249 research outputs found

    Recent trends in the wind-driven California current upwelling system

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    This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordLong-term changes in the marine ecosystems of the Eastern Boundary Upwelling Systems (EBUS) are predicted due to anthropogenic climate change. In particular, global ocean acidification is having a profound effect on the coastal waters of the EBUS, affecting the entire trophic chain, net primary production (NPP) and related economic activities such as fisheries. Another predicted change related to human activity is that of upwelling dynamics with expected long-term changes in upwelling winds as proposed by Bakun (1990), Bakun et al. (2015) and Rykaczewski et al. (2015). Although these predicted long-term changes may emerge only later in the 21st century, this has fueled many studies using historical data. Long-term increase in upwelling winds has thus been a much debated topic, showing that there is considerable uncertainty depending on the EBUS considered, the effect of natural climate fluctuations, the choice of wind dataset, the time period considered, and the methodologies and significance tests applied. Therefore, there is an immediate interest in being able to monitor upwelling using verified and self-consistent wind data sets. This work focused on a sensitivity study of the estimated trends in upwelling winds in the California Current Upwelling System (CCUS), for the most recent period 1996–2018, using the two state-of-the-art satellite wind analyses and two atmospheric model re-analyses. Embedded into the strong modulation by natural climate fluctuations on interannual and decadal time scales, we do see an increase in upwelling-favorable winds in the core of the CCUS, with a local increase of more than 25% in seasonal upwelling transport for the period considered. In this central upwelling zone, a good agreement on stronger equatorward winds for the winter and spring seasons is found between the different datasets, although with different significance levels. Conversely, conflicting results are found in the southernmost part of the CCUS between the satellite analyses and the model reanalyses. Systematic, time-dependent differences are found between the wind products, highlighting the need to further investigate the poorly documented temporal stability of these widely used wind long-term climatology products. The observed spatial structuring of the estimated wind trends is consistent with the trend analysis of water chlorophyll-a, partial pressure of CO2, and basity (pH) analysis products. This result is consistent with changes being important for modulating the carbonate system within the CCUS.European Space Agenc

    Medicosocial outcome after admission in post-intensive care unit at PRM St-Hélier, Rennes

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    IntroductionPost-Intensive Care Units (PICU) are PRM structures aiming to start the appropriated rehabilitative care as early as possible even though persistent complex medical issues.ObjectiveTo assess medicosocial outcomes of patients away from their admission in PICU.MethodsA retrospective descriptive study that included 81 consecutive patients (mean age 51 years) admitted from 2008 to 2012 in the PICU of Pôle St-Helier Rennes based on called semi-structured interviews between March 2014 and March 2015. Exhaustive data (only 4 lost, 5%) by the patient himself and/or a member of family on autonomy, place of life, structures since the release and reintegration, of patients for 85% of them brain damaged.ResultsThere is 29% (21/77) of death (post-exit life: 1,6 years±1.18). Eighty percent live at home (46/56) of which only 5 without family environment, 10% (5/56) in medicosocial structures (foster or nursing homes…), 10% in hospital (hospital at home, persistent vegetative units…). Fourteen percent (8/56) are completely autonomous and work, all with adaptations. Twenty-three percent (13/56) had a significant dependence for activities of daily life and instrumental ones. Forty percent (22/56) have no hobby. Use of different downstream structures, long-term readaptative monitoring, legal and families’ feelings were also analyzed.Discussion and ConclusionMedical and social outcome of patients in the aftermath of a stay in PICU is disparate, depending on the pathology involved, but also the pre-social situation that seems to be the main predictor of returning home. Most patients have regained a relatively large autonomy for the daily life activities but are embarrassed to complex instrumental activities impeding social inclusion. These results are consistent with those of the literature on head trauma patients but no other study has focused for the moment on the specific population of patients admitted to the PICU. We see the value of such early rehabilitative care units with a real impact on the subsequent independence and opportunities back home

