Absolute calibration of a streaked optical pyrometer at nanosecond time scale with a luminescent concentrator.

The Streaked Optical Pyrometer (SOP) is a visible diagnostic widely used to study the warm dense matter regime at high energy laser facilities, gas guns, or ion accelerators. It is usually coupled with a Velocity Interferometer System for Any Reflector (VISAR) diagnostic for simultaneous shock wave velocity, reflectivity, and temperature measurements to study the Equation of State (EOS) of materials. While VISAR is a well-mastered technology that provides velocity measurements with low relative uncertainties (close to percent), SOP diagnostics still suffer from high imprecision. In this article, we present a new calibration method in order to obtain absolute temperature measurements with reduced uncertainties. This approach is based on a novel light source: a Ce:YAG luminescent concentrator pumped by LEDs. This device produces enough optical power for calibration at the nanosecond sweep duration of the streak camera. As a demonstration, it has first been installed at the LULI facility and tested on quartz samples shocked at temperatures above 4000 K.

Time-resolved near backscatter imaging system on Laser MegaJoule.

The newly operating near-backscattering imaging (NBI) system on the Laser MegaJoule (LMJ) is briefly described with emphasis on the temporally resolved measurements and their synchronization with the LMJ laser pulse through target shots taken as part of the diagnostic commissioning campaign. The NBI measures the stimulated Brillouin and Raman scattered light around two quadruplets (one inner and one outer) of the upper LMJ hemisphere. The temporal resolution is achieved with a unique system: a specifically designed wide-open optical lens images 40 points of a diffuser onto an array of optical fibers with the scattered light recorded on a multiplexed photodiode array.

Dynamic cardiorespiratory changes in obese women.

AIM: This study examined the effects of an exercise training program on ventilatory function at rest and the exercise cardiorespiratory pattern in relation to body composition in obese individuals (53.4±7.6 years; 158.6±6.7 cm). METHODS: After initial tests (exercise testing and anthropometric assessment), ten women participated in a 12-week training program combining strength exercise and aerobic exercise at the ventilatory threshold, three times per week for 90 minutes. RESULTS: The post-training mean ventilatory efficiency (ΔE/ΔCO(2)) and cardiac efficiency (ΔHR/ΔO(2)) were improved (P<0.05, respectively). Decreased fat mass (-1.2 kg, P<0.01), increased lean body mass (+1 kg, P<0.01), and decreased waist and hip circumferences (-5.5 cm and -5 cm, respectively, P<0.05) were also obtained after training. CONCLUSION: The program significantly improved a number of physiological variables in our obese patients, although not to sedentary healthy levels. The results show that a functional exercise program has the potential to improve physiological variables and dynamic cardiorespiratory response to exercise in obese women.

Quality of life and obesity class relationships.

The aim of this study was to quantify the impact of obesity class on Health-Related Quality Of Life (HRQOL) and Total daily Energy Expenditure (TEE). 69 obese individuals were self-selected to 1 of 3 groups based upon Body Mass Index (BMI). Anthropometric parameters (height, weight, waist and hip circumference, fat mass, lean body mass), biological parameters (high density lipoprotein, low density lipoprotein, triglycerides, glycaemia, total cholesterol), and resting energy expenditure were assessed for each group. The Short Form Health Survey (SF-36) questionnaire and Hospital Anxiety Depression (HAD) scale were used to measure HRQOL, and TEE was estimated by Kurpad's method. Class 3 obesity was associated with greater impairment of the physical aspects of the SF-36 (37.2±11.3), greater depression risk (8.2±4.1), and higher TEE (30.0±7.9 Kcal·day (-1)·kg (-1)) than the lower obesity classes. No difference was observed among the 3 groups in the mental and psychosocial aspects of HRQOL. Impaired physical functioning was correlated with fat mass, age, waist circumference, glycaemia control and bodily pain. TEE was positively correlated with BMI, weight, fat mass and lean body mass. The obesity class had a negative impact on the physical health aspect of HRQOL, depression risk and energy expenditure. These impairments were associated with excess fat mass, waist circumference and glycaemia parameters.

Effect of force symmetry on coordination in crawl.

