Change in diaphragmatic morphology in single-lung transplant recipients: a computed tomographic study

Introduction: The influence of lung disease on the diaphragm has been poorly studied. The study aimed to evaluate the diaphragm morphology (height and thickness) in single-lung transplantation (SLTx), using computed tomography (CT), by assessing the evolution of the hemidiaphragm of the transplanted and the native side.Methods: Patients who underwent single lung transplantation in our center (Marseille, France) between January 2009 and January 2022 were retrospectively included. Thoracic or abdominal CT scans performed before and the closest to and at least 3 months after the surgery were used to measure the diaphragm crus thickness and the diaphragm dome height.Results: 31 patients mainly transplanted for emphysema or pulmonary fibrosis were included. We demonstrated a significant increase in diaphragm crus thickness on the side of the transplanted lung, with an estimated difference of + 1.25 mm, p = <0.001, at the level of the celiac artery, and + 0.90 mm, p < 0.001, at the level of the L1 vertebra while no significant difference was observed on the side of the native lung. We showed a significant reduction in the diaphragm height after SLTx on the transplanted side (−1.20 cm, p = 0.05), while no change on the native side (+0.02 cm, p = 0.88).Conclusion: After a SLTx, diaphragmatic morphology significantly changed on the transplanted lung, while remaining altered on the native lung. These results highlights that an impaired lung may have a negative impact on its diaphragm. Replacement with a healthy lung can promote the recovery of the diaphragm to its anatomical morphology, reinforcing the close relationship between these two organs

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Multiple star systems in the Orion nebula

This is the author accepted manuscript. The final fersion is available from EDP Sciences via the DOI in this record.This work presents an interferometric study of the massive-binary fraction in the Orion Trapezium cluster with the recently comissioned GRAVITY instrument. We observed a total of 16 stars of mainly OB spectral type. We find three previously unknown companions for θ1 Ori B, θ2 Ori B, and θ2 Ori C. We determined a separation for the previously suspected companion of NU Ori. We confirm four companions for θ1 Ori A, θ1 Ori C, θ1 Ori D, and θ2 Ori A, all with substantially improved astrometry and photometric mass estimates. We refined the orbit of the eccentric high-mass binary θ1 Ori C and we are able to derive a new orbit for θ1 Ori D. We find a system mass of 21.7 M⊙ and a period of 53 days. Together with other previously detected companions seen in spectroscopy or direct imaging, eleven of the 16 high-mass stars are multiple systems. We obtain a total number of 22 companions with separations up to 600 AU. The companion fraction of the early B and O stars in our sample is about two, significantly higher than in earlier studies of mostly OB associations. The separation distribution hints toward a bimodality. Such a bimodality has been previously found in A stars, but rarely in OB binaries, which up to this point have been assumed to be mostly compact with a tail of wider companions. We also do not find a substantial population of equal-mass binaries. The observed distribution of mass ratios declines steeply with mass, and like the direct star counts, indicates that our companions follow a standard power law initial mass function. Again, this is in contrast to earlier findings of flat mass ratio distributions in OB associations. We excluded collision as a dominant formation mechanism but find no clear preference for core accretion or competitive accretion.Marie Skłodowska-Curie Grant AgreementFCT-PortugalERC Starting Gran

