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COVID-19 is a viral infection with predominant respiratory tropism. In its most severe forms, the initial viral aggression leads to acute respiratory failure due to damage secondary to an exacerbated inflammatory response provoked by the activation of innate, followed by adaptive immunity. The inflammatory response may entail respiratory distress syndrome, if not multivisceral failure and death. IL-6 receptor inhibitors (Tocilizumab and Sarilumab) have been proposed as treatments. Numerous studies have provided new information, which remains heterogeneous and difficult to interpret. This review is aimed at clarifying the potential role of IL-6 receptor inhibitors in severe forms of COVID-19.

Spinal cord injury (SCI) is a complex disease that affects not only sensory and motor pathways below the neurological level of injury (NLI) but also all the organs and systems situated below this NLI. This multisystem impairment implies comprehensive management in dedicated SCI specialized centers, by interdisciplinary and multidisciplinary teams, able to treat not only the neurological impairment, but also all the systems and organs affected. After a brief history of the Spinal Cord Medicine, the author describes how to determine the level and severity of a SCI based on the International Standards for Neurological Classification of Spinal Cord Injury and the prognosis factors of recovery. This article provides also a review of the numerous SCI-related impairments (except for urinary, sexual problems and pain treated separately in this issue), their principles of management and related complications.

Brillouin-Optical Time Domain Analysis and Rayleigh-Optical Frequency Domain Reflectometry, are exploited to improve the understanding of the longitudinal strain distribution along the optical fiber of a quadrupolar sensing coil of a fiber-optic gyroscope.

Context. The substellar triple system VHS J125601.92−125723.9 (hereafter VHS 1256−1257) is composed of an equal-mass M7.5 brown dwarf binary and an L7 low-mass substellar object. In Guirado et al. (2018, A&A, 610, A23) we published the detection of radio emission at 8.4 GHz coming from the central binary and making it an excellent target for further observations. Aims. We aim to identify the origin of the radio emission occurring in the central binary of VHS 1256−1257 while discussing the expected mechanisms involved in the radio emission of ultra-cool dwarfs. Methods. We observed this system with the Karl G. Jansky Very Large Array, the European very-long-baseline interferometry (VLBI) Network, the enhanced Multi-Element Remotely Linked Interferometer Network, the NOrthern Extended Millimeter Array, and the Atacama Large Millimetre Array at frequencies ranging from 5 GHz up to 345 GHz in several epochs during 2017, 2018, and 2019. Results. We found radio emission at 6 GHz and 33 GHz coincident with the expected position of the central binary of VHS 1256−1257. The Stokes I density fluxes detected were 73 ± 4 μJy and 83 ± 13 μJy, respectively, with no detectable circular polarisation or pulses. No emission is detected at higher frequencies (230 GHz and 345 GHz), nor at 5 GHz with VLBI arrays. The emission appears to be stable over almost three years at 6 GHz. To explain the constraints obtained both from the detections and non-detections, we considered multiple scenarios including thermal and nonthermal emission, and different contributions from each component of the binary. Conclusions. Our results can be well explained by nonthermal gyrosynchrotron emission originating at radiation belts with a low plasma density (ne = 300−700 cm−3), a moderate magnetic field strength (B ≈ 140 G), and an energy distribution of electrons following a power-law (dN/dE ∝ E−δ) with δ fixed at 1.36. These radiation belts would need to be present in both components and also be viewed equatorially. © ESO 2022., We sincerely thank the anonymous referee for his/her very useful and constructive criticisms and suggestions. This paper is based on observations carried out with the IRAM NOEMA interferometer and the IRAM 30-m telescope. IRAM is supported by INSU/CNRS (France), MPG (Germany), and IGN (Spain). JBC and JCG were partially supported by the Spanish MINECO projects AYA2015-63939-C2-2-P, PGC2018-098915-B-C22 and by the Generalitat Valenciana project GVPROMETEO2020−080. MPT acknowledges financial support from the State Agency for Research of the Spanish MCIU through the “Center of Excellence Severo Ochoa” award to the Instituto de Astrofísica de Andalucía (SEV-2017-0709) and through grants PGC2018-098915-B-C21 and PID2020-117404GB-C21 (MCI/AEI/FEDER, UE). RA was supported by the Generalitat Valenciana postdoctoral grant APOSTD/2018/177. BG acknowledges support from the UK Science and Technology Facilities Council (STFC) via the Consolidated Grant ST/R000905/1. MRZO and VJSB acknowledge the financial support from PID2019-109522GB-C51 and PID2019-109522GB-C53, respectively.

A recent JEOS-RP publication proposed Comments about Dispersion of Light Waves, and we present here complementary comments for birefringence dispersion in polarization-maintaining (PM) fibers, and for its measurement techniques based on channeled spectrum analysis. We start by a study of early seminal papers, and we propose additional explanations to get a simpler understanding of the subject. A geometrical construction is described to relate phase birefringence to group birefringence, and it is applied to the measurement of several kinds of PM fibers using stress-induced photo-elasticity, or shape birefringence. These measurements confirm clearly that the difference between group birefringence and phase birefringence is limited to 15–20% in stress-induced PM fibers (bow-tie, panda, or tiger-eye), but that it can get up to a 3-fold factor with an elliptical-core (E-core) fiber. There are also surprising results with solid-core micro-structured PM fibers, that are based on shape birefringence, as E-core fibers.

Background: Few studies have considered aircraft noise annoyance and noise sensitivity in analyses of the health effects of aircraft noise, especially in relation to medication use. This study aims to investigate the moderating and mediating role of these two factors in the relationship between aircraft noise levels and medication use among 5860 residents of ten European airports included in the HYENA and DEBATS studies. Methods: Information on aircraft noise annoyance, noise sensitivity, medication use, and demographic, socio-economic and lifestyle factors was collected during a face-to-face interview at home. Medication was coded according to the Anatomical Therapeutic Chemical (ATC) classification. Outdoor aircraft noise exposure was estimated by linking the participant’s home address to noise contours using Geographical Information Systems (GIS) methods. Logistic regressions with adjustment for potential confounding factors were used. In addition, Baron and Kenny’s recommendations were followed to investigate the moderating and mediating effects of aircraft noise annoyance and noise sensitivity. Results: A significant association was found between aircraft noise levels at night and antihypertensive medication only in the UK (OR = 1.43, 95%CI 1.19–1.73 for a 10 dB(A)-increase in Lnight). No association was found with other medications. Aircraft noise annoyance was significantly associated with the use of antihypertensive medication (OR = 1.33, 95%CI 1.14–1.56), anxiolytics (OR = 1.48, 95%CI 1.08–2.05), hypnotics and sedatives (OR = 1.60, 95%CI 1.07–2.39), and antasthmatics (OR = 1.44, 95%CI 1.07–1.96), with no difference between countries. Noise sensitivity was significantly associated with almost all medications, with the exception of the use of antasthmatics, showing an increase in ORs with the level of noise sensitivity, with differences in ORs among countries only for the use of antihypertensive medication. The results also suggested a mediating role of aircraft noise annoyance and a modifying role of both aircraft noise annoyance and noise sensitivity in the association between aircraft noise levels and medication use. Conclusions: The present study is consistent with the results of the small number of studies available to date suggesting that both aircraft noise annoyance and noise sensitivity should be taken into account in analyses of the health effects of exposure to aircraft noise. © 2021, The Author(s).

