Using a Claims-Based Frailty Index to Investigate Frailty, Survival, and Healthcare Expenditures among Older Adults Hospitalized for COVID-19 at an Academic Medical Center.

BACKGROUND: Frailty is associated with mortality in older adults hospitalized with COVID-19, yet few studies have quantified healthcare utilization and spending following COVID-19 hospitalization. OBJECTIVE: To evaluate whether survival and follow-up healthcare utilization and expenditures varied as a function of claims-based frailty status for older adults hospitalized with COVID-19. DESIGN: Retrospective cohort study. PARTICIPANTS: 136 patients aged 65 and older enrolled in an Accountable Care Organization (ACO) risk contract at an academic medical center and hospitalized for COVID-19 between March 11, 2020 - June 3, 2020. MEASUREMENTS: We linked a COVID-19 Registry with administrative claims data to quantify a frailty index and its relationship to mortality, healthcare utilization, and expenditures over 6 months following hospital discharge. Kaplan Meier curves and Cox Proportional Hazards models were used to evaluate survival by frailty. Kruskal-Wallis tests were used to compare utilization. A generalized linear model with a gamma distribution was used to evaluate differences in monthly Medicare expenditures. RESULTS: Much of the cohort was classified as moderate to severely frail (65.4%), 24.3% mildly frail, and 10.3% robust or pre-frail. Overall, 27.2% (n=37) of the cohort died (n=26 during hospitalization, n=11 after discharge) and survival did not significantly differ by frailty. Among survivors, inpatient hospitalizations during the 6-month follow-up period varied significantly by frailty (p=0.02). Mean cost over follow-up was $856.37 for the mild and $4914.16 for the moderate to severe frailty group, and monthly expenditures increased with higher frailty classification (p <.001). CONCLUSIONS: In this cohort, claims-based frailty was not significantly associated with survival but was associated with follow-up hospitalizations and Medicare expenditures.

Sustaining yield and nutritional quality of peanuts in harsh environments: Physiological and molecular basis of drought and heat stress tolerance.

Climate change is significantly impacting agricultural production worldwide. Peanuts provide food and nutritional security to millions of people across the globe because of its high nutritive values. Drought and heat stress alone or in combination cause substantial yield losses to peanut production. The stress, in addition, adversely impact nutritional quality. Peanuts exposed to drought stress at reproductive stage are prone to aflatoxin contamination, which imposes a restriction on use of peanuts as health food and also adversely impact peanut trade. A comprehensive understanding of the impact of drought and heat stress at physiological and molecular levels may accelerate the development of stress tolerant productive peanut cultivars adapted to a given production system. Significant progress has been achieved towards the characterization of germplasm for drought and heat stress tolerance, unlocking the physiological and molecular basis of stress tolerance, identifying significant marker-trait associations as well major QTLs and candidate genes associated with drought tolerance, which after validation may be deployed to initiate marker-assisted breeding for abiotic stress adaptation in peanut. The proof of concept about the use of transgenic technology to add value to peanuts has been demonstrated. Advances in phenomics and artificial intelligence to accelerate the timely and cost-effective collection of phenotyping data in large germplasm/breeding populations have also been discussed. Greater focus is needed to accelerate research on heat stress tolerance in peanut. A suits of technological innovations are now available in the breeders toolbox to enhance productivity and nutritional quality of peanuts in harsh environments. A holistic breeding approach that considers drought and heat-tolerant traits to simultaneously address both stresses could be a successful strategy to produce climate-resilient peanut genotypes with improved nutritional quality.

Contribution to a better analysis of spermatic and ultrasound testicular parameters in the follow-up of male infertility at the Histology Embryology Cytogenetic Laboratory of Cheikh Anta Diop University (UCAD).

