Facteurs associés au dépistage sous-optimal de C. trachomatis et de N. gonorrhoeae aux sites extragénitaux dans la population HARSAH de Montréal

Les infections répertoriées à gonorrhée et à chlamydia (CT/NG) augmentent au Québec, spécialement chez les hommes ayant des relations sexuelles avec d’autres hommes (HARSAH). Des écrits rapportent fréquemment leur dépistage sous-optimal aux sites extragénitaux (SEG), soit le rectum et le pharynx. Cette étude secondaire vise à déterminer la proportion d’HARSAH montréalais ayant reçu un dépistage sous-optimal de CT/NG aux SEG lors de leur dernier dépistage de routine des ITSS et d’explorer les facteurs qui pourraient être associés. Elle s’appuie sur les données collectées entre février 2017 et juin 2018 auprès de 651 HARSAH montréalais ayant rapporté un dépistage dans les six mois précédant leur participation à l’étude Engage et au moins une analyse lors de leur dernier dépistage. Les analyses portent sur les variables provenant de facteurs sociodémographiques, relatifs aux suivis de l’état de santé et liés aux comportements sexuels identifiés dans les écrits scientifiques. Lors de leur dernier dépistage de routine des ITSS, 11,6% des participants auraient fourni uniquement un échantillon de sang et d’urine, sans fournir de prélèvement à un SEG. Ultimement, 19,8% des répondants auraient reçu un dépistage sous-optimal de CT/NG aux SEG, c’est-à-dire sans appliquer les recommandations locales actuelles de dépistage. Par ailleurs, la fréquence des dépistages sous-optimaux de CT/NG aux SEG serait plus fréquente chez les HARSAH ayant un nombre inférieur de partenaires sexuels et chez les non-utilisateurs de la PPrE. S’appuyant sur le cadre des domaines théoriques, ce travail souhaite favoriser la transition des soins selon les résultats probants, spécialement auprès des populations vulnérables à CT/NG.Gonorrhea and chlamydia (CT/NG) infections are increasing in Quebec, especially among men who have sex with men (MSM). While recommendations encourage screening at all anatomical sites exposed during sexual intercourse, suboptimal screening at extragenital sites (ESG), the rectum and the pharynx, has been documented in the literature. The purpose of this secondary study is to determine the proportion of MSM in Montreal who received suboptimal screening for CT/NG at SEG during their last STBBI screening; and to explore the factors that could be associated with suboptimal screening. The study uses data from Montreal MSM participants in the Engage study, a Canadian biobehavioral study where baseline data were collected between February 2017 and June 2018. Analyses focus on variables identified in the literature, specifically, sociodemographic factors, and factors relating to health status and to sexual behavior. Of 651 MSM participants who reported STBBI screening, 11.6% were tested using blood and urine samples, without providing a sample from an ESG. Ultimately, based on reported sexual behaviors, 19.8 % received suboptimal CT/NG screening at SEG. The frequency of suboptimal CT/NG screenings at SEG was associated with a lower number of sexual partners and among non-users of PrEP. Based on the Theoretical Domains Framework, this research aspires to promote evidence-based practice, particularly among vulnerable populations

Urodele p53 tolerates amino acid changes found in p53 variants linked to human cancer

<p>Abstract</p> <p>Background</p> <p>Urodele amphibians like the axolotl are unique among vertebrates in their ability to regenerate and their resistance to develop cancers. It is unknown whether these traits are linked at the molecular level.</p> <p>Results</p> <p>Blocking p53 signaling in axolotls using the p53 inhibitor, pifithrin-α, inhibited limb regeneration and the expression of p53 target genes such as Mdm2 and Gadd45, suggesting a link between tumor suppression and regeneration. To understand this relationship we cloned the p53 gene from axolotl. When comparing its sequence with p53 from other organisms, and more specifically human we observed multiple amino acids changes found in human tumors. Phylogenetic analysis of p53 protein sequences from various species is in general agreement with standard vertebrate phylogeny; however, both mice-like rodents and teleost fishes are fast evolving. This leads to long branch attraction resulting in an artefactual basal emergence of these groups in the phylogenetic tree. It is tempting to assume a correlation between certain life style traits (e.g. lifespan) and the evolutionary rate of the corresponding p53 sequences. Functional assays of the axolotl p53 in human or axolotl cells using p53 promoter reporters demonstrated a temperature sensitivity (ts), which was further confirmed by performing colony assays at 37°C. In addition, axolotl p53 was capable of efficient transactivation at the Hmd2 promoter but has moderate activity at the p21 promoter. Endogenous axolotl p53 was activated following UV irradiation (100 j/m²) or treatment with an alkylating agent as measured using serine 15 phosphorylation and the expression of the endogenous p53 target Gadd45.</p> <p>Conclusion</p> <p>Urodele p53 may play a role in regeneration and has evolved to contain multiple amino acid changes predicted to render the human protein defective in tumor suppression. Some of these mutations were probably selected to maintain p53 activity at low temperature. However, other significant changes in the axolotl proteins may play more subtle roles on p53 functions, including DNA binding and promoter specificity and could represent useful adaptations to ensure p53 activity and tumor suppression in animals able to regenerate or subject to large variations in oxygen levels or temperature.</p