Background The impact of social support on the long-term condition after a spinal cord injury (SCI) varies across studies mainly involving self-report questionnaires. Objective We aimed to establish the common factors associated with social support leading individuals with an SCI to the effective prevention of secondary complications, including via adherence to medical follow-up. Methods Inclusion criteria were a history of acquired SCI of any etiology, wheelchair use, and age ≥ 18 years at the time of the study. Participants should have completed their initial rehabilitation program in France ≥ 1 year earlier and were also enrolled according to 2 related study variables: routine medical follow-up (patients were or were not followed up) and the medically supervised reporting of a pressure ulcer after the initial rehabilitation session (0 or ≥ 1 pressure ulcers). We performed a preparatory quantitative and qualitative literature review to identify factors affecting long-term follow-up after SCI, then adopted a narrative design with semi-structured interviews, transcribed and analyzed progressively by using qualitative analysis software. Results We included 32 participants. We categorized our results based on the knowledge, attitudes, beliefs and practices of participants with respect to pressure ulcer prevention and long-term medical follow-up. Our narrative approach allowed us to identify 3 main domains relevant to social support: reciprocity, self-management and timing related to social support. Conclusions Our study showed social support as a dynamic process, a reciprocal phenomenon evolving in variations over time. These findings should be central to short- and long-term therapeutic education programs for patients and for people providing social support. Effective changes should also be implemented through the concept of the Learning Health System.

In Hirschsprung’s disease (HSCR), postoperative course remains unpredictable. Our aim was to define predictive factors of the main postoperative complications: obstructive symptoms (OS) and Hirschsprung-associated enterocolitis (HAEC). In this prospective multicentre cohort study, samples of resected bowel were collected at time of surgery in 18 neonates with short-segment HSCR in tertiary care hospitals. OS and HAEC were noted during postoperative follow-up. We assessed the enteric nervous system and the intestinal epithelial barrier (IEB) in ganglionic segments by combining immunohistochemical, proteomic and transcriptomic approaches, with functional ex vivo analysis of motility and para/transcellular permeability. Ten HSCR patients presented postoperative complications (median follow-up 23.5 months): 6 OS, 4 HAEC (2 with OS), 2 diarrhoea (without OS/HAEC). Immunohistochemical analysis showed a significant 41% and 60% decrease in median number of nNOS-IR myenteric neurons per ganglion in HSCR with OS as compared to HSCR with HAEC/diarrhoea (without OS) and HSCR without complications (p = 0.0095; p = 0.002, respectively). Paracellular and transcellular permeability was significantly increased in HSCR with HAEC as compared to HSCR with OS/diarrhoea without HAEC (p = 0.016; p = 0.009) and HSCR without complications (p = 0.029; p = 0.017). This pilot study supports the hypothesis that modulating neuronal phenotype and enhancing IEB permeability may treat or prevent postoperative complications in HSCR.

International audience; Cooking-induced conversion of starch, the major carbohydrate in pulses, is crucial for the digestibility of the seed. The gelatinization-melting transition of lentil, bean and chickpea starches was studied using Differential Scanning Calorimetry at different temperatures (T values ranged from 20 to 160 ◦C) and water contents (X from 0.2 to 3 kg kg 1 db). Gelatinization and melting endotherms were successfully modeled as two desummed Gaussian functions. This modeling enabled to generate the degree of starch conversion for any T and X conditions, a valuable indicator that could be used in predictive cooking models. As previously reported for melting, the temperature of gelatinization was found to depend on moisture in a way that can be modeledusing the FloryHuggins equation. The results suggest that starch undergoes melting transition irrespective of water content. The similar starch conversion diagram for the three pulses suggest that starches have similar thermal behavior.

International audience; The physiopathology of digestive disorders in patients with spinal cord injury (SCI) remains largely unknown, particularly the involvement of the enteric nervous system (ENS). We aimed in a rat model of chronic thoracic SCI to characterize (1) changes in the neurochemical coding of enteric neurons and their putative consequences upon neuromuscular response, and (2) the inflammatory response of the colon. Ex vivo motility of proximal and distal colon segments of SCI and control (CT) rats were studied in an organ chamber in response to electrical field stimulation (EFS) and bethanechol. Immunohistochemical analysis of proximal and distal segments was performed using antibodies again Hu, neuronal nitric oxide synthase, (nNOS), and choline acetyltransferase. Colonic content of acetylcholine and acetylcholinesterase was measured; messenger RNA (mRNA) expression of inflammatory cytokines was measured using reverse transcription quantitative polymerase chain reaction (RT-qPCR) approaches. Compared with the CT rats, the contractile response to bethanechol was significantly decreased in the proximal colon of SCI rats but not in the distal colon. The proportion of nNOS immunoreactive (IR) neurons was significantly reduced in the proximal but not distal colon of SCI rats. No change in proportion of choline acetyltransferase (ChAT)-IR was reported; the tissue concentration of acetylcholine was significantly decreased in the proximal colon of SCI rats. The expression of tumor necrosis factor alpha (TNF-α) and intercellular adhesion molecule-1 (ICAM-1) was significantly reduced in the proximal and distal colon of SCI rats. This study demonstrates that functional motor and enteric neuroplastic changes affect preferentially the proximal colon compared with the distal colon. The underlying mechanisms and factors responsible for these changes remain to be discovered.

