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Recent studies indicate that outpatient total shoulder arthroplasty (TSA) is cost-effective and may have a low complication rate similar to inpatient TSA. However, existing studies have included younger patient cohorts who typically possess fewer medical comorbidities. Patients aged ≥65 years are commonly enrolled in Medicare, which has traditionally designated TSA as an inpatient-only procedure. The purpose of this study was to compare surgical complication rates and 90-day readmission rates between inpatient and outpatient TSA performed in adults aged ≥65 years.Medical records for all patients aged ≥65 years who underwent primary anatomic or reverse TSA by a single surgeon from July 2015 to May 2020 were reviewed. Patients were preselected for outpatient or inpatient surgery based on lack of significant cardiopulmonary comorbidities and patient preference. Demographics, body mass index (BMI), and American Society of Anesthesiologists (ASA) scores were collected in addition to emergency department (ED) visits and readmissions within 90 days of the index surgery. Relationships among frequency and types of complications and surgical setting (inpatients vs. outpatient) were assessed. Complication rates and demographic variables between inpatient and outpatient procedures were compared. Logistic regressions were performed to account for interacting predictor variables on the odds of having complications.A total of 145 shoulders (138 patients; 95 male, 43 female) were included in the analysis, of which 98 received inpatient TSA and 47 received outpatient TSA. Average age was 75.5 ± 7.2 for inpatient TSA and 70.5 ± 4.5 for outpatient TSA (P.001). Patient age (P.001), ASA score ≥3 (P.001), and reverse TSA (P = .002) were significantly positively correlated with receiving inpatient surgery. There were 16 complications (16.3%) in the inpatient group and 9 complications (19.1%) in the outpatient group (P = .648). There were no significant differences in the frequency of postoperative complications, return to the ED, or reoperations between inpatient and outpatient procedures (P.05). Each 1-year increase in age increased the predicted odds of having a surgical complication by 14% (odds ratio = 1.14; P = .021), irrespective of surgical setting. Those who underwent inpatient TSA had a significantly higher frequency of 90-day readmission (inpatient=16, outpatient=1; P = .034).Postoperative complications and ED returns were not significantly different between inpatient and outpatient TSA. Each 1-year increase in age increased the odds of postoperative surgical complications by 14%, regardless of surgical setting. Outpatient TSA was found to be safe for appropriately selected patients aged ≥65 years, and re-evaluation of TSA as an inpatient-only procedure should be considered.

Een 53-jarige man werd doorverwezen door de huisarts vanwege pijnloze macroscopische hematurie. Hij bleek recent ook 5 kg vermagerd te zijn. Via oppuntstelling en stagering door middel van een CT-scan van het abdomen, een cystoscopie en een PET-CT-scan rees het vermoeden van urachuskanker. Een echografisch geleide biopsie van een supraclaviculaire pathologisch vergrote klier links bevestigde deze diagnose. Palliatieve chemotherapie met oxaliplatine, 5-fluoruracil (5FU) en levofolinezuur (FOLFOX) werd opgestart. Zes maanden na het opstarten van de behandeling vertoonde de patiënt complete respons. Urachuskanker is een zeldzame ziekte die zich vaak aandient aan de hand van pijnloze macroscopische hematurie. Indien er op beeldvorming een massa wordt gezien ter hoogte van de anterieure blaaswand of het blaasdak, moet men steeds denken aan deze diagnose. Een standaardbehandeling voor deze ziekte bestaat tot op heden echter niet.

The first implementation and use of an in situ size exclusion chromatography (SEC) system on a small-angle neutron scattering instrument (SANS) is described. The possibility of deploying such a system for biological solution scattering at the Institut Laue–Langevin (ILL) has arisen from the fact that current day SANS instruments at ILL now allow datasets to be acquired using small sample volumes with exposure times that are often shorter than a minute. This capability is of particular importance for the study of unstable biological macromolecules where aggregation or denaturation issues are a major problem. The first use of SEC-SANS on ILL's instrument D22 is described for a variety of proteins including one particularly aggregation-prone system.

Few data are available on the treatment of the disease asso­ciated with the immature form of Calicophoron daubneyi. To study the efficacy of closantel in this infestation, ten lambs were kept for 42 days on a plot known to be infested by C. daubneyi and were then divided into two groups, control and treatment. They were autopsied seven to ten days after treat­ment. Parasites in the duodenum were counted by differentiat­ing free and intramucosal forms. The decrease in free parasites (61%) was highly variable and not significant. However, the decrease in the number of intramucosal parasites (56%) was highly significant (p = 0.002). As intramucosal larvae are path­ogenic, closantel could be used to treat newly infested ani­mals.

