Les besoins en soins de support chez les patients en phase d'un traitement ambulatoire, suivant l'annonce d'un diagnostic de cancer : étude descriptive transversale

Problématique L'incidence du cancer ne cesse d'augmenter dans les pays occidentaux et en Suisse, en constituant la deuxième cause de mortalité après les maladies cardiovasculaires. Si d'une part, les différents traitements oncologiques ont le potentiel de guérir certains cancers et d'augmenter l'espérance de vie des personnes concernées, ils sont associés à de multiples problèmes physiques et psychosociaux. De même, l'annonce de la maladie provoque une fragilité émotionnelle et sociale et la phase de traitement qui suit le diagnostic de cancer est souvent associé à des besoins psychologiques et d'information élevés. But Cette étude vise à décrire les besoins en soins de support insatisfaits chez les patients nouvellement diagnostiqués d'un cancer, au cours d'un traitement ambulatoire dans un Hôpital Cantonal de la Suisse. Elle vise également à identifier les associations entre les besoins en soins de support insatisfaits et les caractéristiques sociodémographiques et médicales. Méthode Cette étude corrélationnelle descriptive a été conduite auprès de 67 patients nouvellement atteints d'un cancer primaire ou d'une récidive, recrutés selon un échantillonnage non probabiliste par convenance consécutive. Le questionnaire auto-administré comprenait le Supportive Care Needs Survey Short Form 34 et un questionnaire sur des données sociodémographiques. Les données médicales ont été collectées par les chercheurs à travers les dossiers médicaux. Résultats Les trois besoins exprimés comme les plus insatisfaits étaient « la peur que le cancer se propage » (48,5%), « l'incertitude face à l'avenir » (45,4%) et « vos préoccupations face à l'incertitude de vos proches » (43,9%). Nous constatons une insatisfaction plus élevée des besoins psychologiques (M: 32,6 ; ET: 20,4) et des besoins d'information (M: 29,3 ; ET: 17,5) par rapport aux autres dimensions de besoins. À propos des caractéristiques associées a un plus haut niveau de besoins insatisfaits, nous trouvons qu'être plus jeune (29-56 ans) ou âgés de > 72 ans est positivement associé aux besoins insatisfaits du domaine psychologique (F = 3,50 ; p = 0,02) et de l'information/système de santé (F = 3,48 ; p = 0,02). Le jeune âge est aussi associé à plus de besoins dans le domaine sexuel (F = 2,85 ; p = 0,04). Il semble exister une association négative entre le niveau d'instruction et le degré d'insatisfaction des besoins psychologiques (F = 2,92, p = 0,06). Être retraité coïncide avec un plus grand degré d'insatisfaction dans les besoins physiques et des activités de la vie quotidienne (F = 4,64 ; p = 0,013). Finalement, avoir un moins bon état général est relié à plus de besoins physiques et de besoins issus du domaine des activités de la vie quotidienne (t = -2,85 ; p = 0,005). Conclusions Les présents résultats concordent avec les études antérieures. Cette étude a la particularité d'avoir identifié les besoins insatisfaits durant la phase de traitement qui suit l'annonce du diagnostic, sans se restreindre à une maladie cancéreuse spécifique, ce qui a été peu effectué auparavant. Les chercheurs infirmiers devraient poursuivre, en collaboration avec d'autres professionnels de la santé, les recherches visant le développement d'approches efficaces pour réduire les besoins insatisfaits chez des personnes atteintes de maladies cancéreuses.

Inférence de source de traces d'essence retrouvées dans des débris d'incendie: Evaluation de la contribution de la chromatographie en phase gazeuse couplée à la spectrométrie de masse à rapport isotopique

