Objective comparison of image quality and dose between conventional and synchrotron radiation mammography.

The shape of the energy spectrum produced by an x-ray tube has a great importance in mammography. Many anode-filtration combinations have been proposed to obtain the most effective spectrum shape for the image quality-dose relationship. On the other hand, third generation synchrotrons such as the European Synchrotron Radiation Facility in Grenoble are able to produce a high flux of monoenergetic radiation. It is thus a powerful tool to study the effect of beam energy on image quality and dose in mammography. An objective method was used to evaluate image quality and dose in mammography with synchrotron radiation and to compare them to standard conventional units. It was performed systematically in the energy range of interest for mammography through the evaluation of a global image quality index and through the measurement of the mean glandular dose. Compared to conventional mammography units, synchrotron radiation shows a great improvement of the image quality-dose relationship, which is due to the beam monochromaticity and to the high intrinsic collimation of the beam, which allows the use of a slit instead of an anti-scatter grid for scatter rejection.

Serum ficolin-2 correlates worse than fecal calprotectin and CRP with endoscopic Crohn's disease activity.

BACKGROUND AND AIMS: Ficolin-2 is an acute phase reactant produced by the liver and targeted to recognize N-acetyl-glucosamine which is present in bacterial and fungal cell walls. We recently showed that ficolin-2 serum levels were significantly higher in CD patients compared to healthy controls. We aimed to evaluate serum ficolin-2 concentrations in CD patients regarding their correlation with endoscopic severity and to compare them with clinical activity, fecal calprotectin, and CRP. METHODS: Patients provided fecal and blood samples before undergoing ileo-colonoscopy. Disease activity was scored clinically according to the Harvey-Bradshaw Index (HBI) and endoscopically according to the simplified endoscopic score for CD (SES-CD). Ficolin-2 serum levels and fecal calprotectin levels were measured by ELISA. RESULTS: A total of 136 CD patients were prospectively included (mean age at inclusion 41.5±15.4 years, 37.5% females). Median HBI was 3 [2-6] points, median SES-CD was 5 [2-8], median fecal calprotectin was 301 [120-703] μg/g, and median serum ficolin-2 was 2.69 [2.02-3.83] μg/mL. SES-CD correlated significantly with calprotectin (R=0.676, P<0.001), CRP (R=0.458, P<0.001), HBI (R=0.385, P<0.001), and serum ficolin-2 levels (R=0.171, P=0.047). Ficolin-2 levels were higher in CD patients with mild endoscopic disease compared to patients in endoscopic remission (P=0.015) but no difference was found between patients with mild, moderate, and severe endoscopic disease. CONCLUSIONS: Ficolin-2 serum levels correlate worse with endoscopic CD activity when compared to fecal calprotectin or CRP.

Human endometrial carcinomas serially transplanted in nude mice and established in continuous cell lines.

Three out of five human endometrial carcinomas were successfully grafted into nude mice (BALB/c/nu/nu). Two of these tumors could be maintained by serial transplantation. The morphological characteristics displayed by the grafted tumors were comparable to those of the original carcinomas. Permanent cell lines were established from these two tumors. Reinjection of cells grown in vitro into nude mice produced nodules of identical histology as compared to original solid transplants. The influence of medroxyprogesterone acetate on tumor growth in vivo and cell proliferation in vitro was studied. This hormonal treatment did not produce any significant effect on tumor cells, either in vitro or in vivo, for the two endometrial carcinomas. After medroxyprogesterone administration, a slight but non-significant growth inhibition of the tumor cells in vitro was observed and the tumor transplants in vivo did not appear to be influenced. The experiments illustrate the possible use of this model for testing potential anti-cancer agents.

Dermatophyte identification in skin and hair samples using a simple and reliable nested polymerase chain reaction assay.

