Factors Associated with Negative Direct Sputum Examination in Asian and African HIV-Infected Patients with Tuberculosis (ANRS 1260)

OBJECTIVE: To identify factors associated with negative direct sputum examination among African and Cambodian patients co-infected by Mycobacterium tuberculosis and HIV. DESIGN: Prospective multicenter study (ANRS1260) conducted in Cambodia, Senegal and Central African Republic. METHODS: Univariate and multivariate analyses (logistic regression) were used to identify clinical and radiological features associated with negative direct sputum examination in HIV-infected patients with positive M. tuberculosis culture on Lowenstein-Jensen medium. RESULTS: Between September 2002 and December 2005, 175 co-infected patients were hospitalized with at least one respiratory symptom and pulmonary radiographic anomaly. Acid-fast bacillus (AFB) examination was positive in sputum samples from 110 subjects (63%) and negative in 65 patients (37%). Most patients were at an advanced stage of HIV disease (92% at stage III or IV of the WHO classification) with a median CD4 cell count of 36/mm³. In this context, we found that sputum AFB negativity was more frequent in co-infected subjects with associated respiratory tract infections (OR = 2.8 [95%CI:1.1-7.0]), dyspnea (OR = 2.5 [95%CI:1.1-5.6]), and localized interstitial opacities (OR = 3.1 [95%CI:1.3-7.6]), but was less frequent with CD4 ≤ 50/mm³ (OR = 0.4 [95%CI:0.2-0.90), adenopathies (OR = 0.4 [95%CI:0.2-0.93]) and cavitation (OR = 0.1 [95%CI:0.03-0.6]). CONCLUSIONS: One novel finding of this study is the association between concomitant respiratory tract infection and negative sputum AFB, particularly in Cambodia. This finding suggests that repeating AFB testing in AFB-negative patients should be conducted when broad spectrum antibiotic treatment does not lead to complete recovery from respiratory symptoms. In HIV-infected patients with a CD4 cell count below 50/mm3 without an identified cause of pneumonia, systematic AFB direct sputum examination is justified because of atypical clinical features (without cavitation) and high pulmonary mycobacterial burden

Éducation parentale et non parentale : étude comparative auprès dedyades parent-enfant en milieu familial et éducateur-enfant en milieu

Les pratiques éducatives (PE) ont maintes fois fait l’objet d’études auprès de parents mais plus rarement auprès d’éducateurs ayant en charge l’éducation d’enfants hors de leur milieu de vie familial. La présente recherche compare les PE de parents et d’éducateurs. Elle propose également une comparaison entre la perception des enfants des pratiques dont ils font l’objet et l’auto-évaluation des parents/éducateurs de leurs propres pratiques. L’étude s’intéresse enfin aux variations de ces pratiques en fonction des caractéristiques de l’enfant (âge, sexe, durée de placement en milieu résidentiel) et du parent / de l’éducateur (âge, sexe, niveau de scolarisation, expérience professionnelle). Les données ont été collectées auprès de 134 enfants dont 67 vivent en milieu résidentiel et 67 en famille, et 134 adultes, 67 parents et 67 éducateurs. Les résultats ont montré des différences significatives entre les parents et les éducateurs, ces derniers utilisant moins de pratiques de contrôle que les parents. Ils ont aussi indiqué l’importance de la perception propre des enfants à l’égard des pratiques dont ils font l’objet et une surestimation des parents/éducateurs de la valeur de leurs pratiques. Les pratiques varient enfin en fonction de l’âge des enfants et la durée du placement en milieu résidentiel, du sexe des parents/éducateurs et de leur niveau de scolarisation. La discussion porte sur les particularités du milieu résidentiel comme milieu de développement

Les Rhopalocères de Chypre (Lepidoptera: Papilionoidea et Hesperioidea)

info:eu-repo/semantics/publishe

Maturation of somatosensory evoked potentials in man

info:eu-repo/semantics/publishe

Prospects of additive manufacturing for accelerators

International audienceAdditive manufacturing allows the production of mechanical components often much faster than traditional manufacturing. Several accelerators components built using additive manufacturing have already been qualified for use in accelerator. A workshop was held in Orsay in December 2018 to discuss the prospects of using additive manufacturing for particle accelerators and particle detectors. We report here on the prospects as far as accelerators are concerned

