Sub-10 nm Silicon Nanopillar Fabrication Using Fast and Brushless Thermal Assembly of PS-b-PDMS Diblock Copolymer.

A new approach to obtaining spherical nanodomains using polystyrene-block-polydimethylsiloxane (PS-b-PDMS) is proposed. To reduce drastically the process time, we blended a copolymer with cylindrical morphology with a PS homopolymer. Adding PS homopolymer into a low-molar-mass cylindrical morphology PS-b-PDMS system drives it toward a spherical morphology. Besides, by controlling the as-spun state, spherical PDMS nanodomains could be kept and thermally arranged. This PS-homopolymer addition allows not only an efficient, purely thermal arrangement process of spheres but also the ability to work directly on nontreated silicon substrates. Indeed, as shown by STEM measurements, no PS brush surface treatment was necessary in our study to avoid a PDMS wetting layer at the interface with the Si substrate. Our approach was compared to a sphere-forming diblock copolymer, which needs a longer thermal annealing. Furthermore, GISAXS measurements provided complete information on PDMS sphere features. Excellent long-range order spherical microdomains were therefore produced on flat surfaces and inside graphoepitaxy trenches with a period of 21 nm, as were in-plane spheres with a diameter of 8 nm with a 15 min thermal annealing. Finally, direct plasma-etching transfer into the silicon substrate was demonstrated, and 20 nm high silicon nanopillars were obtained, which are very promising results for various nanopatterning applications.

Use of imaging in the follow-up of workers exposed to lung carcinogens: practices in occupational medicine and its determinants.

We studied occupational physicians' (OPs) practices of referrals for imaging of workers occupationally exposed to lung/pleural carcinogens and the factors associated with them. This cross-sectional telephone survey of 379 OPs practicing in Southeastern France showed that 81% of them referred exposed patients for chest radiographs, 33.5% for computed tomography (CT), and 16.1% for neither. Making no referral was positively associated with believing cancer risks are lower in one's own geographic sector than elsewhere and negatively associated with keeping employee risk records up-to-date. Referrals for CT were positively associated with work at in-house occupational health services (OHS), and completing employee exposure histories often/always. Both the OHS type and factors that may shape OPs' awareness of cancer risks in their sector appear to influence imaging referral practices. Occupational physicians would benefit from guidelines clarifying benefits and risks associated with imaging in such patients. An effort to harmonize regulatory provisions and guidelines also appears necessary.

Occupational physicians' attitudes and practices in relation to occupational cancer prevention: a qualitative study in southeastern France.

We conducted a qualitative survey of 20 occupational physicians (OPs) in southeastern France in 2008 to study their attitudes and practices regarding the prevention of occupational cancers. Occupational physicians' practices regarding occupational cancers centered mainly on prevention. Numerous difficulties impeded these activities: attitudes that minimized the carcinogenic risks by employers and employees, the absence or inadequacy of mandatory risk assessment to identify health hazards, and difficulties in obtaining individual exposure forms, which employers are supposed to complete to identify employees exposed to carcinogens. Other problems were related to the resources available to OPs and the constraints on their time. Finally, some OPs reported that they lacked self-efficacy. The results of this study suggested the need to strengthen OPs' initial training, draft and adopt good practice guidelines for various aspects of their practices, and improve collaborations between OPs and other professionals specialized in the prevention of occupational risks.

Different reporting patterns for occupational diseases among physicians: a study of French general practitioners, pulmonologists and rheumatologists.

PURPOSE: Physicians can play an important role in the reporting of occupational diseases (ODs), which are still under-reported in many countries. We aimed to identify physicians' difficulties in recognizing and reporting ODs and to study the characteristics of the physicians that do report ODs. METHODS: We conducted a telephone study in 2006-2007 among general practitioners (GPs), pulmonologists and rheumatologists in south-eastern France, concerning their knowledge, attitudes and practice in occupational health. Simple and multiple logistic regressions were performed to study factors associated with the issue of medical certificates for the claim process. RESULTS: Three hundred and ninety-one GPs, 95 pulmonologists and 96 rheumatologists participated. GPs reported significantly less often than specialists that they questioned their patients on past occupational exposure. They more frequently reported difficulties in identifying the occupational origin of diseases, and lack of knowledge on the OD reporting system. Issue of medical certificates for OD reporting was significantly more frequent among specialists than among GPs, among physicians considering that ODs are a public health problem, among those acquainted with the forms required to establish certificates, using internet to obtain information, having trade union activities, or having contact with occupational physicians (OPs). CONCLUSION: Initial and continuing training should be developed to encourage physicians, in particular GPs, to question patients on their working conditions and to become better acquainted with claim procedures. Physicians should also be provided with tools for identification of ODs that are suited to their practices, and collaboration with OPs should be fostered.

[What barriers hinder the reporting of work related sciatic pain by GPs and rheumatologists?]. / Quels freins à la déclaration d'une lombosciatique en maladie professionnelle pour les médecins généralistes et les rhumatologues?

Despite an epidemic of muscular-skeletal disorders (MSD), they are underreported. We carried out a telephone survey of 391 general practitioners (GPs) and 96 rheumatologists in south-eastern France to study the barriers to physicians' reporting of occupational diseases (OD). We presented them with a case-study of a patient with work-related sciatica. 72% of GPs and 84% of rheumatologists did not recommend to report this OD, for the following reasons, respectively: hesitation due to the possible role of extraprofessional activities as the root cause (77%, 74%), preferably should be reported as an occupational accident (67%, 42%), acknowledgement that the reporting of this is the role of occupational physicians (60% et 60%) and fear of risk of loosing one's job (47%, 36%). Results of multiple regression analyses suggest that the lack of awareness of reporting procedures and the presumption of causality principle may be main barriers to reporting.

