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Expanded criteria donors help to increase graft availability, but provide organs with an increased risk of delayed graft function. We aimed to investigate whether donor hypothermia decreases the risk of delayed graft function compared with normothermia.

ObjectivesThe impact of the systematic screening of Neisseria gonorrhoeae(NG) and Chlamydia trachomatis(CT) in men having sex with men (MSM) on these pathogens’ epidemiology remains unclear. We conducted a modelling study to analyse this impact in French MSM.MethodsWe modelled NG and CT transmission using a site-specific deterministic compartmental model. We calibrated NG and CT prevalence at baseline using results from MSM enrolled in the Dat’AIDS cohort. The baseline scenario was based on 1 million MSM, 40 000 of whom were tested every 90 days and 960 000 every 200 days. Incidence rate ratios (IRRs) at steady state were simulated for NG, CT, NG and/or CT infections, for different combinations of tested sites, testing frequency and numbers of frequently tested patients.ResultsThe observed prevalence rate was 11.0%, 10.5% and 19.1% for NG, CT and NG and/or CT infections. The baseline incidence rate was estimated at 138.2 per year per 100 individuals (/100PY), 86.8/100PY and 225.0/100PY for NG, CT and NG and/or CT infections. Systematically testing anal, pharyngeal and urethral sites at the same time reduced incidence by 14%, 23% and 18% (IRR: 0.86, 0.77 and 0.82) for NG, CT and NG and/or CT infections. Reducing the screening interval to 60 days in frequently tested patients reduced incidence by 20%, 29% and 24% (IRR: 0.80, 0.71 and 0.76) for NG, CT and NG and/or CT infections. Increasing the number of frequently tested patients to 200 000 reduced incidence by 29%, 40% and 33% (IRR: 0.71, 0.60 and 0.67) for NG, CT and NG and/or CT infections. No realistic scenario could decrease pathogens’ incidence by more than 50%.ConclusionsTo curb the epidemic of NG and CT in MSM, it would not only be necessary to drastically increase screening, but also to add other combined interventions.

This study aimed to assess crop yield and soil nitrogen removal by trees from a potential nitrogen leaching pool in Mediterranean agroforestry, in a 15N-labeled fertilizer field experiment. We hypothesized that the applied 15N would be taken up by the trees, understorey vegetation strip (UVS), and soil microbial biomass, and that crop yield would be reduced in agroforestry systems. In a two-block agroforestry design, 15N-labeled urea was applied to the crop-soil surface in agroforestry and monocrop plots. We analyzed the 15N, nitrogen, and carbon contents of the aboveground and belowground compartments of the trees, crops, and UVS, as well as that of the soil microbial biomass. No labelled 15N was found in the trees, UVS and microbial biomass. Additionally, agroforestry-crop yielded a -20% lower yield compared to monocrop. The absence of 15N uptake by trees was attributed to the tree age and rooting pattern, which resulted in the lack of tree roots in contact with the labelled fertilizer. The absence of labelled 15N in the microbial biomass indicated a preference for pre-existing organic matter over newly generated 15N from urea mineralization. The capacity of agroforestry systems on crop yield and potentially leachable nitrate may be influenced by the age of trees and prevailing environmental and management practices. Further investigations after several years of tree growth are necessary to better understand the long-term effects of tree age on crop yield and the nutrient retention capacity, including the response pattern of nitrogen-fixing trees.

The benefits of masting (volatile, quasi-synchronous seed production at lagged intervals) include satiation of seed predators, but these benefits come with a cost to mutualist pollen and seed dispersers. If the evolution of masting represents a balance between these benefits and costs, we expect mast avoidance in species that are heavily reliant on mutualist dispersers. These effects play out in the context of variable climate and site fertility among species that vary widely in nutrient demand. Meta-analyses of published data have focused on variation at the population scale, thus omitting periodicity within trees and synchronicity between trees. From raw data on 12 million tree-years worldwide, we quantified three components of masting that have not previously been analysed together: (i) volatility, defined as the frequency-weighted year-to-year variation; (ii) periodicity, representing the lag between high-seed years; and (iii) synchronicity, indicating the tree-to-tree correlation. Results show that mast avoidance (low volatility and low synchronicity) by species dependent on mutualist dispersers explains more variation than any other effect. Nutrient-demanding species have low volatility, and species that are most common on nutrient-rich and warm/wet sites exhibit short periods. The prevalence of masting in cold/dry sites coincides with climatic conditions where dependence on vertebrate dispersers is less common than in the wet tropics. Mutualist dispersers neutralize the benefits of masting for predator satiation, further balancing the effects of climate, site fertility and nutrient demands.

