Home enteral nutrition in eating disorders

Weight restoration is crucial for successful treatment of anorexia nervosa (AN). Without it, patients may face serious or even fatal complications of severe starvation. Renutrition should take into account clinical characteristics unique to these patients, such as gastroparesis and fear of gaining body weight. The efficacy of tube feeding and home-tube feeding (Home-TF) has been suggested in AN and proven in bulimia nervosa (BN). TF and home-TF allow a better body weight gain (mainly fat-free mass) in AN patients and a strong decrease in the frequency and the intensity of binge-eating/purging episodes at relatively short-term (1 year) in BN patients. In AN, home-TF does not increase anxiety, depression, or worsen the eating behavior. In BN patients, home-TF decreases anxiety and depressive state and improves the quality of life. The goal of home-TF is not to cure the patients, but only to avoid serious malnutrition and its complications and to insure a better investment of the patients for their psychotherapy. Home-TF must be associated with psychotherapy, namely cognitive behavioural therapy and family therapy in adolescents. If the fear of gaining body weight is too high, the risk of failure of home-TF, because of poor compliance, is increasing. In any case, the aims and the goals of home-TF should be extensively explained. (C) 2013 Published by Elsevier Masson SAS. RESUME La nutrition entérale à domicile (NEAD) a fait en partie la preuve de son efficacité en cas d’anorexie mentale. La NEAD est très efficace à court terme contre les crises de boulimie. La NEAD permet une plus grande prise de poids et de masse maigre dans l’anorexie que l’approche classique. La NEAD permet aussi une diminution importante de la fréquence et de l’intensité des crises de boulimie. Elle n’altère pas l’humeur, ni n’aggrave le comportement alimentaire. La NEAD n’a pas pour objectif de guérir les malades, mais de passer un cap et de rendre la psychothérapie plus pertinente. La NEAD ne doit pas remplacer le travail diététique, ni faire faire l’économie du travail cognitif et comportemental. Si le malade a trop peur de grossir, la NEAD a de grandes chances d’être rejetée ou mise en échec. Il est donc essentiel de bien cibler les malades et de bien leur expliquer la démarche thérapeutique

Framework for neurosphere growth modelling under phase-contrast microscopy

L'étude des cellules souches est l'un des champs de recherches les plus importants dans le domaine biomédical. La vision par ordinateur et le traitement d'images ont été fortement mis en avant dans ce domaine pour le développement de solutions automatiques de culture et d'observation de cellules. Ce travail de thèse propose une nouvelle méthodologie pour l'observation et la modélisation de la prolifération de cellule souche neuronale sous microscope à contraste de phase. À chaque observation réalisée par le microscope durant la prolifération, notre système extrait un modèle en trois dimensions de la structure de cellules observées. Cela est réalisé par une suite de processus d'analyse, synthèse et sélection. Premièrement, une analyse de la séquence d'images de contraste de phase permet la segmentation de la neurosphère et des cellules la constituant. À partir de ces informations, combinées avec des connaissances a priori sur les cellules et le protocole de culture, plusieurs modèles 3-D possibles sont générés. Ces modèles sont finalement évalués et sélectionnés par rapport à l¿image d¿observation, grâce à une méthode de recalage 3-D vers 2-D. A travers cette approche, nous présentons un outil automatique de visualisation et d'observation de la prolifération de cellule souche neuronale sous microscope à contraste de phase.The study of stem cells is one of the most important fields of research in the biomedical field. Computer vision and image processing have been greatly emphasized in this area for the development of automated solutions for culture and observation of cells. This work proposes a new methodology for observing and modelling the proliferation of neural stem cell under a phase contrast microscope. At each time lapse observation performed by the microscope during the proliferation, the system determines a three-dimensional model of the structure formed by the observed cells. This is achieved by a framework combining analysis, synthesis and selection process. First, an analysis of the images from the microscope segments the neurosphere and the constituent cells. With this analysis, combined with prior knowledge about the cells and their culture protocol, several 3-D possible models are generated through a synthesis process. These models are finally selected and evaluated according to their likelihood with the microscope image using a 3-D to 2-D registration method. Through this approach, we present an automatic visualisation tool and observation of the proliferation of neural stem cell under a phase contrast microscope.PARIS-JUSSIEU-Bib.électronique (751059901) / SudocSudocFranceF

Structural role of PufX in the dimerization of the photosynthetic core complex of Rhodobacter sphaeroides.

