Alkali to alkaline earth metals: a DFT study of monolayer TiSi2N4 for metal ion batteries

A significant problem in the area of rechargeable alkali ion battery technologies is the exploration of anode materials with overall high specific capacities and superior physical properties. By using first-principles calculations, we have determined that monolayer TiSi2N4 is precisely such a potential anode candidate. Its demonstrated dynamic, thermal, mechanical, and energetic stabilities make it feasible for experimental realization. An important benefit of the electrode conductivity is that the electronic structure reveals that the pristine system experiences a change from a semiconductor to a metal throughout the entire alkali adsorption process. What's more interesting is that monolayer TiSi2N4 can support up to double-sided 3-layer ad-atoms, resulting in extremely high theoretical capacities for Li, Na, Mg, and K of 1004, 854, 492 and 531 mA h g-1 and low average open-circuit voltages of 0.55, 0.25, 0.55, and -1.3 V, respectively. Alkali diffusion on the surface has been demonstrated to occur extremely quickly, with migration energy barriers for Li, Na, Mg, and K as low as 0.25, 0.14, 0.10, and 0.07 eV, respectively. The results reveal that the migration barrier energy is the lowest for Li and Mg from path-2 and Na and K from path-1. Overall, these findings suggest that monolayer TiSi2N4 is a suitable anode candidate for use in high-performance and low-cost metal-ion batteries.

Use of Radiomics to Predict Treatment Response in CNS, Head, Neck and Lung Tumors

PURPOSE/OBJECTIVE(S)

The ability to predict treatment response and local tumor control in cancers treated with radiation might allow for treatment de-escalation in responsive tumors and treatment escalation in non-responsive tumors. The past decade has seen substantial developments in radiomic technology, with some investigators finding radiomic models that predict treatment response and toxicities. While it is standard of care to adapt treatment volumes in the setting of significant tumor shrinkage, it is unclear if deescalating their overall treatment might jeopardize their treatment outcomes. The purpose of this study is to investigate the radiomic features in patients receiving definitive treatment that were re-simulated for significant tumor shrinkage.

MATERIALS/METHODS

We looked for radiomic features correlating with tumor response in 12 female and 16 male patients with a median age of 64 and ECOG status between 0-2. These patients received radiation with curative intent in the CNS, head, neck, or lungs. These patients were re-simulated during the course of their treatment for significant tumor shrinkage to optimize their treatment volumes and minimize radiation dose to organs at risk. Of the 28, 1 patient had CNS cancer, 22 had head or neck cancers, and 15 had lung cancer. Pre- and post- radiation CT planning scans were assessed after the initial gross tumor volume (GTV) was shrunk by 3mm to avoid interface effects of proximal structures. Slope for a straight-line fit was computed between each potential radiomic feature and post-treatment tumor reduction (as calculated using GTV - 3mm) to identify radiomic features that correlate with treatment response. We used the criteria slope >0.5, and slope > 0.6 cut offs to determine the highly predictive radiomic features.

RESULTS

First order mean, which is a surrogate for CT density or the HU value showed a slope of 0 indicating HU as a poor predictor of treatment response. This radiomic feature was deemed stable between patients and between scans. 17 radiomic features showed a slope >0.5 and 5 features demonstrated a slope > 0.6. The 5 most promising included: original_firstorder_minimum, original_glcm_joint average, original_glcm_SumAverage, original_gldm_LargeDependenceHighGrayLevelEmphasis and original_glxzm_LargeAreaHighGrayLevelEmphasis. Of the patients within this group of predictive radiomic features, none had recurrence at the treated disease site.

CONCLUSION

Our study identified 22 radiomic features that might be used to predict treatment response in malignant tumors of the CNS, head, neck and lung. Current tools we use in the clinic, including density and HU values, showed no predictive power for tumor progression but remained stable between patients and between scans. Further research is necessary to determine if these 22 unique radiomic features can be utilized in predicting patient outcomes.

Initial Report of a Randomized Trial Comparing Conventional vs. Novel Treatment Planning Technique to Ameliorate Immunosuppression from Lung SBRT

PURPOSE/OBJECTIVE(S)

SBRT is highly effective against early-stage non-small cell lung cancer. Radiation Therapy (RT) is known to modulate the immune system and contribute to the generation of anti-tumor T cells and stimulate T cell infiltration into tumors. However, this anti-tumor activity is offset by radiation-induced immunosuppression (RIIS) which results in lower tumor control and survival. Lymphocytes are highly radiosensitive and RIIS means destroying existing as well as newly created cytotoxic and helper T lymphocytes. We hypothesized that optimizing RT treatment planning by considering circulating blood and lymphatics as a critical Organ at Risk (OAR) may mitigate RIIS.

