Biological Criteria Research Articles

Novel topical nano-colloidal carrier loaded with cyclosporine: Biological evaluation potentially for psoriasis treatment

Psoriasis is an autoimmune condition appeared as a skin disease, spotted as dry skin with red and thick plagues, which commonly induce itchiness and extreme uncomfortable feeling to the patient. In any level of psoriasis, topical treatment has always been the first line treatment given to patients as this method is more patient compliance. The idea of incorporating an established immunosuppressant, cyclosporine into nanoemulsion system could be the best option for the drug to be delivered topically and skip its toxicity issues. Cyclosporine-loaded nanoemulsion was developed which consists of virgin coconut oil and nutmeg oil mixture (15.00–20.00%), cyclosporine (1.00%), surfactant (15.00%), xanthan gum (0.75%) and deionized water (67.55% and 62.55%). Despite the physicochemical and rheological characteristics, biological criteria have also been a big concern in making sure the safety of this product for future application. In this study, these newly developed nanoemulsions containing cyclosporine exhibited good results concerning biological aspects such as the toxicity assay, colony counting, transepidermal water loss and skin moisturizing studies by fifteen normal volunteers' skin and irritancy study. The result showed nanoemulsion carrier was proven in making the harmful cyclosporine became non-toxic (IC50 > 1000 mg/mL) towards the primary keratinocytes (HaCaT cells). For sterility potential test, a negative result was obtained with zero colony (neither positive nor negative gram microbes) counted on the nutrient agar. Cyclosporine-loaded nanoemulsion has successfully increased the water storage for all healthy volunteers’ skin with maximum increment up to 54.67% and 68.87% by the application of Opt1 and Opt2, respectively. No record of acute irritancy side effect reported by volunteers which supported the low Human Irritancy Equivalent (HIE) values obtained from the irritancy analysis. The current finding suggested that the formulated nanoemulsions could be used to improve the skin condition of individual with psoriasis.

Evolutionary Local Search Algorithm for the biclustering of gene expression data based on biological knowledge

Biclustering is an unsupervised classification technique that plays an increasingly important role in the study of modern biology. This data mining technique has provided answers to several challenges raised by the analysis of biological data and more particularly the analysis of gene expression data. It aims to cluster simultaneously genes and conditions. These unsupervised techniques are based essentially on the assumption that the extraction of the co-expressed genes allows to have co-regulated genes. In addition, the integration of biological information in the search process may induce to the extraction of relevant and non-trivial biclusters. Therefore, this work proposes an evolutionary algorithm based on local search method that relies on biological knowledge. An experimental study is achieved on real microarray datasets to evaluate the performance of the proposed algorithm. The assessment and the comparison are based on statistical and biological criteria. A cross-validation experiment is also used to estimate its accuracy. Promising results are obtained. They demonstrate the importance of the integration of the biological knowledge in the biclustering process to foster the efficiency and to promote the discovery of non-trivial and biologically relevant biclusters.

Realizing the Social Dimension of EU Coastal Water Management

In the last 20 years, the EU has adopted some rather ambitious pieces of legislation with the aim to achieve a good environmental status in freshwater and marine ecosystems. Both the Water Framework Directive (WFD) and the Marine Strategy Framework Directive (MSFD) have a strong focus on the natural environment and biological criteria for assessing the status of the relevant ecosystems. In the same time period, much research on environmental governance has focused on the interconnectedness of social systems and ecosystems, so-called social-ecological systems (SES). While having high aspirations, the legal frameworks underpinning current EU water and marine management do not necessarily reflect the advances of contemporary science relating to SES. Using the geographical intersection of the two directives, i.e., coastal waters as a focal point, the paper explores the inchoate integration of social and ecological perspectives in the EU marine governance. What are the main challenges for the current EU legal regimes for managing coastal waters in a way that builds on the understanding of social and ecological systems as interconnected? Having explored the two directives, the paper introduces the possibility of using marine spatial planning (MSP), and the EU directive establishing a framework for maritime spatial planning (MSPD) as a bridge between the social and ecological dimensions and discusses what implications this would have for the current system for governing coastal waters in Europe.

