Transport Properties of Li-TFSI Water-in-Salt Electrolytes.

Water-in-salts are a new family of electrolytes that may allow the development of aqueous Li-ion batteries. They have a structure that is reminiscent of ionic liquids, and they are characterized by a high concentration of ionic species. In this work, we study their transport properties and how they evolve with concentration by using molecular dynamic simulations. We first focus on the choice of the force field. By comparing the simulated viscosities and self-diffusion coefficients with experimental measurements, we select a set of parameters that reproduces well the transport properties. We then use the selected force field to study in detail the variations of the self and collective diffusivities of all the species as well as the transport number of the lithium ion. We show that correlations between ions and water play an important role over the whole concentration range. In the water-in-salt regime, the anions form a percolating network that reduces the cation-anion correlations and leads to rather large values for the transport number compared to other standard electrolytes.

Biredox ionic liquids: new opportunities toward high performance supercapacitors.

Nowadays commercial supercapacitors are based on purely capacitive storage at the porous carbons that are used for the electrodes. However, the limits that capacitive storage imposes on energy density calls to investigate new materials to improve the capacitance of the device. This new type of electrodes (e.g., RuO2, MnO2…) involves pseudo-capacitive faradaic redox processes with the solid material. Ion exchange with solid materials is, however, much slower than the adsorption process in capacitive storage and inevitably leads to significant loss of power. Faradaic process in the liquid state, in contrast can be similarly fast as capacitive processes due to the fast ion transport. Designing new devices with liquid like dynamics and improved specific capacitance is challenging. We present a new approach to increase the specific capacitance using biredox ionic liquids, where redox moieties are tethered to the electrolyte ions, allowing high redox concentrations and significant pseudo-capacitive storage in the liquid state. Anions and cations are functionalized with anthraquinone (AQ) and 2,2,6,6-tetramethylpiperidinyl-1-oxyl (TEMPO) moieties, respectively. Glassy carbon, carbon-onion, and commercial activated carbon electrodes that exhibit different double layer structures and thus different diffusion dynamics were used to simultaneously study the electrochemical response of biredox ionic liquids at the positive and negative electrode.

Haemorrhagic shock, therapeutic management.

The management of a patient in post-traumatic haemorrhagic shock will meet different logics that will apply from the prehospital setting. This implies that the patient has beneficiated from a "Play and Run" prehospital strategy and was sent to a centre adapted to his clinical condition capable of treating all haemorrhagic lesions. The therapeutic goals will be to control the bleeding by early use of tourniquet, pelvic girdle, haemostatic dressing, and after admission to the hospital, the implementation of surgical and/or radiological techniques, but also to address all the factors that will exacerbate bleeding. These factors include hypothermia, acidosis and coagulopathy. The treatment of these contributing factors will be associated to concepts of low-volume resuscitation and permissive hypotension into a strategy called "Damage Control Resuscitation". Thus, the objective in situation of haemorrhagic shock will be to not exceed a systolic blood pressure of 90 mmHg (in the absence of severe head trauma) until haemostasis is achieved.

[Who are the recipients of labile blood products? A multicenter nation-wide study--a "donation day." Blood banks, health facilities]. / Qui sont les receveurs de produits sanguins labiles (PSL)? Une étude nationale multicentrique - un jour donné. Etablissement de transfusion sanguine (ETS) - établissements de santé (ES).

During the years 1994-2001, a progressive decrease of the number of blood units transfused has been reported in France. In contrast, since 2002, there is an increasing number of blood units issuing (+7.6% between 2001 and 2006) and this must be investigated. On behalf of the French Society of Blood Transfusion, the "Recipients" working group promoted a nation wide survey with the support of the regional blood transfusion centres. This survey was aimed at describing the profiles of the transfused patients: socio-demographical patterns, and reasons of the blood transfusion (main and associated diagnoses). A cross-sectional survey was designed. All the patients who received a blood unit during a specific day were considered as the population of the study. They were identified by the regional transfusion centres by means of the "individual issuing form". Survey forms were fully filled for 90% of the patients. It has been considered as a good answer rate. Seven thousand four hundred and twenty-two blood units, delivered to 3450 patients were analyzed. Three groups of pathologies were found as a reason of transfusion: haematology-oncology (52.70% of the prescriptions) with 892 patients (27.8%) for haematological malignancies; surgical procedures (23.99%); intensive care and medicine procedures (21.92%). More than 50% of the recipients are 70 years old and more. This result is explained by the age distribution of inpatients. In a context of lack of donors and consequently difficulties to provide patients with optimal number of blood units, this study is helpful. Variability of blood unit issuings must be detected, analyzed and monitored in real time by the actors of the transfusion process, using computerized dashboards: the blood units provider (in order to adjust the strategy of blood units provision) and the health care establishment as well as care blood components prescribers (reasons of blood transfusion and evaluation of practices).

