Interview with Wilda Obrey

An interview with Wilda Aubrey regarding her experiences in a one-room school house.https://scholars.fhsu.edu/ors/1143/thumbnail.jp

Infection néonatale bactérienne précoce : Quand mettre sous antibiotique et quelle antibiothérapie ? Early bacterial neonatal infection: When to indicate antibiotic treatment and what antibiotic therapy ?

Objective. Propose a relevant management strategy that can identify newborns with a bacterial infectious risk and those under clinical monitoring alone or in combination with parenteral antibiotic therapy.Methods. Retrospective study carried out between SA < 42, suspected of early bacterial infection and monitored in Maternity and in the Neonatology Unit of the Hospital Group Carnelle Portes of Oise [Val France]. The clinical-biological and bacteriological data, the therapeutic strategy and the evolution are analyzed. Results. Two hundred and forty newborns were eligible and divided into three groups: 120 asymptomatic newborns with antenatal criteria for bacterial infectious risk [G1NAS], 70 symptomatic newborns with antenatal criteria for bacterial infectious risk [G2NSCARIB] and 50 symptomatic newborns without antenatal criteria of bacterial infectious risk [G3NSSCARIB]. Inflammatory biology is limited tocolonized G1NAS newborns and symptomatic groups. The identified bacteria [Peripheral samples, gastric fluid, blood and cerebrospinal fluid] were mainly the Streptococcus of the group and the E Coli. Antibiotic therapy has been shown to be useful in asymptomatic newborns with inflammatory syndrome and bacteria identified on peripheral samples and gastric fluid, but  also in all symptomatic newborns. Conclusion. In a early bacterial infection, an interventionist attitude is required, but early antibiotic therapy is only useful in the situation of symptomatic newborns. On the otherhand, in the asymptomatic newborns, antibiotic therapy will be reserved for those carrying both an identified bacteria and an inflammatory syndrome. Contexte et objectif. L‟infection néonatale bactérienne précoce est greffée d‟une forte mortalité et morbidité conduisant à une antibiothérapie probabiliste sans délai souvent à posteriori inutile. L‟objectif du présent travail était de proposer une stratégie de prise en charge pertinente susceptible de bien identifier les nouveau-nés à risque infectieux bactérien et ceux relevant d‟une surveillance clinique seule ou associée à une antibiothérapie parentérale.    Méthodes. Etude documentaire menée entre janvier 2014 et janvier 2016 sur des nouveau-nés de 36≥SA<42, suspects d‟infection bactérienne précoce et suivis en Maternité et dans l‟unité de Néonatologie du Groupe Hospitalier Carnelle Portes de l‟Oise [Val D‟Oise, France]. Les données clinico-biologiques et bactériologiques, la stratégie thérapeutique et l‟évolution sont analysées.  Résultats. Deux cent quarante nouveau-nés [NNES] ont été éligibles et repartis en trois groupes : 120 NNES asymptomatiques avec critères anténatals de risque infectieux bactérien [G1NAS], 70 NNES symptomatiques avec critères anténatals de risque infectieux bactérien [G2NSCARIB] et 50 NNES symptomatiques sans critères anténatals de risque infectieux bactérien [G3NSSCARIB]. La biologie inflammatoire est limitée aux NNES du groupe G1NAS colonisés et aux groupes symptomatiques. Les germes identifiés [Prélèvements périphériques, liquide gastrique, sang et liquide céphalorachidien] ont été principalement le Streptocoque du groupe β et l‟E Coli. L‟antibiothérapie s‟est avérée utile chez les NNES asymptomatiques avec syndrome inflam-matoire et germes identifiés sur les prélèvements périphériques et liquide gastrique, mais aussi chez tous les NNES symptomatiques.                                                                    Conclusion. Chez un NNE âgé de ≥ 36SA et suspect d‟infection bactérienne précoce, une attitude interventionniste est de rigueur, mais l‟antibiothérapie sans délai n‟est utile que dans les situations des NNES symptomatiques. En revanche, chez les NNES asymptomatiques, l‟antibiothérapie sera réservée à ceux porteurs à la fois d‟un germe et d‟un syndrome inflammatoire

Magnetoelectric MnPS3 thiophosphate as a new candidate for ferrotoroidicity

We have revisited the magnetic structure of manganese phosphorus trisulfide MnPS3 using neutron diffrac- tion and polarimetry. MnPS3 undergoes a transition toward a collinear antiferromagnetic order at 78 K. The resulting magnetic point-group breaks both the time reversal and the space inversion thus allowing a linear magnetoelectric coupling. Neutron polarimetry was subsequently used to prove that this coupling provides a way to manipulate the antiferromagnetic domains simply by cooling the sample under crossed magnetic and electrical fields, in agreement with the nondiagonal form of the magnetoelectric tensor. In addition, this tensor has, in principle, an antisymmetric part that results in a toroidic moment and provides with a pure ferrotoroidic compound

