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The Arctic is warming faster than any other region on Earth. Putting this rapid warming into perspective is challenging because instrumental records are often short or incomplete in polar regions and precisely-dated temperature proxies with high temporal resolution are largely lacking. Here, we provide this long-term perspective by reconstructing past summer temperature variability at Yamal Peninsula – a hotspot of recent warming – over the past 7638 years using annually resolved tree-ring records. We demonstrate that the recent anthropogenic warming interrupted a multi-millennial cooling trend. We find the industrial-era warming to be unprecedented in rate and to have elevated the summer temperature to levels above those reconstructed for the past seven millennia (in both 30-year mean and the frequency of extreme summers). This is undoubtedly of concern for the natural and human systems that are being impacted by climatic changes that lie outside the envelope of natural climatic variations for this region. © 2022, The Author(s). Natural Environment Research Council, NERC: NE/S015582/1; Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, SNF: 183571; Russian Foundation for Basic Research, РФФИ: 18-05-00575; Russian Science Foundation, RSF: 182398, 21-14-00330 R.M.H., S.G.S., A.Y.S., and L.A.G. received funding from the Russian Foundation for Basic Research (no. 18-05-00575). M.S., C.C., S.G., and P.F. received funding from the SNF Sinergia project CALDERA (no. 183571). V.V.K. acknowledges support from the Russian Science Foundation (no. 21-14-00330). G.vA. acknowledges support from the SNF project XELLCLIM (no. 182398). T.J.O. acknowledges support from UK NERC project GloSAT (no. NE/S015582/1).

Background. Direct-acting antiviral agents (DAAs) have shown high rates of sustained virological response in chronic hepatitis C virus (HCV) infection. However, the influence of DAAs on the course of kidney involvement in HCV-associated mixed cryoglobulinaemia (HCV-MC) has been little studied. The aim of this study was to analyse the effects of antiviral treatment on kidney prognosis and evolution in patients diagnosed with HCV-MC. Methods. The RENALCRYOGLOBULINEMIC study is an observational multicentre cohort study of 139 patients with HCV-MC from 14 Spanish centres. Clinical and laboratory parameters were measured before and after antiviral treatment. Primary endpoints were kidney survival and mortality after HCV-MC diagnosis. Secondary endpoints were clinical, immunological and virological responses after antiviral treatment. Results. Patients were divided into three groups based on the treatment received: treatment with DAAs (n=100) treatment with interferon (IFN) and ribavirin (RBV) (n=24) and no treatment (n=15). Patients were followed up for a median duration of 138 months (interquartile range 70-251. DAA treatment reduced overall mortality {hazard ratio [HR] 0.12 [95% confidence interval (CI) 0.04-0.40]; P

Objectives: Although an association between uric acid (UA) levels and obstructive sleep apnea (OSA) has been reported, the effect of continuous positive airway pressure (CPAP) on this measure is yet unclear. We aimed to investigate the effect of CPAP therapy on serum UA levels in patients with OSA. Methods: We conducted a multicenter, open-label, randomized controlled trial in 307 women diagnosed with moderate-to-severe OSA (apnea-hypopnea index [AHI] >= 15) in 19 Spanish Sleep Units. Women were randomized to CPAP (n =151) or conservative treatment (n =156) for 12 weeks. Changes in serum UA measures were assessed on an intention-to-treat basis. Additional analyses were conducted in the subgroup of women with CPAP adherence >= 4 hinight and those with UA levels >= 6 mg/dl. Results: Women had a mean (SD) age of 57.1 (10.1) years, median (first-third quartile) body mass index of 33.7 (29.0-38.5) mg/kg(2) and AHI of 32.0 (22.6-48.5). The average serum UA measure was 5.11 (1.26) mg/dl, and 80 (26.1%) participants had UA >= 6 mg/dl. Compared with the control group, the CPAP group did Keywords: not achieve any reduction in UA levels (non-adjusted intergroup difference -0.03 mg/dl, 95%CI-0.20 to 0.13; p = 0.702) after 12 weeks of follow-up. These results did not change when the analysis was restricted to women with CPAP adherence >= 4 h/night, or the subgroup of women with hyperuricemia. Conclusions: Twelve weeks of CPAP therapy does not reduce UA levels compared to conservative treatment in women with moderate-to-severe OSA. (C) 2018 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.

Although an association between uric acid (UA) levels and obstructive sleep apnea (OSA) has been reported, the effect of continuous positive airway pressure (CPAP) on this measure is yet unclear. We aimed to investigate the effect of CPAP therapy on serum UA levels in patients with OSA.

