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Ambiguity and uncertainty are unavoidable elements of clinical practice. Although they can cause discomfort for both clinicians and patients, they can also be used to positive effect ensuring safer clinical practice that is tailored to individuals. As paramedics generally work in areas of practice where they encounter undifferentiated complaints with limited resources to investigate, diagnostic uncertainty can prove a challenge on a regular basis. Similarly, even when paramedics are fairly confident of the diagnosis, optimal management is frequently unclear or unachievable. This article presents practical short-term strategies to manage both diagnostic and management uncertainty in clinical practice. This article also suggests longer-term tactics that can be developed individually and collectively beginning with developing capability over competence through to changing culture and providing space for supervision. While these strategies may not completely eliminate the discomfort that can arise when faced with ambiguity and uncertainty, they can enable a greater tolerance for it, improve clinical practice, and ultimately benefit patients.

The role of Human pegivirus (HPgV) in patients with encephalitis has been recently questioned. We present cases of 4 patients with similar clinical, biological, and radiological characteristics, including a past history of transplantation with long-term immunosuppression and a progressive course of severe and predominantly myelitis, associated in 3 cases with optic neuropathy causing blindness. Extensive workup was negative but analysis of the CSF by use of pan-microorganism DNA- and RNA-based shotgun metagenomics was positive for HPgV. This case series further supports the hypothesis of HPgV CNS infection and highlights the utility of metagenomic next-generation sequencing of CSF in immunocompromised patients.

The value of hair in forensic toxicology has already been widely demonstrated. It offers a much wider detection window than other matrices, and its segmental analysis allows the documentation of a single, occasional or regular consumption of a large number of molecules. To date, considerable efforts are being made to achieve very high sensitivity using increasingly effective techniques in the forensic analysis of hair (gas chromatography with electron ionization mass spectrometry (GC--EI-MS); gas chromatography with chemical ionization mass spectrometry (GC--CI-MS); gas chromatography–tandem mass spectrometry (GC--MS-MS); high or ultra performance liquid chromatography–tandem mass spectrometry (HPLC–MS-MS and UPLC–MS-MS)). Since the early 2000s, work has been carried out to analyze hair using matrix-assisted laser desorption ionization (MALDI) coupled with imaging mass spectrometry (IMS). Intact, cut or pulverized, human head hairs are analyzed in all their forms. With a simplified and rapid sample preparation protocol, MALDI-IMS appears to be an attractive option for the forensic interpretation of hair analysis. The high spatial resolution clearly competes with conventional methods and strand segmentation. This article provides a complete overview on MALDI techniques used and its applications to better understand the pre-analytical and the analytical parts in the hair analysis.

Background: Many specialist paramedics are moving from the ambulance service to primary care. There is a lack of empirical literature regarding this transition. Aims: This study aims to improve support for specialist paramedics undertaking the transition by ascertaining factors that may hinder or facilitate the process. Methods: The study used semi-structured interviews with eight specialist paramedics working in primary care in England. An interpretative phenomenological analysis approach was used to analyse data, and this was informed by a review of theoretical and empirical literature. Findings: Facilitators and barriers to transition were found, along with information regarding the transition. Five facilitators were identified: previous clinical experience; mentorship; support; clear role parameters; and opportunity to develop. Four barriers were identified: role misunderstanding; changing scope of clinical practice; time pressures; and gaps in education and knowledge. Conclusion: This study contributes to a limited field of research by highlighting barriers and facilitators to the transition of specialist paramedics to primary care. Practical steps can be taken to smooth this transition.

Headaches are a common disorder, are the fourth commonest reason for attending an emergency department (ED) and account for around 1% of 999 calls. They are often poorly managed. Paramedics will encounter patients with headache disorders regardless of where they work. These presentations, however, can challenge clinicians because of the complexities of assessment and the potential repercussions of missing a significant pathology. The vast majority of headaches that present to the ED are primary migraines. Nonetheless, paramedics need to be aware of the potential for sinister causes; around 0.5% of sinister headache pathologies are missed at first presentation. This article gives an overview of headache categorisation and diagnosis, discusses the characteristics of migraines given their prevalence, and outlines how to assess and manage patients in emergency and urgent care settings.

