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Jing Y, Kong Y, Allard D, Liu B, Kolawole E, Sprouse M, Evavold B, Bettini M, Bettini M. Increased TCR signaling in regulatory T cells is disengaged from TCR affinity. bioRxiv 2023:2023.01.17.523999. [PMID: 36711832 PMCID: PMC9882247 DOI: 10.1101/2023.01.17.523999] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Foxp3+ regulatory T cells (Tregs) are capable suppressors of aberrant self-reactivity. However, TCR affinity and specificities that support Treg function, and how these compare to autoimmune T cells remain unresolved. In this study, we used antigen agnostic and epitope-focused analyses to compare TCR repertoires of regulatory and effector T cells that spontaneously infiltrate pancreatic islets of non-obese diabetic mice. We show that effector and regulatory T cell-derived TCRs possess similar wide-ranging reactivity for self-antigen. Treg-derived TCRs varied in their capacity to confer optimal protective function, and Treg suppressive capacity was in part determined by effector TCR affinity. Interestingly, when expressing the same TCR, Tregs showed higher Nur77-GFP expression than Teffs, suggesting Treg-intrinsic ability to compete for antigen. Our findings provide a new insight into TCR-dependent and independent mechanisms that regulate Treg function and indicate a TCR-intrinsic insufficiency in tissue-specific Tregs that may contribute to the pathogenesis of type 1 diabetes.
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2
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Abstract
The importance of regulatory T cells (Tregs) in preventing autoimmunity has been well established; however, the precise alterations in Treg function in autoimmune individuals and how underlying genetic associations impact the development and function of Tregs is still not well understood. Polygenetic susceptibly is a key driving factor in the development of autoimmunity, and many of the pathways implicated in genetic association studies point to a potential alteration or defect in regulatory T cell function. In this review transcriptomic control of Treg development and function is highlighted with a focus on how these pathways are altered during autoimmunity. In combination, observations from autoimmune mouse models and human patients now provide insights into epigenetic control of Treg function and stability. How tissue microenvironment influences Treg function, lineage stability, and functional plasticity is also explored. In conclusion, the current efficacy and future direction of Treg-based therapies for Type 1 Diabetes and other autoimmune diseases is discussed. In total, this review examines Treg function with focuses on genetic, epigenetic, and environmental mechanisms and how Treg functions are altered within the context of autoimmunity.
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Affiliation(s)
- Arielle Raugh
- Department of Pathology, Microbiology and Immunology, University of Utah, Salt Lake City, UT, United States
- Translational Biology and Molecular Medicine Graduate Program, Baylor College of Medicine, Houston, TX, United States
| | - Denise Allard
- Department of Pathology, Microbiology and Immunology, University of Utah, Salt Lake City, UT, United States
| | - Maria Bettini
- Department of Pathology, Microbiology and Immunology, University of Utah, Salt Lake City, UT, United States
- *Correspondence: Maria Bettini,
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3
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Kong Y, Jing Y, Allard D, Scavuzzo MA, Sprouse ML, Borowiak M, Bettini ML, Bettini M. A dormant T cell population with autoimmune potential exhibits low self-reactivity and infiltrates islets in type 1 diabetes. Eur J Immunol 2022; 52:1158-1170. [PMID: 35389516 DOI: 10.1002/eji.202149690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 11/09/2022]
Abstract
The contribution of low affinity T cells to autoimmunity in the context of polyclonal T cell responses is understudied due to the limitations in their capture by tetrameric reagents and low level of activation in response to antigenic stimulation. As a result, low affinity T cells are often disregarded as non-antigen specific cells irrelevant to the immune response. Our study aimed to assess how the level of self-antigen reactivity shapes T cell lineage and effector responses in the context of spontaneous tissue specific autoimmunity observed in NOD mice. Using multi-color flow cytometry in combination with Nur77GFP reporter of TCR signaling we identified a dormant population of T cells that infiltrated the pancreatic islets of pre-diabetic NOD mice, which exhibited reduced level of self-tissue reactivity based on expression of CD5 and Nur77GFP . We showed that these CD5low T cells had a unique TCR repertoire, exhibited low activation and minimal effector function; however, induced rapid diabetes upon transfer. The CD4+ CD5low T cell population displayed transcriptional signature of central memory T cells, consistent with the ability to acquire effector function post-transfer. Transcriptional profile of CD5low T cells was similar to T cells expressing a low affinity TCR, indicating TCR affinity to be the important factor in shaping CD5low T cell phenotype and function at the tissue site. Overall, our study suggests that autoimmune tissue can maintain a reservoir of undifferentiated central memory-like autoreactive T cells with pathogenic effector potential that might be an important source for effector T cells during long-term chronic autoimmunity. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yuelin Kong
- Section of Diabetes and Endocrinology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, 77030
| | - Yi Jing
- Section of Diabetes and Endocrinology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, 77030.,Department of Pathology, Microbiology and Immunology, University of Utah, Salt Lake City, UT, 84112
| | - Denise Allard
- Department of Pathology, Microbiology and Immunology, University of Utah, Salt Lake City, UT, 84112
| | - Marissa A Scavuzzo
- Program in Developmental Biology, Baylor College of Medicine, Houston, TX, 77030
| | - Maran L Sprouse
- Section of Diabetes and Endocrinology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, 77030
| | - Malgorzata Borowiak
- Program in Developmental Biology, Baylor College of Medicine, Houston, TX, 77030.,Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, 77030.,Center for Cell and Gene Therapy, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, 77030.,McNair Medical Institute, Houston, TX, 77030
| | - Matthew L Bettini
- Section of Diabetes and Endocrinology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, 77030.,Department of Pathology, Microbiology and Immunology, University of Utah, Salt Lake City, UT, 84112.,McNair Medical Institute, Houston, TX, 77030
| | - Maria Bettini
- Section of Diabetes and Endocrinology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, 77030.,Department of Pathology, Microbiology and Immunology, University of Utah, Salt Lake City, UT, 84112.,McNair Medical Institute, Houston, TX, 77030
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4
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Adams JH, Ahmad S, Allard D, Anzalone A, Bacholle S, Barrillon P, Bayer J, Bertaina M, Bisconti F, Blaksley C, Blin-Bondil S, Bobík P, Cafagna F, Campana D, Capel F, Casolino M, Cassardo C, Catalano C, Cremonini R, Dagoret-Campagne S, Danto P, del Peral L, de la Taille C, Díaz Damian A, Dupieux M, Ebersoldt A, Ebisuzaki T, Eser J, Evrard J, Fenu F, Ferrarese S, Fornaro C, Fouka M, Gorodetzky P, Guarino F, Guzman A, Hachisu Y, Haungs A, Judd E, Jung A, Karczmarczyk J, Kawasaki Y, Klimov PA, Kuznetsov E, Mackovjak S, Manfrin M, Marcelli L, Medina-Tanco G, Mercier K, Merino A, Mernik T, Miyamoto H, Morales de los Ríos JA, Moretto C, Mot B, Neronov A, Ohmori H, Olinto AV, Osteria G, Panico B, Parizot E, Paul T, Picozza P, Piotrowski LW, Plebaniak Z, Pliego S, Prat P, Prévôt G, Prieto H, Putis M, Rabanal J, Ricci M, Rojas J, Rodríguez Frías MD, Roudil G, Sáez Cano G, Sahnoun Z, Sakaki N, Sanchez JC, Santangelo A, Sarazin F, Scotti V, Shinozaki K, Silva H, Soriano JF, Suino G, Szabelski J, Toscano S, Tabone I, Takizawa Y, von Ballmoos P, Wiencke L, Wille M, Zotov M. A Review of the EUSO-Balloon Pathfinder for the JEM-EUSO Program. Space Sci Rev 2022; 218:3. [PMID: 35153338 PMCID: PMC8807436 DOI: 10.1007/s11214-022-00870-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 12/31/2021] [Indexed: 06/14/2023]
Abstract
EUSO-Balloon is a pathfinder for JEM-EUSO, the mission concept of a spaceborne observatory which is designed to observe Ultra-High Energy Cosmic Ray (UHECR)-induced Extensive Air Showers (EAS) by detecting their UltraViolet (UV) light tracks "from above." On August 25, 2014, EUSO-Balloon was launched from Timmins Stratospheric Balloon Base (Ontario, Canada) by the balloon division of the French Space Agency CNES. After reaching a floating altitude of 38 km, EUSO-Balloon imaged the UV light in the wavelength range ∼290-500 nm for more than 5 hours using the key technologies of JEM-EUSO. The flight allowed a good understanding of the performance of the detector to be developed, giving insights into possible improvements to be applied to future missions. A detailed measurement of the photoelectron counts in different atmospheric and ground conditions was achieved. By means of the simulation of the instrument response and by assuming atmospheric models, the absolute intensity of diffuse light was estimated. The instrument detected hundreds of laser tracks with similar characteristics to EASs shot by a helicopter flying underneath. These are the first recorded laser tracks measured from a fluorescence detector looking down on the atmosphere. The reconstruction of the direction of the laser tracks was performed. In this work, a review of the main results obtained by EUSO-Balloon is presented as well as implications for future space-based observations of UHECRs.