Objectives: Although an association between uric acid (UA) levels and obstructive sleep apnea (OSA) has been reported, the effect of continuous positive airway pressure (CPAP) on this measure is yet unclear. We aimed to investigate the effect of CPAP therapy on serum UA levels in patients with OSA. Methods: We conducted a multicenter, open-label, randomized controlled trial in 307 women diagnosed with moderate-to-severe OSA (apnea-hypopnea index [AHI] >= 15) in 19 Spanish Sleep Units. Women were randomized to CPAP (n =151) or conservative treatment (n =156) for 12 weeks. Changes in serum UA measures were assessed on an intention-to-treat basis. Additional analyses were conducted in the subgroup of women with CPAP adherence >= 4 hinight and those with UA levels >= 6 mg/dl. Results: Women had a mean (SD) age of 57.1 (10.1) years, median (first-third quartile) body mass index of 33.7 (29.0-38.5) mg/kg(2) and AHI of 32.0 (22.6-48.5). The average serum UA measure was 5.11 (1.26) mg/dl, and 80 (26.1%) participants had UA >= 6 mg/dl. Compared with the control group, the CPAP group did Keywords: not achieve any reduction in UA levels (non-adjusted intergroup difference -0.03 mg/dl, 95%CI-0.20 to 0.13; p = 0.702) after 12 weeks of follow-up. These results did not change when the analysis was restricted to women with CPAP adherence >= 4 h/night, or the subgroup of women with hyperuricemia. Conclusions: Twelve weeks of CPAP therapy does not reduce UA levels compared to conservative treatment in women with moderate-to-severe OSA. (C) 2018 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.

This paper addresses the meaning and implications of international experience at the individual level by focusing on the transformative effects of international mobility. We conceive the international mobility of researchers as a potentially transformative process subject to strong uncertainty. In addition, we understand individual research careers as ‘self-discovery’ processes, over which researchers progressively builds their identity. We conduct an empirical analysis drawing upon research undertaken in the course of a European Project across 13 countries, throughout which a total of 358 interviews were conducted addressing the factors shaping the careers of doctorate holders in the social sciences and humanities. We consider how trans-national mobility stimulates and shapes processes of transformation and self-discovery within three differentiated contexts of change: i) cognitive changes; ii) changes in the professional-organisational context; and iii) changes in the socio-cultural environment.

International audience

A measurement of the direct production of photons with high transverse momentum from {Mathematical expression} collisions at {Mathematical expression} GeV is presented. The structure of events containing a high transverse momentum photon is studied. The results support predictions from QCD theory. © 1988 Springer-Verlag.

Rationale: Continuous positive airway pressure (CPAP) is the treatment of choice in patients with symptomatic obstructive sleep apnea (OSA). CPAP treatment improves quality of life (QoL) in men with OSA, but its role in women has not yet been assessed. Objectives: To investigate the effect of CPAP on QoL in women with moderate to severe OSA. Methods: We conducted a multicenter, open-label randomized controlled trial in 307 consecutive women diagnosed with moderate to severe OSA (apnea-hypopnea index, >= 15) in 19 Spanish sleep units. Women were randomized to receive effective CPAP therapy (n = 151) or conservative treatment (n = 156) for 3 months. The primary endpoint was the change in QoL based on the Quebec Sleep Questionnaire. Secondary endpoints included changes in daytime sleepiness, mood state, anxiety, and depression. Data were analyzed on an intention-to-treat basis with adjustment for baseline values and other relevant clinical variables. Measurements and Main Results: The women in the study had a mean (SD) age of 57.1 (10.1) years and a mean (SD) Epworth Sleepiness Scale score of 9.8 (4.4), and 77.5% were postmenopausal. Compared with the control group, the CPAP group achieved a significantly greater improvement in all QoL domains of the Quebec Sleep Questionnaire (adjusted treatment effect between 0.53 and 1.33; P < 0.001 for all domains), daytime sleepiness (-2.92; P < 0.001), mood state (-4.24; P = 0.012), anxiety (-0.89; P = 0.014), depression ( 0.85; P = 0.016), and the physical component summary of the 12-item Short Form Health Survey (2.78; P = 0.003). Conclusions: In women with moderate or severe OSA, 3 months of CPAP therapy improved QoL, mood state, anxiety and depressive symptoms, and daytime sleepiness compared with conservative treatment.

International audience; La technique ICP-MS couplée à un système d’ablation laser est utilisée comme outil de cartographie spatiale (2D ou 3D) multi-élémentaire et isotopique de surface d’échantillons solides. Le couplage ICP-MS laser pour l’analyse élémentaire et isotopique est rapide, sélectif, très sensible, quasi non-destructif, opérationnel avec une préparation minimale de l’échantillon et il offre une résolution spatiale à l’échelle micrométrique (10-100µm). En fonctionnant avec un plasma sec, la technique ICP-MS laser a aussi pour avantage de contourner le problème des interférences polyatomiques inhérent à l’ICP-MS solution. L’ICP-MS-HR laser disponible au laboratoire Subatech combine le système d’ablation laser Nd-YAG UP213 de New Wave Research au spectromètre ICP-MS Haute-Résolution Element XR de Thermo Scientific. La cartographie 2D multi-élémentaire par ICP-MS-HR laser a été développée dans le cadre de la zone atelier « Territoires Uranifères » afin d’y étudier la distribution spatiale multi-élémentaire à la surface des cernes d’un chêne pluri-centenaire (Quercus Petraea). La carotte d’arbre de longueur 24mm et de diamètre 5mm a été prélevée en aval de la mine d’uranium Rophin (Puy de Dôme) exploitée entre 1948 et 1957. De précédentes analyses dendrochimiques par ICP-MS laser ont montré que les cernes de croissance des arbres étaient de parfaits enregistreurs des modifications/pollutions environnementales [1,2].La cartographie 2D multi-élémentaire (B, Mg, Ca, Fe, Cu, Cd, Ce, Pb et U) par ICP-MS-HR laser sur une surface de 5mm2 d’un cerne de l’échantillon a été réalisée en cinq heures à partir de 108 lignes d’ablation (dimension : longueur=150µm ; largeur=90µm). Ce travail exploratoire a montré la faisabilité de la technique ICP-MS-HR laser pour mettre en évidence la distribution variable des macro-éléments (Ca, Mg), micro-éléments (B, Fe) et traces toxiques et radio-toxiques (Ce, Cd, Cu, Pb, U) à la surface du cerne avec une résolution spatiale de l’ordre de 100µm. Ce travail a été réalisé pour le cerne de croissance correspondant à l’année 1850, témoin de la signature de l’arbre en contexte naturel (c.a.d. hors exploitation minière).1S. A. Watmough, Environmental Pollution, 106 (1999), 391-4032A. Märten et al., Environmental Science and Pollution Research, 22, 19417-19425 (2015)