A 53-year-old man developed aLegionella pneumophilapneumonia complicated by rhabdomyolysis, acute kidney injury, and protracted ileus. Risk factors were smoking and chronic alcoholism, but the patient had no history of previous abdominal surgery. Hemodialysis was required for a period of 5 weeks with a full renal recovery. Pneumonia required respiratory support but for a limited period of 6 days. The protracted course of the ileus led to explorative laparotomy despite negative computed tomography findings. No cause of mechanical obstruction was found at surgery and common etiologies of intestinal obstruction were excluded. Parenteral nutrition was needed for a total of 4 weeks, before recovery of intestinal motility. This case illustrates the apparent discrepancy between the pulmonary symptoms and the extrapulmonary manifestations that could be seen as a consequence of an exaggerated immune response.

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical science. © The Author(s) 2019. Published by Oxford University Press.

International audience; Preliminary data suggest that topical eprinomectin in goat shows an individual variation in anthelmintic efficacy when used off-license at a dose rate of 0.5 or 1.0mg/kg BW. As a result, the use of oral administration of topical formulation of eprinomectin tends to develop in dairy goat farms in France. The plasma levels and milk excretion as well as the anthelmintic efficacy of eprinomectin were determined in goats following oral administration of a topical formulation of the drug at dose rates of 0.5 and 1mg/kg BW. The area under the concentration-time curve (AUC) values were 17.62±9.68ngday/ml and 6.56±4.00ngday/ml for plasma and milk respectively after the administration of 0.5mg/kg BW and 45.32±13.90ngday/ml and 13.88±1.77ngday/ml for plasma and milk, respectively after the administration of 1mg/kg BW. The milk-to-plasma ratio ranged from 0.33 to 0.36 and the amount of drug recovered in the milk was 0.4% of the total administered dose. The maximum concentrations of eprinomectin residues determined in milk after oral treatment were

BACKGROUND This study reviewed the outcomes of a screening protocol for BK viremia to determine if early diagnosis, followed by immunosuppression minimization, would prevent progression to nephropathy and graft loss. METHODS This review included 369 renal transplant recipients tested for BK virus at serial time points after transplantation. Management included immunosuppression minimization plus cidofovir treatment for BK nephropathy. RESULTS Recipients received tacrolimus-based immunosuppression, with 8% prednisone-free and 6% who received desensitization. With a mean follow-up of 22 ± 10 months, 16% (n = 57) of recipients became BK viremia positive. The median (range) time to diagnosis was 3 (1-17) months. Because renal biopsy was performed selectively, 59% of recipients underwent biopsy, with 47% showing BK nephropathy. Seventy-four percent of recipients cleared the virus at a median (range) time of 9 (3-33) months, with four grafts lost to BK nephropathy. Cidofovir-treated recipients displayed a higher viral load at diagnosis but showed equivalent renal function at last evaluation. In multivariate analysis, recipient age, Asian ethnicity, deceased donor, and prednisone use were factors independently associated with BK viremia. Actuarial survival of BK-positive grafts was worse than that of BK-negative grafts (P

Increasing evidence suggests a detrimental effect of donor-specific antibodies directed against the human leukocyte antigen (HLA)-A, -B, and -DR loci on renal allograft outcomes. Limited data exist on the impact of de novo HLA-DQ antibodies. Over a 3-year period, we prospectively monitored 347 renal transplant recipients without pre-transplant donor-specific antibodies for their development de novo . After 26 months of follow-up, 62 patients developed donor-specific antibodies, of which 48 had a HLA-DQ antibody either alone (33 patients) or in combination with an HLA-A, -B, or -DR antibody (15 patients). Only 14 patients developed a donor-specific HLA-A, -B, or -DR antibody without a HLA-DQ antibody present. Acute rejection occurred in 21% of the HLA-DQ–only patients, insignificant when compared with 11% of patients without donor-specific antibodies. At the last follow-up, the mean serum creatinine and the fraction of patients with proteinuria were significantly higher in those that developed only HLA-DQ than those without antibodies. The 3-year graft survival was significantly worse when HLA-DQ antibodies were combined with non-DQ antibodies (52%) compared with HLA-DQ alone, non-DQ antibodies alone, or no antibodies (92–94%). Thus, our prospective monitoring study found that donor-specific HLA-DQ antibodies were the most common type detected and these antibodies may contribute to inferior graft outcomes. Ongoing surveillance is necessary to determine the long-term outcome of patients developing HLA-DQ donor-specific antibodies.