BACKGROUND: Dermatophyte identification in tinea capitis is essential for choosing the appropriate treatment and in tinea infections to identify the possible source. The failure of fungi to grow in cultures frequently occurs, especially in cases of previous antifungal therapy. OBJECTIVES: To develop a rapid polymerase chain reaction (PCR) sequencing assay for dermatophyte identification in tinea capitis and tinea corporis. MATERIAL AND METHODS: Fungal DNA was extracted from hair and skin samples that were confirmed to be positive by direct mycological examination. Dermatophytes were identified by the sequence of a 28S ribosomal DNA subunit amplicon generated by nested PCR. RESULTS: Nested PCR was found to be necessary to obtain amplicons in substantial amounts for dermatophyte identification by sequencing. The results agreed with those of classical mycological identification in 14 of 23, 6 of 10, and 20 of 23 cases of tinea capitis, tinea corporis and tinea pedis, respectively, from which a dermatophyte was obtained in culture. In seven of the 56 cases, another dermatophyte was identified, revealing previous misidentification. A dermatophyte was identified in 12 of 18, three of five, and four of nine cases of tinea capitis, tinea corporis and tinea pedis, respectively, in cases in which no dermatophyte grew in culture. CONCLUSIONS: Although the gold standard dermatophyte identification from clinical samples remains fungal cultures, the assay developed in the present study is especially suitable for tinea capitis. Improved sensitivity for the identification of dermatophyte species was obtained as it is possible to identify the dermatophyte when the fungus fails to grow in cultures.

Urea nitrogen, creatinine, and uric acid levels in postmortem serum, vitreous humor, and pericardial fluid.

Urea nitrogen, creatinine, and uric acid are relatively stable in postmortem serum and may, therefore, be used for diagnostic purposes when chronic kidney disease and end-stage renal failure are investigated as causes of death. Nevertheless, uncertainties remain in defining the best alternative to postmortem serum for the identification and assessment of significantly decreased kidney function. In this study, we investigated urea nitrogen, creatinine, and uric acid levels in postmortem serum, pericardial fluid, and vitreous humor in a series of medico-legal cases (500 autopsies) with various causes of death. No postmortem interval-related differences were observed in any of the investigated fluids for any analyzed parameter, confirming the biochemical stability of all compounds after death. Data analysis failed to reveal statistically significant differences between postmortem serum and pericardial fluid urea nitrogen, creatinine, and uric acid concentrations. Conversely, statistically significant differences were observed in all analyzed biomarkers between postmortem serum and vitreous humor levels, with lower concentrations of all markers measured in vitreous. The results of this study suggest that, in order to estimate as accurately as possible blood analyte concentrations at the time of death, pericardial fluid should be preferred to vitreous humor.

Mecanismos de deformación en aceros inoxidables austeníticos metaestables

La deformación plástica puede inducir a la transformación de la austenita a martensita en los aceros inoxidables austeníticos metaestables. Para analizar este hecho, el inoxidable austenítico metaestable grado AISI 301 LN fue estudiado en dos condiciones diferentes: recocido y laminado en frío. En el primer caso, el acero era completamente austenítico, mientras que después de la laminación presentaba un importante porcentaje de α’-martensita. Se evaluó el cambio de fase cuando el acero es sometido a ensayos monotónicos y cíclicos, así como cuando ha sido modificada la superficie mediante el granallado o se han realizado tratamientos térmicos de reversión. Se utilizaron diferentes técnicas de caracterización microestructural para detectar y cuantificar la martensita, como microscopía óptica, difracción de rayos-X (DRX) y difracción de electrones retrodispersados (EBSD); como también de caracterización mecánica para evaluar el comportamiento de los aceros, trabajo esencial de fractura (TEF), conformabilidad, fatiga de alto número de ciclos (HCF) y nanoindentación. Los resultados mostraron un incremento en la resistencia mecánica del acero laminado en comparación al acero recocido; este hecho está relacionado con la presencia de martensita originada por la laminación. Sin embargo, en términos de deformación y endurecimiento el acero recocido presenta un mejor desempeño como consecuencia del elevado porcentaje de fase austenítica. Así mismo, revertir la martensita de laminación a austenita y refinar la austenita presente permite obtener un acero con una propiedades mecánicas similares a cuando esta en la condición laminado.