Introduction: Many studies, including the HYENA and the DEBATS studies, showed a significant association between aircraft noise exposure and the risk of hypertension. Few studies have considered aircraft noise annoyance and noise sensitivity as factors of interest, especially in relation to hypertension risk, or as mediating or modifying factors. The present study aims 1) to investigate the risk of hypertension in relation to aircraft noise annoyance or noise sensitivity; and 2) to examine the role of modifier or mediator of these two factors in the association between aircraft noise levels and the risk of hypertension. Methods: This study included 6,105 residents of ten European airports from the HYENA and DEBATS studies. Information on aircraft noise annoyance, noise sensitivity, and demographic, socioeconomic and lifestyle factors was collected during an interview performed at home. Participants were classified as hypertensive if they had either blood pressure levels above the WHO cut-off points or physician-diagnosed hypertension in conjunction with the use of antihypertensive medication. Outdoor aircraft noise exposure was estimated for each participant's home address. Poisson regression models with adjustment for potential confounders were used. Interactions between noise exposure and country were tested to consider possible differences between countries. Results: An increase in aircraft noise levels at night was weekly but significantly associated with an increased risk of hypertension (RR = 1.03, 95% CI 1.01–1.06 for a 10-dB(A) increase in Lnight). A significant association was found between aircraft noise annoyance and hypertension risk (RR = 1.06, 95%CI 1.00–1.13 for highly annoyed people compared to those who were not highly annoyed). The risk of hypertension was slightly higher for people highly sensitive to noise compared to people with low sensitivity in the UK (RR = 1.29, 95%CI 1.05-1.59) and in France (RR = 1.11, 95%CI 0.68-1.82), but not in the other countries. The association between aircraft noise levels and the risk of hypertension was higher among highly sensitive participants (RR = 1.00, 95%CI 0.96–1.04; RR = 1.03, 95%CI 0.90–1.11; RR = 1.12, 95%CI 1.01–1.24, with a 10-dB(A) increase in Lnight for low, medium, and high sensitive people respectively) or, to a lesser extent, among highly annoyed participants (RR = 1.06, 95%CI 0.95-1.18 for a 10-dB(A) increase in Lnight among highly annoyed participants, and RR = 1.02, 95%CI 0.99–1.06 among those not highly annoyed). Conclusions: The present study confirms findings in the small number of available studies to date suggesting adverse health effects associated with aircraft noise annoyance and noise sensitivity. The findings also indicate possible modifier effects of aircraft noise annoyance and noise sensitivity in the relationship between aircraft noise levels and the risk of hypertension. However, further investigations are needed to better understand this role using specific methodology and tools related to mediation analysis and causal inference. © 2020

Interest in the different surgical approaches to total hip arthroplasty remains high, but without any real consensus on which approach is the most beneficial. Several recent technical innovations have made it possible to reduce the risk of dislocation, therefore improving the efficacy of the posterolateral approach. Since 2003, we have been using a modified minimally invasive posterolateral approach called SPARTAQUUS (Spare the Piriformis And Respect The Active QUadratus femoris and gluteus mediUS), which spares the piriformis tendon, the quadratus femoris muscle and the gluteus medius muscle, and involves direct capsular repair. The "active posterosuperior hammock" effect of the piriformis tendon is therefore coupled with the "passive posterosuperior hammock" effect of the capsular repair, thus limiting the risks of posterior dislocation of the prosthetic hip joint.

Dispersion of light waves is well known, but the subject deserves some comments. Certain classical equations do not fully respect causality; as an example, group velocity vg is usually given as the first derivative of the angular frequency ω with respect to the angular spatial frequency km (or wavenumber) in the medium, whereas it is km that depends on ω. This paper also emphasizes the use of phase index n and group index ng, as inverse of their respective velocities, normalized to 1/c, the inverse of free-space light velocity. This clarifies the understanding of dispersion equations: group dispersion parameter D is related to the first derivative of ng with respect to wavelength λ, whilst group velocity dispersion GVD is also related to the first derivative of ng, but now with respect to angular frequency ω. One notices that the term second order dispersion does not have the same meaning with λ, or with ω. In addition, two original and amusing geometrical constructions are proposed; they simply derive group index ng from phase index n with a tangent, which helps to visualize their relationship. This applies to bulk materials, as well as to optical fibers and waveguides, and this can be extended to birefringence and polarization mode dispersion in polarization-maintaining fibers or birefringent waveguides.

In case reports or small studies, percutaneous endoscopic caecostomy (PEC) has been proposed as an alternative to the Malone intervention to perform antegrade colonic enemas. Our goal was to assess the feasibility, efficacy, and tolerance of PEC in a large group of patients with refractory colorectal functional disorders. From September 2006 to April 2014, all patients undergoing PEC for constipation, fecal incontinence, and incontinence after rectal resection in two expert centers were studied. The PEC procedure consisted in anchoring the caecum to the abdominal wall (caecopexy) and placing a specifically designed tube in the colonic lumen to perform antegrade enemas. The quality of life (GIQLI), constipation (Kess), and incontinence (Cleveland) scores were assessed before PEC and at 3, 6, 12, and 24 months. A total of 69 patients were included. GIQLI scores were significantly improved in constipation group (n = 43), incontinence group (n = 19), and rectal resection group (n = 10). In the constipation group, Kess score decreased from 25.9 before PEC to 20.6 at 2 years (p = 0.01). In the incontinence and post-rectal resection groups, Cleveland scores decreased from 14.3 before PEC to 2.7 at 6 months (p = 0.01) and to 10.4 at 2 years (p = 0.04). Overall, PEC was considered successful by patients in 58%, 74%, and 90% of cases, in constipation, incontinence, and rectal resection groups, respectively. Chronic pain (52%) at the catheter site was the most frequent complication. Percutaneous endoscopic caecostomy for antegrade colonic enemas improves significantly the quality of life of patients with colorectal disorder refractory to medical treatment.

