Chiral Spin Texture in the Charge-Density-Wave Phase of the Correlated Metallic Pb/Si(111) Monolayer.

We investigate the 1/3 monolayer α-Pb/Si(111) surface by scanning tunneling spectroscopy (STS) and fully relativistic first-principles calculations. We study both the high-temperature sqrt[3]×sqrt[3] and low-temperature 3×3 reconstructions and show that, in both phases, the spin-orbit interaction leads to an energy splitting as large as 25% of the valence-band bandwidth. Relativistic effects, electronic correlations, and Pb-substrate interaction cooperate to stabilize a correlated low-temperature paramagnetic phase with well-developed lower and upper Hubbard bands coexisting with 3×3 periodicity. By comparing the Fourier transform of STS conductance maps at the Fermi level with calculated quasiparticle interference from nonmagnetic impurities, we demonstrate the occurrence of two large hexagonal Fermi sheets with in-plane spin polarizations and opposite helicities.

The effect of body weight on intravenous diltiazem in patients with atrial fibrillation with rapid ventricular response.

WHAT IS KNOWN AND OBJECTIVES: To assess the effect of body weight on the total dose of intravenous (IV) diltiazem needed to reach goal heart rate (HR) for atrial fibrillation (Afib) with rapid ventricular response (RVR) in the emergency department (ED) setting. METHODS: A single-center retrospective cohort was ascertained using electronic medical record data from January 2013 to December 2016. Inclusion criteria consisted of new onset Afib with RVR, receipt of IV diltiazem in the ED, and age ≥18 years old. The primary outcome was the total dose of diltiazem needed to reach goal HR <100, stratified by patients who were <100 kg and those ≥100 kg. The secondary outcome was the total time required to reach goal HR. Demographic, clinical and medication-related data were collected, including selected safety endpoints. RESULTS AND DISCUSSION: A total of 328 patients were included. Patients required a mean of 30.1 mg (±24.6) of diltiazem and 2.3 hours (±2.9) to reach goal HR. The total dose of diltiazem was similar for patients <100 kg and ≥100 kg (28.7 vs 34.3 mg; P = .068) as was the time to reach goal HR (2.3 vs 2.3 hours; P = .949), respectively. No differences were noted in incidence of hypotension, bradycardia or need for additional rate control agents. WHAT IS NEW AND CONCLUSION: No difference in the total amount of diltiazem or time to reach goal HR was found in patients according to body weight stratification.

[Emerging uropathogens: Point for urologists and biologists]. / Mise au point : les uropathogènes émergents.

INTRODUCTION: Technological advances during the last years in bacterial identification by molecular biology and mass spectrometry, or Matrix Assisted Laser Desorption Ionisation-Time of Flight (MALDI-TOF) have allowed identifying new bacteria involved in urinary tract infections. The purpose of this review is to familiarize clinicians with these bacteria so that they can look at a particular target population and help biologists to suspect and identify them. METHOD: A bibliographic research was performed using the Medline database concerning the keywords Aerococcus, Actinobaculum, Alloscardovia, Trueperella. RESULTS: If Aerococcus sp. is now well known, Actinobaculum sp., Alloscardovia sp. and Trueperella sp. remain rarely isolated and unknown from clinicians. Importance of these germs could be underestimated because of the identifying and isolation difficulties which existed beforehand. They are particularly found in a population of elderly people with underlying conditions or urological risk factors of urinary tract infection. Actinobaculum schaalii is also found more frequently in young children. CONCLUSION: Aerococcus sp. et A. schaalii are true uropathogens not to be underestimated. Further studies are still needed to confirm the specific involvement of Trueperella and Alloscardovia in urinary diseases.

Picometer-scale surface roughness measurements inside hollow glass fibres.

