Identifying the spatial pattern and the drivers of the decline in the eastern English Channel chlorophyll-a surface concentration over the last two decades

It has been established from previous studies that chlorophyll-a surface concentration has been declining in the eastern English Channel. This decline has been attributed to a decrease in nutrient concentrations in the rivers. However, the decrease in river discharge could also be a cause. In our study, rivers outflows and in-situ data have been compared to time series of satellite-derived chlorophyll-a concentrations. Dynamic Linear Model has been used to extract the dynamic and seasonally adjusted trends of several environmental variables. The results showed that, for the 1998-2019 period, chlorophyll-a levels stayed significantly lower than average and satellite images revealed a coast to offshore gradient. Chlorophyll-a concentration of coastal stations appeared to be related to the declining fluxes of phosphate while offshore stations were more related to nitrate-nitrite. Therefore, we can exclude that the climate variability, through river flows alone, has a dominant effect on the decline of chlorophyll-a concentration.

Inpatient target discharge weight for early-onset anorexia nervosa: Restoring premorbid BMI percentile to improve height prognosis

OBJECTIVE

Early-onset anorexia nervosa (EO-AN) is characterized by restricted food intake leading to low body weight, emerging before 14 years old. Most patients reaching a target body mass index (BMI) around the 25th percentile at hospitalization discharge display an incomplete prospective height catch-up. A better understanding of height prognosis determinants is required.

METHODS

In 74 children with an EO-AN, we collected height and weight premorbidly, at hospitalization, and at discharge, 6 months, 12 months, and at longer-term follow-up of 36 months. We defined a height prognosis parameter (HPP) as the difference between the height percentile at follow-up times and the premorbid height percentile. We explored the relationship between weight parameters and height catch-up at follow-up with linear regression analyses.

RESULTS

A higher weight suppression (WS) - i.e., difference between premorbid and current BMI - at admission and discharge was associated with lower HPP - i.e., a greater loss of height - at 12 months and 36 months follow-up. Similarly, a higher premorbid BMI percentile was associated with a lower HPP at 12 and 36 months.

CONCLUSION

Target discharge weight for EO-AN patients should be tailored and based on premorbid BMI trajectory to improve height prognosis.

Trajectories of nutrients concentrations and ratios in the French coastal ecosystems: 20 years of changes in relation with large-scale and local drivers

Along with their important diversity, coastal ecosystems receive various amounts of nutrients, principally arising from the continent and from the related human activities (mainly industrial and agricultural activities). During the 20th century, nutrients loads have increased following the increase of both the global population and need of services. Alongside, climate change including temperature increase or atmospheric circulation change has occurred. These processes, Ecosystem state changes are hard to monitor and predict. To study the long-term changes of nutrients concentrations in coastal ecosystems, eleven French coastal ecosystems were studied over 20 years as they encompass large climatic and land pressures, representative of temperate ecosystems, over a rather small geographical area. Both univariate (time series decomposition) and multivariate (relationships between ecosystems and drivers) statistical analyses were used to determine ecosystem trajectories as well as typologies of ecosystem trajectories. It appeared that most of the French coastal ecosystems exhibited trajectories towards a decrease in nutrients concentrations. Differences in trajectories mainly depended on continental and human influences, as well as on climatic regimes. One single ecosystem exhibited very different trajectories, the Arcachon Bay with an increase in nutrients concentrations. Ecosystem trajectories based on ordination techniques were proven to be useful tools to monitor ecosystem changes. This study highlighted the importance of local environments and the need to couple uni- and multi-ecosystem studies. Although the studied ecosystems were influenced by both local and large-scale climate, by anthropogenic activities loads, and that their trajectories were mostly similar based on their continental influence, non-negligible variations resulted from their internal functioning.