INTRODUCTION: In Senegal, marital infertility is a real problem for society. We undertook the study of this subject to make an analysis of the spermatic parameters of the infertile Senegalese man and to better understand the impact of testicular morphological anomalies on male fertility. PATIENTS AND METHODS: We conducted a cross-sectional, descriptive, retrospective study of 100 infertile patients followed at the Histology-Embryology-Cytogenetics laboratory of UCAD in Dakar, during the year 2020. Sperm parameters, presence of varicocele, and testicular volume were evaluated in our patients. RESULTS/DISCUSSION: The mean age of the patients was 35.17±8.7 years. A history of sexually transmitted infections was found in 57% of patients. The mean duration of infertility was 5.67±3.2 years. The mean sperm count was 14,871,230/ml±4,950,000. Necrospermia was the most frequent abnormality found (60%), followed by asthenospermia (51%). The high rate of necrospermia could be explained by the high frequency of sexually transmitted infections. Other abnormalities were oligospermia (48%, including 09% cryptospermia), azoospermia (19%), teratospermia (19%), and hypospermia (13%). The predominance of azoospermia and oligospermia should prompt a search for a genetic predisposition in these subjects. The mean testicular volume was 10.3±4.9 cc on the right and 9.5±4.8 cc on the left. A single or bilateral varicocele was found in 43% of subjects. Patients with azoospermia and teratospermia were associated with testicular hypotrophy with a significant value (p=0.04). CONCLUSION: Overall, the senegalese man consulting for infertility is a young adult, married for an average of 5 years. Necrospermia is the most frequently found anomaly. The severity of both qualitative and quantitative abnormalities should lead to a systematic search for a genetic origin. The etiological research of infertile patients must be done within a multidisciplinary framework to propose better management of these patients.

Base Editing in Peanut Using CRISPR/nCas9.

Peanut (Arachis hypogaea L.), an allotetraploid legume of the Fabaceae family, is able to thrive in tropical and subtropical regions and is considered as a promising oil seed crop worldwide. Increasing the content of oleic acid has become one of the major goals in peanut breeding because of health benefits such as reduced blood cholesterol level, antioxidant properties and industrial benefits such as longer shelf life. Genomic sequencing of peanut has provided evidence of homeologous AhFAD2A and AhFAD2B genes encoding Fatty Acid Desaturase2 (FAD2), which are responsible for catalyzing the conversion of monounsaturated oleic acid into polyunsaturated linoleic acid. Research studies demonstrate that mutations resulting in a frameshift or stop codon in an FAD2 gene leads to higher oleic acid content in oil. In this study, two expression vectors, pDW3873 and pDW3876, were constructed using Cas9 fused to different deaminases, which were tested as tools to induce point mutations in the promoter and the coding sequences of peanut AhFAD2 genes. Both constructs harbor the single nuclease null variant, nCas9 D10A, to which the PmCDA1 cytosine deaminase was fused to the C-terminal (pDW3873) while rAPOBEC1 deaminase and an uracil glycosylase inhibitor (UGI) were fused to the N-terminal and the C-terminal respectively (pDW3876). Three gRNAs were cloned independently into both constructs and the functionality and efficiency were tested at three target sites in the AhFAD2 genes. Both constructs displayed base editing activity in which cytosine was replaced by thymine or other bases in the targeted editing window. pDW3873 showed higher efficiency compared to pDW3876 suggesting that the former is a better base editor in peanut. This is an important step forward considering introgression of existing mutations into elite varieties can take up to 15 years making this tool a benefit for peanut breeders, farmers, industry and ultimately for consumers.

CRISPR/Cas9 Based Site-Specific Modification of FAD2 cis-Regulatory Motifs in Peanut (Arachis hypogaea L).

Peanut (Arachis hypogaea L.) seed is a rich source of edible oil, comprised primarily of monounsaturated oleic acid and polyunsaturated linoleic acid, accounting for 80% of its fatty acid repertoire. The conversion of oleic acid to linoleic acid, catalyzed by Fatty Acid Desaturase 2 (FAD2) enzymes, is an important regulatory point linked to improved abiotic stress responses while the ratio of these components is a significant determinant of commercial oil quality. Specifically, oleic acid has better oxidative stability leading to longer shelf life and better taste qualities while also providing nutritional based health benefits. Naturally occurring FAD2 gene knockouts that lead to high oleic acid levels improve oil quality at the potential expense of plant health though. We undertook a CRISPR/Cas9 based site-specific genome modification approach designed to downregulate the expression of two homeologous FAD2 genes in seed while maintaining regulation in other plant tissues. Two cis-regulatory elements the RY repeat motif and 2S seed protein motif in the 5'UTR and associated intron of FAD2 genes are potentially important for regulating seed-specific gene expression. Using hairy root and stable germ line transformation, differential editing efficiencies were observed at both CREs when targeted by single gRNAs using two different gRNA scaffolds. The editing efficiencies also differed when two gRNAs were expressed simultaneously. Additionally, stably transformed seed exhibited an increase in oleic acid levels relative to wild type. Taken together, the results demonstrate the immense potential of CRISPR/Cas9 based approaches to achieve high frequency targeted edits in regulatory sequences for the generation of novel transcriptional alleles, which may lead to fine tuning of gene expression and functional genomic studies in peanut.

