Parkinsonian gait in elderly people: Significance of the threshold value of two and more falls per year.

OBJECTIVES: Parkinsonism in the elderly presents a major risk factor for recurrent falls (2 and more falls per year), which is associated with increased morbidity. The main objective was to investigate explanatory variables relating to the risk of being recurrent fallers (RF) in persons with parkinsonian gait. METHODS: Seventy-nine among 172 eligible persons were enrolled in this prospective study, the findings of which were analyzed at 12 months. Motor and non-motor features, as well as follow-up interviews to identify falls, loss of ability to walk, fluctuating cognition, traumatic falls, all-cause hospitalizations and deaths were collated and results compared between non RF (zero and one fall per year) and RF. Bayesian model averaging was used to predict the probability of patients being RF from their medical history as well as from cognitive assessment, gait velocity, vision and posture. RESULTS: N=79, 0.58 men, 50% had Parkinson's disease, 14% other neurodegenerative parkinsonian syndrome, 23% vascular parkinsonism and 13% Lewy body disease, 58% were RF. Median age 81.2 years and median MMSE 25/30. A history of falls and of hallucinations, median odds ratio respectively 9.06 (CI 2.34-38.22), 4.21 (CI 1.04-18.67) were associated with the highest odds ratios along with fluctuating cognition and abnormal posture. Two or more falls a year was a relevant threshold to distinguish a population with a high risk of comorbidity. CONCLUSION: The whole history of falls, hallucinations and fluctuating cognition can be considered predictive of recurrent falls in elderly people with parkinsonian gait and provide a tracking tool for patient management.

Hypertrophic reversed palmaris longus muscle: a cadaveric finding.

Variations of the forearm musculature are vastly described in the literature. The palmaris longus muscle is one of the most variable structures of the human body. It usually arises from the medial epicondyle of the humerus and inserts itself into the palmar aponeurosis. Anatomy textbooks and recent papers state that this muscle may act as a weak wrist flexor. The present work aims to report an anatomical variation where the palmaris longus muscle was abnormally hypertrophied and was completely fleshy throughout the whole forearm. Anatomical variations of the palmaris longus may induce symptoms of neurovascular bundle compression, especially of the median nerve. The palmaris longus muscle may be used in tendon graft or muscle graft, due to its lack of apparent function. Furthermore, it is one of the anatomical landmarks for local anaesthesia procedures. (Folia Morphol 2018; 77, 2: 403-405).

Real time monitoring of water level and temperature in storage fuel pools through optical fibre sensors.

We present an innovative architecture of a Rayleigh-based optical fibre sensor for the monitoring of water level and temperature inside storage nuclear fuel pools. This sensor, able to withstand the harsh constraints encountered under accidental conditions such as those pointed-out during the Fukushima-Daiichi event (temperature up to 100 °C and radiation dose level up to ~20 kGy), exploits the Optical Frequency Domain Reflectometry technique to remotely monitor a radiation resistant silica-based optical fibre i.e. its sensing probe. We validate the efficiency and the robustness of water level measurements, which are extrapolated from the temperature profile along the fibre length, in a dedicated test bench allowing the simulation of the environmental operating and accidental conditions. The conceived prototype ensures an easy, practical and no invasive integration into existing nuclear facilities. The obtained results represent a significant breakthrough and comfort the ability of the developed system to overcome both operating and accidental constraints providing the distributed profiles of the water level (0-to-5 m) and temperature (20-to-100 °C) with a resolution that in accidental condition is better than 3 cm and of ~0.5 °C respectively. These new sensors will be able, as safeguards, to contribute and reinforce the safety in existing and future nuclear power plants.

Radiation effects on optical frequency domain reflectometry fiber-based sensor.

We investigate the radiation effects on germanosilicate optical fiber acting as the sensing element of optical frequency domain reflectometry devices. Thanks to a new setup permitting to control temperature during irradiation, we evaluate the changes induced by 10 keV x rays on their Rayleigh response up to 1 MGy in a temperature range from -40°C up to 75°C. Irradiation at fixed temperature points out that its measure is reliable during both irradiation and the recovery process. Mixed temperature and radiation measurements show that changing irradiation temperature leads to an error in distributed measurements that depends on the calibration procedure. These results demonstrate that Rayleigh-based optical fiber sensors are very promising for integration in harsh environments.

Vulnerability of OFDR-based distributed sensors to high γ-ray doses.

Vulnerability of Optical Frequency Domain Reflectometry (OFDR) based sensors to high γ-ray doses (up to 10 MGy) is evaluated with a specific issue of a radiation-hardened temperature and strain monitoring system for nuclear industry. For this, we characterize the main radiation effects that are expected to degrade the sensor performances in such applicative domain: the radiation-induced attenuation (RIA), the possible evolution with the dose of the Rayleigh scattering phenomenon as well as its dependence on temperature and strain. This preliminary investigation is done after the irradiation and for five different optical fiber types covering the range from radiation-hardened fibers to highly radiation sensitive ones. Our results show that at these high dose levels the scattering mechanism at the basis of the used technique for the monitoring is unaffected (changes below 5%), authorizing acceptable precision on the temperature or strain measurements. RIA has to be considered as it limits the sensing range. From our vulnerability study, the OFDR sensors appear as promising candidates for nuclear industry even at doses as high as 10 MGy.

Radiation tolerant fiber Bragg gratings for high temperature monitoring at MGy dose levels.

We report a method for fabricating fiber Bragg gratings (FBG) resistant to very severe environments mixing high radiation doses (up to 3 MGy) and high temperatures (up to 230°C). Such FBGs have been written in two types of radiation resistant optical fibers (pure-silica and fluorine-doped cores) by exposures to a 800 nm femtosecond IR laser at power exceeding 500 mW and then subjected to a thermal annealing treatment of 15 min at 750°C. Under radiation, our study reveals that the radiation induced Bragg wavelength shift (BWS) at a 3 MGy dose is strongly reduced compared to responses of FBGs written with nonoptimized conditions. The BWS remains lower than 10 pm for temperatures of irradiation ranging from 25°C to 230°C without noticeable decrease of the FBG peak amplitude. For an applicative point of view, this radiation induced BWS corresponds to an additional error on the temperature measurements lower than 1.5°C, opening the way to the development of radiation-tolerant multi-point temperature sensors for nuclear industry.

[Treatment of a case of multiple tooth agenesis: an orthodontic and implant solution]. / Traitement d'un cas d'agénésies dentaires multiples: solution orthodontique et implantaire.

Now, the excellent long term results observed in oral implantology allow use of implants in young people. They change habitual prosthetic indications which need healthy teeth mutilations. The authors present a case of multiple dental agenesis in a young girl. She was treated by orthodontic preparation and implants with a good final result (2 years end treatment follow up).

Geographical distribution and recent changes in world supply of vitamin A.

Deficiency of vitamin A mainly affects infants and children up to the age of five years, and is often associated with protein-energy deficiency. The earliest symptom is night blindness. The most serious clinical manifestation is xerophthalmia which, depending upon the severity of the deficiency, may lead to partial or total blindness. Hypovitaminosis A is in fact a major cause of preventable blindness and must therefore be considered a serious public health problem. Hypovitaminosis A occurs in many developing countries and is particularly prevalent in South and East Asia. While the incidence and degree of severity varies from country to country, the population groups most affected are those of low socioeconomic status, usually with defective diets and living in poor sanitary environments. Poor dietary intake, however, appears to be the principal factor. The analysis that follows assesses the dynamics of the potential per caput supply situation as revealed by aggregate data at national level.