Line Managers' Perspectives and Responses when Employees Burn Out.

PURPOSE: Little is known about whether burnout can be stopped at an emerging stage. To develop this knowledge, we focus on line managers' perspectives and responses when an employee who seems to be heading for burnout is still at work. METHODS: We interviewed 17 line managers working in the educational and health care sectors, who had been confronted with the sickness absence of at least one employee due to burnout in the past. Interviews were transcribed, coded, and analyzed thematically. RESULTS: During the period that the employee seemed to be developing burnout while still at work, line managers experienced three different, successive phases: picking up signals, role-taking, and re-evaluation. Line managers' personal frame of reference (e.g., having experience with burnout) seemed to influence whether and how they picked up signals of burnout. Line managers not picking up signals, did not take any action. When picking up the signals, the managers however generally took an active role: they started a conversation, changed work tasks, and - at a later stage - adapted the employee's job description, sometimes without consulting the employee. The managers felt powerless yet learned from the experience when subsequently re-evaluating the period during which employees developed symptoms of burnout. These re-evaluations resulted in an adapted personal frame of reference. CONCLUSION: This study shows that improving line managers' frame of reference, e.g., by organizing meetings and/or training, may help them to detect early signals of burnout and take action. This is a first step to prevent the further development of early burnout symptoms.

Updating dataset of measurements for the experimental CEA-beam benchmark structure subjected to one stochastic broadband excitation with dataset of measurements for the CEA-beam system subjected to two correlated or uncorrelated broadband random excitations.

This data article comprises data to investigate the non-linear dynamic behavior of the beam benchmark structure that is a clamped-clamped steel beam with non-ideal boundary conditions subjected to two broadband correlated or uncorrelated random excitations. Experiments have been performed on the CEA-CESTA laboratory. The data provided include output measurements for the nonlinear dynamic behavior of the CEA-beam (i.e., the accelerations amplitudes for the three accelerometers on the beam), as well as the two input forces amplitudes. In comparison with the data provided in [4] which only considers the case of a single exitation, experimental results are extended for the CEA-beam system subjected to two correlated or uncorrelated broadband random excitations. All the results from this data will help researchers and engineers in proper analysis of the nonlinearities of the clamped-clamped beam and the effects of the correlation between two broadband correlated or uncorelated random excitations on the nonlinear signature of this academic structure. One of the main original contributions is to share the data sets to give the opportunity to researchers for testing and validating analytical or numerical models of a nonlinear beam with non-ideal boundary conditions and subjected to multipoint correlated or uncorrelated random excitations. This Data in Brief article is an additional item directly alongside the following paper published in the Elsevier journal: S. Talik, J-J. Sinou, M. Claeys and J-P. Lambelin, Nonlinear vibrations of a beam subjected to two broadband correlated or uncorrelated broadband random excitations - experiments, modeling and simulations, Communications in Nonlinear Science and Numerical Simulation, 106328, 2022.

Organization of intensive cardiac care units in Europe: Results of a multinational survey.

BACKGROUND: The present survey aims to describe the intensive cardiac care unit organization and admission policies in Europe. METHODS: A total of 228 hospitals (61% academic) from 27 countries participated in this survey. In addition to the organizational aspects of the intensive cardiac care units, including classification of the intensive cardiac care unit levels, data on the admission diagnoses were gathered from consecutive patients who were admitted during a two-day period. Admission policies were evaluated by comparing illness severity with the intensive cardiac care unit level. Gross national income was used to differentiate high-income countries (n=13) from middle-income countries (n=14). RESULTS: A total of 98% of the hospitals had an intensive cardiac care unit: 70% had a level 1 intensive cardiac care unit, 76% had a level 2 intensive cardiac care unit, 51% had a level 3 intensive cardiac care unit, and 60% of the hospitals had more than one intensive cardiac care unit level. High-income countries tended to have more level 3 intensive cardiac care units than middle-income countries (55% versus 41%, p=0.07). A total of 5159 admissions were scored on illness severity: 63% were low severity, 24% were intermediate severity, and 12% were high severity. Patients with low illness severity were predominantly admitted to level 1 intensive cardiac care units, whereas patients with high illness severity were predominantly admitted to level 2 and 3 intensive cardiac care units. A policy mismatch was observed in 12% of the patients; some patients with high illness severity were admitted to level 1 intensive cardiac care units, which occurred more often in middle-income countries, whereas some patients with low illness severity were admitted to level 3 intensive cardiac care units, which occurred more frequently in high-income countries. CONCLUSION: More than one-third of the admitted patients were considered intermediate or high risk. Although patients with higher illness severity were mostly admitted to high-level intensive cardiac care units, an admission policy mismatch was observed in 12% of the patients; this mismatch was partly related to insufficient logistic intensive cardiac care unit capacity.

