Collaboration entre cliniciens et chercheurs autour de la "consultation systémique": double regard sur un cas clinique

Cet article vise à montrer comment chercheurs et cliniciens peuvent collaborer et s'enrichir mutuellement en utilisant la «consultation systémique», en deux séances, dont le but est l'évaluation des interactions familiales, avec mise en lumière des ressources comme des difficultés de la famille. Lors d'une première rencontre, les questions qui motivent les parents et/ou le(s) thérapeute(s) à consulter sont formulées et la famille est invitée à faire des jeux familiaux semi-standardisés qui sont filmés. Lors d'une deuxième rencontre réunissant les mêmes personnes, un visionnement d'extraits des films sert de base aux réponses des chercheurs et à une discussion commune. Une vignette clinique, concernant des violences intrafamiliales, illustrera la richesse et l'utilité de ces consultations et montrera qu'une collaboration entre chercheurs et cliniciens est fructueuse pour toutes les parties concernées.

Perceptions de la performance et comportements de agents publics suisses dans un environnement en constante évolution

Alors que les modèles et notions de performance généralement analysés dans les recherches sont presque toujours ceux du management et des cadres dirigeants, cet article propose de s'arrêter sur la vision des employés, en l'occurrence des agents publics suisses. Il présente, à la lumière des réformes entreprises dans l'administration publique en Suisse, d'une part la conception générale qu'ont les agents publics de la performance du service public, et d'autre part leur perception de l'évolution des performances organisationnelle, individuelle, ainsi que celle en lien avec les prestations fournies aux bénéficiaires. L'analyse de la performance perçue est effectuée à travers la mise en évidence de l'existence de plusieurs mondes de référence auxquels se rapportent les agents publics lorsqu'ils parlent de leur travail. Les résultats révèlent la prégnance du monde industriel, devançant le monde civique qui, lui-même, relègue les mondes domestique et marchand respectivement en troisième et quatrième position. Un intérêt particulier est également accordé aux différents comportements, découlant des réformes du service public, qu'adoptent les agents publics, et aux liens qui pourraient exister entre ces comportements et les différents mondes de référence. Un mariage entre deux mondes, potentiellement contradictoires, semble se dessiner dans l'esprit des agents publics. Il pourrait constituer une réponse à une forme de crise identitaire, mise en avant par de nombreux spécialistes, provoquée par des injonctions contradictoires auxquelles sont soumis actuellement les agents publics.

Distinct sets of alphabeta TCRs confer similar recognition of tumor antigen NY-ESO-1157-165 by interacting with its central Met/Trp residues.

Naturally acquired immune responses against human cancers often include CD8(+) T cells specific for the cancer testis antigen NY-ESO-1. Here, we studied T cell receptor (TCR) primary structure and function of 605 HLA-A*0201/NY-ESO-1(157-165)-specific CD8 T cell clones derived from five melanoma patients. We show that an important proportion of tumor-reactive T cells preferentially use TCR AV3S1/BV8S2 chains, with remarkably conserved CDR3 amino acid motifs and lengths in both chains. All remaining T cell clones belong to two additional sets expressing BV1 or BV13 TCRs, associated with alpha-chains with highly diverse VJ usage, CDR3 amino acid sequence, and length. Yet, all T cell clonotypes recognize tumor antigen with similar functional avidity. Two residues, Met-160 and Trp-161, located in the middle region of the NY-ESO-1(157-165) peptide, are critical for recognition by most of the T cell clonotypes. Collectively, our data show that a large number of alphabeta TCRs, belonging to three distinct sets (AVx/BV1, AV3/BV8, AVx/BV13) bind pMHC with equal antigen sensitivity and recognize the same peptide motif. Finally, this in-depth study of recognition of a self-antigen suggests that in part similar biophysical mechanisms shape TCR repertoires toward foreign and self-antigens.