This chapter commences the presentation of the unique quality of foreign language use found in the hands-on and skill-based setting of the current study. In particular, it presents and analyzes the participants’ use of content and language scaffolding in peer interactions. The usages of these forms of peer scaffolding demonstrate how novices can continue to participate in classroom activities and maintain fluency of communication with the help of expert peers. Patterns in interactions reveal that content scaffolds may aid novice peers so that they can remain involved in classroom activities. By contrast, language scaffolds appear to be employed by expert peers in order to repair trouble sources for temporarily novice speakers so that intersubjectivity can be reached. The classroom examples presented in this chapter demonstrate that peers can and do scaffold each other’s content understanding and foreign language use while engaging in various activities.

By presenting classroom examples of language in use during peer interactions, this chapter considers a salient aspect of sociocultural learning, namely mediation. It suggests that noticing and achievement strategies during conversations indicate that speakers can independently self-regulate oral activity in their attempts to achieve intersubjectivity. Furthermore, this chapter reports on the role of negotiation of meaning. Negotiations demonstrate how participants use the FL as a semiotic tool and physical dimensions (i.e., space, actions, and self) as tools to trigger and mediate content- and language-related problems. Additionally, negotiation of content afforded the participants in the study longer sequences for conversational practice in the FL. One example presented in this chapter demonstrates how the participants maintained their German conversational style while using their foreign language. Nevertheless, such meaningful language practice is considered to be beneficial for the language learning process. In sum, this chapter shows how the context afforded meaningful learning tasks, various types of peer interactions, opportunities for genuine communication, and opportunities for emotional engagement, allowing the participants to demonstrate different levels of autonomous FL use and abilities during negotiations with peers.

This chapter discusses some of the ideas of social interaction as a resource for learning. To begin, it outlines the role of interaction and how the frequency of available interactions may afford active participants valuable means for learning. Further, Vygotsky’s notions of play are presented to demonstrate how it can create optimal situations for the generation of zones of proximal development (ZPDs). The term “scaffolding” represents the aid and support that is needed within the ZPD to help novice learners reach a higher level of understanding and maintain intersubjectivity. Next, this chapter explores some of the theoretical underpinnings of language learning through interaction and by talking. Finally, it reviews some of the current research on spoken language use and interactions in a variety of CLIL contexts. Some quasi-experimental studies and other classroom research suggest that CLIL learners are generally more linguistically proficient than their non-CLIL peers are. However, other studies point out that more rigorous and robust empirical research must be conducted in order for these claims to be substantiated. Meanwhile, recent research using conversation analysis (CA) in CLIL classrooms provides qualitative evidence of what teachers and learners are capable of achieving in joint interactions. It additionally indicates that content learning can occur during peer interactions despite limited foreign language proficiency.

This chapter presents theoretical concepts of how language learning and sports could be integrated through the school subject of physical education (PE). It reviews the current position of CLIL PE in Europe and Germany and points out different perspectives on the roles of CLIL PE in bilingual programs. It also outlines early connections between physical activity and language learning made by methods such as Total Physical Response (TPR). However, in contrast to TPR, a new perspective on integrating sports and language learning posits that the benefits do not necessarily lie in the physical activity per se, but rather in the potential for a rich variety of interactions and language practice through greater individual space and other noncognitive affordances. Thus, it suggests that PE creates an arena in which learners can practice and experience language in interactions on different levels. This chapter also discusses how the setting can be used to encourage a “community of learners” based on some principles of social constructivism as well as provide learners with multisensory input and physical engagement with the target language. It additionally outlines how motivation plays an important role in CLIL PE, as research suggests that it has the potential to be high; however, it also acknowledges that this may not always be the case for some learners.

This chapter presents and analyzes the use of private speech and language play in peer interactions that took place during the study. Private speech is understood as language use that is linked to the social interactions in the environment. Classroom examples suggest that the ecology of the investigated environment allows learners to use private speech to stay engaged in more overt classroom interactions despite not being directly addressed or involved in them. Further, this chapter goes into depth on language play. It suggests that there are currently two perspectives on language play in second language acquisition literature: First, the Vygotskyan-led notion that language play has an intrapersonal function, and second, the Bakhtinian-led idea that language play possesses an interpersonal function. Concrete examples, ranging from language rehearsal to creating fictions, explore both of these viewpoints. In addition, this chapter suggests that the investigated setting affords learners individual and spatial freedom to counterbalance conservative centripetal forces with more innovative centrifugal forces through playful language use in peer interactions. Finally, other examples of language play in the form of bizarre voices and fake accents additionally demonstrate how learners use the target language to create or maintain a foreign language identity.