International audience; Background: Pressure ulcer risk assessment provides an indicator of quality of care in French health establishments. The reliability and validity of assessment tools have been shown to be lower for people with spinal cord injury (SCI). We hypothesized that skin complications would be less frequent in people with traumatic SCI and tetraplegia (TSCIt), who were initially managed in French regions with a high level of specialized SCI rehabilitation experience.Methods: First, we used the most recent French territorial survey about SCI to determine a 'Level of Regional Experience (LRE) in Specialized Physical Medicine and Rehabilitation'. We then studied the individual variables reported in the Tetrafigap survey (which compiled a cohort of TSCIts people to assess their trajectory and life conditions following their return to community life by questionnaires) using univariate analysis according to these LREs (chi2 test using a significance threshold of P < 0.05). Finally, we performed a series of logistic regressions to determine the link between LREs and pressure ulcers.Results: Management in high-LRE regions was linked with a lower declaration of pressure ulcers during early treatment and in the long term (on average, 8 years post-trauma).Conclusions: Using pressure ulcers as a marker, our study showed the protective element of regional experience in the early management of TSCIts patients. A dilution effect between SCI specialized units and more polyvalent physical medicine and rehabilitation departments should be prevented within each region within the scope of a regional organization that would link referral centres and local health care networks.

Resume Introduction La prevalence des tumeurs de vessie (TV) chez les patients neurologiques semble similaire a celle de la population generale, mais les formes histologiques sont differentes avec une predominance de formes agressives, notamment epidermoides et infiltrantes. L’objectif de notre etude etait de rapporter les etiologies, la prise en charge et l’evolution des TV dans cette population. Materiel et methode Les dossiers des patients neurologiques ayant presente une TV entre 2004 et 2017 ont ete revus retrospectivement. Les donnees suivantes ont ete relevees : âge, sexe, duree d’evolution de la maladie, mode de decouverte, type histologique, traitement et evolution. Resultats Les dossiers de 27 patients ont ete retenus. Les vessies neurologiques concernaient 11 blesses medullaires, 7 maladies de Parkinson, 5 scleroses en plaques, 3 traumatises crâniens, 3 accidents vasculaires cerebraux, 2 paralysies cerebrales et 1 spina bifida. Les types histologiques etaient repartis ainsi : 22 carcinomes urotheliaux, 4 carcinomes epidermoides, un mucineux, un sarcomatoide et un neuroendocrine avec 19 tumeurs de haut grade et 15 tumeurs infiltrantes au diagnostic. Sept patients (26 %) ont presente une TV avant 15 ans d’evolution de la pathologie neurologique. Le recul median etait de 14 mois (1–210 mois) avec 8 deces dont 5 lies au cancer. Le tabac, le mode mictionnel ou les antecedents lithiasiques et infectieux ne semblaient pas lies a la survenue de cancer epidermoide. Conclusion Le stade avance au diagnostic et le caractere agressif des TV dans cette population justifient un suivi neuro-urologique rapproche, y compris avant 15 ans d’evolution de la pathologie neurologique. Niveau de preuve 4.

Introduction et objectifs A l’occasion du 500e anniversaire de la mort de Leonard de Vinci, nous nous sommes interesses a son travail d’anatomiste. Il s’est interesse a l’anatomie des ventricules cerebraux. Il en a realise un moulage sur des cerveaux ovins, a l’aide de cire d’abeille chauffee, afin de mieux comprendre leur structure. Nous n’avons pas la preuve a ce jour qu’il l’ait realise sur des cerveaux humains. Notre objectif etait de reproduire un moulage de la filiere ventriculaire sur un cerveau humain, selon la methode decrite par Leonard au XVIe siecle. Materiels, patients et methodes Nous avons travaille sur six corps du centre de don de Brest. Notre methode de moulage necessitait quatre temps. Le premier permettait la conservation des tissus par une solution de Winckler. Le deuxieme temps, consistait en la realisation de deux trous de trepan de chaque cote de la ligne mediane, afin de ponctionner les ventricules lateraux. Le troisieme temps etait dedie a la ponction du quatrieme ventricule, et l’injection de cire chaude en son sein. Le moulage en cire durcie etait alors recupere lors de la dissection de l’encephale. Resultats Nous sommes parvenus a realiser differents moulages de la filiere ventriculaire, permettant ainsi de representer les quatre ventricules en trois dimensions. Conclusion Bien que difficile a realiser, la methode decrite par Leonard de Vinci, c’est-a-dire la ponction du quatrieme ventricule, semble etre la plus efficace en termes de remplissage de la filiere ventriculaire. Cependant, il nous a ete necessaire d’utiliser les moulages de differents sujets pour reconstituer une filiere ventriculaire complete. Il est donc licite de s’interroger sur le nombre de moulages realises par Leonard pour parvenir a decrire cette anatomie.

Objectif L’atropine est proposee dans le traitement de la sialorrhee d’origine neurologique. Cependant, en l’absence de la forme galenique sublinguale dediee a cette indication, la forme collyre est utilisee hors AMM. Nous rapportons un cas d’intoxication apres erreur d’administration. Methode Il s’agit d’un homme de 48 ans atteint d’un syndrome d’enfermement traite par atropine 1 % (2 gouttes le matin en sublingual). Suite a l’administration de 4 mg au lieu de 1 mg d’atropine, il a presente un syndrome anticholinergique (flush, mydriase bilaterale, hyperemie conjonctivale). Deux prelevements sanguins ont ete realises 12 et 24 h apres l’intoxication presumee et une cinetique a 6 temps (H0,25, H0,5, H1, H2, H4, H5) a ete effectuee trois jours apres, lors de la reintroduction du traitement a 1 mg/jour. La quantification de l’atropine dans le plasma a ete realisee par chromatographie liquide couplee a la spectrometrie de masse en tandem (TSQ Vantage, Thermofisher®) apres extraction liquide-liquide. La methode a ete validee selon les recommandations de l’Agence Europeenne du Medicament (EMA). Les parametres pharmacocinetiques (PK) ont ete calcules grâce au logiciel Micropharm (version 5.2). Resultats La concentration d’atropine mesuree a H12 et a H24 etaient de 6 et Discussion Nous decrivons pour la premiere fois le profil pharmacocinetique de l’atropine apres administration sublinguale suite a une intoxication. Les dosages plasmatiques ont permis d’objectiver le passage systemique de l’atropine administree en sublingual. Le Tmax chez ce patient a ete evalue a 1 heure. Une etude similaire a decrit un pic plus precoce a 15 minutes apres administration de 2 mg d’atropine chez des volontaires sains [1] . Cette observation suggere une variabilite inter-individuelle possiblement liee a l’etat pathologique du patient. La demi-vie d’elimination courte estimee chez ce patient a 1,85 h et associee a une concentration plasmatique d’atropine mesuree tardivement (H12) a 6 ng/mL semblent evoquer une concentration initiale plus elevee d’ordre toxique pouvant expliquer les symptomes observes. Dans l’etude citee precedemment, des signes d’atropinisation ont ete observes chez les volontaires sains meme a concentrations therapeutiques (2–25 ng/mL). En effet, malgre de nombreux cas d’intoxication a l’atropine recenses dans la litterature, aucune relation dose/concentration/effet n‘a ete definie. Conclusion L’utilisation hors AMM de collyre a l’atropine par voie sublinguale est a risque d’intoxication d’une part par l’utilisation d’une forme galenique non adaptee a l’origine d’un surrisque d’erreur d’administration et d’autre part par le passage systemique et rapide de la molecule par cette voie. Des etudes plus importantes s’averent donc necessaires pour evaluer l’efficacite et l’innocuite de l’atropine administree par voie sublinguale et definir des schemas therapeutiques en lien avec la PK du produit.

