Bayesian Modelling of PWR Vessels Flaw Distributions

We present a full Bayesian method for estimating the density and size distribution of subclad-flaws in French Pressurized Water Reactor (PWR) vessels. This model takes into account in service inspection (ISI) data, a flaw size-dependent probability of detection function (different function types are possible) with a threshold of detection, and a flaw sizing error distribution (different distribution types are possible). It is identified through a Markov Chain Monte Carlo (MCMC) algorithm. The article includes discussion for choosing the prior distribution parameters and an illustrative application is presented highlighting its ability to provide good parameter estimates even when a small number of flaws is observed

Equation of state of fully ionized electron-ion plasmas

Thermodynamic quantities of Coulomb plasmas consisting of point-like ions immersed in a compressible, polarizable electron background are calculated for ion charges Z=1 to 26 and for a wide domain of plasma parameters ranging from the Debye-Hueckel limit to the crystallization point and from the region of nondegenerate to fully degenerate nonrelativistic or relativistic electrons. The calculations are based on the linear-response theory for the electron-ion interaction, including the local-field corrections in the electronic dielectric function. The thermodynamic quantities are calculated in the framework of the N-body hypernetted-chain equations and fitted by analytic expressions. We present also accurate analytic approximations for the free energy of the ideal electron gas at arbitrary degeneracy and relativity and for the excess free energy of the one-component plasma of ions (OCP) derived from Monte Carlo simulations. The extension to multi-ionic mixtures is discussed within the framework of the linear mixing rule. These formulae provide a completely analytic, accurate description of the thermodynamic quantities of fully ionized electron-ion Coulomb plasmas, a useful tool for various applications from liquid state theory to dense stellar matter.Comment: 13 pages, 2 tables, 7 figures, REVTeX using epsf.sty. To be published in Phys. Rev. E, vol. 58 (1998

Handheld In Vivo Reflectance Confocal Microscopy for the Diagnosis of Eyelid Margin and Conjunctival Tumors

OBJECTIVE To assess the diagnostic accuracy of handheld in vivo reflectance confocal microscopy (IVCM) for the diagnosis of eyelid margin and conjunctival tumors. DESIGN A prospective observational study was conducted at University Hospital of Saint-Etienne from January 2, 2011, to December 31, 2016 (inclusion of patients until December 31, 2015, and follow-up until December 31, 2016). A total of 278 consecutive patients with eyelid margin or conjunctival lesions were included. Conjunctival lesions were diagnosed with a conventional clinical examination using a slitlamp and by handheld IVCM. Final diagnoses were established by histopathologic examination for 155 neoformations suspicious for being malignant through clinical and/or IVCM examination that were excised and on follow-up of 12 months or longer for the remaining 140 lesions. MAIN OUTCOMES AND MEASURES Sensitivity, specificity, and positive and negative predictive values for malignant tumors of the conjunctiva and eyelid margin were calculated using clinical examination with slitlamp and handheld IVCM. RESULTS In the 278 patients (136 [48.9%] females; mean [SD] age, 59 [21] years), a total of 166 eyelid margin and 129 conjunctival lesions were included in the analysis. Of the 155 excised neoformations with a histopathologic diagnosis, IVCM showed higher sensitivity compared with clinical examination conducted with the slitlamp for malignant tumors of the eyelid margin (98%vs 92%) and conjunctiva (100% vs 88%). The specificity for malignant eyelid margin tumors was higher for IVCMthan for slitlamp examination (74%vs 46%), but slightly less for malignant conjunctival tumors (78%vs 88%). Analysis of all neoformations (155 excised and 140 in follow-up) confirmed these differences in the diagnostic accuracy of the clinical examination and IVCM. The presence of hyperreflective Langerhans cells mimicking malignant melanocytes was the main cause for misdiagnosis of malignant conjunctival tumors with IVCM. CONCLUSIONS AND RELEVANCE Handheld IVCM could be a useful tool for the identification of malignant conjunctival tumors. Further studies are required to confirm the usefulness of this device and identify possible features that can differentiate Langerhans cells from malignant melanocytes to prevent the misdiagnosis of melanoma using IVCM