The relationship between breathing laterality and motor coordination symmetry as a function of the symmetry of medial rotator muscle force in the shoulders was investigated. The principal objective was to distinguish swimmer profiles. Thirteen expert male swimmers performed the front crawl and were assessed for: (i) inter-arm coordination with the IdC and arm coordination symmetry with the Symmetry Index, (ii) breathing laterality, and (iii) the symmetry of the isokinetic force in the shoulder medial rotators. The results indicated that the relative duration of catch+pull was greater for the dominant arm (51.7%) than for the non-dominant arm (48.4%) for the swimmers with force asymmetry (p<0.05) and occurred on the side with the higher force (dominant arm). Two profiles were revealed: (i) swimmers for whom breathing laterality was related to force symmetry and stroke phase duration and (ii) swimmers for whom the impact of breathing laterality on force symmetry and stroke duration was low. The first profile corresponded to sprint specialists and the second profile corresponded more to middle-distance specialists.

RGD peptides grafting onto poly(ethylene terephthalate) with well controlled densities.

The aim of this study was to graft RGD peptides with well controlled densities onto poly(ethylene terephthalate) (PET) film surfaces. Biomimetic modifications were performed by means of a four-step reaction procedure: surface modification in order to create -COOH groups onto polymer surface, coupling agent grafting and finally immobilization of peptides. The originality of this work is to evaluate several grafted densities peptides. Toluidine blue and high-resolution mu-imager (using [(3)H]-Lys) were used to evaluate densities. Moreover, mu-imager has exhibited the stability of peptides grafted onto the surface when treated under harsh conditions. Benefits of the as-proposed method were related to the different concentrations of peptides grafted onto the surface as well as the capacity of RGD peptide to interact with integrin receptors.

Physiological responses to repeated apneas in underwater hockey players and controls.

The aim of this study was to investigate the effects of short repeated apneas on breathing pattern and circulatory response in trained (underwater hockey players: UHP) and untrained (controls: CTL) subjects. The subjects performed five apneas (A1-A5) while cycling with the face immersed in thermoneutral water. Respiratory parameters were recorded 1 minute before and after each apnea and venous blood samples were collected before each apnea and at 0, 2, 5 and 10 minutes after the last apnea. Arterial saturation (SaO2) and heart rate were continuously recorded during the experiment. Before the repeated apneas, UHP had lower ventilation, higher P(ET)CO2 (p < 0.05) and lower P(ET)O2 than CTL (p < 0.001). After the apneas, the P(ET)O2 values were always lower in UHP (p < 0.001) than CTL but with no difference for averaged P(ET)CO2 (p = 0.32). The apnea response, i.e., bradycardia and increased mean arterial blood pressure, was observed and it remained unchanged throughout the series in the two groups. The SaO, decreased in both groups during each apnea but the post-exercise SaO2 values were higher in UHP after A2 to A5 than in CTL (p < 0.01). The post-apnea lactate concentrations were lower in UHP than in CTL. These results indicate that more pronounced bradycardia could lead to less oxygen desaturation during repeated apneas in UHP. The UHP show a specific hypoventilatory pattern after repeated apneas, as well as a more pronounced cardiovascular response than CTL. They indeed showed no detraining of the diving response.

Scalable and practical synthesis of clickable Cu-chelating azides.

A convenient and effective synthetic access to chelating azides was designed enabling the preparation of efficient clickable fluorescent derivatives. The comparison of the reactivity of these chelating azides to regular azides showcased the striking superiority of such derivatives for labeling applications.

A contemporary description of French newborns' growth using the Efemeris cohort.

