Anemia and chronic kidney disease are potential risk factors for mortality in stroke patients : a historic cohort study

Rapport de synthèseApproche et objectifL'objectif de la recherche était de préciser les relations existant entre l'insuffisance rénale chronique, l'anémie et l'accident vasculaire cérébral parmi des patients hospitalisés au Centre Hospitalier Universitaire Vaudois (CHUV) pour un accident vasculaire cérébral (AVC). Les auteurs ont déterminé la prévalence de l'anémie et de l'insuffisance rénale chronique parmi ces patients et examiné s'ils sont des facteurs de risque indépendants de la mortalité suite à un AVC.L'insuffisance rénale chronique est associée à un risque élevé de développer un AVC. L'anémie est une complication et une conséquence fréquente qui découle de l'insuffisance rénale chronique et est également un facteur de risque pour les maladies cérébro- et cardiovasculaires.MéthodeLa présente étude de cohorte rétrospective se base sur le registre des AVC du CHUV et inclut tous les patients traités suite à un premier AVC au service de neurologie du CHUV entre les années 2000 et 2003.Les variables utilisées pour l'analyse sont les caractéristiques démographiques, l'insuffisance rénale chronique, le débit de filtration glomérulaire.(GFR), l'anémie et d'autres facteurs de risque d'AVC. Ils ont été récoltés au moyen du système informatique du laboratoire du CHUV, d'entretiens téléphoniques (patients ou proches) et du registre des AVC du CHUV.L'insuffisance rénale chronique a été calculée sur base de la ,,Kidney Disease Outcomes Quality Initiative (K/DOQI)-CKD Classification", laquelle est divisée en cinq stades. L'anémie a été définie par une hémoglobine de < 120g/L pour les femmes et < 130g/L pour les hommes.Les analyses statistiques réalisées sont des tests Chi-carré, des tests de Τ ainsi que des courbes de Kaplan-Meier et le modèle de régression de Cox.RésultatsParmi 890 patients adultes avec un AVC, le GFR moyen était de 64.3 ml/min/1.73 m2, 17% souffraient d'anémie et 10% sont décédés pendant la première année après la sortie de l'hôpital, suite à l'"AVC index". Parmi ceux-ci, 61% avaient une insuffisance rénale chronique de stade 3-5 et 39% de stade 1 ou 2 selon les critères de K/DOQI.D'autre part un taux d'hémoglobine élevé a pu être associé à un risque moins élevé de mortalité un an après la sortie de l'hôpital.Conclusion et perspectiveNous avons constaté que l'anémie ainsi que l'insuffisance rénale chronique sont fréquents parmi les patients souffrant d'un AVC et qu'ils sont des facteurs de risque d'un taux de mortalité élevé après un an. En conséquence, il pourrait être utile de traiter les patients souffrant d'anémie et d'insuffisance rénale dès que possible afin de diminuer les complications et comorbidités résultants de ces maladies.La perspective est de rendre les cliniciens attentif à l'importance de l'insuffisance rénale et de l'anémie parmi les patients ayants développé un AVC, ainsi que d'initier le traitement approprié afin de diminuer les complications, les comorbidités ainsi que les récidives d'un AVC. L'efficacité et l'économicité des interventions visant à améliorer le pronostic chez les patients présentant un AVC et souffrant d'une insuffisance rénale chronique et / ou d'une anémie doivent être évaluées par des études appropriées

b \bar b b\bar b production in proton-nucleus collisions at the LHC

A sizable rate of events, with several pairs of $b$-quarks produced contemporarily by multiple parton interactions, may be expected at very high energies as a consequence of the large parton luminosities. The production rates are further enhanced in hadron-nucleus reactions, which may represent a convenient tool to study the phenomenon. We compare the different contributions to $b{\bar b}b{\bar b}$ production, due to single and double parton scatterings, in collisions of protons with nuclei at the CERN-LHC.Comment: 13 pages, 4 figure

Photometry of supernovae in an image series : methods and application to the Supernova Legacy Survey (SNLS)