In vitro irradiation of basement membrane enhances the invasiveness of breast cancer cells

Following removal of the primary breast tumour by conservative surgery, patients may still have additional malignant foci scattered throughout the breast. Radiation treatments are not designed to eliminate all these residual cancer cells. Rather, the radiation dose is calculated to optimise long-term results with minimal complications. In a tumour, cancer cells are surrounded by a basement membrane, which plays an important role in the regulation of gene expression. Using an invasion chamber, we have shown that irradiation before cell plating of a reconstituted basement membrane (Matrigel; Becton Dickinson, Bedford, MA, USA) increased the invasiveness of the breast cancer cells MDA-MB-231. This radiation enhancement of invasion was associated with the upregulation of the pro-invasive gene matrix metalloproteinase (MMP)-2. The expression of membrane type 1 matrix metalloproteinase (MT1-MMP) and tissue inhibitor of metalloproteinase-2 (TIMP), which are required to activate the MMP-2, were also increased. Confirming the role of MMP-2 and MT1-MMP, radiation enhancement of cancer cell invasion was prevented by an MMP-2 inhibitor and an anti-MT1-MMP antibody. This study also demonstrated that radiation can potentially enhance the invasion ability by inducing the release of pro-invasive factors stored in the Matrigel. Conversely, no enhancement of invasiveness was observed with the low metastatic cell line MCF-7. This lack of invasiveness correlated with the absence of the MMP-2 activator MT1-MMP in the MCF-7 cells. Radiotherapy is an efficient modality to treat breast cancer which could be further improved by inhibiting the pro-invasive gene upregulated by radiation

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

L' optimisation de la relation médecins/laboratoires pharmaceutiques (l'évolution des besoins des médecins et des réponses apportées par l'industrie pharmaceutique)

LYON1-BU Santé (693882101) / SudocRENNES1-BU Santé (352382103) / SudocSudocFranceF

Analyse du locus de la dihydroptéroate synthétase des souches de Pneumocystis jirovecii isolées au CHRU de Brest (implications cliniques et épidémiologiques)

Les sulfamides sont des molécules largement utilisés pour le traitement préventif et curatif des infections à Pneumocystis jirovecii(P. Jirovecii). Leur mode d'action repose sur l'inhibition de la dihydroptéraote synthétase (DHPS) qui intervient dans la synthèse de l'acide folique. Des mutation ont été décrites en position 165 et 171 sur la séquence du locus DHPS de P. Jirovecii. Il exite un lien entre ces mutations et les échecs de prévention voire les échecs de traitement des infections à P. Jirovecii par les sulfamides. Afin de déterminer la fréquence de ces deux mutations parmi les souches de P. Jirovecii infectant les patients brestois, nous avons étudié 93 échantillons provenant de 85 patients ayant une Pneumonie à Pneumocystis (PPC) (43 patients) ou colonisés par P. Jirovecii (42 patients.) Le génotypage DHPS a été réalisé par une méthodes de PCR-RFLP. Le génotypage a été possible chez 64 des 85 patients, soit 68 des 93 échantillons. Des souches de P. Jirovecii mutantes ont été retrouvées chez deux patients sur 64 (3,1%), alors que 62 patients sont infectés par des couches sauvages(96,9%). Les deux patients, l'un atteint de PPC et l'autre colonisé, ont présenté une évolution favorable. Leur lieu de résidence principale était la région parisienne. Ils ne séjournaient à Brest que depuis 2 à 4 semaines au moment du diagnostic d'infection à P. Jirovecii. D'un point de vue clinique, cette faible prévalence des souches mutantes reflète un risque faible pour les patients brestois de contracter une infection due à des souches de P. Jirovecii potentiellement résistantes aux sulfamides. D'un point de vue épidémiologique, le fait que les deux patients infectés par une souche mutante n'aient pas d'antécédent de traitement par sulfamides et résident dans une région de forte prévalence d'infection à P. Jirovecii mutant, conforte le concept que le lieu de résidence est un facteur de risque de développer une infection par une souche mutante.BREST-BU Médecine-Odontologie (290192102) / SudocSudocFranceF