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Objectives: The aim of this systematic review was to inform the update of European League Against Rheumatism (EULAR) Recommendations for the management of Behçet's syndrome (BS), on the evidence for the treatment of skin, mucosa and joint involvement of BS. Methods: A systematic literature search, data extraction, statistical analyses and assessment of the quality of evidence were performed according to a pre-specified protocol using the PRISMA guidelines. Studies that assessed the efficacy of an intervention in comparison to an active comparator or placebo for oral ulcers, genital ulcers, papulopustular lesions, nodular lesions or arthritis were included. Where possible, risk ratios were calculated for binary outcomes and mean difference for continuous outcomes. Results: Among the 3927 references that were screened, 37 were included in the analyses. Twenty-seven of these assessed mucocutaneous and 17 assessed joint involvement. Twenty-one of these studies were randomised controlled trials (RCTs). RCTs with colchicine, azathioprine, interferon-alpha, thalidomide, etanercept and apremilast showed beneficial results with some differences according to lesion type and gender. These agents were generally well tolerated with few adverse events causing withdrawal from the study. Conclusions: RCTs comprised more than a half (21/37, 57%) of the sources included in the evidence synthesis related to skin, mucosa and joint involvement applicable for the EULAR Recommendations for the management of BS. Differences in the outcome measures that were used across the included studies often made it difficult to combine and compare the results. © 2018 Elsevier Inc.

Several new treatment modalities with different mechanisms of action have been studied in patients with Behçet's syndrome (BS). The aim of the current effort was to update the recommendations in the light of these new data under the auspices of the European League Against Rheumatism (EULAR) Standing Committee for Clinical Affairs. A task force was formed that included BS experts from different specialties including internal medicine, rheumatology, ophthalmology, dermatology, neurology, gastroenterology, oral health medicine and vascular surgery, along with a methodologist, a health professional, two patients and two fellows in charge of the systematic literature search. Research questions were determined using a Delphi approach. EULAR standardised operating procedures was used as the framework. Results of the systematic literature review were presented to the task force during a meeting. The former recommendations were modified or new recommendations were formed after thorough discussions followed by voting. The recommendations on the medical management of mucocutaneous, joint, eye, vascular, neurological and gastrointestinal involvement of BS were modified; five overarching principles and a new recommendation about the surgical management of vascular involvement were added. These updated, evidence-based recommendations are intended to help physicians caring for patients with BS. They also attempt to highlight the shortcomings of the available clinical research with the aim of proposing an agenda for further research priorities. © 2018 Article author(s).

Objective. To assess the efficacy and safety of treatment modalities for major organ involvement of Behçet’s syndrome (BS), in order to inform the update of the EULAR recommendations for the management of BS. Methods. A systematic literature review of all randomized controlled trials, controlled clinical trials, or open label trials assessing eye, vascular, nervous system or gastrointestinal system involvement of BS was performed. If controlled trials were not available for answering a specific research question, uncontrolled studies or case series were also included. Results. We reviewed the titles and abstracts of 3927 references and 161 studies met our inclusion criteria. There were only nine randomized controlled trials. Observational studies with IFN-α and monoclonal anti-TNF antibodies showed beneficial results for refractory uveitis. Meta-analysis of case-control studies showed that immunosuppressives decreased the recurrence rate of deep vein thrombosis significantly whereas anticoagulants did not. CYC and high dose glucocorticoids decreased mortality in pulmonary arterial aneurysms and postoperative complications in peripheral artery aneurysms. Beneficial results for gastrointestinal involvement were obtained with 5-ASA derivatives and AZA as first line treatment and with thalidomide and/or monoclonal anti-TNF antibodies in refractory cases. Observational studies for nervous system involvement showed improved outcome with immunosuppressives and glucocorticoids. Meta-analysis of case-control studies showed an increased risk of developing nervous system involvement with ciclosporin-A. Conclusion. The majority of studies related to major organ involvement that informed the updated EULAR recommendations for the management of BS were observational studies. © The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.

Detecting the cosmological sky-averaged (global) 21 cm signal as a function of observed frequency will provide a powerful tool to study the ionization and thermal history of the intergalactic medium (IGM) in the early Universe ($\sim$ 400 million years after the Big Bang). The greatest challenge in conventional total-power global 21 cm experiments is the removal of the foreground synchrotron emission ($\sim 10^3$-$10^4$ K) to uncover the weak cosmological signal (tens to hundreds of mK), especially since the intrinsic smoothness of the foreground spectrum is corrupted by instrumental effects. Although the EDGES team has recently reported an absorption profile at 78 MHz in the sky-averaged spectrum, it is necessary to confirm this detection with an independent approach. The projection effect from observing anisotropic foreground source emission with a wide-view antenna pointing at the North Celestial Pole (NCP) can induce a net polarization, referred as the Projection-Induced Polarization Effect (PIPE). Due to Earth's rotation, observation centered at the circumpolar region will impose a dynamic sky modulation on the net polarization's waveforms which is unique to the foreground component. In this study, we review the implementation practicality and underlying instrumental effects of this new polarimetry-based technique with detailed numerical simulation and a testbed instrument, the Cosmic Twilight Polarimeter (CTP). In addition, we explore an SVD-based analysis approach for separating the foreground and instrumental effects from the background global 21 cm signal using the sky-modulated PIPE., Comment: 19 pages, 24 figures, 1 table, accepted by ApJ

