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• A massive afflux of coronavirus disease 2019 patients overloaded intensive care units in some regions. • Collective air medical evacuations were conducted to relieve those units. • Biosafety management was 1 of the major concerns of this mission. • A complete risk analysis was the best solution in this unprecedented situation. In March 2020, coronavirus disease 2019 (COVID-19) caused an overwhelming pandemic. To relieve overloaded intensive care units in the most affected regions, the French Ministry of Defence triggered collective air medical evacuations (medevacs) on board an Airbus A330 Multi Role Tanker Transport of the French Air Force. Such a collective air medevac is a big challenge regarding biosafety; until now, only evacuations of a single symptomatic patient with an emergent communicable disease, such as Ebola virus disease, have been conducted. However, the COVID-19 pandemic required collective medevacs for critically ill patients and involved a virus that little is known about still. Thus, we performed a complete risk analysis using a process map and FMECA (Failure Modes, Effects and Criticality Analysis) to assess the risk and implement mitigation measures for health workers, flight crew, and the environment. We report the biosafety management experienced during 6 flights with a total of 36 critically ill COVID-19–positive patients transferred with no casualties while preserving both staffs and aircraft. [ABSTRACT FROM AUTHOR]

• In 2018, 60% of people living with HIV (PLHIV) were receptive to teleconsultations, and even more (75%) in case of prescription renewals. However, more than 61% of hospital practitioners would be uncomfortable teleconsulting due to inadequate data security without it reducing the number of consultations or offering economic benefit. • As for the collection of computerized personal information, more than half of PLHIV and physicians agreed it improved quality of care but one third of them thought it was not sufficiently framed by the law. Only one third of the PLHIV agreed to their health information being stored in a digital vault. • However, 44% of the PLHIV would agree to directly capture their data in their hospital medical record to flag up important information ahead of the consultation thanks to an Internet kiosk in the managing ward. To evaluate the patterns of use and perceived benefits and barriers among people living with HIV and their physicians concerning telemedicine and the collection of computerized personal information. Multicenter online observational survey from October 15 to 19, 2018. Study participation was accepted by 229 physicians and 838/1,377 PLHIV followed in 46 centers, of which 325 (39%) responded online. We found that while 226/302 (75%) PLHIV accept online prescription renewals and 197/302 (65%) accept online medical certificates, 182/302 (60%) PLHIV − who were more often in material/social deprivation (OR = 1.70 ± 0.45; P = 0.045), less often born in Île-de-France (OR = 0.43 ± 0.15; P = 0.018), with lower CD4 T-cell counts (OR = 0.999 ± 0.0004; P = 0.038), and less often on psychiatric treatment (OR = 0.50 ± 0.18; P = 0.047) − were receptive to teleconsultations. However, 137/225 (61%) physicians would be uncomfortable teleconsulting due to inadequate data security without it reducing the number of consultations or offering economic benefit. Asked about collection of computerized personal information, 197/296 (67%) PLHIV and 139/223 (62%) physicians agreed it improved quality of care, but 144 (49%) PLHIV and 94/222 (42%) physicians thought it was not sufficiently framed by the law. eHealth was seen as improving coordination between health professionals by 240/296 (81%) PLHIV and seen as a good thing by 181/225 (81%) physicians. More than half of PLHIV were ready for telemedicine. PLHIV and physicians endorsed the advantage of e-health in terms of better coordination across health professionals but mistrust the data collection factor, which warrants either clarification or stronger legal protections. [ABSTRACT FROM AUTHOR]

