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Globally, there were an estimated 9.8 million measles cases and 207 500 measles deaths in 2019. As the effort to eliminate measles around the world continues, modeling remains a valuable tool for public health decision-makers and program implementers. This study presents a novel approach to the use of a yearly transition function that formulates mathematically the vaccine schedules for different age groups while accounting for the effects of the age of vaccination, the timing of vaccination, and disease seasonality on the yearly number of measles cases in a country. The methodology presented adds to an existing modeling framework and expands its analysis, making its utilization more adjustable for the user and contributing to its conceptual clarity. This article also adjusts for the temporal interaction between vaccination and exposure to disease, applying adjustments to estimated yearly counts of cases and the number of vaccines administered that increase population immunity. These new model features provide the ability to forecast and compare the effects of different vaccination timing scenarios and seasonality of transmission on the expected disease incidence. Although the work presented is applied to the example of measles, it has potential relevance to modeling other vaccine-preventable diseases.
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Sarampo , Vacinas , Humanos , Lactente , Sarampo/epidemiologia , Sarampo/prevenção & controle , Vacinação , Previsões , Surtos de DoençasRESUMO
Treatment options for Hepatitis C infection have greatly improved with direct-acting antiviral (DAA) combinations achieving high cure rates. Nevertheless, the cost of this treatment is still high and access to treatment in many countries has been preferentially reserved for patients with more severe fibrosis (F3 and F4). In this French nationwide study, we investigated the epidemiological characteristics and genotype distribution of hepatitis C virus (HCV) in treatment-naive patients with METAVIR fibrosis stages between F0 and F2 in order to identify patient profiles that became eligible for unrestricted treatment in a second period. Between 2015 and 2016 we collected data from nine French university hospitals on a total of 584 HCV positive patients with absent, mild or moderate liver fibrosis. The most represented genotypes were genotype 1b (159/584; 27.2%), followed by genotype 1a (150/584; 25.7%); genotype 3 (87/584: 14.9%); genotype 4 (80/584; 13.7%). Among genotype 4: 4a was predominantly encountered with 22 patients (27.5% of genotype 4). Genotypes 1b and 1a are currently the most frequent virus types present in treatment-naive patients with mild fibrosis in France. They can be readily cured using the available DAA. Nevertheless, non-a/non-d genotype 4 is also frequent in this population and clinical data on the efficacy of DAA on these subtypes is missing. The GEMHEP is the French group for study and evaluation of viral hepatitis on a national scale. Data collection on epidemiological and molecular aspects of viral hepatitis is performed on a regular basis in all main French teaching hospitals and serves as a basis for surveillance of these infections. Analysis and trends are regularly published on behalf of the GEMHEP group. Data collection was performed retrospectively over the 2015-2016 period, covering nine main university hospitals in France. A total of 584 hepatitis C positive patients were included in this study. Genotyping of the circulating viruses showed a high prevalence of genotypes 1b and 1a in our population. The epidemiology of hepatitis C is slowly changing in France, particularly as a consequence of the rise of 'non-a non-d' genotype 4 viruses mainly originating from African populations. More data concerning treatment efficacy of these genotypes is needed in order to guide clinical care.
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Hepacivirus/isolamento & purificação , Hepatite C Crônica/epidemiologia , Hepatite C Crônica/genética , Cirrose Hepática/epidemiologia , Proteínas Virais/genética , Adulto , Bases de Dados Factuais , Feminino , França/epidemiologia , Genótipo , Hepacivirus/genética , Hepatite C Crônica/diagnóstico , Humanos , Cirrose Hepática/patologia , Cirrose Hepática/virologia , Modelos Logísticos , Masculino , Análise Multivariada , Prevalência , RNA Viral/genética , Estudos Retrospectivos , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Centros de Atenção TerciáriaRESUMO
In this paper, the multimodal nonlinear elastic behavior of concrete, which is representative of a consolidated granular material, is modeled numerically. Starting from a local three-dimensional softening law, the initial stiffness properties are re-estimated according to the local strain field. The experiments deal with samples of thermally damaged concrete blocks successively excited around their first three modes of vibration. The geometry of these samples cannot be described by a one-dimensional approximation in these experiments where compressional and shear motions are strongly coupled. Despite this added complexity, the nonlinear behavior for the three modes of vibration of the samples is well captured by the simulations using a single scalar nonlinear parameter appropriately integrated into the elasticity equations. It is shown that without sufficient attention paid to the latter, the conclusions would have brought erroneous statements such as nonlinearity dispersion or strain type dependence.
