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A multi-particulate fixed-dose combination product, consisting of a combination of two alkalising salts formulated as prolonged-release granules, ADV7103, was developed to obtain a sustained and prolonged alkalising effect. The specific release of both types of granules was shown in vitro through their dissolution profiles, which indicated that potassium citrate was released within the first 2–3 h and potassium bicarbonate up to 10–12 h after administration. The long-lasting coverage of ADV7103 was confirmed through a randomised, placebo-controlled, double-blind, two-period study, measuring its effect on urine pH in healthy adults (n = 16) at doses of alkalising agent ranging between 0.98 and 2.88 meq/kg/day. A significant increase of urine pH with a positive dose–response in healthy adult subjects was shown. Urine pH above 7 was maintained during 24 h with a dosing equivalent to 1.44 meq/kg twice a day, while urine pH was below 6 most of the time with placebo. The effect observed was non-saturating within the range of doses evaluated and the formulation presented a good safety profile. ADV7103 provided an effective prolonged release of alkalising salts to cover a 12-h effect with adequate tolerability and could afford a twice a day (morning and evening) dosing in patients requiring long-term treatment.

Sugammadex, a specific reversal agent for steroidal neuromuscular blocking drugs, has on occasion been reported to be associated with clinical signs of awakening. We performed a study to systematically search for an increase in bispectral index values and signs of awakening in patients maintained under general anaesthesia following sugammadex administration. Patients, scheduled to receive general anaesthesia with neuromuscular blockade, were included in this double-blind randomised crossover study. After surgery was completed, and while the train-of-four ratio was zero, intravenous anaesthesia was continued with the aim of maintaining the bispectral index in the range of 40-60. Patients then received either sugammadex 4 mg.kg-1 or saline. In cases of incomplete reversal of neuromuscular blockade after 5 min, patients received the other drug. Bispectral index and train-of-four monitoring were recorded every minute and clinical signs of awakening noted. Fifty-one patients completed the study. Median (IQR [range]) bispectral index values increased after sugammadex administration from 49 (43-53 [38-64]) to 63 (53-80 [45-97]) (p < 0.01) with an increase of ≥ 20 in 22 patients; 14 (27%) patients had clinical signs of awakening. Saline had no effect on bispectral index values, clinical signs of awakening or degree of neuromuscular blockade. This study confirms that reversal of neuromuscular blockade with sugammadex may be associated with clinical signs of awakening despite maintenance of anaesthesia. Intravenous anaesthesia should be maintained until complete recovery of muscle function is achieved, especially when sugammadex is administered.

Epistasis affects genome evolution together with our ability to predict individual mutation effects. The mechanistic basis of epistasis remains, however, largely unknown. To quantify and better understand interactions between fitness-affecting mutations, we focus on a 11 amino-acid α-helix of the protein β-lactamase TEM-1, and build a comprehensive library of more than 15,000 double mutants. Analysis of the growth rates of these mutants shows pervasive epistasis, which can be largely explained by a non-linear two-state model, where inactivating, destabilizing, neutral, or stabilizing mutations additively contribute to the phenotype. Hence, most epistatic interactions can be predicted by a non-linear model informed by single-point mutational measurements only. Deviations from the two-state model are consistently found for few pairs of residues, in particular when they are in contact. This result, as well as single-point mutation parameters, can be quantitatively found back through direct-coupling-analysis-based statistical models inferred from homologous sequence data. Our results thus shed light on the existence and the origins of the multiple determinants of the epistatic landscape, even at the level of small structural components of a protein, and suggest that the corresponding constraints shape the entire β-lactamase family.

Background The Mitral Regurgitation International Database (MIDA) score is a validated tool for Degenerative Mitral Regurgitation (DMR) management, being able to position a given patient within a continuous spectrum of short and long term mortality. However, whether this score may be applicable and incremental in the entire span of Floppy Mitral Valves (FMV), regardless of DMR severity, remains unsubstantiated. Methods The MIDA-Quantitative (MIDA-Q) unprecedented registries include 8187 consecutive patients (age 64±17 years, 45% women, follow-up 5.5±3.4 years) with isolated degenerative mitral valve disease diagnosed at tertiary (European/ North-American/ Middle Eastern) centers in whom DMR severity used both integrative and quantitative grading. The MIDA-Q Score ranged from 0 to 15 depending on accumulating risk factors. Long-term survival overall, under medical management and post-mitral surgery was analysed. Results By quantitative grading, MR was no/trivial in 1938 (24%), mild in 1423 (17%), moderate in 2027 (25%) and severe in 2799 (34%), with ERO 0.24±24cm2, RVol 37±35mL, and posterior leaflet prolapse in 49%. MIDA-Q Scores stratified in 8 categories were 0 (score 0, n=851), 1 (score 1–2, n=1301), 2 (score 3–4, n=2043), 3 (score 5–6, n=1581), 4 (score 7–8, n=1273), 5 (score 9–10, n=718), 6 (score 11–12, n=331) and 7 (score 13–15, n=89). In the whole MIDA-Q population (n=8187 patients), 5-year survival under medical management with Scores categories 0–1, 2–4, and 5–7 was 96±1%, 73±1%, and 61±3% respectively (P Conclusion This unheard international cohort of patients with FMV and prospective mitral severity quantitative grading, enables for the first time the calculation of a MIDA-Q Score, highly determinant of survival after diagnosis of FMV with any degree of DMR, that may be very useful for mitral valve prolapse management. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Mayo Fundation Figure 1

Core-shell single wall carbon nanotube (SWCNT)/ polyaniline (PANI) nanocomposites were chemically synthesized and their structural, morphological, and dielectric properties were investigated as a function of the nanofiller content. X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM) and transmission electron microscopy (TEM) images confirm the core-shell nanostructural features of the composites. Broadband dielectric spectroscopy allows the detection of an interfacial dielectric relaxation mechanism which is quite dependent on the dispersion of nanoparticles into the semi-conducting polyaniline matrix. Furthermore, the relaxation process analysed through Kohlrausch-William-Watts (KWW) model, is found to take place at lower nanofiller loading but progressively fades away on increasing the amount of SWCNT, yielding relaxation spectra which gradually resemble that of a pure conductor. In addition, it is found that competing processes between electrical percolation and interfacial capacitance effects are inherently dependent on the carbon-filler content. Such a behaviour is ascribed to charge trapping and de-trapping phenomena occurring at core-shell interfaces. The possibility of tuning the composition of the nanocomposites in order to trigger an interplay between capacitance and dc-electrical conduction can be envisioned for their application in the next generation of organic-based supercapacitor or gate memory devices. © 2019 Elsevier B.V.

Purpose The purpose of this study was to examine the ability of persons with aphasia to access interaction and be included in social encounters in long-term care facilities (LTCFs). Method Four persons with aphasia were the focus of this investigation. A qualitative research approach using ethnographic methods was used to conduct participant observation, semistructured interviews, and artifact analysis. Expanded field notes from observations, transcribed interviews, and artifacts were then coded to identify patterns in the data. Results The interactional context of LTCFs negatively influenced the ability of persons with aphasia to communicate with others and develop meaningful relationships. Three major themes emerged from the data detailing the contextual elements leading to communication accessibility and inclusion: (a) lack of support, (b) social hierarchy, and (c) focus on performance. Conclusions Findings highlighted several barriers in LTCFs that worked to discourage persons with aphasia from living social and expressive lives. Specific obstacles included a misunderstanding of aphasia and its influence on communicative exchanges and performance-oriented environment that overlooked psychosocial needs. Speech-language pathologists have an important role for advocacy in LTCFs. Clinical implications for assessment and treatment in institutions are discussed.

Dans le cadre d’un projet europeen LIFE+ Environnement, le departement de la Gironde a mene une experience d’economies d’eau dans les logements, les bâtiments publics et sur les reseaux d’adduction d’eau potable. L’objectif principal du projet est de diminuer l’empreinte des prelevements dans les nappes profondes, sources d’approvisionnement en eau potable du territoire et pour lesquelles l’equilibre quantitatif est menace. L’analyse des resultats issus des actions mises en oeuvre permet de constater que les deux possibilites etudiees sur lesquelles les analyses ont pu etre realisees a ce jour, soit les kits hydro-economes et les modulateurs de pression, ont toutes deux un impact moyen important sur les consommations et les prelevements en eau potable. Leurs ratios cout/efficacite sont interessants et plus faibles que ne le sont les ratios inherents a des strategies de captage de nouvelles ressources, conventionnelles ou non. Le projet constitue une aide a la decision pour differents acteurs qui doivent trouver un equilibre entre une augmentation constante de la population et un enjeu de preservation de la ressource.

Introduction L’evolution terminale des pathologies interstitielles (PI) est une insuffisance respiratoire chronique restrictive. L’hypoxemie est l’anomalie gazometrique predominante. Cependant, certains patients peuvent developper une hypercapnie chronique. La ventilation non invasive (VNI) est le traitement de l’hypercapnie chronique. Cependant, son utilisation est peu decrite dans les PI. L’objectif principal de notre etude etait de decrire les caracteristiques de nos patients appareilles par VNI pour une PI. Les objectifs secondaires etaient d’evaluer l’efficacite du traitement ainsi que la survie des patients appareilles. Methodes Etude retrospective mono-centrique incluant tous les patients atteints d’une PI evoluee justifiant la mise en place d’une VNI entre 2016 et 2019. La qualite de vie etait evaluee par le Severe Respiratory Insufficiency (SRI) questionnaire et celle du sommeil par Pittsburgh Sleep Quality index. Resultats Dix patients ont ete identifies. Leur âge etait de 71 [65–79] ans et 8 etaient de sexe feminin. Leur indice de masse corporelle etait de: 26 [20–32]kg/m2. La PI etait: une PINS (n = 4), secondaire a une connectivite (n = 3) et secondaire a une granulomatose avec polyangeite, une sarcoidose et une pneumopathie d’hypersensibilite (n = 1 respectivement). La mise en place de la VNI survenait 5 [0,5–9] ans apres le debut de la prise en charge de la PI. A l’initiation de la VNI, la dyspnee etait a 3 [3–3] selon l’echelle mMRC. La CVF etait 51 [45–59]%, la CPT etait 64 [54–67]% et la DLCO etait 41 [38–51]%. La capnie diurne etait de 6,5 [6,0–7,1]kPa, celle au reveil etait de 7 [6,9–7,1]. L’index apnee-hypopnee etait de 9 [1–11]/h. La VNI etait reglee avec une pression inspiratoire positive de 18 [16–20]cmH2O et une pression expiratoire positive de 4 [4–5]cmH2O. Lors du suivi, deux patients n’avaient pas utilise leur VNI. L’observance des 8 autres etait de 5,1 [4,3–7,6]h/jour. La capnie en ventilation spontanee etait stable lors du suivi: +0,2 [−0.4–1,1]P (p = 0,43) mais s’ameliorait sous VNI: −0,6 [−0,6–−0,2]P (p = 0,013). Lors du suivi, la qualite du sommeil etait amelioree: −4 [−7–−1]/21 (p = 0,028). La qualite de vie etait amelioree chez 4 des 6 patients ayant eu un SRI a la mise en place et lors du suivi. La duree de suivi etait de 15 [8–31]mois. Deux deces sont survenus a 5 et 27 mois de l’appareillage. Conclusion L’initiation de VNI s’accompagne d’une amelioration de la qualite de vie et du sommeil chez les majorites des patients. Son utilisation doit etre mieux evaluee.

Introduction La ventilation non invasive (VNI) est usuellement administree en mode barometrique avec des reglages de pressions inspiratoire et expiratoire. De nouveaux modes dits automatises permettent d’inclure une consigne de volume et une adaptation automatique de la pression expiratoire positive. Notre objectif etait d’evaluer l’efficacite gazometrique des modes automatises comparativement au mode barometrique. Les objectifs secondaires etaient de comparer les durees de mise en place de la VNI, l’impact sur la qualite de vie et les donnees logicielles des ventilateurs. Methodes Etude mono-centrique retrospective cas-temoins ayant inclus tous les patients ayant un syndrome obesite hypoventilation traites en mode automatise (groupe Auto) entre 05/2017 et 12/2019. Deux temoins (groupe ST) etaient apparies pour chaque cas avec selection sur la capnie et l’index d’apnee-hypopnees (IAH) initial. Les donnees d’efficacite etaient relevees a la premiere reevaluation de la VNI. La qualite de vie etait evaluee par le Severe Respiratory Insuficiency questionnaire. Resultats 51 patients ont ete inclus: 17 dans le groupe Auto, 34 dans le groupe ST. L’IMC moyen etait de 41,75 ± 8,43 kg/m2, la capnie diurne 5,98 ± 0,71 kPa et l’IAH initial 38 ± 25/h. Les deux groupes etaient comparables a la mise en place de la VNI. Dans le groupe Auto, le volume cible prescrit etait de 10 ml/kg poids ideal. Dans le groupe ST, la pression inspiratoire etait 22,8 ± 3,9cmH2O et l’expiratoire 9,0 ± 2,8cmH2O. La duree de mise en place de la VNI etait comparable dans les deux groupes: 2 jours [1–3] (groupe Auto) et 3 [2–4] (p = 0,09). L’amelioration de la qualite de vie (SRI): 3,73 [−4,75; 11,40] (groupe Auto) vs 2,53 [−4,02;9,27] (p = 0,83) Les donnees logicielles montraient un niveau de fuites non intentionnelles plus eleve dans le groupe Auto: 42,0L/min [18,3; 51,3] (groupe Auto) vs 16,0L/min [10,0; 35,5] (p = 0,015), ainsi que le volume courant: 621 mL [502,5; 715] (groupe Auto) vs 512 mL [400; 629] (p = 0,027). La frequence etait plus elevee dans le groupe ST: 16,7 cpm [15,3; 19,0] vs 15,5cpm [15,0; 16,0] (groupe Auto) (p = 0,021). Conclusion Nos donnees suggerent une efficacite similaire des modes standard et automatise. Cependant, la ventilation minute en mode automatise etait preferentiellement due au volume alors que la ventilation en mode standard etait preferentiellement due a la frequence respiratoire. Ces resultats pourraient avoir leur interet dans d’autres populations telles que les patients atteints de BPCO.

L’insuffisance cardiaque (IC) a fonction systolique alteree est une pathologie dont la mortalite reste elevee malgre les progres du traitement medicamenteux des dernieres decennies. Les patients connaissent generalement, au-dela de la periode diagnostique de la maladie, une stabilisation clinique de plusieurs annees. Une degradation de l’IC au cours du temps peut entrainer une limitation fonctionnelle importante, un retentissement systemique important (denutrition, insuffisance renale), particulierement en cas de congestion non maitrisee. Cet etat qualifie d’insuffisance cardiaque avancee (ICA) est souvent difficile a reconnaitre pour le clinicien, alors qu’il s’agit d’une periode charniere ou le projet therapeutique a plus long terme doit etre envisage precocement pour juger de l’eligibilite du patient a des soins lourds que sont la greffe cardiaque, l’implantation d’une assistance ventriculaire gauche. Le poids des comorbidites, le statut psychosocial et le retentissement de l’IC sur l’organisme conditionnent en effet les resultats de ces therapeutiques. Les episodes de decompensations aigues avec etats de choc cardiogenique et defaillance multiviscerale peuvent relever d’une prise en charge en reanimation vers un traitement invasif de la defaillance cardiaque par l’implantation de dispositif d’assistance mecanique et/ou une transplantation cardiaque en urgence. Apres un rappel de la definition de l’ICA, nous aborderons les indications de prise en charge en reanimation des patients en etat de choc cardiogenique, les therapeutiques de support que l’on propose en reanimation et nous discuterons des conditions de realisation des soins de long terme que sont la greffe cardiaque et l’assistance circulatoire.

Bronchiolitis obliterans syndrome (BOS), the main manifestation of chronic lung allograft dysfunction, leads to poor long-term survival after lung transplantation. Identifying predictors of BOS is essential to prevent the progression of dysfunction before irreversible damage occurs. By using a large set of 107 samples from lung recipients, we performed microarray gene expression profiling of whole blood to identify early biomarkers of BOS, including samples from 49 patients with stable function for at least 3 years, 32 samples collected at least 6 months before BOS diagnosis (prediction group), and 26 samples at or after BOS diagnosis (diagnosis group). An independent set from 25 lung recipients was used for validation by quantitative PCR (13 stables, 11 in the prediction group, and 8 in the diagnosis group). We identified 50 transcripts differentially expressed between stable and BOS recipients. Three genes, namely POU class 2 associating factor 1 (POU2AF1), T-cell leukemia/lymphoma protein 1A (TCL1A), and B cell lymphocyte kinase, were validated as predictive biomarkers of BOS more than 6 months before diagnosis, with areas under the curve of 0.83, 0.77, and 0.78 respectively. These genes allow stratification based on BOS risk (log-rank test p

Resume But de l’etude L’immunotherapie specifique est le seul traitement curatif de l’allergie au venin d’hymenoptere. A l’heure actuelle, il n’y a pas de consensus sur la dose d’entretien a utiliser. L’objectif de cette etude etait d’observer l’influence de la dose d’entretien (100 μg versus 200 μg) sur la reponse immunologique apres 5 ans d’immunotherapie allergenique au venin de guepe vespula. Patients et methode Durant la 1 re annee, les patients recevaient tous la dose de 100 μg/mois. En fonction de la dose recue pour la poursuite de l’immunotherapie specifique, ils etaient repartis, de facon retrospective, en 2 groupes. Groupe 200 ( n = 41) : augmentation progressive de la dose d’entretien jusqu’a 200 μg/mois. Groupe 100 ( n = 48) : dose constante de 100 μg/mois. La reponse immunologique etait evaluee sur l’evolution des tests cutanes (modification du seuil de positivite) et des IgE specifiques guepe vespula (pourcentage de decroissance) entre 0 et 5 ans. Une amelioration des tests cutanes etait definie par une positivite avec une concentration de venin plus importante a 5 ans que lors du bilan initial. Resultats Apres 5 ans, l’amelioration du seuil de positivite des tests cutanes etait plus importante ( p = 0,003) dans le groupe 200 (90,2 % des patients) que dans le groupe 100 (74,4 %). La valeur des IgE specifiques guepe vespula, initialement plus elevee dans le groupe 200, devenait identique a celle de l’autre groupe a 5 ans ( p = 0,1). La decroissance globale sur 5 ans des IgE specifiques guepe vespula etait semblable entre les 2 groupes ( p = 0,1). Conclusion L’augmentation des doses de venin a 200 μg s’accompagne d’une amelioration plus importante de la reponse immunologique que le maintien de la dose a 100 μg.

International audience; Objectives: The implantable left ventricular assist device (LVAD) is a major therapeutic development for end-stage heart failure in selected patients. As their use is expanding, infectious complications are emerging, with limited data available to guide their management. We aimed to better characterize LVAD-related infections.Methods: We enrolled all consecutive patients diagnosed with LVAD-related infections in three referral centres in France, using a standardized definition of infections in patients with LVAD. Data were collected from medical charts using a standardized questionnaire.Results: Between 2007 and 2012, 159 patients received LVAD for end-stage heart failure. Among them, 36 (22.6%; 5 women, 31 men) presented at least one infectious complication, after a median time of 2.9 months from LVAD implantation (interquartile range, 1.8-7.5), with a median follow up of 12 months (interquartile range 8-17). Main co-morbidities were alcoholism (33%), diabetes (11%) and immunosuppression (11%). Mean age at implantation was 51 (+/- 11) years. LVAD were implanted as bridge-to-transplantation (n=22), bridge-to-recovery (n=8), destination therapy (n=4), or unspecified (n=2). LVAD-related infections were restricted to the driveline exit site (n=17), had loco-regional extension (n=13), or reached the internal pump (n=3). The main bacteria isolated were Staphylococcus aureus (n=20), coagulase-negative staphylococci (n=7), Enterobacteriaceae (n=14), Pseudomonas aeruginosa (n=10) and Corynebacterium sp. (n=7), with polymicrobial infections in 19 cases. LVAD could be retained in all patients, with the use of prolonged antibacterial treatment in 34 (94%), and debridement in 17 (47%). One patient died due to LVAD-associated infection.Conclusions: LVAD-related infections are common after LVAD implantation, and may be controlled by prolonged antibiotic treatment. (C) 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Background Structural valve degeneration (SVD) remains the main complication of aortic bioprosthesis. The study aimed to evaluate SVD mode, outcome and effect of treatment. Methods Patients with presumed aortic SVD by echocardiography in our institution between January 2010 and December 2016 were included. All-cause mortality, cardiovascular morbidity, and effect of treatment were assessed. Results After exclusion of 4 patients with others causes of increased gradients, 220 patients were analyzed (78 ± 9 years, 52% men). Regurgitant SVD (n = 94, 43%) occurred later than stenotic (n = 126, 57%) SVD (9.2 ± 3.7 vs. 7.9 ± 3.0 years; P = 0.003). Patients with a regurgitant SVD were more symptomatic, had a larger bioprosthesis, and were more often referred to invasive management. Exclusive medical care (Med) was retained in 67 patients, redo-surgery in 89 and VinV in 64. Macroscopic examination of explanted bioprostheses (n = 71) demonstrated severe calcifications in 56.3%, mainly in stenotic SVD (71 vs. 42%, P = 0.02), and leaflet tear in 28%. Overall survival at 35 months was significantly associated with the type of management (VinV: 85.3 ± 4.9%, redo-surgery 86.7 ± 3.8%, Med 60.1 ± 7.7%, P Conclusion Structural valve degeneration remains a matter of concern. Regurgitant SVD occurs later than stenotic SVD which is characterized by a more severe calcification process. Redo-surgery and VinV are associated with a better outcome, independently of failure mode, and should be considered in most SVD patients. Although VinV was proposed to older and higher-risk patients, its effect on overall survival was comparable to redo-surgery in multivariable analysis.