O propósito desta atualização das Recomendações da Sociedade Brasileira de Anestesiologia (SBA) para Segurança em Anestesia Regional foi apresentar novas diretrizes com base na relevância e atualidade clínica nos aspectos de segurança relacionados a analgesia e anestesia regional. Este artigo visa prover uma visão ampla sobre o conhecimento atual no tocante a assepsia e antissepsia pré‐procedimento, fatores de risco, diagnóstico e tratamento das complicações infecciosas decorrentes das técnicas anestésicas. Também visa esclarecer sobre o uso de materiais reprocessados na prática da anestesia regional, estabelecer as implicações no manejo asséptico de frascos e ampolas e elucidar sobre a relação custo‐efetividade no preparo de soluções a serem administradas continuamente em bloqueios regionais. As bases de dados eletrônicas foram pesquisadas entre Janeiro de 2011 (final da pesquisa de literatura das diretrizes anteriores da SBA sobre segurança em anestesia regional) e Setembro de 2019. Um total de 712 artigos foram encontrados, dos quais 201 foram incluídos para análise posterior e 82 novos estudos foram acrescentados nesta revisão. O sistema de Avaliação, Desenvolvimento e Avaliação da Classificação das Recomendações (GRADE) foi utilizado para avaliar a qualidade do estudo individual e classificar a força da evidência. Esta revisão foi elaborada por membros da Comissão de Normas Técnicas da SBA. The purpose of the Brazilian Society of Anesthesiology's (SBA) Regional Anesthesia Safety Recommendations Update is to provide new guidelines based on the current relevant clinical aspects related to safety in regional anesthesia and analgesia. The goal of the present article is to provide a broad overview of the current knowledge regarding pre‐procedure asepsis and antisepsis, risk factors, diagnosis and treatment of infectious complications resulting from anesthetic techniques. It also aims to shed light on the use of reprocessed materials in regional anesthesia practice to establish the effects of aseptic handling of vials and ampoules, and to show cost‐effectiveness in the preparation of solutions to be administered continuously in regional blockades. Electronic databases were searched between January 2011 (final date of the literature search for the past SBA recommendations for safety in regional anesthesia) and September 2019. A total of 712 publications were found, 201 of which were included for further analysis, and 82 new publications were added into the review. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was used to assess the quality of each study and to classify the strength of evidence. The present review was prepared by members of the SBA Technical Standards Committee. [ABSTRACT FROM AUTHOR]

Viscosity exerts a fundamental control on magmatic kinetics and dynamics, controlling magma ascent, eruptive style, and the emplacement of lava. Nanolites – crystals smaller than a micron – are thought to affect magma viscosity, but the underlying mechanisms for this remain unclear. Here, we use a cylinder compression creep technique to measure the viscosity of supercooled silicate liquids with different amounts of iron (0–20 wt% FeO tot) as a function of temperature, applied shear stress, and time. Sample viscosity was independent on the applied shear stresses, and as expected, melt viscosity decreases as temperature is increased, but only until a critical temperature where a time-dependent increase in viscosity occurs for samples contaning 6.0 wt% FeO tot or more. The magnitude of this increase is controlled by the melt iron content. At constant temperature, these changes are substantial and can reach up to three orders of magnitude for the sample with the most iron. Using transmission electron microscopy, X-ray diffraction, and viscosity modelling, we conclude that this viscosity increase is caused by the formation of nanolites. By using scaling approaches to test suspension effects with and without crystal aggregation, we conclude that the nanolites have only a minimal direct physical effect on the observed viscosity change. Rather, our models show that it is the chemical shift in the groundmass silicate melt composition associated with non-stoichiometric crystallisation that dominates the observed viscosity increase. These findings suggest that iron-rich silicates may encounter chemical viscosity jumps once certain elements are removed from the melt phase to form nanolites. Our work demonstrates an underlying mechanism for the role played by nanolites in viscosity changes of magmas. • Iron-rich nanolite crystals form in andesites close to the glass transition temperature. • Nanolites increase bulk viscosity because they cause a silica enrichment in residual melt. • Melt composition changes exert a greater influence on rheology than the physical presence of crystals. [ABSTRACT FROM AUTHOR]

