Demonstration of tritium adsorption on graphene.

In this work, we report on studies of graphene exposed to tritium gas in a controlled environment. The single layer graphene on a SiO2/Si substrate was exposed to 400 mbar of T2, for a total time of ∼55 h. The resistivity of the graphene sample was measured in situ during tritium exposure using the van der Pauw method. We found that the sheet resistance increases by three orders of magnitude during the exposure, suggesting significant chemisorption of tritium. After exposure, the samples were characterised ex situ via spatio-chemical mapping with a confocal Raman microscope, to study the effect of tritium on the graphene structure (tritiation yielding T-graphene), as well as the homogeneity of modifications across the whole area of the graphene film. The Raman spectra after tritium exposure were comparable to previously observed results in hydrogen-loading experiments, carried out by other groups. By thermal annealing we also could demonstrate, using Raman spectral analysis, that the structural changes were largely reversible. Considering all observations, we conclude that the graphene film was at least partially tritiated during the tritium exposure, and that the graphene film by and large withstands the bombardment by electrons from the ß-decay of tritium, as well as by energetic primary and secondary ions.

Elizabethkingia anophelis outbreak in France.

OBJECTIVE: We report an outbreak of Elizabethkingia anophelis infections in France. To the best of our knowledge, this is the first outbreak described in Europe. METHODS: Each E. anophelis-positive microbiological sample was considered a case. All patients were hospitalized in an infectious diseases unit. Clinical, environmental, and microbiological investigations (MALDI-TOF mass spectrometry, PCR, E-test) were performed for each case. RESULTS: Twenty cases were reported from September 2020 to September 2021, mainly community-acquired infections, responsible for nine deaths. The phylogenetic analysis showed a clonal origin and excluded nosocomial transmission. Despite the analysis of multiple environmental specimens, no source of contamination was identified. All strains were highly resistant to cefotaxime, ceftazidime, and imipenem. CONCLUSIONS: Clinicians and microbiologists should be aware of this multidrug-resistant bacterium, capable of causing severe infections. Most strains showed the lowest minimum inhibitory concentration values for cotrimoxazole and ciprofloxacin, making them the best choice for empirical antibiotic therapy.

Pneumocystis exhalation by infants developing Pneumocystis primary infection: putative infectious sources in hospitals and the community.

Pneumocystis jirovecii DNA was detected using a polymerase chain reaction assay in air samples collected using an air-liquid impaction device at 1 m distance from three out of 14 infants who had developed Pneumocystis primary infection. P. jirovecii genotype identification was successful in one out of three pairs of air samples. Matching of P. jirovecii genotypes between the nasopharyngeal and air samples suggested that P. jirovecii was effectively exhaled by the infected infant. These original results represent a proof of concept of the role of infants with primary pneumocystis infection as infectious sources of P. jirovecii in hospitals and in the community.

Clinical course and prognostic factors across different musculoskeletal pain sites: A secondary analysis of individual patient data from randomised clinical trials.

BACKGROUND: Previous research has identified similar prognostic factors in patients with musculoskeletal (MSK) conditions regardless of pain presentation, generating opportunities for management based on prognosis rather than specific pain presentation. METHODS: Data from seven RCTs (2483 participants) evaluating a range of primary care interventions for different MSK pain conditions were used to investigate the course of symptoms and explore similarities and differences in predictors of outcome. The value of pain site for predicting changes in pain and function was investigated and compared with that of age, gender, social class, pain duration, widespread pain and level of anxiety/depression. RESULTS: Over the initial three months of follow-up, changes in mean pain intensity reflected an improvement, with little change occurring after this period. Participants with knee pain due to osteoarthritis (OA) showed poorer long-term outcome (mean difference in pain reduction at 12 months -1.85, 95% CI -2.12 to -1.57, compared to low back pain). Increasing age, manual work, longer pain duration, widespread pain and increasing anxiety/depression scores were significantly associated with poorer outcome regardless of pain site. Testing of interactions showed some variation between pain sites, particularly for knee OA, where age, manual work and pain duration were most strongly associated with outcome. CONCLUSIONS: Despite some differences in prognostic factors for trial participants with knee OA who were older and had more chronic conditions, similarity of outcome predictors across regional MSK pain sites provides evidence to support targeting of treatment based on prognostic factors rather than site of pain. SIGNIFICANCE: Individual patient data analysis of trials across different regional musculoskeletal pain sites was used to evaluate course and prognostic factors associated with pain and disability. Overall, similarity of outcome predictors across these different pain sites supports targeting of treatment based on prognostic factors rather than pain site alone.

Risk factors for persistent pain after urological surgery.

OBJECTIVE: Ten to 50% of patients with post-surgical pain develop chronic pain depending on the type of surgery. The objective of this study was to assess the incidence of persistent post-surgical pain (PPSP) and to identify risk factors following urology surgery. DESIGN: Retrospective observational study. PATIENTS: Two hundred and twenty-eight patients scheduled for urology surgery. Reasons for non-inclusions: patients who underwent a procedure not defined as being associated with PPSP. METHODS: Surgical urologic procedures potentially associated with PPSP were defined. All patients who had one of these procedures during the study period received a questionnaire by mail at least 3 months after the surgery. The files of these patients were retrospectively studied. RESULTS: Eight percent of the patients had preoperative pain. PPSP, assessed approximately 6 months after the surgery, was reported by 24% of the patients. Twenty-five (36%) of them reported neuropathic pain. Patients with PPSP had significantly more preoperative pain and an increased postoperative morphine consumption. Postoperative NSAID administration led to less persistent pain. Multivariate logistic regression analysis identified two independent risk factors of developing persistent pain: preoperative pain (OR=21.6, 95% CI 6.7-69.5, P<0.0001), morphine consumption 48 hours after surgery higher than 6mg (OR=2.3, 95% CI 1.2-4.3, P=0.0118). CONCLUSION: These findings confirm the role of preoperative pain and morphine consumption in the genesis of PPSP and call for establishing clinical perioperative pathways tailored to the patient.

