Comparison of 3 biodegradable polymer and durable polymer-based drug-eluting stents in all-comers (BIO-RESORT): rationale and study design of the randomized TWENTE III multicenter trial.

PubMed

Lam, Ming Kai; Sen, Hanim; Tandjung, Kenneth; van Houwelingen, K Gert; de Vries, Arie G; Danse, Peter W; Schotborgh, Carl E; Scholte, Martijn; Löwik, Marije M; Linssen, Gerard C M; Ijzerman, Maarten J; van der Palen, Job; Doggen, Carine J M; von Birgelen, Clemens

2014-04-01

To evaluate the safety and efficacy of 2 novel drug-eluting stents (DES) with biodegradable polymer-based coatings versus a durable coating DES. BIO-RESORT is an investigator-initiated, prospective, patient-blinded, randomized multicenter trial in 3540 Dutch all-comers with various clinical syndromes, requiring percutaneous coronary interventions (PCI) with DES implantation. Randomization (stratified for diabetes mellitus) is being performed in a 1:1:1 ratio between ORSIRO sirolimus-eluting stent with circumferential biodegradable coating, SYNERGY everolimus-eluting stent with abluminal biodegradable coating, and RESOLUTE INTEGRITY zotarolimus-eluting stent with durable coating. The primary endpoint is the incidence of the composite endpoint target vessel failure at 1 year, consisting of cardiac death, target vessel-related myocardial infarction, or clinically driven target vessel revascularization. Power calculation assumes a target vessel failure rate of 8.5% with a 3.5% non-inferiority margin, giving the study a power of 85% (α level .025 adjusted for multiple testing). The impact of diabetes mellitus on post-PCI outcome will be evaluated. The first patient was enrolled on December 21, 2012. BIO-RESORT is a large, prospective, randomized, multicenter trial with three arms, comparing two DES with biodegradable coatings versus a reference DES with a durable coating in 3540 all-comers. The trial will provide novel insights into the clinical outcome of modern DES and will address the impact of known and so far undetected diabetes mellitus on post-PCI outcome. Copyright © 2014 The Authors. Published by Mosby, Inc. All rights reserved.

PEACE I all-comers registry: patency evaluation after implantation of the 4-French Pulsar-18 self-expanding nitinol stent in femoropopliteal lesions.

PubMed

Lichtenberg, Michael; Kolks, Oliver; Hailer, Birgit; Stahlhoff, Wilhelm-Friedrich; Tiefenbacher, Christiane; Nolte-Ernsting, Claus; Arjumand, Jawed; Wittenberg, Guenther

2014-06-01

To evaluate the 1-year patency of the 4-F Pulsar-18 self-expanding nitinol stent for treatment of femoropopliteal occlusive disease in a national, prospective, multicenter, all-comers registry. Between January and June 2012, the German PEACE I all-comers prospective registry enrolled 148 patients with symptomatic femoropopliteal lesions (Rutherford category 2-5) undergoing recanalization and implantation of the Pulsar-18 SE nitinol stent at 6 clinical centers. Thirty patients did not have the 12-month follow-up visit (18 declined reevaluation, 5 withdrew consent, and 7 died), leaving 118 patients (64 men; mean 71.9±9.6 age years) for the 1-year evaluation. The average lesion length was 111.5±71.4 mm, and 38 of the 118 lesions were classified as TASC II D. More than half the lesions (67, 56.7%) were chronic total occlusions (CTO). The popliteal segment was involved in 22 (18.7%) lesions. The mean stented length was 122.7±64.5 mm. Routine follow-up included duplex ultrasound at 6 and 12 months. Outcome measures were primary patency and no clinically driven target lesion revascularization (TLR) within 12 months. The overall primary patency rates after 6 and 12 months were 87.4% and 79.5%, respectively; in the popliteal segments, the rate was 71.4% after 12 months. The overall freedom from TLR was 93.2% after 6 months and 81% after 12 months. Ankle-brachial index, pain-free walking distance, and Rutherford category all improved significantly (p<0.0001) after 6 and 12 months. The primary patency rates in patients with diabetes (p=1.0) and those with renal insufficiency (p=0.8) were not significantly lower compared to the overall rate. There was no significant difference (p=0.67) in restenosis rate for recanalization of CTOs compared to non-CTO lesions. In this all-comers registry, the use of the Pulsar-18 self-expanding nitinol stent in femoropopliteal lesions averaging 111.5 mm long showed promising primary patency and freedom from TLR after 6 and 12 months. Diabetes had no negative impact on patency. Primary patency in the popliteal segments was acceptable at 12 months.

Books That Made a Difference.

ERIC Educational Resources Information Center

School Administrator, 1998

1998-01-01

Asked to identify one book that profoundly influenced their thinking, eight well-read superintendents recommended titles stressing learning and leadership themes. The list includes James Comer's "Waiting for a Miracle," Paulo Freire's "Pedagogy of the Oppressed," John Dewey's "Experience and Education," Antoine de…

Oblique perspective of portal, due north. Bridge has gable roof ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Oblique perspective of portal, due north. Bridge has gable roof clad with wood shingles and has board and batten siding. - Watson Mill Bridge, Spanning South Fork Broad River, Watson Mill Road, Watson Mill Bridge State Park, Comer, Madison County, GA

Functional Characterization of Four Putative δ1-Pyrroline-5-Carboxylate Reductases from Bacillus subtilis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Forlani, Giuseppe; Nocek, Boguslaw; Chakravarthy, Srinivas

In most living organisms, the amino acid proline is synthesized starting from both glutamate and ornithine. In prokaryotes, in the absence of an ornithine cyclodeaminase that has been identified to date only in a small number of soil and plant bacteria, these pathways share the last step, the reduction of delta(1)-pyrroline-5-carboxylate (P5C) catalyzed by P5C reductase (EC 1.5.1.2). In several species, multiple forms of P5C reductase have been reported, possibly reflecting the dual function of proline. Aside from its common role as a building block of proteins, proline is indeed also involved in the cellular response to osmotic and oxidativemore » stress conditions. Genome analysis of Bacillus subtilis identifies the presence of four genes (ProH, ProI, ProG, and ComER) that, based on bioinformatic and phylogenic studies, were defined as respectively coding a putative P5C reductase. Here we describe the cloning, heterologous expression, functional analysis and small-angle X-ray scattering studies of the four affinity-purified proteins. Results showed that two of them, namely ProI and ComER, lost their catalytic efficiency or underwent subfunctionalization. In the case of ComER, this could be likely explained by the loss of the ability to form a dimer, which has been previously shown to be an essential structural feature of the catalytically active P5C reductase. The properties of the two active enzymes are consistent with a constitutive role for ProG, and suggest that ProH expression may be beneficial to satisfy an increased need for proline.« less

