Excess mortality related to the August 2003 heat wave in France.

Objectives: From August 1st to 20th, 2003, the mean maximum temperature in France exceeded the seasonal norm by 11-12 degrees C on nine consecutive days. A major increase in mortality was then observed, which main epidemiological features are described herein. Methods: The number of deaths observed from August to November 2003 in France was compared to those expected on the basis of the mortality rates observed from 2000 to 2002 and the 2003 population estimates. Results: From August 1st to 20th, 2003, 15,000 excess deaths were observed. From 35 years age, the excess mortality was marked and increased with age. It was 15% higher in women than in men of comparable age as of age 45 years. Excess mortality at home and in retirement institutions was greater than that in hospitals. The mortality of widowed, single and divorced subjects was greater than that of married people. Deaths directly related to heat, heatstroke, hyperthermia and dehydration increased massively. Cardiovascular diseases, ill-defined morbid disorders, respiratory diseases and nervous system diseases also markedly contributed to the excess mortality. The geographic variations in mortality showed a clear age-dependent relationship with the number of very hot days. No harvesting effect was observed. Conclusions: Heat waves must be considered as a threat to European populations living in climates that are currently temperate. While the elderly and people living alone are particularly vulnerable to heat waves, no segment of the population may be considered protected from the risks associated with heat waves

New Trends in Beverage Packaging Systems: A Review

New trends in beverage packaging are focusing on the structure modification of packaging materials and the development of new active and/or intelligent systems, which can interact with the product or its environment, improving the conservation of beverages, such as wine, juice or beer, customer acceptability, and food security. In this paper, the main nutritional and organoleptic degradation processes of beverages, such as oxidative degradation or changes in the aromatic profiles, which influence their color and volatile composition are summarized. Finally, the description of the current situation of beverage packaging materials and new possible, emerging strategies to overcome some of the pending issues are discussed

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)

Comparaison de la néphrectomie partielle par voie ouverte et par voie laparoscopique (étude non appariée et appariée)

A partir d'une base de donnée multicentrique 1214 néphrectomies partielles NP (278 laparoscopiques (NPL) et 936 ouvertes (NPO) ont été comparées, en fonction des données péri-opératoires et anatomopathologiques. Après appariement pour la taille tumorale, l'indication et le siège de la tumeur, 137 NPL et 491 NPO ont été comparées selon les mêmes critères. Les indications de nécessité étaient plus fréquentes pour les NPO. Pour les NPL, les tumeurs étaient plus petites et il y avait moins de tumeurs hilaires. Le clampage pédiculaire était plus fréquent et de durée plus prolongée pour les NPL. Les pertes sanguines et le taux de transfusion étaient en faveur des NPL. La durée opératoire était supérieure pour les NPL. La durée moyenne d'hospitalisation était plus courte pour les NPL. Le taux de fistules urinaires était supérieur dans la NPL. Après appariement, le taux de transfusions était comparable dans les 2 groupes. Le taux de clampage pédiculaire, le temps moyen du clampage, la durée opératoire moyenne et le taux de fistules urinaires restaient en faveur des NPO. Les pertes sanguines moyennes et la durée d'hospitalisation restaient en faveur des NPL.TOULOUSE3-BU Santé-Centrale (315552105) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Epidémiologie des endocardites infectieuses à la Réunion

BORDEAUX2-BU Santé (330632101) / SudocSudocFranceF

Brain decoding of the Human Connectome Project tasks in a dense individual fMRI dataset

Brain decoding aims to infer cognitive states from patterns of brain activity. Substantial inter-individual variations in functional brain organization challenge accurate decoding performed at the group level. In this paper, we tested whether accurate brain decoding models can be trained entirely at the individual level. We trained several classifiers on a dense individual functional magnetic resonance imaging (fMRI) dataset for which six participants completed the entire Human Connectome Project (HCP) task battery >13 times over ten separate fMRI sessions. We evaluated nine decoding methods, from Support Vector Machines (SVM) and Multi-Layer Perceptron (MLP) to Graph Convolutional Neural Networks (GCN). All decoders were trained to classify single fMRI volumes into 21 experimental conditions simultaneously, using ∼7 h of fMRI data per participant. The best prediction accuracies were achieved with GCN and MLP models, whose performance (57–67 % accuracy) approached state-of-the-art accuracy (76 %) with models trained at the group level on >1 K hours of data from the original HCP sample. Our SVM model also performed very well (54–62 % accuracy). Feature importance maps derived from MLP —our best-performing model— revealed informative features in regions relevant to particular cognitive domains, notably in the motor cortex. We also observed that inter-subject classification achieved substantially lower accuracy than subject-specific models, indicating that our decoders learned individual-specific features. This work demonstrates that densely-sampled neuroimaging datasets can be used to train accurate brain decoding models at the individual level. We expect this work to become a useful benchmark for techniques that improve model generalization across multiple subjects and acquisition conditions

Reversible charge storage in a single silicon atom

Équipe 102 : Surfaces et SpectroscopiesInternational audienceThe ultimate miniaturization of electronic devices at the atomic scale with single electrons requires controlling the reversible charge storage in a single atom. However, reversible charge storage is difficult to control as usually only one charge state can be stabilized. Here, combining scanning tunneling microscopy (STM) and density functional theory (DFT), we demonstrate that a single silicon dangling bond of a hydrogenated p-type doped Si(100) surface has two stable charge states (neutral and negatively charged) at low temperature (5 K). Reversible charge storage is achieved using a gate electric field between the STM tip and the surface

Analyse en temps réel par spectrométrie de masse haute résolution de molécules à l'état de traces

National audienc