Computer-assisted cup placement techniques in total hip arthroplasty improve accuracy of placement.

Malposition of the acetabular component during hip arthroplasty increases the occurrence of impingement, reduces range of motion, and increases the risk of dislocation and long-term wear. To prevent malpositioned hip implants, an increasing number of computer-assisted orthopaedic systems have been described, but their accuracy is not well established. The purpose of this study was to determine the reproducibility and accuracy of conventional versus computer-assisted techniques for positioning the acetabular component in total hip arthroplasty. Using a lateral approach, 150 cups were placed by 10 surgeons in 10 identical plastic pelvis models (freehand, with a mechanical guide, using computer assistance). Conditions for cup implantations were made to mimic the operating room situation. Preoperative planning was done from a computed tomography scan. The accuracy of cup abduction and anteversion was assessed with an electromagnetic system. Freehand placement revealed a mean accuracy of cup anteversion and abduction of 10 degrees and 3.5 degrees, respectively (maximum error, 35 degrees). With the cup positioner, these angles measured 8 degrees and 4 degrees (maximum error, 29.8 degrees), respectively, and using computer assistance, 1.5 degrees and 2.5 degrees degrees (maximum error, 8 degrees), respectively. Computer-assisted cup placement was an accurate and reproducible technique for total hip arthroplasty. It was more accurate than traditional methods of cup positioning.

Video-assisted thoracoscopic surgery lobectomy or open lobectomy for non-small-cell lung cancer? Minimizing selection bias in observational studies.

PURPOSE OF REVIEW: Adherence to preventive measures and prescribed medications is the cornerstone of the successful management of hypertension. The role of adherence is particularly important when treatments are not providing the expected clinical results, for example, in patients with resistant hypertension. The goal of this article is to review the recent observations regarding drug adherence in resistant hypertension. RECENT FINDINGS: Today, the role of drug adherence as a potential cause of resistant hypertension is largely underestimated. Most studies suggest that a low adherence to the prescribed medications can affect up to 50% of patients with resistant hypertension.A good adherence to therapy is generally associated with an improved prognosis. Nonetheless, adherence should probably not be a target for treatment per se because data on adherence should always be interpreted in the view of clinical results. In our opinion, the availability of reliable data on drug adherence would be a major help for physicians to manage patients apparently resistant to therapy. SUMMARY: The actual development of new drugs for hypertension is slow. Thus, focusing on drug adherence to the drugs available is an important way to improve blood pressure control in the population. More emphasis should be put on measuring drug adherence in patients with resistant hypertension to avoid costly investigations and treatments.

Strong reproductive barriers in a narrow hybrid zone of West-Mediterranean green toads (Bufo viridis subgroup) with Plio-Pleistocene divergence

Background One key question in evolutionary biology deals with the mode and rate at which reproductive isolation accumulates during allopatric speciation. Little is known about secondary contacts of recently diverged anuran species. Here we conduct a multi-locus field study to investigate a contact zone between two lineages of green toads with an estimated divergence time of 2.7 My, and report results from preliminary experimental crosses. Results The Sicilian endemic Bufo siculus and the Italian mainland-origin B. balearicus form a narrow hybrid zone east of Mt. Etna. Despite bidirectional mtDNA introgression over a ca. 40 km North-South cline, no F1 hybrids could be found, and nuclear genomes display almost no admixture. Populations from each side of the contact zone showed depressed genetic diversity and very strong differentiation (FST = 0.52). Preliminary experimental crosses point to a slightly reduced fitness in F1 hybrids, a strong hybrid breakdown in backcrossed offspring (F1 x parental, with very few reaching metamorphosis) and a complete and early mortality in F2 (F1 x F1). Conclusion Genetic patterns at the contact zone are molded by drift and selection. Local effective sizes are reduced by the geography and history of the contact zone, B. balearicus populations being at the front wave of a recent expansion (late Pleistocene). Selection against hybrids likely results from intrinsic genomic causes (disruption of coadapted sets of genes in backcrosses and F2-hybrids), possibly reinforced by local adaptation (the ranges of the two taxa roughly coincide with the borders of semiarid and arid climates). The absence of F1 in the field might be due to premating isolation mechanisms. Our results, show that these lineages have evolved almost complete reproductive isolation after some 2.7 My of divergence, contrasting sharply with evidence from laboratory experiments that some anuran species may still produce viable F1 offspring after > 20 My of divergence.

