[Relationship between vaping and smoking among 15-year-olds in high school. Results of a descriptive cross-sectional and monocentric observational study conducted in the metropolitan area of Saint-Étienne]. / Relations entre vapotage et tabagisme chez les adolescents en classe de seconde. Résultats d'une étude observationnelle descriptive transversale et monocentrique menée dans l'agglomération stéphanoise.

INTRODUCTION: The initiation of smoking among adolescents by vaping is a subject of controversy. This study focuses on the prevalence of electronic cigarette use among teenagers and its connection with the consumption of tobacco. METHODS: A cross-sectional and monocentric study was conducted in the spring of 2018 and included 1435 students (15-16years old) from the metropolitan area of Saint-Étienne in France. RESULTS: Nearly half of the adolescents experimented with e-cigarettes (50.30%) or tobacco (50.40%). Nearly a quarter are vapers (23.60%) or smokers (28.20%), with low daily use (3.65% for vaping and 9.40% for smoking). In regard to the link between smoking and vaping, 64.85% of adolescents are "non-smokers and non-vapers", 17.60% "smokers and vapers", 11.25% "smokers and non-vapers", and 6.30% "non-smokers and vapers". DISCUSSION: The portrait-types of the vaper and the smoker are similar: boy rather than girl, educated in private school rather than public, and enrolled in a vocational rather than a general educational course. On one hand, the use of electronic cigarettes in non-smoking adolescents does not appear to be a major mode of entry into smoking or nicotine addiction. On the other hand, the use of electronic cigarettes among adolescent's smokers seems to have a beneficial effect on their smoking habit (stopping or reducing the consumption of tobacco).

Control strategy for carbapenemase-producing Enterobacteriaceae in nursing homes: perspectives inspired from three outbreaks.

Three outbreaks of carbapenemase-producing Enterobacteriaceae (CPE) in three nursing homes in western France were retrospectively assessed. In all, ten cases of colonization or infection with CPE were detected upon admission in neighbouring hospitals. Antibiotic consumption or high frailty was infrequent among them. Nursing homes should be included in a regional strategy to limit CPE spread.

Measuring the impact of the pet trade on Indonesian birds.

The trade in wild animals involves one-third of the world's bird species and thousands of other vertebrate species. Although a few species are imperiled as a result of the wildlife trade, the lack of field studies makes it difficult to gauge how serious a threat it is to biodiversity. We used data on changes in bird abundances across space and time and information from trapper interviews to evaluate the effects of trapping wild birds for the pet trade in Sumatra, Indonesia. To analyze changes in bird abundance over time, we used data gathered over 14 years of repeated bird surveys in a 900-ha forest in southern Sumatra. In northern Sumatra, we surveyed birds along a gradient of trapping accessibility, from the edge of roads to 5 km into the forest interior. We interviewed 49 bird trappers in northern Sumatra to learn which species they targeted and how far they went into the forest to trap. We used prices from Sumatran bird markets as a proxy for demand and, therefore, trapping pressure. Market price was a significant predictor of species declines over time in southern Sumatra (e.g., given a market price increase of approximately $50, the log change in abundance per year decreased by 0.06 on average). This result indicates a link between the market-based pet trade and community-wide species declines. In northern Sumatra, price and change in abundance were not related to remoteness (distance from the nearest road). However, based on our field surveys, high-value species were rare or absent across this region. The median maximum distance trappers went into the forest each day was 5.0 km. This suggests that trapping has depleted bird populations across our remoteness gradient. We found that less than half of Sumatra's remaining forests are >5 km from a major road. Our results suggest that trapping for the pet trade threatens birds in Sumatra. Given the popularity of pet birds across Southeast Asia, additional studies are urgently needed to determine the extent and magnitude of the threat posed by the pet trade.

A new species of Muscicapa flycatcher from Sulawesi, Indonesia.

