[A guide to psychiatric prescribing in pregnancy, postpartum and breastfeeding]. / Guide de prescription psychiatrique pendant la grossesse, le postpartum et l'allaitement.

Perinatal psychopharmacology is an emerging specialty that is gradually developing alongside perinatal psychiatry. The management of psychiatric disorders during the perinatal period is a challenge for perinatal practitioners due to the multiple changes occurring during this crucial period. This little-known specialty still suffers from inappropriate considerations on the impact of psychotropic treatments on the mother and the infant during pregnancy and postpartum, which can promote a deficiency in perinatal psychic care. However, the risks associated with insufficient management of mental health are major, impacting both the mental and physical health of the mother and the infant. In this paper, we propose a perinatal psychopharmacology prescription guide based on available scientific evidence and international and national recommendations. We thus propose a decision-making process formalized on simple heuristics in order to help the clinician to prescribe psychotropic drugs during the perinatal period.

[Creation and functioning of Covid-19 pre-hospital triage centres : experience of french-speaking GP-coordinators]. / Face à la COVID-19. Création et fonctionnement des centres de tri pré-hospitaliers : expérience des médecins généralistes coordinateurs francophones.

Pre-hospital triage centres were created during the first wave of Covid-19 in March 2020. The intention was to examine patients in appropriate sanitary conditions and prevent emergency departments from overcrowding. This study describes triage centres in the Federation Wallonia-Brussels. The aim of the study was to collect key aspects of triage centres, implementation and information about the daily functioning interpreted positively or negatively by the GP-coordinators in charge of their management. This study was divided into two parts : an online questionnaire and semi-structured interviews. Overall, 14 questionnaires and 6 interviews were collected among the 44 initially contacted GP-coordinators. Our results point to a highly heterogeneous organisation of the triage centres, nevertheless adapted to local contexts, as well as a gap between local effective dynamics and challenges regarding federal/regional cooperation. This study may help for further crisis management plans.

Lors de la première vague de l'épidémie COVID-19, en mars 2020, des centres de tri (CDT) pré-hospitaliers ont été créés. Leur objectif était double : examiner les patients dans les conditions sanitaires adéquates et limiter l'afflux de patients aux urgences. L'étude vise à décrire ces CDT en Fédération Wallonie-Bruxelles. L'objectif était de relever, auprès des médecins généralistes (MG) coordinateurs de ces centres, les éléments ressentis comme positifs et négatifs dans la mise en place et le fonctionnement quotidien des CDT afin d'améliorer le dispositif pour de futures implémentations. Cette étude comportait deux volets : un questionnaire en ligne et des entretiens semi-structurés. Sur les 44 MG coordinateurs contactés, 14 questionnaires et 6 entretiens ont été récoltés. Nous avons mis en évidence une organisation très hétérogène des CDT, adaptée au contexte local, ainsi qu'un décalage entre la dynamique locale, décrite comme efficace, et les difficultés de coopération avec les niveaux fédéral et régional. Les résultats de cette étude pourraient aider dans l'implémentation de prochains plans de prise en charge en période de crise sanitaire.

[Psychiatry without mind?] / Une psychiatrie sans esprit ?

Philosophy of Mind is currently one of the most prolific fields of research in philosophy and has witnessed a progressive hybridization with cognitive science. It focuses on fundamental questions to neuroscience and psychiatry, such as the nature of mental states and cognitive processes, or the relationships between mental states and the world. Anticipating the accumulation of experimental data from neuroscience, it provides a framework for the generation of theories in cognitive science. Philosophy of mind has thus laid the foundations of the conceptual space within which cognitive sciences have spread: a large part of contemporary theories in cognitive science result from a hybridization of conceptions forged by philosophers of mind and data produced by neuroscientists. Yet contemporary psychiatry is still reluctant to feed on the philosophy of mind, other than through the fragments that emerge from neuroscience. In this paper, we describe the evolution of contemporary philosophy of mind, and we detail its contributions around three central themes for psychiatry: naturalization of mind, mental causality, and subjectivity of mental states. We show how philosophy of mind provide the conceptual framework to link different levels of explanation in psychiatry: from biological to functional, from neurophysiology to cognition, from matter to mind.

