Usefulness of a national hospital database to evaluate the burden of primary joint replacement for coxarthrosis and gonarthrosis in patients aged over 40 years

SummaryObjectiveTo evaluate the 2001 French burden of hospital primary joint replacement (PJR) for coxarthrosis and gonarthrosis.MethodsHospital surgical admissions for coxarthrosis and gonarthrosis in people aged over 40 years were selected from the French National Hospital Database. Of the 73,150 and 58,746 admissions for coxarthrosis and gonarthrosis, respectively, only 96 and 73% of them were analysed (exclusion of stays with no respect of coding guidelines). For each, we described the type of osteoarthritis, gender and age group distribution, incidence rate of PJR adjusted on age and gender, the type of joint replacement (total vs partial), the type of hospital (private vs hospital), the mean length of stay (LOS), the percentage of patients transferred to rehabilitation centre and the hospital costs.ResultsWhatever the type of osteoarthritis, PJR was mainly performed for primary osteoarthritis, in the 71–80 years' age group, in private hospital, with a total replacement procedure. The mean LOS were 13 and 12 days, and the transfers to a rehabilitation centre were 33 and 44%, for hip and knee, respectively. The incident rate of PJR increased significantly with age. It was higher in the 71–80 years' age group and decreased thereafter, whatever the gender and the type of osteoarthritis. The whole hospital costs were 591 and 411 millions of euros for hip and knee, respectively.ConclusionThe French National Hospital Database is a useful tool for assessing the burden of primary PJR for coxarthrosis and gonarthrosis. It might be used for international comparisons

Self-Pulsating Semiconductor Lasers: Theory and Experiment

We report detailed measurements of the pump-current dependency of the self-pulsating frequency of semiconductor CD lasers. A distinct kink in this dependence is found and explained using rate-equation model. The kink denotes a transition between a region where the self-pulsations are weakly sustained relaxation oscillations and a region where Q-switching takes place. Simulations show that spontaneous emission noise plays a crucial role for the cross-over.Comment: Revtex, 16 pages, 7 figure

CD4+ T-cell responses to Epstein-Barr virus (EBV) latent-cycle antigens and the recognition of EBV-transformed lymphoblastoid cell lines

There is considerable interest in the potential of Epstein-Barr virus (EBV) latent antigen-specific CD4$^+$ T cells to act as direct effectors controlling EBV-induced B lymphoproliferations. Such activity would require direct CD4$^+$ T-cell recognition of latently infected cells through epitopes derived from endogenously expressed viral proteins and presented on the target cell surface in association with HLA class II molecules. It is therefore important to know how often these conditions are met. Here we provide CD4$^+$ epitope maps for four EBV nuclear antigens, EBNA1, -2, -3A, and -3C, and establish CD4$^+$ T-cell clones against 12 representative epitopes. For each epitope we identify the relevant HLA class II restricting allele and determine the efficiency with which epitope-specific effectors recognize the autologous EBV-transformed B-lymphoblastoid cell line (LCL). The level of recognition measured by gamma interferon release was consistent among clones to the same epitope but varied between epitopes, with values ranging from 0 to 35% of the maximum seen against the epitope peptide-loaded LCL. These epitope-specific differences, also apparent in short-term cytotoxicity and longer-term outgrowth assays on LCL targets, did not relate to the identity of the source antigen and could not be explained by the different functional avidities of the CD4$^+$ clones; rather, they appeared to reflect different levels of epitope display at the LCL surface. Thus, while CD4$^+$ T-cell responses are detectable against many epitopes in EBV latent proteins, only a minority of these responses are likely to have therapeutic potential as effectors directly recognizing latently infected target cells

Quantifying molecular oxygen isotope variations during a Heinrich stadial

International audienceδ 18 O of atmospheric oxygen (δ 18 O atm) undergoes millennial-scale variations during the last glacial period, and systematically increases during Heinrich stadials (HSs). Changes in δ 18 O atm combine variations in biospheric and water cycle processes. The identification of the main driver of the millennial variability in δ 18 O atm is thus not straightforward. Here, we quantify the response of δ 18 O atm to such millennial events using a freshwater hosing simulation performed under glacial boundary conditions. Our global approach takes into account the latest estimates of isotope frac-tionation factor for respiratory and photosynthetic processes and make use of atmospheric water isotope and vegetation changes. Our modeling approach allows to reproduce the main observed features of a HS in terms of climatic conditions , vegetation distribution and δ 18 O of precipitation. We use it to decipher the relative importance of the different processes behind the observed changes in δ 18 O atm. The results highlight the dominant role of hydrology on δ 18 O atm and confirm that δ 18 O atm can be seen as a global integrator of hydrological changes over vegetated areas

Analgesic Efficacy of Pfannenstiel Incision Infiltration with Ropivacaine 7.5 mg/mL for Caesarean Section

Background. Pain after Caesarean delivery is partly related to Pfannenstiel incision, which can be infiltrated with local anaesthetic solutions. Methods. A double- blind randomized control trial was designed to assess the analgesic efficacy of 7.5 mg/mL ropivacaine solution compared to control group, in two groups of one hundred and forty four parturients for each group, who underwent Caesarean section under spinal anaesthesia: group R (ropivacaine group) and group C (control group). All parturients also received spinal sufentanil (2.5 μg). Results. Ropivacaine infiltration in the Pfannenstiel incision for Caesarean delivery before wound closure leads to a reduction of 30% in the overall consumption of analgesics (348 550 mg for group R versus 504 426 mg for group C with P < .05), especially opioids in the first 24 hours, but also significantly increases the time interval until the first request for an analgesic (4 h 20 min ± 2 h 26 for group R versus 2 h 42 ± 1 h 30 for group C). The P values for the two groups were: P < .0001 for paracetamol, P < .0001 for ketoprofen and P for nalbuphine which was the most significant. There is no significant difference in the threshold of VAS in the two series. Conclusion. This technique can contribute towards a programme of early rehabilitation in sectioned mothers, with earlier discharge from the post-labour suite

