BP (France)

This paper reviews the state of the art of field- programmable gate array (FPGA) design methodologies with a focus on industrial control system applications. This paper starts with an overview of FPGA technology development, followed by a presentation of design methodologies, development tools and relevant CAD environments, including the use of portable hardware description languages and system level programming/design tools. They enable a holistic functional approach with the major advantage of setting up a unique modeling and evaluation environment for complete industrial electronics systems. Three main design rules are then presented. These are algorithm refinement, modularity, and systematic search for the best compromise between the control performance and the architectural constraints. An overview of contributions and limits of FPGAs is also given, followed by a short survey of FPGA-based intelligent controllers for modern industrial systems. Finally, two complete and timely case studies are presented to illustrate the benefits of an FPGA implementation when using the proposed system modeling and design methodology. These consist of the direct torque control for induction motor drives and the control of a diesel-driven synchronous stand-alone generator with the help of fuzzy logic.

International audience

On 20 April 2010, the Deepwater Horizon explosion, which released a US government-estimated 4.9 million barrels of crude oil into the Gulf of Mexico, was responsible for the death of 11 oil workers and, possibly, for an environmental disaster unparalleled in US history. For 87 consecutive days, the Macondo well continuously released crude oil into the Gulf of Mexico. Many kilometers of shoreline in the northern Gulf of Mexico were affected, including the fragile and ecologically important wetlands of Louisiana's Mississippi River Delta ecosystem. These wetlands are responsible for a third of the nation's fish production and, ironically, help to protect an energy infrastructure that provides a third of the nation's oil and gas supply. Here, we provide a basic overview of the chemistry and biology of oil spills in coastal wetlands and an assessment of the potential and realized effects on the ecological condition of the Mississippi River Delta and its associated flora and fauna.

There are still unmet needs in finding new technologies for biomedical diagnostic and industrial applications. A technology allowing the analysis of size and sequence of short peptide molecules of only few molecular copies is still challenging. The fast, low-cost and label-free single-molecule nanopore technology could be an alternative for addressing these critical issues. Here, we demonstrate that the wild-type aerolysin nanopore enables the size-discrimination of several short uniformly charged homopeptides, mixed in solution, with a single amino acid resolution. Our system is very sensitive, allowing detecting and characterizing a few dozens of peptide impurities in a high purity commercial peptide sample, while conventional analysis techniques fail to do so.

Jabre, Patricia*; Belpomme, Vanessa†; Azoulay, Elie‡; Jacob, Line§; Bertrand, Lionel∥; Lapostolle, Frederic*; Tazarourte, Karim¶; Bouilleau, Guillem#; Pinaud, Virginie**; Broche, Claire††; Normand, Domitille*; Baubet, Thierry‡‡; Ricard-Hibon, Agnes†; Istria, Jacques§§; Beltramini, Alexandra∥∥; Alheritiere, Armelle*; Assez, Nathalie¶¶; Nace, Lionel##; Vivien, Benoit***; Turi, Laurent†††; Launay, Stephane‡‡‡; Desmaizieres, Michel*; Borron, Stephen W.§§§; Vicaut, Eric∥∥∥; Adnet, Frederic* Author Information

RATIONALE: The use of noninvasive ventilation (NIV) as an early weaning/extubation technique from mechanical ventilation remains controversial. OBJECTIVES: To investigate NIV effectiveness as an early weaning/extubation technique in difficult-to-wean patients with chronic hypercapnic respiratory failure (CHRF). METHODS: In 13 intensive care units, 208 patients with CHRF intubated for acute respiratory failure (ARF) who failed a first spontaneous breathing trial were randomly assigned to three groups: conventional invasive weaning group (n = 69), extubation followed by standard oxygen therapy (n = 70), or NIV (n = 69). NIV was permitted as rescue therapy for both non-NIV groups if postextubation ARF occurred. Primary endpoint was reintubation within 7 days after extubation. Secondary endpoints were: occurrence of postextubation ARF or death within 7 days after extubation, use of rescue postextubation NIV, weaning time, and patient outcomes. MEASUREMENTS AND MAIN RESULTS: Reintubation rates were 30, 37, and 32% for invasive weaning, oxygen-therapy, and NIV groups, respectively (P = 0.654). Weaning failure rates, including postextubation ARF, were 54, 71, and 33%, respectively (P < 0.001). Rescue NIV success rates for invasive and oxygen-therapy groups were 45 and 58%, respectively (P = 0.386). By design, intubation duration was 1.5 days longer for the invasive group than in the two others. Apart from a longer weaning time in NIV than in invasive group (2.5 vs. 1.5 d; P = 0.033), no significant outcome difference was observed between groups. CONCLUSIONS: No difference was found in the reintubation rate between the three weaning strategies. NIV decreases the intubation duration and may improve the weaning results in difficult-to-wean patients with CHRF by reducing the risk of postextubation ARF. The benefit of rescue NIV in these patients deserves confirmation.