MATERIALS/METHODS

We conducted an IRB approved NCI funded clinical trial for 50 early-stage lung cancer patients treated with SBRT alone, from 2020 to 2023, to investigate the ability to reduce RIIS by reducing dose to circulating blood and lymphatics with the aid of a predictive algorithm. All SBRT plans adhered to treatment parameters from RTOG 0813 (central) or RTOG 0915 (peripheral). Patients were randomized to two arms: experimental optimization for RIIS (to reduce dose to blood and lymphatic rich organs) versus standard SBRT planning (without optimization for RIIS). Peripheral blood samples were collected at baseline, end of Tx, 4 weeks and 6 months post Tx. Patients with baseline absolute lymphocyte counts (ALC) less than 0.5x109 cells/L were ineligible for the trial. Data acquired for all blood cell types as well as lymphocyte sub populations CD3+, CD4+, CD8+, CD19+, CD56+. Two sample t-test was used to determine the statistical significance between the cohorts at the time points.

RESULTS

The standard arm had an ALC reduction of 28% at one week post Tx and a nadir at 4 weeks with a 34% reduction. Absolute percentage reductions in ALC from baseline in the optimized arm compared to the standard arm are: end of treatment point (13%, p = 0.03), 4 weeks (12%, p = 0.08), 6 months (15%, p = 0.1), and all three time points together 13% (p = 0.001). ALC recovery appears to be faster in the optimized arm. Radiation induced suppression of all blood cell types are also reduced in the optimized arm with respect to standard arm (relative percentages): ALC (34%), WBC (47%), RBC (46%), platelets (40%), monocytes (100%), and neutrophils (62%) at 4-week mark. Average percentage reductions on integral doses, and V5 (volume receiving a 5 Gy dose) of optimized compared to standard plans are: aorta: 26%, 41% heart: 8%, 33%, vena cava: 32%, 52%, T spine: 51%, 81%, lymph nodes: 35%, 57%, total lung- ITV: 1.6%, 1%, body: 10%, 14%.

CONCLUSION

For the first time, we have shown that it is possible to reduce RIIS in a statistically significant manner, compared to standard of care, via optimized RT planning using a predictive model. This has implications in increasing the efficacy of immunotherapy by preserving the existing tumor reactive T cells in the immune system to enhance anti-tumor activity, and in reducing hospitalizations and improving survival.

Neutrino-Induced Coherent π^{+} Production in C, CH, Fe, and Pb at ⟨E_{ν}⟩∼6 GeV

MINERvA has measured the ν_{μ}-induced coherent π^{+} cross section simultaneously in hydrocarbon (CH), graphite (C), iron (Fe), and lead (Pb) targets using neutrinos from 2 to 20 GeV. The measurements exceed the predictions of the Rein-Sehgal and Berger-Sehgal PCAC based models at multi-GeV ν_{μ} energies and at produced π^{+} energies and angles, E_{π}>1  GeV and θ_{π}<10°. Measurements of the cross-section ratios of Fe and Pb relative to CH reveal the effective A scaling to increase from an approximate A^{1/3} scaling at few GeV to an A^{2/3} scaling for E_{ν}>10  GeV.

Frequency-Dependent Squeezed Vacuum Source for the Advanced Virgo Gravitational-Wave Detector

In this Letter, we present the design and performance of the frequency-dependent squeezed vacuum source that will be used for the broadband quantum noise reduction of the Advanced Virgo Plus gravitational-wave detector in the upcoming observation run. The frequency-dependent squeezed field is generated by a phase rotation of a frequency-independent squeezed state through a 285 m long, high-finesse, near-detuned optical resonator. With about 8.5 dB of generated squeezing, up to 5.6 dB of quantum noise suppression has been measured at high frequency while close to the filter cavity resonance frequency, the intracavity losses limit this value to about 2 dB. Frequency-dependent squeezing is produced with a rotation frequency stability of about 6 Hz rms, which is maintained over the long term. The achieved results fulfill the frequency dependent squeezed vacuum source requirements for Advanced Virgo Plus. With the current squeezing source, considering also the estimated squeezing degradation induced by the interferometer, we expect a reduction of the quantum shot noise and radiation pressure noise of up to 4.5 dB and 2 dB, respectively.

Simultaneous Measurement of Muon Neutrino ν_{μ} Charged-Current Single π^{+} Production in CH, C, H_{2}O, Fe, and Pb Targets in MINERvA

Neutrino-induced charged-current single π^{+} production in the Δ(1232) resonance region is of considerable interest to accelerator-based neutrino oscillation experiments. In this Letter, high statistic differential cross sections are reported for the semiexclusive reaction ν_{μ}A→μ^{-}π^{+}+ nucleon(s) on scintillator, carbon, water, iron, and lead targets recorded by MINERvA using a wideband ν_{μ} beam with ⟨E_{ν}⟩≈6  GeV. Suppression of the cross section at low Q^{2} and enhancement of low T_{π} are observed in both light and heavy nuclear targets compared with phenomenological models used in current neutrino interaction generators. The cross sections per nucleon for iron and lead compared with CH across the kinematic variables probed are 0.8 and 0.5 respectively, a scaling which is also not predicted by current generators.

