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La norme NFS 90-351 permet les réduits de ventilation dans les blocs opératoires lors de périodes d'inoccupation. L'objectif de cette étude est d'évaluer l'impact d'un passage en mode « Veille » à un mode « Opérationnel » sur les concentrations particulaires par l'usage de capteurs et la simulation fluidique numérique. L'expérimentation a consisté à reproduire ce passage dans une salle de taille réelle et à mesurer les concentrations particulaires grâce à l'utilisation de capteurs. En parallèle, des simulations numériques ont été menées. Les simulations aérauliques et de diffusion particulaire ont été réalisées dans la même configuration que celle des expériences afin de comparer les résultats et valider les conclusions des expérimentations. L'étude a démontré que les passages du mode « Veille » en mode « Opérationnel » peuvent être surveillés en continu par un capteurs installé en zone représentative., The NFS 90-351 standard authorizes a stand-by mode of operating theatres ventilation during periods of inoccupation. The objective of this study is to evaluate the impact of switching from "Standby" to "Operation" mode on particulate matter concentrations by using sensors and numerical fluidic simulation. The experimentation consisted in reproducing this switch in a real size room and in measuring the particulate matter concentrations thanks to the use of sensors. In parallel, numerical simulations were carried out. Airflow and particle diffusion simulations were performed in the same configuration as the experiments in order to compare the results and validate the conclusions of the experiments. This study demonstrated that transitions from "Standby" to "Operation" mode can be continuously assessed by sensors installed in a representative area.

A growing literature shows an improvement of chronic hepatitis C virus (HCV)-related depression after successful treatment with direct-acting antivirals. However, depression after HCV cure remains insufficiently documented in people living with HIV (PLWH) and HCV, a population with specific mental health challenges. This study aimed to (i) document the prevalence of moderate-to-severe depression (PHQ-9 score ≥10) across different age classes in HCV-cured PLWH; (ii) identify associated socio-behavioral correlates.Descriptive analyses were performed on data collected during a cross-sectional survey (February 2018 - May 2019) nested in a prospective, multicenter cohort of individuals living with HIV and HCV (ANRS CO13 HEPAVIH). Socio-behavioral correlates of moderate-to-severe depression were identified using logistic regression.Among the 398 HCV-cured individuals in the study sample (median age [IQR]: 56 [53-59] years; 73.1% men), 23.9% presented with moderate-to-severe depression (PHQ-9 score ≥10). Depressive symptom prevalence rates were as follows: anhedonia: 52.3%; feeling 'down' or feelings of hopelessness: 48.3%; sleeping problems: 65.7%; lack of energy: 70.3%; eating disorders: 51.2%; lack of self-esteem: 34.3%; difficulty concentrating: 34.9%; sluggishness (in movement and voice) or restlessness: 24.6%; suicidal ideation: 17.1%. No significant difference was detected across age classes. Female sex, unhealthy alcohol use, sedentary lifestyle, and unhealthy eating behaviors were associated with increased odds of moderate-to-severe depression.Depressive symptoms were common in this sample of HCV-cured PLWH. Unlike findings for the French general population, the prevalence of depression did not decrease with age class. Mental health remains a key issue for HIV-HCV-coinfected individuals, even after HCV cure, especially in women and in individuals with unhealthy behaviors.Despite potential improvements in mental health after successful treatment with direct-acting antivirals, many people living with HIV (PLWH) and hepatitis C virus (HCV) - even in older age classes - still face depressive symptoms after HCV cure. In this population, women and people reporting unhealthy alcohol use, sedentary lifestyle, or unhealthy eating behaviors are more prone to report depressive symptoms after HCV cure. Mental health and lifestyle-related issues should be integrated in a global care model for PLWH living with or having a history of hepatitis C.

Knowledge on the health of greenspace workers is scarce, even though they are exposed to many occupational hazards. The aim of this study was to analyze mortality by cause, prevalence of some non-cancer diseases, and incidence of the main cancers among greenspace workers.A sub-cohort of greenspace workers was formed within the AGRICAN cohort. Demographic information, health characteristics and self-reported diseases at enrollment were described separately in terms of frequencies (%), median and Interquartile Range (IQR) for greenspace workers, farmers, and other non-agricultural workers. Causes of death and cancer incidence were identified through linkage with cancer registries from enrollment (2005-2007) to 2015. Hazard ratio (HR) and 95% Confidence Intervals [95% CI] were estimated using Cox proportional hazard regression with age as the underlying timescale.The sub-cohort included 6247 greenspace workers who were higher proportion men, younger and more frequently smokers than farmers and non-agricultural workers. Male and female greenspace workers reported more history of allergic diseases; and males, more history of depression. Compared to other workers male greenspace workers showed a non-significant higher mortality from ischemic cardiological diseases (HR = 1.14 [0.81-1.60]). Incidence was higher in male greenspace workers than farmers for overall cancer (HR = 1.15 [1.04-1.27]), cancer of the prostate (HR = 1.21 [1.02-1.44]), thyroid (HR = 2.84 [1.26-6.41]), testis (HR = 3.98 [1.50-10.58]) and skin melanoma (HR = 2.15 [1.33-3.47]). Non-significant increased risks were also found for sarcomas, larynx and breast. In women, risk of breast cancer was higher in greenspace workers than in farmers (HR = 1.71 [1.17-2.50]).Whereas greenspace workers have often been included with other pesticide applicators in epidemiological studies, our analyses highlighted the differences between these two populations. They demonstrate the need to study them separately and to investigate more thoroughly the role of specific occupational exposures such as pesticides as well as the effect on women.

