Disentangling the roles of functional domains in the aggregation and adsorption of the multimodular sea star adhesive protein Sfp1

peer reviewe

On the nanomechanical and viscoelastic properties of coatings made of recombinant sea star adhesive proteins

peer reviewe

Self-assembly of a barnacle cement protein into intertwined amyloid fibres and determination of their adhesive and viscoelastic properties.

peer reviewedThe stalked barnacle Pollicipes pollicipes uses a multi-protein cement to adhere to highly varied substrates in marine environments. We investigated the morphology and adhesiveness of a component 19 kDa protein in barnacle cement gland- and seawater-like conditions, using transmission electron microscopy and state-of-the art scanning probe techniques. The protein formed amyloid fibres after 5 days in gland-like but not seawater conditions. After 7-11 days, the fibres self-assembled under gland-like conditions into large intertwined fibrils of up to 10 µm in length and 200 nm in height, with a distinctive twisting of fibrils evident after 11 days. Atomic force microscopy (AFM)-nanodynamic mechanical analysis of the protein in wet conditions determined E' (elasticity), E'' (viscosity) and tan δ values of 2.8 MPa, 1.2 MPa and 0.37, respectively, indicating that the protein is a soft and viscoelastic material, while the adhesiveness of the unassembled protein and assembled fibres, measured using peak force quantitative nanomechanical mapping, was comparable to that of the commercial adhesive Cell-Tak™. The study provides a comprehensive insight into the nanomechanical and viscoelastic properties of the barnacle cement protein and its self-assembled fibres under native-like conditions and may have application in the design of amyloid fibril-based biomaterials or bioadhesives

Neurological manifestations of COVID-19 in adults and children

Different neurological manifestations of coronavirus disease 2019 (COVID-19) in adults and children and their impact have not been well characterized. We aimed to determine the prevalence of neurological manifestations and in-hospital complications among hospitalized COVID-19 patients and ascertain differences between adults and children. We conducted a prospective multicentre observational study using the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) cohort across 1507 sites worldwide from 30 January 2020 to 25 May 2021. Analyses of neurological manifestations and neurological complications considered unadjusted prevalence estimates for predefined patient subgroups, and adjusted estimates as a function of patient age and time of hospitalization using generalized linear models. Overall, 161 239 patients (158 267 adults; 2972 children) hospitalized with COVID-19 and assessed for neurological manifestations and complications were included. In adults and children, the most frequent neurological manifestations at admission were fatigue (adults: 37.4%; children: 20.4%), altered consciousness (20.9%; 6.8%), myalgia (16.9%; 7.6%), dysgeusia (7.4%; 1.9%), anosmia (6.0%; 2.2%) and seizure (1.1%; 5.2%). In adults, the most frequent in-hospital neurological complications were stroke (1.5%), seizure (1%) and CNS infection (0.2%). Each occurred more frequently in intensive care unit (ICU) than in non-ICU patients. In children, seizure was the only neurological complication to occur more frequently in ICU versus non-ICU (7.1% versus 2.3%, P < 0.001). Stroke prevalence increased with increasing age, while CNS infection and seizure steadily decreased with age. There was a dramatic decrease in stroke over time during the pandemic. Hypertension, chronic neurological disease and the use of extracorporeal membrane oxygenation were associated with increased risk of stroke. Altered consciousness was associated with CNS infection, seizure and stroke. All in-hospital neurological complications were associated with increased odds of death. The likelihood of death rose with increasing age, especially after 25 years of age. In conclusion, adults and children have different neurological manifestations and in-hospital complications associated with COVID-19. Stroke risk increased with increasing age, while CNS infection and seizure risk decreased with age

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Efficacité et apports de la voix chantée dans la prise en soins de la dysphonie dans le cadre de la maladie de Parkinson

Today, few studies focus on dysphonia in Parkinson's disease. Often compare with dysarthria and with decrease of intelligibility, it is, however, a full disorder, frequent and impacting the patients’s everyday life. Singing voice is also a tool increasingly used as a therapeutic tool, which benefits are reported in the literature, both physiologically and psychologically. This study seeks to evaluate the effectiveness of speech therapy in singing voice on dysphonia in Parkinson' s disease. The aims are to compare an intervention by singing with a traditional intervention and this through a subjective and objective analysis. In order to, a 15-week intervention has been proposed to two patients with moderate-stage Parkinson's disease.The results suggest that both types of intervention brought benefits to patients. Their vocal handicap has decreased and their vocals acoustics parameters have improved. In general, we can say that early treatment of parkinsonian dysphonia is beneficial to patients. Nevertheless, these results cannot be generalized due to the limited patient sample and the diversity of their vocal profile.Peu d’études s’intéressent aujourd’hui à la dysphonie dans le cadre de la maladie de Parkinson. Souvent assimilée à la dysarthrie ainsi qu’à la diminution de l’intelligibilité, c’est pourtant un trouble à part entière, fréquent et impactant la vie quotidienne des patients. La voix chantée, est par ailleurs un outil de plus en plus utilisé comme outil thérapeutique et dont les bénéfices sont relatés dans la littérature , tant au niveau physiologique que psychique. Cette étude cherche donc à évaluer l’efficacité d’une intervention orthophonique en voix chantée sur la dysphonie dans le cadre de la maladie de Parkinson. Les objectifs sont de comparer une intervention par le chant à une intervention classique et ce grâce à une analyse subjective et objective. Pour cela une intervention de 15 semaines a été menée auprès de deux patients atteints de la maladie de Parkinson à un stade modéré. Les résultats suggèrent que les deux types d’intervention ont apporté des bénéfices aux patients. Leur handicap vocal a diminué et leurs paramètres acoustiques vocaux se sont améliorés. De manière générale, nous pouvons dire que la prise en soins précoce de la dysphonie parkinsonienne est bénéfique aux patients. Néanmoins ces résultats ne sont pas généralisables en raison de l’échantillon restreint de patient et de la diversité de leur profil vocal

Understanding the environmental impact of generative AI services

International audienceGenerative AI (Gen-AI) represents a new stage in digital transformation through its many applications. Unfortunately, by accelerating the growth of digital technology, Gen-AI is contributing to the multiple environmental damages caused by its sector. The question of the sustainability of IT must include this new technology and its applications, by estimating its environmental impact. We propose various ways of improving the measurement of Gen-AI's environmental impact. Whether using life-cycle analysis methods or direct measurement experiments, we illustrate our methods by studying Stable Diffusion a Gen-AI image generation available as a service. By calculating the environmental costs of this Gen-AI service from end to end, we broaden our view of the impact of these technologies. We show that Gen-AI, as a service, generates an impact through the use of numerous user terminals and networks. We also show that decarbonizing the sources of electricity for these services will not be enough to solve the problem of their sustainability, due to their consumption of energy and rare metals. This consumption will inevitably raise the question of feasibility in a world of finite resources. We therefore propose our methodology as a means of measuring the impact of Gen-AI in advance. Our approach differentiates the embodied and operational impacts of Gen-AI in order to consider the sustainability of models and equipment. Such solution will provide valuable data for discussing the sustainability or otherwise of Gen-AI solutions in a more transparent and comprehensive way

EVALUATION DE L'ECOUTE MUSICALE AU COURS DE L'ANALGESIE PERIDURALE OBSTETRICALE (RESULTATS PRELIMINAIRES D'UNE ETUDE PROSPECTIVE RANDOMISEE)

GRENOBLE1-BU Médecine pharm. (385162101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF