Search

The surface species formed during the hydrogenation of CO2 with H2 over a ZrO2-supported Cu catalyst were investigated by operando diffuse reflectance FT-IR spectroscopy at 220 °C and 3 bar. The reactivity of two different formates located on zirconia could be unraveled. The data pointed to ZrO2 hydroxyl groups at 3755 cm−1 as the sites on which carbonates and then formates were hydrogenated to methoxy species. Formate hydrogenation appeared as the slowest step. The most reactive ZrO2-bound formates exhibited a rate constant of reaction about 65 times higher than that of the slower formate.

Contrast-enhanced ultrasonography (CEUS) is a potential interesting method for assessing accurately Crohn’s disease (CD) activity. We compared the value of intestinal ultrasonography (US) coupled with contrast agent injection with that of magnetic resonance enterography (MRE) in the assessment of small bowel CD activity using surgical histopathology analysis as reference. Seventeen clinically active CD patients (14 women, mean age 33 years) requiring an ileal or ileocolonic resection were prospectively enrolled. All performed a MRE and a US coupled with contrast agent injection (CEUS) less than 8 weeks prior to surgery. Various imaging qualitative and quantitative parameters were recorded and their respective performance to detect disease activity, disease extension and presence of complications was compared to surgical histopathological analysis. The median wall thickness measured by US differed significantly between patients with non-severely active CD (n = 5) and those with severely active CD (n = 12) [7.0 mm, IQR (6.5–9.5) vs 10.0 mm, IQR (8.0–12.0), respectively; p = 0.03]. A non-significant trend was found with MRE with a median wall thickness in severe active CD of 10.0 mm, IQR (8.0–13.7) compared with 8.0 mm, IQR (7.5–10.5) in non-severely active CD (p = 0.07). The area under the ROC curve (AUROC) of the wall thickness assessed by US and MRE to identify patients with or without severely active CD on surgical specimens were 0.85, 95% CI (0.64–1.04), p = 0.03 and 0.80, 95% CI (0.56–1.01), p = 0.07, respectively. Among the parameters derived from the time-intensity curve during CEUS, time to peak and rise time were the two most accurate markers [AUROC = 0.88, 95% CI (0.70–1.04), p = 0.02 and 0.86, 95% CI (0.68–1.04), p = 0.03] to detect patients with severely active CD assessed on surgical specimens. The accuracy of intestinal CEUS is close to that of conventional US to detect disease activity. A thickened bowel and shortened time to peak and rise time were the most accurate to identify CD patients with severe histological disease activity.

Background The prevalence of nonadherence to major treatments and the subsequent adverse outcomes in IBD patients during the first wave of COVID-19 pandemic remain scarce. Aim to investigate the risk of early disease relapse in a cohort of IBD patients under immunosuppressants and/or biologics who decided themselves to discontinue their IBD-related major treatments without previous medical advice during the first wave of COVID-19 pandemic. Methods All consecutive patients with inactive IBD under immunosuppressants and/or biologics who acknowledged having withdrawn their major therapy for IBD without previous medical advice during the first wave of COVID-19 (from March 2020 to December 2020) were enrolled. The primary endpoint was the survival rate without disease relapse. Kaplan-Meier curves were plotted for time from inclusion to IBD relapse and a logistic regression model with uni- and multivariate analyses was performed to identify predictors of relapse after drug discontinuation. Results During the study period, among the 862 IBD patients followed as outpatients either treated with infliximab or vedolizumab (outpatient clinics n= 368) or treated with oral azathioprine, adalimumab, golimumab or ustekinumab alone or in combination (n= 494), 54 patients (6.2 %) (42 CD, 12 UC, 28 F, median age 36 years) who had discontinued themselves their IBD-related major therapy without previous medical advice were included. The median duration of drug withdrawal was 7.0 weeks (range 2-24) and the median time to relapse was 9.0 weeks (range 4-20). The most treatments withdrawn were adalimumab (n=19), ustekinumab (n=19), azathioprine (n= 12), golimumab (n=1) and a lesser degree infliximab (n=7) eand vedolizumab (n=6). During the median follow-up period of 24 weeks (range 5-42), 22 out of 54 patients (40.7 %) who discontinued their IBD treatment experienced a relapse in whom 6 requiring administration of oral steroids, 4 hospitalization and 2 IBD-related surgery. By univariate analysis, past IBD related surgery was identified as the only predictor of disease relapse after drug withdrawal (OR=3.3 CI 95 % [1.08-10.38]. Conclusion In IBD patients, major treatment discontinuation by the patients themselves without medical advices during the first wave of pandemic Covid-19 including the lockdown was associated with a substantial risk of disease relapse occurring in around 4 out of 10 patients and subsequent further risk of need for steroids, hospitalization and surgery. Strategies targeting the adherence to therapy and patient’s informations about the real risks leading to drug discontinuation are of paramount interest, especially during health crisis to minimize such issues.