Abstract Travel and migration are the major drivers of human brucellosis in Western Europe. The infection is usually transmitted through the consumption of unpasteurized milk or dairy products in or from endemic regions. Although eradicated from livestock in Germany and most Member States of the European Union, considerable numbers of domestic human brucellosis cases have been reported annually. The actual source of these autochthonous cases in non-endemic countries remains to be elucidated. We therefore evaluated the presence of Brucella spp. in 200 cheese samples originating from endemic countries which were sold at weekly markets, in supermarkets and by delis in Berlin (Germany) as well as online. The cheese samples included loose, non-labelled and pre-packed, labelled cheese of five types (brine, cream, soft, semi-hard and hard cheese), made from bovine, ovine and caprine milk. The cheese was mainly declared as raw milk cheese by the retailers. We screened for and confirmed the presence of Brucella -DNA in cheese using genus-specific quantitative real-time PCRs targeting IS711 and bcsp31 , respectively. The molecular prevalence of Brucella was 20.5% (n = 41), but viable Brucellae could not be isolated from the positively tested samples using classical culture methods. The logistic regression model indicated that Brucella was significantly more often detected in late summer purchases (p = 0.036) as well as in cheese from Bulgaria, France, Greece and Turkey (p = 0.017). In contrast to the vendor information, essentially only three positive cheese samples were made from raw milk. Moreover, positive samples clustered at certain vendors which indicates large-scale illegal imports. In summary, Brucella in imported raw milk cheese seems to be still a challenge for food safety standards in the European Union. Uncontrolled import of dairy products from endemic regions might explain human Brucella infections acquired in non-endemic EU countries. Highlights • Brucella -positive raw milk cheese is available at German retail level. • Brucellosis is still a foodborne zoonosis in non-endemic countries. • Uncontrolled imports of cheese do not comply with food safety standards. [ABSTRACT FROM AUTHOR]

Upon proinflammatory challenges, endothelial cell surface presentation of the leukocyte receptor P-selectin, together with the stabilizing co-factor CD63, is needed for leukocyte capture and is mediated via demand-driven exocytosis from the Weibel-Palade bodies that fuse with the plasma membrane. We report that neutrophil recruitment to activated endothelium is significantly reduced in mice deficient for the endolysosomal cation channel TPC2 and in human primary endothelial cells with pharmacological TPC2 block. We observe less CD63 signal in whole-mount stainings of proinflammatory-activated cremaster muscles from TPC2 knockout mice. We find that TPC2 is activated and needed to ensure the transfer of CD63 from endolysosomes via Weibel-Palade bodies to the plasma membrane to retain P-selectin on the cell surface of human primary endothelial cells. Our findings establish TPC2 as a key element to leukocyte interaction with the endothelium and a potential pharmacological target in the control of inflammatory leukocyte recruitment. [Display omitted] • Endothelial two-pore channel 2 (TPC2) governs leukocyte capture on activated endothelium • Histamine activates TPC2 to release endolysosomal Ca2+ • TPC2 promotes CD63 loading onto Weibel-Palade bodies • These findings expand the molecular understanding of leukocyte-endothelium interactions Goretzko et al. report that the endolysosomal two-pore channel 2 (TPC2) affects leukocyte recruitment to activated endothelium. They find that TPC2 controls postendolysosomal trafficking of the P-selectin stabilizing co-factor CD63 to the Weibel-Palade bodies in endothelial cells, thus affecting CD63 and P-selectin cell surface presentation and leukocyte capture. [ABSTRACT FROM AUTHOR]

Purpose: Surgically assisted rapid maxillary expansion (SARME) is a procedure routinely performed to correct transverse maxillary deformities and can be performed with or without pterygomaxillary disjunction (PD). The aim of the present study was to measure the effect of the amount of expansion and stability of SARME with or without PD.Patients and Methods: We designed and implemented a double-blind, randomized clinical trial. The patients were randomly assigned to 2 groups: group 1, SARME without PD; and group 2, SARME with PD. Cone-beam computed tomography scans were performed at 3 points: baseline (T0), after maxillary expansion (T1), and at the end of the retention period (T2). Dental and bone expansion and dental inclination at the maxillary canine and first molar regions were assessed. Two-way repeated measures analysis of variance was used to evaluate the differences between the 2 groups at the 3 evaluation periods (T0, T1, and T2), using a level of significance of P < .05.Results: A total of 24 patients underwent maxillary surgical expansion (group 1, n = 12; and group 2, n = 12). Both techniques promoted a significant transverse dental expansion in the first molar at T2 (with PD, 5.4 mm; vs without PD, 6.4 mm; change, -6.18 mm to 1.48 mm). However, no statistically significant differences were observed between the 2 groups. The tipping molars at T2 remained at a higher level in the SARME, no PD group than in the SARME, PD group (with PD, 2.3°; vs no PD, 4.6° for 3 teeth; change, -12.72° to 5.57°; and with PD, 1.6° vs without PD, 3.6° for 14 teeth; change, -9.96° to 9.83°).Conclusions: SARME with and without PD is a reliable method for obtaining maxillary expansion, with slight differences in the patterns of skeletal and dental alterations. [ABSTRACT FROM AUTHOR]