Il Discorso dell'amore verso la patria (1631) di Ludovico Zuccolo

Scopo di questo studio è la disamina e la divulgazione dei pregi letterari e del valore concettualmente innovativo del Discorso dell 'amore verso la patria di Ludovico Zuccolo. L'analisi dei contenuti dell'opera, unitamente alla puntualizzazione delle sue caratteristiche formali e stilistiche, permette di vedere come questo scrittore proponga, utilizzando la forma letteraria del discorso politico, una riuscita codificazione della tematica dei diritti e dei doveri dei cittadini verso la patria; operazione in cui si sostanzia, a mio avviso, l'apporto innovativo dello Zuccolo. Dopo l'iniziale riscoperta, da parte di Benedetto Croce, del capitolo delle Considerazioni sulla Ragion di Stato, l`opera dello Zuccolo ha generato un certo interesse critico fra gli studiosi di letteratura politica del "900" senza tuttavia divenire oggetto di contributi esaustivi malgrado, a nostro parere, la presenza di elementi di originalità di pensiero nel Discorso dell 'amore verso la patria. Inoltre, l'opinione degli specialisti non è mai stata unanime riguardo al valore e ai contenuti delle opere di questo autore. Se per il Croce, ne << La Critica >> del 1926, egli appare come colui che ha prodotto, «Lo scritto più acuto e originale sull'argomento [della Ragion di Stato], composto in quel seco1o.>> (p. 301), per altri egli si presenta come un dotto estensore di trattati politici nei quali sfoggia abilmente la sua erudizione classica e Luigi Firpo arriva a suggerire addirittura che lo Zuccolo sia colpevole di plagio proprio laddove tratta il tema della Ragion di Stato : Al punto in cui siamo, una cosa è certa, e cioè che i conti non tornano : non riesco a credere che uno scrittore inzeppi centinaia e centinaia di pagine di luoghi comuni, di erudizione d"accatto, di oziosità accademiche, e poi un bel mattino, morso dalla tarantola o baciato in fronte da Minerva, metta in carta il piccolo capolavoro, le pagine meditate e profonde, e perciò lungamente soffeite, che pure gli appartengono per una paternità incontestata e certa. Dico questo, perché in un caso del genere, non al miracolo s"avrebbe da credere, ma, semmai, al plagio. (1). Catherine Pitiot, nel suo saggio La retorica politica nell 'opera utopica di Ludovico Zuccolo, coglie invece in questo autore unicamente l"utopista che << lntende allontanarsi dalla realtà contemporanea per modificarla, correggerla e presentare un'in1magine che sia fondamentalmente diversa, a livello strutturale. >> (2). Di parere diametralmente opposto Rodolfo de Mattei, che attribuisce allo Zuccolo lo status di anti-utopista per eccellenza, tipico di uno scrittore che, Non ha voluto usufruire della facile libertà della fantasia per sovvertire l'ordine storico e per alterare arbitrariamente la natura umana, cioé per proporre un ordinamento mirante ad una radicale trasformazione della società e quindi di assai dubbia realizzazione. (3). Altri studiosi, fra cui Bruno Nediani, si sono dedicati alla descrizione della personalità dello Zuccolo, attingendo alle sue lettere - che lo stesso Nediani ha riscoperto - oltre che ai brevi accermi che di sé fa lo Zuccolo negli scritti. Dal saggio del Nediani, La personalità di Ludovico Zuccolo (1969), emerge la figura di un uomo tormentato e insoddisfatto, ossessionato dal sospetto dell"autorità ecclesiastica, costretto a procacciarsi impieghi inadeguati presso i potenti, all'inseguimento dell'obiettivo di una carriera che, comunque, finisce con il risultargli sempre, prima o poi, insopportabile. Più recentemente, Sergio Bertelli, nel suo contributo alla Storia della letteratura di Cecchi e Sapegno, ha aperto una nuova prospettiva sullo Zuccolo proponendolo come colui che, Spezza finalmente il cerchio moralistico costruito dal Botero attorno al pensiero machiavelliano e la ragion di stato cessa di essere giudicata vera o falsa, buona o malvagia, interessando in sé e per sé, cioé nei suoi presupposti e nei suoi fini esclusivamente politici. (4).

