Pivoting output unit control systems activated by jacks

An invention to be used for controlling aircraft flaps is described. It is applicable to control systems with two coaxial output units which pivot simultaneously with respect to two fixed units and which are activated by two opposed, straight coaxial jacks

Inflammation associée à l'agression rénale aiguë : contribution de la polarisation macrophagique, visualisation de VCAM-1 en imagerie moléculaire

L'agression rénale aigüe (ARA) secondaire à la rhabdomyolyse est une situation fréquente, mais les données histologiques sont rares, et la physiopathologie est surtout attribuée à la toxicité de la myoglobine. Nous avons fait l'hypothèse que cette entité nosologique pouvait impliquer des macrophages (MØ), polarisés vers le phénotype M1 (pro-inflammatoire) ou M2 (réparateur). Dans un modèle murin, nous avons phénotypé les MØ rénaux. A J2, des R1 (F4/80loCD11bhi) sont recrutés, alors qu'à J8, des R2 (F4/80hiCD11b+) réparateurs deviennent dominants. Une étude transcriptionnelle sur cellule unique révèle que R1 et R2 sont dans un état de polarisation mixte et co-expriment des marqueurs M1 et M2. La déplétion des MØ par le clodronate liposomal (CL) réduit la mortalité des souris, et indique que les R1 jouent un rôle clé dans l'évolution de la pathologie via la sécrétion de composants de la matrice extra-cellulaire et de chimiokines. La myoglobine per se entraîne la production de chimiokines par les cellules rénales et les MØ, et polarise ces derniers. A 7 mois, alors que la fonction rénale est quasi-restaurée, on note une fibrose rénale, qui est partiellement réduite par le CL. Ces données indiquent: l'existence de lésions infra-cliniques de fibrose rénale à distance d'une rhabdomyolyse et le rôle pronostique déterminant des MØ inflammatoires. En parallèle, nous avons pu appliquer une technique non-invasive de mesure de l'inflammation endothéliale à l'étude de différents modèles d'ARA en ciblant VCAM-1 (vascular cell adhesion molecule-1) par imagerie moléculaire. Ce travail établit l'importance des phénomènes inflammatoires dans l'ARA, qu'elle soit d'origine immune ou non.Rhabdomyolysis is a frequent cause of acute kidney injury (AKI). The toxic effect of myoglobin was thought to be the main factor involved in this disease. Since macrophages (MØ) have been suspected to populate the kidney after rhabdomyolysis, we set out to investigate their role and polarization status, whereby MØ are classified as either M1 (pro-inflammatory) or M2 (wound-healing). Diverse renal MØ phenotypes were observed in a mouse model: two days after rhabdomyolysis, R1 (F4/80loCD11bhi) were dominant. By day 8, R2 (F4/80hiCD11b+) became dominant. Liposomal clodronate (CL)-mediated MØ depletion indicated that the early infiltration of R1 was deleterious. Transcriptionally regulated targets, such as chemokines and extra-cellular matrix components were identified and verified to be expressed in a MØ-dependent manner. Via single-cell analysis R1 and R2 were shown to express both M1 and M2 markers. Inflammatory processes seemed to be directly favoured by myoglobin since it induced in vitro tubular cells to secrete chemokines and MØ to change their polarization status. Early CL-mediated MØ depletion improved kidney repair and mouse survival. Seven months after rhabdomyolysis, the fibrotic lesions were significantly reduced in the CL-treated group, suggesting that early MØ depletion limits long-term injuries. We also performed a study to assess the interest of detecting endothelial inflammation during AKI via enhanced molecular imaging targeting VCAM-1 (vascular cell adhesion molecule-1). This non-invasive technology appears to be a relevant approach

The European Regulatory Framework and its implementation in influencing organic inspection and certification systems in the EU

