La lombalgie commune est un problème de santé publique (> 6 millions consultations/an en France) dont les risques psychosociaux de chronicisation peuvent être identifiés grâce au concept de drapeaux ...jaunes. En parallèle, le Pacte français de refondation des urgences de 2019 donne la possibilité aux masseurs-kinésithérapeutes de traiter les patients atteints de lombalgie commune en accès direct.
Investiguer dans quelle mesure les masseurs-kinésithérapeutes connaissent et maîtrisent les concepts à la fois de drapeaux jaunes et d’exercice en accès direct.
Enquête par questionnaire d’évaluation des pratiques professionnelles.
Les 594 réponses obtenues montrent que les masseurs-kinésithérapeutes libéraux français connaissent le concept de drapeau jaune (73,4%) et se sentent pour une très grande majorité (74,4%) prêts à exercer en accès direct. Toutefois, les résultats montrent que la maîtrise de ces deux concepts est encore largement imparfaite, pour les drapeaux jaunes que seuls 10,8% des masseurs-kinésithérapeutes arrivent à les identifier correctement comme pour l’exercice en accès direct dont seuls 4,2% des sondés connaissent parfaitement les modalités d’application.
Les masseurs-kinésithérapeutes français sont fortement sensibilisés aux risques psychosociaux liés à la lombalgie commune ainsi qu’à l’exercice en accès direct, mais un effort de formation doit encore être fait pour que ces deux concepts soient maîtrisés par une majorité d’entre eux.
5.
Low back pain is a major public health problem (> 6 millions consultations/year). Psychosocial risks of chronic low back pain can be identified through the concept of yellow flags. In correlation, the 2019 French government report “Pact for the Refoundation of emergency” allows the possibility for physiotherapists to intervene by direct access intervention on patients with low back pain.
To investigate the extent to which physiotherapits are familiar with and master the concepts of both yellow flags and direct access interventions.
A questionnaire survey to evaluate professional practices.
Out of the 594 French independent practitioners who responded, 73.4% know the concept of yellow flag and 74.4% are ready to intervene in direct access. Yet, the results show that the expertise of these two concepts is still largely imperfect: whether for yellow flags where only 10.8% of physiotherapists manage to determine its use correctly, nor for direct access interventions where only 4.2% of physiotherapists are aware of the procedural requirements.
Physiotherapists are highly aware of the psychosocial risks associated with low back pain as well as direct access intervention. However, efforts must be made through professional training to consolidate the knowledge of these two concepts for the large majority of practitioners.
5.
Summary
In Congo, urgent efforts are needed to help with the revision of the national antimalarial drug policy. Despite its high resistance level, chloroquine (CQ) is still extensively used as the ...first‐line treatment for uncomplicated Plasmodium falciparum malaria. The study was conducted in children under 5 years with uncomplicated malaria in Pointe‐Noire and Brazzaville, the two largest cities that contain approximately 60% of the population of Congo. We investigated by polymerized chain reaction and sequencing methods the frequency distribution of molecular markers for antimalarial drug resistance, including mutations in P. falciparum chloroquine resistance transporter (pfcrt) gene associated with CQ resistance and mutations in dihydrofolate reductase (dhfr) and dihydropteroate synthetase (dhps) genes conferring resistance to sulphadoxine/pyrimethamine (SP) among pre‐treatment P. falciparum isolates, as well as assessing antimalarial drug use in the community. pfcrt (K76T) mutation was present in most isolates (96.4%, n = 138) and high frequency (69.2%, n = 133) of triple‐mutant dhfr‐S108N, N51I, C59R was observed. The quintuple mutant (dhfr‐S108N, N51I, C59R and dhps‐A437G or S436A, K540E) considered as molecular marker for SP treatment failure was not found because dhps‐K540E mutation was absent in isolates tested; this is a clear evidence for the excellent efficacy of SP that we previously described in the same population. The complete absence of the dhps‐K540E mutation is a deterrent component for using this molecular marker as an early warning tool for SP resistance testing in that population. Poor compliance issues related to the antimalarial drug use including inappropriate manufacturing practices reported in this study require intensive attention and should be taken into account when implementing drug policy change. If Congo changes its treatment policy from CQ to SP monotherapy, this will not last long. The strategy of combining SP with other affordable and effective antimalarial drugs such as the artemisinin derivatives to improve efficacy and to delay the development of parasite resistance is essential.
Black Leaf Streak Disease (BLSD), caused by the fungus Pseudocercospora fijiensis, is a recent pandemic and the most economically and environmentally important leaf disease of banana. To assist ...breeding of varieties with durable resistance to the rapidly evolving P. fijiensis, we used a diploid genitor ‘IDN 110’ with partial resistance to BLSD to search for QTLs. We assessed diploid progeny of 73 hybrids between ‘IDN 110’ and the diploid cultivar ‘Khai Nai On’, which is susceptible to BLSD. Hybrids were phenotyped with artificial inoculation under controlled conditions. This method allowed us to focus on resistance in the early stages of the interaction already identified as strongly influencing BLSD epidemiology. Progeny were genotyped by sequencing. As both parents are heterozygous for large reciprocal translocations, the distribution of recombination was assessed and revealed regions with low recombination rates. Fourteen non-overlapping QTLs of resistance to BLSD were identified of which four main QTLs from the ‘IDN110‘ parent, located on chromosomes 06, 07, 08, and 09, were shown to be of interest for marker-assisted selection. Genes that underline those four QTLs are discussed in the light of previous literature.
