Early Interleukin-6 and Slope of Monocyte Human Leukocyte Antigen-DR: A Powerful Association to Predict the Development of Sepsis after Major Trauma

OBJECTIVE: Major trauma is characterized by a pro-inflammatory response, followed by an immunosuppression. Recently, in trauma patients, the lack of recovery of monocyte Human Leukocyte Antigen DR (mHLA-DR, a biomarker of ICU-acquired immunosuppression) between days 1-2 and days 3-4 has been demonstrated to be independently associated with sepsis development. The main objective of this study was to determine whether early measurements of IL-6 (interleukin-6) and IL-10 plasma concentrations (as markers of initial severity) could improve, in association with mHLA-DR recovery, the prediction of sepsis occurrence in severe trauma patients. DESIGN: Prospective observational study over 24 months in a Trauma ICU at university hospital. PATIENTS: Trauma patients with an ISS over 25 and age over 18 were included. MEASUREMENTS AND MAIN RESULTS: mHLA-DR was assessed by flow cytometry, IL-6 and IL-10 concentrations by ELISA. 100 consecutive severely injured patients were monitored (mean ISS 37±10). 37 patients developed sepsis. IL-6 concentrations and slope of mHLA-DR expression between days 1-2 and days 3-4 were significantly different between septic and non-septic patients. IL-10 was not detectable in most patients. After adjustment for usual clinical confounders, when assessed as a pair, multivariate logistic regression analysis revealed that a slope of mHLA-DR expression (days 3-4/days 1-2)≤1.1 and a IL-6 concentration ≥ 67.1 pg/ml remained highly associated with the development of sepsis (adjusted OR 18.4, 95% CI 4.9; 69.4, p = .00002). CONCLUSIONS: After multivariate regression logistic analysis, when assessed as a pair, a high IL-6 concentration and a persistent mHLA-DR decreased expression were found to be in relation with the development of sepsis with the best predictive value. This study underlines the usefulness of daily monitoring of immune function to identify trauma patients at a high risk of infection

African-European contacts in the Kongo Kingdom (sixteenth-eighteenth centuries): new archaeological insights from Ngongo Mbata (Lower Congo, DRC)

Ngongo Mbata, the main and most affluent center of the Kongo kingdom’s Mbata province in the 17th century, is well known from the historical sources, but virtually unexplored in archaeological publications. Ngongo Mbata is unique in that it hosted a monumental stone building about which the historical record remains silent. This makes it particularly challenging from the point of view of historical archaeology. In this paper historical data, unpublished excavation results from the 1930s and our own fieldwork undertaken in 2012-2013 are brought together, to tell a new story of early African-European contacts in the interior of West Central Africa

Spectacularization of Play in Live-Streaming Speedrun Marathons: From Performance to Mediation

