032: Thirty months outcomes after PCI of unprotected left main coronary artery according to the SYNTAX score

AimsTo assess middle term outcomes according to SYNTAX score and rates of delayed surgical/bleeding events after unprotected left main (LM) coronary artery (ULMCA) PCI in an unselected patients population.MethodsConsecutive patients treated by PCI for ULMCA were included among a single center 3508 PCI database within 36 months. Syntax scores were calculated, post discharge extracardiac surgery or hemorrhage were recorded during follow-up as clinical outcomes (Death, TVR, MACCE=cardiovascular death+MI+stroke+TLR).Results102 (3.6%) patients underwent PCI of the LM, including 21 protected LM. Among the 81 patients with PCI of ULMCA, mean age was 65±13, 27% had urgent PCI for AMI or cardiogenic shock, 61% had DES.SYNTAX score was 28±14 in mean and ≤22 in 30 (37%), 23 to 32 in 22 (27%) and ≥33 in 29 (36%) patients.At 30±11 months follow up (98% of the patients), death occurred in 24 patients (30%), TVR in 16 (20%) and MACCE in 35 (43%). Clinical events according to the SYNTAX score are shown in figure. No cardiovascular death occurred in patients with syntax ≤22. MACCE rates were significantly lower when DES were used (24% vs. 64%, p<0.05) and in case of non-urgent PCI (36% vs. 71%, p<0.05).During follow-up, 20 (25%) and 12 (15%) patients underwent unplanned extracardiac surgery and/or hemorrhage, leading to antiplatelet withdrawal in 31% of the cases.ConclusionsIn unselected patients treated by PCI of ULMCA with Syntax score ≤22, outcomes were found to be excellent with no cardiovascular death observed at 30 months. DES and non-urgent PCI were associated with a better prognosis. One patient out of three underwent unplanned extracardiac surgery or hemorrhage during follow up.Figure: 30-months outcomes according to SYNTAX scor

Association of the PHACTR1/EDN1 genetic locus with spontaneous coronary artery dissection

Background: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndromes (ACS) afflicting predominantly younger to middle-aged women. Observational studies have reported a high prevalence of extracoronary vascular anomalies, especially fibromuscular dysplasia (FMD) and a low prevalence of coincidental cases of atherosclerosis. PHACTR1/EDN1 is a genetic risk locus for several vascular diseases, including FMD and coronary artery disease, with the putative causal noncoding variant at the rs9349379 locus acting as a potential enhancer for the endothelin-1 (EDN1) gene. Objectives: This study sought to test the association between the rs9349379 genotype and SCAD. Methods: Results from case control studies from France, United Kingdom, United States, and Australia were analyzed to test the association with SCAD risk, including age at first event, pregnancy-associated SCAD (P-SCAD), and recurrent SCAD. Results: The previously reported risk allele for FMD (rs9349379-A) was associated with a higher risk of SCAD in all studies. In a meta-analysis of 1,055 SCAD patients and 7,190 controls, the odds ratio (OR) was 1.67 (95% confidence interval [CI]: 1.50 to 1.86) per copy of rs9349379-A. In a subset of 491 SCAD patients, the OR estimate was found to be higher for the association with SCAD in patients without FMD (OR: 1.89; 95% CI: 1.53 to 2.33) than in SCAD cases with FMD (OR: 1.60; 95% CI: 1.28 to 1.99). There was no effect of genotype on age at first event, P-SCAD, or recurrence. Conclusions: The first genetic risk factor for SCAD was identified in the largest study conducted to date for this condition. This genetic link may contribute to the clinical overlap between SCAD and FMD

Semi-autonomous robotic system for marine species observation

L'objectif de cette thèse, en collaboration avec une équipe de biologistes de Marbec, est de développer un système robotisé semi-autonome pour l’observation des espèces marines. Pour cela, ce système devra effectuer les protocoles biologistes connus ainsi que de nouveaux protocoles tout en démontrant son efficacité par rapport à un plongeur. Pour réaliser correctement les protocoles, nous avons développé les lois de commande associées ainsi qu'un système de gestion de mission pour permettre la construction, la validation formelle et l'exécution d'une telle mission. Enfin, pour répondre à la problématique de faisabilité de l'observation par un robot, nous avons mené les expérimentations à Mayotte.The goal of this thesis, in collaboration with a biologists team of Marbec, is to develop a semi-autonomous robotic system for marine species observation. For this, this system will have to perform the known biologist protocols as well as new protocols while proving its effectiveness compared to a diver. To achieve the protocols, we have developed the associated control laws and a mission management system to allow the construction, the formal validation and the execution of a mission. Finally, to answer the problem of feasibility of observation by a robot, we conducted the experiments in Mayotte

