BACKGROUND Childhood maltreatment has a potentially lasting influence on subthreshold depressive symptoms(SDS)and major depressive disorder(MDD).This study aimed to explore the association of childhood maltreatment wi...BACKGROUND Childhood maltreatment has a potentially lasting influence on subthreshold depressive symptoms(SDS)and major depressive disorder(MDD).This study aimed to explore the association of childhood maltreatment with MDD and SDS,focusing on the differences between young and middle-aged adults.AIMTo examine the associations among childhood maltreatment, SDS, and MDD in young and middle-aged adults.METHODSA total of 3209 adults were recruited from 34 primary healthcare settings. The Childhood Trauma Questionnaire-28item Short Form was used to assess childhood maltreatment. The Patient Health Questionnaire-9 was used toassess SDS and the Mini-International Neuropsychiatric Interview depression module was used to assess MDD.RESULTSChildhood maltreatment was significantly associated with higher odds of developing SDS and MDD than in thenon-depressed control group (P < 0.05). Childhood maltreatment significantly increased the risk of developing SDSin young adults but was not significantly associated with SDS in middle-aged adults (P = 0.055). Conversely,childhood maltreatment was significantly associated with MDD in both young (P < 0.001) and middle-aged adults(P < 0.05). In young adults, various types of childhood maltreatment were associated with MDD;however, onlyemotional abuse and neglect were significantly associated with MDD in middle-aged adults.CONCLUSIONOur study revealed a strong association among childhood maltreatment, SDS, and MDD across age groups,highlighting the impact of emotional abuse and need for trauma-informed depression care.展开更多
Video capsule endoscopy (VCE) was launched in 2000 and has revolutionized direct endoscopic imaging of the gut. VCE is now a first-line procedure for exploring the small bowel in cases of obscure digestive bleeding an...Video capsule endoscopy (VCE) was launched in 2000 and has revolutionized direct endoscopic imaging of the gut. VCE is now a first-line procedure for exploring the small bowel in cases of obscure digestive bleeding and is also indicated in some patients with Crohn’s disease, celiac disease, and polyposis syndrome. A video capsule has also been designed for visualizing the esophagus in order to detect Barrett’s esophagus or esophageal varices. Different capsules are now available and differ with regard to dimensions, image acquisition rate, battery life, field of view, and possible optical enhancements. More recently, the use of VCE has been extended to exploring the colon. Within the last 5 years, tremendous developments have been made toward increasing the capabilities of the colon capsule. Although colon capsule cannot be proposed as a first-line colorectal cancer screening procedure, colon capsule may be used in patients with incomplete colonoscopy or in patients who are unwilling to undergo colonoscopy. In the near future, new technological developments will improve the diagnostic yield of VCE and broaden its therapeutic capabilities.展开更多
Objective:To investigate the chemical composition of a moderately polar extract(CHC1_3 soluble part of the MeOH-H_2O extract) obtained from the aerial parts(leaves and flowers) of Centaurea diluta Ait.subsp.algeriensi...Objective:To investigate the chemical composition of a moderately polar extract(CHC1_3 soluble part of the MeOH-H_2O extract) obtained from the aerial parts(leaves and flowers) of Centaurea diluta Ait.subsp.algeriensis(Coss.& Dur.) Maire,a species endemic to Algeria and Morocco on which no reports are available to date.To evaluate in vitro the cytotoxic,antifungal and antimicrobial activities of this extract and the cytotoxic and antimicrobial activities of its isolated secondary metabolites.Methods:The cytotoxic effects of the extract were investigated on 3 human cancer cell lines i.e.the A549 non-small-cell lung carcinoma(NSCLC),the MCF7 breast adenocarcinoma and the U373 glioblastoma using a MTT colorimetric assay.Biological data allowed to guide the fractionation of the extract by separation and purification on silica gel 60(CC and TLC).The isolated compounds which were characterized by spectral analysis,mainly HR-ESIMS,HR-EIMS,UV and NMR experiments(~1H,^(13)C,COSY,ROESY,HSQC and HMBC) and comparison of their spectroscopic data with those reported in the literature,were evaluated for cytotoxic activities on six cancer cell lines(A549,MCF7,U373,Hs683 human glioma,PC3 human prostate and B16-F10 murine melanoma).The direct and indirect antibacterial and antifungal activities were determined using microdilution methods for the raw extract and TLC-bioautography and microdilution methods against standard and clinical strains for the isolated compounds.Results:The raw extract reduced cell viability with IC_(50)s of 27,25 and 21 μg/mL on A549,MCF7 and U373,respectively.Five secondary metabolites:two phenolic compounds(vanillin 1,paridol 3),a lignan[(-)-arctigenin 2]and two flavonoid aglycones(eupatilin 4 and jaceosidin 5),were then isolated from this extract.Moderate cytotoxic effects were observed for(-)-arctigenin 2(IC_(50)s:28 and 33μM on Hs683 and B16-F10,respectively),eupatilin 4(IC_(50)s:33 and 47 μM on B16-F10 and PC3,respectively) and jaceosidin 5(IC_(50)s:32 and 40 μM on PC3 and B16-F10,respectively).Conclusions:All the isolated compounds were described for the first time from this species.Although inactive against 7 tested microorganisms(fungi,bacteria and yeast,human or plant pathogens),the raw extract was able to potentiate the effect of beta-lactam antibiotics on methicillin-resistant Staphylococcus aureus(MRSA),reducing the minimal inhibitory concentrations(MICs) by a factor of 2-32-fold.No synergy was found between the extract and streptomycin.From the five isolated compounds only jaseosidin 5 showed a moderate antimicrobial activity.展开更多
Breast cancer is one of the most frequently diagnosed malignancies during pregnancy. Here, we review the management of women with breast cancer during pregnancy(BCP), focusing on biology, diagnosis and staging, local ...Breast cancer is one of the most frequently diagnosed malignancies during pregnancy. Here, we review the management of women with breast cancer during pregnancy(BCP), focusing on biology, diagnosis and staging, local and systemic treatments, obstetric care and long-term follow-up of children with prenatal exposure to anticancer treatments.展开更多
Ampullary carcinoma(AC) is a rare gastrointestinal tumor without clear treatment recommendations.The management of this tumor is usually extrapolated from the treatment of pancreatic,biliary duct and intestinal cancer...Ampullary carcinoma(AC) is a rare gastrointestinal tumor without clear treatment recommendations.The management of this tumor is usually extrapolated from the treatment of pancreatic,biliary duct and intestinal cancers.Few papers have studied the AC as an independent entity and yet succombs to several limitations.These studies were retrospective single institutional experiences with limited sample sizes recruited over a long period of time.Unlike metastatic ACs where chemotherapy is the only recommended option,localized AC once excised may be approached by either chemotherapy alone or concomitant chemoradiation therapy.In this review,we report the overall survival and recurrence factors of more than 1000 patients from all the studies treating exclusively ACs.We also review the medical treatment of this tumor and conclude to the necessity of multi-institutional randomized controlled studies for AC exclusively.展开更多
Relapse prevention remains a major challenge in psychiatry,thus indicating that the established treatment methods combining psychotherapy with neuropharmacological interventions are not entirely effective.In recent ye...Relapse prevention remains a major challenge in psychiatry,thus indicating that the established treatment methods combining psychotherapy with neuropharmacological interventions are not entirely effective.In recent years,several intervention strategies have been devised that are aimed at improving psychiatric treatment by providing a complementary set of add-on tools that can be used by clinicians to improve current patient assessment.Among these,cognitive eventrelated potentials(ERPs)have been indexed as valuable biomarkers of the pathophysiological mechanisms of various mental illnesses.However,despite decades of research,their clinical utility is still controversial and a matter of debate.In this opinion review,I present the main arguments supporting the use of cognitive ERPs in the management of psychiatric disorders,stressing why it is currently still not the case despite the vast number of ERP studies to date.I also propose a clinically-oriented suitable way in which this technique could—in my opinion—be effectively incorporated into individual patient care by promotion of the use of individual ERP test-retest sessions and the use of a multi-component approach.展开更多
In oncosurgical approach to colorectal liver metastases, surgery remains considered as the only potentially curative option, while chemotherapy alone represents a strictly palliative treatment. However, missing metast...In oncosurgical approach to colorectal liver metastases, surgery remains considered as the only potentially curative option, while chemotherapy alone represents a strictly palliative treatment. However, missing metastases, defined as metastases disappearing after chemotherapy, represent a unique model to evaluate the curative potential of chemotherapy and to challenge current therapeutic algorithms. We reviewed recent series on missing colorectal liver metastases to evaluate incidence of this phenomenon, predictive factors and rates of cure defined by complete pathologic response in resected missing metastases and sustained clinical response when they were left unresected. According to the progresses in the efficacy of chemotherapeutic regimen, the incidence of missing liver metastases regularly increases these last years. Main predictive factors are small tumor size, low marker level, duration of chemotherapy, and use of intra-arterial chemotherapy. Initial series showed low rates of complete pathologic response in resected missing metastases and high recurrence rates when unresected. However, recent reports describe complete pathologic responses and sustained clinical responses reaching 50%, suggesting that chemotherapy could be curative in some cases. Accordingly, in case of missing colorectal liver metastases, the classical recommendation to resect initial tumor sites might have become partially obsolete. Furthermore, the curative effect of chemotherapy in selected cases could lead to a change of paradigm in patients with unresectable liver-only metastases, using intensive first-line chemotherapy to intentionally induce missing metastases, followed by adjuvant surgery on remnant chemoresistant tumors and close surveillance of initial sites that have been left unresected.展开更多
