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Reliable image comparisons, based on fast and accurate deformable registration methods, are recognized as key steps in the diagnosis and follow-up of cancer as well as for radiation therapy planning or surgery. In the particular case of abdominal images, the images to compare often differ widely from each other due to organ deformation, patient motion, movements of gastrointestinal tract or breathing. As a consequence, there is a need for registration methods that can cope with both local and global large and highly non-linear deformations. Deformable registration of medical images traditionally relies on the iterative minimization of a cost function involving a large number of parameters. For complex deformations and large datasets, this process is computationally very demanding, leading to processing times that are incompatible with the clinical routine workflow. Moreover, the highly non-convex nature of these optimization problems leads to a high risk of convergence toward local minima. Recently, deep learning approaches using Convolutional Neural Networks (CNN) have led to major breakthroughs by providing computationally fast unsupervised methods for the registration of 2D and 3D images within seconds. Among all the proposed approaches, the VoxelMorph learning-based framework pioneered to learn in an unsupervised way the complex mapping, parameterized using a CNN, between every couple of 2D or 3D pairs of images and the corresponding deformation field by minimizing a standard intensity-based similarity metrics over the whole learning database. Voxelmorph has so far only been evaluated on brain images. The present study proposes to evaluate this method in the context of inter-subject registration of abdominal CT images, which present a greater challenge in terms of registration than brain images, due to greater anatomical variability and significant organ deformations. The performances of VoxelMorph were compared with the current top-performing non-learning-based deformable registration method "Symmetric Normalization" (SyN), implemented in ANTs, on two representative databases: LiTS and 3D-IRCADb-01. Three different experiments were carried out on 2D or 3D data, the atlas-based or pairwise registration, using two different similarity metrics, namely (MSE and CC). Accuracy of the registration was measured by the Dice score, which quantifies the volume overlap for the selected anatomical region. All the three experiments exhibit that the two deformable registration methods significantly outperform the affine registration and that VoxelMorph accuracy is comparable or even better than the reference non-learning based registration method ANTs (SyN), with a drastically reduced computation time. By substituting a time consuming optimization problem, VoxelMorph has made an outstanding achievement in learning-based registration algorithm, where a registration function is trained and thus, able to perform deformable registration almost accurately on abdominal images, while reducing the computation time from minutes to seconds and from seconds to milliseconds in comparison to ANTs (SyN) on a CPU. • Deformable registration of abdominal images is done using deep learning technique. • Three experiments are done: 2D atlas based, 2D pairwise and 3D pairwise registration. • Inter-subject registration results show competitive outcomes with reduced runtime. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: The aim of this study was to assess and compare oral health-related quality of life (OHRQOL) in women with temporomandibular joint (TMJ) disk displacement without reduction, before disk repositioning and anchoring surgery, in short-term follow-up, in different age groups, and with use of the Oral Health Impact Profile (OHIP-14).Study Design: Fifty women ages between 17 and 60 years were divided into 4 age groups: 17-27, 28-38, 39-49, and 50-60 years. All the patients were asked to answer the OHIP-14 form before surgery and during their short-term follow-up. Seven domains of OHRQOL were rated on a 5-point Likert scale from 0 (never) to 4 (very often). Domains' scores and total OHIP-14 were compared between times by using Student's t test in the whole sample and in the 4 age groups.Results: Both the whole sample and the age groups (17-27, 28-38, 39-49 years) showed a statistically significant decrease in all scores (P < .01). The age group 50-60 years showed a decrease in scores significant only in functional limitation (P = .05) CONCLUSIONS: TMJ disk anterior displacement had a negative impact on women's OHRQOL because of physical pain, physical disability, and psychological discomfort. TMJ disk repositioning and anchoring surgery improved overall OHRQOL in patients between 17 and 49 years of age; however, in patients between 50 and 60 years of age, there was improvement only in physical pain. [ABSTRACT FROM AUTHOR]

This study aims at quantifying and characterising microplastics (MP) distribution in the water column of the NW Mediterranean Sea as well as MP ingestion by the 2 main planktivorous fish of the area, sardine and anchovy. Debris of similar sizes were found in all water column samples and in all but 2 fish guts (out of 169). MP were found in 93% of water column samples with an average concentration of 0.23 ± 0.20 MP·m−3, but in only 12% of sardines (0.20 ± 0.69 MP·ind−1) and 11% of anchovies (0.11 ± 0.31 MP·ind−1). Fibres were the only shape of MP encountered and polyethylene terephthalate was the main polymer identified in water columns (61%), sardines (71%) and anchovies (89%). This study confirms the ubiquity of MP in the Mediterranean Sea and imparts low occurrence in fish digestive tracts. • Microplastics were studied in the NW Mediterranean Sea using 17 stations in 2015. • Microplastic concentration averaged 0.23 ± 0.20 MP·m−3 in the water column. • Microplastic ingestion occurred in only 11–12% of anchovies and sardines. • The main polymer type recovered in each sample was polyethylene terephtalate. • Fibres were the only microplastic shape encountered. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The great incidence and controversies related to the diagnosis, treatment, surgical accesses, and type of osteosynthesis materials confer an outstanding role to condylar fractures among facial fractures. Plate configurations, with diverse formats and sizes, may be used to surgically resolve condylar fractures. With the purpose of improving the advantages and minimizing the disadvantages of fixation techniques, the neck screw was developed aiming at the needed stabilization to render a correct fixation through a system of dynamic compression. This is achieved by increasing the contact between the fractured bone stumps, as well as assisting at the time of fracture reduction. The present paper aims at comparing the fixation and stability of mandibular condylar fractures using the neck screw and an overlaid “L”-shaped-4-hole-2 mm plate on the one hand, with a system in which the neck screw and the “L”-shaped plate form a single structure, having been joined by a welded point, on the other hand. The results with the neck screw are satisfactory, and, thus, it is an alternative for the reduction and fixation of fractures of the mandibular condyle, whether or not a plate is joined to the structure, provided it is correctly prescribed and with adequate surgical sequence and technique. [ABSTRACT FROM AUTHOR]