The number of cancer survivors increases and their risks of recurrence, second cancer, morbidity and death is high; measures to prevent these risks are thus critical. Knowing the factors that lead cancer survivor to adopt or not healthy behaviours is crucial for designing effective prevention campaigns and better support them in after-cancer. Our study attempts to provide additional knowledge in this direction.

Objective:Recurrent diabetic foot ulcers (DFUs) are associated with poor health-related quality of life and reduced mobility. Current guidelines recommend application of non-removable offloading devices (NROLDs) as they may improve the healing of DFUs, but there is a lack of information on the wider effects of wearing these devices. Few studies have examined the impact of NROLDs on holistic wellbeing or physical activity. We aimed to investigate the short-term impact of NROLDs on physical activity and DFU-related quality of life (DFU-QoL) in a small sample of community-dwelling people with recurrent DFUs.Method:We measured DFU-QoL and physical activity (GPAQ) in people with DFUs, recruited from a single clinic before NROLD application, and at three and six weeks after device fitting. Participants were aged from 39–81 years (mean 58.4±10.1 years) with an equal number of male and female participants.Results:The study cohort comprised 18 participants, of whom 14 (78%) completed six-week questionnaires. Although there was some interim decline observed within individual domains of the DFU-QoL (financial: mean difference (MD) 16.2 (95% confidence interval (CI) 2.1, 30.2); p=0.03); non-compliance: MD 12.5 (95% CI–0.2, 25.2); p=0.05), no differences were observed over six weeks. Levels of physical activity declined over time, with over half (56%) of participants classified as having low levels of physical activity at baseline, rising to two-thirds (67%) at follow-up.Conclusion:Future studies should explore the longer-term holistic impact of NROLDs and develop more personalised approaches to care at the point of prescription, during and post-device use.

Quelques études ont mis en évidence l'impact socialement différencié de l’épidémie de COVID-19 en France. Les inégalités sociales étant hétérogènes, notre objectif était d’évaluer leur impact selon les métropoles françaises à une échelle géographique fine (IRIS) en cernant les variations locales.

•Documented or clinically suspected postoperative infections after cephalic pancreaticoduodenectomy occur in more than two thirds of patients and are associated with high antibiotic consumption.•Documented postoperative infections in patients with bile colonization involve a microorganism isolated from the bile in 2/3 of cases and may be associated with a higher rate of severe complications.•The most frequently isolated microorganisms in bile were Gram-negative bacilli (GNB) (57%) with a predominance of Escherichia coliand Klebsiellaspp., followed by Gram-positive cocci (GPC) (43%) with a predominance of Enterococciand Streptococci.•Bile colonization and postoperative infections with Enterococcus faeciumand Candidaspp. remain scarce.•A short-term probabilistic perioperative antibiotic therapy adapted to the bile bacterial ecology rather than a surgical antibiotic prophylaxis may be prescribed to patients undergoing cephalic pancreaticoduodenectomy. This has to be evaluated in prospective, randomized, controlled trials.

Understanding how structural, social and psychosocial factors come to affect our health resulting in health inequalities is more relevant now than ever as trends in mortality gaps between rich and poor appear to have widened over the past decades. To move beyond description, we need to hypothesise about how structural and social factors may cause health outcomes. In this paper, we examine the construction of health over the life course through the lens of influential theoretical work. Based on concepts developed by scholars from different disciplines, we propose a novel framework for research on social-to-biological processes which may be important contributors to health inequalities. We define two broad sets of mechanisms that may help understand how socially structured exposures become embodied: mechanisms of exogenous and endogenous origin. We describe the embodiment dynamic framework, its uses and how it may be combined with an intersectional approach to examine how intermeshed oppressions affect social exposures which may be expressed biologically. We explain the usefulness of this framework as a tool for carrying out research and providing scientific evidence to challenge genetic essentialism, often used to dismiss social inequalities in health.

Depuis plusieurs décennies, de nombreux rapports insistent sur la nécessité de diffuser les soins palliatifs en formant les étudiants en médecine à cette pratique. Dans ce contexte, l’évaluation des dispositifs pédagogiques est un impératif. Une recherche qualitative est réalisée auprès de 18 internes en médecine ayant effectué un stage de 6 mois dans une équipe de soins palliatifs, fixe ou mobile. Cette étude exploratoire vise à recueillir le retour qu’ils font sur leurs vécus lors du stage, les compétences qu’ils ont acquises, leurs appréciations sur les modalités pédagogiques. Après analyse des entretiens, cinq thématiques sont identifiées. Les internes décrivent une déstabilisation initiale en début de stage. Ils relatent un renforcement de leurs compétences professionnelles avec l’apprentissage d’un meilleur rapport à leurs émotions. Ils font le constat que de nombreuses compétences sont transférables dans leur spécialité, mais que, bien souvent, la compétence délibérative ne peut être vécue qu’individuellement. Ils mentionnent une expérience de questionnement et de réflexivité sur leur parcours professionnel et personnel. Ils soulignent le rôle favorable de l’accompagnement pédagogique. Si l’apport d’un stage en équipe de soins palliatifs apparaît manifeste, il importe que les référents pédagogiques mènent une réflexion éthique afin de bien comprendre les fondements de la clinique palliative mais aussi les décalages, les tensions, voire les paradoxes vis-à-vis du référentiel médical actuel.