Fertilization response likelihood for the interpretation of leaf analyses

Leaf analysis is the chemical evaluation of the nutritional status where the nutrient concentrations found in the tissue reflect the nutritional status of the plants. Thus, a correct interpretation of the results of leaf analysis is fundamental for an effective use of this tool. The purpose of this study was to propose and compare the method of Fertilization Response Likelihood (FRL) for interpretation of leaf analysis with that of the Diagnosis and Recommendation Integrated System (DRIS). The database consisted of 157 analyses of the N, P, K, Ca, Mg, S, Cu, Fe, Mn, Zn, and B concentrations in coffee leaves, which were divided into two groups: low yield (< 30 bags ha-1) and high yield (> 30 bags ha-1). The DRIS indices were calculated using the method proposed by Jones (1981). The fertilization response likelihood was computed based on the approximation of normal distribution. It was found that the Fertilization Response Likelihood (FRL) allowed an evaluation of the nutritional status of coffee trees, coinciding with the DRIS-based diagnoses in 84.96 % of the crops.

Exporting Contours to DICOM-RT Structure Set

This paper presents an ITK implementation for exportingthe contours of the automated segmentation results toDICOM-RT Structure Set format. The âeurooeradiotherapystructure setâeuro&#157; (RTSTRUCT) object of the DICOM standard isused for the transfer of patient structures and relateddata, between the devices found within and outside theradiotherapy department. It mainly contains theinformation of regions of interest (ROIs) and points ofinterest (E.g. dose reference points). In many cases,rather than manually drawing these ROIs on the CT images,one can indeed benefit from the automated segmentationalgorithms already implemented in ITK. But at present, itis not possible to export the ROIs obtained from ITK toRTSTRUCT format. In order to bridge this gap, we havedeveloped a framework for exporting contour data toRTSTRUCT. We provide here the complete implementation ofRTSTRUCT exporter and present the details of the pipelineused. Results on a 3-D CT image of the Head and Neck(H&N) region are presented.

Lentivector immunization induces tumor antigen-specific B and T cell responses in vivo.

Expression of the cancer/germ-line antigen NY-ESO-1 by tumors elicits spontaneous humoral and cellular immune responses in some cancer patients. Development of vaccines capable of stimulating such comprehensive immune responses is desirable. We have produced recombinant lentivectors directing the intracellular synthesis of NY-ESO-1 (rLV/ESO) and have analyzed the in vivo immune response elicited by this vector. Single injection of rLV/ESO into HLA-A2-transgenic mice elicited long-lasting B and T cell responses against NY-ESO-1. CD8+ T cells against the HLA-A2-restricted peptide NY-ESO-1(157-165) were readily detectable ex vivo and showed restricted TCR Vbeta usage. Moreover, rLV/ESO elicited a far greater anti-NY-ESO-1(157-165) CD8+ T cell response than peptide- or protein-based vaccines. Anti-NY-ESO-1 antibodies were rapidly induced after immunization and their detection preceded that of the antigen-specific CD8+ T cells. The rLV/ESO also induced CD4+ T cells. These cells played an essential role as their depletion completely abrogated B cell and CD8+ T cell responses against NY-ESO-1. The induced CD4+ T cells were primarily directed against a single NY-ESO-1 epitope spanning amino acids 81-100. Altogether, our study shows that rLV/ESO induces potent and comprehensive immune responses in vivo.

Ultraviolet optical and microstructural properties of MgF2 and LaF3 coatings deposited by ion-beam sputtering and boat and electron-beam evaporation

Single layers of MgF2 and LaF3 were deposited upon superpolished fused-silica and CaF2 substrates by ion-beam sputtering (IBS) as well as by boat and electron beam (e-beam) evaporation and were characterized by a variety of complementary analytical techniques. Besides undergoing photometric and ellipsometric inspection, the samples were investigated at 193 and 633 nm by an optical scatter measurement facility. The structural properties were assessed with atomic-force microscopy, x-ray diffraction, TEM techniques that involved conventional thinning methods for the layers. For measurement of mechanical stress in the coatings, special silicon substrates were coated and analyzed. The dispersion behavior of both deposition materials, which was determined on the basis of various independent photometric measurements and data reduction techniques, is in good agreement with that published in the literature and with the bulk properties of the materials. The refractive indices of the MgF2 coatings ranged from 1.415 to 1.440 for the wavelength of the ArF excimer laser (193 nm) and from 1.435 to 1.465 for the wavelength of the F2 excimer laser (157 nm). For single layers of LaF3 the refractive indices extended from 1.67 to 1.70 at 193 nm to ~1.80 at 157 nm. The IBS process achieves the best homogeneity and the lowest surface roughness values (close to 1 nmrms) of the processes compared in the joint experiment. In contrast to MgF2 boat and e-beam evaporated coatings, which exhibit tensile mechanical stress ranging from 300 to 400 MPa, IBS coatings exhibit high compressive stress of as much as 910 MPa. A similar tendency was found for coating stress in LaF3 single layers. Experimental results are discussed with respect to the microstructural and compositional properties as well as to the surface topography of the coatings.