Long-term effect of atrial fibrillation on the evolution of mitral and tricuspid valve regurgitation.

Objective: The present study aims to identify the long-term effects of atrial fibrillation (AF) on atrial remodelling and on the progression of mitral/tricuspid valve regurgitation (MR/TR).Methods: The severity of MR/TR was assessed by the colour jet area and by multi-integrative approach at baseline and after a period of 65 ± 10 months in 37 patients with permanent AF, in 80 patients with non-permanent AF (of whom 43 were treated with ablation) and in 53 control patients with sinus rhythm.Results: At baseline, AF patients had larger MR jet areas than control patients. At follow up, progression of MR, expressed as delta MR jet area, was 0.05 ± 1.3 cm2 in the control group, 0.73 ± 2.1 cm2 in the non-permanent AF group and 1.95 ± 3.6 cm2 in the permanent AF group (p = .001). Severe MR at follow up was observed in 0%, 2.5%, 8%, respectively. There was a significant positive correlation between progression of MR and increase of left atrium volume (r = 0.31, p < .001). After adjustment for baseline clinical and echocardiographic parameters, permanent AF remained independently associated with the progression of MR. Although rhythm control was better with AF ablation than with medical treatment only, the MR evolution was similar. Comparable findings, albeit less pronounced, were observed for the association between of AF and TR progression.Conclusions: The presence of longstanding AF is associated with a significant progression of MR/TR mainly due to atrial remodelling. Our data showed a beneficial effect of sustained rhythm control, either medically or by ablation, on MR/TR progression.

Dataset of multi-harmonic measurements for the experimental CEA-beam benchmark structure.

This data article comprises post-processed data to investigate the non-linear dynamic behavior of the CEA-beam benchmark structure that is a clamped-clamped steel beam with non-ideal boundary conditions. Experiments have been performed on the CEA-CESTA laboratory. The data provided include output measurements for the nonlinear dynamic behavior of the CEA-beam (i.e. the displacement amplitudes for each harmonic component at the middle of the beam), as well as the complete input acceleration signal harmonics amplitude. All the results from this data will help researchers and engineers in proper analysis of the nonlinearities of the clamped-clamped beam and the effect of the non-ideal input signal and advanced understanding of links between different excitation signal and the multi-harmonic responses of the CEA-beam. One of the main original contribution is to share the data sets to give the opportunity to researchers for testing and validating analytical or numerical models of a nonlinear beam with non-ideal boundary conditions and subjected to low and high levels of excitation signal. This Data in Brief article is an additional item directly alongside the following paper published in the Elsevier journal Communications in Nonlinear Science and Numerical Simulation: M. Claeys, J-J. Sinou, J-P. Lambelin and B. Alcoverro, Multi-harmonic measurements and numerical simulations of nonlinear vibrations of a beam with non-ideal boundary conditions, Communications in Nonlinear Science and Numerical Simulation, 19(12), 4196-4212, 2014. https://doi.org/10.1016/j.cnsns.2014.04.008.

Air pollution and ST-elevation myocardial infarction: A case-crossover study of the Belgian STEMI registry 2009-2013.