EcoTransLearn: an R-package to easily use transfer learning for ecological studies-a plankton case study

SUMMARY

In recent years, Deep Learning (DL) has been increasingly used in many fields, in particular in image recognition, due to its ability to solve problems where traditional machine learning algorithms fail. However, building an appropriate DL model from scratch, especially in the context of ecological studies, is a difficult task due to the dynamic nature and morphological variability of living organisms, as well as the high cost in terms of time, human resources and skills required to label a large number of training images. To overcome this problem, Transfer Learning (TL) can be used to improve a classifier by transferring information learnt from many domains thanks to a very large training set composed of various images, to another domain with a smaller amount of training data. To compensate the lack of 'easy-to-use' software optimized for ecological studies, we propose the EcoTransLearn R-package, which allows greater automation in the classification of images acquired with various devices (FlowCam, ZooScan, photographs, etc.), thanks to different TL methods pre-trained on the generic ImageNet dataset.

AVAILABILITY AND IMPLEMENTATION

EcoTransLearn is an open-source package. It is implemented in R and calls Python scripts for image classification step (using reticulate and tensorflow libraries). The source code, instruction manual and examples can be found at https://github.com/IFREMER-LERBL/EcoTransLearn.

SUPPLEMENTARY INFORMATION

Supplementary data are available at Bioinformatics online.

ESA’s Lidar Missions Aeolus and EarthCARE

ESAs Earth Explorer Aeolus was launched in August 2018. Aboard the first spaceborne wind lidar ALADIN (Atmospheric LAser Doppler INstrument) was switched on in early September 2018 and demonstrated the capability to provide atmospheric wind profiles globally from particle and molecular backscatter. In doing so, it will contribute to the improvement in numerical weather prediction (NWP) and the understanding of global dynamics. At the same, it is a major step for powerful and frequency stabilized ultraviolet (UV) lasers for space applications. In parallel, ESA and its partners continue the development of this technology by setting up further ground tests based on Aeolus, and preparing the next milestone with ATLID (ATmospheric LIDar) for the Earth Cloud, Aerosol and Radiation Explorer (EarthCARE) mission. ATLID is currently fully integrated and getting prepared for its on-ground testing.

Eutrophication: A new wine in an old bottle?

Eutrophication is one of the most common causes of water quality impairment of inland and marine waters. Its best-known manifestations are toxic cyanobacteria blooms in lakes and waterways and proliferations of green macro algae in coastal areas. The term eutrophication is used by both the scientific community and public policy-makers, and therefore has a myriad of definitions. The introduction by the public authorities of regulations to limit eutrophication is a source of tension and debate on the activities identified as contributing or having contributed decisively to these phenomena. Debates on the identification of the driving factors and risk levels of eutrophication, seeking to guide public policies, have led the ministries in charge of the environment and agriculture to ask for a joint scientific appraisal to be conducted on the subject. Four French research institutes were mandated to produce a critical scientific analysis on the latest knowledge of the causes, mechanisms, consequences and predictability of eutrophication phenomena. This paper provides the methodology and the main findings of this two years exercise involving 40 scientific experts.

[Bronchoscopic treatment of bronchopleural fistula]

Bronchopleural fistula is an uncommon complication occurring especially following lung resection (pneumonectomy) and associated with high morbidity and mortality rates. The treatment is surgical but some studies reported bronchoscopic treatment. Localization and size of the fistula may indicate different endoscopic procedures. This overview described the different endoscopic procedures and their benefits.

Realized niche analysis of phytoplankton communities involving HAB: Phaeocystis spp. as a case study

The link between harmful algal blooms, phytoplankton community dynamics and global environmental change is not well understood. To tackle this challenging question, a new method was used to reveal how phytoplankton communities responded to environmental change with the occurrence of an harmful algae, using the coastal waters of the eastern English Channel as a case study. The great interannual variability in the magnitude and intensity of Phaeocystis spp. blooms, along with diatoms, compared to the ongoing gradual decrease in anthropogenic nutrient concentration and rebalancing of nutrient ratios; suggests that other factors, such as competition for resources, may also play an important role. A realized niche approach was used with the Outlying Mean Index analysis and the dynamics of the species' realized subniches were estimated using the Within Outlying Mean Indexes calculations under low (L) and high (H) contrasting Phaeocystis spp. abundance. The Within Outlying Mean Indexes allows the decomposition of the realized niche into realized subniches, found within the subset of habitat conditions and constrained by a subset of a biotic factor. The two contrasting scenarios were characterized by significantly different subsets of environmental conditions and diatom species (BV-step analysis), and different seasonality in salinity, turbidity, and nutrients. The subset L environmental conditions were potentially favorable for Phaeocystis spp. but it suffered from competitive exclusion by key diatom species such as Skeletonema spp., Thalassiosira gravida, Thalassionema nitzschioides and the Pseudo-nitzchia seriata complex. Accordingly, these diatoms species occupied 81% of Phaeocystis spp.'s existing fundamental subniche. In contrast, the greater number of diatoms, correlated with the community trend, within subset H exerted a weaker biological constraint and favored Phaeocystis spp. realized subniche expansion. In conclusion, the results strongly suggest that both abiotic and biotic interactions should be considered to understand Phaeocystis spp. blooms with greater consideration of the preceeding diatoms. HABs needs must therefore be studied as part of the total phytoplankton community.