OBJECTIVES To investigate the long-term outcomes of concomitant suture bicuspidization to treat mild or moderate tricuspid regurgitation at the time of mitral valve surgery. METHODS Data from patients who underwent mitral valve surgery for degenerative mitral valve regurgitation with mild or moderate tricuspid regurgitation and annular dilatation between January 2009 and December 2017 were analyzed. The cohort was divided into 2 groups: mitral valve surgery alone and mitral valve surgery with concomitant tricuspid valve repair. RESULTS A total of 196 patients were included in the study. Mitral valve surgery alone and mitral valve surgery with concomitant tricuspid valve repair were performed in 91 (46.4%) and 105 (53.6%) patients, respectively. Propensity score matching analysis identified 54 pairs. In the matched cohort, 30-day mortality (0.0% vs 1.9%, P = 1.0) and new permanent pacemaker implantation (11.1% vs 7.4%, P = 0.740) did not differ significantly between groups. After a mean follow-up of 6.0 (2.8) years, mitral valve surgery with concomitant tricuspid valve repair was not associated with increased mortality risk compared to mitral valve surgery alone (hazard ratio 1.04, 95% confidence interval 0.47–2.28, P = 0.927) with 10-year overall survival rates of 69.9% and 77.2%, respectively. Furthermore, mitral valve surgery with concomitant tricuspid valve repair was associated with a significantly reduced progression of tricuspid valve regurgitation (P CONCLUSION Patients undergoing mitral valve surgery with concomitant tricuspid valve repair had similar 30-day and long-term survival, similar permanent pacemaker implantation rate, and reduced progression of tricuspid valve regurgitation compared to those undergoing mitral valve surgery alone.

Space-based research can provide a major leap forward in the study of key open questions in the fundamental physics domain. They include the validity of Einstein’s Equivalence principle, the origin and the nature of dark matter and dark energy, decoherence and collapse models in quantum mechanics, and the physics of quantum many-body systems. Cold-atom sensors and quantum technologies have drastically changed the approach to precision measurements. Atomic clocks and atom interferometers as well as classical and quantum links can be used to measure tiny variations of the space-time metric, elusive accelerations, and faint forces to test our knowledge of the physical laws ruling the Universe. In space, such instruments can benefit from unique conditions that allow improving both their precision and the signal to be measured. In this paper, we discuss the scientific priorities of a space-based research program in fundamental physics.

En los últimos años se ha visto afectada la infraestructura vial debido al incremento del tráfico y las variaciones de temperatura, esto ha ocasionado la aparición de surcos y grietas. El presente trabajo tiene como objetivo realizar una revisión sistemática de la literatura sobre el uso de etileno vinil acetato (EVA) en mezclas asfálticas. Se realizó una revisión de 50 artículos científicos indexados entre los años 2015 al 2021, recopilados de distintas de datos obtenidas de Scopus, Sciencedirect, ProQuest, IOP Science y Ebsco. Sobre la revisión se encontraron investigaciones de la influencia de EVA en las propiedades del asfalto. Se examinó el proceso de selección de contenido óptimo, los cambios en las propiedades y los resultados obtenidos. Se pudo concluir que la adición de EVA mejora las propiedades, incrementa la estabilidad, disminuye la formación de los surcos y las deformaciones.

La demanda del uso de pavimentos flexibles va creciendo raudamente debido a su buen desempeño, pero este está siendo afectado de manera considerable debido al aumento del tráfico y las variaciones climáticas, esto trae consigo la presencia de fallas considerables en el pavimento, causando que su desempeño disminuya y, por ende, se acorte su tiempo de vida útil. Este documento tiene como objetivo realizar una revisión sistemática de los distintos tipos de fibras usados en las mezclas asfálticas para la mejora de sus propiedades mecánicas, además de estudiar los porcentajes y longitudes óptimas, las pruebas utilizadas, el desempeño de las mezclas según el tipo de betún, el tipo de mezcla asfáltica y, finalmente, se revisa la rentabilidad que proporciona el uso de fibras en las mezclas asfálticas. Se revisaron 81 artículos publicados en las bases de datos de Scopus y Ebsco, entre los años 2014 al 2021, los cuales tuvieron el mismo objetivo de estudiar las características mecánicas de las mezclas asfálticas con adición de fibras. Se concluyó que las fibras, además de mejorar las propiedades de los pavimentos flexibles, son rentablemente buenas ya que, a pesar de tener un aumento en el costo inicial, demuestran un incremento en el ciclo de vida, siendo así económicamente factibles para proyectos viales que se realicen con el uso mezclas asfálticas, además se recomendó proseguir con estudios encaminados a utilizar este tipo de mezclas asfálticas.