Functional Characterization of Four Putative δ1-Pyrroline-5-Carboxylate Reductases from Bacillus subtilis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Forlani, Giuseppe; Nocek, Boguslaw; Chakravarthy, Srinivas

In most living organisms, the amino acid proline is synthesized starting from both glutamate and ornithine. In prokaryotes, in the absence of an ornithine cyclodeaminase that has been identified to date only in a small number of soil and plant bacteria, these pathways share the last step, the reduction of δ1-pyrroline-5-carboxylate (P5C) catalyzed by P5C reductase (EC 1.5.1.2). In several species, multiple forms of P5C reductase have been reported, possibly reflecting the dual function of proline. Aside from its common role as a building block of proteins, proline is indeed also involved in the cellular response to osmotic and oxidativemore » stress conditions. Genome analysis of Bacillus subtilis identifies the presence of four genes (ProH, ProI, ProG, and ComER) that, based on bioinformatic and phylogenic studies, were defined as respectively coding a putative P5C reductase. Here we describe the cloning, heterologous expression, functional analysis and small-angle X-ray scattering studies of the four affinity-purified proteins. Results showed that two of them, namely ProI and ComER, lost their catalytic efficiency or underwent subfunctionalization. In the case of ComER, this could be likely explained by the loss of the ability to form a dimer, which has been previously shown to be an essential structural feature of the catalytically active P5C reductase. The properties of the two active enzymes are consistent with a constitutive role for ProG, and suggest that ProH expression may be beneficial to satisfy an increased need for proline.« less

Safety and efficacy of polymer-free biolimus-eluting stents in all-comer patients: the RUDI-FREE study.

PubMed

Sardella, Gennaro; Stefanini, Giulio G; Briguori, Carlo; Tamburino, Corrado; Fabbiocchi, Franco; Rotolo, Francesco; Tomai, Fabrizio; Paggi, Anita; Lombardi, Mario; Gioffrè, Gaetano; Sclafani, Rocco; Rolandi, Andrea; Sciahbasi, Alessandro; Scardaci, Francesco; Signore, Nicola; Calcagno, Simone; Mancone, Massimo; Chiarito, Mauro; Giordano, Arturo

2018-05-21

Polymer-free biolimus-eluting stents (PF-BES) have been shown superior to bare metal stents in high bleeding risk (HBR) patients treated with 1-month dual antiplatelet therapy (DAPT). However, limited evidence is available on PF-BES in non-HBR patients. We aim to evaluate the safety and efficacy of PF-BES in all-comer patients undergoing percutaneous coronary interventions (PCI). Patients with stable coronary artery disease or acute coronary syndromes (ACS) undergoing PCI with PF-BES in routine clinical practice were included in a multicenter, prospective registry. DAPT duration was left at the discretion of the operator. The primary endpoint was the composite of cardiovascular death, myocardial infarction (MI), and definite/probable stent thrombosis (ST) at 1 year. Overall, 1,104 consecutive patients treated with PF-BES were included at 16 Italian centers. Mean age was 68.7±11.2 years, 77.2% of patients were men, 30% had diabetes, 15.1% had chronic kidney disease, and 40.5% had ACS at baseline. Mean CRUSADE score was 24.1±13.1, and 83.7% of patients did not have high bleeding risk features. At 1-year, the primary endpoint occurred in 4.1% of patients, cardiovascular death in 2.4%, MI in 1.8%, and definite/probable ST in 1.1%. With respect to efficacy, target-lesion revascularization occurred in 1.2% of patients. This is the first study providing clinical evidence on the use of PF-BES in all-comer patients irrespective of HBR status. Our findings suggest that PF-BES has a favorable safety and efficacy profile in a real world clinical setting. Further investigation in randomised clinical trials against new-generation DES is warranted.

Optical Coherence Tomography Substudy of A Prospective Multicenter Randomized Post-Market Trial to Assess the Safety and Effectiveness of the Firehawk™ Rapamycin Target Eluting Cobalt Chromium Coronary Stent System for the Treatment of Atherosclerotic Lesions: TARGET All Comers.

PubMed

Baumbach, Andreas; Lansky, Alexandra J; Onuma, Yoshi; Asano, Taku; Johnson, Thomas; Anderson, Richard; Kiemeneij, Ferdinand; Zheng, Ming; Van Royen, Niels; Slagboom, Ton; Vlachojannis, Georg; Xu, Bo; Serruys, Patrick; Wijns, William

2018-06-12

Durable polymer drug-eluting stents (DP DES) may contribute to persistent inflammation, delayed endothelial healing and subsequent late DES thrombosis. The aim of this Optical Coherence Tomography (OCT) sub-study was to compare healing and neointimal coverage of a novel bioabsorbable polymer sirolimus-eluting stent (FIREHAWK®) (BP DES) versus the DP DES (XIENCE) at 90 days in an all comers patient population. The TARGET All Comers study is a prospective multicenter randomised post-market trial of 1656 patients randomised 1:1 to FIREHAWK or XIENCE at 21 centers in 10 European countries. The TARGET OCT sub-study enrolled 36 consecutive patients with 52 lesions at 6 centers proficient in OCT. Follow-up OCT was performed at 3 months or prior to revascularisation when occurring before the 3-month window. The substudy was designed for non-inferiority of the primary endpoint of neointimal thickness. At follow-up, the mean neointimal thickness by OCT (52 lesions, Firehawk, n=24; Xience, n=28), was not significantly different between groups (Firehawk 75.5μm vs Xience V 82.3 μm) meeting the primary endpoint of non-inferiority (Pnoninferiority<0.001). The percentage of stent strut coverage was high in both groups (strut level: 99.9% ± 0.3 vs 100% ± 0.1, p=0.26), and the proportion of malapposed struts (1.0±1.6% vs. 1.2±2.0%, p=0.51) was low in both groups. Based on OCT, the FIREHAWK BP DES has a similar healing response 3 months after implantation compared to the DP DES, with near complete strut coverage, moderate neointima formation and minimal strut malapposition.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Skurikhin, Alexei N