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INTRODUCTION: Double-button devices for endoscopic management of acute acromioclavicular joint dislocation (ACJD) provide satisfactory short-term functional and radiological results. However, little exists in the literature regarding the long- and medium-term results of these implants, especially regarding the evolution of the acromioclavicular joint (ACJ). HYPOTHESIS: Satisfactory and steady long- and medium-term outcomes can be achieved in patients with acute ACJD undergoing endoscopically assisted ACJ repair using a single double-button device. MATERIAL AND METHOD: A retrospective single-center study was conducted in patients with acute Rockwood III and IV ACJD treated endoscopically with a single double-button device from October 2008 to October 2010, allowing a minimum 5-year follow-up. Functional evaluation used Constant and Quick-DASH scores. Clinical evidence of dislocation recurrence was combined with bilateral Zanca views to assess coracoclavicular distance. Acromioclavicular osteoarthritis was evaluated on the Paxinos test and Zanca views. RESULTS: Nineteen of the 25 operated patients were seen at a mean 76.9±8.5 months' follow-up. Mean age was 34.4±8.3 years. Mean Constant and Quick-DASH scores were 96.2±5.1 and 0.9±1.6 points, respectively. Four patients had a recurrence of their initial dislocation, 3 of whom had positive Paxinos test, whereas the 15 patients without recurrence had a negative test (p=0.004). Five patients had radiological evidence of ACJ osteoarthritis: all 4 patients with recurrence and 1 without (p=0.001). CONCLUSION: Long- and medium-term radioclinical outcome of endoscopically assisted management of acute ACJD using a single double-button device seems to be satisfactory and steady over time. Recurrence of the initial dislocation appears to be related to onset of degenerative ACJ arthropathy. LEVEL OF EVIDENCE: Therapeutic type IV-Retrospective case series.
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Articulação Acromioclavicular/cirurgia , Artroplastia/instrumentação , Artroplastia/métodos , Fixadores Internos , Luxações Articulares/cirurgia , Articulação Acromioclavicular/diagnóstico por imagem , Articulação Acromioclavicular/fisiopatologia , Adulto , Artroscopia , Feminino , Seguimentos , Humanos , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Osteoartrite/diagnóstico por imagem , Radiografia , Recidiva , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVES: Early detection of Pseudomonas aeruginosa lung positivity is a key element in cystic fibrosis (CF) management. PCR has increased the accuracy of detection of many microorganisms. Clinical relevance of P. aeruginosa quantitative PCR (qPCR) in this context is unclear. Our aim was to determine P. aeruginosa qPCR sensitivity and specificity, and to assess the possible time saved by qPCR in comparison with standard practice (culture). METHODS: A multicentre cohort study was conducted over a 3-year period in 96 patients with CF without chronic P. aeruginosa colonization. Sputum samples were collected at each visit. Conventional culture and two-step qPCR (oprL qPCR and gyrB/ecfX qPCR) were performed for 707 samples. The positivity criteria were based on the qPCR results, defined in a previous study as follow: oprL qPCR positivity alone if bacterial density was <730 CFU/mL or oprL qPCR combined with gyrB/ecfX qPCR if bacterial density was ≥730 CFU/mL. RESULTS: During follow up, 36 of the 96 patients with CF were diagnosed on culture as colonized with P. aeruginosa. This two-step qPCR displayed a sensitivity of 94.3% (95% CI 79.7%-98.6%), and a specificity of 86.3% (95% CI 83.4%-88.7%). It enabled P. aeruginosa acquisition to be diagnosed earlier in 20 patients, providing a median detection time gain of 8 months (interquartile range 3.7-17.6) for them. CONCLUSIONS: Implementing oprL and gyrB/ecfX qPCR in the management of patients with CF allowed earlier detection of first P. aeruginosa lung positivity than culture alone.