The new NIKA2 camera at the IRAM 30m radiotelescope was used to observe three known debris disks in order to constrain the SED of their dust emission in the millimeter wavelength domain. We have found that the spectral index between the two NIKA2 bands (1mm and 2mm) is consistent with the Rayleigh-Jeans regime (lambda^{-2}), unlike the steeper spectra (lambda^{-3}) measured in the submillimeter-wavelength domain for two of the three disks $-$ around the stars Vega and HD107146. We provide a succesful proof of concept to model this spectral inversion in using two populations of dust grains, those smaller and those larger than a grain radius a0 of 0.5mm. This is obtained in breaking the slope of the size distribution and the functional form of the absorption coefficient of the standard model at a0. The third disk - around the star HR8799 - does not exhibit this spectral inversion but is also the youngest., Comment: 6 pages, 8 figures, to appear in the proceedings of the international conference entitled mm Universe @ NIKA2, Grenoble (France), June 2019, EPJ Web of conferences

Background: Many studies have demonstrated adverse effects of exposure to aircraft noise on health. Possible biological pathways for these effects include hormonal disturbances. Few studies deal with aircraft noise effects on saliva cortisol in adults, and results are inconsistent. Objective: We aimed to assess the effects of aircraft noise exposure on saliva cortisol levels and its variation in people living near airports. Methods: This study focused on the 1300 residents included in the HYENA and DEBATS cross-sectional studies, with complete information on cortisol sampling. All the participants followed a similar procedure aiming to collect both a morning and an evening saliva cortisol samples. Socioeconomic and lifestyle information were obtained during a face-to-face interview. Outdoor aircraft noise exposure was estimated for each participant's home address. Associations between aircraft noise exposure and cortisol outcomes were investigated a priori for male and female separately, using linear regression models adjusted for relevant confounders. Different approaches were used to characterize cortisol levels, such as morning and evening cortisol concentrations and the absolute and relative variations between morning and evening levels. Results: Statistically significant increases of evening cortisol levels were shown in women with a 10-dB(A) increase in aircraft noise exposure in terms of LAeq, 16h (exp(β) = 1.08; CI95% = 1.00-1.16), Lden (exp(β) = 1.09; CI95% = 1.01-1.18), Lnight (exp(β) = 1.11; CI95% = 1.02-1.20). A statistically significant association was also found in women between a 10-dB(A) increase in terms of Lnight and the absolute variation per hour (exp(β) = 0.90; CI95% = 0.80-1.00). Statistically significant decreases in relative variation per hour were also evidenced in women, with stronger effects with the Lnight (exp(β) = 0.89; CI95% = 0.83-0.96) than with other noise indicators. The morning cortisol levels were unchanged whatever noise exposure indicator considered. There was no statistically significant association between aircraft noise exposure and cortisol outcomes in men. Conclusions: The results of the present study show statistically significant associations between aircraft noise exposure and evening cortisol levels and related flattening in the (absolute and relative) variations per hour in women. Further biological research is needed to deepen knowledge of the pathway between noise exposure and disturbed hormonal regulation, and specially the difference in effects between genders. © 2019 The Author(s).

Introduction The objective of the study is to analyse complications associated with surgery for pelvic pressure ulcers in terms of their frequency, nature and rate of surgical revisions. The secondary aims are to analyse the rate of recurrence, length of stay and time to healing, and to determine factors associated with complications and recurrence. Methods It is a single-centre, retrospective cohort study with a 10-year follow-up setting in Nantes University Hospital, France, a specialist centre for spinal cord injury (SCI). All patients who were admitted to the Neurological Physical Medicine and Rehabilitation (PMR) department for surgery (flap coverage) for pelvic pressure ulcers between 1st of January 2004 and 30th September 2014 were included. The main outcome measures were the rate of complications, rate of recurrence, length of stay and time to healing, as well as factors associated with complications and recurrence. Results One hundred and sixty-six patients underwent 252 flap procedures in 239 operations. The majority of patients had SCI (78.3%). The ulcer sites were mainly ischial (67%), sacral (20%) and trochanteric (12%). Gluteus maximus was used most often (75.3% of flaps) (ischial and sacral ulcers), followed by tensor fascia lata (16.2%) (trochanteric ulcers). The rate of complications that delayed return to wheelchair at 6 weeks was 34.5%. The factors associated with complications were more than one surgical ulcer and drainage time greater than 10 days. The rate of recurrence was 20.04%. The factors related to recurrence were young age, scoliosis and an oblique pelvis. Conclusions Management within a specialised medical-surgical pathway limited post-operative complications and recurrences in this sample of subjects who mostly had SCI.

Taking advantage of the development of optical-fiber communication technologies, the fiber-optic gyroscope (often abbreviated FOG) started to be investigated in the mid-1970s, opening the way for a fully solid-state rotation sensor. It was firstly seen as dedicated to medium-grade applications ( 1 ° / h range), but today, it reaches strategic-grade performance ( 10 − 4 ° / h range) and surpasses its well-established competitor, the ring-laser gyroscope, in terms of bias noise and long-term stability. Further progresses remain possible, the challenge being the ultimate inertial navigation performance of one nautical mile per month corresponding to a long-term bias stability of 10 − 5 ° / h . This paper is also the opportunity to recall the historical context of Sagnac's experiment, the origin of all optical gyros.

