Cartilage repair strategies in the knee according to Dutch Orthopedic Surgeons: a survey study.

BACKGROUND: This study surveyed Dutch orthopedic surgeons on the management of cartilage defects in the knee and the adherence to the recently updated Dutch knee cartilage repair consensus statement (DCS). METHODS: A web-based survey was sent to 192 Dutch knee specialists. RESULTS: The response rate was 60%. Microfracture, debridement and osteochondral autografts are performed by the majority, 93%, 70% and 27% of respondents, respectively. Complex techniques are used by < 7%. Microfracture is mainly considered in defects 1-2 cm2 (by > 80%) but also in 2-3 cm2 (by > 40%). Concomitant procedures, e.g., malalignment corrections, are performed by 89%. Twenty-one percent of surgeons treat patients aged 40-60 years. Microfracture, debridement and autologous chondrocyte implantation are not considered to be highly affected by age > 40 years by any of the respondents (0-3%). Moreover, for the middle-aged there is a large spread in treatments considered. In case of loose bodies, the majority (84%) only performs refixation in the presence of attached bone. CONCLUSION: Small cartilage defects in ideal patients may be well treated by general orthopedic surgeons. The matter becomes complicated in older patients, or in case of larger defects or malalignment. The current study reveals some knowledge gaps for these more complex patients. Referral to tertiary centers might be indicated, as is stated by the DCS, and this centralization should enhance knee joint preservation. Since the data from present study are subjective, registration of all separate cartilage repair cases should fuel objective analysis of clinical practice and adherence to the DCS in the future.

To what extent do social support and mastery mediate the association between childhood maltreatment and depression? A sequential causal mediation analysis.

AIMS: This study aimed to examine the independent roles of various childhood maltreatment (CM) subtypes in the development of depression; quantify the joint mediation effect of social support and mastery in the association between subtypes of CM and depression and examine the additional contribution of mastery beyond the effect that is operating through social support to this relationship. METHODS: Data analysed were from the Zone d'Épidémiologie Psychiatrique du Sud-Ouest de Montréal, an ongoing longitudinal population-based study. In total, 1351 participants with complete information on the studied variables were included. The propensity score matching and inverse-probability weighted regression adjustment estimation methods were used to minimise the potential confounding in the relationship between CM and major depression. We then used inverse odds ratio-weighted estimation to estimate the direct effects of maltreatment and indirect effects of social support and mastery. RESULTS: We found that exposures to all maltreatment subtypes increased the risk of subsequent depression. The joint mediating effect of social support and mastery explained 37.63-46.97% of the association between different maltreatment subtypes and depression. The contribution of these two mediators differed by maltreatment subtypes, with social support being the major contributor to the mediating effect. CONCLUSIONS: The findings of the study not only provide scientific evidence on the importance of psychosocial attributes in the development of major depression but also suggest that prevention and invention strategies should focus on these psychosocial attributes to effectively break the vicious cycle of CM on major depression.

Specific and cumulative lifetime stressors in the aetiology of major depression: A longitudinal community-based population study.

AIMS: Early-life stressful circumstances (i.e. childhood maltreatment) coupled with stressful events later in life increase the likelihood of subsequent depression. However, very few studies have been conducted to examine the specific and cumulative effects of these stressors in the development of depression. There is also a paucity of research that simultaneously considers the role of biological factors combined with psychosocial stressors in the aetiology of depression. Guided by the biopsychosocial model proposed by Engel, the present study aims to examine to what extent the experience of stressors across the lifespan is associated with depression while taking into account the role of genetic predispositions. METHODS: Data analysed were from the Social and Psychiatric Epidemiology Catchment Area of the Southwest of Montreal (ZEPSOM), a large-scale, longitudinal community-based cohort study. A total of 1351 participants with complete information on the lifetime diagnoses of depression over a 10-year follow-up period were included in the study. Stressful events across the lifespan were operationalised as specific, cumulative and latent profiles of stressful experiences. Latent profile analysis (LPA) was used to explore the clustering of studied stressors including childhood maltreatment, poor parent-child relationship, and stressful life events. A polygenetic risk score was calculated for each participant to provide information on genetic liability. Multivariate logistic regression was used to examine the association between specific, cumulative and latent profiles of stressors and subsequent depression. RESULTS: We found that different subtypes of childhood maltreatment, child-parent bonding and stressful life events predicted subsequent depression. Furthermore, a significant association between combined effects of cumulative stressful experiences and depression was found [odds ratio (OR) = 1.20, 95% confidence interval (CI): 1.12-1.28]. Three latent profiles of lifetime stressors were identified in the present study and named as 'low-level of stress' (75.1%), 'moderate-level of stress' (6.8%) and 'high-level of stress' (18.1%). Individuals with a 'high-level of stress' had a substantially higher risk of depression (OR = 1.80, 95% CI: 1.08-3.00) than the other two profiles after adjusting for genetic predispositions, socio-demographic characteristics, and health-related factors. CONCLUSIONS: While controlling for genetic predispositions, the present study provides robust evidence to support the independent and cumulative as well as compositional effects of early- and later-on lifetime psychosocial stressors in the subsequent development of depression. Consequently, mental illness prevention and mental health promotion should target the occurrence of stressful events as well as build resilience in people so they can better cope with stress when it inevitably occurs.

