilitation. New prosthetic feet have been developed for transtibial amputees to mimic ankle adaptability to varying terrain. Among them, Microprocessor Prosthetic Ankles (MPA) have a microprocessor to control an electric or a hydraulic actuator to adapt ankle kinematics in stairs and slopes. The objective is to investigate parameters extracted from the moment-angle curve (MAC) and use them to compare 3 MPA during level and slope locomotion against energy storing and return (ESR) foot. Five persons with lower limb transtibial amputation successively fitted with 3 MPA (Propriofoot™, Elan™, Meridium™) compared to their ESR foot. The participants had 2 weeks of adaptation before data acquisition and then a 3 week wash-out period. Range of motion, equilibrium point, hysteresis, late stance energy released, and quasi-stiffness were computed on level ground and 12% slope (upward and downward) thanks to the MAC at the ankle. The study shows the relevance of MAC parameters to evaluate the behavior of MPA. In particular, compared to ESR, all MPA tested in the present study demonstrated a better angle adaptation between walking conditions but a decrease of available energy for the propulsion. Among MPA, main results were: (i) for the Propriofoot™: an adaptation of the ankle angle without modification of the pattern of the MAC (ii) for the Elan™: a limited adaptation of the range of motion but a modification of the energy released (iii) for the Meridium™, the highest adaptation of the range of motion but the lowest available energy of propulsion. One of the main findings of the research is to show and quantify the relationship between range of motion and energy available when using different prosthetic feet in different walking conditions.

Krabbe disease is a rare neurodegenerative disorder caused by a deficiency in galactocerebrosidase. The only effective treatment is hematopoietic stem cell transplantation (HSCT). Approximately 85% of Krabbe disease cases are the infantile subtypes, among which ∼20% are late infantile. Prior studies have demonstrated that HSCT is effective for early-infantile patients (0-6 months of age) who undergo transplantation while asymptomatic, compared with those receiving transplants while symptomatic. However, no studies evaluated the efficacy of HSCT for late-infantile patients (6-36 months). In this prospective, longitudinal study, patients were evaluated at a single site according to a standardized protocol. Survival analysis was performed using the Kaplan-Meier method. Differences between groups were estimated using mixed regression models to account for within-person repeated measures. Nineteen late-infantile patients underwent HSCT (March 1997 to January 2020). Compared with untreated patients, transplant recipients had a longer survival probability and improved cognitive and language function. Gross and fine motor development were most affected, with variable results. Asymptomatic patients benefitted the most from transplantation, with normal to near-normal development in all domains and some gross motor delays. Among symptomatic patients, those with disease onset at >12 months of age had better cognitive outcomes than untreated patients. Those with disease onset at ≤12 months were comparable to untreated patients. We found that HSCT prolonged the lifespan and improved the functional abilities of late-infantile patients with Krabbe disease, particularly those who underwent transplantation before onset of symptoms. In addition, our findings support prior literature that reclassifies late-infantile Krabbe disease to be symptom onset at 12 to 36 months of age.

In forensic anthropology, the estimation of age at death is required to establish a biological profile and facilitate individual identification. The pubic symphysis represents one of the most studied skeletal structures due to its late maturation. In this respect, the Suchey-Brooks (SB) system is one of the most commonly used methods of assessment based on the morphological characteristics of the pubic symphysis. However, the SB method has certain drawbacks, including frequently inaccurate estimation for individuals over 40 years old. The main aim of this work was to study the inter-observer agreement in the SB method then to test the errors of estimation by three observers with heterogeneous experience from a computed tomography sample for individuals aged between 15 and 98 years old.

Le syndrome de Münchhausen par procuration est décrit comme une forme grave de maltraitance. Sa réelle prévalence est à ce jour méconnue, en lien probablement avec une errance diagnostique induite par la nature même de la pathologie. Nous rapportons les cas de deux frères victimes de ce syndrome, provoqué ici par la mère, comme deux exemples illustrant le caractère insidieux et la potentielle gravité de cette maladie ainsi que la difficulté diagnostique qu’elle représente. Le diagnostic est évoqué après 10 et 3 ans d’évolution respectivement pour l’aîné et le cadet, temps pendant lequel plusieurs diagnostics de pathologies graves ont été posés, impliquant la mise en route de certains traitements médicamenteux lourds et d’autres thérapeutiques fortement invalidantes sur le plan physique (contentions). Outre l’aspect didactique de ces deux cas justifiant leur présentation, nous discuterons des enjeux médico-légaux, à travers les spécificités liées à l’évaluation du dommage corporel et notamment ici de l’importance des préjudices temporaires comparativement à un état séquellaire mineur.

