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Populations of the eastern oyster (Crassostrea virginica) have been historically declining due to both natural and anthropogenic stressors. In response, oyster reefs have been created with many different approaches. This study utilized intertidal reefs constructed with oyster shells recycled from local restaurants to provide oyster settlement substrate, reef-associated faunal habitat, and a barrier to prevent marsh erosion. The objective of this study was to determine how oyster population characteristics changed over four years (2016–2019) on five different reefs within Sweetwater Lake, Galveston Bay, Texas, with a secondary objective to examine how oyster populations responded after Hurricane Harvey. Over the study period, five different reefs were sampled each summer by removing five bags per reef to determine oyster abundance and size demography. For the three years of the study (2017–2019), we also quantified oyster spat recruitment to the reefs. Oyster abundance and size (shell height) varied interactively by year and reef number, whereas oyster recruitment was significantly lower following Hurricane Harvey and then returned to pre-storm levels. Our results further highlight the importance of reef placement for breakwater-style reefs, as it appears the hydrodynamics within Sweetwater Lake influenced both oyster abundance and size among individual reefs. While the created reefs receive limited larval influx due to the narrow opening between Sweetwater Lake and Galveston Bay proper, this limited connectivity seemed to prevent mass mortality from the freshwater influx from Hurricane Harvey. Therefore, projects creating oyster reefs should consider local and regional landscape factors for the long-term success of oyster populations and robustness to natural disasters.

Structurally complex biogenic habitats provide foraging grounds and predation refuges for a myriad of decapod crustaceans. Many of these habitats, such as reefs formed by the eastern oyster (Crassostrea virginica Gmelin, 1791), have been lost due to natural and anthropogenic reasons, leading to the construction of artificial reefs for habitat restoration. Previous studies have investigated the impacts of oyster reef restoration efforts on abundance patterns of decapod crustaceans, such as those of panopeid crabs, but largely ignored the influence of artificial, or created, habitat on other population characteristics such as reproductive output. We sampled five artificial reefs (constructed during 2014 or 2015) in Sweetwater Lake, Galveston Bay, Texas, USA in July-August 2016 to study the population characteristics of female panopeid mud crab Panopeus simpsoniRathbun, 1930. We quantified carapace width, counted eggs and measured dry egg mass to estimate reproductive output and determine how reef-age treatment, live-oyster abundance, and live-oyster size predicted female P. simpsoni abundance and egg production. Oyster size varied significantly (P < 0.001) by age treatment, and oyster abundance and size varied significantly (P < 0.001) between the reefs within each age treatment. The abundance of female P. simpsoni varied significantly (P < 0.001) between the two age treatments and was positively correlated with oyster size and reef age. The percentage of gravid females, which varied significantly (P = 0.027) among the reefs, was positively correlated with oyster abundance, and egg production was positively correlated with body size. These results suggest that oyster development on artificial reefs may influence the abundance and reproductive output of associated crustaceans such as P. simpsoni. We demonstrate that monitoring programs should not only consider population characteristics of reef-building organisms, but also the development of complex habitat structure and its impact on associated crustacean populations when determining the success of artificial habitats.

Summary To convert native seismic data into true amplitude and phase ground seismic motion, for FWI modelling purposes, one has to know the signature of the source, the transfer function of the recording system and of the sensing elements to convert native records into physical units. Source signatures are nowadays recorded for each shot and the transfer function of the recording system is known and stable in time. The less accurately known responses are those related to the analog sensing elements which are subject to manufacturing tolerances and sensitive to temperature and ageing variations. This uncertainty is no longer a concern when using a MEMS technology which is a native digital sensing solution with an exact and invariant response to ground motions. Field test data illustrates how geophone data converted into ground particle velocity exhibits jitter, a consequence of the varying responses of the individual sensors, jitter which is not observed when using MEMS sensors, a consequence of their invariant response. The use of MEMS therefore allows for an exact conversion of the native seismic data into any ground motion units (acceleration, velocity, displacement).