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Affiliation(s)
- J. H. Adams
- University of Alabama in Huntsville, Huntsville, USA
| | - S. Ahmad
- Omega, Ecole Polytechnique, CNRS/IN2P3, Palaiseau, France
| | - D. Allard
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - A. Anzalone
- INAF - Istituto di Astrofisica Spaziale e Fisica Cosmica di Palermo, Palermo, Italy
- Istituto Nazionale di Fisica Nucleare - Sezione di Catania, Catania, Italy
| | - S. Bacholle
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - P. Barrillon
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
| | - J. Bayer
- Institute for Astronomy and Astrophysics, University of Tübingen, Tübingen, Germany
| | - M. Bertaina
- Istituto Nazionale di Fisica Nucleare - Sezione di Torino, Torino, Italy
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | - F. Bisconti
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - C. Blaksley
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - S. Blin-Bondil
- Omega, Ecole Polytechnique, CNRS/IN2P3, Palaiseau, France
| | - P. Bobík
- Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovakia
| | - F. Cafagna
- Istituto Nazionale di Fisica Nucleare - Sezione di Bari, Bari, Italy
| | - D. Campana
- Istituto Nazionale di Fisica Nucleare - Sezione di Napoli, Naples, Italy
| | - F. Capel
- KTH Royal Institute of Technology, Stockholm, Sweden
| | - M. Casolino
- RIKEN, 2-1 Hirosawa, Wako, Saitama Japan
- Istituto Nazionale di Fisica Nucleare - Sezione di Roma Tor Vergata, Roma, Italy
| | - C. Cassardo
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | - C. Catalano
- IRAP, Université de Toulouse, CNRS, Toulouse, France
| | - R. Cremonini
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | | | - P. Danto
- CNES, 18 avenue Edouard Belin, Toulouse, France
| | | | | | | | - M. Dupieux
- IRAP, Université de Toulouse, CNRS, Toulouse, France
| | - A. Ebersoldt
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | | | - J. Eser
- Colorado School of Mines, Golden, USA
| | - J. Evrard
- CNES, 18 avenue Edouard Belin, Toulouse, France
| | - F. Fenu
- Istituto Nazionale di Fisica Nucleare - Sezione di Torino, Torino, Italy
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | - S. Ferrarese
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | | | - M. Fouka
- Center of Research in Astronomy, Astrophysics, and Geophysics, Algiers, Algeria
| | - P. Gorodetzky
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - F. Guarino
- Istituto Nazionale di Fisica Nucleare - Sezione di Napoli, Naples, Italy
- Dipartimento di Scienze Fisiche, Universitá di Napoli Federico II, Naples, Italy
| | - A. Guzman
- Institute for Astronomy and Astrophysics, University of Tübingen, Tübingen, Germany
| | - Y. Hachisu
- RIKEN, 2-1 Hirosawa, Wako, Saitama Japan
| | - A. Haungs
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - E. Judd
- Space Sciences Laboratory, University of California, Berkeley, CA USA
| | - A. Jung
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | | | | | - P. A. Klimov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow, Russia
| | - E. Kuznetsov
- University of Alabama in Huntsville, Huntsville, USA
| | - S. Mackovjak
- Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovakia
| | - M. Manfrin
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | - L. Marcelli
- Istituto Nazionale di Fisica Nucleare - Sezione di Roma Tor Vergata, Roma, Italy
| | - G. Medina-Tanco
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - K. Mercier
- CNES, 18 avenue Edouard Belin, Toulouse, France
| | | | - T. Mernik
- Institute for Astronomy and Astrophysics, University of Tübingen, Tübingen, Germany
| | - H. Miyamoto
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | | | - C. Moretto
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
| | - B. Mot
- IRAP, Université de Toulouse, CNRS, Toulouse, France
| | - A. Neronov
- ISDC Data Centre for Astrophysics, Versoix, Switzerland
| | - H. Ohmori
- RIKEN, 2-1 Hirosawa, Wako, Saitama Japan
| | | | - G. Osteria
- Istituto Nazionale di Fisica Nucleare - Sezione di Napoli, Naples, Italy
| | - B. Panico
- Istituto Nazionale di Fisica Nucleare - Sezione di Napoli, Naples, Italy
- Dipartimento di Scienze Fisiche, Universitá di Napoli Federico II, Naples, Italy
| | - E. Parizot
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - T. Paul
- Lehman College, City University of New York, New York, USA
| | - P. Picozza
- RIKEN, 2-1 Hirosawa, Wako, Saitama Japan
- Istituto Nazionale di Fisica Nucleare - Sezione di Roma Tor Vergata, Roma, Italy
- Dipartimento di Fisica, Universitá di Roma Tor Vergata, Roma, Italy
| | | | - Z. Plebaniak
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
- National Centre for Nuclear Research, Lodz, Poland
| | - S. Pliego
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - P. Prat
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - G. Prévôt
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - H. Prieto
- Universidad de Alcalá, Madrid, Spain
| | - M. Putis
- Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovakia
| | - J. Rabanal
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
| | - M. Ricci
- Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali di Frascati, Frascati, Italy
| | - J. Rojas
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - G. Roudil
- IRAP, Université de Toulouse, CNRS, Toulouse, France
| | | | - Z. Sahnoun
- Center of Research in Astronomy, Astrophysics, and Geophysics, Algiers, Algeria
| | - N. Sakaki
- RIKEN, 2-1 Hirosawa, Wako, Saitama Japan
| | - J. C. Sanchez
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - A. Santangelo
- Institute for Astronomy and Astrophysics, University of Tübingen, Tübingen, Germany
| | | | - V. Scotti
- Istituto Nazionale di Fisica Nucleare - Sezione di Napoli, Naples, Italy
- Dipartimento di Scienze Fisiche, Universitá di Napoli Federico II, Naples, Italy
| | - K. Shinozaki
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
- National Centre for Nuclear Research, Lodz, Poland
| | - H. Silva
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - G. Suino
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | - J. Szabelski
- National Centre for Nuclear Research, Lodz, Poland
| | - S. Toscano
- ISDC Data Centre for Astrophysics, Versoix, Switzerland
| | - I. Tabone
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | | | | | | | - M. Wille
- ECAP, University of Erlangen-Nuremberg, Erlangen, Germany
| | - M. Zotov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow, Russia
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5
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Yee LM, McGee P, Bailit JL, Wapner RJ, Varner MW, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Mallett G, Grobman W, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Leveno K, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, Zhao Y, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Differences in obstetrical care and outcomes associated with the proportion of the obstetrician's shift completed. Am J Obstet Gynecol 2021; 225:430.e1-430.e11. [PMID: 33812810 DOI: 10.1016/j.ajog.2021.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Understanding and improving obstetrical quality and safety is an important goal of professional societies, and many interventions such as checklists, safety bundles, educational interventions, or other culture changes have been implemented to improve the quality of care provided to obstetrical patients. Although many factors contribute to delivery decisions, a reduced workload has addressed how provider issues such as fatigue or behaviors surrounding impending shift changes may influence the delivery mode and outcomes. OBJECTIVE The objective was to assess whether intrapartum obstetrical interventions and adverse outcomes differ based on the temporal proximity of the delivery to the attending's shift change. STUDY DESIGN This was a secondary analysis from a multicenter obstetrical cohort in which all patients with cephalic, singleton gestations who attempted vaginal birth were eligible for inclusion. The primary exposure used to quantify the relationship between the proximity of the provider to their shift change and a delivery intervention was the ratio of time from the most recent attending shift change to vaginal delivery or decision for cesarean delivery to the total length of the shift. Ratios were used to represent the proportion of time completed in the shift by normalizing for varying shift lengths. A sensitivity analysis restricted to patients who were delivered by physicians working 12-hour shifts was performed. Outcomes chosen included cesarean delivery, episiotomy, third- or fourth-degree perineal laceration, 5-minute Apgar score of <4, and neonatal intensive care unit admission. Chi-squared tests were used to evaluate outcomes based on the proportion of the attending's shift completed. Adjusted and unadjusted logistic models fitting a cubic spline (when indicated) were used to determine whether the frequency of outcomes throughout the shift occurred in a statistically significant, nonlinear pattern RESULTS: Of the 82,851 patients eligible for inclusion, 47,262 (57%) had ratio data available and constituted the analyzable sample. Deliveries were evenly distributed throughout shifts, with 50.6% taking place in the first half of shifts. There were no statistically significant differences in the frequency of cesarean delivery, episiotomy, third- or fourth-degree perineal lacerations, or 5-minute Apgar scores of <4 based on the proportion of the shift completed. The findings were unchanged when evaluated with a cubic spline in unadjusted and adjusted logistic models. Sensitivity analyses performed on the 22.2% of patients who were delivered by a physician completing a 12-hour shift showed similar findings. There was a small increase in the frequency of neonatal intensive care unit admissions with a greater proportion of the shift completed (adjusted P=.009), but the findings did not persist in the sensitivity analysis. CONCLUSION Clinically significant differences in obstetrical interventions and outcomes do not seem to exist based on the temporal proximity to the attending physician's shift change. Future work should attempt to directly study unit culture and provider fatigue to further investigate opportunities to improve obstetrical quality of care, and additional studies are needed to corroborate these findings in community settings.
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6
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Grobman WA, Sandoval G, Reddy UM, Tita AT, Silver RM, Mallett G, Hill K, Rice MM, El-Sayed YY, Wapner RJ, Rouse DJ, Saade GR, Thorp JM, Chauhan SP, Iams JD, Chien EK, Casey BM, Gibbs RS, Srinivas SK, Swamy GK, Simhan HN, Macones GA, Peaceman A, Plunkett B, Paycheck K, Dinsmoor M, Harris S, Sheppard J, Biggio J, Harper L, Longo S, Servay C, Varner M, Sowles A, Coleman K, Atkinson D, Stratford J, Dellermann S, Meadows C, Esplin S, Martin C, Peterson K, Stradling S, Willson C, Lyell D, Girsen A, Knapp R, Gyamfi C, Bousleiman S, Perez-Delboy A, Talucci M, Carmona V, Plante L, Tocci C, Leopanto B, Hoffman M, Dill-Grant L, Palomares K, Otarola S, Skupski D, Chan R, Allard D, Gelsomino T, Rousseau J, Beati L, Milano J, Werner E, Salazar A, Costantine M, Chiossi G, Pacheco L, Saad A, Munn M, Jain S, Clark S, Clark K, Boggess K, Timlin S, Eichelberger K, Moore A, Beamon C, Byers H, Ortiz F, Garcia L, Sibai B, Bartholomew A, Buhimschi C, Landon M, Johnson F, Webb L, McKenna D, Fennig K, Snow K, Habli M, McClellan M, Lindeman C, Dalton W, Hackney D, Cozart H, Mayle A, Mercer B, Moseley L, Gerald J, Fay-Randall L, Garcia M, Sias A, Price J, Hale K, Phipers J, Heyborne K, Craig J, Parry S, Sehdev H, Bishop T, Ferrara J, Bickus M, Caritis S, Thom E, Doherty L, de Voest J. Health resource utilization of labor induction versus expectant management. Am J Obstet Gynecol 2020; 222:369.e1-369.e11. [PMID: 31930993 DOI: 10.1016/j.ajog.2020.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/26/2019] [Accepted: 01/06/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although induction of labor of low-risk nulliparous women at 39 weeks reduces the risk of cesarean delivery compared with expectant management, concern regarding more frequent use of labor induction remains, given that this intervention historically has been thought to incur greater resource utilization. OBJECTIVE The objective of the study was to determine whether planned elective labor induction at 39 weeks among low-risk nulliparous women, compared with expectant management, was associated with differences in health care resource utilization from the time of randomization through 8 weeks postpartum. STUDY DESIGN This is a planned secondary analysis of a multicenter randomized trial in which low-risk nulliparous women were assigned to induction of labor at 39 weeks or expectant management. We assessed resource utilization after randomization in 3 time periods: antepartum, delivery admission, and discharge through 8 weeks postpartum. RESULTS Of 6096 women with data available, those in the induction of labor group (n = 3059) were significantly less likely in the antepartum period after randomization to have at least 1 ambulatory visit for routine prenatal care (32.4% vs 68.4%), unanticipated care (0.5% vs 2.6%), or urgent care (16.2% vs 44.3%), or at least 1 antepartum hospitalization (0.8% vs 2.2%, P < .001 for all). They also had fewer tests (eg, sonograms, blood tests) and treatments (eg, antibiotics, intravenous hydration) prior to delivery. During the delivery admission, women in the induction of labor group spent a longer time in labor and delivery (median, 0.83 vs 0.57 days), but both women (P = .002) and their neonates (P < .001) had shorter postpartum stays. Women and neonates in both groups had similar frequencies of postpartum urgent care and hospital readmissions (P > .05 for all). CONCLUSION Women randomized to induction of labor had longer durations in labor and delivery but significantly fewer antepartum visits, tests, and treatments and shorter maternal and neonatal hospital durations after delivery. These results demonstrate that the health outcome advantages associated with induction of labor are gained without incurring uniformly greater health care resource use.
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Darbord D, Cerezo M, Agoussi S, Allard D, Claps G, Girault I, Guemiri R, Libenciuc C, Moya-Plana A, Quidville V, Routier E, Roy S, Shen S, Vagner S, Robert C. Identification de TBX3 comme nouveau régulateur de l’expression de PDL1 dans le mélanome. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Tita AT, Jablonski KA, Bailit JL, Grobman WA, Wapner RJ, Reddy UM, Varner MW, Thorp JM, Leveno KJ, Caritis SN, Iams JD, Saade G, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Wallace M, Northen A, Grant J, Colquitt C, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Shubert P, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Zhao Y, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Neonatal outcomes of elective early-term births after demonstrated fetal lung maturity. Am J Obstet Gynecol 2018; 219:296.e1-296.e8. [PMID: 29800541 DOI: 10.1016/j.ajog.2018.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 11/09/2016] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Studies of early-term birth after demonstrated fetal lung maturity show that respiratory and other outcomes are worse with early-term birth (370-386 weeks) even after demonstrated fetal lung maturity when compared with full-term birth (390-406 weeks). However, these studies included medically indicated births and are therefore potentially limited by confounding by the indication for delivery. Thus, the increase in adverse outcomes might be due to the indication for early-term birth rather than the early-term birth itself. OBJECTIVE We examined the prevalence and risks of adverse neonatal outcomes associated with early-term birth after confirmed fetal lung maturity as compared with full-term birth in the absence of indications for early delivery. STUDY DESIGN This is a secondary analysis of an observational study of births to 115,502 women in 25 hospitals in the United States from 2008 through 2011. Singleton nonanomalous births at 37-40 weeks with no identifiable indication for delivery were included; early-term births after positive fetal lung maturity testing were compared with full-term births. The primary outcome was a composite of death, ventilator for ≥2 days, continuous positive airway pressure, proven sepsis, pneumonia or meningitis, treated hypoglycemia, hyperbilirubinemia (phototherapy), and 5-minute Apgar <7. Logistic regression and propensity score matching (both 1:1 and 1:2) were used. RESULTS In all, 48,137 births met inclusion criteria; the prevalence of fetal lung maturity testing in the absence of medical or obstetric indications for early delivery was 0.52% (n = 249). There were 180 (0.37%) early-term births after confirmed pulmonary maturity and 47,957 full-term births. Women in the former group were more likely to be non-Hispanic white, smoke, have received antenatal steroids, have induction, and have a cesarean. Risks of the composite (16.1% vs 5.4%; adjusted odds ratio, 3.2; 95% confidence interval, 2.1-4.8 from logistic regression) were more frequent with elective early-term birth. Propensity scores matching confirmed the increased primary composite in elective early-term births: adjusted odds ratios, 4.3 (95% confidence interval, 1.8-10.5) for 1:1 and 3.5 (95% confidence interval, 1.8-6.5) for 1:2 matching. Among components of the primary outcome, CPAP use and hyperbilirubinemia requiring phototherapy were significantly increased. Transient tachypnea of the newborn, neonatal intensive care unit admission, and prolonged neonatal intensive care unit stay (>2 days) were also increased with early-term birth. CONCLUSION Even with confirmed pulmonary maturity, early-term birth in the absence of medical or obstetric indications is associated with worse neonatal respiratory and hepatic outcomes compared with full-term birth, suggesting relative immaturity of these organ systems in early-term births.