A giant nektobenthic radiodont from the Burgess Shale and the significance of hurdiid carapace diversity.

Radiodonts, stem-group euarthropods that evolved during the Cambrian explosion, were among the largest and most diversified lower palaeozoic predators. These animals were widespread geographically, occupying a variety of ecological niches, from benthic foragers to nektonic suspension feeders and apex predators. Here, we describe the largest Cambrian hurdiid radiodont known so far, Titanokorys gainesi, gen. et sp. nov., from the Burgess Shale (Marble Canyon, Kootenay National Park, British Columbia). Estimated to reach half a metre in length, this new species bears a very large ovoid-shaped central carapace with distinct short posterolateral processes and an anterior spine. Geometric morphometric analyses highlight the high diversity of carapace shapes in hurdiids and show that Titanokorys bridges a morphological gap between forms with long and short carapaces. Carapace shape, however, is prone to homoplasy and shows no consistent relationship with trophic ecology, as demonstrated by new data, including a reappraisal of the poorly known Pahvantia. Despite distinct carapaces, Titanokorys shares similar rake-like appendages for sediment-sifting with Cambroraster, a smaller but much more abundant sympatric hurdiid from the Burgess Shale. The co-occurrence of these two species on the same bedding planes highlights potential competition for benthic resources and the high diversity of large predators sustained by Cambrian communities.

Off-axis electron holography of Néel-type skyrmions in multilayers of heavy metals and ferromagnets.

Magnetic skyrmions are complex swirling spin structures that are of interest for applications in energy-efficient memories and logic technologies. Multilayers of heavy metals and ferromagnets have been shown to host magnetic skyrmions at room temperature. Lorentz transmission electron microscopy is often used to study magnetic domain structures in multilayer samples using mainly Fresnel defocus imaging. Here, off-axis electron holography is used to obtain in-focus electron optical phase images of Néel-type domains and skyrmions in an Ir/Fe/Co/Pt multilayer sample. The preparation of the sample, reconstruction of the holograms and influence of sample tilt angle on the signal-to-noise ratio in the phase images are discussed. A good agreement is found between images of individual skyrmions that are stabilized using an external magnetic field and simulated images based on theoretical models of Néel-type skyrmions.

Changes in facial signs due to age and their respective weights on the perception of age, on a tired-look or a healthy glow among differently aged Chinese men.

OBJECTIVE: To determine the respective weights of certain facial signs on the assessment of perceived age, tired-look and healthy glow on Chinese men of different ages. MATERIAL AND METHODS: Photographs were taken of the faces of 420 Chinese men of different ages, under standardized conditions. These photographs allowed to focus and define 15 facial signs, which were then graded by 15 experts and dermatologists, using standardized scales provided by a reference Skin Aging Atlas. The facial signs were dispatched into 5 clusters, namely wrinkles/texture, ptosis/sagging, pigmentation disorders, vascular disorders and cheek skin pores. A naïve panel, composed of 80 Chinese women, of similar age range were asked, when viewing full-face photographs, to: (i) attribute on a 0-10 scale their perception of both the tired-look and healthy glow aspects and (ii) estimate the age of the subject. RESULTS: With the exception of vascular disorders, the severity of all 4 clusters increased with age, although at different rates. The ptosis/sagging or pigmentation disorders showed a rather regular progression. Although perceived ages and real ages were found to be closely correlated, the vast majority of subjects were judged older by 2-10 years. The changes in facial signs (and their related clusters) were significantly correlated with perceived age, with the exceptions of skin spot density and cheek skin pores. Although the aspects of tired-look and healthy glow were logically found to be anti-correlated, tired-look was more statistically associated with perceived age for the five clusters. Signs of eye contour appear to be closely correlated with the perception of a tired-look. CONCLUSION: Within facial clinical clusters, wrinkles/texture and ptosis/sagging are major factors in the assessment of perceived age in Chinese men. Tired-look appears to be strongly associated with perceived age.