Lorsque de l'essence est employée pour allumer et/ou propager un incendie, l'inférence de la source de l'essence peut permettre d'établir un lien entre le sinistre et une source potentielle. Cette inférence de la source constitue une alternative intéressante pour fournir des éléments de preuve dans ce type d'événements où les preuves matérielles laissées par l'auteur sont rares. Le but principal de cette recherche était le développement d'une méthode d'analyse de spécimens d'essence par GC-IRMS, méthode pas routinière et peu étudiée en science forensique, puis l'évaluation de son potentiel à inférer la source de traces d'essence en comparaison aux performances de la GC-MS. Un appareillage permettant d'analyser simultanément les échantillons par MS et par IRMS a été utilisé dans cette recherche. Une méthode d'analyse a été développée, optimisée et validée pour cet appareillage. Par la suite, des prélèvements d'essence provenant d'un échantillonnage conséquent et représentatif du marché de la région lausannoise ont été analysés. Finalement, les données obtenues ont été traitées et interprétées à l'aide de méthodes chimiométriques. Les analyses effectuées ont permis de montrer que la méthodologie mise en place, aussi bien pour la composante MS que pour l'IRMS, permet de différencier des échantillons d'essence non altérée provenant de différentes stations-service. Il a également pu être démontré qu'à chaque nouveau remplissage des cuves d'une station-service, la composition de l'essence distribuée par cette station est quasi unique. La GC-MS permet une meilleure différenciation d'échantillons prélevés dans différentes stations, alors que la GC-IRMS est plus performante lorsqu'il s'agit de comparer des échantillons collectés après chacun des remplissages d'une cuve. Ainsi, ces résultats indiquent que les deux composantes de la méthode peuvent être complémentaires pour l'analyse d'échantillons d'essence non altérée. Les résultats obtenus ont également permis de montrer que l'évaporation des échantillons d'essence ne compromet pas la possibilité de grouper des échantillons de même source par GC-MS. Il est toutefois nécessaire d'effectuer une sélection des variables afin d'éliminer celles qui sont influencées par le phénomène d'évaporation. Par contre, les analyses effectuées ont montré que l'évaporation des échantillons d'essence a une forte influence sur la composition isotopique des échantillons. Cette influence est telle qu'il n'est pas possible, même en effectuant une sélection des variables, de grouper correctement des échantillons évaporés par GC-IRMS. Par conséquent, seule la composante MS de la méthodologie mise en place permet d'inférer la source d'échantillons d'essence évaporée. _________________________________________________________________________________________________ When gasoline is used to start and / or propagate an arson, source inference of gasoline can allow to establish a link between the fire and a potential source. This source inference is an interesting alternative to provide evidence in this type of events where physical evidence left by the author are rare. The main purpose of this research was to develop a GC-IRMS method for the analysis of gasoline samples, a non-routine method and little investigated in forensic science, and to evaluate its potential to infer the source of gasoline traces compared to the GC-MS performances. An instrument allowing to analyze simultaneously samples by MS and IRMS was used in this research. An analytical method was developed, optimized and validated for this instrument. Thereafter, gasoline samples from a large sampling and representative of the Lausanne area market were analyzed. Finally, the obtained data were processed and interpreted using chemometric methods. The analyses have shown that the methodology, both for MS and for IRMS, allow to differentiate unweathered gasoline samples from different service stations. It has also been demonstrated that each new filling of the tanks of a station generates an almost unique composition of gasoline. GC-MS achieves a better differentiation of samples coming from different stations, while GC-IRMS is more efficient to distinguish samples collected after each filling of a tank. Thus, these results indicate that the two components of the method can be complementary to the analysis of unweathered gasoline samples. The results have also shown that the evaporation of gasoline samples does not compromise the possibility to group samples coming from the same source by GC-MS. It is however necessary to make a selection of variables in order to eliminate those which are influenced by the evaporation. On the other hand, the carried out analyses have shown that the evaporation of gasoline samples has such a strong influence on the isotopic composition of the samples that it is not possible, even by performing a selection of variables, to properly group evaporated samples by GC-IRMS. Therefore, only the MS allows to infer the source of evaporated gasoline samples.

Safety and immunogenicity of a chimpanzee adenovirus-vectored Ebola vaccine in healthy adults: a randomised, double-blind, placebo-controlled, dose-finding, phase 1/2a study.