The Indonesian island of Sulawesi, a globally important hotspot of avian endemism, has been relatively poorly studied ornithologically, to the extent that several new bird species from the region have been described to science only recently, and others have been observed and photographed, but never before collected or named to science. One of these is a new species of Muscicapa flycatcher that has been observed on several occasions since 1997. We collected two specimens in Central Sulawesi in 2012, and based on a combination of morphological, vocal and genetic characters, we describe the new species herein, more than 15 years after the first observations. The new species is superficially similar to the highly migratory, boreal-breeding Gray-streaked Flycatcher Muscicapa griseisticta, which winters in Sulawesi; however, the new species differs strongly from M. griseisticta in several morphological characters, song, and mtDNA. Based on mtDNA, the new species is only distantly related to M. griseisticta, instead being a member of the M. dauurica clade. The new species is evidently widely distributed in lowland and submontane forest throughout Sulawesi. This wide distribution coupled with the species' apparent tolerance of disturbed habitats suggests it is not currently threatened with extinction.

Does prior conservative surgery affect survivorship and functional outcome in total hip arthroplasty for congenital dislocation of the hip? A case-control study in 159 hips.

INTRODUCTION: The results of total hip arthroplasty (THA) in congenital dislocation of the hip (CDH) are well known, but such is not the case for the impact of prior conservative surgery on THA function and survivorship. The present study compared THA in CDH with prior conservative bone surgery (BS group) versus no prior bone surgery (NBS group), to (1) assess the impact of prior conservative surgery on function and survivorship after THA, and (2) determine whether a particular type of conservative surgery affected function or survivorship. HYPOTHESIS: Prior conservative surgery for CDH does not affect function or survivorship of subsequent THA. PATIENTS AND METHODS: A multicenter retrospective case-control study analyzed 430 THAs in CDH patients (332 patients: 269 female, 63 male; mean age, 56 years [range, 17-80 years]) at a mean 13.2±5.4 years' follow-up (range, 1-29 years). The BS group included 159 hips (37%) (64 pelvic, 81 femoral and 14 combined pelvic and femoral osteotomies), and the NBS group 271 (63%). Groups were comparable for gender, age at surgery, Devane activity score, preoperative Postel Merle d'Aubigné (PMA) functional score and CDH radiographic type following Crowe. RESULTS: At follow-up, PMA scores were comparable: BS, 16.8±1.4 (11-18); NBS, 16.9±1.5 (7-18). Fifteen-year survivorship censored for implant revision for whatever reason did not significantly differ: BS, 87% (95% CI: 83-91%); NBS, 89% (95% CI: 86-92%). Ten-year survivorship on the same criterion did not significantly differ according to type of prior surgery: hip shelf arthroplasty, 97% (95% CI: 95-99%); Chiari osteotomy, 100%; femoral osteotomy, 95% (95% CI: 92-98%); and Milch osteotomy 96% (95% CI: 93-99%). DISCUSSION/CONCLUSION: Conservative surgery for CDH does not impair the functional results or survivorship of subsequent THA. LEVEL OF EVIDENCE: III, case-control study.

Simulated birdwatchers' playback affects the behavior of two tropical birds.

Although recreational birdwatchers may benefit conservation by generating interest in birds, they may also have negative effects. One such potentially negative impact is the widespread use of recorded vocalizations, or "playback," to attract birds of interest, including range-restricted and threatened species. Although playback has been widely used to test hypotheses about the evolution of behavior, no peer-reviewed study has examined the impacts of playback in a birdwatching context on avian behavior. We studied the effects of simulated birdwatchers' playback on the vocal behavior of Plain-tailed Wrens Thryothorus euophrys and Rufous Antpittas Grallaria rufula in Ecuador. Study species' vocal behavior was monitored for an hour after playing either a single bout of five minutes of song or a control treatment of background noise. We also studied the effects of daily five minute playback on five groups of wrens over 20 days. In single bout experiments, antpittas made more vocalizations of all types, except for trills, after playback compared to controls. Wrens sang more duets after playback, but did not produce more contact calls. In repeated playback experiments, wren responses were strong at first, but hardly detectable by day 12. During the study, one study group built a nest, apparently unperturbed, near a playback site. The playback-induced habituation and changes in vocal behavior we observed suggest that scientists should consider birdwatching activity when selecting research sites so that results are not biased by birdwatchers' playback. Increased vocalizations after playback could be interpreted as a negative effect of playback if birds expend energy, become stressed, or divert time from other activities. In contrast, the habituation we documented suggests that frequent, regular birdwatchers' playback may have minor effects on wren behavior.

