We report on the conception and first tests of the General Purpose Ion Buncher (GPIB), the radio-frequency beam-cooler and buncher that will supply the DESIR (Decay, Excitation and Storage of ...Radioactive Ions) experimental hall to be constructed to complement the SPIRAL1 and SPIRAL2 facilities in GANIL. Its goals are both to reduce the emittance and if necessary to bunch the radioactive ion beam from the GANIL production facilities to adapt it to the needs of the different experimental setups in the DESIR hall. The mechanical design is similar to the existing ISCOOL quadrupole at ISOLDE but the new radio-frequency system enables a much stronger radial confinement. The GPIB is developed at LP2i Bordeaux11LP2i Bordeaux was known as Centre d’Études Nucléaires de Bordeaux-Gradignan (CENBG) before the name was changed in 2022. in parallel with the PIPERADE double Penning trap and a beamline has been constructed there to characterize both. The cooling of a 30keV beam to an emittance of 3 π mm mrad and a transmission above 80% in continuous mode is demonstrated for currents up to a few nA. Some first results concerning the bunching mode are also shown though this mode is still under development.
Background
During interventions for deep caries lesions without severe symptoms, preserving pulpal vitality is important to ensure treatment success, improve organ prognosis, and decrease ...cost-effectiveness. Current pre-operative radiographs allow visual estimation but not accurate measurement of lesion depth.
Purpose
Investigate the ability of ratio ‘remaining/total dentin thickness’ (RDT/TDT, as determined on pre-operative radiographs) to predict pulp exposure during excavation.
Methods
This retrospective study (January 2018–June 2020) analyzed data on 360 patients. Four independent raters examined standard pre-operative radiographs and their contrasted versions. Lines put at the dentino-enamel junction, the floor of the carious lesion, and the pulp chamber wall allowed deriving RDT/TDT. Inter-rater agreements and concordance were assessed. A logistic regression accounting for measurement errors provided odds ratios that estimated the ability of the RDT/TDT to predict pulp exposure.
Results
The median RDT/TDT ratio ranges were 16.8–26.5% on standard and 16.2–24.6% on contrasted radiographs. Inter-rater agreements on RDT/TDT were rather poor and inter-rater reliability was low and similar in standard and contrasted radiographs: the concordance correlation coefficients (95% CIs) were estimated at 0.46 (0.40; 0.51) and 0.46 (0.40; 0.52), respectively. The risk of pulp exposure increased by 2.5 times odds ratio (95% CI) 2.57 (2.06; 3.20) per 10-point decrease of the ratio on standard radiographs vs. 4.15 (3.15; 5.46) on contrasted radiographs.
Conclusion
RDT/TDT ratio is potentially helpful in predicting pulp exposure. However, the measurement errors on RDT and TDT being non-negligible and the interrater agreements poor, there is still place for advances through development of an automated process that will improve reliability and reproducibility of pulp exposure risk assessment.
Clinical trial
Trial registration number. ClinicalTrials.gov NCT04607395, October 29, 2020
To describe the outcome and tolerance in patients treated with anti-TNFα in severe and refractory major vessel disease in Behçet's disease (BD).
A multicenter study evaluating 18 refractory BD ...patients with major vessel involvement pulmonary artery (n = 4), aorta (n = 4) or peripheral artery aneurysm (n = 1) and/or pulmonary artery (n = 7), inferior vena cava (n = 5), or intra-cardiac (n = 3) thrombosis or Budd Chiari Syndrome (n = 2) treated with anti-TNFα agents.
Vascular remission was achieved in 16 (89%) patients. The 9 months risk of relapse was significantly higher with conventional immunosuppressants used prior anti-TNFα agents as compared to anti-TNFα therapy OR = 8.7 (1.42–62.6), p = 0.03. The median daily dose of corticosteroids significantly decreased at 12 months. Side effects included infection (n = 4) and pulmonary edema (n = 1).
TNFα-antagonists are safe and might be associated with a decreased risk of relapse at 9 months compared to conventional immunosuppressants in BD patients with major vessels disease.
•Anti-TNFα agents represent an effective and safe therapeutic approach for BD patients with major vessel involvement.•However, relapses can been observed after anti-TNFα withdrawal.•The risk of relapse at 9 months under anti-TNF seems to be decreased compared to that of conventional immunosuppressants.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the production of multiple autoantibodies. Antibodies against Ficolin-3 were previously identified in the sera of ...some SLE patients, but their prevalence and significance have not been yet investigated. The aims of this study were to determine the prevalence of anti-ficolin-3 antibodies among SLE patients and to investigate their potential as diagnostic and/or prognostic biomarkers in SLE. In this retrospective study, sera from SLE patients (n = 165) were selected from a preexisting declared biological collection. Samples from healthy controls (n = 48) were matched with SLE sera. Disease activity was determined according to the SLEDAI score. Anti-ficolin-3, anti-dsDNA and anti-C1q antibodies levels were measured in sera by ELISA. First, a highly significant difference was found in the anti-ficolin-3 levels between SLE patients and healthy subjects. Anti-ficolin-3 antibodies were detected as positive in 56 of 165 (34%) SLE patients. The titer of anti-ficolin-3 antibodies was correlated with the SLEDAI score (r = 0.38, p<0.0001). The presence of anti-ficolin-3 antibodies was associated with anti-C1q and anti-dsDNA antibodies. Regarding associations with clinical manifestations, the presence of active lupus nephritis was significantly associated with the presence of anti-ficolin-3 antibodies (p≤0.001). This association with renal involvement was higher with anti-ficolin-3 or anti-C1q antibodies than with other auto-antibodies. Interestingly, the combination of anti-ficolin-3 and anti-C1q antibodies demonstrated higher specificity than any other serological biomarker. These results suggest that anti-ficolin-3 antibodies could be useful for the diagnosis of active nephritis in SLE patients.