OBJECTIF: De déterminer, pour des hommes chinois d'âges différents, les poids respectifs de certains signes faciaux entrant dans l'estimation de la perception des visages pour l'âge, l'air fatigué ou l'éclat. MATÉRIEL ET MÉTHODES: Les visages de 420 hommes chinois d'âges différents ont été photographiés dans des conditions standardisées. Ces clichés ont permis à 15 experts et dermatologistes d'évaluer 15 signes cliniques selon des échelles éditées dans les références Atlas Cliniques du Vieillissement. Ces signes faciaux sont regroupés dans 5 groupes (rides/texture, ptose/relâchement, désordres pigmentaires, désordres vasculaires, pores de la joue). Un panel de 80 consommatrices chinoises, d'un âge comparable, a été recruté pour donner leurs perceptions sur chaque visage complet photographié: d'abord en attribuant sur une échelle de 0 à 10 un score pour leurs perceptions de l'air fatigué et de l'aspect éclatant de santé, puis en estimant l'âge apparent du volontaire. RÉSULTATS: A l'exception des Désordres vasculaires, la sévérité des 4 groupes cliniques s'accroit avec l'âge selon des cinétiques différentes, parmi lesquelles la ptose/relâchement ou les désordres pigmentaires montrent la progression la plus constante et linéaire. Malgré une très importante et significative corrélation entre âge apparent et âge réel, une majorité des volontaires ont été jugés plus vieux que leurs âges réels, entre 2 et 10 ans. Les variations des signes faciaux (ou des groupes cliniques associés) ont été montrés significativement corrélées à l'âge apparent, à l'exception de la densité des taches pigmentaires et des pores de la joue. Bien que l'air fatigué et l'éclat sont logiquement observés comme anti-corrélés, c'est l'air fatigué qui se trouve le plus relié à l'âge apparent sur les 5 groupes cliniques. Les signes du contour des yeux apparaissent comme les plus corrélés à la perception de l'air fatigué. CONCLUSION: Parmi les groupes cliniques, les rides/texture et la ptose/relâchement sont les facteurs majeurs dans l'attribution d'un âge perçu pour les hommes chinois. L'air fatigué apparaît comme très fortement relié à l'âge apparent.

Invasive group A streptococcal infection outbreaks of typeemm118 in a long-term care facility, and of type emm74 in the homeless population, Montréal, Quebec.

BACKGROUND: Two invasive group A streptococcus (iGAS) infection outbreaks occurred in Montreal in 2016 and 2017; one in a long-term care facility (typeemm118) and one in the community, primarily involving homeless people (typeemm74). OBJECTIVE: To describe two recent iGAS outbreaks in Montréal and highlight the challenges in dealing with these outbreaks and the need to tailor the public health response to control them. METHODOLOGY: All cases of iGAS were investigated and the isolates were sent to the laboratory foremmtyping. In both outbreaks, cases of superficial group Astreptococcus(GAS) infection were identified, through 1) systematic case detection accompanied by screening for asymptomatic carriers among residents and employees of the long-term care facility and 2) sentinel surveillance among homeless people. Visits were made to community organizations providing homeless services (including shelters) and social networks were analyzed to establish whether there were any links among cases of GAS infection (both invasive and noninvasive) and locations frequented. In both outbreaks, recommendations were made to service providers regarding enhancement of infection prevention and control measures. RESULTS: In the long-term care facility, five cases of typeemm118 iGAS were identified over a 22-month period, one of which resulted in death. All residents were screened and no carriers were identified. Among the employees, 81 (65%) were screened and fourcarriers were identified. Of those, one was a carrier of typeemm118 GAS. All carriers were treated, and subsequent follow-up sampling on three carriers (including the one withemm118) was negative.In the community, 23 cases of typeemm74 iGAS were detected over a 16-month period, four of which resulted in death. Half of the cases (n=12) were described as homeless, and six others were users of services for the homeless. Sentinel surveillance of superficial infections yielded 64 cultures with GAS, chiefly on the skin, including 51 (80%) of typeemm74. An analysis of the social networks revealed the large number and variety of resources for the homeless used by the cases. Visits to the community organizations providing homeless services revealed the heterogeneity and precariousness of some of these services, the difficulties encountered in applying adequate health and hygiene measures, and the high degree of mobility amongst those who use these services. CONCLUSION: The detection and control of iGAS outbreaks in both long-term care establishments and among community organizations providing homeless services are very complex. An outbreak of iGAS can develop in the background over a long time and be easily overlooked despite cases being admitted to the hospital.Emmtyping and systematic research of previous cases of iGAS are essential tools for the detection and characterization of outbreaks. Close cooperation among public health agencies, clinical teams, community organizations and laboratories is essential for proper monitoring and the reduction of GAS transmission in the community and health care settings.