[Departement_IRSTEA]Territoires [TR1_IRSTEA]SEDYVIN; International audience; While significant progress has been achieved regarding the modeling of rockfall propagation, including the interaction with forest cover, the estimation of the spatial distribution of rockfall frequency in release areas remains a challenging task. Indeed, the very low number of observed events makes any statistical modeling difficult, so that estimations are generally based on expert knowledge regarding the rock structure of start zone and a few recorded events. Meanwhile, recent dendrochronological studies have shown that trees, as silent witnesses of numerous events, bring information about the spatial distribution of rockfall trajectories. This data can be compared to simulated trajectories in order to reconstruct the most probable start zones. This study presents a methodological framework for the resolution of this problem and a real-case example. Consider a forest patch f located below a cliff with Ns potential rockfall start points. The expected value of the number of impacts in this forest patch during lapse T can be calculated as (1) : Impacts(f)=T*SUM(Pstart(i)*Ppropagation(i,f)) with Pstart(i) the probability of rockfall for the start point I, Ppropagation(i,f) the probability that a rockfall from start point i impacts at least one tree in the forest patch f . The matrix formulation for the whole forest divided in Nf forest patches is (2): Impact=T*Pstart*Propagation. Ppropagation can be estimated with numerical simulations, by taking into account the current state of the forest stand if trees are measured and georeferenced, and if the volume of rockfall is known. Impact can be also be observed on the field. Under the assumption that the forest stand and the start frequencies do not change during lapse T, the equation system (2) can be solved for the coefficients of Pstart. This framework was tested on a rockfall area located in Valdrôme, France, where more than 1000 trees were measured and geolocated in a one hectare stand located below a cliff with rockfall activity. The number of impacts on each tree was observed and starting points were determined based on a slope criterion applied to a digital terrain model. The rockfall trajectories were simulated with the RockyFor3D software. The system (2) was solved with an optimization routine. Results show that the rockfall frequencies display high spatial variability and that 21% of starting points account for more than 50% of rockfall releases. The coefficients of Pstart can then be used to weight the simulated trajectories in order to map the spatial variability of rockfall trajectories and corresponding kinetic energies, which is an important step for a better identification of hazard areas. The proposed framework can thus lead to a numerical solution, but it relies on numerous assumptions. The spatial variations of rockfall volume are not taken into account and the forest stand is supposed time-invariant. This last point could be tackled by simulating trajectories during past stages of the stand evolution with growth simulation models.

INTRODUCTION AND OBJETIVES: Minimal invasive surgery trends to get prompt recovery in terms of inmediate deambulation and early discharge from hospital, without increasing patient's discomfort neither postoperative complications. This "fast-track" protocol is being progresively introduced in a crescent number of urological procedures. We are evaluating the viability of applying it in retroperitoneoscopic prone- position nephrectomy.We have performed a retrospective review of the clinical reports of the patients submitted to prone nephrectomy with hospitalization between 2007 and 2011 and we present patients submitted to this procedure in an outpatient basis (less than 8 hours hospital stay) from 2011. We have recorded epidemiological factors, diagnosis, surgical time, first postoperative week analgesic requirements, parents cofort and postoperative complications.All the procedures were performed retroperitoneoscopically in prone position using two trocars. We included 34 nephrectomies with a mean surgical time of 107 minutes. Mean postoperative stay was under 24 hours in 23 patients, two of them were discharged in the first 8 hours after the procedure. Hospital stay over this time was due to concomitant pre-existent pathology in 6 patients and to non urological fever in the remaining 3. Analgesia was excellent in every patient with endovenous non-steroid drugs, registering no pain after administering them orally. There were no complications.We believe that "fast-track" requirements can be applied to prone-retroperitoneoscopic nephrectomy in pediatric population, as long as they have no associated pathology. In our experience this surgical procedure can be included in day-case surgery, increasing patient's confort and with a positive economical impact.

The incidence of surgical wound infections in neonates is high and it has an associated morbidity which extends hospital stay and gets a worse prognosis. The purpose of this study is to analyze the risk factors associated with the development of surgical wound infection and to identify susceptible patients with modifiable factors.Case-control study of 90 surgical procedures underwent in newborns. We analyze pre-, intra- and postoperative risk factors.There are statically significant differences in terms of wound infection in dirty and contaminated surgery, reoperation, lavage of abdominal cavity, preoperative hospital stay longer than 8 days and wound closure with reabsorbable material. Furthermore, the surgical site infection is more likely in preterms patients, with a previous positive culture infection and the use of invasive devices as mechanical ventilation or central venous access. We found no relationship between wound infection and surgical time, bleeding during surgery and preoperative skin preparation with antiseptics.Reoperative patients, in which dirty and contaminated surgery is performed, absorbable material for skin is used and who have a preoperative hospital stay longer than 8 days, are in risk of developping wound infection and they will require an aggressive antibiotic treatment and special postsurgical care.