An artificial metalloenzyme based on the covalent grafting of a nonheme Fe(II) polyazadentate complex into bovine β-lactoglobulin has been prepared and characterized by using various spectroscopic ...techniques. Attachment of the Fe(II) catalyst to the protein scaffold is shown to occur specifically at Cys121. In addition, spectrophotometric titration with cyanide ions based on the spin-state conversion of the initial high spin (S=2) Fe(II) complex into a low spin (S=0) one allows qualitative and quantitative characterization of the metal center's first coordination sphere. This biohybrid catalyst activates hydrogen peroxide to oxidize thioanisole into phenylmethylsulfoxide as the sole product with an enantiomeric excess of up to 20 %. Investigation of the reaction between the biohybrid system and H2 O2 reveals the generation of a high spin (S=5/2) Fe(III) (η(2) -O2 ) intermediate, which is proposed to be responsible for the catalytic sulfoxidation of the substrate.
Applying a single molecular probe to monitor enzymatic activities in multiple, complementary imaging modalities is highly desirable to ascertain detection and to avoid the complexity associated with ...the use of agents of different chemical entities. We demonstrate here the versatility of lanthanide (Ln3+) complexes with respect to their optical and magnetic properties and their potential for enzymatic detection in NIR luminescence, CEST and T1 MR imaging, controlled by the nature of the Ln3+ ion, while using a unique chelator. Based on X‐ray structural, photophysical, and solution NMR investigations of a family of Ln3+ DO3A‐pyridine model complexes, we could rationalize the luminescence (Eu3+, Yb3+), CEST (Yb3+) and relaxation (Gd3+) properties and their variations between carbamate and amine derivatives. This allowed the design of
LnLGal5
${{{\bf L n L}}_{{\bf G a l}}^{5}}$
probes which undergo enzyme‐mediated changes detectable in NIR luminescence, CEST and T1‐weighted MRI, respectively governed by variations in their absorption energy, in their exchanging proton pool and in their size, thus relaxation efficacy. We demonstrate that these properties can be exploited for the visualization of β‐galactosidase activity in phantom samples by different imaging modalities: NIR optical imaging, CEST and T1‐weighted MRI.
We demonstrate that using a single ligand complexed to different lanthanide ions, successful visualization of β‐galactosidase activity is possible in complementary optical and MR modalities : NIR luminescence (Yb3+), CEST (Yb3+) and T1 (Gd3+) MR imaging.
Managing the dimensional accuracy of parts produced by the Electron Beam Melting process is a challenge. For small dimensions, as in lattice structures (strut diameters), accuracy becomes even more ...important and geometric quality is linked to mechanical properties. The dimensional quality of parts produced by EBM can be influenced by many process parameters. Simulating the process can help the machine user to choose the best process parameters and improve build dimensional accuracy. The work presented here is based on a method for linking process parameters with beam parameters. Once linked, both sets of parameters are then integrated into a full simulation of the process in order to make trajectory optimization possible. First, this paper explains how the finite element model described in the literature can be improved to simulate the multilayer EBM process. It then describes how this simulation is used to develop a method to characterize the machine beam and determine the link between the focus current and the beam diameter. Finally, it shows how this simulation can be applied to a built shape (vertical strut) hence demonstrating improved accuracy of the produced part.
Modern data regarding incidence and modes of death of patients with aortic stenosis (AS) are restricted to tertiary centers or studies of aortic valve replacement (AVR).
To provide new insights into ...the natural history of outpatients with native AS based on a large regionwide population study with inclusion by all cardiologists regardless of their mode of practice.
Between May 2016 and December 2017, consecutive outpatients with mild (peak aortic velocity, 2.5-2.9 m/s), moderate (peak aortic velocity, 3-3.9 m/s), and severe (peak aortic velocity, ≥4 m/s) native AS graded by echocardiography were included by 117 cardiologists from the Nord-Pas-de-Calais region in France. Analysis took place between August and November 2020.
Natural history, need for AVR, and survival of patients with AS were followed up. Indications for AVR were based on current guideline recommendations.
Among 2703 patients (mean SD age, 76.0 10.8 years; 1260 46.6% women), 233 (8.6%) were recruited in a university public hospital, 757 (28%) in nonuniversity public hospitals, and 1713 (63.4%) by cardiologists working in private practice. A total of 1154 patients (42.7%) had mild, 1122 (41.5%) had moderate, and 427 (15.8%) had severe AS. During a median (interquartile range) of 2.1 (1.4-2.7) years, 634 patients underwent AVR and 448 died prior to AVR. Most deaths were cardiovascular (200 44.7%), mainly associated with congestive heart failure (101 22.6%) or sudden death (60 13.4%). Deaths were noncardiovascular in 186 patients (41.5%) and from unknown causes in 62 patients (13.8%). Compared with patients with mild AS, there was increased cardiovascular mortality in those with moderate (hazard ratio, 1.47 95% CI, 1.07-2.02) and severe (hazard ratio, 3.66 95% CI, 2.52-5.31) AS. The differences remained significant when adjusted for baseline characteristics or in time-dependent analyses considering AS progression. In asymptomatic patients, moderate and mild AS were associated with similar cardiovascular mortality (hazard ratio, 0.99 95% CI, 0.44-2.21).
While patients in this study with moderate AS had a slightly higher risk of cardiovascular death than patients with mild AS, this risk was much lower than that observed in patients with severe AS. Moreover, in asymptomatic patients, moderate and mild AS were associated with similar cardiovascular mortality.
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