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Manuck TA, Rice MM, Bailit JL, Grobman WA, Reddy UM, Wapner RJ, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Varner M, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Leveno K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Zhao Y, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Williams T, Spangler T, Lozitska A, Spong C, Tolivaisa S, VanDorsten J. Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. Am J Obstet Gynecol 2016; 215:103.e1-103.e14. [PMID: 26772790 DOI: 10.1016/j.ajog.2016.01.004] [Citation(s) in RCA: 290] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/28/2015] [Accepted: 01/02/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although preterm birth <37 weeks' gestation is the leading cause of neonatal morbidity and mortality in the United States, the majority of data regarding preterm neonatal outcomes come from older studies, and many reports have been limited to only very preterm neonates. Delineation of neonatal outcomes by delivery gestational age is needed to further clarify the continuum of mortality and morbidity frequencies among preterm neonates. OBJECTIVE We sought to describe the contemporary frequencies of neonatal death, neonatal morbidities, and neonatal length of stay across the spectrum of preterm gestational ages. STUDY DESIGN This was a secondary analysis of an obstetric cohort of 115,502 women and their neonates who were born in 25 hospitals nationwide, 2008 through 2011. All liveborn nonanomalous singleton preterm (23.0-36.9 weeks of gestation) neonates were included in this analysis. The frequency of neonatal death, major neonatal morbidity (intraventricular hemorrhage grade III/IV, seizures, hypoxic-ischemic encephalopathy, necrotizing enterocolitis stage II/III, bronchopulmonary dysplasia, persistent pulmonary hypertension), and minor neonatal morbidity (hypotension requiring treatment, intraventricular hemorrhage grade I/II, necrotizing enterocolitis stage I, respiratory distress syndrome, hyperbilirubinemia requiring treatment) were calculated by delivery gestational age; each neonate was classified once by the worst outcome for which criteria was met. RESULTS In all, 8334 deliveries met inclusion criteria. There were 119 (1.4%) neonatal deaths. In all, 657 (7.9%) neonates had major morbidity, 3136 (37.6%) had minor morbidity, and 4422 (53.1%) survived without any of the studied morbidities. Deaths declined rapidly with each advancing week of gestation. This decline in death was accompanied by an increase in major neonatal morbidity, which peaked at 54.8% at 25 weeks of gestation. As frequencies of death and major neonatal morbidity fell, minor neonatal morbidity increased, peaking at 81.7% at 31 weeks of gestation. The frequency of all morbidities fell >32 weeks. After 25 weeks, neonatal length of hospital stay decreased significantly with each additional completed week of pregnancy; among babies delivered from 26-32 weeks of gestation, each additional week in utero reduced the subsequent length of neonatal hospitalization by a minimum of 8 days. The median postmenstrual age at discharge nadired around 36 weeks' postmenstrual age for babies born at 31-35 weeks of gestation. CONCLUSION Our data show that there is a continuum of outcomes, with each additional week of gestation conferring survival benefit while reducing the length of initial hospitalization. These contemporary data can be useful for patient counseling regarding preterm outcomes.
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Cook K, Shpargel K, Starmer J, Whitfield-Larry F, Conley B, Allard D, Magnuson T, Su M, Whitmire J. T cell expression of the histone demethylase UTX promotes clearance of a persistent virus infection by modulating Tfh cell differentiation (VIR1P.1155). The Journal of Immunology 2015. [DOI: 10.4049/jimmunol.194.supp.74.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
T cell differentiation and memory formation are impacted by epigenetic changes that modulate nucleosome structure to regulate transcription factor accessibility. The enzymes and specific targets that mediate these processes within T cells are not clear. We show that UTX, a histone H3 lysine 27 (H3K27) demethylase, promotes the formation of the CD4+ T follicular helper cell (Tfh) phenotype during a chronic virus infection. Mice with T cell specific UTX deletion had defects in Tfh cell generation and function that resulted in reduced germinal center responses and virus-specific immunoglobulin production. Furthermore, clearance of the chronic virus infection was specifically dependent on T cell expression of UTX. H3K27me3-ChIP-sequencing and RNA expression analysis revealed a subset of genes that were specifically regulated by UTX via H3K27 demethylation. This group included IL-6Ra, a known regulator of Tfh responses, as well as other genes, which are potentially novel Tfh effector genes. Thus, we identify a critical link between UTX-dependent H3K27 demethylase activity in T cells and immunity to infection.
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Affiliation(s)
- Kevin Cook
- 1Genetics, Univ. of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Karl Shpargel
- 1Genetics, Univ. of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Joshua Starmer
- 1Genetics, Univ. of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Bridget Conley
- 2Pediatrics, Univ. of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Denise Allard
- 3Microbiology and Immunology, Univ. of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Terry Magnuson
- 1Genetics, Univ. of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Maureen Su
- 2Pediatrics, Univ. of North Carolina at Chapel Hill, Chapel Hill, NC
- 3Microbiology and Immunology, Univ. of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jason Whitmire
- 1Genetics, Univ. of North Carolina at Chapel Hill, Chapel Hill, NC
- 3Microbiology and Immunology, Univ. of North Carolina at Chapel Hill, Chapel Hill, NC
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Bailit JL, Grobman W, Zhao Y, Wapner RJ, Reddy UM, Varner MW, Leveno KJ, Caritis SN, Iams JD, Tita AT, Saade G, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, VanDorsten JP, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Thorp J, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Shubert P, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Williams T, Spong C, Tolivaisa S. Nonmedically indicated induction vs expectant treatment in term nulliparous women. Am J Obstet Gynecol 2015; 212:103.e1-7. [PMID: 24983681 DOI: 10.1016/j.ajog.2014.06.054] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 05/27/2014] [Accepted: 06/23/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to compare maternal and neonatal outcomes in nulliparous women with nonmedically indicated inductions at term vs those expectantly treated. STUDY DESIGN Data were obtained from maternal and neonatal charts for all deliveries on randomly selected days across 25 US hospitals over a 3-year period. A low-risk subset of nulliparous women with vertex nonanomalous singleton gestations who delivered 38 0/7 to 41 6/7 weeks were selected. Maternal and neonatal outcomes for nonmedically indicated induction within each week were compared with women who did not undergo nonmedically indicated induction during that week. Multivariable analysis was used to adjust for hospital, maternal age, race/ethnicity, body mass index, cigarette use, and insurance status. RESULTS We found 31,169 women who met our criteria. Neonatal complications were either less frequent with nonmedically indicated induction or no different between groups. Nonmedically indicated induction was associated with less frequent peripartum infections (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.16-0.98) at 38 weeks of gestation and less frequent third- and fourth-degree lacerations (OR, 0.60; 95% CI, 0.42-0.86) and less frequent peripartum infections (OR, 0.66; 95% CI, 0.49-0.90) at 39 weeks of gestation. Nonmedically indicated induction was associated with a longer admission-to-delivery time by approximately 3-4 hours and increased odds of cesarean delivery at 38 (OR, 1.50; 95% CI, 1.08-2.08) and 40 weeks (OR, 1.30; 95% CI, 1.15-1.46) of gestation. CONCLUSION At 39 weeks of gestation, nonmedically indicated induction is associated with lower maternal and neonatal morbidity than women who are expectantly treated.
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Abreu P, Aglietta M, Ahn EJ, Albuquerque IFM, Allard D, Allekotte I, Allen J, Allison P, Almeda A, Alvarez Castillo J, Alvarez-Muñiz J, Ambrosio M, Aminaei A, Anchordoqui L, Andringa S, Antičić T, Aramo C, Arganda E, Arqueros F, Asorey H, Assis P, Aublin J, Ave M, Avenier M, Avila G, Bäcker T, Balzer M, Barber KB, Barbosa AF, Bardenet R, Barroso SLC, Baughman B, Bäuml J, Beatty JJ, Becker BR, Becker KH, Bellétoile A, Bellido JA, Benzvi S, Berat C, Bertou X, Biermann PL, Billoir P, Blanco F, Blanco M, Bleve C, Blümer H, Boháčová M, Boncioli D, Bonifazi C, Bonino R, Borodai N, Brack J, Brogueira P, Brown WC, Bruijn R, Buchholz P, Bueno A, Burton RE, Caballero-Mora KS, Caramete L, Caruso R, Castellina A, Catalano O, Cataldi G, Cazon L, Cester R, Chauvin J, Cheng SH, Chiavassa A, Chinellato JA, Chirinos Diaz J, Chudoba J, Clay RW, Coluccia MR, Conceição R, Contreras F, Cook H, Cooper MJ, Coppens J, Cordier A, Coutu S, Covault CE, Creusot A, Criss A, Cronin J, Curutiu A, Dagoret-Campagne S, Dallier R, Dasso S, Daumiller K, Dawson BR, de Almeida RM, De Domenico M, De Donato C, de Jong SJ, De La Vega G, de Mello Junior WJM, de Mello Neto JRT, De Mitri I, de Souza V, de Vries KD, Decerprit G, del Peral L, del Río M, Deligny O, Dembinski H, Dhital N, Di Giulio C, Díaz Castro ML, Diep PN, Dobrigkeit C, Docters W, D'Olivo JC, Dong PN, Dorofeev A, dos Anjos JC, Dova MT, D'Urso D, Dutan I, Ebr J, Engel R, Erdmann M, Escobar CO, Espadanal J, Etchegoyen A, Facal San Luis P, Fajardo Tapia I, Falcke H, Farrar G, Fauth AC, Fazzini N, Ferguson AP, Ferrero A, Fick B, Filevich A, Filipčič A, Fliescher S, Fracchiolla CE, Fraenkel ED, Fröhlich U, Fuchs B, Gaior R, Gamarra RF, Gambetta S, García B, Garcia-Gamez D, Garcia-Pinto D, Gascon A, Gemmeke H, Gesterling K, Ghia PL, Giaccari U, Giller M, Glass H, Gold MS, Golup G, Gomez Albarracin