Background: In the last two decades lumbar interspinous decompression systems have gained a wide and often uncontrolled diffusion. Such devices, usually made of titanium or PEEK (polyetheretherketone), are currently implanted in different lumbar spine degenerative disorders, and clinical indications to their use are often confounding. Methods: This is a single center, single arm, 2-year prospective study of 50 patients undergoing lumbar surgical interspinous decompression, in which the BacJac all-PEEK device was implanted. Preoperative diagnosis was: central (CLS) or foraminal (FLS) spinal stenosis, degenerative antero/retro listhesis

Palmar hyperhidrosis (PH) is a relative frequent pathology which basically affects patients' life quality limiting social and laboral life. The treatment of choice is thoracoscopic sympathectomy, most frequently done during adulthood. The aim of our study was to evaluate the degree of satisfaction of the pediatric patients treated in our centre.We retrospectively reviewed the clinical records of the patients controlled and treated in our centre during the last 4 years evaluating the symptoms before surgery, the level of the sympathectomy and postoperative complications. To evaluate the long-term results we developed a telephone questionnaire for all the patients centralized on the grade of satisfaction, the efficiency of the treatment, the compensatory sweating and the observed changes in life quality. The medium follow-up time was 26.5 months (rango 6 months to 4 years).In total 6 patients were reviewed (4 female, 2 male), medium age 12, 8 years (rango 8 to 18 years). Thoracoscopic sympathectomy was done at the level of T2 or T3 associating T4 in 1 case. We just observed 1 postoperative complication which consisted in a disestesia of the upper extremity and which disappeared spontaneously without sequels. Patients referred total relief of palmar sweating. Only 1 case reported residual sweating unilaterally in the tenar region, but in all of them sweating of feet still persisted (3 of low grade and 3 of moderate grade). In 50% of the cases we observed compensatory sweating localized at the back of moderate grade in 2 patients and at the upper legs of more severe grade in 1 of them. Only this last patient reported that the compensatory sweating affected his everyday life. We also observed that the patients where the sympathectomy had affected more than 1 ganglia (T2+T3; T3+T4; T2+T3+T4) referred a higher grade of compensatory sweating. All the cases reported an important improvement in life quality, in the social as in the formative manner. They were all very satisfied with the results of the surgery and none of them (neither the children nor the parents) regretted the intervention. The cosmetic result of the surgical scars was also satisfactory.The thoracoscopic sympathectomy is an efficient procedure for the treatment of palmar hyperhidrosis. Despite the compensatory sweating patients usually are very satisfied with the results. Since palmar hyperhidrosis is not a pathology which improves spontaneously and the surgical treatment has minimal complications we do not think that the surgery should be postponed in pediatric patients.

National audience; Dendrogeomorphology relies on the capacity of ligneous vegetation to react to external stresses induced by changes in the environment and to register these impacts in the form of either characteristic annual rings or morphological anomalies. By analyzing the radial growth of trees (in the form of one or several abnormally narrow or wide tree rings), their morphology (scars, resumption of apical growth, change of growth axis, tilting, adventitious roots) and their associated anomalies (formation of reaction wood, tangential rows of traumatic resin ducts, modification of the cell structure), past events such as debris flows, landslides, rockfalls, snow avalanches and fluvial dynamics can be dated with yearly or even monthly precision. In turn, dating these events allows for the assessment of environmental changes and geomorphic processes on a spatial scale. This document presents the main dendrogeomorphic methods, starting with the Event-Change/Impact/Response concept, and examines the model’s evolution, especially in the Alps. The article also discusses the model’s relevance for the study of geomorphic processes with respect to the knowledge and management of natural hazards and risks.; La dendrogéomorphologie repose sur la capacité des végétaux ligneux à réagir à des stress exogènes, liés aux perturbations ou aux changements qui affectent son milieu de croissance, et sur l'enregistrement de ces réponses dans les caractéristiques des cernes annuels de bois ou dans des anomalies morphologiques visibles. L'analyse de la croissance radiale des arbres (cerne ou série de cernes anormalement étroits ou larges), de leur morphologie (cicatrice, reprise de croissance apicale, changement d’axe, courbure, racine adventive) et de leur anatomie (formation de bois de réaction, de rangées tangentielles de canaux résinifères traumatiques, modifications de la structure cellulaire) permet de dater les événements passés (lave torrentielle, glissement de terrain, chute de pierres, avalanche, crue, tempête, intervention humaine, etc.) avec une résolution temporelle annuelle à mensuelle, de reconstituer les changements environnementaux et de spatialiser et identifier les processus géomorphologiques. Ce texte présente les principes de l'approche basée sur le concept d'"Événement-Changement/Impact/Réponse", ses développements récents, tout particulièrement dans les Alpes, et son intérêt pour l'étude des processus géomorphologiques en vue de la connaissance et de la gestion des risques naturels.

