Role of periosteum during healing of alveolar critical size bone defects in the mandible: a pilot study

Minipigs present advantages for studying oral bone regeneration; however, standardized critical size defects (CSD) for alveolar bone have not been validated yet. The objectives of this study are to develop a CSD in the mandibular alveolar bone in Aachen minipigs and to further investigate the specific role of periosteum

Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation

Abstract Background This study hypothesized that patients with extubation failure exhibit a loss of lung aeration and heterogeneity in air distribution, which could be monitored by chest EIT and lung ultrasound. Patients at risk of extubation failure were included after a successful spontaneous breathing trial. Lung ultrasound [with calculation of lung ultrasound score (LUS)] and chest EIT [with calculation of the global inhomogeneity index, frontback center of ventilation (CoV), regional ventilation delay (RVD) and surface available for ventilation] were performed before extubation during pressure support ventilation (H0) and two hours after extubation during spontaneous breathing (H2). EIT was then repeated 6 h (H6) after extubation. EIT derived indices and LUS were compared between patients successfully extubated and patients with extubation failure. Results 40 patients were included, of whom 12 (30%) failed extubation. Before extubation, when compared with patients with successful extubation, patients who failed extubation had a higher LUS (19 vs 10, p = 0.003) and a smaller surface available for ventilation (352 vs 406 pixels, p = 0.042). After extubation, GI index and LUS were higher in the extubation failure group, whereas the surface available for ventilation was lower. The RVD and the CoV were not different between groups. Conclusion Before extubation, a loss of lung aeration was observed in patients who developed extubation failure afterwards. After extubation, this loss of lung aeration persisted and was associated with regional lung ventilation heterogeneity. Trial registration Clinical trials, NCT04180410, Registered 27 November 2019—prospectively registered, https://clinicaltrials.gov/ct2/show/NCT04180410

Additional file 1 of Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation

Additional file 1. Number of patients at each study’s visit

Additional file 4 of Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation

Additional file 4. Correlations between LUS and EIT derived indices (all data from H0 and H2 pooled together)

Additional file 3 of Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation

Additional file 3. Changes in lung aeration, regional lung ventilation and cardiac function before and after extubation, according to the extubation outcome

Additional file 2 of Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation

Additional file 2. Time-course evolution of EIT derived indices (Regional ventilation delay and Center of Ventilation) before and after extubation, according to the extubation status. The top panel (A) corresponds to the Regional Ventilation Delay, the bottom panel (B) to the Center of Ventilation

Des spécificités de l'indemnisation du dommage corporel

International audienceLa réparation du dommage corporel peut apparaître formellement comme une branche de droit dénuée d’autonomie. En effet, les actions en réparation d’un préjudice corporel se font essentiellement sur les fondements, selon les règles et devant les juridictions du droit de la responsabilité civile.La nature de l’atteinte apporte toutefois d’importantes et indéniables spécificités. D’une part, des mécanismes coexistent avec la responsabilité civile, qui sont parfois dédiés à ce type spécifique de préjudice, parfois non (fonds d’indemnisation, assurances directes, etc.) ; d’autre part, dans la mise en œuvre de la responsabilité civile, des particularismes se manifestent (questions d’expertise, d’appréciation, etc.). Cette interface entre la responsabilité civile et la réparation du dommage corporel ne doit pas occulter que nombre d’autres matières, du droit social au droit des assurances, sont mobilisées pour une telle indemnisation.Le dommage corporel est donc, à la fois, dans et hors de la responsabilité civile. Ce paradoxe génère assurément une tension qui pousse à se demander dans quelle mesure les principes de la responsabilité civile sont directement transposables à la réparation du dommage corporel, ce à quoi le présent ouvrage tente de répondre.Chapitre 1. – Réflexions sur l’autonomie du « droit » du dommage corporelChapitre 2. – Évaluation et réparation du dommage corporel en droit allemandChapitre 3. – La réparation du dommage corporel en droit italien : les préjudices extrapatrimoniauxChapitre 4. – Les principes de la responsabilité civile et la réparation du dommage corporelChapitre 5. – La libre disposition des dommages et intérêtsChapitre 6. – La responsabilité contractuelle et le dommage corporel, un couple en instance de séparationChapitre 7. – Incertitudes et dommage corporel : les changements postérieurs au jugement en droit belgeChapitre 8. – La réparation du préjudice corporel collectifChapitre 9. – Les limites de la réparation du préjudice extrapatrimonial en EuropeChapitre 10. – Analyse critique de quelques critères retenus par la nouvelle loi espagnole de réforme du système pour l’évaluation des dommages causés aux personnes dans des accidents de la circulationChapitre 11. – L’incidence de l’état antérieur de la victime sur la réparation de son dommage corporelChapitre 12. – L’évaluation du dommage corporel : dialogue du juriste et de l’expertChapitre 13. – Le référentiel indicatif d’indemnisation du dommage corporel des cours d’appelChapitre 14. – Quelle méthodologie pour l’indemnisation des préjudices moraux : globalisation ou recours à une nomenclature ?Chapitre 15. – Topographie et Nomenclature : La réparation du préjudice corporel dans les droits européensChapitre 16. – Aides techniques et aides humaines dans la réparation du dommage corporelChapitre 17. – L’espérance de vie de la victimeChapitre 18. – La prise en compte de la spécificité du dommage corporel par l’assurance de responsabilité civileChapitre 19. – La réparation du préjudice corporel en droit de la sécurité socialeChapitre 20. – La contribution à la dette en matière de dommage corporelChapitre 21. – De la nécessité de revoir le critère de revalorisation des rentesChapitre 22. – La dilapidation des indemnités : plaidoyer pour une utilisation étendue de la rent

Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19

BackgroundWe previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15-20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in similar to 80% of cases.MethodsWe report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded.ResultsNo gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5-528.7, P=1.1x10(-4)) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR=3.70[95%CI 1.3-8.2], P=2.1x10(-4)). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR=19.65[95%CI 2.1-2635.4], P=3.4x10(-3)), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR=4.40[9%CI 2.3-8.4], P=7.7x10(-8)). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD]=43.3 [20.3] years) than the other patients (56.0 [17.3] years; P=1.68x10(-5)).ConclusionsRare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old