Resectability of hepatocellular carcinoma in patients with chronic liver disease is dramatically limited by the need to preserve sufficient remnant liver in order to avoid postoperative liver insufficiency. Preoperati...Resectability of hepatocellular carcinoma in patients with chronic liver disease is dramatically limited by the need to preserve sufficient remnant liver in order to avoid postoperative liver insufficiency. Preoperative treatments aimed at downsizing the tumor and promoting hypertrophy of the future remnant liver may improve resectability and reduce operative morbidity. Here we report the case of a patient with a large hepatocellular carcinoma arising from chronic liver disease. Preoperative treatment, including tumor downsizing with transarterial radioembolization and induction of future remnant liver hypertrophy with right portal vein embolization, resulted in a 53% reduction in tumor volume and compensatory hypertrophy in the contralateral liver. The patient subsequently underwent extended right hepatectomy with no postoperativesigns of liver decompensation. Pathological examination demonstrated a margin-free resection and major tumor response. This new therapeutic sequence, combining efficient tumor targeting and subsequent portal vein embolization, could improve the feasibility and safety of major liver resection for hepatocellular carcinoma in patients with liver injury.展开更多
Atmospheric pollution would increase morbidity and mortality rates for various respiratory illnesses in urban areas, and could also be an explanatory factor of higher rates of myocardial infarction in Charleroi compar...Atmospheric pollution would increase morbidity and mortality rates for various respiratory illnesses in urban areas, and could also be an explanatory factor of higher rates of myocardial infarction in Charleroi compared with the other Belgian cities. The present study investigates the health effects of acute exposure to air pollution on cardiovascular morbidity/mortality in Charleroi. The study is based on comparing hospital data taken from the registry of ischaemic cardiopathies in Charleroi (1999 to 2008) to data on the air quality in this region. To measure the association between atmospheric pollution and the number of cases of myocardial infarction, Poisson regression was carried out. The excess risk of myocardial infarction was analysed according to the month of admission. For men, a decrease in the attack rate of myocardial infarction is visible during the first three years of the study, later to remain stable. For women, attack rates are stable throughout the study. Most of the pollutants vary according to season. Except for ozone, concentrations are generally higher in winter. We observe an association between the concentrations of PM10 and NO2 and morbidity/mortality by acute myocardial infarction. The increased risk for an increase of 10 μg/m3 of pollutant is 1.8% for PM10 and 4.0% for NO2. Multivariate models must still be developed and applied to our data.展开更多
Brain plasticity is heterogeneous in mammals：Brain regeneration and repair are the dream of every neurobiologist as well as every common citizen in the world who knows that most neurological diseases,dementia and oth...Brain plasticity is heterogeneous in mammals：Brain regeneration and repair are the dream of every neurobiologist as well as every common citizen in the world who knows that most neurological diseases,dementia and other age-related problems affecting the central nervous system（CNS）do represent a heavy health and social burden.Efficacious re-generative processes are not＂ a natural property of the mammalian CNS, rather, due to evolutionary constraints they seem substantially reduced （if compared to those occurring in non-mammalian vertebrates） and hardly inducible by therapeutic approaches （reviewed in Martino et al., 2011）.展开更多
This paper presents a Torque Sharing Function(TSF)control of Switched Reluctance Machines(SRMs)with different current sensor placements to reconstruct the phase currents.TSF requires precise phase current information ...This paper presents a Torque Sharing Function(TSF)control of Switched Reluctance Machines(SRMs)with different current sensor placements to reconstruct the phase currents.TSF requires precise phase current information to ensure accurate torque control.Two proposed methods with different chopping transistors or a new PWM implementation require four or two current sensors to replace the current sensors on each phase regardless of the phase number.For both approaches,the actual phase current can be easily extracted during the single phase conducting region.However,how to separate the incoming and outgoing phase current values during the commutation region is the difficult issue to deal with.In order to derive these two adjacent currents,the explanations and comparisons of two proposed methods are described.Their effectiveness is verified by experimental results on a four-phase 8/6 SRM.Finally,the approach with a new PWM implementation is selected,which requires only two current sensors for reducing the number of sensors.The control system can be more compact and cheaper.展开更多
Ischemia-reperfusion injury is a determinant in liver injury occurring during surgery,ischemic states and multiple organ failure.The pre-existing nutritional status of the liver,i.e.,fasting,might contribute to the ex...Ischemia-reperfusion injury is a determinant in liver injury occurring during surgery,ischemic states and multiple organ failure.The pre-existing nutritional status of the liver,i.e.,fasting,might contribute to the extent of tissue injury.This study investigated whether alanine,an amino acid precursor of glucose,could protect ex vivo perfused livers of fasting rats from reperfusion injury.The portal vein was cannulated,the liver re-moved and perfused in a closed ex vivo system.Isolated livers were perfused either with glucose 1 g/L and 10 g/L,or with equal concentrations of alanine(n=10 in each group).The experiment consisted of perfusion for 15 min,ischemia for 60 min,and reoxygenation during 60 min.Enzymes,glucose,lactate and bilirubin were analysed in perfusate samples.The proportion of glycogen as well as activation of caspase 3 was determined in biopsies.Alanine at a concentration of 10 g/L attenuated enzymes release in the perfusate during reoxygenation when com-pared to glucose-treated groups.Lactate level in the perfusate was lowest in alanine groups.Ischemia-reperfusion and mainly alanine activated apoptosis,specifically in Kupffer and endothelial cells.Alanine presents a pro-tective effect on normothermic ischemia-reperfusion injury of the fasting rat liver when compared to glucose.展开更多
