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SUMMARY The 15 January 2022 eruption of the Hunga–Tunga volcano generated a Lamb pressure wave propagating all over the globe and triggering a tsunami throughout the planet. A first atmospheric wave arrived 16 hr after the eruption on the French Mediterranean coasts and propagated southward. A second one originating from Africa was observed 4 hr later with an attenuated amplitude. The first wave can be roughly defined either by a N wave or a sinusoid signal with a period close to 50 min and an amplitude of 130 Pa. In the Mediterranean Sea, the tsunami was recorded by almost all standard coastal tide gauges or pressure gauges. The French tide gauge stations recorded water waves with amplitudes ranging from a few centimetres to 10 cm and with periods ranging from 10 min to 1 hr. Numerical simulation of the tsunami is performed by the operational code Taitoko for different atmospheric sources. Non-linear shallow water equations are solved by a finite-difference method, using the nested multigrid approach. The tsunami is generated by calculating analytically the atmospheric pressure gradient in the momentum equations. Comparisons of time-series between numerical solutions and records are satisfactory for most tide-gauges along the French Mediterranean coast. Sensitivity analysis on the atmospheric source and on the resolution is performed. For most tide-gauge stations, numerical results show that the wave forms depend first on local resonance phenomena.

El objetivo del presente estudio es identificar la frecuencia de manifestaciones sistémicas y oculares en pacientes diagnosticados con COVID-19, y analizar los síntomas asociados a la vacunación. Como metodología, se diseñó un cuestionario de 15 preguntas sobre manifestaciones oculares asociadas a la SARS-CoV-2 y síntomas tras la vacunación. Se realizó un análisis descriptivo, incluyendo el uso de porcentajes y frecuencias para variables cualitativas. Se realizaron análisis bivariados según la relación existentes entre las variables de interés. En el estudio participaron 270 personas en los siguientes porcentajes según edad: menores de 18 años, 10,7 % (29 personas); de 18 a 30 años, 85,6 % (231 personas); de 31 a 40 años, 3,3 % (9 personas), y mayores de 41 años, 0,4 % (1 persona). De ellos, el 29,3 % (79 personas) fue diagnosticado con SARS-CoV-2. Las manifestaciones generales y oculares se evaluaron en una escala de 0 a 4, en la que 1 correspondía a síntomas leves, y 4 a síntomas incapacitantes. La pérdida del olfato y del gusto fue relatada como incapacitante en el 7,03 % (19 personas) de los casos, seguida de cefalea en el 5,18 % (14 personas) de los casos. En cuanto a las manifestaciones oculares, el dolor ocular obtuvo un porcentaje del 4,44 % (12 personas) en la escala 3, seguido de la sensibilidad a la luz en un 6,29 % (17 personas) en la escala 2. Los síntomas oculares reportados se presentaron principalmente entre 1 a 3 días en un 12,6 % (34 personas) de los casos. El 95,6 % (258 personas) de los encuestados estaba vacunado contra el SARS-CoV-2. En cuanto a los síntomas sistémicos más frecuentemente reportados como incapacitantes después de la vacunación, se observó dolor de cabeza en el 8,5 % (23 personas) de los casos, seguido de dolor muscular en el 8,1 % (22 personas) de los casos. Dentro de las manifestaciones oculares, predominó el prurito en un 1,4 % (4 personas) de los casos, seguido de la sequedad ocular en un 1,1 % (3 personas) de los casos. Estas manifestaciones se presentaron principalmente entre 1 a 3 días después de la vacunación en el 40 % (108 personas) de los participantes. Como conclusiones, si bien la vacunación contra el SARS-CoV-2 ha sido efectiva, persisten casos positivos en los que los síntomas reportados con mayor frecuencia han sido la pérdida del olfato y del gusto, el dolor de cabeza y la secreción nasal; además, se ha informado dolor ocular incapacitante. En cuanto a los síntomas presentados después de la vacunación, se destacan el dolor muscular, el dolor de cabeza y el picor de ojos.