The molecular determinants of Alzheimer's (AD) disease are still not completely known; however, in the past two decades, a large body of evidence has indicated that an important contributing factor for the disease is the development of an unbalanced homeostasis of two signaling cations: calcium (Ca(2+)) and zinc (Zn(2+)). Both ions serve a critical role in the physiological functioning of the central nervous system, but their brain deregulation promotes amyloid-beta dysmetabolism as well as tau phosphorylation. AD is also characterized by an altered glutamatergic activation, and glutamate can promote both Ca(2+) and Zn(2+) dyshomeostasis. The two cations can operate synergistically to promote the generation of free radicals that further intracellular Ca(2+) and Zn(2+) rises and set the stage for a self-perpetuating harmful loop. These phenomena can be the initial steps in the pathogenic cascade leading to AD, therefore, therapeutic interventions aiming at preventing Ca(2+) and Zn(2+) dyshomeostasis may offer a great opportunity for disease-modifying strategies.

The treatment of hypertrophic pyloric stenosis is the Fredet-Ramstedt pyloromyotomy. It is controversial what surgical approach to choose. We evaluate our outcome with the right upper quadrant (RUQ) and the supraumbilical (SU) approach.Between 2003 and 2007, we performed 38 pyloromyotomies through a RUQ incision and 18 through a SU approach. We analyze patient demographics and pre and postoperative data. We group the complications in major (duodenal perforation, inadequate pyloromyotomy, and wound dehiscence) and minor (seroma, hematoma, wound infection and incisional hernia). A nonrandomized comparison was performed between the two groups.We find significant differences in morbidity: 22.2% of major complications ocurred in the SU group versus 2.6% in the RUQ group, and 44.4% of minor complications were encountered in the SU group versus 2.6% in the RUQ group (P0.005).In our study we found a significantly higher overall complication rate in the SU group (p0.005), possibly because of a more difficult delivery of the pylorus through the SU incision and because of a probably increased rate of wound infection associated with the supraumbilical approach in the pediatric population.

National audience; Extensive areas of the French Alps are underlain by Jurassic black marls. Wherever these so called terres noires' crop out, they are subject to intense erosion, causing major sedimentation in regional reservoirs and river systems. In the badlands near Draix (Alpes de Haute-Provence, France), measured sediment yield obtained by surface elevation change-based methods, indicates denudation rates of more than 5 to 10 mm yr−1. In this study, these measurements, relying on continuous field monitoring of 47 profilometers over 7 years, are compared to an alternative method, based on dendrogeomorphology. A total of 39 exposed roots of Pinus sylvestris were sampled in the badlands and the anatomical variations in annual growth rings due to exposure caused by denudation were analyzed. The first year of exposure was determined by a peculiar reduction in size of earlywood tracheids. The medium-term erosion rate (0.5 mm.yr-1) is significantly correlated to the slope angle (r²(d)=0.39). This value matches with erosion rates derived from monitored iron stakes (5.7 mm.yr-1) or measurements of sediment yields using dams (4.7 mm.yr-1). The detailed knowledge of anatomical changes in roots is though demonstrated a powerful tool for geoscientists to quantify minimal rates of soil erosion in areas where measurements of past processes are not available.; Les marnes noires du Jurassique couvrent de vastes surfaces dans les Alpes françaises du Sud. Partout où elles affleurent, elles sont sujettes à une érosion intense à l'origine de problèmes de sédimentation dans les cours d'eau et d'envasement dans les retenues hydro-électriques. Dans les badlands de Draix (Alpes de Haute-Provence), les vitesses d'érosion obtenues par différentes méthodes de mesure atteignent 5 mm/a à 10 mm/a. Dans cette étude, les vitesses d'érosion quantifiées au moyen d'une approche dendrogéomorphologique sont validées par comparaison avec celles issues du suivi micrométrique d'un réseau de 47 tiges métalliques. Trente-neuf racines de Pinus sylvestris L. déchaussées ont été échantillonnées dans le bassin-versant du Moulin (8 ha) et l'impact de la dénudation sur les variations anatomiques des cernes annuels de croissance a été mesuré. L'année de déchaussement a pu être déterminée via l'étude de la diminution très rapide, de l'ordre de 60 %, de la surface du lumen des trachéides. Les vitesses d'érosion mesurées au moyen de la dendrogéomorphologie sont de l'ordre de 5 mm/a et montrent une corrélation significative [r²(d) = 0,39] mais non exclusive avec la pente locale. Elles concordent avec celles obtenues à partir de mesures micrométriques (5,7 mm/a en moyenne) et par cubages réalisés à l'exutoire du bassin-versant (4,7 mm/a). Dès lors, cette approche offre des perspectives particulièrement intéressantes pour quantifier et spatialiser rapidement les vitesses d'érosion moyennes sur plusieurs décennies, dans des bassins versants non instrumentés.

Dans ce livre, le Cemagref, institut de recherche en sciences et technologies pour l'environnement, fait le point de ses travaux scientifiques menés sur la forêt. Pourquoi une recherche sur la forêt ? D'abord parce qu'elle occupe plus d'un quart de la surface de notre territoire métropolitain. Ensuite, parce qu'elle fournit tout un ensemble de services variés et, pour certains, essentiels à notre société : la production de bois, la protection contre les aléas naturels, la chasse et la promenade en sont de très bonnes illustrations. Enfin, parce qu'elle constitue un milieu naturel riche en biodiversité et occupe une place notable dans les débats sur les enjeux environnementaux. Forts de ce constat, les chercheurs et experts du Cemagref apportent leur contribution en abordant des problématiques majeures pour la gestion durable des forêts : état et dynamique de la forêt, de sa biodiversité, vulnérabilité des forêts aux changements globaux et stratégies d'adaptation, gestion multifonctionnelle des forêts, rôle de protection contre les aléas naturels, place de la forêt dans les territoires et enjeux sociaux. L'interaction entre forêt et gestion se situe ainsi au c½ur de nos travaux.