Application of CRISPR/Cas9 System for Efficient Gene Editing in Peanut.

Peanuts are an economically important crop cultivated worldwide. However, several limitations restrained its productivity, including biotic/abiotic stresses. CRISPR/Cas9-based gene-editing technology holds a promising approach to developing new crops with improved agronomic and nutritional traits. Its application has been successful in many important crops. However, the application of this technology in peanut research is limited, probably due to the lack of suitable constructs and protocols. In this study, two different constructs were generated to induce insertion/deletion mutations in the targeted gene for a loss of function study. The first construct harbors the regular gRNA scaffold, while the second construct has the extended scaffold plus terminator. The designed gRNA targeting the coding sequence of the FAD2 genes was cloned into both constructs, and their functionality and efficiency were validated using the hairy root transformation system. Both constructs displayed insertions and deletions as the types of edits. The construct harboring the extended plus gRNA terminator showed a higher editing efficiency than the regular scaffold for monoallelic and biallelic mutations. These two constructs can be used for gene editing in peanuts and could provide tools for improving peanut lines for the benefit of peanut breeders, farmers, and industry.

Genome-Wide Identification of Powdery Mildew Resistance in Common Bean (Phaseolus vulgaris L.).

Genome-wide association studies (GWAS) have been utilized to detect genetic variations related to several agronomic traits and disease resistance in common bean. However, its application in the powdery mildew (PM) disease to identify candidate genes and their location in the common bean genome has not been fully addressed. Single-nucleotide polymorphism (SNP) genotyping with a BeadChip containing 5398 SNPs was used to detect genetic variations related to PM disease resistance in a panel of 211 genotypes grown under two field conditions for two consecutive years. Significant SNPs identified on chromosomes Pv04 and Pv10 were repeatable, ensuring the phenotypic data's reliability and the causal relationship. A cluster of resistance genes was revealed on the Pv04 of the common bean genome, coiled-coil-nucleotide-binding site-leucine-rich repeat (CC-NBS-LRR, CNL), and Toll/interleukin-1 receptor-nucleotide-binding site-leucine-rich repeat type (TIR-NBS-LRR, TNL)-like resistance genes were identified. Furthermore, two resistance genes, Phavu_010G1320001g and Phavu_010G136800g, were also identified on Pv10. Further sequence analysis showed that these genes were homologs to the disease-resistance protein (RLM1A-like) and the putative disease-resistance protein (At4g11170.1) in Arabidopsis. Significant SNPs related to two LRR receptor-like kinases (RLK) were only identified on Pv11 in 2018. Many genes encoding the auxin-responsive protein, TIFY10A protein, growth-regulating factor five-like, ubiquitin-like protein, and cell wall RBR3-like protein related to PM disease resistance were identified nearby significant SNPs. These results suggested that the resistance to PM pathogen involves a network of many genes constitutively co-expressed.

[Acute Flaccid Paralysis Secondary to Poliomyelitis: 11 Years of Monitoring in Guinea (2005-2015)]. / Paralysies flasques aiguës dues à des poliovirus : bilan de 11 années de surveillance en Guinée (2005-2015).

The sustained worldwide use of the two available types of polio vaccines has significantly reduced the incidence of this disease. Our main objective is to report a 11-year monitoring period for acute flaccid paralysis secondary to poliovirus in Guinea. It was a retrospective descriptive study for all cases of acute flaccid paralysis (AFP) in which poliovirus was isolated by stool examination. During 11 years, 768 cases of AFP, including 8 cases of acute anterior poliomyelitis were collected at a frequency of 1%. The average age was 3.5 years with extremes of 1 year and 6 years, the most represented age group was 0-4 years with 7 cases. Six mothers were housewives doing gold panning as a revenue generating activity. The vaccine virus (serotype 2) was the most isolated with 6 cases.