Patients with Idiopathic Scoliosis demonstrate vestibular and proprioceptive system perturbations. Scoliosis can be treated through spinal fusion. Does spinal fusion present significant effect of dynamic equilibrium in case of lateral oscillations?

Idiopathic scoliosis is described as the most common postural deformity to affect adolescents. These patients demonstrate vestibular system perturbations. Scoliosis can be treated through spinal fusion. Does spinal fusion coupled to rehabilitation program present significant effect of dynamic equilibrium?

ObjectiveThe primary objective was to assess the characteristics and prognosis of pyogenic spondylodiscitis (PS) in patients with infective endocarditis (IE). The secondary objectives were to assess the factors associated with occurrence of PS.MethodsProspective case–control bi-centre study of 1755 patients with definite IE with (n=150) or without (n=1605) PS. Clinical, microbiological and prognostic variables were recorded.ResultsPatients with PS were older (mean age 69.7±18 vs 66.2±14; p=0.004) and had more arterial hypertension (48% vs 34.5%; p<0.001) and autoimmune disease (5% vs 2%; p=0.03) than patients without PS. The lumbar vertebrae were the most frequently involved (84 patients, 66%), especially L4–L5. Neurological symptoms were observed in 59% of patients. Enterococci and Streptococcus gallolyticuswere more frequent (24% vs 12% and 24% vs 11%; p<0001, respectively) in the PS group. The diagnosis of PS was based on contrast-enhanced MRI in 92 patients, bone CT in 88 patients and 18F-FDG PET/CT in 56 patients. In-hospital (16% vs 13.5%, p=0.38) and 1-year (21% vs 22%, p=0.82) mortalities did not differ between patients with or without PS.ConclusionsPS is a frequent complication of IE (8.5% of IE), is observed in older hypertensive patients with enterococcal or S. gallolyticusIE, and has a similar prognosis than other forms of IE. Since PS is associated with specific management, multimodality imaging including MRI, CT and PET/CT should be used for early diagnosis of this complication of endocarditis.

Disadvantaged socioeconomic position (SEP) is widely associated with disease and mortality, and there is no reason to think this will not be the case for the newly emerged coronavirus disease 2019 (COVID-19) that has reached a pandemic level. Individuals with a more disadvantaged SEP are more likely to be affected by most of the known risk factors of COVID-19. SEP has been previously established as a potential determinant of infectious diseases in general. We hypothesise that SEP plays an important role in the COVID-19 pandemic either directly or indirectly via occupation, living conditions, health-related behaviours, presence of comorbidities and immune functioning. However, the influence of socioeconomic factors on COVID-19 transmission, severity and outcomes is not yet known and is subject to scrutiny and investigation. Here we briefly review the extent to which SEP has been considered as one of the potential risk factors of COVID-19. From 29 eligible studies that reported the characteristics of patients with COVID-19 and their potential risk factors, only one study reported the occupational position of patients with mild or severe disease. This brief overview of the literature highlights that important socioeconomic characteristics are being overlooked when data are collected. As COVID-19 spreads worldwide, it is crucial to collect and report data on socioeconomic determinants as well as race/ethnicity to identify high-risk populations. A systematic recording of socioeconomic characteristics of patients with COVID-19 will be beneficial to identify most vulnerable groups, to identify how SEP relates to COVID-19 and to develop equitable public health prevention measures, guidelines and interventions.

•Our results supported higher overall proportions of guidelines-based practices for the former clinical recommendations than for the most recent.•The largest between-centers differences in guidelines adherence were not find for the most recent recommendations.•The mechanisms of guidelines-based practices diffusion are unclear and seem to depend on the type of recommendation.