A differential profilometry technique is adapted to the problem of measuring the roughness of hollow glass fibres by use of immersion objectives and index-matching liquid. The technique can achieve picometer level sensitivity. Cross validation with AFM measurements is obtained through use of vitreous silica step calibration samples. Measurements on the inner surfaces of fibre-sized glass capillaries drawn from high purity suprasil F300 tubes show a sub-nanometer roughness, and the roughness power spectrum measured in the range [5 · 10(-3) m(-1) 10(-1) m(-1)] is consistent with the description of the glass surface as a superposition of frozen capillary waves. The surface roughness spectrum of two capillary tubes of differing compositions can be quantitatively distinguished.

[The Onco-hematology clinical research unit at the Geneva University Hospital: example of a fruitful public-private partners]. / L'Unité de recherche clinique en onco-hématologie aux HUG: un exemple réussi de partenariat public-privé.

A better understanding of the molecular deregulation leading to carcinogenesis allows the development of numerous novel targeted therapeutic candidates. Clinical research in oncology is a critical step to evaluate in a thorough manner the safety and efficacy of these innovative compounds. During the last four years the fruitful partnership between the Geneva University Hospitals and the Dr. Henri Dubois-Ferriere Dinu Lipatti Foundation lead to a dedicated clinical research unit for cancer patients with a staff of ten people. Since 2010, more than 300 patients were enrolled in more than 70 distinct clinical trials evaluating novel therapies for both solid tumors and hematologic malignancies. Interestingly, classical cytostatic drugs now represent only a small fraction of the new anti-cancer therapies in the pipeline.

Scanning tunneling spectroscopy study of the proximity effect in a disordered two-dimensional metal.

The proximity effect between a superconductor and a highly diffusive two-dimensional metal is revealed in a scanning tunneling spectroscopy experiment. The in situ elaborated samples consist of superconducting single crystalline Pb islands interconnected by a nonsuperconducting atomically thin disordered Pb wetting layer. In the vicinity of each superconducting island the wetting layer acquires specific tunneling characteristics which reflect the interplay between the proximity-induced superconductivity and the inherent electron correlations of this ultimate diffusive two-dimensional metal. The observed spatial evolution of the tunneling spectra is accounted for theoretically by combining the Usadel equations with the theory of dynamical Coulomb blockade; the relevant length and energy scales are extracted and found in agreement with available experimental data.

Fungal spore concentrations in two haematopoietic stem cell transplantation (HSCT) units containing distinct air control systems.

Invasive fungal diseases have emerged as important causes of morbidity and mortality in haematological patients. In this study air samples were collected in two haematopoietic stem cell transplantation (HSCT) units, in which distinct air-control systems were in place. In hospital 1 no high-efficiency particulate air (HEPA) filter was available whereas in hospital 2 HSCT rooms were equipped with HEPA filters, with positive air pressure in relation to the corridor. A total of 117 samples from rooms, toilets and corridors were obtained during December 2009 to January 2011, using a six-stage Andersen sampler. In both hospitals, the concentration of potentially pathogenic fungi in the air was reduced in patients' rooms compared to corridors (P < 0·0001). Despite the presence of a HEPA filter in hospital 2, rooms in both hospitals showed similar concentrations of potentially pathogenic fungi (P = 0·714). These findings may be explained by the implementation of additional protective measures in hospital 1, emphasizing the importance of such measures in protected environments.

Telomeric localization of TRF2, a novel human telobox protein.

Natural chromosomal ends are stabilized by proteins that bind duplex telomeric DNA repeats. In human cells, the TTAGGG Repeat Factor 1 (TRF1) was identified by two independent studies, one screening for factors that bind duplex telomeric DNA and the other screening for proteins containing a particular Myb motif called the telobox, which is required for telomeric repeat recognition (Fig. 1a; refs 3-5). A second human open reading frame, orf2, contains a telobox sequence and encodes a polypeptide that specifically recognizes mammalian telomeric repeat DNA in vitro. We show that two proteins of 65 and 69 kD, expressed in HeLa cells, contain the orf2 telobox sequence. These proteins are collectively termed TRF2. Affinity-purified antibodies specific for anti-TRF2 label the telomeres of intact human chromosomes, strengthening the correlation between occurrence of telobox and telomere-repeat recognition in vivo.

