Mise en place d'un registre de patients artériopathes (REPARMI)

Contexte: L'artériopathie périphérique des membres inférieurs (APMI) est une pathologie chronique qui touche les artères des membres inférieurs. Elle est caractérisée par un rétrécissement progressif de la lumière de l'artère, lié le plus souvent à l'athérosclérose. De multiples facteurs de risque cardiovasculaires participent à l'apparition et à l'évolution de l'APMI. Comme il s'agit des mêmes facteurs de risque que pour beaucoup d'autres maladies cardiovasculaires, l'APMI peut être considérée comme un marqueur du risque cardiovasculaire. Pour cette raison, en plus d'une baisse de la qualité de vie, les patients souffrant d'APMI ont un risque accru d'accidents cardiovasculaires. Bien que l'APMI soit une pathologie en pleine expansion (prévalence de 20% dans la population générale âgée de plus de 55 ans et de 30% chez les plus de 70 ans), la plupart des données disponibles ont été extrapolées à partir d'études sur d'autres populations à risque cardiovasculaire (patients avec ischémie cérébrale, infarctus, diabète, etc.). Objectifs: Le registre REPARMI naît suite à l'exigence d'étudier une pathologie qui sera de plus en plus fréquente dans le monde, mais dont l'histoire naturelle reste peu connue. Etudier l'épidémiologie, les facteurs de risque, la prise en charge de l'APMI ainsi que le devenir des patients par le biais d'un registre prospectif avec un suivi au long cours. De cette façon, le registre permettra de: ? Evaluer l'histoire naturelle des patients avec APMI. ? Identifier les facteurs de risque individuels de l'APMI et les différentes modalités de prise en charge médicale. ? Evaluer l'influence que l'APMI a sur la qualité de vie des patients et l'impact de l'APMI en termes de santé publique dans la population. Méthodes: Il s'agit d'une étude prospective, observationnelle avec inclusion non sélectionnée et consécutive des patients avec APMI. Tous les patients avec une APMI confirmée, qui satisfont les critères d'inclusion et qui n'ont pas de critères d'exclusion, peuvent entrer dans l'étude. Pour chaque patient, des informations épidémiologiques et cliniques de base sont recueillies et différentes analyses biologiques seront effectuées. Pendant les 5 ans du suivi tous les patients vont être soumis à des questionnaires et à des contrôles angiologiques périodiques. Puisqu'il s'agit d'une étude observationnelle, la prise en charge des patients recrutés ne sera pas modifiée par rapport à la norme. Résultats attendus: Mieux comprendre l'histoire naturelle de cette maladie et déterminer quels examens et quels éléments anamnestiques sont vraiment utiles pour améliorer la prise en charge. Trouver des marqueurs dans le sang qui pourraient prédire un événement plutôt qu'un autre. Importance: Cette étude permettra à l'avenir d'apprécier dès le début la sévérité de chaque cas et d'améliorer la prise en charge, en sachant que certaines co-morbidités, certains styles de vie, certaines valeurs dans le sang ou autre sont des facteurs de risque pour une mauvaise évolution de la maladie

Assessing rotation-invariant feature classification for automated wildebeest population counts

Accurate and on-demand animal population counts are the holy grail for wildlife conservation organizations throughout the world because they enable fast and responsive adaptive management policies. While the collection of image data from camera traps, satellites, and manned or unmanned aircraft has advanced significantly, the detection and identification of animals within images remains a major bottleneck since counting is primarily conducted by dedicated enumerators or citizen scientists. Recent developments in the field of computer vision suggest a potential resolution to this issue through the use of rotation-invariant object descriptors combined with machine learning algorithms. Here we implement an algorithm to detect and count wildebeest from aerial images collected in the Serengeti National Park in 2009 as part of the biennial wildebeest count. We find that the per image error rates are greater than, but comparable to, two separate human counts. For the total count, the algorithm is more accurate than both manual counts, suggesting that human counters have a tendency to systematically over or under count images. While the accuracy of the algorithm is not yet at an acceptable level for fully automatic counts, our results show this method is a promising avenue for further research and we highlight specific areas where future research should focus in order to develop fast and accurate enumeration of aerial count data. If combined with a bespoke image collection protocol, this approach may yield a fully automated wildebeest count in the near future.CJT is supported by a Complex Systems Scholar Award from the James S. McDonnell Foundation. JGCH is supported by a Lord Kelvin Adam Smith Fellowship, funding from the British Ecological Society and the European Union’s Horizon 2020 research and innovation programme under grant agreement No 641918 AfricanBioServices. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Tortuosity Computations of Porous Materials using the Direct Simulation Monte Carlo

