Survival of a microbial inoculant in soil after recurrent inoculations.

Microbial inoculants are attracting growing interest in agriculture, but their efficacy remains unreliable in relation to their poor survival, partly due to the competition with the soil resident community. We hypothesised that recurrent inoculation could gradually alleviate this competition and improve the survival of the inoculant while increasing its impact on the resident bacterial community. We tested the effectiveness of such strategy with four inoculation sequences of Pseudomonas fluorescens strain B177 in soil microcosms with increasing number and frequency of inoculation, compared to a non-inoculated control. Each sequence was carried out at two inoculation densities (106 and 108 cfu.g soil-1). The four-inoculation sequence induced a higher abundance of P. fluorescens, 2 weeks after the last inoculation. No impact of inoculation sequences was observed on the resident community diversity and composition. Differential abundance analysis identified only 28 out of 576 dominants OTUs affected by the high-density inoculum, whatever the inoculation sequence. Recurrent inoculations induced a strong accumulation of nitrate, not explained by the abundance of nitrifying or nitrate-reducing microorganisms. In summary, inoculant density rather than inoculation pattern matters for inoculation effect on the resident bacterial communities, while recurrent inoculation allowed to slightly enhance the survival of the inoculant and strongly increased soil nitrate content.

Protective effects of Saccharomyces boulardii CNCM I-745 in an experimental model of NSAID-induced enteropathy.

Nonsteroidal anti-inflammatory drugs (NSAIDs) induce a broad spectrum of gastro-intestinal adverse effects, including ulceration and bleeding. The pathophysiology of NSAID enteropathy is complex and incompletely understood, but some evidence showed that NSAIDs impair the intestinal barrier and cause a gut dysbiosis. Identifying new treatments aiming to reverse or attenuate NSAID-induced adverse effects would have a significant impact on a high number of patients. The aim of this work is to assess the effects of the probiotic yeast Saccharomyces boulardii CNCM I-745 (Sb) on a model of NSAID-induced enteropathy. Four groups of mice were tested: Control, Indomethacin, Sb, and Sb + Indomethacin. A clinical score was evaluated throughout the experiment. Faecal calprotectin, microbiota and haemoglobin analyses were performed. At the end of the treatments, the small intestine, colon, and caecum lengths, and intestinal permeability were measured. Sections of ileum and jejunum were observed to assess a histological score and ileal cytokines were measured by immunoassay. Indomethacin-treated animals showed an increase in their clinical scores, reflecting a worsening of their general state. Mice co-treated with Sb and indomethacin displayed an improvement of their clinical score in comparison with mice treated with indomethacin alone. Sb prevented the indomethacin-induced shortening of the small intestine and caecum, and significantly attenuated the severity of intestinal lesions. Sb also prevented the increase in faecal calprotectin, reduced faecal haemoglobin, and prevented the increase of intestinal permeability in mice treated with indomethacin. Sb also counteracted the increase of faecal bacteria associated with the pathogenesis of NSAID-enteropathy. In conclusion, our results show a protective effect of Sb in a model of indomethacin-induced enteropathy. Sb improved the intestinal barrier function and exerted a positive action on gut microbiota composition.

Functional Independence Measure score is associated with mortality in critically ill elderly patients admitted to an intermediate care unit.

