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The Spectacle of humanitarianism? Press and news reporting of suffering during the two sieges of Paris (1870-1871)
No full textLa littérature scientifique, depuis les travaux de Boltanski et Chouliaraki, attribue au spectacle de la souffrance une des origines problématiques de l’humanitaire moderne . Pour les sociologues la souffrance, en contraste avec la douleur, n’existerait que sous sa forme narrative . Paul Ricoeur définit ainsi le concept : « Le terme souffrance [renvoie] à des affects ouverts sur la réflexivité, le langage, le rapport à soi, le rapport à autrui, le rapport au sens, au questionnement ». Du fait de sa mise en récit social la souffrance est un objet partagé et l’humanitaire en ferait le fondement de son action. Cet article part donc de ces prémisses pour en explorer les facettes en 1870-1871, analyser les médiateurs de ces affects et la manière dont la presse en particulier chercha à donner du sens à la souffrance et aux réponses humanitaires durant les deux sièges. Il s’agira de noter la distinction profonde entre les actes humanitaires durant la guerre nationale et la guerre civile
NUC-1031/cisplatin vs gemcitabine/cisplatin in untreated locally advanced/metastatic biliary tract cancer (NuTide:121)
No full textGemcitabine/cisplatin (GemCis) is standard of care for first-line treatment of patients with advanced biliary tract cancer (aBTC); new treatments are needed. NUC-1031 is designed to overcome key cancer resistance mechanisms associated with gemcitabine. The tolerability/efficacy signal of NUC-1031/cisplatin in the phase Ib ABC-08 study suggested this combination may represent a more efficacious therapy than GemCis for patients with aBTC, leading to initiation of the global NuTide:121 study which will include 828 patients ≥18 years with untreated histologically/cytologically-confirmed aBTC (including cholangiocarcinoma, gallbladder, or ampullary cancer); randomised (1:1) to NUC‑1031 (725mg/m2)/cisplatin (25mg/m2) or gemcitabine (1000mg/m2)/cisplatin (25mg/m2), on days 1/8, Q21-days. Primary objectives are OS and ORR. Secondary objectives: PFS, safety, pharmacokinetics, patient‑reported quality of life, and correlative studies
Novel energy efficient process for acetic acid production by methanol carbonylation
No full textAcetic acid is an essential chemical product. The need for ‘green’ acetic acid has spurred new research in developing more sustainable processes. This paper presents an original conceptual design of a low-energy and low-emissions sustainable process for acetic acid manufacturing by methanol carbonylation. The emphasis is set on energy efficiency, since the exothermic reaction releases a large amount of energy that may be more effectively used. Two processes are investigated by rigorous simulation, based on homo- and heterogeneous catalysis. The latter reveals as innovative feature the full valorisation of the energy released in the reaction section, along with reducing the separation sequence to only two distillation columns. The first dewatering column is driven by low-pressure steam generated by the reactor cooling. The second purification column uses heat pumping, in which the energy rejected in condenser is upgraded for reboiler heating by vapor compression (VC), using water as working fluid. The electricity for the vapor compression is ensured by applying an Organic Rankine Cycle (ORC) for waste heat recovery by the reactor cooling. In this way, the new green process needs very little energy (below 1 MJ/kg product). This eco-efficient process shows also superior sustainability metrics (e.g. low emissions of 40 gCO2e/kg) as compared to the homogeneous catalyst process
Refractory very early-onset inflammatory bowel disease associated with Cytosolic Isoleucyl-tRNA synthetase deficiency: A case report
No full textBACKGROUND Aminoacyl tRNA synthetases / ligases (ARSs) are highly conserved enzymes involved in attaching amino acids to tRNA promoting protein synthesis. Although deficiencies of ARSs localized to the mitochondria classically present with neuropathology, the clinical features of cytosolic ARS deficiencies are more variable. They have previously been associated with neonatal hepatitis, but never with early-onset inflammatory bowel disease. CASE SUMMARY A nine-year-old Bangladeshi boy presented with neonatal liver failure and deranged clotting, transaminitis and cholestasis. His parents were first cousins. Two older brothers and a sister were well. The patient suffered from loose stools from early infancy which became more troublesome and persistent from five years old with ten bloody motions a day. Repeated endoscopies showed persistent pancolitis, which was refractory to mesalazine, corticosteroids, azathioprine, sirolimus and anti-TNF (adalimumab) therapy, but has improved recently with subcutaneous methotrexate. Whole Genome Sequencing revealed a novel pathogenic missense variant (c.290A>G) in the cytosolic IARS gene, leading to an amino acid substitution (p.Asp97Gly). Pathogenic variants in other genes associated with IBD (ADAM17, EGFR, FOXP3, IL10RA, IL10RB, IL21R, NCF4, STAT3) were excluded. Cytokine assays demonstrated markedly elevated IL-2, IL-5, IL-13, IL-9 and IL-10 by the patient’s CD4+ T-cells, while IL-17A, IL-17F, IFN were lower, and TNF not significantly different when compared to healthy controls. CONCLUSION This case report provides evidence that recessive mutations in cytosolic IARS are a novel monogenic cause of IBD, which should be considered, particularly in infants and children with a history of neonatal hepatitis and very early-onset IBD poorly responsive to treatment
Applying a combination of Laboratory X-Ray Diffraction and Digital Image Correlation for Recording Uniaxial Stress-Strain Curves in Thin Surface Layers
No full textBy combining laboratory-based x-ray diffraction stress analysis with optical digital image correlation recorded in-situ during tensile loading a new methodology has been developed to obtain for surface specific stress-strain curves. This novel methodology has been validated by comparing the reconstructed stress-strain curves from the x-ray diffraction/optical digital image correlation approach with stress-strain curves recorded using standard methods. The validated methodology enables now the recording of standard mechanical test data of altered surface layers, such as shot peened and machined surfaces or from proton-irradiated samples where the irradiated layer is limited to a depth of 10s of microns
The predictive value of signs and symptoms in predicting adverse maternal and perinatal outcomes in severe preeclampsia in a low-resource setting, findings from a cross-sectional study at Mpilo Central Hospital, Bulawayo, Zimbabwe.