Background Treatment outcomes for multidrug-resistant tuberculosis remain poor. We aimed to estimate the association of treatment success and death with the use of individual drugs, and the optimal number and duration of treatment with those drugs in patients with multidrug-resistant tuberculosis. Methods In this individual patient data meta-analysis, we searched MEDLINE, Embase, and the Cochrane Library to identify potentially eligible observational and experimental studies published between Jan 1, 2009, and April 30, 2016. We also searched reference lists from all systematic reviews of treatment of multidrug-resistant tuberculosis published since 2009. To be eligible, studies had to report original results, with end of treatment outcomes (treatment completion [success], failure, or relapse) in cohorts of at least 25 adults (aged >18 years). We used anonymised individual patient data from eligible studies, provided by study investigators, regarding clinical characteristics, treatment, and outcomes. Using propensity score-matched generalised mixed effects logistic, or linear regression, we calculated adjusted odds ratios and adjusted risk differences for success or death during treatment, for specific drugs currently used to treat multidrug-resistant tuberculosis, as well as the number of drugs used and treatment duration. Findings Of 12030 patients from 25 countries in 50 studies, 7346 (61%) had treatment success, 1017 (8%) had failure or relapse, and 1729 (14%) died. Compared with failure or relapse, treatment success was positively associated with the use of linezolid (adjusted risk difference 0.15, 95% CI 0.11 to 0.18), levofloxacin (0.15, 0.13 to 0.18), carbapenems (0.14,0.06 to 0.21), moxifloxacin (0.11, 0.08 to 0.14), bedaquiline (0.10, 0.05 to 0.14), and clofazimine (0.06, 0.01 to 0.10). There was a significant association between reduced mortality and use of linezolid (-0.20, -0.23 to -0.16), levofloxacin (-0.06, -0.09 to -0.04), moxifloxacin (-0.07, -0.10 to -0.04), or bedaquiline (-0.14, -0.19 to -0.10). Compared with regimens without any injectable drug, amikacin provided modest benefits, but kanamycin and capreomycin were associated with worse outcomes. The remaining drugs were associated with slight or no improvements in outcomes. Treatment outcomes were significantly worse for most drugs if they were used despite in-vitro resistance. The optimal number of effective drugs seemed to be five in the initial phase, and four in the continuation phase. In these adjusted analyses, heterogeneity, based on a simulated I-2 method, was high for approximately half the estimates for specific drugs, although relatively low for number of drugs and durations analyses. Interpretation Although inferences are limited by the observational nature of these data, treatment outcomes were significantly better with use of linezolid, later generation fluoroquinolones, bedaquiline, clofazimine, and carbapenems for treatment of multidrug-resistant tuberculosis. These findings emphasise the need for trials to ascertain the optimal combination and duration of these drugs for treatment of this condition.

We report the results of our long-term monitoring study of cirrus clouds using our locally developed lidar sytem located in Hanoi, Vietnam (21.03°N, 105.85°E). Our data, spanning the period from 2011 to 2017, show that the cirrus clouds above Hanoi are generally found between 6.7 and 18.0 km with a mean height of 14.0 km. The cloud thickness is estimated to vary between 0.2 and 7.0 km with an average thickness of 2.3 ± 1.2 km. We also derive an average optical depth of 0.32 ± 0.22 and an average lidar ratio 30 ± 18. We also compare the geometrical and optical properties of cirrus clouds above Hanoi, where until now lidar study is still lacking, with that obtained for other locations in Asia and around the world.

The human mind is extraordinary in its ability not merely to respond to events as they unfold but also to adapt its own operation in pursuit of its agenda. This 'cognitive control' can be achieved through simple interactions among sensorimotor processes, and through interactions in which one sensorimotor process represents a property of another in an implicit, unconscious way. So why does the human mind also represent properties of cognitive processes in an explicit way, enabling us to think and say 'I'm sure' or 'I'm doubtful'? We suggest that 'system 2 metacognition' is for supra-personal cognitive control. It allows metacognitive information to be broadcast, and thereby to coordinate the sensorimotor systems of two or more agents involved in a shared task. © 2014 Elsevier Ltd.

