Zoledronic Acid in Reducing Clinical Fracture and Mortality after Hip Fracture.

BACKGROUND: Mortality is increased after a hip fracture, and strategies that improve outcomes are needed. METHODS: In this randomized, double-blind, placebo-controlled trial, 1065 patients were assigned to receive yearly intravenous zoledronic acid (at a dose of 5 mg), and 1062 patients were assigned to receive placebo. The infusions were first administered within 90 days after surgical repair of a hip fracture. All patients received supplemental vitamin D and calcium. The median follow-up was 1.9 years. The primary end point was a new clinical fracture. RESULTS: The rates of any new clinical fracture were 8.6% in the zoledronic acid group and 13.9% in the placebo group, a 35% risk reduction (P = 0.001); the respective rates of a new clinical vertebral fracture were 1.7% and 3.8% (P = 0.02), and the respective rates of new nonvertebral fractures were 7.6% and 10.7% (P = 0.03). In the safety analysis, 101 of 1054 patients in the zoledronic acid group (9.6%) and 141 of 1057 patients in the placebo group (13.3%) died, a reduction of 28% in deaths from any cause in the zoledronic-acid group (P = 0.01). The most frequent adverse events in patients receiving zoledronic acid were pyrexia, myalgia, and bone and musculoskeletal pain. No cases of osteonecrosis of the jaw were reported, and no adverse effects on the healing of fractures were noted. The rates of renal and cardiovascular adverse events, including atrial fibrillation and stroke, were similar in the two groups. CONCLUSIONS: An annual infusion of zoledronic acid within 90 days after repair of a low-trauma hip fracture was associated with a reduction in the rate of new clinical fractures and improved survival. (ClinicalTrials.gov number, NCT00046254.).

Biomarkers of oxidative stress and its association with the urinary reducing capacity in bus maintenance workers.

BACKGROUND: Exposure to particles (PM) induces adverse health effects (cancer, cardiovascular and pulmonary diseases). A key-role in these adverse effects seems to be played by oxidative stress, which is an excess of reactive oxygen species relative to the amount of reducing species (including antioxidants), the first line of defense against reactive oxygen species. The aim of this study was to document the oxidative stress caused by exposure to respirable particles in vivo, and to test whether exposed workers presented changes in their urinary levels for reducing species.METHODS: Bus depot workers (n = 32) exposed to particles and pollutants (respirable PM4, organic and elemental carbon, particulate metal content, polycyclic aromatic hydrocarbons, NOx, O3) were surveyed over two consecutive days. We collected urine samples before and after each shift, and quantified an oxidative stress biomarker (8-hydroxy-2'-deoxyguanosine), the reducing capacity and a biomarker of PAH exposure (1-hydroxypyrene). We used a linear mixed model to test for associations between the oxidative stress status of the workers and their particle exposure as well as with their urinary level of reducing species.RESULTS: Workers were exposed to low levels of respirable PM4 (range 25-71 μg/m3). However, urinary levels of 8-hydroxy-2'-deoxyguanosine increased significantly within each shift and between both days for non-smokers. The between-day increase was significantly correlated (p < 0.001) with the concentrations of organic carbon, NOx, and the particulate copper content. The within-shift increase in 8OHdG was highly correlated to an increase of the urinary reducing capacity (Spearman ρ = 0.59, p < 0.0001).CONCLUSIONS: These findings confirm that exposure to components associated to respirable particulate matter causes a systemic oxidative stress, as measured with the urinary 8OHdG. The strong association observed between urinary 8OHdG with the reducing capacity is suggestive of protective or other mechanisms, including circadian effects. Additional investigations should be performed to understand these observations.