Deformed Reality

International audienceWe present Deformed Reality, a new way of interacting with an augmented reality environment by manipulating 3D objects in an intuitive and physically-consistent manner. Using the core principle of augmented reality to estimate rigid pose over time, our method makes it possible for the user to deform the targeted object while it is being rendered with its natural texture, giving the sense of a interactive scene editing. Our framework follows a computationally efficient pipeline that uses a proxy CAD model for both pose computation, physically-based manipulations and scene appearance estimation. The final composition is built upon a continuous image completion and re-texturing process to preserve visual consistency. The presented results show that our method can open new ways of using augmented reality by not only augmenting the environment but also interacting with objects intuitively

Framework for augmented reality in Minimally Invasive laparoscopic surgery

International audienceThis article presents a framework for fusing pre-operative data and intra-operative data for surgery guidance. This framework is employed in the context of Minimally Invasive Surgery (MIS) of the liver. From stereoscopic images a three dimensional point cloud is reconstructed in real-time. This point cloud is then used to register a patient-specific biomechanical model derived from Computed Tomography images onto the laparoscopic view. In this way internal structures such as vessels and tumors can be visualized to help the surgeon during the procedure. This is particularly relevant since abdominal organs undergo large deformations in the course of the surgery, making it difficult for surgeons to correlate the laparoscopic view with the pre-operative images. Our method has the potential to reduce the duration of the operation as the biomechanical model makes it possible to estimate the in-depth position of tumors and vessels at any time of the surgery, which is essential to the surgical decision process. Results show that our method can be successfully applied during laparoscopic procedure without interfering with the surgical work flow

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Deposition of Zinc oxide thin films for application in Bulk Acoustic Wave resonator

International audienceHigh quality piezoelectric zinc oxide (ZnO) thin films were deposited on (I 00)-oriented silicon substrate by reactive rf magnetron sputtering for bulk acoustic wave resonator. In order to improve the ZnO thin films quality, structural and electrical characteristics have been compared before and after annealing in helium (He) by X-ray diffraction and reflection coefficient S11 measurements. Scanning electron microscopy (SEM) was used to study the crystallographic structure. A previous study has shown that a substrate temperature of 100°C, a distance between the target and the substrate of 70 mm, and a pressure of 3.35 x 10-3 Torr in argon and oxygen mixed gas atmosphere, are the optimum conditions to sputter ZnO thin films with good homogeneity and a high degree of crystallinity. These films exhibit an electrical resistivity higher than 1010 Ω cm and an energy band gap of 3.3 eV at room temperature. X-ray diffraction measurements have shown that ZnO films are highly c-axis-oriented with a full width at half maximum (FWHM) below 0.5°. The decrease of the FWHM after annealing treatment has shown the crystal quality improvement. A growth of c-axis (002)-oriented ZnO films allows predominant longitudinal wave propagation. Bulk acoustic wave (BAW) resonators have been fabricated by stacking different layers of Al/ZnO/Pt on a silicon substrate which could be used for the fabrication of humidity sensors based on the quartz microbalance principle

Effect of the annealing on the electrical and optical properties of electron beam evaporated ZnO thin films

International audienceZinc oxide thin films have been grown on (100)-oriented silicon substrate at a temperature of 100 °C by reactive e-beam evaporation. Structural, electrical and optical characteristics have been compared before and after annealing in air by measurements of X-ray diffraction, real and imaginary parts of the dielectric coefficient, refractive index and electrical resistivity. X-ray diffraction measurements have shown that ZnO films are highly c-axis-oriented with a full width at half maximum (FWMH) lower than 0.5°. The electrical resistivity increases from 10-2 Ω cm to reach a value about 109 H cm after annealing at 750 °C. The FWHM decreases after annealing treatment, which proves the crystal quality improvement. Ellipsometer measurements show the improvement of the refractive index and the real dielectric coefficient after annealing treatment at 750 °C of the ZnO films evaporated by electron beam. Atomic force microscopy shows that the surfaces of the electron beam evaporated ZnO are relatively smooth. Finally, a comparative study on structural and optical properties of the electron beam evaporated ZnO and the rf magnetron deposited one is discussed

Urodele p53 tolerates amino acid changes found in p53 variants linked to human cancer-0

<p><b>Copyright information:</b></p><p>Taken from "Urodele p53 tolerates amino acid changes found in p53 variants linked to human cancer"</p><p>http://www.biomedcentral.com/1471-2148/7/180</p><p>BMC Evolutionary Biology 2007;7():180-180.</p><p>Published online 28 Sep 2007</p><p>PMCID:PMC2072957.</p><p></p>μM pifithrin-α, added freshly diluted everyday). Limbs in panels A-D were amputated distally in the middle of the zeugopod and limbs in panels E-G were amputated proximally through the middle of the stylopod (see dotted lines in panels A & E for amputation levels)