Natalizumab treatment shows low cumulative probabilities of confirmed disability worsening to EDSS milestones in the long-term setting.

Abstract Background Though the Expanded Disability Status Scale (EDSS) is commonly used to assess disability level in relapsing-remitting multiple sclerosis (RRMS), the criteria defining disability progression are used for patients with a wide range of baseline levels of disability in relatively short-term trials. As a result, not all EDSS changes carry the same weight in terms of future disability, and treatment benefits such as decreased risk of reaching particular disability milestones may not be reliably captured. The objectives of this analysis are to assess the probability of confirmed disability worsening to specific EDSS milestones (i.e., EDSS scores ≥3.0, ≥4.0, or ≥6.0) at 288 weeks in the Tysabri Observational Program (TOP) and to examine the impact of relapses occurring during natalizumab therapy in TOP patients who had received natalizumab for ≥24 months. Methods TOP is an ongoing, open-label, observational, prospective study of patients with RRMS in clinical practice. Enrolled patients were naive to natalizumab at treatment initiation or had received ≤3 doses at the time of enrollment. Intravenous natalizumab (300 mg) infusions were given every 4 weeks, and the EDSS was assessed at baseline and every 24 weeks during treatment. Results Of the 4161 patients enrolled in TOP with follow-up of at least 24 months, 3253 patients with available baseline EDSS scores had continued natalizumab treatment and 908 had discontinued (5.4% due to a reported lack of efficacy and 16.4% for other reasons) at the 24-month time point. Those who discontinued due to lack of efficacy had higher baseline EDSS scores (median 4.5 vs. 3.5), higher on-treatment relapse rates (0.82 vs. 0.23), and higher cumulative probabilities of EDSS worsening (16% vs. 9%) at 24 months than those completing therapy. Among 24-month completers, after approximately 5.5 years of natalizumab treatment, the cumulative probabilities of confirmed EDSS worsening by 1.0 and 2.0 points were 18.5% and 7.9%, respectively (24-week confirmation), and 13.5% and 5.3%, respectively (48-week confirmation). The risks of 24- and 48-week confirmed EDSS worsening were significantly higher in patients with on-treatment relapses than in those without relapses. An analysis of time to specific EDSS milestones showed that the probabilities of 48-week confirmed transition from EDSS scores of 0.0–2.0 to ≥3.0, 2.0–3.0 to ≥4.0, and 4.0–5.0 to ≥6.0 at week 288 in TOP were 11.1%, 11.8%, and 9.5%, respectively, with lower probabilities observed among patients without on-treatment relapses (8.1%, 8.4%, and 5.7%, respectively). Conclusions In TOP patients with a median (range) baseline EDSS score of 3.5 (0.0–9.5) who completed 24 months of natalizumab treatment, the rate of 48-week confirmed disability worsening events was below 15%; after approximately 5.5 years of natalizumab treatment, 86.5% and 94.7% of patients did not have EDSS score increases of ≥1.0 or ≥2.0 points, respectively. The presence of relapses was associated with higher rates of overall disability worsening. These results were confirmed by assessing transition to EDSS milestones. Lower rates of overall 48-week confirmed EDSS worsening and of transitioning from EDSS score 4.0–5.0 to ≥6.0 in the absence of relapses suggest that relapses remain a significant driver of disability worsening and that on-treatment relapses in natalizumab-treated patients are of prognostic importance

Utilisation de semi-conducteurs organiques comme barrière tunnel pour l'électronique de spin