Tire traces: discrimination and classification of pyrolysis-GC/MS profiles

Tire traces can be observed on several crime scenes as vehicles are often used by criminals. The tread abrasion on the road, while braking or skidding, leads to the production of small rubber particles which can be collected for comparison purposes. This research focused on the statistical comparison of Py-GC/MS profiles of tire traces and tire treads. The optimisation of the analytical method was carried out using experimental designs. The aim was to determine the best pyrolysis parameters regarding the repeatability of the results. Thus, the pyrolysis factor effect could also be calculated. The pyrolysis temperature was found to be five time more important than time. Finally, a pyrolysis at 650 °C during 15 s was selected. Ten tires of different manufacturers and models were used for this study. Several samples were collected on each tire, and several replicates were carried out to study the variability within each tire (intravariability). More than eighty compounds were integrated for each analysis and the variability study showed that more than 75% presented a relative standard deviation (RSD) below 5% for the ten tires, thus supporting a low intravariability. The variability between the ten tires (intervariability) presented higher values and the ten most variant compounds had a RSD value above 13%, supporting their high potential of discrimination between the tires tested. Principal Component Analysis (PCA) was able to fully discriminate the ten tires with the help of the first three principal components. The ten tires were finally used to perform braking tests on a racetrack with a vehicle equipped with an anti-lock braking system. The resulting tire traces were adequately collected using sheets of white gelatine. As for tires, the intravariability for the traces was found to be lower than the intervariability. Clustering methods were carried out and the Ward's method based on the squared Euclidean distance was able to correctly group all of the tire traces replicates in the same cluster than the replicates of their corresponding tire. Blind tests on traces were performed and were correctly assigned to their tire source. These results support the hypothesis that the tested tires, of different manufacturers and models, can be discriminated by a statistical comparison of their chemical profiles. The traces were found to be not differentiable from their source but differentiable from all the other tires present in the subset. The results are promising and will be extended on a larger sample set.

Environmental changes in the aftermath of Neoproterozoic glaciations: a biogeochemical study of sediments from SW-Gondwana