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Fibrose Cística/complicações , Diagnóstico Precoce , Técnicas de Diagnóstico Molecular/métodos , Infecções por Pseudomonas/diagnóstico , Pseudomonas aeruginosa/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real/métodos , Adolescente , Técnicas Bacteriológicas/métodos , Criança , Feminino , Humanos , Masculino , Estudos Prospectivos , Sensibilidade e Especificidade , Escarro/microbiologia , Fatores de TempoRESUMO
Group A rotavirus (RVA) is the leading cause of acute gastroenteritis in young children worldwide. A prospective surveillance network has been set up to investigate the virological and clinical features of RVA infections and to detect the emergence of potentially epidemic strains in France. From 2009 to 2014, RVA-positive stool samples were collected from 4800 children <5 years old attending the paediatric emergency units of 16 large hospitals. Rotaviruses were then genotyped by RT-PCR with regard to their outer capsid proteins VP4 and VP7. Genotyping of 4708 RVA showed that G1P[8] strains (62.2%) were predominant. The incidence of G9P[8] (11.5%), G3P[8] (10.4%) and G2P[4] (6.6%) strains varied considerably, whereas G4P[8] (2.7%) strains were circulating mostly locally. Of note, G12P[8] (1.6%) strains emerged during the seasons 2011-12 and 2012-13 with 4.1% and 3.0% prevalence, respectively. Overall, 40 possible zoonotic reassortants, such as G6 (33.3%) and G8 (15.4%) strains, were detected, and were mostly associated with P[6] (67.5%). Analysis of clinical records of 624 hospitalized children and severity scores from 282 of them showed no difference in clinical manifestations or severity in relation to the genotype. The relative stability of RVA genotypes currently co-circulating and the large predominance of P[8] type strains may ensure vaccine effectiveness in France. The surveillance will continue to monitor the emergence of new reassortants that might not respond to current vaccines, all the more so as all genotypes can cause severe infections in infants.
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Doenças Transmissíveis Emergentes , Serviço Hospitalar de Emergência , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/virologia , Rotavirus/genética , Animais , Pré-Escolar , Fezes/virologia , Feminino , França/epidemiologia , Genótipo , Humanos , Lactente , Recém-Nascido , Masculino , Filogenia , Prevalência , Vírus Reordenados , Rotavirus/classificação , Rotavirus/isolamento & purificação , Infecções por Rotavirus/diagnóstico , Estações do Ano , Índice de Gravidade de DoençaRESUMO
This study demonstrates the feasibility of the dynamic acousto-elastic effect of a continuous high frequency wave for investigating the material nonlinearity upon transient vibration. The approach is demonstrated on a concrete sample measuring 15×15×60cm(3). Two ultrasonic transducers (emitter and receiver) are placed at its middle span. A continuous high frequency wave of 500kHz propagates through the material and is modulated with a hammer blow. The position of the hammer blow on the sample is configured to promote the first bending mode of vibration. The use of a continuous wave allows discrete time extraction of the nonlinear behavior by a short-time Fourier transform approach, through the simultaneous comparison of a reference non-modulated signal and an impact-modulated signal. The hammer blow results in phase shifts and variations of signal amplitude between reference and perturbed signals, which are driven by the resonant frequency of the sample. Finally, a comprehensive analysis of the relaxation mechanisms (modulus and attenuation recovery) is conducted to untangle the coupled fast and slow hysteretic effects.
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BACKGROUND: The NS5A protein of the hepatitis C virus has been shown to be involved in the development of hepatocellular carcinoma. OBJECTIVES: In a French multicenter study, we investigated the clinical and epidemiological features of a new HCV genotype 1b strain bearing a wide insertion into the V3 domain. STUDY DESIGN: We studied NS5A gene sequences in 821 French patients infected with genotype 1b HCV. RESULTS: We identified an uncharacterized V3 insertion without ORF disruption in 3.05% of the HCV sequences. The insertion comprised 31 amino-acids for the majority of patients; 3 patients had 27 amino-acids insertions and 1 had a 12 amino-acids insertion. Sequence identity between the 31 amino-acids insertions and the V3 domain ranged from 48 to 96% with E-values above 4e(-5), thus illustrating sequence homology and a partial gene duplication event that to our knowledge has never been reported in HCV. Moreover we showed the presence of the duplication at the time of infection and its persistence at least during 12 years in the entire quasispecies. No association was found with extrahepatic diseases. Conversely, patients with cirrhosis were two times more likely to have HCV with this genetic characteristic (p=0.04). Moreover, its prevalence increased with liver disease severity (from 3.0% in patients without cirrhosis to 9.4% in patients with both cirrhosis and HCC, p for trend=0.045). CONCLUSIONS: We identified a duplicated V3 domain in the HCV-1b NS5A protein for the first time. The duplication may be associated with unfavorable evolution of liver disease including a possible involvement in liver carcinogenesis.