peer reviewedThis paper proposes to study a particular case of performance play (Pellicone & Ahn, 2017) embedding several spectacular and playful settings: charity marathons of speedrun broadcast in live-streaming on Twitch.tv. We will question the scenographic strategies deployed by performers in this context, and how these can (or cannot) serve as mediation tools for transmitting knowledge, facilitating spectators’ entry into the practice, and guiding audience participation. Speedrun is indeed an example of a gaming practice with a double performative dimension (both competitive, as “display of skills”, and artistic; Huuhka, 2020: 60): it consists in the attempt of completing a game as quickly as possible (see Newman, 2008; Scully-Blaker, 2016; Barnabé, 2017), which can require efforts to optimize the playful gesture, as well as the exploitation of glitches. The practice is currently analyzed through the prisms of its transgressive (Scully-Blaker, 2014; Hemmingsen, 2020), competitive (Barnabé, 2014; Bézaguet, 2016) or artistic dimensions (Hay, 2020). We can also note the recent work of Sher (2019) and Sher & Su (2019) that focuses on streaming technologies and volunteer work in the context of charity speedrun marathons. In recent years, it has become increasingly common for speedrunners to use the live-streaming platform Twitch to broadcast their performances as well as their training sessions. For this paper, we will study a specific case of speedrun spectacularization through streaming: the charity marathon SpeeDons 2022. This event took place from April 15 to 17 and brought together dozens of speedrunners who performed live on stage and on Twitch. Their objective was simple: to finish a game according to a time frame specific to each practitioner, while commentators explained their exploits (haranguing the crowd on the model of sports commentators) and called on the public to donate (raising more than 800 000 euros for the association Médecins du Monde). This object presents several frames of performativity, which the analysis will unravel: on the one hand, gameplay can already be seen as a kind of performance (Huuhka, 2020: 60), involving the adoption of a “make-believe” attitude (or mimicry; Caillois, 1958: 39). On the other hand, speedrun adds to this play frame another staging of the action by introducing a recording device, an audience and additional rules or constraints that transform the meaning of what is shown. Finally, the streaming marathon is itself a show that responds to certain scenographic conventions: it defines a stage, roles for the actors, and even a narrative structure, fed by commentators with the construction of suspense effects and narrative tension (Baroni, 2007: 95). Moreover, this type of event, as game spectatorship practices in general (Cheung & Huang, 2011; Taylor, 2018), may be interpreted as a tool for “secondary play” (Delbouille, 2018), since viewers can indirectly participate to the performance, influence its development and engage in a potentially playful form of experience. Based on the qualitative analysis of 17 semi-structured interviews conducted with participants of SpeeDons 2022, we will question the rhetorical techniques used by practitioners to make the performance spectacular and how these can be used to serve an important dimension of speedrun as a “community of practice” (Berry, 2008): the mediation of knowledge and the facilitation of spectators’ entry into the community. Speedrun is indeed a practice requiring a diversity of skills (“Understand, Investigate, Discover, Plan, Perform”; Koziel, 2019) and the collaboration of the whole community for route planning and glitch hunting. The charity marathon event represents a moment of crystallization of collective intelligence (Jenkins, 2006: 139), during which the spectacle intertwines with the objective of transmitting informational expertise to the audience: what happens on the screen is constantly translated into human language by the commentators, who try to make the gameplay understandable, but also to underline invisible difficulties, to report the history of the tricks used, etc. How does this didactic posture articulate with the performativity (in this context, making an action readable also means guiding the reactions of the audience to perform collective emotions: telling them when to be surprised, tense, appreciative, etc.)? What does the streaming stage mediate exactly (knowledge about the game or the speedrun? participation to the group? aesthetic interpretation of the performance? etc.)? These are the questions this paper will attempt to answer

Prognostic factors in non small cell lung cancer

peer reviewedRésumé : Le cancer pulmonaire non à petites cellules est le plus fréquent des cancers du poumon et son pronostic reste très réservé. Les rechutes sont fréquentes et peuvent même s’observer dans des stades précoces de la maladie, en dépit d’une prise en charge chirurgicale à visée curative. Cette revue de la littérature donne un aperçu des facteurs pronostiques principaux dont les deux plus importants, conditionnant la stratégie thérapeutique, demeurent la stadification («staging») et l’histologie de la tumeur. D’autres facteurs péjoratifs pourraient également s’avérer utiles pour les cliniciens, notamment en orientant le patient vers des thérapies adjuvantes.Summary : Non small cell lung cancer is the most frequent type of lung cancer and its prognosis is still very poor. Relapse is frequent and can be observed even in early stages of the disease, in spite of a surgical management with curative intent. This paper gives an overview of the main prognostic factors, the two most important of which remain the staging and tumor histology. These also determine the therapeutic strategy. Other factors of poor prognosis might also be useful for clinicians, particularly in their decision to refer patients for adjuvant therapies. Keywords : Non-small cell lung cancer – Prognostic factors – Pulmonary oncology – Surger

Thermal boundary layer near roughnesses in turbulent Rayleigh-Bénard convection: flow structure and multistability

We present global heat-transfer and local temperature measurements, in an asymmetric parallelepiped Rayleigh-B ́enard cell, in which controlled square-studs roughnesses have been added. A global heat transfer enhancement arises when the thickness of the boundary layer matches the height of the roughnesses. The enhanced regime exhibits an increase of the heat transfer scaling. Local temperature measurements have been carried out in the range of parameters where the enhancement of the global heat transfer is observed. They show that the boundary layer at the top of the square-stub roughness is thinner than the boundary layer of a smooth plate, which accounts for most of the heat-transfer enhancement. We also report multistability at long time scales between two enhanced heat-transfer regimes. The flow structure of both regimes is imaged with background-oriented synthetic Schlieren and reveals intermittent bursts of coherent plumes

RiskFix: Supporting Expert Validation of Predictive Timeseries Models in High-Intensity Settings

