Demonstration of Muon-Beam Transverse Phase-Space Compression.

We demonstrate efficient transverse compression of a 12.5 MeV/c muon beam stopped in a helium gas target featuring a vertical density gradient and crossed electric and magnetic fields. The muon stop distribution extending vertically over 14 mm was reduced to a 0.25 mm size (rms) within 3.5 µs. The simulation including cross sections for low-energy µ^{+}-He elastic and charge exchange (µ^{+}↔ muonium) collisions describes the measurements well. By combining the transverse compression stage with a previously demonstrated longitudinal compression stage, we can improve the phase space density of a µ^{+} beam by a factor of 10^{10} with 10^{-3} efficiency.

SEGMENTATION OF ORGANS AT RISK IN THORACIC CT IMAGES USING A SHARPMASK ARCHITECTURE AND CONDITIONAL RANDOM FIELDS.

Cancer is one of the leading causes of death worldwide. Radiotherapy is a standard treatment for this condition and the first step of the radiotherapy process is to identify the target volumes to be targeted and the healthy organs at risk (OAR) to be protected. Unlike previous methods for automatic segmentation of OAR that typically use local information and individually segment each OAR, in this paper, we propose a deep learning framework for the joint segmentation of OAR in CT images of the thorax, specifically the heart, esophagus, trachea and the aorta. Making use of Fully Convolutional Networks (FCN), we present several extensions that improve the performance, including a new architecture that allows to use low level features with high level information, effectively combining local and global information for improving the localization accuracy. Finally, by using Conditional Random Fields (specifically the CRF as Recurrent Neural Network model), we are able to account for relationships between the organs to further improve the segmentation results. Experiments demonstrate competitive performance on a dataset of 30 CT scans.

Carotid diaphragm: Atypical fibromuscular dysplasia or atheromatous lesions?

Atypical fibromuscular dysplasia (FMD) is an underdiagnosed cause of ischemic stroke. The typical angiographic pattern of a septum on the posterolateral side of a carotid megabulb is highly suggestive of atypical FMD. We report here on two patients with this highly suggestive pattern of carotid atypical FMD, but which histological examination revealed to be atheromatous lesions. Interestingly, contrast-enhanced ultrasound of the carotid artery showed enhancement of the spur, which should never be the case with an FMD lesion, which has no vasa vasorum. Our findings suggest that the results of studies reporting stenting of atypical FMD in cervical arteries should be interpreted with caution.

A re-examination of antidepressant treatment-emergent mania in bipolar disorders: evidence of gender differences.

OBJECTIVE: To explore the prevalence and clinical profile of males and females who develop antidepressant treatment-emergent mania (ATEM). METHOD: From an original sample of 754 patients with BD, we identified ATEM+ cases (n = 75) and ATEM- controls (n = 135) that met stringent criteria. We specifically examined the combinations of clinical factors that best classified males and females as ATEM+ cases. RESULTS: Seventy-five individuals were classified as ATEM+; 87% of ATEM events occurred during antidepressant monotherapy. Regression analyses demonstrated that the presence of an alcohol and/or substance use disorder [Odds Ratio (OR) 6.37], a history of one or more suicide attempts (OR 4.19) and higher number of depressive episodes per year of illness (OR 1.71) correctly classified 73% of males. In contrast, 84% of females were correctly classified on the basis of a positive history of thyroid disorder (OR 3.23), a positive family history of BD I (OR 2.68) and depressive onset polarity (OR 2.01). CONCLUSION: Using stringent definitions of ATEM status to reduce the probability of inclusion of false-positive cases and false-negative controls, we identified for the first time that the risk profiles for the development of an ATEM differ significantly according to gender.

Childhood trauma and mixed episodes are associated with poor response to lithium in bipolar disorders.

OBJECTIVES: Reliable predictors of response to lithium are still lacking in bipolar disorders (BDs). However, childhood trauma has been hypothesized to be associated with poor response to lithium. METHODS: We included 148 patients with BD, euthymic when retrospectively and clinically assessed for response to lithium and childhood trauma using reliable scales. RESULTS: According to the 'Alda scale', the sample consisted in 20.3% of excellent responders, 49.3% of partial responders and 30.4% of non-responders to lithium. A higher level of physical abuse significantly correlated with a lower level of response to lithium (P = 0.009). As compared to patients not exposed to any abuse, patients with at least two trauma abuses (emotional, physical or sexual) were more at risk of belonging to the non-responders group (OR = 4.91 95% CI (1.01-27.02)). Among investigated clinical variables, lifetime presence of mixed episodes and alcohol misuse were associated with non-response to lithium. Multivariate analyses demonstrated that physical abuse and mixed episodes were independently associated with poor response to lithium (P = 0.005 and P = 0.013 respectively). CONCLUSIONS: Childhood physical abuse might be involved in a poor future response to lithium prophylaxis, this effect being independent of the association between clinical expression of BD and poor response to lithium.

Circadian genes and lithium response in bipolar disorders: associations with PPARGC1A (PGC-1α) and RORA.

Preliminary studies suggest that lithium (Li) response might be associated with some circadian gene polymorphisms, we therefore performed a pharmacogenetic study on the core clock genes in two independent samples suffering from bipolar disorder (BD) and thoroughly characterized for their Li response. Two independent Caucasian samples (165 and 58 bipolar patients) treated with Li were selected from samples recruited in a French multicenter study and assessed for their Li response using the Alda scale. The two samples were genotyped using the Human660 (H660) and OmniExpress (OE) BeadChips and gene-based association analyses of 22 core clock genes were conducted. In the first sample (H660 chip), the RAR-related orphan receptor-a gene (RORA) and the Peroxisome Proliferator-Activated Receptor Gamma, Coactivator 1 Alpha gene (PPARGC1A or PGC-1α) were significantly associated with the Li response (empirical P-value = 0.0015 and 0.04, respectively), and remained significant only for RORA after Bonferroni correction. In the second sample (OE chip), PPARGC1A was significantly associated with the Li response (empirical P-value = 0.04), and did not remain significant after Bonferroni correction. PPARGC1A is a master regulator of mitochondrial function and a key component of the endogenous clock that stimulates the expression of Bmal1 and Rev-erb-alpha through coactivation of RORA. Although the observed associations deserve further replication and investigation, our results suggest genetic associations between Li response and these two close biological partners: PPARGC1A and RORA involved in circadian rhythms and bioenergetics processes in Li response.

Cryogenic distillation facility for isotopic purification of protium and deuterium.

Isotopic purification of the protium and deuterium is an important requirement of many physics experiments. A cryogenic facility for high-efficiency separation of hydrogen isotopes with a cryogenic distillation column as the main element is described. The instrument is portable, so that it can be used at the experimental site. It was designed and built at the Petersburg Nuclear Physics Institute, Gatchina, Russia. Fundamental operating parameters have been measured including a liquid holdup in the column packing, the pressure drops across the column and the purity of the product at different operating modes. A mathematical model describes expected profiles of hydrogen isotope concentration along the distillation column. An analysis of ortho-parahydrogen isomeric composition by gas chromatography was used for evaluation of the column performance during the tuning operations. The protium content during deuterium purification (≤100 ppb) was measured using gas chromatography with accumulation of the protium in the distillation column. A high precision isotopic measurement at the Institute of Particle Physics, ETH-Zurich, Switzerland, provided an upper bound of the deuterium content in protium (≤6 ppb), which exceeds all commercially available products.

[Middle-term results of a Silastic prosthesis used as a temporary spacer for unreconstructable radial head fractures]. / Résultats à moyen terme d'un implant en Silastic utilisé comme espaceur transitoire dans les fractures non synthésables de la tête radiale.