As dynamic cross-linking networks are intrinsically weaker than permanent covalent networks, it is a big challenge to obtain a stiff self-healing polymer using reversible networks. Inspired by the self-healable and mechanically adaptive nature of sea cucumber, we design a water-responsive self-healing polymer system with reversible and permanent covalent networks by cross-linking poly(propylene glycol) with boroxine and epoxy. This double cross-linked structure is self-healing due to the boroxine reversible network as well as showing a room-temperature tensile modulus of 1059 MPa and a tensile stress of 37 MPa, on a par with classic thermosets. The dynamic boroxine bonds provide the self-healing response and enable up to 80% recovery in modulus and tensile strength upon water contact. The system shows superior adhesion to metal substrates by comparison with the commercial epoxy-based structural adhesive. Besides, this system can change modulus from a stiff thermoset to soft rubber (by a factor of 150) upon water stimulus, enabling potential applications of either direct or transform printing for micro/nanofabrication. Moreover, by incorporating conductive nanofillers, it becomes feasible to fabricate self-healing and versatile strain/stress sensors based on a single thermoset, with potential applications in wearable electronics for human healthcare.

Despite offering robust mechanical properties, polymer networks suffer from a lack of recyclability, reshaping, and healability. Designing stiff and remendable polymer networks that can repair under mild conditions remains a challenge to extend their field of applications. Herein, we describe a simple approach to design a nonisocyanate-based polyurethane network featuring multiresponsiveness (to humidity and temperature) and outstanding healing properties, as obtained by combining iminoboronate and boroxine chemistry. In spite of the presence of abundant dynamic bonds, the network has a high stiffness (Young’s modulus of 551 MPa) and tensile strength (11 MPa). C═N iminoboronate and B–O boroxine exchange reactions at high temperature enable efficient network recycling over multiple cycles without compromising its properties. Owing to these features, 3D objects could be designed and printed. The present approach provides excellent sustainable and high-performance substitution to conventional polyurethane networks requiring the use of toxic isocyanates.

The impairments resulting from a stroke can be multiple, including urinary and/or sexual dysfunctions. This acquired brain injury disrupts neurological control of sexual responses. Main objective: to describe sexual disorders, after a first episode of stroke, in a population followed in a physical medicine and rehabilitation (PMR) center. Secondary objectives: to gather patients’ expectations and PMR physicians’ opinions on this subject.

La prise en compte des coûts de prise en charge en fonction des déterminants sociaux de la santé est essentielle pour mesurer leur ampleur sur les systèmes de santé. Cela permettrait de repenser le modèle sociétal et fournir des soins équitables. Néanmoins, la littérature traitant à la fois des coûts et des déterminants sociaux est rare et l'impact des caractéristiques socio-économiques sur l'efficience des programmes de soins reste peu connu. Les questions d'efficience et d’équité des soins semblent donc peu abordées conjointement. L'objectif de ce travail est d'identifier les papiers publiés qui analysent les coûts de santé des survivants d'un traumatisme crânien (TC) en fonction de la position socio-économique (PSE) et d’évaluer la qualité des données utilisées.

In 2011, WHO member states signed up to the 25 × 25 initiative, a plan to cut mortality due to non-communicable diseases by 25% by 2025. However, socioeconomic factors influencing non-communicable diseases have not been included in the plan. In this study, we aimed to compare the contribution of socioeconomic status to mortality and years-of-life-lost with that of the 25 × 25 conventional risk factors.

Social position is known to play a role in the quality of ageing, notably through the stimulation/dysregulation of key physiological systems in response to external stresses. Using data from one wave of Understanding Societyincluding 9088 participants, we defined, as an extension of the allostatic load, a synthetic Biological Health Score (BHS) capturing the wear-and-tear of four physiological systems (endocrine, inflammatory, cardiovascular and metabolic systems) and two organs (liver and kidney). We used 16 established blood-derived biomarkers of these systems to calculate the BHS and explored the relative contribution of socioeconomic position to the BHS and its main components across age groups. We identified a systematic decreasing education-related gradient of the BHS (p<0.001) leading to lower biological risk in participants with longer education. Education-related differences in the BHS were detected early in life, and were not attributable to lifestyle and behavioural factors. We found a consistent contribution of the inflammatory and metabolic systems to the overall score throughout from early adulthood onwards, while the contribution of the other four systems seems to vary across age groups and gender. Our findings highlight the social-to-biological processes ultimately leading to health inequalities, and suggest that such disparities can already be detected in the 20–40 years old age group and cannot be fully explained by lifestyle and behavioural factors. This may define early adulthood social condition as a precursor to accelerated biological ageing and as an important target for public health policies.