Doped ceria is known for its high ionic conductivity which is limited by the creation of defect clusters. We investigate using Molecular Dynamics the evolution of the structure and oxygen diffusivity of the Ce 0.9 M 0.1 O 1.95 (M = Gd, Sm) doped and co-doped CeO 2 systems. Two configurations concerning the introduction of the doping ions and oxygen vacancies inside the structure are generated and compared, the random one (R) and the neighbor one (N). The pair potential parameter set is chosen among three sets by comparison with experimental data. The pair correlation function first peak is fitted by a lognormal function to take into account the asymmetry. The evolution of the coefficient of thermal expansion, the coordination number and the bond lengths of the different ion pairs with the temperature, is presented. The influence of the local C-type sesquioxide M 2 O 3 structure on those parameters is discussed. No significant positive co-doping effect on the oxygen diffusion process is revealed. The random configuration of the defects leads to the highest oxygen diffusivity and to the lower activation energy whatever the doping ion (Gd, Sm or Gd/Sm).

This paper describes the development of an innovative instrumented and automated 2.45GHz multimode microwave cavity for sintering of uranium oxide based nuclear fuels (UO2, (U,Pu)O2, (U,Am)O2 …). The cavity and the sintering cell were designed using Finite Element simulation and the expertise acquired over years on microwave heating. This original setup allows for hybrid and homogeneous heating of nuclear fuels. Reliable in situ monitoring of the samples' shrinkage and temperature is performed with an optical dilatometer and infrared pyrometers calibrated with a specific protocol. A dedicated software including a Proportional-Integral-Derivative (PID) controller was developed to precisely control the sintering cycles like under conventional heating. The setup is also designed for operating in a glovebox under reducing sintering atmosphere. A stable and homogeneous heating with controlled sintering cycles is reached to successfully sinter UO2 crack free pellets to high density. This is a key point of innovation compared to previous studies in the literature on microwave sintering of nuclear ceramics. The pellets' final densities are equivalent to those obtained under conventional sintering, but with a significant decrease in the total duration of the sintering cycle.

Introduction La proportion de surinfections bacteriennes au cours de la COVID-19 varie selon les etudes et est estimee a moins de 10 % en service de medecine. En revanche, des etudes montrent que 60 a 90 % des patients ont recu une antibiotherapie lors de la 1re vague. L’objectif de notre etude est de determiner l’incidence de la prescription des antibiotiques chez les patients hospitalises pour COVID-19 dans un service hospitalo-universitaire de maladies infectieuses et tropicales, et de comparer cette consommation entre les 2 vagues successives. Materiels et methodes Il s’agit d’une etude observationnelle, retrospective. Le recueil des donnees medicales s’est fait par extraction PMSI du dossier medical partage informatique. Ont ete inclus tous les sejours COVID-19 (PCR ou TDM positif) sans passage en reanimation pendant l’annee 2020. Nous avons compare les patients hospitalises lors de la 1re vague (V1) du 28 fevrier au 31 aout et lors de la 2e vague (V2) du 1er septembre au 31 decembre. Les donnees cliniques, paracliniques (microbiologie, radiologie) et therapeutiques (utilisation d’une corticotherapie, antibiotherapie de plus de 48 h) ont ete recueillies. Resultats Au total, 237 patients ont ete inclus, 103 pendant la V1 et 134 pendant la V2. En V1, 55 % des patients (57/103) ont recu une antibiotherapie (duree moyenne 7,7 jours) contre 21 % (28/134), pour une duree moyenne de 6,8 jours, en V2 (p = 4 × 10−8). En V1, 45 % des patients ont beneficie d’un prelevement respiratoire (46/103) contre 31 % (42/134) en V2 (p = 0,028). Quatorze pour cent (8/57 et 4/28) des antibiotherapies en V1 et V2 etaient documentees. La tomodensitometrie retrouvait des images de condensation alveolaire suspectes de surinfection bacterienne chez 25 % (14/57) et 32 % (9/28) des patients sous antibiotherapie en V1 et V2 respectivement. Sur le plan biologique, le taux moyen de CRP etait plus eleve chez les patients traites par antibiotiques (142,2 mg/L en V1 et 135,4 mg/L en V2) en comparaison aux patients non traites (86,4 mg/L et 99 mg/L respectivement). Au total, 69 % des patients hospitalises ont necessite une oxygenotherapie, soit 71 patients en V1 et 92 patients en V2 (p = 0,9). Quatre-vingt-neuf pour cent des patients sous antibiotherapie ont necessite une oxygenotherapie en V1 (51/57) et V2 (25/28), contre 46 % (21/46) et 63 % (67/106) des patients sans antibiotherapie. Sur le plan therapeutique, 9 % (9/103) et 61 % (82/134) des patients ont beneficie d’une corticotherapie en V1 et V2 respectivement. La mortalite dans notre cohorte etait de 5 % en V1 (5/103) et 7 % (10/134) en V2. Conclusion Notre etude montre une incidence nettement inferieure de l’utilisation des antibiotiques au moment de la 2e vague de CoVID-19, chez des patients au profil globalement similaire. Les antibiotiques etaient plus souvent prescrits en cas de CRP elevee et de necessite d’une oxygenotherapie. Nous faisons l’hypothese que ces parametres cliniques et paracliniques ont participe a guider le choix du prescripteur.