This thesis is about the human ability to share and combine representations of the uncertainty associated with individual beliefs – an ability which is called metacognition and facilitates effective cooperation. We distinguish between two metacognitive representations: an implicit confidence variable for oneself and an explicit confidence report for sharing with others. Using visual psychophysics and computational modelling, we address the issues of optimality and flexibility in the formation and the utilisation of these representations. We show that people can compute the confidence variable in an optimal manner (the probability that a given belief is correct as per Bayesian inference). Further, we show that the mapping of this variable onto a confidence report can vary flexibly – with people adjusting their reports according to the history of reports given and feedback obtained. This optimality and flexibility is important for effective cooperation. Being a probability, the optimal confidence variable can be compared across people. However, to facilitate this comparison, people must adapt their confidence reports to each other and develop a common metric for reporting the probability that their belief is correct. We show that people solve this communication problem sub-optimally; they match each other’s mean confidence and confidence distributions, regardless of whether they are equally likely to be correct or not. In addition, we show that, while people can take into account differences in underlying competence to some extent, they fail to do so adequately; they exhibit an equality bias, weighting their partner’s beliefs as if they were as good or as bad as their own, regardless of true differences in their underlying competence. More generally, our results pose a problem for our current understanding of metacognition which assumes that confidence reports are stable over time. In addition, our results show that confidence reports are socially malleable, and thus raise the possibility that well-known biases, such as overconfidence, might reflect particular norms for social interaction.

The cosmological global (sky-averaged) 21-cm signal is a powerful tool to probe the evolution of the intergalactic medium (IGM) in high-redshift Universe ($z \leq 6$). One of the biggest observational challenges is to remove the foreground spectrum which is at least four orders of magnitude brighter than the cosmological 21-cm emission. Conventional global 21-cm experiments rely on the spectral smoothness of the foreground synchrotron emission to separate it from the unique 21-cm spectral structures in a single total-power spectrum. However, frequency-dependent instrumental and observational effects are known to corrupt such smoothness and complicates the foreground subtraction. We introduce a polarimetric approach to measure the projection-induced polarization of the anisotropic foreground onto a stationary dual-polarized antenna. Due to Earth rotation, when pointing the antenna at a celestial pole, the revolving foreground will modulate this polarization with a unique frequency-dependent sinusoidal signature as a function of time. In our simulations, by harmonic decomposing this dynamic polarization, our technique produces two separate spectra in parallel from the same observation: (i) a total sky power consisting both the foreground and the 21-cm background, (ii) a model-independent measurement of the foreground spectrum at a harmonic consistent to twice the sky rotation rate. In the absence of any instrumental effects, by scaling and subtracting the latter from the former, we recover the injected global 21-cm model within assumed uncertainty. We further discuss several limiting factors and potential remedies for future implementation., Comment: 16 pages, 22 figures, 2 tables. Accepted to The Astrophysical Journal. This is the final version after addressing referee's comments

In a range of contexts, individuals arrive at collective decisions by sharing confidence in their judgements. This tendency to evaluate the reliability of information by the confidence with which it is expressed has been termed the ‘confidence heuristic’. We tested two ways of implementing the confidence heuristic in the context of a collective perceptual decision-making task: either directly, by opting for the judgement made with higher confidence, or indirectly, by opting for the faster judgement, exploiting an inverse correlation between confidence and reaction time. We found that the success of these heuristics depends on how similar individuals are in terms of the reliability of their judgements and, more importantly, that for dissimilar individuals such heuristics are dramatically inferior to interaction. Interaction allows individuals to alleviate, but not fully resolve, differences in the reliability of their judgements. We discuss the implications of these findings for models of confidence and collective decision-making.

The Dark Ages Radio Explorer (DARE) is designed to measure the all sky-averaged HI 21-cm signal from the Dark Ages and Epoch of Reionization. DARE will orbit the Moon for a mission lifetime of ≤ 3 years and only take data above the lunar far side. DARE comprises of a single radiometer operating between 40–120 MHz (redshifts z=11–35). The science objectives of DARE include formation of first stars, first accreting black holes, beginning of reionization and end of the Dark Ages. The science instrument is composed of a three-element radiometer, including electrically-short, tapered, bi-conical dipole antennas, a receiver, and a digital spectrometer.

ICSE-7 - 7th International Conference on Scour and Erosion, PERTH, AUSTRALIE, 02-/12/2014 - 04/12/2014; Most of civil engineering structures located along or crossing a river (earthworks, dikes, bridge piers...) are subjected to the problem of scour and erosion. It is a major concern in terms of natural hazards assessment and sustainable development. However, this is a complex problem which involves different scientific areas (soil mechanic, fluid mechanic, physic, geology...). For risk mitigation, most of the existing recommendations are based on an empirical formulation. It points out the need to improve our understanding of scouring and erosion processes, develop appropriate diagnostic methods and mitigation solutions. To update knowledge on these issues and disseminate them widely, research programs have been started in France for over 10 years. This paper reports an overview of research programs which aim to bring solutions in response to these needs.