Normative values of the DASH questionnaire in healthy individuals over 50 years of age.

This study aimed to define the normative values of the DASH score in healthy individuals over 50 years of age. One hundred and twenty subjects equally representing both genders and six age categories (50-54, 55-59, 60-64, 65-69, 70-74 and 75-80 years), with no past medical history affecting the upper limb, were asked to complete the DASH questionnaire. A visual analogue scale for pain and an HAQ-DI questionnaire were also completed to confirm the absence of symptomatic untreated upper limb pathologies. In this series of a priori normal subjects, most had a DASH score greater than 0. Moreover, the DASH score was found to rise with age, with a statistically significant difference between women and men. The DASH questionnaire is widely accepted in the everyday medical practice as a tool to evaluate upper limb function. However, age adjustment of the DASH questionnaire is necessary to correctly evaluate the clinical status and progression of individuals over the age of 50.

Amino-nanopolystyrene exposures of oyster (Crassostrea gigas) embryos induced no apparent intergenerational effects.

Early life stages (ELS) of numerous marine invertebrates mustcope with man-made contaminants, including plastic debris, during their pelagic phase. Among the diversity of plastic particles, nano-sized debris, known as nanoplastics, can induce effects with severe outcomes in ELS of various biological models, including the Pacific oyster Crassostrea gigas. Here, we investigated the effects of a sub-lethal dose (0.1 µg mL-1) of 50 nm polystyrene nanobeads (nano-PS) with amine functions on oyster embryos (24 h exposure) and we assessed consequences on larval and adult performances over two generations of oysters. Only a few effects were observed. Lipid analyses revealed that first-generation (G1) embryos exposed to nano-PS displayed a relative increase in cardiolipin content (+9.7%), suggesting a potential modification of mitochondrial functioning. G1-larvae issued from exposed embryos showed decreases in larval growth (-9%) and lipid storage (-20%). No effect was observed at the G1 adult stage in terms of growth, ecophysiological parameters (clearance and respiration rates, absorption efficiency), or reproductive outputs (gonadic development, gamete quality). Second generation (G2) larvae issued from control G1 displayed a significant growth reduction after G2 embryonic exposure to nano-PS (-24%) compared to control (as observed at the first generation), while no intergenerational effect was detected on G2 larvae issued from G1 exposed embryos. Overall, the present experimental study suggests a low incidence of a short embryonic exposure to nano-PS on oyster phenotypes along the entire life cycle until the next larval generation.

Characterization and calibration of a multilayer coated Wolter optic for an imager on the Z-machine at Sandia National Laboratories.

The need for a time-resolved monochromatic x-ray imaging diagnostic at photon energies >15 keV has motivated the development of a Wolter optic to study x-ray sources on the Z-machine at Sandia National Laboratories. The work is performed in both the LLNL's x-ray calibration facility and SNL's micro-focus x-ray lab. Characterizations and calibrations include alignment, measurement of throughput within the field of view (FOV), the point-spread function within the FOV both in and out of focus, and bandpass in the FOV. These results are compared with ray tracing models, showing reasonable agreement.

Design and raytrace simulations of a multilayer-coated Wolter x-ray optic for the Z machine at Sandia National Laboratories.

Recent breakthroughs in the fabrication of small-radii Wolter optics for astrophysics allow high energy density facilities to consider such optics as novel x-ray diagnostics at photon energies of 15-50 keV. Recently, the Lawrence Livermore National Laboratory, Sandia National Laboratories (SNL), the Smithsonian Astrophysical Observatory, and the NASA Marshall Space Flight Center jointly developed and fabricated the first custom Wolter microscope for implementation in SNL's Z machine with optimized sensitivity at 17.5 keV. To achieve spatial resolution of order 100-200 microns over a field of view of 5 × 5 × 5 mm3 with high throughput and narrow energy bandpass, the geometry of the optic and its multilayer required careful design and optimization. While the geometry mainly influences resolution and the field of view of the diagnostic, the mirror coating determines the spectral response and throughput. Here we outline the details of the design and fabrication process for the first multilayer-coated Wolter I optic for SNL's Z machine (Z Wolter), including its W/Si multilayer, and present results of raytrace simulations completed to predict and verify the performance of the optic.