This chapter deals with the study on which this book is based. It outlines the research setting, defines the research process of the study, and operationalizes the language learner operations (LLOs) which frame the sequences of talk-in-interaction presented in Chaps. 8, 9, and 10. To begin, however, this chapter briefly defines the role “operations” play when observing naturally occurring speech from ecological and sociocultural perspectives. Next, this chapter presents the setting of the study, which was conducted in two separate schools that emphasize sports and extracurricular activities and are located in the German federal state of North-Rhine Westphalia (NRW). The study included learners from three grades (Grades 9, 11, and 12) during various phases of the research process. Audio recordings were collected via lapel microphones, which allowed for a collection of high quality data from the participants. The exploratory nature of data collection as well as the development of indicators aided in the identification and subsequent analysis of the data, which present a new perspective on integrating language learning in new settings. Finally, the LLOs outlined in this chapter build the framework for analysis and interpretation of foreign language use. The list of LLOs dealt with in this chapter include: private speech, noticing, language play, communication strategies, negotiation of meaning, as well as content, language, and binary scaffolding.

This chapter reviews the development CLIL in Europe and worldwide as its own pedagogical approach to integrating language and content learning. To begin, it distinguishes between CLIL, immersion, and content-based teaching and points out the unique features of CLIL, including its dual-focus approach. This chapter additionally discusses CLIL’s development in Europe since the 1990s, which coincides with the EU’s language mandate to expand and improve all EU citizens’ FL learning skills. Moreover, this chapter outlines salient features that make up the CLIL approach which are also suited to the needs of learners and other stakeholders in the Information Age. As an educational approach to teaching and learning content and foreign languages, CLIL appears to be a perfect fit in certain aspects. Further, the recent expansion of CLIL beyond Europe into parts of Asia and Latin America is reviewed. Finally, this chapter presents which school subjects have been taught through the CLIL approach around the world thus far.

This chapter explores the potential of peer interactions as a resource for both content and language learning. It defines peer interactions as communicative activities that occur between peers without intervention from teachers. Although peer interactions demonstrate less institutionalized interaction patterns, they are still framed by socioculturally influenced objectives and education norms, which influence their construction and subsequent foreign language use. Although this chapter merely scratches the surface of the complexity of peer interactions, it suggests nevertheless that two separate layers of interactions may be present in classrooms: First, a more dominant and observable “superordinate layer” and second, “a subordinate layer” that involves a network of peer interactions found below the surface of the first. Within this framework, I suggest that there are four types of peer interactions available for exploration: (1) interactions with more capable peers, (2) interactions with equal peers, (3) interactions with less capable peers, and (4) inner resources. In this chapter, each of these types are explained against the background of sociocultural theory and supported by classroom examples from researchers who have acknowledged the existence and value of these types of interaction.

This chapter outlines various research approaches for investigating and analyzing peer interactions in diverse CLIL contexts. It focuses on some established qualitative methods of research and analysis, as these possess features that allow for a detailed examination of peer interactions. A focus on qualitative research methods which explore language-in-use adheres to the current linguistic and social turns in the social sciences that recognize the powerful role language plays in constructing and co-constructing meaning in interactions. This chapter begins by explaining features of classroom ethnography, which allows for an investigation of peer interactions from a sociocultural perspective and provides additional means to develop hypotheses and theories about how participants construct learning through various interactions. It then outlines characteristics of microethnography, which seeks to discover features of meaning making that often go unnoticed in other research approaches. This chapter additionally outlines two methods of analysis for investigating naturally occurring speech in social research: discourse and conversation analysis (CA). Discourse analysis provides an analytical framework for illustrating the construction, co-construction, and reconstruction of meaning in interaction, while CA is employed in unexplored settings to investigate patterns of talk-in-interaction.