[Resilience and responsiveness of general practice during the COVID-19 pandemic]. / Résilience et réactivité de la médecine générale durant la pandémie COVID-19.

The COVID-19 pandemic has forced general practice to react and adapt its modus operandi in various ways. We describe most important practical adaptations according to the chronology imposed by the different phases of this unprecedented crisis, during the first three quarters of 2020. The Belgian health system and all its components have been put under tension. General medicine has been able to build on its strengths but has also suffered from certain weaknesses. Initial lessons must be learnt in order to better respond to the challenges of tomorrow.

La pandémie COVID-19 a imposé à la médecine générale de nombreuses réactions et adaptations de son mode de fonctionnement. Nous les décrivons dans cet article, selon la chronologie imposée par les différentes phases de cette crise inédite, durant les trois premiers trimestres de 2020. Le système de santé belge a été mis sous tension, dans toutes ses composantes. La médecine générale a pu s'appuyer sur ses forces, mais a également souffert de certaines faiblesses. Des premiers enseignements doivent être tirés pour mieux répondre aux défis de demain.

Molecular dynamics study of nanoconfined TIP4P/2005 water: how confinement and temperature affect diffusion and viscosity.

In the past few decades great effort has been devoted to the study of water confined in hydrophobic geometries at the nanoscale (tubes and slit pores) due to the multiple technological applications of such systems, ranging from drug delivery to water desalination devices. To our knowledge, neither numerical/theoretical nor experimental approaches have so far reached a consensual understanding of structural and transport properties of water under these conditions. In this work, we present molecular dynamics simulations of TIP4P/2005 water under different nanoconfinements (slit pores or nanotubes, with two degrees of hydrophobicity) within a wide temperature range. It has been found that water is more structured near the less hydrophobic walls, independently of the confining geometries. Meanwhile, we observe an enhanced diffusion coefficient of water in both hydrophobic nanotubes. Finally, we propose a confined Stokes-Einstein relation to obtain the viscosity from diffusivity, whose result strongly differs from the Green-Kubo expression that has been used in previous works. While viscosity computed with the Green-Kubo formula (applied for anisotropic and confined systems) strongly differs from that of the bulk, viscosity computed with the confined Stokes-Einstein relation is not so much affected by the confinement, independently of its geometry. We discuss the shortcomings of both approaches, which could explain this discrepancy.

Ultralow-temperature device dedicated to soft X-ray magnetic circular dichroism experiments.

A new ultralow-temperature setup dedicated to soft X-ray absorption spectroscopy and X-ray magnetic circular dichroism (XMCD) experiments is described. Two experiments, performed on the DEIMOS beamline (SOLEIL synchrotron), demonstrate the outstanding performance of this new platform in terms of the lowest achievable temperature under X-ray irradiation (T = 220 mK), the precision in controlling the temperature during measurements as well as the speed of the cooling-down and warming-up procedures. Moreover, owing to the new design of the setup, the eddy-current power is strongly reduced, allowing fast scanning of the magnetic field in XMCD experiments; these performances lead to a powerful device for X-ray spectroscopies on synchrotron-radiation beamlines facilities.

Element specific determination of the magnetic properties of two macrocyclic tetranuclear 3d-4f complexes with a Cu3Tb core by means of X-ray magnetic circular dichroism (XMCD).