Maintaining adequate chloramine and overcoming nitrification are major challenges faced by water utilities where chloramine is used as a disinfectant. Laboratory batch experiments were carried out to evaluate the effectiveness of using zinc and copper as metal inhibitors in drinking water systems under nitrified conditions. The experiments were conducted for bulk water samples that were collected from a real drinking water distribution system. From the batch experimental results, it was found that 0.25 mg/L zinc inhibited nitrification and reduced the chloramine decay rate but that 0.25 mg/L zinc together with 0.2 mg/L copper significantly controlled chloramine decay and inhibited nitrification completely. Biostability analysis showed that the biostable residual concentration (BRC) was lowered with the addition of zinc, and zinc with higher copper concentrations i.e. the lowest BRC was calculated for 0.25 mg/L zinc with 0.2 mg/L copper. Therefore, it can be concluded that zinc alone can be used as an inhibitor of nitrification and chloramine decay but co-inhibition using zinc and copper provides better control of chloramine decay. [ABSTRACT FROM AUTHOR]

Résumé La présence de micropolluants dus, notamment, au déversement de produits du quotidien dans les réseaux d’assainissement préoccupe de plus en plus les pouvoirs publics. Dans ce contexte, notre étude mesure l’intention de substituer ses produits ménagers habituels par un produit fabriqué « maison » à partir d’éléments respectueux de l’environnement. Pour cela, 304 questionnaires ont été remplis par les habitants de l’Eurométropole de Strasbourg, puis analysés via la théorie de l’action planifiée (Ajzen). Les résultats montrent que cette théorie explique 35 % de l’intention d’utilisation du produit « maison ». Cependant, malgré une attitude positive à l’égard de ce dernier, on observe un manque de confiance concernant la désinfection alors qu’elle apparaît comme essentielle dans le choix d’un produit ménager. Partly due to everyday products discharge, the presence of micropollutants in the sewage system highly concerns the public authorities and water stakeholders. Our study is focused on the measurement of the intention to substitute usual household products by a “homemade” product more eco-friendly. 304 questionnaires were completed by the inhabitants of the Strasbourg Eurometropole and were analyzed by using the theory of planned behavior (TPB). The results show that TPB explains 35 % of intention to use the “homemade” product. It seems that the respondents have a positive attitude toward this “homemade” product. It also appears that there is a strong capacity constraint of this product in terms of disinfection although this parameter is essential when choosing a household product. [ABSTRACT FROM AUTHOR]

Objectives: Medication nonadherence is prevalent and associated with adverse outcomes, including hospital readmissions. Outpatient pharmacies within health systems are well positioned to intervene and enhance the discharge process by ensuring that patients leave the hospital with all discharge medications. The goal of this study was to evaluate whether a simply designed discharge prescription program (DPP) could reduce readmission rates and increase patient satisfaction scores for participants versus patients who did not participate.Methods: We conducted a retrospective cohort study across 15 hospital units in a large health system, evaluating inpatient visits from February 2013 to December 2014. Outcomes included the presence of a 7- or 30-day readmission following discharge date and patient satisfaction survey responses.Results: Patients who participated in the DPP during a hospitalization were significantly less likely to be readmitted than patients who did not participate (P < 0.05). Participation in the DPP decreased odds of 7-day readmission by 20% and of 30-day readmission by 16%. An increase in positive responses for care management and overall experience satisfaction questions was also seen.Conclusion: A DPP offers a simple and unique opportunity to reduce readmissions and improve patient satisfaction by dispensing discharge medications before patients leave the hospital. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The objective of this work is to explore a new phycoremediation strategy to convert a dairy by-product into microalgal biomass. A culture strategy involving two different green microalgae species was used to remove lactose from cheese whey permeate. First a co-cultivation experiment involving Scenedesmus obliquus and Chlorella protothecoides showed better utilization of the different sugars (lactose, glucose and galactose) than homogeneous S. obliquus cultures. In a second experiment, sequential cultivation of the two microalgal species allowed to convert 62% of the total lactose into 6.8 ± 0.2 g L − 1 and 6.2 ± 0.4 g L − 1 S. obliquus and C. protothecoides cultures respectively, for a “lactose-to-biomass” yield (Y x/s ) of 0.45. This type of beneficial interaction between two different microbial species represents a simple and sustainable way to improve and diversify the possibilities in the field of industrial microbiology. [ABSTRACT FROM AUTHOR]