F, Gómez Berisso M, Gonçalves P, Gonzalez D, Gonzalez JG, Gookin B, Góra D, Gorgi A, Gouffon P, Gozzini SR, Grashorn E, Grebe S, Griffith N, Grigat M, Grillo AF, Guardincerri Y, Guarino F, Guedes GP, Guzman A, Hague JD, Hansen P, Harari D, Harmsma S, Harrison TA, Harton JL, Haungs A, Hebbeker T, Heck D, Herve AE, Hojvat C, Hollon N, Holmes VC, Homola P, Hörandel JR, Horneffer A, Horvath P, Hrabovský M, Huege T, Insolia A, Ionita F, Italiano A, Jarne C, Jiraskova S, Josebachuili M, Kadija K, Kampert KH, Karhan P, Kasper P, Kégl B, Keilhauer B, Keivani A, Kelley JL, Kemp E, Kieckhafer RM, Klages HO, Kleifges M, Kleinfeller J, Knapp J, Koang DH, Kotera K, Krohm N, Krömer O, Kruppke-Hansen D, Kuehn F, Kuempel D, Kulbartz JK, Kunka N, La Rosa G, Lachaud C, Lauer R, Lautridou P, Le Coz S, Leão MSAB, Lebrun D, Lebrun P, Leigui de Oliveira MA, Lemiere A, Letessier-Selvon A, Lhenry-Yvon I, Link K, López R, Lopez Agüera A, Louedec K, Lozano Bahilo J, Lu L, Lucero A, Ludwig M, Lyberis H, Macolino C, Maldera S, Mandat D, Mantsch P, Mariazzi AG, Marin J, Marin V, Maris IC, Marquez Falcon HR, Marsella G, Martello D, Martin L, Martinez H, Martínez Bravo O, Mathes HJ, Matthews J, Matthews JAJ, Matthiae G, Maurizio D, Mazur PO, Medina-Tanco G, Melissas M, Melo D, Menichetti E, Menshikov A, Mertsch P, Meurer C, Mićanović S, Micheletti MI, Miller W, Miramonti L, Molina-Bueno L, Mollerach S, Monasor M, Monnier Ragaigne D, Montanet F, Morales B, Morello C, Moreno E, Moreno JC, Morris C, Mostafá M, Moura CA, Mueller S, Muller MA, Müller G, Münchmeyer M, Mussa R, Navarra G, Navarro JL, Navas S, Necesal P, Nellen L, Nelles A, Neuser J, Nhung PT, Niemietz L, Nierstenhoefer N, Nitz D, Nosek D, Nožka L, Nyklicek M, Oehlschläger J, Olinto A, Olmos-Gilbaja VM, Ortiz M, Pacheco N, Pakk Selmi-Dei D, Palatka M, Pallotta J, Palmieri N, Parente G, Parizot E, Parra A, Parsons RD, Pastor S, Paul T, Pech M, Pekala J, Pelayo R, Pepe IM, Perrone L, Pesce R, Petermann E, Petrera S, Petrinca P, Petrolini A, Petrov Y, Petrovic J, Pfendner C, Phan N, Piegaia R, Pierog T, Pieroni P, Pimenta M, Pirronello V, Platino M, Ponce VH, Pontz M, Privitera P, Prouza M, Quel EJ, Querchfeld S, Rautenberg J, Ravel O, Ravignani D, Revenu B, Ridky J, Riggi S, Risse M, Ristori P, Rivera H, Rizi V, Roberts J, Robledo C, Rodrigues de Carvalho W, Rodriguez G, Rodriguez Martino J, Rodriguez Rojo J, Rodriguez-Cabo I, Rodríguez-Frías MD, Ros G, Rosado J, Rossler T, Roth M, Rouillé-d'Orfeuil B, Roulet E, Rovero AC, Rühle C, Salamida F, Salazar H, Salesa Greus F, Salina G, Sánchez F, Santo CE, Santos E, Santos EM, Sarazin F, Sarkar B, Sarkar S, Sato R, Scharf N, Scherini V, Schieler H, Schiffer P, Schmidt A, Scholten O, Schoorlemmer H, Schovancova J, Schovánek P, Schröder F, Schulte S, Schuster D, Sciutto SJ, Scuderi M, Segreto A, Settimo M, Shadkam A, Shellard RC, Sidelnik I, Sigl G, Silva Lopez HH, Smiałkowski A, Smída R, Snow GR, Sommers P, Sorokin J, Spinka H, Squartini R, Stanic S, Stapleton J, Stasielak J, Stephan M, Stutz A, Suarez F, Suomijärvi T, Supanitsky AD, Suša T, Sutherland MS, Swain J, Szadkowski Z, Szuba M, Tamashiro A, Tapia A, Tartare M, Taşcău O, Tavera Ruiz CG, Tcaciuc R, Tegolo D, Thao NT, Thomas D, Tiffenberg J, Timmermans C, Tiwari DK, Tkaczyk W, Todero Peixoto CJ, Tomé B, Tonachini A, Travnicek P, Tridapalli DB, Tristram G, Trovato E, Tueros M, Ulrich R, Unger M, Urban M, Valdés Galicia JF, Valiño I, Valore L, van den Berg AM, Varela E, Vargas Cárdenas B, Vázquez JR, Vázquez RA, Veberič D, Verzi V, Vicha J, Videla M, Villaseñor L, Wahlberg H, Wahrlich P, Wainberg O, Walz D, Warner D, Watson AA, Weber M, Weidenhaupt K, Weindl A, Westerhoff S, Whelan BJ, Wieczorek G, Wiencke L, Wilczyńska B, Wilczyński H, Will M, Williams C, Winchen T, Winnick MG, Wommer M, Wundheiler B, Yamamoto T, Yapici T, Younk P, Yuan G, Yushkov A, Zamorano B, Zas E, Zavrtanik D, Zavrtanik M, Zaw I, Zepeda A, Zhu Y, Zimbres Silva M, Ziolkowski M. Measurement of the proton-air cross section at √s=57 TeV with the Pierre Auger Observatory. Phys Rev Lett 2012; 109:062002. [PMID: 23006259 DOI: 10.1103/physrevlett.109.062002] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Indexed: 06/01/2023]
Abstract
We report a measurement of the proton-air cross section for particle production at the center-of-mass energy per nucleon of 57 TeV. This is derived from the distribution of the depths of shower maxima observed with the Pierre Auger Observatory: systematic uncertainties are studied in detail. Analyzing the tail of the distribution of the shower maxima, a proton-air cross section of [505±22(stat)(-36)(+28)(syst)] mb is found.
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Affiliation(s)
- P Abreu
- LIP and Instituto Superior Técnico, Technical University of Lisbon, Lisbon, Portugal
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Richardson GM, Wilson R, Allard D, Purtill C, Douma S, Gravière J. Mercury exposure and risks from dental amalgam in the US population, post-2000. Sci Total Environ 2011; 409:4257-68. [PMID: 21782213 DOI: 10.1016/j.scitotenv.2011.06.035] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 06/08/2011] [Accepted: 06/15/2011] [Indexed: 05/24/2023]
Abstract
Dental amalgam is 50% metallic mercury (Hg) by weight and Hg vapour continuously evolves from in-place dental amalgam, causing increased Hg content with increasing amalgam load in urine, faeces, exhaled breath, saliva, blood, and various organs and tissues including the kidney, pituitary gland, liver, and brain. The Hg content also increases with maternal amalgam load in amniotic fluid, placenta, cord blood, meconium, various foetal tissues including liver, kidney and brain, in colostrum and breast milk. Based on 2001 to 2004 population statistics, 181.1 million Americans carry a grand total of 1.46 billion restored teeth. Children as young as 26 months were recorded as having restored teeth. Past dental practice and recently available data indicate that the majority of these restorations are composed of dental amalgam. Employing recent US population-based statistics on body weight and the frequency of dentally restored tooth surfaces, and recent research on the incremental increase in urinary Hg concentration per amalgam-filled tooth surface, estimates of Hg exposure from amalgam fillings were determined for 5 age groups of the US population. Three specific exposure scenarios were considered, each scenario incrementally reducing the number of tooth surfaces assumed to be restored with amalgam. Based on the least conservative of the scenarios evaluated, it was estimated that some 67.2 million Americans would exceed the Hg dose associated with the reference exposure level (REL) of 0.3 μg/m(3) established by the US Environmental Protection Agency; and 122.3 million Americans would exceed the dose associated with the REL of 0.03 μg/m(3) established by the California Environmental Protection Agency. Exposure estimates are consistent with previous estimates presented by Health Canada in 1995, and amount to 0.2 to 0.4 μg/day per amalgam-filled tooth surface, or 0.5 to 1 μg/day/amalgam-filled tooth, depending on age and other factors.
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Affiliation(s)
- G M Richardson
- SNC-Lavalin Environment, Suite 110, 20 Colonnade Road, Ottawa, ON Canada.
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Frosst G, Tremblay FW, Allard D. LBP-1.06 Infectious syphilis in New Brunswick: using data for action in a small Canadian province. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050119.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lee S, Jang S, Sio T, Segala J, Allard D, Curran B, Sternick E, Wazer D. Dosimetric Comparison of Radiosurgical Modalities using EDR Film: Gamma Knife vs. CyberKnife. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abraham J, Abreu P, Aglietta M, Ahn EJ, Allard D, Allekotte I, Allen J, Alvarez-Muñiz J, Ambrosio M, Anchordoqui L, Andringa S, Anticić T, Anzalone A, Aramo C, Arganda E, Arisaka K, Arqueros F, Asorey H, Assis P, Aublin J, Ave M, Avila G, Bäcker T, Badagnani D, Balzer M, Barber KB, Barbosa AF, Barroso SLC, Baughman B, Bauleo P, Beatty JJ, Becker BR, Becker KH, Bellétoile A, Bellido JA, Benzvi S, Berat C, Bergmann T, Bertou X, Biermann PL, Billoir P, Blanch-Bigas O, Blanco F, Blanco M, Bleve C, Blümer H, Bohácová M, Boncioli D, Bonifazi C, Bonino R, Borodai N, Brack J, Brogueira P, Brown WC, Bruijn R, Buchholz P, Bueno A, Burton RE, Busca NG, Caballero-Mora KS, Caramete L, Caruso R, Castellina A, Catalano O, Cataldi G, Cazon L, Cester R, Chauvin J, Chiavassa A, Chinellato JA, Chou A, Chudoba J, Clay RW, Colombo E, Coluccia MR, Conceição R, Contreras F, Cook H, Cooper MJ, Coppens J, Cordier A, Cotti U, Coutu S, Covault CE, Creusot A, Criss A, Cronin J, Curutiu A, Dagoret-Campagne S, Dallier R, Daumiller K, Dawson BR, de Almeida RM, De Domenico M, De Donato C, de Jong SJ, De La Vega G, de Mello Junior WJM, de Mello Neto JRT, De Mitri I, de Souza V, de Vries KD, Decerprit G, Del Peral L, Deligny O, Della Selva A, Delle Fratte C, Dembinski H, Di Giulio C, Diaz JC, Díaz Castro ML, Diep PN, Dobrigkeit C, D'Olivo JC, Dong PN, Dorofeev A, Dos Anjos JC, Dova MT, D'Urso D, Dutan I, Duvernois MA, Ebr J, Engel R, Erdmann M, Escobar CO, Etchegoyen A, Facal San Luis P, Falcke H, Farrar G, Fauth AC, Fazzini N, Ferrero A, Fick B, Filevich A, Filipcic A, Fleck I, Fliescher S, Fracchiolla CE, Fraenkel ED, Fröhlich U, Fulgione W, Gamarra RF, Gambetta S, García B, García Gámez D, Garcia-Pinto D, Garrido X, Gelmini G, Gemmeke H, Ghia PL, Giaccari U, Giller M, Glass H, Goggin LM, Gold MS, Golup G, Gomez Albarracin F, Gómez Berisso M, Gonçalves P, Gonzalez D, Gonzalez JG, Góra D, Gorgi A, Gouffon P, Gozzini SR, Grashorn E, Grebe S, Grigat M, Grillo AF, Guardincerri Y, Guarino F, Guedes GP, Hague JD, Halenka V, Hansen P, Harari D, Harmsma S, Harton JL, Haungs A, Hebbeker T, Heck D, Herve AE, Hojvat C, Holmes VC, Homola P, Hörandel JR, Horneffer A, Hrabovský M, Huege T, Hussain M, Iarlori M, Insolia A, Ionita F, Italiano A, Jiraskova S, Kadija K, Kaducak M, Kampert KH, Karova T, Kasper P, Kégl B, Keilhauer B, Keivani A, Kelley J, Kemp E, Kieckhafer RM, Klages HO, Kleifges M, Kleinfeller J, Knapik R, Knapp J, Koang DH, Krieger A, Krömer O, Kruppke-Hansen D, Kuehn F, Kuempel D, Kulbartz K, Kunka N, Kusenko A, La Rosa