Simultaneous Measurement of ν_{μ} Quasielasticlike Cross Sections on CH, C, H_{2}O, Fe, and Pb as a Function of Muon Kinematics at MINERvA

This Letter presents the first simultaneous measurement of the quasielasticlike neutrino-nucleus cross sections on C, water, Fe, Pb, and scintillator (hydrocarbon or CH) as a function of longitudinal and transverse muon momentum. The ratio of cross sections per nucleon between Pb and CH is always above unity and has a characteristic shape as a function of transverse muon momentum that evolves slowly as a function of longitudinal muon momentum. The ratio is constant versus longitudinal momentum within uncertainties above a longitudinal momentum of 4.5  GeV/c. The cross section ratios to CH for C, water, and Fe remain roughly constant with increasing longitudinal momentum, and the ratios between water or C to CH do not have any significant deviation from unity. Both the overall cross section level and the shape for Pb and Fe as a function of transverse muon momentum are not reproduced by current neutrino event generators. These measurements provide a direct test of nuclear effects in quasielasticlike interactions, which are major contributors to long-baseline neutrino oscillation data samples.

Signals transduced by Eph receptors and ephrin ligands converge on MAP kinase and AKT pathways in human cancers

Eph receptors, the largest known family of receptor tyrosine kinases, and ephrin ligands have been implicated in a variety of human cancers. The novel bidirectional signaling events initiated by binding of Eph receptors to their cognate ephrin ligands modulate many cellular processes such as proliferation, metastasis, angiogenesis, invasion, and apoptosis. The relationships between the abundance of a unique subset of Eph receptors and ephrin ligands with associated cellular processes indicate a key role of these molecules in tumorigenesis. The combinatorial expression of these molecules converges on MAP kinase and/or AKT/mTOR signaling pathways. The intracellular target proteins of the initial signal may, however, vary in some cancers. Furthermore, we have also described the commonality of up- and down-regulation of individual receptors and ligands in various cancers. The current state of research in Eph receptors illustrates MAP kinase and mTOR pathways as plausible targets for therapeutic interventions in various cancers.

Advanced microstructural substrate detection in pre-hypertrophic HCM and its relationship to arrhythmogenesis; a hybrid CMR-ECG-Imaging study

Background

Hypertrophic cardiomyopathy is defined in three domains; clinically by unexplained hypertrophy, genetically by sarcomeric gene mutations and histologically by disarray, small vessel disease and fibrosis. Both ischaemia and myocyte disarray have been implicated in arrhythmogenesis and sudden cardiac death but whether disarray occurs before hypertrophy and its relationship to ischaemia is unknown.

Diffusion-tensor CMR, perfusion mapping & ECG Imaging (ECGI) can measure disarray, ischaemia and electrical aberrance respectively in vivo. We aimed to investigate these in genotype positive (G+) subjects without hypertrophy (LVH−) to identify further subclinical manifestations of gene expression and whether these relate to ventricular arrhythmia formation.

Methods

Diffusion-tensor CMR (3-Tesla) using a motion-compensated spin-echo sequence was acquired in 3 short-axis slices. Quantitative adenosine stress perfusion mapping was performed using standard clinical protocols. A novel ECGI vest, containing 256 unipolar electrodes acquired a 5-minute recording of body-surface potentials to quantify conduction and repolarisation dynamics intervals.

Results

ECGI/CMR was performed on 68 mutation carriers from 64 families and 24 age sex and ethnicity matched healthy controls. Of the mutation carriers, median age was 33 (24–41 years), 57% (39) were female, and 79% (54) were white. Mutations were 39 (57%) MYBPC3, 19 (28%) MYH7, 1 (1%) MYL2 and 9 (12%) were thin filament/non-sarcomeric mutations. There was no significant difference in ejection fraction or LV mass, however G+LVH− had a higher maximum wall thickness (9 (9–10) vs 8 (7–9) mm p=0.003).

Compared to healthy volunteers, G+LVH− individuals had more perfusion defects (18/64 (30%) vs 0, p=0.004), lower Fractional Anisotropy (FA) (suggestive of more disarray) (0.32±0.02 vs 0.34±0.02, p&lt;0.0001) and more prolonged Activation–Recovery Intervals (ARI, a surrogate for action potential duration (259±40 vs 240±31 ms, p=0.03).

In G+LVH−, patients with perfusion defects had more prolonged ARI (263 (248 vs 292) vs 246 (225–283) ms, p=0.03) and lower FA suggestive of more disarray (0.32±0.2 vs 0.31±0.1, p=0.04).

Conclusion

Ischaemia, myocyte disarray and electrical abnormalities occur even in the absence of hypertrophy in HCM. These abnormalities associate to form a complex a clinical phenotype.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): British Heart FoundationBarts Charity

Search for Subsolar-Mass Binaries in the First Half of Advanced LIGO's and Advanced Virgo's Third Observing Run