The effects of meal size and frequency on equine cecal microbiota are not well documented. We hypothesized that changes in feeding management (including differing meal size and frequency) would alter the equine cecal microbiota. Cecally cannulated horses (n = 6) were utilized in a 3 × 3 Latin square where they received group pasture turnout daily and were stalled overnight in box stalls (3 × 4 m). Treatment diets consisted of Strategy ® concentrate and were as follows: A = one meal, 2.72 kg, 6 AM; B = two meals, 1.36 kg/meal, 6 AM and 4 PM; and C = three meals, 0.91 kg/meal, 6 AM, 12 PM, and 4 PM. Treatment periods consisted of 8 days of acclimation followed by 3 days of collection. All horses received ad libitum access to water, a white salt block, and 3 kg of mixed alfalfa/grass hay offered overnight. Cecal samples were sequenced using 16S rRNA gene-based Illumina technology. Data were analyzed using QIIME 1.8.0 and Proc MIXED of SAS. Weighted principal coordinates analysis values indicated that feeding management impacted cecal microbiota composition with horses fed one large meal having different microbial community than those fed three smaller meals throughout the day ( P = .028). Furthermore, treatment affected ( P < .05) Prevotella, YRC22, Lactobacillus, Streptococcus, Coprococcus , and Phascolarctobacterium . These data demonstrate that feeding a single large bolus meal affects both abundance and composition of the cecal microbiota. Further research is necessary to understand the metabolic and/or health implications related to changes the equine cecal microbiota. [ABSTRACT FROM AUTHOR]

Cyclin D1 protein expression in lymphocytes is classically associated with mantle cell lymphoma. Although increasingly recognized in other lymphoproliferative disorders, cyclin D1 expression and CCND1 gene abnormalities have not been well studied in nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). Using a double stain for CD20/cyclin D1, we quantified cyclin D1 expression in 10 cases of NLPHL and correlated those findings with SOX11 expression, CCND1 gene abnormalities, and clinical data. For comparison, we examined 5 cases of T cell–/histiocyte-rich large B-cell lymphoma (THRLBCL). All cases of NLPHL stained for cyclin D1 showed at least rare positivity in lymphocyte-predominant (LP) cells. In 4 cases, at least 20% of LP cells were positive for CD20/cyclin D1. Neither SOX11 expression nor CCND1 gene rearrangement was found in any of the cases, but fluorescence in situ hybridization showed a proportion of the large cells with 3 to 4 copies of nonfused IGH and CCND1 signals or 3 intact CCND1 break-apart signals. Further study with CCND1/CEP11 showed polysomy in 6 of 9 cases with cyclin D1 expression and 5 of 16 NLPHL not examined for cyclin D1. Two of 5 cases of THRLBCL showed rare positive staining for CD20/cyclin D1; 1 case showed polysomy with CCND1/CEP11. Results show that cyclin D1 may be expressed in LP cells without SOX11 expression or CCND1 translocation. Polysomy with increased copies of CCND1 may account for cyclin D1 expression in some cases. Cyclin D1 expression is not useful for distinguishing NLPHL from THRLBCL and has no apparent clinical significance in NLPHL. [ABSTRACT FROM AUTHOR]

Microplastics have been reported everywhere around the globe. With very limited human activities, the Arctic is distant from major sources of microplastics. However, microplastic ingestions have been found in several Arctic marine predators, confirming their presence in this region. Nonetheless, existing information for this area remains scarce, thus there is an urgent need to quantify the contamination of Arctic marine waters. In this context, we studied microplastic abundance and composition within the zooplankton community off East Greenland. For the same area, we concurrently evaluated microplastic contamination of little auks ( Alle alle ), an Arctic seabird feeding on zooplankton while diving between 0 and 50 m. The study took place off East Greenland in July 2005 and 2014, under strongly contrasted sea-ice conditions. Among all samples, 97.2% of the debris found were filaments. Despite the remoteness of our study area, microplastic abundances were comparable to those of other oceans, with 0.99 ± 0.62 m −3 in the presence of sea-ice (2005), and 2.38 ± 1.11 m −3 in the nearby absence of sea-ice (2014). Microplastic rise between 2005 and 2014 might be linked to an increase in plastic production worldwide or to lower sea-ice extents in 2014, as sea-ice can represent a sink for microplastic particles, which are subsequently released to the water column upon melting. Crucially, all birds had eaten plastic filaments, and they collected high levels of microplastics compared to background levels with 9.99 and 8.99 pieces per chick meal in 2005 and 2014, respectively. Importantly, we also demonstrated that little auks took more often light colored microplastics, rather than darker ones, strongly suggesting an active contamination with birds mistaking microplastics for their natural prey. Overall, our study stresses the great vulnerability of Arctic marine species to microplastic pollution in a warming Arctic, where sea-ice melting is expected to release vast volumes of trapped debris. [ABSTRACT FROM AUTHOR]

Photodynamic therapy has several benefits over chemotherapy and radiotherapy in the treatment of localized tumors such as a high selectivity, low side effects and immune stimulatory properties [1]. Due to the fast spread of multi-resistant microorganisms that represent a threat to public health, antimicrobial photodynamic therapy (a-PDT) is also experiencing renewed interest [2]. A major strength of a-PDT is the absence of bacterial resistance to the treatment and its effectiveness on resistant strains [3]. Nevertheless, treatments based on PDT have severallimitations related to the photosensitizer properties, selectivity, light delivery and tissue oxygenation. Regarding these issues, our group has developed photosensitizers for PDT, a-PDT and theranostic applications that can be excited in the optical therapeutic window for deeper treatment with less photodamage. They are based on porphyrins with an extended π-conjugated system for one or two-photon excitation in the near infrared (Figure 1) [4]. For a-PDT, a porphyrin connected to an antimicrobial peptide was recently synthesized to target and kill bacteria upon near-infrared excitation and its photodynamic disinfection capacity will be discussed [5]. [ABSTRACT FROM AUTHOR]