Introduction Les douleurs ressenties par les patients souffrant d’une arteriopathie obliterante des membres inferieurs (AOMI) symptomatique sont complexes, invalidantes et incompletement soulagees par les antalgiques usuels. Le diagnostic des douleurs neuropathiques a ete facilite par la mise en place de questionnaires valides permettant leur depistage. L’objectif etait d’evaluer la prevalence des douleurs neuropathiques chez les patients avec AOMI symptomatique en ville a l’aide d’une echelle standardisee : Douleur Neuropathique 4 questions ou DN4. Materiel et methode Nous avons realise une etude observationnelle, descriptive, multicentrique en ville aupres de medecins generalistes et de medecins vasculaires entre novembre 2017 et septembre 2018 a l’aide d’un questionnaire rempli par le praticien. La presence d’un diabete ou d’une neuropathie d’une autre etiologie etait un critere d’exclusion. Resultats Cinquante-neuf patients, d’âge moyen 67,6 ± 13 ans, ont ete inclus, dont 51 patients en ischemie d’effort et 8 en ischemie de repos avec douleurs de decubitus. La majorite etait des hommes (44 patients). Leur douleur etait moderee a severe (echelle numerique ≥ 4/10) pour 49 d’entre eux. La prevalence des douleurs neuropathiques etait de 49,2 % (29 sur 59 patients). Une association significative a ete retrouvee entre la severite de l’AOMI et la presence de douleurs neuropathiques (p = 0,002). Chez les patients avec une ischemie au repos, 6 sur 8 soit 75 % presentaient des douleurs neuropathiques versus 23 sur 51 soit 45 % des patients avec ischemie d’effort. Chez les patients presentant une ischemie d’effort, une distance de marche Conclusion La prevalence des douleurs neuropathiques chez les patients presentant une AOMI symptomatique, non diabetiques est donc importante et justifie le depistage de ce type de douleurs afin d’adapter le traitement antalgique specifique (pregabaline, gabapentine, ou amitriptyline en premiere intention) pour ameliorer la qualite de vie de ces patients. Cela ne se substitue en rien a la revascularisation en cas d’indication.

Resume L’arteriopathie obliterante des membres inferieurs (AOMI) est sous-diagnostiquee alors qu’elle est un marqueur de risque de mortalite cardiovasculaire eleve. L’index de pression systolique (IPS) est une mesure simple, fiable et recommandee par la Haute Autorite de sante (HAS) permettant de depister et d’evaluer la severite de l’AOMI. Les medecins generalistes sont trop peu nombreux a l’utiliser. Objectif L’etude vise a identifier les freins et les motivations a l’utilisation de l’IPS en medecine generale. Methode Etude representative, descriptive, transversale aupres de 165 medecins generalistes installes en Ile-de-France interroges selon la methode des quotas stratifies. Resultats Pour 1 praticien sur 5, l’IPS n’est pas un indicateur pertinent, or une opinion favorable predetermine son adoption (OR : 4,9 [IC 95 % : 4,2–5,7]). Seuls 42 % (IC 95 % : 34 %–49 %) des praticiens savent que l’IPS est recommande par la HAS, information essentielle a son acceptation (OR : 3,7 [IC 95 % : 3,2–4,2]). La formation renforce cette acceptation (OR : 5,0 [IC 95 % : 4,4–5,6]) et la formation universitaire apporte une meilleure comprehension de l’IPS (OR : 2,8 [IC 95 % : 2,3–3,4]). Le temps consacre a l’IPS est le principal frein (OR : 0,6 [IC 95 % : 0,6–0,7]). Un kit doppler-reglette de calcul (OR : 11,8 [IC 95 % : 8,9–15,6]), un cout de materiel n’excedant pas 300 euros (OR : 3,4 [IC 99 % : 3,0–3,9]), une cotation cumulable avec la consultation (OR : 2,6 [IC 95 % : 2,3–3,0]) et l’integration au dispositif d’evaluation conventionnel (OR : 2,6 [IC 95 % : 2,3–2,9]) motiveraient davantage de praticiens. Sept praticiens sur 10 approuvent l’interet de l’IPS pour l’observance therapeutique, mais l’IPS reste sous-exploite pour les patients symptomatiques (OR : 0,4 [IC 95 % : 0,3–0,4]). Conclusion Une meilleure information, formation, ainsi qu’une revalorisation de l’acte favoriseraient davantage l’utilisation de l’IPS en medecine de ville.

