Epidémiologie de la tuberculose à l'hôpital Bichat-Claude Bernard de 1998 à 2004 et caractérisation moléculaire des souches du complexe Mycobacterium tuberculosis par spoligotypage

La tuberculose reste un fléau mondial qui touche principalement les pays d'Afrique, l'Inde et plus récemment les pays d'Europe de l'Est. Dans notre pays, l'incidence la plus élevée est retrouvée en Ile de France. Afin de mieux connaître l'épidémiologie des cas à Paris, nous avons analysé les données démographiques et cliniques d'un échantillon de patients représentés par les cas de tuberculose bactériologiquement prouvés de 1998 à 2004 à l'hôpital Bichat-Claude Bernard. Nous avons également analysés la diversité des souches par spoligotypage selon le pays de naissance des patients, la sérologie VIH et la localisation de la tuberculose. Ce typage moléculaire avait également pour but de rechercher d'éventuels cas de transmissions nosocomiales ou communautaires. Les 982 cas de tuberculose diagnostiqués sur la période étudiée sont composés de 71% d'hommes, de 76% de migrants et de 24% de VIH positifs. La moyenne d'âge est de 42 ans. La tuberculose pulmonaire représente 67% des cas. Le taux de multirésistance est de 2%.Les patients VIH positifs sont des étrangers dans 82% des cas et présentent significativement plus de tuberculoses mixtes et plus de multirésistance que les sujets VIH négatifs.Le spoligotypage des souches du Complexe M. tuberculosis a généré 339 profils distincts dont 240 (70%) sont des profils orphelins. Les autres profils se répartissent dans 99 grappes avec en moyenne 7 souches par grappe [2-114]. Les patients originaires d'Asie et les tuberculoses extrapulmonaires présentent plus de profils uniques que de profils en grappes alors que les formes pulmonaires présentent plus de profils en grappes. un cas de transmission nosocomiale est diagnostiquéTuberculosis remains a world health problem which occurs especially in the countries of Africa, India and more recently in Eastern Europe. In our country, the highest incidence is found in Paris area. In order to better know the epidemiology of the cases in Paris, we analyzed retrospectively the demographic and clinical data of patients represented by the cases of tuberculosis during the period of 1998 to 2004 at the hospital Bichat-Claude Bernard. We also analyzed the diversity of the strains obtained by spoligotyping according to the country of birth of the patients, HIV status and the tuberculosis presentation. The purpose of this molecular typing was also to document a possible nosocomial transmission among health care worker and the transmitted cases in the community. The 982 cases of tuberculosis diagnosed over the studied period are composed of 71% male , 76% of migrants and 24% HIV positive. The average age is 42 years. The pulmonary tuberculosis accounts for 67% of cases. The rate of multidrug resistance is of 2%.Les patient HIV positive are foreigners in 82% of the cases and significantly present more mixed tuberculosis and more multidrug résistance that HIV negative subjects. The spoligotyping of the strains of the Mycobacterium tuberculosis Complex generated 339 distinct profiles of which 240 (70%) are orphan profiles. The other profiles are distributed in 99 clusters with on average of 7 strains per cluster [ 2-114 ]. The Asian patients and extra pulmonary tuberculosis present more orphan profiles than the clustered profiles whereas the pulmonary tuberculosis present more profiles in clusters. A nosocomial transmission of tuberculosis was foundPARIS12-CRETEIL BU Médecine (940282101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

A Classification Approach for an Accurate Analog/RF BIST Evaluation Based on the Process Parameters

International audienceSpecifications of Radio Frequency (RF) analog integrated circuits have increased strictly as their applications tend to be more complicated and high test cost demanding. This makes them very expensive due to an increased test time and to the use of sophisticated test equipment. Alternative test measures, extracted by means of Built-In Self Test (BIST) techniques, are useful approaches to replace standard specification-based tests. One way to evaluate the efficiency of the CUT measures at the design stage is by estimating the Test Escapes (T E) and the Yield Loss (Y L) at ppm level. Unfortunately, an important number of Monte Carlo simulations must be run in order to guarantee their accuracy. For certain types of circuits, this requires many months or even years to generate millions of circuits. To overcome this limitation, we present in this paper a new technique where a small number of simulations is sufficient to reach an important precision. This method is based on a classification using machine learning methods, such as SVM and Neural Networks based classifiers to determine pass/fail regions. The proposed approach requires a few number of simulations only to determine the region separating the process parameters generating good and faulty, or pass and fail circuits. Then only this region is needed to estimate the test metrics without running any additional simulation. The proposed methodology is illustrated for the evaluation of a filter BIST technique

Local Emergence of a del HV69-70 SARS-CoV-2 Variant in Burgundy, France

In the autumn of 2020, a short-lived epidemic of a spike del69-70 deletion variant of SARS-CoV-2 was identified, with most cases (n = 95) found in Montceau-les-Mines, France. This spike gene target failure (SGTF) variant spread quickly in nursing homes. The Alpha variant, which also harbors this deletion, appeared in Burgundy in January 2021 after the disappearance of the Montceau-les-Mines del69-70 variant. Our findings illustrate the risk of the fast spread of geographically isolated variants and reinforce the need for the continuous tracking of outbreaks. In some cases, these studies may reveal emerging variants that affect public health or vaccine development