The Phase Diagram of Disordered Vortices from London Langevin Simulations

We study the phase diagram of vortex matter in disordered type-II superconductors. We performed numerical simulations in the London Langevin approximation, using a new realistic representation of the disorder. At low magnetic fields we find a disentangled and dislocation free Bragg-glass regime. Increasing the field introduces disorder-driven entanglement in a discontinuous manner, leading to a vortex-glass phase, which subsequently melts into the vortex liquid. The obtained phase boundaries are in quantitative agreement with the experimental data.Comment: 4 pages, revtex, 8 postscript figures include

Pre-hospital assessment of the role of adrenaline : measuring the effectiveness of drug administration in cardiac arrest (PARAMEDIC-2) : trial protocol

Despite its use since the 1960s, the safety or effectiveness of adrenaline as a treatment for cardiac arrest has never been comprehensively evaluated in a clinical trial. Although most studies have found that adrenaline increases the chance of return of spontaneous circulation for short periods, many studies found harmful effects on the brain and raise concern that adrenaline may reduce overall survival and/or good neurological outcome. The PARAMEDIC-2 trial seeks to determine if adrenaline is safe and effective in out-of-hospital cardiac arrest. This is a pragmatic, individually randomised, double blind, controlled trial with a parallel economic evaluation. Participants will be eligible if they are in cardiac arrest in the out-of-hospital environment and advanced life support is initiated. Exclusions are cardiac arrest as a result of anaphylaxis or life threatening asthma, and patient known or appearing to be under 16 or pregnant. 8000 participants treated by 5 UK ambulance services will be randomised between December 2014 and August 2017 to adrenaline (intervention) or placebo (control) through opening pre-randomised drug packs. Clinical outcomes are survival to 30 days (primary outcome), hospital discharge, 3, 6 and 12 months, health related quality of life, and neurological and cognitive outcomes (secondary outcomes). Trial registration (ISRCTN73485024)

Consumption of fish oil providing amounts of eicosapentaenoic acid and docosahexaenoic acid that can be obtained from the diet reduces blood pressure in adults with systolic hypertension: a retrospective analysis

Background: Although a large number of randomized controlled trials (RCTs) have examined the impact of the n-3 (ω-3) fatty acids EPA (20:5n-3) and DHA (22:6n-3) on blood pressure and vascular function, the majority have used doses of EPA+DHA of > 3 g per d,which are unlikely to be achieved by diet manipulation. Objective: The objective was to examine, using a retrospective analysis from a multi-center RCT, the impact of recommended, dietary achievable EPA+DHA intakes on systolic and diastolic blood pressure and microvascular function in UK adults. Design: Healthy men and women (n = 312) completed a double-blind, placebo-controlled RCT consuming control oil, or fish oil providing 0.7 g or 1.8 g EPA+DHA per d in random order each for 8 wk. Fasting blood pressure and microvascular function (using Laser Doppler Iontophoresis) were assessed and plasma collected for the quantification of markers of vascular function. Participants were retrospectively genotyped for the eNOS rs1799983 variant. Results: No impact of n-3 fatty acid treatment or any treatment * eNOS genotype interactions were evident in the group as a whole for any of the clinical or biochemical outcomes. Assessment of response according to hypertension status at baseline indicated a significant (P=0.046) fish oil-induced reduction (mean 5 mmHg) in systolic blood pressure specifically in those with isolated systolic hypertension (n=31). No dose response was observed. Conclusions: These findings indicate that, in those with isolated systolic hypertension, daily doses of EPA+DHA as low as 0.7 g bring about clinically meaningful blood pressure reductions which, at a population level, would be associated with lower cardiovascular disease risk. Confirmation of findings in an RCT where participants are prospectively recruited on the basis of blood pressure status is required to draw definite conclusions

Host PrP glycosylation: a major factor determining the outcome of prion infection

The expression of the prion protein (PrP) is essential for transmissible spongiform encephalopathy (TSE) or prion diseases to occur, but the underlying mechanism of infection remains unresolved. To address the hypothesis that glycosylation of host PrP is a major factor influencing TSE infection, we have inoculated gene-targeted transgenic mice that have restricted N-linked glycosylation of PrP with three TSE strains. We have uniquely demonstrated that mice expressing only unglycosylated PrP can sustain a TSE infection, despite altered cellular location of the host PrP. Moreover we have shown that brain material from mice infected with TSE that have only unglycosylated PrP(Sc) is capable of transmitting infection to wild-type mice, demonstrating that glycosylation of PrP is not essential for establishing infection within a host or for transmitting TSE infectivity to a new host. We have further dissected the requirement of each glycosylation site and have shown that different TSE strains have dramatically different requirements for each of the glycosylation sites of host PrP, and moreover, we have shown that the host PrP has a major role in determining the glycosylation state of de novo generated PrP(Sc)