This study reports the use of silicone prosthesis as a temporary spacer for comminuted fracture of the radial head. Twelve men and eight women with a mean age of 42 years (17-54) were operated on in an average of five days following a comminuted fracture of the radial head. Silicone radial head prosthesis was implanted with a mean duration of eight months (3-18) between implantation and removal. At a mean period of five years after initial surgery, the mean DASH score was 40 (24-82), the mean MEPS score was 86 (60-100) giving ten excellent results, five good and five means. At the last clinical follow-up, the average flexion was 127° (90-140) and 152° (50-180) for pronation-supination. Regarding our results, early removal of the Silastic implant prevented possible synovitis and failure of silicone implant. The stability of the elbow was obtained in all cases with association of a medial collateral ligament repair in case of instability. The use of a silicone radial head implant as a temporary spacer in case of radial head fracture type Mason III or IV seems to be a possible alternative to metal prostheses, whose implantation technique is demanding and sometimes not recommendable in young patients.

Measurement of muon capture on the proton to 1% precision and determination of the pseudoscalar coupling gP.

The MuCap experiment at the Paul Scherrer Institute has measured the rate Λ(S) of muon capture from the singlet state of the muonic hydrogen atom to a precision of 1%. A muon beam was stopped in a time projection chamber filled with 10-bar, ultrapure hydrogen gas. Cylindrical wire chambers and a segmented scintillator barrel detected electrons from muon decay. Λ(S) is determined from the difference between the µ(-) disappearance rate in hydrogen and the free muon decay rate. The result is based on the analysis of 1.2 × 10(10) µ(-) decays, from which we extract the capture rate Λ(S) = (714.9 ± 5.4(stat) ± 5.1(syst)) s(-1) and derive the proton's pseudoscalar coupling g(P)(q(0)(2) = -0.88 m(µ)(2)) = 8.06 ± 0.55.

[Functional MR urography in children]. / Uro-IRM fonctionnelle chez l'enfant.

MR Urography (MRU) provides both morphologic and functional information without radiation exposure. It enables the assessment of split renal function, excretion, and quantification of obstruction. MRU is thus complementary to ultrasonography in the assessment of pre- and post-natal obstructive uropathies in children. If available, MRU should be definitely preferred to intravenous urography.

Measurement of the muon capture rate in hydrogen gas and determination of the proton's pseudoscalar coupling gP.

The rate of nuclear muon capture by the proton has been measured using a new technique based on a time projection chamber operating in ultraclean, deuterium-depleted hydrogen gas, which is key to avoiding uncertainties from muonic molecule formation. The capture rate from the hyperfine singlet ground state of the microp atom was obtained from the difference between the micro(-) disappearance rate in hydrogen and the world average for the micro(+) decay rate, yielding Lambda(S)=725.0+/-17.4 s(-1), from which the induced pseudoscalar coupling of the nucleon, g(P)(q(2)=-0.88m(2)(micro))=7.3+/-1.1, is extracted.

Lyapunov generation of entanglement and the correspondence principle.

We show how a classically vanishing interaction generates entanglement between two initially nonentangled particles, without affecting their classical dynamics. For chaotic dynamics, the rate of entanglement is shown to saturate at the Lyapunov exponent of the classical dynamics as the interaction strength increases. In the saturation regime, the one-particle Wigner function follows classical dynamics better and better as one goes deeper and deeper in the semiclassical limit. This demonstrates that quantum-classical correspondence at the microscopic level does not require coupling to a large number of external degrees of freedom.

Quantum reversibility and echoes in interacting systems.

In echo experiments, imperfect time-reversal operations are performed on a subset of the total number of degrees of freedom. To capture the physics of these experiments, we introduce a partial fidelity M(B)(t), the Boltzmann echo, where only part of the system's degrees of freedom can be time reversed. We present a semiclassical calculation of M(B)(t). We show that, as the time-reversal operation is performed more and more accurately, the decay rate of M(B)(t) saturates at a value given by the decoherence rate of the controlled degrees of freedom due to their coupling to uncontrolled ones. We connect these results with NMR spin echo experiments.

Systemic allergy to human insulin and its rapid and long acting analogs: successful treatment by continuous subcutaneous insulin lispro infusion.