BACKGROUND: Age alone is not a robust predictor of mortality in critically ill elderly patients. Chronic health status and functional status before admission could be better predictors. This study aimed to determine whether functional status, assessed using the Functional Independence Measure (FIM), could be an independent predictor of mortality in a geriatric population admitted to an intermediate care unit (IMCU). METHODS: A monocentric, retrospective, observational study of all patients aged ≥75 years old admitted to Geneva University Hospitals' geriatric IMCU between 01.01.2012 and 31.05.2016. The study's primary outcome metrics were one-year mortality's associations with a pre-admission FIM score and other relevant prospectively recorded prognostic variables. RESULTS: A total of 345 patients were included (56% female, mean age 85 +/- 6.5 years). Mean FIM score was 66 +/- 26. One-year mortality was 57%. Dichotomized low (≤ 63) and high FIM (> 63) scores were associated with one-year mortalities of 68 and 44%, respectively. Logistic regression calculations found an association between pre-admission FIM score and one-year mortality (p <  0.0001), including variables usually associated with mortality (e.g., age, sex, comorbidities, mini-mental health state score, renal function). Multivariate survival analysis showed a significant difference between groups, with a hazard ratio of 0.29 (95% CI: 0.13-0.65) for patients with high FIM scores. CONCLUSIONS: In the present study, higher functional status, assessed using the FIM tool before admission to an IMCU, was significantly and independently associated with lower one-year mortality. This opens up perspectives on the potential value of FIM for establishing a finer prognosis and better triage of critically ill older patients.

Saccharomyces boulardii CNCM I-745 changes lipidemic profile and gut microbiota in a hamster hypercholesterolemic model.

Hypercholesterolemia is a main risk factor of cardiovascular disease. Probiotics are a safe approach to reduce elevated cholesterol without any deleterious effect to human health. Saccharomyces boulardii CNCM I-745 probiotic properties are well documented in a context of intestinal dysbiosis. Recent in vitro and preclinical studies have suggested its potential effects on dyslipidemia. This is the first controlled study investigating the effects of S. boulardii CNCM I-745 on lipidemic profile and gut microbiota in a hamster hypercholesterolemic model. Daily administration (3 g/kg) of S. boulardii for 21 or 39 days in hamsters fed a 0.3% cholesterol-diet significantly reduced total plasma cholesterol (P<0.001) and increased faecal total cholesterol (P<0.05) compared to vehicle-treated animals. S. boulardii significantly modified the gut microbiota composition of the hamster fed a 0.3% cholesterol-diet. These microbial abundancy modifications of the microbiota were correlated to variations of lipidemic values or liver genes expressions. In particularly we found that abundance of g_Allobaculum, the most modified taxon after S. boulardii treatment (+236%; P<0.05), was correlated to variations in plasmatic lipoproteins level and ABCG5 hepatic gene expression. We also observed a not previously described correlation between the levels of g_Oxalobacter in the gut microbiota and total cholesterol plasma concentration. In conclusion, we confirmed the cholesterol-lowering effects of S. boulardii intake and we demonstrated for the first time the S. boulardii effect on gut microbiota in the context of hypercholesterolemia in hamsters. Our results provide new insights for a beneficial and safe approach of hypercholesterolemia treatment and could be considered for clinical development, alone or in addition to conventional treatment.

Graded SiGe waveguides with broadband low-loss propagation in the mid infrared.

Mid-infrared (mid-IR) silicon photonics is expected to lead key advances in different areas including spectroscopy, remote sensing, nonlinear optics or free-space communications, among others. Still, the inherent limitations of the silicon-on-insulator (SOI) technology, namely the early mid-IR absorption of silicon oxide and silicon at λ~3.6 µm and at λ ~8.5 µm respectively, remain the main stumbling blocks that prevent this platform to fully exploit the mid-IR spectrum (λ ~2-20 µm). Here, we propose using a compact Ge-rich graded-index Si1-xGex platform to overcome this constraint. A flat propagation loss characteristic as low as 2-3 dB/cm over a wavelength span from λ = 5.5 µm to 8.5 µm is demonstrated in Ge-rich Si1-xGex waveguides of only 6 µm thick. The comparison of three different waveguides design with different vertical index profiles demonstrates the benefit of reducing the fraction of the guided mode that overlaps with the Si substrate to obtain such flat low loss behavior. Such Ge-rich Si1-xGex platforms may open the route towards the implementation of mid-IR photonic integrated circuits with low-loss beyond the Si multi-phonon absorption band onset, hence truly exploiting the full Ge transparency window up to λ ~15 µm.

The impact of failure: unsuccessful bacterial invasions steer the soil microbial community away from the invader's niche.

