Cirrhosis Diagnosis and Liver Fibrosis Staging: Transient Elastometry Versus Cirrhosis Blood Test.

International audience

Transient hyperglycemia in patients with tuberculosis in Tanzania: implications for diabetes screening algorithms.

BACKGROUND: Diabetes mellitus (DM) increases tuberculosis risk while tuberculosis, as an infectious disease, leads to hyperglycemia. We compared hyperglycemia screening strategies in controls and patients with tuberculosis in Dar es Salaam, Tanzania. METHODS: Consecutive adults with tuberculosis and sex- and age-matched volunteers were included in a case-control study between July 2012 and June 2014. All underwent DM screening tests (fasting capillary glucose [FCG] level, 2-hour CG [2-hCG] level, and glycated hemoglobin A1c [HbA1c] level) at enrollment, and cases were tested again after receipt of tuberculosis treatment. Association of tuberculosis and its outcome with hyperglycemia was assessed using logistic regression analysis adjusted for sex, age, body mass index, human immunodeficiency virus infection status, and socioeconomic status. Patients with tuberculosis and newly diagnosed DM were not treated for hyperglycemia. RESULTS: At enrollment, DM prevalence was significantly higher among patients with tuberculosis (n = 539; FCG level > 7 mmol/L, 4.5% of patients, 2-hCG level > 11 mmol/L, 6.8%; and HbA1c level > 6.5%, 9.3%), compared with controls (n = 496; 1.2%, 3.1%, and 2.2%, respectively). The association between hyperglycemia and tuberculosis disappeared after tuberculosis treatment (adjusted odds ratio [aOR] for the FCG level: 9.6 [95% confidence interval {CI}, 3.7-24.7] at enrollment vs 2.4 [95% CI, .7-8.7] at follow-up; aOR for the 2-hCG level: 6.6 [95% CI, 4.0-11.1] vs 1.6 [95% CI, .8-2.9]; and aOR for the HbA1c level, 4.2 [95% CI, 2.9-6.0] vs 1.4 [95% CI, .9-2.0]). Hyperglycemia, based on the FCG level, at enrollment was associated with tuberculosis treatment failure or death (aOR, 3.3; 95% CI, 1.2-9.3). CONCLUSIONS: Transient hyperglycemia is frequent during tuberculosis, and DM needs confirmation after tuberculosis treatment. Performance of DM screening at tuberculosis diagnosis gives the opportunity to detect patients at risk of adverse outcome.

Accidents at work by excessive efforts / inappropriate movements in nurses

Nurses continuously develop various activities that expose them to excessive force and inappropriate movements. Characterize the accidents reported by overexertion and inappropriate movements in Portuguese nurses during 2009 and 2010. Retrospective cross-sectional study, covering the period from January 1, 2009 to December 31, 2010. Were defined as inclusion criteria, be nurse and having notified by excessive straining and improper motion accident. The information was obtained by reference to the computer record of accidents at work General Administration of Health Services, relating to 672 nurses. There were 672 notifications of accidents by overexertion/ inappropriate moves in Portuguese nurses. The higher prevalence of these accidents was in nurses with over 10 years of service 277 (41.2%), 565 were female (42.6%) in the age group 25-29 (29.9%) and practice time for 555 shifts (82.6%). At admission there were 387 (57.3%) within 3 hours of work 330 (49.1%) and the third day after weekly rest 216 (32.1%). The Mobilization of patients was the most frequent cause of this accident 430 (64.0%). The main effects were the sprains and strains 321 (47.8%), mainly the trunk reached 367 (54.7%) and absenteeism caused 373 (55.5%). On average 17.7 days missed a total of 12.054 days. There was a high prevalence of accidents during the mobilization of prayer on patients so importante to invest in the implementation of mechanical equipment for the mobilization and transport of patients.

Analysis of deep levels in a phenylenevinylene polymer by transient capacitance methods

Transient capacitance methods were applied to the depletion region of an abrupt asymmetric n(+) -p junction of silicon and unintentionally doped poly[2-methoxy, 5 ethyl (2' hexyloxy) paraphenylenevinylene] (MEH-PPV). Studies in the temperature range 100-300 K show the presence of a majority-carrier trap at 1.0 eV and two minority traps at 0.7 and 1.3 eV, respectively. There is an indication for more levels for which the activation energy could not be determined. Furthermore, admittance data reveal a bulk activation energy for conduction of 0.12 eV, suggesting the presence of an additional shallow acceptor state. (C) 1999 American Institute of Physics. [S0003-6951(99)02308-6].

Transient scaling and resurgence of chimera states in networks of Boolean phase oscillators.