Portland cements are integral components in the oilfield well construction process; however, the confluence of various business drivers have created the need to find sustainable alternatives materials. Geopolymers, already well known in traditional construction industries, show promise as alternatives to Portland cement in oilfield wells. Yet, successfully moving geopolymers from a concept in the laboratory to execution at the wellsite remains to be established. This paper presents evaluation of geopolymer cementing for use in oil and gas wells, specifically the primary cementing of liner strings in the Permian Basin. To evaluate geopolymer cementing for oil and gas well construction, a field example project was divided into four phases: development of robust slurry design in the laboratory, confirmation of compatibility with oilfield equipment, scalability for safe execution in the field, and validation through post-job evaluation techniques. The laboratory work included an engineered, innovative approach to chemistry to obtain a slurry matching and exceeding performance of Portland cement−based designs. Yard trials were performed to verify compatibility of geopolymers with industry-standard oilfield cementing equipment. The geopolymer-based designs were then scaled up to meet typical cementing job volumes and executed at the wellsite without deviating from conventional operating procedures. Post-job evaluation techniques to validate the placement included pressure matching and cement bond logs. Results have shown that for primary cementing applications, geopolymers can be an effective alternative to Portland cements. This case demonstrates that geopolymer cementing was able to fit into the oilfield cementing workflow without major changes to job design process, onsite execution, or post-job evaluation. Post-job pressure match of hydraulic simulations versus recorded pressure during job execution confirmed proper placement and conventional sonic and ultrasonic cement bond logging tools were able to confirm the presence of geopolymers within the wellbore providing further assurance. Introduction of geopolymer cementing requires the adaptation of innovative chemistry into the slurry design and consequently sourcing of materials typically not used in Portland cement blends. Additionally, attention to quality control of raw materials is required to ensure consistency of performance. Overall, geopolymer cementing can be successfully implemented into oilfield primary casing cementing applications using the existing infrastructure that has evolved from the historic use of Portland cement. Geopolymer cementing offers a unique opportunity for the oilfield industry to decrease CO2 emissions related to well construction and reduce dependence on the constrained supply of Portland cements. The case of cementing intermediate liner in the Permian Basin validates the scalability of the concept from inception in the laboratory to wellsite execution.

IntroductionDrought and submergence are contrasting abiotic stresses that often occur in the same rice crop season and cause complete crop failure in many rain-fed lowland areas of Asia.MethodsTo develop rice varieties with good tolerances to drought and submergence, 260 introgression lines (ILs) selected for drought tolerance (DT) from nine BC2 populations were screened for submergence tolerance (ST), resulting in 124 ILs with significantly improved ST.ResultsGenetic characterization of the 260 ILs with DNA markers identified 59 DT quantitative trait loci (QTLs) and 68 ST QTLs with an average 55% of the identified QTLs associated with both DT and ST. Approximately 50% of the DT QTLs showed ‘epigenetic’ segregation with very high donor introgression and/or loss of heterozygosity (LOH). Detailed comparison of the ST QTLs identified in ILs selected only for ST with ST QTLs detected in the DT-ST selected ILs of the same populations revealed three groups of QTLs underlying the relationship between DT and ST in rice: a) QTLs with pleiotropic effects on both DT and ST; b) QTLs with opposite effects on DT and ST; and c) QTLs with independent effects on DT and ST. Combined evidence identified most likely candidate genes for eight major QTLs affecting both DT and ST. Moreover, group b QTLs were involved in the Sub1regulated pathway that were negatively associated with most group aQTLs.DiscussionThese results were consistent with the current knowledge that DT and ST in rice are controlled by complex cross-talks between or among different phytohormone-mediated signaling pathways. Again, the results demonstrated that the strategy of selective introgression was powerful and efficient for simultaneous improvement and genetic dissection of multiple complex traits, including DT and ST.