El espasmo acomodativo es una entidad multifactorial en la que se produce una hiperfunción del músculo ciliar que induce miopía. Se puede desarrollar con posterioridad a la cirugía refractiva, generando reducción de expectativas y síntomas visuales molestos para el paciente. En este artículo se reporta un caso de espasmo de acomodación en el ojo no operado posterior a la Lasik, con refracción sin cicloplejia OD + 0,25 OI -3,00 Sph y con cicloplejia OD -0,25 OI +0,25 Sph. La respuesta visual y refractiva fue adecuada al tratamiento de relajación y flexibilidad de acomodación con lente positivo y flippers. Por lo anterior, el objetivo de este escrito fue revisar la terapia visual posquirúrgica y la etiología que subyace a esta condición inusual.

Background The COVID-19 pandemic catalyzed the adoption of telerehabilitation in various healthcare settings. However, there was neither a pre-existing national guideline in the Philippines nor an internationally agreed standard on telerehabilitation. The literature lacks nationwide studies documenting how physiatrists perceived and experienced telerehabilitation during the pandemic. Objective To determine the perceptions and experiences of physiatrists in the Philippines regarding telerehabilitation. Design Online survey originally developed by the authors with inputs from local experts in telehealth or telerehabilitation. Setting Nationwide, involving board-certified physiatrists practicing in the Philippines. Participants Fellows of the Philippine Academy of Rehabilitation Medicine (PARM) (N = 259) with Internet access. Main outcomes Self-reported telerehabilitation knowledge, skills, and experience; key concerns; preferred clients, service offerings, and methods (technology, duration, charging). Results The respondents (n = 161; 62.2% response-rate) had a mean age of 48.1±9.6 years, were mostly females (57.8%), and mostly practiced in private hospitals and urban settings. The majority reported inadequate telerehabilitation knowledge (61.5%), skills (58.4%), and experience (72.1%). The most common sources of telerehabilitation knowledge were colleagues (52.8%), PARM (51.6%), and telemedicine-related websites (41.6%). Most of the respondents preferred to conduct telerehabilitation with former patients over new ones, and prescribe telerehabilitation programs for physical, occupational, psychological, and speech-language therapy, but not for swallowing therapy. Videoconferencing was the most common telerehabilitation method. More than half of the respondents charged lesser fees for telerehabilitation compared to in-person consultations. While the majority recognized the need for telerehabilitation, their key concerns included the lack of thorough patient examination, and medicolegal liability issues. Conclusion Despite their limited baseline knowledge, skills and experience regarding telerehabilitation, many physiatrists in the Philippines learned to adopt this service delivery method during the pandemic. Their perceptions and experiences could be used in formulating practice-based guidelines and strategies to improve the conduct of telerehabilitation in the country. This article is protected by copyright. All rights reserved.

La evaluación precisa de la presión intraocular (PIO) permite el diagnóstico oportuno del glaucoma infantil. El objetivo fue analizar la PIO medida con el tonómetro de rebote iCare ic100 en niños. Se realizó un estudio transversal en una muestra consecutiva de niños que asistieron a consulta de optometría. Fueron atendidos 100 pacientes, la edad promedio fue de 7,5±2,6 años y 55 % eran de sexo masculino. La medida se realizó con éxito en 97 % de los ojos. La PIO fue en promedio 13,8±3,5 mmHg para ojo derecho (OD) y 13,9±4,1 mmHg (OI) para ojo izquierdo (OI) (p=0,6411); en niñas fue de 13,8±3,1 mmHg [IC 95 % 12,8-14,7] en OD y de 13,6±3,0 mmHg [IC 95 % 12,7-14,5] en OI. La PIO en niños fue de 13,8±3,8 mmHg [IC 95 % 12,7-14,8] en OD y de 14,1±4,9 mmHg [IC 95 % 12,8-15,4] en OI. La PIO con el tonómetro de rebote resultó dentro de los valores de normalidad clínica en niños, sin diferencias significativas entre sexo o edad. Por la alta tasa de éxito en la medición, se propone la valoración de la PIO con el tonómetro ic100 en niños, para la identificación temprana de casos de glaucoma.