Bilateral plication of the puborectal muscles: A new surgical concept for treating vulvar widening

OBJECTIVES

This study describe a new myorraphy technique by bilateral plication of the puborectalis bundles (PRP) of the levator ani muscle to treat vulvovaginal widening. The aim of this work was to report our preliminary experience in terms of morbidity and results (anatomical and functional) in the short and medium term.

MATERIALS AND METHODS

This single centre retrospective study concerned 69 women who underwent PRP between January 2011 and December 2014. The main criterion for judging success was the GH before and after surgery (Genital Hiatus in the POP-Q classification: Pelvic Organ Prolapse Quantification System). The secondary criteria were the quality of sexual intercourse and the morbidity.

RESULTS

The average GH post-surgery was 31, 35 and 35mm at 6 weeks, 6 and 12 months respectively compared to 65±5mm preoperatively (P<0.00001). Among the 27 patients who were sexually active prior to surgery, 18.52% deemed the quality of sexual intercourse satisfactory. After surgery, more than 88% of the patients observed an improvement (P<0.00001). After the surgery the reported rate of minor complications was under 3%.

CONCLUSION

This preliminary study of PRP confirms the feasibility of the procedure, its low morbidity and the stability of the anatomical outcomes at 12 months.

Detection of temporal clusters of health care-associated infections or colonizations with Pseudomonas aeruginosa

We investigated temporal clusters of Pseudomonas aeruginosa cases between 2005 and 2014 in 1 French university hospital, overall and by ward, using the Kulldorff method. Clusters of positive water samples were also investigated at the whole hospital level. Our results suggest that water outlets are not closely involved in the occurrence of clusters of P aeruginosa cases.

Association between Pseudomonas aeruginosa positive water samples and healthcare-associated cases: nine-year study at one university hospital

OBJECTIVE

To study the association between the results of water samples and Pseudomonas aeruginosa healthcare-associated cases in a French university hospital.

METHODS

Generalized Estimating Equations were used on complete case and imputed datasets. The spatial unit was the building and the time unit was the quarter.

RESULTS

For the period 2004-2013, 2932 water samples were studied; 17% were positive for P. aeruginosa. A higher incidence of P. aeruginosa cases was associated with a higher proportion of positive water samples (P=0.056 in complete case analysis and P=0.031 with the imputed dataset). The association was no longer observed when haematology and intensive care units were excluded, but was significant in analyses of data concerning intensive care units alone (P<0.001).

CONCLUSION

This study suggests that water outlet contamination in hospitals can lead to an increase in healthcare-associated P. aeruginosa cases in wards dealing with susceptible patients, but does not play a significant role in other wards.

Information concerning multidrug-resistant bacterial colonization or infection in the medical transfer letter

OBJECTIVES

The aim of this study was to evaluate the proportion of transfer letters that contained information relative to infection or colonization by multidrug-resistant (MDR) bacteria and factors associated with the presence of that information.

PATIENTS AND METHODS

Patients for whom at least one of these selected MDR bacteria (methicillin-resistant Staphylococcus aureus, extended-spectrum β-lactamase-producing Enterobacteriaceae, or MDR Pseudomonas aeruginosa) was isolated during their hospitalization and who were transferred to another health care facility between 2009 and 2012 were included. Information of the MDR bacterium and the mention of isolation precautions were evaluated in the electronic medical record.