[Conclusions and recommendations of a WHO expert consultation meeting on iron supplementation for infants and young children in malaria endemic areas]. / Conclusions et recommandations à l'issue de la consultation de l'OMS sur la lutte contre la carence martiale chez le nourrisson et le jeune enfant dans les pays d'endémie palustre.

This article presents the results of an expert consultation meeting aimed at evaluating the safety and public health implications of administering supplemental iron to infants and young children in malaria-endemic areas. Participants at this meeting that took place in Lyon, France on June 12-14, 2006 reached consensus on several important issues related to iron supplementation for infants and young children in malaria-endemic areas. The conclusions in this report apply specifically to regions where malaria is endemic.

Relationship between quality of life and cognitive decline in dementia.

AIMS: We aimed to examine the association of cognitive decline with quality of life (QoL) in dementia compared to controls and to determine variables associated with QoL. METHODS: Every subject was placed within a specific group depending on their designation by the Mini Mental State Examination and evaluated by the Alzheimer's Disease Related Quality of Life (ADRQL) and clinical assessments. RESULTS: QoL for the mild dementia group was lower (p = 0.08) than that of controls. The very severe dementia group had a significantly lower QoL than the other dementia groups, which all had similar ADRQL scores. The only predictor of ADRQL scores was found to be the behavioral and psychological symptoms of dementia. CONCLUSION: There is no direct relationship between cognitive decline and QoL.

WITHDRAWN: Rice-based oral rehydration solution for treating diarrhoea.

BACKGROUND: Oral rehydration therapy is used to treat dehydration caused by diarrhoea. However the rehydration solution does not reduce stool loss or length of illness. A solution able to do this may lessen the use of ineffective diarrhoea treatments as well as improve morbidity and mortality related to diarrhoea. OBJECTIVES: The objective of this review was to assess the effects of rice-based oral rehydration salts solution compared with glucose-based oral rehydration salts solution on reduction of stool output and duration of diarrhoea in patients with acute watery diarrhoea. SEARCH STRATEGY: We searched the Cochrane Infectious Diseases Group trials register, the Cochrane Controlled Trials Register, Medline, Embase, Lilacs and the reference lists of relevant articles. We also contacted researchers in the field. SELECTION CRITERIA: Randomized trials comparing standard World Health Organization oral rehydration solution with an experimental oral rehydration salts solution in which glucose (20 grams per litre) was replaced by 50-80 grams per litre of rice powder, with the electrolytes remaining unchanged. DATA COLLECTION AND ANALYSIS: Data were extracted independently by a statistician and a clinician. MAIN RESULTS: Twenty-two trials were included. Concealment of allocation was adequate in 15 of these trials. Irrespective of age, people with cholera who were given rice oral rehydration salts solution had substantially lower rates of stool loss than those given oral rehydration salts solution in the first 24 hours. Mean stool outputs in the first 24 hours were lower by 67 millilitres/kg of body weight (weighted mean difference -67.40, 95% confidence interval -94.26 to -41.53) in children, and by 51 millilitres/kg of body weight (weighted mean difference -51.07, 95% confidence interval -65.87 to -36.27) in adults. The rate of stool loss in infants and children with acute non-cholera diarrhoea was reduced by only four millilitres/kg of body weight (weighted mean difference -4.29, 95% confidence interval -9.36 to 0.78). AUTHORS' CONCLUSIONS: Rice-based oral rehydration appears to be effective in reducing stool output in people with cholera. This effect was not apparent in infants and children with non-cholera diarrhoea.

[Zinc and treatment of diarrhoea]. / Zinc et traitement de la diarrhée.