Information technologies and communication between parents and children

This is an exploratory study that aims, on the one hand, to examine in more detail how children between 12 and 16 years of age use different audiovisual technologies, what they feel and think when using them, and whom they like to speak to about such experiences. On the other hand, we look more deeply into the interactions between adults and children, particularly between parents and their children, in relation to these technologies when children use them at home or in other places. We analysed responses to questionnaires with several common items, administered separately to parents and children. Children’s responses reflect an important level of dissatisfaction when talking with different adults about media activities. Our findings support the thesis that more and more children socialise through new information and communication technologies with little or no recourse to adult criteria, giving rise to the emergence of specific children’s cultures. Crossing of the responses of parents and those of their own children shows us which aspects of media reality adults overestimate or underestimate in comparison to children, and to what degree certain judgements coincide and differ between generations. The results can be applied to the improvement of relations between adults and adolescents, taking advantage of adolescents’ strong motivation to engage in activities using audiovisual media

Technologies de procédé et de contrôle pour réduire la teneur en sel du jambon sec et des saucissons

Dans certains pays européens, les produits carnés élaborés peuvent représenter près de 20% de la consommation journalière de sodium. De ce fait, les industries de la viande tentent de réduire la teneur en sel dans les produits carnés pour répondre, d’une part aux attentes des consommateurs et d’autre part aux demandes des autorités sanitaires. Le système Quick‐Dry‐Slice process (QDS®), couplé avec l’utilisation de sels substituant le chlorure de sodium (NaCl), a permis de fabriquer, avec succès, des saucisses fermentées à basse teneur en sel en réduisant le cycle de fabrication et sans ajout de NaCl supplémentaire. Les technologies de mesure en ligne non destructives, comme les rayons X et l’induction électromagnétique, permettent de classifier les jambons frais suivant leur teneur en gras, un paramètre crucial pour adapter la durée de l’étape de salaison. La technologie des rayons X peut aussi être utilisée pour estimer la quantité de sel incorporée pendant la salaison. L’information relative aux teneurs en sel et en gras est importante pour optimiser le processus d’élaboration du jambon sec en réduisant la variabilité de la teneur en sel entre les lots et dans un même lot, mais aussi pour réduire la teneur en sel du produit final. D’autres technologies comme la spectroscopie en proche infrarouge (NIRS) ou spectroscopie microondes sont aussi utiles pour contrôler le processus d’élaboration et pour caractériser et classifier les produits carnés élaborés, selon leur teneur en sel. La plupart de ces technologies peuvent être facilement appliquées en ligne dans l’industrie afin de contrôler le processus de fabrication et d’obtenir ainsi des produits carnés présentant les caractéristiques recherchées.

Coupled reproductive ecologies in a plant-pollinator-seed predator system

Résumé de la thèseBien que le mutualisme puisse être considéré comme une relation harmonieuse entre différentes espèces, son étude révèle plutôt une exploitation réciproque où chaque partenaire tente de maximiser ses bénéfices tout en réduisant ses coûts. Dans ce contexte, l'identification des facteurs qui favorisent ou contrarient, au cours de l'évolution, une issue mutualiste est une étape majeure pour pouvoir reconstruire les étapes clés menant à l'apparition et au maintien des interactions mutualistes. Le but de ce doctorat était l'identification des traits phénotypiques qui permettent à la plante Silene latofolia (Caryophyllacée)et à son pollinisateur - prédateur de graines, la phalène Hadena bicruris (Noctuidé), d'augmenter les bénéfices nets que chacun retire de l'interaction. Ce système d'étude est particulièrement bien approprié à l'étude de ces traits, car on peut assez facilement estimer la qualité et la quantité des descendants (fitness) des deux partenaires. En effet, la femelle papillon pond un oeuf dans la fleur qu'elle pollinise et sa larve se développe dans le fruit, consommant les graines de la plante. Ainsi, sur une même plante, il est possible d'estimer les succès respectifs de la plante et du papillon à obtenir une descendance. De plus, le conflit d'intérêt autour des graines qui sont indispensables, à la fois à la plante et au papillon, peut stimuler l'évolution de traits qui limitent la surexploitation réciproque des partenaires. Dans une première étude, j'ai montré que le papillon mâle était un pollinisateur efficace de S. latifolia et qu'ainsi, il permettait à la plante d'augmenter le nombre de graines produites (i.e.bénéfice) sans pour autant augmenter la quantité de larves sur la plante. Dans ce système, les papillons pondent un seul oeuf par fleur, déposé soit à l'intérieur de la fleur, dans le tube de corolle, soit sur le pétale. Ma seconde étude montre que les plantes répondent différemment à la présence des oeufs suivant leur position. Aussi, quand l'oeuf est placé dans la fleur, la plante a davantage tendance à ne pas développer le fruit de la fleur infesté ou bien à produire des fruits plus petits que lorsque l'oeuf est placé sur le pétale. Enfin, j'ai montré que la femelle du papillon pond plus souvent sur le pétale lorsque elle visite des fleurs dotées d'un long tube de corolle, et que les larves issues de ces oeufs ont moins de chances de réussir à pénétrer dans le fruit que les larves issues des oeufs placés à l'intérieur de la fleur. Aussi, la variation observée du site de ponte pourrait être causé par la morphologie de la fleur qui contraint le papillon à pondre sur le pétale. Vu dans leur ensemble, les résultats obtenus pendant ce doctorat suggèrent que la participation des mâles à la pollination, l'absence de développement des fruits et la profondeur du tube de corolle pourraient réduire les coûts que S. latifolia subit dans son interaction avec H. bicruris. Par ailleurs, je n'ai pas détecté de mécanismes qui permettraient au papillon de réduire les coûts que la plante pourrait lui imposer. La prochaine étape serait de déterminer l'effet des traits identifiés dans ce doctorat sur la fitness globale de la plante et du papillon pour estimer pleinement leur efficacité à réduire les coûts et à favoriser une issue mutualiste. De même, il faudrait évaluer l'effet de ces traits en populations naturelles pour identifier le rôle des facteurs environnementaux sur leur efficacité.AbstractAlthough mutualisms can be regarded as harmonious relationships between the interacting partners, they are best conceptualized as reciprocal exploitations in which each partner attempts to increase its own benefits and decrease its costs. To date, identifying the factors which promote or discourage mutualistic outcomes remains a major goal to reconstruct the ecological conditions leading to mutualisms. The aim of this PhD thesis was to identify phenotypic traits that may increase the net benefits of each partner in the interaction between the plant Silene latifolia (Caryophyllaceae) and its pollinator / seed predator, the moth Hadena bicruris (Noctuidae). This study system is particularly well suited because the fitness of both interacting species can be assessed. The female moth lays its egg in the flower it pollinated, and its offspring grows in the fruit, feeding on the seeds of the plant, which allows for the follow-up of both larva and fruit fates. Furthermore, the inherent conflict of interest over the seeds as plant progeny vs. larval resource may stimulate the evolution of traits that reduce overexploitation in both the moth and plant. In a first study, I show that male moths are efficient pollinators, hence increasing seed production without increasing oviposition. The contribution of male moths to pollination might thus improve the net benefits of the interaction for the host plant. Females of the H. bicruris moth lay a single egg per flower, and place it either inside the corolla tube or on the petal. My second study shows that plants are more likely to abort the infested flower or to produce a smaller fruit when the egg was experimentally placed inside the flower compared to plants that received an egg on the petal. Finally, female moths were found to lay their eggs more frequently on the petal when visiting a flower with a deep corolla tube, and larvae hatching from these eggs less likely to successfully attack the fruit. Variation in egg position on the flower may thus be the result of a constraint imposed by floral morphology. Overall, this PhD work suggests that the pollination by male moths, flower abortion, and deep corolla tube may efficiently reduce the costs experienced by S. latifolia in its interaction with H. bicruris. Interestingly, no apparent mechanism of costs reduction was detected for the moth. Further studies should focus on the effects of these traits (i) in the long term fitness of both the plant and the insect and (ii) their interactions with environmental factors (biotic and abiotic) that may affect their efficiency in natural populations.

Male sexuality-related concerns: what use of the internet?