BACKGROUND: Exophiala species are mostly responsible for skin infections. Invasive Exophiala dermatitidis disease is a rare and frequently fatal infection, with 42 cases reported. About half of these cases had no known risk factors. Similarly, invasive Exophiala spinifera disease is extremely rare, with only 3 cases reported, all in patients with no known immunodeficiency. Autosomal recessive CARD9 deficiency has recently been reported in otherwise healthy patients with severe fungal diseases caused by Candida species, dermatophytes, or Phialophora verrucosa. METHODS: We investigated an 8-year-old girl from a nonconsanguineous Angolan kindred, who was born in France and developed disseminated E. dermatitidis disease and a 26 year-old woman from an Iranian consaguineous kindred, who was living in Iran and developed disseminated E. spinifera disease. Both patients were otherwise healthy. RESULTS: We sequenced CARD9 and found both patients to be homozygous for loss-of-function mutations (R18W and E323del). The first patient had segmental uniparental disomy of chromosome 9, carrying 2 copies of the maternal CARD9 mutated allele. CONCLUSIONS: These are the first 2 patients with inherited CARD9 deficiency and invasive Exophiala disease to be described. CARD9 deficiency should thus be considered in patients with unexplained invasive Exophiala species disease, even in the absence of other infections.

We show that if a solution of the defocusing cubic NLS in 3d remains bounded in the homogeneous Sobolev norm of order <inline-formula content-type="math/mathml"> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="1 slash 2"> <mml:semantics> <mml:mrow> <mml:mn>1</mml:mn> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mo>/</mml:mo> </mml:mrow> <mml:mn>2</mml:mn> </mml:mrow> <mml:annotation encoding="application/x-tex">1/2</mml:annotation> </mml:semantics> </mml:math> </inline-formula> in its maximal interval of existence, then the interval is infinite and the solution scatters. No radial assumption is made.

AIM: To study the effect of antiseptics on bacterial biofilm formation. METHODS AND RESULTS: Biofilm formation and planktonic growth were tested in microtiter plates in the presence of antiseptics. For Escherichia coli G1473 in the presence of chlorhexidine or benzalkonium chloride, for Klebsiella pneumoniae CF504 in the presence of chlorhexidine and for Pseudomonas aeruginosa PAO1 in the presence of benzalkonium chloride, biofilm development and planktonic growth were affected at the same concentrations of antiseptics. For PAO1 in the presence of chlorhexidine and CF504 in the presence of benzalkonium chloride, planktonic growth was significantly inhibited by a fourfold lower antiseptic concentration than biofilm development. For Staphylococcus epidermidis CIP53124 in the presence of antiseptics at the minimal inhibitory concentration (MIC), a total inhibition of biofilm formation was observed. For Staph. epidermidis exposed to chlorhexidine at 1/2, 1/4 and 1/8 MIC, or to benzalkonium chloride at 1/8, 1/16 or 1/32 MIC, biofilm formation was increased from 11.4% to 22.5% without any significant effect onto planktonic growth. CONCLUSIONS: Chlorhexidine and benzalkonium chloride inhibited biofilm formation of different bacterial species but were able to induce biofilm development for the Staph. epidermidis CIP53124 strain at sub-MICs. SIGNIFICANCE AND IMPACT OF THE STUDY: Sublethal exposure to cationic antiseptics may contribute to the persistence of staphylococci through biofilm induction.