An x-ray optic calibration facility for high energy density diagnostics.

A facility to calibrate x-ray imaging optics was built at Lawrence Livermore National Laboratory to support high energy density (HED) and inertial confinement fusion (ICF) diagnostics such as those at the National Ignition Facility and the Sandia Z-Machine. Calibration of the spectral reflectivity and resolution of these x-ray diagnostics enable absolute determination of the x-ray flux and wavelengths generated in the HED and ICF experiments. Measurement of the optic point spread function is used to determine spatial resolution of the optic. This facility was constructed to measure (1) the x-ray reflectivity to ±5% over a spectral range from 5 to 60 keV; (2) point spread functions with a resolution of 50 µm (currently) and 13 µm (future) in the image plane; and (3) optic distance relative to the x-ray source and detector to within ±100 µm in each dimension. This article describes the capabilities of the calibration facility, concept of operations, and initial data from selected x-ray optics.

A Wolter imager on the Z machine to diagnose warm x-ray sources.

A new Wolter x-ray imager has been developed for the Z machine to study the emission of warm (>15 keV) x-ray sources. A Wolter optic has been adapted from observational astronomy and medical imaging, which uses curved x-ray mirrors to form a 2D image of a source with 5 × 5 × 5 mm3 field-of-view and measured 60-300-µm resolution on-axis. The mirrors consist of a multilayer that create a narrow bandpass around the Mo Kα lines at 17.5 keV. We provide an overview of the instrument design and measured imaging performance. In addition, we present the first data from the instrument of a Mo wire array z-pinch on the Z machine, demonstrating improvements in spatial resolution and a 350-4100× increase in the signal over previous pinhole imaging techniques.

Advanced phosphorus removal via coagulation, flocculation and microsieve filtration in tertiary treatment.

The applicability of microsieve technology together with coagulation and flocculation for advanced phosphorus removal was investigated. A pilot unit including a microsieve with 10 µm mesh size was operated continuously with secondary effluent from Ruhleben wastewater treatment plant in Berlin. By applying a pretreatment of 0.07-0.09 mmol/L (as metal) coagulant and 1.5-2 mg/L cationic polymer, total phosphorus values below 80 µg/L were achieved. Coagulation with polyaluminum chloride (PACl) produced a better effluent quality compared to FeCl3, as less suspended solids and less residual coagulant were found in the microsieve effluent. In addition, the transmittance of UV radiation through the water was improved by using PACl. The produced amount of backwash water was always below 3% (on average 1.6%). Under optimized mixing conditions, polymer doses of 0.6 mg/L were possible without losses in water quality and filtration performance. Microsieving with chemical pretreatment is a viable option for high quality effluent polishing.

A new time and space resolved transmission spectrometer for research in inertial confinement fusion and radiation source development.

We describe the design and function of a new time and space resolved x-ray spectrometer for use in Z-pinch inertial confinement fusion and radiation source development experiments. The spectrometer is designed to measure x-rays in the range of 0.5-1.5 Å (8-25 keV) with a spectral resolution λ/Δλ ∼ 400. The purpose of this spectrometer is to measure the time- and one-dimensional space-dependent electron temperature and density during stagnation. These relatively high photon energies are required to escape the dense plasma created at stagnation and to obtain sensitivity to electron temperatures ≳3 keV. The spectrometer is of the Cauchois type, employing a large 30 × 36 mm2, transmissive quartz optic for which a novel solid beryllium holder was designed. The performance of the crystal was verified using offline tests, and the integrated system was tested using experiments on the Z pulsed power accelerator.

ß-arrestin-1 participates in thrombosis and regulates integrin aIIbß3 signalling without affecting P2Y receptors desensitisation and function.