espanolEn los ultimos anos, la prevalencia de la miopia en el mundo ha aumentado significativamente. El objetivo de este trabajo fue identificar la prevalencia combinada de la miopia en America segun las siguientes categorias: edad, raza, genero y region. Se realizo una revision sistematica de la literatura en las bases de datos Medline, Embase y Lilacs, con el objetivo de buscar estudios transversales con informacion sobre la prevalencia de miopia. Para encontrar la prevalencia combinada se utilizo el metodo de doble arco sinusoidal de efectos fijos o aleatorios de Freeman-Tukey. Se analizaron 15 estudios que incluyeron a 45.349 personas de Estados Unidos, Brasil y Paraguay, de 0 a 96 anos. El rango de prevalencia vario del 1,2 % al 48 % con diferencias entre hombres y mujeres del 18,4 % [IC del 95 %: 13,9-22,8] y el 19,8 % [IC del 95 %: 18,9-20,7], respectivamente. La prevalencia global en las zonas rurales fue del 1,4% [IC del 95 %: 1,3-1,5] y en las zonas urbanas del 14,3 % [IC del 95 %: 13,3-15,2]. Al mismo tiempo, se identificaron algunas diferencias basadas en la raza. En el caso de la raza blanca 15,4 % [IC 95 %: 14,4-16,3], raza negra 20,6 % [IC 95 %: 19,6-21,5] y otras razas (espanola, no espanola y afroamericana) 2,9 % [95 % CI: 1,97-3,82]. Las cifras mas bajas de prevalencia de miopia se identificaron en areas rurales en ninos en edad preescolar; Es probable que exista una relacion en el uso y el tiempo de exposicion a elementos electronicos como pantallas en contraste con el desarrollo de otras actividades en interiores. EnglishIn recent years, prevalence of myopia in the world has increased significantly. The aim of this research work is to consider the combined prevalence of myopia in America, according to the following categories: age, race, gender, and region. Such research will be done also in harmony with the reports found in scientific literature. A systematic review of the literature found in the following databases was carried out: medline, embase, and lilacs. The aim was searching cross-sectional studies containing myopia prevalence information. To find the combined prevalence, the double arc sine method of fixed or random effects by Freeman-Tukey was used. 15 research studies that included 45.349 individuals from the United States, Brazil, and Paraguay, were identified in the literature; studies of subjects aged 0-96 years old. The prevalence of myopia varied from 1,2% to 48% with differences between male and female of 18,4% [95% CI: 13,9-22,8] and 19,8% [95% CI: 18,9-20,7], respectively. The global prevalence of myopia in rural areas was 1,4% [95% CI: 1,3-1,5], and in urban areas 14,3% [95% CI: 13,3-15,2]. At the same time, some differences were identified based on race. In the case of the white race 15,4% [95% CI: 14,4-16,3], Afrodescendants 20,6% [95% CI: 19,6-21,5] and other races (Spanish, non-Spanish, and African American) 2,9% [95% CI: 1,97-3,82]. The lowest figures of myopia prevalence were identified in rural areas in pre-school children (14,1%). There is, probably, a relationship in use and exposure time to electronic items such as screens, in contrast with the development of other indoor activities as outdoor exposure as an environmental factor to slow myopia.