BACKGROUND: Overweight and obesity in childhood are a major concern in developed countries. Reference growth curves are used in current practice to identify children at risk, especially at risk of overweight or obesity. National reference growth curves were published 35 years ago from children born in the 1950s to study growth from birth to adulthood. Additionally, more recent national curves exist to study birth weight and height according to gestational age. The primary objective was to describe anthropometric measurements of French children born in the 2000s and to compare them with the French references. The secondary objective was to describe overweight indicators during infancy. METHODS: A total of 77,315 singletons live-born from 1 July 2004 to 31 December 2013 recorded in the Efemeris (a French cohort of women and their children) were included. The z-score means based on the French references for weight, height, and body mass index (BMI) at birth, 9 months, and 24 months were calculated. RESULTS: At birth, the weight and height of the cohort did not deviate from the recent French references taking into account gestational age. At 9 and 24 months, the cohort was between 0.12 and 0.39 standard deviations (SD) heavier and between 0.70 and 0.97 SD taller than the old French reference population. Between 0 and 2 years, 28.6% of the children underwent a rapid weight gain (change in SD scores>0.67). The prevalence of overweight at 2 years was between 5 and 6% using the International obesity task force (IOTF) references. CONCLUSION: The distributions of the height, weight, and BMI during early childhood differ from those of children in the national growth references. Contemporary children at 2 years are taller and heavier than children born in the 1950s. Approximately one in 20 children is overweight at 2 years.

Hip passive range of motion and frequency of radiographic hip osteoarthritis in former elite handball players.

OBJECTIVE: To establish the relation between handball playing, passive hip range of motion (ROM), and the development of radiological hip osteoarthritis (OA) in former elite handball players. Two related issues are addressed: (a) the relation between long term elite handball playing and the incidence of hip OA; (b) the relations between hip ROM, OA, and pain. METHODS: Data on 20 former elite handball players and 39 control subjects were collected. A questionnaire yielded personal details, loading patterns during physical activity, and previous lower limb joint injury. Bilateral radiographs were analysed to diagnose and classify hip OA. Passive hip ROM was measured bilaterally with a goniometer. RESULTS: A close relation was found between long term elite handball practice and the incidence of hip OA: 60% of the handball players were diagnosed with OA in at least one of the hip joints compared with 13% of the control subjects. Passive ROM measured in the handball players was significantly lower for hip flexion and medial rotation and higher for abduction, extension, and lateral rotation than the control values. The handball players with OA reported less pain in the hip joints during daily activities than the control subjects with OA. CONCLUSION: The risk of developing premature hip OA seems high for retired handball players and significantly greater than for the general population. Pain and discomfort represent two difficult diagnostic challenges to the sports physician, as the repetitive nature of movements that are specific to handball can lead to alterations that are rarely seen in the general population.

[Faisability of foetal monitoring in prehospital care]. / Faisabilité du monitorage du rythme cardiaque foetal par cardiotocographe en Smur.

The use of mobile monitoring system for foetal cardiotachometry has never been evaluated in the prehospital care. The aim of the survey was to evaluate the faisability of this device. Twenty-five patients were enrolled, mostly within the context of interhospital transfer because of threatening premature delivery (n = 20). Foetal monitoring was effective for 64 % of the patients during initial physical examination and for 52 % during transport by ambulance. Prehospital treatment was improved in one case of eclampsia after on-scene fetal monitoring. Cardiotocography can be easily performed in the prehospital setting.

[Induction of labor in twin pregnancies compared to singleton pregnancies; risk factors for failure]. / Déclenchement du travail des grossesses gémellaires: comparaison avec les grossesses monofœtales et facteurs associés au risque d'échec.

OBJECTIVES: The aim of this study was to evaluate the modalities of induction of labour in twin pregnancies compared with singleton pregnancies and to identify risk factors for failure. MATERIALS ET METHODS: A retrospective population-based study was conducted at the Toulouse University Hospital to compare a cohort of diamniotic twin gestations (Twin A in vertex presentation), with induction of labour ≥36 weeks of gestation, between January 2007 and December 2012, to a singleton's cohort that were induced ≥36 weeks of gestation during the 2007 year. One singleton pregnancy was matched for each twin pregnancy with parity and gestational age. RESULTS: One hundred and fifty-six twins pregnancies met the inclusion criteria for an induction of labor and were compared to 156 single pregnancies. The same and standard protocol of induction of labor was used for the two cohorts (intrauterine balloon catheter±dinoprostone/ocytocine). The cesarean section rate for failed labor induction (cesarean in latent phase) was similar in the 2 populations (14.7% for twin vs 13.5% for single; P=0.66). The factors associated to failed induction of labor in the total population were nulliparity (OR=1.49) and Bishop score<6 at the beginning of the induction (OR=2.83). CONCLUSION: Twin did not appear as risk of failed induction. The protocol for induction of labor in singletons may be safely proposed to twin gestations.

Out-of-hospital thrombolytic therapy during cardiopulmonary resuscitation in refractory cardiac arrest due to acute myocardial infarction.

Out-of-hospital thrombolytic therapy was administrated to a 53-year-old woman with confirmed acute myocardial infarction and refractory cardiac arrest. Standard advanced cardiac life support measures were performed by an out-of-hospital critical care team but they were unsuccessful. Thrombolytic therapy was given as a rescue therapy after prolonged cardiopulmonary resuscitation. The patient recovered a sinus rhythm and circulation 20 minutes after a bolus infusion of tissue plasminogen activator and was fit to be transported to the hospital. Reversal of arterial occlusion was confirmed at the hospital. There was no sequelae related to thrombolytic therapy and the patient was finally discharged 21 days later. This is the first published report of out-of-hospital thrombolytic therapy during cardiopulmonary resuscitation for a patient with refractory cardiac arrest due to acute myocardial infarction.

Heart rate variation after breath hold diving with different underwater swimming velocities.

BACKGROUND: The aim of this study was to demonstrate the kinetics of heart rate and blood lactate level obtained after repeated short breath holds with muscular effort in a swimming pool. EXPERIMENTAL DESIGN: each subject had to perform a series of breath hold diving at rest and three series for different underwater swimming velocities. A series corresponded to six dives of a 30 sec duration separated by a recovery period of 30 sec. Heart rates and blood lactate levels were measured at rest and at the end of each series of breath holds. PARTICIPANTS: the population was composed of 10 male subjects divided into one trained group (5 experts) and one group of 5 beginners. RESULTS: Results indicated a higher bradycardia for the expert group at static breath hold (54.25 vs 65.5 beats x min-1). At the end of a series of breath holds, tachycardia was higher for beginners at different underwater swimming velocities. These values were less significant than the heart rate measured in laboratory despite trials that were abandoned due to high blood lactate levels above 3.5 mmol x l-1. In order to avoid the breath hold breaking point, the maximum heart rate had to correspond to the heart rate of the ventilatory threshold measured in the laboratory, minus the variations of bradycardia measured at rest. CONCLUSIONS: For the training coach, bradycardia was determined by water immersion during a static breath hold. This permitted an evaluation of the level of diver training. A maximal heart rate was attempted to avoid the breath hold breaking point. The results of this study may be useful in creating an effective diver training program.

[Out-of hospital management of elderly patients]. / Prise en charge préhospitalière médicalisée des personnes âgées.

OBJECTIVE: To evaluate prehospital management of elderly patients, agreement between prehospital and hospital diagnosis and to observe clinical course during hospitalization. TYPE OF STUDY: Retrospective study. PATIENTS AND METHOD: Out-of hospital patients of 65-year-old or more were included. Apart from demographic data, were collected: reasons for call, medicalization length, SAPS score, prehospital management, destination, prehospital and hospital diagnosis and patients evolution. Three groups were defined: G1 (65-74), G2 (75-84), G3 (> 84 year old). Statistical analysis was done by an Anova for quantitative data and by a Chi squared test for qualitative data. RESULTS: Two hundred and seventy-one patients were included (mean age 80 +/- 8 years, 43% of men). Eighty-two per cent of interventions were followed by a medicalized transport. Twelve per cent of patients died in the field. Forty-four per cent were hospitalised in intensive care unit, but patients of more than 84 year-old were significantly less often admitted in intensive care unit. There was no difference between the three groups in term of degree medicalization during transport. Eight per cent of patients required tracheal intubation in the field. Prehospital diagnoses were in agreement with reason for call in 61% of patients and with in-hospital diagnosis in 85% of patients. Fifty three per cent of patients came back home after hospitalisation. CONCLUSION: Analysis of elderly patient evolution after hospitalisation confirms the idea that the age should not influence the decision and the degree of prehospital medicalization.

