Low prevalence of coagulation F2 and F5 polymorphisms in mothers and children in a large cohort of patients with neonatal arterial ischemic stroke

International audienc

The use of positive behaviour support plans in mental health inpatient care: a mixed methods study

An international drive is to minimise restrictive practices in mental healthcare. Positive behaviour support Plans (PBSPs) help staff prevent behaviour which would require restrictive intervention. Originating in learning disability services, data within mental healthcare are limited. To evaluate PBSPs within a mental health‐inpatient service; understand mental health nurses’ and relatives’ attitudes to them and understand the barriers and facilitators for their use in routine mental healthcare. Mixed methods ‐ quality‐ratings and interviews with relatives and nurses. PBSPs were poorly implemented. Relatives and nurses valued the potential of PBSPs to facilitate holistic care, though no relative had contributed to one and not every eligible patient had one. Barriers to their use included confusion around positive behaviour support, including how, when and for whom PBSPs should be used, and difficulties describing the function of a behaviour. The potential of PBSPs to improve mental healthcare is recognised. However, there are barriers to their use which should be addressed to ensure that PBSPs have been properly implemented before their impact on patient care can be assessed. Mental health professionals implementing PBSPs should engage with relatives and patients, gain organizational commitment and ensure that those involved understand fully the positive behaviour support approach

Utilisation d'ions lithium pour l'analyse des surfaces et des couches minces

Dans la tendance actuelle à utiliser des ions plus lourds que les particules α en rétrodiffusion élastique (domaine d'énergie de l'ordre du MeV), l'emploi d'ions lithium apparaît constituer une amélioration notable des caractéristiques essentielles de la méthode. Ceci est particulièrement vrai en ce qui concerne la résolution en profondeur, avec le maintien de la résolution des détecteurs, pour ce type d'ions. Nous présentons ici, en même temps qu'une étude comparative des performances analytiques des ions Li et d'autres particules, quelques applications en montrant l'intérêt dans l'étude des surfaces et des couches minces. Parmi les applications les plus caractéristiques, citons, pour des échantillons épais, l'étude simultanée de la composition des couches d'oxydation anodique formées à la surface d'aluminium et du comportement de l'impureté majeure du bain de formation. Dans les études de couches minces, outre la détermination précise de la stoechiométrie des couches diélectriques AlN, SiO, Al2O3, des effets d'implantation pourront être étudiés, comme l'oxygène dans les couches SiO

Prenatal dexamethasone treatment for classic 21-hydroxylase deficiency in Europe

Dexamethasone; PrenatalDexametasona; PrenatalDexametasona; PrenatalObjective To assess the current medical practice in Europe regarding prenatal dexamethasone (Pdex) treatment of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. Design and methods A questionnaire was designed and distributed, including 17 questions collecting quantitative and qualitative data. Thirty-six medical centres from 14 European countries responded and 30 out of 36 centres were reference centres of the European Reference Network on Rare Endocrine Conditions, EndoERN. Results Pdex treatment is currently provided by 36% of the surveyed centres. The treatment is initiated by different specialties, that is paediatricians, endocrinologists, gynaecologists or geneticists. Regarding the starting point of Pdex, 23% stated to initiate therapy at 4–5 weeks postconception (wpc), 31% at 6 wpc and 46 % as early as pregnancy is confirmed and before 7 wpc at the latest. A dose of 20 µg/kg/day is used. Dose distribution among the centres varies from once to thrice daily. Prenatal diagnostics for treated cases are conducted in 72% of the responding centres. Cases treated per country and year vary between 0.5 and 8.25. Registries for long-term follow-up are only available at 46% of the centres that are using Pdex treatment. National registries are only available in Sweden and France. Conclusions This study reveals a high international variability and discrepancy in the use of Pdex treatment across Europe. It highlights the importance of a European cooperation initiative for a joint international prospective trial to establish evidence-based guidelines on prenatal diagnostics, treatment and follow-up of pregnancies at risk for CAH.This work was supported by the Deutsche Forschungsgemeinschaft (Heisenberg Professorship, 325768017 to N R and 314061271-TRR205 to N R and A H), the European Commission for funding EndoERN CHAFEA FPA grant no. 739527, the Eva Luise und Horst Köhler Stiftung & Else Kröner-Fresenius-Stiftung (2019_KollegSE.03 to H N) and the Stockholm County Council (Senior clinical research fellowship dnr RS 2019-1140 to S L), Stiftelsen Frimurare Barnhuset i Stockholm and Lisa and Johan Grönbergs Stiftelse