L’enfant et la mort dans l’Antiquité III. Le matériel associé aux tombes d’enfants

Ce volume rassemble les communications presentées à la troisième et dernière réunion scientifique organisée dans le cadre du programme « L’enfant et la mort dans l’Antiquité : des pratiques funéraires à l’identité sociale » (EMA), financé par l’Agence nationale de la recherche (ANR) de novembre 2007 à novembre 2011. Les 26 contributions - rédigées en français, en italien ou en anglais - envisagent la question du matériel associé aux tombes d’enfants. Dépose-t-on autant d’objets auprès des tout-petits, des enfants de 6-7 ans et de 12-13 ans ? La nature de ces offrandes varie-t-elle en fonction du sexe ? Dans quelle mesure certaines d’entre elles - « biberons », vases miniatures, astragales, figurines en terre cuite sont-elles caractéristiques des sépultures d’immatures ? Ces questions se posent-elles de la même façon dans les différentes régions du monde méditerranéen et tout au long des douze siècles environ que couvre notre enquête ? Les articles réunis ici envisagent ces problèmes dans un cadre plus large que celui du monde méditerranéen classique - Grèce et Rome -, en intégrant des études relatives à l’Égypte préhellénistique, à Carthage, au monde celtique du Midi et à la Gaule non méditerranéenne. Certaines de ces contributions présentent des découvertes récentes, partiellement ou entièrement inédites.Ce volume rassemble les communications presentées à la troisième et dernière réunion scientifique organisée dans le cadre du programme « L’enfant et la mort dans l’Antiquité : des pratiques funéraires à l’identité sociale » (EMA), financé par l’Agence nationale de la recherche (ANR) de novembre 2007 à novembre 2011. Les 26 contributions - rédigées en français, en italien ou en anglais - envisagent la question du matériel associé aux tombes d’enfants. Dépose-t-on autant d’objets auprès des tout-petits, des enfants de 6-7 ans et de 12-13 ans ? La nature de ces offrandes varie-t-elle en fonction du sexe ? Dans quelle mesure certaines d’entre elles - « biberons », vases miniatures, astragales, figurines en terre cuite sont-elles caractéristiques des sépultures d’immatures ? Ces questions se posent-elles de la même façon dans les différentes régions du monde méditerranéen et tout au long des douze siècles environ que couvre notre enquête ? Les articles réunis ici envisagent ces problèmes dans un cadre plus large que celui du monde méditerranéen classique - Grèce et Rome -, en intégrant des études relatives à l’Égypte préhellénistique, à Carthage, au monde celtique du Midi et à la Gaule non méditerranéenne. Certaines de ces contributions présentent des découvertes récentes, partiellement ou entièrement inédites

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Intérêt du scanner hélical dans l'imagerie de la colique néphrétique (étude prospective comparative avec l'urographie intra veineuse)

AMIENS-BU Santé (800212102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

From `optimal' to `borderline' blood pressure in subjects under chronic antihypertensive therapy

Objectives The ESH2003 report (J Hypertens 2003, 21: 1011-1053) has classified brachial blood pressure into six groups reflecting the consistently increasing cardiovascular risk caused by high blood pressure. Chronically treated hypertensive individuals with well-controlled blood pressure retain higher cardiovascular risk than normotensive untreated individuals. Differences between these groups in arterial stiffness, pressure wave reflections and central blood pressure, which are all predictors of cardiovascular risk independently of peripheral blood pressure, have never been studied. Methods A cohort of 216 treated subjects with controlled hypertension was compared with 105 never-treated normotensive controls, according to the ESH2003 blood pressure groups. Aortic stiffness (pulse wave velocity; PWV), carotid wave reflections (augmentation index; AI) and carotid pressures were measured non-invasively, by pulse wave analysis. Systolic blood pressure (SBP) and pulse pressure (PP) amplification between brachial and carotid arteries were estimated. Results The distribution of subjects in each subgroup of the untreated and treated populations was: ‘optimal’, 21 versus 43; ‘normal’, 44 versus 77; ‘borderline’, 40 versus 96. Brachial blood pressure, carotid SBP and PP did not differ between the two populations, but a constant interaction between blood pressure classification and treatment effect on PWV, AI and blood pressure amplification was found. Compared with untreated subjects, treated subjects had higher AI and lower blood pressure amplification (in the optimal group) and higher PWV (in the borderline group). Conclusion ‘Optimal’ to ‘borderline’ blood pressure control in chronically treated hypertensive individuals is associated with impaired properties of the large and small arteries. These results suggest that antihypertensive treatment strategies with more beneficial effects on arterial properties are needed