Background Understanding the nature of suicidal ideation, or how suicidal ideation is experienced by the individual in its course and development, is important for informing suicidal ideation assessment and treatment. In this study, we conducted qualitative interviews with a national sample of fifty United States (U.S.) military veterans with recent suicide attempts to elucidate the nature of suicidal ideation from the perspective of those with lived experience. Methods We interviewed 25 women and 25 men veterans from Veterans Health Administration healthcare facilities across the U.S. who made a recent (prior 6 months) suicide attempt. Data were analyzed using a thematic analysis approach. Results Suicidal ideation was characterized as chronic, varying in severity and duration. Two typologies characterized increases in suicidal ideation severity: those whose ideation increases due to negative self-evaluations and those whose ideation increases without clear warning. Additionally, participants described needing help recovering from severe episodes of suicidal ideation, which often disrupted their lives and everyday functioning. Limitations This was a study of U.S. military Veterans with a recent suicide attempt; our findings may differ from studies of nonveterans or those with suicidal ideation but have never attempted suicide. Conclusions Our findings align with prior research that suicidal ideation is often experienced as chronic, fluctuating, and nonlinear. Suicide risk assessment may benefit from use of a combination of ideation severity and functional measures. Future work should investigate treatment of suicidal ideation that targets active symptom management and ameliorates the negative impacts that suicidal ideation has on patients’ functioning.

Contrast-enhanced ultrasonography (CEUS) is a potential interesting method for assessing accurately Crohn's disease (CD) activity. We compared the value of intestinal ultrasonography (US) coupled with contrast agent injection with that of magnetic resonance enterography (MRE) in the assessment of small bowel CD activity using surgical histopathology analysis as reference.Seventeen clinically active CD patients (14 women, mean age 33 years) requiring an ileal or ileocolonic resection were prospectively enrolled. All performed a MRE and a US coupled with contrast agent injection (CEUS) less than 8 weeks prior to surgery. Various imaging qualitative and quantitative parameters were recorded and their respective performance to detect disease activity, disease extension and presence of complications was compared to surgical histopathological analysis.The median wall thickness measured by US differed significantly between patients with non-severely active CD (n = 5) and those with severely active CD (n = 12) [7.0 mm, IQR (6.5-9.5) vs 10.0 mm, IQR (8.0-12.0), respectively; p = 0.03]. A non-significant trend was found with MRE with a median wall thickness in severe active CD of 10.0 mm, IQR (8.0-13.7) compared with 8.0 mm, IQR (7.5-10.5) in non-severely active CD (p = 0.07). The area under the ROC curve (AUROC) of the wall thickness assessed by US and MRE to identify patients with or without severely active CD on surgical specimens were 0.85, 95% CI (0.64-1.04), p = 0.03 and 0.80, 95% CI (0.56-1.01), p = 0.07, respectively. Among the parameters derived from the time-intensity curve during CEUS, time to peak and rise time were the two most accurate markers [AUROC = 0.88, 95% CI (0.70-1.04), p = 0.02 and 0.86, 95% CI (0.68-1.04), p = 0.03] to detect patients with severely active CD assessed on surgical specimens.The accuracy of intestinal CEUS is close to that of conventional US to detect disease activity. A thickened bowel and shortened time to peak and rise time were the most accurate to identify CD patients with severe histological disease activity.