Recently WHO and UNICEF issued a joint statement revising guidelines for clinical management of diarrhoea. These updated recommendations take into account new research findings showing the beneficial effects of oral rehydration salts (ORS) containing lower concentrations of glucose and salts and of zinc supplementation. In combination with prevention and treatment of dehydration with appropriate fluids, breastfeeding, continued feeding and selective use of antibiotics, these two advances can drastically diminish the number of child deaths by reducing the duration and severity of diarrhoeal episodes and lowering their incidence. The purpose of this report is to present the research findings that demonstrated the efficacy of zinc supplementation in the management of diarrhoea and led to revision of WHO/UNCEF guidelines.

Multilobulated "flower" cells in a subcutaneous mass aspirate from a cat.

An 8-year-old intact male cat was presented with a subcutaneous mass in the region of the right jugular vein. Cytologic and histopathologic examinations revealed cells with multilobulated nuclei (flower cells). Immunochemistry using a panel of markers showed vimentin-positivity on cytologic specimens, and postive staining for CD79a and BLA36 on histologic specimens. The final diagnosis was lymphoma of B-cell origin. We have observed similar multilobulated cells in ascites fluid, thoracic fluid, and peripheral blood from dogs and cats with a variety of lymphoid and myeloid neoplasms. Cells with multilobulated nuclei that resemble flower petals also have been described in humans. These cells are infrequently observed in canine and feline cytology specimens and require immunochemistry to determine their cell of origin.

[Ethics, motivations of plasmapheresis donors]. / Ethiques, motivations des donneurs d'aphérèse plasmatique.

For 50 years, the French Blood Transfusion Service has been developing ethical concepts of anonymous, voluntary and non-profit donation. The subject of this work is the study of ethical aspects and motivations of plasmapheresis donors. Three hundred donors were questioned on these subjects. The questionnaire was created after analysing the semi-orientated interviews of ten donors. The donors are male, aged over 35, with relatively high social and professional backgrounds. The main reason given for the first donation is the request by a relative or another person. With regards to further donations, solidarity with patients is mentioned as a reason. Even if the majority of the donors are aware of the ethical aspects of donation, over 50% of them accept to give plasmapheresis regardless of these principles. Plasmapheresis donors are primarily motivated by solidarity reasons. Thereby, they are fully active in the evolution of society.

[Blood transfusion safety: current progress]. / Sécurité transfusionnelle: contribution des progrès réalisés.

For the past ten years, a real improvement in knowledge and methods concerning blood transfusion safety has been made. In this observation, concerning a polytraumatism patient who received massive blood transfusion with no immunologic nor infectious complications occurring one year later, brings evidence of real progress on blood transfusion safety for improvement in short and long term prognosis for polytransfused patients.

Complementary food supplements to achieve micronutrient adequacy for infants and young children.

Many children in developing countries survive on a nutritionally inadequate diet. Dietary inadequacies during the complementary feeding period can be prevented by using complementary food supplements (CFSs) such as water dispersible or crushable micronutrient tablets, micronutrient sprinkles added to food just before feeding, or fortified spreads added to food just before feeding or fed as a snacks. A meeting was convened to discuss technical and operational issues related to the development of these new approaches and to identify knowledge gaps. The technical issues covered: what micronutrients to include, tolerable upper intake limits, bioavailability, micronutrient and macronutrient stability, package systems and amounts, encapsulation technologies, methods to limit or eliminate allergens, bacterial and chemical contamination, interactions between CFSs and complementary foods, and flavoring agents. Operational issues included: identifying the market positioning of CFSs, cost positioning of CFSs, regulatory requirements, CFS production and technology transfer, quality assurance, and public-private sector partnership and coordination. Intervention trials are needed to determine the efficacy of CFSs in preventing micronutrient deficiencies. Other important knowledge gaps relate to technical and operational issues. Sprinkles and tablets are produced using well-known technologies, but further research is needed to modify them for use as CFSs. Spread development is not as advanced as sprinkle and tablet development, and further research is needed to improve the technology. Although none of the products is ready for widespread use, enough information is available to set research priorities and accelerate product development and implementation.

An extended field test of the WHO severe malnutrition guidelines in hospitals in developing countries: preliminary observations.