Demand for live trivalent tick fever vaccine containing Babesia bovis, Babesia bigemina and Anaplasma centrale produced by the Department of Primary Industries, Queensland, has increased from less than 10,000 doses in 1988 to 500,000 doses in 2001. This paper describes a series of trials aimed at overcoming certain constraints to obtain B. bigemina parasitised erythrocytes (PEs) on a large enough scale from infected splenectomised calves to meet the demand. Passage through a series of splenectomised calves failed to increase the yield per calf but we showed that the dose rate of infected cells could be reduced from the long-time standard of 1x10(7) to 2.5x10(6) without affecting immunogenicity and still leaving a safety margin of at least 50-fold for infectivity. This change quadrupled the potential yield of doses per calf and allowed the DPI to meet the increased demand for B bigemina in vaccine. Due to the high cost and limited availability of suitable, health tested donors, calves previously infected with B. bovis or A. centrale were used to provide B. bigemina organisms but the practice resulted in red cell agglutination in some batches of prepared vaccine. A trial is described where B. bigemina-infected red cells were washed by centrifugation to remove agglutinating antibodies. Washing had no effect on parasite viability and this method is now in routine use in the production of trivalent vaccine.

Background. Preemptive transplantation results in excellent patient and graft survival yet most transplant candidates are referred for transplantation after initiation of dialysis. The goal of this study was to determine barriers to preemptive renal transplantation. Methods. A nonvalidated questionnaire was administered to prospective kidney transplant recipients to determine factors that hindered or favored referral for transplantation before the initiation of dialysis. Results. One hundred ninety-seven subjects referred for a primary renal transplant completed the questionnaire. Ninety-one subjects (46%) had been informed of preemptive transplantation before referral, and 80 (41%) were predialysis at the time of evaluation. The median time from diagnosis of renal disease to referral was 60 months (range, 2Y444 months). In bivariate analysis, among other factors, knowledge of preemptive transplantation was highly associated (odds ratio=94.69) with referral before initiation of dialysis. Given the strong association between knowledge of preemptive transplantation and predialysis referral, this variable was not included in the multivariate analysis. Using multivariate logistic regression analysis, white recipient race, referral by a transplant nephrologist, recipient employment, and the diagnosis of polycystic kidney disease were significantly associated with presentation to the pretransplant clinic before initiation of dialysis. Conclusion. The principle barrier to renal transplantation referral before dialysis was patient education regarding the option of preemptive transplantation. Factors significantly associated with referral before dialysis were the diagnosis of polycystic kidney disease, white recipient race, referral by a transplant nephrologist, and employed status. Greater effort should be applied to patient education regarding preemptive transplantation early after the diagnosis of end-stage renal disease.

Background In renal transplantation, BK virus infection can result in significant graft nephropathy and loss. While reduction in immunosuppression (IS) is considered standard therapy, adjunct agents may be warranted. Data are suggestive of a possible role of cidofovir for the management of BK. This study aims to describe the course of BK viremia (BKV) in a large cohort of renal transplant patients receiving adjunct cidofovir. Methods We evaluated kidney and kidney-pancreas recipients who received cidofovir combined with reduced IS for management of high-level BKV or BK virus nephropathy (BKVN). We examined the rate and timing of BKV clearance, and performed a multivariate analysis to identify risk factors associated with long-term (>6 months) viremia. Results In total, 75 patients received a median of 13 doses of cidofovir in conjunction with reduced IS; 32 patients (43%) had short-term BKV (≤6 months), and 43 (57%) had long-term BKV. Overall, 53 of 75 patients (71%) eventually cleared BKV at a median of 4.2 months (interquartile range 2.1–9.3 months). Independent factors associated with long-term BKV included older age (odds ratio [OR] 1.1, P = 0.02), delayed graft function (OR 31.4, P = 0.01), and higher peak BKV (OR 12.8, P = 0.02), while BKV reduction by at least 1 log10copies/mL at 1 month of treatment was associated with clearance within 6 months (OR 49.3, P

Background. Renal transplant recipients with de novo DSA (dDSA) experience higher rates of rejection and worse graft survival than dDSA-free recipients. This study presents a single-center review of dDSA monitoring in a large, multi-ethnic cohort of renal transplant recipients. Methods. The authors performed a nested case-control study of adult kidney and kidney-pancreas recipients from July 2007 through July 2011. Cases were defined as dDSA-positive whereas controls were all DSA-negative transplant recipients. DSA were determined at 1, 3, 6, 9, and 12 months posttransplant, and every 6 months thereafter. Results. Of 503 recipients in the analysis, 24% developed a dDSA, of whom 73% had dDSA against DQ antigen. Median time to dDSA was 6.1 months (range 0.2Y44.6 months). After multivariate analysis, African American race, kidney-pancreas recipient, and increasing numbers of human leukocyte antigen mismatches were independent risk factors for dDSA. Recipients with dDSA were more likely to suffer an acute rejection (AR) (35% vs. 10%, PG0.001), an antibody-mediated AR (16% vs. 0.3%, PG0.001), an AR ascribed to noncompliance (8% vs. 2%, P=0.001), and a recurrent AR (6% vs. 1%, P=0.002) than dDSA-negative recipients. At a median follow-up of 31 months, the deathcensored actuarial graft survival of dDSA recipients was worse than the DSA-free cohort (P=0.002). Yet, for AR-free recipients, there was no difference in graft survival between cohorts (P=0.66). Conclusions. Development of dDSA was associated with an increased incidence of graft loss, yet the detrimental effect of dDSA was limited in the intermediate term to recipients with AR.