Partial nitritation-anammox was carried out successfully in a continuous fed Sequencing Batch Reactor (cf-SBR), composed of 3 compartments operated in continuous mode. The reactor was operated with floccular biomass (flocs) and biofilm to remove nitrogen from the anaerobic effluent from the potato industry at different nitrogen loading rates (0.16 g TN L−1 d−1 - 0.8 g TN L−1 d−1). At the maximum nitrogen loading rate (NLR) evaluated the nitrogen removal and ammonia oxidation achieved were 62% and 74% respectively. During the evaluation of the NLR, it was observed an improvement of the characteristics of the sludge, improving the Sludge Volumetric Index (SVI) from 228 to 63 mL g−1 MLSS. Moreover, molecular analysis (qPCR) confirmed the presence of anammox bacteria on the flocs and in the biofilm from the cf-SBR. The results showed the capability of the reactor to carry out the partial nitritation-anammox in the same reactor at pilot scale. The cf-SBR was presented as a suitable and feasible technology for advanced nitrogen removal under partial nitritation and anammox conditions.

CSIRO, Boeing, DSTG and the RAAF have undertaken a number of monitoring programs of microclimate and corrosion within different internal spaces in a number of aircraft. Past programs have looked at conditions within an RAAF-707 (sub-floor area) and an Air New Zealand 747 (sub-galley). The current program looks at a number of spaces in two RAAF C-130s based at Richmond, NSW. The spaces include Empennage, Cargo door and above LH Main Wheel Well. Monitoring of the C130s is now in its second year of engagement. The data derived in each monitoring program includes the ambient air relative humidity, surface relative humidity, ambient air temperature, surface air temperature, surface wetness and corrosion as measured by a corrosion sensor. This data allows relationships between microclimate, wetness and corrosion to be established as well as relationships between base location, flight patterns, position in aircraft and microclimate to be derived. It is observed that in some cases wetness and corrosion are directly related to microclimate and are associated with such phenomena as condensation or “rain in plane”. In other cases there is no apparent microclimatic cause for wetness or corrosion events. The relevance of the data to the corrosivity of different aircraft spaces, base locations and flight patterns is reviewed and implications for maintenance are assessed using the current data from the C130s. Work is progressing on deriving generic software for predicting aircraft internal microclimate from flight path, time of day and month of year using this data.

Social Media Intelligence and Learning Environment (SMILE) is an open source framework bringing cutting-edge computational models on social media data to social science researchers and students with any level of programming and computation expertise. Many existing social media analysis tools require programming knowledge, a fee, or are closed source, making it challenging for social science researchers to apply existing and new methods to social media data. SMILE provides a user-friendly web interface, through which researchers can perform a wide spectrum of research tasks, ranging from social media data collection, natural language processing, text classification, social network analysis, and generating human readable outputs and visualizations. SMILE has adopted several technologies to support its needs. The data service of SMILE leverages the GraphQL language to provide an efficient and succinct API for client to communicate with a heterogeneous collection of social media APIs, including Twitter and Reddit. SMILE implements a microservices design and utilizes Amazon AWS services, such as Lambda and Batch for computation, S3 for data storage, and Elasticsearch for a Twitter streaming database, which makes it more portable, economic, and resilient. Analysis outputs can be shared with the larger community using Clowder, an open source data management system to support data curation of long tail data and metadata. SMILE is one of the main applications deployed as a standalone tool within the Social Media Macroscope (SMM), a science gateway based on the HUBzero platform. Over 200 users have used SMILE since its first release in 2018.

Resume La prise en charge des patients porteurs d’une embolie pulmonaire diagnostiquee aux urgences depend du risque de mortalite precoce. Une prise en charge ambulatoire est envisageable chez les patients a faible risque. Nous presentons ici les differents scores de risque existants, et la strategie proposee par le reseau Nord-Alpin des urgences, qui utilise le score PESI (Pulmonary Embolism Severity Index) dans sa version simplifiee pour selectionner les patients a bas risque, candidats a une prise en charge ambulatoire.