Salmonella strains colonize the digestive tract of farm livestock, such as chickens or pigs, without affecting them, and potentially infect food products, representing a threat for human health ranging from food poisoning to typhoid fever. It has been shown that the ability to excrete the pathogen in the environment and contaminate other animals is variable. This heterogeneity in pathogen carriage and shedding results from interactions between the host’s immune response, the pathogen and the commensal intestinal microbiota. In this paper we propose a novel generic multiscale modeling framework of heterogeneous pathogen transmission in an animal population. At the intra-host level, the model describes the interaction between the commensal microbiota, the pathogen and the inflammatory response. Random fluctuations in the ecological dynamics of the individual microbiota and transmission at between-host scale are added to obtain a drift-diffusion PDE model of the pathogen distribution at the population level. The model is further extended to represent transmission between several populations. The asymptotic behavior as well as the impact of control strategies including cleaning and antimicrobial administration are investigated through numerical simulation. MOMIRPPC MOMIR PPC

This article describes the use of student feedback questionnaires by history teacher license candidates in a classroom-based approach called “Conferring with Students.” During the past five years, ...

Type 2 diabetes (T2D) in children and adolescents is a significant health issue. The onset of pediatric T2D is more rapid in onset and progression compared to adults. Prompt diagnosis and treatment, with lifestyle changes that include nutrition, physical activity, and metformin ± insulin, is critical. Complications and comorbidities associated with T2D need to be assessed and treated.

Introduction Lors d’une retransplantation hepatique elective (ReTH), le remplacement de la veine cave est souvent juge plus facile. La faisabilite et les avantages potentiels de la conservation de la veine cave (CVC) restent inconnus. L’objectif de cette etude est d’evaluer la faisabilite de la CVC et son impact sur les suites operatoires dans le cadre d’une reTH elective. Methodes Tous les patients ayant eu une retransplantation hepatique elective (> 90 jours apres 1re TH) dans un seul centre ont ete inclus depuis 2013 a 2018. La technique etait laissee au choix de l’operateur. Les deux groupes CVC + et CVC ont ete compares. Resultats Un total de 73 patients a ete inclus. La ReTH avec CVC a faite chez 28 patients (38 %). Les caracteristiques morphologiques des receveurs etaient identiques entre les deux groupes. La CVC etait plus souvent realisee lorsque l’anastomose cave precedente etait un piggy back sur 3 veines (43 % vs 7 %, p = 0,001). Le nombre de culots globulaires transfuses etait moindre apres CVC (4 vs 8, p = 0,003). Le taux de creatinine postoperatoire (j1, j3, j5, j7) etait significativement plus faible dans le groupe CVC+, ainsi que la duree de sejour en reanimation. La survie greffon et globale etaient similaires dans les deux groupes. Conclusion La CVC est possible en reTH elective et s’associe a une meilleure fonction renale postoperatoire. Sa realisation est facilitee par l’existence d’une anastomose de type piggy back sur les 3 veines. Le remplacement cave de principe en ReTH n’est pas justifie.

Introduction La prise en charge optimale des metastases hepatiques de cancers colorectaux repose sur une chimiotherapie avant resection chirurgicale. Le score anatomopathologique Tumor Regression Grade (TRG) est l’un des plus utilises pour evaluer la reponse a la chimiotherapie. Le pronostic des reponses heterogenes pour les metastases multiples demeure inconnu. Le but de cette etude etait d’evaluer le pronostic des patients ayant des tumeurs avec un score de TRG heterogene. Methodes Tous les patients ayant eu une resection pour metastases hepatiques multiples de cancers colorectaux apres chimiotherapie neoadjuvante ont ete inclus d’octobre 2000 a juillet 2019 dans deux centres tertiaires. Les caracteristiques oncologiques des groupes TRG 1-2-3, TRG 4-5 et TRG heterogene ont ete comparees. Resultats Parmi les 282 patients inclus, 122 (43,3 %) avaient une bonne reponse (TRG 1 a 3), 107 (37,9 %) une mauvaise reponse (TRG 4–5) et 55 (18,8 %) une reponse heterogene. Il n’y avait pas de difference significative concernant le type de chimiotherapie entre les trois groupes, ni le nombre de cycles. Le statut KRAS etait comparable entre les groupes ainsi que la taille des tumeurs. Le nombre de tumeurs etait significativement associe a l’heterogeneite TRG (p Conclusion Le statut TRG heterogene est frequent dans les metastases hepatiques multiples et augmente avec le nombre de metastases. Son pronostic est comparable a celui du statut TRG 4-5 (mauvaise reponse histologique).