Low-density carbon fiber preforms, used as thermal protection systems (TPS) materials for planetary entry systems, have permeable, highly porous microstructures consisting of interlaced fibers. Internal gas transport in TPS is important in modeling the penetration of hot boundary-layer gases and the in-depth transport of pyrolysis and ablation products. The gas effective diffusion coefficient of a porous material must be known before the gas transport can be modeled in material response solvers; however, there are very little available data for rigid fibrous insulators used in heritage TPS.The tortuosity factor, which reflects the efficiency of the percolation paths, can be computed from the effective diffusion coefficient of a gas inside a porous material and is based on the micro-structure of the material. It is well known, that the tortuosity factor is a strong function of the Knudsen number. Due to the small characteristic scales of porous media used in TPS applications (typical pore size of the order of 50 micron), the transport of gases can occur in the rarefied and transitional regimes, at Knudsen numbers above 1. A proper way to model the gas dynamics at these conditions consists in solving the Boltzmann equation using particle-based methods that account for movement and collisions of atoms and molecules.In this work we adopt, for the first time, the Direct Simulation Monte Carlo (DSMC) method to compute the tortuosity factor of fibrous media in the rarefied regime. To enable realistic simulations of the actual transport of gases in the porous medium, digitized computational grids are obtained from X-ray micro-tomography imaging of real TPS materials. The SPARTA DSMC solver is used for simulations. Effective diffusion coefficients and tortuosity factors are obtained by computing the mean-square displacement of diffusing particles.We first apply the method to compute the tortuosity factors as a function of the Knudsen number for computationally designed materials such as random cylindrical fibers and packed bed of spheres with prescribed porosity. Results are compared to literature values obtained using random walk methods in the rarefied and transitional regime and a finite-volume method for the continuum regime. We then compute tortuosity factors for a real carbon fiber material with a transverse isotropic structure (FiberForm), quantifying differences between through-thickness and in-plain tortuosities at various Knudsen regimes

A randomized crossover trial assessing patient preference for two different types of portable infusion-pump devices

Background: A variety of anticancer agents are better tolerated and more effective if given as continuous compared to bolus administration. Portable pump devices are needed to allow outpatient continuous infusion. Different types of portable pumps are available and we tested patient preference in a randomized crossover design. Patients and methods: Patients on continuous infusion fluorouracil were randomly assigned to start treatment with an elastomeric infusor (Baxter) or a mechanical, electronically controlled pump (CADD-1™, Pharmacia) and crossed over to the alternative model after three weeks. After exposure to both pump types patients were asked to indicate their preferred device. Results: After 10 patients the study was closed because all study participants preferred the elastomeric pump (P < 0.01). Reasons were pump weight (100%), smaller pump size (89%), interference with daily activities (89%), user friendliness (56%), impact on sleep (44%), and lack of technical problems (22%). Although the mechanical pump required more handling time for the first two refillings, the learning curve suggested about equal time requirement thereafter. Conclusion: In the interest of patient comfort, the disposable elastomeric infusor is an acceptable alternative to the more accurate electronically controlled pumps especially for drugs with a short half-life and a favorable toxicity profil

Fluorinated beta-sheet breaker peptides

The aggregation of amyloid-beta peptide (Ab) has been linked to the formation of neuritic plaques, which are pathological hallmarks of Alzheimer's disease. We synthesized peptides containing fluorinated amino acids and studied their effect on the Ab aggregation. The peptides were based on the sequence LVFFD, in which valine was substituted by either 4,4,4-trifluorovaline or 4-fluoroproline, or the phenylalanine at position 3 was replaced by 3,4,5-trifluorophenylalanine. Our results demonstrate that fluorination of the hydrophobic residue valine or phenylalanine is effective in preventing the Ab aggregation. This study opens up the possibility of using new sequences based on fluorinated amino acids to inhibit the amyloid- fibril formation

5-Fluorouracil as protracted continuous intravenous infusion can be added to full-dose docetaxel (Taxotere®)-cisplatin in advanced gastric carcinoma: a phase I-II trial

Background: A phase I-II multicenter trial was conducted to define the maximum tolerated dose (MTD) according to tolerance and toxicity (primary objective), as well as to describe the clinical activity, in terms of response and survival (secondary objectives), of a combination of 5-fluorouracil (5-FU) in protracted continuous intravenous infusion (p.i.v.) with docetaxel and cisplatin for patients with advanced gastric cancer. Patients and methods: Patients with measurable unresectable and/or metastatic gastric carcinoma, World Health Organization performance status ≤1, normal hematological and renal functions, adequate hepatic function and not pretreated for advanced disease by chemotherapy, received up to eight cycles of a combination of docetaxel on day 1, cisplatin on day 1 and 5-FU p.i.v. on days 1-14 (TCF) every 3 weeks, which was escalated up to the MTD, defined by the occurrence of dose-limiting toxicity in two patients in one dose level. Results: Fifty-two patients were accrued and treated (43 in the phase I part of the trial and nine additional at the recommended dose level). A median of five cycles/patient was given. The recommended dose of TCF was docetaxel 85 mg/m2 on day 1, cisplatin 75 mg/m2 on day 1 and 5-FU p.i.v. 300 mg/m2/day on days 1-14. Grade ≥3 toxicities were neutropenia 79%, alopecia 46%, fatigue 23%, mucositis 10%, diarrhea 19%, nausea/vomiting 13%, neurological 4% and palmar-plantar 2%. Ten non-fatal febrile neutropenia episodes were recorded in eight patients. There were no treatment-related deaths. Among 41 patients with measurable disease (79%), we observed one complete and 20 partial responses for an overall intent-to-treat response rate of 51% (95% confidence interval 35-67%). Five patients (20%) had stable disease for ≥12 weeks (four cycles). The median overall survival was 9.3 months. Conclusions: 5-FU p.i.v. at 300 mg/m2/day for 2 weeks out of three could be safely added to the docetaxel-cisplatin (TC) combination, but the dose of docetaxel had to be reduced to 75 mg/m2 in a subsequent phase II trial. This drug regimen seems to be very active in advanced gastric cancer. Comparison with both TC and ECF in a randomized SAKK trial is ongoin