The report presents a review of the most important European and international legislation that set the framework for organic certification, of reports prepared by international agencies working with organic standard setting and certification, and of relevant scientific literature. It discusses problems, future challenges of the organic control systems in Europe leading to suggestions for improvement. Food quality assurance is of key importance for the future development of the Common Agricultural Policy of the EU. A large number of mandatory and voluntary assurance and certification schemes exist for agriculture and in the food industry leading to the risk of increased costs for producers and confusion of consumers. Such schemes include the setting of requirements and bodies that undertake control and provide certificates. Requirements can be divided into statutory regulations regarding food safety and good agricultural practice and standards for voluntary attributes. Basic requirements of food safety, animal health and animal welfare are controlled by the Official Food and Feed Control (OFFC) systems, governed by Council Regulation (EC) 882/2004. Third party certification provides credibility to claims related to voluntary standards and is communicated to the consumers through the use of certification marks. The EU has developed a legislative basis for quality claims in relation to geographical indications, traditional specialities and organic farming and considers introducing labelling rules in relation to animal welfare, environmental impact and the origin of raw materials. Organic certification is one of a number of overlapping and competing schemes. The development of organic standards and certification in Europe started with private standards and national rules, leading to Regulation (EEC) 2092/1991. The requirements for competent authorities, control bodies and operators in this regulation regarding the control systems are reviewed. The discussion highlights the low level of knowledge among consumers of the requirements of organic certification, a weak emphasis of the control system on operator responsibility for organic integrity, issues of competition and surveillance of control bodies, a lack of consideration of risk factors in designing the inspection systems and a lack of transparency. A total revision of the European Regulations on organic production began in 2005. One important change introduced by the new Council Regulation (EC) 834/2007 for Organic Food and Farming is that the organic control system is placed under the umbrella of Council Regulation (EC) 882/2004 on Official Food and Feed Controls. Regulation (EC) 834/2007 also requires that control bodies have to be accredited according to general requirements for bodies operating product certification systems (ISO Guide 65/EN 45011). From July 2010 packaged organic products will have to carry the new EU logo as well as the compulsory indication of the control body. The report reviews the requirements for competent authorities, control bodies and operators from the various legal sources. The discussion highlights a lack of clarity on the impact of the OFFC regulation on the organic control system including how risk based inspections are to be implemented and the potential for in-consistencies in the enforcement of the regulation. A number of international initiatives concerned with the harmonisation of organic standards and to a lesser extent certification are reviewed, such as the International Task Force on Harmonisation and Equivalence (ITF)1 Two main alternative guarantee systems for organic production have been developed and researched by a number of organisations including IFOAM, ISEAL, FAO and the EU Commission. Smallholder Group Certification based on an Internal Control System (ICS) and Participatory Guarantee Systems (PGS) could also represent ways to minimize certification costs also for European farmers, in particular for operators that market directly or through very short supply chains. Both systems also illustrate examples of certification systems with a focus on system development and improvement. , the European Organic Certifiers Council (EOOC), the International Social and Environmental Accreditation and Labelling Alliance (ISEAL) and the Anti-Fraud Initiative (AFI). The multilateral initiatives have led to a better understanding of current problems and the scope and limitations for harmonisation. They have also contributed to the sharing of tools and methods and the identification of best practice. Apart from organic farming the European Union has two other food quality schemes: Regulation (EC) 510/2006 on geographical indications and Regulation (EC) 509/2006 on traditional specialities. The report explores the potential for combining these with organic certification, and draws lessons for organic certification based on Italian experience. The final chapter summarises problems and challenges from the previous chapters. Suggestions for improvements of the organic control system focus on two issues: the need for further harmonisation of the surveillance of control bodies and enforcement of the regulation and how operators’ responsibility for further development of organic systems could be supported in the control and certification system

Case Report Beneficial Effect of Conversion to Belatacept in Kidney-Transplant Patients with a Low Glomerular-Filtration Rate

