Clinical autonomic nervous system laboratories in Europe. A joint survey of the European Academy of Neurology and the European Federation of Autonomic Societies

Background and purpose: Disorders of the autonomic nervous system (ANS) are common conditions, but it is unclear whether access to ANS healthcare provision is homogeneous across European countries. The aim of this study was to identify neurology-driven or interdisciplinary clinical ANS laboratories in Europe, describe their characteristics and explore regional differences. Methods: We contacted the European national ANS and neurological societies, as well as members of our professional network, to identify clinical ANS laboratories in each country and invite them to answer a web-based survey. Results: We identified 84 laboratories in 22 countries and 46 (55%) answered the survey. All laboratories perform cardiovascular autonomic function tests, and 83% also perform sweat tests. Testing for catecholamines and autoantibodies are performed in 63% and 56% of laboratories, and epidermal nerve fiber density analysis in 63%. Each laboratory is staffed by a median of two consultants, one resident, one technician and one nurse. The median (interquartile range [IQR]) number of head-up tilt tests/laboratory/year is 105 (49–251). Reflex syncope and neurogenic orthostatic hypotension are the most frequently diagnosed cardiovascular ANS disorders. Thirty-five centers (76%) have an ANS outpatient clinic, with a median (IQR) of 200 (100–360) outpatient visits/year; 42 centers (91%) also offer inpatient care (median 20 [IQR 4–110] inpatient stays/year). Forty-one laboratories (89%) are involved in research activities. We observed a significant difference in the geographical distribution of ANS services among European regions: 11 out of 12 countries from North/West Europe have at least one ANS laboratory versus 11 out of 21 from South/East/Greater Europe (p = 0.021). Conclusions: This survey highlights disparities in the availability of healthcare services for people with ANS disorders across European countries, stressing the need for improved access to specialized care in South, East and Greater Europe

EFAS/EAN survey on the influence of the COVID-19 pandemic on European clinical autonomic education and research

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Purpose: To understand the influence of the coronavirus disease 2019 (COVID-19) pandemic on clinical autonomic education and research in Europe. Methods: We invited 84 European autonomic centers to complete an online survey, recorded the pre-pandemic-to-pandemic percentage of junior participants in the annual congresses of the European Federation of Autonomic Societies (EFAS) and European Academy of Neurology (EAN) and the pre-pandemic-to-pandemic number of PubMed publications on neurological disorders. Results: Forty-six centers answered the survey (55%). Twenty-nine centers were involved in clinical autonomic education and experienced pandemic-related didactic interruptions for 9 (5; 9) months. Ninety percent (n = 26/29) of autonomic educational centers reported a negative impact of the COVID-19 pandemic on education quality, and 93% (n = 27/29) established e-learning models. Both the 2020 joint EAN-EFAS virtual congress and the 2021 (virtual) and 2022 (hybrid) EFAS and EAN congresses marked higher percentages of junior participants than in 2019. Forty-one respondents (89%) were autonomic researchers, and 29 of them reported pandemic-related trial interruptions for 5 (2; 9) months. Since the pandemic begin, almost half of the respondents had less time for scientific writing. Likewise, the number of PubMed publications on autonomic topics showed the smallest increase compared with other neurological fields in 2020-2021 and the highest drop in 2022. Autonomic research centers that amended their trial protocols for telemedicine (38%, n = 16/41) maintained higher clinical caseloads during the first pandemic year. Conclusions: The COVID-19 pandemic had a substantial negative impact on European clinical autonomic education and research. At the same time, it promoted digitalization, favoring more equitable access to autonomic education and improved trial design.info:eu-repo/semantics/publishedVersio

Une balance aréométrique à lecture directe

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Leçons de radio-électricité

Introduction ; étude des circuits ; les tubes électroniques ; réception radio-électrique ; les tubes électroniques à plusieurs grilles et les tubes à pente variable, leurs applications ; l'émission ; radiateurs et collecteurs d'ondes ; les ondes ultra-courtes

Les spectres de bandes

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Remarques sur la théorie de Ritz du phénomène de Zeeman

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Projet d'appareil de mesure des courants continus très intenses. le kiloampèremètre et le magnémètre

Pour mesurer un courant continu de plusieurs milliers d'ampères, on peut le faire passer dans un conducteur cylindrique au centre duquel le champ magnétique est proportionnel au courant avec un coefficient qu'il est facile de calculer avec une précision de quelques unités pour mille. On peut mesurer le champ, qui est de plusieurs centaines de gauss, par la rotation d'une aiguille liée à un petit barreau de permalloy aimanté à saturation dans ce champ. L'aiguille prend une position d'équilibre déterminée par le couple que le champ exerce sur le barreau d'une part, et d'autre part par un couple directeur exercé sur elle par un ressort spiral. On peut étendre considérablement l'échelle des mesures en liant l'extrémité du ressort spiral à une roue dont la rotation modifie le couple directeur

La bande λ = 3 064 Å de l'oxygène. Sa modification par le champ magnétique

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Oscillations pendulaires et de relaxation

Discussion de la définition des oscillations de relaxation de van der Pol. Cette définition ne s'applique pas à la plupart des oscillations décrites sous ce nom, qui s'opposent aux oscillations pendulaires par leur caractère d'irréversibilité. Les oscillations de relaxation s'établissent dans les systèmes qui évoluent entre deux régimes et passent alternativement de l'un à l'autre en décrivant un cycle dans un sens déterminé. S'il arrive que l'organe qui crée les deux régimes impose une amplitude déterminée aux oscillations de relaxation, cette constance ne peut pas être considérée comme une règle générale