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Carcinoma Hepatocelular/virologia , Hepacivirus/genética , Cirrose Hepática/virologia , Neoplasias Hepáticas/virologia , Mutagênese Insercional , Proteínas não Estruturais Virais/genética , Adulto , Idoso , Estudos Transversais , Feminino , França , Duplicação Gênica , Hepatite C Crônica/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estrutura Terciária de Proteína , RNA Viral/análise , Análise de Sequência de RNA , Proteínas não Estruturais Virais/químicaRESUMO
Developed in the late 1980s, Nonlinear Resonant Ultrasound Spectroscopy (NRUS) has been widely employed in the field of material characterization. Most of the studies assume the measured amplitude to be proportional to the strain amplitude which drives nonlinear phenomena. In 1D resonant bar experiments, the configuration for which NRUS was initially developed, this assumption holds. However, it is not true for samples of general shape which exhibit several resonance mode shapes. This paper proposes a methodology based on linear resonant ultrasound spectroscopy, numerical simulations and nonlinear resonant ultrasound spectroscopy to provide quantitative values of nonlinear elastic moduli taking into account the 3D nature of the samples. In the context of license renewal in the field of nuclear energy, this study aims at providing some quantitative information related to the degree of micro-cracking of concrete and cement based materials in the presence of thermal damage. The resonance based method is validated as regard with concrete microstructure evolution during thermal exposure.
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BACKGROUND: Cervical cancer is caused by persistent infection with high-risk human papillomavirus (HR-HPV). Conventional human papillomavirus (HPV) testing requires cervical sampling. However, vaginal and urine self-sampling methods are more acceptable for patients and result in increased participation when they are available in screening programs. In this context, we have developed a non-invasive screening method via the detection of HPV DNA in urine samples. PURPOSE: To compare HPV viral loads and genotypes in paired cervical and urine samples, and to assess correlation between virological and cytological results in women seeking gynecological consultation. METHODS: Paired urine and cervical specimens were collected and analyzed from 230 of 245 women participating in the previously described prospective PapU study. HPV DNA detection and quantification were performed using a real-time PCR method with short fragment PCR primers. Genotyping was carried out using the INNO-LiPA HPV genotyping assay. RESULTS: The prevalence of HPV in the 230 paired urine and cervical smear samples was 42 and 49 %, respectively. Overall agreement for HPV positivity and negativity between the paired samples was 90 % (κ = 0.80). High HPV viral load in both cervical and urine samples was associated with cytological abnormalities. HPV-positive women were mostly infected with HR-HPV types. The agreement between high- and low-risk HPV (LR-HPV) detection in both samples was 97 % (κ = 0.95 for HR-HPV and κ = 0.97 for LR-HPV). CONCLUSIONS: High concordance rates for HPV-DNA quantification and high/low-risk HPV genotyping in paired urine/cervical samples suggest that urinary HPV DNA testing could be useful for cervical lesion screening.