Belatacept has been found to be efficient at preserving good kidney function in maintenance kidney-transplant patients. Herein, we report on the use of belatacept as a rescue therapy for two kidney-transplant patients presenting with severe adverse events after treatment with calcineurin inhibitors (CNIs) and mammalian target-of-rapamycin (mTOR) inhibitors. Two kidney-transplant patients developed severely impaired kidney function after receiving CNIs. The use of everolimus was associated with severe angioedema. Belatacept was then successfully used to improve kidney function in both cases, even though estimated glomerularfiltration rate before conversion was <20 mL/min. These case reports show that belatacept can be used as a rescue therapy, even if kidney function is very low in kidney-transplant patients who cannot tolerate CNIs and/or mTOR inhibitors

Single fraction radiosurgery using Rapid Arc for treatment of intracranial targets

<p>Abstract</p> <p>Background</p> <p>Stereotactic-Radio-Surgery (SRS) using Conformal-Arc-Therapy (CAT) is a well established irradiation technique for treatment of intracranial targets. Although small safety margins are required because of very high accuracy of patient positioning and exact online localisation, there are still disadvantages like long treatment time, high number of monitor units (MU) and covering of noncircular targets. This planning study analysed whether Rapid Arc (RA) with stereotactic localisation for single-fraction SRS can solve these problems.</p> <p>Methods</p> <p>Ten consecutive patients were treated with Linac-based SRS. Eight patients had one or more brain metastases. The other patients presented a symptomatic vestibularis schwannoma and an atypic meningeoma. For all patients, two plans (CAT/RA) were calculated and analysed.</p> <p>Results</p> <p>Conformity was higher for RA with additional larger low-dose areas. Furthermore, RA reduced the number of MU and the treatment time for all patients. Dose to organs at risk were equal or slightly higher using RA in comparison to CAT.</p> <p>Conclusions</p> <p>RA provides a new alternative for single-fraction SRS irradiation combining advantages of short treatment time with lower number of MU and better conformity in addition to accuracy of stereotactic localisation in selected cases with uncomplicated clinical realization.</p

Incidence and outcomes of kidney replacement therapy for end-stage kidney disease due to primary glomerular disease in Europe:Findings from the ERA Registry

Background and hypothesis: Primary glomerular disease (PGD) is a major cause of end-stage kidney disease (ESKD) leading to kidney replacement therapy (KRT). We aimed to describe incidence (trends) in individuals starting KRT for ESKD due to PGD and to examine their survival and causes of death.Methods: We used data from the European Renal Association (ERA) Registry on 69,854 patients who started KRT for ESKD due to PGD between 2000 and 2019. ERA primary renal disease codes were used to define six PGD subgroups. We examined age and sex standardized incidence, trend of the incidence, and survival.Results: The standardized incidence of KRT for ESKD due to PGD was 16.6 per million population (pmp), ranging from 8.6 pmp in Serbia to 20.0 pmp in France. IgA nephropathy (IgAN) and focal segmental glomerulosclerosis (FSGS) had the highest incidence of 4.6 pmp and 2.6 pmp, respectively. Histologically non-examined PGDs represented over 50% of cases in Serbia, Bosnia and Herzegovina, and Romania and were also common in Greece, Estonia, Belgium, and Sweden. The incidence declined from 18.6 pmp in 2000 to 14.5 pmp in 2013, after which it stabilized. All PGD subgroups had five-year survival probabilities above 50%, with crescentic glomerulonephritis having the highest risk of death (adjusted hazard ratio: 1.8 [95% confidence interval: 1.6-1.9]) compared with IgAN. Cardiovascular disease was the most common cause of death (33.9%).Conclusion: The incidence of KRT for ESKD due to PGD showed large differences between countries and was highest for IgAN and FSGS. Lack of kidney biopsy facilities in some countries may have affected accurate assignment of the cause of ESKD. The recognition of the incidence and outcomes of KRT among different PGD subgroups may contribute to a more individualized patient care approach

The Diverse Function of Macrophages in Renal Disease

Experimental and human studies indicate that macrophages play a key role within the diseased kidney and represent a target for novel therapies. This brief review outlines the involvement and nature of macrophages in renal disease and highlights the phenotypic plasticity of these cells and their responsiveness to the renal microenvironment