RESULTS

Information (mention of MDR bacterium or isolation precaution) was present in 57% [52; 65] of records. Full information (genus and species, concept of MDR bacterium and mention of isolation precaution) was found in 20% [16; 25]. The presence of a dedicated item in the standard medical discharge letter was associated with more frequent information. Less information was retrieved with P. aeruginosa cases than with the other 2 MDR bacteria.

CONCLUSION

The presence of the information has improved, but it is still insufficiently reported. Measures to improve information are needed. Indeed, information on MDR bacterial colonization or infection is the first step for isolation precautions. An item could be added to all standard medical discharge letters. An item could also be added to the indicators used to assess quality and safety in healthcare facilities.

[Relationship between intravitreal anti-VEGF therapy and subretinal hemorrhage in patients with exudative age-related macular degeneration]

PURPOSE

To assess and compare frequencies and incidence rates of subretinal hemorrhage (SRH) after intravitreal anti-VEGF injections and spontaneous SRH in patients with exudative age-related macular degeneration (AMD).

PATIENTS AND METHODS

This retrospective monocentric study included 1079 patients followed for exudative AMD in the ophthalmology department of the university hospital of Dijon from January 2007 to July 2012. For each SRH occuring during this period, the number of previous treatments with intravitreal anti-VEGF was determined, as well as the time between the last injection and the hemorrhage. The SRH was considered as an adverse effect of the anti-VEGF injection if it occurred within 2 months after the last IVT (post-IVT SRH). Frequencies and incidence rates of post-IVT SRH and spontaneous SRH were calculated.

RESULTS

Sixty-six SRH's occurred during the study period with a total frequency of 6.12% (CI95% [4.69-7.55]). Frequencies of spontaneous and post-IVT SRH were respectively 5.65% (CI95% [4.28-7.03]) and 0.46% (CI95% [0.06-0.87]), representing a 12.2 ratio. Post-IVT SRH incidence was 8.3/1000 patient-years (CI95% [1.0-15.5]) and the spontaneous SRH incidence rate was 11.6/1000 patient-years (CI95% [8.3-14.8]), (P=0.472). The incidence rate ratio was 0.72 (CI95% [0.29-1.78]).

CONCLUSION

This study did not show a statistically significant change in the incidence of SRH after intravitreal anti-VEGF therapy. The benefit/risk ratio of intravitreal anti-VEGF injections for exudative AMD remains high.

Distribution of total DNA and cccDNA in serum and PBMCs may reflect the HBV immune status in HBsAg+ and HBsAg- patients coinfected or not with HIV or HCV

BACKGROUND

The potential reservoir role of serum and peripheral blood mononuclear cells (PBMCs) for total HBV DNA (tDNA) and cccDNA still remains unknown.

MATERIAL AND METHODS

We analyzed tDNA and cccDNA with a single sensitive and validated standardized real-time PCR method in serum and PBMCs in two populations of chronic HBV infection coinfected or not with HCV and/or HIV viruses: a retrospective cohort of 130 HBsAg-negative (HBsAg-) patients with "anti-HBc alone" or anti-HBc and anti-HBs antibodies (Ab) and a cohort of 70 HBsAg-positive patients, 16 of them being prospectively followed under treatment.

RESULTS

Among HBsAg- patients, HBV DNA was detected in serum or PBMCs in about half of the cases with various distributions of tDNA and cccDNA: in HIV-negative patients with an "antiHBc alone" profile, tDNA was mostly detected in PBMCs suggesting a possible active role of PBMCs; although cccDNA was not detected in PBMCs in HIV-positive patients, tDNA and cccDNA were mostly observed in serum, suggesting a specific pattern of more "persistent" than "occult" infection in this population. Patients with anti-HBc and anti-HBs Ab harbored tDNA in serum or in PBMCs, regardless of their HIV or HCV status, raising the question of a viral reactivation risk during immunosupression in these patients. Among HBsAg+ patients, tDNA was detected in serum and PBMCs of 88.5% of the cases and cccDNA in 22%. Levels of tDNA in both compartments were highly correlated during treatment, suggesting a passive reservoir role for PBMCs.