<p align="justify"> <span style="font-family:Verdana;">Background:<span style="font-family:Verdana;"> Indigent selected for their health care is complex and poses enormo...<p align="justify"> <span style="font-family:Verdana;">Background:<span style="font-family:Verdana;"> Indigent selected for their health care is complex and poses enormous challenges. The actors involved have an influence on health actions and their perception is decisive for better care for the indigent. Little evidence exists on these perceptions and this paper has captured this. <span style="font-family:Verdana;">Methods:<span style="font-family:Verdana;"> A case study involved 163 participants with a questionnaire and an interview guide. The quantitative responses were classified according to a measurement scale, proportions and overall indices of perception (Ip) and satisfaction (CSAT) were calculated. The relationship between variables was investigated using chi-square. Thematic analysis was used with qualitative data. The study met ethical requirements. <span style="font-family:Verdana;">Results: <span style="font-family:Verdana;">The participants had a positive perception of the selection: Ip = 0.77, but a minority (1/5) were dissatisfied with the selection. The perception of selection did not differ significantly depending on the experience of the actors. For the vast majority, the definition of indigent was satisfactory (CSAT = 91.4). The selection was done in a top down fashion and steps such as setting up committees, informing stakeholders, had shortcomings which negatively impacted the effectiveness of the selection. The needs of the participants included transparency in the indigent select process, matching the tools for selecting the indigent to the context, strengthening of local action, deconstruction of prejudices in terms of the indigent, power of actors to act, and importance for health services to reach out to the indigent. <span style="font-family:Verdana;">Conclusion: <span style="font-family:Verdana;">Considering the perception of the actors as well as their needs will improve the selection for effective care of the indigent.展开更多
In the previous paper (JMP 2014) we showed that there exists a NeoMinkowskian Gravitational Expanding Solution of GR (General Relativity) with CC (Cosmological Constant). We prove now that NeoMinkowskian Vacuum (non-b...In the previous paper (JMP 2014) we showed that there exists a NeoMinkowskian Gravitational Expanding Solution of GR (General Relativity) with CC (Cosmological Constant). We prove now that NeoMinkowskian Vacuum (non-baryonic Fluid), with gravitational (first) density (dark energy) and gravitational waves (at light speed), corresponds to the Gravitation Field of a Cosmological Black Hole (CBH). The latter predicts furthermore a basic emission of Radiation (CBR) from Hubble spherical singular Horizon to the inside of CBH (unlike Hawking’s emission) at an initial singular time. Our solution is then compatible with a well-tempered Big Bang and Expanding Universe (Escher’s Figure, see Penrose, 3) but incompatible with inflation. The latter is based on Hypothesis of a so-called Planck’s particle (Lemaitre’s primitive atom) characterized by a so-called Planck length. We prove that we can short-circuit this unstable particle with a stable cosmological Poincaré’s electron with gravific pressure. It is well known that electron is a stranger in usual Minkowskian vacuum (dixit Einstein). The stranger electron can be perfectly integrated in NeoMinkowskian Radiation fluid and then also (with its mass, charge and wavelength) in (second density of) CBR. Everything happens as if the leptonic mass of the electron were induced by our cosmological field. The unexpected cosmological model proposed here is the only one that predicts numerical values of (second) density and temperature of CBR very close to the observed (COBE) values.展开更多
Introduction: Child abuse is a serious health problem with compelling evidence that the phenomenon is common throughout the world. The Center “SOS enfants ULB” is a specialized team, established in a pediatric ward,...Introduction: Child abuse is a serious health problem with compelling evidence that the phenomenon is common throughout the world. The Center “SOS enfants ULB” is a specialized team, established in a pediatric ward, which had mission to prevent and to treat the situations of children victims of physical, sexual, psychological abuse or of neglect. Our objectives were to describe the characteristics of 439 children hospitalized for (suspicion of) maltreatment and to investigate different factors potentially associated with the children at risk of neglect or maltreatment, the children victims of neglect and the physically maltreated children. Methods: Chi square test and multinomial logistic regression models with clustered robust standard error were applied to assess the relationship between the three types of mistreatment and the potential associated factors. Results: Maltreatment was observed for almost one in two children (48.7%) and approximately four on ten (41.5%) were considered at risk. Physical abuse was the most prevalent (57.9%) among the maltreated children and neglect was the second most prevalent (37.4%) form of maltreatment. Regarding the criteria leading to hospitalisation, at least one protective criterion was observed for a little more than eight children on ten. The parental criteria have shown that social problems and conjugal conflicts were the most prevalent for this category of hospitalisation criteria. Conclusion: These data, concerning the hospitalized children for which there is (suspicion of) mistreatment, collected by this team make important contribution to describing child maltreatment and its associated factors. Despite the fact that these hospitalized cases may be probably more serious than those who were not reported, every event, however small it may be, should be known for better organizing each level of prevention.展开更多
