摘要： BACKGROUND Sugammadex allows for rapid reversal of muscle relaxation after the use of rocuronium or vecuronium. The lowest recommended dose is 2 mg kg(-1) intravenously when there are two twitches during the train-of-four stimulation. OBJECTIVE To study the efficacy and risks of a lower dose of sugammadex administered earlier. DESIGN Monocentric randomised controlled double-blind study. SETTING Academic hospital. PATIENTS Eighty patients were enrolled and randomised in 8 groups of 10 patients, 56 were finally evaluated. INTERVENTIONS Patients were distributed in two clusters constituting four groups each. In the first cluster, injections were administered after the return of one twitch with the train-of-four (TOF1). In the second cluster, injections were delivered after the return of two twitches with the TOF (TOF2). We created four groups in each cluster for different dosages: placebo, 0.5, 1 or 2 mg kg(-1). MAIN OUTCOME MEASURES Time between the injection of sugammadex and full recovery (TOF ratio > 0.9) that is expressed in minutes. RESULTS Fifty-six successive patients were assessed between February and August 2018. The difference to TOF greater than 0.9 was not statistically significant between groups with the same dose administered at different times (F value = 0.001, P value = 0.975). There was a significant difference between groups with a different dosage administered at the same time (F ratio = 28.34;P value <0.0001). Concerning the time to TOF greater than 0.9 from the time point of TOF1, the timing of the dosages were statistically significant using log rank test (P < 0.0001). No patient presented a reparalysis. CONCLUSION No difference between injecting sugammadex at TOF1 or TOF2 was found regarding time to full recovery. Difference regarding sugammadex quantity was found and compatible with other studies.

关键词： Biodiversity offsetting   Ecological compensation   No net loss   Trade ratio   Biodiversity calculation method  

摘要： The rates of ecosystem degradation and biodiversity loss are alarming and current conservation efforts are not sufficient to stop them. The need for new tools is urgent. One approach is biodiversity offsetting: a developer causing habitat degradation provides an improvement in biodiversity so that the lost ecological value is compensated for. Accurate and ecologically meaningful measurement of losses and estimation of gains are essential in reaching the no net loss goal or any other desired outcome of biodiversity offsetting. The chosen calculation method strongly influences biodiversity outcomes. We compare a multiplicative method, which is based on a habitat condition index developed for measuring the state of ecosystems in Finland to two alternative approaches for building a calculation method: an additive function and a simpler matrix tool. We examine the different logic of each method by comparing the resulting trade ratios and examine the costs of offsetting for developers, which allows us to compare the cost-effectiveness of different types of offsets. The results show that the outcomes of the calculation methods differ in many aspects. The matrix approach is not able to consider small changes in the ecological state. The additive method gives always higher biodiversity values compared to the multiplicative method. The multiplicative method tends to require larger trade ratios than the additive method when trade ratios are larger than one. Using scoring intervals instead of using continuous components may increase the difference between the methods. In addition, the calculation methods have differences in dealing with the issue of substitutability.

关键词： Neurosurgery   Neurosciences  

关键词： Thermal    pretreatment   Dewatering   Thermophilic anaerobic digestion   High-rate bioreactor   Biogas    production   Microbial community analysis  

摘要： To address the limitations associated with the disposal management and the treatment process of POME, an alternative process that consists of eliminating the cooling ponds and integrating a pretreatment technology combined with a dewatering device was proposed. Since the proposed treatment process has not been tested previously, the objective of this study is to investigate the effect of thermal pretreatment and solid loading alteration via dewatering on a thermophilic continuous set up consisting of an upflow anaerobic sludge blanket - hollow centered packed bed (UASB-HCPB) bioreactor. It was established that the best performing solid loading was the 40S:60L, which is made up of 40% by volume of POME settled solids and 60% of clarified liquid. Thermally pretreated 40S:60L solid loading had a significantly enhanced biogas production, methane purity, chemical oxygen demand (COD), biological oxygen demand (BOD), and total suspended solids (TSS) removal efficiencies. The reactor exhibited stability owing to the low volatile fatty acid/alkalinity ratio obtained throughout the run. With a reactor capacity of 5L, thermally pretreated 40S:60L achieved a daily biogas production volume of 48L and a methane purity of 77.2%. The COD, BOD, and TSS removal efficiencies of the thermally pretreated 40S:60L solid loading were evaluated to be 97.5, 95.1, and 94.5%. The enhanced process performance is due to the consistent solids concentration, which allowed a more effective mass transfer and transport in the medium. Meanwhile, thermal pretreatment promoted cell lysis, making the intercellular organic matter readily available for the bacteria consortium.

关键词： Acute cholangitis   Temocillin   Antibiotic resistance  

摘要： With rising antibiotic resistance, alternatives to carbapenems are needed for acute cholangitis (AC). Temocillin reaches high biliary concentrations with limited impact on microbiota. We retrospectively included 140 AC episodes and assessed the efficacy of temocillin using microbiology susceptibility testing from blood cultures. Considering all bacteria collected by episode, resistance to temocillin, PIP/TAZ and 3GC occurred in 27/140 (26%), 32 (22.8%) and 31 (22%) episodes, respectively (p = 0.7). After documentation, temocillin could have spared PIP/TAZ or carbapenems in 14/26 and 4/11 episodes. Temocillin may constitute an alternative treatment after microbiological documentation by sparing carbapenems and/or PIP/TAZ, but not as an empirical therapeutic option.

摘要： Understanding how protein function has evolved and diversified is of great importance for human genetics and medicine. Here, we tackle the problem of describing the whole transcript variability observed in several species by generalizing the definition of splicing graph. We provide a practical solution to construct parsimonious evolutionary splicing graphs where each node is a minimal transcript building block defined across species. We show a clear link between the functional relevance, tissue regulation, and conservation of alternative transcripts on a set of 50 genes. By scaling up to the whole human protein-coding genome, we identify a few thousand genes where alternative splicing modulates the number and composition of pseudorepeats. We have implemented our approach in ThorAxe, an efficient, versatile, robust, and freely available computational tool.

关键词： inhibition kinetics   luteolin   Moringa oleifera   screening   tyrosinase   uncompetitive inhibitor  

摘要： Tyrosinase (TYR) is a type III copper oxidase present in fungi, plants and animals. The inhibitor of human TYR plays a vital role in pharmaceutical and cosmetic fields by preventing synthesis of melanin in the skin. To search for an effective TYR inhibitor from various plant extracts, a kinetic study of TYR inhibition was performed with mushroom TYR. Among Panax ginseng, Alpinia galanga, Vitis vinifera and Moringa oleifera, the extracts of V. vinifera seed, A. galanga rhizome and M. oleifera leaf reversibly inhibited TYR diphenolase activity with IC50 values of 94.8 +/- 0.2 mu g/mL, 105.4 +/- 0.2 mu g/mL and 121.3 +/- 0.4 mu g/mL, respectively. Under the same conditions, the IC50 values of the representative TYR inhibitors of ascorbic acid and kojic acid were found at 235.7 +/- 1.0 and 192.3 +/- 0.4 mu g/mL, respectively. An inhibition kinetics study demonstrated mixed-type inhibition of TYR diphenolase by A. galanga and V. vinifera, whereas a rare uncompetitive inhibition pattern was found from M. oleifera with an inhibition constant of K-ii 73 mu g/mL. Phytochemical investigation by HPLC-MS proposed luteolin as a specific TYR diphenolase ES complex inhibitor, which was confirmed by the inhibition kinetics of luteolin. The results clearly showed that studying TYR inhibition kinetics with plant extract mixtures can be utilized for the screening of specific TYR inhibitors.

关键词： alternative scoring   bolt-on   Dermatology Life Quality Index   psoriasis   psychometrics   questionnaire modifications   skin disease   systematic review  

摘要： Objectives: Dermatology Life Quality index (DLQI) is the most widely used health-related quality of life questionnaire in dermatology. Little is known about existing questionnaire or scoring modifications of the DLQI. We aimed to systematically review, identify, and categorize all modified questionnaire versions and scoring methods of the DLQI. Methods: We performed a systematic literature search in PubMed, Web of Science, CINAHL, and PsychINFO. Methodologic quality and evidence of psychometric properties were assessed using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) and Terwee checklists. Results: The included 81 articles reported on 77 studies using 59 DLQI modifications. Modifications were used for a combined sample of 25 509 patients with 47 different diagnoses and symptoms from 28 countries. The most frequently studied diseases were psoriasis, hirsutism, acne, alopecia, and bromhidrosis. The modifications were categorized into the following nonmutually exclusive groups: bolt-ons or bolt-offs (48%), disease, symptom, and body part specifications (42%), changes in existing items (34%), scoring modifications (27%), recall period changes (19%), response scale modifications (15%), and illustrations (3%). The evidence concerning the quality of measurement properties was heterogeneous: 4 of 13 studies were rated positive on internal consistency, 1 of 3 on reliability, 3 of 5 on content validity, 9 of 22 on construct validity, 6 of 6 on criterion validity, and 1 of 1 on responsiveness. Conclusion: An exceptionally large number of DLQI modifications have been used that may indicate an unmet need for adequate health-related quality of life instruments in dermatology. The psychometric overview of most questionnaire modifications is currently incomplete, and additional efforts are needed for proper validation.

关键词： Meat sheep   Selection objective   Genetic evaluation   Prolificacy   Weight at 30 days of age   Litter weight  

摘要： Weight of lambs produced per ewe is an important economic-related trait for French meat sheep farmers. Consequently, genetic improvement of their ewes is based on selecting maternal traits using a global index, called MAT, which combines estimated breeding values for litter size at lambing (LS), weight at 30 days of age (W30D) and viability over the same period. The frame of this study is to compare the official approach to genetic evaluation of maternal traits which combine several estimated breeding values with a direct genetic evaluation of a proxy trait of the farmer's objective. The weight of lambs produced per ewe and per lambing was chosen as this proxy of meat production potential of ewes. In a first step, we estimated the genetic parameters of this alternative criterion, the litter weight (LW), which is the sum of the W30Ds of lambs of the same litter. In a second step, we compared these parameters with those of LS, W30D and MAT, which are routinely used. Datasets comprising 2006-2018 records of 190,883 and 271,963 litters of the Ile de France (IF) and Blanche du Massif Central (BMC) breeds respectively, were analysed. The genetic evaluations were performed using Asreml software according to BLUP animal models, which were the closest to the models used in routine evaluation. Two models are presented: a two-trait model LS and W30D and a two-trait model LS and LW. For LS and LW, records are linked to ewes. For W30D, both direct and maternal effects were considered. Direct animal variance (sigma 2a_LW = 28.02 for IF and sigma 2a_LW = 16.55 for BMC) and heritability (h2a_LW = 0.06 for IF and h2a_LW = 0.04 for BMC) of LW suggest it is possible to select based on this trait while simultaneously improving LS (rga_LS/a_LW = 0.78 for IF and rga_LS/a_LW = 0.67 for BMC). Moreover, the genetic progress curves of MAT and LW indicate that the selection based on MAT gave a positive correlated response on LW. Highly correlations between MAT and LW breeding values were esti