BACKGROUND: The ongoing Ebola outbreak led to accelerated efforts to test vaccine candidates. On the basis of a request by WHO, we aimed to assess the safety and immunogenicity of the monovalent, recombinant, chimpanzee adenovirus type-3 vector-based Ebola Zaire vaccine (ChAd3-EBO-Z). METHODS: We did this randomised, double-blind, placebo-controlled, dose-finding, phase 1/2a trial at the Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Participants (aged 18-65 years) were randomly assigned (2:2:1), via two computer-generated randomisation lists for individuals potentially deployed in endemic areas and those not deployed, to receive a single intramuscular dose of high-dose vaccine (5 × 10(10) viral particles), low-dose vaccine (2·5 × 10(10) viral particles), or placebo. Deployed participants were allocated to only the vaccine groups. Group allocation was concealed from non-deployed participants, investigators, and outcome assessors. The safety evaluation was not masked for potentially deployed participants, who were therefore not included in the safety analysis for comparison between the vaccine doses and placebo, but were pooled with the non-deployed group to compare immunogenicity. The main objectives were safety and immunogenicity of ChAd3-EBO-Z. We did analysis by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02289027. FINDINGS: Between Oct 24, 2014, and June 22, 2015, we randomly assigned 120 participants, of whom 18 (15%) were potentially deployed and 102 (85%) were non-deployed, to receive high-dose vaccine (n=49), low-dose vaccine (n=51), or placebo (n=20). Participants were followed up for 6 months. No vaccine-related serious adverse events were reported. We recorded local adverse events in 30 (75%) of 40 participants in the high-dose group, 33 (79%) of 42 participants in the low-dose group, and five (25%) of 20 participants in the placebo group. Fatigue or malaise was the most common systemic adverse event, reported in 25 (62%) participants in the high-dose group, 25 (60%) participants in the low-dose group, and five (25%) participants in the placebo group, followed by headache, reported in 23 (57%), 25 (60%), and three (15%) participants, respectively. Fever occurred 24 h after injection in 12 (30%) participants in the high-dose group and 11 (26%) participants in the low-dose group versus one (5%) participant in the placebo group. Geometric mean concentrations of IgG antibodies against Ebola glycoprotein peaked on day 28 at 51 μg/mL (95% CI 41·1-63·3) in the high-dose group, 44·9 μg/mL (25·8-56·3) in the low-dose group, and 5·2 μg/mL (3·5-7·6) in the placebo group, with respective response rates of 96% (95% CI 85·7-99·5), 96% (86·5-99·5), and 5% (0·1-24·9). Geometric mean concentrations decreased by day 180 to 25·5 μg/mL (95% CI 20·6-31·5) in the high-dose group, 22·1 μg/mL (19·3-28·6) in the low-dose group, and 3·2 μg/mL (2·4-4·9) in the placebo group. 28 (57%) participants given high-dose vaccine and 31 (61%) participants given low-dose vaccine developed glycoprotein-specific CD4 cell responses, and 33 (67%) and 35 (69%), respectively, developed CD8 responses. INTERPRETATION: ChAd3-EBO-Z was safe and well tolerated, although mild to moderate systemic adverse events were common. A single dose was immunogenic in almost all vaccine recipients. Antibody responses were still significantly present at 6 months. There was no significant difference between doses for safety and immunogenicity outcomes. This acceptable safety profile provides a reliable basis to proceed with phase 2 and phase 3 efficacy trials in Africa. FUNDING: Swiss State Secretariat for Education, Research and Innovation (SERI), through the EU Horizon 2020 Research and Innovation Programme.

Security Authentication using Phase-Encoded Nanoparticle Structures and Polarized Light

Phase encoded nano structures such as Quick Response (QR) codes made of metallic nanoparticles are suggested to be used in security and authentication applications. We present a polarimetric optical method able to authenticate random phase encoded QR codes. The system is illuminated using polarized light and the QR code is encoded using a phase-only random mask. Using classification algorithms it is possible to validate the QR code from the examination of the polarimetric signature of the speckle pattern. We used Kolmogorov-Smirnov statistical test and Support Vector Machine algorithms to authenticate the phase encoded QR codes using polarimetric signatures.