Los efectos nocivos de la radiación solar en la piel y en la superficie ocular se conocen claramente; sin embargo, los daños fotoquímicos en la retina aún son motivo de investigación. Se ha documentado que incluso el tiempo reducido, único o recurrente de exposición a la radicación puede inducir cambios histológicos que afectan la calidad de la visión, desde alteraciones transitorias hasta maculopatías irreversibles. Pese a esto, existe limitada información sobre la prevalencia e incidencia de los casos relacionados a exposición lumínica ambiental u ocupacional. Esta investigación tuvo propósito identificar la etiología y factores asociados a fototoxicidad retinal adquirida y se utilizó como metodología de investigación la secundaria de tipo revisión narrativa. Como resultado se encontró que la liberación de radicales libres debido a la exposición directa a un estímulo luminoso puede producir daños irreversibles en los fotorreceptores y, consecuentemente, puede existir una reducción de la agudeza visual y anomalías en la percepción del color. Como conclusión, la exposición solar ha sido claramente descrita en la literatura científica como un factor asociado a fototoxicidad retinal. Sin embargo, aunque se conoce que algunas prácticas clínicas y procedimientos quirúrgicos oftalmológicos inducen lesiones toxicas por la liberación de radicales libres sobre la retina, existe escasa documentación sobre el tema

In the present work, two different approaches for obtaining dynamic fracture properties of concrete are analyzed. Spalling tests over cylindrical samples using a modified Hopkinson Bar were carried to measure the tensile strength and the fracture energy of conventional concrete. Results for strain rates ranging from 60 to 130 s are presented for both techniques and compared to the respective quasi-static values. Moreover, two different projectile shapes (cylindrical and conical) have also been evaluated. In this sense, a deep qualitative and quantitative analysis is also performed, regarding the variations in tensile stress evolution of the pulses. Validation of both methodologies is achieved by comparing the obtained results.

Objective: To know the frequency and characteristics of contact lens use in professionals and patients during the COVID-19 pandemic. Method: A digital questionnaire was used to obtain demographic information, use and frequency of contact lenses in professionals and fitting or refitting in patients before and during the COVID-19 pandemic. Results: 172 professionals participated in the survey, of which 70.3% were women. There were refractive errors in 74.4%, and only 32.0% have used contact lenses during the COVID-19 pandemic. The lenses most used by professionals are silicone hydrogel, 99.9%. The replacement modality has been 69.0% biweekly or monthly. Optometrists (63.4%) reported that the frequency of fitting and/ or refitting contact lenses decreased during the pandemic. Before and during the pandemic, the lens material used more frequently was silicone hydrogel with 79.7% and 76.7%, respectively.The replacement modality was biweekly or monthly, with 76.2% before and 73.3% during the pandemic. Of all the participants, 58.1% consider that the sale of contact lenses has decreased. Conclusions: During the pandemic, the fitting, refitting, and sale of contact lenses have decreased. The lenses most used by professionals and patients are silicone hydrogels replaced every two weeks or monthly.

Objetivo: Conocer la frecuencia y las características de uso de lentes de contacto en profesionales y pacientes durante la pandemia de COVID-19. Método: Se utilizó un cuestionario digital para obtener información demográfica, uso y frecuencia de lentes de contacto en los profesionales, y adaptación o readaptación a sus pacientes antes y durante la pandemia de COVID-19. Resultados: Participaron en la encuesta 172 profesionales, de los cuales el 70,3% eran mujeres. El 74.4% tiene un defecto refractivo y solo el 32.0% han utilizado lentes de contacto durante la pandemia de COVID-19. Los lentes más usados por los profesionales son de hidrogel de silicona, en un 99.9%. La modalidad de reemplazo ha sido en un 69.0% quincenal o mensual. El 63.4% de los optómetras manifestaron que la frecuencia de adaptación o readaptación de lentes de contacto disminuyó durante la pandemia. Antes y durante la pandemia, el material de lentes más adaptado fue en hidrogel de silicona, con un 79.7% y un 76.7%, respectivamente. La modalidad de reemplazo fue quincenal o mensual, con un 76.2% antes y un 73.3% durante la pandemia. El 58.1% de los encuestados consideran que la venta de lentes de contacto se ha reducido. Conclusiones: Durante la pandemia, la adaptación, la readaptación y la venta de lentes de contacto ha disminuido. Los lentes más utilizados por profesionales y pacientes son en hidrogel de silicona y de reemplazo quincenal omensual.