Introduction Si les avantages de la laparoscopie en chirurgie hepatique sont etablis, les couts sont rarement evalues. Le but de cette etude etait de determiner le cout des hepatectomies laparoscopiques (HL) selon la difficulte chirurgicale et le type de complications. Methodes Tous les patients operes entre 2014 et 2018 d’une HL etaient inclus. La difficulte des HL etait evaluee selon la classification de l’IMM (I simple, II intermediaire, III expert). Les couts directs (personnel, materiel, bloc, imagerie, gestion des lits, depot de sang, anesthesie, hospitalisation, reanimation) etaient estimes par une approche combinee de micro-costing et bottom-up. Resultats Parmi les 270 sejours, 136 etaient dans le groupe I, 60 dans le groupe II et 74 dans le groupe III. Les postes les plus couteux etaient l’anesthesie (1751 € ± 764), la gestion des lits mutualises (1555 € ± 1596), le personnel medical (1282 € ± 1084), les dispositifs medicaux (1111 € ± 572), le bloc (1089 € ± 474), notamment le Thunderbeat®, et la reanimation (780 € ± 2721). Les couts differaient significativement entre le groupe I (7157 € ± 3431), II (9211 € ± 6063) et III (11328 € ± 6415) (p Conclusions Plus les HL sont complexes, plus les couts augmentent, et cela independamment de la survenue de complications. Les principaux facteurs de risque d’augmentation des couts sont la transfusion et l’admission en reanimation.

Introduction Le pronostic des pheochromocytomes localement avances (PLA) est inconnu. L’objectif etait de caracteriser cette population et sa survie sans recidive (SSR). Patients et methodes Etude multicentrique retrospective des PLA definis par une rupture capsulaire et/ou une invasion vasculaire et/ou une invasion du tissu adipeux et/ou une adenopathie locoregionale au diagnostic sans metastases a distance. La SSR, les facteurs pronostiques de recidive, le traitement des metastases et la survie globale ont ete evalues. Resultats Parmi 950 patients avec pheochromocytomes, 55 PLA (61 % d’hommes, 28 % predisposes genetiquement, 84 % secretant) avec statut R0 apres chirurgie ont ete inclus dans 11 centres Francais avec un suivi median de 54 mois. Les caracteristiques histologiques etaient : 31 (56 %) ruptures capsulaires, 27 (49 %) invasions graisseuses, 6 (11 %) adenopathies locoregionales et 22 (40 %) invasions vasculaires. Douze patients (22 %, taux de rechute : 4,2/100 pers/an) ont recidive (recidive locale pour 2 patients, a distance pour 3 et globale pour 7 patients) et 4 (7 %) sont decedes. La mediane de SSR etait de 115 mois. La mediane de survie globale des patients avec recidive etait de 157 mois. Le Ki67 % > 2 et la taille superieure a 6,5 cm etaient des facteurs pronostics de recidive en analyse multivariee ; les genes de predisposition du cluster 1 et la secretion predominante de normetanephrine en analyse univariee. Conclusion Les PLA representent 6 % de la population des pheochromocytomes. Ils sont de comportement malin intermediaire entre les pheochromocytomes localises et metastatiques. Cette etude ouvre la voie a une classification pTNM des pheochromocytomes.