Une personne amputée du membre inférieur peut retrouver l’usage du déplacement bipodal grâce à une rééducation et un appareillage appropriés. Cet appareillage consiste en un assemblage de composants visant à restaurer au mieux les fonctions des articulations amputées ainsi qu’à se fixer au segment de membre résiduel de l’utilisateur, de manière à assurer confort mais aussi contrôle de la prothèse. Ces composants doivent par ailleurs assurer une sécurité à l’utilisateur, dans toutes les situations rencontrées. Les limitations des appareillages peuvent entraîner des compensations et boiteries chez l’utilisateur, facilitant l’apparition de troubles musculosquelettiques à long terme. Des troubles cutanéomusculaires peuvent aussi apparaître à court terme, limitant alors le port de l’appareillage le temps de la cicatrisation. Les acteurs de l’appareillage et de la recherche visent à repousser ces limitations, notamment par l’adjonction de composants électroniques ou la recherche sur de nouveaux matériaux ou formes d’emboîture et de manchon. Il n’existe pas à ce jour de prothèse universelle permettant de réaliser toute activité aussi parfaitement qu’un membre vivant.

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The Solfatara volcano is the main degassing area of the Campi Flegrei caldera, characterized by 60 years of unrest. Assessing such renewal activity is a challenging task because hydrothermal interactions with magmatic gases remain poorly understood. In this study, we decipher the complex structure of the shallow Solfatara hydrothermal system by performing the first 3‐D, high‐resolution, electrical resistivity tomography of the volcano. The 3‐D resistivity model was obtained from the inversion of 43,432 resistance measurements performed on an area of ~0.68 km2. The proposed interpretation of the multiphase hydrothermal structures is based on the resistivity model, a high‐resolution infrared surface temperature image, and 1,136 soil CO2flux measurements. In addition, we realized 27 soil cation exchange capacity and pH measurements demonstrating a negligible contribution of surface conductivity to the shallow bulk electrical conductivity. Hence, we show that the resistivity changes are mainly controlled by fluid content and temperature. The high‐resolution tomograms identify for the first time the structure of the gas‐dominated reservoir at 60 m depth that feeds the Bocca Grande fumarole through a ~10 m thick channel. In addition, the resistivity model reveals a channel‐like conductive structure where the liquid produced by steam condensation around the main fumaroles flows down to the Fangaia area within a buried fault. The model delineates the emplacement of the main geological structures: Mount Olibano, Solfatara cryptodome, and tephra deposits. It also reveals the anatomy of the hydrothermal system, especially two liquid‐dominated plumes, the Fangaia mud pool and the Pisciarelli fumarole, respectively. A 3‐D gas‐dominated reservoir feeds the Bocca Grande fumarole at 164 degrees Celsius through a ~10 m thick conduitThe Fangaia mud pool and Pisciarelli fumarole are both conductive liquid‐dominated plumeA buried fault drives the condensate water from the main fumaroles toward the Fangaia mud pool

La cirugía de las glándulas paratiroideas se dirige en la gran mayoría de los casos a los hiperparatiroidismos. Gracias a los avances de las técnicas de imagen y la generalización del uso de las determinaciones peroperatorias de las concentraciones séricas de parathormona intacta, el acceso quirúrgico en los hiperparatiroidismos primarios es cada vez con más frecuencia microinvasivo, lo que ofrece una baja morbilidad y permite una actitud terapéutica ambulatoria. Por el contrario, el riesgo quirúrgico en caso de hipercalcemia grave o en los hiperparatiroidismos secundarios y terciarios es alto, y depende de la existencia de trastornos del ritmo o de la conducción cardíaca mantenidos por la hipercalcemia o de la gravedad de las comorbilidades, en particular la enfermedad renal crónica, lo que puede comprometer el pronóstico vital.