This thesis concerns the fabrication of organic magnetics tunnel junctions. Organic MTJs replace the barrier with a molecule. First, we had to overcome the problems of MTJ manufacturing. Indeed, this type of junction is very fragile from the point of view of its manufacturing because they are incompatible with solvents. A new manufacturing process has been developed. This process uses small nanometric "beads" scattered on the surface of a sample. This method has been used successfully and we obtained a magnetic response of the samples. XAS and magneto-transport measurements were conducted on MgO junctions. An innovative in operando approach was used. These measurements revealed that the presence of oxide at the interfaces limits the TMR. Finally, SR-PES measurements were carried out in order to study the Cu/MnPc interface polarization in the Cu (100)//Co/Cu/MnPc system. These measurements revealed that this interface is strongly spin polarized. Structures appearing in the spectra cannot be explained by a simple attenuation of the cobalt signal due to molecule coverage.Cette thèse s’intéresse à la fabrication de jonctions magnétiques à effet tunnel organiques. Les MTJ organiques remplacent la barrière par une molécule. Il a fallu d’abord vaincre les problèmes liés à la fabrication de ces MTJ. En effet, ce type de jonction est très fragile du point de vue de sa fabrication, car incompatible avec les solvants. Un nouveau procédé de fabrication a été mis au point. Ce procédé fait appel à de petites « billes » nanométriques dispersées à la surface d’un échantillon. Ce procédé a été utilisé avec succès. Nous avons obtenu une réponse magnétique des échantillons. Des mesures XAS et de magnéto-transport ont été menées sur des jonctions MgO. Une approche in operando innovante a été utilisée. Ces mesures ont démontré que la présence d’oxyde de fer aux interfaces limite la TMR. Pour finir, des mesures SR-PES ont été menées dans le but d’étudier la polarisation d’interface de Cu/MnPc dans le système Cu(100)//Co/Cu/MnPc. Ces mesures ont révélé que cette interface est très fortement polarisée en spin. Les structures qui apparaissent dans les spectres ne peuvent être expliquées par une simple atténuation du signal du cobalt due à la couverture de molécules

Use of organic semiconductors as a tunnel barrier for spin electronics

Cette thèse s’intéresse à la fabrication de jonctions magnétiques à effet tunnel organiques. Les MTJ organiques remplacent la barrière par une molécule. Il a fallu d’abord vaincre les problèmes liés à la fabrication de ces MTJ. En effet, ce type de jonction est très fragile du point de vue de sa fabrication, car incompatible avec les solvants. Un nouveau procédé de fabrication a été mis au point. Ce procédé fait appel à de petites « billes » nanométriques dispersées à la surface d’un échantillon. Ce procédé a été utilisé avec succès. Nous avons obtenu une réponse magnétique des échantillons. Des mesures XAS et de magnéto-transport ont été menées sur des jonctions MgO. Une approche in operando innovante a été utilisée. Ces mesures ont démontré que la présence d’oxyde de fer aux interfaces limite la TMR. Pour finir, des mesures SR-PES ont été menées dans le but d’étudier la polarisation d’interface de Cu/MnPc dans le système Cu(100)//Co/Cu/MnPc. Ces mesures ont révélé que cette interface est très fortement polarisée en spin. Les structures qui apparaissent dans les spectres ne peuvent être expliquées par une simple atténuation du signal du cobalt due à la couverture de molécules.This thesis concerns the fabrication of organic magnetics tunnel junctions. Organic MTJs replace the barrier with a molecule. First, we had to overcome the problems of MTJ manufacturing. Indeed, this type of junction is very fragile from the point of view of its manufacturing because they are incompatible with solvents. A new manufacturing process has been developed. This process uses small nanometric "beads" scattered on the surface of a sample. This method has been used successfully and we obtained a magnetic response of the samples. XAS and magneto-transport measurements were conducted on MgO junctions. An innovative in operando approach was used. These measurements revealed that the presence of oxide at the interfaces limits the TMR. Finally, SR-PES measurements were carried out in order to study the Cu/MnPc interface polarization in the Cu (100)//Co/Cu/MnPc system. These measurements revealed that this interface is strongly spin polarized. Structures appearing in the spectra cannot be explained by a simple attenuation of the cobalt signal due to molecule coverage

Use of organic semiconductors as a tunnel barrier for spin electronics

Cette thèse s’intéresse à la fabrication de jonctions magnétiques à effet tunnel organiques. Les MTJ organiques remplacent la barrière par une molécule. Il a fallu d’abord vaincre les problèmes liés à la fabrication de ces MTJ. En effet, ce type de jonction est très fragile du point de vue de sa fabrication, car incompatible avec les solvants. Un nouveau procédé de fabrication a été mis au point. Ce procédé fait appel à de petites « billes » nanométriques dispersées à la surface d’un échantillon. Ce procédé a été utilisé avec succès. Nous avons obtenu une réponse magnétique des échantillons. Des mesures XAS et de magnéto-transport ont été menées sur des jonctions MgO. Une approche in operando innovante a été utilisée. Ces mesures ont démontré que la présence d’oxyde de fer aux interfaces limite la TMR. Pour finir, des mesures SR-PES ont été menées dans le but d’étudier la polarisation d’interface de Cu/MnPc dans le système Cu(100)//Co/Cu/MnPc. Ces mesures ont révélé que cette interface est très fortement polarisée en spin. Les structures qui apparaissent dans les spectres ne peuvent être expliquées par une simple atténuation du signal du cobalt due à la couverture de molécules.This thesis concerns the fabrication of organic magnetics tunnel junctions. Organic MTJs replace the barrier with a molecule. First, we had to overcome the problems of MTJ manufacturing. Indeed, this type of junction is very fragile from the point of view of its manufacturing because they are incompatible with solvents. A new manufacturing process has been developed. This process uses small nanometric "beads" scattered on the surface of a sample. This method has been used successfully and we obtained a magnetic response of the samples. XAS and magneto-transport measurements were conducted on MgO junctions. An innovative in operando approach was used. These measurements revealed that the presence of oxide at the interfaces limits the TMR. Finally, SR-PES measurements were carried out in order to study the Cu/MnPc interface polarization in the Cu (100)//Co/Cu/MnPc system. These measurements revealed that this interface is strongly spin polarized. Structures appearing in the spectra cannot be explained by a simple attenuation of the cobalt signal due to molecule coverage

