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Rat bite fever is characterized by a clinical triad of symptoms, fever, rash and arthritis. It is transmitted by rodents and mainly due to infection by Streptobacillus moniliformis, a fastidious bacterium carried by Rattus norvegicus. This case report presents the case of a patient who developed septic arthritis and fever after a wild rat bite, with subsequent isolation of S. moniliformis from the joint fluid. Upon reviewing 45 other published case reports of S. moniliformis osteoarticular infections following contact with either a rat or its secretions, it was firstly observed that the rat bite fever clinical triad was incomplete in over half of the cases, mainly because rash was infrequently observed among adult patients. Secondly, the clinical presentation of rat bite fever is quite non-specific and rodent exposure is not mentioned by patients in a third of cases upon admission. Altogether, diagnosing rat bite fever is a significant clinical challenge suggesting that it might be significantly underdiagnosed. In addition to these clinical aspects, no evidence was found supporting immunological mechanisms, as suggested in some literature. Instead, when excluding five improperly performed cultures, S. moniliformis was cultured in 25 reported cases and identified twice by direct PCR sequencing amounting to a detection rate of 90% (n = 27/30) on joint fluids. Cultures should be performed in medium containing yeast extract, complete peptic digest of animal tissue and at least 5% blood. Knowing that S. moniliformis is very sensitive to many antibiotics thereby making the culture negative, direct 16S rRNA gene sequencing on joint fluid is an alternative method in the case of clinical and cytological evidence of osteoarticular infections with sterile culture of joint fluid.

Abstract Background Self-discharge is a risk factor for readmission and excess mortality. We assess the rate of self-discharge from the emergency department (ED) among presentations for acute recreational drug toxicity and identify factors associated with self-discharge. Methods From the Euro-DEN Plus database of presentations to the ED with acute recreational drug toxicity, we extracted data from 11 centres in seven European countries from 2014 to 2017. Self-discharge was defined as taking one’s own discharge or escaping from the ED before being medically cleared. We used multiple logistic regression analyses to look for factors associated with self-discharge. Results Among 15,135 included presentations, 1807 (11.9%) self-discharged. Self-discharge rates varied from 1.7 to 17.1% between centres. Synthetic cannabinoids were associated with self-discharge, adjusted odds ratio 1.44 (95% confidence interval 1.10–1.89), as were heroin, 1.44 (1.26–1.64), agitation, 1.27 (1.10–1.46), and naloxone treatment, 1.27 (1.07–1.51), while sedation protected from self-discharge, 0.38 (0.30–0.48). Conclusion One in eight presentations self-discharged. There was a large variation in self-discharge rates across the participating centres, possibly partly reflecting different discharge procedures and practices. Measures to improve the management of agitation and cautious administration of naloxone to avoid opioid withdrawal symptoms may be approaches worth exploring to reduce self-discharge.

Thermophilic C. jejuni/coli is reported to be the first bacterial cause of gastroenteritis worldwide and the most common zoonosis in Europe. Although non-jejuni/coli Campylobacter sp. are increasingly suspected to be responsible for diarrhoea or to be involved in inflammatory bowel disease, they remain poorly isolated due to their fastidious and non-thermophilic nature. Additionally, they are not targeted by commercial syndromic PCR assays. In this study, we present routine diagnostic results over 6 years (2017–2019 and 2021–2023) of Campylobacter sp. and related species, obtained by optimised culture from 51,065 stools by both 0.65 µm pore filtration on antibiotic-free agar, incubated in an H2-enriched atmosphere at 37 °C (also known as the Cape Town protocol), and the use of selective inhibitory Butzler medium incubated at 42 °C. This allowed the isolation of 16 Campylobacter species, 2 Aliarcobacter species, and 2 Helicobacter species, providing a completely different view of the epidemiology of Campylobacterales, in which C. jejuni/coli represents only 30.0% of all isolates, while C. concisus represents 44.4%. C. ureolyticus, representing only 5.5% of all Campylobacterales pre-COVID-19, represented 20.6% of all strains post-COVID-19 (218% increase; p < 0.05). At the same time, the proportions of C. jejuni, C. coli, and C. concisus decreased by 37, 53, and 28%, respectively (p < 0.05).

Catalytic total oxidation is an effective technique for the treatment of industrial VOCs principally resulting from industrial processes using solvents and usually containing mono-aromatics (BTEX) and oxygenated compounds (acetone, ethanol, butanone). The aim of this work is to deposit gold nanoparticles on CoAl mixed oxide issued from layered double hydroxide (LDH) precursor by using the deposition precipitation (DP) method, which is applied with two modifications, labeled method (A) and method (B), in order to enhance the interaction of the HAuCl4 precursor with the support. Method (A) involves the hydrolysis of the HAuCl4 precursor after addition of the support, while in method (B), the gold precursor is hydrolyzed before adding the support. The two methods were applied using as support the CoAl mixed oxide and the LDH precursor. Samples were characterized by several physical chemical techniques and evaluated for ethanol total oxidation. Method (B) allowed the ethanol oxidation activity to be enhanced for the resulting Au/CoAlOx catalysts thanks to the high surface concentration of Co2+ and improved reducibility at low temperature. The presence of gold permits to minimize the formation of by-products, notably, methanol, allowed for a total oxidation of ethanol at lower temperature than the corresponding support.

Abstract Background Subcutaneous tocilizumab (TCZ SC) is approved globally for giant cell arteritis (GCA). This phase Ib study investigated the pharmacokinetics, pharmacodynamics, safety, and exploratory efficacy of intravenous (IV) TCZ 6 and 7 mg/kg in patients with GCA. This study explored an IV dose resulting in a minimum exposure level within the range of effective trough concentrations achieved with TCZ SC dosing in GCA and not exceeding the exposure of the well-tolerated 8 mg/kg IV every 4 weeks (Q4W) in rheumatoid arthritis (RA). Methods Patients with GCA who had received ≥ 5 doses of TCZ IV 8 mg/kg Q4W and achieved remission were enrolled. Patients received 5 doses of TCZ IV 7 mg/kg Q4W in period 1 and, if still in remission, 5 doses of 6 mg/kg Q4W in period 2. Pharmacokinetic endpoints were maximum concentration (C max), minimum concentration (C trough), area under the curve over a dosing interval (AUC τ ), and mean concentration (C mean) of TCZ after the last dose of each period. Other endpoints included pharmacodynamic markers, safety, and exploratory efficacy. Results In 24 patients, the median (range) age was 65.5 (57–90) years, and 62.5% were female. TCZ exposures (C max and AUC τ ) were 11.2% and 20.0% lower at the 6- than 7-mg/kg dose. The mean interleukin 6 (IL-6) serum concentrations were elevated at baseline and remained elevated, with slightly higher concentrations in period 1 than in period 2. The mean serum soluble IL-6 receptor concentrations were elevated at baseline and comparable between the 2 doses at steady state. C-reactive protein levels and most erythrocyte sedimentation rates were within normal ranges throughout the study. Overall, 22 patients (91.7%) had ≥ 1 adverse event, and 4 (16.7%) had a serious adverse event. No patients experienced a GCA flare, and all remained in remission throughout the study. Conclusions Both doses of TCZ IV Q4W were generally well tolerated in patients with GCA. The C max and C mean achieved with 6 mg/kg IV Q4W in patients with GCA were similar to those in patients with RA treated with 8 mg/kg IV Q4W, and C trough was within the range observed in patients with GCA treated with SC dosing every week or every 2 weeks. Trial registration ClinicalTrials.gov , NCT03923738

Since early 2020, the COVID-19 pandemic has had a dramatic impact on the way we live, with European countries having to introduce unprecedented measures to protect public health. As with all areas of life, drug consumption, related harms and drug markets have been impacted, as have the drug services established to respond to drug-related problems. Since the start of the pandemic in March 2020, the European Monitoring Centre for Drugs and Drug Addiction instigated three rapid assessment studies to identify the initial impact and implications of COVID-19 on drug markets, use, harms and drug services in the community and in prisons. Findings from these studies revealed that the pandemic and associated health prevention measures implemented by the countries impacted drug markets and use differently depending on the different periods and events throughout the pandemic, but also according to particular drugs or user characteristics. Most drug services remained operational throughout the pandemic in order to assure continuity of care. This was achieved by innovation and adaptation of their services, especially during the different lockdown periods. Thus, the results from these rapid assessments provide a glimpse into new developments in the drugs field across European countries emerging both during and in response to the pandemic, and which could have important implications for the future.

Restoration of an anatomic joint line after anatomic total shoulder arthroplasty and of the optimal lateral offset after reverse total shoulder arthroplasty may be relatively straightforward when the glenoid does not present with severe erosion. However, in cases of severe glenoid bone loss, the surgeon is left with no preoperative landmark to restore these parameters. The objective of this study was to use statistical shape modeling, to predict the premorbid morphology of the glenoid. We hypothesized that this would allow us to accurately determine premorbid glenoid version and inclination, in addition to accurately quantifying bone loss and medialization. Fifty-six bilateral computed tomography scans of the shoulders of patients scheduled for shoulder arthroplasty and determined to have unilateral osteoarthritis (primary osteoarthritis or cuff tear arthropathy with a healthy contralateral side) were obtained. A statistical shape model was automatically applied on the pathologic arthritic side to predict its premorbid anatomy. Glenoid version, inclination, height, width, and glenoid and scapula lateral offset were measured automatically. These measurements were obtained on the pathological arthritic cases, on the contralateral control healthy cases, and on the premorbid predictions of the pathological arthritic cases and were compared pair by pair. The mean difference between the pathological arthritic side and the contralateral healthy side was 9.1° ± 7.3° for version, 4.8° ± 4.8° for inclination, 4.9 ± 4.5 mm for height, 4.7 ± 5.3 mm for width, 2.4 ± 1.9 mm for scapula lateral offset, and the glenoid lateral offset was 1.5 ± 1.5 mm. The mean difference between the premorbid prediction of the pathological side and the contralateral healthy side was reduced to 3.3° ± 2.4° for version, 3.4° ± 2.6° for inclination, 3.0 ± 1.9 mm for height, 2.3 ± 1.4 mm for width, 2.2 ± 1.7 mm for scapula lateral offset, and the glenoid lateral offset was 0.9 ± 0.8 mm. This study shows that statistical shape modeling can allow accurate prediction of the premorbid morphology of the glenoid. This could help optimize implant selection and positioning after anatomic total shoulder arthroplasty and reverse total shoulder arthroplasty to restore optimal soft-tissue tension. [ABSTRACT FROM AUTHOR]