Plot of the HR efficiencies measured after expression of either WT BRCA1 or VUS normalized to the HR efficiency after expression of WT BRCA1. The HR efficiencies are here plotted as a function of the position of the mutation in the BRCA1 sequence. Statistical significance was calculated using a one-side paired student t-test. To account for the multiple testing, the p-values were adjusted using the Benjamini-Horchberg method at a level a=0.05. HR efficiencies significantly different from the WT value are marked by asterisks. They are indicated by * if p < 0.05 and ** if p < 0.01. All 7 (likely) causal (noted LC or C) variants (in red) caused a significantly decreased HR efficiency whereas all 6 (likely) neutral (noted LN or N) variants (in blue) caused no significant HR difference. Twenty-four VUS of class 3 could not provide WT HR efficiency.

Isothermal Titration Calorimetry curves obtained by adding the different phosphopeptides at (A-B) 200 mM onto the WT BRCT domains at 20 mM and (C-D) 100 mM onto the WT BRCT domains at 10 mM .

BRCA1 mutations have been identified that increase the risk of developing hereditary breast and ovarian cancers. Genetic screening is now offered to patients with a family history of cancer, to adapt their treatment and the management of their relatives. However, a large number of BRCA1 variants of uncertain significance (VUS) are detected. To better understand the significance of these variants, a high-throughput structural and functional analysis was performed on a large set of BRCA1 VUS. Information on both cellular localization and homology-directed DNA repair (HR) capacity was obtained for 78 BRCT missense variants in the UMD-BRCA1 database and measurement of the structural stability and phosphopeptide-binding capacities was performed for 42 mutated BRCT domains. This extensive and systematic analysis revealed that most characterized causal variants affect BRCT-domain solubility in bacteria and all impair BRCA1 HR activity in cells. Furthermore, binding to a set of 5 different phosphopeptides was tested: all causal variants showed phosphopeptide-binding defects and no neutral variant showed such defects. A classification is presented on the basis of mutated BRCT domain solubility, phosphopeptide-binding properties, and VUS HR capacity. These data suggest that HR-defective variants, which present, in addition, BRCT domains either insoluble in bacteria or defective for phosphopeptide binding, lead to an increased cancer risk. Furthermore, the data suggest that variants with a WT HR activity and whose BRCT domains bind with a WT affinity to the 5 phosphopeptides are neutral. The case of variants with WT HR activity and defective phosphopeptide binding should be further characterized, as this last functional defect might be sufficient per se to lead to tumorigenesis.Implications:The analysis of the current study on BRCA1 structural and functional defects on cancer risk and classification presented may improve clinical interpretation and therapeutic selection.

The black bar corresponds to WT BRCA1, the blue bars to VUS of classes 1 and 2, the grey bars to VUS of class 3 and the red bars to VUS of classes 4 and 5. Bars boxed in green correspond to mutants that are defective in phosphopeptide-binding, as observed using fluorescence based thermal shift assays. HR- marks VUS that are HR-defective.

FBTSA assay revealing that binding of the WT BRCA1 BRCT domains to ACC1-P, BACH1-P, CtiP-P, AB-1P and AB-2P induce a measurable increase in the BRCT thermostability that raises with peptide concentration.

Mutated BRCT domains fused to GST were expressed in E. coli and purified by affinity chromatography using glutathione beads. This figure shows a SDS-PAGE gel with samples from the bacterial pellet (P), supernatant (S) and the glutathione beads (G) after incubation with the supernatant and washing. VUS were classified into 3 groups as a function of the amount of (1) soluble and (2) purified protein obtained from bacterial cultures. Lanes corresponding to a typical insoluble fusion protein, a typical poorly soluble fusion protein and a typical fusion protein as soluble as the WT fusion protein are boxed in orange, grey and black, respectively (colors are as in Figure 4 excepted for mutations that cause aggregation during purification, which are in yellow on Figure 4 even if they displayed a "grey-like" profile at the expression and first affinity purification stages).

Size Exclusion Chromatography profiles obtained on BRCA1 BRCT domains free (red curve) or in complex with BACH1-P (purple), AB-1P (green), AB-2P (blue). The experiment was performed using a Superdex-75 10/300 GL column (GE Healthcare) pre-equilibrated with 50mM Tris-HCl pH 7.5, 150 mM NaCl, 10 mM β-mercaptoethanol and protease inhibitors (Roche).

FBTSA assays performed to measure binding of the mutated BRCA1 BRCT domains to ACC1-P, BACH1-P, CtiP-P, AB-1P and AB-2P.

El ladrillos es uno de los materiales mas requeridos para la construcción de viviendas, los cuales debido a un exceso de compra, o por rotura mediante traslado no se utilizan totalmente. El presente trabajo tiene como objetivo lograr una revisión sistematica sobre el uso de ladrillos triturados en el concreto, con el fin de sintetizar los resultados obtenidos y discutir la posibilidad de poder utilizar en las diferentes áreas de la construcción este material reciclado. Se hizo una revisión de 50 articulos indexados entre los años 2015 al 2021, distribuido de la siguiente manera: 40 articulos son de Scopus y 10 de Sciencedirect, de los cuales muestran como influye el ladrillo triturado en las propiedades del concreto. La revisión de los resultados constataron que los agregados de ladrillos reciclados (RBA) generan una deficiencia en resistencia a la compresión y una mayor porosidad a diferencia del agregado natural (NA).

Laser Interferometer Space Antenna (LISA) will observe gravitational waves from galactic binaries (GBs) of white dwarfs or neutron stars. Some of these objects are among the most magnetic astrophysical objects in the Universe. Magnetism, by secularly disrupting the orbit, can eventually affect the gravitational waves emission and could then be potentially detected and characterized after several years of observations by LISA. Currently, the data processing pipeline of the LISA Data Challenge (LDC) for GBs does not consider either magnetism or eccentricity. Recently, it was shown [Bourgoin et al. PRD 105, 124042 (2022)] that magnetism induces a shift on the gravitational wave frequencies. Additionally, it was argued that, if the binary's orbit is eccentric, the presence of magnetism could be detected by LISA. In this work, we explore the consequences of a future data analysis conducted on quasi-circular and magnetic GB systems using the current LDC tools. We first show that a single eccentric GB can be interpreted as several GBs and this can eventually bias population studies deduced from LISA's future catalog. Then, we confirm that for quasi-circular orbits, the secular magnetic energy of the system can be inferred if the signal-to-noise ratio of the second harmonic is high enough to be detected by traditional quasi-monochromatic source searching algorithms. LISA observations could therefore bring new insights on the nature and origin of magnetic fields in white dwarfs or neutron stars., Comment: 18 pages, 6 figures

In a first pre-registered experiment (detailed at length here: https://osf.io/jtsuf) conducted on healthy participants, we studied the effect of spatial attention on the line bisection and visual vertical tasks. We found that shifting spatial attention to the left or the right by means of exogenous visual cues could bias the subjective line midpoint (in the line bisection task), as classically reported in the literature (e.g., Sosa et al., 2011). In contrast, this intervention had no significant effect on the subjective vertical. The first goal of the present experiment will be to replicate these results, by using the same methodology. The second goal will be to generalize our results and test the effect of spatial attention on egocentric spatial processes as measured by the straight-ahead task. We will test whether the eventual presence of egocentric biases (subjective straight-ahead) are correlated with the allocentric biases (subjective line midpoint) observed in the line bisection task. In this second experiment, we will thus add a visual straight-head task to the protocol and test the effect of the visual lateralized cue on this task. In a third experiment, we will ask healthy participants to perform (only) a proprioceptive straight-ahead task, during which continuous auditory cues will be presented to the left or right of the participant. This control experiment will eliminate the possible confounding effect of visual saccade on the subjective straight-ahead measured in Experiment 2. In experiment 2, visual straight-head deviation induced by the presence of the visual cue could in fact be due (at least in part) to eye deviation toward the cue. If the modulation of spatial attention is not modality-specific, Experiment 2 and 3 should yield similar egocentric biases induced by the cue.