Purpose To compare the mechanical stress on the mandibular condyle after the reduction and fixation of mandibular condylar fractures using the neck screw and 2 other conventional techniques according to 3-dimensional finite element analysis. Materials and Methods A 3-dimensional finite element model of a mandible was created and graphically simulated on a computer screen. The model was fixed with 3 different techniques: a 2.0-mm plate with 4 screws, 2 plates (1 1.5-mm plate and 1 2.0-mm plate) with 4 screws, and a neck screw. Loads were applied that simulated muscular action, with restrictions of the upper movements of the mandible, differentiation of the cortical and medullary bone, and the virtual “folds” of the plates and screws so that they could adjust to the condylar surface. Afterward, the data were exported for graphic visualization of the results and quantitative analysis was performed. Results The 2-plate technique exhibited better stability in regard to displacement of fractures, deformity of the synthesis materials, and minimum and maximum tension values. The results with the neck screw were satisfactory and were similar to those found when a miniplate was used. Conclusion Although the study shows that 2 isolated plates yielded better results compared with the other groups using other fixation systems and methods, the neck screw could be an option for condylar fracture reduction. [ABSTRACT FROM AUTHOR]

Dentofacial deformities and their treatment have physical and psychological repercussions on quality of life (QOL). Seventy-four patients were evaluated preoperatively (T0) and at 4–6 months postoperatively (T1). Oral health-related QOL was assessed using the short form of the Oral Health Impact Profile (OHIP-14). There was a statistically significant reduction in the average overall OHIP-14 score between T0 (13.23 ± 6.45) and T1 (3.26 ± 4.19). In addition, there were significant decreases in all seven OHIP-14 domains. Class III patients benefited in all domains evaluated, while a significant improvement was seen only in the psychological disability domain for class I patients. Class II patients showed a significant benefit in all domains except the domain of functional limitation. With regard to the total sample ( n = 74) and class III patients ( n = 58), correlations between domains were identified for all domains. The same correlation was not identified for class I ( n = 5) and II ( n = 11) patients. The entire sample and class III patients showed significant improvements in OHIP-14 scores for all degrees of postoperative sensory disturbance in the upper and lower lips, except for patients with degree 5 (extreme) disturbance of the upper lip. Orthognathic surgical treatment had a positive impact on oral health-related QOL in the patients evaluated. [ABSTRACT FROM AUTHOR]

Microalgae mass cultivation for biodiesel production might very well become the next marketable biofuel. The main challenge to overcome however is the development of high efficiency strategies for the large-scale production of oleaginous microalgae at low costs. In the present work, the use of cheese whey permeate (WP) in mixotrophic microalgae cultures is proposed. Pure lactose, the main constituent of WP (> 80% w/w of the total dissolved solids), can support Scenedesmus growth under heterotrophic culture conditions (absence of light). Substituting 40% (v/v) of the culture medium with WP significantly stimulates Scenedesmus obliquus growth under mixotrophic (μ max = 1.083 ± 0.030 day − 1 ) and heterotrophic (μ max = 0.702 ± 0.025 day − 1 ) conditions, compared to photoautotrophic control cultures (μ max = 0.267 ± 0.083 day − 1 ). As growth occurs in the presence of lactose, a significant reduction of its concentration is observed, while the galactose and glucose concentrations actually increase in the culture medium. Culture medium analyses showed complete exhaustion of extracellular nitrogen (nitrate and ammonium), while intracellular lipid analyses showed neutral lipid (NL) accumulation, particularly under conditions of high pH (> 9.5). Photoautotrophic control cultures accumulated more lipids (per dry weight) than WP-supplemented cultures, an aspect which is discussed in the context of lipid enrichment strategies. A fast and simple method for NL cellular content estimation is also described. [ABSTRACT FROM AUTHOR]

Background: The core features of borderline personality disorder (BPD) are affective instability, unstable relationships and identity disturbance. Axis I comorbidities are frequent, in particular affective disorders. The concept of atypical depression is complex and often underestimated. The purpose of the study was to investigate the comorbidity of atypical depression in borderline patients regarding anxiety-related psychopathology and interpersonal problems. Methods: Sixty patients with BPD were assessed with the Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID I, SCID II) as well as the Atypical Depression Diagnostic Scale (ADDS). Additionally, patients completed a questionnaire (SCL-90-R, BDI, STAI, STAXI, HP-C). Results: Forty-five BPD patients (81.8%) had a comorbid affective disorder of which 15 (27.3%) were diagnosed with an atypical depression. In comparison to patients with major depressive disorder or no comorbid depression, patients with atypical depression showed significant higher scores in psychopathological symptoms regarding anxiety and global severity as well as interpersonal problems. Conclusions: The presence of atypical depression in borderline patients is correlated with psychopathology, anxiety, and interpersonal problems and seems to be of clinical importance for personalized treatment decisions. [ABSTRACT FROM AUTHOR]

Background: Isotretinoin is a vitamin A derivative, indicated for the treatment of patients with severe acne, which shows several side effects on bone metabolism. Objective: This study analyzed the process of bone repair in rats receiving 7.5 mg/kg/day of oral isotretinoin. Methods: Thirty-three male albino Wistar rats, at approximately 60 days of age, were randomly assigned to control (n = 15) and experimental (n = 18) groups. Only the experimental group underwent oral isotretinoin therapy. In both groups, a 2-mm cavity was established in the calvarium of each animal. The animals were euthanize 21, 28 and 90 days postoperatively. The parietal bone was removed and the surgical specimens underwent histological examination. Computed histomorphometry allowed the measurement of the total area of bone defects and the proportion of newly formed bone at the different observation time points. Results: In the experimental group, the results, expressed as mean percentage of newly formed bone, were: 25.37% (±9.14) at day 21; 41.78% (±7.00) at day 28; and 57.51% (±11.62) at day 90. In the control group, the results were: 17.10% (±9.23) at day 21; 34.42% (±7.70) at day 28; and 48.49% (±16.40) at day 90. Conclusion: These results enabled us to conclude that isotretinoin promoted acceleration in the process of new bone formation in rat calvaria, although this increase was not statistically significant. [ABSTRACT FROM AUTHOR]