Monomeric and dimeric PufX-containing core complexes have been purified from membranes of wild-type Rhodobacter sphaeroides. Reconstitution of both samples by detergent removal in the presence of lipids leads to the formation of two-dimensional crystals constituted of dimeric core complexes. Two-dimensional crystals were further analyzed by cryoelectron microscopy and atomic force microscopy. A projection map at 26-A resolution reveals that core complexes assemble in an "S"-shaped dimeric complex. Each core complex is composed of one reaction center, 12 light-harvesting 1 alpha/beta-heterodimers, and one PufX protein. The light-harvesting 1 assemblies are open with a gap of density of approximately 30-A width and surround oriented reaction centers. A maximum density is found at the dimer junction. Based on the projection map, a model is proposed, in which the two PufX proteins are located at the dimer junction, consistent with the finding of dimerization of monomeric core complexes upon reconstitution. This localization of PufX in the core complex implies that PufX is the structural key for the dimer complex formation rather than a channel-forming protein for the exchange of ubiquinone/ubiquinol between the reaction center and the cytochrome bc1 complex

Modeling the influence of eutrophication and redox conditions on mercury cycling at the sediment-water interface in the Berre Lagoon

This study presents a specifically designed Mercury module in a coupled benthic-pelagic reactive-transport model - Bottom RedOx Model (BROM) that allows to study mercury (Hg) biogeochemistry under different conditions. This module considers the transformation of elemental mercury (Hg(0)), divalent mercury (Hg(II)) and methylmercury (MeHg). The behavior of mercury species in the model is interconnected with changes of oxygen, hydrogen sulfide, iron oxides, organic matter, and biota. We simulated the transformation and transport of Hg species in the water column and upper sediment layer under five different scenarios, combining various levels of oxygenation and trophic state in the Berre lagoon, a shallow eutrophic lagoon of the French Mediterranean coast subjected to seasonal anoxia. The first scenario represents the conditions in the lagoon that are compared with experimental data. The four other scenarios were produced by varying the biological productivity, using low and high nutrient (N and P) concentrations, and by varying the redox conditions using different intensity of vertical mixing in the water column. The results of the simulation show that both oxidized and reduced sediments can accumulate Hg, but any shifts in redox conditions in bottom water and upper sediment layer lead to the release of Hg species into the water column. Eutrophication and/or restricted vertical mixing lead to reducing conditions and intensify MeHg formation in the sediment with periodic release to the water column. Oxygenation of an anoxic water body can lead to the appearance of Hg species in the water column and uptake by organisms, whereby Hg may enter into the food web. The comparison of studied scenarios shows that a well-oxygenated eutrophic system favors the conditions for Hg species bioaccumulation with a potential adverse effect on the ecosystem. The research is relevant to the UN Minimata convention, EU policies on water, environmental quality standards and Mercury in particular.publishedVersio

Hooking the scientific community on thorny-headed worms: interesting and exciting facts, knowledge gaps and perspectives for research directions on Acanthocephala

Although interest in Acanthocephala seems to have reached only a small community of researchers worldwide, we show in this opinion article that this group of parasites is composed of excellent model organisms for studying key questions in parasite molecular biology and cytogenetics, evolutionary ecology, and ecotoxicology. Their shared ancestry with free-living rotifers makes them an ideal group to explore the origins of the parasitic lifestyle and evolutionary drivers of host shifts and environmental transitions. They also provide useful features in the quest to decipher the proximate mechanisms of parasite-induced phenotypic alterations and better understand the evolution of behavioral manipulation. From an applied perspective, acanthocephalans’ ability to accumulate contaminants offers useful opportunities to monitor the impacts – and evaluate the possible mitigation – of anthropogenic pollutants on aquatic fauna and develop the environmental parasitology framework. However, exploring these exciting research avenues will require connecting fragmentary knowledge by enlarging the taxonomic coverage of molecular and phenotypic data. In this opinion paper, we highlight the needs and opportunities of research on Acanthocephala in three main directions: (i) integrative taxonomy (including non-molecular tools) and phylogeny-based comparative analysis; (ii) ecology and evolution of life cycles, transmission strategies and host ranges; and (iii) environmental issues related to global changes, including ecotoxicology. In each section, the most promising ideas and developments are presented based on selected case studies, with the goal that the present and future generations of parasitologists further explore and increase knowledge of Acanthocephala