Introduction Sleep apnea syndrome (SAS) frequently occurs after a stroke. Its association with a poor prognosis is open to discussion. Objective To study, in a physical and rehabilitation medicine (PRM) unit, the possible repercussions of SAS on neurological and functional recovery as well as attentional abilities following a stroke. Patients and methods Forty-five patients, all of whom had recently had a stroke without previously documented SAS, were screened using the ApneaLink® system. An apnea-hypopnea index (AHI) score ≥10 was considered as indicative of SAS. The NIHSS, Fugl-Meyer (FM) and Functional Independence Measure (FIM) Scales were applied on admission and at two months as means of assessing neurological and functional recovery, which was expressed by the difference between the first and the second scores (delta FM, delta NIHSS, delta FIM). The Battery Attention William Lennox (BAWL) Test was given once in order to evaluate attention disorders. SAS severity was categorized according to the AHI. We compared the groups formed (mild, moderate and severe) using the same method. Results Twenty-eight patients (62.2%) presented AHI ≥ 10. Stroke characteristics were comparable in the SAS+ and the SAS– groups, with average post-stroke time lapse of 26 days, initial average FIM score of 71.2 points ± 26.3 and initial average NIHSS score of 8.9 ± 4.9. The demographic characteristics of the two groups were likewise comparable with the exception of age, as the SAS+ group was pronouncedly older (65.4 vs. 53.5 years). As for delta FIM, which evaluated functional recovery, it averaged 31.8 ± 20.6. Cases of SAS were found to be mild (37.1%), moderate (28.6%) or severe (34.3%). No significant difference was observed on admission or at 2 months as regards the clinical scales or the BAWL test between the two groups or according to severity, except for the NIHSS score at 2 months in the severe sub-group. Discussion and conclusion This study did not demonstrate the supposed repercussions of SAS on the recovery or attentional abilities of post-stroke patients. The tests were maybe given too early; they should take place at a lengthier time interval after the stroke, and also to be more complete.

International audience; Steroidogenic factor 1 (encoded by SF1/NR5A1) is a transcription factor with multiple target genes involved in the development and function of multiple steroidogenic and non-steroidogenic tissues. NR5A1 mutations lead to several phenotypes, including sex reversal, spermatogenesis failure, premature ovarian failure and adrenocortical insufficiency. The implication of NR5A1 mutations in spleen development anomalies was recently highlighted. We provide new evidence of this involvement, describing a novel heterozygous non-sense NR5A1 mutation in a 46,XY-DSD with polysplenia female proband and her father, who had hypospadias and asplenia.

Introduction The results of total hip arthroplasty (THA) in congenital dislocation of the hip (CDH) are well known, but such is not the case for the impact of prior conservative surgery on THA function and survivorship. The present study compared THA in CDH with prior conservative bone surgery (BS group) versus no prior bone surgery (NBS group), to (1) assess the impact of prior conservative surgery on function and survivorship after THA, and (2) determine whether a particular type of conservative surgery affected function or survivorship. Hypothesis Prior conservative surgery for CDH does not affect function or survivorship of subsequent THA. Patients and methods A multicenter retrospective case-control study analyzed 430 THAs in CDH patients (332 patients: 269 female, 63 male; mean age, 56 years [range, 17–80 years]) at a mean 13.2 ± 5.4 years’ follow-up (range, 1–29 years). The BS group included 159 hips (37%) (64 pelvic, 81 femoral and 14 combined pelvic and femoral osteotomies), and the NBS group 271 (63%). Groups were comparable for gender, age at surgery, Devane activity score, preoperative Postel Merle d’Aubigne (PMA) functional score and CDH radiographic type following Crowe. Results At follow-up, PMA scores were comparable: BS, 16.8 ± 1.4 (11–18); NBS, 16.9 ± 1.5 (7–18). Fifteen-year survivorship censored for implant revision for whatever reason did not significantly differ: BS, 87% (95% CI: 83–91%); NBS, 89% (95% CI: 86–92%). Ten-year survivorship on the same criterion did not significantly differ according to type of prior surgery: hip shelf arthroplasty, 97% (95% CI: 95–99%); Chiari osteotomy, 100%; femoral osteotomy, 95% (95% CI: 92–98%); and Milch osteotomy 96% (95% CI: 93–99%). Discussion/Conclusion Conservative surgery for CDH does not impair the functional results or survivorship of subsequent THA. Level of evidence III, case-control study.

Resume Introduction La maladie luxante de hanche (MLH) pose de difficiles problemes de prise en charge a l’âge adulte. La strategie chirurgicale repose notamment sur une evaluation radiologique des lesions. Il existe dans la litterature anglo-saxonne plusieurs classifications evaluees mais la classification francaise dite de Cochin n’a ete que tres peu etudiee. Son interet principal reside dans sa capacite a decrire finement les lesions en raison du nombre eleve de classes qui la constituent. L’hypothese etait que la reproductibilite intra- et inter-observateurs de la classification dite de Cochin modifiee SOFCOT etait equivalente a celle des classifications de Crowe et d’Hartofilakidis. Materiel et methodes Cinq chirurgiens orthopedistes francophones experts de la MLH ont classe deux fois, selon Crowe (Cr), Hartofilikadis (Ha) et Cochin modifiee (Co), 94 radiographies de bassin de face correspondant a 179 hanches lors de deux tours de lecture a un mois d’intervalle. L’analyse de la reproductibilite intra-observateur a ete effectuee par le calcul des coefficients ponderes Kappa et de concordance. L’analyse de la reproductibilite inter-observateur a ete effectuee par le calcul du coefficient Kappa multi juges sur chacune des deux series de donnees. Resultats Concernant la reproductibilite intra-observateur, on retrouve (intervalle de confiance de 95 %) des coefficients de concordance ponderes moyens de [88,62 ; 94,52] pour Cr, [89,43 ; 93,80] pour Ha et [92,14 ; 95,71] pour Co. Les coefficients Kappa ponderes moyens sont de [0,70 ; 0,85] pour Cr, [0,67 ; 0,82] pour Ha et [0,75 ; 0,83] pour Co. Concernant la reproductibilite inter-observateur, on retrouve respectivement pour chaque tour un Kappa de 0,57 et 0,48 pour Cr, 0,43 et 0,44 pour Ha et 0,43 et 0,37 pour Co. Discussion La classification de Cochin modifiee presente une reproductibilite intra- et inter-observateurs identiques a celle des classifications de Crowe et Hartofilakidis. L’avantage theorique de cette classification en termes de planification operatoire devra etre confirme a posteriori par une confrontation avec les constatations anatomiques, obtenues en peroperatoire. Niveau de preuve avec le type d’etude IV.

