Status of the SPIRAL2 injector commissioning.

The SPIRAL2 injector, installed in its tunnel, is currently under commissioning at GANIL, Caen, France. The injector is composed of two low energy beam transport lines: one is dedicated to the light ion beam production, the other to the heavy ions. The first light ion beam, created by a 2.45 GHz electron cyclotron resonance ion source, has been successfully produced in December 2014. The first beam of the PHOENIX V2 18 GHz heavy ion source was analyzed on 10 July 2015. A status of the SPIRAL2 injector commissioning is given. An upgrade of the heavy ion source, named PHOENIX V3 aimed to replace the V2, is presented. The new version features a doubled plasma chamber volume and the high charge state beam intensity is expected to increase by a factor of 1.5 to 2 up to the mass ∼50. A status of its assembly is proposed.

Metallic beam developments for the SPIRAL 2 project.

The SPIRAL 2 facility, currently under construction, will provide either stable or radioactive beams at high intensity. In addition to the high intensity of stable beams, high charge states must be produced by the ion source to fulfill the RFQ LINAC injection requirements: Q/A = 1/3 at 60 kV ion source extraction voltage. Excepting deuterons and hydrogen, most of the stable beam requests concern metallic elements. The existing 18 GHz electron cyclotron resonance ion source (ECRIS) Phoenix V2 designed at LPSC Grenoble has been used for the tests and will be the source for the SPIRAL 2 commissioning. The tests performed at LPSC for calcium ((40)Ca(14+) and (40)Ca(16+)), nickel ((58)Ni(19+)), and sulfur ((32)S(11+)) are described and discussed. Due to the very high charge states required, the oven method has been chosen. An intensity of 1 pµA has been reached for those elements. The performance and the beam stability have been studied using different buffer gases, and some ionization efficiency preliminary results are given.

Roadmap for the design of a superconducting electron cyclotron resonance ion source for Spiral2.

A review of today achieved A∕Q = 3 heavy ions beams is proposed. The daily operation A∕Q = 3 ion beam intensities expected at Spiral2 are at the limit or above best record 3rd generation electron cyclotron resonance ion source (ECRIS) intensities. The necessity to build a new fully superconducting to fulfill these requirements is outlined. A discussion on the volume of the future source is proposed and the minimum value of 12 liters is derived. An analysis of the x-ray absorption superconducting ECRIS is presented based on VENUS experimental data and geometry. This study underlines the necessity to include a complete x-ray study at the time of source conception. The specifications foreseen for the new ECRIS are presented, followed with the roadmap for the design.

Status of the ion sources developments for the Spiral2 project at GANIL.

The SPIRAL 2 facility is now under construction and will deliver either stable or radioactive ion beams. First tests of nickel beam production have been performed at GANIL with a new version of the large capacity oven, and a calcium beam has been produced on the heavy ion low energy beam transport line of SPIRAL 2, installed at LPSC Grenoble. For the production of radioactive beams, several target∕ion-source systems (TISSs) are under development at GANIL as the 2.45 GHz electron cyclotron resonance ion source, the surface ionization source, and the oven prototype for heating the uranium carbide target up to 2000 °C. The existing test bench has been upgraded for these developments and a new one, dedicated for the validation of the TISS before mounting in the production module, is under design. Results and current status of these activities are presented.

[A protocol for the cessation of sedation in brain-injured patients]. / Évaluation d'un protocole d'arrêt de la sédation chez le patient cérébrolésé

OBJECTIVES: The cessation of sedation in brain-injured patients may result in severe agitation and/or acute withdrawal syndrome related to the prolonged administration of large doses of benzodiazepines and/or opioids. The aim of the present study was to assess the clinical efficacy of a written protocol to withdraw sedation for these patients. STUDY DESIGN: Observational prospective study. PATIENTS AND METHODS: After approval by the Institutional Review Board, 40 severely brain-injured patients were included. They had received continuous administration of midazolam and sufentanil or fentanyl for median 15 days. On cessation of midazolam infusion, patients were given clorazepate for 3 days. On cessation of opioid infusion and clorazepate, clinical data were collected for 48 hours: heart rate, systolic blood pressure, respiratory rate, agitation, and pupil diameter. If an opioid withdrawal syndrome occurred, patients received a 48-hour continuous infusion of buprenorphine. RESULTS: Of 40 patients, there were 10 who did not require buprenorphine. An agitation occurred 5 hours (1-21) after cessation of opioid, associated with tachycardia, arterial hypertension, and tachypnea. After 6 hours buprenorphine treatment, these parameters were normalized. No patient needed the reintroduction of the initial sedation. CONCLUSION: The cessation of sedation in severely brain-injured patients can be successfully managed with the use of clorazepate, associated with buprenorphine in the presence of agitation.