BACKGROUND: Previous studies have shown that air pollution particulate matter (PM) is associated with an increased risk for myocardial infarction. The effects of air pollution on the risk of ST-elevation myocardial infarction (STEMI), in particular the role of gaseous air pollutants such as NO2 and O3 and the susceptibility of specific populations, are still under debate. METHODS: All patients entered in the Belgian prospective STEMI registry between 2009 and 2013 were included. Based on a validated spatial interpolation model from the Belgian Environment Agency, a national index was used to address the background level of air pollution exposure of Belgian population. A time-stratified and temperature-matched case-crossover analysis of the risk of STEMI was performed. RESULTS: A total of 11,428 STEMI patients were included in the study. Each 10µg/m3 increase in PM10, PM2.5 and NO2 was associated with an increased odds ratio (ORs) of STEMI of 1.026 (CI 95%: 1.005-1.048), 1.028 (CI 95%: 1.003-1.054) and 1.051 (CI 95%: 1.018-1.084), respectively. No effect of O3 was found. STEMI was associated with PM10 exposure in patients ≥75y.o. (OR: 1.046, CI 95%: 1.002-1.092) and with NO2 in patients ≤54y.o. (OR: 1.071, CI 95%: 1.010-1.136). No effect of air pollution on cardiac arrest or in-hospital STEMI mortality was found. CONCLUSION: PM2.5 and NO2 exposures incrementally increase the risk of STEMI. The risk related to PM appears to be greater in the elderly, while younger patients appear to be more susceptible to NO2 exposure.

The effects of different flooring types on the behavior, health, and welfare of finishing beef steers.

Raising beef cattle on concrete floors can negatively impact their welfare by increasing joint swelling and body lesions, as well as abnormalities in resting behavior and postural changes. We hypothesized that the addition of rubber mats to concrete pens would improve beef cattle welfare by improving performance, health, hygiene, and resting behavior. Forty-eight crossbred Angus steers were housed in pens of 4 and randomly assigned to a single flooring treatment: (1) fully slatted concrete (CON), (2) fully slatted rubber mat (SLAT), or (3) solid rubber mat (SOLID; 60% of pen floor) from 36 to 48 wk of age. Weight, ADG, lesions, gait score, joint swelling, and animal and pen cleanliness were collected every 2 wk. Behavioral time budgets and frequency of postural changes (an indicator of floor traction and comfort) were collected at 0, 6, and 12 wk. No differences in weight gain or ADG were observed. Steers on SOLID flooring (0.80 ± 0.08) showed increased lesions compared to SLAT (0.38 ± 0.08) and CON (0.37 ± 0.08; both, = 0.05); however, there was no difference between SLAT and CON. SLAT steers (1.69 ± 0.04) showed a reduced gait score compared to SOLID (1.95 ± 0.04) and CON (1.98 ± 0.04; both, < 0.05), but SOLID and CON did not differ. Steers on SLAT flooring had less joint swelling (both knees and hocks) compared to SOLID and CON (all comparisons, < 0.05), but SOLID and CON did not differ. Steers on SOLID (3.64 ± 0.05) flooring were dirtier than those on SLAT (2.27 ± 0.05) and CON (2.19 ± 0.05; both, < 0.001), whereas SLAT and CON were similar. Additionally, SOLID and SLAT pens were less clean than CON pens ( < 0.001 and = 0.094, respectively), and SOLID was less clean than SLAT ( < 0.001). Time budget behavior was affected by treatment ( = 0.043), where SOLID differed from CON and SLAT (both, < 0.05). Steers on SOLID flooring preferred to rest on the rubber mat vs. slatted concrete ( = 0.001). Steers on SLAT flooring changed their posture more frequently than those on SOLID and CON flooring (both, < 0.05), but SOLID and CON did not differ. Compared to CON steers, SOLID steers showed an increase in lesions and a reduction in cleanliness, whereas SLAT steers showed a decrease in gait score and joint swelling and an increase in postural changes. Combined, these data suggest that the addition of slatted rubber mats to concrete pens may improve beef cattle welfare.

[Psychometric properties of the Hospital Ethical Climate Survey: a cross-sectional study among Belgian psychiatric nurses]. / Psychometrische kwaliteiten van de Hospital Ethical Climate Survey: een cross-sectionele studie bij Belgische psychiatrische verpleegkundigen.