We study networks of nonlocally coupled electronic oscillators that can be described approximately by a Kuramoto-like model. The experimental networks show long complex transients from random initial conditions on the route to network synchronization. The transients display complex behaviors, including resurgence of chimera states, which are network dynamics where order and disorder coexists. The spatial domain of the chimera state moves around the network and alternates with desynchronized dynamics. The fast time scale of our oscillators (on the order of 100ns) allows us to study the scaling of the transient time of large networks of more than a hundred nodes, which has not yet been confirmed previously in an experiment and could potentially be important in many natural networks. We find that the average transient time increases exponentially with the network size and can be modeled as a Poisson process in experiment and simulation. This exponential scaling is a result of a synchronization rate that follows a power law of the phase-space volume.

Risk of Wheezing Attacks in Infants With Transient Tachypnea Newborns

Background: The most common reason of respiratory distress in the newborn is transient tachypnea of the newborn (TTN). There are some reports saying that TTN is associated with increased frequencies of wheezing attacks. Objectives: The aims of this study were to determine the risk factors associated with TTN and to determine the association between TTN and the development of wheezing syndromes in early life. Materials and Methods: In a historical cohort study, we recorded the characteristics of 70 infants born at the Shohadaye Kargar Hospital in Yazd between March 2005 and March 2009 and who were hospitalized because of TTN in the neonatal intensive-care unit. We called their parents at least four years after the infants were discharged from the hospital and asked about any wheezing attacks. Seventy other infants with no health problems during the newborn period were included in the study as the control group. Results: The rate of wheezing attacks in newborns with TTN was more than patients with no TTN diagnosis (P = 0.014). TTN was found to be an independent risk factor for later wheezing attacks (relative risk [RR] = 2.8). Conclusions: The most obvious finding of this study was that TTN was an independent risk factor for wheezing attacks. So long-term medical care is suggested for these patients who may be at risk, because TTN may not be as transient as has been previously thought.

Ultrafast transient absorption spectroscopy: principles and applications

The study of photophysical and photochemical processes crosses the interest of many fields of research in physics, chemistry and biology. In particular, the photophysical and photochemical reactions, after light absorption by a photosynthetic pigment-protein complex, are among the fastest events in biology, taking place on timescales ranging from tens of femtoseconds to a few nanoseconds. Among the experimental approaches developed for this purpose, the advent of ultrafast transient absorption spectroscopy has become a powerful and widely used technique.[1,2] Focusing on the process of photosynthesis, it relies upon the efficient absorption and conversion of the radiant energy from the Sun. Chlorophylls and carotenoids are the main players in the process. Photosynthetic pigments are typically arranged in a highly organized fashion to constitute antennas and reaction centers, supramolecular devices where light harvesting and charge separation take place. The very early steps in the photosynthetic process take place after the absorption of a photon by an antenna system, which harvests light and eventually delivers it to the reaction center. In order to compete with internal conversion, intersystem crossing, and fluorescence, which inevitably lead to energy loss, the energy and electron transfer processes that fix the excited-state energy in photosynthesis must be extremely fast. In order to investigate these events, ultrafast techniques down to a sub-100 fs resolution must be used. In this way, energy migration within the system as well as the formation of new chemical species such as charge-separated states can be tracked in real time. This can be achieved by making use of ultrafast transient absorption spectroscopy. The basic principles of this notable technique, instrumentation, and some recent applications to photosynthetic systems[3] will be described. Acknowledgements M. Moreno Oliva thanks the MINECO for a “Juan de la Cierva-Incorporación” research contract. References [1] U. Megerle, I. Pugliesi, C. Schriever, C.F. Sailer and E. Riedle, Appl. Phys. B, 96, 215 – 231 (2009). [2] R. Berera, R. van Grondelle and J.T.M. Kennis, Photosynth. Res., 101, 105 – 118 (2009). [3] T. Nikkonen, M. Moreno Oliva, A. Kahnt, M. Muuronen, J. Helaja and D.M. Guldi, Chem. Eur. J., 21, 590 – 600 (2015).

Analysis of deep levels in a phenylenevinylene polymer by transient capacitance methods

Transient capacitance methods were applied to the depletion region of an abrupt asymmetric n(+) -p junction of silicon and unintentionally doped poly[2-methoxy, 5 ethyl (2' hexyloxy) paraphenylenevinylene] (MEH-PPV). Studies in the temperature range 100-300 K show the presence of a majority-carrier trap at 1.0 eV and two minority traps at 0.7 and 1.3 eV, respectively. There is an indication for more levels for which the activation energy could not be determined. Furthermore, admittance data reveal a bulk activation energy for conduction of 0.12 eV, suggesting the presence of an additional shallow acceptor state. (C) 1999 American Institute of Physics. [S0003-6951(99)02308-6].

