Pore geometry and isosteric heat : an analysis for the carbon dioxyde adsorption on activated carbon.

International audienceThe isosteric heat of the carbon dioxide adsorption on activated carbon is determined by grand canonical Monte Carlo simulations. The results, obtained at room temperature and low pressures for an adorbent model with a slit type porosity, show that the isosteric heat depends strongly on the slit width. The maximun of the isosteric heat is reached for a pore with a width such as cooperative effects between the adsorbed molecules enhance the adsorption. The possibility to estimate the isosteric heat of a macroscopic sample, from adsorption isotherms computed for a distribution of slit pores with given sizes, is discussed

Effective interactions in the colloidal suspensions from HNC theory

The HNC Ornstein-Zernike integral equations are used to determine the properties of simple models of colloidal solutions where the colloids and ions are immersed in a solvent considered as a dielectric continuum and have a size ratio equal to 80 and a charge ratio varying between 1 and 4000. At an infinite dilution of colloids, the effective interactions between colloids and ions are determined for ionic concentrations ranging from 0.001 to 0.1 mol/l and compared to those derived from the Poisson-Boltzmann theory. At finite concentrations, we discuss on the basis of the HNC results the possibility of an unambiguous definition of the effective interactions between the colloidal molecules.Comment: 26 pages, 15 figure

Rituximab therapy for refractory interstitial lung disease related to antisynthetase syndrome

SummaryObjectiveTo report our experience using rituximab as therapy for refractory antisynthetase syndrome (ASS)-associated interstitial lung disease.MethodsWe retrospectively evaluated the medical records of 7 ASS patients with refractory interstitial lung disease, which had previously failed to respond to prednisone and/or other cytotoxic drugs. All 7 patients received rituximab therapy, i.e.: 1 g at days 0 and 14 and at 6-month follow-up. Data on pulmonary symptoms, pulmonary function tests and high resolution computed tomography (HRCT) scan of the lungs were collected: 1) before rituximab initiation; and 2) at 6-month and one-year follow-up after the first infusion of rituximab.ResultsAt one-year follow-up, ASS patients had resolution (n = 2) or improvement of pulmonary clinical manifestations. Patients also exhibited significant improvement of interstitial lung disease parameters: 1) on pulmonary function tests: FVC (p = 0.03) and DLCO (p = 2 × 10−5); 2) and HRCT-scan of the lungs. Due to clinical resolution/improvement of interstitial lung disease, the median daily dose of oral prednisone could be reduced in these 7 ASS patients at one-year follow-up, compared with baseline (20 mg/day vs. 9 mg/day; p = 0.015).ConclusionOur findings suggest that rituximab may be a helpful therapy for refractory interstitial lung disease in patients with ASS

Liquid-vapor transition of systems with mean field universality class

We have considered a system where the interaction, v(r) = v_IS(r) + xi^2 v_MF(r), is given as a linear combination of two potentials, each of which being characterized with a well-defined critical behavior: for v_IS(r) we have chosen the potential of the restricted primitive model which is known to belong to the Ising 3D (IS) universality class, while for v_MF(r) we have considered a long-range interaction in the Kac-limit, displaying mean field (MF) behavior. We study the performance of two theoretical approaches and of computer simulations in the critical region for this particular system and give a detailed comparison between theories and simulation of the critical region and the location of the critical point. Both, theory and simulation give evidence that the system belongs to the MF universality class for any positive value of xi and that it shows only non-classical behavior for xi=0. While in this limiting case theoretical approaches are known to fail, we find good agreement for the critical properties between the theoretical approaches and the simulations for xi^2 larger than 0.05.Comment: 9 pages, 11 figures, 3 table

Moderate to severe acute pain disturbs motor cortex intracortical inhibition and facilitation in orthopedic trauma patients : a TMS study

Objective Primary motor (M1) cortical excitability alterations are involved in the development and maintenance of chronic pain. Less is known about M1-cortical excitability implications in the acute phase of an orthopedic trauma. This study aims to assess acute M1-cortical excitability in patients with an isolated upper limb fracture (IULF) in relation to pain intensity. Methods Eighty-four (56 IULF patients <14 days post-trauma and 28 healthy controls). IULF patients were divided into two subgroups according to pain intensity (mild versus moderate to severe pain). A single transcranial magnetic stimulation (TMS) session was performed over M1 to compare groups on resting motor threshold (rMT), short-intracortical inhibition (SICI), intracortical facilitation (ICF), and long-interval cortical inhibition (LICI). Results Reduced SICI and ICF were found in IULF patients with moderate to severe pain, whereas mild pain was not associated with M1 alterations. Age, sex, and time since the accident had no influence on TMS measures. Discussion These findings show altered M1 in the context of acute moderate to severe pain, suggesting early signs of altered GABAergic inhibitory and glutamatergic facilitatory activities