Resume Les spondyloarthrites constituent un groupe de maladies rhumatismales dont le point commun est l’atteinte du rachis et des articulations sacro-iliaques (ASI). Un diagnostic precoce est requis pour une prise en charge therapeutique precoce et un meilleur pronostic. Les nouvelles molecules, en particulier anti-TNF alpha ont fait la preuve de leur efficacite dans le controle de l’inflammation et la prevention de l’evolution vers l’ankylose. L’imagerie permet actuellement un diagnostic plus precoce, en particulier l’imagerie par resonance magnetique (IRM) du rachis et des ASI.

Previous research has reported an association between balance and cognitive function; however, there is a paucity of data on this relationship over time. This study examined the cross-sectional and longitudinal association between balance and cognitive function in 4,811 participants aged 65 years and older in the Cardiovascular Health Study (CHS). Cognitive function measures included the Modified Mini-Mental State Examination (3MSE) and Digit Symbol Substitution Test (DSST); measures were collected annually for six years, starting in 1992-1993. A tandem stance balance test was administered at baseline; this test was held for 5 seconds. Cross-sectional and longitudinal models were adjusted for demographics, behavioral and disease covariates. We found that participants with worse balance scores had lower cognitive function scores, and this effect was limited to participant who were above the median age (76 years) (p-value for interaction = 0.03 in a demographic-adjusted model). Participants 76 years and older who failed the balance test had an average adjusted decline of -0.97 (95% CI: 1.20, 2.29) 3MSE scores per year more than participants who completed the balance test. DSST showed similar results; participants with poor balance decreased -0.21 (95% CI: -0.37, -0.05) points per year more than participants who completed the balance test. The adjusted Cox proportional hazard model found participants with poorer balance had a higher risk of cognitive impairment over the six years (HR= 1.72 95% CI: 1.30, 2.29). A better understanding of the pathophysiological link between balance and cognition may inform strategies to prevent cognitive decline.

The CHaracterizing ExOPlanet Satellite (CHEOPS), to be launched in December 2019, will detect and characterize small size exoplanets via ultra high precision photometry during transits. CHEOPS is designed as a follow-up telescope and therefore it will monitor a single target at a time. The scientific users will retrieve science-ready light curves of the target, automatically generated by the CHEOPS data reduction pipeline of the Science Operations Centre. This paper describes how the pipeline processes the series of raw images and, in particular, how it handles the specificities of CHEOPS data, such as the rotating field of view, the extended irregular Point Spread Function, and the data temporal gaps in the context of the strict photometric requirements of the mission. The current status and performance of the main processing stages of the pipeline, that is the calibration, correction and photometry, are presented to allow the users to understand how the science-ready data have been derived. Finally, the general performance of the pipeline is illustrated via the processing of representative scientific cases generated by the mission simulator., Comment: Accepted for publication in A&A. 14 pages, 23 figures

A prospective multicenter phase II trial to evaluate the survival outcomes of percutaneous radiofrequency ablation (RFA) for patients with stage IA non-small cell lung cancer (NSCLC), ineligible for surgery. Patients with a biopsy-proven stage IA NSCLC, staging established by a positron emission tomography-computed tomography (PET-CT), were eligible. The primary objective was to evaluate the local control of RFA at 1-year. Secondary objectives were 1- and 3-year overall survival (OS), 3-year local control, lung function (prior to and 3 months after RFA) and quality of life (prior to and 1 month after RFA). Of the 42 patients (mean age 71.7 y) that were enrolled at six French cancer centers, 32 were eligible and assessable. Twenty-seven patients did not recur at 1 year corresponding to a local control rate of 84.38% (95% CI, [67.21–95.72]). The local control rate at 3 years was 81.25% (95% CI, [54.35–95.95]). The OS rate was 91.67% (95% CI, [77.53–98.25]) at 1 year and 58.33% (95% CI, [40.76–74.49]) at 3 years. The forced expiratory volume was stable in most patients apart from two, in whom we observed a 10% decrease. There was no significant change in the global health status or in the quality of life following RFA. RFA is an efficient treatment for medically inoperable stage IA NSCLC patients. RFA is well tolerated, does not adversely affect pulmonary function and the 3-year OS rate is comparable to that of stereotactic body radiotherapy, in similar patients. ClinicalTrials.gov Identifier NCT01841060 registered in November 2008.