L'utilisation soutenue à l'échelle mondiale des deux types de vaccins antipoliomyélitiques disponibles a considérablement diminué l'incidence de cette affection. Il s'agit ici d'une étude rétrospective de type descriptive, portant sur tous les cas de paralysie flasque aiguë (PFA) due aux poliovirus en Guinée chez lesquels le poliovirus a été isolé des selles, faisant l'état des lieux de 11 années de surveillance de la PFA. En 11 ans, 768 cas de PFA, dont huit cas de poliomyélite antérieure aiguë ont été enregistrés, soit une fréquence de 1 %. L'âge moyen était de 3,5 ans [1­6 ans]. La tranche d'âge de 0­4 ans était la plus représentée avec 7 cas. La majeure partie (6 cas) des mères des enfants étaient des agricultrices exerçant l'orpaillage. Les souches majoritairement isolées étaient dérivées du vaccin VDPV2.

[Pulmonary Metastase of a Knee Mycetoma in Senegal]. / Métastase pulmonaire d'un mycétome du genou au Sénégal.

Mycetoma is transmitted by thorns infected. The commonest site for mycetoma is the foot. The primary pulmonary are rare and usually secondary to other primary site. We report a case of pulmonary fungal mycetoma secondary to primary site in the knee. We do a review of the literature and we discuss the way of dissemination.

Le mycétome se transmet principalement par piqures d'épines d'arbustes infectés. Les localisations primitives au niveau du pied sont les plus fréquentes. Les localisations pulmonaires sont exceptionnelles et secondaires à des localisations périphériques primitives. Nous rapportons un cas de localisation pulmonaire d'un mycétome fongique secondaire à une localisation au niveau du genou, puis nous faisons une revue de la littérature et nous discutons de la voie de dissémination.

Nicotiana species as surrogate host for studying the pathogenicity of Acidovorax citrulli, the causal agent of bacterial fruit blotch of cucurbits.

Bacterial fruit blotch (BFB) caused by Acidovorax citrulli is one of the most important bacterial diseases of cucurbits worldwide. However, the mechanisms associated with A. citrulli pathogenicity and genetics of host resistance have not been extensively investigated. We idenitfied Nicotiana benthamiana and Nicotiana tabacum as surrogate hosts for studying A. citrulli pathogenicity and non-host resistance triggered by type III secreted (T3S) effectors. Two A. citrulli strains, M6 and AAC00-1, that represent the two major groups amongst A. citrulli populations, induced disease symptoms on N. benthamiana, but triggered a hypersensitive response (HR) on N. tabacum plants. Transient expression of 19 T3S effectors from A. citrulli in N. benthamiana leaves revealed that three effectors, Aave_1548, Aave_2708, and Aave_2166, trigger water-soaking-like cell death in N. benthamiana. Aave_1548 knockout mutants of M6 and AAC00-1 displayed reduced virulence on N. benthamiana and melon (Cucumis melo L.). Transient expression of Aave_1548 and Aave_2166 effectors triggered a non-host HR in N. tabacum, which was dependent on the functionality of the immune signalling component, NtSGT1. Hence, employing Nicotiana species as surrogate hosts for studying A. citrulli pathogenicity may help characterize the function of A. citrulli T3S effectors and facilitate the development of new strategies for BFB management.

Insecticide resistance in Anopheles arabiensis populations from Dakar and its suburbs: role of target site and metabolic resistance mechanisms.

BACKGROUND: Urban malaria is an increasing concern in most of the sub-Saharan Africa countries. In Dakar, the capital city of Senegal, the malaria epidemiology has been complicated by recurrent flooding since 2005. The main vector control measure for malaria prevention in Dakar is the community use of long-lasting insecticide-treated nets. However, the increase of insecticide resistance reported in this area needs to be better understood for suitable resistance management. This study reports the situation of insecticide resistance and underlying mechanisms in Anopheles arabiensis populations from Dakar and its suburbs. RESULTS: All the populations tested showed resistance to almost all insecticides except organophosphates families, which remain the only lethal molecules. Piperonil butoxide (PBO) and ethacrinic acid (EA) the two synergists used, have respectively and significantly restored the susceptibility to DDT and permethrin of Anopheles population. Molecular identification of specimens revealed the presence of An. arabiensis only. Kdr genotyping showed the presence of the L1014F mutation (kdr-West) as well as L1014S (kdr-East). This L1014S mutation was found at very high frequencies (89.53%) in almost all districts surveyed, and in association with the L1014F (10.24%). CONCLUSION: Results showed the contribution of both target-site and metabolic mechanisms in conferring pyrethroid resistance to An. arabiensis from the flooded areas of Dakar suburbs. These data, although preliminary, stress the need for close monitoring of the urban An. arabiensis populations for a suitable insecticide resistance management system to preserve core insecticide-based vector control tools in this flooded area.