In order to allow more reliable predictions on the lower head response under core melt-down conditions, the temperature distribution has been analysed including the natural convection in the corium pool. Furthermore, the mechanical models and the failure criteria have been improved based on the RUPTHER and FASTHER experiments where typical temperature gradients are simulated. Lower head local melting as well as corium crust development has been addressed in the CORVIS experiments studying the contact between an alumina/iron thermite and a thick steel plate. The upper head loading by corium impact due to a postulated in-vessel steam explosion has been investigated by the BERDA experiments. Similarity rules were considered such that the results can be directly converted to reactor conditions. Based on these investigations admissible steam explosion energy releases are determined which the upper head can carry. If these limits are not exceeded the reactor containment cannot be endangered by broken head fragments. To provide the necessary basic data, mechanical material tests have been performed.

To enhance the assessment of reactor pressure vessel life under severe accident, a cooperative research program is conducted between CEA, EDF, and Framatome, parts of which are supported by the European Commission. Within the framework of this program, a model based on Lemaitre and Chaboche with predictive capability in the field of viscoplastic flow, material damage, and failure has been generalized and implemented in CASTEM 2000 finite element code. In order to validate the model in mechanical situations featuring the same basic characteristics as the severe accident scenarios, analytical experiments are conducted on the RUPTHER facility: a thin shell tube is loaded with an internal pressure and submitted to an axial thermal gradient with elevated temperatures. The specific question of the interest of the coupled damage approach in the failure prediction is addressed. Comparisons of the predictions relying on coupled and uncoupled damage-viscoplasticity models show that, at higher temperatures, failure could be predicted through uncoupled damage evaluation provided the main nonlinear effects like large displacements and updated pressure are taken into account, while at lower temperatures coupling between damage and deformation is necessary. Examples based on some RUPTHER creep test predictions are given.

The function of CD28 molecules that are present on malignant plasma cells of human myeloma cell lines (HMCL) was studied. First, myeloma cells expressed a similar density of CD28 antigen to that of normal T cells. The myeloma CD28 molecules were able to bind B7-Ig molecules as well as L cells transfected with a B7-1 cDNA, and anti-CD28 mAb inhibited the binding. Myeloma cells did not express B7-1 antigens but a low density of B7-2 antigens. The myeloma B7-2 molecules of two HMCL were able to bind CTLA-4 protein. No autocrine CD28:B7-2 activation could be evidenced as we found no spontaneous binding of the p85 subunit of PI-3 kinase to CD28 molecules. In addition, a blocking anti-CD28 mAb did not affect the IL-6-dependent or autonomous proliferation of the HMCL. The activation of myeloma CD28 molecules with or without TPA stimulation did not affect the proliferation, survival, differentiation, expression of activation antigens and cytokine receptors or cytokine production of myeloma cells. However, the triggering of myeloma CD28 molecules by B7-1 transfectant cells resulted in binding of the p85 subunit of PI-3 kinase to CD28 molecules as previously shown for T cell CD28 molecules. This expression of a large density of CD28 molecules able to bind B7 molecules might contribute to a downregulation of the immune control of myeloma cells.

Multispecific resistance to benzimidazoles was studied in three selected farms. These farms had bred dairy goats for more than 15 years. The helminths were introduced with the goats at the establishment of the farms which afterwards remained isolated. Nematode resistance could then be related to their own management practices. Faecal egg count tests and egg hatch assays were performed to assess intensity of resistance. The generic (infective larvae in faecal cultures) and specific richness (adult worms) were assessed. The resistant species were Trichostrongylus colubriformis, Teladorsagia circumcincta, Haemonchus contortus and Oesophagostomum venulosum. Faecal egg count reduction tests and egg-hatch assays did not match exactly. Faecal larval counts after treatments gave a distorted picture of multispecific resistance: Haemonchus and Oesophagostomum were very largely over represented. The number of species found in the three farms was relatively low compared with other reports in goat farms of the area. This reduction of diversity might also be due in part to characteristics of breeding management and history (use of permanent pasture and introduction of goats at the establishment of farm).