Abstract: Control of endothelial phenotype involves a variety of signaling pathways and transcriptional regulators, including the junctional protein β-catenin. This multifunctional signaling molecule is part of adhesion contacts in the endothelium and is able to translocate into the nucleus to activate genetic programs and control proliferation and the fate of the cells. We investigated the influence of laser-generated nanopatterns on polymeric cell culture substrates on endothelial tissue architecture, proliferation and β-catenin signaling. For our experiments human microvascular endothelial cells or CD34+ endothelial progenitor cells, isolated from human adipose tissue, were cultured on polyethylene terephthalate (PET) substrates with oriented nanostructures with lateral periodicities of 1.5μm and 300nm, respectively. The surface topography and chemistry of the PET substrates were characterized by electron microscopy, atomic force microscopy, water contact angle measurement and X-ray photoelectron spectroscopy. Analysis of cell phenotype markers as well as β-catenin signaling revealed that short-term culture of endothelial cells on nanostructured substrates generates a proliferative cell phenotype associated with nuclear accumulation of β-catenin and activation of specific β-catenin target genes. The effects of the nanostructures were not directly correlated with nanostructure-induced alignment of cells and were also clearly distinguishable from the effects of altered PET surface chemistry due to photomodification. In summary, we present a novel mechanism of surface topology-dependent control of transcriptional programs in mature endothelium and endothelial progenitor cells. [Copyright &y& Elsevier]

Abstract: Background: Natural orifice translumenal endoscopic surgery is an emerging surgical phenomenon. Although the development of “pure” natural orifice translumenal endoscopic surgical techniques in humans has been slowed by major technical hurdles, “hybrid” or combined variants have been increasingly reported. Laparoscopic sleeve gastrectomy (SG) is a commonly performed treatment of morbid obesity. We have developed a combined variant of SG for patients with morbid obesity. Our aim was to assess the feasibility and safety of such an approach, which could eventually reduce the postoperative pain, preserve the abdominal wall, and enhance cosmesis. Methods: Combined, transvaginal and abdominal SG was attempted in 20 patients. The inclusion criteria were morbid obesity (body mass index <50 kg/m2), female gender, an absence of gynecologic disorders, and the absence of major previous abdominal surgery. The local ethical committee approved the present study. The technique was performed using a vaginal incision with 1 or 2 abdominal ports. Results: The procedure was a success in 14 patients (70%). In 6 patients, conversion to a more conventional laparoscopic SG was required, with ≥1 abdominal ports added. The mean operative time was 116 minutes (range 54–231). The postoperative complication rate was 5% (1 patient developed pneumonia). No hemorrhage, surgical site infection, or fistula was encountered. The mean length of hospital stay was 72 hours (range 24–144). Conclusion: Our combined, transvaginal and abdominal variant of laparoscopic SG was sure and feasible in a small series of selected patients with morbid obesity. [Copyright &y& Elsevier]

Intubation research on both direct laryngoscopy and alternative intubation devices has focused on laryngeal exposure and not the mechanics of actual endotracheal tube delivery or insertion. Although there are subtleties to tracheal intubation with direct laryngoscopy, the path of tube insertion and the direct line of sight are relatively congruent. With alternative intubation devices, this is not the case. Video or optical elements in alternative intubation devices permit looking around the curve of the tongue, without a direct line of sight to the glottic opening. With these devices, laryngeal exposure is generally the simple part of the procedure, and conversely, tube delivery to the glottic opening and advancement into the trachea are sometimes not straightforward. This article presents the mechanical and optical complexities of endotracheal tube insertion in both direct laryngoscopy and alternative devices. An understanding of these complexities is critical to facilitate rapid tracheal intubation and to minimize unsuccessful attempts. [Copyright &y& Elsevier]

Abstract: This paper presents an integrated learning project of 8 months duration, suitable for chemical engineering students entering their First year of major concentration. This project prepares students for a career in chemical engineering and aids their performance in multi-task problem solving using a teamwork approach. In the process, they develop essential competences, such as communication, perseverance, time management, and autonomy. [Copyright &y& Elsevier]

Summary: Background: Selective laser sintering (SLS), three-dimensional printing (3DP™) and PolyJet™ are rapid prototyping (RP) techniques to fabricate prototypes from virtual biomedical images. To be used in maxillofacial surgery, these models must accurately reproduce the craniofacial skeleton. Purpose: To analyze the capacity of SLS, 3DP™ and PolyJet™ models to reproduce mandibular anatomy and their dimensional error. Material: Dry mandible, helical CT images, SLS, 3DP™ and PolyJet™ prototypes, and digital electronic caliper. Methods: Helical CT images were acquired from a dry mandible (criterion standard) and manipulated with the InVesalius software. Prototypes were produced using SLS, 3DP™ and PolyJet™ techniques. Thirteen linear measurements of each prototype were made and compared with the dry mandible measurements. Results: The results showed a dimensional error of 1.79%, 3.14% and 2.14% for SLS, 3DP™ and PolyJet™ models, respectively. The models satisfactorily reproduced anatomic details and the SLS and PolyJet™ prototypes showed greater dimensional precision and reproduced mandibular anatomy more accurately than the 3DP™ model. Conclusions: The SLS prototype had a greater dimensional accuracy than the PolyJet™ and 3DP™ models. The PolyJet™ technique reproduced anatomic details of the mandible more accurately. [Copyright &y& Elsevier]