No full textObjectives In low resource settings symptoms and signs may be used to identify which women require intervention to mitigate the risks of severe preeclampsia. This study aimed to report the frequency of signs and symptoms in women with severe preeclampsia and to determine their predictive value for adverse maternal and perinatal outcomes. Study design A retrospective cross-sectional study of women with severe preeclampsia from 01/01/2016 to 31/12/2018 at Mpilo Central Hospital, Bulawayo, Zimbabwe. Multivariate logistic regression was used to determine whether symptoms and signs were independently associated with the co-primary outcomes. Main outcome measures The co-primary outcome measures were a composite of maternal complications including major organ dysfunction or mortality and a composite measure of severe perinatal morbidity or mortality. Results Symptoms were present in 58.8% of women with severe preeclampsia; headache and epigastric pain were most commonly reported (47.9% and 22.4% of women respectively). Most symptoms and signs were not independently predictive of adverse maternal or perinatal outcomes. Vaginal bleeding with abdominal pain reduced odds of adverse maternal outcome (Adjusted Odds Ratio (AOR) 0.16, 95% Confidence Interval (CI) 0.03, 0.84; p=0.03), systolic blood pressure of 161-180 mmHg increased odds of adverse maternal outcome (AOR 2.71, 95% CI 1.14, 6.41, p=0.03) and birthweight ≤1500g increased odds of adverse perinatal outcome (AOR 23.21, 95% CI 7.70, 69.92, p<0.001). Conclusions Maternal signs and symptoms are ineffective predictors of maternal or perinatal morbidity and mortality; as such they cannot be used alone to predict which women would benefit from intervention in severe preeclampsia
The DisEntangling Chronic Obstructive pulmonary Disease Exacerbations clinical trials NETwork: DECODE-NET. Rationale and vision
No full textMainstreaming germline BRCA1/2 testing in non-mucinous epithelial ovarian cancer in the North West of England
No full textPoly(ADP-ribose) polymerase (PARP) inhibitors improve survival in BRCA-mutant high grade serous ovarian carcinoma. As a result, germline and somatic BRCA1/2 testing have become standard practice in women diagnosed with ovarian cancer. We outline changes in testing and detection rates of germline BRCA1/2 pathogenic variants (PVs) in cases of non mucinous EOC diagnosed during three eras, spanning 12 years, within the North West of England and compare the uptake of cascade testing in families identified by oncology-led mainstreaming versus regional genetics clinics. Eras included: Period 1 (20% risk threshold for testing): between Jan/07 and May/13; Period 2 (10% risk threshold for testing): between Jun/13 and Oct/17 and; Period 3 (mainstream testing): between Nov/17 and Nov/19. A total of 1,081 women underwent germline BRCA1/2 testing between Jan/07 and Nov/19 and 222 (20.5%) were found to have a PV. The monthly testing rate increased by 3.3-fold and 2.5-fold between Periods 1 to 2 and Periods 2 to 3, respectively. A similar incidence of germline BRCA1/2 PVs were detected in Period 2 (17.2%) and Period 3 (18.5%). Uptake of cascade testing from first-degree relatives was significantly lower in those women undergoing mainstream testing compared with those tested in regional genetics clinics (31.6% versus 47.3%, P=0.038). Mainstream testing allows timely detection of germline BRCA1/2 status to select patients for PARP inhibitors, but shortfalls in the uptake of cascade testing in first73 degree relatives requires optimisation to broaden benefits within families
Evaluation and comparison of automated and manual ELISA for diagnosis of chronic pulmonary aspergillosis (CPA) in Indonesia
No full textPulmonary tuberculosis (TB) is one of the common risk factors for chronic pulmonary aspergillosis (CPA). A positive Aspergillus IgG is a key element of the diagnosis of CPA but this has not been studied in Indonesia. We conducted studies with patients at the end of TB therapy in Indonesia. We performed receiver operating curve (ROC) analysis to determine the optimum cutoff of the Aspergillus-specific IgG level (Immulite and Dynamiker ELISA) in those patients who met criteria of CPA in relation to control groups. In 203 TB patients, 26 (13%) patients had clinical and radiological features of CPA. We derived optimum cutoffs for Immulite Aspergillus-specific IgG of 11.5 mg/L and Dynamiker anti-galactomannan IgG of 106.8 AU/mL (sensitivity 89% and 83%, specificity 78% and 51%, respectively). The currently accepted Aspergillus-specific IgG cutoff of Immulite and Dynamiker assays for CPA diagnosis may require slight adjustment for the Indonesian population