Test-retest reliability of thermal quantitative sensory testing on two sites within the L5 dermatome of the lumbar spine and lower extremity.

INTRODUCTION: Quantitative sensory testing (QST) is widely used in human research to investigate the integrity of the sensory function in patients with pain of neuropathic origin, or other causes such as low back pain. Reliability of QST has been evaluated on both sides of the face, hands and feet as well as on the trunk (Th3-L3). In order to apply these tests on other body-parts such as the lower lumbar spine, it is important first to establish reliability on healthy individuals. The aim of this study was to investigate intra-rater reliability of thermal QST in healthy adults, on two sites within the L5 dermatome of the lumbar spine and lower extremity. METHODS: Test-retest reliability of thermal QST was determined at the L5-level of the lumbar spine and in the same dermatome on the lower extremity in 30 healthy persons under 40 years of age. Results were analyzed using descriptive statistics and intraclass correlation coefficient (ICC). Values were compared to normative data, using Z-transformation. RESULTS: Mean intraindividual differences were small for cold and warm detection thresholds but larger for pain thresholds. ICC values showed excellent reliability for warm detection and heat pain threshold, good-to-excellent reliability for cold pain threshold and fair-to-excellent reliability for cold detection threshold. ICC had large ranges of confidence interval (95%). CONCLUSION: In healthy adults, thermal QST on the lumbar spine and lower extremity demonstrated fair-to-excellent test-retest reliability.

Variabilidade espacial de atributos de solos coesos do leste maranhense

A demanda nacional e internacional por mapas de atributos do solo tem aumentado. Os objetivos deste trabalho foram caracterizar e associar a variabilidade da granulometria, os atributos químicos e a cor de solos coesos a diferentes formas de paisagem, em áreas agrícolas e de vegetação nativa, por meio de técnicas geoestatísticas. Para a instalação do experimento, foram escolhidas três áreas representadas por uma área cultivada com soja e, contígua a essa, uma com cobertura vegetal remanescente de três feições de cerrado, designadas de Cerradão (A), Cerrado (B) e Campo Cerrado (C). As áreas A e B estão localizadas em pedoforma côncava e a área C, na convexa. Em cada área, foram estabelecidas malhas de amostragem com 121 pontos; nas áreas com cobertura vegetal construíram-se transeções com cinco pontos espaçados em 20 m. Os maiores alcances médios, considerando ambas as profundidades avaliadas, foram encontrados para a área A, sendo de 115 m para granulometria, 157 m para atributos químicos e 168 m para a cor do solo. A área B apresentou alcances médios de 95, 64 e 160 m para granulometria, atributos químicos e cor do solo, respectivamente. A área C, por sua vez, exibiu alcances médios de 63, 65 e 58 m para granulometria, atributos químicos e cor do solo, respectivamente. O ambiente com maior variabilidade (área C) está relacionado com locais de ocorrência de vegetação do tipo Campo Cerrado e pedoforma convexa. Esse mesmo local evidenciou a menor capacidade de resposta ao manejo da cultura de soja, evidenciado pelos índices de fertilidade do solo para essa cultura, com destaque para os baixos valores de matéria orgânica (9,20 mg kg-1) e CTC (29,60 mmol c dm-3). Assim, pode-se afirmar que para o compartimento geológico estudado, os ambientes de alta variabilidade sempre estão associados a áreas com menor resposta ao manejo do solo para a cultura da soja.