Pollen diversity matters: revealing the neglected effect of pollen diversity on fitness in fragmented landscapes.

Few studies have documented the impacts of habitat fragmentation on plant mating patterns together with fitness. Yet, these processes require urgent attention to better understand the impact of contemporary landscape change on biodiversity and for guiding native plant genetic resource management. We examined these relationships using the predominantly insect-pollinated Eucalyptus socialis. Progeny were collected from trees located in three increasingly disturbed landscapes in southern Australia and were planted out in common garden experiments. We show that individual mating patterns were increasingly impacted by lower conspecific density caused by habitat fragmentation. We determined that reduced pollen diversity probably has effects over and above those of inbreeding on progeny fitness. This provides an alternative mechanistic explanation for the indirect density dependence often inferred between conspecific density and offspring fitness.

Comparison of the outcome following the fixation of osteotomies or fractures associated with total hip replacement using cables or wires: the results at five years.

There are no recent studies comparing cable with wire for the fixation of osteotomies or fractures in total hip replacement (THR). Our objective was to evaluate the five-year clinical and radiological outcomes and complication rates of the two techniques. We undertook a review including all primary and revision THRs performed in one hospital between 1996 and 2005 using cable or wire fixation. Clinical and radiological evaluation was performed five years post-operatively. Cables were used in 51 THRs and wires in 126, and of these, 36 THRs with cable (71%) and 101 with wire (80%) were evaluated at follow-up. The five-year radiographs available for 33 cable and 91 wire THRs revealed rates of breakage of fixation of 12 of 33 (36%) and 42 of 91 (46%), respectively. With cable there was a significantly higher risk of metal debris (68% vs. 9%; adjusted relative risk (RR) 6.6; 95% confidence interval (CI) 3.0 to 14.1), nonunion (36% vs. 21%; adjusted RR 2.0; 95% CI 1.0 to 3.9) and osteolysis around the material, acetabulum or femur (61% vs 19%; adjusted RR 3.9; 95% CI 2.3 to 6.5). Cable breakage increased the risk of osteolysis to 83%. There was a trend towards foreign-body reaction and increased infection with cables. Clinical results did not differ between the groups. In conclusion, we found a higher incidence of complications and a trend towards increased infection and foreign-body reaction with the use of cables.

Gold and iron oxide hybrid nanocomposite materials.

This critical review provides an overview of current research activities that focused on the synthesis and application of multi-functional gold and iron oxide (Au-Fe(x)O(y)) hybrid nanoparticles and nanocomposites. An introduction of synthetic strategies that have been developed for generating Au-Fe(x)O(y) nanocomposites with different nanostructures is presented. Surface functionalisation and bioconjugation of these hybrid nanoparticles and nanocomposites are also reviewed. A variety of applications such as theranostics, gene delivery, biosensing, cell sorting, bio-separation, and catalysis is discussed and highlighted. Finally, future trends and perspectives of these sophisticated nanocomposites are outlined. Underpinning the fundamental requirements for effectively forming Au-Fe(x)O(y) hybrid nanocomposite materials would shed light on future development of nanotheranostics, nanomedicines, and chemical technologies. It would be interesting to investigate such multi-component composite nanomaterials with different novel morphologies in the near future to advance chemistry, biology, medicine, and engineering multi-disciplinary research (120 references).

The world's rediscovered species: back from the brink?

Each year, numerous species thought to have disappeared are rediscovered. Yet, do these rediscoveries represent the return of viable populations or the delayed extinction of doomed species? We document the number, distribution and conservation status of rediscovered amphibian, bird, and mammal species globally. Over the past 122 years, at least 351 species have been rediscovered, most occurring in the tropics. These species, on average, were missing for 61 years before being rediscovered (range of 3-331 years). The number of rediscoveries per year increased over time and the majority of these rediscoveries represent first documentations since their original description. Most rediscovered species have restricted ranges and small populations, and 92% of amphibians, 86% of birds, and 86% of mammals are highly threatened, independent of how long they were missing or when they were rediscovered. Under the current trends of widespread habitat loss, particularly in the tropics, most rediscovered species remain on the brink of extinction.