基金Supported by National Natural Science Foundation of China,No.82373660 and No.81761128030Sanming Project of Medicine in Shenzhen Nanshan,No.11the China Scholarship Council。
文摘BACKGROUND Childhood maltreatment has a potentially lasting influence on subthreshold depressive symptoms(SDS)and major depressive disorder(MDD).This study aimed to explore the association of childhood maltreatment with MDD and SDS,focusing on the differences between young and middle-aged adults.AIMTo examine the associations among childhood maltreatment, SDS, and MDD in young and middle-aged adults.METHODSA total of 3209 adults were recruited from 34 primary healthcare settings. The Childhood Trauma Questionnaire-28item Short Form was used to assess childhood maltreatment. The Patient Health Questionnaire-9 was used toassess SDS and the Mini-International Neuropsychiatric Interview depression module was used to assess MDD.RESULTSChildhood maltreatment was significantly associated with higher odds of developing SDS and MDD than in thenon-depressed control group (P < 0.05). Childhood maltreatment significantly increased the risk of developing SDSin young adults but was not significantly associated with SDS in middle-aged adults (P = 0.055). Conversely,childhood maltreatment was significantly associated with MDD in both young (P < 0.001) and middle-aged adults(P < 0.05). In young adults, various types of childhood maltreatment were associated with MDD;however, onlyemotional abuse and neglect were significantly associated with MDD in middle-aged adults.CONCLUSIONOur study revealed a strong association among childhood maltreatment, SDS, and MDD across age groups,highlighting the impact of emotional abuse and need for trauma-informed depression care.
文摘Video capsule endoscopy (VCE) was launched in 2000 and has revolutionized direct endoscopic imaging of the gut. VCE is now a first-line procedure for exploring the small bowel in cases of obscure digestive bleeding and is also indicated in some patients with Crohn’s disease, celiac disease, and polyposis syndrome. A video capsule has also been designed for visualizing the esophagus in order to detect Barrett’s esophagus or esophageal varices. Different capsules are now available and differ with regard to dimensions, image acquisition rate, battery life, field of view, and possible optical enhancements. More recently, the use of VCE has been extended to exploring the colon. Within the last 5 years, tremendous developments have been made toward increasing the capabilities of the colon capsule. Although colon capsule cannot be proposed as a first-line colorectal cancer screening procedure, colon capsule may be used in patients with incomplete colonoscopy or in patients who are unwilling to undergo colonoscopy. In the near future, new technological developments will improve the diagnostic yield of VCE and broaden its therapeutic capabilities.
文摘Objective:To investigate the chemical composition of a moderately polar extract(CHC1_3 soluble part of the MeOH-H_2O extract) obtained from the aerial parts(leaves and flowers) of Centaurea diluta Ait.subsp.algeriensis(Coss.& Dur.) Maire,a species endemic to Algeria and Morocco on which no reports are available to date.To evaluate in vitro the cytotoxic,antifungal and antimicrobial activities of this extract and the cytotoxic and antimicrobial activities of its isolated secondary metabolites.Methods:The cytotoxic effects of the extract were investigated on 3 human cancer cell lines i.e.the A549 non-small-cell lung carcinoma(NSCLC),the MCF7 breast adenocarcinoma and the U373 glioblastoma using a MTT colorimetric assay.Biological data allowed to guide the fractionation of the extract by separation and purification on silica gel 60(CC and TLC).The isolated compounds which were characterized by spectral analysis,mainly HR-ESIMS,HR-EIMS,UV and NMR experiments(~1H,^(13)C,COSY,ROESY,HSQC and HMBC) and comparison of their spectroscopic data with those reported in the literature,were evaluated for cytotoxic activities on six cancer cell lines(A549,MCF7,U373,Hs683 human glioma,PC3 human prostate and B16-F10 murine melanoma).The direct and indirect antibacterial and antifungal activities were determined using microdilution methods for the raw extract and TLC-bioautography and microdilution methods against standard and clinical strains for the isolated compounds.Results:The raw extract reduced cell viability with IC_(50)s of 27,25 and 21 μg/mL on A549,MCF7 and U373,respectively.Five secondary metabolites:two phenolic compounds(vanillin 1,paridol 3),a lignan[(-)-arctigenin 2]and two flavonoid aglycones(eupatilin 4 and jaceosidin 5),were then isolated from this extract.Moderate cytotoxic effects were observed for(-)-arctigenin 2(IC_(50)s:28 and 33μM on Hs683 and B16-F10,respectively),eupatilin 4(IC_(50)s:33 and 47 μM on B16-F10 and PC3,respectively) and jaceosidin 5(IC_(50)s:32 and 40 μM on PC3 and B16-F10,respectively).Conclusions:All the isolated compounds were described for the first time from this species.Although inactive against 7 tested microorganisms(fungi,bacteria and yeast,human or plant pathogens),the raw extract was able to potentiate the effect of beta-lactam antibiotics on methicillin-resistant Staphylococcus aureus(MRSA),reducing the minimal inhibitory concentrations(MICs) by a factor of 2-32-fold.No synergy was found between the extract and streptomycin.From the five isolated compounds only jaseosidin 5 showed a moderate antimicrobial activity.