In this paper we shall show that the boundary <inline-formula content-type="math/mathml"> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="partial-differential upper I Subscript p comma q"> <mml:semantics> <mml:mrow> <mml:mi mathvariant="normal"> ∂ </mml:mi> <mml:msub> <mml:mi>I</mml:mi> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mi>p</mml:mi> <mml:mo>,</mml:mo> <mml:mi>q</mml:mi> </mml:mrow> </mml:msub> </mml:mrow> <mml:annotation encoding="application/x-tex">\partial I_{p,q}</mml:annotation> </mml:semantics> </mml:math> </inline-formula> of the hyperbolic building <inline-formula content-type="math/mathml"> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="upper I Subscript p comma q"> <mml:semantics> <mml:msub> <mml:mi>I</mml:mi> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mi>p</mml:mi> <mml:mo>,</mml:mo> <mml:mi>q</mml:mi> </mml:mrow> </mml:msub> <mml:annotation encoding="application/x-tex">I_{p,q}</mml:annotation> </mml:semantics> </mml:math> </inline-formula> considered by M. Bourdon admits Poincaré type inequalities. Then by using Heinonen-Koskela’s work, we shall prove Loewner capacity estimates for some families of curves of <inline-formula content-type="math/mathml"> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="partial-differential upper I Subscript p comma q"> <mml:semantics> <mml:mrow> <mml:mi mathvariant="normal"> ∂ </mml:mi> <mml:msub> <mml:mi>I</mml:mi> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mi>p</mml:mi> <mml:mo>,</mml:mo> <mml:mi>q</mml:mi> </mml:mrow> </mml:msub> </mml:mrow> <mml:annotation encoding="application/x-tex">\partial I_{p,q}</mml:annotation> </mml:semantics> </mml:math> </inline-formula> and the fact that every quasiconformal homeomorphism <inline-formula content-type="math/mathml"> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="f colon partial-differential upper I Subscript p comma q Baseline long right-arrow partial-differential upper I Subscript p comma q Baseline"> <mml:semantics> <mml:mrow> <mml:mi>f</mml:mi> <mml:mo>:</mml:mo> <mml:mi mathvariant="normal"> ∂ </mml:mi> <mml:msub> <mml:mi>I</mml:mi> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mi>p</mml:mi> <mml:mo>,</mml:mo> <mml:mi>q</mml:mi> </mml:mrow> </mml:msub> <mml:mo stretchy="false"> ⟶ </mml:mo> <mml:mi mathvariant="normal"> ∂ </mml:mi> <mml:msub> <mml:mi>I</mml:mi> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mi>p</mml:mi> <mml:mo>,</mml:mo> <mml:mi>q</mml:mi> </mml:mrow> </mml:msub> </mml:mrow> <mml:annotation encoding="application/x-tex">f : \partial I_{p,q} \longrightarrow \partial I_{p,q}</mml:annotation> </mml:semantics> </mml:math> </inline-formula> is quasisymmetric. Therefore by these results, the answer to questions 19 and 20 of Heinonen and Semmes ( <italic>Thirty-three YES or NO questions about mappings, measures and metrics</italic> , Conform Geom. Dyn. 1 (1997), 1–12) is NO.

International audience

BACKGROUND: Mortality of ST-segment-elevation myocardial infarction (STEMI) decreased drastically, mainly through reduction in inhospital mortality. Prehospital sudden cardiac arrest (SCA) became one of the most feared complications. We assessed the incidence, outcome, and prognosis' predictors of prehospital SCA occurring after emergency medical services (EMS) arrival. METHODS AND RESULTS: Data were taken between 2006 and 2014 from the e-MUST study (Evaluation en Médecine d'Urgence des Strategies Thérapeutiques des infarctus du myocarde) that enrolls all STEMI managed by EMS in the Greater Paris Area, including those dead before hospital admission. Among 13 253 STEMI patients analyzed, 749 (5.6%) presented EMS-witnessed prehospital SCA. Younger age, absence of cardiovascular risk factors, symptoms of heart failure, extensive STEMI, and short pain onset-to-call and call-to-EMS arrival delays were independently associated with increased SCA risk. Mortality rate at hospital discharge was 4.0% in the nonSCA group versus 37.7% in the SCA group ( P<0.001); 26.8% of deaths occurred before hospital admission. Factors associated with increased mortality after SCA were age, heart failure, and extensive STEMI, while male sex and cardiovascular risk factors were associated with decreased mortality. Among patients admitted alive, PCI was the most important mortality-reduction predictor (odds ratio, 0.40; 95% CI, 0.25-0.63; P<0.0001). CONCLUSIONS: More than 1 of 20 STEMI presents prehospital SCA after EMS arrival. SCA occurrence is associated with a 10-fold higher mortality at hospital discharge compared with STEMI without SCA. PCI is the strongest survival predictor, leading to a twice-lower mortality. This highlights the persistently dramatic impact of SCA on STEMI and the major importance of PCI in this setting.