International audience; Trees produce reaction wood when they are exposed to geomorphological and hydrolocical processes like snow avalanches, floods or landslides that lead to changes of the tree position, of the growth conditions or to direct mechanical damage. This wood has a different cell structure that is clearly visible when extracted from a tree. In this way trees record, from a certain threshold of intensity, duration or recurrence, geomorphological and hydrological processes that lead to disturbances in their environment. Consequently the identification of zones of reaction wood in tree stems can be used to identify previous disturbance and to reconstruct the triggering events in time, space and intensity. In this study we reconstructed the activity of four landslides in the Southern French Alps by using the forest cover on the landslide body as a silent witness of the past. We assessed the growth disturbances related tolandslide activity of 75 damaged Pinus uncinata trees. In total we identified 139 growth disturbances that indicate 6 different periods of landslide activity between 1947 and 2004 although only one event was clearly identified by historical records. Besides, this study shows that dendrogeomorphical methods are innovative techniques offering perspectives for a better understanding of natural hazards.

Introduction of advanced therapeutic modalities for diaphragmatic congenital hernia (CDH) has allowed to reach considerable improvements in survival rate. Nevertheless, there are few studies which analyze the clinical evolution of the long-term survivors. The aim of this work is to analyze the outcomes of the patients with CDH in our hospital.Fifty-five neonates with CDH were treated in our center between 1998 and 2005. We included in the study those patients that were alive at the moment of first hospital discharge (72%; n=40 patients). ECMO therapy was needed in 6 of them during neonatal treatment. A descriptive transverse review of the clinical record as well as a telephonic interview to the parents was performed for the respiratory, cardiological, digestive and neurological conditions, following standard diagnostic studies in every case. The mean age of the children in the moment of the study was 4.2 years (1-9).The 8.3% of the children needed domiciliary oxygen therapy during a maximum of 3 months in all the cases. 22% of the cases suffered from respiratory problems, being bronchiolitis and pneumonia the most frequent diagnoses. Only a patient developed asthma. The gastroesophageal reflux is the most frequent long-term condition (47%), but only 8.3% needs surgical treatment. Regarding to cardiological problems, 14% developed pulmonary hypertension, being slight - moderate in all the cases but in one case who was the only deceased of the series. Regarding to neurological problems only 1 patient developed serious alterations (brain paralysis), having suffered a hemorrhage parenquimatosa during the treatment with ECMO. No other patient presents motor, visual nor auditory alterations in the development, last mild alteration in language (4 patients). Differences do not exist with the group of patients that did not need ECMO during the treatment in cardiological and digestive complications, being higher percentage with respiratory problems.In our sample only 2 patients present serious sequels (5%). Of this preliminary study we can conclude that the comorbility in the CDH is very low having these patient a good development and good quality of life.

The management of complex subglottic stenosis is difficult, existing different surgical techniques for its treatment, depending on type and grade of stenosis, comorbidities and the state of the patient. We studied the management of the complicated patients in our centre analyzing the applied treatment, the type and grade of stenosis, and the results in order to develop a treatment protocol of complex subglottic stenosis.Of a total of 120 patients diagnosed of subglottic stenosis in follow-up in our centre we retrospectively reviewed 15 patients (5 boys, 10 girls; medium age 1.63 years, range 0.05 to 13 years) who had suffered mayor complications and who had required reinterventions (1 to 6). We analyzed the employed techniques in relation to the observed complications and the previous treatment, the results and the decanulation index. All diagnoses were established by fiberbronchoscopy and the initial treatment was realized following the actuation guidelines of Cotton.The global decanulation index in this group of patients was 80%. The patients in who initially a anterior cricoid split had been done and who developed a subglottic stenosis grade III were 8. Rescue treatment consisted in anterior laringotracheoplasty in 7 cases managing decanulation in 6 patients (75%). The medium number of reinterventions was 2.5. Patients treated initially with Laser (n=4) developed a subglottic stenosis grade III in two cases and grade IV in the rest. Subglottic stenosis grade IV were corrected by cricotracheal resection and subglottic stenosis grade IV by anterior laringotracheoplasties with a medium reoperation Lumber of 1.25. All patients achieved decanulation (100%). Failed anterior laringotracheoplasties with cartilaginous grafts (n=2) developed grade III subglottic stenosis, one was treated with a double laringotracheoplasty and the other with a cricotracheal resection reaching decanu-lation in both patients (100%). Reintervention number was one to four. Only one cricotracheal resection as initial treatment failed. This patient required 3 reinterventions not being decanulation possible (0%).Patients with complex subglottic stenosis often require more than one reintervention until reaching decanulation. Decanulation index in these patients is satisfactory. The development of a management protocol for these cases is very difficult and treatment should be individualized.

