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L’insomnie chronique est un problème de santé majeur avec une prévalence pouvant atteindre 50 % en soin courant. Le traitement de première intention recommandé est la thérapie cognitive et comportementale pour l’insomnie (TCCi), malheureusement peu accessible. La digitalisation offre la possibilité de réduire les inégalités d’accès aux soins en proposant des options de soins plus flexibles et accessibles. De plus, la TCCi numérique s’est avérée aussi efficace que la TCCi en personne. Cependant, comme pour les soins traditionnels, une approche basée sur des preuves et l’engagement des patients demeure fondamentale. Objectif Développement d’un programme de TCCi numérique basé sur des connaissances théoriques et cliniques, et pensé pour être efficacement mis en œuvre dans le système de santé.

O’Neill’s recent Review on Antimicrobial Resistance expressed the view that by 2020 high-income countries should make it mandatory to support antimicrobial prescribing with rapid diagnostic evidence whenever possible.

•Two main strategies are commonly used for p-PBPK models building.•More and more time-varying parameters specific to pregnancy in PBPK models.•Data required to better characterize placental transfers and fetal distribution.•p-PBPK models are key tools for fetal exposure assessment in a DOHaD context.

ABSTRACTHaemophilus influenzaeis a significant causative agent of respiratory tract infections (RTI) worldwide. The development of a rapid H. influenzaediagnostic assay that would allow for the implementation of infection control measures and also improve antimicrobial stewardship for patients is required. A number of nucleic acid diagnostics approaches that detect H. influenzaein RTIs have been described in the literature; however, there are reported specificity and sensitivity limitations for these assays. In this study, a novel real-time PCR diagnostic assay targeting the smpBgene was designed to detect all serogroups of H. influenzae. The assay was validated using a panel of well-characterized Haemophilusspp. Subsequently, 44 Haemophilusclinical isolates were collected, and 36 isolates were identified as H. influenzaeusing a gold standard methodology that combined the results of matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) and a fucKdiagnostic assay. Using the novel smpBdiagnostic assay, 100% concordance was observed with the gold standard, demonstrating a sensitivity of 100% (95% confidence interval [CI], 90.26% to 100.00%) and a specificity of 100% (95% CI, 63.06% to 100.00%) when used on clinical isolates. To demonstrate the clinical utility of the diagnostic assay presented, a panel of lower RTI samples (n= 98) were blindly tested with the gold standard and smpBdiagnostic assays. The results generated were concordant for 94/98 samples tested, demonstrating a sensitivity of 90.91% (95% CI, 78.33% to 97.47%) and a specificity of 100% (95% CI, 93.40% to 100.00%) for the novel smpBassay when used directly on respiratory specimens.

Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) continue to present very significant diagnostic and management challenges. The development, introduction and use of a wider range of immunosuppressive therapies are leading to a broader spectrum of microorganisms causing HAP and VAP. The persistent clinical dilemma regarding their cause is that detection of a microorganism from a respiratory tract sample does not necessarily signify it is the causative agent of the pneumonia. The ever-increasing antibiotic resistance problem means that HAP and VAP are becoming progressively more difficult to treat. In this article, we review the cause, antimicrobial resistance, diagnosis and treatment of HAP and VAP and encapsulate recent developments and concepts in this rapidly moving field.

L’épuisement professionnel correspond à la fois à un dysfonctionnement social, à une forme d’adaptation en situation adversive(coping), à une perte de motivation. Ces phénomènes sont analysés à travers trois points : l’absence de stratégies adéquates ; l’impression de subir ; l’absence d’intelligibilité.

Information about an array of managerial and political topics discussed at a symposium held February 16, 2007 organized by the Académie des Sciences d'Outre-Mer on the past, current, and future prospects of the prestigious society, and on the politics and government of Africa is presented. It includes a welcoming speech for Boutros Boutros-Ghali by member Gérard Conac, and speeches by Boutros-Ghali who introduces Laurent Personne, and by Personne who discusses the current trends and future prospects of Egypt's Senghor University, located in Alexandria.

Reference scattering curves for polarization and intensity produced by aggregates and agglomerates of ethylene and kerosene soot are obtained for scattering angles in the 10–170° range. The polarization measurements were obtained with the Propriétés Optiques des Grains Astronomiques et Atmosphériques instrument for particles that levitate in microgravity during parabolic flights and on the ground by an air draught technique. The intensity measurements were obtained also on the ground with a Laboratoire de Metéorologie Physique nephelometer. The maximum polarization is of the order of 80% at a scattering angle of 80° at λ = 632.8 nm and approximately 75% at an angle of 90° at λ = 543.5 nm. The polarization increases by approximately 10% when the size of the agglomerate increases from 10 μm to a few hundred micrometers. The intensity curve exhibits a strong increase at small scattering angles. These reference curves will be used in the near future for the detection of stratospheric soot by remote-sensing measurement techniques.

Root water uptake is a key element for analysing the evolution of soil water content, which regulates crop transpiration. Our objective was to design a model taking into account the vertical water redistribution and the root water uptake in order to assess the regulation of plant transpiration induced by the effective soil water availability. To do so, the root water uptake is described with a microscopic-scale model integrated within a classical model of vertical water redistribution. For root water uptake, the root water potential, leading the water transfer from soil to roots, is calculated in order to satisfy the climatic demand... By coupling the microscopic and macroscopic approaches to soil water transfer, the regulation of transpiration can be directly linked to soil hydraulic properties and to effective soil water availability: the numerical model is applied to simulate soil water movement with root water uptake, and simulation results are compared with a series of findings on plant functioning obtained by previous work. Qualitatively, simulated transpiration in response to the soil water content is reasonably consistent with the description of crop behaviour in drying soils and in soil with vertical water heterogeneity. The results are also compared with experimental results in order to evaluate the usefulness of this model: with conventional measurements under field conditions, the prediction of water balance evolution is rather consistent with experimental results.

Background: Calcium gluconate gel, applied after initial rinsing with water, has a documented effect as first aid treatment for hydrofluoric acid burns. Hexafluorine®is a novel liquid compound developed especially for emergency decontamination of hydrofluoric acid eye and skin exposures. However, scientific documentation of the effect of Hexafluorine is insufficient. This study was undertaken to compare Hexafluorine with water rinsing plus topical calcium and with water rinsing alone. Methods: Thirty-five Sprague–Dawley rats were anesthetized and their backs shaved. Four filter papers 10 mm in diameter were soaked in 50 hydrofluoric acid and applied on the shaved area of each rat for 3 minutes. Thirty seconds later, the acid-exposed skin areas were rinsed with 500 mL Hexafluorine for 3 minutes (group H, n10), 500 mL water for 3 minutes (group W, n10) or 500 mL water for 3 minutes followed by a single application of 2.5 calcium gluconate gel (group Ca, n10), or received no treatment (controls, n5). The animals were closely observed for 5 days. Daily at 4 P.M. each of the four burns on every rat was rated on a modified Draize scale graded from 0 to 5 (0no visible injury, 1diffuse erythema, 2distinct erythema, 3distinct erythema plus wounds or discolored spots, 4distinct erythema plus wounds or discolored areas covering >50 of the burn, 5a necrotic wound covering the whole burn). The mean of the four scores was then calculated for each animal and day. The rating procedure was performed by one laboratory assistant who was unaware of the treatment given. Kruskal–Wallis analysis was used to evaluate possible differences between treatment groups on each of the 5 days. If the p-value obtained was <0.05, correction for multiple comparisons was made. Results: The mean severity score in group H was significantly higher than that in group Ca on days 2 and 3. Moreover, Hexafluorine showed a consistent trend towards a worse outcome, both in comparison to water plus topical calcium and to water rinsing alone. Conclusion: Based on these observations it is concluded that water rinsing followed by topical calcium should remain the standard first aid treatment for skin exposure to hydrofluoric acid.