Wave scattering over a sinusoidal bottom in the presence of a vertically sheared current is investigated experimentally and compared with a modified-mild slope model taking into account a linear vertical shear. Waves were generated in a flume without or with an opposing sheared current and propagated over a patch of 10 sinusoidal bars before dissipating on a beach. The shear of the current was controlled using a perforated screen. The Doppler shift of resonant Bragg frequency in the presence of a sheared current is observed. The modified mild-slope model taking into account both incoming and reflected waves predicts both the location and the amplitude of the peak of reflection at the Bragg resonance conditions, which are found to be sensitive to both the surface current intensity and the vertical shear.

El metil mercurio (MeHg) es un contaminante ambiental tóxico y nocivo que se bioacumula y biomagnifica en la cadena trófica. La tortuga Trachemys scripta elegans (Tse), considerada centinela de contaminación ambiental debido a su longevidad, posee eritrocitos (RBCs) nucleados con afinidad del 90% por MeHg. Este estudio determinó la citotoxicidad y genotoxicidad in vitro del MeHg sobre RBCs de Tse a concentraciones de 0, 0,5, 0,7, 1, 10, 20, 50 y 100 mg/L-1 a las 24 y 96 h de exposición. Los RBCs se aislaron por centrifugación y se emplearon 1,69 x 106 RBCs por tratamiento. Se determinó el porcentaje de viabilidad, concentración letal media (CL50) y se verificaron cambios citológicos a las 24 y 96 h. El ADN fue extraído a las 96 h y se evaluó la genotoxicidad por marcadores RAPDs calculando el porcentaje de polimorfismo, índice de estabilidad genética (GST) y coeficiente de disimilaridad de Jaccard (dJSC). A las 96 h la viabilidad a 0,5, 0,7 y 1 mgL-1 de MeHg fue del 99% y 10, 20, 50 y 100 mgL-1 de MeHg fue de 94%, 20% y 0%. La CL50 determinada en 22,55 mgL-1 de MeHg. El análisis celular mostró en las diferentes concentraciones de MeHg, inclusiones citoplasmáticas, desvanecimiento o ruptura de membrana, núcleos excéntricos y lisis celular. El polimorfismo identificado fue del 85% y 50% y dJSC de 0,5 y 0,63 en 50 a 100 mgL-1 de MeHg comparado con el grupo control. La GST disminuyó hasta 42% a 100 mgL-1 de MeHg. Se concluye que el MeHg es citotóxico y genotóxico a concentraciones mayores de 10 mgL-1 en RBCs de Tse. Este estudio representa una línea base para estudios en toxicología por Hg en RBCs de Tse.

No presente estudo, foram investigadas diferentes substâncias para atuarem como modificadores químicos na determinação direta de cádmio em soro e urina humanos sem digestão prévia das amostras. A preparação da amostra foi feita diretamente nos copos do amostrador automático por diluição 1+4 de soro e 1+1 de urina com ácido nítrico 1% v/v contendo 0.02% v/v de cloreto de tricetil metil amônio (CTAC). Foram investigadas as melhores condições de determinação por meio de curvas de temperatura de pirólise e atomização na presença da matriz e do analito levando-se em conta a forma do pulso de absorção, baixas temperaturas na atomização, fundo corrigido e sensibilidade. Foram efetuados estudos na ausência de modificador e com a mistura universal em solução de Pd e Mg (10 e 15 µg, respectivamente) e com rutênio (500 µg) e irídio (500 µg) como modificadores permanentes. Para Ir permanente, as massas características foram 0.8 pg para soro e 0.7 pg para urina (recomendado de 2 pg). Na investigação do uso de Ir permanente, foi observado que o pico foi simétrico, retornando à linha de base em 3s e com fundo corrigido completamente com valores ótimos por pirólises e atomização de 300 e 1000°C para soro e 300 e 1100ºC para urina. A calibração foi feita por ajuste de matriz e apresentou coeficiente de correlação de regressão linear típico de 0.999. Análises de soro e urina fortificados mostraram recuperações que variaram entre 99.3 e 103.2 com um desvio padrão relativo (RSD, n=3) menor que 12% para soro e entre 93.1 e 102.2% com um RSD menor que 3% para urina. O limite de detecção (k=3, n=10) foi de 8 e 9 pg para soro e urina, respectivamente.