International audience; Debris-flow risk analysis in mountainous terrains requires a better characterization of the frequency and the propagation area of debris-flow events. This characterization is generally based on the analysis of historical records, which are more or less incomplete and sometimes inexistent for small pristine catchments. To complete and enhance the historical record analysis, the dendrogeomorphological survey of alluvial fans has proved to be an efficient and attractive tool. The purposes of the study conducted on a torrent of the Northern French Prealps (Manival Torrent, drainage area: 7 km²) are: (i) to date the debris-flow events from dendrogeomorphological evidences on the wooded alluvial fan, and (ii) to analyze the evolution of debris-flow activity through time from the historical record completed with dendrogeomorphological surveys. From the study of the growth disturbances of 250 Pinus sylvestris located in abandoned channels and associated banks, we reconstructed the geomorphic activity of old debris-flow channels of the Manival. Ten events were identified by dendrogeomorphological survey. Only three of them were previously known from historical records.

The neonatal intensive care unit (NICU) is used in many centres as operating room in order to avoid the co-morbidities that there produces the movement of critical patients. The motive of this work is to analyze the advantages and disadvantages of this type of surgical interventions.Between January, 2004 and December, 2007 405 newborns were operated in the NICU. The most frequent surgical realized interventions were: deferred closing breastbone (172), placement of ECMO (42), ligation of patent ductus arteriosus (45), laparotomies for necrotising enterocolitis (27), repair of congenital diaphragmatic hernia (20), plicate of diaphragms (5) and closing of gastroschisis (4). We realize a retrospective study of a group of 40 patients operated by diaphragmatic hernia and necrotising enterocolitis in the UCIN (group A) and compare them with a group of patients operated in the operating room with the same pathology (group B). We study 22 variables preoperatory, intraoperatory and postoperatory. For the statistical analysis T-student and Chi-square was in use, being considered to be statistically significant p0.05.The average ages of the patients to the intervention were 11.1 +/- 8 days being the predominant sex the masculine one (60 %). The age gestational and the average weight for the group A was 31.9 +/- 5.7 weeks and 1,735 +/- 123 grams being for the group B of 34 +/- 3.5 weeks and 2,037 +/- 728 grams respectively (p = N.S.). 89.3% of the patients of the group A was with intubation orotracheal before the surgery, being 57.2% for the group B. The needs of high frequency ventilation and vasoactives drugs were higher for the group A (p0.01) and the operative time was similar in both groups (81 +/- 34 vs. 98 +/- 33 minutes). We find a difference of corporal temperature pre-post surgery of 0.60 +/- 0.48 degrees C for the group A and 2.18 +/- 0.93 degrees C in the B (p0.01). We don't estimate differences as for episodes of infection of wound, intraabdominal infection or need of reintervention. The survival of the patients was discreetly higher for the group operated in the operating room (82.3%) with regard to the group operated in the NICU (60%) without statistically significant differences existed.In our experience the NICU is a suitable place to realize surgical interventions in critical patients. The higher mortality for the group controlled in the UCIN explains for a major instability preoperatory. The maintenance of the corporal temperature avoiding the hypothermia it's one of the decisive factors to diminish the morbi-mortality.

"Sodium alginate, k-carrageenan, mesquite gum and/or whey protein concentrate were used alone or blended for obtaining edible films, using sorbitol as plasticizer. Film mechanical properties were determined with a TA-XT2 texture analyzer. Films with greater breaking factor, tensile strength, tensile strength at break, and tensile energy at break were obtained when sodium alginate was used alone. Low Young´s modulus values were obtained with blends of sodium alginate and k-carrageenan (with the latter predominating in the blend) and mesquite gum-whey protein concentrate (with the former predominating in the blend). The latter blend exhibited highest elongation. Films containing pure sodium alginate or k-carrageenan or blended with the other gums (with sodium alginate predominating) could be classified as hard, strong and resistant. Films where mesquite gum or whey protein concentrates were on their or where their blend predominated over that of sodium alginate and/or k-carragenan were mostly soft and weak."

A case of isolated schwannoma of the orbit, arising from the terminal branches of the abducens nerve to the lateral rectus muscle, is reported. The patient presented with a painless proptosis of the left eye. Preoperative diagnosis of benign intraorbital neoplasm was made by means of CT and MR scans; the mass was radically excised through a microsurgical lateral orbitotomy and the pathological examination revealed a schwannoma. Features of orbital schwannoma are described, together with some details concerning the surgical strategy and the history of the evolution of the lateral orbitotomy.