    Elastomeric cardiopatch scaffold for myocardial repair and ventricular support

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    [EN] OBJECTIVES: Prevention of postischaemic ventricular dilatation progressing towards pathological remodelling is necessary to decrease ventricular wall deterioration. Myocardial tissue engineering may play a therapeutic role due to its capacity to replace the extracellular matrix, thereby creating niches for cell homing. In this experimental animal study, a biomimetic cardiopatch was created with elastomeric scaffolds and nanotechnologies. METHODS: In an experimental animal study in 18 sheep, a cardiopatch was created with adipose tissue-derived progenitor cells seeded into an engineered bioimplant consisting of 3-dimensional bioabsorbable polycaprolactone scaffolds filled with a peptide hydrogel (PuraMatrix (TM)). This patch was then transplanted to cover infarcted myocardium. Non-absorbable poly(ethyl) acrylate polymer scaffolds were used as controls. RESULTS: Fifteen sheep were followed with ultrasound scans at 6 months, including echocardiography scans, tissue Doppler and spectral flow analysis and speckle-tracking imaging, which showed a reduction in longitudinal left ventricular deformation in the cardiopatch-treated group. Magnetic resonance imaging (late gadolinium enhancement) showed reduction of infarct size relative to left ventricular mass in the cardiopatch group versus the controls. Histopathological analysis at 6 months showed that the cardiopatch was fully anchored and integrated to the infarct area with minimal fibrosis interface, thereby promoting angiogenesis and migration of adipose tissue-derived progenitor cells to surrounding tissues. CONCLUSIONS: This study shows the feasibility and effectiveness of a cardiopatch grafted onto myocardial infarction scars in an experimental animal model. This treatment decreased fibrosis, limited infarct scar expansion and reduced postischaemic ventricular deformity. A capillary network developed between our scaffold and the heart. The elastomeric cardiopatch seems to have a positive impact on ventricular remodelling and performance in patients with heart failure.The RECATABI Project (Regeneration of Cardiac Tissue Assisted by Bioactive Implants) was financially supported by the 7th Framework Programme (FP7) of the European Commission. Project ID: 229239. Funded under FP7-NMP and the European Regional Development Fund (FEDER Spain).Chachques, JC.; Lila, N.; Soler Botija, C.; Martínez-Ramos, C.; Vallés Lluch, A.; Autret, G.; Perier, M.... (2020). Elastomeric cardiopatch scaffold for myocardial repair and ventricular support. European Journal of Cardio-Thoracic Surgery. 57(3):545-555. https://doi.org/10.1093/ejcts/ezz252S545555573Madonna, R., Van Laake, L. W., Botker, H. E., Davidson, S. M., De Caterina, R., Engel, F. B., … Sluijter, J. P. G. (2019). ESC Working Group on Cellular Biology of the Heart: position paper for Cardiovascular Research: tissue engineering strategies combined with cell therapies for cardiac repair in ischaemic heart disease and heart failure. Cardiovascular Research, 115(3), 488-500. doi:10.1093/cvr/cvz010Nielsen, S. H., Mouton, A. J., DeLeon-Pennell, K. Y., Genovese, F., Karsdal, M., & Lindsey, M. L. (2019). Understanding cardiac extracellular matrix remodeling to develop biomarkers of myocardial infarction outcomes. Matrix Biology, 75-76, 43-57. doi:10.1016/j.matbio.2017.12.001Spinale, F. G., Frangogiannis, N. G., Hinz, B., Holmes, J. W., Kassiri, Z., & Lindsey, M. L. (2016). Crossing Into the Next Frontier of Cardiac Extracellular Matrix Research. Circulation Research, 119(10), 1040-1045. doi:10.1161/circresaha.116.309916Chachques, J. C., Pradas, M. M., Bayes-Genis, A., & Semino, C. (2013). Creating the bioartificial myocardium for cardiac repair: challenges and clinical targets. Expert Review of Cardiovascular Therapy, 11(12), 1701-1711. doi:10.1586/14779072.2013.854165Bayés-Genís, A., Gálvez-Montón, C., & Roura, S. (2016). Cardiac Tissue Engineering. Journal of the American College of Cardiology, 68(7), 724-726. doi:10.1016/j.jacc.2016.05.055Shafy, A., Fink, T., Zachar, V., Lila, N., Carpentier, A., & Chachques, J. C. (2012). Development of cardiac support bioprostheses for ventricular restoration and myocardial regeneration. European Journal of Cardio-Thoracic Surgery, 43(6), 1211-1219. doi:10.1093/ejcts/ezs480Castells-Sala, C., Recha-Sancho, L., Llucià-Valldeperas, A., Soler-Botija, C., Bayes-Genis, A., & Semino, C. E. (2016). Three-Dimensional Cultures of Human Subcutaneous Adipose Tissue-Derived Progenitor Cells Based on RAD16-I Self-Assembling Peptide. Tissue Engineering