BACKGROUND: The task of caring for psychiatric patients is so complex that it often leads to ethical dilemmas. The ethical climate on a ward is a crucial factor. This is the first study about the ethical climate in mental healthcare. AIM: To investigate whether the only instrument currently available for measuring the ethical climate in general hospitals, namely the 'Hospital Ethical Climate Survey' (HECS), is a reliable and valid instrument for use on psychiatric wards. METHOD: A cross-sectional study was performed in a psychiatric hospital in Belgium. All 320 nurses were invited to participate (response rate = 265). The factor structure of the HECS was examined by means of explorative principal component analysis (PCA) and confirmatory factor analysis (CFA). The reliability of the constructed scale and subscales was investigated. RESULTS: Five factors were identified. The structure of these factors in the translated list was almost identical to the structure obtained with the original instrument and its underlying theoretical basis. Items relating to several other allied healthcare professions were added. This addition widened the subscale 'relationship with physician' so that it included 'relationship with other disciplines' (medical and allied healthcare workers). CONCLUSION: The reliability of the instrument appeared to be good and yielded scores comparable to those obtained as a result of earlier research performed in general hospitals. The setting for our investigation produced a significantly higher main score for the ethical climate than did previous studies.

Supplemental ß-carotene I: effect on plasma vitamin A, growth, performance, and carcass characteristics of feedlot cattle.

To evaluate the effects of ß-carotene (ßC) on performance and carcass characteristics, 112 crossbred calves were allotted to 4 treatments consisting of retinyl palmitate (RP) supplemented at 2200IU/kg, and synthetic ß-carotene supplemented at 1 (SßC1X), 5 (SßC5X), or 10 (SßC10X) times RP. Compared to RP, SßC1X did not impact performance (P≥0.25) or plasma concentrations of retinoids or carotenoids (P≥0.26). Increasing dietary ßC increased (P≤0.04) plasma concentrations of RP and all of the isomers of ßC, but did not affect weight, gain, or gain:feed (P≥0.24). Marbling and fat thickness did not differ between RP and SßC1X or because of amount of ßC (P≥0.35). Lightness (L*) of LM decreased with increasing concentration of SßC (linear; P=0.01). Yellowness (b*) increased (P=0.04) and redness (a*) tended to increase (P=0.09) in subcutaneous fat as SßC amount increased (quadratic).

Effect of decreasing dietary cation anion difference on feedlot performance, carcass characteristics, and beef tenderness.

The manipulation of acid-base balance has been extensively investigated as a means of manipulating Ca homeostasis and managing milk fever in dairy cows. A low dietary cation anion difference (DCAD) increases urinary Ca, blood-ionized Ca, and responsiveness to Ca-homeostatic hormones. Very little attention has been focused on the possibility of using a low dietary DCAD to increase muscle Ca availability, calpain activity, and meat tenderness of beef cattle. Thus, 90 Angus × Simmental crossbred steers were allotted by weight (590.1 ± 2.4 kg) and breed composition (% Simmental) to 3 treatments (6 pens/treatment, 5 steers/pen) to evaluate the effects of DCAD on beef tenderness. Treatments were initiated 2 wk before slaughter and consisted of 3 DCAD (mEq/100 g) treatments: -16, 0, and +16. Basal diets (DM basis) were 62 to 64% corn, 6 to 9% soybean meal, and 20% corn silage, and were formulated to contain similar concentrations of protein, energy (NEm; NEg), and minerals, with the exception of sodium and chlorine. A commercial chloride ion supplement (PASTURChlor, West Central, Ralston, IA) was added to diets to decrease DCAD and sodium bicarbonate was added to diets to increase DCAD. Performance before initiation of the study did not differ among treatments (P > 0.22). Urine pH did not differ at the initiation of the study (P > 0.57), but did increase at a decreasing rate on d 7 (6.37, 7.69, 8.13) and d 14 (5.68, 7.66, 8.03) of the study as DCAD increased from -16 to 0 to +16, respectively (quadratic, P < 0.02). Gain and gain:feed responded quadratically to DCAD (P < 0.01), increasing from -16 to 0 DCAD and decreasing from 0 to +16 DCAD. Hot carcass weight, dressing percent, fat thickness, LM area, yield grade, marbling score, quality grade distribution, 48 h muscle pH, and Ca content of muscle did not differ among treatments (P > 0.16). In addition, DCAD did not affect Warner-Bratzler shear force among treatments after 7 and 21 d of aging (P > 0.23). Although urine pH was decreased by feeding a -16 DCAD diet, Ca influx into the LM and beef tenderness were not affected by altering the DCAD in finishing beef cattle diets.