We report on a search for compact binary coalescences where at least one binary component has a mass between 0.2  M_{⊙} and 1.0  M_{⊙} in Advanced LIGO and Advanced Virgo data collected between 1 April 2019 1500 UTC and 1 October 2019 1500 UTC. We extend our previous analyses in two main ways: we include data from the Virgo detector and we allow for more unequal mass systems, with mass ratio q≥0.1. We do not report any gravitational-wave candidates. The most significant trigger has a false alarm rate of 0.14  yr^{-1}. This implies an upper limit on the merger rate of subsolar binaries in the range [220-24200]  Gpc^{-3} yr^{-1}, depending on the chirp mass of the binary. We use this upper limit to derive astrophysical constraints on two phenomenological models that could produce subsolar-mass compact objects. One is an isotropic distribution of equal-mass primordial black holes. Using this model, we find that the fraction of dark matter in primordial black holes in the mass range 0.2  M_{⊙}<m_{PBH}<1.0  M_{⊙} is f_{PBH}≡Ω_{PBH}/Ω_{DM}≲6%. This improves existing constraints on primordial black hole abundance by a factor of ∼3. The other is a dissipative dark matter model, in which fermionic dark matter can collapse and form black holes. The upper limit on the fraction of dark matter black holes depends on the minimum mass of the black holes that can be formed: the most constraining result is obtained at M_{min}=1  M_{⊙}, where f_{DBH}≡Ω_{DBH}/Ω_{DM}≲0.003%. These are the first constraints placed on dissipative dark models by subsolar-mass analyses.

Toxicity Profiles and Protective Effects of Antifreeze Proteins From Insect in Mammalian Models

Antifreeze proteins (AFPs), found in many cold-adapted organisms, can protect them from cold and freezing damages and have thus been considered as additional protectants in current cold tissue preservation solutions that generally include electrolytes, osmotic agents, colloids and antioxidants, to reduce the loss of tissue viability associated with cold-preservation. Due to the lack of toxicity profile studies on AFPs, their inclusion in cold preservation solutions has been a trial-and-error process limiting the development of AFPs' application in cold preservation. To assess the feasibility of translating the technology of AFPs for mammalian cell cold or cryopreservation, we determined the toxicity profile of two highly active beetle AFPs, DAFP1 and TmAFP, from Dendroides canadensis and Tenebrio molitor in this study. Toxicity was examined on a panel of representative mammalian cell lines including testicular spermatogonial stem cells and Leydig cells, macrophages, and hepatocytes. Treatments with DAFP1 and TmAFP at up to 500μg/mL for 48 and 72hours were safe in three of the cell lines, except for a 20% decrease in spermatogonia treated with TmAFP. However, both AFPs at 500μg/mL or below reduced hepatocyte viability by 20 to 40% at 48 and 72h. At 1000μg/mL, DAFP1 and TmAFP reduced viability in most cell lines. While spermatogonia and Leydig cell functions were not affected by 1000μg/mL DAFP1, this treatment induced inflammatory responses in macrophages. Adding 1000μg/ml DAFP1 to rat kidneys stored at 4°C for 48hours protected the tissues from cold-related damage, based on tissue morphology and gene and protein expression of two markers of kidney function. However, DAFP1 and TmAFP did not prevent the adverse effects of cold on kidneys over 72hours. Overall, DAFP1 is less toxic at high dose than TmAFP, and has potential for use in tissue preservation at doses up to 500μg/mL. However, careful consideration must be taken due to the proinflammatory potential of DAFP1 on macrophages at higher doses and the heighten susceptibility of hepatocytes to both AFPs.

Simultaneous Measurement of Proton and Lepton Kinematics in Quasielasticlike ν_{μ}-Hydrocarbon Interactions from 2 to 20 GeV

Neutrino charged-current quasielastic-like scattering, a reaction category extensively used in neutrino oscillation measurements, probes nuclear effects that govern neutrino-nucleus interactions. This Letter reports the first measurement of the triple-differential cross section for ν_{μ} quasielastic-like reactions using the hydrocarbon medium of the MINERvA detector exposed to a wideband beam spanning 2≤E_{ν}≤20  GeV. The measurement maps the correlations among transverse and longitudinal muon momenta and summed proton kinetic energies, and compares them to predictions from a state-of-art simulation. Discrepancies are observed that likely reflect shortfalls with modeling of pion and nucleon intranuclear scattering and/or spectator nucleon ejection from struck nuclei. The separate determination of leptonic and hadronic variables can inform experimental approaches to neutrino-energy estimation.

Thermally controlled optical resonator for vacuum squeezed states separation

Future gravitational-wave detectors will use frequency-dependent squeezed vacuum states to obtain broadband reduction of quantum noise. Quantum noise is one of the major limitations to the sensitivity of these detectors. Advanced LIGO+, Advanced Virgo+, and KAGRA plan to generate frequency-dependent squeezed states by coupling a frequency-independent squeezed light state with a filter cavity. An alternative technique is under consideration, based on conditional squeezing with quantum entanglement: Einstein-Podolsky-Rosen (EPR) squeezing. In the EPR scheme, two vacuum entangled states, the signal field at ω₀ and the idler field at ω₀+Δ, must be spatially separated with an optical resonator and sent to two separate homodyne detectors. In this framework, we have designed and tested a solid Fabry-Perot etalon, to be used in an EPR table-top experiment prototype, thermally controlled without the use of a control probe optical beam. This device can also be used in optical experiments where the use of a bright beam to control an optical resonator is not possible, or where a simpler optical device is preferred.