Rationale and objectives To evaluate the mean skill level of radiology residents in chest X-ray (CXR) reading, with regard to cognitive mechanisms involved in this task and to investigate for potential factors influencing residents’ skill. Materials and methods Eighty-one residents were evaluated through a test set including CXR expected to mobilize detection skills ( n = 10), CXR expected to mobilize interpretation skills ( n = 10) and normal CXR ( n = 4). For each radiograph, residents were asked to answer three questions: Does this radiograph show normal or abnormal findings? Does it require complementary computed tomography study? What is your diagnosis? Residents’ answers were evaluated against an experts’ consensus and analyzed according to year of residency, attendance at CXR training course during residency and the average number of CXR read per week. Results Residents’ mean success rate was 90.4%, 76.6% and 52.7% for the three questions, respectively. Year of residency was associated with better diagnostic performances in the detection CXR category ( P = 0.025), while attendance at CXR training course was associated with better performances in the interpretation CXR category ( P = 0.031). There was no influence of the number of CXR read per week. Conclusion These results may suggest promoting systematic CXR theoretical training course in the curriculum of radiology residents.

Understanding the formation and evolution of giant planets ($\ge$1 $M_{Jup}$) at wide orbital separation ($\ge$5 AU) is one of the goals of direct imaging. Over the past 15 years, many surveys have placed strong constraints on the occurrence rate of wide-orbit giants, mostly based on non-detections, but very few have tried to make a direct link with planet formation theories. In the present work, we combine the results of our previously published VLT/NaCo large program with the results of 12 past imaging surveys to constitute a statistical sample of 199 FGK stars within 100 pc, including 3 stars with sub-stellar companions. Using Monte Carlo simulations and assuming linear flat distributions for the mass and semi-major axis of planets, we estimate the sub-stellar companion frequency to be within 0.75-5.7% at the 68% confidence level (CL) within 20-300 AU and 0.5-75 $M_{Jup}$, which is compatible with previously published results. We also compare our results with the predictions of state-of-the-art population synthesis models based on the gravitational instability (GI) formation scenario by Forgan & Rice (2013), with and without scattering. We estimate that in both the scattered and non-scattered populations, we would be able to detect more than 30% of companions in the 1-75 $M_{Jup}$ range (95% CL). With the 3 sub-stellar detections in our sample, we estimate the fraction of stars that host a planetary system formed by GI to be within 1.0-8.6% (95% CL). We also conclude that even though GI is not common, it predicts a mass distribution of wide-orbit massive companions that is much closer to what is observed than what the core accretion scenario predicts. Finally, we associate the present paper with the release of the Direct Imaging Virtual Archive (DIVA, http://cesam.lam.fr/diva/), a public database that aims at gathering the results of past, present, and future direct imaging surveys., 20 pages, 11 figures. Accepted for publication in A&A

La resection pulmonaire en cas de cancer colorectal metastatique est possible si la maladie est stable et sous controle. Les patients sont admissibles apres une evaluation stricte et une longue periode de remission. Nous avons effectue une revue de la litterature recente portant sur la resection pulmonaire en cas de cancer colorectal metastatique en comparant particulierement le role de la chirurgie conventionnelle face a la thoracotomie et a la videothoracoscopie. La survie a cinq ans de ces patients varie entre 35 et 61,4 % selon les series. La chirurgie videothoracoscopique permet une resection complete de la maladie (R0), mais seule la chirurgie conventionnelle semble offrir un bon curage ganglionnaire. Il est etabli que la videothoracoscopie peut etre une alternative pour les patients fragiles et difficilement operables. La chirurgie ouverte reste aujourd’hui la reference ; cependant, et a notre connaissance, elle est controversee, car il n’existe pas d’etudes randomisees solides pour demontrer son efficacite. La chirurgie est plus susceptible de detecter une petite tumeur via palpation bidigitale du reste du poumon. Elle reste aujourd’hui la meilleure strategie possible pour les patients atteints de cancers metastatiques dont la fonction pulmonaire permet une resection du poumon. Dans ce contexte, la mediastinoscopie garde clairement une place preponderante dans la strategie therapeutique, car elle definit le staging ganglionnaire. L’ablation par radiofrequence (RF) et la radiotherapie stereotaxique ablative sont aussi des alternatives appropriees pour le controle local. Pour les patients fragiles, elles representent une therapeutique acceptable.