Abstract The late Neoproterozoic or Ediacaran period, (635 to -543 Ma) is a primordial time in the Earth history corresponding to the beginning of animal life and the most extreme ice ages on Earth. In this dissertation, palaeoenvironmental conditions were reconstructed for Ediacaran, post-Gaskiers shelf deposits in SW- Gondwana and their changes were evaluated according to the diversity of organisms. The present study addresses the question of interactions between biodiversity and environmental change by using the elemental and isotopic geochemistry of sedimentary rocks and associated organic matter, as well as the distribution of hydrocarbon biomarkers. The studied sedimentary sequences are from a large basin extended from the Paraguay belt to the Rio de la Plata craton, including the Corumbâ Group in SW-Brazil (Paraguay belt), the Arroyo del Soldado Group in Uruguay and the Sierras Bayas Group in Argentina (both in the Rio de la Plata craton). Several geochemical signatures of the sediments from Corumbâ and Sierras Bayas groups provides evidence for an euxinic setting in the Ediacaran Ocean: 1) The occurrence of syngenetic pyrite in the Corumbâ Group together with hydrocarbon biomarkers of an anoxic microbial consortium including traces of gammacerane, a distribution of hopanes with maxima at C29 as well as a low pristane/phytane (Pr/Ph) ratio; 2) the occurrence of 34S enrichments within sulfides of the Sierras Bayas Group exceeding the sulfur isotopic composition of coeval carbonate-associated sulfate. In the Arroyo del Soldado Group, an event of reducing conditions was revealed by higher concentrations of redox-sensitive trace elements and negative 513Ccar shifts in all sections. This event is extended to the whole unit in the deepest section and is restricted to tempestites in the two other shallow sections. The persistent negative. ôl3Ccar values recorded at the basinal setting implies strong isotopic gradient between shallow and deep water environments and therefore, a locus of deposition below the redox chemocline. In all studied sections, the excursions, the strong enrichment of authigenic trace-elements, the occurrence of longer chain «-alkanes, gammacerane and low Pr/Ph and Ph/>;-C]a ratios, combined with the previous sedimentological and paleontological observations indicate that the chemistry of the ocean was strongly controlled by the oxygen availability; waters being moderately oxic at the surface and anoxic at depth for much of the Neoproterozoic. This water column stratification was favourable to the storage of large amounts of nutrients in the deep ocean. During upwelling periods, the export of these nutrient-rich waters may have triggered an important bioproductivity in surface waters. Drops in Al3Cc,,.](Cr and positive ôl3Ccllr excursions highlight the increase in primary productivity. Preservation of organic carbon was ensured by reducing conditions at the bottom. The Al3ccar.kcr excursions could also reflect changes in the composition of the primary biomass. New geochemical evidence from SW-Gondwana sections supports a stratified Ediacaran ocean, outside restricted or hypersaline environments, in the aftermath of glaciations. The association of ocean stratification and the appearance of metazoans support the model that the evolution of eukaryotic life was related to the increase of oxygen levels in surface environments due to an efficient recycling of nutrients in the anoxic deep ocean. Résumé Le Néoprotérozoïque terminal, ou Édiacarien (635 à -543 Ma), est un période de première importance dans l'histoire de la Terre, car elle correspond a l'apparition des métazoaires pendant un intervalle de glaciations extrêmes. Le présent mémoire se propose de reconstituer les conditions paléoenvironnementales des dépôts de plateforme mis en place durant l'Édiacarien, au sud-ouest du Gondwana. Les interactions entre changements environnementaux et biodiversité sont évaluées en s'appuyant d'une part sur la composition élémentaire et isotopique des roches sédimentaires et de leur matière organique, et d'autre part sur la distribution moléculaire de biomarqueurs hydrocarbonés. Les séquences sédimentaires étudiées proviennent d'un grand bassin qui s'étend de la chaîne du Paraguay jusqu'au craton du Rio de la Plata. La séquence du Groupe Corumbâ au Sud Ouest du Brésil se situe dans la chaîne du Paraguay, tandis que le Groupe Arroyo del Soldado en Uruguay et le Groupe Sierras Bayas en Argentine sont situés sur le craton du Rio de la Plata. L'étude géochimique des sédiments des groupes Corumbâ et Sierras Bayas révèle de façon claire des conditions euxiniques dans l'océan édiacarien. On trouve ainsi, dans le Groupe Corumbâ, les biomarqueurs d'un cortège microbien anoxique et sulfurique comprenant des bactéries sulfato-réductrices, et dans les sulfures du Groupe Sierras Bayas, des enrichissements en Î4S excédant les rapports isotopiques du soufre dans le sulfate cogénétique associé aux carbonates. Dans la séquence de l'Arroyo del Soldado, un événement réducteur est mis en évidence par des teneurs plus élevées en éléments traces sensibles aux conditions redox et par des excursions négatives du 613Ccardans toutes les coupes. Cet événement affecte la totalité de la section la plus profonde et n'apparaît que dans les tempestites dans les sections les moins profondes. La persistance de valeurs négatives du ô13Ccarau large implique un gradient isotopique prononcé entre les environnements superficiels et profonds, et donc, ta présence d'une chémocline redox. Les excursions du. ôBCcar, l'enrichissement authigène en éléments traces, la présence de gammacérane et de rt-alcanes à longue chaîne, ainsi que de faibles rapports Pr/Ph et Ph/«-Cl8, viennent s'ajouter aux observations préliminaires sur la sédimentologie et la paléontologie pour indiquer que la chimie de l'océan était fortement contrôlée par la disponibilité d'oxygène, les eaux étant modérément oxiques à la surface et anoxiques en profondeur pendant la plus grande partie du Néoprotérozoïque. La stratification de la colonne d'eau était favorable au stockage de grandes quantités de nutriments dans l'océan profond. Dans les zones d'upwelling, la migration d'eaux profondes riches en nutriment vers la surface a pu provoquer une bioproductivité prononcée dans les eaux de surface. La conservation du carbone organique était assurée par les conditions anoxiques prévalant au fond. Les excursions du A13Ccar.kt.r pourraient aussi refléter des changements dans la biomasse primaire. Le présent travail apporte donc de nouvelles preuves qu'un océan stratifié s'est maintenu à la suite des glaciations néoprotérozoïques dans le Sud Ouest du Gondwana. L'association d'un océan stratifié et de l'apparition de la vie animale est en accord avec le modèle stipulant que l'évolution de la vie est associée à une meilleure oxygénation des environnements de surface. Résumé pour le grand public La période Ediacarienne (635 à -543 Ma) à la fin du Précambrien est l'une de plus énigmatiques dans l'histoire de la Terre, car elle est caractérisée par la diversification de la vie multicellulaire (eucaryote) pendant un intervalle de glaciations extrêmes. Dans ce travail de thèse, nous cherchons à déceler l'existence éventuelle d'un lien entre ces changements environnementaux et l'évolution de la vie eucaryote à travers une étude biogéochimique. La biogéochimie est l'étude des activités biologiques dans la géosphère, telles que celles intervenant dans les cycles des éléments chimiques (y compris les isotopes stables) et celles de production de composés carbonés caractérisant certains groups d'organismes ou taxons. La recherche des signatures paléoenvironnementales dans les roches précambriennes a été fortement facilitée par l'utilisation des biomarqueurs ou fossiles moléculaires. Ces composés, provenant des lipides biologiques (molécules avec des fonctions spécifiques dans les organismes), peuvent être reliés à des taxons spécifiques ou à des voies métaboliques. La transformation d'un biolipide en fossile moléculaire intervient lorsque des restes organiques déposés dans un substrat subissent un enfouissement et une augmentation de la pression (diagenèse). Ce processus mène à la formation de kérogène, un grand agrégat chimique de matière organique insoluble dans des solvants organiques, et de bitume ou fraction soluble (extractible) de la matière organique. L'analyse intégrée du kérogène et du bitume fournit des indications précieuses pour les reconstitutions paléoenvironnementales. Des conditions paléoenvironnementales ont ainsi été déterminées pour une plateforme marine Ediacarienne située dans la partie sud-américaine du bloc occidental du paléocontinent Gondwana. Les séquences sédimentaires étudiées appartiennent au même bassin qui s'étend de la ceinture du Paraguay (Groupe Corumbâ, Brésil) au craton du Rio de la Plata (Groupes Arroyo del Soldado, Uruguay et Sierras Bayas, Argentina). Nous nous sommes intéressés aux isotopes stables de carbonates et de la matière organique associée (kérogène et bitume), aux éléments majeurs et traces, ainsi qu'aux biomarqueurs caractérisant ces roches. Les résultats de cette dissertation suggèrent qu'au cours de l'Édiacarien, suite aux glaciations néoprotérozoïques dans le bloc occidental du Gondwana, l'océan était stratifié en zones spécifiques d'eaux riches en sulfures et dépourvues d'oxygène (euxiniques). L'association d'un océan stratifié et de l'apparition de la vie animale est en accord avec le modèle stipulant que l'évolution de la vie est associée à une meilleure oxygénation des environnements de surface. Les excursions isotopiques (tendance à des valeurs positives ou négatives) en constante fluctuation pour le carbone et très positives pour le soufre des sulfures, l'enrichissement en éléments trace et la présence de certains composés (e.g. gammacerane; Pr/Ph et Ph/«-Ci8 en basse proportion) conjugués aux observations sédimentologiques et paléontologiques des différents profils étudiés indiquent que la chimie de l'océan était fortement contrôlée par la disponibilité d'oxygène, avec des eaux modérément oxygénées en surface et euxiniques en profondeur pour la plupart du Néoprotérozoïque.