Abstract: The inventory of muddy floods in France indicates that the occurrence of these events seriously increased in the North West and the East of the country. Muddy floods triggering can largely be explained by physical characteristics such as a hilly topography, soils prone to crust, and/or heavy rainfall in spring. Although the physical processes are well known by now and despite increasing information about the need of mitigation measures, no significant reduction of these disasters has been registered. Therefore, this should be explained by factors others than scientific reasons or technical knowledge acquisition difficulties. This paper deals with a study of muddy flood risk in five municipalities belonging to three catchments (Alsace—NE France). These catchments have been suffering from several muddy flood events in the past 20 years, and, despite the implementation of mitigation measures, no decrease of their frequency has occurred. This study focuses on risk perception: we assume that obtaining information on risk perception contributes to the understanding of the main social factors that should be taken into account in an efficient muddy flood risk management policy. To gather data, we used surveys based on individuals’ interviews and questionnaires, focusing on the local stakeholders in charge of the risk management. A sampling strategy based on a spatial distinction of runoff areas was used to select the areas to be surveyed. The surveys results highlight significant differences in perception between respondents. These differences depend in particular on their location within the catchment (i.e. erosion or sedimentation area). Moreover, almost the half of the respondents trusts in information provided by the local authorities. Our results provide some insights about the type and the source of information related to risk mitigation that should be considered when implementing an efficient regulation policy. [Copyright &y& Elsevier]

Abstract: The use of plates for the treatment of fractures can affect craniofacial bone development. This study investigated the effect of bioabsorbable plates and titanium microscrews on the growth of the craniofacial skeleton of rabbits (Oryctolagus cuniculus), in the neonatal period. A LactoSorb® plate and PROMM® titanium microscrews were positioned across the coronal suture in animals in the study group. In the control group, only PROMM® titanium microscrews were attached to the cranium. Anteroposterior linear measurements were obtained using 3 different gauging devices: digital precision caliper, EKG caliper and nylon string. Frontal-nasal (FN) distances were statistically different between the left and right side when the digital caliper (P ≤0.01), EKG caliper (P ≤0.01) and nylon string (P ≤0.05) were used. Mean right-side FN distances in the control and study groups were significantly different (P ≤0.05) when measured with the EKG caliper. Normal neonatal craniofacial growth of rabbits was affected by the use of bioabsorbable plates in this study. Further studies should be conducted to investigate whether these plates affect growth in human beings. [Copyright &y& Elsevier]

Background & Aims: The identification of precursor lesions has a great impact on the understanding of tumorigenesis. Precursor lesions of endocrine tumors are known to occur in the setting of the MEN1 syndrome. The aim of this study was to test the hypothesis that MEN1-associated duodenal gastrinomas originate from diffuse preneoplastic gastrin cell changes. Precursor lesions may precede the development of duodenal gastrinomas because, in contrast to sporadic gastrinomas, these tumors are usually multiple. Methods: The distribution of endocrine cells in the nontumorous duodenal tissue was analyzed qualitatively and quantitatively for 25 patients operated on for a duodenal gastrinoma. MEN1 status was assessed clinically and by polymerase chain reaction-based mutational analysis. Results: Fourteen of 25 patients with gastrinoma had proliferative, hyperplastic lesions consisting of gastrin cells in the nontumorous duodenal mucosa, similar to the gastric enterochromaffin-like cell lesions observed in chronic atrophic gastritis. All patients with Zollinger-Ellison syndrome with proven MEN1 had such proliferative gastrin cell lesions, and all patients with Zollinger-Ellison syndrome without precursor lesions were MEN1 negative. Conclusions: Duodenal gastrinomas in MEN1, but not sporadic duodenal gastrinomas, are associated with proliferative gastrin cell changes within the nontumorous mucosa. It is likely that these lesions precede the development of MEN1-associated duodenal gastrinomas. [Copyright &y& Elsevier]

Rationale and objectives: Most methods used in functional MRI (fMRI) brain mapping require restrictive assumptions about the shape and timing of the fMRI signal in activated voxels. Consequently, fMRI data may be partially and misleadingly characterized, leading to suboptimal or invalid inference. To limit these assumptions and to capture the broad range of possible activation patterns, a novel statistical fMRI brain mapping method is proposed. It relies on hidden semi-Markov event sequence models (HSMESMs), a special class of hidden Markov models (HMMs) dedicated to the modeling and analysis of event-based random processes. Materials and methods: Activation detection is formulated in terms of time coupling between (1) the observed sequence of hemodynamic response onset (HRO) events detected in the voxel’s fMRI signal and (2) the “hidden” sequence of task-induced neural activation onset (NAO) events underlying the HROs. Both event sequences are modeled within a single HSMESM. The resulting brain activation model is trained to automatically detect neural activity embedded in the input fMRI data set under analysis. The data sets considered in this article are threefold: synthetic epoch-related, real epoch-related (auditory lexical processing task), and real event-related (oddball detection task) fMRI data sets. Results: Synthetic data: Activation detection results demonstrate the superiority of the HSMESM mapping method with respect to a standard implementation of the statistical parametric mapping (SPM) approach. They are also very close, sometimes equivalent, to those obtained with an “ideal” implementation of SPM in which the activation patterns synthesized are reused for analysis. The HSMESM method appears clearly insensitive to timing variations of the hemodynamic response and exhibits low sensitivity to fluctuations of its shape (unsustained activation during task). Real epoch-related data: HSMESM activation detection results compete with those obtained with SPM, without requiring any prior definition of the expected activation patterns thanks to the unsupervised character of the HSMESM mapping approach. Along with activation maps, the method offers a wide range of additional fMRI analysis functionalities, including activation lag mapping, activation mode visualization, and hemodynamic response function analysis. Real event-related data: Activation detection results confirm and validate the overall strategy that consists in focusing the analysis on the transients, time-localized events that are the HROs. Conclusion: All the experiments performed on synthetic and real fMRI data demonstrate the relevance of HSMESMs in fMRI brain mapping. In particular, the statistical character of these models, along with their learning and generalizing abilities are of particular interest when dealing with strong variabilities of the active fMRI signal across time, space, experiments, and subjects. [Copyright &y& Elsevier]