A new tube degradation mechanism was observed in a recirculating steam generator (SG) with an integral preheater tube at the clearance gap between the tube and the preheater baffle. The general pattern of the damage and material composition in the degraded region suggested that the degradation was cavitation erosion. Cavitation erosion occurs when vapour bubbles exist or form in the flowing liquid and then these bubbles collapse violently in the vicinity of a solid wall. The bubbles collapse when they contact water that is sufficiently subcooled, i.e., below the saturation temperature. In the clearance gap between the tube and the preheater baffle, secondary fluid flow exists due to the pressure difference across the baffle plate. Meanwhile, heat transfer occurs from the primary-side fluid to the secondary-side fluid within this clearance gap, driven by the primary-to-secondary temperature difference. Factors such as the tube position in the baffle hole and fouling may influence the local flow and heat transfer conditions and can cause subcooled boiling that results in cavitation. This paper presents a numerical analysis of flow and heat transfer phenomena to determine the factors contributing to cavitation erosion of tubes in the preheater of a recirculating SG. The analysis used the THIRST code for a 3-dimensional thermalhydraulic simulation of steam generator and the ANSYS Fluent® code for detailed calculations of flow and heat transfer in the clearance gaps. A detailed temperature distribution in the gap was obtained using this analysis to determine the regions where subcooled boiling could occur by comparing the local fluid temperature with its saturation temperature. The susceptibility to cavitation was found to increase with increased inclination (i.e., tilt) and eccentricity (i.e., off-centre) of the tube in the baffle plate gap, and increased fouling on baffle plate surfaces. This methodology could be applied to analyze the cavitation susceptibility for other preheater types with this “tube to baffle plate” gap, as these preheaters might have conditions where boiling followed by the rapid condensation of the steam bubbles are present.

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The steam generator transfers the heat from the primary fluid to the secondary fluid. In the secondary fluid steam is generated that drives the turbine to produce electricity. The resulting thermalhydraulics establish the thermal performance of the steam generator. In this chapter, the thermalhydraulics of vertical steam generators, recirculating, and once-through will be discussed and include: (i) the flow paths and heat transfer for both the primary and secondary fluids; (ii) the effects of specific design features on these parameters; and (iii) the effects of flow and heat on aging-related thermal performance and material degradation. Theoretical approaches to solve the thermalhydraulics are also discussed.

Introduction Les germinomes sont des tumeurs cerebrales rares developpees a partir de cellules germinales primitives, touchant l’enfant et l’adulte jeune, dont environ 20 % siegent dans la region sellaire [1] . Leur prise en charge est radicalement differente de celle des craniopharyngiomes, les germinomes etant tres radiosensibles [2] . Observations Nous rapportons ici la prise en charge et l’evolution clinique de 3 patients presentant des lesions suprasellaires atypiques. Ces patients, âges de 20 a 28 ans, ont consulte en endocrinologie pour des symptomes endocriniens et/ou neurologiques variables qui ont motive la realisation d’une IRM cerebrale mettant en evidence une lesion hypothalamo-hypophysaire evocatrice de craniopharyngiome. Le bilan hormonal realise au diagnostic mettait en evidence chez ces 3 patients un panhypopituitarisme et un diabete insipide central. Ces trois patients ont ete operes avec un diagnostic anatomopathologique de germinome. Les marqueurs tumoraux (alpha-foetoproteine et HCG) etaient negatifs en postoperatoire dans le sang et le LCR chez les trois patients. Le bilan d’extension etait negatif et un traitement complementaire par radiotherapie et/ou chimiotherapie a ete realise permettant dans les trois cas une remission. Discussion Ces observations soulignent les difficultes que pose le diagnostic de ces lesions suprasellaires atypiques chez l’adulte.

Crise, A. ... et. al.-- 12 pages, 1 figure, 5 tables, PERSEUS project aims to identify the most relevant pressures exerted on the ecosystems of the Southern European Seas (SES), highlighting knowledge and data gaps that endanger the achievement of SES Good Environmental Status (GES) as mandated by the Marine Strategy Framework Directive (MSFD). A complementary approach has been adopted, by a meta-analysis of existing literature on pressure/impact/knowledge gaps summarized in tables related to the MSFD descriptors, discriminating open waters from coastal areas. A comparative assessment of the Initial Assessments (IAs) for five SES countries has been also independently performed. The comparison between meta-analysis results and IAs shows similarities for coastal areas only. Major knowledge gaps have been detected for the biodiversity, marine food web, marine litter and underwater noise descriptors. The meta-analysis also allowed the identification of additional research themes targeting research topics that are requested to the achievement of GES. © 2015 The Authors, This work has been partially funded by the EC FP7 PERSEUS Project (Grant. Agr. 287600)