Langages métaphoriques en formation et en thérapie : sur les traces d'Edith Tilmans-Ostyn

Préface / Gilbert Pregno - Représentations métaphoriques d'Edith Tilmans-Ostyn - La création du système formatif - Création de l'espace thérapeutique - S'il vous plaît, dessine-moi une métaphore ! - Les métaphores individuelles en formation - Les métaphores individuelles en thérapie - Les métaphores relationnelles en formation - Les métaphores relationnelles en thérapie - CONTES : Voyage au pays des contes - Les contes dans la postformation - Les contes en thérapie - LES SCULPTURES : Les sculptures - En formation - Et en thérapie familiale - Postface / Edith Tilmans-Ostyn

Detecting the oxidative reactivity of nanoparticles: a new protocol for reducing artifacts

Understanding the oxidative reactivity of nanoparticles (NPs; <100 nm) could substantially contribute to explaining their toxicity. We attempted to refine the use of 2′7-dichlorodihydrofluorescein (DCFH) to characterize NP generation of reactive oxygen species (ROS). Several fluorescent probes have been applied to testing oxidative reactivity, but despite DCFH being one of the most popular for the detection of ROS, when it has been applied to NPs there have been an unexplainably wide variability in results. Without a uniform methodology, validating even robust results is impossible. This study, therefore, identified sources of conflicting results and investigated ways of reducing occurrence of artificial results. Existing techniques were tested and combined (using their most desirable features) to form a more reliable method for the measurement of NP reactivity in aqueous dispersions. We also investigated suitable sample ranges necessary to determine generation of ROS. Specifically, ultrafiltration and time-resolved scan absorbance spectra were used to study possible optical interference when using high sample concentrations. Robust results were achieved at a 5 µM DCFH working solution with 0.5 unit/mL horseradish peroxidase (HRP) dissolved in ethanol. Sonication in DCFH-HRP working solution provided more stable data with a relatively clean background. Optimal particle concentration depends on the type of NP and in general was in the µg/mL range. Major reasons for previously reported conflicting results due to interference were different experimental approaches and NP sample concentrations. The protocol presented here could form the basis of a standardized method for applying DCFH to detect generation of ROS by NPs.