With increasing deployment of satellite imaging systems, only a small fraction of collected data can be subject to expert scrutiny. We present and evaluate a two-tier approach to broad area search for signs of anthropogenic activities in high-resolution commercial satellite imagery. The method filters image information using semantically oriented interest points by combining Harris corner detection and spatial pyramid matching. The idea is that anthropogenic structures, such as rooftop outlines, fence corners, road junctions, are locally arranged in specific angular relations to each other. They are often oriented at approximately right angles to each other (which is known as rectilinearitymore » relation). Detecting the rectilinearity provides an opportunity to highlight regions most likely to contain anthropogenic activity. This is followed by supervised classification of regions surrounding the detected corner points as man-made vs. natural scenes. We consider, in particular, a search for anthropogenic activities in uncluttered areas. In this paper, we proposed and evaluated a two-tier approach to broad area search for signs of anthropogenic activities. Results from experiments on high-resolution ({approx}0.6m) commercial satellite image data showed the potential applicability of this approach and its ability of achieving both high precision and recall rates. The main advantage of combining corner-based cueing with general object recognition is that the incorporation of domain specific knowledge even in its more general form, such as presence of comers, provides a useful cue to narrow the focus of search for signs of anthropogenic activities. Combination of comer based cueing with spatial pyramid matching addressed the issue of comer categorization. An important practical issue for further research is optimizing the balance between false positive and false negative rates. While the results presented in the paper are encouraging, the problem of an automated broad area search for signs of anthropogenic activities remains challenging.« less

Oblique perspective, due east by 70 degrees. Note concrete pier, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Oblique perspective, due east by 70 degrees. Note concrete pier, added CA. 1930's. Other piers and abutments are heavily mortared rubble stone. - Watson Mill Bridge, Spanning South Fork Broad River, Watson Mill Road, Watson Mill Bridge State Park, Comer, Madison County, GA

CRE8 in All Comers Patients

ClinicalTrials.gov

2016-06-27

Consecutive Subjects Who Are Suitable for a Coronary; Angioplasty of de Novo Lesion(s) in Native Coronary; Arteries Should be Screened for Eligibility.; A Total Number of 200 Patients Fulfilling the Selection; Criteria and Willing to Sign the Informed Consent Should; be Enrolled in the Trial.

Japan: Language Policy and Planning in Transition

ERIC Educational Resources Information Center

Gottlieb, Nanette

2008-01-01

This monograph discusses the language situation in Japan, with an emphasis on language planning and policy. Japan has long considered itself to be a monoethnic and therefore monolingual society, despite the existence of substantial old-comer ethnic minorities, and this--with the instrumental exception of English--has been reflected in its language…

The Myth about the Special Education Gap

ERIC Educational Resources Information Center

Winters, Marcus A.

2015-01-01

As public schools, charter schools are legally required to educate all students regardless of the difficulties they bring with them into the classroom. Nonetheless, many are concerned that the charter sector fails to educate all comers. Charter schools are often criticized for not enrolling similar proportions of students with disabilities as are…

Developmental Pathways and Technology: The Foundations of Enhanced Intellectual Excellence.

ERIC Educational Resources Information Center

Williamson, Edward A.; Slye, Gail L.

The combination of technology applications and an understanding of developmental pathways theory enhances intellectual growth for preservice teachers. Utilizing the theories developed by Dr. James Comer and integrating them with state of the art technological applications, this paper describes one model of preservice education that has been…

76 FR 55349 - Honey From Argentina: Notice of Extension of Time Limit for Preliminary Results and Partial...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-07

...-Natural Foods Lavalle, Apidouro Comerical Exportadora E Importadora Ltda., Bomare S.A., Compania Apicola...-Natural Foods Lavalle, (2) Alma Pura, (3) Apidouro Comercial Exportadora E Importadora Ltda., (4) Bomare S... companies: (1) Alimentos Naturales-Natural Foods Lavalle, (2) Alma Pura, (3) Apidouro Comercial Exportadora...

2. OBLIQUE VIEW LOOKING NORTHWEST FROM 21ST STREET VIADUCT TOWARDS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. OBLIQUE VIEW LOOKING NORTHWEST FROM 21ST STREET VIADUCT TOWARDS 2000 BLOCK OF MORRIS AVENUE WITH HEAVIEST CORNER ON EARTH BUILDINGS (TOP LEFT) AND COMER BUILDING (TOP RIGHT) - Morris Avenue Warehouse District, 2000-2400 blocks of Morris Avenue & 2100-2500 blocks of First Avenue, North, Birmingham, Jefferson County, AL

Detecting Deception in the Military Infosphere: Improving and Integrating Human Detection Capabilities with Automated Tools

DTIC Science & Technology

2007-04-25

the coders. Figure 1 la shows the basic Analyzer screen before any specific template is selected. Eft , *NN __ N O... ............... .. ]. . iiii...eyes and comers of the mouth, and reductions in gesturing or other gross body movements like foot tapping . D-DIMS captures facial and gross body

Proceedings of the First National Workshop on the Global Weather Experiment: Current Achievements and Future Directions, volume 1

NASA Technical Reports Server (NTRS)

1985-01-01

A summary of the proceedings in which the most important findings stemming from the Global Weather Experiment (GWE) are highlighted, additional key results and recommendations are comered, and the presentations and discussion are summarized. Detailed achievements, unresolved problems, and recommendations are included.

Twelve-month results of a prospective, multicentre trial to assess the everolimus-eluting coronary stent system (PROMUS Element): the PLATINUM PLUS all-comers randomised trial.