Supplemental vitamin D3 and zilpaterol hydrochloride. I. Effect on performance, carcass traits, tenderness, and vitamin D metabolites of feedlot steers.

Angus × Simmental steers (n = 210; initial BW 314 ± 11 kg) were separated into heavy and light BW blocks and allotted evenly by BW to 6 treatments (3 heavy and 2 light pens per treatment) to determine the effect of supplemental vitamin D3: 0 IU (no D), 250,000 IU for 165 d (long-term D), or 5 × 10(6) IU for 10 d (short-term D) on performance, carcass traits, vitamin D metabolites, and meat tenderness in steers fed either 0 (NZ) or 8.38 mg/kg zilpaterol hydrochloride (ZH) daily for 21 d. Placebo or ZH was added to the diet 24 d, and short-term D was added 13 d before slaughter. Vitamin D3, ZH, and placebo were all removed from the diet 3 d before slaughter. Steers fed ZH tended to have improved overall G:F compared with steers not fed ZH (P < 0.09). Overall performance was not affected by long-term D, with or without ZH (P = 0.11) compared with no D, with or without ZH. Short-term D decreased final BW, ADG, and G:F (P = 0.04) compared with no D, when ZH was not fed. Zilpaterol hydrochloride increased HCW, dressing percentage, and LM area (P < 0.01); and decreased fat thickness, yield grade, and marbling (P < 0.03). Carcass traits were not impacted by long-term D without ZH (P > 0.13), but long-term D with ZH decreased percentage KPH (P < 0.02). Compared with no D, short-term D tended to decrease HCW (P < 0.07), decreased fat thickness (P < 0.01), and tended to increase dressing percentage (P < 0.10) when ZH was not fed, yet did not impact carcass traits when ZH was fed (P < 0.13). Feeding ZH tended to decrease (P < 0.09) LM 1,25-dihydroxyvitamin D3 [1,25(OH)2D3]. The long-term D treatment increased LM vitamin D3 and 25-hydroxyvitamin D3 (25OHD3) 18- and 5-fold, respectively, when ZH was not fed (P < 0.04) and increased LM 25OHD3 by 4-fold when ZH was fed (P < 0.01). Short-term D increased LM vitamin D3 and 25OHD3 by 52- and 9-fold, respectively, when ZH was not fed (P < 0.01), and by 24- and 9-fold, respectively, when ZH was fed (P < 0.01). Also, short-term D increased LM 1,25(OH)2D3 by 2-fold (P < 0.04) when ZH was fed. Warner-Bratzler shear force (WBSF) was greater for ZH steaks than non-ZH steaks at 7, 14, and 21 d postmortem aging (P < 0.01). Vitamin D did not reduce WBSF (P = 0.18). When ZH was fed, long-term D tended to increase WBSF in steaks aged 21 d (P = 0.06). In conclusion, ZH improved carcass leanness and decreased tenderness, and vitamin D feeding increased vitamin D3 metabolites in LM, but did not improve tenderness in steers fed ZH.

Supplemental vitamin D3 and zilpaterol hydrochloride. II. Effect on calcium concentration, muscle fiber type, and calpain gene expression of feedlot steers.