ResumenLa prevalencia de miopía varía en las diferentes poblaciones del mundo y la incidencia aumenta de una forma acelerada, motivo por el cual los defectos refractivos se convierten en un problema de salud pública, con un impacto económico y social.La progresión de la miopía puede desencadenar cambios patológicos en el globo ocular que afectan estructuras como el cristalino, la retina, la coroides y la mácula. Estos cambios degenerativos constituyen la causa más frecuente de pérdida de visión y se relacionan con un incremento en los valores refractivos, que ascienden desde la infancia hasta la adultez.El desarrollo y progresión se relacionan con un componente genético y hereditario, sin embargo, hay una compleja interacción con factores externos, los cuales podrían explicar el incremento de casos en algunas poblaciones, en donde se perciben aumentos de urbanización y la necesidad por alcanzar altos niveles de educación. Además, otros factores ambientales como destinar mayor tiempo a actividades al aire libre puede ser un hábito favorable para evitar la aparición de la enfermedad.AbstractThe prevalence of myopia varies in different populations in the world and the incidence increases in an accelerated manner, why refractive defects becomes a public health problem, with an economic and social impact.The progression of myopia can trigger pathological changes in the eyeball, affecting structures such as the lens, retina, choroid and macula. These degenerative changes are the most common cause of vision loss and are associated with an increase in refractive values that rise from childhood to adulthood.The development and progression are related to a genetic and hereditary component, however there is a complex interaction with external factors, which could explain the increase in cases among some populations, where increased urbanization and the need is perceived to achieve high levels of education. In addition, other environmental factors such as spend more time in the outdoors can be a favorable habit to prevent the onset of disease.

Tailings facilities and associated waters often generate major environmental concerns due to the contaminant potential of the solids and the resulting acid mine drainage. The present study is focused on an area with mining tradition in the department of Santander, Cordillera Oriental - Colombia, where the evolution of mine tailings from gold exploitation resulted in acid mine drainage. An integrated approach led to a global characterization to the tailings and associated waters, including petrography, mineralogy, geochemistry, and hydrogeochemistry methods. The obtained results indicated that mine tailings are composed of sulfides (primarily pyrite with minor chalcopyrite, sphalerite, molybdenite, and galena), barite, silver, goethite, rare earths elements minerals, iron and titanium oxides, associated with quartz, muscovite and feldspar. The mine tailings are mainly in the silty range, and fire tests emphasized their compositional heterogeneity, namely for gold and silver, with the spatial distribution throughout the facility remaining unknown. Geochemical static tests, such as neutralization potential and acidity potential, allow the classification of these mine tailings as acid generators, as per the physical-chemical properties of the water samples. These samples were characterized before and after treatment with natural zeolite-rich tuff and siliceous sand with different weight ratios and days of duration of the experiment. Initially, chemical analyzes in the water showed an acidic pH of 2.96, high concentrations of sulfides (162 mg S−2/L) and Fe (10.41 mg Fe/L), being classified as high-acid, high-metal water. The column experiments revealed that the best relationship for remediation of this contaminated water was the one with the highest zeolite content, obtaining neutral pH values close to 7 and iron values on average

International audience; A coupled numerical scheme, based on modal expansions and boundary integral representations , is developed for treating propagation and scattering by dense arrays of impenetrable cylinders inside a waveguide. Numerical results are presented and discussed concerning reflection and transmission, as well as the wave details both inside and outside the array. The method is applied to water waves propagating over an array of vertical cylinders in constant depth extended all over the water column, operating as a porous breakwater unit in a periodic arrangement (segmented breakwater). Focusing on the reflection and transmission properties, a simplified model is also derived, based on Foldy-Lax theory. The latter provides an equivalent index of refraction of the medium representing the porous structure, modeled as an inclusion in the waveguide. Results obtained by the present fully coupled and approximate models are compared against experimental measurements, collected in wave tank, showing good agreement. The present analysis permits an efficient calculation of the properties of the examined structure, reducing the computational cost and supporting design and optimization studies.