One of the key features of rapid-eye movement (REM) sleep is the presence of bursts of REMs. Sleep studies routinely use REMs to classify sleep stages. Moreover, REM count or density has been used in studies involving learning and various psychiatric disorders. Most of these studies have been based on the visual identification of REMs, which is generally a very time-consuming task. This and the varying definitions of REMs across scorers have warranted the development of automatic REM detection methodologies. In this paper, we present a new detection scheme that combines many of the intrinsic properties of REMs and requires minimal parameter adjustments. In the proposed method, a single parameter can be used to control the REM detection sensitivity and specificity tradeoff. Manually scored training data are used to develop the method. We assess the performance of the method against manual scoring of individual REM events and present validation results using a separate data set. The ability of the method to discriminate fast horizontal ocular movement in REM sleep from other types of events is highlighted. A key advantage of the presented method is the minimal a priori information requirement. The results of training data (recordings from five subjects) show an overall sensitivity of 78.8% and specificity of 81.6%. The performance on the testing data (recording from five subjects different from the training data) showed overall sensitivity of 67.2% and specificity of 77.5%.

Objectif de l’etude L’insuffisance antehypophysaire est une complication tardive de la radiotherapie des tumeurs cerebrales et de la base du crâne. L’objectif de ce travail etait d’evaluer la toxicite antehypophysaire dans une cohorte de patients adultes ayant recu une radiotherapie pour des chondrosarcomes de la base du crâne. Les chondrosarcomes sont en effet des tumeurs de pronostic tres favorable avec un taux de controle tumoral de 93,5 % a 10 ans. Materiel et methode Les dossiers de 113 patients ont ete revus retrospectivement. L’âge moyen lors de la radiotherapie etait de 43 ans (extremes : 17–76 ; rapport hommes/femmes : 55/44 %). L’irradiation a delivre une dose moyenne de 67 Gy (extremes : 45–71 Gy) dans la tumeur, et 59 Gy (extremes : 50–66 Gy) dans l’hypophyse. La duree moyenne du suivi endocrinologique etait de 7 ans (extremes : 4–17 ans). Resultats Une anomalie du bilan hypophysaire est survenue chez 78 patients (69 %) a 4 ans de la radiotherapie. La prevalence des anomalies etait de 40 % pour l’hyperprolactinemie, de 36 % pour l’insuffisance thyreotrope, de 31 % pour l’insuffisance corticotrope, 25 % pour l’insuffisance gonadotrope. Le delai d’apparition des anomalies pour les differents axes n’est pas significativement different. En analyse multifactorielle, les facteurs de risque pouvant augmenter l’atteinte arterielle secondaire a la radiotherapie (sexe, âge, tabagisme, hypertension arterielle, dyslipidemie ou diabete sucre) n’etaient pas associes a un surrisque d’insuffisance hypophysaire. Conclusion La toxicite hypothalamohypophysaire de la radiotherapie etait donc frequente apres 4 ans dans cette etude. Du fait de l’hyperprolactinemie se pose la question d’une atteinte hypothalamique premiere. Un suivi prospectif est necessaire pour confirmer ces resultats et proposer des recommandations. On peut neanmoins proposer d’alleger la surveillance biologique des patients avant 3 ans pour ce schema d’irradiation de la base du crâne.

Context and the pervasive environment play a much greater role in mobile technology usage than stationary technology for which usability standards and methods were traditionally developed. The examination of mobile usability shows complex issues due to the ubiquitous and portable nature of mobile devices. This chapter presents the current state of mobile usability testing. More specially, topics covered are various usability testing methods, contextual complexity, audio interfaces, eye and hands-free interactions, augmented reality, and recommendation systems.