Purpose: Although young males encounter sexually-related concerns, they are mostly absent from specialized services. Our objective is to assess whether the internet is used by boys to find answers to these types of problems and questions. Methods: In the context of a qualitative study assessing young males' barriers to access sexual and reproductive health facilities, we conducted two focus groups gathering 12 boys aged 17-20. Discussions were triggered through the presentation of four vignettes corresponding to questions posted by 17-20 year old boys and girls on an information website for adolescents (www.ciao.ch), concerning various sexual dysfunction situations. In order to avoid having to talk about their own experience, participants were asked what they would do in those cases. Results: In general, the internet was mentioned quite thoroughly as a means of searching for information through research engines and a place to address professionals for advice.Within the hierarchy of consultation possibilities, the internet was given the first place as a way to deal with these types of problems presenting many advantages: (1) the internet enables to maintain intimacy; (2) it is anonymous (use of a pseudo); (3) it avoids having to confront someone face-to-face with personal problems which can be embarrassing and challenging for one's pride; (4) it is free; and (5) it is accessible at all times. In other words, participants value the internet as a positive tool to avoid many barriers which prevent offline consultations to take place. Most participants consider the internet at least as a first step in trying to solve a problem; for instance, by better defining the seriousness of a problem and judging if it is worth consulting a doctor. However, despite the positive qualities of the internet, they do put forward the importance of having specialists answering questions, trustworthiness, and being followed-up by the same person. Participants suggested that a strategy to break down barriers for boys to consult in face-to-face settings is to have a consultation on the internet as a first step which could then guide the person to an in-person consultation if necessary. Conclusions: The internet as a means of obtaining information or consulting received high marks overall. Although the internet cannot replace an in-person consultation, the screen and the keyboard have the advantage of not involving a face-to-face encounter and raise the possibility of discussing sexual problems anonymously and in private. The internet tools together with other new technologies should continue to develop in a secure manner as a space providing prevention messages and to become an easy access door to sexual and reproductive health services for young men, which can then guide youths to appropriate resource persons. Sources of support: This study was supported by the Maurice Chalumeau Foundation, Switzerland.

Massive nest-box supplementation boosts fecundity, survival and even immigration without altering mating and reproductive behaviour in a rapidly recovered bird population.

Habitat restoration measures may result in artificially high breeding density, for instance when nest-boxes saturate the environment, which can negatively impact species' demography. Potential risks include changes in mating and reproductive behaviour such as increased extra-pair paternity, conspecific brood parasitism, and polygyny. Under particular cicumstances, these mechanisms may disrupt reproduction, with populations dragged into an extinction vortex. With the use of nuclear microsatellite markers, we investigated the occurrence of these potentially negative effects in a recovered population of a rare secondary cavity-nesting farmland bird of Central Europe, the hoopoe (Upupa epops). High intensity farming in the study area has resulted in a total eradication of cavity trees, depriving hoopoes from breeding sites. An intensive nest-box campaign rectified this problem, resulting in a spectacular population recovery within a few years only. There was some concern, however, that the new, high artificially-induced breeding density might alter hoopoe mating and reproductive behaviour. As the species underwent a serious demographic bottleneck in the 1970-1990s, we also used the microsatellite markers to reconstitute the demo-genetic history of the population, looking in particular for signs of genetic erosion. We found i) a low occurrence of extra-pair paternity, polygyny and conspecific brood parasitism, ii) a high level of neutral genetic diversity (mean number of alleles and expected heterozygosity per locus: 13.8 and 83%, respectively) and, iii) evidence for genetic connectivity through recent immigration of individuals from well differentiated populations. The recent increase in breeding density did thus not induce so far any noticeable detrimental changes in mating and reproductive behaviour. The demographic bottleneck undergone by the population in the 1970s-1990s was furthermore not accompanied by any significant drop in neutral genetic diversity. Finally, genetic data converged with a concomitant demographic study to evidence that immigration strongly contributed to local population recovery.

Fécondation in vitro: intérêt et désavantage du remboursement par l'assurance maladie en Suisse [In-vitro fertilization: advantage and disadvantage of covering the costs of IVF/ICSI by the health insurance in Switzerland]

In-vitro fertilization: advantage and disadvantage of covering the costs of IVF/CSI by the health insurance in Switzerland The reimbursement of certain infertility treatments (stimulation with/without insemination) whereas IVF/ICSI is not leads patients with an indication of IVF to prefer treatments of low efficacy. The costs of multiple pregnancies issued by reimbursed or non-reimbursed fertility treatments are paid by the society. There should be measures to reduce these costs and to take the money used today to pay the complications of infertility treatments to reimburse IVF. The efficacy of such a system (single embryo transfer) has been proven in Belgium since several years. The dangers of complete reimbursement (IVF treatment in cases without any chances of success, only because it is for free) can be avoided by an Efficacy and Safety Board.