Hall Effect and transient surface photovoltage (SPV) study of Cu3BiS3 thin films

Se presentan las propiedades eléctricas del compuesto Cu3BiS3 depositado por co-evaporación. Este es un nuevo compuesto que puede tener propiedades adecuadas para ser utilizado como capa absorbente en celdas solares. Las muestras fueron caracterizadas a través de medidas de efecto Hall y fotovoltaje superficial transiente (SPV). A través de medidas de efecto Hall se encontró que la concentración de portadores de carga n es del orden de 1016 cm-3 independiente de la relación de masas de Cu/Bi. También se encontró que la movilidad de este compuesto (μ del orden de 4 cm2V -1s-1) varía de acuerdo con los mecanismos de transporte que la gobiernan en dependencia con la temperatura. A partir de las medidas de SPV se encontró alta densidad de defectos superficiales, defectos que son pasivados al superponer una capa buffer sobre el compuesto Cu3BiS3.

Non-specific transient mutualism between the plant parasitic nematode, Bursaphelenchus xylophilus , and the opportunistic bacterium Serratia quinivorans BXF1, a plant-growth promoting pine endophyte with antagonistic effects

The aim of this study is to understand the biological role of Serratia quinivorans BXF1, a bacterium commonly found associated with Bursaphelenchus xylophilus, the plant parasitic nematode responsible for pine wilt disease. Therefore, we studied strain BXF1 effect in pine wilt disease. We found that strain BXF1 promoted in vitro nematode reproduction. Moreover, the presence of bacteria led to the absence of nematode chitinase gene (Bxcht-1) expression, suggesting an effect for bacterial chitinase in nematode reproduction. Nevertheless, strain BXF1 was unable to colonize the nematode interior, bind to its cuticle with high affinity or protect the nematode from xenobiotic stress. Interestingly, strain BXF1 was able to promote tomato and pine plant-growth, as well as to colonize its interior, thus, acting like a plant-growth promoting endophyte. Consequently, strain BXF1 failed to induce wilting symptoms when inoculated in pine shoot artificial incisions. This bacterium also presented strong antagonistic activities against fungi and bacteria isolated from Pinus pinaster. Our results suggest that B. xylophilus does not possess a strict symbiotic community capable of inducing pine wilt disease symptoms as previously hypothesized. We show that bacteria like BXF1, which possess plant-growth promoting and antagonistic effects, may be opportunistically associated with B. xylophilus, possibly acquired from the bacterial endophytic community of the host pine.

A methodological approach for the performance optimization of transient seepage models through inverse analysis

The topic of the Ph.D project focuses on the modelling of the soil-water dynamics inside an instrumented embankment section along Secchia River (Cavezzo (MO)) in the period from 2017 to 2018 and the quantification of the performance of the direct and indirect simulations . The commercial code Hydrus2D by Pc-Progress has been chosen to run the direct simulations. Different soil-hydraulic models have been adopted and compared. The parameters of the different hydraulic models are calibrated using a local optimization method based on the Levenberg - Marquardt algorithm implemented in the Hydrus package. The calibration program is carried out using different types of dataset of observation points, different weighting distributions, different combinations of optimized parameters and different initial sets of parameters. The final goal is an in-depth study of the potentialities and limits of the inverse analysis when applied to a complex geotechnical problem as the case study. The second part of the research focuses on the effects of plant roots and soil-vegetation-atmosphere interaction on the spatial and temporal distribution of pore water pressure in soil. The investigated soil belongs to the West Charlestown Bypass embankment, Newcastle, Australia, that showed in the past years shallow instabilities and the use of long stem planting is intended to stabilize the slope. The chosen plant species is the Malaleuca Styphelioides, native of eastern Australia. The research activity included the design and realization of a specific large scale apparatus for laboratory experiments. Local suction measurements at certain intervals of depth and radial distances from the root bulb are recorded within the vegetated soil mass under controlled boundary conditions. The experiments are then reproduced numerically using the commercial code Hydrus 2D. Laboratory data are used to calibrate the RWU parameters and the parameters of the hydraulic model.

Defect states in MAPbBr3 by photo-induced current transient spectroscopy

In the past decade, perovskites have been under the spotlight as promising semicon- ductors with unique properties. Hybrid halide perovskites show excellent characteristic properties suitable for optoelectronic applications as tunable band gap, high absorption coefficient, large mobility and long carrier recombination lifetime. However, a complete understanding of environmental instability and the nature of defects in these materials is still lacking, hindering the development of perovskite-based technologies. In this work we studied MAPbBr3 single crystals, fabricated with Inverse Temperature Crystallization (ITC) technique, with Photo-Induced Current Transient Spectroscopy (PICTS). PICTS is a transient photocurrent measurement rarely employed for studying perovskites mate- rials, that allows for the defects characterization in high resistivity materials. We studied the samples under different conditions, such as negative and positive voltage biases, bias stress, different contact geometries and different illumination wavelengths, in order to study their effect on the material physical properties and to evaluate the trap activation energies and their behavior under different working conditions.