La chirurgia delle paratiroidi è utilizzata, nella maggior parte dei casi, negli iperparatiroidismi. Grazie ai progressi nel campo della diagnostica per immagini e alla generalizzazione dei dosaggi perioperatori di paratormone intatto, l’accesso chirurgico negli iperparatiroidismi primari è sempre più spesso microinvasivo, gravato da una debole morbilità e con una gestione ambulatoriale. Al contrario, il rischio di un intervento chirurgico in caso di ipercalcemia severa o negli iperaparatiroidismi secondari e terziari è elevato, per via dell’esistenza di disturbi del ritmo o della conduzione cardiaca nel contesto dell’ipercalcemia o della gravità delle comorbilità, in particolare la malattia renale cronica, e può mettere in pericolo la prognosi vitale.

Dans le domaine de l’expertise médicale en dommage corporel, le préjudice sexuel englobe tous les préjudices touchant à la sphère sexuelle et limitant la victime dans sa sexualité depuis l’évènement traumatique. Il couvre la période allant de la consolidation jusqu’au décès de l’individu (avant la consolidation, le préjudice sexuel est inclus dans le déficit fonctionnel temporaire). De récentes études ont émis l’hypothèse selon laquelle l’évaluation neutre du préjudice sexuel se heurtait à des conceptions normatives de la sexualité et aux rapports de genre. Dans ce contexte, nous avons tenté de déterminer quels facteurs influençaient l’indemnisation de ce chef de préjudice.

Grímsvötn Volcano is the most active volcano in Iceland, and its last three eruptions were in 1998, 2004, and 2011. Here we analyze the displacement around Grímsvötn during these last three eruptive cycles using 10 GPS stations. The observed displacements in this region generally contain a linear component of tectonic and glacio‐isostatic origin, in agreement with the previously estimated values of plate motions and vertical rebound. Larger amplitude deformation observed close to Grímsvötn at the GFUM continuous GPS station clearly reflects a major volcanic contribution superimposed on a tectonic component. We estimate and subtract the tectonic trend at this station using regional observed displacement. The direction and pattern of the residual volcanic displacement (for coeruptive and intereruptive periods) are consistent for all three of these eruptive cycles. The posteruptive inflation is characterized by an exponential trend, followed by a linear trend. In this study, we explain this temporal behavior using a new analytic model that has two connected magma chambers surrounded by an elastic medium and fed by a constant basal magma inflow. During the early posteruptive phase, pressure readjustment occurs between the two reservoirs, with replenishment of the shallow chamber from the deep chamber. Afterward, due to the constant inflow of magma into the deep reservoir, the pressurization of the system produces linear uplift. A large deep reservoir favors magma storage rather than surface emission. Based on displacement measured at GFUM station, we estimate an upper limit for the radius of the deep reservoir of ∼10 km. GPS time series for the last three intereruptive cycles of Grimsvotn are analyzedWe propose a model with two connected magmatic chambers, with basal magma inflowThe vertical deformation limits the lateral extension of the deep reservoir

New, multigram routes to suitably protected L-iduronyl monosaccharide donors 4 and 5 and 2-azidoglucose acceptors 6 and 7 are described. The L-iduronyl and D-glucuronyl disaccharides 1−3 were then prepared from these compounds, by means of efficient and regioselective protective group manipulations. These disaccharides form the basis of a combinatorial approach toward the synthesis of heparan sulfate fragments representative of the heterogeneous regions of this polysaccharide. (© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2003)Introduction

Studies of the biogenesis of the photosynthetic protein complexes in the unicellular green alga Chlamydomonas reinhardtii have pointed to the importance of the concerted expression of nuclear and chloroplast genomes. The accumulation of chloroplast- and nuclear-encoded subunits is concerted, most often as a result of the rapid proteolytic disposal of unassembled subunits, but the rate of synthesis of some chloroplast-encoded subunits from photosynthetic protein complexes, designed as CES proteins (Controlled by Epistasy of Synthesis), is regulated by the availability of their assembly partners from the same complex. Cytochrome f, a major subunit of the cytochrome b6f complex is a model protein for the study of the CES process. In the absence of subunit IV, another subunit of the cytochrome b6f complex, its synthesis is decreased by 90%. This results from a negative autoregulation of cytochrome f translation initiation, mediated by a regulatory motif carried by the C-terminal domain of the unassembled protein [Choquet, Stern, Wostrikoff, Kuras, Girard-Bascou and Wollman (1998) Proc. Natl. Acad. Sci. U.S.A. 95, 4380–4385]. Using site-directed mutagenesis, we have characterized this regulatory motif. We discuss the possible implications regarding the mechanism of the CES process for cytochrome f expression. We have studied the possible generalization of this mechanism to other CES proteins.