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To determine the effectiveness of endoscopic cricopharyngeal myotomy on upper oesophageal sphincter dysfunction in adults with upper oesophageal sphincter dysfunction and neurological disease. Published and unpublished studies with a quasi-experimental design investigating endoscopic cricopharyngeal myotomy effects on upper oesophageal sphincter dysfunction in humans were considered eligible. Electronic databases, grey literature and reference lists of included studies were systematically searched. Data were extracted by two independent reviewers. Methodological quality was assessed independently using the PEDro scale and MINORS tool. Of 2938 records identified, 2 studies were eligible. Risk of bias assessment indicated areas of methodological concern in the literature. Statistical analysis was not possible because of the limited number of eligible studies. No determinations could be made regarding endoscopic cricopharyngeal myotomy effectiveness in the cohort of interest. Reliable and valid evidence on the following is required to support increasing clinical usage of endoscopic cricopharyngeal myotomy: optimal candidacy selection; standardised post-operative management protocol; complications; and endoscopic cricopharyngeal myotomy effects on aspiration of food and laryngeal penetration, mean upper oesophageal sphincter resting pressure and quality of life.

From 2009 to 2014, we prospectively enrolled 132 children with perianal infections. The presentation of painful defecation, anal fissures, and macroscopic blood in stools was highly suggestive of group A streptococcal perianal infection (probability 83.3%). We found a high sensitivity of a group A streptococcal rapid diagnostic testing (98%) but relatively low specificity (72.8%).

Chromospheric plages are distributed between mid-latitude and the Equator and never close to the Poles. Therefore, we suspect that the inclination angle of the solar rotation axis has an impact on the observable chromospheric emission. We reproduce the solar images from any inclination in order to study the effect of the inclination axis on the solar variability by using direct observations of the Sun in the Ca II K line. More than 2700 days of observations since the beginning of the Ca II K observations with USET, in July 2012, were used in our analysis. For each observation day, we produce synoptic maps to map the entire solar surface during a full solar rotation. Then by choosing a given inclination, we generate solar-disk views, representing the segmented brightest structures of the chromosphere (plages and enhanced network), as seen under this inclination. The area fraction are extracted from the masks for each inclination and we compare the evolution of those time series to quantify the impact of the inclination angle. We find a variation of the area fraction between an Equator-on view and a Pole-on view. Our results show an important impact of the viewing angle on the detection of modulation due to the solar rotation. With the dense temporal sampling of USET data, the solar rotation is detectable up to an inclination of about \\(|i| = 70^\\) and the solar-cycle modulation is clearly detected for all inclinations, though with a reduced amplitude in polar views. When applying a sparse temporal sampling typical for time series of solar-like stars, the rotational modulation is no longer detected, whatever the inclination. On the other hand, we find that the activity-cycle modulation remains detectable as long as the sampling contains at least 20 observations per year and the cycle amplitude reaches at least 30\\% of the solar-cycle amplitude.

Full disk observations of the solar chromosphere in the Ca II K line represent a valuable dataset for studies of solar magnetic activity. The S-index is widely used to investigate the magnetic activity of stars, however, its connection to the coverage of stellar magnetic structure is still poorly understood. We use the archives of full disk Ca II K images taken by the Royal Observatory of Belgium with the USET to derive the area fraction of the brightest chromospheric structures over the last decade. These data allowed us to study the end of the solar cycle 24 and the beginning of solar cycle 25. The brightest regions of the solar surface were then segmented using an algorithm based on an intensity threshold. We computed the area fraction over the solar disk and compared it with the S-index from TIGRE. For the detection of periodic modulations, we applied a discrete Fourier power spectrum method to both datasets. A tight linear relationship was found between the USET area fraction and the TIGRE S-index, with an improved correlation obtained in the low-activity regime by considering the enhanced network. In both time series, we detected the modulation caused by the rotation of bright structures on the solar disk. However, this detection is constrained in the case of TIGRE due to its observation strategy. We studied the correlation between the disk coverage with chromospheric structures and the variability of the S-index on an overlapping period of ten years. We concluded that the disk coverage index is a good proxy for the S-index and will be useful in future studies of the magnetic activity of solar-type stars. The USET area fraction dataset is most appropriate for evaluating the solar rotation period and will be used in future works to analyze the impact of the inclination of the stellar rotation axis on the detectability of such periodic modulations in solar-type stars.

SC599 vaccine is a live Shigella dysenteriae 1 strain attenuated by deletion of invasion [ icsA], iron chelation [ ent, fep] and shiga toxin A subunit [ stxA] genes. In a preliminary Phase 1 single dose prospective study, we showed that SC599 vaccine was well tolerated, and the maximum tolerable dose was greater than 10 8 CFU [Sadorge C, Ndiaye A, Beveridge N, Frazer S, Giemza R, Jolly N, et al. Phase 1 clinical trial of live attenuated Shigella dysenteriae type-1 Δ icsA Δ ent Δ fep Δ stxA:HgR oral vaccine SC599 in healthy human adult volunteers. Vaccine 2008; 26(7):978–8]. In this Phase 2 trial, three groups of volunteers ingested a single dose of SC599 [10 5 CFU, n = 38; 10 7 CFU, n = 36] or placebo [ n = 37]. Both 10 5 and 10 7 CFU doses were immunogenic, inducing significant IgA and IgG LPS-specific ASCs and antibody responses, comparable in magnitude to those of other strains that prevented illness following experimental challenge. In the intention to treat analysis, 34.2% and 44.4% IgA ASC responders were detected in the 10 5 and 10 7 CFU groups respectively ( p < 0001 vs placebo for both groups), as well as 31.6% and 33.3% serum IgA responders ( p < 001 and p < 0.001 vs placebo for 10 5 and 10 7 CFU groups, respectively). No difference between the two vaccine groups was observed. No stxB-specific antibody response was detected in the vaccines. SC599 excretion occurred in 23.7 and 30.6% of subjects in the 10 5 and 10 7 CFU groups, respectively. SC599 vaccine was well tolerated, and the reported adverse events were mainly digestive. These results indicate that a single oral immunization of SC599 vaccine elicits a significant circulating IgA ASC and serum antibody response that may confer protection against the most severe symptoms of Shigellosis in responders to the vaccine.