Clarification et correction d'indices segmentaux : une étude pilote sur les consonnes occlusives du français

International audienceClarification and correction of segment cues: a pilot study on French stop consonants. This study deals with the question of the voicing feature and the articulation place of French stop consonants, using a new paradigm of segment correction. It aims at testing 1) which acoustic cues speakers enhance when they are misunderstood by an interlocutor, and 2) whether this enhancement is always the same or depends on the misperceived consonant. One speaker played with the experimenter a game designed to simulate natural situations of misunderstanding. The speakers showed several modifications of her stop consonants in clear speech and in situations of segment corrections (duration of the occlusion phase, VOT, burst intensity, …). However, hardly no descriptor was modified in a different way, depending on the perceptual error made by the interlocutor (on the voicing feature or on the articulation place).Cette étude aborde la question du trait de voisement et de la place d'articulation des consonnes occlusives du Français à l'aide d'un nouveau paradigme de correction segmentale, de façon à tester 1) quels indices de ces consonnes des locuteurs renforcent lorsqu'ils ont été mal compris par leur interlocuteur, et 2) si le renforcement de ces indices est toujours le même ou dépend de la consonne entendue à la place. Une locutrice jouait avec l'expérimentatrice à un jeu conçu pour simuler des situations d'incompréhension assez naturelles. La locutrice a montré plusieurs modifications de ses consonnes occlusives en parole claire et en situation de correction d'un mot mal compris (durée de la phase d'occlusion, VOT, intensité du bruit, …). En revanche, quasiment aucun descripteur n'a été modifié de façon différente en fonction du type d'erreur perceptive commise par l'interlocutrice (portant sur le trait de voisement ou sur le lieu d'articulation)

Clarification et correction d'indices segmentaux : une étude pilote sur les consonnes occlusives du français

International audienceClarification and correction of segment cues: a pilot study on French stop consonants. This study deals with the question of the voicing feature and the articulation place of French stop consonants, using a new paradigm of segment correction. It aims at testing 1) which acoustic cues speakers enhance when they are misunderstood by an interlocutor, and 2) whether this enhancement is always the same or depends on the misperceived consonant. One speaker played with the experimenter a game designed to simulate natural situations of misunderstanding. The speakers showed several modifications of her stop consonants in clear speech and in situations of segment corrections (duration of the occlusion phase, VOT, burst intensity, …). However, hardly no descriptor was modified in a different way, depending on the perceptual error made by the interlocutor (on the voicing feature or on the articulation place).Cette étude aborde la question du trait de voisement et de la place d'articulation des consonnes occlusives du Français à l'aide d'un nouveau paradigme de correction segmentale, de façon à tester 1) quels indices de ces consonnes des locuteurs renforcent lorsqu'ils ont été mal compris par leur interlocuteur, et 2) si le renforcement de ces indices est toujours le même ou dépend de la consonne entendue à la place. Une locutrice jouait avec l'expérimentatrice à un jeu conçu pour simuler des situations d'incompréhension assez naturelles. La locutrice a montré plusieurs modifications de ses consonnes occlusives en parole claire et en situation de correction d'un mot mal compris (durée de la phase d'occlusion, VOT, intensité du bruit, …). En revanche, quasiment aucun descripteur n'a été modifié de façon différente en fonction du type d'erreur perceptive commise par l'interlocutrice (portant sur le trait de voisement ou sur le lieu d'articulation)