Using high-resolution melting (HRM) analysis, we developed a cost-effective method to genotype a set of 13 phylogenetically informative single-nucleotide polymorphisms (SNPs) within the genome of Bacillus anthracis . SNP discrimination assays were performed in monoplex or duplex and applied to 100 B. anthracis isolates collected in France from 1953 to 2009 and a few reference strains. HRM provided a reliable and cheap alternative to subtype B. anthracis into one of the 12 major sublineages or subgroups. All strains could be correctly positioned on the canonical SNP (canSNP) phylogenetic tree, except the divergent Pasteur vaccine strain ATCC 4229. We detected the cooccurrence of three canSNP subgroups in France. The dominant B.Br.CNEVA sublineage was found to be prevalent in the Alps, the Pyrenees, the Auvergne region, and the Saône-et-Loire department. Strains affiliated with the A.Br.008/009 subgroup were observed throughout most of the country. The minor A.Br.001/002 subgroup was restricted to northeastern France. Multiple-locus variable-number tandem-repeat analysis using 24 markers further resolved French strains into 60 unique profiles and identified some regional patterns. Diversity found within the A.Br.008/009 and B.Br.CNEVA subgroups suggests that these represent old, ecologically established clades in France. Phylogenetic relationships with strains from other parts of the world are discussed.

Repetitive activation of excitatory synapses in the hippocampus produces a persistent enhancement of synaptic efficiency known as long-term potentiation (LTP). In anesthetized and in freely moving rats, the induction of LTP in the perforant path led to a transient increase in the amount of messenger RNA (mRNA) coding for a presynaptic glutamate receptor (GR33) in dentate granule cells. The amount of GR33 mRNA was increased for at least 5 hours after the induction of LTP but was indistinguishable from control values 1 day after induction. The N-methyl-D-aspartate receptor antagonist 2-aminophosphonovalerate prevented the induction of both LTP and the increase in GR33 mRNA. The amount of GR33 protein was increased in the mossy fiber terminal zone of dentate granule cells 5 hours after the induction of LTP. These results suggest that the induction of LTP in synapses at one stage in a neural network may lead to modification in synaptic function at the next stage in the network.

International audience; It has been proposed that the physical substrate of memory resides in alterations of the strengths or weights of modifiable synaptic connections. In recent years, the hypothesis that the mechanisms underlying a particular form of synaptic plasticity, known as long-term potentiation, or LTP, are activated during learning and may actually subserve the formation of associative memories, has gained much empirical support. This paper reviews experimental studies suggesting that changes in synapse physiology and chemistry are involved in the formation of neural associative representation in hippocampal networks during classical conditioning. Recent experiments investigating LTP and learning-induced synaptic changes at hippocampal outputs to the prefrontal cortex are reported. The results provide a working framework within which the dynamics of information storage in hippocampal and prefrontal cortical networks is profiled.

As teachers of technical communication, we have come to understand and realize the importance of User-Centered Design (UCD) principles required in and applied to technical communication. With the technical communication field changing so rapidly, this particular issue is of crucial importance; this issue is particularly acute within the confines of the self-service society where users are often thrust into learning products and services with no support. Users increasingly demand products and services that they can understand with little outside help; interactions should be intuitive and experiences satisfying rather than frustrating. With this shift, technical communicators are increasingly expected to be true end-user advocates and participate earlier in the product life-cycle development. This workshop will help practitioners understand UCD, rapidly iterate designs, and provide educators with approaches that engage and prepare students (and teachers). Failure to adapt these methods quickly in both the classroom and the profession will invariably lead to the field's further decline and likely extinction as we currently understand it.

We report the case of a sixty-eight years old patient, who was admitted to the emergency for paresthesis associated with dysarthra and speech complaints. Neuroimaging revealed the presence of stenosis caused by arteritis. The notion of history of syphilis infection led to diagnosis of neurosyphilis. Diagnosis is difficult due to its clinical polymorphism and requires using several tests in the cerebrospinal fluid (CSF) because infection involving the central nervous system. Neurosyphilis is diagnosed by finding elevated cell count (80 leukocytes/mm3), high protein level (1.07 g/L) and positive IgG oligoclonal bands. In addition CSF and blood should be titrated with the VDRL and TPHA tests which are difficult to interpret. The diagnosis of active neuro-syphilis requires positive, non specific and specific inflammatory tests.

As part of the monitoring of needlestick Injuries (NSI), there is no data available on the risk of healthcare workers NSI in nursing homes for dependent seniors.