G, Lachaud C, Lago BL, Lautridou P, Leão MSAB, Lebrun D, Lebrun P, Lee J, Leigui de Oliveira MA, Lemiere A, Letessier-Selvon A, Lhenry-Yvon I, López R, Lopez Agüera A, Louedec K, Lozano Bahilo J, Lucero A, Ludwig M, Lyberis H, Maccarone MC, Macolino C, Maldera S, Mandat D, Mantsch P, Mariazzi AG, Marin V, Maris IC, Marquez Falcon HR, Marsella G, Martello D, Martínez Bravo O, Mathes HJ, Matthews J, Matthews JAJ, Matthiae G, Maurizio D, Mazur PO, McEwen M, Medina-Tanco G, Melissas M, Melo D, Menichetti E, Menshikov A, Meurer C, Micanović S, Micheletti MI, Miller W, Miramonti L, Mollerach S, Monasor M, Monnier Ragaigne D, Montanet F, Morales B, Morello C, Moreno E, Moreno JC, Morris C, Mostafá M, Mueller S, Muller MA, Mussa R, Navarra G, Navarro JL, Navas S, Necesal P, Nellen L, Nhung PT, Nierstenhoefer N, Nitz D, Nosek D, Nozka L, Nyklicek M, Oehlschläger J, Olinto A, Oliva P, Olmos-Gilbaja VM, Ortiz M, Pacheco N, Pakk Selmi-Dei D, Palatka M, Pallotta J, Palmieri N, Parente G, Parizot E, Parlati S, Parra A, Parrisius J, Parsons RD, Pastor S, Paul T, Pavlidou V, Payet K, Pech M, Pekala J, Pelayo R, Pepe IM, Perrone L, Pesce R, Petermann E, Petrera S, Petrinca P, Petrolini A, Petrov Y, Petrovic J, Pfendner C, Piegaia R, Pierog T, Pimenta M, Pirronello V, Platino M, Ponce VH, Pontz M, Privitera P, Prouza M, Quel EJ, Rautenberg J, Ravel O, Ravignani D, Redondo A, Revenu B, Rezende FAS, Ridky J, Riggi S, Risse M, Ristori P, Rivière C, Rizi V, Robledo C, Rodriguez G, Rodriguez Martino J, Rodriguez Rojo J, Rodriguez-Cabo I, Rodríguez-Frías MD, Ros G, Rosado J, Rossler T, Roth M, Rouillé-d'Orfeuil B, Roulet E, Rovero AC, Salamida F, Salazar H, Salina G, Sánchez F, Santander M, Santo CE, Santos E, Santos EM, Sarazin F, Sarkar S, Sato R, Scharf N, Scherini V, Schieler H, Schiffer P, Schmidt A, Schmidt F, Schmidt T, Scholten O, Schoorlemmer H, Schovancova J, Schovánek P, Schroeder F, Schulte S, Schüssler F, Schuster D, Sciutto SJ, Scuderi M, Segreto A, Semikoz D, Settimo M, Shadkam A, Shellard RC, Sidelnik I, Siffert BB, Sigl G, Smiałkowski A, Smída R, Snow GR, Sommers P, Sorokin J, Spinka H, Squartini R, Stasielak J, Stephan M, Strazzeri E, Stutz A, Suarez F, Suomijärvi T, Supanitsky AD, Susa T, Sutherland MS, Swain J, Szadkowski Z, Tamashiro A, Tamburro A, Tapia A, Tarutina T, Taşcău O, Tcaciuc R, Tcherniakhovski D, Tegolo D, Thao NT, Thomas D, Tiffenberg J, Timmermans C, Tkaczyk W, Todero Peixoto CJ, Tomé B, Tonachini A, Travnicek P, Tridapalli DB, Tristram G, Trovato E, Tueros M, Ulrich R, Unger M, Urban M, Valdés Galicia JF, Valiño I, Valore L, van den Berg AM, Vázquez JR, Vázquez RA, Veberic D, Venters T, Verzi V, Videla M, Villaseñor L, Vorobiov S, Voyvodic L, Wahlberg H, Wahrlich P, Wainberg O, Warner D, Watson AA, Westerhoff S, Whelan BJ, Wieczorek G, Wiencke L, Wilczyńska B, Wilczyński H, Williams C, Winchen T, Winnick MG, Wundheiler B, Yamamoto T, Younk P, Yuan G, Yushkov A, Zas E, Zavrtanik D, Zavrtanik M, Zaw I, Zepeda A, Ziolkowski M. Measurement of the depth of maximum of extensive air showers above 10{18} eV. Phys Rev Lett 2010; 104:091101. [PMID: 20366976 DOI: 10.1103/physrevlett.104.091101] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Indexed: 05/29/2023]
Abstract
We describe the measurement of the depth of maximum, X{max}, of the longitudinal development of air showers induced by cosmic rays. Almost 4000 events above 10;{18} eV observed by the fluorescence detector of the Pierre Auger Observatory in coincidence with at least one surface detector station are selected for the analysis. The average shower maximum was found to evolve with energy at a rate of (106{-21}{+35}) g/cm{2}/decade below 10{18.24+/-0.05} eV, and (24+/-3) g/cm{2}/decade above this energy. The measured shower-to-shower fluctuations decrease from about 55 to 26 g/cm{2}. The interpretation of these results in terms of the cosmic ray mass composition is briefly discussed.
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Affiliation(s)
- J Abraham
- National Technological University, Faculty Mendoza (CONICET/CNEA), Mendoza, Argentina
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Bel L, Allard D, Laurent J, Cheddadi R, Bar-Hen A. CART algorithm for spatial data: Application to environmental and ecological data. Comput Stat Data Anal 2009. [DOI: 10.1016/j.csda.2008.09.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abraham J, Abreu P, Aglietta M, Aguirre C, Allard D, Allekotte I, Allen J, Allison P, Alvarez-Muñiz J, Ambrosio M, Anchordoqui L, Andringa S, Anzalone A, Aramo C, Argirò S, Arisaka K, Armengaud E, Arneodo F, Arqueros F, Asch T, Asorey H, Assis P, Atulugama BS, Aublin J, Ave M, Avila G, Bäcker T, Badagnani D, Barbosa AF, Barnhill D, Barroso SLC, Baughman B, Bauleo P, Beatty JJ, Beau T, Becker BR, Becker KH, Bellido JA, Benzvi S, Berat C, Bergmann T, Bernardini P, Bertou X, Biermann PL, Billoir P, Blanch-Bigas O, Blanco F, Blasi P, Bleve C, Blümer H, Bohácová M, Bonifazi C, Bonino R, Brack J, Brogueira P, Brown WC, Buchholz P, Bueno A, Burton RE, Busca NG, Caballero-Mora KS, Cai B, Camin DV, Caramete L, Caruso R, Carvalho W, Castellina A, Catalano O, Cataldi G, Cazon L, Cester R, Chauvin J, Chiavassa A, Chinellato JA, Chou A, Chudoba J, Chye J, Clark PDJ, Clay RW, Colombo E, Conceição R, Connolly B, Contreras F, Coppens J, Cordier A, Cotti U, Coutu S, Covault CE, Creusot A, Criss A, Cronin J, Curutiu A, Dagoret-Campagne S, Daumiller K, Dawson BR, de Almeida RM, De Donato C, de Jong SJ, De La Vega G, Junior WJMDM, Neto JRTDM, De Mitri I, de Souza V, Del Peral L, Deligny O, Della Selva A, Fratte CD, Dembinski H, Di Giulio C, Diaz JC, Diep PN, Dobrigkeit C, D'Olivo JC, Dong PN, Dornic D, Dorofeev A, Dos Anjos JC, Dova MT, D'Urso D, Dutan I, Duvernois MA, Engel R, Epele L, Erdmann M, Escobar CO, Etchegoyen A, Luis PFS, Falcke H, Farrar G, Fauth AC, Fazzini N, Ferrer F, Ferrero A, Fick B, Filevich A, Filipcic A, Fleck I, Fracchiolla CE, Fulgione W, García B, Gámez DG, Garcia-Pinto D, Garrido X, Geenen H, Gelmini G, Gemmeke H, Ghia PL, Giller M, Glass H, Gold MS, Golup G, Albarracin FG, Berisso MG, Gonçalves P, do Amaral MG, Gonzalez D, Gonzalez JG, González M, Góra D, Gorgi A, Gouffon P, Grassi V, Grillo AF, Grunfeld C, Guardincerri Y, Guarino F, Guedes GP, Gutiérrez J, Hague JD, Halenka V, Hamilton JC, Hansen P, Harari D, Harmsma S, Harton JL, Haungs A, Hauschildt T, Healy MD, Hebbeker T, Hebrero G, Heck D, Hojvat C, Holmes VC, Homola P, Hörandel JR, Horneffer A, Hrabovský M, Huege T, Hussain M, Iarlori M, Insolia A, Ionita F, Italiano A, Kaducak M, Kampert KH, Karova T, Kasper P, Kégl B, Keilhauer B, Kemp E, Kieckhafer RM, Klages HO, Kleifges M, Kleinfeller J, Knapik R, Knapp J, Koang DH, Krieger A, Krömer O, Kuempel D, Kunka N, Kusenko A, La Rosa G, Lachaud C, Lago BL, Lebrun D, Lebrun P, Lee J, de Oliveira MAL, Letessier-Selvon A, Leuthold M, Lhenry-Yvon I, López R, Agüera AL, Bahilo JL, Lucero A, García RL, Maccarone MC, Macolino C, Maldera S, Mancarella G, Manceñido ME, Mandat D, Mantsch P, Mariazzi AG, Maris IC, Falcon HRM, Martello D, Martínez J, Bravo OM, Mathes HJ, Matthews J, Matthews JAJ, Matthiae G, Maurizio D, Mazur PO, McCauley T, McEwen M, McNeil RR, Medina MC, Medina-Tanco G, Melo D, Menichetti E, Menschikov A, Meurer C, Meyhandan R, Micheletti MI, Miele G, Miller W, Mollerach S, Monasor M, Ragaigne DM, Montanet F, Morales B, Morello C, Moreno JC, Morris C, Mostafá M, Muller MA, Mussa R, Navarra G, Navarro JL, Navas S, Necesal P, Nellen L, Newman-Holmes C, Newton D, Nhung PT, Nierstenhoefer N, Nitz D, Nosek D, Nozka L, Oehlschläger J, Ohnuki T, Olinto A, Olmos-Gilbaja VM, Ortiz M, Ortolani F, Ostapchenko S, Otero L, Pacheco N, Selmi-Dei DP, Palatka M, Pallotta J, Parente G, Parizot E, Parlati S, Pastor S, Patel M, Paul T, Pavlidou V, Payet K, Pech M, Pekala J, Pelayo R, Pepe IM, Perrone L, Pesce R, Petrera S, Petrinca P, Petrov Y, Pichel A, Piegaia R, Pierog T, Pimenta M, Pinto T, Pirronello V, Pisanti O, Platino M, Pochon J, Privitera P, Prouza M, Quel EJ, Rautenberg J, Redondo A, Reucroft S, Revenu B, Rezende FAS, Ridky J, Riggi S, Risse M, Rivière C, Rizi V, Roberts M, Robledo C, Rodriguez G, Martino JR, Rojo JR, Rodriguez-Cabo I, Rodríguez-Frías MD, Ros G, Rosado J, Roth M, Rouillé-d'Orfeuil B, Roulet E, Rovero AC, Salamida F, Salazar H, Salina G, Sánchez F, Santander M, Santo CE, Santos EM, Sarazin F, Sarkar S, Sato R, Scherini V, Schieler H, Schmidt A, Schmidt F, Schmidt T, Scholten O, Schovánek P, Schroeder F, Schulte S, Schüssler F, Sciutto SJ, Scuderi M, Segreto A, Semikoz D, Settimo M, Shellard RC, Sidelnik I, Siffert BB, Sigl G, Grande NSD, Smiałkowski A, Smída R, Smith AGK, Smith BE, Snow GR, Sokolsky P, Sommers P, Sorokin J, Spinka H, Squartini R, Strazzeri E, Stutz A, Suarez F, Suomijärvi T, Supanitsky AD, Sutherland MS, Swain J, Szadkowski Z, Takahashi J, Tamashiro A, Tamburro A, Tarutina T, Taşcău O, Tcaciuc R, Thao NT, Thomas D, Ticona R, Tiffenberg J, Timmermans C, Tkaczyk W, Peixoto CJT, Tomé B, Tonachini A, Torres I, Travnicek P, Tripathi A, Tristram G, Tscherniakhovski D, Tuci V, Tueros M, Tunnicliffe V, Ulrich R, Unger M, Urban M, Galicia JFV, Valiño I, Valore L, van den Berg AM, van Elewyck V, Vázquez RA, Veberic D, Veiga A, Velarde A, Venters T, Verzi V, Videla M, Villaseñor L, Vorobiov S, Voyvodic L, Wahlberg H, Wahrlich P, Wainberg O, Walker P, Warner D, Watson AA, Westerhoff S, Wieczorek G, Wiencke L, Wilczyńska B, Wilczyński H, Wileman C, Winnick MG, Wu H, Wundheiler B, Yamamoto T, Younk P, Zas E, Zavrtanik D, Zavrtanik M, Zaw I, Zepeda A, Ziolkowski M. Observation of the suppression of the flux of cosmic rays above 4 x 10 (19) eV. Phys Rev Lett 2008; 101:061101. [PMID: 18764444 DOI: 10.1103/physrevlett.101.061101] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2008] [Indexed: 05/26/2023]
Abstract
The energy spectrum of cosmic rays above 2.5 x 10;{18} eV, derived from 20,000 events recorded at the Pierre Auger Observatory, is described. The spectral index gamma of the particle flux, J proportional, variantE;{-gamma}, at energies between 4 x 10;{18} eV and 4 x 10;{19} eV is 2.69+/-0.02(stat)+/-0.06(syst), steepening to 4.2+/-0.4(stat)+/-0.06(syst) at higher energies. The hypothesis of a single power law is rejected with a significance greater than 6 standard deviations. The data are consistent with the prediction by Greisen and by Zatsepin and Kuz'min.