Analysis of technological accidents triggered by natural events (Natech) in the perspective of climate change

The severe accidents deriving from the impact of natural events on industrial installations have become a matter of growing concern in the last decades. In the literature, these events are typically referred to as Natech accidents. Several peculiarities distinguish them from conventional industrial accidents caused by internal factors, such as the possible occurrence of multiple simultaneous failures, and the enhanced probability of cascading events. The research project provides a comprehensive overview of Natech accidents that occurred in the Chemical and Process Industry, allowing for the identification of relevant aspects of Natech events. Quantified event trees and probability of ignition are derived from the collected dataset, providing a step forward in the quantitative risk assessment of Natech accidents. The investigation of past Natech accidents also demonstrated that wildfires may cause technological accidents. Climate change and global warming are promoting the conditions for wildfire development and rapid spread. Hence, ensuring the safety of industrial facilities exposed to wildfires is paramount. This was achieved defining safety distances between wildland vegetation and industrial equipment items. In addition, an innovative methodology for the vulnerability assessment of Natech and Domino scenarios triggered by wildfires was developed. The approach accounted for the dynamic behaviour of wildfire events and related technological scenarios. Besides, the performance of the emergency response and the related intervention time in the case of cascading events caused by natural events were evaluated. Overall, the tools presented in this thesis represent a step forward in the Quantitative Risk Assessment of Natech accidents. The methodologies developed also provide a solid basis for the definition of effective strategies for risk mitigation and reduction. These aspects are crucial to improve the resilience of industrial plants to natural hazards, especially considering the effects that climate change may have on the severity of such events.

Synergies among safety and security in the prevention of major accidents related to dangerous substances

Historical evidence shows that chemical, process, and Oil&Gas facilities where dangerous substances are stored or handled are target of deliberate malicious attacks (security attacks) aiming at interfering with normal operations. Physical attacks and cyber-attacks may generate events with consequences on people, property, and the surrounding environment that are comparable to those of major accidents caused by safety-related causes. The security aspects of these facilities are commonly addressed using Security Vulnerability/Risk Assessment (SVA/SRA) methodologies. Most of these methodologies are semi-quantitative and non-systematic approaches that strongly rely on expert judgment, leading to security assessments that are not reproducible. Moreover, they do not consider the synergies with the safety domain. The present 3-year research is aimed at filling the gap outlined by providing knowledge on security attacks, as well as rigorous and systematic methods supporting existing SVA/SRA studies suitable for the chemical, process, and Oil&Gas industry. The different nature of cyber and physical attacks resulted in the development of different methods for the two domains. The first part of the research was devoted to the development and statistical analysis of security databases that allowed to develop new knowledge and lessons learnt on security threats. Based on the obtained background, a Bow-Tie based procedure and two reverse-HazOp based methodologies were developed as hazard identification approaches for physical and cyber threats respectively. To support the quantitative estimation of the security risk, a quantitative procedure based on the Bayesian Network was developed allowing to calculate the probability of success of physical security attacks. All the developed methods have been applied to case studies addressing chemical, process and Oil&Gas facilities (offshore and onshore) proving the quality of the results that can be achieved in improving site security. Furthermore, the outcomes achieved allow to step forward in developing synergies and promoting integration among safety and security management.

The Consequences Of Refractory Epilepsy And Its Treatment.

Seizures in some 30% to 40% of patients with epilepsy fail to respond to antiepileptic drugs or other treatments. While much has been made of the risks of new drug therapies, not enough attention has been given to the risks of uncontrolled and progressive epilepsy. This critical review summarizes known risks associated with refractory epilepsy, provides practical clinical recommendations, and indicates areas for future research. Eight international epilepsy experts from Europe, the United States, and South America met on May 4, 2013, to present, review, and discuss relevant concepts, data, and literature on the consequences of refractory epilepsy. While patients with refractory epilepsy represent the minority of the population with epilepsy, they require the overwhelming majority of time, effort, and focus from treating physicians. They also represent the greatest economic and psychosocial burdens. Diagnostic procedures and medical/surgical treatments are not without risks. Overlooked, however, is that these risks are usually smaller than the risks of long-term, uncontrolled seizures. Refractory epilepsy may be progressive, carrying risks of structural damage to the brain and nervous system, comorbidities (osteoporosis, fractures), and increased mortality (from suicide, accidents, sudden unexpected death in epilepsy, pneumonia, vascular disease), as well as psychological (depression, anxiety), educational, social (stigma, driving), and vocational consequences. Adding to this burden is neuropsychiatric impairment caused by underlying epileptogenic processes (essential comorbidities), which appears to be independent of the effects of ongoing seizures themselves. Tolerating persistent seizures or chronic medicinal adverse effects has risks and consequences that often outweigh risks of seemingly more aggressive treatments. Future research should focus not only on controlling seizures but also on preventing these consequences.