Brillouin-Raman microspectroscopy for the morpho-mechanical imaging of human lamellar bone.

Bone has a sophisticated architecture characterized by a hierarchical organization, starting at the sub-micrometre level. Thus, the analysis of the mechanical and structural properties of bone at this scale is essential to understand the relationship between its physiology, physical properties and chemical composition. Here, we unveil the potential of Brillouin-Raman microspectroscopy (BRaMS), an emerging correlative optical approach that can simultaneously assess bone mechanics and chemistry with micrometric resolution. Correlative hyperspectral imaging, performed on a human diaphyseal ring, reveals a complex microarchitecture that is reflected in extremely rich and informative spectra. An innovative method for mechanical properties analysis is proposed, mapping the intermixing of soft and hard tissue areas and revealing the coexistence of regions involved in remodelling processes, nutrient transportation and structural support. The mineralized regions appear elastically inhomogeneous, resembling the pattern of the osteons' lamellae, while Raman and energy-dispersive X-ray images through scanning electron microscopy show an overall uniform distribution of the mineral content, suggesting that other structural factors are responsible for lamellar micromechanical heterogeneity. These results, besides giving an important insight into cortical bone tissue properties, highlight the potential of BRaMS to access the origin of anisotropic mechanical properties, which are almost ubiquitous in other biological tissues.

Modeling variability of the lactation curves of cows in automated milking systems.

Historically, cow selection criteria were developed for conventional milking systems that have regular milking intervals (MI). However, in automatic milking systems (AMS), there is variability in MI within and between cows. These sources of variability provide an opportunity to identify cows with high daily milk yield (DY) and long MI. An extended MI (longer than 16 h in pasture-based systems) has a negative effect on DY. Cows that tolerate extended MI and maintain high DY can be considered more efficient than cows with low DY and long MI, or with high DY but short MI, thereby improving robotic system use. Knowledge of the behavior and parameters of lactation curves of cows in AMS could help farmers to identify cows with a specific lactational phenotype. The objective of this study was to identify individual cows with high DY and long MI within herds, which could reflect increased tolerance to milk accumulation under AMS. A database containing records for 773,483 milking events for one year (July 2016-June 2017) from 4 pasture-based AMS farms was used. Lactation curves within each herd were fitted using several mixed models including fixed effects for the parameters of the lactation curve and random cow effects. Predicted curves of average DY according to parity (multiparous and primiparous) were obtained. The best linear unbiased prediction of the random cow effect allowed us to categorize lactations as having either high or low milk production. The median MI of each lactation was then used to categorize cows as having either short or long MI. Daily yield at the peak of lactation, days to peak and 305-d cumulative milk production were used to compare the effect of DY and MI categories, as well as the DY × MI interaction. Milk production by multiparous and primiparous cows with high DY and long MI was between 35 and 45% higher than that of the low DY and short MI. From all lactations analyzed, the incidence of animals with high DY and long MI across farms was 7.5%. We have identified and quantified a new, AMS-specific, phenotype (the combination of a relatively higher DY with relatively longer MI) with potential to increase use of AMS units. Identifying more efficient animals should help generate new approaches for differential management and for selecting cows in AMS.

Bilateral unicompartmental knee arthroplasty: one stage or two stages?

BACKGROUND: Bilateral unicompartmental knee arthroplasty (UKA) may be performed as one- or two-stage procedure. Previous reports suggest that UKA provides a more rapid functional recovery than total knee arthroplasty. However, little data exist on whether bilateral UKA can be performed without increasing the perioperative risk compared with unilateral cases. METHODS: We retrospectively compared 51 patients treated between January 2014 and March 2017 with single-stage UKA (group A) with 51 patients who underwent unilateral procedure (group B) to evaluate perioperative complications. We noted no statistically significant difference between the two groups in terms of gender, age and body mass index. RESULTS: Patients who underwent single-stage bilateral UKA had longer operating room time with respect to single procedure (93.2 min vs. 50.7 min). However, the bilateral group had a shorter cumulative operating room time (93.2 min) compared to the unilateral group (101.5 min) with a statistically significant difference (p < 0.05). Average hemoglobin loss at discharge was 3.1 points for group A and 2.4 for group B, with a statistically significant difference (p < 0.05). CONCLUSION: Our results demonstrated that bilateral simultaneous UKA does not increase the risk for perioperative complications. Total blood loss at discharge is statistically higher in bilateral UKA rather than unilateral UKA; however, cumulative hemoglobin loss is statistically lower in bilateral group. Patients can benefit from a single hospital admission and anesthetic time, while the shorter total inpatient stay and lower blood loss can reduce hospital costs in cases of bilateral surgery. LEVEL OF EVIDENCE IV: Retrospective study.

Validation of an original questionnaire for patients with psoriatic arthritis: the Psoriatic Arthritis Impact Profile (PAIP).

BACKGROUND AND AIMS: There is a wide evidence that Psoriatic Arthritis (PsA) as well as Psoriasis (Ps) lead to significant health problems and interfere with the patient quality of life (QoL). Even though a validated questionnaire for Ps is available, no questionnaire for PsA is currently present in literature. The aim of our work has been to confirm the efficacy of our original questionnaire as well as to validate it, through the comparison with other existing recognised and accepted questionnaires, such as MOF-SF36, HAQ, McGill Pain Questionnaire, and Zeung Self-Rating Depression and Anxiety Scales. MATERIALS AND METHODS: We have realized a questionnaire for PsA (Psoriatic Arthritis Impact Questionnaire, PAIP), in terms of psychological and rheumatological evaluation, QoL, social and economic assets. RESULTS: The statistical comparisons between PAIP and the accepted questionnaires (see above) confirm that PAIP is widely validated and represents a useful tool suitable for clinical evaluation and management of patients with PsA. CONCLUSIONS: The indexes of the correlation among the different parts of PAIP and the other questionnaires have shown positive correlations. Moreover, PAIP presents a dedicated unit for the economical and therapeutic parameters, The short time for compilation (15 minutes), the easy of comprehension of the questions, and - above all - the validation of PAIP, make our questionnaire a useful tool, suitable for the clinical management of the patients with PsA.