Investigation of the High-Energy Oxidation of FiberForm from DSMC Analysis of Molecular Beam Experiments

A collaborative effort between the University of Illinois at Urbana-Champaign (UIUC), NASA Ames Research Center (ARC) and Montana State University (MSU) succeeded at developing a new finite-rate carbon oxidation model from molecular beam scattering experiments on vitreous carbon (VC). We now aim to use the direct simulation Monte Carlo (DSMC) code SPARTA to apply the model to each fiber of the porous fibrous Thermal Protection Systems (TPS) material FiberForm (FF). The detailed micro-structure of FF was obtained from X-ray micro-tomography and then used in DSMC. Both experiments and simulations show that the CO/O products ratio increased at all temperatures from VC to FF. We postulate this is due to the larger number of collisions an O atom encounters inside the porous FF material compared to the flat surface of VC. For the simulations, we particularly focused on the lowest and highest temperatures studied experimentally, 1023 K and 1823 K, and found good agreement between the finite-rate DSMC simulations and experiments

AP-4-mediated axonal transport controls endocannabinoid production in neurons

Davies et al. identify a putative mechanism underlying the childhood neurological disorder AP-4 deficiency syndrome. In the absence of AP-4, an enzyme that makes 2-AG is not transported to the axon, leading to axonal growth defects, which can be rescued by inhibition of 2-AG breakdown. The adaptor protein complex AP-4 mediates anterograde axonal transport and is essential for axon health. AP-4-deficient patients suffer from a severe neurodevelopmental and neurodegenerative disorder. Here we identify DAGLB (diacylglycerol lipase-beta), a key enzyme for generation of the endocannabinoid 2-AG (2-arachidonoylglycerol), as a cargo of AP-4 vesicles. During normal development, DAGLB is targeted to the axon, where 2-AG signalling drives axonal growth. We show that DAGLB accumulates at the trans-Golgi network of AP-4-deficient cells, that axonal DAGLB levels are reduced in neurons from a patient with AP-4 deficiency, and that 2-AG levels are reduced in the brains of AP-4 knockout mice. Importantly, we demonstrate that neurite growth defects of AP-4-deficient neurons are rescued by inhibition of MGLL (monoacylglycerol lipase), the enzyme responsible for 2-AG hydrolysis. Our study supports a new model for AP-4 deficiency syndrome in which axon growth defects arise through spatial dysregulation of endocannabinoid signalling.Special thanks to the MPIB Imaging Facility for outstanding technical support, in particular to Giovanni Cardone for his advice and assistance with the implementation of image analysis pipelines, as well as feedback on the manuscript, and to Martin Spitaler for his expert technical advice for imaging experiments

Unbiased proteomic profiling of host cell extracellular vesicle composition and dynamics upon HIV-1 infection

Cells release diverse types of extracellular vesicles (EVs), which transfer complex signals to surrounding cells. Specific markers to distinguish different EVs (e.g. exosomes, ectosomes, enveloped viruses like HIV) are still lacking. We have developed a proteomic profiling approach for characterizing EV subtype composition and applied it to human Jurkat T cells. We generated an interactive database to define groups of proteins with similar profiles, suggesting release in similar EVs. Biochemical validation confirmed the presence of preferred partners of commonly used exosome markers in EVs: CD81/ADAM10/ITGB1, and CD63/syntenin. We then compared EVs from control and HIV-1-infected cells. HIV infection altered EV profiles of several cellular proteins, including MOV10 and SPN, which became incorporated into HIV virions, and SERINC3, which was re-routed to non-viral EVs in a Nef-dependent manner. Furthermore, we found that SERINC3 controls the surface composition of EVs. Our workflow provides an unbiased approach for identifying candidate markers and potential regulators of EV subtypes. It can be widely applied to in vitro experimental systems for investigating physiological or pathological modifications of EV release