Latest developments at GANIL for stable and radioactive ion beam production.

In the frame of the SPIRAL II (Système de Production d'Ions Radioactifs Accélérés en Ligne Partie II) project, several developments of stable and radioactive ion production systems have been started up. In parallel, GANIL has the ambition to preserve the existing stable and radioactive beams and also to increase its range by offering new ones. In order to identify the best directions for this development, a new group called GANISOL has been formed. Its preliminary conclusions and the latest developments at GANIL are presented.

[Sedation in neurointensive care unit]. / Neurosédation en réanimation.

The objectives for using sedation in neurointensive care unit (neuroICU) are somewhat different from those used for patients without severe brain injuries. One goal is to clinically reassess the neurological function following the initial brain insult in order to define subsequent strategies for diagnosis and treatment. Another goal is to prevent severely injured brain from additional aggravation of cerebral blood perfusion and intracranial pressure. Depending on these situations is the choice of sedatives and analgesics: short-term agents, e.g., remifentanil, if a timely neurological reassessment is required, long-term agents, e.g., midazolam and sufentanil, as part of the treatment for elevated intracranial pressure. In that situation, a multimodal monitoring is needed to overcome the lack of clinical monitoring, including repeated measurements of intracranial pressure, blood flow velocities (transcranial Doppler), cerebral oxygenation (brain tissue oxygen tension), and brain imaging. The ultimate stop of neurosedation can distinguish between no consciousness and an alteration of arousing in brain-injured patients. During this period, an elevation of intracranial pressure is usual, and should not always result in reintroducing the neurosedation.

Status report of stable and radioactive ion beam production at GANIL.

GANIL has been producing many stable and radioactive ion beams for nearly 25 years. Constant progresses have been made in terms of intensity, stability, and reliability. The intensity for some stable metallic beams now exceeds or approaches the p microA level at an energy up to 95 MeV/u, e.g., 1.14 p microA for (36)S (65% enriched) at 77 MeV/u, 0.35 p microA for (58)Ni (63% enriched) at 74 MeV/u. Some recent results with Magnesocene using the metallic ions from volatile compounds method should also make possible the production of metallic beams with an intensity greater than 1 p microA. This has still to be measured. The ISOL facility SPIRAL I has been in operation for almost six years. Up to now, 17 exotic He experiments have been done with 14 target/ion-source (TIS) units; 19 other experiments (with O, Ne, Ar, and Kr) have been achieved with 14 TISs. Statistics show a fairly good ratio of available beam time to scheduled beam time. The radioactive beams and available intensities are compiled in this report. Future developments on radioactive ion beam production are briefly presented, while more details will be discussed elsewhere at this conference.

[Long-term outcome of patients after aneurysmal SAH]. / Devenir à long terme des patients après une HSA anévrismale.

Adequate instruments for measuring patient outcome after subarachnoid aneurysmal haemorrhage (SAH) are required to interpret results of clinical trials before making clinical recommendations. Graded measures are generally used, e.g. Glasgow Outcome Scale (GOS) and the modified Rankin Scale (mRS). However, these scales are inappropriate to measure cognitive dysfunction, particularly in patients with good outcome. We investigated the most frequent complains, the working status and the self-assessment of handicap (quality of life) in GOS-5 patients after their surgical treatment of a ruptured aneurysm. A questionnaire was sent to 126 patients one year following their discharge from hospital. The questionnaire assessed their motor activity, vitality and psychological troubles and handicap. Over 84 patients with GOS-5, 55 (65%) had persistent cognitive and psychological troubles including memory deficit, vitality and depressive troubles. Providing the use of combined scales to assess handicap and quality of life, these results suggest that SAH can result in a persistent alteration of cognitive function in patients, even in those classified as having a good outcome using the routine graded scales.