A Nine-year series of daily oxygen and hydrogen isotopic composition of precipitation at Concordia station, East Antarctica

The atmospheric processes determining the isotopic composition of precipitation on the Antarctic plateau are yet to be fully understood, as well as the post-depositional processes altering the snow pristine isotopic signal. Improving the comprehension of these physical mechanisms is of crucial importance for interpreting the isotopic records from ice cores drilled in the low accumulation area of Antarctica, e.g., the upcoming Beyond EPICA drilling at Little Dome C. Up to now, few records of the isotopic composition of precipitation in Antarctica are available, most of them limited in time or sampling frequency. Here we present a 9-year long δ18O and δD record (2008-2016) of precipitation at Concordia base, East Antarctica. The snow is collected daily on a raised platform (1 m), positioned in the clean area of the station; the precipitation collection is still being carried out each year by the winter over personnel. A significant positive correlation between isotopes in precipitation and 2-m air temperature is observed at both seasonal and interannual scale; the lowest temperature and isotopic values are usually recorded during winters characterized by a strongly positive Southern Annular Mode index. To improve the understanding of the mechanisms governing the isotopic composition of precipitation, we compare the isotopic data of Concordia samples with on-site observations, meteorological data from the Dome C AWS of the University of Wisconsin-Madison, as well as with high-resolution simulation results from the isotope-enabled atmospheric general circulation models ECHAM5-wiso and ECHAM6-wiso, nudged with the ERA-Interim and ERA5 reanalyses respectively

Détermination de l'âge des bovins par l'examen de la dentition. Méthodologie et principaux résultats acquis en milieu villageois dans le Nord de la Côte d'Ivoire

Les auteurs décrivent une nouvelle méthode pour l'étude de la dynamique de l'éruption des incisives de remplacement chez les bovins. Adaptée au cas des populations animales où la date de naissance des animaux est inconnue, elle permet d'obtenir rapidement des résultats précis. Cette méthode a été appliquée au cheptel bovin sédentaire du Nord de la Côte-d'Ivoire. Les principaux résultats obtenus concernent la durée des stades dentaires et l'âge à l'éruption des incisives adultes pour les types génétiques suivants: Baoulé (West African Shorthorn). Métis N'Dama x Baoulé et Zébu x Baoulé. On n'observe pas d'effet significatif des facteurs sexe, région et saison de naissance sur les variables étudiées. Les résultats obtenus par type génétique sont peu différents. Les liaisons entre les durées respectives des stades dentaires sont faibles. D'une façon générale, les taurins de l'Afrique de l'Ouest et leurs métis sont plus précoces que les animaux zébus, eux-mêmes plus précoces que les races européennes en ce qui concerne le rythme de remplacement des dent

Wave: A New Family of Trapdoor One-Way Preimage Sampleable Functions Based on Codes

We present here a new family of trapdoor one-way Preimage Sampleable Functions (PSF) based on codes, the Wave-PSF family. The trapdoor function is one-way under two computational assumptions: the hardness of generic decoding for high weights and the indistinguishability of generalized $(U,U+V)$-codes. Our proof follows the GPV strategy [GPV08]. By including rejection sampling, we ensure the proper distribution for the trapdoor inverse output. The domain sampling property of our family is ensured by using and proving a variant of the left-over hash lemma. We instantiate the new Wave-PSF family with ternary generalized $(U,U+V)$-codes to design a "hash-and-sign" signature scheme which achieves existential unforgeability under adaptive chosen message attacks (EUF-CMA) in the random oracle model. For 128 bits of classical security, signature sizes are in the order of 15 thousand bits, the public key size in the order of 4 megabytes, and the rejection rate is limited to one rejection every 10 to 12 signatures.Comment: arXiv admin note: text overlap with arXiv:1706.0806

EKF for joint mitigation of phase noise, frequency offset and nonlinearity in 400 Gb/s PM-16-QAM and 200 Gb/s PM-QPSK systems

The performance of higher order modulation formats such as 16-quadrature amplitude modulation (QAM) coherent optical communication systems are limited due to several linear and nonlinear impairments such as phase noise, frequency offset, chromatic dispersion, and fiber nonlinearities. For a satisfactory system performance, these impairments need to be eliminated either by all-optical and/or electronic means. In this paper, we use the extended Kalman filter (EKF) algorithm to jointly mitigate laser phase noise, frequency offset, and nonlinear channel impairments, namely self phase modulation and nonlinear phase noise in polarization multiplexed 400 Gb/s 16-QAM and 200 Gb/s quadrature phase shift keying (QPSK) systems. We consider a two-state EKF with phase as one state and frequency offset as another. Simulation results for transmission over 1000 km (10 × 100 km) of standard single mode fiber show a Q-factor of 12 dB for PM-16-QAM at frequency offset of 1 GHz and laser linewidth of 100 kHz and a Q-factor of 18 dB for PM-QPSK at 1 MHz linewidth. Further, phase trajectories corresponding to tracked laser phase noise and frequency offset show that EKF can suppress laser phase noise up to 10 MHz and frequency offset up to 5 GHz, thereby eliminating the requirement of using separate algorithms for phase noise and frequency offset estimation