Spatial neglect after right hemisphere stroke (RHS) was recently found to encompass lateropulsion, a deficit in body orientation with respect to gravity caused by altered brain processing of graviception. By analogy, we hypothesized that spatial neglect after RHS might encompass an altered representation of verticality. We also assumed a strong relation between body neglect and impaired postural vertical, both referring to the body. To tackle these issues, we performed contingency and correlation analyses between two domains of spatial neglect (body, extra-body) and two modalities of verticality perception (postural, visual) in 77 individuals (median age = 67) with a first-ever subacute RHS (1-3 months). All individuals with a transmodal (postural and visual) tilt in verticality perception (n = 26) had spatial neglect, but the reverse was not found. Correlation and multivariate analyses revealed that spatial neglect (and notably body neglect) was associated more with postural than visual vertical tilts. These findings indicate that after RHS, an impaired verticality representation results from a kind of graviceptive neglect, bearing first on somaesthetic graviception and second on vestibular graviception. They also suggest that the human brain uses not only a mosaic of 2D representations but also 3D maps involving a transmodal representation of verticality.

Background Climate change and the current phase-out of fossil fuel-fired power generation are currently expanding the market of renewable energy and more especially photovoltaic (PV) panels. Contrary to other types of renewable energies, such as wind and hydroelectricity, evidence on the effects of PV panels on biodiversity has been building up only fairly recently. PV panels have been linked to substantial impacts on species and ecosystems, the first and most obvious one being the degradation of natural habitats but they may also lead to mortality of individuals and displacements of populations. Hence, we propose a systematic map aiming to draw a comprehensive panorama of the available knowledge on the effects of photovoltaic and solar thermal (PVST) installations, whatever their scales (i.e. cells, panels, arrays, utility-scale facilities), on terrestrial and semi-aquatic species and natural/semi-natural habitats and ecosystems. This work aims at providing decision-makers with a better understanding of the effects of PVST installations and, therefore, help them further protect biodiversity while also mitigating anthropogenic climate change. Methods We will follow the collaboration for environmental evidence guidelines and search for relevant peer-reviewed and grey literature in English or French. The search string will combine population (all wild terrestrial and semi-aquatic species—e.g. animals, plants, fungi, microorganisms—as well as natural/semi-natural terrestrial habitats and ecosystems) and exposure/intervention (all technologies of PVST panels at all scales of installations and therefore excluding concentrated solar power) terms. A pre-built test list of relevant articles will be used to assess the comprehensiveness of the search string. Extracted citations will be screened at title and full-text stages thanks to pre-defined inclusion/exclusion criteria. Accepted citations will then be split into studies and observations, from which relevant metadata (e.g. taxon, exposure/intervention, outcome) will be extracted and their internal validity assessed through a critical appraisal. The database will be accessible alongside a map report which will draw a landscape of eligible studies. By describing studied populations, exposures/interventions, outcomes and internal study validity results, the report will identify potential knowledge clusters and gaps regarding the effects of PVST installations on biodiversity and ecosystems.

Shoulder elevation, defined here as arm raising, being essential for activities of daily living, dysfunctions represent a substantial burden in patients’ lives. Owing to the complexity of the shoulder joint, the tightly coordinated muscular activity is a fundamental component, and neuromuscular impairments have devastating effects. A single-joint shoulder type version of the Hybrid Assistive Limb (HAL) allowing motion assistance based on the intention of the user via myoelectric activation has recently been developed, and its safety was demonstrated for shoulder rehabilitation. Yet, little is known about the physiological effects of the device. This study aims to monitor the changes in muscle activity and motion during shoulder HAL rehabilitation in several patients suffering from shoulder elevation dysfunction from cervical radicular origin. 8 patients (6 males, 2 females, mean age 62.4 ± 9.3 years old) with weakness of the deltoid muscle resulting from a damage to the C5 nerve root underwent HAL-assisted rehabilitation. We combined surface electromyography and three-dimensional motion capture to record muscular activity and kinematics. All participants showed functional recovery, with improvements in their Manual Muscle Testing (MMT) scores and range of motion (ROM). During training, HAL decreased the activity of deltoid and trapezius, significantly more for the latter, as well as the coactivation of both muscles. We also report a reduction of the characteristic shrugging compensatory motion which is an obstacle to functional recovery. This reduction was notably demonstrated by a stronger reliance on the deltoid rather than the trapezius, indicating a muscle coordination tending toward a pattern similar to healthy individuals. Altogether, the results of the evaluation of motion and muscular changes hint toward a functional recovery in acute, and chronic shoulder impairments from cervical radicular origin following shoulder HAL rehabilitation training and provide information on the physiological effect of the device.