Background: SARS-CoV-2 positive pregnant women are at higher risk of adverse outcomes, but little evidence is available on how variants impact that risk. We aim to evaluate maternal and perinatal outcomes among unvaccinated pregnant women that tested positive for SARS-CoV-2, stratified by pre-Delta, Delta, and Omicron periods. Methods: This prospective study enrolled women from March 2020 to September 2022. Exposure to the different SARS-CoV-2 variants was defined by their periods of predominance. The primary outcome was severe maternal adverse outcome defined as either intensive care unit admission, acute respiratory distress syndrome, advanced oxygen supplementation, or maternal death. The secondary outcomes were preterm birth and other perinatal outcomes. Findings: Overall, 1402, 262, and 391 SARS-CoV-2 positive pregnant women were enrolled during the pre-Delta, Delta, and Omicron periods respectively. Severe maternal adverse outcome was reported in 3.4% (n = 947/1402; 95% confidence intervals (95%CI) 2.5-4.5), 6.5% (n = 7/262; 95%CI 3.8-10.2), and 1.0% (n = 4/391; 95%CI 0.3-2.6) of women during the pre-Delta, Delta, and Omicron periods. The risk of severe maternal adverse outcome was higher during the Delta vs pre-Delta period (adjusted risk ratio (aRR) = 1.8; 95%CI 1.1-3.2) and lower during the Omicron vs pre-Delta period (aRR = 0.3; 95%CI, 0.1-0.8). The risks of hospitalization for COVID-19 were 12.6% (n = 176/1402; 95%CI 10.9-14.4), 17.2% (n = 45/262; 95%CI 12.8-22.3), and 12.5% (n = 49/391; 95%CI 9.4-16.2), during the pre-Delta, Delta, and Omicron period, respectively. Pregnancy complications occurred after SARS-CoV-2 exposure in 30.0% (n = 363/1212; 95%CI 27.4-32.6), 35.2% (n = 83/236; 95%CI 29.1-41.6), and 30.3% (n = 105/347; 95%CI 25.5-35.4) of patients during the pre-Delta, Delta, and Omicron periods, respectively. Stillbirths were reported in 0.5% (n = 6/1159; 95%CI 0.2-1.1), 2.8% (n = 6/210; 95%CI 1.0-6.0), and 0.9% (n = 2/213; 95%CI 0.1-3.4) or patients during the pre-Delta, Delta, and Omicron periods respectively. Interpretation: The Delta period was associated with a higher risk of severe maternal adverse outcome and the Omicron period with a lower risk of severe adverse outcome compared to pre-Delta era. The reported risk of hospitalization was high during the Omicron period and should not be trivialized. Funding: Swiss Federal Office of Public Health, Fondation CHUV.

BACKGROUND: In France, the August 2003 heat wave was responsible for considerable excess mortality among the elderly. We wonder whether the dependency level could be a marker of the risk for mortality during this heat wave. METHODS: Retrospective cohort study of deaths that occurred between 1 and 20 August 2003, conducted in five departments in the Paris area (Ile-de-France) among the beneficiaries of the Allocation personnalisée d'autonomie (APA), a stipend specifically allocated to dependent subjects > or =60 years of age. Their dependency level was determined by the GIR group (defined by the French law) used to fix the APA amount. Subjects' GIR group classification and demographic variables were obtained from departmental administrative files. RESULTS: Among the 31,603 APA beneficiaries alive on 31 July 2003, 16,779 were community dwellers and 14,824 lived in institutions. Between 1 and 20 August 2003, 858 subjects died: 300 community dwellers and 558 institutionalised (mortality rates of 2.7, 1.8 and 3.8 per cent, respectively). Independent risk factors for mortality were: age, sex and GIR group in community dwellers; age, GIR group and living in a region highly exposed to heatwave mortality for institutionalised elderly; independent factors for mortality were age, sex, GIR group, type of residence (institution/community), living in a region highly exposed to heatwave mortality and income for the overall population. CONCLUSION: The dependency level was associated with mortality during the 2003 heatwave in France, especially for elderly community dwellers. Dependency might help identify high-risk subjects and guide targeted prevention measures against heatwave-associated mortality.