Pulmonary embolism (PE) and deep vein thrombosis (DVT) are two replicates of the same pathology, frequently associated. Isolated DVT has lower complication rates than PE. One third of clinically-overt DVTs are associated with a silent PE while the reported rates of concomitant DVT in PE are ranging from 10 to 93%. Whether the association of DVT and PE has a poorer prognosis than isolated PE is not known. Literature analysis shows conflicting data regarding the association of DVT and outcomes such as death and recurrence and the prognostic significance of coexisting deep vein thrombosis (DVT) in acute pulmonary embolism (PE) remains controversial. This study aimed to provide routine patient care data on the impact of this association on PE severity and 3-month outcomes in a population presenting with symptomatic venous thromboembolism (VTE), from the REMOTEV registry. REMOTEV is a prospective, non-interventional study of patients with acute symptomatic VTE, treated with direct oral anticoagulants (DOACs) or standard anticoagulation (vitamin K antagonists (VKA) or parenteral heparin/fondaparinux alone) for at least 3 months with a follow-up of 1 year for VTE recurrence, death and bleeding complications. From November 1, 2013 to February 28, 2018, among 1241 consecutive patients included, 1192 had a follow-up of at least 3 months and, among them, 1037 had PE with (727) or without DVT (310). The median age was 69 (55–80, 25th–75th percentiles). Patients with PE-associated DVT had more severe forms of PE (P < 0.0001). However, no significant difference in all-cause mortality rate [HR 1.36 (CI 95%: 0.69–2.92)], or in the composite criterion of all-cause mortality and recurrence rate [HR 1.56 (CI 95%: 0.83–3.10)] was noted at 3 months of follow-up. In REMOTEV, coexisting DVT was associated with a higher severity of PE, with no impact on short-term prognosis (death and VTE recurrence). [ABSTRACT FROM AUTHOR]

Abstract: Trocar site hernia is a known complication after laparoscopic surgery, especially at 10-mm and larger port sites. Only a few cases of herniation through 5-mm port sites are reported in the literature. We describe 2 cases of bowel herniation and bowel obstruction through 5-mm port sites. The patients were 63 and 74 years old; both had endometrial cancer and underwent an uncomplicated hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy with peritoneal drains left at the lateral 5-mm port sites. Each patient presented symptoms of small bowel obstruction after which the drains were removed and were found to have evisceration through a laterally placed 5-mm port site. The bowel was reduced locally, and a segmental bowel resection was needed in 1 case. Bowel herniation can occur through the fascial defect after placement of a 5-mm port, especially if drains have been placed at the port site. [Copyright &y& Elsevier]

SARS-CoV-2 infection was associated with a higher thrombotic risk, partially explained by intense systemic inflammatory reaction, longer hospitalizations and intubations as well as central catheters and extracorporeal membrane oxygenation devices. Intrinsic thrombotic potential is questioned as certain patients had plasma lupus anticoagulant (LAC). This study aimed to evaluate the frequency of venous thromboembolism (VTE) among adult patients hospitalized for COVID-19. This is a retrospective analysis of consecutively hospitalized adult patients with SARS-CoV-2 infection (positive rtPCR) admitted to the University Hospital of Strasbourg from the 25th Feb, 2020 to the 1st Apr, 2020. Patients hospitalized for less than 24 h were excluded and the observation period ended at hospital discharge. During the study period, 943 COVID-19 patients were hospitalized in our institution, of whom 772 were included in this analysis. The median age was 68 (56–79) years old and 58 patients had previously known VTE. Overall, VTE occurred in 60 patients (7.8%): 43 pulmonary embolisms (PE), 15 isolated deep vein thrombosis and 2 superficial vein thrombosis. Of note, 81% of patients had been prescribed an anticoagulant treatment on admission. VTE incidence was higher in patients with more severe forms of pneumonia defined as either leading to death, and/or requiring intubation/high flow nasal oxygen/non-invasive ventilation (21% versus 2%, P < 0.001). Overall mortality was 21% and death rate was higher in patients that presented a VTE event (35% versus 20%, P = 0.012). Among VTE patients, a search for LAC was performed in 72% of them and came back positive in 88% of cases. Overall, 33 major bleeding complications (4.3%) were observed of which 42% were intracranial. Our study showed that in-hospital VTE occurred more frequently in case of severe COVID-19 pneumonia and was associated with higher death rates. [ABSTRACT FROM AUTHOR]

Renin angiotensin system inhibitors (RASi) are largely prescribed in hypertensive patients. As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) penetrates respiratory epithelium through angiotensin converting enzyme 2 (ACE2) binding, the association between RASi and poorer outcomes has been questioned. This study aimed to provide insight on the impact of RASi on SARS-CoV-2 outcomes in a population of patients hospitalized for COVID-19. This is a retrospective analysis of consecutively hospitalized adult patients with SARS-CoV-2 infection (positive rtPCR) admitted to the University Hospital of Strasbourg from the 25th Feb, 2020 to the 1st Apr, 2020. Patients hospitalized for less than 24 h were excluded and the observation period ended at hospital discharge. During the study period, 943 COVID-19 patients were hospitalized in our institution, of whom 772 were included in this analysis. Among them, 431 patients had previously known hypertension. The median age was 68 (56–79). The cohort was divided into two subgroups based on RASi treatment on admission: "RASi" (n = 282) and "RASi-free" (n = 490). Both groups had similar clinical presentations and equivalent recourse to endotracheal intubation, high flow nasal oxygen (HFNO) or non-invasive ventilation (NIV). Overall, 220 patients were placed under mechanical ventilation of whom 30% died. Severe pneumonia (defined as either leading to death, and/or requiring intubation, HFNO, NIV and/or requiring an oxygen rate flow ≥ 5l/min) and death occurred more frequently in RASi treated patients (63% vs. 53% and respectively 27.3% versus 18.2%). In a multivariate logistic-regression model, neither severe pneumonia nor death were associated with RASi treatment. Our study showed no correlation between RASi treatment and death or severe COVID-19 pneumonia. [ABSTRACT FROM AUTHOR]

In phase 3 clinical trials, direct oral anticoagulants (DOACs) as compared to standard anticoagulation (SACO) showed non-inferiority in terms of efficacy (venous thromboembolism (VTE) recurrence, all-cause death) and significantly reduced major bleeding risk. However, real-life studies remain of paramount importance when extending this observation to the general population. This study aimed to provide safety and efficacy data of DOACs use in routine patient care in a non-selected symptomatic VTE population, from the REMOTEV registry. REMOTEV is a prospective, non-interventional study of patients with acute symptomatic VTE, treated with DOACs (rivaroxaban or apixaban) or SACO (vitamin K antagonists or low molecular weight heparin alone) for at least 3 months with a follow-up of 1 year for VTE recurrence, death and bleeding complications. Patients with active cancer were excluded. From October 23rd, 2013 to December 15th, 2017, among 1159 consecutive patients included in REMOTEV, 908 were cancer-free and had completed the follow-up of 12 months or until death occurred. Among them, 905 received an anticoagulant treatment with DOAC (n = 724, 80%) or SACO (n = 181, 20%). The median age was 68 (51–79, 25th–75th percentiles), 88% had PE with (62%) or without (26%) deep vein thrombosis. The major bleeding, VTE recurrence and all-cause death rates were of 3.2%, 3.8%, 4.4% in the DOAC group and, respectively, of 6.6%, 5.5% and 12.1% in the SACO group. Major bleeding (HR 0.47 [95% CI, 0.24–0.94], P < 0.05), all-cause death (HR 0.36 [95% CI, 0.21–0.61], P < 0.001) and the composite of recurrent VTE, major bleeding and all-cause mortality (HR 0.52 [95% CI, 0.36–0.75], P < 0.001), but not VTE recurrence (HR 0.70 [95% CI, 0.34–1.41], P = 0.32) were significantly lower in the DOAC group compared to the SACO group (Fig. 1). In REMOTEV, DOAC treatment was associated with a lower risk of major bleeding and all-cause death after 1-year follow-up. [ABSTRACT FROM AUTHOR]

The article reports that the study aims at comparing the fixation and stability of mandibular condylar fractures using the Neck Screw and an L-shaped plate and to compare to two conventional techniques according to 3dimensional finite element analysis (FEA).

The article presents a case study of a 37-year-old male with extensive lip-palate fissure who complained of difficulty in chewing, swallowing, phonation and breathing and evaluates temporal muscle flap (TMF) as a type of technique used to reconstruct defects in the cranium and face.

Balloon atrial septostomy (BAS) increases peripheral oxygen saturation in neonates with transposition of the great vessels (TGV). Effect of BAS on cerebral oxygenation remains little known. We aimed to describe the modification of regional cerebral tissue oxygen saturation (rcSaO 2 ) during the catheterization. Methods we prospectively included 6 neonates with TGV and restrictive inter-atrial shunt who required BAS. BAS was performed in catheterization laboratory by an interventional pediatric cardiologist. rcSaO 2 was measured using near-infrared spectroscopy (NIRS) during the whole procedure. Results Median rcSa0 2 at the beginning of the procedure was 52.5% ranging from 21% to 78%. Median rcSaSaO 2 after the BAS was 69.5% ranging from 64% to 94%. The rcSa0 2 increased significantly immediately after the BAS (p=0.0273 by Wilcoxon signed rank test). Median rcSa0 2 delta between before and after BAS was 19% ranging from 11 to 43%. The rcSaO 2 delta was higher although not significantly when rcSa02 before the BAS was less than 50% (31% vs 16%, p=0.14). Linear regression analysis revealed that the delta of rcSaO 2 was significantly inversely related to the rcSa0 2 at the beginning of the procedure (Delta= –0.45 x rcSaO 2 av + 45.8, p=0.37, R 2 =0.70). Conclusion BAS improves cerebral oxygen saturation during the catheterization in neonates with TGV and restrictive inter-atrial shunt. The increase is proportional to the degree of alteration before the procedure. [ABSTRACT FROM AUTHOR]