Plant transpiration (T), biologically controlled movement of water from soil to atmosphere, currently lacks sufficient estimates in space and time to characterize global ecohydrology. Here we describe the Transpiration Estimation Algorithm (TEA), which uses both the signals of gross primary productivity and evapotranspiration (ET) to estimate temporal patterns of water use efficiency (WUE, i.e., the ratio between gross primary productivity and T) from which Tis calculated. The method first isolates periods when Tis most likely to dominate ET. Then, a Random Forest Regressor is trained on WUE within the filtered periods and can thus estimate WUE and Tat every time step. Performance of the method is validated using terrestrial biosphere model output as synthetic flux data sets, that is, flux data where WUE dynamics are encoded in the model structure and Tis known. TEA reproduced temporal patterns of Twith modeling efficiencies above 0.8 for all three models: JSBACH, MuSICA, and CASTANEA. Algorithm output is robust to data set noise but shows some sensitivity to sites and model structures with relatively constant evaporation levels, overestimating values of Twhile still capturing temporal patterns. The ability to capture between‐site variability in the fraction of Tto total ET varied by model, with root‐mean‐square error values between algorithm predicted and modeled T/ETranging from 3% to 15% depending on the model. TEA provides a widely applicable method for estimating WUE while requiring minimal data and/or knowledge on physiology which can complement and inform the current understanding of underlying processes. While it is widely known that plants need water to survive, exactly how much water plants in an ecosystem use is hard to quantify. However, many places have been measuring how much total water leaves an ecosystem, both the water plants use directly and the water that simply evaporates from the soil or the surfaces of leaves, using eddy covariance towers. These eddy covariance towers also measure the coming and going of carbon, such as the total amount of carbon taken up by photosynthesis. Here we present the idea that by using the signals from both photosynthesis and total water losses together, we can capture the water signal related to plants, namely, transpiration, using an algorithm called Transpiration Estimation Algorithm (TEA). To verify that TEA is working the way we expect, we test it out using artificial ecosystem simulations where transpiration and photosynthesis come from mathematical models. By thoroughly testing TEA, we have a better idea of how it will work in a real world situation, hopefully opening the door for a better understanding on how much water ecosystems are using and how it might affect our changing planet. TEA is a method for extracting water use efficiency (WUE) dynamics from flux data with minimal assumptionsValidation shows that TEA is able to derive patterns of WUE and transpiration from three different modelsMethod is applicable to eddy covariance data sets, opening the door to wide‐scale transpiration estimates

This study explored the use of non-cancer drugs in lymphoma survivors during the early trajectory (0 to 2 years) of cancer survivorship and determined the factors that influenced this consumption.

En 2020, face à la rapidité du déploiement du virus SARS-CoV-2 sur tous les continents et territoires insulaires, la communauté scientifique internationale de la recherche en santé des populations a dû faire preuve de réactivité. Sans pouvoir toujours être en mesure d'appliquer l'ensemble du cahier des charges propre à sa discipline. Ces contraintes ont pu favoriser l'innovation. L'objectif principal de notre étude était d'illustrer, dans le cadre d'un retour d'expérience, les méthodes et les processus mis en œuvre par l'enquête transversale Ré-Conf-ISS. L'objectif secondaire sera de discuter la diversité des méthodes et processus de la recherche utilisés par la communauté scientifique pour décrire les inégalités sociales de santé (ISS) associées aux confinements de 2020 en France.

Dans un contexte national où l’on cherche à développer les soins palliatifs par le biais de la formation, nous avons mené une expérimentation sur l’apprentissage de la compétence relationnelle des internes lorsqu’ils effectuent un stage dans une structure de soins palliatifs.

L’objectif de cette étude était de recueillir le bilan des compétences et le vécu des médecins à l’issue du diplôme d’études supérieures complémentaires « Médecine de la douleur et médecine palliative ».

Dans le cancer du sein, si un grand intérêt a été porté à l'impact des caractéristiques socioéconomiques des patients sur le parcours de soins, peu d’études se sont intéressées aux caractéristiques liées aux fournisseurs de soins. En dépit du nombre important d'acteurs pouvant intervenir dans la prise en charge des patients atteints de cancers du sein, on ignore si la complexité des parcours de soins, en nombre et type de centres fréquentés, affectent les délais de prises en charge alors que des données régionales françaises estiment à 25 %, la proportion de patientes dont la chirurgie et la chimiothérapie ont été effectuées dans des centres différents (Boinot, Gautreau et al. 2007). Dans une étude préliminaire sur un échantillon représentatif des femmes prises en charge pour un nouveau cancer du sein dans la région Midi-Pyrénées (Etude EvaSein), nous avons montré que le délai d'initiation de traitement était plus souvent supérieur à six semaines pour les patients ayant fréquenté différents centres entre la biopsie et le premier traitement (Martinez, Daubisse-Marliac et al. Under Review). Ici, nous proposons d'estimer la part des parcours de soins complexes, parmi les femmes prises en charge dans la région Midi-Pyrénées en 2015.