A new hurdiid radiodont from the Burgess Shale evinces the exploitation of Cambrian infaunal food sources.

Radiodonts, a clade of Cambro-Devonian stem group euarthropods, have classically been regarded as nektonic apex predators. However, many aspects of radiodont morphology and ecology have remained unclear because of the typically fragmentary nature of fossil material. Here, we describe a new hurdiid radiodont based on abundant and exceptionally well-preserved fossils from the Burgess Shale (Marble Canyon area, British Columbia, Canada). Cambroraster falcatus gen. et sp. nov. is characterized by an extra-large horseshoe-shaped head carapace, bearing conspicuous posterolateral spinous processes, and partially covering a short trunk with eight pairs of lateral flaps. Each of the pair of frontal appendages possess five mesially curving rake-like endites equipped with a series of anteriorly directed hooked spines, altogether surrounding the oral cone. This feeding apparatus suggests a micro to macrophagous sediment-sifting feeding ecology. Cambroraster illuminates the evolution of Hurdiidae and evinces the exploitation of the diversifying infauna by these large and specialized nektobenthic carnivores in the aftermath of the Cambrian explosion.

Burgess Shale fossils shed light on the agnostid problem.

Agnostids (agnostinids and eodiscinids) are a widespread and biostratigraphically important group of Cambro-Ordovician euarthropods whose evolutionary affinities have been highly controversial. Their dumbbell-shaped calcified tergum was traditionally suggested to unite them with trilobites, but agnostinids have alternatively been interpreted as stem-crustaceans, based on Orsten larval material from the Cambrian of Sweden. We describe exceptionally preserved soft tissues from mature individuals of the agnostinids Peronopsis and Ptychagnostus from the middle Cambrian (Wuliuan Stage) Burgess Shale (Walcott Quarry and Marble Canyon, British Columbia, Canada), facilitating the testing of alternative hypotheses. The digestive tract includes conspicuous ramifying cephalic diverticulae. The cephalon carries one pair of elongate spinous antennules projecting to the front, two pairs of appendages with distally setose, oar-like exopods, and three pairs of presumably biramous appendages with endopods sporting club-shaped exites. The trunk bears five appendage pairs, at least the first two of which are similar to the posteriormost cephalic pairs. The combined evidence supports a nektobenthic and detritivorous lifestyle for agnostinids. A head with six appendiferous segments contrasts strikingly with the four known in trilobites and five typical of mandibulates. Agnostinids are retrieved as the sister group to polymeroid trilobites in our phylogeny, implying that crustacean-like morphologies evolved homoplastically. This result highlights the variability in segmental composition of the artiopodan head. Finally, our study emphasizes the continued role of Burgess Shale-type fossils in resolving the affinities of problematic biomineralizing taxa.

On the Hydrodynamics of Anomalocaris Tail Fins.

Anomalocaris canadensis, a soft-bodied stem-group arthropod from the Burgess Shale, is considered the largest predator of the Cambrian period. Thanks to a series of lateral flexible lobes along its dorso-ventrally compressed body, it is generally regarded as an efficient swimmer, well-adapted to its predatory lifestyle. Previous theoretical hydrodynamic simulations have suggested a possible optimum in swimming performance when the lateral lobes performed as a single undulatory lateral fin, comparable to the pectoral fins in skates and rays. However, the role of the unusual fan-like tail of Anomalocaris has not been previously explored. Swimming efficiency and maneuverability deduced from direct hydrodynamic analysis are here studied in a towing tank facility using a three-vane physical model designed as an abstraction of the tail fin. Through direct force measurements, it was found that the model exhibited a region of steady-state lift and drag enhancement at angles of attack greater than 25° when compared with a triangular-shaped reference model. This would suggest that the resultant normal force on the tail fin of Anomalocaris made it well-suited for turning maneuvers, giving it the ability to turn quickly and through small radii of curvature. These results are consistent with an active predatory lifestyle, although detailed kinematic studies integrating the full organism, including the lateral lobes, would be required to test the effect of the tail fin on overall swimming performance. This study also highlights a possible example of evolutionary convergence between the tails of Anomalocaris and birds, which, in both cases, are well-adapted to efficient turning maneuvers.