SummaryBackground Leg ulcers (LUs) are a chronic and severe complication of sickle cell disease (SCD). A prospective study in patients with SCD to identify factors associated with complete healing and recurrence of LUs is lacking. Objectives To determine clinical and biological factors associated with SCD-LU complete healing and recurrence. Methods This prospective, observational cohort study was conducted at two adult SCD referral-centre sites (2009–2015) and included 98 consecutive patients with at least one LU lasting ≥ 2 weeks. The primary end points compared patients with healed vs. nonhealed LUs at week 24, and patients with vs. without recurrence during follow-up. Results The median (interquartile range) LU area, duration and follow-up were, respectively, 6·2 cm2 (3–12·8), 9 weeks (4–26) and 65·8 weeks (23·8–122·1). At week 24, LUs were healed in 47% of patients, while 49% of LUs recurred. Univariate analyses identified inclusion LU area < 8 cm2 (82% vs. 35%; P < 0·001), inclusion LU duration < 9 weeks (65% vs. 35%; P = 0·0013) and high median fetal haemoglobin level (P = 0·008) as being significantly associated with complete healing at week 24, and low lactate dehydrogenase level (P = 0·038) as being associated with recurrence. Multivariate analyses retained LU area < 8 cm2 (odds ratio 6·73, 95% confidence interval 2·35–19. 31; P < 0·001) and < 9 weeks’ duration (OR 3·19, 95% confidence interval 1·16–8·76; P = 0·024) as being independently associated with healing at week 24. Factors independently associated with recurrence could not be identified. Conclusions SCD-LU complete healing is independently associated with the clinical characteristics of LUs rather than the clinical or biological characteristics of SCD.

To estimate the impact of adding low-molecular-weight heparin (LMWH) or unfractionated heparin to low-dose aspirin started ≤ 16 weeks' gestation on the prevalence of pre-eclampsia (PE) and the delivery of a small-for-gestational-age (SGA) neonate.A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed by searching the medical databases PubMed, EMBASE, Web of Science and Cochrane Central. Pregnant women randomized to receive LMWH or unfractionated heparin in addition to low-dose aspirin were compared with those who received low-dose aspirin alone. Outcome measures were PE, severe PE, early-onset PE and SGA. Pooled relative risks (RRs) with 95% CI were calculated using a random-effects model.Eight RCTs met the inclusion criteria; the indication for recruitment was previous recurrent miscarriage in five studies (three included women with thrombophilia) and a history of severe or early-onset PE in three studies (including women with thrombophilia in one). LMWH was administered in seven studies and unfractionated heparin in one. In women with a history of PE, treatment with LMWH and aspirin, compared with aspirin alone, was associated with a significant reduction in development of PE (three trials (n = 379); RR, 0.54 (95% CI, 0.31-0.92); P = 0.03) and in delivery of SGA neonates (two trials (n = 363); RR, 0.54 (95% CI, 0.32-0.91); P = 0.02). These outcomes were not significantly reduced in women with recurrent miscarriage who received LMWH and aspirin, compared with aspirin alone. The small number of studies precluded sensitivity analyses and the evaluation of publication biases. Blinding to the allocation treatment was absent in all RCTs.Based on limited evidence, the addition of LMWH to low-dose aspirin could reduce the prevalence of PE and SGA in women with a history of PE. This observation should be the basis of a well-conducted future trial rather than a recommendation for immediate clinical application. Copyright © 2015 ISUOG. Published by John WileySons Ltd.

Resume Inscrites en preambule dans toutes les recommandations officielles sur la prise en charge de l'hypertension arterielle, les mesures hygienodietetiques ont fait la preuve de leur efficacite sur la reduction des chiffres de pression arterielle. Bien que l'impact reel de ces mesures non medicamenteuses sur le niveau de risque cardiovasculaire prete encore a discussion, elles sont ou devraient etre partie prenante du traitement antihypertenseur. Les cinq mesures efficaces sont : la reduction ponderale, un regime peu sale, une alimentation de type DASH (Dietary Approaches to Stop Hypertension) (favorisant les fruits, les legumes et les produits alleges en graisse), la pratique d'une activite physique et la reduction de la consommation d'alcool. Ces modifications de l'hygiene de vie ont demontre leur capacite a reduire la pression arterielle, quel que soit le niveau tensionnel initial. Il semble raisonnable de considerer que ces mesures non medicamenteuses agissent de facon au mieux additive avec les therapeutiques pharmacologiques. Sachant qu'il est toujours tres difficile d'obtenir une bonne observance des patients a ces mesures souvent contraignantes, l'education pour la sante et les mesures de sante publique devraient etre associees au colloque singulier pour esperer controler efficacement la pression arterielle en population generale.

The genome size and base composition of diploid plant species from three genera of the Casuarinaceae family were determined by flow cytometry. Casuarina glauca Sieb. ex Spring. and Gymnostoma deplancheana (Miq.) L. Johnson showed a small genome with 2C = 0.70 pg, 58.6% AT, 40.5% GC for the first species and 2C = 0.75 pg, 58.7% AT, 40.5% GC for the second. Allocasuarina verticillata (Lam.) L. Johnson had a larger genome: 2C = 1.90 pg, 59.3% AT, 41.1% GC. One haploid genome of C. glauca is therefore about 340×106 base pairs. In leaves, roots or bark of these three species, polysomaty was virtually absent: a maximum frequency of 4C nuclei of only 0.08 was found in bark of C. glauca. The genome sizes of C. glauca and G. deplancheana are among the smallest described for higher plants. Small genome size, diploidy and the absence of polysomaty are advantageous traits for facilitating molecular approaches to improvement of these actinorhizal plants and developing the study of their symbiotic interactions with Frankia.