AB1570-PARE PROFILING LOW BACK PAIN PATIENTS FOR THE DEVELOPMENT OF A PERSONALIZED COACHING APPLICATION

Background

Low back pain is a major public health problem that is increasing with the aging of the population. It is the leading cause of disability in most countries [1]. The recommendations of Inserm (2019) include personalized physical activity programs according to the individual characteristics (motivation, preferences, attitude towards physical activity) and life context of each patient (family and professional load, socioeconomic level, living place) [2]. However, the current management of chronic low back pain includes rehabilitation programs that are costly and/or not always personalized, which reduces their effectiveness.

Objectives

The objective of this research is to better understand the characteristics of people with chronic low back pain to identify main motivational profiles that will allow us to offer personalized coaching via a mobile application.

Methods

After a review of the literature and following advice from experts in the management of chronic low back pain, we selected 8 scales to characterize patients: General Health Status (MYMOP), Treatment Burden (TBQ), Quality of Life (EQ-5D-5L), Level (IPAQ), Fears and Beliefs (FABQ-AP), and Motivation (EMAPS) for physical activity, Emotional Status (PHQ-9), and Sense of Self-Efficacy (FC-CPSES). These questionnaires were administered online to participants in the ComPaRe (Community of Patients for Research) chronic low back pain cohort. An initial descriptive analysis of the results allowed us to describe our sample. In order to distinguish different motivational profiles of patients towards physical activity, we performed a Agglomerative Hierarchical Clustering (AHC) and a principal component analysis (PCA) of the results of the EMAPS, PHQ-9, FABQ-AP and FC-CPSES scales.

Results

A total of 193 patients with chronic low back pain were included (m ≃ 54years, s ≃ 13years; majority women (74%); duration of low back pain: m ≃ 15years, s ≃ 12years; occupational status: 44% employed, 22% on disability, 19% retired). Clustering analysis allowed us to distinguish 4 main profiles that we named as follows: (1) “Amotivated,” characterized by the lowest motivation and highest amotivation toward physical activity (i.e. they do not understand why it is useful), (2) “Cautious” with low motivation and having the highest fears and beliefs toward physical activity, (3) “Depressed” with good intrinsic motivation but also a significant level of depressive symptoms, and (4) “Confident” also showing good intrinsic motivation and having the highest sense of self-efficacy.

Conclusion

The main novelty of this research is a new classification of 4 motivational profiles in the low back pain population determined by a clustering method. This typology is in line with the HAPA model of behavior change [3]. It will allow us to make recommendations for the design of a personalized mobile coaching application. Future work will aim to test and evaluate the personalization of e-coaching according to these profiles.

References

[1]Hurwitz, E.L., Randhawa, K., Yu, H. et al. Initiative mondiale de soins de la colonne vertébrale: un résumé du fardeau mondial des études sur les douleurs lombaires et cervicales. Eur Spine J 27, 796–801 (2018). https://doi.org/10.1007/s00586-017-5432-9

[2]Julie Boiche, Béatrice Fervers, Damien Freyssenet, Isabelle Gremy, Thibaut Guiraud, et al. Activité physique: Prévention et traitement des maladies chroniques. [Rapport de recherche] Institut national de la santé et de la recherche médicale(INSERM). 2019, Paris: Inserm: Éditions EDP Sciences (ISSN: 0990-7440) / 824 p.〈inserm-02102457〉

[3]Schwarzer, R. (2016). Health action process approach (HAPA) as a theoretical framework to understand behavior change. Actualidades en Psicología, 30(121), 119–130. https://doi.org/10.15517/ap.v30i121.23458

Disclosure of Interests

None declared

Taux de couverture vaccinale (CV) contre la grippe, le pneumocoque et le Covid-19 en 2021 comparé à 2012 dans une population traitée par immunosuppresseurs pour un rhumatisme inflammatoire chronique (RIC)

Introduction

La vaccination contre le pneumocoque, la grippe saisonnière et récemment le Covid-19 est recommandée par les sociétés savantes chez les patients immunodéprimés.

L'objectif de l'étude est d'évaluer la CV pour ces 3 vaccins sur un échantillon de patients suivis sous immunosuppresseurs pour un RIC.

Matériels et méthodes

Etude transversale et multicentrique réalisée sur 3 sites hospitaliers entre mai et août 2021. Les données ont été recueillies sous la forme d'un questionnaire lors du suivi ambulatoire auprès de 207 patients atteints de RIC dont 127 sous biothérapie et 80 sous DMARD (Disease Modifying Anti Rheumatic Drug). Les paramètres étudiés étaient le statut vaccinal et les raisons de non vaccination. Ces données ont pu être comparée avec celles d'une étude de la même équipe en 2012 concernant 51 patients sous biothérapie.

Résultats

Avec 100 % de réponses au questionnaire, le taux de CV était de 81 % contre le pneumocoque, de 84 % contre le Covid-19 (atteignant 87,9 % en comptant les intentions de vaccination) et de 78 % contre la grippe saisonnière 2020/21, soit 3 points de plus par rapport à l'hiver 2019/20 .

Par rapport à 2012, les patients sous biothérapie en 2021 présentaient un taux de vaccination contre le pneumocoque plus faible, passant de 88 % à 82,7 %. En ce qui concerne la CV anti-grippale, le taux était meilleur en 2021, passant de 72 % à 77 %.

Les raisons de non vaccination en 2021 contre la grippe étaient représentées en pourcentage sur l'ensemble des 207 patients étudiés, par la non proposition /non indication par un médecin pour 7,2 %, la crainte des effets secondaires pour 5,3 %, le refus par manque de confiance pour 5,3 % et la non disponibilité pour 4,3 %. Les raisons de non vaccination pour le covid étaient la crainte d'un nouveau vaccin dans 9,2 %, la non disponibilité dans 3,9 % et la non proposition par un médecin dans 1,9 %. Les raisons de non vaccination grippale en 2012 étaient le refus par manque de confiance (27 % des 51 patients) ou la non prescription par le médecin.

Le fait d'avoir été vacciné contre le pneumocoque (p<0,001), la grippe en 2019/20 (p<0.001) et la covid 19 (p=0,004) sont associées à une meilleure adhésion à la vaccination contre la grippe en 2020/21. Pour la vaccination contre la covid-19, les facteurs associés à une meilleure CV sont l'âge (p<0,001), le fait d'avoir été vacciné contre la grippe en 2019/20 (p=0.0027) et en 2020/21 (p=0,004).

Conclusion

La CV contre le pneumocoque et la grippe des patients sous biothérapies dans notre étude est plus élevée que celle de l'étude de Fernandez-Prada et al. * (respectivement 75,2 % et 78,8 %). Il existe une baisse modérée de la CV contre le pneumocoque en 2021 pour nos patients, peut-être en raison du schéma de vaccination désormais à 2 doses (conjugué puis non conjugué) ? En revanche, la CV contre la grippe saisonnière s'améliore, évoquant une meilleure confiance et probablement une meilleure accessibilité et offre vaccinale (pharmacien, infirmier, ..) La meilleure adhésion concernait en aout 2021 la vaccination contre la covid19, en lien avec une meilleure information et communication auprès des personnes fragiles.

Aucun lien d'intérêt

Cross-Sectional Characteristics of Pediatric-Onset Discoid Lupus Erythematosus: Results of a Multicenter, Retrospective Cohort Study

• Discoid lupus may be associated with SLE. In this study, most children with discoid lupus did not have systemic disease. Concurrent SLE was highest in female adolescents (>10 years of age) with generalized discoid lupus, who had clinically aggressive disease. • Discoid lupus in adolescence should prompt thorough evaluation for SLE.

Cognitive dysfunction and adverse events during oral anticoagulant: a prospective cohort study

Background

Oral anticoagulants (AC), represent the leading cause of iatrogenic morbimortality in France. AC are widely prescribed among the elderly. The assessment of the cognitive dysfunction (CD) is not included within the common thrombotic and bleeding risk scores.

Purpose

The objective of this study was to examine an association between CD and adverse events (AE) in patients receiving oral AC.

Methods

A prospective monocentric cohort study was conducted in patients (≥60 years-old) on oral AC. Death, hemorrhages, falls, hospital readmission, thromboembolic events were collected over 6 months follow-up. Patients were included during an hospitalization for any medical or surgical condition and divided in three groups, according to their Mini Mental State Examination (MMSE): Group 1 (absence of CD) MMSE ≥27, Group 2 (mild CD) 24&lt;mmse&lt;26, &gt;≤MMSE≤26, Group 3 (significant CD) MMSE ≤23.

Results

Among 120 patients (mean age: 82,2±8,8 years), the all-causes mortality (n=25) was significantly higher in the Group 3 (n=17, p=0,006); this also applies to the incidence of falls (n=34, p=0,009) or major hemorrhages (n=10, p=0,023). There was no thromboembolic event. Minor hemorrhages and hospital readmissions were not different in the 3 groups. Multivariate analysis shows a significant risk of mortality (OR 4.3, (p=0,025, IC [1,20–15,42]) in group 3.

Conclusion

After 6 months of follow up, the cognitive dysfunction was associated with mortality, major hemorrhages and falls among the elderly receiving oral AC. A systematic assessment of cognitive functions of these patients seems to be essential to analyze the global risk and the risks related to the AC treatment.&lt;/mmse&lt;26,&gt;

Funding Acknowledgement

Type of funding sources: None.

Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run

We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.

Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run

We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.

Ab initio prediction of semiconductivity in a novel two-dimensional Sb2X3 (X= S, Se, Te) monolayers with orthorhombic structure

[Formula: see text] and [Formula: see text] are well-known layered bulk structures with weak van der Waals interactions. In this work we explore the atomic lattice, dynamical stability, electronic and optical properties of [Formula: see text], [Formula: see text] and [Formula: see text] monolayers using the density functional theory simulations. Molecular dynamics and phonon dispersion results show the desirable thermal and dynamical stability of studied nanosheets. On the basis of HSE06 and PBE/GGA functionals, we show that all the considered novel monolayers are semiconductors. Using the HSE06 functional the electronic bandgap of [Formula: see text], [Formula: see text] and [Formula: see text] monolayers are predicted to be 2.15, 1.35 and 1.37 eV, respectively. Optical simulations show that the first absorption coefficient peak for [Formula: see text], [Formula: see text] and [Formula: see text] monolayers along in-plane polarization is suitable for the absorption of the visible and IR range of light. Interestingly, optically anisotropic character along planar directions can be desirable for polarization-sensitive photodetectors. Furthermore, we systematically investigate the electrical transport properties with combined first-principles and Boltzmann transport theory calculations. At optimal doping concentration, we found the considerable larger power factor values of 2.69, 4.91, and 5.45 for hole-doped [Formula: see text], [Formula: see text], and [Formula: see text], respectively. This study highlights the bright prospect for the application of [Formula: see text], [Formula: see text] and [Formula: see text] nanosheets in novel electronic, optical and energy conversion systems.