Although many environments like soils are constantly subjected to invasion by alien microbes, invaders usually fail to succeed, succumbing to the robust diversity often found in nature. So far, only successful invasions have been explored, and it remains unknown to what extent an unsuccessful invasion can impact resident communities. Here we hypothesized that unsuccessful invasions can cause impacts to soil functioning by decreasing the diversity and niche breadth of resident bacterial communities, which could cause shifts to community composition and niche structure-an effect that is likely exacerbated when diversity is compromised. To examine this question, diversity gradients of soil microbial communities were subjected to invasion by the frequent, yet oft-unsuccessful soil invader, Escherichia coli, and evaluated for changes to diversity, bacterial community composition, niche breadth, and niche structure. Contrary to expectations, diversity and niche breadth increased across treatments upon invasion. Community composition and niche structure were also altered, with shifts of niche structure revealing an escape by the resident community away from the invader's resources. Importantly, the extent of the escape varied in response to the community's diversity, where less diverse communities experienced larger shifts. Thus, although transient and unsuccessful, the invader competed for resources with resident species and caused tangible impacts that modified both the diversity and functioning of resident communities, which can likely generate a legacy effect that influences future invasion attempts.

Ge-rich graded-index Si1-xGex waveguides with broadband tight mode confinement and flat anomalous dispersion for nonlinear mid-infrared photonics.

This work explores the use of Ge-rich graded-index Si1-xGex rib waveguides as building blocks to develop integrated nonlinear optical devices for broadband operation in the mid-IR. The vertical Ge gradient concentration in the waveguide core renders unique properties to the guided optical mode, providing tight mode confinement over a broadband mid-IR wavelength range from λ = 3 µm to 8 µm. Additionally, the gradual vertical confinement pulls the optical mode upwards in the waveguide core, overlapping with the Ge-rich area where the nonlinear refractive index is larger. Moreover, the Ge-rich graded-index Si1-xGex waveguides allow efficient tailoring of the chromatic dispersion curves, achieving flat anomalous dispersion for the quasi-TM optical mode with D ≤ 14 ps/nm/km over a ~1.4 octave span while retaining an optimum third-order nonlinear parameter, γeff. These results confirm the potential of Ge-rich graded-index Si1-xGex waveguides as an attractive platform to develop mid-IR nonlinear approaches requiring broadband dispersion engineering.

High quality entanglement on a chip-based frequency comb.

We report an efficient energy-time entangled photon-pair source based on four-wave mixing in a CMOS-compatible silicon photonics ring resonator. Thanks to suitable optimization, the source shows a large spectral brightness of 400 pairs of entangled photons /s/MHz for 500 µW pump power, compatible with standard telecom dense wavelength division multiplexers. We demonstrate high-purity energy-time entanglement, i.e., free of photonic noise, with near perfect raw visibilities (> 98%) between various channel pairs in the telecom C-band. Such a compact source stands as a path towards more complex quantum photonic circuits dedicated to quantum communication systems.

The changing face of internal medicine: patient centred care.

Patient centred care is now considered the gold standard and there should be 'no decision about me, without me'. Internists who treat patients with complex multi-morbidities should consider patients' preferred outcomes, following a 'goal-oriented' principle. Perhaps the most important barrier to goal-oriented care is that medicine is deeply rooted in a disease-outcome-based paradigm. Rather than asking what patients want, the culture of modern medicine has prioritised optimal disease management according to guidelines and population goals. Doing what is right for the patient should be based on trust. Patients and internists must therefore meet as equals: 'I' and 'you' should be replaced by 'we'.

Low loss 40 Gbit/s silicon modulator based on interleaved junctions and fabricated on 300 mm SOI wafers.

We demonstrate high-speed silicon modulators based on carrier depletion in interleaved pn junctions fabricated on 300 mm-SOI wafers using CMOS foundry facilities. 950 µm-long Mach Zehnder (MZ) and ring resonator (RR) modulator with a 100 µm radius, were designed, fabricated and characterized. 40 Gbit/s data transmission has been demonstrated for both devices. The MZ modulator exhibited a high extinction ratio of 7.9 dB with only 4 dB on-chip losses at the operating point.

[Training in internal medicine: the young internists' point of view]. / La formation en médecine interne vue par les jeunes internistes.

In France, internal medicine is a speciality obtained after 5 years of theoretical and practical training, often completed by additional years. The last version of the official training program was released in 2004 and was characterised by its polyvalence. After the reform of medical studies was announced, the French young internists group decided to carry out a survey in order to know the vision of the young internist about their initial theoretical and practical training. This survey was done online using a questionnaire from February 10th to April 8th, 2010. One hundred and twenty-three young internists under training completed the questionnaire. The results showed that a high number of trainees chose a subspeciality and took a complementary training afterwards. About 63% of them would rather have more theoretical training through lectures (72%) and oral presentations (58%). Eighty-eight per cent of young internists would rather have a national frame of reference with a common training program. According to 73% of the young internists who completed the survey, the practical training is adapted but 95% of them would like to be given the opportunity to have some consultation during their initial training. Seventy-nine per cent of the young internists seem to be interested in the clinical research but most of them (89%) think to be not well trained enough to do it.

[Epidemiological and clinical features of enteroviral meningitis: a case series of 59 adult patients]. / Caractéristiques clinicobiologiques des méningites à Enterovirus de l'adulte : étude de 59 cas.

PURPOSE: To describe the epidemiological and clinical features of enteroviral meningitis as well as the biological profile of the cerebrospinal fluid (CSF). METHODS: A retrospective study conducted in a single centre between 2004 and 2008. All aseptic meningitis due to Enterovirus were included. RESULTS: Fifty-nine patients were included. The triad including fever, headache and neck stiffness was reported in 62% of patients. Twelve patients (20%) had a neutrophilic leukocytosis and 23 (39%) an elevated CRP level. Twenty-eight patients (47%) had a prominent neutrophilic reaction in the CSF and nine (15.2%) had a low glucose concentration. A presumptive anti-bacterial treatment was initiated in 47 patients (80%) for an average of 3.2 days. CONCLUSION: Due to the lack of specificity of clinical features and biological manifestations of Enterovirus meningitis, the widespread use of real-time Enterovirus PCR is a priority for reducing the number of unnecessary anti-bacterial treatment. Guidelines based on clinical and biological features may be associated to help physicians in the differential diagnosis between bacterial and viral meningitides.

[Guillain-Barré syndrome and anti-hepatitis A vaccination]. / Syndrome de Guillain-Barré et vaccination contre l'hépatite A.

The Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuritis. The pathophysiology remains unknown but the existence of triggering factors such as external antigens is regularly suspected. We report the case of a 30-year-old patient with a past medical history of Graves disease, who presented with GBS within the month after receiving an anti-hepatitis A vaccination. GBS rarely happens after a hepatitis A vaccination. However, the responsibility of this vaccine should be considered in the clinical presentation of an acute polyradiculoneuritis.

[Duodenal ulcers caused by chloroquine-proguanil association]. / Ulcérations duodénales dues à l'association chloroquine-proguanil.

Chloroquine-proguanil association is recommended for prophylaxis against falciparum malaria in countries with a low prevalence of chloroquine resistance. It is usually well tolerated with mild side effects consisting mainly of transient digestive discomfort and buccal manifestations (mouth sores or ulcers). The purpose of this report is to describe a case of duodenal ulcers presenting as epigastric pain with 10-kg weight-loss in a 32-year-old man taking chloroquine-proguanil for malaria prophylaxis during a stay in Haiti. No other causes of duodenal ulcers or weight-loss were found. Chloroquine-proguanil prophylaxis was discontinued and replaced by omeprazole for four weeks. Symptoms improved quickly and full recovery was observed within one month. To our knowledge, the occurrence of duodenal ulcers under chloroquine-proguanil association is quite rare, but possibly severe. Upper digestive endoscopy should be performed if a patient under chloroquine-proguanil develops abdominal pain especially in association with weight-loss. If endoscopy reveals duodenal ulcers, chloroquine-proguanil should be discontinued and replaced by another prophylactic regimen.

Shifts between Nitrospira- and Nitrobacter-like nitrite oxidizers underlie the response of soil potential nitrite oxidation to changes in tillage practices.

Despite their role in soil functioning, the ecology of nitrite-oxidizing bacteria, NOB, and their response to disturbances such as those generated by agricultural practices are scarcely known. Over the course of 17 months, we surveyed the potential nitrite oxidation, PNO, the abundance of the Nitrobacter- and Nitrospira-like NOB (by quantitative PCR) and the community structure of the Nitrobacter-like NOB (by PCR-DGGE and cloning-sequencing targeting the nxrA gene) in soils for four treatments: after establishment of tillage on a previously no-tillage system, after cessation of tillage on a previously tillage system, and on control tillage and no-tillage systems. Key soil variables (moisture, organic carbon content and gross mineralization--i.e. ammonification--measured by the 15N dilution technique) were also surveyed. PNO was always higher for the no-tillage than tillage treatments. Establishment of tillage led to a strong and rapid decrease in PNO whereas cessation of tillage did not change PNO even after 17 months. PNO was strongly and positively correlated to the abundance of Nitrobacter-like NOB and was also strongly related to gross mineralization, a proxy of N-availability; in contrast, PNO was weakly and negatively correlated to the abundance of Nitrospira-like NOB. Selection of a dominant population was observed under no-tillage, and PNO was loosely correlated to the community structure of Nitrobacter-like NOB. Our results demonstrate that Nitrobacter-like NOB are the key functional players within the NOB community in soils with high N availability and high activity level, and that changes in PNO are due to shifts between Nitrospira-like and Nitrobacter-like NOB and to a weaker extent by shifts of populations within Nitrobacter-like NOB.

[Idiopathic intracranial hypertension as a side effect of doxycycline]. / Hypertension intracrânienne bénigne secondaire à la prise de doxycycline.

Idiopathic intracranial hypertension is a rare disorder characterized by elevated intracranial pressure without hydrocephaly or intracranial process. Its mechanism is poorly understood. Most cases of benign intracranial hypertension are presumed to be idiopathic but some of them may be related to some treatment. We report a 26-year-old female with benign intracranial hypertension due to tetracycline, revealed by headaches and gradual visual loss. Standard investigations were unremarkable and favourable outcome after therapeutic lumbar puncture confirmed the diagnosis.

[Interferon-beta retinopathy]. / Rétinopathie liée à l'interféron-beta 1a sous-cutané

INTRODUCTION: Interferon-alpha associated retinopathy is an ocular complication of hepatitis C treatment well established in the literature. But, there are far fewer reports on multiple sclerosis related interferon-beta retinopathy. CASE REPORT: A 58-year-old male while receiving subcutaneous interferon-beta 1a 44microg thrice a week since 2001 for multiple sclerosis developed blurred vision. Visual acuity remained stable throughout the course of surveillance. Cotton wool spots were found on fundus exam. The retinopathy disappeared without specific therapy 2 months after discontinuing interferon injections. The diagnosis of interferon-beta 1a retinopathy was retained due to the lack of any other etiology. CONCLUSION: An ophthalmological examination including a fundus examination to search for a retinopathy should be undertaken when new ocular symptoms develop in a multiple sclerosis patient receiving interferon. An adverse event linked to interferon can be discussed and favored if the retinopathy resolves after interferon withdrawal.

[Mushroom poisoning by brunneoincarnata: about two cases]. / Intoxication par brunneoincarnata: à propos de deux cas.

Amatoxin poisoning constitutes the main cause of death due to mushroom intoxication in Europe. This one was initially reported for the ingestion of Amanita phalloides with frequently fatal outcome. Prognosis of amatoxin poisoning initialy depends on the acute deshydratation and secondarily of the liver failure. Emergency liver transplantation is sometimes necessary. With the knowledge of mushroom, most of them involved other species which can often be linked to edible mushroom. We report a collective intoxication by Lepiota brunneoincarnata.