PubMed

Fajadet, Jean; Neumann, Franz-Josef; Hildick-Smith, David; Petronio, Sonia; Zaman, Azfar; Spence, Mark; Wöhrle, Jochen; Elhadad, Simon; Roberts, David; Hovasse, Thomas; Valdés, Mariano; Silber, Sigmund

2017-01-20

The aim of the study was to compare the safety and efficacy of the platinum-chromium-based everolimus-eluting stent (EES) with a cobalt-chromium EES. We performed a prospective, multicentre, single-blind non-inferiority all-comers study randomising patients with stable or unstable coronary artery disease (2:1) to treatment with the platinum-chromium EES (n=1,952) or the control cobalt-chromium EES (n=1,028) in Europe (PLATINUM PLUS trial). The primary endpoint was target vessel failure (TVF) at 12 months, a composite of target vessel-related cardiac death, myocardial infarction (MI), and ischaemia-driven target vessel revascularisation (TVR). Among 2,980 patients, 33% presented with acute coronary syndromes, and 48% with multivessel disease. At 12 months, the intention-to-treat analysis determined that the platinum-chromium EES was non-inferior to the cobalt-chromium EES for the primary endpoint (86 [4.6%] patients vs. 32 [3.2%], absolute difference 1.4%, 95% confidence interval [CI]: -0.1-2.9; upper limit of the one-sided 95% CI: 2.57%; non-inferiority p=0.012; superiority analysis: hazard ratio [HR] 1.44, 95% CI: 0.96-2.16, p=0.08). In the per protocol analysis, however, the primary endpoint was significantly more common in the platinum-chromium EES (HR 1.64, 95% CI: 1.05-2.55, p=0.03). There were no significant differences in the rates of cardiac death (1.1% vs. 1.0%, p=0.78), MI (1.6% vs. 0.8%, p=0.09), or ischaemia-driven TLR (2.0% vs. 1.6%, p=0.49). The rates of ARC definite or probable stent thrombosis were comparable between platforms (0.8% vs. 0.5%, p=0.44). At one year, the platinum-chromium EES satisfied the pre-specified criteria for non-inferiority relative to the control cobalt-chromium EES in this all-comers trial.

Transcatheter aortic valve implantation using the ACURATE TA™ system: 1-year outcomes and comparison of 500 patients from the SAVI registries.

PubMed

Börgermann, Jochen; Holzhey, David M; Thielmann, Matthias; Girdauskas, Evaldas; Schroefel, Holger; Hofmann, Steffen; Treede, Hendrik; Matschke, Klaus; Hilker, Michael; Strauch, Justus T; Carrel, Thierry; Wahlers, Thorsten; Diegeler, Anno; Kempfert, Jörg; Walther, Thomas

2017-05-01

The ACURATE TA TM system is a self-expanding transcatheter heart valve system designed for transapical access which has been proven to be safe and effective in the controlled setting of clinical trials. The SAVI-1 and SAVI-2 registries aimed to assess whether these promising outcomes can be translated into all-comers clinical routine. From November 2011 to 2012 (SAVI-1), and November 2013 to 2014 (SAVI-2), a total of 500 patients were enrolled in the prospective, all-comers, multicentre, multinational SAVI registries. Patients were treated according to the standard of care at their respective hospitals. We report and compare 30-day and 1-year clinical outcomes between SAVI-1 and -2. Patients were 80.8 ± 6.1 years old, the mean logistic EuroSCORE-I was 23.4 ± 14.3%. Valves were deployed under rapid pacing in 71.3% of the procedures in SAVI-1, and in 3.6% in SAVI-2. There was no relevant difference in clinical and echocardiographic outcomes between SAVI-1 and SAVI-2. Overall mortality at 30 days and 1 year was 6.8% and 19.9%, the stroke rate was 2.2% and 3.7%, respectively; 10.2% of patients had received a permanent pacemaker, and no transcatheter valve-related complications after discharge were observed. Paravalvular leakage ≥2+ was reported in 1.9% of the patients at the early follow-up, and in 2.6% at the 1-year follow-up. The SAVI-registries have confirmed that transapical implantation using the ACURATE TA TM device is safe and effective in an all-comers setting with low complication rates and stable performance outcomes at short-term and 1 year; outcomes were similar between SAVI-1 and -2. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.

Teacher Perceptions and Experiences with the Comer Developmental Pathways: A Qualitative Case Study

ERIC Educational Resources Information Center

Stewart, Melanie Sanders

2016-01-01

Academic performance of students in public schools is a growing concern for school districts in the United States. The No Child Left Behind Act (No Child Left Behind [NCLB] 2001) has attempted to increase academic success, improve behavior, and promote positive school culture. Although equity has been achieved in some areas, the achievement gap…

Comparison of test protocols for standard room/corner tests

Treesearch

R. H. White; M. A. Dietenberger; H. Tran; O. Grexa; L. Richardson; K. Sumathipala; M. Janssens

1998-01-01

As part of international efforts to evaluate alternative reaction-to-fire tests, several series of room/comer tests have been conducted. This paper reviews the overall results of related projects in which different test protocols for standard room/corner tests were used. Differences in the test protocols involved two options for the ignition burner scenario and whether...

Boys No More: A Black Psychlogist's View of Community. Insight Series Studies in Contemporary Issues.

ERIC Educational Resources Information Center

Thomas, Charles W.

Contents of this book include:Introduction (Charles Thomas); White racism: Its roots, form, and function (James P. Comer); Boys no more: Some social psychological aspects of the new Black ethic (Charles W. Thomas); General systems theory and Black Studies: Some points of convergence (Cedric Clark); The misuse of a so-called psychological…

Race, Class, and Family Intervention: Engaging Parents and Families for Academic Success

ERIC Educational Resources Information Center

Sampson, William Alfred

2007-01-01

In recent times, actor, comedian, and educator, Bill Cosby sparked a national debate over the role of poor black families in raising their children. Additionally, scholars including Reginald Clark, Annette Lareau, John Ogbu, Javier Tapia, James Comer, and William A. Sampson have done research that suggests that many poor black and Latino families…

Parents' and Teachers' Perceptions of Effective Communication in Two Schools in One Division in Virginia

ERIC Educational Resources Information Center

Lipscomb, Kecia O.

2015-01-01

Parents often perceive schools as the sole educator of their child when in actuality the school prefers parents to be involved as partners in the learning process (Comer & Haynes, 1991). Likewise, schools make the assumption that parents realize their role in the learning process, but do not effectively communicate the partnership to parents,…

Making Room at the Inn: Implications of "Christian Legal Society v. Martinez" for Public College and University Housing Professionals

ERIC Educational Resources Information Center

Waggoner, Michael D.; Russo, Charles J.