Ten new insights in climate science 2022

Non-technical summary We summarize what we assess as the past year's most important findings within climate change research: limits to adaptation, vulnerability hotspots, new threats coming from the climate–health nexus, climate (im)mobility and security, sustainable practices for land use and finance, losses and damages, inclusive societal climate decisions and ways to overcome structural barriers to accelerate mitigation and limit global warming to below 2°C. Technical summary We synthesize 10 topics within climate research where there have been significant advances or emerging scientific consensus since January 2021. The selection of these insights was based on input from an international open call with broad disciplinary scope. Findings concern: (1) new aspects of soft and hard limits to adaptation; (2) the emergence of regional vulnerability hotspots from climate impacts and human vulnerability; (3) new threats on the climate–health horizon – some involving plants and animals; (4) climate (im)mobility and the need for anticipatory action; (5) security and climate; (6) sustainable land management as a prerequisite to land-based solutions; (7) sustainable finance practices in the private sector and the need for political guidance; (8) the urgent planetary imperative for addressing losses and damages; (9) inclusive societal choices for climate-resilient development and (10) how to overcome barriers to accelerate mitigation and limit global warming to below 2°C. Social media summary Science has evidence on barriers to mitigation and how to overcome them to avoid limits to adaptation across multiple fields

Impact of early enteral versus parenteral nutrition on mortality in patients requiring mechanical ventilation and catecholamines: study protocol for a randomized controlled trial (NUTRIREA-2)

BACKGROUND: Nutritional support is crucial to the management of patients receiving invasive mechanical ventilation (IMV) and the most commonly prescribed treatment in intensive care units (ICUs). International guidelines consistently indicate that enteral nutrition (EN) should be preferred over parenteral nutrition (PN) whenever possible and started as early as possible. However, no adequately designed study has evaluated whether a specific nutritional modality is associated with decreased mortality. The primary goal of this trial is to assess the hypothesis that early first-line EN, as compared to early first-line PN, decreases day 28 all-cause mortality in patients receiving IMV and vasoactive drugs for shock. METHODS/DESIGN: The NUTRIREA-2 study is a multicenter, open-label, parallel-group, randomized controlled trial comparing early PN versus early EN in critically ill patients requiring IMV for an expected duration of at least 48 hours, combined with vasoactive drugs, for shock. Patients will be allocated at random to first-line PN for at least 72 hours or to first-line EN. In both groups, nutritional support will be started within 24 hours after IMV initiation. Calorie targets will be 20 to 25 kcal/kg/day during the first week, then 25 to 30 kcal/kg/day thereafter. Patients receiving PN may be switched to EN after at least 72 hours in the event of shock resolution (no vasoactive drugs for 24 consecutive hours and arterial lactic acid level below 2 mmol/L). On day 7, all patients receiving PN and having no contraindications to EN will be switched to EN. In both groups, supplemental PN may be added to EN after day 7 in patients with persistent intolerance to EN and inadequate calorie intake. We plan to recruit 2,854 patients at 44 participating ICUs. DISCUSSION: The NUTRIREA-2 study is the first large randomized controlled trial designed to assess the hypothesis that early EN improves survival compared to early PN in ICU patients. Enrollment started on 22 March 2013 and is expected to end in November 2015. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01802099 (registered 27 February 2013)

A comprehensive survey of the analytical, numerical and experimental methodologies for dynamics of multibody mechanical systems with clearance or imperfect joints

"Available online 19 December 2017"A comprehensive survey of the literature of the most relevant analytical, numerical, and experimental approaches for the kinematic and dynamic analyses of multibody mechanical systems with clearance joints is presented in this review. Both dry and lubricated clearance joints are addressed here, and an effort is made to include a large number of research works in this particular field, which have been published since the 1960′s. First, the most frequently utilized methods for modeling planar and spatial multibody mechanical systems with clearance joints are analyzed, and compared. Other important phenomena commonly associated with clearance joint models, such as wear, non-smooth behavior, optimization and control, chaos, and uncertainty and links’ flexibility, are then discussed. The main assumptions procedures and conclusions for the different methodologies are also examined and compared. Finally, future developments and new applications of clearance joint modeling and analysis are highlighted.This research was supported in part by the China 111 Project (B16003) and the National Natural Science Foundation of China under Grants 11290151, 11472042 and 11221202. The work was also supported by the Portuguese Foundation for Science and Technology with the reference project UID/EEA/04436/2013, by FEDER funds through the COMPETE 2020 – Programa Operacional Competitividade e Internacionalização (POCI) with the reference project POCI-01-0145-FEDER-006941.info:eu-repo/semantics/publishedVersio

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe