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This study assessed whether S-100β protein could be measured in urine when detectable in plasma after a mild traumatic brain injury (mTBI). Clinical data, plasma and urine samples were collected for the 46 adult patients prospectively enrolled in the emergency department (ED) of a Level 1 trauma center. S-100β protein concentrations were analysed using ELISA. S-100β protein was detectable in 91% and 71% of plasma and urine samples, but values were not correlated (r = 0.002). Urine sampling would have been a non-invasive procedure, but it does not appear to be useful in the ED during the acute phase after an mTBI.
New technological methods, such as rapidly developing molecular approaches, often provide new tools for scientific advances. However, these new tools are often not utilized equally across different research areas, possibly leading to disparities in progress between these areas. Here, we use empirical evidence from the scientific literature to test for potential discrepancies in the use of genetic tools to study parasitic vs non-parasitic organisms across three distinguishable molecular periods, the allozyme, nucleotide and genomics periods. Publications on parasites constitute only a fraction (<5%) of the total research output across all molecular periods and are dominated by medically relevant parasites (especially protists), particularly during the early phase of each period. Our analysis suggests an increasing complexity of topics and research questions being addressed with the development of more sophisticated molecular tools, with the research focus between the periods shifting from predominantly species discovery to broader theory-focused questions. We conclude that both new and older molecular methods offer powerful tools for research on parasites, including their diverse roles in ecosystems and their relevance as human pathogens. While older methods, such as barcoding approaches, will continue to feature in the molecular toolbox of parasitologists for years to come, we encourage parasitologists to be more responsive to new approaches that provide the tools to address broader questions.
Banked human milk (BHM) has inherent infectious risks, even when pasteurized. Because of the ubiquity of Bacillus cereus in the environment and its ability to resist the Holder pasteurization process, there is a concern that BHM might lead to severe B. cereus infections.
We reviewed observed and published cases to determine the potential causal role of BHM as the source of these infections.
Two infants in the province of Québec (Canada) developed a B. cereus neonatal infection, and both had received BHM. We conducted bacteriological studies to compare clinical isolates and those found in these cases.
After extended culture of BHM retention lots, B. cereus was found to have been involved in batches related to the first case. However, molecular typing showed that the strain was different from the clinical isolate, therefore excluding BHM as the source of contamination. In the second case, a Brevibacillus spp was isolated, a species distinct from the clinical isolate.
Based on these cases and others reported in the literature, a causal link between B. cereus contaminated BHM and preterm neonatal infection has never been documented. Therefore, the risk that BHM can cause this infection remains theoretical. Given the widespread presence of B. cereus in the hospital environment and its capacity to resist standard cleaning procedures, it seems likely that airborne or direct or indirect contact are the main sources of most, if not all, cases of severe B. cereus neonatal infections, even in babies exposed to BHM.
Incentive Spirometry is commonly used for respiratory recovery. The literature on incentive spirometry and its impact on patients with rib fracture is unclear and there are no recommendations regarding its use in the Emergency Department (ED), particularly in rib fracture patients, which are known for increasing the risk of pulmonary complication. Therefore, the objective of this study was to assess the use of incentive spirometry and to measure its impacts on delayed complications in patients discharged from the ED with confirmed rib fracture.
This is a planned sub-study of a prospective observational cohort recruited in 4 Canadians ED between November 2006 and May 2012. Non-admitted patients over 16 y.o. with at least one confirmed rib fracture on radiographs were included. Prescription of incentive spirometry was left to attending physician. Main outcomes were development of pneumonia, atelectasis, and hemothorax within 14 days. Propensity score matching analyses were performed.
439 patients were included and 182 (41.5%) patients received incentive spirometry. There were 99 cases of hemothorax (22.6%), 103 cases of atelectasis (23.5%) and 4 cases of pneumonia (0.9%). The use of incentive spirometry was not protector for hemothorax [RR = 1.03 (0.66–1.64)] and atelectasis or pneumonia [RR = 1.07 (0.68–1.72)].
Our results suggest that unsupervised incentive spirometry use does not have a protective effect against delayed pulmonary complications after rib fracture. Further research should be conducted to assess the usefulness of incentive spirometry in specific injured population in the ED.
We study the destabilization of a round liquid jet by a fast annular gas stream. We measure the frequency of the shear instability waves for several geometries and air/water velocities. We then carry out a linear stability analysis, and show that there are three competing mechanisms for the destabilization: a convective instability, an absolute instability driven by surface tension and an absolute instability driven by confinement. We compare the predictions of this analysis with experimental results, and propose scaling laws for wave frequency in each regime. We finally introduce criteria to predict the boundaries between these three regimes.
Because the glacier snowline is easy to identify on optical satellite images and because in certain conditions it can be used as an indicator of the equilibrium line, it may be a relevant parameter for the study of the relationships between climate and glaciers. Although several studies have shown that the snowline altitude (SLA) at the end of the hydrological year is a good indicator of the equilibrium-line altitude (ELA) for mid-latitude glaciers, such a relationship remains conjectural for tropical glaciers. Indeed, unlike in mid-latitudes, tropical climate conditions result in a distinct seasonality of accumulation/ablation processes. We examine this relationship using direct field ELA and mass-balance measurements made on Glaciar Zongo, Bolivia (~16° S), vand Glaciar Artesonraju, Peru (~9° S), and the SLA retrieved from satellite images acquired in the past two decades. We show that on glaciers in the outer tropics: (1) ablation is reduced during the dry season in austral winter (May-August), the SLA does not change much, and satellite images acquired between May and August could be used to compute the SLA; and (2) the highest SLA detected on a number of satellite images acquired during the dry season provides a good estimate of the annual ELA. However, as snowfall events can occur during the dry season, the SLA detected on satellite images tends to underestimate the ELA. Thus, we recommend validating the SLA computed from satellite images with field data collected on a benchmark glacier before measuring the SLA on other glaciers in the same mountain range for which no field data are available. This study is a major step towards extending the measurement of glacier parameters (ELA and mass balance) at the scale of a whole mountain range in the outer tropics to better document the relationships between climate and glaciers.
Alpine glaciers are very sensitive to climate fluctuations, and their mass balance can be used as an indicator of regional-scale climate change. Here, we present a method to calculate glacier mass balance using remote-sensing data. Snowline measurements from remotely sensed images recorded at the end of the hydrological year provide an effective proxy of the equilibrium line. Mass balance can be deduced from the equilibrium-line altitude (ELA) variations. Three well-documented glaciers in the French Alps, where the mass balance is measured at ground level with a stake network, were selected to assess the accuracy of the method over the 1994–2002 period (eight mass-balance cycles). Results obtained by ground measurements and remote sensing are compared and show excellent correlation (r2 > 0.89), both for the ELA and for the mass balance, indicating that the remote-sensing method can be applied to glaciers where no ground data exist, on the scale of a mountain range or a given climatic area. The main differences can be attributed to discrepancies between the dates of image acquisition and field measurements. Cloud cover and recent snowfalls constitute the main restrictions of the image-based method.
Annual equilibrium-line altitude (ELA) and surface mass balance of Glacier Blanc, Ecrins region, French Alps, were reconstructed from a 25 year time series of satellite images (1981–2005). The remote-sensing method used was based on identification of the snowline, which is easy to discern on optical satellite images taken at the end of the ablation season. In addition, surface mass balances at the ELA were reconstructed for the same period using meteorological data from three nearby weather stations. A comparison of the two types of series reveals a correlation of r > 0.67 at the 0.01 level of significance. Furthermore, the surface mass balances obtained from remote-sensing data are consistent with those obtained from field measurements on five other French glaciers (r = 0.76, p < 0.01). Also consistent for Glacier Blanc is the total mass loss (10.8 m w.e.) over the studied period. However, the surface mass balances obtained with the remote-sensing method show lower interannual variability. Given that the remote-sensing method is based on changes in the ELA, this difference probably results from the lower sensitivity of the surface mass balance to climate parameters at the ELA.
The supply of glacier water to La Paz city, Bolivia, between 1963 and 2006 was assessed at annual and seasonal timescales based on the mass-balance quantification of 70 glaciers located within the drainage basins of La Paz. Glaciers contributed ∼15% of water resources at an annual scale (14% in the wet season, 27% in the dry season). Uncertainties in our estimation are related to the assumed constant precipitation (∼0.5% for ice-free areas and up to 6.5% for glaciated areas), the constant runoff coefficient (∼1%), the surface areas of the glaciers and catchments (∼5%) and the mean mass-balance uncertainty of the 21 glaciers used to obtain the mass balance of the 70 glaciers (12% of the total discharge). Despite the loss of 50% of the glacierized area during the study period, runoff at La Paz did not change significantly, showing that increase in ice melt rates compensated for reduction in the surface area of the glaciers. In the future, assuming complete disappearance of the glaciers and no change in precipitation, runoff should diminish by ∼12% at an annual scale, 9% during the wet season and 24% during the dry season.
The conduct of high-quality nutrition research requires the selection of appropriate markers as outcomes, for example as indicators of food or nutrient intake, nutritional status, health status or disease risk. Such selection requires detailed knowledge of the markers, and consideration of the factors that may influence their measurement, other than the effects of nutritional change. A framework to guide selection of markers within nutrition research studies would be a valuable tool for researchers. A multidisciplinary Expert Group set out to test criteria designed to aid the evaluation of candidate markers for their usefulness in nutrition research and subsequently to develop a scoring system for markers. The proposed criteria were tested using thirteen markers selected from a broad range of nutrition research fields. The result of this testing was a modified list of criteria and a template for evaluating a potential marker against the criteria. Subsequently, a semi-quantitative system for scoring a marker and an associated template were developed. This system will enable the evaluation and comparison of different candidate markers within the same field of nutrition research in order to identify their relative usefulness. The ranking criteria of proven, strong, medium or low are likely to vary according to research setting, research field and the type of tool used to assess the marker and therefore the considerations for scoring need to be determined in a setting-, field- and tool-specific manner. A database of such markers, their interpretation and range of possible values would be valuable to nutrition researchers.
Remote sensing is a powerful method to reconstruct annual mass-balance series over past decades by exploiting archives of available images, as well as to study glaciers in inaccessible regions. We present the application of a methodological framework based only on optical satellite images to retrieve glacier-wide annual mass balances for 30 glaciers in the French Alps. The glacier-wide annual mass balance for the period 1983–2014 was reconstructed by combining changes in glacier volumes computed from remote-sensing derived DEMs with annual measurements of the snow line altitude on satellite images. Data from direct observations on two of the glaciers confirmed the accuracy of the annual mass balances quantified by remote sensing with an average difference of ~0.3 m w.e., within the uncertainty range of the methods. Our results confirm the significant increase in mass loss since the early 2000s, with a difference >1 m w.e. a−1 between the periods 1983–2002 and 2003–14. The region-wide mass balance for the French Alps over the period 1979–2011 was −0.66 ± 0.27 m w.e. a−1, close to that of the European Alps. We also show that changes in glacier surface area or length are not representative of changes in mass balance at the scale of a few decades.
Radiocarbon dating of the carbonate remaining in calcined bones is widely regarded as a viable alternative to date skeletal remains in situations where collagen is no longer present. However, anomalously low δ13C values measured in calcined bones prompted questions about the origin of the carbon used for dating. The goal of this study was to quantify the magnitude of carbon isotope exchange between bone carbonate and environmental CO2 for bones calcined under natural conditions. Four archaeological bones ranging in age between the Neolithic and the Medieval period were combusted on a separate open fire for up to 4 hr and subsamples of calcined bones were taken every hour. All the bones experienced a significant increase in IRSF values and decrease in carbonate content and δ13C values. 14C ages measured in the carbonate fraction of well-calcined bones indicate that 67 ± 3% to 91 ± 8% of the carbon present in bone carbonate was replaced by carbon from the atmosphere of combustion. This finding confirms previous results obtained under laboratory conditions and has serious implications for 14C dating of calcined bones found in archaeological contexts. The 14C age obtained on a calcined bone will only reflect the true age of the bone sample if the age difference between the bone and the charcoal can be neglected. Our results show also that δ13C values of calcined bones can be used to estimate the degree of C exchange and control for post-burial diagenetic alteration.
The aim of this study is to directly radiocarbon date pottery from prehistoric rock-art shelters in the Tassili n'Ajjer (central Sahara). We used a combined geochemical and microscopic approach to determine plant material in the pottery prior to direct 14C dating. The ages obtained range from 5270 ± 35 BP (6276–5948 cal BP) to 8160 ± 45 BP (9190–9015 cal BP), and correlate with the chronology derived from pottery typology. Our results document the transition from pre-Pastoral to Pastoral contexts, dated to the early-mid Holocene transition, and confirm that vegetal temper in pottery can provide reliable 14C ages within Saharan contexts.
One century after its discovery, the Columns Tomb of Kumbi Saleh (Mauritania) remains an archaeological riddle. Since 1914, six field programs have been successively carried out at the medieval urban site of Kumbi Saleh, which now is commonly identified as Ghana. The latter was the famous capital city of the medieval West African state, which controlled the gold mines of West Africa and was involved in the gold trade with North Africa and the Mediterranean Basin. However, interpretation of the tomb, the largest structure from the necropolis, is still an issue as its dating itself has never been firmly established. As a consequence, scholars have usually referred to an unsatisfactory timeframe spanning 1000 years. The study of this monument was recently resumed, motivated by the rediscovery of bones collected in the tomb in 1914 and stored at the Musée de 1'Homme (Paris, France). AMS radiocarbon dating of the bone and tooth apatite fraction of three skulls demonstrates that the three individuals occupying the main vault of the tomb died between the end of the 11th century and the 12th century, precisely at the time of expansion of the Muslim Almoravid movement south of Sahara.
The best strategy for controlling extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) transmission in intensive care units (ICUs) remains elusive.
We developed a stochastic transmission model to quantify the effectiveness of interventions aimed at reducing the spread of ESBL-PE in an ICU.
We modeled the evolution of an outbreak caused by the admission of a single carrier in a 10-bed ICU free of ESBL-PE. Using data obtained from recent muticenter studies, we studied 26 strategies combining different levels of the following 3 interventions: (1) increasing healthcare worker compliance with hand hygiene before and after contact with a patient; (2) cohorting; (3) reducing antibiotic prevalence at admission with or without reducing antibiotherapy duration.
Improving hand hygiene compliance from 55% before patient contact and 60% after patient contact to 80% before and 80% after patient contact reduced the nosocomial incidence rate of ESBL-PE colonization by 91% at 90 days. Adding cohorting to hand hygiene improvement intervention decreased the proportion of ESBL-PE acquisitions by an additional 7%. Antibiotic restriction had the lowest impact on the epidemic. When combined with other interventions, it only marginally improved effectiveness, despite strong hypotheses regarding antibiotic impact on transmission.
Our results suggest that hand hygiene is the most effective intervention to control ESBL-PE transmission in an ICU.
Infect. Control Hosp. Epidemiol. 2016;37(3):272–280
Patients with pulmonary regurgitation after tetralogy of Fallot repair have impaired aerobic capacity; one of the reasons is the decreasing global ventricular performance at exercise, reflected by decreasing peak oxygen pulse. The aims of our study were to evaluate the impact of pulmonary valve replacement on peak oxygen pulse in a population with pure pulmonary regurgitation and with different degrees of right ventricular dilatation and to determine the predictors of peak oxygen pulse after pulmonary valve replacement.
The mean and median age at pulmonary valve replacement was 27 years. Mean pre-procedural right ventricular end-diastolic volume was 182 ml/m2. Out of 24 patients, 15 had abnormal peak oxygen pulse before pulmonary valve replacement. We did not observe a significant increase in peak oxygen pulse after pulmonary valve replacement (p=0.76). Among cardiopulmonary test/MRI/historical pre-procedural parameters, peak oxygen pulse appeared to be the best predictor of peak oxygen pulse after pulmonary valve replacement (positive and negative predictive values, respectively, 0.94 and 1). After pulmonary valve replacement, peak oxygen pulse was well correlated with left ventricular stroke and end-diastolic volumes (r=0.67 and 0.68, respectively).
Our study confirms the absence of an effect of pulmonary valve replacement on peak oxygen pulse whatever the initial right ventricular volume, reflecting possible irreversible right and/or left ventricle lesions. Pre-procedural peak oxygen pulse seemed to well predict post-procedural peak oxygen pulse. These results encourage discussions on pulmonary valve replacement in patients showing any decrease in peak oxygen pulse during their follow-up.
Research suggests that exposure to music may enhance autobiographical recall in Alzheimer's Disease (AD) patients. This study investigated whether exposure to music could enhance the production of self-defining memories, that is, memories that contribute to self-discovery, self-understanding, and identity in AD patients.
Twenty-two mild-stage AD patients and 24 healthy controls were asked to produce autobiographical memories in silence, while listening to researcher-chosen music, and to their own-chosen music.
AD patients showed better autobiographical recall when listening to their own-chosen music than to researcher-chosen music or than in silence. More precisely, they produced more self-defining memories during exposure to their own-chosen music than to researcher-chosen music or during silence. Additionally, AD patients produced more self-defining memories than autobiographical episodes or personal-semantics during exposure to their own-chosen music. This pattern contrasted with the poor production of self-defining memories during silence or during exposure to researcher-chosen music. Healthy controls did not seem to enjoy the same autobiographical benefits nor the same self-defining memory enhancement in the self-chosen music condition.
Poor production of self-defining memories, as observed in AD, may somehow be alleviated by exposure to self-chosen music.
Since 1991, in France, studies on the conditioning of iodine were carried out to assess the potential of several specific inorganic host matrices. The apatite family has been mainly studied because of its good chemical durability and its ability to confine iodine over geological time scales. A lead-bearing apatite, Pb10(VO4)4.8(PO4)1.2I2, and a calcium-bearing apatite, Ca10(PO4)6(OH)2-x(IO3)x, were selected on the basis of their incorporation rate (between 7 and 10 wt.%) and a satisfactory resistance to leaching (V0(50 °C, pure water) ∼ 10-2 g.m-2.d-1; Vr(50 °C, pure water) < 10-4 g.m-2.d-1). However, with such materials, the removal of open porosity requires non conventional sintering techniques like spark plasma sintering to decrease the surface exposed to water. This is why, in parallel, other matrices, like silver phosphate glasses, have also been investigated. To improve the chemical durability and thermal properties of these glasses, cross-linking reagents were added to their formulation.