Investigation of design space in manufacturing meta-biomaterials by additive manufacturing

Topology features such as interconnectivity, pore shape and size, porosity, struts thickness, and used materials play the key roles for mechanical and biological properties of meta-biomaterials structures. However, the influences of morphological geometries on the mechanical and biological properties are not certainly intuitive. This paper develops parametric model that use to visualize the morphological geometries of unit cell of meta-biomaterials on design space that governing the manufacturing limitation, mechanical and biological requirements. The selected samples within design spaces tested to determine manufacturing accuracy and effective elastic modulus by finite element analysis. The geometries discrepancies between designed models and manufactured samples obtained percentage of average errors of 13% for diamonds structures and 21% for square structures. The proposed technique yielded average error reduced to 74.4% for diamond structures and 44.4% for square structures of effective elastic modulus from theoretical calculation. The approach and the implications of the results discussed in the context of mechanical and biological criteria with highlight of advantages and limitations of meta-biomaterials manufactured by additive manufacturing for orthopaedic implants.

Bronze Age innovations and impact on human diet: A multi-isotopic and multi-proxy study of western Switzerland.

The archaeological Bronze Age record in Europe reveals unprecedented changes in subsistence strategies due to innovative farming techniques and new crop cultivation. Increasing cultural exchanges affected the economic system. The inhabitants of Switzerland played a pivotal role in this European context through relationships with the Mediterranean, the High and Middle Danube regions and the Alps thanks to the area’s central position. This research aims to reconstruct, for the first time in Switzerland, human socio-economic systems through the study of human diet, herding and farming practices and their changes throughout the Bronze Age (2200–800 BCE) by means of biochemical markers. The study includes 41 human, 22 terrestrial and aquatic animal specimens and 30 charred seeds and chaff samples from sites in western Switzerland. Stable isotope analyses were performed on cereal and legume seeds (δ13C, δ15N), animal bone collagen (δ13Ccoll, δ15N, δ34S), human bone and tooth dentine collagen (δ13Ccoll, δ15N,) and human tooth enamel (δ13Cenamel). The isotopic data suggest a) an intensification of soil fertilization and no hydric stress throughout the Bronze Age, b) a human diet mainly composed of terrestrial resources despite the proximity of Lake Geneva and the Rhone river, c) a diet based on C3 plants during the Early and Middle Bronze Age as opposed to the significant consumption of 13C-enriched resources (probably millet) by individuals from the Final Bronze Age, d) no important changes in dietary patterns throughout an individual’s lifespan but a more varied diet in childhood compared to adulthood, e) no differences in diet according to biological criteria (age, sex) or funerary behavior (burial architecture, grave goods).

Feasibility of Complete Cytoreduction in Advanced Epithelial Ovarian Cancer

Objective: Complete resectability of all visualized tumor implants at debulking surgery for advanced epithelial ovarian cancer is confirmed to be the single most important prognostic factor. This study aims to develop preoperative predicting score based on clinical, biological, and radiological criteria of epithelial ovarian cancer to assess the feasibility of complete cytoreduction. Study Design: A retrospective record-based study. Patients and Methods: The study was conducted upon 50 consecutive patients managed for epithelial ovarian cancer with FIGO stage III. Patients’ data were collected from records of the Gyne-Oncology Clinic of El Shatby University Maternity Hospital affiliated to Alexandria University. Results: Many parameters were significantly associated with completeness of resectability in univariate analysis; including age, BMI, CA125, albumin, pre-albumin, PCI, mesenteric, and right copula of diaphragm affection by CT scan (p value .05). A 100-point predictability score was developed, 10 for BMI ≥ 35 kg/m2, 25 points for Pre albumin points for mesenteric affection, and 30 points for affection of Rt. copula of diaphragm. The overall accuracy of the score was 92%. Conclusion: In advanced ovarian cancer, pre-operative predicting score (including clinical, biological, and radiological criteria) can be used as a roadmap for prediction of feasibility of complete resectability. However, more research is needed on larger sample sizes.