Over-Detection of Melanoma-Suspect Lesions by a CE-Certified Smartphone App: Performance in Comparison to Dermatologists, 2D and 3D Convolutional Neural Networks in a Prospective Data Set of 1204 Pigmented Skin Lesions Involving Patients’ Perception

The exponential increase in algorithm-based mobile health (mHealth) applications (apps) for melanoma screening is a reaction to a growing market. However, the performance of available apps remains to be investigated. In this prospective study, we investigated the diagnostic accuracy of a class 1 CE-certified smartphone app in melanoma risk stratification and its patient and dermatologist satisfaction. Pigmented skin lesions ≥ 3 mm and any suspicious smaller lesions were assessed by the smartphone app SkinVision® (SkinVision® B.V., Amsterdam, the Netherlands, App-Version 6.8.1), 2D FotoFinder ATBM® master (FotoFinder ATBM® Systems GmbH, Bad Birnbach, Germany, Version 3.3.1.0), 3D Vectra® WB360 (Canfield Scientific, Parsippany, NJ, USA, Version 4.7.1) total body photography (TBP) devices, and dermatologists. The high-risk score of the smartphone app was compared with the two gold standards: histological diagnosis, or if not available, the combination of dermatologists’, 2D and 3D risk assessments. A total of 1204 lesions among 114 patients (mean age 59 years; 51% females (55 patients at high-risk for developing a melanoma, 59 melanoma patients)) were included. The smartphone app’s sensitivity, specificity, and area under the receiver operating characteristics (AUROC) varied between 41.3–83.3%, 60.0–82.9%, and 0.62–0.72% according to two study-defined reference standards. Additionally, all patients and dermatologists completed a newly created questionnaire for preference and trust of screening type. The smartphone app was rated as trustworthy by 36% (20/55) of patients at high-risk for melanoma, 49% (29/59) of melanoma patients, and 8.8% (10/114) of dermatologists. Most of the patients rated the 2D TBP imaging (93% (51/55) resp. 88% (52/59)) and the 3D TBP imaging (91% (50/55) resp. 90% (53/59)) as trustworthy. A skin cancer screening by combination of dermatologist and smartphone app was favored by only 1.8% (1/55) resp. 3.4% (2/59) of the patients; no patient preferred an assessment by a smartphone app alone. The diagnostic accuracy in clinical practice was not as reliable as previously advertised and the satisfaction with smartphone apps for melanoma risk stratification was scarce. MHealth apps might be a potential medium to increase awareness for melanoma screening in the lay population, but healthcare professionals and users should be alerted to the potential harm of over-detection and poor performance. In conclusion, we suggest further robust evidence-based evaluation before including market-approved apps in self-examination for public health benefits

Integrating acute stroke telemedicine consultations into specialists' usual practice: a qualitative analysis comparing the experience of Australia and the United Kingdom

Stroke telemedicine can reduce healthcare inequities by increasing access to specialists. Successful telemedicine networks require specialists adapting clinical practice to provide remote consultations. Variation in experiences of specialists between different countries is unknown. To support future implementation, we compared perceptions of Australian and United Kingdom specialists providing remote acute stroke consultations. Specialist participants were identified using purposive sampling from two new services: Australia's Victorian Stroke Telemedicine Program (n = 6; 2010-13) and the United Kingdom's Cumbria and Lancashire telestroke network (n = 5; 2010-2012). Semi-structured interviews were conducted pre- and post-implementation, recorded and transcribed verbatim. Deductive thematic and content analysis (NVivo) was undertaken by two independent coders using Normalisation Process Theory to explore integration of telemedicine into practice. Agreement between coders was M = 91%, SD = 9 and weighted average κ = 0.70. Cross-cultural similarities and differences were found. In both countries, specialists described old and new consulting practices, the purpose and value of telemedicine systems, and concerns regarding confidence in the assessment and diagnostic skills of unknown colleagues requesting telemedicine support. Australian specialists discussed how remote consultations impacted on usual roles and suggested future improvements, while United Kingdom specialists discussed system governance, policy and procedures. Australian and United Kingdom specialists reported telemedicine required changes in work practice and development of new skills. Both groups described potential for improvements in stroke telemedicine systems with Australian specialists more focused on role change and the United Kingdom on system governance issues. Future research should examine if cross-cultural variation reflects different models of care and extends to other networks