Barriers to physician reporting of workers' compensation cases in France.

Studies suggest strong underreporting of occupational diseases in industrialized countries. We studied physician-related barriers to reporting of occupational sciatica (with herniated disk). We conducted a telephone survey of 391 general practitioners (GPs) and 96 rheumatologists in southeastern France with a standardized questionnaire and case-vignette of a patient with occupational sciatica. Our results show that 71% of GPs and 78% of rheumatologists would not recommend that the case-vignette patient file a workers' compensation claim, for the following reasons: possible role of nonwork-related activities (77%, 74%), should be reported as an occupational accident (67%, 42%), recommendation should be made by occupational physicians (60%, 60%), and risk of patient's losing his job (47%, 38%). Our results suggest that occupational sciatica is underreported in France. Physicians' lack of knowledge of reporting principles and procedures and their ethical dilemma regarding job loss may be barriers to reporting.

[Factors associated with physicians' under-reporting of asbestos-related bronchopulmonary cancers. Telephone survey conducted among general practitioners and pulmonologists randomly selected in the French region of Provence-Alpes-Côte-d'Azur]. / Facteurs associés à la sous-déclaration par les médecins des cancers bronchopulmonaires liés à l'amiante. Enquête téléphonique auprès d'un échantillon représentatif de médecins généralistes et de pneumologues de la région Provence-Alpes-Côte-d'Azur.

OBJECTIVES: To study the difficulties faced by general practitioners to detect and report asbestos-related cancers, focusing on the influence of patients' tobacco use, physicians' training and role perception. METHOD: Telephone survey conducted among 486 general practitioners and pulmonologists randomly selected in the French region of Provence-Alpes-Côte d'Azur, with: 1) a standardized questionnaire on their behaviors, attitudes and practices in the field of occupational health; 2) a clinical case (case vignette) about a lung cancer patient with occupational asbestos exposure. Two alternative versions of the clinical case varying only in the patient's smoking status were presented randomly to two subgroups of general practitioners and pulmonologists. The primary variable examined was the physician recommendation that the patient described in the vignette file an occupational disease claim. RESULTS: The response rate was 64.4% among general practitioners and 62.5% among pulmonologists. In multiple logistic regressions, the recommendation to file an occupational disease claim was significantly associated with specialty (OR = 4,46; 95% CI: 2.38-8.37 for pulmonologists versus general practitioners), patient's smoking status (OR = 3.15; 95% CI: 2.11-4.70, for non-smokers versus smokers), physician's workload (OR =1,8; 95% CI:1.17-2.88, for physicians examining less than 25 patients per day versus those examining more than 25) and role perception (OR = 2.00; 95% CI:1.22-3.27, for those who considered completing occupational disease medical certificates to be part of their role versus those who did not). CONCLUSION: For a certain number of physicians, tobacco use often over-shadows the role of environmental carcinogens in the development of cancers. Those responsible for initial and continuing medical education should give occupational health higher priority in their programs. Tools designed to help physicians detecting and managing occupational diseases should be developed and disseminated.

Protein phosphorylation corrects the folding defect of the neuroblastoma (S120G) mutant of human nucleoside diphosphate kinase A/Nm23-H1.

Human nucleoside diphosphate (NDP) kinase A is a 'house-keeping' enzyme essential for the synthesis of nonadenine nucleoside (and deoxynucleoside) 5'-triphosphate. It is involved in complex cellular regulatory functions including the control of metastatic tumour dissemination. The mutation S120G has been identified in high-grade neuroblastomas. We have shown previously that this mutant has a folding defect: the urea-denatured protein could not refold in vitro. A molten globule folding intermediate accumulated, whereas the wild-type protein folded and associated into active hexamers. In the present study, we report that autophosphorylation of the protein corrected the folding defect. The phosphorylated S120G mutant NDP kinase, either autophosphorylated with ATP as donor, or chemically prosphorylated by phosphoramidate, refolded and associated quickly with high yield. Nucleotide binding had only a small effect. ADP and the non-hydrolysable ATP analogue 5'-adenyly-limido-diphosphate did not promote refolding. ATP-promoted refolding was strongly inhibited by ADP, indicating protein dephosphorylation. Our findings explain why the mutant enzyme is produced in mammalian cells and in Escherichia coli in a soluble form and is active, despite the folding defect of the S120G mutant observed in vitro. We generated an inactive mutant kinase by replacing the essential active-site histidine residue at position 118 with an asparagine residue, which abrogates the autophosphorylation. The double mutant H118N/S120G was expressed in inclusion bodies in E. coli. Its renaturation stops at a folding intermediate and cannot be reactivated by ATP in vitro. The transfection of cells with this double mutant might be a good model to study the cellular effects of folding intermediates.

France: genetics education for non-genetics health care providers.

OBJECTIVE: This paper explores the treatment of medical genetics in undergraduate medical education, specialists' training and continuing medical education (CME) for general practitioners, specialists, nurses and midwives. METHODS: We conducted a qualitative survey of websites, published or unpublished documents, telephone interviews and mailed questionnaires. RESULTS: Genetics is a medical specialty in France, and the small number of university professors in genetics are in charge of the genetic component of medical training of all future practitioners. The study was complicated by the ongoing waves of reforms in the French health and educational systems and by the autonomy of the faculties. Specialist training and CME in genetics is heterogeneous and not organised as a priority. CONCLUSIONS: Specialist education and CME in genetics of non-geneticist health care providers needs to be adapted to the fast ongoing developments of this field of knowledge.