Eric Gillot, Mark Gibson, Dominique Verneau, and Stephane Laroche explain how 3D seismic imaging was able to prove an attractive alternative to ‘total drilling’ in the context of a platinum mining production project.

International audience; We have used differential display to profile and compare the mRNAs expressed in the hippocampus of freely moving animals after the induction of long-term potentiation (LTP) at the perforant path-dentate gyrus synapse with control rats receiving low-frequency stimulation. We have combined this with in situ hybridization and have identified A-kinase anchoring protein of 150 kDa (AKAP-150) as a gene selectively up-regulated during the maintenance phase of LTP. AKAP-150 mRNA has a biphasic modulation in the dentate gyrus following the induction of LTP. The expression of AKAP-150 was 29% lower than stimulated controls 1 h after the induction of LTP. Its expression was enhanced 3 (50%), 6 (239%) and 12 h (210%) after induction, returning to control levels by 24 h postinduction. The NMDA receptor antagonist CPP blocked the tetanus-induced modulation of AKAP-150 expression. Interestingly, strong generalized stimulation produced by electroconvulsive shock did not increase the expression of AKAP-150. This implies that the AKAP-150 harbours a novel property of selective responsiveness to the stimulation patterns that trigger NMDA-dependent LTP in vivo. Its selective up-regulation during LTP and its identified functions as a scaffold for protein kinase A, protein kinase C, calmodulin, calcineurin and ionotropic glutamate receptors suggest that AKAP-150 encodes is an important effector protein in the expression of late LTP.

Les crâniopharyngiomes sont des tumeurs rares dont l’extension tumorale ou le traitement entrainent une obesite dans pres de 50 % des cas [1] . Dans une meta-analyse recente, notre equipe a mis en evidence que la perte de poids a 1 an apres chirurgie bariatrique etait de 15,1 kg (IC 95 % –31,7, +1,4) en moyenne [2] . Nus rapportons ici l’evolution metabolique et hormonale en preoperatoire puis a 1, 6 et 12 mois chez trois patients atteints de crâniopharyngiome ayant beneficie d’une chirurgie bariatrique. Ces patients presentaient une obesite hypothalamique sequellaire de la chirurgie d’exerese avec troubles de la satiete. Ils ont beneficie pour deux d’entre eux d’un by-pass gastrique et pour le dernier d’une sleeve-gastrectomie. Les resultats a 1 an montrent une perte de poids de 22 kg en moyenne chez les 3 patients avec une amelioration de l’insulinoresistance sur le calcul du HOMA. Le dosage plasmatique de GLP1 apres repas test montre une restauration du pic post-prandial qui n’existait pas avant la chirurgie. Concernant l’hormonotherapie substitutive, l’absorption de l’hydrocortisone etait diminuee apres by-pass alors qu’elle semblait augmentee apres sleeve-gastrectomie. Ces resultats posent des questions quant a l’interet de l’utilisation eventuelle d’analogues du GLP1 chez ces patients particuliers et quant a l’absorption du traitement hormonal substitutif d’un pan-hypopituitarisme apres chirurgie bariatrique.

