Risk factors for death in hospitalized dysentery patients in Rwanda.

To evaluate the management of severe dysentery cases in in-patient facilities during an epidemic of Shigella dysenteriae type 1 (Sd1), and to identify the factors associated with the risk of death, we conducted a prospective cohort study in 10 Rwandese hospitals between September and December 1994. Data were obtained from 849 cases admitted to hospitals with diarrhoea and visible blood in stools. The proportion of patients with persistent bloody diarrhoea was 51.0% at treatment day 3 and 27.9% at treatment day 5. At discharge, 79.9% had improved or were cured. The case fatality ratio was 13.2%, higher for patients treated with nalidixic acid than for those treated with ciprofloxacin (12.2% vs. 2.2%, RR = 5.80, 95% CI = 0.83-40.72). In a logistic regression model three risk factors were significantly associated with an increased risk of death during hospitalization: severe dehydration on admission (adjusted OR = 2.79, 95% CI = 1.46-5.33), age over 50 (adjusted OR vs. 5-49 age group = 3.22, 95% CI = 1.70-6.11) and prescription of nalidixic acid (adjusted OR vs. ciprofloxacin = 8.66, 95% CI = 1.08-69.67). Those results were consistent with reported high levels of resistance of Sd1 to the commonest antibiotics, including nalidixic acid. Patients belonging to groups with a higher risk of dying should be given special medical attention and supportive care. In areas of high resistance to nalidixic acid, severe cases of dysentery should be treated with fluoroquinolones in order to reduce the mortality associated with these epidemics

In situ TEM study of twin boundary migration in sub-micron Be fibers

Deformation twinning in hexagonal crystals is often considered as a way to palliate the lack of independent slip systems. This mechanism might be either exacerbated or shut down in small-scale crystals whose mechanical behavior can significantly deviate from bulk materials. Here, we show that sub-micron beryllium fibers initially free of dislocation and tensile tested in-situ in a transmission electron microscope (TEM) deform by a $\{ 10\bar{1}2 \}$ $\langle 10\bar{1}1 \rangle$ twin thickening. The propagation speed of the twin boundary seems to be entirely controlled by the nucleation of twinning dislocations directly from the surface. The shear produced is in agreement with the repeated lateral motion of twinning dislocations. We demonstrate that the activation volume ($V$) associated with the twin boundary propagation can be retrieved from the measure of the twin boundary speed as the stress decreases as in a classical relaxation mechanical test. The value of $V \approx 8.3 \pm 3.3 \times 10^{-29}m^3$ is comparable to the value expected from surface nucleation.Comment: 13 pages, 9 figure

In vitro susceptibility of 120 strains of Neisseria gonorrhoeae isolated in Kyrghyzstan.

BACKGROUND: The World Health Organization has established a worldwide program for gonococcal antimicrobial surveillance, but so far no data on gonococcal susceptibility in Central Asia are available. GOAL: The need for biological data on the susceptibility of Neisseria gonorrhoeae in Kyrghyzstan, to enable adaptation of the national treatment protocol for gonococcal infections, led Médecins Sans Frontières and Epicentre to conduct a survey in collaboration with the Alfred Fournier Institute in Paris and the health authorities in Bishkek. STUDY DESIGN: In vitro susceptibility of N gonorrhoeae strains was determined with use of the reference agar-plate dilution technique. RESULTS: Results for 11 antibiotics tested on 120 strains of gonococci showed a low proportion (11.7%) of penicillinase-producing N gonorrhoeae and high proportions of intermediate or resistant strains to the majority of the antibiotics tested, including fluoroquinolones (>or=25% of strains resistant). All the strains were susceptible to spectinomycin, and only two strains had decreased susceptibility to cefixime. CONCLUSION: The therapeutic choices available in Kyrghyzstan appear to be limited to cephalosporins and spectinomycin

Caractérisation des sous-unités principales et auxiliaires des canaux sodium dépendant du potentiel exprimées dans le système nerveux central de l'insecte Periplaneta americana (Thèse de Doctorat d'Université)