Quelle place pour la psychologie positive dans le champ de la psychothérapie ? Perspectives théoriques et empiriques

Ce travail vise à exposer le courant de la psychologie positive et à présenter une tentative d'articulation entre ce courant et le champ de la pratique psychothérapeutique. Nous présenterons, dans un premier temps, les fondements de la psychologie positive et les axes principaux qui la constituent. Dans cette perspective, la théorie des émotions positives de Fredrickson et la classification des vertus et des forces de caractères de Peterson et Seligman sont exposées plus en détails. Dans un second temps et à partir des travaux récents, deux facçons d'établir un pont entre psychologie positive et la psychothérapie sont discutées : (i) le développement de nouvelles stratégies thérapeutiques issues de la psychologie positive et (ii) une relecture des principaux modèles psychothérapeutiques au regard de la psychologie positive. / This article aims to present the field of positive psychology and the way it could be integrated in the area of psychotherapy. First, the historical grounding and the main contributions of positive psychology are presented. In this perspective, the Fredrickson's theory of positive emotions and the Peterson's classification of character strengths and virtues are particularly detailed. Secondly, based on recent research, two ways to link positive psychology to clinical practice emerged: (i) the development of new therapeutic strategies anchored in the positive psychology, and (ii) a critical look at different psychotherapeutic modalities based on positive psychology.

Sandfly species diversity in association with human activities in the Kani tribe settlements of the Western Ghats, Thiruvananthapuram, Kerala, India

Sandfly prevalence in the Kani tribe settlements of Western Ghats in India was investigated. A total of 1,279 sandflies comprising 17 species was obtained. Sandfly abundance showed a negative correlation (r = -0.97, p = 0.003) with increase in altitudinal ranges from 0-1,000 m. When sandfly samples were grouped according to landscape characteristics of the location, the estimated Shannon-Weiner index (H) and species richness index (S) were high and species evenness index (J) was low in settlements located at 0-300 m altitudinal range. On the contrary, the values of H and J were high, while S was low at 301-600 m altitudinal range. With further increase in altitude, species diversity, S and J were low. Though the relative abundance of sandflies decreased with increase in altitude, the influence of altitudinal variation could not be attributed to determine sandfly diversity, since the number of sampling units were not uniform at all the altitudinal gradients due to nonavailability of suitable resting shelters. Sandfly species showed great aggregation at 0-300 m altitude interval, where not only the number of settlements were maximum (n = 19), but also the environmental conditions favoured sandfly abundance due to the concentration of tribal settlements, human dwellings and his activities.

Incidence of HIV-1 drug resistance among antiretroviral treatment-naive individuals starting modern therapy combinations.

BACKGROUND: Estimates of drug resistance incidence to modern first-line combination antiretroviral therapies against human immunodeficiency virus (HIV) type 1 are complicated by limited availability of genotypic drug resistance tests (GRTs) and uncertain timing of resistance emergence. METHODS: Five first-line combinations were studied (all paired with lamivudine or emtricitabine): efavirenz (EFV) plus zidovudine (AZT) (n = 524); EFV plus tenofovir (TDF) (n = 615); lopinavir (LPV) plus AZT (n = 573); LPV plus TDF (n = 301); and ritonavir-boosted atazanavir (ATZ/r) plus TDF (n = 250). Virological treatment outcomes were classified into 3 risk strata for emergence of resistance, based on whether undetectable HIV RNA levels were maintained during therapy and, if not, whether viral loads were >500 copies/mL during treatment. Probabilities for presence of resistance mutations were estimated from GRTs (n = 2876) according to risk stratum and therapy received at time of testing. On the basis of these data, events of resistance emergence were imputed for each individual and were assessed using survival analysis. Imputation was repeated 100 times, and results were summarized by median values (2.5th-97.5th percentile range). RESULTS: Six years after treatment initiation, EFV plus AZT showed the highest cumulative resistance incidence (16%) of all regimens (<11%). Confounder-adjusted Cox regression confirmed that first-line EFV plus AZT (reference) was associated with a higher median hazard for resistance emergence, compared with other treatments: EFV plus TDF (hazard ratio [HR], 0.57; range, 0.42-0.76), LPV plus AZT (HR, 0.63; range, 0.45-0.89), LPV plus TDF (HR, 0.55; range, 0.33-0.83), ATZ/r plus TDF (HR, 0.43; range, 0.17-0.83). Two-thirds of resistance events were associated with detectable HIV RNA level ≤500 copies/mL during treatment, and only one-third with virological failure (HIV RNA level, >500 copies/mL). CONCLUSIONS: The inclusion of TDF instead of AZT and ATZ/r was correlated with lower rates of resistance emergence, most likely because of improved tolerability and pharmacokinetics resulting from a once-daily dosage.