Cirrhosis: Therapeutic Aspects and Outcome for Hospitalized Patients in Burkina Faso

Introduction: Cirrhosis represents 27.63% of the hepatobiliary diseases in Burkina Faso. We aimed at studying the therapeutic and evolutionary features of the cirrhosis. Patients and methods: We implemented a cross-sectional and descriptive study, collecting retrospectively the data from 1st January 2012 to 31st March 2014. The diagnosis of cirrhosis was based on 1) clinical criteria (an edema-ascitic syndrome with a heterogeneous hepatomegaly with a sharp inferior border or atrophic liver and a portal hypertension); 2) biological criteria (a hepatocellular insufficiency syndrome); and 3) ultrasound imaging suggesting cirrhosis. Qualitative variables were presented as frequencies and percentages while quantitative ones were presented as means. Results: The data of 273 patients representing 33.9% of all hospitalizations were analyzed. The hepatobiliary diseases represented 74.7% of all diagnosis. The participants’ mean age was 46.9 years and the sex ratio, 2.7. The HBs antigen and anti-HCV antibodies were positive in 76.5% and 14.6% of the cases, respectively. Ascites was treated with puncture in 40.2% of patients, a salt-free diet (38.8%) and diuretics (54.2%). Hepatic encephalopathy was treated with lactulose in 73.6% of patients and two patients (1.3%) underwent esophageal varices ligation to treat their gastrointestinal bleeding. Lamivudine, tenofovir, and lamivudine-tenofovir combination were administered to 57.4%, 32.8%, and 10% of HBs Antigen positive patients, respectively. Conclusion: Cirrhosis still mostly affects the young and active male population at the gastro-enterology department of the university teaching hospital Yalgado Ouédraogo. Patients show up at a very advanced stage of the disease in poorly prepared health centres. In this context, prevention by the anti-hepatitis B immunization and early systematic screening with treatment when indicated are very efficient weapons at our disposal.

COVID-19 and Digestive Surgical Emergencies: Experience of the General Surgery Department of Tangier University Hospital.

On March 11, 2020, the WHO declared that the epidemic of COVID-19 had become a pandemic, and this disrupted all the regulated operative programs. On the other hand and by its urgent nature, the emergency surgery was maintained with particularity in some situations, an association with infection by COVID-19. The circumstances of diagnosis of the association of infection by COVID-19 and surgical emergency are based on clinical, radiological, and biological criteria. In this work we report the experience of the University Hospital of Tangier concerning the management of three patients with the particularity of associating a covid infection and a digestive surgical emergency, we will discuss through these cases, the necessary protective measures in intraoperative and the impact of the covid infection on the morbi-mortality Concerning the impact of covid infection on postoperative morbidity and mortality, there are generally two situations: When the covid infection is benign, the prognosis depends on the severity of the surgical emergency and in this situation the prognosis is the same as for patients not infected by covid, this is the case of the first and third cases. The second situation; when the covid infection is severe, it has a great impact on the prognosis and the postoperative care in intensive care. With this publication, we are trying to provide information to help surgeons better manage this category of patients, especially in view of the panic caused by the pandemic, and the difficulty of adapting to the new patient circuit, but more studies recruiting more cases are needed to confirm our findings.

Combined Surgical and Medical Treatment for Vancouver B1 and C Periprosthetic Femoral Fractures: A Proposal of a Therapeutic Algorithm While Retaining the Original Stable Stem.