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Affiliation(s)
- J Abraham
- Universidad Tecnológica Nacional, FR-Mendoza, Argentina
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Abraham J, Abreu P, Aglietta M, Aguirre C, Allard D, Allekotte I, Allen J, Allison P, Alvarez-Muñiz J, Ambrosio M, Anchordoqui L, Andringa S, Anzalone A, Aramo C, Argirò S, Arisaka K, Armengaud E, Arneodo F, Arqueros F, Asch T, Asorey H, Assis P, Atulugama BS, Aublin J, Ave M, Avila G, Bäcker T, Badagnani D, Barbosa AF, Barnhill D, Barroso SLC, Bauleo P, Beatty JJ, Beau T, Becker BR, Becker KH, Bellido JA, BenZvi S, Berat C, Bergmann T, Bernardini P, Bertou X, Biermann PL, Billoir P, Blanch-Bigas O, Blanco F, Blasi P, Bleve C, Blümer H, Bohácová M, Bonifazi C, Bonino R, Boratav M, Brack J, Brogueira P, Brown WC, Buchholz P, Bueno A, Burton RE, Busca NG, Caballero-Mora KS, Cai B, Camin DV, Caramete L, Caruso R, Carvalho W, Castellina A, Catalano O, Cataldi G, Cazon L, Cester R, Chauvin J, Chiavassa A, Chinellato JA, Chou A, Chye J, Clark PDJ, Clay RW, Colombo E, Conceição R, Connolly B, Contreras F, Coppens J, Cordier A, Cotti U, Coutu S, Covault CE, Creusot A, Criss A, Cronin J, Curutiu A, Dagoret-Campagne S, Daumiller K, Dawson BR, de Almeida RM, De Donato C, de Jong SJ, De La Vega G, de Mello Junior WJM, de Mello Neto JRT, DeMitri I, de Souza V, del Peral L, Deligny O, Della Selva A, Delle Fratte C, Dembinski H, Di Giulio C, Diaz JC, Dobrigkeit C, D'Olivo JC, Dornic D, Dorofeev A, dos Anjos JC, Dova MT, D'Urso D, Dutan I, DuVernois MA, Engel R, Epele L, Erdmann M, Escobar CO, Etchegoyen A, Facal San Luis P, Falcke H, Farrar G, Fauth AC, Fazzini N, Ferrer F, Ferry S, Fick B, Filevich A, Filipcic A, Fleck I, Fonte R, Fracchiolla CE, Fulgione W, García B, García Gámez D, Garcia-Pinto D, Garrido X, Geenen H, Gelmini G, Gemmeke H, Ghia PL, Giller M, Glass H, Gold MS, Golup G, Gomez Albarracin F, Gómez Berisso M, Gómez Herrero R, Gonçalves P, Gonçalves do Amaral M, Gonzalez D, Gonzalez JG, González M, Góra D, Gorgi A, Gouffon P, Grassi V, Grillo AF, Grunfeld C, Guardincerri Y, Guarino F, Guedes GP, Gutiérrez J, Hague JD, Hamilton JC, Hansen P, Harari D, Harmsma S, Harton JL, Haungs A, Hauschildt T, Healy MD, Hebbeker T, Hebrero G, Heck D, Hojvat C, Holmes VC, Homola P, Hörandel J, Horneffer A, Horvat M, Hrabovský M, Huege T, Hussain M, Iarlori M, Insolia A, Ionita F, Italiano A, Kaducak M, Kampert KH, Karova T, Kégl B, Keilhauer B, Kemp E, Kieckhafer RM, Klages HO, Kleifges M, Kleinfeller J, Knapik R, Knapp J, Koang DH, Krieger A, Krömer O, Kuempel D, Kunka N, Kusenko A, La Rosa G, Lachaud C, Lago BL, Lebrun D, Lebrun P, Lee J, Leigui de Oliveira MA, Letessier-Selvon A, Leuthold M, Lhenry-Yvon I, López R, Lopez Agüera A, Lozano Bahilo J, Luna García R, Maccarone MC, Macolino C, Maldera S, Mancarella G, Manceñido ME, Mandat D, Mantsch P, Mariazzi AG, Maris IC, Marquez Falcon HR, Martello D, Martínez J, Martínez Bravo O, Mathes HJ, Matthews J, Matthews JAJ, Matthiae G, Maurizio D, Mazur PO, McCauley T, McEwen M, McNeil RR, Medina MC, Medina-Tanco G, Meli A, Melo D, Menichetti E, Menschikov A, Meurer C, Meyhandan R, Micheletti MI, Miele G, Miller W, Mollerach S, Monasor M, Monnier Ragaigne D, Montanet F, Morales B, Morello C, Moreno JC, Morris C, Mostafá M, Muller MA, Mussa R, Navarra G, Navarro JL, Navas S, Necesal P, Nellen L, Newman-Holmes C, Newton D, Nguyen Thi T, Nierstenhoefer N, Nitz D, Nosek D, Nozka L, Oehlschläger J, Ohnuki T, Olinto A, Olmos-Gilbaja VM, Ortiz M, Ortolani F, Ostapchenko S, Otero L, Pacheco N, Pakk Selmi-Dei D, Palatka M, Pallotta J, Parente G, Parizot E, Parlati S, Pastor S, Patel M, Paul T, Pavlidou V, Payet K, Pech M, Pekala J, Pelayo R, Pepe IM, Perrone L, Petrera S, Petrinca P, Petrov Y, Pham Ngoc D, Pham Ngoc D, Pham Thi TN, Pichel A, Piegaia R, Pierog T, Pimenta M, Pinto T, Pirronello V, Pisanti O, Platino M, Pochon J, Privitera P, Prouza M, Quel EJ, Rautenberg J, Redondo A, Reucroft S, Revenu B, Rezende FAS, Ridky J, Riggi S, Risse M, Rivière C, Rizi V, Roberts M, Robledo C, Rodriguez G, Rodríguez Frías D, Rodriguez Martino J, Rodriguez Rojo J, Rodriguez-Cabo I, Ros G, Rosado J, Roth M, Rouillé-d'Orfeuil B, Roulet E, Rovero AC, Salamida F, Salazar H, Salina G, Sánchez F, Santander M, Santo CE, Santos EM, Sarazin F, Sarkar S, Sato R, Scherini V, Schieler H, Schmidt A, Schmidt F, Schmidt T, Scholten O, Schovánek P, Schüssler F, Sciutto SJ, Scuderi M, Segreto A, Semikoz D, Settimo M, Shellard RC, Sidelnik I, Siffert BB, Sigl G, Smetniansky De Grande N, Smiałkowski A, Smída R, Smith AGK, Smith BE, Snow GR, Sokolsky P, Sommers P, Sorokin J, Spinka H, Squartini R, Strazzeri E, Stutz A, Suarez F, Suomijärvi T, Supanitsky AD, Sutherland MS, Swain J, Szadkowski Z, Takahashi J, Tamashiro A, Tamburro A, Taşcău O, Tcaciuc R, Thomas D, Ticona R, Tiffenberg J, Timmermans C, Tkaczyk W, Todero Peixoto CJ, Tomé B, Tonachini A, Torres I, Torresi D, Travnicek P, Tripathi A, Tristram G, Tscherniakhovski D, Tueros M, Tunnicliffe V, Ulrich R, Unger M, Urban M, Valdés Galicia JF, Valiño I, Valore L, van den Berg AM, van Elewyck V, Vázquez RA, Veberic D, Veiga A, Velarde A, Venters T, Verzi V, Videla M, Villaseñor L, Vorobiov S, Voyvodic L, Wahlberg H, Wainberg O, Walker P, Warner D, Watson AA, Westerhoff S, Wieczorek G, Wiencke L, Wilczyńska B, Wilczyński H, Wileman C, Winnick MG, Wu H, Wundheiler B, Yamamoto T, Younk P, Zas E, Zavrtanik D, Zavrtanik M, Zech A, Zepeda A, Ziolkowski M. Upper limit on the diffuse flux of ultrahigh energy tau neutrinos from the Pierre Auger Observatory. Phys Rev Lett 2008; 100:211101. [PMID: 18518595 DOI: 10.1103/physrevlett.100.211101] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2007] [Indexed: 05/26/2023]
Abstract
The surface detector array of the Pierre Auger Observatory is sensitive to Earth-skimming tau neutrinos that interact in Earth's crust. Tau leptons from nu(tau) charged-current interactions can emerge and decay in the atmosphere to produce a nearly horizontal shower with a significant electromagnetic component. The data collected between 1 January 2004 and 31 August 2007 are used to place an upper limit on the diffuse flux of nu(tau) at EeV energies. Assuming an E(nu)(-2) differential energy spectrum the limit set at 90% C.L. is E(nu)(2)dN(nu)(tau)/dE(nu)<1.3 x 10(-7) GeV cm(-2) s(-1) sr(-1) in the energy range 2 x 10(17) eV< E(nu)< 2 x 10(19) eV.
