The provision of care to minor patients: A three-party relationship with a specific legal framework.

The provision of medical care for minors can be complicated. On the one hand, the pattern of the traditional family has changed and many parents are separated while retaining parental authority, which can make the pursuit of parental consent even more complex. In addition, French law, in line with international law, has modified the place of minors in the healthcare relationship, acknowledging the importance of seeking their consent. Such consent is sometimes even required for certain medical procedures. This consent from minors may even allow care to be provided to them without the consent of their parents.

Sex-specific plasticity and genotype × sex interactions for age and size of maturity in the sheepshead swordtail, Xiphophorus birchmanni.

Responses to sexually antagonistic selection are thought to be constrained by the shared genetic architecture of homologous male and female traits. Accordingly, adaptive sexual dimorphism depends on mechanisms such as genotype-by-sex interaction (G×S) and sex-specific plasticity to alleviate this constraint. We tested these mechanisms in a population of Xiphophorus birchmanni (sheepshead swordtail), where the intensity of male competition is expected to mediate intersexual conflict over age and size at maturity. Combining quantitative genetics with density manipulations and analysis of sex ratio variation, we confirm that maturation traits are dimorphic and heritable, but also subject to large G×S. Although cross-sex genetic correlations are close to zero, suggesting sex-linked genes with important effects on growth and maturation are likely segregating in this population, we found less evidence of sex-specific adaptive plasticity. At high density, there was a weak trend towards later and smaller maturation in both sexes. Effects of sex ratio were stronger and putatively adaptive in males but not in females. Males delay maturation in the presence of mature rivals, resulting in larger adult size with subsequent benefit to competitive ability. However, females also delay maturation in male-biased groups, incurring a loss of reproductive lifespan without apparent benefit. Thus, in highly competitive environments, female fitness may be limited by the lack of sex-specific plasticity. More generally, assuming that selection does act antagonistically on male and female maturation traits in the wild, our results demonstrate that genetic architecture of homologous traits can ease a major constraint on the evolution of adaptive dimorphism.

Phosphorus-31 MAS NMR investigations of pyridine stabilized dithiomonometaphosphoryl halides.

Phosphorus-31 magic-angle spinning NMR spectroscopy was chosen in order to study a series of N-donor stabilized dithiomonometaphosphoryl halides (F, Cl, and Br) and to extract structural and bonding information from their spectra. Additionally, an unusual line splitting was observed in the 31P MAS NMR spectra of pyridine dithiomonometaphosphoryl chloride (Py-->PS2Cl) and the analogous bromide (Py-->PS2Br). It is shown that this effect is due to a residual dipolar coupling between phosphorus and chlorine or bromine, respectively. This work is to our knowledge the first observation of this effect between P and Br in 31P MAS NMR spectra.

The rapid whole blood agglutination d-dimer assay has poor sensitivity for use as an exclusion test in suspected deep vein thrombosis.

AIMS: Several clinical studies have proposed using d-dimer as an initial screening test to exclude thrombosis in cases of suspected (DVT). In published series, these assays have variable sensitivity, raising concerns that they may not be sufficiently robust for clinical practice. The aim of the study was to examine the sensitivity of two commercially available d-dimer assays and to assess their value and safety as initial screening tests in suspected DVT. METHODS: In this prospective study, blood samples were collected for d-dimer measurement (SimpliRED assay and IL test d-dimer) in all patients presenting to the emergency department over a twelve month period. All patients underwent compression ultrasound scanning as the primary diagnostic procedure. RESULTS: 235 patients were included in the study. 51(22.8%) had a DVT confirmed on ultrasound. The SimpliRED assay was positive in only 33 cases, with seventeen cases of confirmed DVT giving a negative result (six cases with proximal vein thrombosis). Assay sensitivity was 66%, with a negative predictive value of 88.9%. The IL test gave three false negatives (all below knee thromboses) giving assay sensitivity and negative predictive value of 94.1% and 96.8% respectively. CONCLUSIONS: The precise role of d-dimer testing in the diagnosis of venous thrombosis has yet to be established. From our results and a review of published series, we conclude that the SimpliRED assay is too insensitive to use as a reliable exclusion test in cases of suspected DVT, however, the more sensitive automated IL test d-dimer may have a role in the initial assessment. We propose that the IL d-dimer test is used in conjunction with a pre-test probability score to identify patients at low risk of DVT and recommend that this approach is tested in a clinical study before introduction into practice.

29Si chemical shift tensors of silyl silicate cages.

Static and 29Si CP MAS spectra (spinning rates of 2000 and 500 Hz) of six silyl silicate cages are analyzed by deconvolution and simulation. The principal values of the various 29Si chemical shift tensors provide information about the point symmetry of the Si sites. The intensities of the signals correspond sufficiently well with the stoichiometries.