We apply X-ray magnetic circular dichroism to study the internal magnetic structure of two very promising star shaped macrocyclic complexes with a CuII3TbIII core. These complexes are rare examples prepared with a macrocyclic ligand that show indications of SMM (Single Molecule Magnet) behavior, and they differ only in ring size: one has a propylene linked macrocycle, [CuII3TbIII(LPr)(NO3)2(MeOH)(H2O)2](NO3)·3H2O (nickname: Cu3Tb(LPr)), and the other has the butylene linked analogue, [CuII3TbIII(LBu)(NO3)2(MeOH)(H2O)](NO3)·3H2O (nickname: Cu3Tb(LBu)). We analyze the orbital and spin contributions to the Cu and Tb ions quantitatively by applying the spin and orbital sum rules concerning the L2 (M4)/L3 (M5) edges. In combination with appropriate ligand field simulations, we demonstrate that the Tb(iii) ions contribute with high orbital magnetic moments to the magnetic anisotropy, whereas the ligand field determines the easy axis of magnetization. Furthermore, we confirm that the Cu(ii) ions in both molecules are in a divalent valence state, the magnetic moments of the three Cu ions appear to be canted due to 3d-3d intramolecular magnetic interactions. For Cu3Tb(LPr), the corresponding element specific magnetization loops reflect that the Cu(ii) contribution to the overall magnetic picture becomes more important as the temperature is lowered. This implies a low value for the 3d-4f coupling.

[Echography at the point of care : stethoscope of the future for the General Practitioner ?] / L'échographie en situation de soin : stéthoscope du futur pour le médecin généraliste ?

Ultrasound is presently emerging not only as a specialist-delegated diagnostic procedure, but also as a tool used by clinicians for guiding decision. If this paradigm shift has taken roots in places like emergency departments, initiatives are also set up here and there in general practice. The aim of this article is , through a literature review, to identify possible indications of ultrasound performed by the general practitioner and to initiate a discussion about the obstacles and opportunities associated with its introduction in Belgian General Practice settings.

L'échographie ne se profile plus seulement comme un acte diagnostique délégué à un spécialiste, mais comme un outil utilisé en situation de soin par le clinicien pour guider la décision. Si ce changement de paradigme a bien pris pied dans une discipline comme les urgences, par exemple, des initiatives émergent ça et là pour adopter ce nouvel outil en médecine générale. Cet article se propose, à travers une revue de la littérature, de recenser les indications possibles de l'échographie réalisée par le médecin généraliste; puis, d'amorcer une discussion sur les freins et les opportunités associées à son introduction dans le contexte de la médecine générale belge.

Versatile variable temperature insert at the DEIMOS beamline for in situ electrical transport measurements.

The design and the first experiments are described of a versatile cryogenic insert used for its electrical transport capabilities. The insert is designed for the cryomagnet installed on the DEIMOS beamline at the SOLEIL synchrotron dedicated to magnetic characterizations through X-ray absorption spectroscopy (XAS) measurements. This development was spurred by the multifunctional properties of novel materials such as multiferroics, in which, for example, the magnetic and electrical orders are intertwined and may be probed using XAS. The insert thus enables XAS to in situ probe this interplay. The implementation of redundant wiring and careful shielding also enables studies on operating electronic devices. Measurements on magnetic tunnel junctions illustrate the potential of the equipment toward XAS studies of in operando electronic devices.

Quantum tunnelling of the magnetization in a monolayer of oriented single-molecule magnets.

A fundamental step towards atomic- or molecular-scale spintronic devices has recently been made by demonstrating that the spin of an individual atom deposited on a surface, or of a small paramagnetic molecule embedded in a nanojunction, can be externally controlled. An appealing next step is the extension of such a capability to the field of information storage, by taking advantage of the magnetic bistability and rich quantum behaviour of single-molecule magnets (SMMs). Recently, a proof of concept that the magnetic memory effect is retained when SMMs are chemically anchored to a metallic surface was provided. However, control of the nanoscale organization of these complex systems is required for SMMs to be integrated into molecular spintronic devices. Here we show that a preferential orientation of Fe(4) complexes on a gold surface can be achieved by chemical tailoring. As a result, the most striking quantum feature of SMMs-their stepped hysteresis loop, which results from resonant quantum tunnelling of the magnetization-can be clearly detected using synchrotron-based spectroscopic techniques. With the aid of multiple theoretical approaches, we relate the angular dependence of the quantum tunnelling resonances to the adsorption geometry, and demonstrate that molecules predominantly lie with their easy axes close to the surface normal. Our findings prove that the quantum spin dynamics can be observed in SMMs chemically grafted to surfaces, and offer a tool to reveal the organization of matter at the nanoscale.