Part C: Methods, 22(2), 113-124. doi:10.1089/ten.tec.2015.0270Martínez-Ramos, C., Rodríguez-Pérez, E., Garnes, M. P., Chachques, J. C., Moratal, D., Vallés-Lluch, A., & Monleón Pradas, M. (2014). Design and Assembly Procedures for Large-Sized Biohybrid Scaffolds as Patches for Myocardial Infarct. Tissue Engineering Part C: Methods, 20(10), 817-827. doi:10.1089/ten.tec.2013.0489Biswas, M., Sudhakar, S., Nanda, N. C., Buckberg, G., Pradhan, M., Roomi, A. U., … Houle, H. (2013). Two- and Three-Dimensional Speckle Tracking Echocardiography: Clinical Applications and Future Directions. Echocardiography, 30(1), 88-105. doi:10.1111/echo.12079Dorsey, S. M., McGarvey, J. R., Wang, H., Nikou, A., Arama, L., Koomalsingh, K. J., … Burdick, J. A. (2015). MRI evaluation of injectable hyaluronic acid-based hydrogel therapy to limit ventricular remodeling after myocardial infarction. Biomaterials, 69, 65-75. doi:10.1016/j.biomaterials.2015.08.011Chachques, J. C. (2009). Cellular cardiac regenerative therapy in which patients? Expert Review of Cardiovascular Therapy, 7(8), 911-919. doi:10.1586/erc.09.84Chachques, J. (1997). Dynamic cardiomyoplasty: clinical follow-up at 12 years. European Journal of Cardio-Thoracic Surgery, 12(4), 560-568. doi:10.1016/s1010-7940(97)00214-5Varela, C. E., Fan, Y., & Roche, E. T. (2019). Optimizing Epicardial Restraint and Reinforcement Following Myocardial Infarction: Moving Towards Localized, Biomimetic, and Multitherapeutic Options. Biomimetics, 4(1), 7. doi:10.3390/biomimetics4010007Van den Borne, S. W. M., Cleutjens, J. P. M., Hanemaaijer, R., Creemers, E. E., Smits, J. F. M., Daemen, M. J. A. P., & Blankesteijn, W. M. (2009). Increased matrix metalloproteinase-8 and -9 activity in patients with infarct rupture after myocardial infarction. Cardiovascular Pathology, 18(1), 37-43. doi:10.1016/j.carpath.2007.12.012Ducharme, A., Frantz, S., Aikawa, M., Rabkin, E., Lindsey, M., Rohde, L. E., … Lee, R. T. (2000). Targeted deletion of matrix metalloproteinase-9 attenuates left ventricular enlargement and collagen accumulation after experimental myocardial infarction. Journal of Clinical Investigation, 106(1), 55-62. doi:10.1172/jci8768Sieminski, A. L., Semino, C. E., Gong, H., & Kamm, R. D. (2008). Primary sequence of ionic self-assembling peptide gels affects endothelial cell adhesion and capillary morphogenesis. Journal of Biomedical Materials Research Part A, 87A(2), 494-504. doi:10.1002/jbm.a.31785Bagó, J. R., Soler-Botija, C., Casaní, L., Aguilar, E., Alieva, M., Rubio, N., … Blanco, J. (2013). Bioluminescence imaging of cardiomyogenic and vascular differentiation of cardiac and subcutaneous adipose tissue-derived progenitor cells in fibrin patches in a myocardium infarct model. International Journal of Cardiology, 169(4), 288-295. doi:10.1016/j.ijcard.2013.09.013Chachques, J. C., Trainini, J. C., Lago, N., Cortes-Morichetti, M., Schussler, O., & Carpentier, A. (2008). Myocardial Assistance by Grafting a New Bioartificial Upgraded Myocardium (MAGNUM Trial): Clinical Feasibility Study. The Annals of Thoracic Surgery, 85(3), 901-908. doi:10.1016/j.athoracsur.2007.10.052Lee, H., Ahn, S., Bonassar, L. J., & Kim, G. (2012). Cell(MC3T3-E1)-Printed Poly(ϵ-caprolactone)/Alginate Hybrid Scaffolds for Tissue Regeneration. Macromolecular Rapid Communications, 34(2), 142-149. doi:10.1002/marc.201200524Strub, M., Van Bellinghen, X., Fioretti, F., Bornert, F., Benkirane-Jessel, N., Idoux-Gillet, Y., … Clauss, F. (2018). Maxillary Bone Regeneration Based on Nanoreservoirs Functionalizedε-Polycaprolactone Biomembranes in a Mouse Model of Jaw Bone Lesion. BioMed Research International, 2018, 1-12. doi:10.1155/2018/7380389Rohman, G., Huot, S., Vilas-Boas, M., Radu-Bostan, G., Castner, D. G., & Migonney, V. (2015). The grafting of a thin layer of poly(sodium styrene sulfonate) onto poly(ε-caprolactone) surface can enhance fibroblast behavior. Journal of Materials Science: Materials in Medicine, 26(7). doi:10.1007/s10856-015-5539-7Spadaccio, C., Nappi, F., De Marco, F., Sedati, P., Taffon, C., Nenna, A., … Rainer, A. (2017). Implantation of a Poly-l-Lactide GCSF-Functionalized Scaffold in a Model of Chronic Myocardial Infarction. Journal of Cardiovascular Translational Research, 10(1), 47-65. doi:10.1007/s12265-016-9718-9Monnet, E., & Chachques, J. C. (2005). Animal Models of Heart Failure: What Is New? The Annals of Thoracic Surgery, 79(4), 1445-1453. doi:10.1016/j.athoracsur.2004.04.002Bellin, G., Gardin, C., Ferroni, L., Chachques, J., Rogante, M., Mitrečić, D., … Zavan, B. (2019). Exosome in Cardiovascular Diseases: A Complex World Full of Hope. Cells, 8(2), 166. doi:10.3390/cells802016