Contents Embryonic diapause is an evolutionary strategy to ensure that offspring are born when maternal and environmental conditions are optimal for survival. In many species of carnivores, obligate embryonic diapause occurs in every gestation. In mustelids, the regulation of diapause and reactivation is influenced by photoperiod, which then acts to regulate the secretion of pituitary prolactin. Prolactin in turn regulates ovarian steroid function. Reciprocal embryo transplant studies indicate that this state of embryonic arrest is conferred by uterine conditions and is presumed to be due to a lack of specific factors necessary for continued development. Studies of global gene expression in the mink (Neovison vison) revealed reduced expression of a cluster of genes that regulate the abundance of polyamines in the uterus during diapause, including the rate-limiting enzyme in polyamine production, ornithine decarboxylase (ODC). In addition, in this species, in vivo inhibition of the conversion of ornithine to the polyamine, putrescine, induces a reversible arrest in embryonic development and an arrest in both trophoblast and inner cell mass proliferation in vitro. Putrescine, at 0.5, 2 and 1,000 μM concentrations induced reactivation of mink embryos in culture, indicated by an increase in embryo volume, observed within five days. Further, prolactin induces ODC1 expression in the uterus, thereby regulating uterine polyamine levels. These results indicate that pituitary prolactin acts on ovarian and uterine targets to terminate embryonic diapause. In summary, our findings suggest that the polyamines, with synthesis under the control of pituitary prolactin, are the uterine factor whose absence is responsible for embryonic diapause in mustelid carnivores.

Introduction et but de l’etude L’agression et les deficits (deglutition, cognitifs, moteurs) expliquent que les patients handicapes neuro-moteurs admis en reeducation post-reanimation (SRPR) soient a risque de denutrition. De plus, de faibles niveaux d’activite physique et les modifications de la composition corporelle sont associes a des anomalies metaboliques. Dans cette etude, l’etat nutritionnel et le profil metabolique des patients a l’admission et a la sortie de SRPR adulte, ainsi que les differences selon les groupes etiologiques et les modes d’assistance nutritionnelle et ventilatoire, ont ete investigues en tenant compte des fortes contraintes d’exploration de ces patients fragiles. Materiel et methodes Une evaluation clinique et anthropometrique, des dosages biochimiques et hormonaux, une estimation des besoins energetiques ainsi qu’un recueil des apports proteino-energetiques ont etaient realises chez 65 patients (50H, 15F) d’âge 45(± 18)ans a l’admission et a la sortie de SRPR sur une periode de 12 mois. La duree moyenne de sejour en SRPR etait de 27(± 20)j. Les criteres utilises pour le diagnostic de denutrition et de syndrome metabolique etaient ceux de la HAS et de l’OMS respectivement. La resistance a l’insuline a ete calculee par l’Homeostasis Model Assessment for insulin resistance (HOMA-IR, seuil a 2,4). Les patients ont ete divises en sous-groupes selon la presence (n = 44) ou non d’une tracheotomie et/ou d’une gastrostomie (n = 32) et selon l’etiologie (traumatisme crânien [TC] [n = 22], AVC [n = 16], autres [n = 27]). Les donnees ont ete analysees de facon descriptive et comparative. Resultats et analyse statistique La prevalence de la denutrition etait de 33 % a l’admission et de 14 % a la sortie (p Conclusion Les prevalences de la denutrition et de l’insulinoresistance des patients handicapes neuromoteur admis en SRPR sont eleves. L’etat nutritionnel et l’autonomie alimentaire est ameliore a la sortie, notamment chez ceux ayant necessite une assistance nutritionnelle par gastrostomie. Une evaluation et un controle periodique de l’etat nutritionnel et metabolique sont donc fortement recommandes afin d’accompagner le besoin en assistance nutritionnelle.

Taking advantage of the development of optical-fiber communication technologies, the fiber-optic gyroscope started to be investigated in the mid 1970s, opening the way for a fully solid-state rotation sensor. It was firstly seen as dedicated to medium-grade applications, but today, it reaches strategic-grade performance and surpasses its well-established competitor, the ring-laser gyroscope, in terms of bias noise and long-term stability. Further progresses remain possible, the challenge being the ultimate inertial navigation performance of one nautical mile per month corresponding to a long-term bias stability of 10 −5 °/h.

The study of prestellar cores starts with establishing their density and temperature structures. To explore the densest part, deu-terated species, N-bearing molecules, or dust are usually considered. Among prestellar cores, IRAS16293E is a rare case of a core being perturbed by the outflow of a nearby protostar (IRAS16293-2422 A/B). A part of the outflow hits the core and heats it, introducing a temperature gradient that makes the analysis difficult. It is only after having gathered observations from Spitzer, Herschel, SCUBA, MAMBO, and of various molecular lines from CSO, APEX, JCMT and IRAM that a clearer picture of this core has finally arisen.

This 40th anniversary is the opportunity to recall how fascinating is the fiber-optic gyro with its potential perfection. Pure unaided strapdown inertial navigation yielding drift of less than one nautical mile in a month has been demonstrated in a laboratory. This paper also adds several comments about points that could be better known and should be outlined.

Brominated flame retardants (BFRs) are stable environmental contaminants known to exert endocrine-disrupting effects. Developmental exposure to polybrominated diphenyl ethers (PBDEs) is correlated with impaired thyroid hormone signaling, as well as estrogenic and anti-androgenic effects. As previous studies have focused on a single congener or technical mixture, the purpose of the current study was to examine the effects of gestational and early postnatal exposure to an environmentally relevant mixture of BFRs designed to reflect house dust levels of PBDEs and hexabromocyclododecane on postnatal developmental outcomes. Pregnant Sprague-Dawley rats were exposed to the PBDE mixture from preconception to weaning (PND 21) through the diet containing 0, 0.75, 250, and 750 mg mixture/kg diet. BFR exposure induced transient reductions in body weight at PND 35 in male and from PND 30-45 in female offspring (250 and 750 mg/kg). Liver weights (PND 21) and xenobiotic metabolizing enzyme activities (PND 21 and 46) were increased in both male and female offspring exposed to 250 and 750 mg/kg diets. Furthermore, serum T4 levels were reduced at PND 21 in both,male and female offspring (250 and 750 mg/kg). At PND 21, Serum alkaline phosphatase (ALP) was decreased in males exposed to 750 mg/kg dietat, and females exposed to 250 and 750 mg/kg diets. At PND 46 ALP was significantly elevated in males (250 and 750 mg/kg). Variations in the cervical vertebrae and phalanges were observed in pups at PND 4 (250 and 750 mg/kg). Therefore, BFR exposure during gestation through to weaning alters developmental programming in the offspring. The persistence of BFRs in the environment remains a cause for concern with regards to developmental toxicity.