Since the introduction of highly purified human recombinant insulin, allergy to insulin has become a very rare clinical situation, encountered in less than 1% of patients. It results in potentially life-threatening immediate or delayed, local and general manifestations. Different treatments of unequal efficiency have been proposed, the use of insulin analogs showing benefits in certain situations. We report the case of a type 2 diabetic patient who presented local reactions and then an anaphylactic shock after the introduction of insulin analog premixes. Intra-dermal reactions performed with porcine, human and insulin analogs preparations (aspart, lispro, glargine) were all positive, as well as the specific anti-insulin IgE measurement. Because we could not achieve normoglycaemia with maximal oral treatment and low caloric diet, we decided to attempt a desensitisation by continuous subcutaneous infusion of insulin lispro, since the lowest skin reaction was obtained with this insulin. We were able to induce a tolerance, by means of very low basal rate, very slowly increased, without any boluses, and maintaining antihistamine therapy. Six months later, the patient remains free of any symptom and has achieved a quite good glycaemic control. We describe for the first time a case of allergy to human insulin and to all available rapid and long acting analogs. We show the interest of a treatment with CSII of analogs in order to induce tolerance.

Measurement of the resonant d(mu)t molecular formation rate in solid HD.

Measurements of muon-catalyzed dt fusion ( d(mu)t-->4He + n + mu(-)) in solid HD have been performed. The theory describing the energy dependent resonant molecular formation rate for the reaction (mu)t + HD-->[(d(mu)t)pee](*) is compared to experimental results in a pure solid HD target. Constraints on the rates are inferred through the use of a Monte Carlo model developed specifically for the experiment. From the time-of-flight analysis of fusion events in 16 and 37 microg x cm(-2) targets, an average formation rate consistent with 0.897+/-(0.046)(stat)+/-(0.166)(syst) times the theoretical prediction was obtained.

[Analgesia with oxygen-nitrous oxide mixture during percutaneous renal biopsy in children]. / Analgésie par le protoxyde d'azote pour la réalisation de la biopsie rénale percutanée chez l'enfant.

UNLABELLED: The efficacy of an inhaled equimolar mixture of nitrous oxide and oxygen (Entonox/MEOPA) to prevent procedural pain during renal percutaneous biopsies in children was assessed. PATIENTS AND METHODS: One hundred and seven children who underwent 113 renal biopsies during a 17-month period were included in a prospective uncontrolled pediatric study. Efficacy was evaluated using patients' answers to a questionnaire and nurses' observations. RESULTS: Pain was absent in 86.5% of the cases. Mild adverse events were noted in one-third of the procedures, and were always reversible within a few minutes when the inhalation stopped. Acceptability was good. The use of this gas is easy and safe provided a few precautions are observed. CONCLUSION: Inhaled equimolar mixture of nitrous oxide and oxygen prevents procedural pain during renal percutaneous biopsies.

Resonant formation of d&mgr;t molecules in deuterium: An atomic beam measurement of muon catalyzed dt fusion

Resonant formation of d&mgr;t molecules in collisions of muonic tritium ( &mgr;t) on D2 was investigated using a beam of &mgr;t atoms, demonstrating a new direct approach in muon catalyzed fusion studies. Strong epithermal resonances in d&mgr;t formation were directly revealed for the first time. From the time-of-flight analysis of 2036+/-116 dt fusion events, a formation rate consistent with 0.73+/-(0.16)(meas)+/-(0.09)(model) times the theoretical prediction was obtained. For the largest peak at a resonance energy of 0.423+/-0.037 eV, this corresponds to a rate of (7.1+/-1.8)x10(9) s(-1), more than an order of magnitude larger than those at low energies.

[Mental anorexia in aging. Report of a case]. / Anorexie mentale au cours du vieillissement. A propos d'un cas.

Elderly subjects who refuse to eat, and thus develop malnutrition, can be observed both in institutional and community settings. Causes include physiological changes related to the aging process, mental disorders and environmental factors. Most cases of anorexia nevrosa begin in adolescence but a sizeable number may develop at a later age. The term anorexia nevrosa in the elderly is proposed to describe this clinical entity observed in a woman who developed anorexia nevrosa at the age of 76 years. This entity is examined in comparison with prolonged earlier-onset anorexia nevrosa and late-onset anorexia.