We present a technique to measure lightcurves of time-variable point sources on a spatially structured background from imaging data. The technique was developed to measure light curves of SNLS supernovae in order to infer their distances. This photometry technique performs simultaneous PSF photometry at the same sky position on an image series. We describe two implementations of the method: one that resamples images before measuring fluxes, and one which does not. In both instances, we sketch the key algorithms involved and present the validation using semi-artificial sources introduced in real images in order to assess the accuracy of the supernova flux measurements relative to that of surrounding stars. We describe the methods required to anchor these PSF fluxes to calibrated aperture catalogs, in order to derive SN magnitudes. We find a marginally significant bias of 2 mmag of the after-resampling method, and no bias at the mmag accuracy for the non-resampling method. Given surrounding star magnitudes, we determine the systematic uncertainty of SN magnitudes to be less than 1.5 mmag, which represents about one third of the current photometric calibration uncertainty affecting SN measurements. The SN photometry delivers several by-products: bright star PSF flux mea- surements which have a repeatability of about 0.6%, as for aperture measurements; we measure relative astrometric positions with a noise floor of 2.4 mas for a single-image bright star measurement; we show that in all bands of the MegaCam instrument, stars exhibit a profile linearly broadening with flux by about 0.5% over the whole brightness range.Comment: Accepted for publication in A&A. 20 page

Synthetic blocks for bone regeneration : A systematic review and meta-analysis

This systematic review is aimed at evaluating the effectiveness of synthetic block materials for bone augmentation in preclinical in vivo studies. An electronic search was performed on Pubmed, Scopus, EMBASE. Articles selected underwent risk-of-bias assessment. The outcomes were: new bone formation and residual graft with histomorphometry, radiographic bone density, soft tissue parameters, complications. Meta-analysis was performed to compare new bone formation in test (synthetic blocks) vs. control group (autogenous blocks or spontaneous healing). The search yielded 214 articles. After screening, 39 studies were included, all performed on animal models: rabbits (n = 18 studies), dogs (n = 4), rats (n = 7), minipigs (n = 4), goats (n = 4), and sheep (n = 2). The meta-analysis on rabbit studies showed significantly higher new bone formation for synthetic blocks with respect to autogenous blocks both at four-week (mean difference (MD): 5.91%, 95% confidence intervals (CI): 1.04, 10.79%, p = 0.02) and at eight-week healing (MD: 4.44%, 95% CI: 0.71, 8.17%, p = 0.02). Other animal models evidenced a trend for better outcomes with synthetic blocks, though only based on qualitative analysis. Synthetic blocks may represent a viable resource in bone regenerative surgery for achieving new bone formation. Differences in the animal models, the design of included studies, and the bone defects treated should be considered when generalizing the results. Clinical studies are needed to confirm the effectiveness of synthetic blocks in bone augmentation procedures

Possible explanations for different surface quality in laser cutting with 1 micron and 10 microns beams

In laser　cutting　of　thick　steel　sheets,　quality　difference　is　observed　between　cut　surfaces　obtained　with 1 micron and 10 micron laser beams. This paper investigates physical mechanisms for this interesting and important problem of the wavelength dependence. First, striation generation process is described, based on a 3D structure of melt flow on a kerf front, which was revealed for the first time by our recent experimental observations. Two fundamental processes are suggested to explain the difference in the cut surface quality: destabilization of the melt flow in the central part of the kerf front and downward displacement of discrete melt accumulations along the side parts of the front. Then each of the processes is analyzed using a simplified analytical model. The results show that in both processes, different angular dependence of the absorptivity of the laser beam can result in the quality difference. Finally we propose use of radial polarization to improve the quality with the 1 micron wavelength

An environment to share in-service training on the net: An action-research about charge in primary and middle school

The net was one of the determining factors in a training of a Group of 4 primary and middle school teachers (L. M. in Forni Di Sopra and C. D. F. in Villa Santina, P. C. in Tolmezzo and D. S. in Gemona, all places in the mountains of Friuli, in the Nord-East of Italy) in an action-research on the electric charge. It was developed through meetings with researchers in physics education and Exchange and sharing of experiences and projects on the net, in an environment designed for teaching activities and under the guidance of a project tutor. The environment allowed to establish different kinds of relations: between teachers, between them and researchers, between classes. It offered to teachers (two in middle school and two in primary school) a place for discussions during the design of paths to be presented to their classes, to structure and share the products of their training both during and after it, to reflect on their training path

Double parton scatterings in b-quark pairs production at the LHC

A sizable rate of events where two pairs of b-quarks are produced contemporarily is foreseen at the CERN LHC, as a consequence of the large parton luminosity. At very high energies both single and the double parton scatterings contribute to the process, the latter mechanisms, although power suppressed, giving the dominant contribution to the integrated cross section.Comment: 17 pages, 6 figure

Stuck Outside and Inside: An Exploratory Study on the Effects of the COVID-19 Outbreak on Italian Parents and Children\u2019s Internalizing Symptoms