Introduction Lors de transfusion, l’EFS attribue les poches de CG en delivrant la poche la plus ancienne compatible. L’impact de l’âge des CG sur la morbi-mortalite des patients transfuses reste tres discute. Ce travail avait pour objectif principal d’evaluer l’impact de l’âge des CG transfuses sur la morbi-mortalite des patients de chirurgie cardiaque. Materiel et methodes Etude retrospective monocentrique observationnelle analytique validee par l’institution et la CNIL. Les criteres d’inclusion etaient: patient consecutifs operes de chirurgie cardiaque au CHRU de Besancon entre decembre 2008 et mai 2010 et transfuses d’au moins 1 CG durant l’intervention ou dans les 48 heures post operatoires. Les patients ont ete separes en 2 groupes selon l’âge des CG transfuses: un groupe CG « jeunes » definit par les patients recevant exclusivement des CG dont le stockage est ≤14 jours (j) ; un groupe CG « âges » constitues des patients recevant au moins 1 CG > 14 j. Le critere d’evaluation principal etait composite, constitue des evenements suivants : deces toutes causes survenant dans les 30 j ; apparition d’une insuffisance renale aigue; d’une infection post-operatoire; AVC et apparition d’une ischemie post-operatoire. La duree d’hospitalisation etait egalement recueillie. Les comparaisons inter-groupe ont ete effectuees par des tests non parametriques. Les facteurs associes a la survenue du critere composite etaient etudies en analyse multivariee (regression logistique). Un p Resultats Deux cent quatre-vingt-cinq patients ont ete inclus et analyses. Cent cinquante-huit patients constituent le groupe CG ≤ 14j vs 127 dans le groupe CG > 14 j. Les principales caracteristiques des 2 groupes sont donnees dans le tableau 1 . L’analyse univariee retrouve un taux de complication moins important dans le groupe CG ≤ 14 j (37,97 % [30,41; 45,54] vs 56,69 % [48,08; 65,31]; p = 0,0016). La duree d’hospitalisation en soins intensifs est moins importante dans le groupe CGR « jeunes » (5,32 j ± 7,7 vs 8,13 j ± 10,22, p = 0,0003). En analyse multivariee, la transfusion de CGR > 14 j (Odds ratio (OR) = 2 ; p = 0,004), l’Euroscore > 10 % (OR = 2,3 ; p = 0,0013) et le nombre de CG transfuses > 2 (OR = 2,07 ; p = 0,0013) etaient des facteurs independants de complications post operatoires. Discussion Ce travail suggere un interet de transfuser des patients avec des CG de moins de 14 j. Des etudes prospectives sont necessaires pour repondre a cette question.

OBJECTIVES: The medical device implantation techniques via percutaneous aboard tend to substitute to surgical techniques, in various cardio-vascular therapeutics. However, prosthesis implantation is often accompanied high implementation costs (linked to the device acquisition) which are difficult to justify to the decision-maker, in a context of high financial constraint. METHOD: Available clinical data show similarity of effectiveness and complication rates between these two techniques. Therefore, the economic appraisal consists in a cost minimization approach. First, we modeled the two technique protocols before costing each action (personnel, facilities, … ) according to the internal costs of Grenoble hospital. Moreover, we estimated the budgetary productivity of these two strategies using the French DRG classification system used to adjust the annual financial allocation of French public hospitals. RESULTS: Results show the percutaneous technique (septal occluder Amplatzer®) is dominant (1.5 times less expensive than surgery), mainly by decreasing the hospital stay (two hospitalization days instead of 12 days in the surgery strategy). DRG system classification generates 1473 ISA (hospital productivity index) for the percutaneous technique and 7556 ISA for invasive surgery. CONCLUSIONS: Comparing between cost-minimization technic using internal costs and incremental budgetary impact using French DRG classification, we conclude that the prosthesis implantation via percutaneous aboard is economically dominant (cheaper than invasive surgery) but 5 times less contributive to annual budget allocation. Therefore incitation for the hospital decision-maker to use septal occluders must come with the adaptation to new technologies of financial public allocation using the DRG classification.

International audience; Syntaxin 1B and alphaCaMKII are two genes that are upregulated after the induction of LTP and appear to underlie different mechanisms of synaptic plasticity. alphaCaMKII is directly implicated in strengthening the synapses that have been modified, whereas syntaxin 1B has been implicated in a mechanism for the propagation of synaptic plasticity within neural circuits. In these experiments we have investigated whether the regulation of these genes is altered after the induction of LTP in aged rats. We found, three hours after the induction of LTP in the dentate gyrus, that aged rats could be subgrouped into those in which LTP was maintained and those in which LTP had decayed back to basal levels. Both genes were upregulated in young adult rats, whereas there was a differential pattern of LTP-induced expression in the aged rats. Dendritic alphaCaMKII was upregulated in aged rats only when LTP was maintained. In contrast, regulation of syntaxin 1B and alphaCaMKII was absent in the granule cell bodies of the aged rats regardless of whether LTP was maintained or not. These results suggest that molecular mechanisms implicated in two aspects of hippocampal synaptic plasticity malfunction during normal ageing and therefore may have some contributory role in the decline in memory function routinely observed in ageing.