In insects, only one gene encodes the α pore-forming subunit of voltage-gated sodium channel (Nav). In addition, four to five genes encode the β auxiliary subunits. Although the American cockroach, Periplaneta americana, is a model in insect neurophysiology, few data describe the molecular structures at the base of the Nav. The aim of our study was to characterize the subunits expressed in the nerve cord (NC), the terminal abdominal ganglion (TAG) and DUM neurons of this particular species. First, we showed that the molecular diversity of the α subunit is generated by alternative splicing in NC and TAG. The main alternative exons identified in the cloned cDNA are A (loop L1), EFGHG1129 (loop L2) and G1 (IIIS3-S4). Despite of the molecular diversity, only one 6153-bp cDNA encoding PaNav1 has been identified. This isoform is characterized by the alternative exons (J, A; E; F; G1129, H and G1) highly expressed in the NC and TAG. On the opposite, only one type of cDNA has been identified in DUM neurons. Altogether, these results show that molecular diversity is lower at the cellular level. Moreover, a bioinformatic analysis showed the optional exons I and F are the most divergent currently known exons between insect orders. In addition, we discovered two full-length cDNAs encoding atypical α subunits named PaFPC1 and PaFPC2. They contain 1553 amino acid residues and differ from each other by eight punctual mutations. They share 59% protein identity with PaNav1. The absence of the inactivation particle MFMT suggests that these novel subunits mediate original electrophysiological properties. However, a detailed phylogenetic analysis puts forward that PaFPC is a novel member of the insect Nav channels. Hence; this discovery shows for the first time the existence of an ancestral duplication event of the Nav gene in insects. Finally, we cloned two cDNA populations encoding auxiliary subunits named PaTEH1.1 and PaTEH1.2. A phylogenetic analysis clarifies the relationships between the different families of insect auxiliary subunit. Moreover, a preliminary electrophysiological study showed that PaTEH1.1 increased significatively the expression of the pore-forming subunit of insect Nav in Xenopus oocytes. In conclusion, our results constitute new insights in insect ion channels field. In addition, they open new research perspectives for understanding the molecular basis of the membrane excitability in insects

Performance evaluation of stochastic systems with dedicated delivery bays and general on-street parking

As freight deliveries in cities increase due to retail fragmentation and e-commerce, parking is becoming a more and more relevant part of transportation. In fact, many freight vehicles in cities spend more time parked than they are moving. Moreover, part of the public parking space is shared with passenger vehicles, especially cars. Both arrival processes and parking and delivery processes are stochastic in nature. In order to develop a framework for analysis, we propose a queueing model for an urban parking system consisting of delivery bays and general on-street parking spaces. Freight vehicles may park both in the dedicated bays and in general on-street parking, while passenger vehicles only make use of general on-street parking. Our model allows us to create parsimonious insights into the behavior of a delivery bay parking stretch as part of a limited length of curbside. We are able to find explicit expressions for the relevant performance measures, and formally prove a number of monotonicity results. We further conduct a series of numerical experiments to show more intricate properties that cannot be shown analytically. The model helps us shed light onto the effects of allocating scarce urban curb space to dedicated unloading bays at the expense of general on-street parking. In particular, we show that allocating more space to dedicated delivery bays can also make passenger cars better off

Des insecticides plus sélectifs

La découverte d\u27un gène spécifique élargit les voies de recherche pouvant permettre de réduire les "dommages collatéraux" des insecticides

How does calcium-dependent intracellular regulation of voltage-dependent sodium current increase the sensitivity to the oxadiazine insecticide indoxacarb metabolite decarbomethoxylated JW062 (DCJW) in insect pacemaker neurons

Decarbomethoxylated JW062 (DCJW), the active component of the oxadiazine insecticide (S)-methyl 7-chloro-2,5-dihydro-2-[[(methoxycarbonyl)[4-(trifluoromethoxy)phenyl] amino]carbonyl] indeno[1,2-e][1,3,4]oxadiazine-4a(3H)-carboxylate (DPX-JW062) (indoxacarb), was tested on 2 inward voltage-dependent sodium currents (named INa1 and INa2) expressed in short-term cultured dorsal unpaired median neurons of the cockroach Periplaneta americana. Under whole-cell voltage-clamp conditions, application of DCJW resulted in a biphasic dose-dependent inhibition of the global sodium current amplitude illustrating the differing sensitivity of sodium channels to DCJW. INa2 was less sensitive to DCJW [half-maximal inhibitory concentration (IC(50)) = 1.6 microM] compared with INa1 (IC(50) = 1.7 nM). Although a previous study demonstrated that INa1 was regulated by the cAMP/protein kinase A cascade, we showed that INa2 was mainly regulated in an opposite way by the activation of calcium-calmodulin-dependent protein phosphatase 2B (PP2B) and calcium-calmodulin-dependent protein kinase II (CaM-kinase II). Furthermore, we demonstrated that activation of CaM-kinase II by intracellular calcium via the calcium-calmodulin complex affected the sensitivity of INa2 channels to DCJW. By increasing the intracellular calcium concentration and/or using 1,2-bis(o-aminophenoxy)ethane-N,N,N\u27,N\u27-tetraacetic acid (BAPTA) (a calcium chelator), N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide hydrochloride (W7) (a calmodulin inhibitor), cyclosporine A (a PP2B inhibitor), and 1-[N,O-bis(5-isoquinolinesulfonyl)-N-methyl-L-tyrosyl]-4-phenylpiperazine (KN-62) (a CaM-kinase II inhibitor), we revealed that activation of CaM-kinase II was involved in the modulation of the voltage dependence of steady-state inactivation and that the CaM-kinase II pathway activated by elevation of the intracellular calcium concentration might render INa2 channels approximately 3000-fold more sensitive to DCJW. These results indicated that manipulating specific intracellular signaling pathways involved in the regulation of sodium channels might have fundamental consequences for the sensitivity of insects to insecticides. This finding reveals an exciting research area that could lead to improvement in the efficiency of insecticides