In this study, the mechanical properties of biofilms formed at the surface of nano-filtration (NF) membranes from a drinking water plant were analysed. Confocal laser scanning microscopy observations revealed that the NF biofilms formed a dense and heterogeneous structure at the membrane surface, with a mean thickness of 32.5 +/- 17.7 mum. The biofilms were scraped from the membrane surface and analysed in rotation and oscillation experiments with a RheoStress 150 rotating disk rheometer. During rotation analyses, a viscosity decrease with speed of shearing characteristic of rheofluidification was observed (eta = 300 Pa s for ý = 0.3 s(-1)). In the oscillation analyses with a sweeping of frequency (1-100 Hz), elasticity (G') ranged from 3000 to 3500 Pa and viscosity (G'') from 800 to 1200 Pa. Creep curves obtained with an application of a shear stress of 30 Pa were viscoelastic in nature. The G(0) and eta values were, respectively, 1.4 +/- 0.3 x 10(3) Pa and 3.3 +/- 0.65 x 10(6) Pa s. The relationship between the characteristics of NF biofilms and the flow conditions encountered during NF is discussed.

BACKGROUND.: This study investigated the centre effect on the risk of peritonitis in peritoneal dialysis (PD) patients. METHODS.: This was a retrospective cohort study based on data from the French Language Peritoneal Dialysis Registry. We analysed 5017 incident patients starting PD between January 2008 and December 2012 in 127 PD centres. The end of the observation period was 1 January 2014. The event of interest was the first peritonitis episode. The analysis was performed with a multilevel Cox model and a Fine and Gray model. RESULTS.: Among the 5017 patients, 3190 peritonitis episodes occurred in 1796 patients. There was significant heterogeneity between centres (variance of the random effect: 0.11). The variance of the centre effect was reduced by 9% after adjusting for patient characteristics and by 35% after adjusting on centre covariate. In the multivariate analysis with a multilevel Cox model, centre with a nurse specialized in PD or centre providing home visits before dialysis initiation decreased the centre effect on peritonitis. Patients treated in centres with a nurse specialized in PD or in centres providing home visits before dialysis initiation had a lower risk of peritonitis [cause-specific hazard ratio (cs-HR): 0.75 (95% confidence interval, CI, 0.67-0.83) and cs-HR: 0.87 (95% CI 0.76-0.97), respectively]. The data show that neither centre type nor centre volume influenced peritonitis risk. In the competing risk analysis, centre with a nurse specialized in PD and centre with home visits had a protective effect on peritonitis [sub-distribution HR (sd-HR): 0.77 (95% CI 0.70-0.85) and sd-HR: 0.85 (95% CI 0.77-0.94), respectively]. CONCLUSION.: There is a significant centre effect on the risk of peritonitis that can be decreased by home visits before dialysis initiation and by the presence of a nurse specialized in PD.

BACKGROUND: The appropriate antithrombotic regimen for patients with chronic coronary syndrome who are at high atherothrombotic risk and receiving long-term oral anticoagulation remains unknown. METHODS: We conducted a multicenter, double-blind, randomized, placebo-controlled trial in France involving patients with chronic coronary syndrome who had undergone a previous stent implantation (>6 months before enrollment) and were at high atherothrombotic risk and currently receiving long-term oral anticoagulation. The patients were randomly assigned in a 1:1 ratio to receive aspirin (100 mg once daily) or placebo; all the patients continued to receive their current oral anticoagulation therapy. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, stroke, systemic embolism, coronary revascularization, or acute limb ischemia. The key safety outcome was major bleeding. RESULTS: A total of 872 patients underwent randomization; 433 were assigned to the aspirin group, and 439 to the placebo group. The trial was stopped early at the advice of the independent data and safety monitoring board after a median follow-up of 2.2 years because of an excess of deaths from any cause in the aspirin group. A primary efficacy outcome event occurred in 73 patients (16.9%) in the aspirin group and in 53 patients (12.1%) in the placebo group (adjusted hazard ratio, 1.53; 95% confidence interval [CI], 1.07 to 2.18; P = 0.02). Death from any cause occurred in 58 patients (13.4%) in the aspirin group and in 37 (8.4%) in the placebo group (adjusted hazard ratio, 1.72; 95% CI, 1.14 to 2.58; P = 0.01). Major bleeding occurred in 44 patients (10.2%) in the aspirin group and in 15 patients (3.4%) in the placebo group (adjusted hazard ratio, 3.35; 95% CI, 1.87 to 6.00; P<0.001). A total of 467 and 395 serious adverse events were reported in the aspirin group and placebo group, respectively. CONCLUSIONS: Among patients with chronic coronary syndrome at high atherothrombotic risk who were receiving an oral anticoagulant, the addition of aspirin led to a higher risk of cardiovascular death, myocardial infarction, stroke, systemic embolism, coronary revascularization, or acute limb ischemia than placebo, as well as higher risks of death from any cause and major bleeding. (Funded by the French Ministry of Health and Bayer Healthcare; ClinicalTrials.gov number, NCT04217447.).