Introduction Les classes juridiques disponibles des etablissements de Soins de suite et de readaptation (SSR) ne traduisent pas une realite complexe. Dans le contexte du financement des etablissements par Dotation modulee a l’activite, nous proposons une classification des etablissements, a partir des donnees d’activite. Methodes Sur la Base SSR 2016 des sejours hospitaliers francais (BDHF-FHF, source ATIH), les variables actives sont ete isolees par analyse en composantes principales ; la partition d’etablissements se fonde sur les methodes de classification ascendante hierarchique sur les axes de l’ACP, puis de centres mobiles. Resultats L’analyse de 1328 etablissements et 55 variables actives montre trois premiers axes : geriatrie et severite, lourdeur et dependance, specialisation, et une partition en cinq classes. La classe 1 (n = 560), « Polyvalents lourds », de petits etablissements, tres diversifies, accueillent les patients les plus âges, polypathologiques, dependants physiquement sans activite de reeducation, avec un taux d’ETP soignant le plus eleve. La classe 2 (n = 426) d’etablissements « Polyvalents » differe de la precedente par plus d’activite pour l’appareil locomoteur et moins pour le systeme nerveux, les patients sont moins severes, moins lourds. La classe 3 inclut des etablissements specialises « Locomoteur et systeme nerveux » (n = 233) de grande taille, peu diversifies, avec le plus de medecins reeducateurs, ou les sujets moins âges et moins dependants qu’ailleurs, sortent plus souvent d’un sejour chirurgical. Les etablissements de la classe 4 « Specialises autres » (n = 62) de taille assez elevee, a activite cardiovasculaire, traitent les sujets les moins polypathologiques et les moins dependants. La classe 5 « Specialises enfants » (n = 47), majoritairement des PSPH de faible taille, peu diversifies, accueille pour des pathologies du systeme nerveux des enfants severes avec des dependances physiques et cognitives les plus elevees, un fort taux de journees en reeducation. Discussion/Conclusion Cette etude departage les etablissements SSR polyvalents et specialises. Elle sera reiteree en raison de l’amelioration attendue de la qualite et de l’exhaustivite du PMSI liee a son impact sur le financement.

Some studies have shown that performing a second flush during embryo collection can increase the number of embryos recovered. However, this technique results in greater uterine manipulation that may increase PGF2α in the uterine fluid of donor cows and affect pregnancy rate in recipient females. Two experiments were conducted (1) to determine whether PGF2α concentration in uterine fluid was affected by treatment with a non-steroidal anti-inflammatory drug (NSAID) before embryo recovery and (2) to determine whether the percent of recipients becoming pregnant following embryo transfer (P/ET) was affected by flush number. In both experiments, lactating Holstein cows were used as donors (n=18 and 34, respectively) and subjected to a standard superovulation protocol (Baracaldo et al. 2000 Theriogenology 53, 1239-1250, DOI: 10.1016/S0093-691X(00)00268-5). Embryo recovery was performed using 2 catheters that were inserted simultaneously into the uterus, 1 into each horn. During the first flush, a volume of 300mL of flush medium was used in each horn. At the end of the first flush approximately 75mL of fluid was left and, after 1h, a second flush was performed to recover the remaining fluid. Samples were taken from each horn at the first and second flush to determine PGF2α concentration using a bovine PGFM ELISA kit. Data for PGF2α concentrations in uterine fluid were presented as the average of both uterine horns. In Exp. 1, donors were randomly assigned to be treated with or without 1.2g of the NSAID Anafen (ketoprofen) IM 20min before embryo recovery. In Exp. 2, recovered grade-1 embryos from the first and second flush procedures were frozen in ethylene glycol and subsequently transferred to synchronized Holstein heifers (n=106 and 49 for the first and second flushes, respectively). Pregnancy was diagnosed by rectal palpation at Day 60. All data were analysed using t-test. In Exp. 1, Anafen treatment 20min before embryo recovery reduced PGF2α in uterine fluid during the second flush procedure (105.9±11.4v. 43.6±5.7 pg/mL; P