Introduction of external magnetic fields in entropic moment modelling for radiotherapy.

One of the big challenges of the emerging MRI-guided radiotherapy is the prediction of an external magnetic field effect on the deposited dose induced by a beam of charged particles. In this paper, we present the results of the implementation of the Lorentz force in the deterministic M1 model. The validation of our code is performed by comparisons with the Monte-Carlo code FLUKA. The relevant examples show a significant modification of the shape of dose deposition volume induced by the external magnetic field in presence of heterogeneities. A gamma-index analysis 3%/3mm shows a good agreement of our model with FLUKA simulations.

[Clinical audit on drug prescriptions for elderly patients hospitalized in a unit of psychiatry]. / Audit clinique ciblé sur la prise en charge médicamenteuse chez le sujet âgé hospitalisé en psychiatrie.

BACKGROUND: The elderly are particularly vulnerable to the iatrogenic effects of drugs that are a major public health problem. In a geriatric care unit of a psychiatric hospital, the pharmacist, in close cooperation with the various health professionals, takes part in the optimization of drug therapy of these patients during cross-professional consultation meetings. From 2009 to 2011, an evaluation of professional practices was run through a targeted clinical audit on the theme of "prescription drugs at the age of 75 and over". The main objective of this study is to measure the differences between the practices and the guidelines for prescription drugs concerning the elderly, and then to analyze and amend these differences. The secondary objective is to gather data on the prescription drugs for the elderly in the particular context of a psychiatric unit. METHODS: The evaluation was performed using two standards: the evaluation chart of prescriptions of the Professional College of French Geriatrics (CPGF) and the French National Authority for Health and the list of Laroche et al. In the first round, after analyzing the prescriptions of 105 patients, the gap between practice and accepted standards led to the definition of three areas of improvement on the associations of neuroleptics, on the use of anticholinergic drugs and on the prescription of benzodiazepines, the latter being subject of another communication. After reassessment, the prescriptions of 101 patients were thereafter analyzed in relation to the identified areas of improvement. RESULTS: Patient samples of both phases were statistically homogeneous. Between the two evaluations, the percentage of prescriptions with at least two neuroleptics remained stable, the decline was not significant (18.1% to 13.9%, P≥0.05). However, it was observed that the second suggested a "conditional" decline with dosages less than or equal to those recommended for the elderly dosages. The proportion of patients who did not take anticholinergic drugs increased from 30% to 60% (P≤0.01). In parallel to the improvement of these criteria, it was noted that the average number of psychotropic drugs prescribed was significantly reduced (from 3.3 to 2.79 psychotropic/patients, P=0.078). DISCUSSION: The involvement of a pharmacist in cross-professional meetings of a care unit of psychiatry for the elderly has contributed in setting up a clinical audit focused on the drug management of these patients. This work enabled measurement of the progress made in the use of anticholinergic drugs, following the guidelines. In the mean time, it has been highlighted that the standards used are difficult to comply with regarding some criteria. For instance, the use of neuroleptics in the case of elderly patients hospitalized in the unit of psychiatry and not in the unit of geriatrics requires specific adjustments. Indeed, there are patients whose disorders have led to psychiatric hospitalization, which may require a combination of two neuroleptics. This paved the way for us to develop, within a working group representative of all professionals involved, a list fitting our medical practice and integrated into a guidebook adapted to the drug therapy management of elderly patients in psychiatry. The approach being successful, this targeted clinical audit will be extended to patients aged 75 years and over, hospitalized in other care units of the hospital.

Laryngeal advancement surgery improves swallowing function in a reversible equine dysphagia model.