ß-arrestin-1 (ß-arr1) and ß-arrestin-2 (ß-arr2) are cytosolic proteins well-known to participate in G protein-coupled receptor desensitisation and signalling. We used genetically-inactivated mice to evaluate the role of ß-arr1 or ß-arr2 in platelet function, P2Y receptor desensitisation, haemostasis and thrombosis. Platelet aggregation, soluble fibrinogen binding and P-selectin exposure induced by various agonists were near normal in ß-arr1-/- and ß-arr2-/- platelets. In addition, deficiency in ß-arr1 or ß-arr2 was not critical for P2Y receptors desensitisation. A functional redundancy between ß-arr1 and ß-arr2 may explain these unchanged platelet responses. Interestingly, ß-arr1-/- but not ß-arr2-/- mice were protected against laser- and FeCl3-induced thrombosis. The tail bleeding times, number of rebleeds and volume of blood loss were unchanged in ß-arr1-/- and ß-arr2-/- mice, suggesting no defect in haemostasis. ß-arr1-/- platelet activation upon adhesion to immobilised fibrinogen was inhibited, as attested by a 37 ± 5% (n = 3, p<0.0001) decrease in filopodia extension, suggesting defective signalling through integrin αIIbß3. ß-arr1 appeared to be located downstream of Src family kinases and to regulate αIIbß3 signalling by increasing Akt phosphorylation. Overall, this study supports a role for ß-arr1 in promoting thrombus formation, in part through its participation in αIIbß3 signalling, and no role of ß-arr1 and ß-arr2 in agonist-induced platelet activation and P2Y receptors desensitisation.

Biochemical acidogenic potential in domestic wastewaters: effect of sampling and storage to characterize daily average composite samples.

To estimate the expectable enhanced biological phosphorus removal value of a wastewater, the concentration of volatile fatty acids (VFAs) and the biochemical acidogenic potential (BAP) are generally determined on grab samples of wastewater, as these variables are prone to rapid change after sampling. However, such sampling technique do not take into account the variations of these parameters during the day. This work has evaluated the changes of VFAs and BAP occurring during sampling and storage in an automatic sampler over 24 h. The consequences of waterfall oxygen input during sampling, and changes during storage (fermentation and sulfatereducing process) were studied. The results for two wastewaters showed that the sampling technique used for daily flow proportional composite samples provided a correct estimation of VFAs, and underestimated BAP by up to 25%. For hourly-average composite samples of wastewaters, significant modifications of the concentrations of these two parameters were recorded around the daily average values.

Intravenous magnesium sulfate treatment for acute asthma in the emergency department: a systematic review of the literature.

STUDY OBJECTIVES: There is some evidence that magnesium, when infused into asthmatic patients, can produce bronchodilation in addition to that obtained from standard treatments. This systematic review examined the effect of intravenous magnesium sulfate used for patients with acute asthma managed in the emergency department. METHODS: Only randomized controlled trials were eligible for inclusion. Studies were included if patients presented with acute asthma and were treated with intravenous magnesium sulfate versus placebo. Trials were identified from the Cochrane Airways Review Group register, which consists of a combined search of EMBASE, MEDLINE, and CINAHL databases and hand-searching of 20 key respiratory journals. Bibliographies from included studies and known reviews were searched. Primary authors and content experts were contacted. Data were extracted and methodologic quality was assessed independently by 2 reviewers. Missing data were obtained from authors. RESULTS: Seven trials (5 adult, 2 pediatric) involving a total of 668 patients were included. Overall, admission to hospital was not statistically reduced using magnesium sulfate (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.09 to 1.02). In the severe subgroup, admissions were reduced in those receiving magnesium sulfate (OR 0.10, 95% CI 0.04 to 0.27). Overall, patients receiving magnesium sulfate demonstrated nonsignificant improvements in peak expiratory flow rates (PEFR) when all studies were pooled (weighted mean difference [WMD] 29 L/min, 95% CI -3 to 62). In studies of patients with severe acute asthma, PEFR WMD improved by 52 L/min (95% CI 27 to 78) favoring magnesium sulfate treatment. The absolute FEV(1) also improved by 10% predicted (95% CI 4 to 16) in patients with severe acute asthma. No clinically important changes in vital signs or side effects were reported. CONCLUSION: Current evidence does not clearly support routine use of intravenous magnesium sulfate in all patients with acute asthma presenting to the ED. However, magnesium sulfate appears to be safe and beneficial for patients who present with severe acute asthma. Practice guidelines need to be changed to reflect these results.