A novel approach to reducing number of sensing units for wearable gait analysis systems.

Gait analysis methods to estimate spatiotemporal measures, based on two, three or four gyroscopes attached on lower limbs have been discussed in the literature. The most common approach to reduce the number of sensing units is to simplify the underlying biomechanical gait model. In this study, we propose a novel method based on prediction of movements of thighs from movements of shanks. Datasets from three previous studies were used. Data from the first study (ten healthy subjects and ten with Parkinson's disease) were used to develop and calibrate a system with only two gyroscopes attached on shanks. Data from two other studies (36 subjects with hip replacement, seven subjects with coxarthrosis, and eight control subjects) were used for comparison with the other methods and for assessment of error compared to a motion capture system. Results show that the error of estimation of stride length compared to motion capture with the system with four gyroscopes and our new method based on two gyroscopes was close ( -0.8 ±6.6 versus 3.8 ±6.6 cm). An alternative with three sensing units did not show better results (error: -0.2 ±8.4 cm). Finally, a fourth that also used two units but with a simpler gait model had the highest bias compared to the reference (error: -25.6 ±7.6 cm). We concluded that it is feasible to estimate movements of thighs from movements of shanks to reduce number of needed sensing units from 4 to 2 in context of ambulatory gait analysis.

Réduction de la consommation de sel: une mesure importante de santé publique en Suisse. [Reducing dietary salt intake: an important public health strategy in Switzerland]

La consommation actuelle de sel (chlorure de sodium) est très supérieure aux besoins physiologiques (1,5 g par jour, soit environ 550 mg par jour de sodium) dans la plupart des pays (> 8 g par jour). Les principales sources de sel sont les pains, les fromages, les produits dérivés de la viande et les plats précuisinés. En moyenne, une consommation élevée de sel est associée à une pression artérielle plus élevée. En Suisse, un adulte sur trois souffre d'hypertension artérielle. La moitié des accidents vasculaires cérébraux et des maladies cardiaques ischémiques sont attribuables à une pression artérielle trop élevée. L'Office fédéral de la santé publique conduit actuellement une stratégie visant à diminuer la consommation de sel dans la population suisse à moins de 5 g par jour sur le long terme (Salz Strategie 2008-2012). [Abstract] Current dietary salt (sodium chloride) intake largely exceeds physiological needs (about 1.5 g salt per day, or 550 mg sodium per day) in most countries (> 8 g salt per day). The main sources of dietar salt intake are breads, cheeses, products derived from meat and ready-to-eat meals. On average, a high-salt diet is associated with higher blood pressure levels. In Switzerland, one out of three adults suffers from arterial hypertension. Half of cerebrovascular events and ischaemic cardiac events are attributable to elevated blood pressure. The Swiss Federal Office of Public Health is currently running a strategy aiming at reducing dietary salt intake in the Swiss population to less than 5 g per day on the long run (Salz Strategie 2008-2012).

Situating forensic traces in time

Situating events and traces in time is an essential problem in investigations. To date, among the typical ques- 21¦tions issued in forensic science, time has generally been unexplored. The reason for this can be traced to the 22¦complexity of the overall problem, addressed by several scientists in very limited projects usually stimulated 23¦by a specific case. Considering that such issues are recurrent and transcending the treatment of each trace 24¦separately, the formalisation of a framework to address dating issues in criminal investigation is undeniably 25¦needed. Through an iterative process consisting of extracting recurrent aspects discovered from the study of 26¦problems encountered by practitioners and reported in the literature, common mechanisms were extracted 27¦and provide understanding of underlying factors encountered in forensic practise. Three complementary ap- 28¦proaches are thus highlighted and described to formalise a preliminary framework that can be applied for the 29¦dating of traces, objects, persons and indirectly events.