Hysteresis and change of transition temperature in thin films of Fe{[Me2Pyrz]3BH}2, a new sublimable spin-crossover molecule.

Thin films of the spin-crossover (SCO) molecule Fe{[Me2Pyrz]3BH}2 (Fe-pyrz) were sublimed on Si/SiO2 and quartz substrates, and their properties investigated by X-ray absorption and photoemission spectroscopies, optical absorption, atomic force microscopy, and superconducting quantum interference device. Contrary to the previously studied Fe(phen)2(NCS)2, the films are not smooth but granular. The thin films qualitatively retain the typical SCO properties of the powder sample (SCO, thermal hysteresis, soft X-ray induced excited spin-state trapping, and light induced excited spin-state trapping) but present intriguing variations even in micrometer-thick films: the transition temperature decreases when the thickness is decreased, and the hysteresis is affected. We explain this behavior in the light of recent studies focusing on the role of surface energy in the thermodynamics of the spin transition in nano-structures. In the high-spin state at room temperature, the films have a large optical gap (∼5 eV), decreasing at thickness below 50 nm, possibly due to film morphology.

A new protocol for evaluating the efficacy of some dispensing systems of a packaging in the microbial protection of water-based preservative-free cosmetic products.

OBJECTIVE: A new protocol is described for assessing the efficacy of the dispenser of some packaging systems (PSs) of preservative-free cosmetic products in protecting both their contained formula and their delivered doses. METHODS: Practically, aiming at mimicking contacts with a non-sterile skin or fingers, the dispensing system is put into contact with a pre-contaminated fabric by a standardized colonization of P. aeruginosa. RESULTS: When applied to three different types of packaging, results show clear differences in both criteria between these conditioning articles, that is variable efficacies in protecting the contained product and the delivered doses, knowing that the first aspect is of paramount importance. CONCLUSION: The proposed protocol is proved being able to discriminate between different PSs and provides information on strong and weak features of certain types dispensing technologies prone to efficiently decrease either the dose contamination or to prevent contamination in reaching the contained product. Therefore, the proposed protocol can contribute to an objective selection of a PS for protecting a cosmetic care product with a low content of preservative or preservative free.

Fast continuous energy scan with dynamic coupling of the monochromator and undulator at the DEIMOS beamline.

In order to improve the efficiency of X-ray absorption data recording, a fast scan method, the Turboscan, has been developed on the DEIMOS beamline at Synchrotron SOLEIL, consisting of a software-synchronized continuous motion of the monochromator and undulator motors. This process suppresses the time loss when waiting for the motors to reach their target positions, as well as software dead-time, while preserving excellent beam characteristics.

Generalized lock-in detection for interferometry: application to phase sensitive spectroscopy and near-field nanoscopy.

A generalized lock-in detection method is proposed to extract amplitude and phase from optical interferometers when an arbitrary periodic phase or frequency modulation is used. The actual modulation function is used to create the reference signals providing an optimal extraction of the useful information, notably for sinusoidal phase modulation. This simple and efficient approach has been tested and applied to phase sensitive spectroscopy and near-field optical measurements. We analyze the case where the signal amplitude is modulated and we show how to suppress the contribution of unmodulated background field.

First glimpse of the soft x-ray induced excited spin-state trapping effect dynamics on spin cross-over molecules.