Peripheral arterial disease (PAD) is under-diagnosed despite its predictive value for cardiovascular mortality. The ankle brachial index (ABI), a simple reliable measure recommended by the French health authorities to detect and evaluate the severity of PAD, is used by too few general practitioners (GPs).This study aimed at identifying motivations and barriers for using ABI in general practice.A representative, descriptive, cross-sectional survey was conducted amongst 165 GPs practicing in Île-de-France who were interviewed using stratified quotas.Although 1 out of 5 GPs considered ABI to be an irrelevant indicator, most had a favorable opinion about its use (OR: 4.9 [CI 95 %: 4.2-5.7]). Only 42 % (CI 95 %: 34 %-49 %) of GPs knew ABI was recommended by the health authorities. This information had a critical impact on the acceptance of ABI relevancy (OR: 3.7 [CI 95 %: 3.2-4.2]). Training reinforced acceptance (OR: 5.0 [CI 95 %: 4.4-5.6]) and pre-residency education provided a better understanding of ABI (OR: 2.8 [CI 95 %: 2.3-3.4]). Time needed to measure ABI was the main barrier (OR: 0.6 [CI 95 %: 0.6-0.7]). A Doppler-calculation kit (OR: 11.8 [CI 95 %: 8.9-15.6]), equipment cost≤300Euros (OR: 3.4 [CI 99 %: 3.0-3.9]), a specific fee in addition to the regular consultation fee (OR: 2.6 [CI 95 %: 2.3-3.0]) and inclusion of ABI in the GP's evaluation scheme (OR: 2.6 [CI 95 %: 2.3-2.9]) would motivate more GPs. Seven out of 10 GPs agreed that ABI has a positive impact on patient adherence to treatment and follow-up, but ABI remained underexploited for symptomatic patients (OR: 0.4 [CI 95 %: 0.3-0.4]).Better communication and training together with an upgraded status for ABI would provide motivation for GPs to measure ABI.

Introduction La drepanocytose homozygote SS et la S/s0 thalassemie sont les plus graves des syndromes drepanocytaires majeurs (SDM). Les ulceres de jambe (UJ) sont une des complications chroniques severes des SDM, dont l’incidence varie entre 5 et 40 % des malades homozygotes. La morbidite de ces UJ-SDM est elevee, le pronostic de cicatrisation est inconnu et le traitement mal codifie. Cette etude prospective avait pour objectif d’etudier pour la 1re fois les facteurs pronostiques de cicatrisation des UJ-SDM. Materiel et methodes Cette etude de cohorte observationnelle prospective, multicentrique, a inclus entre 2009 et 2014 tous les malades atteints de SDM presentant un UJ, et suivis dans un des 2 des sites du centre de reference adulte des SDM. Les donnees cliniques, biologiques, evolutives et therapeutiques du SDM et de l’UJ, ainsi que la cicatrisation a 6 mois ont ete recueillies a l’aide d’un dossier type. L’etude des facteurs associes a la cicatrisation complete et des facteurs lies a leur recidive a ete realisee grâce a une regression logistique multivariee en pas a pas descendant. Le seuil de significativite etait de 0,2 pour la phase univariee et de 0,05 pour la phase multivariee. Resultats Parmi les 98 malades inclus, le genotype etait SS dans 98 % des cas. A l’inclusion, 73 % des UJ evoluaient depuis plus de 24 semaines ; 59 % des UJ mesuraient plus de 8 cm2. Une cicatrisation complete a ete observee dans 46,5 % a 6 mois, et une recidive dans 49 % des cas avec un delai median de 12 semaines (interquartile 46,5). Les autres caracteristiques sont resumees dans le tableau. L’analyse multivariee a identifie comme facteurs independants associes a la cicatrisation a 6 mois : une surface Discussion Cette etude est la plus large cohorte de malades presentant des UJ-SDM, ce qui a permis, d’une part, de confirmer leur severite et, d’autre part, d’identifier pour la premiere fois des facteurs predictifs de cicatrisation. Dans cette etude, la cicatrisation des UJ-SDM est associee a des caracteristiques propres a l’UJ (surface 2) et non a des facteurs lies aux caracteristiques cliniques, biologiques ou therapeutiques du SDM. Conclusion Notre etude souligne la severite de l’UJ-SDM qui appelle la recherche active de solutions therapeutiques. La mise en place d’une compression veineuse de classe > 2 devrait etre systematiquement proposee. Du fait de la resistance apparente des UJ aux traitements de fond du SDM, des solutions therapeutiques innovantes devront viser specifiquement a favoriser les mecanismes de la cicatrisation.

Atypical clinical and/or EEG presentation may complicate the diagnosis of juvenile myoclonic epilepsy (JME). To assess the sensitivity of a standard EEG recording, we retrospectively evaluated the EEG performed at their first referral in 56 consecutive JME patients first seen between 1986 and 1992 (26 M, 30 F, aged 12-53, mean 24.4, with onset of JME at age 10-33, mean 14.3). The diagnosis had been made in none of these patients prior to referral, and was often confirmed only during follow-up. A 20-minute standard EEG was recorded, including hyperventilation (HV) and intermittent light stimulation (ILS). This EEG was normal in 15 cases (27%), showing aspecific or misleading changes in 11 cases (20%) and typical changes in only 30 cases (54%). The baseline EEG was normal in 25 (45%), atypical in 11 (20%), and typical for JME in only 20 (35%). HV and ILS yielded 37 and 39 normal, 10 and 7 aspecific and 9 and 10 specific findings, respectively. A single standard EEG without activation may thus be inconclusive or misleading for the diagnosis of JME in more than 50% of newly referred patients.