Interception of wet deposited atmospheric pollutants by herbaceous vegetation: Data review and modelling.

Better understanding and predicting interception of wet deposited pollutants by vegetation remains a key issue in risk assessment studies of atmospheric pollution. We develop different alternative models, following either empirical or semi-mechanistic descriptions, on the basis of an exhaustive dataset consisting of 440 observations obtained in controlled experiments, from 1970 to 2014, for a wide variety of herbaceous plants, radioactive substances and rainfall conditions. The predictive performances of the models and the uncertainty/variability of the parameters are evaluated under Hierarchical Bayesian modelling framework. It is demonstrated that the variability of the interception fraction is satisfactorily explained and quite accurately modelled by a process-based alternative in which absorption of ionic substances onto the foliage surfaces is determined by their electrical valence. Under this assumption, the 95% credible interval of the predicted interception fraction encompasses 81% of the observations, including situations where either plant biomass or rainfall intensity are unknown. This novel approach is a serious candidate to challenge existing empirical relationships in radiological or chemical risk assessment tools.

Résultats de la technique de Mac Intosh au Fascia Lata Modifiée par Jaeger dans les instabilités antérieures chroniques du genou

Objectif: Il existe plusieurs techniques de reconstruction des ruptures anciennes du ligament croisé antérieur du genou. Le but de cette étude était d'évaluer à moyen terme les résultats de la technique de Mac Intosh au fascia lata modifiée par Jaeger. Matériel et méthodes: Dans cette étude rétrospective réalisée entre janvier 2005 et décembre 2013, 56 genoux (56 patients) ont été opérés par la technique de Jaeger à ciel ouvert pour des ruptures anciennes du ligament croisé antérieur. Elle a concerné des adultes jeunes masculins. Cinquante (89%) patients étaient sportifs. Un patient avait une arthrose débutante classée stade 2 Alhbäck modifiée. L'évaluation fonctionnelle des résultats a été faite selon le score IKS (globale, genou et fonction). L'examen clinique était basé sur la mobilité du genou, le test de Lachman-Trillat, et la recherche du ressaut. Le positionnement du tunnel tibial a été analysé à la radiographie. Le stade arthrosique a été apprécié selon les critères d'Alhbäck modifié . La ligamentisation du transplant à l'IRM a été étudiée chez quatre patients. Résultats: Au recul moyen de 7 ans, 85% des patients étaient satisfaits du résultat fonctionnel avec un score IKS genou de 96,1 en moyenne, un score IKS fonction de 100, et un score IKS global de 196,1. La mobilité était complète sans flessum résiduel. Le test de Lachman-Trillat était négatif (n= 38 ; 68%). Il était positif avec arrêt dur (n=16 ; 29%) et retardé (n=2 ; 3%). Le ressaut rotatoire a été neutralisé chez tous les patients. L'angle tibial moyen de face était de 61°. Il n'y avait pas de ballonisation des tunnels. Cinquantedeux (93%) patients étaient classés Alhbäck 1 et quatre (7%) Alhbäck 2. La ligamentisation a été constante à l'IRM. Conclusion: La ligamentoplastie du croisé antérieur au fascia lata modifiée par Jaeger donne de bons résultats fonctionnels et anatomiques avec une réduction significative de l'apparition de l'arthrose secondaire

Traitement des fractures complexes des plateaux tibiaux par la méthode d'Ilizarov

Objectif: Evaluer les résultats du traitement des fractures complexes des plateaux tibiaux opérés par la méthode d'Ilizarov. Matériel et méthodes: Une étude rétrospective continue de patients admis entre janvier 2010 et décembre 2014 a été réalisée. Quatorze fractures complexes des plateaux tibiaux classées type V (n=4) et type VI (n=10) selon Schatzker ont été traitées. Les critères de Duparc et Cavagna et Lysholm ont été utilisés pour évaluer respectivement les résultats anatomiques et fonctionnels au recul moyen de 34 mois. Résultats: Toutes les fractures ont consolidé dans un délai moyen de 118 jours. Tous les patients avaient un bon résultat anatomique. Le score fonctionnel était bon (n=12) et moyen (n=2). Conclusion: La méthode d'Ilizarov est une technique fiable dans le traitement des fractures complexes des plateaux tibiaux. Son faible risque infectieux justifie sa vulgarisation dans les pays à ressources limitées

Evaluating variability and uncertainty in radiological impact assessment using SYMBIOSE.