BACKGROUND: Axial Spondyloarthritis (AxSpA) and chronic low back pain are rheumatic diseases that impact patients' health-related quality of life (HRQoL). In other chronic conditions, HRQoL was positively associated with dispositional optimism, a personality trait. The objective was to explore the relationship between optimism and HRQoL in these two diseases. METHOD: A cross-sectional study was performed in 2 tertiary care hospitals and 2 private practices in France. Patients had definite AxSpA or chronic low back pain according to the rheumatologist. A generic HRQoL questionnaire (Short Form, SF-12) with physical and mental composite scores (PCS and MCS respectively) and an optimism questionnaire (the Life Orientation Test-revised, LOT-R) were collected. Analyses included non-parametric correlations and multiple regression analyses to study the effect of optimism on PCS and MCS. RESULTS: In all, 288 (199 AxSpA and 89 low back pain) patients were included: mean age, 47.3 ± 11.9 years, 48.6 % were males. Pain levels (0-10) were 4.5 ± 2.4 and 4.3 ± 2.4 in AxSpA and LOW BACK PAIN patients, respectively. HRQoL was similarly altered in both diseases, for both physical and mental composite scores (mean PCS: 43.7 ± 8.2 vs. 41.9 ± 7.1; mean MCS: 45.9 ± 7.8 vs. 46.7 ± 8.1 for AxSpA and low back pain respectively). Optimism was moderate and similar in both populations. Optimism was positively correlated to MCS in both diseases (rho = 0.54 and 0.58, respectively, both p <0.01) and these relations persisted in multivariate analyses (beta = 1.03 and 1.40, both p <0.0001). CONCLUSIONS: Optimism was similar in these 2 chronic diseases and was an explanatory factor of the mental component of HRQoL, but not physical HRQoL. Physical HRQoL may reflect more the disease process than character traits.

Brucellosis is usually acquired by humans through contact with infected animals or the consumption of raw milk from infected ruminants. Brucella suis biovar 2 (BSB2) is mainly encountered in hares and wild boars (Sus scrofa), and is known to have very low pathogenicity to humans with only two case reports published in the literature. Human cases of brucellosis caused by BSB2 were identified through the national mandatory notification of brucellosis. The identification of the bacterium species and biovar were confirmed by the national reference laboratory. Epidemiological data were obtained during medical follow-up visits. Seven human cases were identified between 2004 and 2016, all confirmed by the isolation of BSB2 in clinical specimens. All patients had direct contact with wild boars while hunting or preparing wild boar meat for consumption. Five patients had chronic medical conditions possibly responsible for an increased risk of infection. Our findings suggest that BSB2 might be an emerging pathogen in hunters with massive exposure through the dressing of wild boar carcasses. Hunters, especially those with chronic medical conditions, should be informed about the risk of BSB2 infection and should receive information on protective measures.

This article gives a semiclassical description of nucleonic propagation through codimension two crossings of electronic energy levels. Codimension two crossings are the simplest energy level crossings, which affect the Born–Oppenheimer approximation in the zeroth order term. The model we study is a two-level Schrödinger equation with a Laplacian as kinetic operator and a matrix-valued linear potential, whose eigenvalues cross, if the two nucleonic coordinates equal zero. We discuss the case of well-localized initial data and obtain a description of the wavefunction’s two-scaled Wigner measure and of the weak limit of its position density, which is valid globally in time.