HIL Simulator for AUV with ContrACT

National audienceLe processus de conception d’un syst`eme est compos´e de diff ´erentes ´etapes de validation. La validation estd’autant plus importante dans le contexte de syst `emes embarqu´es critiques, et donc soumis `a des contraintestemporelles strictes, comme c’est le cas pour la robotique sous-marine en milieu naturel. Notre méthodologiede conception démarre par l’étude théorique et finit bien sûr par les essais sur le terrain, mais le passage parla simulation est obligatoire afin de valider les concepts au plus tôt. De par l’augmentation de la complexitédes missions et la difficulté qu’apporte l’expérimentation dans le milieu subaquatique, la simulation Hardware In-the-Loop (HIL) est un outil très précieux. Nous avons donc conçu un simulateur HIL de notre robot, quiest utilisé pour la validation de nos missions dans le cadre de l’étude de la biodiversité marine du lagon deMayotte. Il est basé sur le middleware ContrACT, lui-même installé sur le système d’exploitation temps réel LinuxXenomai. Notre simulateur se veut le plus transparent possible afin de minimiser son impact sur le contrôle,mais également le plus précis possible dans les modèles et la gestion du temps afin de rendre la validation laplus réaliste

Electroless deposition of copper on to alumina sub-micronic powders and sintering

This work has been initiated in order to find new routes for the preparation of 3D interconnected ceramic-metal composites, usually obtained by direct metal oxidation or liquid infiltration of a ceramic preform. The system under investigation is the alumina-copper system. The key point of this new route was the preparation of very fine composite powders, which allowed the material to be densified by natural sintering. The first part of the presentation deals with the preparation of the composite powders, which was achieved using an electroless process. Influence of experimental parameters controlling the deposition of a copper layer on a sub-micronic alumina powder was investigated. The second part deals with the processing of the composite. A statistical design methodology was applied to determine the main parameters controlling the shrinkage. For some conditions, a new in situ Cu-CuAlO2 composite is formed, which presents an interesting microstructure with CuAlO2 acicular grains

Hydrogen Production Properties of Aluminum–Magnesium Alloy Presenting β-Phase Al₃Mg₂

In this study, aluminum–magnesium (Al-Mg) bulk porous materials were fabricated by using uniaxial hot pressing to control the porosity rate of the material over a wide range (up to 50%). The fabricated materials were analyzed by X-ray diffraction and scanning electron microscopy. The results demonstrated the appearance of intermetallic (IM) phase Al3Mg2, and its quantity increased with the applied pressure. In the context of the decline of global fossil fuel reserves, the revalorization of these materials by hydrogen (H2) production was investigated. Hydrolysis of the Al-Mg materials was carried out in a simulated seawater solution (aqueous solution of sodium chloride 35 g/L). The results showed the role of the porosity rate in the H2 production properties of the fabricated materials; the increase of porosity rate from 10% to 50% cuts the reaction time in half. Finally, the role of IM phase Al3Mg2 in H2 production was highlighted through galvanic coupling

Quadruplex Real-Time PCR Assay Using Allele-Specific Scorpion Primers for Detection of Mutations Conferring Clarithromycin Resistance to Helicobacter pylori ▿ †

We developed a single-vessel multiplex real-time PCR assay that detects Helicobacter pylori infection and identified the four existing alleles of the 23S rRNA genes of H. pylori—the wild-type sequence and the three mutations conferring clarithromycin resistance—using allele-specific Scorpion primers directly on biopsy specimens. The Scorpion primers combine a primer and a probe in a single molecule and are able to distinguish single-nucleotide polymorphism. Fluorescent signals, produced when the probes are annealed, are read in four channels by a SmartCycler thermocycler. The assay was first applied successfully on 4 reference and 61 clinical strains. MICs of clarithromycin were determined by the Etest method. A perfect concordance was obtained between Etest and Scorpion PCR. Mixed populations were better detected by Scorpion PCR. We examined 259 biopsies from 229 patients by culture, PCR-restriction fragment length polymorphism (RFLP), and Scorpion PCR. One biopsy, positive for culture, exhibited inhibitors for both PCR-RFLP and Scorpion PCR. Twelve biopsies were positive for PCR-RFLP and Scorpion PCR but negative for culture with concordant determination of mutations in the 23S rRNA genes by the two PCR assays. Three biopsies were positive for Scorpion PCR only. Compared to culture, the sensitivity of Scorpion PCR was 98.3% and the specificity was 92.5%. The Scorpion PCR assay provides a highly accurate, rapid, and precise method for the detection and determination of mutations conferring clarithromycin resistance to H. pylori