IntroductionThere is lack of consensus regarding best operative fixation strategy for periprosthetic femoral fractures (PFFs) around a stable stem. Evidence exists that some patterns of fracture around a stable stem are better treated with revision surgery than with standard fixation. Anyway, a more aggressive surgical procedure together with medical treatment could allow for stem retention, and reduced risk of nonunion/hardware failure, even in these cases.SignificanceThis paper is placed in a broader context of lack of studies on the matter, and its aim is to shed some light on the management of PFFs around a stable stem, when peculiar mechanical and biological aspects are present.ResultsBased on our casuistry in the treatment of nonunions after PFF successfully treated with original stem retention, and on review of Literature about risk factors for fixation failure, an algorithm is proposed that can guide in choosing the ideal surgical technique even for first-time PFFs with a stable stem, without resorting to revision. Mechanical (major and minor) and biological (local and systemic) factors that may influence fracture healing, leading to nonunion and hardware failure, and subsequent need for re-operation, are considered. The proposed surgical technique consists of rigid fixation with absolute stability (using a plate and structural allograft) plus local biological support (structural allograft and autologous bone marrow concentrate over a platelet-rich plasma-based scaffold) at fracture site. Systemic anabolic treatment (Teriparatide) is also administered in the post-operative period.ConclusionMechanical factors are not the only issues to be considered when choosing the surgical approach to PFFs over a stable stem. Systemic and local biological conditions should be taken into account, as well. A therapeutic algorithm is proposed, given the prosthetic stem to be stable, considering mechanical and biological criteria.

Nosocomial infections: Importance of rapid and early detection of ESBL Enterobacteriaceae by molecular biology

Nosocomial infections are a major public health problem. They are mainly caused by bacteria that often present antibiotic resistance profiles, which complicates their management. The diagnosis of these infections is based on clinical and biological criteria that lack sensitivity and specificity, and on microbiological examinations that are lengthy. Unfortunately, the inadequate empirical antibiotic therapy in many cases, and the late implementation of an effective treatment, are associated with the emergence and spread of bacteria that are multi-resistant to antibiotics, i.e. strains producing extended-spectrum beta-lactamases (ESBL). Rapid diagnostic methods, identifying the pathogen and its resistance profile, are therefore necessary. Our laboratory is committed to develop PCR techniques to genotypically identify the most frequent ESBLs from four hospital facilities. Among all the enterobacteria detected, we observed the predominance of OXA type ESBL (38%), followed by CTX-M type ESBL (33%). TEM and SHV genes represent respectively 19% and 10%.The optimization of these technologies could allow the identification of all known resistance mechanisms in only a few hours and find new preventive or curative strategies in the fight against these nosocomial infections, to better respond to this health threat.

Extracorporeal membrane oxygenation for fulminant myocarditis: A 10-year multidisciplinary experience

Fulminant myocarditis is a life-threatening condition characterized by hemodynamic instability leading to cardiogenic shock or cardiac arrest. Veno-arterial extracorporeal membrane oxygenation (ECMO) could be used in patients refractory to conventional treatment. We aimed to investigate the clinical characteristics and outcomes of fulminant myocarditis patients managed with ECMO at a single-centre, multidisciplinary experience. We performed a retrospective observational analysis of our local database. The diagnosis of myocarditis was made from clinical, biologic and imaging criteria according to European guidelines. The primary endpoint was survival to hospital discharge. Of the 577 patients who had ECLS from January 2010 to December 2019, 16 (2.7%) were treated for fulminant myocarditis. The mean age was 38.5 years (range 21–69 years) and 68.7% were female. Main symptoms at hospital admission were: chest pain ( N = 6, 37.5%), heart failure ( N = 6, 37.5%), syncope ( N = 3, 18.7%) and cardiogenic shock ( N = 1, 6.2%). Seven (43.7%) patients presented a flu-like syndrome prior to the first medical contact. Complementary diagnostic tools included endomyocardial biopsy ( N = 8, 50%) and cardiac magnetic resonance imaging ( N = 7, 43.7%). ECMO was implanted during on-going cardiopulmonary resuscitation in 2 (12.5%) patients. Five (31.3%) patients died during ECMO support while 10 (62.5%) were successfully weaned after a mean ECMO support of 9.3 days. One (6.2%) patient was switched to a left ventricular assist device as a bridge-to-transplantation. Overall survival to hospital discharge was 68.7% ( N = 11). After the acute phase, most (72.7%) of the survivors displayed a normal left ventricular ejection fraction at hospital discharge. ECMO offered a satisfactory survival to hospital discharge in these critically ill patients. Our results underscore the high potential of myocardial recovery after the acute phase of fulminant myocarditis.

