Modern approach to infectious disease management using infrared thermal camera scanning for fever in healthcare settings.

International audienceWe conducted a prospective study to assess the value of the use of infrared thermal cameras in detecting fevers in both patients and healthcare workers between May 2015 and February 2016 in a university hospital center in Southern France

Statistical models for company growth

We study Sutton's `microcanonical' model for the internal organisation of firms, that leads to non trivial scaling properties for the statistics of growth rates. We show that the growth rates are asymptotically Gaussian in this model, at variance with empirical results. We also obtain the conditional distribution of the number and size of sub-sectors in this model. We formulate and solve an alternative model, based on the assumption that the sector sizes follow a power-law distribution. We find in this new model both anomalous scaling of the variance of growth rates and non Gaussian asymptotic distributions. We give some testable predictions of the two models that would differentiate them further. We also discuss why the growth rate statistics at the country level and at the company level should be identical.Comment: Minor changes, submitted to Physica

Tumor Necrosis Factor Inhibitors Exacerbate Whipple’s Disease by Reprogramming Macrophage and Inducing Apoptosis

International audienceTropheryma whipplei is the agent of Whipple’s disease, a rare systemic disease characterized by macrophage infiltration of the intestinal mucosa. The disease first manifests as arthralgia and/or arthropathy that usually precede the diagnosis by years, and which may push clinicians to prescribe Tumor necrosis factor inhibitors (TNFI) to treat unexplained arthralgia. However, such therapies have been associated with exacerbation of subclinical undiagnosed Whipple’s disease. The objective of this study was to delineate the biological basis of disease exacerbation. We found that etanercept, adalimumab or certolizumab treatment of monocyte-derived macrophages from healthy subjects significantly increased bacterial replication in vitro without affecting uptake. Interestingly, this effect was associated with macrophage repolarization and increased rate of apoptosis. Further analysis revealed that in patients for whom Whipple’s disease diagnosis was made while under TNFI therapy, apoptosis was increased in duodenal tissue specimens as compared with control Whipple’s disease patients who never received TNFI prior diagnosis. In addition, IFN-γ expression was increased in duodenal biopsy specimen and circulating levels of IFN-γ were higher in patients for whom Whipple’s disease diagnosis was made while under TNFI therapy. Taken together, our findings establish that TNFI aggravate/exacerbate latent or subclinical undiagnosed Whipple’s disease by promoting a strong inflammatory response and apoptosis and confirm that patients may be screened for T. whipplei prior to introduction of TNFI therapy

Cervical osteomyelitis: A new identity of dreaded complication following pharyngeal cancer treatment

Background: Cervical osteomyelitis following the treatment of pharyngeal cancer with laryngectomy and chemoradiotherapy is poorly reported. Methods: Six cases of cervical osteomyelitis occurring over a 1-year period are described herein. These are reviewed alongside four cases reported previously in the literature. Results: Among the total 10 cases, the average age of the patients was 58.7 years. The period between laryngectomy and the diagnosis of cervical osteomyelitis was on average 3 years and 1 month and the male to female sex ratio was 9:1. Two patients had a history of cervical fistula with an esophageal prosthesis, one had a spontaneous cervical fistula, one had a pharyngeal cutaneous fistula, and one had an esophageal prosthesis without any fistula. At the time of diagnosis, seven had a history of cervical pain (70%) and nine had a neurological deficit (90%). Seven patients (70%) underwent surgery; one (10%) was contraindicated for a general anesthetic and two (20%) died before any intervention. The indication for surgery was a neurological deficit for six patients (60%) and the requirement for lavage and debridement for two patients (20%). The average length of antimicrobial treatment was 12.7 weeks. The outcome was favorable for six patients. Four patients died. Conclusions: Cervical osteomyelitis is a serious but rarely reported complication following the treatment of pharyngeal cancer with chemoradiotherapy and laryngectomy. Cervical pain was the first sign to appear, sometimes 1 year before any other sign. Physicians should be aware of this dreaded complication, which is probably underdiagnosed and is related to an increased mortality rate. Keywords: Cervical osteomyelitis, Laryngectomy, Larynx carcinoma, Cervical cancer, Infectio

Tropheryma whipplei Increases Expression of Human Leukocyte Antigen-G on Monocytes to Reduce Tumor Necrosis Factor and Promote Bacterial Replication

International audienceInfection with Tropheryma whipplei has a range of effects-some patients can be chronic carriers without developing any symptoms whereas others can develop systemic Whipple disease, characterized by a lack a protective inflammatory immune response. Alterations in major histocompatibility complex, class I, G (HLA-G) function have been associated with several diseases. We investigated the role of HLA-G during T whipplei infection

First on-sky results of the CAWS wavefront sensor on the CANARY experiment

Point-diffraction interferometers are a class of wavefront sensors which can directly measure the phase with great accuracy, regardless of defects such as vortices and disconnected apertures. Due to these properties, they have been suggested in applications such as cophasing of telescope segments, wavefront sensing impervious to the island effect and high-contrast AO and imaging. This paper presents an implementation of this class of interferometer, the Calibration &amp; Alignment~WFS (CAWS), and the results of the first on-sky tests in the visible behind the SCAO loop of the CANARY AO experiment at the William Herschel Telescope. An initial analysis of AO residuals is performed in order to retrieve the SNR of interference fringes and assess the instrument's performance under various observing conditions. Finally, these results are used to test the validity of our models, which would allow for rapid implementation-specific modelling to find minimum-useful flux and other CAWS limits.</p

Data-based modelling of low-order modes for AO control: what do on-sky experiments tell us?