    Promoting ecological solutions for sustainable infrastructure

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    Linear infrastructure networks such as roads, railways, navigation and irrigation canals, and power lines have grown exponentially since the mid-20th century. Most of these networks built before the 1990s have a significant impact on the environment. While there is no doubt that humanity needs infrastructure to ensure safe, secure and sufficient access to food, water and energy, it is essential to prevent the loss of biodiversity and ecosystems which are also at the basis of the provision of such fundamental services. Those complex, interconnected issues cannot be tackled without research and innovation, both in the fields of biodiversity and of infrastructure.IENE (Infrastructure Ecology Network Europe) was set up in 1996 to meet this need. Its mission is to promote the exchange of knowledge, experience and best practice in safe and sustainable pan-European transport infrastructure. With a status of an association today, this independent network has more than 400 members consisting of researchers, engineers, decision makers and infrastructure operators. IENE functions as an international and interdisciplinary forum. It supports cross-border cooperation in research, mitigation, planning, design, construction and maintenance in the field of biodiversity and transport infrastructure.Every two years, IENE organises an international conference to present cutting-edge research, identify pressing issues and problems, discuss effective solutions and map out future activities in the field of transport ecology and infrastructure. We are very glad to present you in this special issue some of the best scientific outcomes of the IENE 2020 conference, hoping that it will contribute to further breakthroughs in science and uptake in policy-making and practices on the ground. We commend the organising team of the University of Evora, Portugal, for their excellent programming of the conference and for having gathered exceptional scientists on the topic of biodiversity and infrastructure. They managed to host a high-quality event, despite the many adjustments that had to be done because of the covid-19, including postponing the conference to January 2021 and holding it entirely online.The topic of IENE conference 2020 was “Linear Infrastructure Networks with Ecological Solutions” and the motto was “working together”. This means that every stakeholder has a role to play, and that biodiversity should be considered at all governance scales and during all phases of the set-up of infrastructure. The papers selected here are of particular interest to follow the path set forth in the conference’s final declaration, that is included in this issue

    Unusual cause of severe toxic methemoglobinemia in an infant: a case report

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    Toxic methemoglobinemia is an uncommon blood disorder induced by exposure to certain oxidizing agents and drugs. In severe cases, this condition may rapidly lead to major cardiopulmonary compromise and constitutes an emergency requiring prompt recognition and early management. We report an unusual case of severe toxic methemoglobinemia following wide cutaneous application of a pomade containing benzocaine, resorcin, and oxyquinoline (Nestosyl®) in an infant

    Paracetamol serum concentrations in preterm infants treated with paracetamol intravenously: a case series

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    <p>Abstract</p> <p>Introduction</p> <p>Until now, studies on paracetamol given intravenously have mainly been performed with the pro-drug propacetamol or with paracetamol in preterm babies above 32 weeks of gestation. Studies in these babies indicate that intravenous paracetamol is tolerated well, however studies on the efficacy of intravenous paracetamol are lacking. There are no pharmacokinetic data on the administration of multiple doses of paracetamol in preterm babies with a gestational age below 32 weeks.</p> <p>Case presentation</p> <p>We present a case series of nine Caucasian preterm babies, six boys and three girls, with a mean gestational age of 28.6 weeks (range 25.9 to 31.6 weeks). Case one, a girl with a gestational age of 25 weeks and six days, presented with necrotizing enterocolitis. In the second case, a female baby with a gestational age of 26 weeks and two days presented with hematoma. In case three, a female baby with a gestation of 26 weeks and one day developed intraventricular hemorrhage. In case four, a male baby with a gestational age of 31 weeks and four days presented with pain after vacuum delivery. Case five, a female baby born after a gestation of 29 weeks and six days presented with hematoma. In case six, a male baby with a gestation of 30 weeks and six days presented with hematoma. In case seven, a male baby, born with a gestational age of 30 weeks and six days, presented with caput succedaneum and hematoma. In case eight, a male baby, born after a gestation of 28 weeks and four days, developed abdominal distention. Case nine, a female baby, born with a gestational age of 27 weeks and three days presented with hematoma. These babies were treated with intravenous paracetamol 15 mg/kg every six hours. Serum concentrations and aspartate transaminase were determined after prolonged administration. Pain scores were assessed using the Premature Infant Pain Profile.</p> <p>Conclusion</p> <p>Paracetamol serum concentrations ranged from 8 to 64 mg/L after eight to 12 doses of intravenous paracetamol. Adequate analgesia was obtained in seven babies. During paracetamol therapy the median serum level of aspartate transaminase was 20 U/L (range 12 to 186 U/L). This case series indicates that prolonged intravenous administration of paracetamol in preterm babies with a gestational age of less than 32 weeks is tolerated well in the first days after birth. However, in the absence of proper pharmacokinetic data in this age group we cannot advocate the use of paracetamol intravenously.</p