2014-01-01

The supreme court's ruling in "Christian Legal Society v. Martinez", its most important case to date on student associational activities, upheld a policy at a public law school in California that required recognized student organizations (or clubs) to admit "all-comers" even if they disagreed with organizational goals and…

School and Moral Justice: The School Development Program as a Case Study

ERIC Educational Resources Information Center

Comer, James P.

2013-01-01

In this article, James P. Comer reflects on his work, informed by his research and practice in medicine, public health, psychiatry and child development, and in schools; but most heavily informed by his life experience as an African American male from a low income background, and his effort to understand his more fortunate outcome than that of…

Six Pathways to Healthy Child Development and Academic Success: The Field Guide to Comer Schools in Action

ERIC Educational Resources Information Center

Comer, James P., Ed.; Joyner, Edward T., Ed.; Ben-Avie, Michael, Ed.

2004-01-01

Children and adolescents who enjoy healthy growth and development along six primary pathways are the students who learn well and achieve success in school and in life. But children from poorly functioning families and impoverished social networks too often find themselves without adequate preparation and support for the academic challenges that…

KENNEDY SPACE CENTER, FLA. - Posing with the plaque dedicated to Columbia Jan. 29, 2004, are (left to right) United Space Alliance project leader for Columbia reconstruction Jim Comer, Shuttle Launch Director Mike Leinbach, astronauts Douglas Hurley and Pam Melroy, Center Director Jim Kennedy and NASA Vehicle Manager Scott Thurston. The dedication of the plaque was made in front of the 40-member preservation team in the “Columbia room,” a permanent repository in the Vehicle Assembly Building of the debris collected in the aftermath of the tragic accident Feb. 1, 2003, that claimed the orbiter and lives of the seven-member crew.

NASA Image and Video Library

2004-01-29

KENNEDY SPACE CENTER, FLA. - Posing with the plaque dedicated to Columbia Jan. 29, 2004, are (left to right) United Space Alliance project leader for Columbia reconstruction Jim Comer, Shuttle Launch Director Mike Leinbach, astronauts Douglas Hurley and Pam Melroy, Center Director Jim Kennedy and NASA Vehicle Manager Scott Thurston. The dedication of the plaque was made in front of the 40-member preservation team in the “Columbia room,” a permanent repository in the Vehicle Assembly Building of the debris collected in the aftermath of the tragic accident Feb. 1, 2003, that claimed the orbiter and lives of the seven-member crew.

Influence of cross-sectional ratio of down comer to riser on the efficiency of liquid circulation in loop air lift bubble column

NASA Astrophysics Data System (ADS)

Yamamoto, Tatsumi; Kawasaki, Hiroyuki; Mori, Hidetoshi

2017-11-01

Loop type bubble columns have good performance of liquid circulation and mass transfer by airlift effect, where the liquid circulation time is an important measurable characteristic parameter. This parameter is affected by the column construction, the aspect ratio of the column, the cross-sectional area ratio of down comer to riser (R), and the superficial gas velocity in the riser (UGR). In this work, the mean gas holdup and the liquid circulation time (TC) have been measured in four types of loop airlift type bubble column: concentric tube internal loop airlift type, rectangular internal loop airlift type, external loop airlift type, external loop airlift with separator. Air and tap water were used as gas and liquid phase, respectively. The results have demonstrated that the mean gas holdup in riser increases in proportion to UGR, and that it in downcomer changes according to the geometric parameters of each bubble column. TC has been found to conform to an empirical equation which depends on UGR and the length of draft tube or division plate in the region of 0.33 < R < 1.

Analysis on Students' Late-Coming Factors in Selected Secondary Schools in Zaria: Implications for Educational Managers

ERIC Educational Resources Information Center

Jumare, Abubakare M.; Maina, Bashir A.; Ankoma-Sey, Vera Rosemary

2015-01-01

This study attempted to answer the following research questions among others: Has gender any relation with students' late-coming to school? Has age any relation with students' late-coming to school? Do senior students come to school later than juniors? Four secondary schools were selected for the study. A sample of sixty students late comers were…

CAD Extensions and Other Refinements to the LOCATE Workplace Layout Tool

DTIC Science & Technology

2000-05-01

25 - Scrolling and Nudging ........................................................................................ 25 System Checks...Motif’s default behaviour when creating or renaming items in pop-up menus. (0) Rotation • Provide a rotation mode to allow for multiple rotations. (0...EObs (and other objects) expand from the top left comer or the centre. (0) System Checks • Update (or close) all open windows when changes are made to

Biodegradable Polymer Biolimus-Eluting Stents Versus Durable Polymer Everolimus-Eluting Stents in Patients With Coronary Artery Disease: Final 5-Year Report From the COMPARE II Trial (Abluminal Biodegradable Polymer Biolimus-Eluting Stent Versus Durable Polymer Everolimus-Eluting Stent).

PubMed

Vlachojannis, Georgios J; Smits, Pieter C; Hofma, Sjoerd H; Togni, Mario; Vázquez, Nicolás; Valdés, Mariano; Voudris, Vassilis; Slagboom, Ton; Goy, Jean-Jaques; den Heijer, Peter; van der Ent, Martin

2017-06-26

This analysis investigates the 5-year outcomes of the biodegradable polymer biolimus-eluting stent (BP-BES) and durable polymer everolimus-eluting stent (DP-EES) in an all-comers population undergoing percutaneous coronary intervention. Recent 1- and 3-year results from randomized trials have indicated similar safety and efficacy outcomes of BP-BES and DP-EES. Whether benefits of the biodegradable polymer device arise over longer follow-up is unknown. Moreover, in-depth, prospective, long-term follow-up data on metallic drug-eluting stents with durable or biodegradable polymers are scarce. The COMPARE II trial (Abluminal Biodegradable Polymer Biolimus-Eluting Stent Versus Durable Polymer Everolimus-Eluting Stent) was a prospective, randomized, multicenter, all-comers trial in which 2,707 patients were randomly allocated (2:1) to BP-BES or DP-EES. The pre-specified endpoint at 5 years was major adverse cardiac events, a composite of cardiac death, nonfatal myocardial infarction, or target vessel revascularization. Five-year follow-up was available in 2,657 patients (98%). At 5 years, major adverse cardiac events occurred in 310 patients (17.3%) in the BP-BES group and 142 patients (15.6%) in the DP-EES group (p = 0.26). The rate of the combined safety endpoint all-cause death or myocardial infarction was 15.0% in the BP-BES group versus 14.8% in the DP-EES group (p = 0.90), whereas the efficacy measure target vessel revascularization was 10.6% versus 9.0% (p = 0.18), respectively. Interestingly, definite stent thrombosis rates did not differ between groups (1.5% for BP-BES vs. 0.9% for DP-EES; p = 0.17). The 5-year analysis comparing biodegradable polymer-coated BES and the durable polymer-coated EES confirms the initial early- and mid-term results regarding similar safety and efficacy outcomes in this all-comers percutaneous coronary intervention population. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Analytical model of flame spread in full-scale room/corner tests (ISO9705)

