Ostéogenèse imparfaite type III de découverte tardive: à propos d’un cas

Patient âgé de 52 ans, était admis dans notre établissement pour des polyarthralgies chroniques, plutôt mécaniques, touchant spécialement lesarticulations du membre inférieur. L’interrogatoire retrouvait l’antécédent de fractures répétées depuis l’enfance, pour des traumatismes minimes,suite à des chutes par glissement. Les signes cliniques et radiologiques, notamment, les fractures récurrentes, sclérotiques bleues, hyperlaxitéligamentaire, dentinogenèse imparfaite, syndrome dysmorphique, ostéoporose densitométrique importante, plaidaient tous en faveur d’uneostéogénèse imparfaite type III. Le patient a initié le traitement, par prise régulière du calcium (1g/jour), supplémentation en vitamine D et il estprogrammé pour perfusion de Bisphosphonate (Pamidronate 60mg). Ce cas illustre une forme rare de découverte tardive d’ostéogénèse imparfaitetype III.Key words: Ostéogenèse imparfaite, fractures, pathologie hétérogène, bisphosphonates, ostéodensitométrie

Functionally Dissociable Influences on Learning Rate in a Dynamic Environment

Maintaining accurate beliefs in a changing environment requires dynamically adapting the rate at which one learns from new experiences. Beliefs should be stable in the face of noisy data but malleable in periods of change or uncertainty. Here we used computational modeling, psychophysics, and fMRI to show that adaptive learning is not a unitary phenomenon in the brain. Rather, it can be decomposed into three computationally and neuroanatomically distinct factors that were evident in human subjects performing a spatial-prediction task: (1) surprise-driven belief updating, related to BOLD activity in visual cortex; (2) uncertainty-driven belief updating, related to anterior prefrontal and parietal activity; and (3) reward-driven belief updating, a context-inappropriate behavioral tendency related to activity in ventral striatum. These distinct factors converged in a core system governing adaptive learning. This system, which included dorsomedial frontal cortex, responded to all three factors and predicted belief updating both across trials and across individuals

Iron supplement use in pregnancy – are the right women taking the right amount?

Objectives: To examine the prevalence and determinants of iron supplement use and the amount of iron consumed from iron-containing supplements. Methods: A cross-sectional survey was performed in antenatal clinics in two tertiary hospitals in Sydney, Australia between January and March 2014. Results: Of 612 (91% response rate) pregnant women, 589 with complete data were analysed. The overall prevalence of iron-containing supplement use was 88.0%, of which 70.1% was MV only, 7.2% was iron-only and 22.2% was both. Use of iron-containing supplements was associated with increased gestational age, a diagnosis of anaemia or iron deficiency (ID) in the current pregnancy and pre-pregnancy use of an iron-containing supplement. Several risk factors for ID or anaemia such as on-red meat eating and previous miscarriage were not associated with current iron supplement use. About 65% of women diagnosed with ID, and 62.3% of women diagnosed with anaemia were taking an iron-only supplement, with or without a MV. The proportion of women consuming low (<30), preventative (30-99) and treatment (≥100) mg/day doses were 36.8%, 45.4%, and 17.8%, respectively. Only 46.7% of women diagnosed with ID were taking ≥100 mg/day iron from supplements, while 23.3% were taking <30 mg/day. Conclusion: Women are consuming varying doses of iron and some high-risk women are taking inadequate doses of iron to prevent or treat ID or iron deficiency anaemia. Healthcare professionals are best positioned to advise women on iron supplement use in pregnancy and should educate women individually about the type and dose of supplement best suited to their needs.NHMR

Dietary vitamin, mineral and herbal supplement use: a cross-sectional survey of before and during pregnancy use in Sydney, Australia.

AIM: To describe use of dietary vitamin, mineral and herbal supplements before and during pregnancy. METHODS: Pregnant women attending antenatal care at two tertiary Sydney hospitals between January and March 2014 completed an anonymous survey. Information on general maternal and pregnancy characteristics and the use of dietary and herbal supplements, including type, duration, and sources of information was collected. Frequency and contingency tabulations were performed. RESULTS: 612 women agreed to participate (91% response rate). 23 were excluded due to incomplete data. Of 589 women included in the analysis, the mean gestational age at the time of survey was 28.5 weeks (SD 8.3), 55% had no children, and 67% were tertiary educated. Overall 62.9% of women reported taking a multivitamin (MV) and/or folic acid (FA) supplement in the 3 months pre-pregnancy. At the time of the survey 93.8% of women were taking at least one supplement (median 2, range 1-13). During pregnancy 79.1% of women were taking MVs, including 59.2% taking MV only and 19.9% taking MV and FA. The 5 most common supplements outside of a MV were FA (31%), iron (30%), vitamin D (23%), calcium (13%) and fish oil (12%). CONCLUSION: Use of folic acid and MVs and other supplements during and pre-pregnancy is relatively high, although pre-pregnancy FA supplementation rates could still be improved. Further research on the actual dosages and dietary intakes consumed are needed to examine whether pregnant women have adequate intake of nutrients, regardless of supplement use.NHMR

A Real-Time Communication Architecture for Metal Powder Bed Fusion Additive Manufacturing

Recent advancements in the field of additive manufacturing continue to push its application deeper into commercial use. However, concerns persist regarding the consistency of part quality, methodologies for quality assurance, and cyber-physical system security. These concerns are exacerbated by the closed-system architecture implemented by most commercial powder bed fusion additive manufacturing (PBFAM) machine manufacturers. Though implementation of device and process monitoring equipment is often suggested to address these concerns, deployment is hampered by the inability to extract real-time information from closed systems during the build process, including scanner position, laser power, sensor data, etc. Here, a framework for an open and transparent communication protocol for PBFAM systems is developed and implemented on a 3DSystems ProX-200 machine. Real-time measurement of build process parameters and synchronization with an optical emission sensor is demonstrated. The utility of the protocol and real-time sensing for PBFAM are discussed.Mechanical Engineerin