    GATE : a simulation toolkit for PET and SPECT

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    Monte Carlo simulation is an essential tool in emission tomography that can assist in the design of new medical imaging devices, the optimization of acquisition protocols, and the development or assessment of image reconstruction algorithms and correction techniques. GATE, the Geant4 Application for Tomographic Emission, encapsulates the Geant4 libraries to achieve a modular, versatile, scripted simulation toolkit adapted to the field of nuclear medicine. In particular, GATE allows the description of time-dependent phenomena such as source or detector movement, and source decay kinetics. This feature makes it possible to simulate time curves under realistic acquisition conditions and to test dynamic reconstruction algorithms. A public release of GATE licensed under the GNU Lesser General Public License can be downloaded at the address http://www-lphe.epfl.ch/GATE/

    Placebo and other psychological interactions in headache treatment

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    We present a theory according which a headache treatment acts through a specific biological effect (when it exists), a placebo effect linked to both expectancy and repetition of its administration (conditioning), and a non-specific psychological effect. The respective part of these components varies with the treatments and the clinical situations. During antiquity, suggestions and beliefs were the mainstays of headache treatment. The word placebo appeared at the beginning of the eighteenth century. Controversies about its effect came from an excessive interpretation due to methodological bias, inadequate consideration of the variation of the measure (regression to the mean) and of the natural course of the disease. Several powerful studies on placebo effect showed that the nature of the treatment, the associated announce, the patients’ expectancy, and the repetition of the procedures are of paramount importance. The placebo expectancy is associated with an activation of pre-frontal, anterior cingular, accumbens, and periacqueducal grey opioidergic neurons possibly triggered by the dopaminergic meso-limbic system. In randomized control trials, several arms design could theoretically give information concerning the respective part of the different component of the outcome and control the natural course of the disease. However, for migraine and tension type headache attacks treatment, no three arm (verum, placebo, and natural course) trial is available in the literature. Indirect evidence of a placebo effect in migraine attack treatment, comes from the high amplitude of the improvement observed in the placebo arms (28% of the patients). This figure is lower (6%) when using the harder criterium of pain free at 2 h. But these data disregard the effect of the natural course. For prophylactic treatment with oral medication, the trials performed in the last decades report an improvement in 21% of the patients in the placebo arms. However, in these studies the duration of administration was limited, the control of attacks uncertain as well as the evolution of the co-morbid psycho-pathology. Considering the reviews and meta-analysis of complex prophylactic procedures, it must be concluded that their effect is mostly linked to a placebo and non-specific psychological effects. Acupuncture may have a slight specific effect on tension type headache, but not on migraine. Manual therapy studies do not exhibit difference between manipulation, mobilization, and controls; touch has no proven specific effect. A comprehensive efficacy review of biofeedback studies concludes to a small specific effect on tension type headache but not on migraine. A review of behavioral treatment conclude to an interesting mean improvement but did not demonstrated a specific effect with the exception of a four arm study including a pseudo meditation control group. Expectation-linked placebo, conditioning, and non-specific psychological effects vary according clinical situations and psychological context; likely low in RCT, high after anempathic medical contact, and at its maximum with a desired charismatic healer. The announcements of doctors strongly influence the beliefs of patients, and in consequence their pain and anxiety sensibilities; this modulates the amplitude of the placebo and the non-specific psychological effects and is therefore a major determinant of the therapeutic success. Furthermore, any repetitive contact, even through a placebo, may interfere positively with the psychopathological co-morbidity. One has to keep in mind that the non-specific psychological interactions play a major role in the improvement of the majority of the headache sufferers
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