97 research outputs found

    Symphonie massively parallel computer, modelling and design

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    The goal of this paper is to present an embedded calculator for image processing SYMPHONIE and the methodology used for its realization. In this calculator we could have up to 1024 processors . Its first application will take place in the french Rafale Aircraft as core of the infra-red system . For this application, low size and low consumption will be very important and an ASIC of a million gates has been developped . To succeed in this realization we used a VHDL model allowing simulations on the full system . Then we used VHDL synthesis methods for the conception of the ASIC . We will conclude this paper by a presentation of some perfomances of the system in some applications fields .L'objectif de cet article est de présenter le calculateur embarqué de traitement d'image SYMPHONIE, ainsi que la méthodologie mise en oeuvre pour sa réalisation. Ce calculateur dont une des applications se situe au coeur du systÚme de veille infrarouge de l'avion Rafale pourra comporter jusqu'à 1024 processeurs. Afin de tenir compte des contraintes de volume et de consommation, un ASIC d'un million de portes a été développé. Pour réussir cette réalisation un modÚle VHDL a été écrit permettant des simulations de l'ensemble du systÚme. Par ailleurs, ce modÚle a permis d'aborder la réalisation du circuit ASIC en faisant appel aux outils de synthÚse VHDL. Nous terminerons cette présentation par quelques performances dans différents domaines d'applications

    Multicentre prospective evaluation of histological and molecular criterion for diagnosis of prosthetic-joint infection

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    Objectives: This multicenter prospective study was performed to assess the contribution of broad range PCR diagnosis in prosthetic-joint infection (PJI). Methods: Adult patients treated for PJI at 7 centers were included between December 2010 and March 2012. Six per-operative samples were obtained for each patient, 5 for conventional cultures and 16S rRNA gene real-time PCR followed by sequencing, and 1 for histopathological classification according to Morawietz. Cultures and PCR were performed in a highly standardized manner, with 3 quality controls of PCR analyses. An infection was considered as proved (3 criteria: per-operative, bacteriological and histological), probable (clinical or bacteriological criterium), or excluded (no criterium). Molecular criterium for predicting PJI was determined using the bacteriological one as reference (>=1 positive sample for virulent organism, and >=3 positive samples for coagulase-negative staphylococci (CoNS) and P. acnes). Results: 299 patients were included, 264 with suspicion of sepsis (S) and 35 as controls (C). The 264 S presented with acute (19%), or chronic suspicion of PJI (81%). Infection was proved or probable in 212/264 S (80%), with the bacteriological criterium in 189/212 S (89%). Out of these, 156 (83%) had monomicrobial and 33 (17%) polymicrobial infections. The isolated pathogens were S. aureus (40%), CoNS (25%), streptococci (14%), Gram-Negative rods (10%), and anaerobes 8%. Histology results were not available for 55 patients, leaving 244 patients available for analysis. Histological findings of infection (Morawietz types II or III) were present in 128/169 (76%) proved or probable infections, in 3 patients without any other criterium, and were absent in excluded infections (n=42) and controls (n=29). PCR results were not analysable for 32 patients (S=28, C=4), leaving 267 patients (S=236, C=31) available for analysis. Molecular criterium of infection was present in 63/68 (93%) proved infections, 83/124 (67%) probable infections, 3/42 excluded infections, 0/2 histological criterium alone and 2/31 controls. Molecular criterium of infection was absent in 34/189 (18%) culture-positive S, and present in 8/23 culture-negative S (8 patients treated with antibiotics). Conclusions: According to this multicenter prospective study, 16S rRNA gene real-time PCR is less susceptible than culture for diagnosis of PJI. Molecular analysis could be recommended in culture-negative patients who were receiving antibiotics

    Evaluation of 16S rRNA gene PCR sensitivity and specificity for diagnosis of prosthetic joint infection: a prospective multicenter cross-sectional study

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    There is no standard method for the diagnosis of prosthetic joint infection (PJI). The contribution of 16S rRNA gene PCR sequencing on a routine basis remains to be defined. We performed a prospective multicenter study to assess the contributions of 16S rRNA gene assays in PJI diagnosis. Over a 2-year period, all patients suspected to have PJIs and a few uninfected patients undergoing primary arthroplasty (control group) were included. Five perioperative samples per patient were collected for culture and 16S rRNA gene PCR sequencing and one for histological examination. Three multicenter quality control assays were performed with both DNA extracts and crushed samples. The diagnosis of PJI was based on clinical, bacteriological, and histological criteria, according to Infectious Diseases Society of America guidelines. A molecular diagnosis was modeled on the bacteriological criterion (≄ 1 positive sample for strict pathogens and ≄ 2 for commensal skin flora). Molecular data were analyzed according to the diagnosis of PJI. Between December 2010 and March 2012, 264 suspected cases of PJI and 35 control cases were included. PJI was confirmed in 215/264 suspected cases, 192 (89%) with a bacteriological criterion. The PJIs were monomicrobial (163 cases [85%]; staphylococci, n = 108; streptococci, n = 22; Gram-negative bacilli, n = 16; anaerobes, n = 13; others, n = 4) or polymicrobial (29 cases [15%]). The molecular diagnosis was positive in 151/215 confirmed cases of PJI (143 cases with bacteriological PJI documentation and 8 treated cases without bacteriological documentation) and in 2/49 cases without confirmed PJI (sensitivity, 73.3%; specificity, 95.5%). The 16S rRNA gene PCR assay showed a lack of sensitivity in the diagnosis of PJI on a multicenter routine basis

    The boron-oxygen core of borinate esters is responsible for the store-operated calcium entry potentiation ability