• Patients with long COVID tend to have persistent symptoms at 12 months. • At 12 months, only 8.7% of patients with long COVID are in complete remission. • There is profound impact on daily life, work, and daily activities. • SARS-CoV-2 antibodies prior to vaccination appear to be linked with better recovery. • Ageusia is associated with reduced chances of improvement at 12 months. This study examines long COVID symptoms course over 12 months, their impact on daily life, and associated factors for symptom relief. A prospective cohort study included 231 participants with long COVID at 12-month follow-up. Data on characteristics, symptom course, and remission were collected using a questionnaire and a remission scale. Poisson regression models were used to estimate the prevalence rate ratio (PRR) and 95% confidence intervals (CIs) for factors associated with symptom improvement. Of the 231 participants, 63.2% developed SARS-CoV-2 antibodies before COVID-19 vaccination. At 12 months, only 8.7% (95% CI: 5.4-13.1%) reported complete remission, while 28.6% noted significant improvement. Most symptoms remained prevalent: asthenia (83.1%), neurocognitive/neurological (93.9%), cardiothoracic (77.9%), Musculoskeletal (78.8%). During long COVID, 62.2% stopped working, and only 32.5% resumed full-time professional activities. Presence of SARS-CoV-2 antibodies before vaccination increased the probability of improvement (aPRR: 1.60, P = 0.028), while ageusia at initial long COVID phase decreased the probability (aPRR: 0.38, P = 0.007). Long-COVID symptoms persisted in the majority of participants after 12 months, with significant impacts on daily life and work. SARS-CoV-2 antibodies were associated with better prognosis, while persistent ageusia indicated a lower probability of improvement. These findings highlight the need for ongoing support and care for individuals with long COVID. [ABSTRACT FROM AUTHOR]

• The Authors hypothesize that JC virus (JCV) may be implicated in the onset of multiple system atrophy (MSA). • JCV DNA was reported in the brain of some immunocompetent subjects, mainly in oligodendrocytes. • Infections can trigger α-synuclein accumulation, a potential antimicrobial peptide. • JCV may be implicated in the onset of early neurogenic urinary symptoms in MSA. • The onset of MSA may require the presence of specific susceptibility factors. [ABSTRACT FROM AUTHOR]