REASONS FOR PERFORMING STUDY: Pharyngeal dysphagia is a debilitating, sometimes fatal condition in horses, with multiple aetiologies. The pathophysiology is complex and not fully understood. Treatment is largely supportive. Laryngeal advancement surgery may diminish symptoms of dysphagia and improve swallowing in affected horses. OBJECTIVES: 1) to induce reversible moderate and marked pharyngeal dysphagia by regional anaesthesia of branches of the glossopharyngeal (IX), vagus (X) and hypoglossal (XII) nerves; 2) to characterise the dysphagia produced by each model; and 3) to determine whether laryngeal advancement surgery improves swallowing in these models. STUDY DESIGN: Experimental design using 6 adult horses. METHODS: Two dysphagia models were produced by blocking IX, the pharyngeal branch of X and XII unilaterally (moderate model) and only the pharyngeal branch of X bilaterally (marked model) within the guttural pouches. Both models were performed on each horse before and after surgery in order to assess the effectiveness of the surgical procedure as a potential treatment for pharyngeal dysphagia. Dysphagia was scored by partly blinded observers on a scale of 0-12 based on observations of eating (nonblinded), endoscopic examinations and fluoroscopic swallowing (blinded), where 0 = normal swallow and 12 = severe dysphagia with tracheal aspiration. Data were analysed by 3-factor ANOVA, with significance taken as P<0.05. RESULTS: Dysphagia models were reversible, and horses swallowed normally within 3 h of model induction. The marked dysphagia model impaired movement of feed from the base of the tongue to the oesophagus and caused severe airway contamination. The average dysphagia score (mean ± s.d.) for the marked dysphagia model was 10.6 ± 1.1 before surgery and 6.1 ± 4.3 after surgery (P = 0.007). Laryngeal advancement surgery did not significantly improve the dysphagia scores in the moderate model (P = 0.5). CONCLUSIONS: Laryngeal advancement surgery may improve swallowing and reduce aspiration in horses affected with diseases that cause pharyngeal dysphagia.

Deterministic model for the transport of energetic particles: Application in the electron radiotherapy.

A new deterministic method for calculating the dose distribution in the electron radiotherapy field is presented. The aim of this work was to validate our model by comparing it with the Monte Carlo simulation toolkit, GEANT4. A comparison of the longitudinal and transverse dose deposition profiles and electron distributions in homogeneous water phantoms showed a good accuracy of our model for electron transport, while reducing the calculation time by a factor of 50. Although the Bremsstrahlung effect is not yet implemented in our model, we propose here a method that solves the Boltzmann kinetic equation and provides a viable and efficient alternative to the expensive Monte Carlo modeling.

Interest of the Ergo-Kit(®) for the clinical practice of the occupational physician. A study of 149 patients recruited in a rehabilitation program.

OBJECTIVE: Functional capacity evaluation is commonly used to assess the abilities of patients to perform some tasks. Ergo-Kit(®) is a validated tool assessing both functional capacities of patients and workplace demands. The objective of this study was to evaluate the relevance of the Ergo-Kit(®) data for occupational physicians during the return-to-work process. METHODS: A retrospective and monocenter study was conducted on all patients included in a rehabilitation program and assessed with the Ergo-Kit(®) tool between 2005 and 2014. Workplace demands and patients' functional capacities were evaluated and confronted. Self-beliefs and perceived disability were also assessed and compared to the functional capacity evaluation. RESULTS: One hundred and forty-nine working-age patients (85 men, 64 women; 39±12 years) suffering from musculoskeletal disorders or other diseases were included. Main causes of mismatch between workplace demands and functional capacities were manual handling of loads, postures with arms away from the body and repetitive motions at work; sitting posture was correlated with a lesser physical workload; and Oswestry score was correlated with functional capacities evaluated by the Ergo-Kit(®). CONCLUSION: Ergo-Kit(®) is a relevant tool to assess the multidimensional aspects of workplace demands and functional capacities. It could be very helpful for occupational physicians to manage return-to-work.

Block Magnetic Excitations in the Orbitally Selective Mott Insulator BaFe_{2}Se_{3}.

Iron pnictides and selenides display a variety of unusual magnetic phases originating from the interplay between electronic, orbital, and lattice degrees of freedom. Using powder inelastic neutron scattering on the two-leg ladder BaFe_{2}Se_{3}, we fully characterize the static and dynamic spin correlations associated with the Fe_{4} block state, an exotic magnetic ground state observed in this low-dimensional magnet and in Rb_{0.89}Fe_{1.58}Se_{2}. All the magnetic excitations of the Fe_{4} block state predicted by an effective Heisenberg model with localized spins are observed below 300 meV and quantitatively reproduced. However, the data only account for 16(3)µ_{B}^{2} per Fe^{2+}, approximatively 2/3 of the total spectral weight expected for localized S=2 moments. Our results highlight how orbital degrees of freedom in iron-based magnets can conspire to stabilize an exotic magnetic state.