The dynamics of the soft x-ray induced excited spin state trapping (SOXIESST) effect of Fe(phen)2(NCS)2 (Fe-phen) powder have been investigated by x-ray absorption spectroscopy (XAS) using the total electron yield method, in a wide temperature range. The low-spin (LS) state is excited into the metastable high-spin (HS) state at a rate that depends on the intensity of the x-ray illumination it receives, and both the temperature and the intensity of the x-ray illumination will affect the maximum HS proportion that is reached. We find that the SOXIESST HS spin state transforms back to the LS state at a rate that is similar to that found for the light induced excited spin state trapping (LIESST) effect. We show that it is possible to use the SOXIESST effect in combination with the LIESST effect to investigate the influence of cooperative behavior on the dynamics of both effects. To investigate the impact of molecular cooperativity, we compare our results on Fe-phen with those obtained for Fe{[Me2Pyrz]3BH}2 (Fe-pyrz) powder, which exhibits a similar thermal transition temperature but with a hysteresis. We find that, while the time constant of the dynamic is identical for both molecules, the SOXIESST effect is less efficient at exciting the HS state in Fe-pyrz than in Fe-phen.

Low thoracic skeletal muscle index is associated with negative outcomes in 244 patients with respiratory COVID-19.

BACKGROUND: Sarcopenia is associated with negative outcomes in intensive care unit (ICU) patients and during chronic diseases. We aimed to evaluate if low skeletal muscle index (SMI) measured by computed tomography (CT) at the thoracic level is associated with poor outcomes in hospitalized patients with respiratory COVID-19. METHODS: Patients admitted to the hospital between March 1st and June 9, 2020 with a confirmed diagnosis of respiratory COVID-19 in the Emergency Department were included in this retrospective cohort study. SMI was assessed from a transverse CT image at the T12 level. We analysed the association between thoracic SMI and mortality, ICU admissions, infections, length of stay and gravity scores. RESULTS: We included 244 patients, whose median age was 62 (20-95) years, mean body mass index was 28,6 kg/m2, and 34% were obese patients. 102 patients (41,8%) had low thoracic SMI. On multivariable analysis, low thoracic SMI was associated with more infections (OR = 1,88 [1,06-2,98]) and increased length of stay (OR = 1,87 [1,14-3,49]) but not with mortality (OR = 1.37 [0.54-3.52]), whereas it was inversely associated with ICU admission (OR = 5,56 [1,96-16,67]. CONCLUSION: Low SMI measured by CT at the thoracic level T12 is associated with negative outcomes in patients with respiratory COVID-19.

What do French patients and geneticists think about prenatal and preimplantation diagnoses in Marfan syndrome?

OBJECTIVES: Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder with manifestations mainly involving the skeletal, ocular, and cardiovascular systems. The phenotypic variability observed in MFS makes genetic counselling difficult. Prenatal diagnosis (PND) and preimplantation genetic diagnosis are technically feasible when a causal mutation is identified, but both raise many ethical questions in this condition. Little is known about opinions and practices in such reproductive issues in MFS. The goal of this study was to report on patients' points of view and geneticists' standard practices. METHODS: Two different questionnaires were produced. RESULTS: Fifty geneticists filled in the questionnaire. Twenty-two per cent thought that PND was acceptable, 72% debatable and 6% not acceptable. Preimplantation genetic diagnosis was more often reported acceptable (34% of answers). Results varied according to the physician's experience with the disease. Fifty-four answers were collected for patients' questionnaires. Most of them (74%) were favourable to the development of prenatal testing, and believed that the choice should be given to parents. However, only a minority would opt for prenatal diagnosis for themselves. CONCLUSION: This study showed that the majority of patients were in favour of PND and that opinions among practitioners varied widely, but that overall, practitioners favoured a systematic multidisciplinary evaluation of the couple's request.

[The invisible pregnancy: Clinical characteristics and perspectives about denial of pregnancy]. / La grossesse invisible : caractéristiques cliniques et perspectives autour du déni de grossesse.