Multidimensional subtypes and treatment outcome in first-time DWI offenders.

The concurrent and predictive validity of Type A and B alcoholism subtypes was evaluated in 246 first-time driving-while-intoxicated (DWI) offenders. K-means analysis indicated that a two-cluster solution was optimal with Type Bs (28%) exhibiting greater premorbid risk factors, alcohol and psychosocial severity, drinking consequences, psychopathology, higher stage of change, and less coping confidence in comparison to less severe Type As (72%). After baseline assessment, participants were randomly assigned to one of three 10-week group treatments (DWI Education, Coping Skills, Interactional), and reassessed at termination, and at 6-month and 1-year follow-ups. Type B was associated with more severe symptoms after treatment, but there was no evidence for patient-treatment matching effects. Although Type A/B may be an important theoretical model for guiding alcoholism research, it usefulness and efficiency for treatment matching, planning, or placement purposes is questioned.

[Resuscitation in severe hepatic injuries]. / La réanimation des traumatismes hépatiques graves.

Hepatic injuries account for about 45% of all abdominal traumas and for 30 to 40% of penetrating abdominal injuries. In 60% of the cases, they are associated with other lesions, especially life-threatening head injuries. Abdominal ultrasonography, a short and safe procedure enabling guided puncture, has developed rapidly relegating to the second rank other diagnostic techniques such as peritoneal lavage and CT scan. First line treatment of severe trauma complicated by haemorragic shock combines fluid resuscitation, prevention of hypothermia and administration of broad spectrum antibiotics. Surgical care, relying mainly on perihepatic packing and vascular exclusion techniques must remain as conservative as possible. Once haemodynamics have been stabilized in patients who do not present any other abdominal lesion requiring laparotomy, the non-interventional attitude is often successful and bears lower morbidity.

[Value of the renal graft as a function of blood creatinine of the donors]. / Valeur du greffon rénal en fonction de la créatininémie du donneur.

In a series of 851 renal transplantations, the fate of the grafted kidneys was studied in relation to the donors' renal function. The actuarial survival curves of the grafts showed no significant difference at 24 months between donors with blood creatinine levels below or above 150 mumol.l-1. Seventy-five of the 99 kidneys obtained from donors with high blood creatinine were functioning at 2 years. It would appear that the classical doubts about renal procurement from donors with high blood creatinine levels should be reconsidered.

[Spontaneous rupture of the esophagus]. / La rupture spontanée de l'oesophage.

Eighteen patients (16 men and two women), aged 20 to 77 years, were admitted to the University hospital between 1973 and 1984 for a Boerhaave's syndrome. Fourteen over eighteen were more than forty years old. Other particular features were the frequency of alcoholism (11 patients) and the lack of preexisting gastrointestinal symptomatology. The cardinal symptom, pain, occurred in 17 cases. It was preceded in 10 subjects by vomiting. Subcutaneous emphysema was only found in five patients, but standard chest X-ray showed seven times a pneumomediastinum. Pleural effusion was present in 14 subjects. Thirteen patients underwent thoracotomy: five within 48 h (1 death) and eight after 48 h (4 deaths); two further deaths were due to withholding surgery, and a third by performing bipolar oesophageal exclusion at a late stage (8th day); six of these deaths were related to local infection. The clinical and radiological features of Boerhaave's syndrome are presented in a review of the literature; particular attention is paid to the various methods of treatment.

[Effects of administering diets with starch or sucrose basis on certain parameters of calcium metabolism in the young, growing rat]. / Etude, chez le jeune rat en croissance, des effets de l'administration d'un régime a base d'amidon ou de saccharose sur certains paramètres du métabolisme calcique

The important role of many carbohydrates on calcium metabolism has been demonstrated by FOURNIER and DUPUIS. Starch, however, neither influences the absorption nor the retention of calcium. Less is known about the effects of sucrose. In this study the influence of starch on calcium metabolsim has been compared with that of sucrose. Male weanling Wistar rats were divided into three groups according to their diets. The first group received a refined and well-balanced diet (except for the absence of vitamin D), containing 68 p. 100 of starch. The second group received the same diet except sucrose was substituted for the starch. The third group received the same diet as Group 1, with the addition of vitamin D. Plasma calcium citrate and urinary citrate and calcium were determined. At the age of 2 months after one night of fasting, each group of rats was injected intraperitoneally with a 1 ml, aqueous solution containing 1 mg calcium and 0, 6 mu Ci45Ca. Twenty-four hours later the animals were sacrificed and the calcium femur percentage, radioactivity p. 1,000 of the injected dose of 45Ca, and specific radioactivity were determined. When performance data from Group 3 were compared to Group 1 and Group 2, the following results were obtained: --Group 1 (starch diet without vitamin D) had very low plasma calcium levels; urinary calcium, plasma citrate and urinary citrate levels were lowered, and the calcium femur percentage was smaller. Bone avidity for calcium was found. --Group 2 (sucrose diet without vitamin D) had normal plasma calcium levels. Urinary calcium and citrate and plasma citrate did not show significant differences from those of animals receiving vitamin D. No significant differences were found in the specific radioactivity and radioactivity p. 1,000 of the administered dose. Contrary to starch, sucrose maintained calcium homeostasis, and apparently, normal ossification, although the femur was lighter than those of animals receiving vitamin D. Further work is necessary to determine whether the fructose component of the sucrose molecule is responsible for the increased calcium utilization and, if so, what levels of ingestion are necessary for this activity.