[Pharmacovigilance center --internal medicine interactions: A useful diagnostic tool]. / Interactions pharmacovigilance--service de médecine interne: une aide précieuse au diagnostic.

PURPOSE: Patients hospitalized in internal medicine often have unexplained clinical symptoms for which a drug origin can be considered. The prevalence of patients hospitalized for iatrogenic is estimated between 4-22%. We wanted to evaluate the diagnostic value of the regional center of pharmacovigilance to identify or confirm an iatrogenic disease in the department of internal medicine of Lille and characterize factors associated with drug-related side effect. METHODS: This is a single-center prospective diagnostic study. We included all subsequent requests from the department of internal medicine with the Nord-Pas-de-Calais regional pharmacovigilance center between 2010 and 2012. The opinion of the regional pharmacovigilance centre was held on the record of the adverse drug reaction in the national pharmacovigilance database and analyzed according to the conclusion of iatrogenic used by clinicians in internal medicine (reference diagnosis) with a follow-up to June 2013. The variables relating to the patient, medication and adverse events were analyzed by binary logistic regression. RESULTS: We analyzed 160 contacts: 118 concordant cases, 38 false-positives (drug-related side effect retained by the regional pharmacovigilance center only), 4 false negatives. Registration in the national pharmacovigilance database had a sensitivity of 96% (95% CI [0.92 to 0.99]), a specificity of 46% (95% CI [0.38 to 0.53]), a value positive predictive of 69% (95% CI [0.62 to 0.76]), a negative predictive value of 89% (95% CI [0.84 to 0.94]) and a negative likelihood ratio of 0.1. False-positive had chronological and semiological accountabilities questionable (adjusted RR=2.1, 95% CI [1.2 to 2.8]). CONCLUSION: In our study, the regional pharmacovigilance center confirms the clinician's suspicion of drug-related side effects and helps to exclude drug-induced with a high negative predictive value.

Norms of the Attitudes Toward Intellectual Disability Questionnaire.

BACKGROUND: The Attitudes Toward Intellectual Disability Questionnaire (ATTID) has demonstrated good psychometric qualities for measuring the attitudes of different groups of adults in the general population toward intellectual disability (ID). A significant advantage of the ATTID is that it addresses the concept of attitudes using a three-dimensional model (affective, cognitive and behavioural). To our knowledge, there are no normative data published regarding attitudes toward ID on general population-based samples. METHODS: The sample of 1605 men and women was stratified to be representative of the general adult population of Quebec. The ATTID was administered by phone interview through an independent survey firm. RESULTS: Normative data are presented as percentile scores associated with the raw score of the ATTID by gender and age categories. Analysis of the variance yielded significant differences in attitude by gender and age. The directions and the strength of these associations vary according to each of the five factors used to define attitudes. CONCLUSION: These norms will provide an essential tool to compare different groups and assess the effectiveness of various public campaigns to encourage more positive attitudes towards persons with ID. These norms would also allow international comparisons.

Do anti-inflammatory drugs worsen odontogenic cervico-facial cellulitis?

OBJECTIVE: The aim of this prospective study was to determine the influence of anti-inflammatory drugs on the severity of odontogenic cellulitis in patients admitted to our hospital emergency unit. STUDY DESIGN: The study was made from April 30 to October 31 2006. The clinical and pharmacological data was prospectively collected at admission, during hospitalization, and during systematic follow-up. We first studied the whole population and then compared the 2 groups: patients having received anti-inflammatory drugs before admission or not. RESULTS: Two hundred and sixty-seven patients were included. The only severity criterion significantly different between the 2 groups was spreading of cervical lymphangitis (P=0.028). None of the 4 studied parameters was identified as a risk factor for spreading of cervical lymphangitis in multivariate analysis: anti-inflammatory use (OR=5.99, 95%CI [0.71-50.88]), alcohol abuse (OR=4.00, 95%CI [0.66-24.12]), dental hygiene (OR=1.53, 95%CI [0.36-6.56]), and tobacco use (OR=0.27, 95%CI [0.57-1.28]). DISCUSSION: The use of anti-inflammatory drugs during the initial phase of an odontogenic infection was not related to the severity of infection.