Membrane-associated and soluble lipoxygenases from green tomato (Lycopersicon esculentum Mill. cv Ailsa Craig) fruit have been identified. Microsomal lipoxygenase was localized partly in the plasma membrane and tonoplast fractions. The possibilities of glycosyl-phosphatidylinositol or transmembrane polypeptide anchors in the membrane were ruled out by differential solubilization and temperature-induced phase separation in Triton X-114. High performance liquid chromatography of reaction products combined with polarography showed that tomato lipoxygenase is capable of specific oxygenation of fatty acids esterified in phospholipids. This possibility of direct action on membrane phospholipids strengthened the hypothesis of a role for lipoxygenase in plant senescence and membrane turnover. Membrane-associated lipoxygenase is polymorphic, with two forms differing by their isoelectric points (pls) (around 4.2 and 5.1). The pl of the soluble lipoxygenase corresponds to the minor microsomal enzyme, with a pl of 5.1. The charge-differing isoforms were separated and analyzed by western blotting using anti-soybean lipoxygenase antibodies. A single polypeptide with an apparent molecular weight of 92,000 was identified in each case for the soluble and microsomal enzymes. It is suggested that a charge modification of the soluble lipoxygenase allows its association with the membrane.

In this short paper, we present a few preliminary results from the ambitious ATLAS3D project, which intends to probe the first volume-limited sample of early-type galaxies observed via multi-band photometry, integral-field spectroscopy, radio and millimeter observations, and supported by a large library of numerical simulations and models. We more specifically address the existence of two main families of early-type galaxies, the slow and fast rotators. © 2010 American Institute of Physics.

We study resolution effects in numerical simulations of gas-rich (20% of the total baryonic mass) major mergers, and show that the formation of slowly-rotating elliptical galaxies requires a resolution that is beyond the present-day standards to be properly modelled. Our findings show that a high-enough resolution is required to accurately model the global properties of merger remnants and the evolution of their angular momentum. The role of wet mergers of spiral galaxies in the formation of slow-rotating ellipticals may therefore have been underestimated. © 2010 American Institute of Physics.

Brain maturation and GABA metabolism are known to play a key role in epileptogenesis. The metabolism of the polyamines (putrescine, spermidine and spermine) is closely linked to the process of brain maturation. Putrescine has been shown to be catabolized to GABA in brain tissue and astrocytes. In order to better understand the importance of glial putrescine transport and metabolism, a model of age-dependent epilepsy was used to study the kinetic properties of [14C]putrescine uptake into cultured astrocytes from normal C57/BL and audiogenic DBA/2 newborn mice, and the subsequent GABA formation. (1) Putrescine uptake exhibited non-Michaelian allosteric kinetics with positive co-operativity (Hill factor = 2), suggesting a physiological importance of putrescine uptake by astrocytes. (2) The Vmax of putrescine uptake was significantly higher in C57/BL astrocytes than in DBA/2J, but the uptake affinity for putrescine was higher in DBA/2J than in C57/BL. (3) High K+ concentrations (18 mM) had little effect on putrescine uptake in either strain. (4) Ten-micromolar N-acetylputrescine, the first putrescine metabolite, stimulated putrescine uptake into astrocytes of both strains, but to a different degree: +46% in C57/BL and +102% in DBA/2J. (5) The specific radioactivity of the GABA formed from labelled putrescine was four times higher in astrocytes from DBA/2J than from C57/BL mice. (6) The molar ratio of glutamate/GABA in the cerebral cortex of the DBA/2J mice was significantly higher during the period of audiogenic seizure susceptibility than in age-matched C57/BL mice. Our results show characteristics of putrescine uptake into astrocytes; we demonstrated distinct kinetic properties between normal and epileptic strains of mice. Moreover, astrocytic polyamine contents and putrescine catabolism into GABA were increased for the audiogenic mice.

Drive-by download is a term used to describe a download that happens without the knowledge or conscious intervention of the computer user. In computer security terms, a drive-by download is usually triggered by the exploitation of a vulnerability in an Internet browser. The file that is downloaded is usually a malicious program that installs itself on the victims computer, or is an installer for another malicious program. In this paper, we describe the problem posed by drive-by downloads from different perspectives. We also explain the difficulties of dealing with drive-by infections and propose various approaches that could solve part of the problem. Drive-by downloads are a prime example of the exponential rate at which malware infection can increase on the Internet. The primary purpose of this paper is to bring the drive-by download problem to the attention of the research community, in an effort to inspire further research initiatives in this area.