Aplicação de SPME (Solid Phase Micro-Extraction) na análise de águas potáveis de três localidades do estado de São Paulo

The technique of solid phase microextraction (SPME) was used for the extraction of halogenated contaminants of water samples from three cities of the State of São Paulo and the extracts were submitted to gas chromatographic analysis with electron capture detection (GC-ECD). In the samples of water collected at the city of São Paulo the detected level of trihalomethanes (THM) expressed as the sum of chloroform, dibromochloromethane and dichlorobromomethane, were higher than the permissible limit established by the Brazilian regulation. In the samples collected at the two other cities the level of any of the three THM remained below the sensitivity of the ECD.

Inclusion complex of the antiviral drug acyclovir with cyclodextrin in aqueous solution and in solid phase

Complexation between acyclovir (ACV), an antiviral drug used for the treatment of herpes simplex virus infection, and beta-cyclodextrin (beta-CD) was studied in solution and in solid states. Complexation in solution was evaluated using solubility studies and nuclear magnetic resonance spectroscopy (¹H-NMR). In the solid state, X-ray diffraction, differential scanning calorimetry (DSC), thermal gravimetric analysis (TGA) and dissolution studies were used. Solubility studies suggested the existence of a 1:1 complex between ACV and beta-CD. ¹H-NMR spectroscopy studies showed that the complex formed occurs with a stoichiometry ratio of 1:1. Powder X-ray diffraction indicated that ACV exists in a semicrystalline state in the complexed form with beta-CD. DSC studies showed the existence of a complex of ACV with beta-CD. The TGA studies confirmed the DSC results of the complex. Solubility of ACV in solid complexes was studied by the dissolution method and it was found to be much more soluble than the uncomplexed drug.

Highly functional binding surface for miniaturised solid-phase immunoassays. - A spot story -

Several bioaffinity assays are based on the detection of an analyte which is bound on a solid substrate via biochemical interaction. These so called solid phase assays are based on the adhesion of the primary binding partner on a solid surface, which then binds the analyte to be detected. In this thesis work a novel solid phase based assay technology, known as spot technology, was developed. The spot technology is based on combination of high-capacity solid phases, concentrated in a spot format, utilising modified streptavidin molecules and recombinant antibody fragments. The reduction of the solid phase binding surface to a size of a spot enabled denser binding of the target molecules, providing improved signal intensities and signal-to-background ratio when applied in different solid phase immunoassays. Streptavidin-biotin interactions are commonly utilised in numerous different bioaffinity assays and the ultimate nature of streptavidin to bind biotin is among the strongest non-covalent interaction reported between two biomolecules. In this study native core streptavidin was chemically modified to provide polymerised streptavidin molecules with altered adsorption properties. These streptavidin conjugates, when coated onto polystyrene surface, provided enhanced biotin binding capacity and surface stability when compared to a reference coating constructed with native streptavidin. Furthermore, the combination of chemically modified streptavidin, sitespecifically biotinylated antibody fragments and the spot coating technology provided highly dense solid phase coating with improved binding properties. The performance of the spot assay technology was further demonstrated in different immunoassay configurations. Human thyroid stimulating hormone (TSH) and human cardiac troponin I (cTnI) were used as model analytes to show the applicability of the highly sensitive spot-based solid-phase immunoassay for detection of very low levels of analytes. It was demonstrated that the spot technology provided an assay concept with enhanced sensitivity and short turn-around times, characteristics that are highly suitable for point-of-care applications.

Gas-phase ion chemistry of silyl cations obtained from hexamethyldisilazane

The gas-phase ion-molecule reactions of the Me3SiN(H)SiMe2+ ion, obtained by electron ionization from Me3SiN(H)SiMe3, have been studied in a Fourier transform ion cyclotron resonance spectrometer in order to understand the mechanistic details of an important chemical system presently used in film formation. This silyl cation has been observed to undergo addition reactions at electron rich centers to form stable adducts that may undergo further methane elimination in the case of alcohols and amines. The most important feature of these reactions is the fact that a metathesis type reaction can be observed in the presence of H2O, and other hydrogen labile substrates like alcohols, leading to the formation of the corresponding oxygen-containing ion, i.e. Me3SiOSiMe2+. For alcohols (ROH), facile formation of a tertiary product ion, presumably corresponding to an Me3Si-O-Si(Me)=O+-R structure with elimination of an amine reveals the strong tendency of these nitrogen-containing ions to undergo metathesis type reactions with oxygen containing substrates.