文摘Breast cancer is one of the most frequently diagnosed malignancies during pregnancy. Here, we review the management of women with breast cancer during pregnancy(BCP), focusing on biology, diagnosis and staging, local and systemic treatments, obstetric care and long-term follow-up of children with prenatal exposure to anticancer treatments.
文摘Ampullary carcinoma(AC) is a rare gastrointestinal tumor without clear treatment recommendations.The management of this tumor is usually extrapolated from the treatment of pancreatic,biliary duct and intestinal cancers.Few papers have studied the AC as an independent entity and yet succombs to several limitations.These studies were retrospective single institutional experiences with limited sample sizes recruited over a long period of time.Unlike metastatic ACs where chemotherapy is the only recommended option,localized AC once excised may be approached by either chemotherapy alone or concomitant chemoradiation therapy.In this review,we report the overall survival and recurrence factors of more than 1000 patients from all the studies treating exclusively ACs.We also review the medical treatment of this tumor and conclude to the necessity of multi-institutional randomized controlled studies for AC exclusively.
基金I thank the Belgian Fund for Scientific Research(F.N.R.S.,Belgium)the Brugmann Foundation(CHU Brugmann,Brussels,Belgium).A special thanks also to all collaborators of my EEG team(Kajosch H,Hanard F,Schroder E,Dousset C and Ingels A)to Guérit JM and Debatisse D who were my mentors in using ERPs,and to Boutros N and Otte G for their support on this topic.
文摘Relapse prevention remains a major challenge in psychiatry,thus indicating that the established treatment methods combining psychotherapy with neuropharmacological interventions are not entirely effective.In recent years,several intervention strategies have been devised that are aimed at improving psychiatric treatment by providing a complementary set of add-on tools that can be used by clinicians to improve current patient assessment.Among these,cognitive eventrelated potentials(ERPs)have been indexed as valuable biomarkers of the pathophysiological mechanisms of various mental illnesses.However,despite decades of research,their clinical utility is still controversial and a matter of debate.In this opinion review,I present the main arguments supporting the use of cognitive ERPs in the management of psychiatric disorders,stressing why it is currently still not the case despite the vast number of ERP studies to date.I also propose a clinically-oriented suitable way in which this technique could—in my opinion—be effectively incorporated into individual patient care by promotion of the use of individual ERP test-retest sessions and the use of a multi-component approach.
文摘In oncosurgical approach to colorectal liver metastases, surgery remains considered as the only potentially curative option, while chemotherapy alone represents a strictly palliative treatment. However, missing metastases, defined as metastases disappearing after chemotherapy, represent a unique model to evaluate the curative potential of chemotherapy and to challenge current therapeutic algorithms. We reviewed recent series on missing colorectal liver metastases to evaluate incidence of this phenomenon, predictive factors and rates of cure defined by complete pathologic response in resected missing metastases and sustained clinical response when they were left unresected. According to the progresses in the efficacy of chemotherapeutic regimen, the incidence of missing liver metastases regularly increases these last years. Main predictive factors are small tumor size, low marker level, duration of chemotherapy, and use of intra-arterial chemotherapy. Initial series showed low rates of complete pathologic response in resected missing metastases and high recurrence rates when unresected. However, recent reports describe complete pathologic responses and sustained clinical responses reaching 50%, suggesting that chemotherapy could be curative in some cases. Accordingly, in case of missing colorectal liver metastases, the classical recommendation to resect initial tumor sites might have become partially obsolete. Furthermore, the curative effect of chemotherapy in selected cases could lead to a change of paradigm in patients with unresectable liver-only metastases, using intensive first-line chemotherapy to intentionally induce missing metastases, followed by adjuvant surgery on remnant chemoresistant tumors and close surveillance of initial sites that have been left unresected.