Identification of the advanced glycation end products N(epsilon)-carboxymethyllysine in the synovial tissue of patients with rheumatoid arthritis.

BACKGROUND: Generation of advanced glycation end products (AGEs) is an inevitable process in vivo and can be accelerated under pathological conditions such as oxidative stress. In serum and synovial fluid of patients with rheumatoid arthritis (RA) raised AGE levels have been found. OBJECTIVE: To determine the presence of N(epsilon)-carboxymethyllysine (CML; marker of oxidative stress) in RA synovial tissue by immunohistology. METHODS: Frozen synovial tissue samples from 10 patients with RA and eight controls (four patients without joint disease and four patients with osteoarthritis (OA)) were treated with rabbit-anti-CML-IgG and goat-antirabbit-IgG. Immunostaining was visualised by streptavidine-alkaline phosphatase (chromogen fuchsin). Cell differentiation was performed with antibodies against CD68, CD45RO, and CD20. RESULTS: CML was detected in the synovial lining, sublining, and endothelium in 10/10 RA and 4/4 OA synovial specimens. In RA some macrophages (CD68+) and T cells (CD45RO+) showed positive immunostaining for CML, whereas B cells were negative. Staining in OA synovial sublining was weak compared with RA. CONCLUSIONS: CML was detected for the first time in RA and OA synovial tissue. Different patterns of immunostaining in RA and OA and the presence of CML on macrophages and T cells, suggest a role for CML in the pathogenesis of RA. This might be due to presentation of new epitopes which can maintain or even trigger an autoimmune response.

Importance of international cooperation in food safety.

All countries need to ensure that national food supplies are safe, of good quality and available in adequate amounts at affordable prices to ensure good nutrition and health for all population groups. The enforcement of food standards by efficient national food control authorities in domestic markets and at the points of import and export has been increasingly recognized as a means of raising the value of exported goods by reducing the number of rejected or reconditioned consignments, and of ensuring the safety of the food and its acceptability by the final consumer. However, those national efforts have sometimes induced some non-tariff barriers to food trade and distribution. In addition, new developments in the technologies of food production, processing and marketing pose a new challenge to ensure safety of food. The strengthening of national food control infrastructures in particular in developing countries including the strengthening of staff capabilities, the need for harmonization of food at international levels, the need for collection and exchange of data on food control and food contamination issues are essential elements to ensure food safety in the world. International cooperation has an important role to play in achieving these essential elements.

[How can we organize the fight against H.I.V.?]. / Comment s'organise la lutte contre le V.I.H.?

The aim of this article is to highlight the different ways of fighting against H.I.V. With AZT, using peptide T, the author has looked at the latest theories and research being undertaken and their respective successes. He reminds us that the AIDS vaccination is not to be found tomorrow.

[An orodental epidemiologic survey conducted in the school environment in the Great Southwest of France]. / Enquête épidémiologique bucco-dentaire menée en milieu scolaire dans le Grand Sud-Ouest.

Within the framework of a national epidemiological study, a regional study of the oral conditions of a representative survey of 1174 schoolchildren aged 6 to 15 years, was conducted in the south-west Region of France. This Region studied by the Dental School of Bordeaux comprised the departments of Dordogne, Gironde, Landes, Lot-et-Garonne, Pyrénées-Atlantiques, Charente and Charente-Maritime. Only 8.8% of the 15 years old children were caries free. The mean DMFT was 4.3 at age 12 years whereas the mean DMFS at the same age was 6.6. At the age of 15, these indices reached respectively the values of 6.5 and 11.4. The most affected sites were the pits and fissures, followed by the approximal and smooth surfaces (respectively 59.3%, 25.4% and 15.3% at age 15). The plaque index varied only slightly around 0.9, whereas the calculus index increased regularly from 0.0 to 0.4 between the ages of 6 to 15 years. The gingival index, which was 0.1 at age 6, remained stable around 0.3 between 8 and 15 years of age.