Rhinoplasty. The Difficult Nasal Tip: Total Resection of the Alar Cartilages

There are many ways to reconstruct and make nasal tips more attractive. Sometimes we cannot find the best way unless we at least remove all surplus from the tip. This may occur in primary or secondary rhinoplasty. In principle, anything is possible when relocating and reconstructing. However, sometimes we face reality when we uncover the tip: broken or bulging cartilages that are difficult to put right. For this reason, in 1987 we thought of totally resectioning the alar cartilages in a case of secondary rhinoplasty with an unsightly appearance. After a year the result was seen to be correct from an aesthetic and a functional perspective and is still so today. Aesthetically, it kept its shape and did not collapse with nasal respiratory failure. We covered the end of the crus medialis with a small, temporary, one- to two-layered fascia patch. Except in exceptional cases, we now use this procedure: Total sectioning of the alar cartilages including the domes, or maintenance of them by preserving the fibroadipose tip tissue with a suture in the middle of the end of the crus medialis and by covering this with temporary fascia, which usually has two layers depending on the thickness of the skin of the tip. This procedure is indicated mainly in secondary rhinoplasty when the cartilages of the tip are completely destroyed, and in primary rhinoplasty when the tip is excessively wide and bulbous. Our philosophy is, therefore, elegance and beauty of the nasal tip with a solid and equilateral base without prejudices

Possible fabrication techniques and welding specifications for the external cylinder of the CMS coil

The Compact Muon Solenoid (CMS) is one of the experiments, which are being designed in the framework of the Large Hadron Collider (LHC) project at CERN. The design field of the CMS magnet is 4 T, the magnetic length is 12.5 m and the free aperture is 6 m in diameter. This is achieved with a 4 layer and 5 module superconducting Al- stabilized coil energized at a nominal current of 20 kA at 4.5 K. In the CMS coil the structural function is ensured, unlike in other existing Al-stabilized thin solenoids, both by the Al-alloy reinforced conductor and the external cylinder. The calculated stress level in the cylinder at operating conditions is particularly severe. In this paper the different possible fabrication techniques are assessed and compared and a possible welding specification for this component is given. (9 refs)

Factors Influencing the Participation of Older People in Clinical Trials : Data Analysis from the MAVIS Trial

Peer reviewedPostprin

Helix straminea Briganti, 1825 in Italy (Gastropoda: Pulmonata): taxonomic history, morphology, biology, distribution and phylogeny

The land snail taxon Helix straminea Briganti, 1825 has been reintroduced as a valid species in 2014. We provide here a comprehensive account of its taxonomy, distribution, anatomy, phylogeny and karyology in Italy. An overview of the historical views on the validity of the species is presented and faunistic data are reviewed and implemented with new records from Campania and Basilicata. A lectotype is fixed for H. straminea from the syntypes stored in the Muséum d'Histoire Naturelle of Genève, as well as for three other taxa (Helix straminiformis Bourguignat, 1876, Helix yleobia Bourguignat, 1883 and Helix straminea ssp. elongata Bourguignat, 1860). Genital system, radula and karyotype are described for the first time. Molecular analysis of two mitochondrial genes combining GenBank data and the new sequences presented in this paper showed no differentiation between the northern and southern Italian populations. The conservation status of the species and its possible threats are discussed

Helix straminea Briganti, 1825 in Italy (Gastropoda: Pulmonata): taxonomic history, morphology, biology, distribution and phylogeny

The land snail taxon Helix straminea Briganti, 1825 has been reintroduced as a valid species in 2014. We provide here a comprehensive account of its taxonomy, distribution, anatomy, phylogeny and karyology in Italy. An overview of the historical views on the validity of the species is presented and faunistic data are reviewed and implemented with new records from Campania and Basilicata. A lectotype is fixed for H. straminea from the syntypes stored in the Muséum d’Histoire Naturelle of Genève, as well as for three other taxa (Helix straminiformis Bourguignat, 1876, Helix yleobia Bourguignat, 1883 and Helix straminea ssp. elongata Bourguignat, 1860). Genital system, radula and karyotype are described for the first time. Molecular analysis of two mitochondrial genes combining GenBank data and the new sequences presented in this paper showed no differentiation between the northern and southern Italian populations. The conservation status of the species and its possible threats are discussed

Pharmacological therapies in post stroke recovery: Recommendations for future clinical trials

Stroke is a leading cause of serious long-term disability in adults and is the second leading cause of death worldwide. Early reperfusion and neuroprotection techniques have been the focus of much effort with the aim of very acute treatment of the stroke. Targeting different mechanisms, pharmacological therapies have the potential to reduce disability in a large fraction of patients who survive the acute stroke. The brain's capacity to reorganize after stroke through plasticity mechanisms can be modulated by pharmacological agents. A number of therapeutic interventions are under study, including small molecules, growth factors, and monoclonal antibodies. Recently it has been shown that the SSRI fluoxetine improved motor deficit in patients with ischaemic stroke and hemiplegia which appeared to be independent of the presence of depression. In this context, it is of major importance to support innovative research in order to promote the emergence of new pharmacological treatments targeting neurological recovery after stroke, as opposed to acute de-occlusion and neuroprotection. This paper is the work of a group of 14 scientists with aim of (1) addressing key areas of the basic and clinical aspects of human brain plasticity after stroke and potential pharmacological targets for recovery, (2) asking questions about the most appropriate characteristics of clinical trials testing drugs in post stroke recovery and (3) proposing recommendations for future clinical trials. © 2013 Springer-Verlag Berlin Heidelberg