Determination of the optical depth of a DI diesel spray

The optical depth is responsible of limiting the optical diagnostic using visible wavelength in the sprays. This paper proposes to measure the optical depth directly in a real Diesel spray through line-of-sight laser extinction measurements. This easily reproducible method which does not require expensive or complex optical techniques is detailed and the measurement procedure is presented in this paper. As diesel sprays are mostly optically thick, the measurements in the denser region are not reliable and a fuel concentration model has been used to derive the results to the entire spray. This work provides values of SMD at different distance from the nozzle tip depending on the specific parameters like injection pressure or discharge density. The values extracted from a combined experimental/computational approach have been compared to PDPA measurements under the same testing conditions. The results have shown that the maximum optical depth was higher than 10 and that an increase of the injection pressure led to higher ¿ values. The SMD values appeared to be below the results measured by the PDPA and the droplet diameter showed to be the main responsible of the optical depth of the jet under the tested conditions. © 2011 The Korean Society of Mechanical Engineers and Springer-Verlag Berlin Heidelberg.Payri González, F.; Pastor, JV.; Payri, R.; Manin, JL. (2011). Determination of the optical depth of a DI diesel spray. Journal of Mechanical Science and Technology. 25(1):209-219. https://doi.org/10.1007/s12206-010-1024-xS209219251L. Pickett and D. Siebers, Non-sooting, low flame temperature mixing-controlled DI diesel combustion, SAE Paper, 2004-01-1399 (2004).S. Cheng, A. Upatnieks and C. J. Mueller, Investigation of fuel effects on dilute, mixing-controlled combustion in an optical direct-injection diesel engine, Energy & Fuels, 21 (2007) 1989–2002.S. Park, H. 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Powell, R. Poola and J. Wang, Quantitative measurements of diesel fuel spray characteristics in the near-nozzle region by using x-ray absorption, Atomization Sprays, 11(4) (2001).M. Linne, M. Paciaroni, T. Hall and T. Parker, Ballistic imaging of the near field in a diesel spray, Experiments in Fluid,s 40(6) (2006) 836–846.H. E. Albrecht, N. Damaschke, M. Borys and C. Tropea, Laser Doppler and Phase Doppler Measurement Techniques, Springer Berlin (2003).R. Domann and Y. Hardalupas, Quantitative Measurement of planar Droplet Sauter Mean Diameter in sprays using Planar Droplet Sizing, 11th Int. Symp. on App. of Laser Techniques to Fluid Mechanics (Lisbon Portugal) (2002).M. Van der Mark, M. Van Albada and A. Lagendijk, Light scattering in strongly scattering media: Multiple scattering and weak localization, Physical Review, B 37(7) (1988).L. Araneo and R. 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Manin, Experimental Study of Biodiesel Blends’ Effects on Diesel Injection Processes, Energy & Fuels, 23 (2009) 3227–3235.C. R. Kitchin, Stars, Nebulae and the Interstellar Medium: Observational Physics and Astrophysics CRC Press (1987).M. A. Linne, Spectroscopic Measurement: An Introduction to the Fundamentals, Academic Press (London, UK) (2002).J. V. Pastor, J. J. Lopez, J. E. Juliá and J. V. Benajes, Planar laser-induced fluorescence fuel concentration measurements in isothermal sprays, Opt. Express, 10(7) (2002) 309–323.J. Benajes, R. Payri, S. Molina, A.H. Plazas, Investigation of the influence of injection rate shaping on the spray characteristics in a diesel common rail system equipped with a piston amplifier, Journal of fluids engineering-transactions of the ASME, 127(6) (2005) 1102–1110.V. Bermudez, R. Payri, F. J. Salvador and A. H. 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Laven, Simulation of Rainbows, Coronas and Glories by the use of Mie theory, Applied Optics 43(3) (2003) 436–444.J. M. Desantes, R. Payri, J. M. Garcia and F. J. Salvador, A contribution to the understanding of isothermal diesel spray dynamics, Fuel, 86(7–8) (2007) 1093–1101.R. Payri, L. Araneo, J. Shakal and V. Soare, Phase doppler measurements: system set-up optimization for characterization of a diesel nozzle, J. Mech. Sci. Technol., 22 (2008) 1620–1632.E. Berrocal, D. L. Sedarsky, M. E. Paciaroni, I. V. Meglinski and M. A. Linne, Laser light scattering in turbid media Part I: Experimental and simulated results for the spatial intensity distribution, Optics Express, 15 (2007) 10649–10665.C. Roze, T. Girasole, L. Mevcs, G. Grehan, L. Hespel and A. Delfour, Interaction between ultra short pulses and a dense scattering medium by Monte Carlo simulation: consideration of particle size effect, Optics Communications, 220(4–6) (2003) 237–245.E. Berrocal, D. L. Sedarsky, M. E. Paciaroni, I. 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Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Photo-induced heating of nanoparticle arrays

International audienceThe temperature distribution throughout arrays of illuminated metal nanoparticles is investigated numerically and experimentally. The two cases of continuous and fs-pulsed illumination are addressed. In the case of continuous illumination, two distinct regimes are evidenced: a temperature confinement regime - where the temperature increase remains confined at the vicinity of each nanosource of heat - and a temperature delocalization regime - where the temperature is uniform throughout the whole nanoparticle assembly despite of their nanometric size. We show that the occurrence of one regime or another simply depends on the geometry of the nanoparticle distribution. In particular, we derived simple expressions of i) dimensionless parameters aimed at predicting the degree of temperature confinement and ii) analytical expressions aimed at estimating the actual temperature increase at the centre of an assembly of nanoparticles under illumination, preventing heavy numerical simulations. All these theoretical results are supported by experimental measurements of the temperature distribution on regular arrays of gold nanoparticles under illumination. In the case of fs-pulsed illumination, we explain what are the two conditions that must be fulfilled to observe a further enhanced temperature spatial confinement

Lung involvement associated with anti-NXP2 autoantibodies in inflammatory myopathies: a French monocenter series

International audienceBackground Inflammatory myopathies (IM) are characterized by muscular inflammation that can be associated with systemic disorders including lung. Anti-NXP2 antibody (Ab) is a rare myositis-specific antibody and its association with pulmonary involvement is still unknown. In this study, we investigated the characteristics of lung disease in patients with IM associated with anti-NXP2 Ab. Methods Adult patients with confirmed IM and positive anti-NXP2 antibodies were recruited in our University departments (Assistance Publique- Hopitaux de Marseille, France), between 2015 and 2019 to perform a retrospective study. Results Seven patients were identified. Mean age was 55 +/- 13 years, with a predominance of females (71%). Two patients (29%) had respiratory symptoms. CT-scan shows abnormalities in three patients (organizing pneumonia, nonspecific interstitial pneumonia, and bilateral pleural effusion). An altered diffusing capacity for carbon monoxide was found in four patients. Conclusion We observed that subclinical lung involvement is not rare in patients with IM associated with positive anti-NXP2 Ab, with various radiological patterns and a significant lung function defect. Such data deserve to be known by the pulmonologist in order to perform a complete lung screening in all patients with positive anti-NXP2 antibody and to detect earlier a concomitant lung impairment