Evidence of growing spatial correlations during the aging of glassy glycerol.

We have measured, as a function of the age t(a), the aging of the nonlinear dielectric susceptibility χ(3) of glycerol below the glass transition. Whereas the linear susceptibility can be accurately accounted for in terms of an age dependent relaxation time τ(α)(t(a)), this scaling breaks down for χ(3), suggesting an increase of the amplitude of χ(3). This is a strong indication that the number N(corr) of molecules involved in relaxation events increases with t(a). For T=0.96×T(g), we find that N(corr) increases by ~10% when t(a) varies from 1 to 100 ks. This sheds new light on the relation between length scales and time scales in glasses.

Epidemiology and clinical characteristics of Klebsiella spp. meningitis in France.

OBJECTIVES: To describe the epidemiology of Klebsiella spp. meningitis in France with respect to clinical and bacteriological data. METHODS: We performed a four-year multicenter, retrospective, observational study. The primary objective was to provide a clinical description of patients with Klebsiella spp. meningitis. Secondary objectives were to compare community-acquired meningitis and healthcare-associated meningitis and to analyze factors associated with mortality. RESULTS: We enrolled 131 patients with Klebsiella spp. meningitis. Eighty-two (62.6%) infections were reported following neurosurgery. Twenty-eight strains (21.4%) were resistant to third-generation cephalosporins (3GC). The median [IQR] cellularity was 980/mm3 [116-5550], the median protein level was 5.67 [1.62-9] g/L and the median CSF glucose level was 2.5 [0-3.4] mmol/L. The in-hospital mortality rate was 23.6%. Community-acquired meningitis isolates were more frequently susceptible to 3GC than isolates from healthcare-associated meningitis (89.2% versus 72%; P=0.04). Comorbidities reported for patients with community-acquired meningitis were mainly diabetes mellitus and liver cirrhosis. In multivariate analysis, focal neurological disorder at the time of diagnosis was the only factor associated with in-hospital mortality (P=0.01). CONCLUSIONS: Purulent meningitis caused by Klebsiella spp. needs to be considered in patients with community-acquired meningitis and preexisting conditions, as well as in case of meningitis following neurosurgical procedures.

Third harmonics nonlinear susceptibility in supercooled liquids: a comparison to the box model.

The box model, originally introduced to account for the nonresonant hole burning (NHB) dielectric experiments in supercooled liquids, is compared to the measurements of the third harmonics P(3) of the polarisation, reported recently in glycerol, close to the glass transition temperature T(g) [C. Crauste-Thibierge, C. Brun, F. Ladieu, D. L'Hôte, G. Biroli, and J.-P. Bouchaud, Phys. Rev. Lett. 104, 165703 (2010)]. In this model, each box is a distinct dynamical relaxing entity (hereafter called dynamical heterogeneity (DH)) which follows a Debye dynamics with its own relaxation time τ(dh). When it is submitted to a strong electric field, the model posits that a temperature increase δT(dh), depending on τ(dh), arises due to the dissipation of the electrical power. Each DH has thus its own temperature increase, on top of the temperature increase of the phonon bath δT(ph). Contrary to the "fast" hole burning experiments where δT(ph) is usually neglected, the P(3) measurements are, from a thermal point of view, fully in a stationary regime, which means that δT(ph) can no longer be neglected a priori. This is why the version of the box model that we study here takes δT(ph) into account, which implies that the δT(dh) of the DHs are all coupled together. The value of P(3), including both the "intrinsic" contribution of each DH as well as the "spurious" one coming from δT(ph), is computed within this box model and compared to the P(3) measurements for glycerol, in the same range of frequencies and temperatures T. Qualitatively, we find that this version of the box model shares with experiments some nontrivial features, e.g., the existence of a peak at finite frequency in the modulus of P(3) as well as its order of magnitude. Quantitatively, however, some experimental features are not accounted for by this model. We show that these differences between the model and the experiments do not come from δT(ph) but from the "intrinsic" contribution of the DHs. Finally, we show that the interferences between the 3ω response of the various DHs are the most important issue leading to the discrepancies between the box model prediction and the experiments. We argue that this could explain why the box model is quite successful to account for some kinds of nonlinear experiments (such as NHB) performed close to T(g), even if it does not completely account for all of them (such as the P(3) measurements). This conclusion is supported by an analytical argument which helps understanding how a "space-free" model as the box model is able to account for some of the experimental nonlinear features.