Two hundred and ten Angus × Simmental steers (initial BW 314 ± 11 kg) were separated into heavy and light BW blocks and allotted evenly by BW to 6 treatments (3 heavy and 2 light pens per treatment) to determine the effect of supplemental vitamin D3: 0 IU (no D), 250,000 IU for 165 d (long-term D), or 5 × 10(6) IU for 10 d (short-term D) on plasma and muscle calcium concentrations and gene expression in steers fed either 0 (NZ) or 8.38 mg/kg (ZH) zilpaterol hydrochloride (ZH) daily for 21 d. Placebo or ZH was added to the diet 24 d, and short-term D was added 13 d before slaughter. Treatments were removed from all diets 3 d before slaughter. Plasma total calcium (Ca(2+)) was determined at study initiation, start of ZH and short-term D feedings, and at vitamin D3 and ZH withdrawal. Both plasma total and ionic Ca(2+) were determined when animals were sent to harvest. Longissimus muscle total and ionic Ca(2+) were determined in meat aged 7 and 4 d postmortem, respectively. When ZH was fed, long-term D decreased plasma total Ca(2+) at slaughter (P < 0.04). Short-term D increased (P < 0.01) plasma total and ionic Ca(2+) at slaughter regardless of ZH inclusion in the diet. Long- and short-term D, with or without ZH, did not affect (P > 0.28) LM total Ca(2+); however, both long- and short-term D increased LM ionic Ca(2+) when ZH was not fed (P < 0.01). Long-term D reduced LM ionic Ca(2+) when ZH was fed (P < 0.02). Neither long- nor short-term D affected PPARα or δ gene expression (P = 0.19) whether or not ZH was fed. Expression of MYH1 and 2A (P < 0.05) but not 2X (P = 0.21) was decreased in steers fed ZH. Long-term D had no effect on MYH2A expression (P = 0.21). Short-term D increased MYH2A expression when ZH was not fed (P < 0.03). Calpain mRNA tended to be lower in steers fed ZH (P = 0.09), but was not affected by long- or short-term D regardless of whether or not ZH was fed (P = 0.39). Expression of calpastatin did not differ with vitamin D supplementation (P = 0.35). In conclusion, ZH decreased oxidative myosin expression, and when combined with long-term D, ZH decreased LM ionic Ca(2+). Moreover, vitamin D3 supplementation did not increase calpain mRNA. These results help explain why vitamin D3 does not improve tenderness in steers fed ZH.

Effect of increasing distillers grains inclusion on performance and carcass characteristics of early-weaned steers.

Dried distillers grains with solubles (DDGS) contain elevated concentrations of CP, oil, and S, which can negatively impact performance and carcass characteristics in steers weaned at 205 d of age. Early weaned (EW) cattle, however, consume less DM and require increased CP. Furthermore, the energy required to dispose of excess N may actually decrease excessive fat accumulation, which can occur in EW cattle. Thus, we hypothesized that feeding diets with increased concentrations of DDGS to EW steers for the first 99 d would decrease fat thickness and increase harvest weights, and would not inhibit performance or marbling deposition. To test this hypothesis, 90 Angus × Simmental steers (199.7 ± 12.2 kg) were weaned at 134 d of age (EW) and allotted to 3 high concentrate diets (20% corn silage) containing either 0%, 30%, or 60% DDGS (15.7%, 15.8% and 21.7% CP, respectively). Dietary treatments were fed for 99 d, after which steers were placed on a common diet containing no DDGS (12.9% CP) until harvest at a common weight of 599 kg. Concentration of dietary DDGS did not affect ADG, DMI, or G:F during the growing phase (P > 0.41), did not produce any carryover effects on ADG, DMI, or G:F during the finishing phase (P > 0.26), and resulted in similar overall performance (P > 0.52). Dressing percentage (P < 0.05), HCW (P = 0.06), fat thickness (P = 0.10), and % KPH (P = 0.08) responded quadratically to early DDGS supplementation, increasing from 0 to 30% DDGS inclusion and decreasing from 30 to 60% DDGS inclusion, respectively. Marbling score was not affected (P > 0.46) by DDGS inclusion, but there was a tendency (P = 0.08) for the ratio of subcutaneous (SC) to intramuscular (IM) fat to be altered by DDGS inclusion. The ratio of IM to SC fat decreased from 0 to 30% DDGS inclusion and increased from 30 to 60% DDGS inclusion. These data suggest that inclusion of increased concentrations of dietary DDGS early in the feedlot phase does not negatively impact growth and performance of EW cattle, but does partition energy from carcass to noncarcass components. However, increased concentrations of DDGS did not negatively impact IM fat deposition. Utilization of energy for disposal of excess N may be responsible for changes in carcass weight and SC fat deposition.

Impaired coronary flow reserve after a recent myocardial infarction: correlation with infarct size and extent of microvascular obstruction.