To compare the measurement of the angle of the anterior chamber using ultrasound biomicroscopy (UBM), gonioscopy and the Van Herick examination.An observational comparative study was carried out between 3different methods for the estimation of the iridocorneal angle. A total of 30 subjects with open and closed angles were evaluated using UBM, gonioscopy and Van Herick. In the UBM and gonioscopy assessment all the quadrants were included in the analysis, and in the Van Herick examination the nasal and temporal quadrant were also analysed. All the examinations included the assessment of both eyes under photo-optical and scotopic illumination conditions. These findings were compared with the kappa concordance test.There was no statistically significant difference between the 3methods in the evaluation of the state of the iridocorneal angle. The consistency between UBM and gonioscopy was better (kappa 0.93) in relation to the estimation of the angle with Van Herick (kappa 0.83).The UBM, gonioscopy and Van Herick examinations have comparable results, although gonioscopy in the first instance would be indicated as a routine test for identification of angular closure.

A coupled-mode model is developed for treating the wave–current–seabed interaction problem, with application to wave scattering by non-homogeneous, sheared current with linear vertical velocity profile, over general bottom topography. The wave potential is represented by a series of local vertical modes containing the propagating and evanescent modes, plus additional terms accounting for the satisfaction of the boundary conditions. Using the above representation, in conjunction with a variational principle, a coupled system of differential equations on the horizontal plane is derived, with respect to the unknown modal amplitudes. In the case of small-amplitude waves, a linearized version of the above coupled-mode system is obtained, extending previous analysis by Belibassakis et al. (2011) to the propagation of water waves over variable bathymetry regions in the presence of vertically sheared currents. Keeping only the propagating mode in the vertical expansion of the wave potential, the present system reduces to a one-equation model, that is shown to extend known mild-slope mild vertical shear equation concerning wave–current interaction over slowly varying topography. After additional simplifications, the latter model is shown to be compatible with the extended mild-slope mild-shear equation by Touboul et al. (2016). Results are presented for various representative test cases demonstrating the usefulness of the present coupled mode system and the importance of various terms in the modal expansion, and compared against experimental data collected in wave flume validating the present method. The analytical structure of the present system facilitates extensions to model non-linear effects and applications concerning wave scattering by inhomogeneous currents in coastal regions with general 3D bottom topography.

A form of encephalitis associated with anti– N -methyl-d-aspartate receptor (anti–NMDA-R) antibodies has recently been described.1 Reported patients are mainly young women, presenting with severe encephalitis and additional distinctive neurological features. Around 60% have an ovarian teratoma.1 The severe course of the disease does not rule out favourable prognosis. Immunotherapy is advocated1–3 and appears to be associated with improved outcome. We present a patient with anti–NMDA-R encephalitis and serial [18F]-fluorodeoxyglucose–positron emission tomography (FDG-PET) examinations showing markedly increased activity in the basal ganglia as compared with that in the cortex when extrapyramidal features were prominent, which normalised after improvement of this movement disorder. A 25-year old woman developed language difficulties, followed by repeated complex-partial seizures with rare secondary generalisations. On admission 3 weeks later (day 0), the patient had developed fluctuating obtundation, mutism and episodic laughter with dysautonomia (bilateral mydriasis, tachycardia and facial flush), catatonia and progressive limb rigidity with plantar flexor response. The findings of an extended etiological workup (blood cell counts; routine serum chemical analysis and cerebrospinal fluid analysis of infectious, inflammatory, metabolic and paraneoplastic parameters) and a body computed tomographic …

Les lesions cerebrales fœtales et neonatales liees a une hemorragie secondaire a une thrombocytopenie par allo-immunisation necessitent une evaluation precise en imagerie, afin de permettre une prise en charge optimale foetomaternelle et postnatale. Un conseil genetique parental et familial, un diagnostic de risque d’allo-immunisation et un traitement gestationnel ulterieur codifie doivent permettre de prevenir la survenue d’hemorragies fœtales.