The Covid-19 outbreak and the subsequent lockdown have profoundly impacted families\u2019 daily life, challenging their psychological resilience. Our study aimed to investigate the immediate psychological consequences of the pandemic on Italian parents and children focusing on internalizing and post-traumatic symptoms. We also wanted to explore the impact of possible risk and resilience factors, e.g., lifestyle and behaviors, emotional and cognitive beliefs, on parents and children\u2019s reaction to the emergency distress. An online survey was administered during the country\u2019s nationwide lockdown to 721 Italian parents of at least one child aged between 6 and 18 years. The respondent completed the survey for himself/herself and his/her child. The survey included socio-demographic items and validated questionnaires on parents\u2019 post-traumatic stress symptoms, depression and anxiety levels, and on children\u2019s internalizing problems. Parents were asked to fill the questionnaires twice: once referring to the current emergency condition and once recalling how they and their child felt a few months before Covid-19 outbreak. Multiple regression analyses showed that specific demographic characteristics (i.e., sex and age) and psychological factors of children and parents, such as fear of contagion and the opportunity to think about possible secondary positive effects of the pandemic, had a predictive value on the presence of internalizing symptoms of both parents and children. Moreover, parents\u2019 behaviors during the lockdown period (i.e., employment status and sport practiced) were significantly related to their own internalizing symptoms; these symptoms, in turn, had a strong and positive predictive value on children\u2019s internalizing problems. Besides, analyses of variance showed that internalizing symptoms of parents and children were significantly higher during the Covid-19 pandemic than before it started. In addition to showing a direct effect of the pandemic on the psychological health of parents and children, the present results also give a series of important information on how parents perceive, and therefore influence, their children in this period of emergency. Our findings thus highlight the urgent need to provide parents with adequate support to take care of their own psychological wellbeing and to help their children coping with the direct and indirect effects of the pandemic

Recognition and genotyping of minor germplasm of Friuli Venezia Giulia revealed high diversity

The wealth of vine varieties that used to exist in Friuli Venezia Giulia has been progressively lost. In order to ascertain the current situation regarding vine germplasm in the region, between 2001 and 2008, a wide-ranging study was conducted of recovery, conservation and molecular characterization with microsatellite markers (SSR) of accessions of minor germplasm at risk of erosion or extinction. A total of 178 accessions were analyzed and 93 varieties identified. Of these, 44 are already registered in the Italian Catalogue, 8 have been imported and are well-known foreign varieties even if not registered in the Italian Catalogue, 38 are potentially autochthonous and of these only 15 are described or at least cited in the literature; there are no hypotheses on the remaining three. In order to obtain information on possible genetic similarities, three types of software were used to process the molecular data, but only Structure allowed the existence of two principal groupings to be hypothesized for some of the presumed Friuli autochthons: one that gravitates around ‘Prosecco’ and the other around ‘Refoscone’.

Severe bicompartmental bone bruise is associated with rotatory instability in anterior cruciate ligament injury

Purpose: The presence and severity of bone bruise is more and more investigated in the non-contact anterior cruciate ligament (ACL) injury context. Recent studies have advocated a correlation between bone bruise and preoperative knee laxity. The aim of the present study was to investigate the correlation between bone bruise and preoperative rotatory knee laxity. Methods: Twenty-nine patients (29.1 ± 9.8 years) with MRI images at a maximum of 3 months after ACL injury (1.6 ± 0.8 months) were included. The bone bruise severity was evaluated according to the International Cartilage Repair Society (ICRS) scale for lateral femoral condyle, lateral tibial plateau, medial femoral condyle, and medial tibial plateau. The intraoperative rotational knee laxity was evaluated through a surgical navigation system in terms of internal–external rotation at 30° and 90° of knee flexion (IE30, IE90) and internal–external rotation and acceleration during pivot-shift test (PS IE, PS ACC). The KOOS score was also collected. The association between ICRS grade of bone bruise and rotational laxity or KOOS was investigated. Results: Significant correlation (p < 0.05) was found between the bone bruise severity on the medial tibial plateau and rotational laxity (IE90, PS IE, and PS ACC) and between the severity of bone bruise on femoral lateral condyle and KOOS-Symptoms sub-score. The presence of bone bruise on the medial tibial plateau was significantly associated with a lateral femoral notch sign > 2 mm (very strong odds ratio). No kinematical differences were found between none-to-deep and extensive-generalized lateral bone bruise, while higher IE30 and IE90 were found in extensive-generalized bicompartmental bone bruise than isolated extensive-generalized lateral bone bruise. Conclusion: A severe bicompartmental bone bruise was related to higher rotatory instability in the intraoperative evaluation of ACL deficient knees. The severity of edema on the medial tibial plateau was directly correlated with higher intraoperative pivot shift, and the size of edema on the lateral femoral condyle was associated with lower preoperative clinical scores. Level of evidence: Level II