This study aimed to characterize patients admitted to critical care following Emergency Department (ED) presentation with acute recreational drug toxicity and to identify determinants of admission to critical care. A retrospective multicenter matched case-control study was conducted by the European Drug Emergency Network Plus (Euro-DEN Plus) over the period 2014–2021. The cases were ED presentations with acute recreational drug toxicity admitted to critical care, the controls consisted of ED presentations with acute recreational drug toxicity medically discharged directly from the ED. The potential determinants of admission to critical care were assessed through multivariable conditional stepwise logistic regression analysis and multiple imputation was used to account for the missing data. From 2014 to 2021, 3448 Euro-DEN Plus presentations involved patients admitted to critical care (76.9% males; mean age 33.2 years; SD 10.9 years). Patient age ≥35 years (as compared to ≤18 years) was a determinant of admission to critical care following acute recreational drug toxicity (adjusted odds ratio, aOR, 1.51, 95% confidence interval, CI, 1.15–1.99), along with polydrug use (aOR 1.39, 95% CI 1.22–1.59), ethanol co-ingestion (aOR 1.44, 95% CI 1.26–1.64), and the use of gamma-hydroxybutyrate/gamma-butyrolactone (GHB/GBL, aOR 3.08, 95% CI 2.66–3.57). Conversely, lower odds of admission to critical care were associated with the use of cocaine (aOR 0.85, 95% CI 0.74–0.99), cannabis (aOR 0.44, 95% CI 0.37–0.52), heroin (aOR 0.80, 95% CI 0.69–0.93), and amphetamine (aOR 0.65, 95% CI 0.54–0.78), as was the arrival to the ED during the night (8 p.m.–8 a.m., aOR 0.88, 95% CI 0.79–0.98). These findings, which deserve confirmation and further investigation, could contribute to a more complete understanding of the decision-making process underlying the admission to critical care of patients with acute recreational drug toxicity.

Cu (10 wt%) materials on silica nanotubes were prepared via two different synthetic approaches, co-synthesis and wetness impregnation on preformed SiO2 nanotubes, both as dried or calcined materials, with Cu(NO3)2.5H2O as a material precursor. The obtained silica and the Cu samples, after calcination at 550 °C for 5 h, were characterized by several techniques, such as TEM, N2 physisorption, XRD, Raman, H2-TPR and XPS, and tested for toluene oxidation in the 20–450 °C temperature range. A reference sample, Cu(10 wt%) over commercial silica, was also prepared. The copper-based silica nanotubes exhibited the best performances with respect to toluene oxidation. The Cu-based catalyst using dried silica nanotubes has the lowest T50 (306 °C), the temperature required for 50% toluene conversion, compared with a T50 of 345 °C obtained for the reference catalyst. The excellent catalytic properties of this catalyst were ascribed to the presence of easy copper (II) species finely dispersed (crystallite size of 13 nm) on the surface of silica nanotubes. The present data underlined the impact of the synthetic method on the catalyst properties and oxidation activity.

The adsorption of proteins on surfaces has been studied for a long time, but the relationship between the structural and functional properties of the adsorbed protein and the adsorption mechanism remains unclear. Using hemoglobin adsorbed on silica nanoparticles, we have previously shown that hemoglobin’s affinity towards oxygen increases with adsorption. Nevertheless, it was also shown that there were no significant changes in the quaternary and secondary structures. In order to understand the change in activity, we decided in this work to focus on the active sites of hemoglobin, the heme and its iron. After measuring adsorption isotherms of porcine hemoglobin on Ludox silica nanoparticles, we analyzed the structural modifications of adsorbed hemoglobin by X-ray absorption spectroscopy and circular dichroism spectra in the Soret region. It was found that upon adsorption, there were modifications in the heme pocket environment due to changes in the angles of the heme vinyl functions. These alterations can explain the greater affinity observed.

The effect of the Co-Cu oxide catalysts composition on their physicochemical properties and performance in the deep oxidation of ethanol was studied. The catalysts with Co:Cu molar ratios of 4:1, 1:1, and 1:4 were obtained by calcination (4 h at 500 °C in air) of the coprecipitated precursors and characterized in detail using powder XRD, Raman spectroscopy, N2 physisorption, H2-TPR, and XPS. The powder XRD and Raman spectroscopy indicated the formation of Co3O4 and CuO mixtures rather than Co-Cu mixed oxides. The CuO promoted the Co3O4 reduction; the Co-Cu catalysts were reduced more easily than the single-component Co and Cu oxides and the main reduction maxima were shifted to lower temperatures with increasing cobalt content in the catalysts. The Co-Cu oxide catalyst with a Co:Cu molar ratio of 4:1 exhibited the best performance in ethanol gas-phase oxidation, showing the lowest T50 (91 °C) and T90(CO2) (159 °C) temperatures needed for 50% ethanol conversion and 90% conversion to CO2, respectively. The excellent catalytic properties of this Co-Cu oxide catalyst were ascribed to the synergistic effect of Co and Cu components. The high activity and selectivity of the Co-Cu catalyst was attributed to the presence of finely dispersed CuO particles on the surface of Co3O4.