Attrition in the Swiss Household Panel: Is change associated with drop-out?

This study examines the importance of change in characteristics and circumstances ofhouseholds and household members for contact and cooperation patterns. The literaturesuggests that there might be an underrepresentation of change in panel studies, becauserespondents facing more changes would be more likely to drop out. We approach this problemby analysing whether previous changes are predictive of later attrition or temporary drop-out,using eleven waves of the Swiss Household Panel (1999-2009). Our analyses supportprevious findings to some extent. Changes in household composition, employment status andsocial involvement as well as moving are associated mainly with attrition and less withtemporary drop-out. These changes affect obtaining cooperation rather than obtaining contact,and tend to increase attrition.

Insuffisance rénale terminale d'origine lithiasique : fréquence, causes et prévention [Nephrolithiasis-induced ESRD: frequency, causes and prevention].

Nephrolithiasis still remains a too frequent - and under-appreciated - cause of end-stage renal disease (ESRD), and this is all the most unfortunate since such an untoward course is now preventable in most cases. Among 1391 patients who started maintenance dialysis at Necker hospital between 1989 and 2000, nephrolithiasis was identified as the cause of ESRD in 45 of them, an overall prevalence of 3.2%. Infection stones accounted for 42.2% of cases, calcium stones for 26.7%, uric acid stones for 17.8% and hereditary diseases for 13.3%. The proportion of nephrolithiasis-associated ESRD declined from 4.7% to 2.2% from the 1989-1991 to the 1998-2000 period, as a result of the decreased incidence of ESRD in patients with infection and calcium nephrolithiasis. Based on our observations and on published reports, it emerges that most cases of nephrolithiasis-associated ESRD were due to sub-optimal management (especially in the case of infection or cystine stones) or to late (or erroneous) etiologic diagnosis, precluding early institution of appropriate therapeutic measures. In particular, several patients with primary hyperoxaluria or 2,8-dihydroxyadeninuria were diagnosed while already on dialysis or after unsuccessful kidney transplantation, due to wrong initial diagnosis. In conclusion, thanks to recent advances in diagnosis and management of stone formers, ESRD should now be prevented in the great majority of patients, at the condition of early etiologic diagnosis based on accurate morphoconstitutional analysis of calculi and metabolic evaluation, and early implementation of appropriate preventive medical treatment.

Duration of untreated psychosis: a proposition regarding treatment definition.

Aim: Duration of untreated psychosis (DUP) refers to the time elapsing between psychosis onset and treatment initiation. Despite a certain degree of consensus regarding the definition of psychosis onset, the definition of treatment commencement varies greatly between studies and DUP may be underestimated due to lack of agreement. In the present study, three sets of criteria to define the end of the untreated period were applied in a first-episode psychosis cohort to assess the impact of the choice of definition on DUP estimation. Methods: The DUP of 117 patients admitted in the Treatment and Early Intervention in Psychosis Program Psychosis in Lausanne was measured using the following sets of criteria to define treatment onset: (i) initiation of antipsychotic medication; (ii) entry into a specialized programme; and (iii) entry into a specialized programme and adequate medication with a good compliance. Results: DUP varied greatly according to definitions, the most restrictive criteria leading to the longest DUP (median DUP1 = 2.2 months, DUP2 = 7.4 months and DUP3 = 13.6 months). A percentage of 19.7 of the patients who did not meet these restrictive criteria had poorer premorbid functioning and were more likely to use cannabis. Longer DUP3 was associated with poorer premorbid functioning and with younger age at onset of psychosis. Conclusion: These results underline the need for a unique and standardized definition of the end of DUP. We suggest that the most restrictive definition of treatment should be used when using the DUP concept in future research.

Tools and Trends, July 2001, Issue 16

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