[COP21 - Organization and activity of a medical cover under "pressure"]. / COP21 ­ Organisation et bilan d'une médicalisation sous haute tension.

INTRODUCTION: The United Nations Climate Conference (COP21) gathered in France for delegations from all around the world, with 20,000 delegates from 195 countries every day, including 150 heads of states during the first 48hours. A specific medical cover was organized in a particular "post-attacks" context and with harsh constraints due to delimitation of an inner zone under the sole UN authority ("blue zone"). OBJECTIVE: To evaluate medical means involved and medical activity. METHODS: Medical cover was managed by SAMU 93 in collaboration with zonal SAMU and regional health agency for the entire site including the "blue zone". End-points: engaged workforce, number of visits, including transfers and medicalized transfers. RESULTS: In "France zone" (operational headquarters): an emergency physician dispatcher and an assistant for 20 days. In "blue zone": 20 rescuers, mobile intensive care unit H24 and two emergency physicians (consultations) 12/24hours for 16 days. A total of 47 doctors, 25 nurses, 25 paramedics and 20 assistants participated in the medical service. This corresponded to three emergency physician full medical time equivalents (FMTE) for 16 days. Consultations performed: 1238 or 97/day resulting in 34 (3%) transfers including seven medicalized. Patients were 706 (57%) men and 495 (43%) women, with mean age of 43±1 years. Trauma patients were most numerous (20%). CONCLUSION: Medical means involved were consistent for 16 days. The medical activity was sustained, but medicalized transfer rarely required.

Strengthened Ebola surveillance in France during a major outbreak in West Africa: March 2014-January 2016.

Introduction An unprecedented outbreak of Ebola virus diseases (EVD) occurred in West Africa from March 2014 to January 2016. The French Institute for Public Health implemented strengthened surveillance to early identify any imported case and avoid secondary cases. METHODS: Febrile travellers returning from an affected country had to report to the national emergency healthcare hotline. Patients reporting at-risk exposures and fever during the 21st following day from the last at-risk exposure were defined as possible cases, hospitalised in isolation and tested by real-time polymerase chain reaction. Asymptomatic travellers reporting at-risk exposures were considered as contact and included in a follow-up protocol until the 21st day after the last at-risk exposure. RESULTS: From March 2014 to January 2016, 1087 patients were notified: 1053 were immediately excluded because they did not match the notification criteria or did not have at-risk exposures; 34 possible cases were tested and excluded following a reliable negative result. Two confirmed cases diagnosed in West Africa were evacuated to France under stringent isolation conditions. Patients returning from Guinea (n = 531; 49%) and Mali (n = 113; 10%) accounted for the highest number of notifications. CONCLUSION: No imported case of EVD was detected in France. We are confident that our surveillance system was able to classify patients properly during the outbreak period.

Optimally efficient swimming in hyper-redundant mechanisms: control, design, and energy recovery.

Hyper-redundant mechanisms (HRMs), also known as snake-like robots, are highly adaptable during locomotion on land. Researchers are currently working to extend their capabilities to aquatic environments through biomimetic undulatory propulsion. In addition to increasing the versatility of the system, truly biomimetic swimming could also provide excellent locomotion efficiency. Unfortunately, the complexity of the system precludes the development of a functional solution to achieve this. To explore this problem, a rapid optimization process is used to generate efficient HRM swimming gaits. The low computational cost of the approach allows for multiple optimizations over a broad range of system conditions. By observing how these conditions affect optimal kinematics, a number of new insights are developed regarding undulatory swimming in robotic systems. Two key conditions are varied within the study, swimming speed and energy recovery. It is found that the swimmer mimics the speed control behaviour of natural fish and that energy recovery drastically increases the system's efficiency. Remarkably, this efficiency increase is accompanied by a distinct change in swimming kinematics. With energy recovery, the swimmer converges to a clearly anguilliform gait, without, it tends towards the carangiform mode.

A trajectory tracking controller for an underwater hexapod vehicle.

This paper describes work done in the modeling and control of a low speed underwater vehicle that uses paddles instead of thrusters to move in the water. A review of previously modeled vehicles and of controller designs for underwater applications is presented. Then, a method to accurately predict the thrust produced by an oscillating flexible paddle is developed and validated. This is followed by the development of a method to determine the ideal paddle motion to produce a desired thrust. Several controllers are then developed and tested using a numerical simulation of the vehicle. We found that some model-based controllers could improve the performance of the system while others showed no benefit. Finally, we report results from experimental trials performed in an open water environment comparing the performance of the controllers. The experimental results showed that all the model-based controllers outperform the simple proportional-derivative controller. The controller giving the best performance was the model-based nonlinear controller. We also found that the vehicle was able to follow a change of a roll angle of 90 degrees in 0.7 s and to precisely follow a sinusoidal trajectory with a period of 6.28 s and an amplitude of 5 degrees.

2000 Judson C. Hickey Scientific Writing Award. Effect of impression materials on hybridized dentin.

STATEMENT OF PROBLEM: Tooth sensitivity after crown preparation is not an uncommon complication. For dentin bonding agents to be effective in preventing postoperative sensitivity, they must remain intact throughout the fixed prosthodontic procedures. PURPOSE: This study evaluated, by analyzing the change in dentin permeability, whether a dentin bonding agent was removed from the surface of prepared teeth in the process of making an impression. MATERIAL AND METHODS: Eighty extracted human molars were cut horizontally apical to the cemento-enamel junction and horizontally through the middle of the clinical crown. The specimens were prepared to measure dentin permeability (fluid flow rate, Lp). The specimens (n = 40) were randomly assigned to either the primer-only group (PO) or the primer + adhesive group (PA). Five different impression materials were tested: vinyl polysiloxane, polyether, polysulfide, irreversible hydrocolloid, and reversible hydrocolloid. Dentinal permeability was measured after smear layer removal (control, etched Lp = ELp), after coating the dentin with either PO or PA (coated Lp = CLp), and again after making an impression (impression Lp = ILp). A 1-way ANOVA of differences, followed by a Student-Newman-Keuls test (alpha=.05), was performed to compare the ELp, CLp, and ILp values. RESULTS: A statistically significant difference was found between the CLp and ELp for all 5 impression materials in both groups (PO and PA). No difference was found between the CLp and ILp values for any of the impression materials. No significant differences were found between any of the 5 impression materials or either of the dentin surface treatments (PO or PA) when measuring the CLp and ILp. CONCLUSION: The dentin bonding agent had a significant effect in decreasing the Lp of the treated specimens. None of the impression materials significantly affected the measured CLp. There was no significant difference between the PO or PA (CLp) values.