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Affiliation(s)
- J Abraham
- Centro de Investigaciones en Laseres y Aplicaciones, CITEFA and CONICET, Argentina
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Abraham J, Abreu P, Aglietta M, Aguirre C, Allard D, Allekotte I, Allen J, Allison P, Alvarez C, Alvarez-Muñiz J, Ambrosio M, Anchordoqui L, Andringa S, Anzalone A, Aramo C, Argirò S, Arisaka K, Armengaud E, Arneodo F, Arqueros F, Asch T, Asorey H, Assis P, Atulugama BS, Aublin J, Ave M, Avila G, Bäcker T, Badagnani D, Barbosa AF, Barnhill D, Barroso SLC, Bauleo P, Beatty J, Beau T, Becker BR, Becker KH, Bellido JA, BenZvi S, Berat C, Bergmann T, Bernardini P, Bertou X, Biermann PL, Billoir P, Blanch-Bigas O, Blanco F, Blasi P, Bleve C, Blümer H, Boháčová M, Bonifazi C, Bonino R, Boratav M, Brack J, Brogueira P, Brown WC, Buchholz P, Bueno A, Busca NG, Caballero-Mora KS, Cai B, Camin DV, Caruso R, Carvalho W, Castellina A, Catalano O, Cataldi G, Cazón-Boado L, Cester R, Chauvin J, Chiavassa A, Chinellato JA, Chou A, Chye J, Clark PDJ, Clay RW, Colombo E, Conceição R, Connolly B, Contreras F, Coppens J, Cordier A, Cotti U, Coutu S, Covault CE, Creusot A, Cronin J, Dagoret-Campagne S, Daumiller K, Dawson BR, de Almeida RM, De Donato C, de Jong SJ, De La Vega G, de Mello Junior WJM, de Mello Neto JRT, De Mitri I, de Souza V, del Peral L, Deligny O, Selva AD, Fratte CD, Dembinski H, Di Giulio C, Diaz JC, Dobrigkeit C, D'Olivo JC, Dornic D, Dorofeev A, Anjos JCD, Dova MT, D'Urso D, DuVernois MA, Engel R, Epele L, Erdmann M, Escobar CO, Etchegoyen A, Luis PFS, Falcke H, Farrar G, Fauth AC, Fazzini N, Fernández A, Ferrer F, Ferry S, Fick B, Filevich A, Filipčič A, Fleck I, Fonte R, Fracchiolla CE, Fulgione W, García B, García Gámez D, Garcia-Pinto D, Garrido X, Geenen H, Gelmini G, Gemmeke H, Ghia PL, Giller M, Glass H, Gold MS, Golup G, Albarracin FG, Berisso MG, Herrero RG, Gonçalves P, do Amaral MG, Gonzalez D, Gonzalez JG, González M, Góra D, Gorgi A, Gouffon P, Grassi V, Grillo A, Grunfeld C, Guardincerri Y, Guarino F, Guedes GP, Gutiérrez J, Hague JD, Hamilton JC, Hansen P, Harari D, Harmsma S, Harton JL, Haungs A, Hauschildt T, Healy MD, Hebbeker T, Heck D, Hojvat C, Holmes VC, Homola P, Hörandel J, Horneffer A, Horvat M, Hrabovský M, Huege T, Iarlori M, Insolia A, Ionita F, Italiano A, Kaducak M, Kampert KH, Keilhauer B, Kemp E, Kieckhafer RM, Klages HO, Kleifges M, Kleinfeller J, Knapik R, Knapp J, Koang DH, Kopmann A, Krieger A, Krömer O, Kümpel D, Kunka N, Kusenko A, La Rosa G, Lachaud C, Lago BL, Lebrun D, LeBrun P, Lee J, de Oliveira MAL, Letessier-Selvon A, Leuthold M, Lhenry-Yvon I, López R, Lopez Agüera A, Bahilo JL, Maccarone MC, Macolino C, Maldera S, Malek M, Mancarella G, Manceñido ME, Mandat D, Mantsch P, Mariazzi AG, Maris IC, Martello D, Martínez J, Bravo OM, Mathes HJ, Matthews J, Matthews JAJ, Matthiae G, Maurizio D, Mazur PO, McCauley T, McEwen M, McNeil RR, Medina MC, Medina-Tanco G, Meli A, Melo D, Menichetti E, Menschikov A, Meurer C, Meyhandan R, Micheletti MI, Miele G, Miller W, Mollerach S, Monasor M, Ragaigne DM, Montanet F, Morales B, Morello C, Moreno E, Moreno JC, Morris C, Mostafá M, Muller MA, Mussa R, Navarra G, Navarro JL, Navas S, Nellen L, Newman-Holmes C, Newton D, Thi TN, Nierstenhöfer N, Nitz D, Nosek D, Nožka L, Oehlschläger J, Ohnuki T, Olinto A, Olmos-Gilbaja VM, Ortiz M, Ostapchenko S, Otero L, Selmi-Dei DP, Palatka M, Pallotta J, Parente G, Parizot E, Parlati S, Pastor S, Patel M, Paul T, Pavlidou V, Payet K, Pech M, Pȩkala J, Pelayo R, Pepe IM, Perrone L, Petrera S, Petrinca P, Petrov Y, Ngoc D, Ngoc D, Thi TNP, Pichel A, Piegaia R, Pierog T, Pimenta M, Pinto T, Pirronello V, Pisanti O, Platino M, Pochon J, Porter TA, Privitera P, Prouza M, Quel EJ, Rautenberg J, Reucroft S, Revenu B, Rezende FAS, Řídký J, Riggi S, Risse M, Rivière C, Rizi V, Roberts M, Robledo C, Rodriguez G, Frías DR, Martino JR, Rojo JR, Rodriguez-Cabo I, Ros G, Rosado J, Roth M, Rouillé-d'Orfeuil B, Roulet E, Rovero AC, Salamida F, Salazar H, Salina G, Sánchez F, Santander M, Santo CE, Santos EM, Sarazin F, Sarkar S, Sato R, Scherini V, Schieler H, Schmidt F, Schmidt T, Scholten O, Schovánek P, Schüssler F, Sciutto SJ, Scuderi M, Segreto A, Semikoz D, Settimo M, Shellard RC, Sidelnik I, Siffert BB, Sigl G, De Grande NS, Smiałkowski A, šmída R, Smith AGK, Smith BE, Snow GR, Sokolsky P, Sommers P, Sorokin J, Spinka H, Squartini R, Strazzeri E, Stutz A, Suarez F, Suomijärvi T, Supanitsky AD, Sutherland MS, Swain J, Szadkowski Z, Takahashi J, Tamashiro A, Tamburro A, Taşcău O, Tcaciuc R, Thomas D, Ticona R, Tiffenberg J, Timmermans C, Tkaczyk W, Peixoto CJT, Tomé B, Tonachini A, Torresi D, Travnicek P, Tripathi A, Tristram G, Tscherniakhovski D, Tueros M, Tunnicliffe V, Ulrich R, Unger M, Urban M, Galicia JFV, Valiño I, Valore L, van den Berg AM, van Elewyck V, Vázquez RA, Veberič D, Veiga A, Velarde A, Venters T, Verzi V, Videla M, Villaseñor L, Vorobiov S, Voyvodic L, Wahlberg H, Wainberg O, Waldenmaier T, Walker P, Warner D, Watson AA, Westerhoff S, Wieczorek G, Wiencke L, Wilczyńska B, Wilczyński H, Wileman C, Winnick MG, Wu H, Wundheiler B, Xu J, Yamamoto T, Younk P, Zas E, Zavrtanik D, Zavrtanik M, Zech A, Zepeda A, Ziolkowski M. Correlation of the Highest-Energy Cosmic Rays with Nearby Extragalactic Objects. Science 2007; 318:938-43. [DOI: 10.1126/science.1151124] [Citation(s) in RCA: 560] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Allard D, Froidevaux R, Biver P. Conditional Simulation of Multi-Type Non Stationary Markov Object Models Respecting Specified Proportions. ACTA ACUST UNITED AC 2007. [DOI: 10.1007/s11004-006-9057-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Allard D. La préparation des enfants (et de leurs parents) aux examens radiologiques. Arch Pediatr 2006; 13:810. [PMID: 16690280 DOI: 10.1016/j.arcped.2006.03.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- D Allard
- Service de radiologie Mère-Enfant, hôpital Nord, CHU de Saint-Etienne, France
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Ferigo N, Cottalorda J, Allard D, Gentil-Perret A, Fessy M, Berger C, Stéphan JL. Successful treatment via chemotherapy and surgical resection of a femoral hemangiopericytoma with pulmonary metastasis. J Pediatr Hematol Oncol 2006; 28:237-40. [PMID: 16679922 DOI: 10.1097/01.mph.0000212903.61276.4b] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hemangiopericytoma (HPC) is a soft-tissue neoplasm composed of proliferating capillary pericytes. It has variable and unpredictable malignancy and most commonly occurs in the fifth or sixth decade of life. Diagnosis is based on the histological aspect. HPC is exceedingly rare in childhood. In both adults and children, curative surgery is the most important predictor of survival. The place of chemotherapy in the treatment of HPC is not well established. We describe a case of adult-type metastatic HPC of the thigh in a 13-year-old boy. The response to neoadjuvant chemotherapy was excellent, and local control of this initially unresectable tumor was achieved without radiation therapy or mutilating surgery. The child is alive and well and has had 8 years of follow-up after treatment.
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Affiliation(s)
- N Ferigo
- Pediatric Hematology and Oncology Unit, Hôpital Nord, University of Saint Etienne, Saint Etienne 42055, France
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Allard D, Ito F, Gobin B, Tsuji K, Billen J. Differentiation of the reproductive tract between dominant and subordinate workers in the Japanese queenless ant Diacamma sp. ACTA ZOOL-STOCKHOLM 2005. [DOI: 10.1111/j.1463-6395.2005.00197.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Allard D, Burch VC. The cost of treating serious abdominal firearm-related injuries in South Africa. S Afr Med J 2005; 95:591-4. [PMID: 16201002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
INTRODUCTION Firearms, the leading external cause of non-natural deaths in South Africa, claim approximately 15,000 lives annually. Up to 127,000 firearm-injured victims seek state health care assistance per annum. The fiscal burden of treating these injuries is not known. METHODS All serious abdominal firearm-related injuries (requiring admission to hospital and emergency surgery) presenting to a state hospital over a 6-month period were reviewed. A cost analysis using five variables was performed: operating theatre time, duration of hospital and high-care unit stay, pharmaceutical and blood products used, laboratory services used and diagnostic imaging studies performed. RESULTS Twenty-three patients with serious abdominal gunshot injuries were admitted, of whom 21 (91%) were treated at the hospital from admission until discharge. Each admission cost approximately US dollars 1,467. Hospital stay (47%) and operating theatre (30%) costs accounted for most of the total cost. Pharmaceuticals and blood products (20%), laboratory services (2%) and imaging studies (1%) contributed less than 25% to the total cost. CONCLUSION Serious abdominal gunshot injuries cost at least 13-fold more than the annual per capita South African government expenditure on health. This fiscal burden of approximately US dollars 2.9 million, almost 4% of the annual health budget, does not include the cost of treating other serious gunshot injuries. These findings highlight the need for successful violence prevention strategies in South African.
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Affiliation(s)
- D Allard
- Department of Surgery, G F Jooste Hospital, Cape Town.
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Abifadel M, Jambart S, Allard D, Rabès JP, Varret M, Derré A, Chouery E, Salem N, Junien C, Aydénian H, Boileau C. Identification of the first Lebanese mutation in the LPL gene and description of a rapid detection method. Clin Genet 2004; 65:158-61. [PMID: 14984478 DOI: 10.1111/j.0009-9163.2004.00205.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Allard D, Allard S, Brehmer M, Conrad L, Zentel R, Stromberg C, Schultze J. Micro- and nanostructuring of oligo- and polythiophenes in two and three dimensions. Electrochim Acta 2003. [DOI: 10.1016/s0013-4686(03)00343-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Affiliation(s)
- J Cottalorda
- Service de chirurgie infantile, hôpital Nord, 42055 Saint-Etienne, France.
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Depras A, Chabrier S, Allard D, Gérard C, Lauras B. [Radiological case of the month. Acquired idiopathic Brown's syndrome in a 10-year-old boy]. Arch Pediatr 2002; 9:737-8. [PMID: 12162163 DOI: 10.1016/s0929-693x(01)00976-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- A Depras
- Service de pédiatrie et génétique, CHU de Saint-Etienne, hôpital Nord, 42055 Saint-Etienne, France
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Billiemaz K, Lavocat MP, Teyssier G, Chavrier Y, Allard D, Varlet F. [Varicella complicated with necrotizing fasciitis caused by group A hemolytic Streptococcus]. Arch Pediatr 2002; 9:262-5. [PMID: 11938537 DOI: 10.1016/s0929-693x(01)00762-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED Chickenpox has a high risk of invasive group A streptococcal disease and necroziting fasciitis. CASE REPORT A five-year-old girl, during chickenpox treated with ibuprofen, developed sepsis and edematous and necrotic lesions of the pelvis and the abdominal wall. The child improved with surgical treatment and adjunction of clindamycin to the antibiotic therapy. CONCLUSION We review the optimal medical and surgical treatment of necrotizing fasciitis and discuss the role of chickenpox and non steroidal antiinflammatory agents in this disease.
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Affiliation(s)
- K Billiemaz
- Service de réanimation pédiatrique et néonatologie, hôpital Nord, 42055 Saint-Etienne, France
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Abstract
UNLABELLED Chronic recurrent multifocal osteitis (OCRM) is a rare condition in children, of unknown aetiology, which may be misdiagnosed as osteomyelitis, arthritis or tumour. PATIENTS AND METHODS We present a retrospective multicentric study of 17 patients (five boys and 12 girls) with an average follow-up of 7.5 years (six months-25 years). RESULTS A spectrum of presenting features is possible, ranging from bone lesions alone to lesions combined with arthritis, palmoplantar pustulosis or psoriasis. The diagnosis was delayed from two weeks to five years. Roentgenographic evaluation was often normal at the beginning of the disease or showed nonspecific bone reactions. Radioisotope bone scans assisted in establishing the diagnosis and in identifying lesions that were initially clinically silent. Bone biopsies were performed in seven cases. Histopathological examination showed only mild inflammatory nonspecific changes. Microbiological cultures were always negative. Treatments were different according to the evolution of the disease and the hospital. There was no response to antibiotics in seven patients. The response to nonsteroidal anti-inflammatory agents and steroids was moderate and often transient. Salazopyrine and pamidronate treatment used in two patients allowed a durable remission. We lost sight of four patients, pain persisted in three in spite of treatment, it disappeared in two with treatment, mild pain persisted in five without treatment and remission occurred in three without treatment. CONCLUSION This study clarifies the clinical and radiologic features of chronic recurrent multifocal osteomyelitis. The recognition of this rare entity is often delayed and difficulties in patient management sometimes emerge from its usual protracted course.