The WHO has published guidelines for the inpatient management of severe malnutrition. A qualitative study in hospitals in developing countries is being conducted to document the re-organisation of the clinical ward and support services required to implement these guidelines and to gain an impression of the feasibility and sustainability of such a re-organisation. Following a postal survey of experts in the management of malnutrition in children in developing countries, hospitals were contacted and asked if they were interested to participate in the study. If so, they were requested to submit background information about admission patterns, the frequency of malnutrition, and current practice. Based on this information, hospitals are selected for a preliminary visit. Following this, and the final selection, a paediatrician conducts three visits to the study hospital over a one-year period to appraise the current practice, assist the health staff in recognising the strengths and shortcomings of their current management, help them find locally appropriate solutions, support the implementation process through a participatory approach and assess the outcome. A structured survey instrument is used to guide the assessment and identification of problems. Results of the first visit, which documents the existing situation, and changes identified by staff and implemented during the second visit are presented.

[Update on oral rehydration salt solutions used for treatment of childhood diarrhea]. / Actualités sur les solutions de sels de réhydratation par voie orale dans le traitement des diarrhées de l'enfant.

After 20 years of research to improve oral rehydration salts (ORS), a new formula has been developed and is now recommended by the World Health Organization (WHO) and the United Nations International Children's Emergency Fund (UNICEF). The new formula that contains slightly less sodium and glucose than previously not only decreases the volume of diarrhea and vomiting in children presenting acute non-cholera-related diarrhea but also, and above all, significantly reduces the need for intravenous fluid treatment. This new so-called reduced osmolarity formulation has been included in the WHO's list of essential drugs.

Improved storage of erythrocytes by prior leukodepletion: flow cytometric evaluation of stored erythrocytes.

In vivo phagocytosis of senescent red blood cells (RBCs) by macrophages occurs 120 days after their release into the circulation. It depends on two sequential signals that trigger phagocytosis: (1) desialylation of membrane glycoconjugates with the exposure of the penultimate beta-galactosyl residues and (2) exposure of phosphatidylserine in the membrane outer leaflet. Leukodepleted and nonleukodepleted RBCs were compared using flow cytometric procedures to determine whether the in vitro deterioration of RBCs during storage might be attributable to an identical mechanism of desialylation induced by leukocyte neuraminidases, resulting in exposure of beta-galactosyl and subsequently phosphatidylserine residues - signals of senescent RBCs. Without prior leukodepletion, stored RBCs showed an increased population of senescent RBCs (using light scatter measurements), extensive desialylation with the exposure of beta-galactosyl residues (using specific fluorescein isothiocyanate [FITC]-lectins), significant exposure of phosphatidylserine in the outer leaflet of the RBC membrane (using FITC-annexin V), and extensive in vitro phagocytosis (using PKH-26-labeled RBCs). There were minimal changes observed with the leukodepleted RBCs. These results lead to the conclusion that leukocyte enzymes, including neuraminidases, are definitive contributers to the desialylation of RBCs during storage and to the exposure of phosphatidylserine residues. These deleterious effects resulting from highly active leukocyte enzymes are preventable by prior leukodepletion of the stored RBCs. Previously developed flow cytometric procedures to detect in vivo "RBC senescence" have been applied and proved to be reliable criteria to monitor the viability of stored RBCs.

[Improving doctor's communication skills in oncology: review and future perspectives]. / Améliorer les stratégies de communication des médecins en oncologie: état des lieux et perspectives futures.

The aim of this review is to discuss the different communication skills training designed to physician interactions with cancer patients. The development of medicine and chronic cancer treatments indicates the need to improve communication skills that combine appropriate assessment, information and support. Literature shows however that numerous factors may jeopardize the mastery of those skills. As a consequence, initiatives have been made to improve oncologists' communication skills. The objectives of those training programs are to improve patients' as well as the medical staffs' quality of life. A critical review of objectives and used techniques (theorical information, case discussion, role playing, feed-back) is presented here. This review includes also the discussion about training module integrating several techniques. This review shows the efficacy of experiential techniques as well as participative techniques. The results of available studies are finally emphasizing two difficulties: the maintenance and the consolidation of the various skills acquired over time and their successful transfer to the clinical practice.

Effect of zinc supplementation on clinical course of acute diarrhoea.

This report summarizes the current knowledge on the effects of zinc supplementation on the management of acute diarrhoea. All published and unpublished studies on this topic, conducted in hospitals and in the community, were reviewed. Based on the results of this review, it is concluded that there is now enough evidence demonstrating the efficacy of zinc supplementation on the clinical course of diarrhoea, with regard to the severity and duration of the episode. However, the meeting also concluded that effectiveness studies to assess the feasibility, sustainability, and cost-effectiveness of different strategies for delivering zinc supplementation should be undertaken.