Real-world implementation of a geriatric-specific ERAS protocol in patients undergoing colonic cancer surgery.

BACKGROUND: The aim of this single-center observational study was to evaluate the impact of implementing Enhanced Recovery After Surgery (ERAS) protocols, combined with systematic geriatric assessment and support, on surgical and oncological outcomes in patients aged 70 or older undergoing colonic cancer surgery. METHODS: Two groups were formed from an actively maintained database from all patients undergoing laparoscopic colonic surgery for neoplasms during a defined period before (standard group) or after (ERAS group) the introduction of an ERAS program associated with systematic geriatric assessment. The primary outcome was postoperative 90-day morbidity. Secondary outcomes were total length of hospital stay, initiated and completed adjuvant chemotherapy (AC) rate, and 1-year mortality rate. RESULTS: A total of 266 patients (135 standard and 131 ERAS) were included in the study. Overall 90-day morbidity and mean hospital stay were significantly lower in the ERAS group than in the standard group (22.1% vs. 35.6%, p = 0.02; and 6.2 vs. 9.3 days, p < 0.01, respectively). There were no differences in readmission rates and anastomotic complications. AC was recommended in 114 patients. The rate of initiated treatment was comparable between the groups (66.6% vs. 77.7%, p = 0.69). The rate of completed AC was significantly higher in the ERAS group (50% vs. 20%, p < 0.01) with a lower toxicity rate (57.1% vs. 87.5%, p = 0.002). The 1-year mortality rate was higher in the standard group (7.4% vs. 0.8%, p < 0.01). CONCLUSIONS: The combination of ERAS protocols and geriatric assessment and support reduces the overall morbidity rate and improves 12-month oncologic outcomes.

A re-innervated in vitro skin model of non-histaminergic itch and skin neurogenic inflammation: PAR2-, TRPV1- and TRPA1-agonist induced functionality.

Background: Skin, and epidermis, is innervated by sensory nerve fibres. Interactions between them and signal transduction are only partially elucidated in physiological/pathological conditions, especially in pruritus. Objectives: To study the mechanisms involved in pruritus in vitro, we developed a skin explant model re-innervated by sensory neurons. Methods: This model is based on the co-culture of human skin explants and sensory neurons from dorsal root ganglia of rats. Innervation and the expression of protease activated receptor 2 (PAR2), transient receptor potential vanilloid 1 (TRPV1) and transient receptor potential ankyrin one (TRPA1) was analysed by immunostaining. The response of the model to TRPV1, PAR2 and TRPA1 agonists was analysed by patch-clamp, qPCR and enzyme-linked immunosorbent assay. Results: After 5 days of re-innervating nerve fibres was evidenced in the epidermis. Re-innervation was correlated with decrease of epidermal thickness and the number of apoptotic cells in the tissue. The major actors of non-histaminergic itch (PAR-2, thymic stromal lymphopoietin [TSLP], TSLP-R, TRPA1 and TRPV1) were expressed in neurons and/or epidermal cells of skin explants. After topical exposure of TRPV1-(Capsaicin), TRPA1-(Polygodial) and PAR2-agonist (SLIGKV-NH2) activation of reinnervating neurons could be shown in patch-clamp analysis. The release of TSLP was increased with capsaicin or SLIGKV but decreased with polygodial. Release of CGRP was increased by capsaicin and polygodial but decreased with SLIGKV. Activation by SLIGKV showed a decrease of VEGF; polygodial induced an increase of TSLP, Tumour necrosis factor (TNF) and nerve growth factor and capsaicin lead to a decrease of sema3 and TNF expression. Conclusion: The present model is suitable for studying itch and neurogenic inflammation pathways in vitro. We observed that activation of TRPV1, TRPA1 and PAR-2 leads to different response profiles in re-innervated skin explants.