Total shoulder arthroplasty (TSA) aims to reconstruct the premorbid anatomy of a pathologic shoulder. A healthy contralateral shoulder could be useful as a template in planning TSA. The symmetry between the left and right shoulders in healthy patients remains to be proved. The purpose of this study was to compare the 3-dimensional anatomy of the glenoid between sides in a healthy population. A multinational computed tomography scan database was retrospectively reviewed for all healthy bilateral shoulders in patients aged between 18 and 50 years. One hundred thirty pairs of healthy shoulder computed tomography scans were analyzed, and glenoid version, inclination, width, and height, as well as glenoid lateral offset and scapula lateral offset, were measured. All anatomic measures were computed with Blueprint, validated 3-dimensional planning software. The intraclass correlation coefficient was determined for each measure between left and right shoulders. The minimal detectable change (MDC) was calculated using the following formula: MDC = 2 × 1.96 × Standard error of measurement. The comparison between 130 pairs of healthy scapulae showed statistically significant differences in absolute values between right and left glenoid version (−5.3° vs. −4.6°, P <.01), inclination (8.4° vs. 9.3°, P <.01), and width (25.6 mm vs. 25.4 mm, P <.01), as well as scapula offset (105.8 mm vs. 106.2 mm, P <.01). Glenoid height was comparable between right and left shoulders (33.3 mm vs. 33.3 mm, P =.9). The differences between the means were always inferior to the MDC regarding glenoid version, inclination, height, and width, as well as scapula offset. Very strong intraclass correlation coefficients between the left and right shoulders were found for all evaluated paired measures. Healthy contralateral scapulae are highly reliable to predict inclination, height, width, and scapula offset and are reliable to predict version of a given scapula. Paired right and left scapulae were not statistically symmetrical regarding mean glenoid version, inclination, and width, as well as scapula offset. Nevertheless, the reported differences were not higher than the MDC for this cohort, confirming that healthy contralateral shoulders can be a useful template in TSA preoperative planning. [ABSTRACT FROM AUTHOR]

Abstract During bloodstream infections, rapid adaptation of empirical treatment according to the microorganism identified is essential to decrease mortality. The aim of the present study was to assess the microbiological performances of a new rapid version of the Sepsityper® kit (Bruker Daltonics) allowing identification of bacteria and yeast by MALDI-TOF mass spectrometry directly from positive blood cultures in 10 min and of the specific MBT-Sepsityper module for spectra analysis, designed to increase identification performance. Identification rates were determined prospectively on 350 bacterial and 29 fungal positive blood cultures, and compared to conventional diagnostic method. Our rapid diagnosis strategy (Rapid Sepsityper® protocol: one spot with and one without formic acid extraction step) combined to MBT-Sepsityper module provided 65.4%, 78.9% and 62% reliable identification to the species level of monomicrobial positive blood cultures growing respectively Gram-positive, Gram-negative bacteria or yeast. Importantly, identification rates of Gram-positive bacteria were higher in anaerobic than in aerobic bottles (77.8% vs 22.2%; p = 0.004), if formic acid extraction step was performed (60.8% vs 39.2%; p = 1.8e−6) and if specific MBT-Sepsityper module was used (76.2% vs 61.9%, p = 0.041) while no significant differences were observed for Gram-negative bacteria. For yeasts identification, formic acid extraction step improved rapid identification rate by 37.9% while the specific MBT-Sepsityper module increased overall performances by 38%, providing up to 89.7% reliable identification if associated with the standard Sepsityper® protocol. These performances, associated with a reduce turnaround time, may help to implement a rapid identification strategy of bloodstream infections in the routine workflow of microbiology laboratories.

It is common knowledge that Breton folk songs, called gwerzioù, tell a true or supposedly true story. Passed down through the generations by word of mouth, some have enjoyed a lengthy run in the Breton oral tradition. However, this transmission from one memory to the next over many decades and even centuries in some cases is thought to have inevitably impacted their content. Hence, because they come with this caveat, these pieces have long been neglected by historians. However, Donatien Laurent’s work in this field has changed this situation. By cross-analysing the events presented in the songs with written archive documents, he has been able to prove their veracity. The present study was in line with Laurent’s work. The results confirmed that a priest from Pont-Melvez was assassinated in 1670 by another cleric over a matter of jealousy between two families.

The discussion here involves four union leaders (two male and two female) looking at how they have positioned and continue to position themselves vis-a-vis France’s Yellow Jackets movement. The first thing to note is an occasional divergence in the way that the four individuals – two belonging to the Solidaires union and two to the CGT - analyse the situation. Interestingly, their differences cannot be explained by the unions to which they below nor by the particular nature of the socioeconomic regions where they operate (Greater Paris and the areas around Orléans or Toulouse). All signs point to the likelihood that the social movement’s impact on French unions will be permanent.

BackgroundThis study was conducted to retrospectively assess the relationships between: rhabdomyolysis (quantified by creatine kinase (CK) activity) and kidney injury (quantified by serum creatinine concentration), sex, age, body temperature on admission, presence of seizures, and agitation or aggression in patients presenting to the Emergency Department with acute recreational drug toxicity. We also investigated the association with the substances ingested.MethodsAll presentations to the 16 sentinel Euro-DEN centres in 10 European countries with acute recreational drug toxicity during the first year of the Euro-DEN study (October 2013 to September 2014) were considered. Cases that had abnormal CK activity recorded as part of routine clinical care were divided into 3 cohorts depending on peak CK activity. Cases with normal CK activity were included as a control group (4th cohort).ResultsOnly 1,015 (18.4%) of the 5,529 Euro-DEN presentations had CK activity concentration recorded. Of this group 353 (34.8%) had also creatinine concentration measured. There were 375 (36.9%) with minor rhabdomyolysis, 69 (6.8%) with moderate rhabdomyolysis, and 24 (2.4%) with severe rhabdomyolysis; 547 (53.9%) were included in the control group. There was a positive correlation between CK activity and creatinine concentration (correlation coefficient r = 0.71, pConclusionsAbnormal values of CK activity occurred in almost half (46.1%) of presentations to the Emergency Department with acute recreational drug toxicity in whom CK activity was measured; however, severe rhabdomyolysis is seen in only a small minority (2.4%). Those with rhabdomyolysis are at significantly higher risk of kidney injury and have a longer length of hospital stay.