A new experimental procedure to obtain titania powders as anatase phase by a sol-gel process

Titania powders were synthesized by a sol-gel process using titanium tetrabutoxide as precursor. The syntheses were performed in water or in solutions of dimethylformamide (dmf) or dimethylsulfoxide (dmso). It is demonstrated, by X-ray diffraction patterns of the synthesized powders, that the samples obtained in dmf or dmso solutions are crystalline (anatase phase) with some minor amount of brookite phase, whereas the sample synthesized in water is amorphous. The anatase phase can be obtained independently of any previous or further treatment of the synthesized powder, such as hydrothermal or heat treatment, providing a new, simple, quick and inexpensive route to synthesize anatase powders. From the peak broadening of the anatase (101) diffraction, the crystallite sizes were calculated as 6 nm.

Phase behavior and rheological analysis of reverse liquid crystals and W/I2, W/H2 gel emulsions using an amphiphilic block copolymer.

This article reports the phase behavior determi- nation of a system forming reverse liquid crystals and the formation of novel disperse systems in the two-phase region. The studied system is formed by water, cyclohexane, and Pluronic L-121, an amphiphilic block copolymer considered of special interest due to its aggregation and structural proper- ties. This system forms reverse cubic (I2) and reverse hexagonal (H2) phases at high polymer concentrations. These reverse phases are of particular interest since in the two-phase region, stable high internal phase reverse emulsions can be formed. The characterization of the I2 and H2 phases and of the derived gel emulsions was performed with small-angle X-ray scattering (SAXS) and rheometry, and the influence of temperature and water content was studied. TheH2 phase experimented a thermal transition to an I2 phase when temperature was increased, which presented an Fd3m structure. All samples showed a strong shear thinning behavior from low shear rates. The elasticmodulus (G0) in the I2 phase was around 1 order of magnitude higher than in theH2 phase. G0 was predominantly higher than the viscousmodulus (G00). In the gel emulsions,G0 was nearly frequency-independent, indicating their gel type nature. Contrarily to water-in-oil (W/O) normal emulsions, in W/I2 and W/H2 gel emulsions, G0, the complex viscosity (|η*|), and the yield stress (τ0) decreased with increasing water content, since the highly viscous microstructure of the con- tinuous phase was responsible for the high viscosity and elastic behavior of the emulsions, instead of the volumefraction of dispersed phase and droplet size. A rheological analysis, in which the cooperative flow theory, the soft glass rheology model, and the slip plane model were analyzed and compared, was performed to obtain one single model that could describe the non-Maxwellian behavior of both reverse phases and highly concentrated emulsions and to characterize their microstructure with the rheological properties.

Solid phase extraction of iron and lead in environmental matrices on amberlite xad-1180/pv

A solid phase extraction procedure using Amberlite XAD-1180/Pyrocatechol violet (PV) chelating resin for the determination of iron and lead ions in various environmental samples was established. The procedure is based on the sorption of lead(II) and iron(III) ions onto the resin at pH 9, followed by elution with 1 mol/L HNO3 and determination by flame atomic absorption spectrometry. The influence of alkaline, earth alkaline and some transition metals, as interferents, are discussed. The recoveries for the spiked analytes were greater than 95%. The detection limits for lead and iron by FAAS were 0.37 µg/L and 0.20 µg/L, respectively. Validation of the method described here was performed by using three certified reference materials (SRM 1515 Apple Leaves, SRM 2711 Montana Soil and NRCC-SLRS-4 Riverine Water). The procedure was successfully applied to natural waters and human hair.

Critical behavior in nonequilibrium phase transitions

The nonequilibrium phase transitions occurring in a fast-ionic-conductor model and in a reaction-diffusion Ising model are studied by Monte Carlo finite-size scaling to reveal nonclassical critical behavior; our results are compared with those in related models.