BACKGROUND: The exact relationship between the coronary flow reserve (CFR) and infarct size remains unknown. In this prospective study the relationship between the CFR both in the infarcted and remote myocardium and infarct size was investigated. Furthermore, the diagnostic value of the CFR to predict the extent of microvascular obstruction (MO) was evaluated. METHODS: In thirty patients the CFR was measured with a Doppler guide wire 6 ± 3 days after a first myocardial infarction (MI) in the infarct related and in a reference coronary artery. MO and infarct size were determined with magnetic resonance imaging. RESULTS: The CFR was inversely related to infarct size in the infarcted and remote myocardium (respectively, r=-0.60, p<0.01 and r=-0.62, p<0.01). In the infarcted myocardium the extent of MO was strongly related to the infarct size and was in a multivariate analysis the single significant determinant of the CFR and the hyperaemic flow. In the remote myocardium no relationship was present between infarct size and hyperaemic flow, but the baseline flow increased as the infarct size became larger (r=0.58, p<0.01). In a receiver operator characteristic (ROC) analysis, a CFR value ≤ 2 in the infarct related coronary artery offered the best sensitivity (65%) and specificity (71%) to detect the presence of MO (p<0.05). CONCLUSIONS: After MI, the CFR both in the infarcted and remote myocardium is inversely related to infarct size. In the infarcted myocardium, a CFR value ≤ 2 predicts the presence of MO with moderate sensitivity and specificity.

Overexpression of arginase in Arabidopsis thaliana influences defence responses against Botrytis cinerea.

Arabidopsis possesses two arginase-encoding genes, ARGAH1 and ARGAH2, catalysing the catabolism of arginine into ornithine and urea. Arginine and ornithine are both precursors for polyamine biosynthetic pathways. We observed an accumulation of ARGAH2 mRNA in Arabidopsis upon inoculation with the necrotrophic pathogen Botrytis cinerea. Transgenic lines displaying either overexpression of ARGAH2 or simultaneous silencing of both Arabidopsis arginase-encoding genes were created and their resistance to B. cinerea infection evaluated. Overexpression of arginase resulted in changes in amino acid accumulation, while polyamine levels remained largely unaffected. Silencing lines were affected in both amino acid and putrescine accumulation. Arabidopsis plants overexpressing the arginase gene were less susceptible to B. cinerea, whereas silencing lines remained as susceptible as the wild type. We discuss how arginase might interact with plant defence mechanisms. These results provide new insights into amino acid metabolic changes under stress.

[Intensity-modulated radiation therapy for anal carcinoma]. / Radiothérapie conformationnelle avec modulation d'intensité des cancers de l'anus.

Anal canal carcinoma are highly curable by irradiation, combined with chemotherapy in locally advanced disease, with preservation of sphincter function. The clinical target volume for the nodes is extended, often including the inguinal nodes, which is not usual for other pelvic tumours. Acute and late effects are correlated with the volume and dose delivered to organs at risk, i. e. small bowel, bladder and increased by concomitant chemotherapy. Intensity modulated irradiation (IMRT) makes it possible to optimize the dose distribution in this "complex U shaped" volume, while maintaining the dose distribution for the target volumes. The conversion from conformal irradiation to IMRT necessitates good knowledge of the definition and skills to delineate target volumes and organs at risk, including new volumes needed to optimize the dose distribution. Dosimetric and clinical benefits of IMRT are described, based on early descriptions and evidence-based publication. The growing development of IMRT in anal canal radiotherapy must be encouraged, and long-term benefits should be soon published. Radiation oncologists should precisely learn IMRT recommendations before starting the technique, and evaluate its early and late results for adverse effects, but also for long-term tumour control.

An extensin-rich matrix lines the carinal canals in Equisetum ramosissimum, which may function as water-conducting channels.