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Colo do Útero/virologia , DNA Viral/análise , DNA Viral/urina , Testes de DNA para Papilomavírus Humano/métodos , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/virologia , Adolescente , Adulto , Idoso , Feminino , França/epidemiologia , Genótipo , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Gravidez , Prevalência , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , Sensibilidade e Especificidade , Esfregaço Vaginal , Carga ViralRESUMO
AIM: This study aimed to gain a better understanding of the psychological impact of participating in a clinical trial for patients with Pompe disease (Acid Maltase Deficiency). Attitudes and expectations of adult patients with neuromuscular diseases regarding medical trials are as yet unreported. In order to learn about the psychological consequences of participating in a clinical trial, we conducted a prospective assessment of patients with late-onset Pompe Disease, a rare genetic condition, for which no treatment had been available before. This psychological study was carried out as an ancillary study to the randomized double-blind placebo-controlled trial described elsewhere (van der Ploeg et al., 2010). SUBJECTS AND METHODS: We assessed patients (n=8) at inclusion, and at 12 and 18 months for six psychological dimensions: depression (Beck Depression Inventory, BDI), hopelessness (Beck Hopelessness Scale, BHS), anxiety (STAI A-B), quality of life (Whoqol-26), social adjustment (S.A.S-self-report) and locus of control (IPC Levenson). We produced a self-administered questionnaire in order to assess the attitudes, motivations and expectations of patients during the trial. RESULTS: At 12 months, mean social adjustment (SAS-SR, P=0.02) had improved, and at 18 months mean depression score had improved as well (BDI, P=0.03). The quality of life of patients (Whoqol-26) remained unchanged. Throughout the study, patients were more likely to have an internal locus of control than an external one (IPC Levenson). The self-administered questionnaire showed that patients' expectations were disproportionate compared to the medical information they had received starting the trial. For all patients, the first motivation for being enrolled in a clinical trial was "to help research", for half of them the motivation was to "improve their health". Whether patients believed to be part of one group or another (placebo or treatment) depended on their subjective perception of improvement during the trial. CONCLUSION: Given the small sample size, the conclusions of this study are preliminary. However, findings do suggest that there is a positive psychological impact of participating in a treatment trial. Moreover, the patients' reactions upon unblinding have led us to recommend that patients be asked whether they would like their group assignation disclosed to them or not.
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Atitude , Ensaios Clínicos como Assunto/psicologia , Doenças Neuromusculares/psicologia , Participação do Paciente/psicologia , Percepção , Adulto , Idoso , Ensaios Clínicos como Assunto/estatística & dados numéricos , Terapia de Reposição de Enzimas/psicologia , Feminino , Seguimentos , Doença de Depósito de Glicogênio Tipo II/tratamento farmacológico , Doença de Depósito de Glicogênio Tipo II/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Neuromusculares/epidemiologia , Doenças Neuromusculares/terapia , Participação do Paciente/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
Recent studies show the ability of diffuse ultrasound to characterize surface breaking cracks in concrete. However, derived parameters are sensitive to the presence of partially opened zones along the crack whose pattern may differ from one sample to another. The aim of this letter is to study the variation of diffuse ultrasound parameters while the sample is driven by a low frequency bending load which alternatively opens and closes the crack, allowing to access supplementary information about its morphology. The results show the sensitivity of the method for various crack depths and highlight its potential for concrete nondestructive evaluation.
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Materiais de Construção , Arquitetura de Instituições de Saúde , Som , Ultrassom , Estudos de Viabilidade , Teste de Materiais , Modelos Teóricos , Movimento (Física) , Processamento de Sinais Assistido por Computador , Espectrografia do Som , Propriedades de Superfície , Fatores de Tempo , Transdutores , Ultrassom/instrumentaçãoRESUMO
Shewanella putrefaciens is rarely involved in human infectious disease. We report here a case of soft tissue infection with bacteremia on a patient with risk factors (liver cirrhosis, diabetes mellitus).
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Bacteriemia/etiologia , Infecções por Bactérias Gram-Negativas/complicações , Shewanella putrefaciens/fisiologia , Infecções dos Tecidos Moles/etiologia , Idoso , Bacteriemia/diagnóstico , Complicações do Diabetes/etiologia , Complicações do Diabetes/microbiologia , Infecções por Bactérias Gram-Negativas/diagnóstico , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/microbiologia , Masculino , Shewanella putrefaciens/isolamento & purificação , Infecções dos Tecidos Moles/diagnósticoRESUMO
In the frame of the fourth generation forum, France decided to develop sodium fast nuclear reactors. French Safety Authority requests the associated monitoring of argon gas into sodium. This implies to estimate the void fraction, and a histogram indicating the bubble population. In this context, the present letter studies the possibility of achieving an accurate determination of the histogram with acoustic methods. A nonlinear, two-frequency mixing technique has been implemented, and a specific optical device has been developed in order to validate the experimental results. The acoustically reconstructed histograms are in excellent agreement with those obtained using optical methods.