Evidence of growing spatial correlations at the glass transition from nonlinear response experiments.

The ac nonlinear dielectric response chi3(omega,T) of glycerol was measured close to its glass transition temperature T(g) to investigate the prediction that supercooled liquids respond in an increasingly nonlinear way as the dynamics slows down (as spin glasses do). We find that chi3(omega,T) indeed displays several nontrivial features. It is peaked as a function of the frequency omega and obeys scaling as a function of omega tau(T), with tau(T) the relaxation time of the liquid. The height of the peak, proportional to the number of dynamically correlated molecules N(corr)(T), increases as the system becomes glassy, and chi3 decays as a power law of omega over several decades beyond the peak. These findings confirm the collective nature of the glassy dynamics and provide the first direct estimate of the T dependence of N(corr).

Study of the heating effect contribution to the nonlinear dielectric response of a supercooled liquid.

We present a detailed study of the heating effects in dielectric measurements carried out on a liquid. Such effects come from the dissipation of the electric power in the liquid and give contribution to the nonlinear third harmonics susceptibility χ(3), which depends on the frequency and temperature. This study is used to evaluate a possible "spurious" contribution to the recently measured nonlinear susceptibility of an archetypical glassforming liquid (glycerol). Those measurements have been shown to give a direct evaluation of the number of dynamically correlated molecules temperature dependence close to the glass transition temperature T(g) ≈ 190 K [Crauste-Thibierge et al., Phys. Rev. Lett. 104, 165703 (2010)]. We show that the heating contribution is totally negligible (i) below 204 K at any frequency; (ii) for any temperature at the frequency where the third harmonics response χ(3) is maximum. Besides, this heating contribution does not scale as a function of f/f(α), with f(α)(T) the relaxation frequency of the liquid. In the high frequency range, when f/f(α) ≥ 1, we find that the heating contribution is damped because the dipoles cannot follow instantaneously the temperature modulation due to the heating phenomenon. An estimate of the magnitude of this damping is given.

[Pays de la Loire Pneumococcus Observatory: antimicrobial resistance of Streptococcus pneumoniae in 2007]. / Observatoire régional du pneumocoque en région Pays de la Loire: résistance de Streptococcus pneumoniae aux antibiotiques en 2007.

OBJECTIVES: Between 1st January and 31st December 2007, 331 Streptococcus pneumoniae strains were collected from 20 participating laboratories in the Pneumococcus Network Pays de la Loire county to assess their susceptibility to antibiotics and to evaluate serogroups of strains. METHOD: The coordinating centre performed MICs of penicillin G, amoxicillin and cefotaxime by the reference agar dilution method. Results were interpreted according to CA-SFM breakpoints. Sensitivity to other antibiotics were studied and serotyping of each strain performed. RESULTS: Three hundred and thirty one strains were isolated in 2007. They were collected from 30 cerebrospinal fluids, 239 blood samples, 53 middle ear fluids and nine pleural fluids. The percentage of pneumococci with decreased susceptibility to penicillin G (PDSP) was 39% and was higher in children (51%) than in adults (35%). The PDSP were often multidrug resistants especially with a high percentage of resistance to erythromycin (87.6% versus 8.4% for pneumococci sensitive to penicillin G). Finally, the most prevalent serogroup was the serogroup 19 (29.6% of isolates). CONCLUSION: A decrease of PDSP was observed since 2001 and high-level resistant strains to beta-lactams remain low. The rate of PDSP in Pays de la Loire is in the national average.

Fosfomycin, from susceptibility to resistance: Impact of the new guidelines on breakpoints.