Background-Aims: New psychoactive substances (NPS) are new narcotic or psychotropic drugs that are not controlled by the drug conventions of the United Nations. In the last 10 years, numerous NPS have been identified in Europe but there is no comprehensive overview of mortality related to them. This study aims to estimate the mortality related to NPS in Europe in 2016 and 2017. Methods: The number of drug-related deaths (DRD) 2016-2017 was retrieved from a) the annual national reports of European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) countries (Statistical Bulletin (2018/2019) and ‘Harms and harm reduction workbooks’ (2017/2018)) and b) EMCDDA Risk Assessment Reports of the EU Early Warning System on several specific NPS (2017-2018). Population data was retrieved from Eurostat (2016/2017). Incidence of DRD and of DRD involving at least one NPS was calculated. Findings: Of all DRD recorded in Europe, 11.7% in 2016 and 18.1% in 2017 involved at least one NPS (NPS-DRD), from 2.7 to 4.9 deaths per million of 15 to 64-year-old inhabitants. Between 2016 and 2017, a significant increase was observed (30%, odds ratio 1.33, CI95% 1.26-1.45, p

In the autumn of 2020, a short-lived epidemic of a spike del69-70 deletion variant of SARS-CoV-2 was identified, with most cases (n = 95) found in Montceau-les-Mines, France. This spike gene target failure (SGTF) variant spread quickly in nursing homes. The Alpha variant, which also harbors this deletion, appeared in Burgundy in January 2021 after the disappearance of the Montceau-les-Mines del69-70 variant. Our findings illustrate the risk of the fast spread of geographically isolated variants and reinforce the need for the continuous tracking of outbreaks. In some cases, these studies may reveal emerging variants that affect public health or vaccine development.

BackgroundNeuromyelitis optica spectrum disorders (NMOSD) is a primary astrocytopathy driven by antibodies directed against the aquaporin-4 water channel located at the end-feet of the astrocyte. Although blood-brain barrier (BBB) breakdown is considered one of the key steps for the development and lesion formation, little is known about the molecular mechanisms involved. The aim of the study was to evaluate the effect of human immunoglobulins from NMOSD patients (NMO-IgG) on BBB properties.MethodsFreshly isolated brain microvessels (IBMs) from rat brains were used as a study model. At first, analysis of the secretome profile from IBMs exposed to purified NMO-IgG, to healthy donor IgG (Control-IgG), or non-treated, was performed. Second, tight junction (TJ) proteins expression in fresh IBMs and primary cultures of brain microvascular endothelial cells (BMEC) was analysed by Western blotting (Wb) after exposition to NMO-IgG and Control-IgG. Finally, functional BBB properties were investigated evaluating the presence of rat-IgG in tissue lysate from brain using Wb in the rat-model, and the passage of NMO-IgG and sucrose in a bicameral model.ResultsWe found that NMO-IgG induces functional and morphological BBB changes, including: 1) increase of pro-inflammatory cytokines production (CXCL-10 [IP-10], IL-6, IL-1RA, IL-1β and CXCL-3) in IBMs when exposed to NMO-IgG; 2) decrease of Claudin-5 levels by 25.6% after treatment of fresh IBMs by NMO-IgG compared to Control-IgG (p = 0.002), and similarly, decrease of Claudin-5 by at least 20% when BMEC were cultured with NMO-IgG from five different patients; 3) a higher level of rat-IgG accumulated in periventricular regions of NMO-rats compared to Control-rats and an increase in the permeability of BBB after NMO-IgG treatment in the bicameral model.ConclusionHuman NMO-IgG induces both structural and functional alterations of BBB properties, suggesting a direct role of NMO-IgG on modulation of BBB permeability in NMOSD.

Neuromyelitis optica spectrum disorder (NMOSD) is a rare and severe auto-immune disease of the central nervous system driven by pathogenic antibodies mainly directed against aquaporin-4 (AQP4-Ab). Treatment of NMOSD currently relies on immunosuppressants (mycophenolate mofetil, azathioprine) or B-cell-depleting therapy (rituximab). B-cell differentiation into antibody-producing cells requires T follicular helper cells (Tfh). There are several Tfh subsets that differentially affect B-cell differentiation; Tfh2 and Tfh17 subsets strongly support B-cell differentiation. By contrast, Tfh1 lack this capacity and T follicular regulatory cells (Tfr), inhibit B-cell differentiation into antibody-producing cells. We performed a broad characterization of circulating Tfh subsets in 25 NMOSD patients and analyzed the impact of different treatments on these subsets. Untreated NMOSD patients presented a Tfh polarization toward excessive B-helper Tfh subsets with an increase of Tfh17 and (Tfh2+Tfh17)/Tfh1 ratio and a decrease of Tfr and Tfh1. Rituximab restored the Tfh polarization to that of healthy controls. There was a trend toward a similar result for azathioprine and mycophenolate mofetil. Our results suggest that NMOSD patients present an impaired balance in Tfh subsets favoring B-cell differentiation which may explain the sustained antibody production. These findings provide new insights into the pathophysiology of NMOSD, and further suggest that Tfh and Tfr subsets could be considered as potential therapeutic target in NMOSD because of their upstream role in antibody production.