Cellulose nanocrystals (CNCs) are ideal rheological modifiers for aqueous oil and gas extraction fluids. CNCs are typically produced with sulfuric acid and their aqueous suspensions have uniform and predictable properties under ambient conditions; however, drastic changes occur at elevated temperatures. Herein, the effects of high temperature treatments (ranging from 80 to 180 °C for 1 h to 7 days) on the properties (including uniformity, colloidal stability, and color) of sulfated, phosphated, and carboxylated CNC suspensions were studied. Additionally, cellulose molecular weight, and CNC surface charge content and crystallinity index were quantified before and after heating. CNCs underwent few morphological changes; their molecular weight and crystallinity index were largely unchanged under the conditions tested. Their surface charge content, however, was significantly decreased after heat treatment which resulted in loss of colloidal stability and aggregation of CNCs. The largest change in suspension properties was observed for sulfated CNCs whereas CNCs with a combination of sulfate and phosphate esters, or carboxylate groups, were less affected and maintained colloidal stability at higher temperatures. In fact, desulfation was found to occur rapidly at 80 °C, while many carboxylate groups persisted at temperatures up to 180 °C; calculated rate constants (based on second order kinetics) suggested that desulfation is 20 times faster than decarboxylation but with a similar activation energy. Overall, this study elucidates CNC suspension behavior after heat exposure and demonstrates routes to produce CNCs with improved high temperature performance.

The main aim of this project is to replicate the study of Blini et al. (2013) in order to evaluate the effect of listening numbers of different magnitude on the signed errors of the visual rod bisection (RB) task and proprioceptive straight-ahead (SA) task. Blini et al. (2013) initially found a significant “numerical magnitude effect” in the RB task, but a null effect in the SA task. This second result is unclear, as our power analysis suggests that the study of Blini et al. had not enough power (46%) to detect significant effect on the perceived SA (n=24). To tackle this issue, we plan to replicate their study by recruiting a larger number of participants, estimated at n=43 according to our post-hoc power analysis. In addition, we will investigate in a more exploratory fashion whether the numerical magnitude effect can modulate the signed error of a lateralized spatial task performed in another dimension, such as the visual vertical (VV) task. Blini, E., Cattaneo, Z., & Vallar, G. (2013). Different effects of numerical magnitude on visual and proprioceptive reference frames. Frontiers in Psychology, 4(APR), 1–6. https://doi.org/10.3389/fpsyg.2013.00190

The general purpose of this study is to explore how the human brain code for spatial representation and whether spatial coding in different dimensions share common processes. To this end, we will investigate within the same participants whether sensory and/or motor perturbations can shift the orientation of the perceived visual vertical (VV) and straight-ahead (SA) in a congruent, co-dependent, fashion. We will use the tilted-room immersion and prismatic adaptation, two sensory and/or motor perturbations known to modulate the orientation of VV and SA respectively (Bringoux et al., 2009; Howard & Hu, 2001; Odin et al., 2018; Prablanc et al., 2020; Rossetti et al., 1998). These interventions consist to immerge participants for 10 minutes in different virtual environments tilted by 18° clockwise or counter-clockwise (tilted room immersion), and to ask participants to perform a dynamic pointing task while bearing glasses shifting the visual field by 10° rightward or leftward (prismatic adaptation). These interventions will be applied within the same participant through two separate sessions during which VV and SA will be measured before and after intervention.

The purpose of this study is to explore how the human brain code for spatial representation and whether spatial coding in different dimensions share common processes. To this end, we will investigate within the same participants whether prism adaptation (Prablanc et al., 2020; Rossetti et al., 1998) can shift the orientation of the perceived visual vertical (VV) and straight-ahead (SA) in a congruent, co-dependent, fashion. During prism adaptation, participants will be asked to perform a dynamic pointing task while bearing glasses shifting the visual field by 10° rightward or leftward. Each participant will undergo the left prisms and right prisms conditions across two sessions separated by at least one week. VV and SA will be measured before and after prism adaptation. In a first recent pre-registered study (https://osf.io/dfe7t), we found the VV shifts (posttest – pretest) to differ significantly (p = .025) between the left and right prisms conditions. Nevertheless, in this first study the left and right prisms conditions were performed by two independent groups, resulting in weak statistical power (around 50%). To be more confident that prisms can bias verticality perception or not, we will therefore try to replicate this effect with a well-powered (80%) within-subjects design.