Adoption des articles 9, 10, 11, et 12 du décret sur les apanages, lors de la séance du 13 août 1790

Enjubault de la Roche René Urbain, Moreau Etienne Vincent. Adoption des articles 9, 10, 11, et 12 du décret sur les apanages, lors de la séance du 13 août 1790. In: Archives Parlementaires de 1787 à 1860 - Première série (1787-1799) Tome XVIII - Du 12 aout au 15 septembre 1790. Paris : Librairie Administrative P. Dupont, 1884. p. 47

Hippocrate: A safe robot arm for medical applications with force feedback

We have developed a robotic system to assist doctors when they are moving ultrasonic probes on the patient's skin while exerting a given effort. The probes are used to monitor arteries for cardiovascular disease prevention, namely to reconstruct the 3D profile of arteries. A preliminary feasibility study making use of an industrial robot has been made to validate the force control scheme. It has proven the interest of the robotized approach for such a medical application where force control is needed. In order to comply with safety constraints, a dedicated robotic system Hippocrate has been designed. This paper describes the arm and the controller architectures, with emphasis on design strategies selected to meet safety requirements. Preliminary in vivo results are presented as well as a possible new application of Hippocrate as a tool for reconstructive surgery.

Amendements de MM. Enjubault et Regnaud sur l'article du décret sur les apanages, lors de la séance du 20 décembre 1790

Enjubault de la Roche René Urbain, Regnaud de Saint-Jean d'Angely Michel Louis Etienne. Amendements de MM. Enjubault et Regnaud sur l'article du décret sur les apanages, lors de la séance du 20 décembre 1790. In: Archives Parlementaires de 1787 à 1860 - Première série (1787-1799) Tome XXI - Du 26 novembre 1790 au 2 janvier 1791. Paris : Librairie Administrative P. Dupont, 1885. p. 595

Amendements de MM. Enjubault et Regnaud sur l'article du décret sur les apanages, lors de la séance du 20 décembre 1790

Enjubault de la Roche René Urbain, Regnaud de Saint-Jean d'Angély Michel Louis Etienne. Amendements de MM. Enjubault et Regnaud sur l'article du décret sur les apanages, lors de la séance du 20 décembre 1790. In: Archives Parlementaires de 1787 à 1860 - Première série (1787-1799) Tome XXI - Du 26 novembre 1790 au 2 janvier 1791. Paris : Librairie Administrative P. Dupont, 1885. p. 595

Recommendations for the treatment of epilepsies in general practice in Belgium

The large choice of antiepileptic drugs (AEDs) in Belgium complicates the selection of the appropriate product for the individual patient. International guidelines on the treatment of epilepsy have been published, but are not tailored to the Belgian situation. This publication presents recommendations from a group of Belgian epilepsy experts for the practical management of epilepsy in general practice in Belgium. It includes recommendations for initial monotherapy and add-on treatment in adult patients (>= 16 years) and initial monotherapy in paediatric patients (< 16 years). For these three situations a first choice AED is recommended. One or more alternative first choice AEDs are defined for patients in which certain patient- or AED-related factors preclude the use of the first choice product. Selection of compounds was based on the registration and reimbursement status in Belgium, the level of evidence of efficacy, common daily practice and the personal views and experiences of the authors. The paper reflects the situation in 2008. In addition to the treatment recommendations, other relevant points to consider in the treatment of epilepsy with AEDs are addressed, including comorbidity and age of the patient, the interaction potential, pharmacokinetic properties and safety profile of the AEDs, and generic substitution