Trichloroethylene (TCE) removal was investigated in a post-plasma catalysis (PPC) configuration in nearly dry air (RH = 0.7%) and moist air (RH = 15%), using, for non-thermal plasma (NTP), a 10-pin-to-plate negative DC corona discharge and, for PPC, Ce0.01Mn as a catalyst, calcined at 400 °C (Ce0.01Mn-400) or treated with nitric acid (Ce0.01Mn-AT). One of the key points was to take advantage of the ozone emitted from NTP as a potential source of active oxygen species for further oxidation, at a very low temperature (100 °C), of untreated TCE and of potential gaseous hazardous by-products from the NTP. The plasma-assisted Ce0.01Mn-AT catalyst presented the best CO2 yield in dry air, with minimization of the formation of gaseous chlorinated by-products. This result was attributed to the high level of oxygen vacancies with a higher amount of Mn3+, improved specific surface area and strong surface acidity. These features also allow the promotion of ozone decomposition efficiency. Both catalysts exhibited good stability towards chlorine. Ce0.01Mn-AT tested in moist air (RH = 15%) showed good stability as a function of time, indicating good water tolerance also.

Red mud waste from the aluminium industry was modified by leaching using hydrochloric acid or oxalic acid with additives, followed by precipitation or evaporation. The prepared catalysts were characterized in detail and tested for toluene total oxidation. The samples prepared by precipitation of the leachate by adding a base gave a much better performance in catalytic oxidation than the ones prepared by just evaporating the leachate. These improved performances can be correlated to the enhanced textural and redox properties of the catalysts due to the better dispersion and higher enrichment of Fe oxides at their surface. The best performing catalyst had a light-off temperature of around 310 °C and complete oxidation took place at around 380 °C.

The abatement of toluene was studied in a sequential adsorption-plasma catalysis (APC) process. Within this process, Hopcalite was used as bifunctional material: as adsorbent (storage stage) and as catalyst via the oxidation of adsorbed toluene (discharge stage). It was observed that the desorption and oxidation activity of the adsorbed toluene was significantly affected the process variables. In addition, the adsorption time influenced the CO2 selectivity and CO2 yield by changing the interaction between the catalyst and the plasma generated species. At least four APC sequences were performed for each examined condition suggesting that Hopcalite is very stable under plasma exposure during all the sequences. Consequently, these results could contribute to advance the plasma–catalyst system with an optimal VOC oxidation efficiency. The catalytic activity, amount of toluene adsorbed, amount of toluene desorbed and product formation have been quantified by FT-IR. Moreover, the catalyst was characterized by XRD, H2-TPR, N2 adsorption–desorption analysis and XPS. Hopcalite shows a good CO2 selectivity and CO2 yield when the APC process is performed with an adsorption time of 20 min and a plasma treatment with a discharge power of 46 W which leads to a low energy cost of 11.6 kWh·m−3 and energy yields of toluene and CO2 of 0.18 (±0.01) g·kWh−1 and 0.48 (±0.06) g·kWh−1 respectively.

Aims: The initial management of acute recreational drug and new psychoactive substance (NPS) toxicity is often by non-specialists working in the night-time economy. The aim was as part of the European Drug Emergencies Network (Euro-DEN) project to pilot training of these workers in multiple European countries. Methods: Following evaluation of training needs, guidelines and training package were developed. Night-time economy workers in London, UK; Pärnu/Tallinn, Estonia; and Oslo, Norway participated in a 1- to 2-h interactive case-based training session. Participants completed a questionnaire pre-/post-training to assess confidence in managing acute recreational drug/NPS toxicity and evaluate the training package/guidelines. Findings: 98 (London: 42; Oslo: 39; Pärnu/Tallinn: 17) completed both pre-/post-training questionnaires. Participants felt significantly more confident in managing someone unwell following classical recreational drug use compared to NPS (5.6 ± 2.9 vs. 4.3 ± 2.7, p < 0.001); this difference persisted after the training (7.6 ± 1.9 vs. 6.9 ± 2.0, p < 0.001). 147 (London: 42; Oslo: 88; Pärnu/Tallinn: 17) completed the post-training evaluation; the training session and the guidelines were rated 8.2 ± 1.4 and 8.7 ± 1.7, respectively (out of 10). Conclusions: The guidelines and training were well received by night-time economy workers in three European countries and improved confidence in managing acute recreational drug/NPS toxicity. Appropriate national and European bodies need to look at wider dissemination of this work.

Summary: Immune checkpoint inhibitors have revolutionized cancer treatment. However, many cancers are resistant to ICIs, and the targeting of additional inhibitory signals is crucial for limiting tumor evasion. The production of adenosine via the sequential activity of CD39 and CD73 ectoenzymes participates to the generation of an immunosuppressive tumor microenvironment. In order to disrupt the adenosine pathway, we generated two antibodies, IPH5201 and IPH5301, targeting human membrane-associated and soluble forms of CD39 and CD73, respectively, and efficiently blocking the hydrolysis of immunogenic ATP into immunosuppressive adenosine. These antibodies promoted antitumor immunity by stimulating dendritic cells and macrophages and by restoring the activation of T cells isolated from cancer patients. In a human CD39 knockin mouse preclinical model, IPH5201 increased the anti-tumor activity of the ATP-inducing chemotherapeutic drug oxaliplatin. These results support the use of anti-CD39 and anti-CD73 monoclonal antibodies and their combination with immune checkpoint inhibitors and chemotherapies in cancer. : The production of adenosine via CD39 and CD73 ectoenzymes participates in an immunosuppressive tumor microenvironment. Perrot et al. generated two antibodies, IPH5201 and IPH5301, targeting human CD39 and CD73, respectively. In vitro and in vivo data support the use of anti-CD39 and anti-CD73 mAbs in combination cancer therapies. Keywords: CD39, CD73, cancer immunotherapies, therapeutic antibodies, adenosine pathway, tumor micro-environment, immunosuppression

An aqueous impregnation method using manganese (II) nitrate precursor, followed by calcination at 400 °C, was carried out for the preparation of manganese doped hydroxyapatite catalysts (MnxHap; x = Mn wt.%: 2.5, 5.0, 10, 20, and 30 based on MnO2). Methods of characterization including inductively coupled plasma spectroscopy (ICP), N2 physisorption, X-ray Diffraction (XRD), Fourier-Transform Transmission Infrared (FT-IR), Raman, and Thermal gravimetric analysis (TGA/MS) analysis were used for the identification of Mn species and its surrounding environment. Raman spectroscopy indicated the presence of the ε-MnO2 phase for Mn20Hap and Mn30Hap in agreement with the XRD results and the presence of β-MnOOH species for Mn5Hap and Mn10Hap. The formaldehyde total oxidation was investigated on these catalysts and it was shown that Mn5Hap was the most active catalyst, achieving a normalized rate of formaldehyde (HCHO) conversion into CO2 per mole of Mn of 0.042 h−1 at a temperature of 145 °C. The well dispersed oxidized manganese species on Hap with a medium Mn AOS (average oxidation state) were mainly responsible for this performance. Since HCHO was retained on the surface of all catalysts during the catalytic test, the combined Diffuse Reflectance Infrared Fourier Transform spectroscopy (DRIFT) experiment at room temperature and thermodesorption (TD)-FTIR identified formate species as their oxidation consumed surface OH groups. A stability test and moisture effect study showed that the presence of water vapor has a beneficial effect on the performances of the catalyst.

Multiple modes of interventions are available when implementing an antibiotic stewardship program (ASP), however, their complementarity has not yet been assessed. In a 938-bed hospital, we sequentially implemented four combined modes of interventions over one year, centralized by one infectious diseases specialist (IDS): (1) on-request infectious diseases specialist consulting service (IDSCS), (2) participation in intensive care unit meetings, (3) IDS intervention triggered by microbiological laboratory meetings, and (4) IDS intervention triggered by pharmacist alert. We assessed the complementarity of the different cumulative actions through quantitative and qualitative analysis of all interventions traced in the electronic medical record. We observed a quantitative and qualitative complementarity between interventions directly correlating to a decrease in antibiotic use. Quantitatively, the number of interventions has doubled after implementation of IDS intervention triggered by pharmacist alert. Qualitatively, these kinds of interventions led mainly to de-escalation or stopping of antibiotic therapy (63%) as opposed to on-request IDSCS (32%). An overall decrease of 14.6% in antibiotic use was observed (p = 0.03). Progressive implementation of the different interventions showed a concrete complementarity of these actions. Combined actions in ASPs could lead to a significant decrease in antibiotic use, especially regarding critical antibiotic prescriptions, while being well accepted by prescribers.

A novel strategy for toluene abatement was investigated using a sequential adsorption-regeneration process. Commercial Hopcalite (CuMn2Ox, Purelyst101MD), Ceria nanorods, and UiO-66-SO3H, a metal–organic framework (MOF), were selected for this study. Toluene was first adsorbed on the material and a mild thermal activation was performed afterwards in order to oxidize toluene into CO2 and H2O. The materials were characterized by XRD, N2 adsorption-desorption analysis, H2-TPR and TGA/DSC. The best dynamic toluene adsorption capacity was observed for UiO-66-SO3H due to its hierarchical porosity and high specific surface area. However, in terms of balance between storage and catalytic properties, Hopcalite stands out from others owing to its superior textural/chemical properties promoting irreversible toluene adsorption and outstanding redox properties, allowing a high activity and CO2 selectivity in toluene oxidation. The high conversion of toluene into CO2 which easily desorbs from the surface during heating treatment shows that the sequential adsorption-catalytic thermal oxidation can encompass a classical oxidation process in terms of efficiency, CO2 yield, and energy-cost saving, providing that the bifunctional material displays a good stability in repetitive working conditions.

Toluene is a major air pollutant emitted from painting and metal coating processes and might have some health effects. Adsorption and catalytic complete oxidation are promising ways to retain or convert toluene into harmless products. The present work aims to develop a bifunctional material which can be used as an adsorbent and catalyst for low-temperature toluene removal. Copper zeolites were obtained by exchanging the sodium in the parent NaX zeolite with copper from aqueous solutions of Cu(NO3)2∙2.5H2O. Several characterization techniques, H2-TPR, XPS, XRD and N2 physisorption, were used in order to evaluate the redox, surface, structural and textural properties of the materials, respectively. The various materials were tested in adsorption and catalytic processes. The sample with low copper content (1 wt. %) exhibited promising features in terms of toluene adsorption capacity and total oxidation. The results can be correlated to the presence of micropores and well-dispersed CuO species.