[Peroxisome proliferator-activated receptor (PPAR) gamma: a new target for the treatment of inflammatory bowel disease]. / Le récepteur activé par les proliférateurs des peroxysomes (PPAR) gamma: une nouvelle cible thérapeutique pour le traitement des maladies inflammatoires chroniques de l'intestin.

UNLABELLED: The peroxisome proliferator-activated receptor (PPAR) gamma is highly expressed in the colon mucosa. In vitro, it regulates inflammation. AIM: To evaluate the anti-inflammatory functions of PPARgamma agonist during a trinitrobenzene sulfonic acid (TNBS)-induced colitis in mice. METHODS: Colitis was induced in Balb/c mice after intra-rectal administration of TNBS. The intensity of inflammation was assessed 2 and 5 days after colitis induction by macroscopic and histologic scores and by the quantification of colon myeloperoxidase (MPO), IL-1B and TNFalpha mRNA concentrations. The therapeutic role of PPARgamma agonist given by oral gavage was assessed in preventive and treatment modes. RESULTS: TNBS induced severe macroscopic and histologic lesions, with high mucosal MPO, IL-1B and TNFalpha mRNA concentrations. PPARgamma agonist given preventively or in treatment mode allowed a significant decrease of macroscopic and histologic scores through a normalization of MPO, IL-1B and TNFalpha mRNA concentrations. CONCLUSION: PPARgamma agonist decreases the intensity of TNBS induced colitis through normalization of IL-1B and TNFalpha expression. PPARgamma agonists may be proposed as new therapeutic agents in inflammatory bowel diseases.

Magnesium sulfate for treating exacerbations of acute asthma in the emergency department.

BACKGROUND: Treatment of acute asthma is based on rapid reversal of bronchospasm and arresting airway inflammation. There is some evidence that intravenous magnesium can provide additional bronchodilation when given in conjunction with standard bronchodilating agents and corticosteroids. No systematic review of this literature has been completed on this topic. OBJECTIVES: To examine the effect of additional intravenous magnesium sulfate in patients with acute asthma managed in the emergency department. SEARCH STRATEGY: Randomised controlled trials were identified from the Cochrane Airways Review Group register. Bibliographies from included studies, known reviews and texts were searched. Primary authors and content experts were contacted. SELECTION CRITERIA: Randomised controlled trials or quasi-randomised trials were eligible for inclusion. Studies were included if patients presented with acute asthma and were treated with IV magnesium sulfate vs placebo. DATA COLLECTION AND ANALYSIS: Data were extracted and methodological quality was assessed independently by two reviewers. Missing data were obtained from authors. MAIN RESULTS: Seven trials were included (5 adult, 2 pediatric). A total of 665 patients were involved. Patients receiving magnesium sulfate demonstrated non-significant improvements in peak expiratory flow rates when all studies were pooled (weighted mean difference: 29.4 L/min; 95% confidence interval: -3.4 to 62). In studies of people with severe acute asthma, peak expiratory flow rate improved by 52.3 L/min (95% confidence interval: 27 to 77.5). The forced expiratory volume in one second also improved by 9.8 % predicted (95% confidence interval: 3.8 to 15.8). Overall, admission to hospital was not reduced, odds ratio: 0.31 (95% confidence interval: 0.09 to 1.02). In the severe subgroup, admissions were reduced in those receiving magnesium sulfate (odds ratio: 0.10, 95% confidence interval: 0.04 to 0.27). No clinically important changes in vital signs or adverse side effects were reported. REVIEWER'S CONCLUSIONS: Current evidence does not support routine use of intravenous magnesium sulfate in all patients with acute asthma presenting to the emergency department. Magnesium sulfate appears to be safe and beneficial in patients who present with severe acute asthma.

A multicentre study comparing cervicography and cytology in the detection of cervical intraepithelial neoplasia.