Background : Pediatric dysphagia arises from various etiologies but often coincides with complex health issues. Tasks associated with the management of pediatric dysphagia are often unfamiliar and arduous, leaving a heavy burden on the primary caregiver. Little is known regarding how these experiences affect caregivers and family systems. Aims : This study was conducted to examine dysphagia and its vast implications from a caregiver’s perspective in order to reveal a perceived role in management. Methods & Procedures : A qualitative case study design was chosen. Consistent with this tradition of inquiry, naturalistic data were collected through ethnographic interviewing procedures, collection of artifacts for analysis, and multiple lamination sessions obtained through electronic mail messages. These data were analyzed inductively, in which authors independently reviewed data several times and coded the data line by line with a category of idea or action that represented the raw data. As data collection and analysis continued in a cyclical fashion, several initial categories clumped into more abstract overarching themes related to the participant’s experience with dysphagia. Outcomes & Results : Data interpretation suggests that encounters associated with caring for multiple children with dysphagia are multifaceted and that consequences of dysphagia extend far beyond the individual with dysphagia and into the entire family system. Conclusion : This paper argues for further consideration of social and affective factors in pediatric dysphagia management and the inspection of dysphagia from a dynamic lens that accounts for all layers of the disorder.

Resume Objectif L’hospitalisation en reanimation d’un nouveau-ne (NN) complique la mise en place de l’allaitement maternel (AM). Notre etude recherchait les facteurs gestationnels et maternels, pouvant influencer le taux d’allaitement maternel (TAM) en reanimation. Patients et methodes Etude retrospective en reanimation neonatale a l’hopital Beclere, centre perinatal de type 3, du 1 er mai 2009 au 30 avril 2010 avec recueil des donnees maternelles, neonatales et de l’alimentation neonatale dans les dossiers. Resultats Les prematures representaient 74,8 % des 460 dossiers etudies. Le poids de naissance (PN) median etait de 1900 g. Le TAM initial, de 58,7 %, diminuait a 43,9 % a la sortie du service. Un TAM plus important etait associe : aux grossesses par procreation medicalement assistee (PMA) (70,3 % versus 55,8 %, p p p Discussion Le TAM etait inferieur aux recommandations internationales. Chez les NN en reanimation, une grossesse issue de PMA est decrite pour la premiere fois comme facteur positif pour l’AM. Un âge maternel plus eleve et un nombre de grossesses multiples plus frequent en cas de PMA peuvent l’expliquer, mais aussi une information – allaitement plus soutenue en prenatal. L’initiation de l’AM et sa prolongation necessitent une formation des personnels pour un discours precoce unique et coherent.

This paper explores whether the poor mastery of morphosyntax exhibited by second language (L2) learners can be tied to difficulties with non-syntactic processing. Specifically, we examine whether problems with English regular and irregular past tense are related to poor L2 phonological ability and lexical access, respectively. In Experiment 1, L2 learners showed poorer past tense mastery than native English speakers in grammaticality judgment and production tasks. L2 phonological ability was positively correlated with correct performance on regular verbs and negatively with unmarked production. L2 lexical access was positively correlated with correct performance on irregular verbs, and negatively with overregularization production. Experiment 2 simulated these difficulties in native English speakers by placing them under phonological processing (noise) or lexical access (deadline) stress. Noise selectively impacted regular verbs in grammaticality judgment but impacted all verb types in production. Deadline pressure impacted irregular verbs while sparing regular verbs across both tasks. Thus, non-syntactic processing difficulties can have specific impacts on morphosyntactic performance in both non-native and native English speakers.

This perceptual study describes changes in how listeners perceive VCV elements within successive truncations taken from an iambic phrase containing /l/ (e.g. a leaf, or a load) spoken by four male speakers of General American English. Evidence of the respective roles of dorsal gestural affiliation between /l/ and the reduced vowel, (V(1)CV(2)), and gestural separation from a tautosyllabic high front vowel (V(2)) were demonstrated. Coproduction of dark-l with a preceding reduced vowel was evident in early reports of back vowels or diphthongs, particularly when the carrier word contained a front vowel, and was noted more in darker-l than lighter-l speakers. The pairing of /l/ with a tautosyllabic front vowel reduced earlier identification of /l/, whereas its pairing with a back vowel enhanced early identification. The role of perceived contrast in identification of /l/ was reflected in changes in listener's perception of the reduced vowel across successive truncations. Clinical implications are addressed.

Auteur(s) : D Leguay, E Giraud-Baro, B Lievre, J Dubuis, A Cochet, C Roussel, M Duprez, P Bantman, J-L Roelandt, G Vidon Comite francais pour la rehabilitation psychosociale (Reh@b’) Avant-propos A Versailles, le bureau du Comite francais pour la rehabilitation psychosociale (CFRP) a pris le risque de proposer aux congressistes, pour amendements et validation, un texte d’orientation rassemblant les « fondamentaux » de la rehabilitation psychosociale et formulant un certain [...]