BACKGROUND AND AIMS: The anatomy of Equisetum stems is characterized by the occurrence of vallecular and carinal canals. Previous studies on the carinal canals in several Equisetum species suggest that they convey water from one node to another. METHODS: Cell wall composition and ultrastructure have been studied using immunocytochemistry and electron microscopy, respectively. Serial sectioning and X-ray computed tomography were employed to examine the internode-node-internode transition of Equisetum ramosissimum. KEY RESULTS: The distribution of the LM1 and JIM20 extensin epitopes is restricted to the lining of carinal canals. The monoclonal antibodies JIM5 and LM19 directed against homogalacturonan with a low degree of methyl esterification and the CBM3a probe recognizing crystalline cellulose also bound to this lining. The xyloglucan epitopes recognized by LM15 and CCRC-M1 were only detected in this lining after pectate lyase treatment. The carinal canals, connecting consecutive rings of nodal xylem, are formed by the disruption and dissolution of protoxylem elements during elongation of the internodes. Their inner surface appears smooth compared with that of vallecular canals. CONCLUSIONS: The carinal canals in E. ramosissimum have a distinctive lining containing pectic homogalacturonan, cellulose, xyloglucan and extensin. These canals might function as water-conducting channels which would be especially important during the elongation of the internodes when protoxylem is disrupted and the metaxylem is not yet differentiated. How the molecularly distinct lining relates to the proposed water-conducting function of the carinal canals requires further study. Efforts to elucidate the spatial and temporal distribution of cell wall polymers in a taxonomically broad range of plants will probably provide more insight into the structural-functional relationships of individual cell wall components or of specific configurations of cell wall polymers.

Ultrastructure and composition of cell wall appositions in the roots of Asplenium (Polypodiales).

Cell wall appositions (CWAs), formed by the deposition of extra wall material at the contact site with microbial organisms, are an integral part of the response of plants to microbial challenge. Detailed histological studies of CWAs in fern roots do not exist. Using light and electron microscopy we examined the (ultra)structure of CWAs in the outer layers of roots of Asplenium species. All cell walls studded with CWAs were impregnated with yellow-brown pigments. CWAs had different shapes, ranging from warts to elongated branched structures, as observed with scanning and transmission electron microscopy. Ultrastructural study further showed that infecting fungi grow intramurally and that they are immobilized by CWAs when attempting to penetrate intracellularly. Immunolabelling experiments using monoclonal antibodies indicated pectic homogalacturonan, xyloglucan, mannan and cellulose in the CWAs, but tests for lignins and callose were negative. We conclude that these appositions are defense-related structures made of a non-lignified polysaccharide matrix on which phenolic compounds are deposited in order to create a barrier protecting the root against infections.

[High dose rate vaginal brachytherapy in endometrial cancer after surgery]. / Curiethérapie postopératoire du fond vaginal de haut débit de dose dans le cancer endométrial.

PURPOSE: This study aimed at analyzing the evolution and type of recurrence in patients treated for stage I endometrial carcinomas, in order to define the respective roles of adjuvant radiotherapy and brachytherapy. PATIENTS AND METHODS: This monocentric retrospective study was conducted at Centre Alexis-Vautrin, Nancy, France, between January 1995 and December 2000 on all the patients surgically treated for an endometrial cancer, and then treated with high dose rate vaginal brachytherapy. The brachytherapy was delivered in two or three fractions of 7 Gy at 5 mm from the applicator. RESULTS: In the good prognosis group, the specific and overall survivals at 5 years were respectively 96.5 and 94.2% with no local recurrence demonstrated. In the intermediate prognostic group, the specific and overall survivals at 5 years were respectively 88 and 85%, with six locoregional recurrences observed among those who did not undergo lymphadenectomy; the overall survival at 5 years was significantly decreased in the absence of external radiation. In the group of poor prognosis (stages II and III), the specific survival at 5 years was respectively 72.8 and 67 %, and the overall survival at 5 years 66.7 and 56.4%. CONCLUSION: Results for local control and survival as well as for tolerance were good. So we have decided to deliver high rate brachytherapy for all intermediate or poor prognosis patients and we have abandoned pelvic radiotherapy for good prognosis tumours (stages IA: no myometrium invasion with grade 3 and >50% of myometrium invasion with grades 1 and 2), whatever the lymph nodes surgery they had. We now propose pelvic radiotherapy only for intermediate prognosis tumours (such as IA>50% of myometrium invasion with grade 3 and IB stages), if patients did not have any lymphatic surgery, or for bad prognosis tumours.