The prevalence of neurological disorders such as stroke, spinal cord injury and traumatic brain injury is increasing quickly in the industrialised societies. Although the benefit of the use of technology in rehabilitation and neurorehabilitation programs is proved, the presence of mechatronic systems is still very low. This paper proposes a new lower limb exoskeleton for functional rehabilitation in persons with neurological pathologies. Since potential users have very reduced mobility even to start common daily movements, the control of the exoskeleton has to be intention based The estimation of the intention of the user is based on hip and knee angle, and the EMG signal is monitored for intention detection, control and neurofeedback aims. A novel approach of a whole mechatronic system has been done in order to approach functional rehabilitation in patients with neurological disorders and stroke. The EMG to force conversion in paraplegic patients is also described.

Technology has big presence in our lives and we are surrounded by lot of peripheral devices supposed to make our daily life easier; TV, computer, cellular phone and internet for example. The way we interact with these devices is critical for making them accessible and useful. This article presents an alternative, universal, non invasive and wireless interface to control peripheral devices by means of head movements, which is patent pending. The interface is expected to be a communication alternative for many users with mobility impairments in upper-extremities, enabling interaction with most of external devices needed for developing a normal life activity, gaining autonomy and independence. The interface is non-invasive, light weight and wireless, avoiding uncomfortable use, allowing a long term use and minimizing visual and ergonomic impact.

One of the largest successes of modern medicine is the total hip replacement. Presently this procedure has one of the highest success rate among surgical interventions, only second to the appendix removal procedure. However the lifetime of the prosthesis itself is still limited to 10 to 20 years, which means that for numerous patients replacement of the procedure will become mandatory. This replacement finds its origin in aseptic loosening of the prosthesis mainly caused by the formation of wear particles at articular joints and by the difference in stiffness between the bone and the metallic prosthesis leading phenomena called stress shielding. To overcome this problem, new designs of more biomimetic prostheses, with stiffness similar to that of cortical bone, are being studied. Among the latter, a novel design based on polymer composite materials of total hip replacement prosthesis is under development. One of the key characteristics of this biomimetic prosthesis is its hydroxyapatite coating, which permits Osseo integration (integration into the bone). Thermally sprayed hydroxyapatite coatings are already used successfully for metallic implants, but plasma sprayed hydroxyapatite coatings have yet to be developed for polymer composites due to quite challenging heat management and adhesion concerns. This paper describes and discusses the optimization of the plasma sprayed technique and the formation of the adequate underlayer enabling the plasma spray on highly heat sensitive substrate. Adhesion, shear and fatigue results are presented. Abstract only; no full-text paper available.

A high density 2D transducer array designed for 3 MHz echocardiography imaging has been developed in the frame of a real-time 3D ultrasound system project. This 2D array is using advanced interconnect and microstructuring technologies. The interconnect structure is fabricated through the backing material by placing microflex circuits perpendicular to the array plane. The structuring of small transducer elements with 308 micrometer pitch is done by a combination of controlled saw dicing of the piezoelectric material and laser ablation of the matching layers. Design, fabrication and characterization of the first prototypes are presented.

Our objective was to evaluate the risks of maternal and perinatal morbidity associated with induction of labour in uncomplicated term pregnancies. We conducted a retrospective cohort study including 7,430 women, not referred from another institution, with a single baby in vertex presentation, and delivering between 38 and 40 weeks of pregnancy. Among these women, 3,546 were excluded for prelabour pregnancy complications. Relative risks (RR), adjusted for parity, were computed to compare 3,353 women who went into labour spontaneously with 531 women whose labour was induced. Induction of labour was found to be associated with a higher risk of caesarean section [RR = 2.4, 95% CI 1.8, 3.4]. Use of non-epidural [RR = 1.5, 95% CI 1.2, 1.8] and of epidural analgesia [RR = 1.4, 95% CI 1.1, 1.7] was more frequent after labour induction. Resuscitation [RR = 1.2, 95% CI 1.0, 1.5], admission to the intensive care unit [RR = 1.6, 95% CI 1.0, 2.4] and phototherapy [RR = 1.3, 95% CI 1.0, 1.6] were more frequent after induction of labour. Results were similar when controlling simultaneously for parity, maternal age, gestational age, year of delivery, birthweight and the physician in charge of delivery in a logistic regression analysis. The results of this study suggests that induction of labour is associated with a higher risk of caesarean section and of some perinatal adverse outcomes. Induction of labour should be reserved for cases where maternal and perinatal benefits outweigh the risk of these complications.

Mild personality problems have been described in patients with juvenile myoclonic epilepsy (JME), but clinical practice shows that JME can be diagnosed in patients with more or less severe psychiatric disorders (PD). The presence in JME patients of personality disorders has been described repeatedly, but never quantified. We thus decided to evaluate, using the DSM IV, the current prevalence and types of PD in a large series of consecutive, newly referred patients with JME. Among 170 consecutive JME cases referred to two departments of epileptology (Marseilles and Nice) between 1981 and 1998 (66 males, 104 females; aged 11.7-70; mean+/-SD 32.4+/-10.4 follow-up 12.7+/-10 [0.5-52]), we found 45 patients (26.5p.100) with PD. According to the DSM IV, they could be classified as severe mental retardation (main diagnosis) (one case); pervasive developmental disorders (2 cases); tic disorder (1 case); enuresis (1 case); psychotic disorders (5 cases, including schizophrenia paranoid type (1 case), disorganized type (1 case), delusional disorder (1 case), unspecified (2 cases)); depressive disorders (3 cases); generalized anxiety (6 cases); anorexia nervosa (2 cases); personality disorders (24 cases, including borderline personality (11 cases), dependent personality (5 cases), histrionic personality (2 cases), obsessive-compulsive personality (1 case), not specified (5 cases)). Sudden unexplained death occurred in 2 cases (borderline personality and pervasive developmental disorder not otherwise specified, respectively) and death due to pneumonia in 1 cases (anorexia). Although uncommonly severe cases of JME may have been selected in our referral centers, it appears that JME may be associated with PD. Comparatively mild personality disorders are the most common finding, and may be part of the clinical picture to some extent, while severe PD are less common, and probably coincidental. The presence of PD does not exclude the diagnosis of JME, and PD may represent a further challenge in the comprehensive care of these patients.