文摘Resectability of hepatocellular carcinoma in patients with chronic liver disease is dramatically limited by the need to preserve sufficient remnant liver in order to avoid postoperative liver insufficiency. Preoperative treatments aimed at downsizing the tumor and promoting hypertrophy of the future remnant liver may improve resectability and reduce operative morbidity. Here we report the case of a patient with a large hepatocellular carcinoma arising from chronic liver disease. Preoperative treatment, including tumor downsizing with transarterial radioembolization and induction of future remnant liver hypertrophy with right portal vein embolization, resulted in a 53% reduction in tumor volume and compensatory hypertrophy in the contralateral liver. The patient subsequently underwent extended right hepatectomy with no postoperativesigns of liver decompensation. Pathological examination demonstrated a margin-free resection and major tumor response. This new therapeutic sequence, combining efficient tumor targeting and subsequent portal vein embolization, could improve the feasibility and safety of major liver resection for hepatocellular carcinoma in patients with liver injury.
文摘Atmospheric pollution would increase morbidity and mortality rates for various respiratory illnesses in urban areas, and could also be an explanatory factor of higher rates of myocardial infarction in Charleroi compared with the other Belgian cities. The present study investigates the health effects of acute exposure to air pollution on cardiovascular morbidity/mortality in Charleroi. The study is based on comparing hospital data taken from the registry of ischaemic cardiopathies in Charleroi (1999 to 2008) to data on the air quality in this region. To measure the association between atmospheric pollution and the number of cases of myocardial infarction, Poisson regression was carried out. The excess risk of myocardial infarction was analysed according to the month of admission. For men, a decrease in the attack rate of myocardial infarction is visible during the first three years of the study, later to remain stable. For women, attack rates are stable throughout the study. Most of the pollutants vary according to season. Except for ozone, concentrations are generally higher in winter. We observe an association between the concentrations of PM10 and NO2 and morbidity/mortality by acute myocardial infarction. The increased risk for an increase of 10 μg/m3 of pollutant is 1.8% for PM10 and 4.0% for NO2. Multivariate models must still be developed and applied to our data.
基金supported by MIUR-PRIN2015(grant 2015Y5W9YP)University of Turin(Ricerca locale 2016)
文摘Brain plasticity is heterogeneous in mammals：Brain regeneration and repair are the dream of every neurobiologist as well as every common citizen in the world who knows that most neurological diseases,dementia and other age-related problems affecting the central nervous system（CNS）do represent a heavy health and social burden.Efficacious re-generative processes are not＂ a natural property of the mammalian CNS, rather, due to evolutionary constraints they seem substantially reduced （if compared to those occurring in non-mammalian vertebrates） and hardly inducible by therapeutic approaches （reviewed in Martino et al., 2011）.
基金The test bench was supported by The Future Planning(NRF-2016H1D5A1910536)“Human Resources Program in Energy Technology”of the Korea Institute of Energy Technology Evaluation and Planning(KETEP),granted financial resource from the Ministry of Trade,Industry&Energy,Republic of Korea.(No.20164010200940)The authors would like to thank FONDS DAVID ET ALICE VAN BUUREN and FONDATION JAUMOTTE-DEMOULIN for the funding“Prix Van Buuren-Jaumotte-Demoulin”.
文摘This paper presents a Torque Sharing Function(TSF)control of Switched Reluctance Machines(SRMs)with different current sensor placements to reconstruct the phase currents.TSF requires precise phase current information to ensure accurate torque control.Two proposed methods with different chopping transistors or a new PWM implementation require four or two current sensors to replace the current sensors on each phase regardless of the phase number.For both approaches,the actual phase current can be easily extracted during the single phase conducting region.However,how to separate the incoming and outgoing phase current values during the commutation region is the difficult issue to deal with.In order to derive these two adjacent currents,the explanations and comparisons of two proposed methods are described.Their effectiveness is verified by experimental results on a four-phase 8/6 SRM.Finally,the approach with a new PWM implementation is selected,which requires only two current sensors for reducing the number of sensors.The control system can be more compact and cheaper.
基金The authors are grateful to Laurence Seidel,MSc(Biostatistician,Department of Biostatistics,University of Liege,Liege,Belgium),to Professor Adelin Albert,PhD(Professor of Biostatistics,Department of Biostatistics,University of Liege,Liege,Belgium)for his advice and con-structive criticism so freely given and to Saad Guendouz BSc(Laboratory of Pathological Anatomy(ULB unit 724)Free University of Brussels,Brussels,Belgium)for tech-nical help.
文摘Ischemia-reperfusion injury is a determinant in liver injury occurring during surgery,ischemic states and multiple organ failure.The pre-existing nutritional status of the liver,i.e.,fasting,might contribute to the extent of tissue injury.This study investigated whether alanine,an amino acid precursor of glucose,could protect ex vivo perfused livers of fasting rats from reperfusion injury.The portal vein was cannulated,the liver re-moved and perfused in a closed ex vivo system.Isolated livers were perfused either with glucose 1 g/L and 10 g/L,or with equal concentrations of alanine(n=10 in each group).The experiment consisted of perfusion for 15 min,ischemia for 60 min,and reoxygenation during 60 min.Enzymes,glucose,lactate and bilirubin were analysed in perfusate samples.The proportion of glycogen as well as activation of caspase 3 was determined in biopsies.Alanine at a concentration of 10 g/L attenuated enzymes release in the perfusate during reoxygenation when com-pared to glucose-treated groups.Lactate level in the perfusate was lowest in alanine groups.Ischemia-reperfusion and mainly alanine activated apoptosis,specifically in Kupffer and endothelial cells.Alanine presents a pro-tective effect on normothermic ischemia-reperfusion injury of the fasting rat liver when compared to glucose.