Background. Current knowledge of risk assessment in survivors of myocardial infarction is largely based on data gathered before the advent of thrombolysis. It must be determined whether and to what extent available information and proposed criteria of prognostication are applicable in the thrombolytic era. Methods and Results. We reassessed risk prediction in the 10 219 survivors of myocardial infarction with follow-up data available (ie, 98% of the total) who had been enrolled in the GISSI-2 trial, relying on a set of prespecified variables. The 3.5% 6-month all-cause mortality rate of these patients compared with the higher value of 4.6% found in the corresponding GISSI-1 cohort, originally allocated to streptokinase therapy, indicates a 24% reduction in postdischarge 6-month mortality. On multivariate analysis (Cox model), the following variables were predictors of 6-month all-cause mortality: ineligibility for exercise test for both cardiac (relative risk [RR], 3.30; 95% confidence interval [CI], 2.36-4.62) and noncardiac reasons (RR, 3.28; 95% CI, 2.23-4.72), early left ventricular failure (RR, 2.41; 95% Cl, 1.87-3.09), echocardiographic evidence of recovery phase left ventricular dysfunction (RR, 2.30; 95% CI, 1.78-2.98), advanced (more than 70 years) age (RR, 1.81; 95% Cl, 1.43 -2.30), electrical instability (ie, frequent and/or complex ventricular arrhythmias) (RR, 1.70; 95% Cl, 1.32-2.19), late left ventricular failure (RR, 1.54; 95% Cl, 1.17-2.03), previous myocardial infarction (RR, 1.47; 95% CI, 1.14-1.89), and a history of treated hypertension (RR, 1.32; 95% Cl, 1.05-1.65). Early post-myocardial infarction angina, a positive exercise test, female sex, history of angina, history of insulin-dependent diabetes, and anterior site of myocardial infarction were not risk predictors. On further multivariate analysis, performed on 8315 patients with the echocardiographic indicator of left ventricular dysfunction available, only previous myocardial infarction was not retained as an independent risk predictor. Conclusions. A decline in 6-month mortality of myocardial infarction survivors, seen within 6 hours of symptom onset, has been observed in recent years. Ineligibility for exercise test, early left ventricular failure, and recovery-phase left ventricular dysfunction are the most powerful (RR, >2) predictors of 6-month mortality among patients recovering from myocardial infarction after thrombolysis. Qualitative variables reflecting residual myocardial ischemia do not appear to be risk predictors. The lack of an independent adverse influence of early post-myocardial infarction angina on 6-month survival represents a major difference between this study and those of the prethrombolytic era.

A measurement of the direct production of photons with high transverse momentum from {Mathematical expression} collisions at {Mathematical expression} GeV is presented. The structure of events containing a high transverse momentum photon is studied. The results support predictions from QCD theory. © 1988 Springer-Verlag.

Phimosis is perhaps one of the most frequent consultation on pediatric surgery clinics throught the world. The aim of this study is to compare the two procedures more frequently performed in our hospital: dorsal slit and circumcision. PATIENTS Y METHODS: Retrospective study of 1698 patients who were admitted for elective surgical treatment of phimosis between 2003 and 2009. We analyzed age, surgical and anesthethic times, surgical technique and complications. We also did transversal descriptive study through telephonic survey on parents and patients older than 16 years old.There was 76.6% of dorsal slit (n = 1300) and 23.4% (n= 398) of circumcisions. Mean age was 7.15 years y mean time of follow up was 42.3 months. Surgical time was significantly higher in circumcision (p0.0001). There were 3% (n = 51) of reoperations, no differences between groups. We didn't find differences in postoperative stenosis, but bleeding was more frequent in circumcision group (1.7%; p = 0.03). There were no differences on parental appreciation of postoperative pain, or functional and esthetic satisfaction between groups.We didn't find differences on subjective satisfaction between groups. Even if there are differences n postoperative bleeding, global incidence is very low. In our experience both techniques are valid and safe, so surgeon and parents must jointly make the decision.

The eruption of Samalas in Indonesia in 1257 ranks among the largest sulfur-rich eruptions of the Common Era with sulfur deposition in ice cores reaching twice the volume of the Tambora eruption in 1815. Sedimentological analyses of deposits confirm the exceptional size of the event, which had both an eruption magnitude and a volcanic explosivity index of 7. During the Samalas eruption, more than 40 km$^3$ of dense magma was expelled and the eruption column is estimated to have reached altitudes of 43 km. However, the climatic response to the Samalas event is debated since climate model simulations generally predict a stronger and more prolonged surface air cooling of Northern Hemisphere summers than inferred from tree-ring-based temperature reconstructions. Here, we draw on historical archives, ice-core data and tree-ring records to reconstruct the spatial and temporal climate response to the Samalas eruption. We find that 1258 and 1259 experienced some of the coldest Northern Hemisphere summers of the past millennium. However, cooling across the Northern Hemisphere was spatially heterogeneous. Western Europe, Siberia and Japan experienced strong cooling, coinciding with warmer-than-average conditions over Alaska and northern Canada. We suggest that in North America, volcanic radiative forcing was modulated by a positive phase of the El Niño–Southern Oscillation. Contemporary records attest to severe famines in England and Japan, but these began prior to the eruption. We conclude that the Samalas eruption aggravated existing crises, but did not trigger the famines.

Ranking among the largest volcanic eruptions of the Common Era (CE), the ‘Millennium Eruption’ of Changbaishan produced a widely-dispersed tephra layer (known as the B-Tm ash), which represents an important tie point for palaeoenvironmental studies in East Asia. Hitherto, there has been no consensus on its age, with estimates spanning at least the tenth century CE. Here, we identify the cosmogenic radiocarbon signal of 775 CE in a subfossil larch engulfed and killed by pyroclastic currents emplaced during the initial rhyolitic phase of the explosive eruption. Combined with glaciochemical evidence from Greenland, this enables us to date the eruption to late 946 CE. This secure date rules out the possibility that the Millennium Eruption contributed to the collapse of the Bohai Kingdom (Manchuria/Korea) in 926 CE, as has previously been hypothesised. Further, despite the magnitude of the eruption, we do not see a consequent cooling signal in tree-ring-based reconstructions of Northern Hemisphere summer temperatures. A tightly-constrained date for the Millennium Eruption improves the prospect for further investigations of historical sources that may shed light on the eruption's impacts, and enhances the value of the B-Tm ash as a chronostratigraphic marker.