LaBO3 (B: Mn, Fe) perovskites were synthesized using a three-step reactive grinding process followed by a calcination at 400 °C for 3 h. The three successive steps are: (i) solid state synthesis (SSR); (ii) high-energy ball milling (HEBM); (iii) low-energy ball milling (LEBM) in wet conditions. The impact of each step of the synthesis on the material characteristics was deeply investigated using physico-chemical techniques (X-ray diffraction (XRD), N2-physisorption, scanning electron microscopy (SEM), transmission electron microscopy (TEM), temperature-programmed reduction (H2-TPR), X-ray photoelectron spectroscopy (XPS)) and the catalytic performances of the synthesized materials were evaluated for the toluene total oxidation reaction. Starting from single oxides, microcrystalline perovskite phase, exhibiting negligible surface areas, is obtained after the SSR step. The HEBM step leads to a drastic reduction of the mean crystal size down to ~20 nm, along with formation of dense aggregates. Due to this strong aggregation, surface area remains low, typically below 4 m2·g−1. In contrast, the second grinding step, namely LEBM, allows particle deagglomeration resulting in increasing the surface area up to 18.8 m2·g−1 for LaFeO3. Regardless of the perovskite composition, the performance toward toluene oxidation reaction increases at each step of the process: SSR < HEBM < LEBM.

Non-thermal plasma technique can be easily integrated with catalysis and adsorption for environmental applications such as volatile organic compound (VOC) abatement to overcome the shortcomings of individual techniques. This review attempts to give an overview of the literature about the application of zeolite as adsorbent and catalyst in combination with non-thermal plasma for VOC abatement in flue gas. The superior surface properties of zeolites in combination with its excellent catalytic properties obtained by metal loading make it an ideal packing material for adsorption plasma catalytic removal of VOCs. This work highlights the use of zeolites for cyclic adsorption plasma catalysis in order to reduce the energy cost to decompose per VOC molecule and to regenerate zeolites via plasma.

Since the 1960s and the first steps towards the unification of the school system, reflections on educational adaptation have fuelled several reforms meant to deal with the heterogeneity of the student population. Presented as a “revolution of personalization” by the Education Secretary Luc Chatel, the 2010 reform of high school is part of this process, particularly through the implementation of the Personalized Support programme. An ethnographic inquiry into the reception of this requirement to personalize teaching reveals a divide among teachers. For some of them, personalization is a source of fulfilment and individual emancipation from the constraints of the school system. For others, personalizing school careers generates inequalities which compromise emancipation from the reproduction of social roles. Finally, the mix of representations and practices in the face of this reform suggests that teachers are guided by a multiplicity of logics that are ultimately likely to create cracks in the teaching profession.

In this work, the activity of bimetallic Pd-Au doped hierarchically structured titania catalysts has been investigated in the total oxidation of toluene. In earlier works, doping titania with group Vb metal oxides ensured an increased catalytic performance in the elimination of VOC molecules. A synergy between gold and palladium loaded at the surface of titania supports provided better performances in VOC oxidation reactions. Therefore, the main focus in this work was to investigate the durability of the prepared catalysts under long time-on-stream periods. Vanadium-doped catalysts showed a stable activity throughout the whole 110 h test, whereas, surprisingly, niobium-doped catalysts presented a cycle-like activity while nevertheless maintaining a high performance in toluene elimination. Operando Diffuse Reflectance Infrared Fourrier Transform spectroscopy (DRIFT) experiments revealed that variations in the presence of OH radicals and the presence of carbonaceous compounds adsorbed at the surface of spent catalysts varies with the occurrence of oscillations. X-ray Photoelectron Spectroscopy (XPS) results show that interactions between the material and the active phase provided extra amounts of mobile oxygen species and participated in easing the reduction of palladium. An enhanced redox reaction scheme is thus obtained and allows the occurrence of the cyclic-like performance of the catalyst.

Few researchers have been interested in the collection of these small pieces that folklorists have called « popular blazon ». One of the only works on the subject was published by Paul Sébillot (1843-1918) and Henri Gaidoz (1842-1932). Here is how they defined them: « Under the name of popular blazon, one designates the whole of the qualifiers that the inhabitants of a country, of a province, sometimes of a commune, address to their neighbors. Some of them are the simple statement, without epigram, of a real or supposed quality; others allude to a local fact - or supposed to be such - generally comical. Most of them are satirical and contain hurtful allusions, like those that Homer's heroes used to send back to each other before the battle ». How can we explain the birth of these popular blazon? What are their different forms? To which persons of the society did they attack? What were their shortcomings? These are the questions that this article tries to answer.

Spinal muscular atrophy (SMA) is caused by insufficient levels of the survival motor neuron (SMN) protein leading to muscle paralysis and respiratory failure. In mouse, introducing the human SMN2 gene partially rescues Smn-/- embryonic lethality. However current models were either too severe or nearly unaffected precluding convenient drug testing for SMA. We report here new SMN2;Smn-/- lines carrying one to four copies of the human SMN2 gene. Mice carrying three SMN2 copies exhibited an intermediate phenotype with delayed appearance of motor defects and developmental breathing disorders reminiscent of those found in severe SMA patients. Although normal at birth, at 7 days of age respiratory rate was decreased and apnea frequency was increased in SMA mice in parallel with the appearance of neuromuscular junction defects in the diaphragm. With median survival of 15 days and postnatal onset of neurodegeneration, these mice could be an important tool for evaluating new therapeutics.