Many real-world machine learning workflows exist in longitudinal, interactive machine learning (ML) settings. This longitudinal nature is often due to incremental increasing of data, e.g., in clinical settings, where observations about patients evolve over their care period. Additionally, experts may become a bottleneck in the workflow, as their limited availability, combined with their role as human oracles, often leads to a lack of ground truth data. In such cases where ground truth data is small, the validation of interactive machine learning workflows relies on domain experts. Only those humans can assess the validity of a model prediction, especially in new situations that have been covered only weakly by available training data. Based on our experiences working with domain experts of a pediatric hospital's intensive care unit, we derive requirements for the design of support interfaces for the validation of interactive ML workflows in fast-paced, high-intensity environments. We present RiskFix, a software package optimized for the validation workflow of domain experts of such contexts. RiskFix is adapted to the cognitive resources and needs of domain experts in validating and giving feedback to the model. Also, RiskFix supports data scientists in their model-building work, with appropriate data structuring for the re-calibration (and possible retraining) of ML models

New Dependability Approach for Implanted Medical Devices

International audienceFunctional Electrical Stimulation (FES) is an attractive solution to restore some lost or failing physiological functions. Obviously, the FES system may be hazardous for patient and the reliability and dependability of the system must be maximal. Unfortunately, the present context, where the associated systems are more and more complex and their development needs very cross-disciplinary experts, is not favorable to safety. Moreover, the direct adaptation of the existing dependability techniques from domains such as space or automotive is not suitable. Firstly, this paper proposes a strategy for risk management at system level for FES medical implant. The idea is to give a uniform framework where all possible hazards are highlighted and associated consequences are minimized. Then, the paper focuses on one of the most critical part of the FES system: analog micro-circuit which generates the electrical signal to electrode. As this micro-circuit is the closest to the human tissue, any failure might involve very critical consequences for the patient. We propose a concurrent top-down and bottom-up approach where the critical element

Biodiversity and ecosystem services: think functional!

During the last years, several studies and reviews have considered the relation between biodiversity and ecosystem functioning or the provision of ecosystem services. Many studies found that plant functional traits and plant functional diversity (FD) are key drivers in this relation in terrestrial ecosystems. Researchers used different methods to obtain a gradient in plant FD to examine the effect on ecosystem services, going from observational studies of natural communities to synthetic assemblages. Furthermore, different methods exist to quantify plant FD going from simple functional trait richness to indices, distance-based frameworks and the division into FD components. In the AgricultureIsLife project, we set up a field experiment aiming to examine the biodiversity – ecosystem service relation in agricultural context. The experiment consists of perennial wildflower strips with different plant functional diversities in an arable field with conventional crop production. The wildflower strips were sown as synthetic assemblages but are subject to natural succession during the following years. We monitor the evolution of FD from the sowing to the establishment of a typical wildflower strip using Rhao’s quadratic entropy index to quantify FD. In addition, the flower strips will be monitored for four ecosystem services they are expected to provide: pollination, pest control, biodiversity support and provision of valuable compounds.AgricultureIsLif

Contribution of a tyrosine-based motif to cellular trafficking of wild-type and truncated NPY Y(1) receptors.

peer reviewedThe human NPY Y(1) receptor undergoes fast agonist-induced internalization via clathrin-coated pits then recycles back to the cell membrane. In an attempt to identify the molecular determinants involved in this process, we studied several C-terminal truncation mutants tagged with EFGP. In the absence of agonist, Y(1) receptors lacking the last 32 C-terminal amino acids (Y(1)Delta32) are constitutively internalized, unlike full-length Y(1) receptors. At steady state, internalized Y(1)Delta32 receptors co-localize with transferrin, a marker of early and recycling endosomes. Inhibition of constitutive internalization of Y(1)Delta32 receptors by hypertonic sucrose or by co-expression of Rab5aS34N, a dominant negative form of the small GTPase Rab5a or depletion of all three isoforms of Rab5 indicates the involvement of clathrin-coated pits. In contrast, a truncated receptor lacking the last 42 C-terminal amino acids (Y(1)Delta42) does not constitutively internalize, consistent with the possibility that there is a molecular determinant responsible for constitutive internalization located in the last 10 amino acids of Y(1)Delta32 receptors. We show that the agonist-independent internalization of Y(1)Delta32 receptors involves a tyrosine-based motif YXXPhi. The potential role of this motif in the behaviour of full-length Y(1) receptors has also been explored. Our results indicate that a C-terminal tyrosine-based motif is critical for the constitutive internalization of truncated Y(1)Delta32 receptors. We suggest that this motif is masked in full-length Y(1) receptors which do not constitutively internalize in the absence of agonist