Component impingement in total hip arthroplasty: frequency and risk factors. A continuous retrieval analysis series of 416 cup.

INTRODUCTION: Impingement is a factor of failure in total hip replacement (THR), causing instability and early wear. Its true frequency is not known; cup-retrieval series reported rates varying from 27 to 84%. HYPOTHESIS: The hypothesis was that a large continuous series of THR cup removals would help determine the frequency of component impingement. OBJECTIVES: The hypothesis was tested on a continuous retrospective series of cups removed in a single center, with a secondary objective of identifying risk factors. MATERIAL AND METHODS: [corrected] Macroscopic examination looked for component impingement signs in 416 cups retrieved by a single operator between 1989 and 2004. Risk factors were investigated by uni- and multivariate analyses in the 311 cases for which there were complete demographic data. In these 311 cases, removal was for aseptic loosening (131 cases), infection (43 cases), instability (56 cases), osteolysis (28 cases) or unexplained pain (48 cases); impingement was explicitly implicated in only five cases (1.6%), always with hard-on-hard bearing components. RESULTS: Impingement was found in 214 of the 416 cups (51.4%) and was severe (notch>1mm) in 130 (31.3%). In the subpopulation of 311 cups, impingement was found in 184 cases (59.2%) and was severe in 109 (35%). Neither duration of implant use nor cup diameter or frontal orientation emerged as risk factors. On univariate analysis, impingement was more frequently associated with revision for instability, young patient age at THR, global hip range of motion >200° or use of an extended femoral head flange (or of an elevated antidislocation rim liner), and was more severe in case of head/neck ratio<2. On multivariate analysis, only use of an extended head flange (RR 3.2) and revision for instability (RR 4.2) remained as independent risk factors for impingement. DISCUSSION: Component impingement is frequently observed in cups after removal, but is rarely found as a direct indication for revision, except in case of hard-on-hard friction couples (polyethylene being the most impingement-tolerant material). Systematic use of extended head flanges and elevated antidislocation rims is not to be recommended, especially in case of excessive ROM. A good head/neck ratio should be sought, notably by increasing the head diameter in less impingement-tolerant hard-on-hard friction couples. Although not identified as a risk factor in the present study, implant orientation should be checked; computer-assisted surgery can be useful in this regard, for adaptation to the patient's individual range-of-motion cone.

Shelf arthroplasties long-term outcome: influence of labral tears. A prospective study at a minimal 16 years' follows up.

INTRODUCTION: Osteoarthritis lesions extent and dysplasia severity (negative vertical center edge [CE] angle) are recognized as unfavorable criteria for the survival of shelf arthroplasties performed for correcting hip dysplasia. Labral tears have recently been described on dysplastic hips, indicating beginning osteoarthritis and worsening the risk of instability. HYPOTHESIS: The labral tears identified in the course of shelf arthroplasty procedures for correction of hip dysplasia carry a predictive value for the survival of this operation. OBJECTIVES: Evaluate this hypothesis at the intermediate term in a long-term prospective observational study. PATIENT AND METHODS: Eighteen adult patients (18 dysplastic hips) having undergone shelf arthroplasty were included consecutively in a continuous prospective study. At the time the shelf arthroplasty was performed, a hip arthroscopic exam was carried out to search for and resect a labral tear if necessary. Fifteen patients were reviewed with a minimum follow-up of 16 years. Two patients died and one patient was lost to follow-up. RESULTS: During arthroscopic exploration, 10 hips presented labral tears (55.6%). At a mean follow-up of 16.3 years (range, 16-18 years), eight hips underwent hip arthroplasty. Of these hips, only one did not present a labral tear. The seven other hips had a tear of the labrum (p<0.001). The overall survival rate was 41.3%; it was 83.3% for hips with no labral tear and 15.2% for hips with a lesion of the labrum (p=0.048). DISCUSSION AND CONCLUSION: Labral tears had a negative impact on the outcome of shelf arthroplasty for hip dysplasia. This lesion therefore warrants being sought using appropriate exploration techniques (MRI or CT-arthrography) before shelf arthroplasty surgery. The existence of a preoperative labral tear does not seem to cast doubt on shelf arthroplasty itself. However, it should be identified so as to set objectives and expectations: long-term survival is significantly lower in the presence of a labral tear. It seems preferable to repair this type of lesion with arthroscopic guidance during shelf arthroplasty to prevent a potential source of residual pain, keeping in mind that secondary resection will be more difficult after covering the lesion. LEVEL OF EVIDENCE: Level 3 prospective observational prognostic study.