In the following study, participants encoded blocked DRM word lists and we varied whether they received information before test about the utility of mnemonic features that potentially discriminate between veridical and false memories. The results of three experiments revealed that this manipulation successfully reduced false recognition of critical theme words. We also found that this manipulation was effective for younger but not older adults. Furthermore, calling attention to the features in test instructions alone was sufficient for reducing false recognition and its effectiveness was not enhanced by also asking participants to rate their phenomenal experience. We argue that providing diagnostic information before test allows participants to establish more accurate expectations about the task and thus improves the efficacy of retrieval and monitoring processes that are subsequently engaged.

Background: The EDIFICE survey aimed to investigate the compliance of the general population to the screening tests available in France for the 4 most common cancers: breast, colorectal, prostate and lung. Implementation of breast cancer screening has been generalized in France since 2003: women aged between 50 and 74 years are systematically invited to perform a mammography every second year. Results pertaining to breast cancer are reported hereafter. Methods: This nationwide observational survey was carried out in France from 18 January to 2 February 2005 among representative samples of 773 women aged between 40 and 75 years and 600 general practitioners (GPs). Information collected included socio-demographic characteristics, attitude towards cancer screening and actual experience of cancer screening, as well as GPs' practice regarding screening. The precision of the results is ± 4.3% for a 95% confidence interval. Results: Among the 507 participating women aged between 50 and 74 years, 92.5% (469/507) had undergone at least one mammography: 54.6% (256/469) underwent this test on their own initiative and 44.6% (209/469) of women performed it in the framework of a systematic screening plan. Most women participating in the systematic screening (89.0% i.e. 186/209) had a mammography within the last dating from less than 2 years versus 73.8% (189/256) of those who performed it outside the screening program (Chi2 test; p Conclusion: The main result of the EDIFICE survey is the high rate of women's attendance at mammography screening. The EDIFICE survey pointed out that systematic and organized screening played a major role in the regularity of screening tests for breast cancer every second year. GPs and gynaecologist are key actors in heightening public awareness.

According to signal detection theory (SDT), retrieval warnings may decrease false memory in the associative list paradigm either by inducing a conservative criterion shift or by decreasing the amount of evidence that critical theme words were studied. Fitting a SDT model to 12 existing datasets revealed suggestive evidence that warnings impact critical theme evidence, and two new experiments confirmed this conclusion. We argue that this pattern of results is consistent with warned participants relying less on relational and more on item-specific forms of information at retrieval as compared to unwarned participants. We conclude that warnings enhance metamnemonic awareness, thus allowing participants to select a retrieval strategy that capitalizes on discriminative forms of evidence.

Three experiments explored the issue of whether enhanced metamnemonic knowledge at retrieval can improve participants' ability to make difficult source discriminations in the context of the eyewitness suggestibility paradigm. The 1st experiment documented differences in phenomenal experience between veridical and false memories. Experiment 2 revealed that drawing participants' attention to these differences by pairing the ratings of the features with instructions about their utility was successful in reducing source misattributions of suggested items to the event. The results of Experiment 3 showed that participants can make online adjustments in the types of evidence used to make source judgments, as participants who received correct feedback during the training portion of the test reduced misattribution errors on the remainder of the test where feedback was not provided. Altogether, these studies suggest that people can discover and benefit from updated knowledge of the types of memorial evidence that discriminate between sources of information in memory.

This paper presents a four-subject study that examines the relative influence of syllable position and stress, together with vowel context on the colouring of the dark-l characteristic of speakers of General American English. Most investigators report lighter /l/ tokens in syllable onsets and darker tokens in coda positions. The present study demonstrates that when dark-l serves as an onset in iambic intervocalic context with tautosyllabic high front vowels, it is fully dark as a result of domain-initial strengthening. By contrast, when dark-l is abutted across a word boundary to word-final or word-initial consonants, or when it is contained in a foot-internal context (preboundary intervocalic rime with trochaic stress) its dorsal gesture is constrained, resulting in less dark tokens. In the case of dark-l, articulatory undershoot must be understood not only in terms of the alveolar gesture, but also the dorsal gesture.

We present a new mobile instrument for measuring dynamically the gravity vector and its gradients in underwater environment, named GRAVIMOB. Our instrument is a strapdown sensor, consisted of electrostatic accelerometers installed in a waterproof sphere. It is designed to be embedded in an Autonomous Underwater Vehicle (AUV). Since the positioning of an AUV is approximate in underwater environment, the key issue raised here is to estimate the uncertainty in the gravity field resulting from the use of such position data. This paper focuses on the assessment of the system performances. The latter have been studied by simulation with reference data calculated from actual submarine geological structures, on which different noise models have been added. Results show that spatial evolutions of the gravity field and statistical properties of stochastic processes affecting the measurements have to be considered carefully in order the minimize the error. The Unscented Kalman Filter (UKF) has been favored to the Extended Kalman Filter (EKF) by its ease of implementation and its better robustness to non-linearities.