Résumé Objectifs En venant compléter deux publications relatives à l’enquête Hepaig-quali, l’une consacrée à la sexualité et l’autre à l’usage de drogues, cet article s’intéresse à la dimension psychodynamique des récits recueillis auprès d’homosexuels masculins séropositifs pour le VIH. L’enquête Hepaig-quali constitue l’un des volets de l’étude épidémiologique Hepaig, portant sur les « hépatites aiguës C chez des homosexuels atteints par le VIH », coordonnée par l’Institut de veille sanitaire (France). En complément de résultats recueillis par questionnaire, et à partir du point focal de « l’événement hépatite C », l’objectif de ce volet qualitatif visait à recueillir des récits de pratiques relatifs à la sexualité et à l’usage de drogues, à connaître les motivations de tels choix et à les replacer dans la trame biographique des sujets, à détailler les événements survenus dans leurs parcours de soins et à explorer les représentations relatives à leur santé physique et psychique. Méthode L’enquête repose sur la réalisation de deux entretiens successifs réalisés auprès de 31 hommes, initialement inclus dans l’étude Hepaig. Ces entretiens, intégralement retranscrits, ont fait l’objet d’une double lecture, psychodynamique et sociologique, selon une posture épistémologique se référant à une approche compréhensive des comportements. Résultats Cet article s’intéresse spécifiquement à la santé psychique des enquêtés et à la dimension psychodynamique de leurs récits. Bien que les entretiens, réalisés par le sociologue, ne soient pas l’équivalent de « cas cliniques », les enjeux psychiques y sont très présents. Les répondants évoquent, avec leurs mots, leurs expériences du stress, de la « déprime » et évoquent pour certains leurs idées suicidaires. Ils abordent en majorité leurs pratiques, et les motivent selon un discours de recherche de jouissance et de maîtrise rationnelle des risques. Discussion À bien des égards, les enquêtés apparaissent comme des « hommes ordinaires », notamment du point de vue de leur socialisation sexuée et de leur représentation du risque. Leur spécificité du point de vue de la santé psychique tiendrait à leur expérience des discriminations et à leur vécu d’une maladie chronique. En exprimant une tension permanente entre pulsion et raison, entre recherche de jouissance et besoin de maîtrise de leur vie, ils présentent les caractéristiques de l’individu hypermoderne dont les contradictions se révèlent dans le rapport à l’autre. Conclusion Les enquêtés, bien informés, adhèrent au discours médical positif des soignants, qui les soutient psychiquement face au poids de morbidité des infections par le VIH et le VHC. L’évolution des cultures sexuelles se traduit, pour ces hommes, par un rejet de la norme du préservatif et par l’adoption de pratiques décrites comme plus satisfaisantes, mais pouvant comporter des risques accrus. Leurs comportements sont toutefois régis par d’autres dimensions que la connaissance et la rationalité. La recherche de jouissance ne s’embarrasse pas toujours des freins et des empêchements que la raison imposerait. Cela devrait conduire les soignants à mieux entendre et accompagner les efforts de réduction des risques de leurs patients. Objectives This paper focuses on the psychodynamic dimension of narratives collected in interviews carried out with HIV-positive gay men, and completes two previous publications concerning the Hepaig-quali study, one centred on sexuality and the other on drug use. The Hepaig-quali study was part of the Hepaig epidemiological survey on acute hepatitis C among HIV-infected gay men, coordinated by the Institut de Veille Sanitaire (InVS, France). In addition to the results gathered from questionnaires, and with a focus on the “hepatitis C event”, the present study aimed to describe sexual practices and drug use among HCV-infected gay men, to assess the motivations of these choices, to position them in relation to their life histories and healthcare experiences, and to explore how they viewed their physical and mental health. Methodology Our study was based on two successive in-depth interviews with 31 men previously included in the Hepaig survey. These interviews, conducted by a sociologist, were fully transcribed, and analysed from a dual psychodynamic and sociological viewpoint, an epistemological stance related to the comprehensive approach to behaviours. Results Thirty-one men were included in this qualitative study. We focused specifically on the mental health of the respondents and the psychodynamic dimension of their narratives. Despite the fact that these interviews were not equivalent to “clinical cases”, psychic issues were very much present. In their own words, the respondents talked of their experiences of stress and depression, and some mentioned suicidal ideations. Most talked readily about their practices and explained them via discourse on achieving pleasure, alongside the rational control of risks. Discussion In many respects, the respondents appeared as “ordinary men”, in particular with respect to their gendered socialisation and their representations of the risks. From a mental health perspective, some specificities were linked to the experiences of discrimination and chronic illness. With the permanent tension between impulse and reason, between the search for pleasure and the need to control their lives, they present the characteristics of the hypermodern individual whose contradictions are revealed in their relationship with the other. Conclusion Accurately informed, the respondents also embraced the positivist medical discourse of their caregivers, which provides them with support and helps them to face the burden of HIV and HCV infections. The evolution of gay sexual culture leads these men, via the rejection of the “condom norm”, to choose practices described as more satisfying, but entailing greater risks. Nevertheless, as with any topic, their behaviours are regulated by other dimensions than knowledge and rationality. The search for pleasure is not always restrained by the hindrance and impediments of reason. This should lead caregivers to better understand and support the efforts that their patients make to reduce risks. [ABSTRACT FROM AUTHOR]