Geometrical Behavior of Nb3_{3}Sn Rutherford Cables During Heat Treatment

In Nb$_{3}$Sn accelerator magnets, non-superconducting precursor cables are wound into their final coil shape and then heat treated at a high temperature to form the A15 superconducting phase. The growth of cable strands during reaction and the differential thermal dilatation in the coil components lead to both stress in the cable and geometrical deformations of the winding, with possible consequences on magnet performances. An experimental campaign on different types of Rutherford cables has been carried out at CEA Saclay, in collaboration with CERN, in order to measure cable dimension changes in all directions, with respect to cable configuration and winding geometry. A 700-mm-long versatile test bench has been designed for several cable topologies up to 22 mm in width. This paper describes the tooling and presents the results of the experimental campaign led on the cables, made of powder-in-tube and restacked-rod-process strands, of FRESCA2, a 13-T dipole magne

R2D2, the CEA Graded Nb3_3Sn Research Racetrack Dipole Demonstrator Magnet

As a part of a collaborative effort with CERN on the long road to FCC-hh, CEA is developing a 1.4 m-long single aperture short dipole demonstrator. This Nb$_3$Sn block dipole, named F2D2, is foreseen to produce 15.5 T with a 14% margin at 1.9 K, and will use a shell-based support structure. In order to be compact, this magnet relies on the use of different cable grades in each coil. Among the milestones in this project, a single-layer graded racetrack dipole will be constructed in order to demonstrate grading in a simplified geometry while preserving key features of F2D2. This magnet, named Research Racetrack Dipole Demonstrator (R2D2), will permit the mastering of the fabrication methods foreseen for F2D2 and to confirm the behavior of Nb$_3$Sn cables representative of FCC. It should also validate some key technological aspects: compactness, operation at high-current (up to 16 kA), intermediate magnetic field (in the range of 11-12 T), and quench protection at very high energy/unit length (up to 650 kJ/m, corresponding to 168 MJ/m$^3$)

Probing the specific interactions and structures of gas-phase vancomycin antibiotics with cell-wall precursor through IRMPD spectroscopy

International audienc

3D Conceptual Design of F2D2, the FCC Block-Coil Short Model Dipole

F2D2, the FCC Flared-ends Dipole Demonstrator, is a 15 T single-aperture short model being developed within a collaboration between CEA Paris-Saclay and CERN. The design phase is ongoing at CEA; the magnet will be fabricated at CEA and then tested at CERN. The 2D magnetic and mechanical designs have been optimized previously and allowed defining the operating points and the required structural components. This paper reports on the preliminary design phase, focused on 3D mechanical optimizations of coils and structure. F2D2 will be the first Nb3Sn block-coil magnet using two cable grades. The cables will be spliced outside of the magnet, which represents one of the most complex design feature, and requires a special focus on the magnet ends. To do so, the design of the magnet has been performed using a CAD (Computer Aided Design) and both magnetic and mechanical 3D FEM (Finite-Elements Models). The CAD defines precisely the complex coil-ends shape that allows positioning the layer jumps and routing the cable exits. The FEM are used to optimize the longitudinal pre-load system in order to contain the large Lorentz forces during operation. The magnet is pre-loaded transversally with bladders and keys and with an external Al shell; and longitudinally with Al tie-rods and end-plates. The pre-load levels are computed to operate the magnet under sufficient compression, while minimizing the stress in the coil and avoid degradation

A Multi-Week Assessment of a Mobile Exergame Intervention in an Elementary School

Background: Exergaming is potentially useful to promote physical activity in children; however, long-term effectiveness is unclear. MobileKids Monster Manor (MKMM) is a mobile exergame developed with the help of young advisors. The game wirelessly transmits physical activity data from an accelerometer to a mobile device. Players’ steps are redeemed for in-game rewards, for example, new characters. Objective: First, to evaluate whether increased physical activity previously observed in a 1-week intervention is sustained over a 2-week intervention and 1-week follow-up, and second, to compare impact in schools within different socioeconomic environments. Methods: Thirty-seven elementary school students participated in a 4-week randomized controlled study (1- week baseline; 2-week intervention [with only the Game group receiving MKMM]; and 1-week follow-up). All participants wore a Tractivity accelerometer throughout. Linear mixed models were applied to assess sustainability; a second 42-children-based dataset and age-/sex-adjusted linear regression models were used to compare effect across socioeconomic environments. Results: In the first week of intervention, the Game group compared to the Control group showed a greater increase in physical activity (of 1,758 steps/day [95% confidence interval, CI = 133–3,385] and 31 active minutes/ day [95% CI = 4–59]), relative to baseline (13,986 steps/day; 231 active minutes/day). However, this was not sustained in the second intervention week or follow-up. The school within a lower socioeconomic status environment showed lower baseline activity and the 1-week intervention resulted in a greater increase relative to baseline (3,633 steps/day more [95% CI = 1,281–5,985]). Conclusion: MKMM could be a useful short-term physical activity promotion tool; however, effectiveness may decrease as novelty diminishes