Growth arrest and DNA damage-inducible gene 34 (GADD34) is an inducible cofactor of protein phosphatase 1, which has an important role in the unfolded protein response. GADD34 has been shown to be ...necessary for type I interferon and proinflammatory cytokine production in response to viral infection in murine models. We investigate the expression of GADD34 in rheumatoid arthritis (RA), in which proinflammatory cytokines have an important pathogenic role. The objective of this study was to evaluate the potential of GADD34 expression as a biomarker in RA patients. We report a case-control study on GADD34 gene expression in peripheral blood mononuclear cells of patients (n = 75) with RA and age- and sex-matched healthy controls (n = 25). The study was approved by the relevant local ethics committees. GADD34 gene expression level in peripheral blood mononuclear cells was measured by quantitative PCR and analyzed with Mann-Whitney test. The relation between GADD34 gene overexpression and clinical or biological characteristics was analyzed with univariate and multivariate analysis. GADD34 gene expression was significantly higher in RA patients compared with healthy controls (p ≤ 0.001). Interestingly, GADD34 overexpression in PBMC of patients was related to the presence of circulating anti-citrullinated protein antibodies (p = 0.030). Data of this study strengthen the evidence of an unfolded protein response during the course of RA and provide an insight of the potential interest in GADD34 as a relevant marker for RA.
Bradykinin mediated angioedema (BK-AE) can be associated either with C1Inhibitor deficiency (hereditary and acquired forms), either with normal C1Inh (hereditary form and drug induced AE as ...angiotensin converting enzyme inhibitors…). In case of high clinical suspicion of BK-AE, C1Inh exploration must be done at first: C1Inh function and antigenemy as well as C4 concentration. C1Inh deficiency is significant if the tests are below 50 % of the normal values and controlled a second time. In case of C1Inh deficiency, you have to identify hereditary from acquired forms. C1q and anti-C1Inh antibody tests are useful for acquired BK-AE. SERPING1 gene screening must be done if a hereditary angioedema is suspected, even if there is no family context (de novo mutation 15 %). If a hereditary BK-AE with normal C1Inh is suspected, F12 and PLG gene screening is suitable.
Les angioedèmes (AE) bradykiniques sont soit associés à un déficit héréditaire ou acquis en C1Inhibiteur (C1Inh) soit associés à un C1Inh normal dans certaines formes héréditaires et en cas ...d’iatrogénie (AE secondaire aux inhibiteurs de l’enzyme de conversion de l’angiotensine). Quand il existe une forte suspicion clinique d’angioedème bradykinique, une exploration de C1Inh doit être réalisée. Cette exploration doit toujours comporter un dosage fonctionnel et pondéral de C1Inh ainsi qu’un dosage du C4. Un déficit pathologique en C1Inh peut être affirmé lorsque les taux sont inférieurs à 50 % des valeurs normales sur 2 prélèvements distincts. Si le déficit en C1Inh se confirme, des examens plus approfondis doivent être réalisés afin de déterminer le caractère héréditaire ou acquis du déficit. Le dosage du C1q et la recherche d’un anticorps anti-C1Inh peuvent alors être proposés. La recherche d’une mutation sur le gène SERPING1 s’impose, même en l’absence d’antécédents familiaux. L’absence de déficit en C1Inh n’exclut pas un angioedème héréditaire. Dans ce cas-là, après validation du tableau clinique par un expert du CREAK, la recherche de mutation sur les gènes F12 et PLG sera proposée.
Bradykinin mediated angioedema (BK-AE) can be associated either with C1Inhibitor deficiency (hereditary and acquired forms), either with normal C1Inh (hereditary form and drug induced AE as angiotensin converting enzyme inhibitors…). In case of high clinical suspicion of BK-AE, C1Inh exploration must be done at first: C1Inh function and antigenemy as well as C4 concentration. C1Inh deficiency is significant if the tests are below 50 % of the normal values and controlled a second time. In case of C1Inh deficiency, you have to identify hereditary from acquired forms. C1q and anti-C1Inh antibody tests are useful for acquired BK-AE. SERPING1 gene screening must be done if a hereditary angioedema is suspected, even if there is no family context (de novo mutation 15 %). If a hereditary BK-AE with normal C1Inh is suspected, F12 and PLG gene screening is suitable.
Bradykinin mediated angioedema (BK-AE) can be associated either with C1Inhibitor deficiency (hereditary and acquired forms), either with normal C1Inh (hereditary form and drug induced AE as ...angiotensin converting enzyme inhibitors…). In case of high clinical suspicion of BK-AE, C1Inh exploration must be done at first: C1Inh function and antigenemy as well as C4 concentration. C1Inh deficiency is significant if the tests are below 50 % of the normal values and controlled a second time. In case of C1Inh deficiency, you have to identify hereditary from acquired forms. C1q and anti-C1Inh antibody tests are useful for acquired BK-AE. SERPING1 gene screening must be done if a hereditary angioedema is suspected, even if there is no family context (de novo mutation 15 %). If a hereditary BK-AE with normal C1Inh is suspected, F12 and PLG gene screening is suitable.
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