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Affiliation(s)
- E Coinde
- Service de pédiatrie, hôpital Edouard-Herriot, Lyon, France
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Abstract
Dependencies between two types of points in a spatial point process can be due either to a real dependence between the two types or to the dependence on common underlying variables. We propose a global test for dependence between two point processes that is valid for a wide range of models. In contrast with previously proposed methods, it is based on a number of local test statistics, which makes it possible to map the local association between the two processes. The behavior of the test is evaluated by a simulation study. It is then applied to a vegetation pattern data set from Burkina Faso.
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Affiliation(s)
- D Allard
- Institut National de la Recherche Agronomique, Unité de Biométrie, Domaine Saint-Paul, Avignon, France.
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Abstract
Associations between two spatial processes can be due to a real dependence between the two processes or to the dependence on common underlying variables. We propose to test the existence of a real dependence by use of local tests, leading to a global test of real dependence and a map of local interactions. We present first how classical interaction tests based on random rotations between completely observed processes such as those developed by Berman (Berman. Appl. Statist. (1986) 35, 54-62), can be integrated in local analyses. For this purpose, tests are first performed locally, and the distribution of their p-values is then compared to the corresponding value under the null hypothesis. A similar approach is proposed to test non-stationarity of a point pattern by using distance statistics popularized by Diggle (Diggle. Statistical Analysis of Spatial Point Patterns. (1983) Academic Press, New York). The problem of testing the interaction between a random field and a censoring area pattern process is discussed and an approach similar to the preceding ones is then proposed. The methods are mainly applied to agricultural examples but they can be applied to any microscopical images for which one wishes to analyse the spatial structure.
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Affiliation(s)
- J Chadoeuf
- Biometrie, INRA, Domaine St Paul, 84914 Avignon Cedex 9, France; Department of Mathematics and Statistics, Lancaster University, U.K. ; CSIRO Land and Water, Butler Laboratory, GPO Box 1666, Canberra ACT 2601, Australia
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Cottalorda J, Stéphan JL, Bourelle S, Allard D, Chavrier Y. [Radiologic case of the month. Myositis ossificans]. Arch Pediatr 2000; 7:763-5. [PMID: 10941494 DOI: 10.1016/s0929-693x(00)80159-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- J Cottalorda
- Service de chirurgie infantile, CHU de Saint-Etienne, France
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Cottalorda J, Stephan JL, Berger C, Kohler R, Dutour N, Allard D, Chavrier Y. [Surgical management of malignant bone tumors in the child. Saint-Etienne Hospital experience, apropos of 17 cases]. Ann Chir 1998; 52:45-51. [PMID: 9752408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
From 1980 to 1997, seventeen children were treated for malignant bone tumors in the Department of Paediatric Surgery of the Saint-Etienne Hospital, with an average follow-up of 6 years and 3 months (2M-17Y). The histologic diagnoses were osteosarcomas (12 cases) and Ewing's sarcomas (5 cases). All children were treated surgically. For the 12 lower limb tumors, the techniques used were prosthetic replacement in 7 cases (associated with bone allograft in 3 cases), amputation in 3 cases and isolated bone allograft in 2 cases. The two ilium tumors were treated by resection and reconstruction with autologous bone graft. A single resection was performed for the shoulder-blade Ewing's tumors and a prosthesis for the 2 proximal humerus tumors. Six children died during follow-up. The authors stress that carcinologic resection is a priority before functional results. They insist on the mechanical failures of implants and on the difficulties of reoperations.
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Affiliation(s)
- J Cottalorda
- Service de Chirurgie Infantile, Hôpital Nord, CHU de Saint-Etienne
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Lavocat MP, Granjon D, Guimpied Y, Dutour N, Allard D, Prevôt N, Dubois F. The importance of 99Tcm-DMSA renal scintigraphy in the follow-up of acute pyelonephritis in children: comparison with urographic data. Nucl Med Commun 1998; 19:703-10. [PMID: 9853352 DOI: 10.1097/00006231-199807000-00013] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
At present, 99Tcm-dimercaptosuccinic acid (DMSA) renal scintigraphy is the most sensitive examination for the detection of parenchymal damage during acute pyelonephritis (APN) in children. This prospective study had three aims: (1) to evaluate the medium-term evolution of the scintigraphic abnormalities, to find a prognostic criterion of scintigraphic evolution; (2) to assess the correlation between the severity of early or late scintigraphic damage and selected clinical factors; and (3) to compare the permanent scintigraphic renal scars with intravenous urography (IVU) 2 years after the acute infection. Seventy-four children (mean age 32 months), presenting with a first clinical episode of pyelonephritis and an initial scintigraphic abnormality, were included in the study. Patients with a history of urinary tract infection (UTI), uropathy other than vesico-ureteral reflux (VUR) and a relapse of acute pyelonephritis were excluded. All children underwent control scintigraphy (mean 9 months after APN) and 43 had an IVU (mean 26 months after APN). Fifty-seven children (77%) still have scintigraphic abnormalities of varying severity (7 atrophic kidneys). Initial relative DMSA uptake of less than 45% results in a worse scintigraphic prognosis. The age of the child has no bearing on the severity of the initial renal involvement or on the evolution of the scintigraphic abnormalities. The rapid introduction of antibiotics (< 12 h) significantly improves the scintigraphic prognosis (P < 0.01). The presence of reflux (n = 39) leads to more serious initial damage, but we did not find any effect on later evolution in this study, in which all reflux was low grade in nature. Among the 43 children who had an IVU, 5 showed typical urographic and scintigraphic renal scars in the corresponding region and 38 showed a normal IVU with 28 cases of scintigraphic abnormalities. A DMSA scan is more sensitive than IVU for the detection of renal scarring after a first episode of APN.
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Affiliation(s)
- M P Lavocat
- Department of Paediatrics, CHU Saint Etienne, Hôpital Nord, Saint Etienne, France
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Baulieux R, Dutour N, Taimi A, Allard D. [Sturge-Weber syndrome]. J Radiol 1997; 78:231-3. [PMID: 9113152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- R Baulieux
- Unité de Radiologie Mère-Enfant, Service de Radiologie, Hôpital Nord CHU, de Saint-Etienne
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Abstract
OBJECTIVE Accurate diagnosis of pyelonephritis using clinical and laboratory parameters is often difficult, especially in children. The main aims of this prospective study were to compare the value of different imaging techniques [renal sonography, cortical scintigraphy with technetium-99m dimercaptosuccinic acid (99mTc DMSA) and computed tomography (CT)] in detecting renal involvement in acute urinary tract infections and to determine the sensitivity of DMSA scans for permanent renal scars 6 months later. MATERIALS AND METHODS Between February 1992 and January 1993, 55 children admitted to our pediatric unit with febrile symptomatic urinary tract infections were eligible for analysis. Ultrasonography (US), DMSA scanning and micturating cystourethrography were performed in every case. Only 18 children underwent CT. A second DMSA scan was performed in 48 children a mean of 7.5 months after the first. RESULTS US abnormalities were found in 25 children (45 %). The first DMSA scan showed a parenchymal aspect suggestive of pyelonephritis in 51 patients (93 %). Among the 18 patients studied by CT, 14 had abnormalities. Normal US findings did not rule out renal parenchymal involvement. Scintigraphy appeared to be more sensitive than CT for renal involvement. The frequency and degree of initial renal parenchymal damage seemed to correlate with vesicoureteral reflux, but the most severe initial parenchymal defects were not associated with marked clinical or laboratory manifestations. Repeat DMSA scans, performed on 45 kidneys with abnormalities at the first examination, showed resolution in 19, improvement in 16, persistence in 8 and deterioration in 2. The prevalence of vesicoureteral reflux was not higher in patients with renal scarring on the second DMSA scan than in patients whose scans showed an improvement. CONCLUSION DMSA scans should be considered as a reference in the detection and follow-up of renal scarring associated with acute urinary tract infection as this technique is more sensitive than US and CT, the latter being unsuitable because it entails radiation exposure and sedation of patients.
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Affiliation(s)
- M P Lavocat
- Department of Pediatrics, CHU de Saint Etienne, Hôpital Nord, F-42055 Saint Etienne Cedex, France
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Abstract
We report a case of salmonella spondylitis in an adolescent without sickle cell disease or any history of salmonella gastroenteritis. The infecting organism (cultured from material aspirated from the bone lesion) was Salmonella enterica serovar Newport. With nonoperative treatment, evolution was favorable.
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Affiliation(s)
- J Cottalorda
- Department of Pediatric Surgery, Hôpital Nord, Saint-Etienne, France
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Cottalorda J, Benallègue S, Allard D, Dutour N, Chavrier Y. [Radiological case of the month. Subacute osteomyelitis of the ankle]. Arch Pediatr 1996; 3:1276-7. [PMID: 9033796 DOI: 10.1016/s0929-693x(97)85942-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- J Cottalorda
- Service de chirurgie infantile, hôpital Nord, Saint-Etienne, France
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Galarneau L, Paré JF, Allard D, Hamel D, Levesque L, Tugwood JD, Green S, Bélanger L. The alpha1-fetoprotein locus is activated by a nuclear receptor of the Drosophila FTZ-F1 family. Mol Cell Biol 1996; 16:3853-65. [PMID: 8668203 PMCID: PMC231382 DOI: 10.1128/mcb.16.7.3853] [Citation(s) in RCA: 190] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The alpha1-fetoprotein (AFP) gene is located between the albumin and alpha-albumin genes and is activated by transcription factor FTF (fetoprotein transcription factor), presumed to transduce early developmental signals to the albumin gene cluster. We have identified FTF as an orphan nuclear receptor of the Drosophila FTZ-F1 family. FTF recognizes the DNA sequence 5'-TCAAGGTCA-3', the canonical recognition motif for FTZ-F1 receptors. cDNA sequence homologies indicate that rat FTF is the ortholog of mouse LRH-1 and Xenopus xFF1rA. Rodent FTF is encoded by a single-copy gene, related to the gene encoding steroidogenic factor 1 (SF-1). The 5.2-kb FTF transcript is translated from several in-frame initiator codons into FTF isoforms (54 to 64 kDa) which appear to bind DNA as monomers, with no need for a specific ligand, similar KdS (approximately equal 3 x 10(-10) M), and similar transcriptional effects. FTF activates the AFP promoter without the use of an amino-terminal activation domain; carboxy-terminus-truncated FTF exerts strong dominant negative effects. In the AFP promoter, FTF recruits an accessory trans-activator which imparts glucocorticoid reactivity upon the AFP gene. FTF binding sites are found in the promoters of other liver-expressed genes, some encoding liver transcription factors; FTF, liver alpha1-antitrypsin promoter factor LFB2, and HNF-3beta promoter factor UF2-H3beta are probably the same factor. FTF is also abundantly expressed in the pancreas and may exert differentiation functions in endodermal sublineages, similar to SF-1 in steroidogenic tissues. HepG2 hepatoma cells seem to express a mutated form of FTF.
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Affiliation(s)
- L Galarneau
- Le Centre de Recherche en Cancérologie de 1' Université Laval, L' Hôtel-Dieu de Québec, Canada
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Affiliation(s)
- J Cottalorda
- Department of Orthopaedic Pediatric Surgery, Saint-Etienne University School of Medicine, France
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Abstract
We report the case of a patient with occipital condyle fracture who was neurologically intact. The patient was treated conservatively with a neck collar, and the symptoms resolved in 3 months. This diagnosis can be suspected in high-velocity road traffic accidents, in a patient with neck pain, disproportionate torticollis, or lower cranial nerve symptoms. Skull radiography and cervical spine films can be normal. The diagnosis is best made by high-resolution computed tomographic (CT) scanning with sagittal and coronal reconstruction.
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Affiliation(s)
- J Cottalorda
- Service de Chirurgie Infantile, Hôpital Nord, Saint-Etienne, France
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Damon G, Allard D, Blanchon Y, Revol M. Épilepsie partielle avec calcifications occipitales bilatérales d'évolution favorable avec suspicion de maladie cœliaque. Arch Pediatr 1995. [DOI: 10.1016/0929-693x(95)90459-g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lavocat MP, Allard D, Dutour N, Gerbay A, Trombert B. Échographic rénale systématique à la naissance: résultats préliminaires d'une étude prospective réalisée à la maternité du CHU de Saint-Étienne. Arch Pediatr 1995. [DOI: 10.1016/0929-693x(95)90257-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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