Treesearch

Mark Dietenberger; Ondrej Grexa

1999-01-01

A physical, yet analytical, model of fire growth has predicted flame spread and rate of heat release (RHR) for an ISO9705 test scenario using bench-scale data from the cone calorimeter. The test scenario simulated was the propane ignition burner at the comer with a 100/300 kW program and the specimen lined on the walls only. Four phases of fire growth were simulated....

A Reassessment of Heavy-Duty Truck Aerodynamic Design Features and Priorities

NASA Technical Reports Server (NTRS)

Saltzman, Edwin J.; Meyer, Robert R., Jr.

1999-01-01

Between 1973 and 1982, the NASA Dryden Flight Research Center conducted "coast-down" tests demonstrating means for reducing the drag of trucks, buses, and motor homes. Numerous configurations were evaluated using a box-shaped test van, a two-axle truck, and a tractor-semitrailer combination. Results from three configurations of the test van are of interest now in view of a trucking industry goal of a 0.25 drag coefficient for tractor-semitrailer combinations. Two test van configurations with blunt-base geometry, similar to present day trucks (one configuration has square front comers and the other has rounded front comers), quantify the base drag increase associated with reduced forebody drag. Hoemer's equations predict this trend; however, test van results, reinforced by large-scale air vehicle data, indicate that Hoemer's formula greatly underestimates this dependence of base drag on forebody efficiency. The demonstrated increase in base drag associated with forebody refinement indicates that the goal of a 0.25 drag coefficient will not be achieved without also reducing afterbody drag. A third configuration of the test van had a truncated boattail to reduce afterbody drag and achieved a drag coefficient of 0.242. These results are included here and references are identified for other means of reducing afterbody drag.

A Unified View of Global Instabilities of Compressible Flow Over Open Cavities

DTIC Science & Technology

2005-06-30

the early work of Rossiter [3], have treated the shear-layer emanating from the upstream comer of the cavity in isolation ( using parallel flow... using a domain-decomposition method. The code has optional equation sets to solve either (i) nonlinear Navier-Stokes, (ii) Navier-Stokes equations...early experments of Maull and East [15]. They used oil flow visualization of surface streamlines on the cavity bottom to show the existence, under certain

Room/corner tests of wall linings with 100/300 kW burner

Treesearch

M. A. Dietenberger; O. Grexa; R. H. White; M. S. Sweet; M. Janssens

1995-01-01

Six room/comer tests of common wall linings were conducted with gypsum-lined ceiling exposed to propane burning at 100 kW for 10 min followed by 300 kW for 10 min. This test protocol is an option provided by ISO 9705. The flashover event occurred at 1,000 kW rate of heat release within several seconds of observing flames out the doorway. The time to flashover of the...

Assessing Air Force Investment and Opportunities in Information Superiority

DTIC Science & Technology

1999-06-01

Jones, Rosanne Martin, and Pete Worden; Lieutenant Colonel Ann McLeod; Majors Karen Bridges, Randy Comer, Greg Rattray, and Laura Sakos; and Captain...far less vulnerable to information- hungry weapons.2 The leadership of the United States Air Force is wrestling the nature of the this new information...that are used describe representative information age organizational frameworks conducive to innovation—“the organization as a brain ” and the “garbage

Multi-Scale Computational Analyses of JP-8 Fuel Droplets and Vapors in Human Respiratory Airway Models

DTIC Science & Technology

2007-10-31

equation of ultrafine particles , or (JP-8) fuel vapor, whose dominant radial transfer mechanisms are Brownian motion and turbulent dispersion is given in...Deposition of ultrafine particles at carinal ridges of the upper bronchial airways. Aerosol Science and Technology 38, 991-1000. Comer, J.K...from studies of ultrafine particles . Environmental Health Perspectives 113, 823-839. Ritchie, G., Still, K., Rossi III, J., Bekkedal, M., Bobb, A. and

Searching for self-enrichment in Cygnus OB2

NASA Astrophysics Data System (ADS)

Berlanas, Sara R.; Herrero, Artemio; Comerón, Fernando; Pasquali, Anna; Simón-Díaz, Sergio

2017-11-01

Cygnus OB2 is a rich and relatively close (d~1.4 kpc) OB association in our Galaxy. It represents an ideal testbed for our theories about self-enrichment processes produced by pollution of the interstellar medium by successive generations of massive stars. Comerón & Pasquali (2012, A&A, 543, A101) found a correlation between the age of young stellar groups in Cygnus OB2 and their Galactic longitude. If is associated with a chemical composition gradient, it could support these self-enrichment processes.

F-35A Training Basing Environmental Impact Statement. Volume 2. Appendix D - Comment Response Document. Book 1

DTIC Science & Technology

2012-06-01

Brening Sharon Peoria AZ 10560 Breniser Suzanne Phoenix AZ 4567 Brennan Barbara Sun City West AZ 6556 Brennan Leo Litchfield Park AZ 11324 Bresler...Goodyear AZ 9865 Comer Karen Litchfield Park AZ 10019 Commandeur Leo Anthem AZ 7363 Compton Charles Avondale AZ 7787 Compton Esther Litchfield Park AZ...Goodyear AZ 8503 Lee Jeffrey Glendale AZ 4248 Lee Joel Peoria AZ 9649 Lee John Sun City AZ 10037 Lee Lawrence Phoenix AZ 6557 Lee Leo Lakeside

Reduced Gravity Gas and Liquid Flows: Simple Data for Complex Problems

NASA Technical Reports Server (NTRS)

McQuillen, John; Motil, Brian

2001-01-01

While there have been many studies for two-phase flow through straight cylindrical tubes, more recently, a new group of studies have emerged that examine two-phase flow through non-straight, non-cylindrical geometries, including expansions, contractions, tees, packed beds and cyclonic separation devices. Although these studies are still, relatively speaking, in their infancy, they have provided valuable information regarding the importance of the flow momentum, and the existence of liquid dryout due to sharp comers in microgravity.