MitraClip (Abbott Laboratories, Abbott Park, IL) is validated in high-risk patients with severe degenerative mitral regurgitation (MR); however, it is not well established for functional MR in hypertrophic cardiomyopathy (HCM). We share a case of a 68-year-old man with HCM hospitalized for multiple incidents of acute pulmonary edema caused by a dynamic MR and successfully treated with the MitraClip device. Novel teaching points emerging from this case are that MRs in HCM can often be explained by mixed mechanisms, and properly identifying the MR mechanism is essential to choose optimal treatment. Furthermore, MitraClip can simultaneously treat MR secondarily to annular dilation and systolic anterior motion.

OBJECTIVES The aim of this study was to assess the long-term outcomes of patients treated by anatomical pulmonary resection with the video-assisted thoracoscopic surgery (VATS) approach, VATS requiring intraoperative conversion to thoracotomy or an upfront open thoracotomy for lung cancer surgery. METHODS We performed a retrospective single-centre study that included consecutive patients between January 2011 and December 2018 treated either by VATS (with or without intraoperative conversion) or open thoracotomy for non-small-cell lung cancer (NSCLC). Patients treated for a benign or metastatic condition, stage IV disease, multiple primary lung cancer or by resection, such as pneumonectomies or angioplastic/bronchoplastic/chest wall resections, were excluded. RESULTS Among 1431 patients, 846 were included: 439 who underwent full-VATS, 94 who underwent VATS-conversion (21 emergent, 73 non-emergent) and 313 treated with upfront open thoracotomy. The median follow-up was 37 months. There were no statistical differences in stage-specific overall survival between the full-VATS, VATS-conversion, and open thoracotomy groups, with 5-year OS for stage I NSCLC of 76%, 72.3% and 69.4%, respectively (P = 0.47). There was a difference in disease-free survival for stage I NSCLC, with 71%, 60.2% and 53%, respectively at 5 years (P = 0.013). Fewer complications occurred in the full-VATS group (pneumonia, arrhythmia, length of stay), but complication rates were similar between the VATS-conversion and thoracotomy groups. CONCLUSIONS VATS resection for NSCLC with intraoperative conversion does not appear to alter the long-term oncological outcome relative to full-VATS or open upfront thoracotomy. Postoperative complications were higher than for full-VATS and comparable to those for thoracotomy. VATS should be favoured when possible.

Multiple clinical studies have documented the dominance of the right cerebral hemisphere in spatial attention and verticality perception. Individuals with right hemisphere stroke frequently show spatial biases in the horizontal plane (spatial neglect) and verticality perception biases in the frontal plane (Dai et al., 2021; Kerkhoff, 1999; Pérennou, 2006). Of note, a large body of evidence has shown that these two disorders frequently occured together (Dai et al., 2021 ; Kerkhoff, 1999), were correlated in severity (Utz et al., 2011), shared similar neural substrates (Baier et al., 2021), and were both attenuated by similar experimental manipulation as vestibular stimulation (Oppenländer et al., 2015; Vallar et al., 1990). These results suggest a functional and structural dependence between the processing of attentional and graviceptive signals subtented by the right hemisphere. One way to test (at least partially) this hypothesis of dependency between both these processes is to probe, in healthy adults, the effect of an experimental manipulation on both spatial biases in the horizontal plane and verticality perception biases in the frontal plane. We chose to experimentally modulate spatial attention, as it is well known to induce spatial attention biases in the horizontal plane, in order to test if this manipulation is also efficient to induce verticality perception biases. To this end we will use the paradigm described in (Sosa & McCourt, 2011), consisting in presenting transient exogenous visual cues to either the left or right. Sosa & McCourt showed that visual cues flashed just before the presentation of a line tended to bias the subjective line midpoint toward the cue, compared to a no-cue condition. We reason that if visual cues can modulate spatial perception in the horizontal plane, it might also modulate spatial perception in the frontal plane, assuming that spatial attention and verticality perception are subtended by partially-dependent processes. In the present study, we will therefore use the procedure of Sosa & McCourt to assess the effect of the visual cue conditions (left-cue, no-cue, right-cue) on both the subjective line midpoint and subjective visual vertical, within the same participants.