[A case of digestive occlusion on an endometriosis lesion after treatment by GnRH agonist]. / Un cas d'occlusion digestive sur lésion d'endométriose sous agoniste de la GnRH.

Endometriosis concerns 10% of childbearing age women and frequently affects the digestive tract. We report here the case of a 31-year-old patient presenting a severe occlusive syndrome while being treated with GnRH agonist, within the framework of an in vitro fertilization. The surgical treatment will find a deep endometriosis affecting the sigmoid and colorectal junction and leading to a colorectal resection. These endometriosis lesion recurrences during ovarian stimulation or by GnRH flare up effect is rare and often debated. The surgical treatment of the lesions, before the medically assisted procreation, seems to prevent these complications.

[Robot-assisted laparoscopic myomectomy: comparison with abdominal myomectomy]. / La myomectomie par cœlioscopie avec assistance robotique: comparaison avec la laparotomie.

OBJECTIVE: To compare morbidity of robot-assisted laparoscopic myomectomy versus those performed by laparotomy. PATIENTS AND METHODS: It reports a monocentric retrospective case matched analysis enrolling 22 patients (six laparotomic and 16 robot-assisted laparoscopic myomectomies), needing a surgical treatment for at least one myoma oversizing 6cm. RESULTS: Both patient groups were comparable regarding their age, their weight and myoma's size. There were more complications in the laparotomy group in comparison with the robotic group (66.7%, versus 0%; P=0.002). Average intraoperative blood losses were respectively 397±377mL versus 387±349mL (P=0.71) and length of stay 7.2±0.8 days versus 3.9±2.8 days (P<0.001). None of the robot-assisted laparoscopic myomectomy needed any conversion to laparotomy. CONCLUSION: Robot-assisted laparoscopic myomectomy seems to be feasible for heavy fibroids, with a lower morbidity in comparison with laparotomy. These results must be confirmed by several wider prospective studies.

[Robotic surgery in gynecologic oncology: Retrospective and comparative study with laparotomy and laparoscopy]. / Chirurgie robotique en cancérologie gynécologique: étude rétrospective comparative avec la laparotomie et la cœlioscopie traditionnelle.

OBJECTIVES: To compare robot-assisted laparoscopy with conventional laparoscopy and laparotomy in gynecologic oncology. PATIENTS AND METHODS: This is a monocentric retrospective study enrolling 92 patients who underwent a standard or radical hysterectomy (with parametrectomy) with or without pelvic lymphadenectomy between January 2008 and December 2010. All patients were diagnosed for a cervical or endometrial cancer. Laparotomy was performed for 33 patients, conventional laparoscopy for 20 patients, and robot-assisted laparoscopy for 39 patients. The main parameter was the length of hospital stay in the three groups. RESULTS: Length of hospital stay significantly decreased in the robotic group in comparison with the laparotomic group (median 5 and 8 days respectively, P<0.0001), but no differences were found between the robotic and laparoscopic groups (P=0.77). Intraoperative blood loss was lower in the robotic group. Intraoperative complications and lymph nodes removed were equal in the three groups. Regarding the data recorded, there were no significant differences between conventional and robotic laparoscopy. Hysterectomies performed after pelvic radiation, which were all made by laparotomy before the robot's arrival, were all performed with robotic laparoscopy since its arrival. CONCLUSION: Robotic surgery allows a reduced length of hospital stay and a lower blood loss in comparison with laparotomy, without any worse oncologic results. Robotic surgery changed our practice, especially hysterectomy after pelvic radiation, performed by laparotomy before.

Electron mass in dilute nitrides and its anomalous dependence on hydrostatic pressure.

The dependence of the electron mass on hydrostatic pressure P in N-diluted GaAs1-xNx (x=0.10% and 0.21%) is investigated by magnetophotoluminescence. Exceedingly large fluctuations (up to 60%/kbar) in the electron mass with increasing P are found. These originate from a pressure-driven tuning of the hybridization degree between the conduction band minimum and specific nitrogen-related states. Present results suggest a hierarchy between different nitrogen complexes as regards the extent of the perturbation these complexes exert on the electronic properties of the GaAs host.

Evaluation of the IL-Phoenix chemistry electrolyte analyser.

This paper reports an evaluation of the IL-Phoenix Chemistry/Electrolyte Analyser; the evaluation was carried out in accordance with internationally recognized guidelines. The evaluation was performed in three steps: evaluation in routine conditions; assessment of interferences; and study of practicability. Seven constituents were studied under routine working conditions. Within-run imprecision rangedfrom 0.6% (CV) for chloride to 3.1% (CV) for glucose. Between-run imprecision ranged from 0.9% for sodium to 6.0% (CV) for urea. Sample-related carryover was not significant. The relative inaccuracy was acceptable; drift was negligible; linearity was agreed with the range showed by the supplier. Haemoglobin produced negative interferences with sodium and chloride. Turbidity interfered negatively with sodium, chloride, potassium and total calcium, andpositively with glucose. Bilirubin showed a negative interference with sodium, chloride and creatinine.