Up & comers succeed by motivating others.

PubMed

Greene, J

1990-06-18

Few clues in the early lives of Modern Healthcare's 1990 Up & Comers indicate that they were destined to become young leaders of the healthcare industry. A diverse group, they started out in strikingly different directions. Gary Shorb trained as an engineer and aspired to be an admiral in the Navy. Deborah Johnson studied law but had dreams of becoming a professional musician. Larry Hough started out as a certified public accountant. Somewhere along the line, they were attracted to the healthcare profession. Despite their differences, they have much in common. A psychological survey conducted for the magazine by Michael Leibman of Caliper Human Strategies indicates they are strong motivators who set the tone for their organizations by soliciting the views of their staffs and structuring the agenda. As a group, they are bright, shrewd and goal-oriented. They also fully understand their role. As David Jimenez, president of Hialeah (Fla.) Hospital, said, "Every day you've got to go out there and demonstrate that you're capable of holding down the job, that you deserve to be the leader." These 12 executives, all 40 or younger, were chosen from more than 50 candidates suggested by Modern Healthcare's editorial staff and readers. They represent many facets of the industry and come from every part of the country. As the healthcare industry continues to evolve, they are well positioned to play a leadership role in meeting the challenges of providing high-quality and cost-efficient patient care.

Archeological Data Recovery by Controlled Surface Collection in the Portion of 23SO496 to be Adversely Affected by the Castor River Enlargement Project, Stoddard County, Missouri

DTIC Science & Technology

1990-04-01

Breckenridge and Tom’s Brook shelters). During this long period a large number of different projectile point types were produced (i.e., Rice Lobed...Big Sandy, Graham Cave, Kirk Comer Notched, White River Archaic, Hidden Valley Stemmed, Hardin Barbed, Searcy, Rice Lanceolate, Jakie Stemmed, and...point did not exhibit basal grinding); one was a Middle Archaic point similar to the Rice Lobed; two were Late Archaic Rice Sidenotched; five were

Soil Quality Assessment Is a Necessary First Step for Designing Urban Green Infrastructure.

PubMed

Montgomery, James A; Klimas, Christie A; Arcus, Joseph; DeKnock, Christian; Rico, Kathryn; Rodriguez, Yarency; Vollrath, Katherine; Webb, Ellen; Williams, Allison

2016-01-01

This paper describes the results of a preliminary project conducted by a team of DePaul University undergraduate students and staff from the Gary Comer Youth Center located on Chicago's South Side. The team assessed soil quality on 116 samples collected among four abandoned residential lots adjacent to the Comer Center. Soil quality data will be used in a follow-up study to determine the suitability of each lot for green infrastructure implementation. Green infrastructure may be a useful approach for providing ecosystem services and mitigating food deserts in inner-city communities. Soil quality on all lots was poor. All soils had pH >8.0, low biological activity, and low N mineralization potential. The soils were rich in available P and had mean total Pb concentrations above the USEPA threshold (400 mg kg) for children's playlots. Mean bioavailable Pb on the largest of the four lots was 12% of total Pb, indicating that most of the total Pb is not bioavailable. This result is encouraging because high bioavailable Pb concentrations are linked with negative health effects, particularly in children. All lots had NO-N concentrations below those considered to be appropriate for plant growth. On the other hand, no significant differences in mean concentrations of the other analytes were found. The poor soil quality in the four lots presents an opportunity to use green infrastructure to enhance ecosystem services, improve community and environmental health, and provide more equitable access to green space. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Estimation of treatment effects in all-comers randomized clinical trials with a predictive marker.

PubMed

Choai, Yuki; Matsui, Shigeyuki

2015-03-01

Recent advances in genomics and biotechnologies have accelerated the development of molecularly targeted treatments and accompanying markers to predict treatment responsiveness. However, it is common at the initiation of a definitive phase III clinical trial that there is no compelling biological basis or early trial data for a candidate marker regarding its capability in predicting treatment effects. In this case, it is reasonable to include all patients as eligible for randomization, but to plan for prospective subgroup analysis based on the marker. One analysis plan in such all-comers designs is the so-called fallback approach that first tests for overall treatment efficacy and then proceeds to testing in a biomarker-positive subgroup if the first test is not significant. In this approach, owing to the adaptive nature of the analysis and a correlation between the two tests, a bias will arise in estimating the treatment effect in the biomarker-positive subgroup after a non-significant first overall test. In this article, we formulate the bias function and show a difficulty in obtaining unbiased estimators for a whole range of an associated parameter. To address this issue, we propose bias-corrected estimation methods, including those based on an approximation of the bias function under a bounded range of the parameter using polynomials. We also provide an interval estimation method based on a bivariate doubly truncated normal distribution. Simulation experiments demonstrated a success in bias reduction. Application to a phase III trial for lung cancer is provided. © 2014, The International Biometric Society.

KSC-04PD-0077

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Posing with the plaque dedicated to Columbia Jan. 29, 2004, are (left to right) United Space Alliance project leader for Columbia reconstruction Jim Comer, Shuttle Launch Director Mike Leinbach, astronauts Douglas Hurley and Pam Melroy, Center Director Jim Kennedy and NASA Vehicle Manager Scott Thurston. The dedication of the plaque was made in front of the 40-member preservation team in the Columbia room, a permanent repository in the Vehicle Assembly Building of the debris collected in the aftermath of the tragic accident Feb. 1, 2003, that claimed the orbiter and lives of the seven-member crew.

Uncooled Infrared Microbolometers and Silicon Germanium Oxide (SixGe1-xOy) Infrared Sensitive Material for Long Wavelength Detection

DTIC Science & Technology

2014-10-10

Hooge ’s parameters and 1/f noise at the comer frequency for the four wafers are shown in Table 6. We see in the table that the average value of ywas...voltage noise power spectral densities were analyzed and Hooge’s parameters were determined. UNCOOLED MICROBOLOMETER A thermal detector exhibits a...annealing at 200 °C, 250 °C, and 300 °C for duration from 1 hour to 5 hours using a bias current of 0.07 µA. The corresponding Hooge’s parameters for

Effects of controlled dog hunting on movements of female white-tailed deer.