SYMBIOSE is a modelling platform that accounts for variability and uncertainty in radiological impact assessments, when simulating the environmental fate of radionuclides and assessing doses to human populations. The default database of SYMBIOSE is partly based on parameter values that are summarized within International Atomic Energy Agency (IAEA) documents. To characterize uncertainty on the transfer parameters, 331 Probability Distribution Functions (PDFs) were defined from the summary statistics provided within the IAEA documents (i.e. sample size, minimal and maximum values, arithmetic and geometric means, standard and geometric standard deviations) and are made available as spreadsheet files. The methods used to derive the PDFs without complete data sets, but merely the summary statistics, are presented. Then, a simple case-study illustrates the use of the database in a second-order Monte Carlo calculation, separating parametric uncertainty and inter-individual variability.

Connaissances et pratiques de la prescription du fer par le personnel du service de pediatrie du chu Gabriel Toure de Bamako

But : Evaluer les connaissances et les pratiques relatives a la prescription du fer dans le service de pediatrie du Centre Hospitalier Universitaire Gabriel Toure (CHU-GT) de Bamako; Mali. Materie( et methodes: Il s'agissait d'une etude transversale realisee du 1 er au 30 Juillet 2012 a la pediatrie. Nous avons soumis un questionnaire aux prestataires et analyse les dossiers des enfants ages de 1 a 60 mois hospitalises ayant recu du fer. Le consentement des prescripteurs a ete demande et obtenu au prealable. Resu(tats: nous avons enquete cinquante prestataires dont 10 pediatres (20%); 31 medecins CES de pediatrie (62 %); 2 medecins generalistes (4%); 7 etudiants en fin de cycle medical (14%) et analyse 100 dossiers. Trente pour cent des prestataires ont correctement defini le fer. Plus de la moitie des prestataires connaissaient les besoins en fer chez l'enfant. Les reserves en fer etaient connues de 42% des prestataires. Huit pour cent des prestataires savaient que les fers apportes par l'alimentation etaient le fer heminique ou le fer non heminique. Trente pourcent des malades ont recu le fer a la dose de 8 a 10mg/kg. La duree du traitement n'a pas ete precisee chez 92% des malades. Conc(us ion : Dans notre contexte la bonne connaissance theorique des indications et des regles de prescription du fer chez l'enfant n'excluait pas les mauvaises pratiques de sa prescription. D'autres travaux devraient analyser les raisons de cette discordance

Comparative Analysis of Type III Secreted Effector Genes Reflects Divergence of Acidovorax citrulli Strains into Three Distinct Lineages.

Acidovorax citrulli causes bacterial fruit blotch of cucurbits, a serious economic threat to watermelon (Citrullus lanatus) and melon (Cucumis melo) production worldwide. Based on genetic and biochemical traits, A. citrulli strains have been divided into two distinct groups: group I strains have been mainly isolated from various non-watermelon hosts, while group II strains have been generally isolated from and are highly virulent on watermelon. The pathogen depends on a functional type III secretion system for pathogenicity. Annotation of the genome of the group II strain AAC00-1 revealed 11 genes encoding putative type III secreted (T3S) effectors. Due to the crucial role of type III secretion for A. citrulli pathogenicity, we hypothesized that group I and II strains differ in their T3S effector repertoire. Comparative analysis of the 11 effector genes from a collection of 22 A. citrulli strains confirmed this hypothesis. Moreover, this analysis led to the identification of a third A. citrulli group, which was supported by DNA:DNA hybridization, DNA fingerprinting, multilocus sequence analysis of conserved genes, and virulence assays. The effector genes assessed in this study are homologous to effectors from other plant-pathogenic bacteria, mainly belonging to Xanthomonas spp. and Ralstonia solanacearum. Analyses of the effective number of codons and gas chromatography content of effector genes relative to a representative set of housekeeping genes support the idea that these effector genes were acquired by lateral gene transfer. Further investigation is required to identify new T3S effectors of A. citrulli and to determine their contribution to virulence and host preferential association.