Les adolescents, Internet et les nouvelles technologies: un nouveau pays des merveilles ? [Adolescents, Internet and new technologies: a new wonderland?]

Cet article passe en revue les côtés positifs et les risques liés à l'utilisation des nouvelles technologies. Parmi les aspects positifs, figurent l'accès rapide à des informations à caractère éducatif, la possibilité d'échanges à caractère social ou intellectuel, et l'ouverture à des renseignements dans le domaine de la santé, des drogues ou de la sexualité. Les menaces sont liées à l'inexpérience et à la difficulté à juger de la validité des informations, ou du risque que les jeunes prennent en diffusant des informations sur le web. La dépendance à internet et le risque de violence sont probablement surestimés. Un monitorage ouvert et interactif de la part des parents constitue une bonne prévention. L'investigation du rapport que chaque jeune patient entretient avec ces outils fait partie intégrante de tout bilan de santé. [Abstract] This reviews the use of new technologies with its benefits and pitfalls. Among the positive aspects are instant access to educational information, the possibility to connect with mates and to develop social exchanges, as well as an access to preventive contents in the field of health, substances or sexuality. The risks are linked with inexperience and the adolescent's inability to assess the validity of information collected on Internet, as well as a lack of insights of the consequences of launching information or images on the web. The menace of addiction or of violence induced by intemet is probably overestimated by many adults but should be taken into account. Parents should monitor their adolescents' activity in an open and interactive way. Moreover, any adolescent medical check-up should touch on the use of new technologies.

Improved earthquake response via simulation and integrated space- and ground-based technologies: the TREMOR proposal

Earthquakes occurring around the world each year cause thousands ofdeaths, millions of dollars in damage to infrastructure, and incalculablehuman suffering. In recent years, satellite technology has been asignificant boon to response efforts following an earthquake and itsafter-effects by providing mobile communications between response teamsand remote sensing of damaged areas to disaster management organizations.In 2007, an international team of students and professionals assembledduring theInternational Space University’s Summer Session Program in Beijing, Chinato examine how satellite and ground-based technology could be betterintegrated to provide an optimised response in the event of an earthquake.The resulting Technology Resources for Earthquake MOnitoring and Response(TREMOR) proposal describes an integrative prototype response system thatwill implement mobile satellite communication hubs providing telephone anddata links between response teams, onsite telemedicine consultation foremergency first-responders, and satellite navigation systems that willlocate and track emergency vehicles and guide search-and-rescue crews. Aprototype earthquake simulation system is also proposed, integratinghistorical data, earthquake precursor data, and local geomatics andinfrastructure information to predict the damage that could occur in theevent of an earthquake. The backbone of these proposals is a comprehensiveeducation and training program to help individuals, communities andgovernments prepare in advance. The TREMOR team recommends thecoordination of these efforts through a centralised, non-governmentalorganization.

Energy requirements during reproduction and reproductive effort in shrews (Soricidae)

The energy requirements of reproducing and non-reproducing females of three species of Crocidura (C. russula, C. viaria, C. olivieri), and two species of Sorex (S. coronatus, S. minutus) were measured. Members of these two genera show different rates of metabolism and reproductive strategies (extreme altriciality and larger litter size in Sorex). During pregnancy, the daily energy intake (on either an absolute or a mass-specific basis) remained close to the non-reproductive value in all species. The absolute energy intake increased strongly after parturition and was influenced by the litter size. Peak energy intake of lactating females was extremely high, typically between 100% and 200% above the non-reproductive requirements in the Crocidura and about 300% above the non-reproductive intake in the Sorex. The mass-specific daily energy intake was reduced during lactation in the three smaller species but not in C. viaria and C. olivieri. This decrease probably involves the different thermoregulatory abilities and/or basal rate of metabolism of the pups. Average reproductive effort was about 50%, in the Crocidura species and above 150% in the Sorex species. The higher effort in the latter is partly due to a larger litter size. But in addition, extreme altriciality in the Sorex leads to an earlier increase in the energy requirements and thus is an energetically more expensive reproductive mode. The present results support the hypothesis that a higher basal rate of metabolism is associated with a higher reproductive effort in shrews.