Contexte et but de l'etude :Le statut socio-economique est suspecte d'avoir une influence significative sur l'incidence des attaques cerebrales (AVC), sur les facteurs de risque cardio-vasculaire, ainsi que sur le pronostic. L'influence de ce statut socio-economique sur la severite de l'AVC et sur les mecanismes physiopathologiques sous-jacents est moins connue.Methode :Sur une periode de 4 ans, nous avons collecte de maniere prospective (dans un registre) des donnees concernant tous les patients avec AVC aigus admis a l'Unite Cerebrovasculaire du CHUV. Les donnees comprenaient le statut assecurologique du patient (assurance privee ou generale), les donnees demographiques, les facteurs de risque cerebrovasculaires, l'utilisation de traitements aigus de recanalisation vasculaire, le delai avant l'admission a l'hopital, ainsi que la severite et le pronostic de l'AVC en phase aigue, a 7 jours et a 3 mois des symptomes. Les patients avec assurance privee ont ete compares a ceux avec assurance generale.Resultats :Sur 1062 patients avec AVC, 203 avaient une assurance privee et 859 avaient une assurance generale. Il y a avait 585 hommes et 477 femmes. Les deux populations etaient similaires en âge. Les facteurs de risque cardio-vasculaire, la medication preventive, le delai d'arrivee a l'hopital, l'incidence du taux de thrombolyse et l'etiologie de l'AVC ne differaient pas dans les deux populations. Le score de gravite de l'AVC en phase aigue, mesure par le NIHSS, etait significativement plus eleve chez les patients avec assurance generale. Un pronostic favorable, mesure par le score de Rankin modifie (mRS), etait plus frequemment obtenu a 7 jours et a 3 mois chez les patients avec assurance privee.Commentaires :Un statut socio-economique bas est associe a une incidence plus elevee de maladies cerebrovasculaires ainsi qu'a un plus mauvais pronostic, comme cela a ete demontre dans differents pays. Il a ete suspecte que l'acces a une prise en charge specialisee en phase aigue ou en reeducation soit different selon le statut socio-economique. Comme la Suisse a un systeme de sante universel, avec une couverture assecurologique obligatoire pour chaque habitant, il y a la une occasion unique de comparer l'influence de l'aspect socio-economique sur la severite et le pronostic de l'AVC. De plus, les patients ont ete admis dans la meme Unite Cerebrovasculaire et pris en charge par la meme equipe medicale.Conclusion et perspectives :Le lien entre le statut assecurologique et le statut socio-economique a deja ete prouve par le passe dans d'autres pays. Nous avons mis en evidence une severite plus importante et un plus mauvais pronostic chez les patients avec assurance generale dans la population etudiee. L'etiologie de cette difference dans un systeme de sante a couverture universelle comme celui de la Suisse reste peu claire. Elle devrait etre etudiee a plus grande echelle.

The most frequent clinical manifestation of borreliosis in Switzerland is erythema migrans, with about 2500 patients each year. Neurological manifestations are rare, mostly hyperalgesic radiculitis (Bannwarth syndrome), aseptic meningitis or cranial nerve involvement. We report the first Swiss patient with meningovasculitis due to neuroborreliosis, with recurrent multiple ischemic strokes in multiple vascular territories. The treatment with ceftriaxone stopped the progression, but the patient is still suffering from severe invalidating cognitive disorders. We also comment on the pathophysiology and review the literature of other clinical cases.