OBJECTIVE: To evaluate in a multicentre setting the performance of cervicography compared with cytology for the detection of cervical intraepithelial neoplasia. DESIGN: Prospective comparative multicentre study. SETTING: Three hospitals with outpatient gynaecology clinics and three cancer screening clinics. PARTICIPANTS AND METHODS: Cervical cytology and cervicography were performed on 5724 women. If one or both tests showed an abnormality suggestive of at least a low grade squamous intraepithelial lesion, a colposcopy with directed biopsy was carried out. Cervicograms were evaluated by four experienced 'senior' assessors and by ten new 'junior' assessors. RESULTS: Results were fully analysed for 5192 women (91%). A cervical biopsy was carried out on 228 women and this confirmed a true positive lesion in 116 cases (incidence rate: 2.2%). Of these, 72 cases (62.1%) were detected by cervicography and 64 (55.2%) by cytology. This difference was not statistically significant (McNemar: P=0.475). Only 20 cases of CIN (17%) were concordantly detected by both tests. Senior assessors performed significantly better with a detection capacity of 80.6% compared to a detection capacity of 56.6% for the junior assessors (chi2 test: P=0.034). CONCLUSIONS: Cervicography must be considered as a complementary test to cytology. Overall detection of CIN is improved, but this is mainly due to the detection of more low grade lesions. The lower sensitivity and specificity in high grade lesions compared with cervical cytology is the main limitation of cervicography in screening for CIN. An important finding was that the performance of cervicography was highly dependent on the assessors' experience.

Epidemiological survey of preinvasive breast cancer.

DCIS and LCIS are different breast diseases at various points of view. DCIS has in most cases a clinical or mammographical pattern, whereas LCIS represents an incidental finding in breast tissue removed for another reason. However, DCIS found incidental to benign disease may be a more innocuous form of tumour. Multifocal foci are more frequent in LCIS than in DCIS, but microinvasion and coexisting unsuspected infiltration carcinoma are more often found in DCIS. Contralateral in situ breast carcinoma is a rare event in DCIS. It is seldom found in LCIS. The risk of development of an infiltrating ipsilateral carcinoma after biopsy or excision showing in situ carcinoma is higher for DCIS than for LCIS. However, in most cases the invasive tumour occurs at or near the site of the original biopsy. Among LCIS patients, invasive carcinoma occurs anywhere in the breast parenchyma. The risk of development of contralateral invasive cancer is very low in DCIS patients, but it is high in LCIS patients. It may be lobular, ductal or a mixture of different types. DCIS has to be considered as a truly preinvasive lesion although LCIS is rather a marker of increased risk.

Breast cancer screening programmes--results of studies in foreign countries--situation in Belgium.

Results of randomized trials and case-control studies on breast cancer screening are reviewed. A combined analysis of data from the randomized studies indicates that a mortality reduction (29%) can be achieved by mammographic screening in women. Regular breast cancer screening by mammography for women aged 50-69 years reduces breast cancer mortality by 40% (confidence interval [CI] 95% about 27-55) in women who are screened at least once. In younger women, the results are inconclusive. The programme Europe against Cancer has recommended the setting-up of a network of pilot studies on breast cancer screening by mammography in the European Community in order to obtain the necessary experience, with a view to implementation of a national screening programme before the year 2000. In the Brussels project, the main objective is to develop a programme of quality assurance. In Belgium, there are other projects with different designs, for which the results are not yet available.

[Systematic mammographic screening for breast cancer in asymptomatic women]. / Dépistage du cancer du sein par mammographie systématique chez des femmes asymptomatiques.

It appears that the mortality rate from breast cancer decreases in 50-year-old (and over) women submitted to mammographic screening. Since 1980, the Unit of Cancer Prevention of the UCL is proposing mammographic screening to women with normal clinical examination but belonging to a "high-risk" group. Among the 5651 mammographies which were performed on 2924 women, 24 biopsies have been proposed and 16 cases of cancer have been diagnosed. 5.5% breast cancers have been detected. This result is consistent with the average figures reported in the screening programmes abroad. Questions about the age at which cancer screening should start and about the number of views that should be taken are also discussed.