The fosfomycin breakpoint using the disc diffusion method (DDM) changed in the 2019 CA-SFM/EUCAST guidelines v2 (24mm versus 19mm). We assessed its impact on categorization of Enterobacterales recovered from urine samples in emergency departments. A total of 7749 and 2348 strains were tested using the DDM and the broth microdilution method (BMD), respectively. The DDM with the 19-mm breakpoint was in accordance with the BMD. Using the 24-mm breakpoint, the overall rate of fosfomycin resistance in Enterobacterales increased by three-fold (5.6% vs 18.1%, P<0.01) and reached 2.8% and 86.5% in E. coli and K. pneumoniae, respectively. French guidelines for the management of community-acquired UTI remain appropriate. The accuracy of the methods for routine fosfomycin susceptibility testing should be assessed. The role of fosfomycin in the treatment of documented CA-UTI due to Enterobacterales other than E. coli should be evaluated considering its rate of resistance and recent data reporting low accuracy.

From sequence to chromosome: the tip of the X chromosome of D. melanogaster.

One of the rewards of having a Drosophila melanogaster whole-genome sequence will be the potential to understand the molecular bases for structural features of chromosomes that have been a long-standing puzzle. Analysis of 2.6 megabases of sequence from the tip of the X chromosome of Drosophila identifies 273 genes. Cloned DNAs from the characteristic bulbous structure at the tip of the X chromosome in the region of the broad complex display an unusual pattern of in situ hybridization. Sequence analysis revealed that this region comprises 154 kilobases of DNA flanked by 1.2-kilobases of inverted repeats, each composed of a 350-base pair satellite related element. Thus, some aspects of chromosome structure appear to be revealed directly within the DNA sequence itself.

Atherosclerosis knowledge of general practice residents: Diagnosis and management in primary care.

OBJECTIVES: Cardiovascular diseases represent the leading cause of death worldwide. In a previous survey, we have shown that the management of patients with atherosclerosis by general practitioners depends on the locations of the disease. The aim of this survey was to assess general practice residents' (GPR) knowledge on three clinical presentations which are ischemic stroke, coronary artery disease (CAD), and peripheral artery disease (PAD). MATERIALS AND METHODS: Between May 2017 and September 2017, a national self-administered survey that we previously used to assess the GPs' knowledge was emailed to GPRs from French medicine faculties. The questionnaire was composed of three clinical cases dealing with transient ischemic attack (TIA), stable angina (SA) and intermittent claudication (IC). Each clinical case was explored by seven similar questions. The primary endpoint was the number of GPRs who correctly answered 5 of the 7 questions for each clinical case. RESULTS: Five hundred and fifty-three GPRs (10%) answered the questionnaire entirely. There is a significant difference between TIA knowledge (19.9% of correct answers) which is greater than SA knowledge (0.9%) and IC knowledge (0.4%). The diagnosis was correctly done by 525 (94.9%) GPRs for TIA, 513 (92.8%) for SA, and 532 (96.2%) for IC. The main difficulties encountered by the GPRs concerned complementary investigations and treatment. CONCLUSION: As for general practitioners, this study reveals a difference in GPRs' knowledge depending on the location of the atherosclerosis. Considering the results, the improvement of initial training and continuing medical education (CME) in general medicine would be desirable.

[Use of 4D-CT: Main technical aspects and clinical benefits]. / Utilisation de la scanographie quadridimensionnelle : principaux aspects techniques et intérêts cliniques.

The four-dimensional scannography, also called 4D-CT, was created in the early 2000s. This method enables the aquistion of CT-scans synchronised with the patient's breathing. It allows an anatomical observation depending on the time. Different systems have been marketed. They are commonly used in treatment planning. It allows to take into account respiratory motion, considering the changes of shape and position of the tumor and organs. In the age of new techniques and stereotactic irradiations, 4D-CT is a valuable tool for estimating the uncertainties associated with respiratory movements, This technique also presents some limitations, including artifacts. The quality of the examination can be degraded in some patients with irregular respiration. Here we propose a summary of this technique detailing its principle of operation, its advantages and its main limits.