Nintedanib for Systemic Sclerosis-Associated Interstitial Lung Disease

BACKGROUND: Interstitial lung disease (ILD) is a common manifestation of systemic sclerosis and a leading cause of systemic sclerosis-related death. Nintedanib, a tyrosine kinase inhibitor, has been shown to have antifibrotic and antiinflammatory effects in preclinical models of systemic sclerosis and ILD. METHODS: We conducted a randomized, double-blind, placebo-controlled trial to investigate the efficacy and safety of nintedanib in patients with ILD associated with systemic sclerosis. Patients who had systemic sclerosis with an onset of the first non-Raynaud's symptom within the past 7 years and a high-resolution computed tomographic scan that showed fibrosis affecting at least 10% of the lungs were randomly assigned, in a 1:1 ratio, to receive 150 mg of nintedanib, administered orally twice daily, or placebo. The primary end point was the annual rate of decline in forced vital capacity (FVC), assessed over a 52-week period. Key secondary end points were absolute changes from baseline in the modified Rodnan skin score and in the total score on the St. George's Respiratory Questionnaire (SGRQ) at week 52. RESULTS: A total of 576 patients received at least one dose of nintedanib or placebo; 51.9% had diffuse cutaneous systemic sclerosis, and 48.4% were receiving mycophenolate at baseline. In the primary end-point analysis, the adjusted annual rate of change in FVC was 1252.4 ml per year in the nintedanib group and 1293.3 ml per year in the placebo group (difference, 41.0 ml per year; 95% confidence interval [CI], 2.9 to 79.0; P=0.04). Sensitivity analyses based on multiple imputation for missing data yielded P values for the primary end point ranging from 0.06 to 0.10. The change from baseline in the modified Rodnan skin score and the total score on the SGRQ at week 52 did not differ significantly between the trial groups, with differences of 120.21 (95% CI, 120.94 to 0.53; P=0.58) and 1.69 (95% CI, 120.73 to 4.12 [not adjusted for multiple comparisons]), respectively. Diarrhea, the most common adverse event, was reported in 75.7% of the patients in the nintedanib group and in 31.6% of those in the placebo group. CONCLUSIONS: Among patients with ILD associated with systemic sclerosis, the annual rate of decline in FVC was lower with nintedanib than with placebo; no clinical benefit of nintedanib was observed for other manifestations of systemic sclerosis. The adverse-event profile of nintedanib observed in this trial was similar to that observed in patients with idiopathic pulmonary fibrosis; gastrointestinal adverse events, including diarrhea, were more common with nintedanib than with placebo

Chronic lithium treatment influences impulse control and cognition and regulates gene expression

Lithium is an effective treatment for bipolar disorder (BD) as it reduces the occurrence of mania, which is associated with deficits in impulse control, pathological gambling, drug-seeking, and suicidality. Whether lithium regulates impulsivity directly is unclear. We determined the effects of chronic lithium administration on performance of the five-choice serial reaction time task (5-CSRTT)—a rodent analogue of the continuous performance test used clinically—and the delay discounting task (DDT), as well as its influence on drug-induced behaviours. In the 5-CSRTT, animals respond to a brief visual stimulus to earn a reward. Accuracy of target detection measures attentional ability whilst responses made prior to stimulus presentation provide an index of motor impulsivity. The DDT measures impulsive choice by assessing animals' tendency to choose smaller, immediate food rewards over larger, delayed rewards. Lithium treatment improved target detection and attenuated stress-induced impulsive responding. There were no differences between the groups on the initial delay discounting task—animals abruptly shifted their preference towards the smaller reward as the larger reward became increasingly delayed. We re-trained these animals using shorter delays to obtain a more meaningful discounting pattern. Lithium treatment facilitated behavioural flexibility as rats adapted this change more rapidly, and animals displayed a consistent pattern of choice between both delay sets. We trained another cohort of animals using the shorter delays only. Again, lithium treatment accelerated task acquisition, but did not affect choice behaviour. Lithium treatment blocked stimulant-induced changes in choice behaviour. Real-time PCR analyses revealed that lithium treatment decreased gene expression in the prefrontal cortex and nucleus accumbens. Notable changes were detected in intracellular components and neuronal processes associated with a behavioural and cognitive profile relevant to BD and other impulse control disorders, including monoaminergic receptors, neurotrophins, synaptic proteins, signalling kinases, and transcription and apoptotic factors, to name a few. Results generated herein suggest that chronic lithium treatment may enhance attention, attenuate stress-induced motor impulsivity, accelerate task acquisition, enhance behavioural flexibility, and block stimulant-induced changes in choice behaviour. These findings contribute to our understanding of lithium’s clinical efficacy and may lead to better treatments for BD and other impulse-control disorders.Medicine, Faculty ofGraduat