Introduction Dans l’etude des cellules souches pluripotentes, l’injection des cellules souches pluripotentes induites a des souris immunodeprimees est une etape habituelle. Cette etape est censee verifier la pluripotence de ces cellules, par la genese d’un teratome multi-tissulaire. L’examen anatomopathologique joue a ce niveau un role primordial. Il permet, de meme, de verifier certaines etapes cruciales de l’embryogenese. Objectifs Souligner l’interet de l’anatomie pathologie dans le domaine des cellules souches et la comprehension des mecanismes de l’embryogenese. Methodes Nous rapportons les resultats d’un travail effectue avec l’equipe de la plateforme de reprogrammation cellulaire de l’institut de recherche en biotherapie de Montpellier et le service de biopathologie du centre de lutte contre le cancer Jean-Perrin de Clermont-Ferrand. Au cours de ce travail, nous avons procede a 12 injections des cellules souches pluripotentes induites (IPS) a 10 souris immunodeprimees. Resultats L’evolution a ete marquee par l’apparition de teratomes multi-tissulaires. L’etude anatomopathologique a permis de mettre en evidence plusieurs structures histologiques issues des 3 feuillets embryologiques dont des structures de l’appareil respiratoire. L’etude immunohistochimique a permis de mettre en evidence sa naissance a partir d’une structure digestive. Discussion La presence de differentes structures issues des 3 feuillets embryologiques rend compte du caractere pluripotent des cellules injectees. Les rapports entre les structures respiratoires et digestives rejoignent les etapes de l’embryogenese normale. Conclusion L’etude anatomopathologique prend de plus en plus un role capital dans le domaine de l’etude des cellules souches. Elle permet de repertorier les differentes structures realisees par le teratome et confirme ainsi, la pluripotence des cellules injectees. Elle permet aussi de faire des correlations avec les etapes de l’embryogenese normale.

Introduction Management of renal transplant recipients with a negative complement-dependent cytotoxicity-antihuman globulin (CDC-AHG) cross-match and pretransplant donor-specific antibody (DSA) is controversial. We sought to compare outcomes of immunologically high-risk living donor (LD) renal transplant recipients with and without DSA. Methods We conducted a single-center, retrospective review of all high immune-risk LD renal transplant recipients with a negative CDC-AHG cross-match performed between January 2008 and December 2010. Pretransplant desensitization for DSA was not utilized. Immunosuppression consisted of thymoglobulin induction, followed by tacrolimus, myeophenolate mofetil, and prednisone. DSA was assessed pretransplant and at 1, 3, 6, 9, and 12 months, and every 6 months thereafter. Results Between January 2008 and December 2010, 44 LD renal transplants were performed in high immune-risk recipients with a negative CDC-AHG cross-match. Outcomes of 14 recipients with pretransplant DSA were compared with 30 recipients with no DSA. After a median follow-up of 26 months (range, 12–40), overall death-censored graft survival was 100%, with no acute rejection episodes in the DSA group and 1 antibody-mediated rejection in the non-DSA cohort. Mean serum creatinines of the DSA and non-DSA groups at 1 year post-transplant were 1.0 ± 0.4 and 1.2 ± 0.6 mg/dL (P = NS), respectively. Among the pretransplant DSA cohort, 5 of the 14 (36%) developed persistent post-transplant DSA at a median of 9 months (range, 3–24) versus 2 of 30 (7%; P = .025) at a median of 12 months post-transplant in the non-DSA cohort. All recipients in the pretransplant DSA group underwent renal biopsy for persistent post-transplant DSA. Three of 5 biopsies showed C4D deposition in peritubular capillaries without glomerulopathy or arteriopathy. Conclusions Early post-transplant outcomes for LD recipients with a negative cross-match and pretransplant DSA were excellent. In recipients with good and stable renal function, the significance of persistent post-transplant DSA in combination with C4D deposition on biopsy is unclear at this time.