The progress in micro electronic and the avaibility to develop custom electronic chips allow to realize a new kind of 2D detectors, the pixel detectors. They can be considered as an array of photon counters with a size of some tenth of millimeters. They allow to obtain images with a higher dynamical range allowing to study complex diffraction systems including weak diffusion.

•Among the children of a large French region, 2.4% were dispensed benzodiazepine.•Association between socioeconomic status and benzodiazepine use was significant.•Association between the level of social disadvantage and this drug use wasn't linear.•Benefiting from full insurance coverage lead to an even greater benzodiazepine use.•GP's are mostly implied in the dispensing of benzodiazepine for deprived children.

Silicon pixel detectors are beginning to be used in large particle physics experiments. The hybrid technique (detector and electronics on two separate wafers) allows large surfaces to be built. For ATLAS at LHC it is proposed to cover areas of more than 1 m2with 5000 to 10000 pixels/cm2. Each pixel has a full electronic chain directly connected which means very low input capacitance and no integration of dark current. Furthermore, silicon strip detectors and CCD's have been successfully tested for x-ray detection. Recent results indicate that a spatial resolution in the micron range can be obtained. Building on the CCD developments, the pixel detectors are becoming the best candidate for 2-D X-ray detection, with high speed, high spatial resolution and on-chip smart readout.

Recent empirical evidence links migrant remittances, savings and return migration, and stresses the inaccuracy of return migration plans. This paper presents a model of endogenous remittances, savings and return decisions under uncertainty. In our framework, migrants make remittance and saving decisions at an early stage of migration, when their long term economic performance in the host country is still uncertain. Over time, information about professional prospects is acquired, and conditionally on past decisions, migrants adjust their return plans. We show that when migrants expect large gains from migration and face relatively low wage risks in the host country, they tend to remit less, save more and are less likely to return migrate. These results are in line with recent empirical evidence and provide a rationale for the support by relatives in the sending country of low-skill, illegal migration. JEL codesD13; D80; JE

Several studies have shown that the ability to identify the timbre of musical instruments is reduced in cochlear implant (CI) users compared with normal-hearing (NH) listeners. However, most of these studies have focused on tasks that require specific musical knowledge. In contrast, the present study investigates the perception of timbre by CI subjects using a multidimensional scaling (MDS) paradigm. The main objective was to investigate whether CI subjects use the same cues as NH listeners do to differentiate the timbre of musical instruments.

To explore current evidence of the physiological embedding of stress to discuss whether adverse childhood experiences (ACE) causing chronic or acute stress responses may alter fundamental biological functions.A non-systematic review of the literature was carried out using keyword searches in Pubmed and the web of science from May to October 2011. In reference to the literature identified, we examine the potential biological pathways potentially linking exposure to ACE and cancer development and progression in adulthood.These mechanisms, in interaction with social position, and mediated by subsequent environmental exposures, may ultimately lead to the development of cancer. The experience of acute or chronic stressors during sensitive periods of childhood development which can induce several known biological responses, are likely to have an impact on subsequent biological and behavioural functions depending on the timing of initial exposures, and subsequently mediated by later exposures. For this reason, childhood exposure to adversity is a likely source of both acute and chronic stressors, and can be examined as an important initial exposure on a pathway towards adult ill health.Such pathways justify a life course approach to understanding cancer aetiology, which may have its origins early in life.

Pour faciliter la gestion des réunions de concertation pluridisciplinaire (RCP), les réseaux régionaux de cancérologie ont développé un dossier communicant. La région Midi-Pyrénées regroupe le réseau Oncomip et un registre de cancers dans le département du Tarn. Leur collaboration permet d'évaluer la prise en charge des patients. Les objectifs de cette étude étaient de mesurer l'exhaustivité du passage en RCP et ses déterminants (âge et facteurs pronostiques), et d'étudier la qualité des RCP des cancers du sein diagnostiqués dans le Tarn en 2007. Une trace de passage en RCP chronologiquement conforme a été trouvée dans 70,5 % des dossiers. L'exhaustivité semblait moindre chez les femmes les plus âgées et les paramètres conditionnant la décision d'un traitement non chirurgical étaient associés à une présentation plus fréquente en RCP. Le quorum était respecté pour 53,9 % des dossiers présentés avant tout traitement et pour 71,3 % des dossiers présentés après chirurgie. Le partenariat qui existe entre le registre des cancers du Tarn et le réseau Oncomip rend possible la réalisation d'études similaires en population sur d'autres cancers.