CONCLUSION

The respective distribution of tDNA and cccDNA in serum and PBMCs may reflect the different immune statuses of the host in HBsAg+ and HBsAg- patients. The frequency of HBV DNA in PBMCs from AgHBs- patients suggests a viral reactivation risk during immunodepression in those patients.

Depressive symptoms are prevalent in childhood-onset systemic lupus erythematosus (cSLE)

Background

Depressive symptoms are common in adolescence and young adulthood; however, their prevalence in childhood-onset systemic lupus erythematosus (cSLE) is unknown.

Objective

The objective of this study was to examine the prevalence of depressive symptoms and their association with disease characteristics in children, adolescents, and young adults with cSLE.

Methods

A cross-sectional sample of patients with cSLE between 10 to 24 years old completed standardized depression inventories. Demographics and disease characteristics were collected.

Results

Total depression inventory scores reported were below standard cut-off values for depression. However, 26% (10/38) of children and adolescents, and 44% (seven of 16) of young adults had scores at or above established cut-offs for elevated depression symptoms. Physical symptoms of depression were endorsed most frequently. There were no differences in depressive symptoms by disease characteristics including disease duration, health-related quality of life inventory scores, antiphospholipid antibody status, and a history of renal involvement or neuropsychiatric SLE (NPSLE). However, two patients had a history of depression as an NPSLE manifestation of their SLE. In the children and adolescents, prednisone dose was associated with negative self-esteem ( r = 0.37, p = 0.04) and somatic depressive symptoms ( r = 0.39, p = 0.02), but we did not observe a significant association in the young adults.

Conclusion

Depressive symptoms in cSLE are frequent, although similar to the high prevalence rates in the general population. Physical symptoms are most frequently endorsed. Further study will determine if serial evaluations are recommended for early detection in this at-risk population.

Analysis of Incidence-Severity Relationships for Strawberry Powdery Mildew as Influenced by Cultivar, Cultivar Type, and Production Systems

The relationships between strawberry powdery mildew incidence (I) and severity (S) were investigated for various cultivars, for June-bearing and day-neutral cultivars, and for production systems (open-field and plastic-tunnel) with the objective of deriving a simple relationship for predicting severity (proportion of leaf area diseased [PLAD]) from incidence (proportion of diseased leaves). Data were collected from 2006 to 2011 at 11 commercial and experimental sites, for a total of 2,326 observations (n). For the cultivars grown in open fields, higher severity was observed on 'Seascape', with mean PLAD of 0.299 (n = 427); followed by 'Chambly', with 0.133 (n = 334); 'Cavendish', with 0.115 (n = 250); 'Darselect', with 0.111 (n = 321); and 'Jewel', with 0.105 (n = 276). In general, mean severity was higher when the strawberry plants were grown in plastic tunnels, with PLAD of 0.204, 0.199, and 0.181 for Chambly (n = 204), Darselect (n = 261), and Jewel (n = 253), respectively. A linear model based on complementary log-log transformation of I and S provided a good fit of the data (coefficient of determination [R²] adjusted for degrees of freedom from 0.82 to 0.96). A covariance analysis indicated that the sampling year and site of sampling did not significantly influence the estimated slope of the I-S relationship, nor did the specific cultivar among the June-bearing ones, whereas the production system (open-field versus plastic-tunnel) and the cultivar type (June-bearing versus day-neutral) significantly influenced the estimated slope. From this analysis, we were able to develop three specific models for open-field-grown June-bearing cultivars (R² = 0.90), for the open-field-grown day-neutral cultivar (Seascape, R²= 0.91), and for June-bearing cultivars grown in plastic tunnels (R² = 0.92). From these results, it was concluded that strawberry powdery mildew leaf severity can be accurately estimated from incidence of diseased leaves. The I-S relationships developed in the present study may be used in making practical disease management decisions, especially for management programs that use information on disease level in the field to initiate fungicide spraying programs or to time the interval between sprays.