This paper investigates the applicability of the soft phonation index (SPI) as an indicator of vocal fold adduction. The SPI is one of 33 acoustic parameters calculated and displayed from a single vocalization by the multi-dimensional voice program (MDVP). A review of pertinent literature revealed that while increased values of SPI are presumed to be associated with incomplete adduction of the vocal folds, results should be interpreted cautiously as the index has not been sufficiently studied. The purpose of this pilot study was to determine how consistently SPI tracks systematic changes in vocal fold adduction. Samples of normal, breathy and pressed phonation produced by female speakers were analysed. As predicted, a significant increase in SPI for breathy productions was demonstrated. However, increases in SPI were also noted for pressed phonation. Possible explanations and implications for clinical application are discussed.

This paper presents a single-subject case study illustrating the need to closely examine effects of dialect from syllable position on l-colouring, and the effects of domain-initial strengthening in General American English. Most investigators report lighter /l/ tokens in syllable onsets and darker tokens in coda positions in isolated words. The present study demonstrates an enhanced darkened onset /l/ in front vowel prosodic word (PW) boundaries, but lighter codas at PW-internal boundaries. We address the importance for clinicians of recognizing the impact of prosody on restructuring syntactic boundaries and its consequent effects on /l/ articulation.

Introduction Face a un tableau d’angiœdeme (AO) histaminique, il est d’usage d’ecarter un AO bradykinique. L’association concomitante d’un AO brakykinique hereditaire par deficit en C1 inhibiteur et d’un AO histaminique n’a jamais ete rapportee. Resultats Nous rapportons le cas d’une patiente de 22 ans ayant presente 2 episodes d’anaphylaxie a l’âge de 15 ans a type d’AO du visage, dyspnee et douleurs abdominales suite a la consommation de blanc d’œuf cru. Le test cutane etait positif pour le blanc d’œuf a 30 mm. Les IgE ovalbumine etaient a 50,4 KU/L et les IgE ovomucoide a 27,6 KU/L. La patiente rapportait egalement des episodes d’anaphylaxie apres prise d’arachie et soja, avec tests cutanes et IgE positifs. Le diagnostic d’AO histaminique etait retenu avec disparition des symptomes apres regime d’eviction. La patiente rapportait egalement de violentes douleurs digestives durant 48–72 heures mais sans œdeme de Quincke et necessitant de multiples hospitalisations. Le taux de CH50 etait effondre et le dosage ponderal du C1 inhibiteur etait abaisse a 162 mg/L (N : 210–355), tout comme l’activite inhibitrice. L’analyse genetique mettait en evidence une variation heterozygote dans l’exon 7 du gene SERPING1. Le diagnostic d’AO hereditaire par deficit en C1 inhibiteur etait retenu. Le traitement consistait en la mise a disposition d’une trousse d’urgence contenant de l’adrenaline en cas de reaction anaphylactique et de l’icatibant acetate (FIRAZYR™) en cas d’AO bradykinique. Au cours de la derniere annee, la patiente a rapporte un episode de douleurs abdominales par mois, necessitant une fois sur deux l’injection de FIRAZYR™ avec une tres bonne et rapide efficacite. Discussion Il s’agit du premier cas rapporte d’AO bradykinique hereditaire par deficit en C1 inhibiteur associe a un AO histaminique par allergies alimentaires severes. Le diagnostic d’AO histaminique ne doit pas exclure de facon systematique le diagnostic d’AO bradykinique car ces deux entites peuvent etre associees. Il est pertinent de rechercher un AO bradykinique en cas de reponse incomplete au traitement de l’AO histaminique, en cas d’atypie clinique ou d’histoire familiale.

Summary Polyglycerol (PG), an agricultural by-product of diester industry, was reacted with maleic anhydride (MA) to give heat curable compounds which are useful for impregnating wood to improve biological resistance, dimensional stability and strength. The relationships between reaction conditions of polyglycerol/maleic anhydride (PG/MA) adduct treatment and performance of treated solid wood were investigated. Conditions recommended for producing PG/MA treated wood durable for a long time are vacuum/pressure impregnation of aqueous solutions of PG/MA adduct (30%) in the presence of 2-butanone peroxide (2%) and cobalt naphthenate (2%).