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    International audienceBACKGROUND: Store-Operated Calcium Entry (SOCE) is the major Ca2+ ion entry pathway in lymphocytes and is responsible of a severe combined immunodeficiency (SCID) when deficient. It has recently been observed or highlighted in other cell types such as myoblasts and neurons, suggesting a wider physiological role of this pathway. Whereas Orai1 protein is considered to be the channel allowing the SOCE in T cells, it is hypothesized that other proteins like TRPC could associate with Orai1 to form SOCE with different pharmacology and kinetics in other cell types. Unraveling SOCE cell functions requires specific effectors to be identified, just as dihydropyridines were crucial for the study of Ca2+ voltage-gated channels, or spider/snake toxins for other ion channel classes. To identify novel SOCE effectors, we analyzed the effects of 2-aminoethyl diphenylborinate (2-APB) and its analogues. 2-APB is a molecule known to both potentiate and inhibit T cell SOCE, but it is also an effector of TRP channels and endoplasmic reticulum Ca2+-ATPase. RESULTS: A structure-function analysis allowed to discover that the boron-oxygen core present in 2-APB and in the borinate ester analogues is absolutely required for the dual effects on SOCE. Indeed, a 2-APB analogue where the boron-oxygen core is replaced by a carbon-phosphorus core is devoid of potentiating capacity (while retaining inhibition capacity), highlighting the key role of the boron-oxygen core present in borinate esters for the potentiation function. However, dimesityl borinate ester, a 2-APB analogue with a terminal B-OH group showed an efficient inhibitory ability, without any potentiating capacity. The removal or addition of phenyl groups respectively decrease or increase the efficiency of the borinate esters to potentiate and inhibit the SOCE. mRNA expression revealed that Jurkat T cells mainly expressed Orai1, and were the more sensitive to 2-APB modulation of SOCE. CONCLUSIONS: This study allows the discovery of new boron-oxygen core containing compounds with the same ability as 2-APB to both potentiate and inhibit the SOCE of different leukocyte cell lines. These compounds could represent new tools to characterize the different types of SOCE and the first step in the development of new immunomodulators

    The interest of gait markers in the identification of subgroups among fibromyalgia patients

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    <p>Abstract</p> <p>Background</p> <p>Fibromyalgia (FM) is a heterogeneous syndrome and its classification into subgroups calls for broad-based discussion. FM subgrouping, which aims to adapt treatment according to different subgroups, relies in part, on psychological and cognitive dysfunctions. Since motor control of gait is closely related to cognitive function, we hypothesized that gait markers could be of interest in the identification of FM patients' subgroups. This controlled study aimed at characterizing gait disorders in FM, and subgrouping FM patients according to gait markers such as stride frequency (SF), stride regularity (SR), and cranio-caudal power (CCP) which measures kinesia.</p> <p>Methods</p> <p>A multicentre, observational open trial enrolled patients with primary FM (44.1 ± 8.1 y), and matched controls (44.1 ± 7.3 y). Outcome measurements and gait analyses were available for 52 pairs. A 3-step statistical analysis was carried out. A preliminary single blind analysis using k-means cluster was performed as an initial validation of gait markers. Then in order to quantify FM patients according to psychometric and gait variables an open descriptive analysis comparing patients and controls were made, and correlations between gait variables and main outcomes were calculated. Finally using cluster analysis, we described subgroups for each gait variable and looked for significant differences in self-reported assessments.</p> <p>Results</p> <p>SF was the most discriminating gait variable (73% of patients and controls). SF, SR, and CCP were different between patients and controls. There was a non-significant association between SF, FIQ and physical components from Short-Form 36 (p = 0.06). SR was correlated to FIQ (p = 0.01) and catastrophizing (p = 0.05) while CCP was correlated to pain (p = 0.01). The SF cluster identified 3 subgroups with a particular one characterized by normal SF, low pain, high activity and hyperkinesia. The SR cluster identified 2 distinct subgroups: the one with a reduced SR was distinguished by high FIQ, poor coping and altered affective status.</p> <p>Conclusion</p> <p>Gait analysis may provide additional information in the identification of subgroups among fibromyalgia patients. Gait analysis provided relevant information about physical and cognitive status, and pain behavior. Further studies are needed to better understand gait analysis implications in FM.</p

    Care of Women with Obesity in Pregnancy:Green-top Guideline No. 72

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    ECMO for COVID-19 patients in Europe and Israel

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    Since March 15th, 2020, 177 centres from Europe and Israel have joined the study, routinely reporting on the ECMO support they provide to COVID-19 patients. The mean annual number of cases treated with ECMO in the participating centres before the pandemic (2019) was 55. The number of COVID-19 patients has increased rapidly each week reaching 1531 treated patients as of September 14th. The greatest number of cases has been reported from France (n = 385), UK (n = 193), Germany (n = 176), Spain (n = 166), and Italy (n = 136) .The mean age of treated patients was 52.6 years (range 16–80), 79% were male. The ECMO configuration used was VV in 91% of cases, VA in 5% and other in 4%. The mean PaO2 before ECMO implantation was 65 mmHg. The mean duration of ECMO support thus far has been 18 days and the mean ICU length of stay of these patients was 33 days. As of the 14th September, overall 841 patients have been weaned from ECMO support, 601 died during ECMO support, 71 died after withdrawal of ECMO, 79 are still receiving ECMO support and for 10 patients status n.a. . Our preliminary data suggest that patients placed on ECMO with severe refractory respiratory or cardiac failure secondary to COVID-19 have a reasonable (55%) chance of survival. Further extensive data analysis is expected to provide invaluable information on the demographics, severity of illness, indications and different ECMO management strategies in these patients
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