THE IMPORTANCE OF THE SELECTION PROCESS IN BASKETBALL. THE ANALYSIS OF THE SPECIALISTS’ OPINION

"objective: The purpose of this study was to identify the specialists’ in the field opinion on the selection process in the basketball game.Method: Data were collected through a questionnaire survey consisting of 27 items, divided into two sections. In this study, 25 specialists participated, out of whom 22 were basketball coaches and 3 were Physical Education and Sports teachers, specializing in basketball.Results: The questionnaire had an Alpha Cronbach fidelity index value of .766. Conclusions: The analysis of the answers received based on the questionnaire highlights the need to improve the secondary selection process in basketball.Key words: basketball, sports selection, questionnaire. 1 Transilvania University of Braşov 1. Introduction The selection or ""identification of talents"" is an organized activity, with a repetitive character, of early detection of children with special skills for practicing certain branches or sports, based on medical, biological, socio-psychological and motor criteria [1], [15], [16]. The selection process and the analysis of the young players’ potential skills has as ultimate goal their preparation for the requirements of the higher leagues and the access into these higher leagues as well as the capitalization on the basketball players’ full potential [11], [18], [19]. This process of identifying talents is a complex one because it requires defining efficient selection criteria and involving several professionals, as follows: coaches, physical trainers, doctors, kinesiologists, psychologists, etc. [13]. In general, the selection process [2] is developed in three stages: STAGE I - the initial or primary selection, which involves attracting, discovering and selecting talented children, with skills for playing basketball. STAGE II – the intermediate or secondary selection, which is considered the most important stage of the selection process because it takes place around the pre-pubertal period when the mental and biological stabilization takes place. The "

Immune-inflammatory markers in remission after a first-episode psychosis in young patients

To study clinical, psychopathological and immunological features of remission after first-episode psychosis in young patients to determine the patterns of this stage and the possibility of using the results for monitoring, prognosis and optimization of therapy. Fifty patients, aged 15-25 years, mean age 20.8±2.2 years, experiencing first-episode psychosis (F20, F25) and 45 healthy age-matched young men (mean age 19.2±3.2 years) were examined. The average age of psychosis manifestation was 19.8±2.5 months. Clinical, psychopathological, psychometric (PANSS and HDRS) and immunological («Neuro-immuno-test» technology) examinations were carried out at the psychotic state, during period of psychopathological symptoms reduction and further for 1-2 years until complete/significant reduction of psychotic symptoms. Three stages of remission are revealed: I - the stage of reduction and modification of leading psychotic symptoms, II - the stage of stabilization of mental functions, III - the stage of reintegration of mental functions. It has been shown that each stage corresponds to different features of clinical symptoms and also certain spectra of immune markers (activity of leukocyte elastase, α1-proteinase inhibitor and level of autoantibodies to S100-B and OBM proteins) in blood serum of patients. The differences in the spectra of immune parameters at the second stage of remission in patients with affective (depressive) disorders define various patterns of post-psychotic development of disease. The most representative are immunological features of the third stage of remission. The dynamics of immune markers in the course of remission can be considered as a biological criterion for assessment of the outcome of the first first-episode psychosis and the completeness of remission.