Context. Extinction and emission of dust models need for observational constraints to be validated. The coreshine phenomenon has already shown the importance of scattering in the 3 to 5 micron range and its ability to validate dust properties for dense cores. Aims. We want to investigate whether scattering can also play a role at longer wavelengths and to place even tighter constraints on the dust properties. Methods. We analyze the inversion of the Spitzer 8 micron map of the dense molecular cloud L183, to examine the importance of scattering as a potential contributor to the line-of-sight extinction. Results. The column density deduced from the inversion of the 8 micron map, when we neglect scattering, disagrees with all the other column density measurements of the same region. Modeling confirms that scattering at 8 microns is not negligible with an intensity of several hundred kJy per sr. This demonstrates the need of efficiently scattering dust grains at MIR wavelengths up to 8 microns. Coagulated aggregates are good candidates and might also explain the discrepancy at high extinction between E(J-K) et tau(9.7) toward dense molecular clouds. Further investigation requires considering efficiently scattering dust grains including ices as realistic dust models., Comment: letter 4 main pages, 2 pages of online material, 7 figures

The project Galactic Cold Cores has made Herschel observations of interstellar clouds where the Planck satellite survey has located cold and compact clumps. The sources range from starless clumps to protostellar cores. We examine 116 Herschel fields to estimate the submillimetre dust opacity and its variations. The submillimetre dust opacity was derived from Herschel data, and near-infrared observations of the reddening of background stars are converted into near-infrared optical depth. We studied the systematic errors affecting these parameters and used modelling to correct for the expected biases. The ratio of 250um and J band opacities is correlated with the cloud location and star formation activity. We find a median ratio of tau(250um)/tau(J)= (1.6+-0.2)*10^-3, which is more than three times the mean value in diffuse medium. Assuming a spectral index beta=1.8 instead of beta=2.0, the value would be lower by ~30%. No significant systematic variation is detected with Galactocentric distance or with Galactic height. The tau(250um)/tau(J) maps reveal six fields with clear increase of submillimetre opacity of up to tau(250um)/tau(J) ~ 4*10^-3. These are all nearby fields with spatially resolved clumps of high column density. We interpret the increase in the far-infrared opacity as a sign of grain growth in the densest and coldest regions of interstellar clouds., 28 pages, A&A, in press

The Galactic Cold Cores project has made Herschel observations of 116 fields where the Planck survey has found signs of cold dust emission. The fields contain sources in different environments and different phases of star formation. The dust opacity spectral index beta and the dust colour temperature T are derived using Herschel and Planck data. The relation between beta and T is examined for the whole sample and inside individual fields. Based on IRAS and Planck data, the fields are characterised by a median colour temperature of 16.1 K and a median opacity spectral index of beta=1.84. We observe a clear T-beta anti-correlation. In Herschel observations, constrained at lower resolution by Planck data, the variations follow the column density structure and beta(FIR) can rise to ~2.2 in individual clumps. The Planck 217 GHz band shows a systematic excess that is consistent with a general flattening of the dust emission spectrum at millimetre wavelengths. When fitted separately below and above 700 um, the median spectral index values are beta(FIR) ~ 1.91 and beta(mm) ~ 1.66. The spectral index changes as a function of column density and wavelength. Beta variations are partly masked by temperature gradients and the changes in the intrinsic grain properties may be even greater., Accepted to A&A, 138 pages

The polyamines are ubiquitous polycationic compounds. Over the past 40 yr, investigation has shown that some of these, namely spermine, spermidine, and putrescine, are essential to male and female reproductive processes and to embryo/fetal development. Indeed, their absence is characterized by infertility and arrest in embryogenesis. Mammals synthesize polyamines de novo from amino acids or import these compounds from the diet. Information collected recently has shown that polyamines are essential regulators of cell growth and gene expression, and they have been implicated in both mitosis and meiosis. In male reproduction, polyamine expression correlates with stages of spermatogenesis, and polyamines appear to function in promoting sperm motility. There is evidence for polyamine involvement in ovarian follicle development and ovulation in female mammals, and polyamine synthesis is required for steroidogenesis in the ovary. Studies of the embryo indicate a polyamine requirement that can be met from maternal sources before implantation, whereas elimination of polyamine synthesis abrogates embryo development at gastrulation. Polyamines play roles in embryo implantation, in decidualization, and in placental formation and function, and polyamine privation during gestation results in intrauterine growth retardation. Emerging information implicates dietary arginine and dietary polyamines as nutritional regulators of fertility. The mechanisms by which polyamines regulate these multiple and diverse processes are not yet well explored; thus, there is fertile ground for further productive investigation.

Embryonic diapause is the reversible arrest of embryo development prior to implantation under a regime of uterine control that is not well understood. Our objective was to explore uterine modifications associated with the emergence of embryonic diapause in the mink, a species in which embryonic diapause characterizes every gestation. We investigated the uterine transcriptome at reactivation using the suppressive subtractive hybridization technique. A library of 123 differentially expressed genes between uteri with blastocysts in diapause and reactivated blastocysts was generated. Among those genes, 41.5% encode for potential secreted products that are implicated in regulation of cell proliferation (14%), homeostasis (14%), protein folding (11%), electron transport chain (8%), and innate immune response (8%), therefore suggesting that these biological processes are implicated in blastocyst reactivation. Two genes, the high-mobility group nucleosome binding domain 1 ( HMGN1), a chromatin remodeling factor, and the secreted protein acidic and cystein-rich ( SPARC), which is implicated in extracellular cell-cell interactions, were submitted to more detailed analysis of expression patterns in the mink uterus at blastocyst reactivation. Expression of both HMGN1 and SPARC was increased significantly in the uterus at embryo reactivation compared with diapause, principally in the endometrial epithelium and subepithelial stroma. These results provide new insight into uterine signaling at the emergence of the blastocyst from diapause and highlight the factors HMGN1 and SPARC as potential inductors of uterine environment modifications underlying uterine signaling during emergence of the embryo from embryonic diapause.