Direct microscopic examination of imprints in patients undergoing cardiac valve replacement

BACKGROUND: Bacteriological analysis of cardiac valves might be indicated in patients with suspected endocarditis. METHODS: We report here a prospective study on fifty-three consecutive patients whose native valves were sent to the bacteriological and pathological laboratories, to investigate the performance of direct microscopic examination of imprints and valve culture. RESULTS: On the basis of a histopathological gold standard to classify the inflammatory valve process, the sensitivity, the specificity, the positive and the negative predictive values of direct microscopic examination of imprints and valve culture were 21%, 100%, 100%, 60%, and 21%, 72%, 38%, 52% respectively. This weak threshold of the direct microscopic examination of imprints could be due to antimicrobial therapy prescribed before cardiac surgery and the fact that the patients came from a tertiary hospital receiving patients with a prolonged history of endocarditis. CONCLUSION: Clinical context and histopathology are indispensable when analyzing the imprints and valve culture

Detour and break optimising distance, a new perspective on transport and urbanism

International audienceFrom a discussion about the mathematical properties of metrics, we identify three fundamental characteristics of distance, which are optimality, detour and break. We then explore the implications of these properties for transport planning, urbanism and spatial planning. We state that distances contain the idea of optimum and that any distance is associated to a search for optimisation. Pedestrian movements obey this principle and sometimes depart from designed routes. Local sub-optimality conveyed by public transport maps has to be corrected by interventions on public space to relieve the load on central parts of networks. The second principle we state is that detour in distances is most often a means to optimise movement. Fast transport systems generates most of the detour observed in geographical spaces at regional scale. This is why detour has to be taken into account in regional transport policies. The third statement is that breaks in movement contribute to optimising distances. Benches, cafés, pieces of art, railway stations are examples of the urban break. These facilities of break represent an urban paradox: they organise the possibility of a break, of a waste of time in a trip, and they also contribute to optimising distances in a wider network. In that sense break should be considered as a relevant principle for the design of urban space in order to support a pedestrian oriented urban form

Risk factors for upper-extremity musculoskeletal disorders in the working population.

OBJECTIVE: To assess the relative importance of personal and occupational risk factors for upper-extremity musculoskeletal disorders in the working population. METHODS: A total of 3,710 workers (58% men) participating in a surveillance program of musculoskeletal disorders in a French region in 2002-2005 were included. Upper-extremity musculoskeletal disorders were diagnosed by 83 trained occupational physicians performing a standardized physical examination. Personal factors and work exposure were assessed by a self-administered questionnaire. Statistical associations between musculoskeletal disorders, personal, and occupational factors were analyzed using logistic regression modeling. RESULTS: A total of 472 workers experienced at least 1 upper-extremity musculoskeletal disorder. The risk of upper-extremity musculoskeletal disorders increased with age for both sexes (P < 0.001, odds ratio [OR] < or =4.9 in men and < or =5.0 in women), and in cases of prior history of upper-extremity musculoskeletal disorders (OR 3.1 and 5.0, respectively, P < 0.001). In men, upper-extremity musculoskeletal disorders were associated with obesity (OR 2.2, P = 0.014), high level of physical demand (OR 2.0, P < 0.001), high repetitiveness of the task (OR 1.5, P = 0.027), postures with the arms at or above shoulder level (OR 1.7, P = 0.009) or with full elbow flexion (OR 1.6, P = 0.006), and high psychological demand (OR 1.5, P = 0.005). In women, upper-extremity musculoskeletal disorders were associated with diabetes mellitus (OR 4.9, P = 0.001), postures with extreme wrist bending (OR 2.0, P < 0.001), use of vibrating hand tools (OR 2.2, P = 0.025), and low level of decision authority (OR 1.4, P = 0.042). CONCLUSION: Personal and work-related physical and psychosocial factors were strongly associated with clinically diagnosed upper-extremity musculoskeletal disorders

Association Between Severity of Obstructive Sleep Apnea and Blood Markers of Liver Injury

Obstructive sleep apnea (OSA) may contribute to the development of nonalcoholic fatty liver disease. We performed a multisite cross-sectional study to evaluate the association between the severity of OSA and blood markers of liver steatosis (using the hepatic steatosis index), cytolysis (based on alanine aminotransferase activity), and significant liver fibrosis (based on the FibroMeter [Echosens] nonalcoholic fatty liver disease score) in 1285 patients with suspected OSA in France. After adjusting for confounders including central obesity, the risk of liver steatosis increased with the severity of OSA (P for trend < .0001) and sleep-related hypoxemia (P for trend < .0003 for mean oxygen saturation). Decreasing mean oxygen saturation during sleep also was associated independently with a higher risk of liver cytolysis (P for trend < .0048). Severe OSA conferred an approximate 2.5-fold increase in risk for significant liver fibrosis compared with patients without OSA, but the association between OSA severity and liver fibrosis was not maintained after adjusting for confounders