Sleep restriction increases the neuronal response to unhealthy food in normal-weight individuals.

CONTEXT: Sleep restriction alters responses to food. However, the underlying neural mechanisms for this effect are not well understood. OBJECTIVE: The purpose of this study was to determine whether there is a neural system that is preferentially activated in response to unhealthy compared with healthy foods. PARTICIPANTS: Twenty-five normal-weight individuals, who normally slept 7-9 h per night, completed both phases of this randomized controlled study. INTERVENTION: Each participant was tested after a period of five nights of either 4 or 9 h in bed. Functional magnetic resonance imaging (fMRI) was performed in the fasted state, presenting healthy and unhealthy food stimuli and objects in a block design. Neuronal responses to unhealthy, relative to healthy food stimuli after each sleep period were assessed and compared. RESULTS: After a period of restricted sleep, viewing unhealthy foods led to greater activation in the superior and middle temporal gyri, middle and superior frontal gyri, left inferior parietal lobule, orbitofrontal cortex, and right insula compared with healthy foods. These same stimuli presented after a period of habitual sleep did not produce marked activity patterns specific to unhealthy foods. Further, food intake during restricted sleep increased in association with a relative decrease in brain oxygenation level-dependent (BOLD) activity observed in the right insula. CONCLUSION: This inverse relationship between insula activity and food intake and enhanced activation in brain reward and food-sensitive centers in response to unhealthy foods provides a model of neuronal mechanisms relating short sleep duration to obesity.

Fibroadenoma: can fine needle aspiration biopsy avoid short term follow-up?

OBJECTIVE: To confirm whether fine needle aspiration biopsy (FNAB) can avoid close monitoring, a source of worry for women patients with a suspected fibroadenoma found by ultrasound, and requiring their compliance. PATIENTS AND METHODS: Over 39months, 427 nodules with a diagnosis of fibroadenoma were sampled in 372 patients using ultrasound-guided FNAB. The sonographic appearance of all the nodules suggested BI-RADS category 3 fibroadenomas. The mean size of the fibroadenomas was 9mm. The mean duration of follow-up was 29.7months. RESULTS: Seven nodules had atypical cytology: a microbiopsy and/or excision found a simple fibroadenoma (n=3), mastitis (n=1), a fibroadenoma associated with a papilloma (n=1), fibrosis (n=1) and normal tissue (n=1). Seven other nodules were resected during treatment for synchronous cancer, and were diagnosed as fibroadenomas. Two hundred and seventy-six nodules were followed-up (121 patients were lost to follow-up [n=132]) and the appearance of 263 nodules (95.29%) was stable. Seven nodules, which had increased in size, underwent another FNAB or microbiopsy or surgery. Five nodules were not found again. The borders of one nodule showed modifications. CONCLUSION: The use of fine needle aspiration biopsy, interpreted by an experienced cytologist, means that short term follow-up of fibroadenomas can be avoided.

[Morel-Lavallée lesion in orthopaedic surgery (Nineteen cases)]. / Épanchement de Morel-Lavallée en chirurgie orthopédique (À propos de 19 cas).

AIMS: The object of this work is the study of especially ancient clinical forms of the effusion of Morel-Lavallée, to discuss the place of deep fascial fenestration by Ronceray and to propose criteria of therapeutic indication. PATIENTS AND METHOD: Our study concerns a continuous retrospective series over 20 years from 1989 till 2009. Eleven men and eight women, 36.7 year-old on average were treated for an effusion of Morel-Lavallée. The dominant etiology was represented by the accidents of the public highway. The collection was discovered after 41.4 days on average (extremes of 1-180 days). The volume of the collection was on average of 1237cm(3) (extremes 60cm(3)-12L). RESULTS: The conservative treatment concerned all patients who had a recent collection lower than three weeks and three others who had an ancient collection. The surgical treatment was established after all 10 times among which four in first intention and six times after failure of the previous treatment. The cure was obtained in 91% of the patients who had a recent collection by the only conservative method and among four patients by the method of Ronceray. To the three others, it was obtained after iterative unbridlings and talcage treatment. CONCLUSION: The authors insist on certain rare forms met in Africa in particular the "virtual form", the ancient forms and the too plentiful forms (12L). They plead for use deep fascial fenestrations by Ronceray for these last ones.