Nasopharyngeal Pneumococcal Colonization Density is Associated with Severe Pneumonia in Young Children in the Lao PDR

Background

No studies have explored the association between pneumococcal nasopharyngeal density and severe pneumonia using the World Health Organization (WHO) 2013 definition. In Lao People’s Democratic Republic (Lao PDR), we determine the association between nasopharyngeal pneumococcal density and severe pneumonia in children.

Methods

A prospective observational study was undertaken at Mahosot Hospital, Vientiane, from 2014 to mid-2018. Children <5 years admitted with acute respiratory infections (ARIs) were included. Clinical and demographic data were collected alongside nasopharyngeal swabs for pneumococcal quantification by lytA real-time quantitative polymerase chain reaction. Severe pneumonia was defined using the 2013 WHO definition. For pneumococcal carriers, a logistic regression model examined the association between pneumococcal density and severe pneumonia, after adjusting for potential confounders including demographic and household factors, 13-valent pneumococcal conjugate vaccine status, respiratory syncytial virus co-detection, and preadmission antibiotics.

Results

Of 1268 participants with ARI, 32.3% (n = 410) had severe pneumonia and 36.9% (n = 468) had pneumococcal carriage. For pneumococcal carriers, pneumococcal density was positively associated with severe pneumonia (adjusted odds ratio, 1.4 [95% confidence interval, 1.1–1.8]; P = .020).

Conclusions

Among children with ARIs and pneumococcal carriage, pneumococcal carriage density was positively associated with severe pneumonia in Lao PDR. Further studies may determine if pneumococcal density is a useful marker for pneumococcal conjugate vaccine impact on childhood pneumonia.

Automated source of squeezed vacuum states driven by finite state machine based software

In the last few decades, much effort has been made for the production of squeezed vacuum states in order to reduce quantum noise in the audio-frequency band. This technique has been implemented in all running gravitational-wave interferometric detectors and helped to improve their sensitivity. While the detectors are acquiring data for astrophysical observations, they must be kept in the operating condition, also called "science mode," that is, a state that requires the highest possible duty-cycle for all the instrumental parts and controls. We report the development of a highly automated setup for the generation of optical squeezed states, where all the required control loops are supervised by a software based on finite state machines; we took special care to grant ease of use, stability of operation, and possibility of auto-recovery. Moreover, the setup has been designed to be compatible with the existing software and hardware infrastructure of the Virgo detector. In this paper, we discuss the optical properties of this squeezing setup, the locking techniques, and the automation algorithms.

First-principles study of the electronic structures and optical and photocatalytic performances of van der Waals heterostructures of SiS, P and SiC monolayers

Designing van der Waals (vdW) heterostructures of two-dimensional materials is an efficient way to realize amazing properties as well as open up opportunities for applications in solar energy conversion, nanoelectronic and optoelectronic devices. The electronic structures and optical and photocatalytic properties of SiS, P and SiC van der Waals (vdW) heterostructures are investigated by (hybrid) first-principles calculations. Both binding energy and thermal stability spectra calculations confirm the stability of these heterostructures. Similar to the corresponding parent monolayers, SiS–P (SiS–SiC) vdW heterostructures are found to be indirect type-II bandgap semiconductors. Furthermore, absorption spectra are calculated to understand the optical behavior of these systems, where the lowest energy transitions lie in the visible region. The valence and conduction band edges straddle the standard redox potentials of SiS, P and SiC vdW heterostructures, making them promising candidates for water splitting in acidic solution.

The electronic structures and optical and photocatalytic properties of SiS, P and SiC van der Waals (vdW) heterostructures are investigated by (hybrid) first-principles calculations.

Changes in plant growth, Cd partitioning and xylem sap composition in two sunflower cultivars exposed to low Cd concentrations in hydroponics

This study characterizes sunflower response to the levels of Cd encountered in moderately Cd-polluted soils. Two sunflower cultivars differing in their ability to sequestrate Cd in roots were exposed to low concentrations of Cd (0.5 nM or 100 nM) in hydroponics and sampled after 18 days (258 degree-days) when ten leaves were fully expanded. Plant growth, Cd uptake and partitioning among organs were monitored along with the ionomic (ICP-MS) and the metabolic (¹H-NMR) composition of the xylem sap. Sunflower tolerance to Cd differed between the two cultivars. The cultivar with the highest ability to sequestrate Cd in roots (Kapllan) was more tolerant to Cd than the one with the lowest ability (ES RICA). The 23% penalization of plant growth observed at 100 nM in cultivar ES RICA was associated with reduced xylem loading fluxes of soluble sugars, perhaps pointing to disruption of carbohydrate metabolism. Retention of Cd in the stem was higher at 100 nM than at 0.5 nM in the Cd-sensitive cultivar ES RICA, which can be seen as a sunflower strategy to restrict the amount of Cd delivered to the leaves under Cd stress. No direct connection was found between the speciation of Cd in the xylem sap and the Cd translocation efficiency, although significant changes in the free ionic fraction of Cd were observed between the two cultivars at 0.5 nM. The relevance of these results in promoting the use of sunflower in phytomanagement of Cd-polluted soils is discussed.