Denial of pregnancy is a public health problem due to maternal, fetal, and neonatal morbidity, affecting both physical and mental health. It generally involves an absence of the physical signals associated with pregnancy such as abdominal swelling, amenorrhea, weight gain, or even perception of fetal movements. Despite the potential consequences for mother and child, there is still little data on its clinical features and the neurocognitive mechanisms involved. In this paper, we provide an update on the clinical, socio-demographic, and psychopathological characteristics of pregnancy denial based on contemporary scientific literature. We first define denial of pregnancy by referring to the history of the concept, previous definitions, and nosographic classifications. We then detail the clinic of denial by distinguishing the physical and psychological symptoms of this disorder, then the socio-demographic, gynecological, and psychiatric characteristics. We describe the consequences of denial on the mother, infant, and the dyad, referring to situations of cryptic neonaticide. Finally, we show the importance of perinatal neuroscience research on maternal interoception to understand the mechanisms involved in denial of pregnancy, and improve their medical management in clinical practice.

Ultimate limit of electron-spin precession upon reflection in ferromagnetic films.

We report the discovery of 180° electron-spin precession in spin-polarized electron-reflection experiments on Fe films on Ag(001), the largest possible precession angle in a single electron reflection. Both experiments as a function of Fe film thickness and ab initio calculations show that the appearance of this ultimate spin precession depends with utmost sensitivity on the relaxation of the Fe surface layers during growth. Similar spin precession is also predicted for other ferromagnetic films.

[Impact of the Lubrizol Rouen plant fire of September 26, 2019 on ophthalmic emergency room visits]. / Impact de l'incendie de l'usine Lubrizol à Rouen le 26 septembre 2019 sur la fréquentation des urgences ophtalmologiques.

INTRODUCTION: A fire at the Lubrizol chemical factory in Rouen on September 26, 2019 generated a huge column of smoke directed northeast toward the city. As the eye might be particularly affected by the smoke and other toxic emissions from the fire, we assessed the impact of this industrial and ecological disaster on irritative eye surface disease in the week following the accident. MATERIALS AND METHODS: We retrospectively collected the medical data of the patients who presented to the Ophthalmology Emergency Department (OED) of Rouen University Hospital (the only OED open during the days following the accident) during the week following the fire (W1). We compared these data with those of patients who presented during the week before the fire (W-1). We also collected data on patients presenting to the ED in general during W-1 and W1, including the number of visits directly related to the fire. RESULTS: 361 patients presented to the OED during W1 following the fire, compared with 384 in W-1. Of these patients, 83 (23%) had ocular surface disease in W1, versus 76 (20%) in W-1. Conjunctivitis was found in 54 patients in W1 (39 viral, 9 allergic, 6 undetermined) versus 44 in W-1 (27 viral, 12 allergic, 5 undetermined). A dry irritative syndrome was present in 29 patients in W1 versus 32 in W-1. Only 4 patients directly attributed their symptoms to the fire: 2 viral conjunctivitis, 1 allergic conjunctivitis and 1 worried patient (at D2, D5, D7 and D7 following the fire respectively). DISCUSSION: The number of emergency eye consultations did not change in the week following the Lubrizol factory fire (except for a decrease the day of the accident, related to the lock-down). There was a higher number of consultations in W1 for conjunctivitis, mostly viral in appearance and probably not directly related to the fire. The number of consultations for dry irritative syndrome was comparable between the two periods. Despite major media coverage of the event at the national level and a very high level of concern among the population, the fire does not seem to have had an effect on OED activity at Rouen University Hospital, nor on general ED visits. The stay-at-home order on the first day may have had a protective effect, avoiding direct exposure to smoke. The long-term consequences of the soot deposits on the ground as the smoke cloud passed over remain undetermined and are under surveillance. A review of the literature on the ocular consequences of industrial accidents is presented. CONCLUSION: The Ophthalmology Emergency Department did not record increased activity in the week following the Lubrizol Rouen fire, and ocular surface disease did not give rise to more consultations than the week before the fire. This suggests that there was no or minimal immediate ocular toxicity of the smoke from the fire.