A 19-year-old woman complained of long-standing, frequent, debilitating brusque movements triggered by unexpected stimuli. She was neurologically normal and neuroimaging was also normal. Conspicuous startle reactions were easily reproduced under EEG and video monitoring: the interictal EEG was normal, the ictal recordings doubtful; clinically, the startle reaction was asymmetric, with elevation of the left limbs. The diagnosis of hyperekplexia and startle epilepsy were discussed. We learned that she had been evaluated at age 3-4 months for spontaneous, generalised tonic-clonic seizures and "infantile spasms", in fact for early-onset startle reactions triggered by noise or contact, in association with prominent EEG changes. A full remission had been achieved under ACTH therapy, but the startle reactions had reappeared at around age six. The patient was successfully treated with carbamazepine. The history, clinical and neurophysiological data led us to discuss the diagnosis of hyperekplexia and startle epilepsy. We concluded that the patient had an unusual form of cryptogenic focal epilepsy originating from the supplementary motor area, presenting as strictly stimulus-triggered "flash" seizures.

Within the framework of a broad program of interspecific crosses involving different Actinidia species and ploidy races, we carried out an assay of interspecific hybridization using a small number of the Actinidia species available in European repositories. Our aim was to conduct a preliminarily assessment of the degree of crossability occurring in the genus and the effectiveness of different techniques and media in rescuing interspecific hybrids. A set of culture media was developed to replace the hybrid embryo's deficient endosperm to ensure survival of the embryos at the globular and heart stages. In several crosses immature embryos that reached the torpedo stage were rescued when incubated in the proper media. The embryo rescue was the unique tool which led to hybrid plantlets for four crosses: A. kolomikta × A. chinensis, A. polygama × A. valvata, A. arguta Issai × A. polygama and A. kolomikta × A. deliciosa. Flow cytometry was used to check the ploidy level of the parental genotypes and the progeny. A wide interspecific crossability was found in Actinidia that involved species belonging to the different sections on the basis of traditional taxonomy.

Patients with systemic rheumatic diseases are rarely admitted in intensive care units and very few studies focusing on the prognosis of those patients have been published.Retrospective study over seven years in two intensive care units.Among 33 patients with systemic disease diagnosed 90 +/- 133 months before admission in the intensive care unit, who were aged 50 +/- 21 years and represented a total of 39 stays in the intensive care unit, the main cause of admission was acute respiratory failure (33%). Mean simplified acute physiology score (SAPS II) was 47 +/- 22. Two-thirds of the patients were under mechanical ventilation. Infection was diagnosed in 33% of the cases and exacerbation of the systemic rheumatic disease in 26%. Nosocomial infection was found in 19 patients (49%). Ten patients died during their stay in the intensive care unit, six from infection, three from an exacerbation of the systemic rheumatic disease, one from an unidentified cause.Even if severity scores of patients suffering from systemic diseases are higher at admission in intensive care units than those of other patients, there is no relevant reason to refuse critical care to these patients.

Objectives : The purpose of this study was to research whether or not video games may induce paroxysmal discharges (PD) in different groups of patients. Methods : One hundred and fifteen subjects from 5 different French laboratories were studied: 33 had seizures exclusively under visual stimuli, 42 had both photogenic seizures and spontaneous seizures occuring independently, and 40 had non-photogenic seizures. The same protocol which included one TV sequence, 3 sequences of video games selected on particular criteria (pattern, luminosity and nature of the scene), were presented at different distances from the TV screen at 50 and 100 Hz. Results : Among the factors provoking paroxysmal discharges (PD) some seem crucial: the frequency of the TV screen (the 100 Hz screen was significantly safer than 50 Hz), the distance from the screen (1 m safer than 50 cm), and, particularly for the 50 Hz screen, the specific pattern of the images and the act of playing. Conclusions : Video games are ineffective for subjects known as having a non-photosensitive epilepsy, but may induce PD on subjects known as photosensitive even when intermittent light stimulation (ILS) is not effective. These results based on a different approach than in other publications confirm data which were suggested by the literature, and suggest that 100 Hz TV screens should be recommended to patients with TV-induced attacks.

Boxy/peanut-shaped bulge galaxies constitute at least 20–30% of all spirals. Distribution functions and numerical simulations studies have shown that the slow decay of the orbit of a companion into a larger spiral can lead to the formation of a boxy/peanut bulge. However, the bar-buckling instability now appears a more likely process. Thin bars either do not form or, as shown by N-body simulations, buckle and settle with an increased thickness, appearing boxy or peanut-shaped when seen edge-on. This project aims to determine the dynamical state of a sample of 30 edge-on spirals, 3/4 of which have boxy/peanut-shaped bulges, half having close-by companions.