The Durom large diameter head acetabular component: early results with a large-diameter metal-on-metal bearing.

Implantation of a large-diameter femoral head prosthesis with a metal-on-metal bearing surface reduces the risk of dislocation, increases the range of movement, minimises the risk of impingement and, in theory, results in little wear. Between February 2004 and March 2007 we implanted 100 consecutive total hip replacements with a metal-on-metal bearing and a large femoral head into 92 patients. There were 51 men and 41 women with a mean age of 50 years (18 to 70) at the time of surgery. Outcome was assessed using the Western Ontario McMaster University osteoarthritis index and the Harris hip score as well as the Devane activity score. These all improved significantly (p < 0.0001). At the last follow-up there were no cases of dislocation, no impingement, a good range of movement and no osteolysis, but seven revisions, two for infection and five for aseptic loosening. The probability of groin pain increased if the other acetabular component inclination exceeded 50 degrees (p = 0.0007). At 4.8 years of follow-up, the projected survival of the Durom acetabular component, with revision for any reason, was 92.4% (sd 2.8) (95% confidence interval 89.6 to 95.2). The design of the component made it difficult both to orientate and seat, which when combined with a poor porous coating, produced unpredictable fixation and a low survival at five years.

[A new type of acetabular fracture: "true" posterosuperior fracture, a case report]. / Nouvelle variété de fracture postéro-supérieure de l'acétabulum: stratégie thérapeutique à propos d'un cas.

We report a new variety of acetabular fracture. This posterosuperior fracture affected the acetabular roof and the iliac wing as other superior fractures and presented a supplementary fracture line disjoining the major part of the posterior wall. Two our knowledge, in a series of 940 fractures of the acetabulum, Letournel alone described two cases of superior fractures involving the roof with a slightly anterior fracture line in the iliac wing but with an intact posterior wall in both cases. The patient was treated by osteosynthesis via the iliofemoral approach described by Judet-Letournel. This approach was warranted to achieve simultaneous exposure of both columns and the posterior wall which was separated from the proximal fragment by a secondary fracture line. At six months, the functional result was considered good as assessed by the Postel-Merle-d'Aubigné score. This case widens the Letournel classification and emphasizes the importance of computed tomography to evaluate, in superior fractures of the acetabulum, the volume of the posterior wall fragment and its continuity with the cranial portion of the acetabulum and the iliac wing. For fixation, the surgical approach must be chosen individually according to the position of the fracture lines visualized on the preoperative computed tomography.

[Contribution to subscapularis nerve supply. 18 dissections]. / Contribution à l'innervation du muscle subscapulaire. A propos de 18 dissections.

INTRODUCTION: Dividing the subscapularis muscle along its fibers axis allows approaching the glenohumeral joint. The more medial its division, the more possible injury of its nerve supply. AIM: The aim of our study was to assess the subscapularis nerve supply through cartography of the entry points of subscapularis nerves from simple landmarks, reproducible by triangulation. MATERIAL AND METHODS: On 18 formalin-preserved shoulders, after dissection of the subscapularis nerves, distances were measured between entry points of subscapularis nerves and the following landmarks: center of the minor tubercle (tm), upper and lower poles of the glenoid cavity (cgs and cgi), apex of the coracoid process (pc). RESULTS: There were in average 3.33 subscapularis nerves (2-4). These different nerves split most often before entering subscapularis muscle; there were in average 5.05 entry points (3-6). Distances between entry points and clinical landmarks were as follows: cgs, 3.9-6.45 cm; cgi, 3.7-5.54 cm; tm, 5.9-7.15 cm; pc, 4.9-7.66 cm. Reporting these measurements onto a frame allowed to show that all these points were located in average medially to the scapular notch and at more than 3 cm from the anterior border of the glenoid cavity. CONCLUSION: If the transverse division does not extend farther than 3 cm from the anterior border of the glenoid cavity and from the medial border of the root of the coracoid process, there should not be any injury of the subscapularis nerves.