[Survey on the use of mannitol in prehospital care in Paris area]. / Enquête sur l'utilisation du mannitol en réanimation préhospitalière en Ile-de-France.

OBJECTIVE: To evaluate the use of mannitol in prehospital care in Paris area. STUDY DESIGN: Survey using telephone interviews. METHODS: Emergency physicians on duty in the 37 emergency departments in charge of prehospital care in Paris area were called by one investigator. They were asked to answer a questionnaire about their own use of mannitol in the prehospital setting. RESULTS: Ninety-six questionnaires were recorded. Physicians were anaesthesiologists (9%) or emergency physicians (87%). In three departments, mannitol was not available in the ambulances. Thirty-five per cent (n = 34) reported no use of mannitol and 17% (n = 16) just once. Fourteen physicians (15%) did not want to use it. The reasons for not using mannitol were lack of knowledge about efficacy for five, need for previous brain imaging for seven or neurosurgeon's agreement before using mannitol for three. For those who had already used mannitol or were ready to use it, the main indication was increased intracranial pressure with clinical signs of brain herniation after severe brain injury for 92% of physicians. Thirty-one % reported not knowing the dose of mannitol, 33% having a memorandum immediately available and among those who answered the question, 63% gave a value compatible with guidelines. CONCLUSION: A significant percentage of physicians tacking part in the French prehospital care system, do not follow published guidelines on the use of mannitol. Actions improving implementation of those guidelines should be supported.

[Exposure of French emergency medical personnel to violence]. / Exposition à la violence en Smur.

OBJECTIVES: Evaluate the problem of violence in French EMS system and characterize assaults. STUDY DESIGN: Multicentric, descriptive, open study. PATIENTS AND METHODS: A questionnaire was given to a sample of prehospital care providers in Paris area. People were asked about assaults during their careers, typology of the assaults and consequences. Results are presented in percentage and means. RESULTS: Two hundred seventy-six questionnaires were returned. One or more assaults were recounted by 23% (61/271) of the sample (median of 8 +/- 7 years experience on the job). The injuries were bruises in 40% (17/43), wounds in 9% (4/43) and fractures in 2% (1/43). Only 4% of assaults were followed by sick leave, 15% by a complaint. After the assaults, 4% (2/45) reported having got therapy against post-traumatic stress disorder. Eighty-eight per cent reported verbal threat and 41% physical threat. Thirteen per cent (25/200) were threatened with a knife and 12% (23/200) with a gun. Only 9% (24/270) had a formal training for management of violence. CONCLUSION: Formal training in the management of violent encounters and prevention of post-traumatic stress should be developed.

[Evaluation of acute pain in prehospital medicine]. / Evaluation de la douleur aiguë en médecine préhospitalière.

OBJECTIVE: To evaluate acute pain in prehospital setting. STUDY DESIGN: Prospective survey. PATIENTS: All eligible patients during a 3-month-period, excepted children less than 10-year-old. METHOD: Pain intensity was evaluated by verbal rating scale with 5 points (VRS), visual analog scale (VAS), demand for antalgics by the patient and the relief obtained. These data were collected at the beginning (T0) and the end (Tend) of medical management. Analgesic treatments were let at the physician's choice. RESULTS: A series of 255 patients were included (mean age 58 +/- 1.5 SEM, sex-ratio 57M/43F). Among them, 42% experienced pain at VRS. VAS could be used in 60% of patients. VRS evaluated by the patient was correlated to the VAS (P < 0.001). Among those with significant pain (defined by a VAS > or = 30 mm), only 31% asked for analgesia and 64% received analgesics. Pain scales (VRS and VAS) were significantly improved (P < 0.001) at the end of the medical management, except for patients who did not receive any treatment. However, mean VAS was still above 30 mm, even in patients receiving analgesics. Only 49% of patients expressed a good relief at the end of the medical management. CONCLUSION: Acute pain is frequently observed in prehospital emergency medicine. Pain scales such as VRS and VAS are used easily and convenient for the assessment of pain intensity in this context. However, even if pain is correctly evaluated, it is still inadequately treated. The reasons of these inadequacies must be assessed and corrected with pain treatment protocols including opioids.