International audienceIt is well-known that data-driven models for the tip-tilt modes significantly improve the performance of Adaptive Optics (AO) systems as it allows to compensate for vibration-induced disturbances. Whether identifying from data the temporal dynamics of more modes makes an impact on the performance has been studied on-sky with the CANARY demonstrator at the William Herschel Telescope in July 2019. In this brief paper, we report on these experiments using both Strehl ratios computed from the science camera in H band or by replaying the AO telemetry data in numerical simulations. We show that Linear Quadratic Gaussian (LQG) controllers that embed a data-driven model for the low-orders (that are not limited to the tip-tilt) improve the performance of the AO for two different dynamical behaviours of the atmospheric turbulence

On-sky results for adaptive optics control with data-driven models on low-order modes

Dedicated tip-tilt loops are commonly implemented on adaptive optics (AO) systems. In addition, a number of recent high-performance systems feature tip-tilt controllers which are more efficient than the integral action controller. In this context, Linear Quadratic Gaussian (LQG) tip-tilt regulators based on stochastic models identified from AO telemetry have demonstrated their capacity to effectively compensate for the cumulated effects of atmospheric disturbance, windshake and vibrations. These tip-tilt LQG regulators can also be periodically re-tuned during AO operations, thus allowing to track changes in the disturbances’ temporal dynamics. This paper investigates the potential benefit of extending the number of low-order modes to be controlled using models identified from AO telemetry. The global stochastic dynamical model of a chosen number of turbulent low-order modes is identified through data-driven modelling from wavefront sensor measurements. The remaining higher modes are modelled using priors with autoregressive models of order 2. The loop is then globally controlled using the optimal LQG regulator build from all these models. Our control strategy allows for combining a dedicated tip-tilt loop with a deformable mirror that corrects for the remaining low-order modes and for the higher orders altogether, without resorting to mode decoupling. Performance results are obtained through evaluation of the Strehl ratio computed on H-band images from the scientific camera, or in replay mode using on-sky AO telemetry recorded in July 2019 on the CANARY instrument

Crise sanitaire : quelles opportunités pour la recherche clinique sur le médicament ?

International audienceLa pandémie de coronavirus disease-19 (COVID-19) a conduit au déploiement d’un effort de recherche académique et industriel sans précédent dont on peut regretter le caractère parfois redondant ainsi que le manque de pilotage tant national qu’international. Pourtant, force est de constater qu’à l’occasion de cette crise, les procédures réglementaires ont été adaptées de même que certains freins dans l’organisation de la recherche clinique ont pu être en partie levés pour contribuer au déploiement d’essais au plus près des patients et faciliter les modalités de suivi et de contrôle. La digitalisation de certains processus et la décentralisation de certaines activités ont pu être mises en œuvre sous couvert d’une mobilisation des autorités et de l’ensemble des acteurs institutionnels, académiques ou industriels. Si outre-manche, l’optimisation des ressources, au travers d’un essai de plateforme unique, a permis de montrer ou d’infirmer l’efficacité de nombreux traitements, en France la crise sanitaire a mis en lumière la fragilité de l’organisation de la recherche clinique, notamment un déficit de coordination et de financement, des difficultés dans la mise en œuvre des études ou encore une certaine frilosité concernant le partage des données. Cependant, la crise a aussi révélé les capacités d’adaptation des différents acteurs et permis l’amélioration de plusieurs processus utiles au déploiement de l’innovation thérapeutique. Gageons que les leçons tirées à l’occasion de cette crise permettront une meilleure efficacité en cas de nouvelle pandémie et surtout que les progrès obtenus continueront de s’appliquer à l’ensemble des activités de recherche clinique futures

Health crisis: What opportunities for clinical drug research?

International audienceThe COVID-19 pandemic led to the deployment of an unprecedented academic and industrial research effort, the sometimes redundant nature of which is regrettable, as is the lack of both national and international management. However, it must be noted that during this crisis, regulatory procedures were adapted and certain obstacles in the organisation of clinical research were partly removed to contribute to the deployment of trials as close as possible to patients and to facilitate monitoring and control procedures. The digitisation of certain processes and the decentralisation of certain activities were implemented under the cover of a mobilisation of the authorities and all institutional, academic and industrial players. While in the UK, the optimisation of resources through a single platform trial has made it possible to demonstrate or invalidate the efficacy of many treatments, in France the health crisis has highlighted the fragility of the organisation of clinical research, in particular a lack of coordination and funding, difficulties in implementing studies and a certain reluctance to share data. However, the crisis has also revealed the adaptability of the various stakeholders and has led to the improvement of several processes useful for the deployment of therapeutic innovation. Let us hope that the lessons learned during this crisis will allow for greater efficiency in the event of a new pandemic and, above all, that the progress made will continue to apply to all future clinical research activities