The Contribution of Lumbar Puncture in Neonatal Infections - About 206 cases

Background: Neonatal meningitis is a serious infection, no clinico-biological score has been established to accurately identify neonates at high risk of developing neonatal meningitis.Objective: The aim of this work is to clarify the place of lumbar puncture in neonatal infections and to identify the predictive factors of meningeal localization in case of neonatal infection.Materials and methods: This is a prospective study of 861 observations of newborns hospitalized in the pediatric department of Mohammed V Hospital, CHU of Tangier, during a 14-month period from 1January 2019 to 29 February 2020. Among these patients the diagnosis of neonatal infection (NNI) was retained in 473 cases. Initial lumbar puncture was performed in 206 cases (43%). We included neonates aged 0 to 28 days, suspected of NNI, who had a lumbar puncture. Neonates treated as carriers of neonatal infection without sufficient anamnestic and clinical evidence and with an inconclusive or unperformed biological workup were excluded from the study.Results: During the study period, 861 newborns were hospitalized and the diagnosis of neonatal infection was retained in 473 cases, a rate of 55%, and the initial lumbar puncture was performed in 206 cases (43%). 61 newborns were diagnosed with neonatal meningitis, with fever in 76% of cases, 85% with convulsions, hypotonia and/or refusal to suckle in 63% of cases, and CRP >25mg/l in 67% of newborns.Conclusion: Lumbar puncture is the only diagnostic means of meningitis. Indeed, the indication of this procedure should not be systematic, but it should be dictated by the careful and simultaneous analysis of the anamnestic, clinical and biological criteria evocative of the infection and its meningeal localization in order to diagnose meningitis early and treat it correctly. The need to establish scores combining these different parameters, in order to accurately identify newborns at high risk of developing neonatal meningitis

Synergies Radiotherapy-Immunotherapy in Head and Neck Cancers. A New Concept for Radiotherapy Target Volumes-"Immunological Dose Painting".

The combination of immune checkpoint inhibitors and definitive radiotherapy is investigated for the multimodal treatment of cisplatin non-eligible locally advanced head and neck cancers (HNC). In the case of recurrent and metastatic HNC, immunotherapy has shown benefit over the EXTREME protocol, being already considered the standard treatment. One of the biggest challenges of multimodal treatment is to establish the optimal therapy sequence so that the synergistic effect is maximal. Thus, superior results were obtained for the administration of anti-CTLA4 immunotherapy followed by hypofractionated radiotherapy, but the anti-PD-L1 therapy demonstrates the maximum potential of radio-sensitization of the tumor in case of concurrent administration. The synergistic effect of radiotherapy–immunotherapy (RT–IT) has been demonstrated in clinical practice, with an overall response rate of about 18% for HNC. Given the demonstrated potential of radiotherapy to activate the immune system through already known mechanisms, it is necessary to identify biomarkers that direct the “nonresponders” of immunotherapy towards a synergistic RT–IT stimulation strategy. Stimulation of the immune system by irradiation can convert “nonresponder” to “responder”. With the development of modern techniques, re-irradiation is becoming an increasingly common option for patients who have previously been treated with higher doses of radiation. In this context, radiotherapy in combination with immunotherapy, both in the advanced local stage and in recurrent/metastatic of HNC radiotherapy, could evolve from the “first level” of knowledge (i.e., ballistic precision, dose conformity and homogeneity) to “level two” of “biological dose painting” (in which the concept of tumor heterogeneity and radio-resistance supports the need for doses escalation based on biological criteria), and finally to the “third level“ ofthe new concept of “immunological dose painting”. The peculiarity of this concept is that the radiotherapy target volumes and tumoricidal dose can be completely reevaluated, taking into account the immune-modulatory effect of irradiation. In this case, the tumor target volume can include even the tumor microenvironment or a partial volume of the primary tumor or metastasis, not all the gross and microscopic disease. Tumoricidal biologically equivalent dose (BED) may be completely different from the currently estimated values, radiotherapy treating the tumor in this case indirectly by boosting the immune response. Thus, the clinical target volume (CTV) can be replaced with a new immunological-clinical target volume (ICTV) for patients who benefit from the RT–IT association (Image 1).