In order to understand the corrosion processes of low-alloyed carbon steel (C-steel) materials in contact with porewater and/or gas in clay environments under reducing conditions at 85 °C, an in situ experiment called “MCO-Gravimetry” has been carried out in the Meuse/Haute–Marne Underground Research Laboratory (Bure, France). In a test chamber drilled in clay rock, samples of C-steel were exposed either to “clay porewater” (actually a liquid phase initially made of synthetic clay porewater gradually replaced by water seepage) or to an atmosphere of gases released by the host rock and by corrosion processes. Samples series were removed from the test chamber at given times (between 3 and 30 months), and the metal loss and corrosion rate ( r ) were quantified by gravimetric measurements. Characterisations of certain coupons were performed by using micro-Raman and X-Ray Diffraction analyses. Chemical and microbial analyses of the water seepage were also performed. Gravimetric measurements showed that r was lower in the gas phase (about 5 μm/yr) than in the liquid phase (up to 200 μm/yr). Two trends were observed in the liquid phase, one with an active behaviour (high r of about 200 μm/yr) and one with a passive behaviour (low r <30 μm/yr). The high r could be explained by the presence of an acidic pH transient that occurred 100 days after the experiment had started and lasted for 200 days. The rods with very low r may have been shielded in the setup, which could explain the comparatively limited damage, even under acidic conditions. Corrosion products (CPs) characterisation mainly showed the presence of siderite. In addition, Fe hydroxychloride was detected at the metal/corrosion product interface on coupons with high r . Finally, results from microbial analysis revealed the presence of sulphate- and thiosulphate-reducing bacteria (SRB and ThRB) in both media. The SRB/ThRB metabolism may explain the presence of sulphide in the CPs. Overall, this study highlights the potential risk of an acidic pH transient that would promote high corrosion rates for the C-steel structural barriers in a high-level nuclear waste repository. Therefore, HLW French repository concept has been modified by adding a cement-bentonite based grout between the host rock and casing. This is expected to neutralise the potential acidity and bring the C-steel surface to the passivity domain. [ABSTRACT FROM AUTHOR]

Objective To describe the evolution after internal fixation using a locking 2.0-mm system plate in the treatment of mandibular fractures that have potential for complications. Method Among 42 patients with mandibular fractures surgically treated, 10 (23.8%) presented 16 mandibular fractures with the potential for complications, due to drug abuse, smoking and/or dental status – partially or completely edentate. They were treated with the locking 2.0-mm system plates, and the evaluations were performed at 1 week and 1, 3 and 6 months postoperatively. The remaining cases received conventional fixation systems. Results Most patients were male with a mean age of 41.2 years, presented with a displaced (81.3%) fracture in the body or angle region and were partially edentulous (60%). There was a predominance of alcoholism (50%), which was followed by illicit drug use (30%) and smoking (30%). All patients recovered well. There was a progressive gain in the values of jaw opening ( p < 0.001), reaching normal values. Conclusion It was concluded that the treatment of displaced mandibular fractures in patients who are addicted to drugs and are partially edentulous was adequate with the use of the locking 2.0-mm fixation system. [ABSTRACT FROM AUTHOR]

Objectives Spinal anaesthesia represents the technique of choice for elective caesarean section. The purpose of this study was to compare the puncture failure rates with 25, 26 or 27 gauge (G) pencil-point, Whitacre type (with introducer) needles during spinal anaesthesia for caesarean section. Study design Prospective, randomised, experimental study in healthy subjects. Patients and methods We recruited 330 adults, consecutively scheduled parturients, randomised into three groups. The subarachnoid puncture procedure was standardised. The flexibility of the three needle types was assessed in vitro, and a force was applied using a dynamometer. The occurrence of postdural puncture headache was also evaluated. Results The number of spinal puncture failures was significantly higher in the 27 G group, than in the 25 G ( P = 0.006) group and the 26 G ( P < 0.001) group, but did not differ between the 25 G and 26 G groups ( P = 0.606). Ten postdural puncture headaches were observed without significant differences among the groups. Conclusions This prospective study showed that puncture failures occur less frequently with the use of 25 G or 26 G pencil-point needles as compared to 27 G needles, probably due to the higher flexibility of the latter. This characteristic was demonstrated in vitro, in a reproducible model. This experiment suggests that a 26 G pencil-point needle is the optimal gauge for performing spinal anaesthesia for scheduled caesarean sections. [ABSTRACT FROM AUTHOR]