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UNLABELLED: The fight against healthcare-associated infections is based on preventive measures of multidrug resistant bacteria diffusion. Hand hygiene is the simplest and the most effective preventive measure to reduce cross-transmission of infectious agents. Hydroalcoholic solutions for hand hygiene was recently introduced in the University Hospital of Brest (France). The aims of the study were: to describe the epidemiology of healthcare-associated infections due to methicillin-resistant Staphylococcus aureus (MRSA); to determine the annual consumptions of antistaphylococcal antibiotics; and to discuss the relation between consumption of antiseptic products or antibiotics and the epidemiology of MRSA. METHODS: A retrospective epidemiological and pharmaco-epidemiological study was realized from January 2004 to December 2007 in the University Hospital of Brest (France). It allowed to bring to light the cases of healthcare-associated infections due to MRSA and to quantify the consumptions of hang hygiene products and antistaphylococcal antibiotics. RESULTS: this retrospective study showed a decrease of healthcare-associated infections due to MRSA and an increase of the consumption of hydroalcoholic solutions. Antistaphylococcal resistance rates also decreased in a context of fall of the global antibiotics consumption in the hospital.
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Antibacterianos/uso terapêutico , Anti-Infecciosos Locais/farmacologia , Infecção Hospitalar/epidemiologia , Desinfetantes/farmacologia , Desinfecção das Mãos , Hospitais Universitários/estatística & dados numéricos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Sabões/farmacologia , Infecções Estafilocócicas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Clorexidina/análogos & derivados , Clorexidina/farmacologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/transmissão , Uso de Medicamentos/estatística & dados numéricos , Feminino , Géis , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Pessoa de Meia-Idade , Povidona-Iodo/farmacologia , Estudos Retrospectivos , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/prevenção & controle , Infecções Estafilocócicas/transmissãoRESUMO
Vibrio cholerae serogroups O1 or O139 are the aetiological agents of cholera. The pathogenicity of non-O1, non-O139 V. cholerae is less well known. These worldwide bacteria are responsible for gastrointestinal infections or, more rarely, bacteraemia in patients with an underlying disease, leading to life-threatening complications. We report a case of non-O1, non-O139 V. cholerae bacteraemia due to a haemolytic strain in a cirrhotic patient. Early antibiotherapy allowed a good outcome. The aim of this case report is to underline the virulence of non-choleragenic Vibrio strains, possibly linked to haemolysin production, and the potential danger of consuming undercooked seafood or exposing wounds to sea water in cirrhotic patients.
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Bacteriemia/diagnóstico , Cirrose Hepática/complicações , Vibrioses/complicações , Vibrioses/diagnóstico , Vibrio cholerae não O1/isolamento & purificação , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Proteínas de Bactérias/metabolismo , Doenças Transmitidas por Alimentos/microbiologia , Proteínas Hemolisinas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Vibrioses/tratamento farmacológico , Vibrioses/microbiologia , Vibrio cholerae não O1/classificação , Fatores de Virulência/metabolismoRESUMO
The aim of the present letter is to identify the contribution of a macroscopic source of elastic nonlinearity in concrete, a medium which by nature is nonlinear, and belongs to the nonlinear mesoscopic class of materials. The influence of real, localized macro-cracks is characterized with respect to the intrinsic nonlinearity of the material. The influence of the size of the source on the amplitude of the measured nonlinearity is qualitatively demonstrated. A comparison is made between the changes in linear and nonlinear parameters.
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Materiais de Construção/análise , Dinâmica não Linear , Elasticidade , Falha de Equipamento , Análise de Falha de Equipamento , Modelos Lineares , Estresse MecânicoRESUMO
Bethlem myopathy and Ullrich congenital muscular dystrophy are part of the heterogeneous group of collagen VI-related muscle disorders. They are caused by mutations in collagen VI (ColVI) genes (COL6A1, COL6A2, and COL6A3) while LMNA mutations cause autosomal dominant Emery-Dreifuss muscular dystrophy. A muscular dystrophy pattern and contractures are found in all three conditions, making differential diagnosis difficult especially in young patients when cardiomyopathy is absent. We retrospectively assessed upper and lower limb muscle CT scans in 14 Bethlem/Ullrich patients and 13 Emery-Dreifuss patients with identified mutations. CT was able to differentiate Emery-Dreifuss muscular dystrophy from ColVI-related myopathies in selected thigh muscles and to a lesser extent calves muscles: rectus femoris fatty infiltration was selectively present in Bethlem/Ullrich patients while posterior thigh muscles infiltration was more prominently found in Emery-Dreifuss patients. A more severe fatty infiltration particularly in the leg posterior compartment was found in the Emery-Dreifuss group.