Estradiol protects against hippocampal damage and some learning impairments resulting from transient global ischemia in rats. Here, we seek to validate a mouse model of transient global ischemia and evaluate the effects of estradiol on ischemia-induced hippocampal damage and behavioral impairments. Female C57Bl6/J mice were ovariectomized and implanted with estradiol- or oil-secreting capsules. One week later, mice experienced 15-min of 2-vessel occlusion (2-VO) or sham surgical procedures. Five days later, mice were exposed to a fear conditioning protocol in which a specific context and novel tone were paired with mild footshock. Twenty-four hours following conditioning, contextual fear was assessed by measuring freezing behavior in the conditioned context (in the absence of the tone). This was followed by assessment of cue fear by measuring freezing behavior to the conditioned tone presented in a new context. When tested in the conditioned context, oil-treated mice that experienced 2-VO exhibited a significant reduction in freezing behavior whereas estradiol-treated mice that experienced 2-VO showed no disruption in freezing behavior. Freezing behavior when presented with the conditioned tone was unaffected by either surgery or hormone treatment. These findings suggest that global ischemia causes impairments in performance on the hippocampally-dependent contextual fear task but not conditioned cue-based fear. Furthermore, estradiol prevented the ischemia-induced impairment in contextual fear conditioning. Fluoro-Jade (FJ) staining revealed neuronal degeneration throughout the dorsal hippocampus of mice that experienced 2-VO. Estradiol treatment reduced the number of FJ+ cells in CA1 and CA2, but not in CA3 or in the dentate gyrus. Together, these findings suggest that 15 min of global ischemia causes extensive hippocampal neurodegeneration and disrupts contextual fear conditioning processes in mice and that estradiol protects against these adverse effects.

A measurement technique is described that is capable of producing accurate numerical maps of the parallelism defect of optically contacted Fabry-Perot etalons. A photoelectric raster scan of the etalon transmission intensity distribution is performed at each of three closely spaced etalon tunings, one at maximum on-axis and two at the half-maxima on-axis positions. Simple data manipulation gives numerical or contour maps of the parallelism defect. Results demonstrating the effect of mechanical constraints on etalon parallelism are presented.

We report two cases of Sneedon’s syndrome. Both cases had widespread livedo reticularis with repeated cerebrovascular accidents without persistent neurological deficit. In one case, hemostatic examina

Advanced techniques are presented which facilitate the development of inert or reducing atmospheres in excess of 2000 K in order to improve processing of containerless capabilities at higher temperatures and to provide more contamination-free environments. Recent testing, in the laboratory and aboard the NASA KC-135 aircraft, of a high-temperature acoustic positioner demonstrated the effectiveness of a specimen motion damping system and of specimen spin control. It is found that stable positioning can be achieved under ambient and heated conditions, including the transient states of heat-up and cool-down. An incorporated high-temperature levitator was found capable of processing specimens of up to 6-mm diameter in a high-purity environment without the contaminating effects of a container at high temperatures and with relative quiescence.

We demonstrate the diverse selectivity of three commercial polyclonal "cyclosporine" immunoassays for cyclosporin (CsA) metabolites by comparing analytical responses of nine metabolites added to drug-free whole-blood specimens (range 0 to 2000 micrograms/L) and assayed by the Abbott TDx fluorescence polarization immunoassay (FPIA), the Incstar Cyclo-Trac radioimmunoassay (RIA), and the Sandoz RIA. Cross-reactivity--defined as the relative response (slope of regression line) of metabolite/parent CsA over the assay's linear range of concentrations--differed for each metabolite among the three assays. Overall, Abbott's antiserum exhibited the greatest affinity for the metabolites, the Sandoz antiserum the least. Ranges of cross-reactivity for the metabolites over all three assays were M1 (14-44%), M8 (9-20%), M13 (13-26%), M17 (50-116%), M18 (17-79%), M21 (4-54%), M25 (less than 1-52%), M26 (less than 1-29%), and M203-218 (7-51%). The specificities of the Abbott, Incstar, and Sandoz polyclonal assays thus differ significantly, and this brings into question the practical utility of comparing data generated for patients' specimens by different procedures.

In total hip replacement (THR) a good initial stability of the prosthetic stem in the femur, which corresponds to a good overall initial contact, will help assure a good long-term result. During the insertion the implant stability increases and, as a consequence, the resonance frequencies increase, allowing the assessment of the implant fixation by vibration analysis. The influence of changing contact conditions on the resonance frequencies was however not yet quantitatively understood and therefore a finite element analysis (FEA) was set up. Modal analyses on the hip stem-femur system were performed in various contact situations. By modelling the contact changes by means of the contact tolerance options in the finite element software, contact could be varied over the entire hip stem surface or only in specific zones (proximal, central, distal) while keeping other system parameters constant. The results are in agreement with previous observations: contact increase causes positive resonance frequency shifts and the dynamic behaviour is most influenced by contact changes in the proximal zone. Although the finite element analysis did not establish a monotonous relationship between the vibrational mode number and the magnitude of the resonance frequency shift, in general the higher modes are more sensitive to the contact change.