Background Systematic retinopathy (ROP) screening using dilated eye examination is currently performed in the neonatal intensive care unit (NICU). In France atropine 0.3% eye drops are currently used as a mydriatic agent, but no systematic assessments of clinical tolerance and efficacy have been described in the literature. Purpose To assess the occurrence of clinical changes in infants at different time periods preceding and following atropine drops and eye examination, as well as the mydriatic efficacy of atropine in this context. Materials and Methods Prospective pilot study, in one NICU (June–September 2012). Atropine 0.3% eye drops (one per eye) were instilled in accordance with French good practise guidelines. Data collection was performed at 3 consecutive periods (P1: H-24 to H0 pre-atropine, P2: H0 to H24 post-atropine, and P3: H24 to H48 post-atropine), and included: abdominal distension, number of episodes of regurgitation or vomiting, necrotizing enterocolitis (NEC), somnolence, number of episodes of severe oxygen desaturation (<70%), bradycardia (<100 bpm) and tachycardia (>180 bpm). Assessment of efficacy was based on possibility for screening or not. McNemar’s Exact Test and Wilcoxon-signed rank Test were used for the binary and continuous variables respectively. Significance was set at p < 0.05. Results 18 children were screened (median gestational age at birth 27.2 weeks (IQR: 25.6–28.7), median corrected age 33.3 weeks (IQR: 32.3–34.3)). None of the variables showed a statistically significant difference between P1 and P3. Occurrence of abdominal distension (P = 0.03), number of tachycardia (P = 0.05) and oxygen desaturation events (P = 0.03) were more frequent in P2 than in P1. No differences were found in thte occurrence of other variables between P1 and P2. No NEC was diagnosed. Effective pupillary dilatation was obtained in 78% of cases. Conclusions Our study suggests that atropine is an efficient mydriatic agent for ROP screening dilated eye exam in preterm neonates. Type and timing of the symptoms in our study suggest systemic muscarinic effects of atropine. A reduction in the concentration of the atropine eye drops could improve tolerance. No conflict of interest.

[...]stimulation of one area of cortex (premotor) can affect processing in an adjacent, connected area of cortex, suggesting that the actions of rTMS can spread away from the site of stimulation and change the way data are processed within functional circuits of the cortex. [...]recent functional neuroimaging data will be presented which examines the neural correlates of visual self recognition Results: The data will show a rather weak contribution of cognitive impairment to awareness of illness in schizophrenia.

We have performed a search for muon neutrinos from dark matter annihilation in the center of the Sun with the 79-string configuration of the IceCube neutrino telescope. For the first time, the DeepCore sub-array is included in the analysis, lowering the energy threshold and extending the search to the austral summer. The 317 days of data collected between June 2010 and May 2011 are consistent with the expected background from atmospheric muons and neutrinos. Upper limits are therefore set on the dark matter annihilation rate, with conversions to limits on spin-dependent and spin-independent WIMP-proton cross-sections for WIMP masses in the range 20 - 5000 GeV. These are the most stringent spin-dependent WIMP-proton cross-sections limits to date above 35 GeV.

We report on a measurement of the cosmic ray energy spectrum with the IceTop air shower array, thesurface component of the IceCube Neutrino Observatory at the South Pole. The data used in this analysiswere taken between June and October, 2007, with 26 surface stations operational at that time, corresponding to about one third of the final array. The fiducial area used in this analysis was 0.122 square kilometers.The analysis investigated the energy spectrum from 1 to 100 PeV measured for three different zenithangle ranges between 0 and 46. Because of the isotropy of cosmic rays in this energy range the spectrafrom all zenith angle intervals have to agree. The cosmic-ray energy spectrum was determined under differentassumptions on the primary mass composition. Good agreement of spectra in the three zenithangle ranges was found for the assumption of pure proton and a simple two-component model. Forzenith angles theta less than 30 deg., where the mass dependence is smallest, the knee in the cosmic ray energy spectrumwas observed at about 4 PeV, with a spectral index above the knee of about -3.1. Moreover, an indicationof a flattening of the spectrum above 22 PeV was observed.

We present the results of a first search for self-annihilating dark matter in nearby galaxies and galaxy clusters using a sample of high-energy neutrinos acquired in 339.8 days of live time during 2009/10 with the IceCube neutrino observatory in its 59-string configuration. The targets of interest include the Virgo and Coma galaxy clusters, the Andromeda galaxy, and several dwarf galaxies. We obtain upper limits on the cross section as a function of the weakly interacting massive particle mass between 300 GeV and 100 TeV for the annihilation into b bbar, W+W-, +-, +-, and bar. A limit derived for the Virgo cluster, when assuming a large effect from subhalos, challenges the weak interacting massive particle interpretation of a recently observed GeV positron excess in cosmic rays.