Development of Chitosan/Starch-Based Forward Osmosis Water Filtration Bags for Emergency Water Supply.

A forward osmosis (FO) membrane was developed from a mixture of chitosan and Dioscorea hispida starch, cross-linked using glutaraldehyde. The cross-linked chitosan/starch membrane was revealed to have high mechanical properties with an asymmetric structure. The prepared membrane’s performance was investigated as an FO filter assembled in a polypropylene water filter bag and aluminum foil plastic. In order to study the FO process, brackish water was used as a feed solution, drawn using three types of solution (fructose, sucrose, and fructose/sucrose mixture, each with 3 M concentration). The maximum water flux (5.75 L/m2 h) was achieved using 3 M sucrose. The cross-linked membrane restrained the ions in the feed with a rejection factor value close to 100%. The water quality parameters were evaluated for the physical, chemical, and biological criteria, such as pH, salinity, conductivity, total dissolved solids (TDS), heavy metals, and Escherichia coli content. The water quality parameters for the FO-processed water met that set by the World Health Organization for drinking water. FO filter bags with cross-linked chitosan/starch membranes can be an option to produce drinking water during an emergency.

Occupational burnout‐like syndrome in early‐onset Alzheimer’s disease

AbstractBackgroundEarly‐onset Alzheimer’s disease (EOAD) differentiates from late‐onset AD by a predominant and early involvement of the parietal neocortex with hippocampal sparing, leading to non‐amnesic cognitive syndromes (deficits in working memory, visuospatial abilities, praxis, or language). The diagnosis of a neurodegenerative disease is often not the first mentioned in such young patients. We aimed to identify the inaugural symptoms and diagnosis in working age EOAD patients.MethodsWe retrospectively reviewed the files of patients younger than 62 years referred to our memory clinic for cognitive dysfunction during the last year. Among 91 patients, 31 were diagnosed with AD based on clinical and biological criteria (cerebrospinal fluid biomarkers). Their mean age was 55±3.8 years.ResultsEleven EOAD patients (35%) were initially diagnosed with an occupational burnout syndrome, while logopenic aphasia or visuo‐spatial deficit were observed in the remaining 20 patients (65%). In the burnout syndrome subgroup, the delay between the first symptoms and neurological examination was 2.6±1.1 years. The initial Mini‐Mental State Examination score was 19.6±4.6/30. Neuropsychological assessment showed a severe working memory deficit, associated with mild cognitive cortical parietal syndrome. Visual inspection of brain MRI and FDG‐PET showed bilateral parietal atrophy and a severe focal hypometabolism of associative parietal cortices. No patient had family history of EAOD and the molecular genetic testing of AD mutation was negative.ConclusionWe describe, for the first time, a new clinical presentation of EOAD mimicking an occupational burnout syndrome. The severe inaugural working memory deficit due to the early cortical parietal damage leads to an inability to carry out concurrent professional tasks, a reduction of professional efficacy and a severe anxiety, in the absence of overt aphasia or episodic memory deficit at the time of initial evaluation. The patient stops working and is often referred to psychiatrists, the diagnosis being delayed until the cognitive deficit worsens, and strongly affects the autonomy at a more advanced stage of the disease. It is crucial to consider this clinical phenotype in the definition of EOAD to avoid delayed diagnosis.

A biologically based measure of turbulence intensity for predicting fish passage behaviours

Many fishways were designed to facilitate upstream migration at anthropogenic barriers for targeted species, such as salmonids, though these designs may impede the passage of non-target species with different swimming capabilities. Developing passage metrics that quantify hydraulic conditions scaled to biological behaviours or traits could identify the causes of challenging passage conditions and aid design of multi-species fishways. Our objective was to test the performance of six velocity- and turbulence-derived metrics for predicting passage behaviours of Pacific Lamprey (Entosphenus tridentatus) under varying hydraulic conditions within an experimental vertical slot. These metrics were the 1) swim path-averaged water velocity, 2) swim path-averaged turbulence kinetic energy ( TKE ¯ ), 3) power, 4) work, 5) a biological turbulence intensity, I ¯ Bio , quantified as the ratio between the root of the TKE ¯ and a biological criterion (the bulk average velocity for which lampreys shift from free-swimming to attachment behaviours, UBio = 1.8 m·s−1) and 6) a flow index I ¯ Bio , which is I ¯ Bio modulated by a dimensionless velocity U* = U/UBio , where U is the mean flow through the vertical slot. We assessed the performance of these metrics by evaluating their relationship with Pacific Lamprey attachment time, which serves as an important behavioural proxy for passage difficulty. Only I ¯ Bio and F were significantly associated with attachment time and we suggest these metrics can be adapted for other fish species based on velocity thresholds inducing key behavioural responses. More broadly, our study demonstrates the importance of accounting for turbulence and employing biological criteria when quantifying fish passage within or across species.

Evaluation of the performance of sysmex XN-3100 automated hematology analyzer regarding the sysmex XE-2100 and microscopic examination

Abstract Objectives We performed a verification study of the Sysmex XN-3100 hematology analyzer in comparison with the XE-2100 according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI) and the International Council for Standardization in Hematology (ICSH). Materials and methods Blood samples and quality control materials were used for precision. For comparison, we used the current XE-2100 as the comparative method and analyzed 540 blood samples. The Passing-Bablok and Bland-Altman tests were performed according to the CLSI EP09-A3 and a carryover study was performed according to the CLSI H26-A2 guidelines. The flagging performance of the two analyzers was compared, using two experienced laboratory technicians as the reference method. Results The Sysmex XN-3100 demonstrated high levels of precision for most parameters. For the comparison analysis, all parameters, except for MCHC, monocytes and basophils were within the systematic error limits of desirable biological variability criterion (SeDBV). The carryover was less than 0.4% for all parameters. The flagging performance of the XN-3100 was satisfactory and the overall efficiency was high. Conclusions The XN-3100 not only showed a strong correlation and agreement with the XE-2100 but also displayed a comparable analytical sensitivity, and increased specificity, which may result in an improved turnaround time and throughpu.

Pulmonary infections complicating ARDS.

Pulmonary infection is one of the main complications occurring in patients suffering from acute respiratory distress syndrome (ARDS). Besides traditional risk factors, dysregulation of lung immune defenses and microbiota may play an important role in ARDS patients. Prone positioning does not seem to be associated with a higher risk of pulmonary infection. Although bacteria associated with ventilator-associated pneumonia (VAP) in ARDS patients are similar to those in patients without ARDS, atypical pathogens (Aspergillus, herpes simplex virus and cytomegalovirus) may also be responsible for infection in ARDS patients. Diagnosing pulmonary infection in ARDS patients is challenging, and requires a combination of clinical, biological and microbiological criteria. The role of modern tools (e.g., molecular methods, metagenomic sequencing, etc.) remains to be evaluated in this setting. One of the challenges of antimicrobial treatment is antibiotics diffusion into the lungs. Although targeted delivery of antibiotics using nebulization may be interesting, their place in ARDS patients remains to be explored. The use of extracorporeal membrane oxygenation in the most severe patients is associated with a high rate of infection and raises several challenges, diagnostic issues and pharmacokinetics/pharmacodynamics changes being at the top. Prevention of pulmonary infection is a key issue in ARDS patients, but there is no specific measure for these high-risk patients. Reinforcing preventive measures using bundles seems to be the best option.