Viewpoint: filovirus haemorrhagic fever outbreaks: much ado about nothing?

The recent outbreak of Marburg haemorrhagic fever in the Democratic Republic of Congo has put the filovirus threat back on the international health agenda. This paper gives an overview of Marburg and Ebola outbreaks so far observed and puts them in a public health perspective. Damage on the local level has been devastating at times, but was marginal on the international level despite the considerable media attention these outbreaks received. The potential hazard of outbreaks, however, after export of filovirus from its natural environment into metropolitan areas, is argued to be considerable. Some avenues for future research and intervention are explored. Beyond the obvious need to find the reservoir and study the natural history, public health strategies for a more timely and efficient response are urgently needed

Organisation of Health Care During an Outbreak of Marburg Haemorrhagic Fever in the Democratic Republic of Congo, 1999.

Organising health care was one of the tasks of the International Scientific and Technical Committee during the 1998-1999 outbreak in Durba/Watsa, in the north-eastern province (Province Orientale), Democratic Republic of Congo. With the logistical support of Médecins sans Frontières (MSF), two isolation units were created: one at the Durba Reference Health Centre and the other at the Okimo Hospital in Watsa. Between May 6th, the day the isolation unit was installed and May 19th, 15 patients were admitted to the Durba Health Centre. In only four of them were the diagnosis of Marburg haemorrhagic fever (MHF) confirmed by laboratory examination. Protective equipment was distributed to health care workers and family members caring for patients. Information about MHF, modes of transmission and the use of barrier nursing techniques was provided to health care workers and sterilisation procedures were reviewed. In contrast to Ebola outbreaks, there was little panic among health care workers and the general public in Durba and all health services remained operational

Soil contamination following an industrial accident : towards efficient investigations and assessment

International audienceWhen an industrial accident occurs, e.g. the explosion or the fire of a chemical facility, soil investigations and subsequent risk mitigation generally need to be decided and performed rapidly. This requires specific organisation and tools: Procedures for an immediate and coordinated intervention of relevant actors: industrials, administrations for industrial facilities, emergency and health, local authorities, environmental consultants and laboratories, NGOs. Models and input data on emission, atmospheric transfer and deposition on soil, for an accidental source; investigation plans and adequate soil quality references, guidelines... But the European Seveso legislation, and its application in France and probably in Europe, is focused on the prevention of immediate impacts on health and constructions; and the Integrated Pollution Prevention and Control (IPPC) legislation deals with the chronic impacts of operating facilities. Thus, post-accidental impacts of industrial accidents are hardly dealt with, the specific organisation and tools are lacking, and when accidents occur, the industrials and administrations concerned are largely unprepared for managing their delayed impacts, first of them on soils

Design optimization and performance capabilities of the fast neutron imaging telescope (FNIT)

We describe the design optimization process and performance characterization of a next generation neutron telescope, with imaging and energy measurement capabilities, sensitive to neutrons in the 1-20 MeV energy range. The response of the Fast Neutron Imaging Telescope (FNIT), its efficiency in neutron detection, energy resolution and imaging capabilities were characterized through a combination of lab tests and Monte Carlo simulations. Monte Carlo simulations, together with experimental data, are also being used in the development and testing of the image reconstruction algorithm. FNIT was initially conceived to study solar neutrons as a candidate instrument for the Inner Heliosphere Sentinel (IHS) spacecraft. However, the design of this detector was eventually adapted to locate Special Nuclear Material (SNM) sources for homeland security purposes, by detecting fission neutrons. In either case, the detection principle is based on multiple elastic neutron-proton scatterings in organic scintillator. By reconstructing event locations and measuring the recoil proton energies, the direction and energy spectrum of the primary neutron flux can be determined and neutron sources identified. This paper presents the most recent results arising from our efforts and outlines the performance of the FNIT detector

Effect of alumina and titanium nitrides inclusions on mechanical properties in high alloyed steels

peer reviewedevery commercial steel product in varying amounts. Since inclusions significantly influence properties and behaviour of materials and at the same time give indications on the quality of the steel, it is quite interesting to precise their nature and their origin. In this paper concerning a project involved in the COST 517 framework, studied alloys are high alloy steels. The raw materials were obtained from the conventionally electrical cast ingot and the Electro Slag Refining processes. The purpose is to compare various inclusions produced by these different processes and their effect on the mechanical properties. The raw material because of the melting processes themselves, leads to a product with a good to a great cleanliness, and tiny inclusions, which are haphazardly distributed. The actual ASTM E45 chart seems to be inappropriate, as the inclusions founded are too small in size. Therefore, we manage to develop a specific procedure for the study of such inclusions. The different types of inclusions encountered are oxides, titanium nitrides, and manganese sulphides. Studying the effect on mechanical properties, oxides often seem to initiate fatigue fracture

Pain management after elective craniotomy: A systematic review with procedure-specific postoperative pain management (PROSPECT) recommendations.

BACKGROUND Pain after craniotomy can be intense and its management is often suboptimal. OBJECTIVES We aimed to evaluate the available literature and develop recommendations for optimal pain management after craniotomy. DESIGN A systematic review using procedure-specific postoperative pain management (PROSPECT) methodology was undertaken. DATA SOURCES Randomised controlled trials and systematic reviews published in English from 1 January 2010 to 30 June 2021 assessing pain after craniotomy using analgesic, anaesthetic or surgical interventions were identified from MEDLINE, Embase and Cochrane Databases. ELIGIBILITY CRITERIA Each randomised controlled trial (RCT) and systematic review was critically evaluated and included only if met the PROSPECT requirements. Included studies were evaluated for clinically relevant differences in pain scores, use of nonopioid analgesics, such as paracetamol and NSAIDs, and current clinical relevance. RESULTS Out of 126 eligible studies identified, 53 RCTs and seven systematic review or meta-analyses met the inclusion criteria. Pre-operative and intra-operative interventions that improved postoperative pain were paracetamol, NSAIDs, intravenous dexmedetomidine infusion, regional analgesia techniques, including incision-site infiltration, scalp nerve block and acupuncture. Limited evidence was found for flupirtine, intra-operative magnesium sulphate infusion, intra-operative lidocaine infusion, infiltration adjuvants (hyaluronidase, dexamethasone and α-adrenergic agonist added to local anaesthetic solution). No evidence was found for metamizole, postoperative subcutaneous sumatriptan, pre-operative oral vitamin D, bilateral maxillary block or superficial cervical plexus block. CONCLUSIONS The analgesic regimen for craniotomy should include paracetamol, NSAIDs, intravenous dexmedetomidine infusion and a regional analgesic technique (either incision-site infiltration or scalp nerve block), with opioids as rescue analgesics. Further RCTs are required to confirm the influence of the recommended analgesic regimen on postoperative pain relief

On-sky results of the adaptive optics MACAO for the new IR-spectrograph CRIRES at VLT

The adaptive optics MACAO has been implemented in 6 focii of the VLT observatory, in three different flavors. We present in this paper the results obtained during the commissioning of the last of these units, MACAO-CRIRES. CRIRES is a high-resolution spectrograph, which efficiency will be improved by a factor two at least for point-sources observations with a NGS brighter than R=15. During the commissioning, Strehl exceeding 60% have been observed with fair seeing conditions, and a general description of the performance of this curvature adaptive optics system is done.Comment: SPIE conference 2006, Advances in adaptive optics, 12 pages, 11 figure