Bioluminescent quantification of viable cells inside three-dimensional porous scaffolds was performed in vitroand in vivo. The assay quantified the bioluminescence of murine stem (C3H10T1/2) cells tagged with the luciferase gene reporter and distributed inside scaffolds of either soft, translucent, AN69 polymeric hydrogel or hard, opaque, coral ceramic materials. Quantitative evaluation of bioluminescence emitted from tagged cells adhering to these scaffolds was performed in situusing either cell lysates and a luminometer or intact cells and a bioluminescence imaging system. Despite attenuation of the signal when compared to cells alone, the bioluminescence correlated with the number of cells (up to 1.5 × 105) present on each material scaffold tested, both in vitroand noninvasively in vivo(subcutaneous implants in the mouse model). The noninvasive bioluminescence measurement technique proved to be comparable to the cell-destructive bioluminescence measurement technique. Monitoring the kinetics of luciferase expression via bioluminescence enabled real-time assessment of cell survival and proliferation on the scaffolds tested over prolonged (up to 59 days) periods of time. This novel, sensitive, easy, fast-to-implement, quantitative bioluminescence assay has great, though untapped, potential for screening and determining noninvasively the presence of viable cells on biomaterial constructs in the tissue engineering and tissue regeneration fields.

Type 4 Waardenburg syndrome represents a well define entity caused by neural crest derivatives anomalies (melanocytes, intrinsic ganglion cells, central, autonomous and peripheral nervous systems) leading, with variable expressivity, to pigmentary anomalies, deafness, mental retardation, peripheral neuropathy, and Hirschsprung disease. Autosomal dominant mode of inheritance is prevalent when Sox10 gene mutation is identified. We report the natural history of a child who presented with synophrys, vivid blue eye, deafness, bilateral complete semicircular canals agenesis with mental retardation, subtle signs for peripheral neuropathy and lack of Hirschsprung disease. SOX10 gene sequencing identified “de novo” splice site mutation (c.698‐2A > C). The present phenotype and the genotype findings underline the wide spectrum of SOX10 gene implication in unusual type 4 Waardenburg syndrome patient. © 2008 Wiley‐Liss, Inc.

Le fibrome de la gaine tendineuse est une tumeur bénigne rare qui affecte généralement les extrémités. Son développement dans la région cervicale est extrêmement inhabituel.

La «scienza delle epidemie» è solo una parte dell’epidemiologia moderna. Una malattia infettiva risulta dall’interazione tra un agente infettivo, il suo ospite e dei fattori ambientali. I compiti di un epidemiologo sono molteplici. II controllo e la prevenzione delle malattie infettive si basano sull’individuazione e il trattamento dei casi individuati, le chemioprofilassi individuali e collettive. la lotta antivettore, il miglioramento delle condizioni di vita e del livello di educazione sanitaria delle popolazioni. La sorveglianza epidemiologica richiede un sistema di raccolta di informazioni continuo, sistematico, rapido e affidabile. Deve essere in grado di dare l’allarme se sopravviene un fenomeno epidemico e di precisarne gli elementi e l’evoluzione. L’investigazione epidemica è un compito complementare del precedente. Si basa sulla realizzazione di indagini destinate a cercare sul terreno le circostanze e ad analizzare le determinanti di un problema di sanità. La finalità di queste indagini è quella di proporre delle raccomandazioni per il controllo e la prevenzione del problema di cui si tratta. L’epidemiologo è implicato nella valutazione delle tecniche e dei programmi di prevenzione (sia primaria sia secondaria), come delle strategie terapeutiche.

La part relative des mécanismes directs et indirects liant la comorbidité à la survie des patients atteints de lymphomes B diffus à grandes cellules (LBGDC) et la contribution des différents facteurs intermédiaires restent mal connue. Dans cette étude, nous nous intéressons au cadre proposé par Vanderweele pour l’analyse de la médiation dans le cas de plusieurs médiateurs causalement ordonnés. Dans cette optique, nous testons l’hypothèse que les mécanismes causaux d’influence de la comorbidité sur la survie des patients traités pour un LBDGC dépendent du lieu de traitement.