文摘<p align="justify"> <span style="font-family:Verdana;">Background:<span style="font-family:Verdana;"> Indigent selected for their health care is complex and poses enormous challenges. The actors involved have an influence on health actions and their perception is decisive for better care for the indigent. Little evidence exists on these perceptions and this paper has captured this. <span style="font-family:Verdana;">Methods:<span style="font-family:Verdana;"> A case study involved 163 participants with a questionnaire and an interview guide. The quantitative responses were classified according to a measurement scale, proportions and overall indices of perception (Ip) and satisfaction (CSAT) were calculated. The relationship between variables was investigated using chi-square. Thematic analysis was used with qualitative data. The study met ethical requirements. <span style="font-family:Verdana;">Results: <span style="font-family:Verdana;">The participants had a positive perception of the selection: Ip = 0.77, but a minority (1/5) were dissatisfied with the selection. The perception of selection did not differ significantly depending on the experience of the actors. For the vast majority, the definition of indigent was satisfactory (CSAT = 91.4). The selection was done in a top down fashion and steps such as setting up committees, informing stakeholders, had shortcomings which negatively impacted the effectiveness of the selection. The needs of the participants included transparency in the indigent select process, matching the tools for selecting the indigent to the context, strengthening of local action, deconstruction of prejudices in terms of the indigent, power of actors to act, and importance for health services to reach out to the indigent. <span style="font-family:Verdana;">Conclusion: <span style="font-family:Verdana;">Considering the perception of the actors as well as their needs will improve the selection for effective care of the indigent.
文摘In the previous paper (JMP 2014) we showed that there exists a NeoMinkowskian Gravitational Expanding Solution of GR (General Relativity) with CC (Cosmological Constant). We prove now that NeoMinkowskian Vacuum (non-baryonic Fluid), with gravitational (first) density (dark energy) and gravitational waves (at light speed), corresponds to the Gravitation Field of a Cosmological Black Hole (CBH). The latter predicts furthermore a basic emission of Radiation (CBR) from Hubble spherical singular Horizon to the inside of CBH (unlike Hawking’s emission) at an initial singular time. Our solution is then compatible with a well-tempered Big Bang and Expanding Universe (Escher’s Figure, see Penrose, 3) but incompatible with inflation. The latter is based on Hypothesis of a so-called Planck’s particle (Lemaitre’s primitive atom) characterized by a so-called Planck length. We prove that we can short-circuit this unstable particle with a stable cosmological Poincaré’s electron with gravific pressure. It is well known that electron is a stranger in usual Minkowskian vacuum (dixit Einstein). The stranger electron can be perfectly integrated in NeoMinkowskian Radiation fluid and then also (with its mass, charge and wavelength) in (second density of) CBR. Everything happens as if the leptonic mass of the electron were induced by our cosmological field. The unexpected cosmological model proposed here is the only one that predicts numerical values of (second) density and temperature of CBR very close to the observed (COBE) values.
文摘Introduction: Child abuse is a serious health problem with compelling evidence that the phenomenon is common throughout the world. The Center “SOS enfants ULB” is a specialized team, established in a pediatric ward, which had mission to prevent and to treat the situations of children victims of physical, sexual, psychological abuse or of neglect. Our objectives were to describe the characteristics of 439 children hospitalized for (suspicion of) maltreatment and to investigate different factors potentially associated with the children at risk of neglect or maltreatment, the children victims of neglect and the physically maltreated children. Methods: Chi square test and multinomial logistic regression models with clustered robust standard error were applied to assess the relationship between the three types of mistreatment and the potential associated factors. Results: Maltreatment was observed for almost one in two children (48.7%) and approximately four on ten (41.5%) were considered at risk. Physical abuse was the most prevalent (57.9%) among the maltreated children and neglect was the second most prevalent (37.4%) form of maltreatment. Regarding the criteria leading to hospitalisation, at least one protective criterion was observed for a little more than eight children on ten. The parental criteria have shown that social problems and conjugal conflicts were the most prevalent for this category of hospitalisation criteria. Conclusion: These data, concerning the hospitalized children for which there is (suspicion of) mistreatment, collected by this team make important contribution to describing child maltreatment and its associated factors. Despite the fact that these hospitalized cases may be probably more serious than those who were not reported, every event, however small it may be, should be known for better organizing each level of prevention.