Input impedance in flow ducts: theory and measurement

This paper presents both a theoretical and an experimental investigation of the influence of the mean flow on the input impedance of a duct. The input impedance of an axisymetrical flow duct is calculated, taking into account the convective effect of a uniform flow, the dissipative effect of a turbulent flow and the radiation in an open jet. Each of these effects is separately studied. An experimental apparatus has been specifically designed to lower flow noise on the transducers, taking advantage of the Two-Microphone-Three-Calibration (TMTC) method [V. Gibiat and F. Laloë, J. Acoust. Soc. Am. 88, 2533-2545 (1990)], whose full calibration process allows any geometry for the measurement head. Theory and experiments are compared for a 1 m long cylindrical duct carrying a flow whose Mach number equals up to 0.15. The resonant frequencies are in close agreement, within 3%. The relative evolution of the magnitude maxima with increasing flow are in good agreement, within 10%. Despite similar tendencies when modifying the mean flow velocity, the amplitude of variation of the magnitude is 2 to 5 times smaller in the experiments.

The three-measurement two-calibration method for measuring the transfer matrix

Extensive use of transfer matrices (TMs) is made in determining the acoustic properties of a duct and in in-duct acoustic propagation models in the automotive industry and for musical acoustics purposes. The experimental apparatuses of classical TM measurement methods feature two measurement heads. Two microphones are flush with the walls of each head. The pressure signals are processed following the transfer function method constructed on an analytical model of acoustic propagation in measurement heads. The present paper aims at presenting a measurement method based on a three-microphone experimental apparatus and on its acoustic calibration through two reference measurements: the three-measurement two-calibration method for measuring the TM (3M2C-TM). Two microphones are flush with the measurement head walls and one is in the cap closing one side of the measured duct. 3M2C-TM proved essential for an accurate measurement of the four TM elements of two different ducts: a cylindrical duct and an expansion chamber.

Influence of hay and animal feed exposure on respiratory status: a longitudinal study

Our aim was to study respiratory symptoms and lung function decline in farmers, with particular attention to the influence of handling hay, straw and animal feed. From a cohort recruited in 1993-1994, 219 (82.6%) dairy farmers, 130 (62.5%) nondairy agricultural workers and 99 (66.4%) controls were re-evaluated in 2006. They answered medical and occupational questionnaires, underwent spirometric tests at both evaluations and pulse oximetry in 2006. Dairy and nondairy agricultural workers showed an increased risk for usual morning phlegm (adjusted OR 4.27 (95% CI 1.41-12.95) and 3.59 (95% CI 1.16-11.10), respectively). Animal feed handling was associated with increased risks of wheezing (p = 0.01) and usual morning phlegm (p = 0.04); hay or straw handling was associated with increased risk of wheezing (p = 0.008). Adjusting for smoking, age, height, sex and altitude, dairy farmers had greater declines in forced expiratory volume in 1 s (FEV(1))/forced vital capacity ratio (p = 0.01) than controls. An increased decline in FEV(1) for all agricultural workers was associated with animal feed handling, both measured as a categorical (currently versus never handling; p = 0.05) or quantitative value (years of exposure during the survey period; p = 0.03). Hay, straw or animal feed handling represents a risk factor of bronchial symptoms and, for animal feed only, of accelerated decline in expiratory flows.

Optimal strokes for axisymmetric microswimmers

We present a theory for low-Reynolds-number axisymmetric swimmers and a general strategy for the computation of strokes of maximal efficiency. An explicit equation characterizing optimal strokes is derived, and numerical strategies to obtain solutions are discussed. The merits of this approach are demonstrated by applying it to two concrete examples: the three linked spheres of Najafi and Golestanian and the pushmepullyou of Avron, Kenneth, and Oakmin.

Composition analysis of semiconductor quantum wells by energy filtered convergent-beam electron diffraction

We show how energy-filtered convergent-beam electron diffraction (EFCBED) patterns can be used to determine the chemical composition of buried semiconductor strained quantum wells. Our method is based on a quantitative analysis of the intensities of high-order Bragg lines in the transmitted disc of EFCBED patterns taken from plan-view samples. This analysis makes it possible to determine the displacement vector R introduced between the top and bottom parts of the matrix by the deformation of the quantum well and consequently to determine its composition. This is illustrated in the case of an In(x)Ga(1-)(x)As quantum well buried in a GaAs matrix. A detailed analysis of the effect of experimental parameters on Bragg lines intensity is performed. In particular, the importance of the choice of the diffraction vector is pointed out. The relative uncertainty on the measurement of the indium content x is found to be lower than 5% and a possible occurrence of slight compositional fluctuations in the (001) growth plane is pointed out.