Hashimoto's encephalopathy: exacerbations associated with menstrual cycle.

The authors report a patient who had five relapses of encephalopathy with seizures and aseptic meningitis that coincided with the end of the menstrual cycle. High titers of antithyroid antibodies and the patient's response to corticosteroids suggested Hashimoto's encephalopathy. Pharmacologic suppression of the menstrual cycle made it possible to withdraw corticosteroids.

Three-dimensional imaging laser radar with a photon-counting avalanche photodiode array and microchip laser.

We have developed a threedimensional imaging laser radar featuring 3-cm range resolution and single-photon sensitivity. This prototype direct-detection laser radar employs compact, all-solid-state technology for the laser and detector array. The source is a Nd:YAG microchip laser that is diode pumped, passively Q-switched, and frequency doubled. The detector is a gated, passively quenched, two-dimensional array of silicon avalanche photodiodes operating in Geigermode. After describing the system in detail, we present a three-dimensional image, derive performance characteristics, and discuss our plans for future imaging three-dimensional laser radars.

Noninvasive pressure support ventilation (NIPSV) with face mask in patients with acute cardiogenic pulmonary edema (ACPE)

OBJECTIVES: To assess (1) the short-term hemodynamic, respiratory and arterial blood gas effects of NIPSV in patients with ACPE who were likely to require endotracheal intubation, (2) the initial causes of failure and (3) the side effects and the difficulties of this technique. DESIGN: Uncontrolled, prospective clinical study. SETTING: Teaching hospital intensive care unit. PATIENTS: 26 consecutive patients with severe ACPE. INTERVENTIONS: Noninvasive ventilation via a face mask, using a pressure support mode (20.5+/-4.7 cm H2O), with an initial fractional inspired oxygen of 93.0+/-16% and a positive end-expiratory pressure of 3.5+/-2.3 cm H2O. The need to intubate the patients within 48 h was considered as a criterion of failure of the procedure. MEASUREMENTS AND RESULTS: Clinical and biological parameters were measured at 15 and 30 minutes, 1 h and 2 h and at 1 h and 2 h, respectively. There were 5 (21%) failures and 21 (79%) successes. In both the success and the failure groups, clinical and blood gas parameters improved at the first measure. In the success group, within 15 min of the start of NIPSV, pulse oximetry saturation (SpO2) had increased from 84+/-12 to 96+/-4% (p<0.001), the respiratory rate (RR) had decreased from 36+/-5.3 to 22.4+/-4.9 breaths/ min (p<0.0001) and within 1 h the arterial oxygen tension and pH, respectively, had increased from 61+/-14 to 270+/-126 mm Hg (p<0.0001) and from 7.25+/-0.11 to 7.34+/-0.07 (p<0.01) and the arterial carbon dioxide tension (PaCO2) had decreased from 54.2+/-15 to 43.4+/-6.4 mm Hg (p<0.01). There were no statistical differences between the success and failure groups for the initial clinical parameters: SpO2, RR, heart rate, mean arterial pressure. The only differences between the success and failure groups were in the PaCO2 (54.2+/-15 vs. 32+/-2.1 mm Hg, p<0.001) and the creatine kinase (CPK) (176+/-149 vs. 1282+/-2080 IU/l, p<0.05); this difference in CPK activity was related to the number of patients who had an acute myocardial infarction (AMI) (4/5 in the failure group vs. 2/21 in the success group, p<0.05). All patients with AMI in the failure group died. CONCLUSION: Among patients in acute respiratory failure, those with severe ACPE could benefit from NIPSV if they are hypercapnic, but NIPSV should be avoided in those with AMI.