Incidence, clinical impact and treatment outcomes of valve thrombosis after transcatheter mitral valve implantation

Background

Transcatheter mitral valve implantation (TMVI) is a new treatment option for high-risk surgical patients with degenerated bioprosthesis (ViV), failed annuloplasty rings (ViR) and severe mitral annular calcification (ViMAC). However, limited data exist on transcatheter heart valve thrombosis.

Purpose

The aim of this study was to report the incidence, clinical impact and treatment outcomes of transcatheter heart valve (THV) thrombosis in patients undergoing TMVI.

Methods

All consecutive patients undergoing TMVI in our center between July 2010 and September 2019 were included. A transoesophageal echocardiography and a computed tomography (CT) were performed before hospital discharge and at each clinical visit, at 3 months, at 1 year and yearly after. THV thrombosis was defined as the presence of at least one thickened leaflet with restricted motion suggestive of thrombus confirmed by TOE and/or contrast CT. All patients received anticoagulation therapy with vitamin K antagonists (VKA) and a low dose of aspirin for the first 3 months.

Results

A total of 132 patients underwent TMVI (62 ViV, 36 ViR and 34 ViMAC). Among them, 16 (12.1%) patients had a THV thrombosis. Median age was 67 years old and 56.2% of patients were women. Median time to diagnosis of THV thrombosis was 78 days. Early THV thrombosis was observed in 7 (43.7%) and in 13 (81.2%) patients THV thrombosis occurred within the first 6 months after the procedure. 8 out 9 patients with subacute or late THV thrombosis were not anticoagulated or with subtherapeutic anticoagulation. No stroke or thromboembolic events occurred in these patients. No change in mitral gradient was observed in 14 out 16 patients. VKA were indicated in all patients. THV thrombosis resolved in all but one patient.

Conclusion

THV thrombosis is frequent after TMVI, occurs mainly within the first 6-months after the procedure, are mostly subclinical and resolves after optimization of anticoagulation treatment. An anticoagulation therapy for at least 6 months may be necessary.

Timing of THV thrombosis

Funding Acknowledgement

Type of funding source: None

Impact of mitral annular calcification associated mitral stenosis on clinical outcomes in patients undergoing transcatheter aortic valve implantation

Introduction

Mitral annular calcification (MAC) is a common finding in patient undergoing transaortic valve implantation (TAVI) and can cause significant mitral stenosis (MS).

Purpose

To assess the impact of MAC associated with significant MS (MAC-MS) on clinical outcomes following TAVR.

Methods

Consecutive patients undergoing TAVI in our institution between January 2008 and May 2018, were evaluated. All echocardiogram exams before intervention were analysed to identify the presence of MAC and MAC was confirmed on computed tomography (CT) scans. Patients were included in the MAC group if there was any calcification on the mitral annulus on CT scan. Severe MAC was considered as calcification of the mitral annulus involving over 50% of the circumference. Patients with a mitral mechanical valve or bioprosthesis and without CT scan available to confirm MAC were excluded (n=62). MAC-MS was defined as the association of MAC and a mean transmitral gradient over 5 mmHg.

Results

Among 1177 consecutive finally included patients, 504 (42.8%) had MAC and 85 had a MAC-MS (7.2%, 16.9% among the MAC population). Compared to MAC without MS (MAC non-MS group) and non-MAC patients, patients with MAC-MS were more frequently women (p&lt;0.0001), had a greater BMI (p=0.002), more previous pacemaker implantation (p=0.035), smaller indexed aortic valve area and left ventricular end systolic diameter (p=0.019 and p=0.038). At 30-days after TAVR, there were no differences in stroke, major vascular complication and pacemaker implantation between groups. However, MAC-MS patients had higher rates of tamponade [Odd Ratio adjusted 3.12, 95% confidence interval (CI) 1.08–9.07, p=0.036] and mortality [Adjusted hazard Ratio (HRa) 2.83, 95% CI 1.39–5.76, p&lt;0.005] after adjustment on baseline characteristics. At 1 year, patients with MAC-MS had a higher risk of death [19 (22.1%) vs. 142 (13%); HRa 1.83, 95% CI 1.14–3.03, p=0.01] compared to MAC non-MS and non-MAC patients. Severe MAC was not a predictor of 1 year mortality.

Conclusions

Mitral stenosis due to mitral annular calcification is infrequent in patient undergoing TAVI but is associated with higher early and mid-term mortality.

Funding Acknowledgement

Type of funding source: None