Objective Bilateral surgery has been largely advocated in premature boys with unilateral inguinal hernia owing to the high incidence of contralateral patent processus vaginalis. Recently, the potential morbidity of herniotomy in low birth-weight babies and the progress in pediatric anesthesia questioned this attitude. This study aims to evaluate the incidence of contralateral metachronous hernia in a large series of premature boys and to compare the morbidity of preventive versus elective surgery. Methods This retrospective multicenter analysis of 964 premature boys presenting with unilateral inguinal hernia operated from 1998 to 2012 included 557 infants who benefited from a unilateral herniotomy and 407 from a bilateral herniotomy (median follow-up 12 months). Results Contralateral metachronous hernia after unilateral surgery occurred in 11% (n = 60) without significant difference according to the initial symptomatic side (9.5% on right vs 13% on left, p > 0.05). Postoperative morbidity on the contralateral side was higher after preventive surgery than elective surgery with metachronous hernia (2.45% versus 0.9%, p = 0.05) especially for secondary cryptorchidism (1% vs 0%, p = 0.03). Despite the risk of metachronous incarcerated hernia, elective surgery did not increase the rate of testicular hypotrophy on the opposite side (0.7%, vs 0.7%, p > 0.05). Conclusion Systematic bilateral herniotomy is unnecessary in almost 90% of patients and has a significant morbidity. Secondary surgery for metachronous hernia does not increase the risk of testicular lesion and even reduces the risk of secondary cryptorchidism. These results, along with the risk of hypofertility reported after bilateral surgery, may justify treating only the symptomatic side in premature boys. [ABSTRACT FROM AUTHOR]

Abstract: The population of Africa is predicted to double over the next 40 years, driving exceptionally high urban expansion rates that will induce significant socio-economic, environmental and health changes. In order to prepare for these changes, it is important to better understand urban growth dynamics in Africa and better predict the spatial pattern of rural-urban conversions. Previous work on urban expansion has been carried out at the city level or at the global level with a relatively coarse 5–10 km resolution. The main objective of the present paper was to develop a modelling approach at an intermediate scale in order to identify factors that influence spatial patterns of urban expansion in Africa. Boosted Regression Tree models were developed to predict the spatial pattern of rural-urban conversions in every large African city. Urban change data between circa 1990 and circa 2000 available for 20 large cities across Africa were used as training data. Results showed that the urban land in a 1 km neighbourhood and the accessibility to the city centre were the most influential variables. Results obtained were generally more accurate than results obtained using a distance-based urban expansion model and showed that the spatial pattern of small, compact and fast growing cities were easier to simulate than cities with lower population densities and a lower growth rate. The simulation method developed here will allow the production of spatially detailed urban expansion forecasts for 2020 and 2025 for Africa, data that are increasingly required by global change modellers. [Copyright &y& Elsevier]

Purpose: Changes in the Th1/Th2 immune balance may play a role in increasing the incidence of radiation-induced toxicity. This study evaluates the consequences of Th1 deficiency on intestinal response (fibrosis and T cell trafficking) to abdominal irradiation and examines in mucosa and mesenteric lymph nodes (MLN) the differential involvement of the two Th1 pathways, T-bet/STAT1 and IL-12/STAT4, in controlling this balance in mice. Methods and Materials: Using T-bet-deficient mice (T-bet−/−), we evaluated the mRNA and protein expression of the Th1 pathways (IFN-γ, T-bet/STAT1, and IL-12/STAT4) and the CD4+ and CD8+ populations in ileal mucosa and MLN during the first 3 months after 10 Gy abdominal irradiation. Results: The T-bet-deficient mice showed an increased fibrotic response to radiation, characterized by higher TGF-β1, col3a1 expression, and collagen deposition in mucosa compared with wild-type mice. This response was associated with drastically lower expression of IFN-γ, the hallmark Th1 cytokine. Analysis of the Th1 expression pathways, T-bet/STAT1 and IL-12/STAT4, showed their equal involvement in the failure of Th1 polarization. A minimal IFN-γ level depended on the IL-23-p19/STAT4 level. In addition, the radiation-induced deficiency in the priming of Th1 by IFN-γ was related to the defective homing capacity of CD8+ cells in the mucosa. Conclusion: Irradiation induces Th2 polarization, and the Th2 immune response may play a role in potentiating irradiation-induced intestinal collagen deposition. [ABSTRACT FROM AUTHOR]