Early outcomes of THA using uncemented dual-mobility cups with additional fixation screws

Background: The use of fixation screws with uncemented cups is controversial particularly for dual mobility (DM) cups where perforation of the articular surface could compromise implant longevity. We aimed to compare outcomes of total hip arthroplasty (THA) using uncemented DM cups with supplementary screw fixation versus simple press-fit fixation. Methods: From 235 consecutive THAs performed using uncemented DM cups, 203 were fixed by simple press-fit and 32 fixed with additional screws. The Oxford hip score (OHS) and EuroQol 5 Dimensions (EQ-5D) score were available at 3.3±1.1 years. To enable direct comparison, each screw fixation cup was matched to three simple press-fit cups using propensity scores, based on age, sex and bone quality. Results: The two groups had equivalent age, body mass index, gender distribution, femoral morphology and bone quality. Compared to the press-fit group (n=96), the screw fixation group had more surgical antecedents (p=0.032), higher femoral neck angles (p=0.028), and received slightly larger cups (p=0.036). Revision was required for two (6%) screw fixation cups (only one implant-related) and one (1%) press-fit cup (none implant-related). There were no differences between OHS (19±8 vs 18±7, p=0.682) nor EQ-5D (0.63±0.37, p=0.257). Conclusions: Revision rates were greater for DM cups fixed with additional screws than for those fixed by simple press-fit, but clinical scores were equivalent. There was only one implant-related revision (acetabular fracture) in the screw fixation group and it is unclear whether this is related to the additional screws or to patient/surgical factors

Could thioredoxin h be involved in early response to gravitropic stimulation of poplar stems?

The perception of gravity is essential for plant development. Trees constantly develop specialized woody tissues, termed « reaction wood » to correct inclined branch and stem growth in order to adopt an optimal position. Despite the economical impact of reaction wood occurrence and itsimportance from a developmental point of view, the perception and response to the gravitational stimulus have not been extensively studied in woody species in which primary and secondary growth occur. Using complementary approaches (proteomics, qRT-PCR, immunolocalization), we have compared straight polar stems to stems that were inclined at 35° from the vertical axis for periods of time varying from 10 min to 6 hours depending on the experiments. The proteomics approach revealed that thirty six percent of the identified proteins that were differentially expressed after gravistimulation were established as potential Thioredoxin targets. qRT-PCR indicated an early induction of Thioredoxin h expression following gravistimulation. In situ immunolocalization indicated that Thioredoxin h protein co-localized with the amyloplasts located in the endodermalcells which may be specialized in gravity perception. These investigations suggest the involvement of Thioredoxin h in the first events of signal transduction in inclined poplar stems, leading to reaction wood formation

SOL RF physics modelling in Europe, in support of ICRF experiments

A European project was undertaken to improve the available SOL ICRF physics simulation tools and confront them with measurements. This paper first reviews code upgrades within the project. Using the multi-physics finite element solver COMSOL, the SSWICH code couples RF full-wave propagation with DC plasma biasing over “antenna-scale” 2D (toroidal/radial) domains, via non-linear RF and DC sheath boundary conditions (SBCs) applied at shaped plasma-facing boundaries. For the different modules and associated SBCs, more elaborate basic research in RF-sheath physics, SOL turbulent transport and applied mathematics, generally over smaller spatial scales, guides code improvement. The available simulation tools were applied to interpret experimental observations on various tokamaks. We focus on robust qualitative results common to several devices: the spatial distribution of RF-induced DC bias; left-right asymmetries over strap power unbalance; parametric dependence and antenna electrical tuning; DC SOL biasing far from the antennas, and RF-induced density modifications. From these results we try to identify the relevant physical ingredients necessary to reproduce the measurements, e.g. accurate radiated field maps from 3D antenna codes, spatial proximity effects from wave evanescence in the near RF field, or DC current transport. Pending issues towards quantitative predictions are also outlined

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

The SIB Swiss Institute of Bioinformatics' resources: focus on curated databases

The SIB Swiss Institute of Bioinformatics (www.isb-sib.ch) provides world-class bioinformatics databases, software tools, services and training to the international life science community in academia and industry. These solutions allow life scientists to turn the exponentially growing amount of data into knowledge. Here, we provide an overview of SIB's resources and competence areas, with a strong focus on curated databases and SIB's most popular and widely used resources. In particular, SIB's Bioinformatics resource portal ExPASy features over 150 resources, including UniProtKB/Swiss-Prot, ENZYME, PROSITE, neXtProt, STRING, UniCarbKB, SugarBindDB, SwissRegulon, EPD, arrayMap, Bgee, SWISS-MODEL Repository, OMA, OrthoDB and other databases, which are briefly described in this article

Nat Genet

The function of the majority of genes in the mouse and human genomes remains unknown. The mouse embryonic stem cell knockout resource provides a basis for the characterization of relationships between genes and phenotypes. The EUMODIC consortium developed and validated robust methodologies for the broad-based phenotyping of knockouts through a pipeline comprising 20 disease-oriented platforms. We developed new statistical methods for pipeline design and data analysis aimed at detecting reproducible phenotypes with high power. We acquired phenotype data from 449 mutant alleles, representing 320 unique genes, of which half had no previous functional annotation. We captured data from over 27,000 mice, finding that 83% of the mutant lines are phenodeviant, with 65% demonstrating pleiotropy. Surprisingly, we found significant differences in phenotype annotation according to zygosity. New phenotypes were uncovered for many genes with previously unknown function, providing a powerful basis for hypothesis generation and further investigation in diverse systems.Comment in : Genetic differential calculus. [Nat Genet. 2015] Comment in : Scaling up phenotyping studies. [Nat Biotechnol. 2015

La notification d’effet indésirable au secours de l’ordonnance « non substituable » !

En août 2012, les médecins généralistes de la Haute-Garonne ont reçu un courrier de la caisse d’Assurance maladie rappelant que la mention « non substituable » peut être apposée sur l’ordonnance suite à une déclaration d'effet indésirable (EI). Comparée à une période équivalente antérieure à ce courrier, nous avons observé une augmentation des déclarations d'EI sous génériques, en particulier, des EI digestifs et des inefficacités