Amines, including those present on proteins, spontaneously react with glucose to form fructosamines in a reaction known as glycation. In the present paper, we have explored, through a targeted gene inactivation approach, the role of FN3K (fructosamine 3-kinase), an intracellular enzyme that phosphorylates free and protein-bound fructose-ϵ-lysines and which is potentially involved in protein repair. Fn3k−/− mice looked healthy and had normal blood glucose and serum fructosamine levels. However, their level of haemoglobin-bound fructosamines was approx. 2.5-fold higher than that of control (Fn3k+/+) or Fn3k+/− mice. Other intracellular proteins were also significantly more glycated in Fn3k−/− mice in erythrocytes (1.8–2.2-fold) and in brain, kidney, liver and skeletal muscle (1.2–1.8-fold), indicating that FN3K removes fructosamines from intracellular proteins in vivo. The urinary excretion of free fructose-ϵ-lysine was 10–20-fold higher in fed mice compared with mice starved for 36 h, and did not differ between fed Fn3k+/+ and Fn3k−/− mice, indicating that food is the main source of urinary fructose-ϵ-lysine in these mice and that FN3K does not participate in the metabolism of food-derived fructose-ϵ-lysine. However, in starved animals, the urinary excretion of fructose-ϵ-lysine was 2.5-fold higher in Fn3k−/− mice compared with Fn3k+/+ or Fn3k+/− mice. Furthermore, a marked increase (5–13-fold) was observed in the concentration of free fructose-ϵ-lysine in tissues of fed Fn3k−/− mice compared with control mice, indicating that FN3K participates in the metabolism of endogenously produced fructose-ϵ-lysine. Taken together, these data indicate that FN3K serves as a protein repair enzyme and also in the metabolism of endogenously produced free fructose-ϵ-lysine.

The “science of outbreaks” is only a small part of modern epidemiology. An infectious disease is the consequence of interactions between the pathogen, the host, and environmental factors. An epidemiologist has several tasks. Infectious diseases control and prevention rely on cases screening and treatment, individual and collective prophylaxis, vector elimination, and improvement of life conditions and sanitary education. A surveillance system providing continuous reliable data within short time delay is essential for epidemiological surveillance. It has to enable giving alert in case of outbreaks with short delay, and to provide sufficient details on the cases and locations. Outbreak management comes next. Ad hoc field studies are expected to provide details on the circumstances and determinants of the disease. These studies should come out with strategies reducing the outbreak related morbidity and mortality. Epidemiologists are also in charge of assessing the efficacy of preventive and therapeutic strategies.

Purpose. To analyse the impact of computer-based patient record systems (CBPRS) on medical practice, quality of care, and user and patient satisfaction.Data sources. Manual and electronic search of the Medline, Cochrane, and Embase databases.Study selection. Selected articles were published from 2000 to March 2003. CBPRS was defined as computer software designed to be used by clinicians as a direct aid in clinical decision making. To be included, the systems should have recorded patient characteristics and offered online advice, or information or reminders specific to clinicians during the consultation.Data extraction. Keywords used for the search were: electronic record, informatic record, electronic medical record, electronic patient record, patient order entry, computer-based patient system, clinical decision support systems, and evaluation.Results. Twenty-six articles were selected. Use of a CBPRS was perceived favourably by physicians, with studies of satisfaction being mainly positive. A positive impact of CBPRS on preventive care was observed in all three studies where this criterion was examined. The 12 studies evaluating the impact on medical practice and guidelines compliance showed that positive experiences were as frequent as experiences showing no benefit. None of the six studies analysing the impact of CBPRS on patient outcomes reported any benefit.Conclusions. CBPRS increased user and patient satisfaction, which might lead to significant improvements in medical care practices. However, the studies on the impact of CBPRS on patient outcomes and quality of care were not conclusive. Alternative approaches considering social, cultural, and organizational factors may be needed to evaluate the usefulness of CBPRS.

Fructosamine 3-kinase (FN3K), an enzyme initially identified in erythrocytes, catalyses the phosphorylation of fructosamines on their third carbon, leading to their destabilization and their removal from protein. We show that human erythrocytes also contain FN3K-related protein (FN3K-RP), an enzyme that phosphorylates psicosamines and ribulosamines, but not fructosamines, on the third carbon of their sugar moiety. Protein-bound psicosamine 3-phosphates and ribulosamine 3-phosphates are unstable, decomposing at pH 7.1 and 37 °C with half-lives of 8.8 h and 25 min respectively, as compared with 7 h for fructosamine 3-phosphates. NMR analysis indicated that 1-deoxy-1-morpholinopsicose (DMP, a substrate for FN3K and FN3K-RP), like 1-deoxy-1-morpholinofructose (DMF, a substrate of FN3K), penetrated erythrocytes and was converted into the corresponding 3-phospho-derivative. Incubation of erythrocytes with 50 mM allose, 200 mM glucose or 10 mM ribose for 24 h resulted in the accumulation of glycated haemoglobin, and this accumulation was approx. 1.9–2.6-fold higher if DMP, a competitive inhibitor of both FN3K and FN3K-RP, was present in the incubation medium. Incubation with 50 mM allose or 200 mM glucose also caused the accumulation of ketoamine 3-phosphates, which was inhibited by DMP. By contrast, DMF, a specific inhibitor of FN3K, only affected the glucose-dependent accumulation of glycated haemoglobin and ketoamine 3-phosphates. These data indicate that FN3K-RP can phosphorylate intracellular, protein-bound psicosamines and ribulosamines, thus leading to deglycation.