Highly selective microbiosensors for in vivo measurement of glucose, lactate and glutamate

An alternative approach to production of amperometric microbiosensors, which combines electrochemical electrometallization and electropolymerisation of phenylene diamine film with covalent binding enzymes, is presented. In this respect, for a sensitive detection of hydrogen peroxide (HP) at +0.4V versus Ag/AgCl (detection limit of 0.5 microM, s/n=3), carbon fiber microelectrodes (30 microm in diameter and 500 microm long) were covered with ruthenium. To obtain a highly selective detection of HP, in the presence of different interfering compounds (ascorbic acid, uric acid, etc.), an additive semi-permeable polymer film was formed on the top of the ruthenium layer by electropolymerisation of m-phenylene diamine (m-PD). The enzymatic selective layers were formed by covalent cross-linking the enzymes (glucose oxidase, lactate oxidase or glutamate oxidase) with BSA by glutaraldehyde in the presence of ascorbate oxidase. An additional polymeric layer based on polyurethane and Nafion was deposited on the top of the enzymatic membrane (glucose oxidase, lactate oxidase, or glutamate oxidase) in order to extend the dynamic range of biosensors up to 4mM for glucose (R=0.997; Y[nA]=-0.22+9.68x[glucose, mM]), 1.75mM for lactate (R=0.991; Y[nA]=0.43+15.36x[lactate, mM]) and 0.25 mM for glutamate (R=0.999; Y[nA]=0.02+29.14x[glutamate, mM]). The developed microbiosensors exhibited also negligible influences from interfering compounds at their physiological concentrations. Microbiosensors remained stable during 10h in a flow injection system at 36 degrees C and pH 7.4. The microbiosensors developed are now used in vivo and, as an example, we report here the data obtained with the glucose biosensor.

Respiratory status deterioration during G-CSF-induced neutropenia recovery

Exacerbation of prior pulmonary involvement may occur during neutropenia recovery. Granulocyte colony-stimulating factor (G-CSF)-related pulmonary toxicity has been documented in cancer patients, and experimental models suggest a role for G-CSF in acute lung injury during neutropenia recovery. We reviewed 20 cases of noncardiac acute respiratory failure during G-CSF-induced neutropenia recovery. Half the patients had received hematopoietic stem cell transplants. All patients experienced pulmonary infiltrates during neutropenia followed by respiratory status deterioration coinciding with neutropenia recovery. Neutropenia duration was 10 (4–22) days, and time between respiratory symptoms and the first day with more than 1000 leukocytes/mm³ was 1 (−0.5 to 2) day. Of the 20 patients, 16 received invasive or noninvasive mechanical ventilation, including 14 patients with acute respiratory distress syndrome (ARDS). Five patients died, with refractory ARDS. In patients with pulmonary infiltrates during neutropenia, G-CSF-induced neutropenia recovery carries a risk of respiratory status deterioration with acute lung injury or ARDS. Clinicians must maintain a high index of suspicion for this diagnosis, which requires eliminating another cause of acute respiratory failure, G-CSF discontinuation and ICU transfer for early supportive management including diagnostic confirmation and noninvasive mechanical ventilation.

[Pulmonary legionellosis at the earliest stage of hairy cell leukemia]

Legionella pneumonia is frequently reported in immunocompromised patients. The most important predisposing factor is a quantitative and qualitative defect of the monocytic-macrophagic system. We report a case of Legionella pneumophila in a 43-year-old man revealing hairy cell leukemia. The patient presented with community-acquired pneumonia resistant to common antibiotics. Serology provided the diagnosis and the patient improved with adequate treatment. Early diagnosis and appropriate treatment may reduce the mortality of this serious complication.