The aim of this study was to determine the effect of propylene glycol (PPG) on serum concentrations of insulin and insulin-like growth factor (IGF)-1 in superovulated dairy heifers. We hypothesised that administration of PPG would have a positive effect on superovulation results via increased insulin and IGF-1. A total of 20 clinically healthy Holstein heifers with an average age of 12 months were used for this experiment. Superovulation was performed using a standard protocol. Briefly, each heifer received 3 mg of oestradiol-17β IM and an intravaginal progesterone-releasing insert (CIDR) containing 1.9 g of progesterone at random stages of the oestrous cycle (designated Day 0). From Day 4 to 8, heifers received a total of 200 mg of NIH-follicle-stimulating hormone-P1 administered intramuscularly through 9 injections of decreasing doses (from 50 to 10 mg) at 12-h intervals. On Day 7, heifers received 2 injections of 500 µg of cloprostenol, a PGF2α analogue, at ~6-h intervals, after which intravaginal inserts were removed. Artificial insemination was performed on Day 10, 12 h after treatment with 100 µg of gonadotropin-releasing hormone IM. Embryos were flushed from the uterus of donor heifers 6 days after AI. The method consisted of simultaneously using 1 catheter per uterine horn. Catheters were maintained in place to perform 2 flushes 1 h apart. A total of 1 L of flushing medium was used, 700 and 300 mL for the first and the second flush, respectively. Embryos were assessed for viability immediately after collection using the IETS classification. Heifers were divided into 2 groups (PPG and control group). From Day 4 to 14 of the superovulation protocol, PPG group received a daily dose of 400 mL of a 66.7% propylene glycol solution, whereas the control group received the same amount of water. Two months later, the same experiment was conducted by inverting the groups. At Day 4 and 14, four blood samples were collected to measure insulin and IGF-1 at 25-min intervals. The first sample (0) was taken before heifers received PPG or water. Insulin was analysed using an ELISA kit following manufacturer’s instructions, whereas IGF-1 was determined using a chemiluminescence immunoassay. Embryo associated data were analysed using t-test. Both IGF-1 and insulin data were analysed using a two-way ANOVA, followed by Bonferroni post-hoc test. Treatment with PPG had no effect on the number of transferable embryos (8 ± 5.1 v. 7 ± 5.5), degenerated embryos (0.5 ± 0.8 v. 1.5 ± 2.4), or unfertilized oocytes (0.3 ± 0.7 v. 0.7 ± 1.2) recovered. There was also no effect of PPG on IGF-1 serum concentrations at the beginning (Day 4) or the end (Day 14) of the treatment regimen. However, PPG treatment enhanced (P = 0.02) serum insulin concentrations 50 min after administration on Day 4 (10.69 v. 6.88 pmol/L), as well as at 25 (19.58 v. 9.64 pmol/L) and 50 min (16.67 v. 8.21 pmol/L) on Day 14. It has been suggested that PPG metabolism may stimulate insulin and IGF-1 secretion, which can promote embryo development. However, in the present study, there was no effect of oral doses of PPG on IGF-1. Although higher serum concentrations of insulin were observed after PPG treatment, there was no effect of PPG treatment on the number of transferable embryos recovered following superovulation.

Resume Les tumeurs primitives de trachee sont rares, representant environ 0,1 % des tumeurs des voies respiratoires. Le carcinome adenoide kystique (ou cylindrome) represente le deuxieme type histologique de tumeurs tracheales par ordre de frequence. Ces lesions comportent trois types histologiques (cribriforme, tubulaire et solide) et se caracterisent par une croissance locale lente, une invasion perinerveuse et une potentielle recurrence locale et a distance. Nous rapportons ici un cas clinique detaillant la prise en charge medicochirurgicale d’un carcinome adenoide kystique de la trachee basse chez une femme de 56 ans. La patiente a beneficie d’une resection R0 avec une reconstruction complete de la carene selon la technique de Grillo sous extra corporeal membrane oxygenation (ECMO). Une revue non exhaustive de la litterature est egalement realisee sur les carcinomes adenoides kystiques de localisation tracheale.

Dielectric breakdown of ceramics is obviously an important failure in the levels of equipment requiring some insulation safety or to ensure their proper functioning. The manifested microscopic damage processes under electrical stress are indisputably related to charge trapping and detrapping and thus related to energy localization on defects. This work enabled the development of a technique (Influence Current Method) using a specific arrangement in a Scanning Electron Microscope chamber, allowing to measure separately and simultaneously the influence and conduction currents. This permits subsequently tracing back to the trapped charge dynamic during and after electron irradiation. The purpose of this paper is to study firstly the stability of trapped charge in ZrO 2 /Y 2 O 3 ceramic and secondly to investigate the grains size effect on charging and discharging processes. Via this results the microstructure - dielectric strength correlations are well justified. Instability of trapped charge was found; the majority was evacuated from the irradiated volume. This entrusts to it a conductive insulator character. It has been found that more the grains size decreases more the amount of stabilized trapped charge decreases. This is due to the eventual increase in the grains boundary density in which the oxygen vacancies are concentrated. Note that the increase of grains size improves the dielectric strength.