The gamma-aminobutyric acid (GABA) is one of the most important inhibitory transmitter in the CNS. When GABA is released in the synaptic cleft, it can act on two types of receptors, type A (GABAA-R) and type B. The GABAA-R is an ionotropic receptor whose subunits form a chloride channel. It contains specific binding sites at least for GABA, benzodiazepines, picrotoxin, barbiturates, anesthetic steroids, divalent cations such as Zn2+ and other compounds. Neurotransmitters and neuropeptides that regulate intracellular second messengers may modulate the responses of GABAA-R in the post-synaptic membrane and thus affect the synaptic plasticity. While consensus sites for several kinases are present on many subunit-subtypes, the functional consequences of these phosphorylations are unclear. However, the maintenance of normal GABA currents required the activity of a unique kinase specific for the GABAA-R. This intracellular regulation site might be involved in synaptic plasticity and considered as a site of vulnerability for epileptogenesis. The generation of epileptic discharge, synchronized burst firing and interictal spikes, can be subsequent to the alteration of GABAA-R function. A consequence of GABAergic disinhibition is the formation of new polysynaptic pathways leading to a network of neurons that were previously not connected. Cell loss and plasticity are currently observed in most patients with temporal lobe epilepsy. CA1 pyramidal cells are missing and mossy fibers of dentate granule cells project back through the granule cell layer to form recurrent terminals on granule cell dendrites. This mossy fiber sprouting leads to the destruction of most dentate hilar somatostatine interneurons. Nevertheless, local circuit neurons containing glutamic acid decarboxylase survive in this layer and in all regions of the sclerotic hippocampus. A decrease of the GABA release has been proposed as a basis for disinhibition temporal-lobe epilepsy is partially characterized by a loss of glutamate-stimulated GABA release that is secondary to a reduction in the number of GABA transporters. A molecular reorganization of GABAA-R subunits has been suggested in the kindling model of temporal lobe epilepsy because the zinc released from abberantly sprouted mossy fiber terminals is responsible for a collapse of augmented inhibition by GABA. These results support the concept of a loss of inhibition in chronic epilepsy models and probably in human epilepsies.

Authors report a case of focal action myoclonus due to a localized hemispheric lesion. The woman had cardiac arrest complicated by ischemic stroke involving the left parietal region. Action myoclonus of the inferior right limb was the sole residual complaint, provoked by movement and maintenance of posture. Patient noted that myoclonus was worsened by carbamazepine and vigabatrin. EEG-EMG polygraphic study demonstrated action myoclonus and showed a particular EEG activity consisting in a volley of spikes on the vertex region during the right inferior limb movements. Contralateral movements did not elicit this activity. Pharmacological response to clonazepam, piracetam and alcohol was studied. A marked improvement of myoclonus was obtained with alcohol. Pathophysiology of this exceptional form of cortical action myoclonus is discussed.

Atypical clinical and/or EEG presentation may complicate the diagnosis of juvenile myoclonic epilepsy (JME). To assess the sensitivity of a standard EEG recording, we retrospectively evaluated the EEG performed at their first referral in 56 consecutive JME patients first seen between 1986 and 1992 (26 M, 30 F, aged 12-53, mean 24.4, with onset of JME at age 10-33, mean 14.3). The diagnosis had been made in none of these patients prior to referral, and was often confirmed only during follow-up. A 20-minute standard EEG was recorded, including hyperventilation (HV) and intermittent light stimulation (ILS). This EEG was normal in 15 cases (27%), showing aspecific or misleading changes in 11 cases (20%) and typical changes in only 30 cases (54%). The baseline EEG was normal in 25 (45%), atypical in 11 (20%), and typical for JME in only 20 (35%). HV and ILS yielded 37 and 39 normal, 10 and 7 aspecific and 9 and 10 specific findings, respectively. A single standard EEG without activation may thus be inconclusive or misleading for the diagnosis of JME in more than 50% of newly referred patients.

Polyclonal antiserum to a new voltage-dependent anion channel protein (B-36 VDAC) isolated during the purification of the GABAA receptor from bovine cerebral cortex was used to determine the localization of this protein in immunocytochemical preparations of cerebral cortex, cerebellum and hippocampal formation of rat, cow and human. The labeling was present in the Purkinje cells and some cells of the molecular layer of the rat cerebellum, as well as in pyramidal and non-pyramidal cells of the rat and human cerebral cortex; the labeling outlined the membrane surface. In the rat granule cells of the dentate gyrus and the pyramidal cells, the labelling was observed within the cells. These results indicate that the B-36 VDAC protein is heterogeneously distributed among different cerebral regions in different species and suggest that this protein would be associated with the alpha-1 subunit of the GABAA receptor (benzodiazepine binding sites).

The stunning accumulation of data on the physiopathology of Alzheimer''s disease is a real hindrance to pharmacologists who have to make decisions as to what molecules should be assessed first in man. Considering the cumbersomeness and cost of clinical trials in that field, a review of potential targets for drugs that are supposed to be active against the disease has become necessary, for a true definition of the rational justifications of trials to be envisaged.