DOE Office of Scientific and Technical Information (OSTI.GOV)

D'Angelo, Gino, J.; Kilgo, John, C.; Comer, Christopher, E.

D'Angelo, Gino, J., John C. Kilgo, Christopher E. Comer, Cory D. Drennan, David A. Osborn, and Karl V. Miller. 2003. Effects of controlled dog hunting on movements of female white-tailed deer. In: Proceedings of the Annu. Conf. Southeast. Assoc. Fish and Wildl. Agencies. 57:317-325. This article explores the relationship between controlled dog hunting and the movements of female white tailed deer at the Savannah River Site, South Carolina. The data suggests that short term, controlled dog hunting has little long-term effect on adult, female white-tailed deer movement on the Savannah River Site.

Generalizability of EXCEL and NOBLE results to a large registry population with unprotected left main coronary artery disease.

PubMed

Lee, Pil Hyung; Kang, Se Hun; Han, Seungbong; Ahn, Jung-Min; Bae, Jae Seok; Lee, Cheol Hyun; Kang, Soo-Jin; Lee, Seung-Whan; Kim, Young-Hak; Lee, Cheol Whan; Park, Seong-Wook; Park, Duk-Woo; Park, Seung-Jung

2017-12-01

The aim of this study was to determine how trial-based findings of EXCEL and NOBLE might be interpreted and generalizable in 'real-world' settings with comparison of data from the large-scaled, all-comer Interventional Research Incorporation Society-Left MAIN Revascularization (IRIS-MAIN) registry. We compared baseline clinical and procedural characteristics and also determined how the relative treatment effect of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) was different in EXCEL and NOBLE, compared with those of the multicenter, IRIS-MAIN registry (n=2481). The primary outcome for between-study comparison was a composite of death, myocardial infarction (MI), or stroke. There were between-study differences in patient risk profiles (age, BMI, diabetes, and clinical presentation), lesion complexities, and procedural characteristics (stent type, the use of off-pump surgery, and radial artery); the proportion of diabetes and acute coronary syndrome was particularly lower in NOBLE than in other studies. Although there was interstudy heterogeneity for the protocol definition of MI, the risks for serious composite outcome of death, MI, or stroke were similar between PCI and CABG in EXCEL [hazard ratio (HR): 1.00; 95% confidence interval (CI): 0.79-1.26; P=0.98] and in the matched cohort of IRIS-MAIN (HR: 1.08; 95%CI: 0.85-1.38; P=0.53), whereas it was significantly higher after PCI than after CABG in NOBLE (HR: 1.47; 95%CI: 1.06-2.05; P=0.02), which was driven by more common MI and stroke after PCI. In the comparison of a large-sized, all-comer registry, the EXCEL trial might represent better generalizability with respect to baseline characteristics and observed clinical outcomes compared with the NOBLE trial.

Gibbs-Thomson Law for Singular Step Segments: Thermodynamics Versus Kinetics

NASA Technical Reports Server (NTRS)

Chernov, A. A.

2003-01-01

Classical Burton-Cabrera-Frank theory presumes that thermal fluctuations are so fast that at any time density of kinks on a step is comparable with the reciprocal intermolecular distance, so that the step rate is about isotropic within the crystal plane. Such azimuthal isotropy is, however, often not the case: Kink density may be much lower. In particular, it was recently found on the (010) face of orthorhombic lysozyme that interkink distance may exceed 500-600 intermolecular distances. Under such conditions, Gibbs-Thomson law (GTL) may not be applicable: On a straight step segment between two corners, communication between the comers occurs exclusively by kink exchange. Annihilation between kinks of opposite sign generated at the comers results in the grain in step energy entering GTL. If the step segment length l much greater than D/v, where D and v are the kink diffusivity and propagation rate, respectively, the opposite kinks have practically no chance to annihilate and GTL is not applicable. The opposite condition of the GTL applicability, l much less than D/v, is equivalent to the requirement that relative supersaturation Delta(sub mu)/kT much less than alpha/l, where alpha is molecular size. Thus, GTL may be applied to a segment of 10(exp 3)alpha approx. 3 x 10(exp -5)cm approx 0.3 micron only if supersaturation is less than 0.1%, while practically used driving forces for crystallization are much larger. Relationships alternative to the GTL for different, but low, kink density have been discussed. They confirm experimental evidences that the Burton-Cabrera-Frank theory of spiral growth is growth rates twice as low as compared to the observed figures. Also, application of GTL results in unrealistic step energy while suggested kinetic law give reasonable figures.

Clinical endpoint adjudication in a contemporary all-comers coronary stent investigation: methodology and external validation.

PubMed

Vranckx, Pascal; McFadden, Eugene; Cutlip, Donald E; Mehran, Roxana; Swart, Michael; Kint, P P; Zijlstra, Felix; Silber, Sigmund; Windecker, Stephan; Serruys, Patrick W C J

2013-01-01

Globalisation in coronary stent research calls for harmonization of clinical endpoint definitions and event adjudication. Little has been published about the various processes used for event adjudication or their impact on outcome reporting. We performed a validation of the clinical event committee (CEC) adjudication process on 100 suspected events in the RESOLUTE All-comers trial (Resolute-AC). Two experienced Clinical Research Organisations (CRO) that had already extensive internal validation processes in place, participated in the study. After initial adjudication by the primary-CEC, events were cross-adjudicated by an external-CEC using the same definitions. Major discrepancies affecting the primary end point of target-lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction (TV-MI), or clinically-indicated target-lesion revascularization (CI-TLR), were analysed by an independent oversight committee who provided recommendations for harmonization. Discordant adjudications were reconsidered by the primary CEC. Subsequently, the RAC database was interrogated for cases that based on these recommendations merited re-adjudication and these cases were also re-adjudicated by the primary CEC. Final discrepancies in adjudication of individual components of TLF occurred in 7 out of 100 events in 5 patients. Discrepancies for the (hierarchical) primary endpoint occurred in 5 events (2 cardiac deaths and 3 TV-MI). After application of harmonization recommendations to the overall RAC population (n=2292), the primary CEC adjudicated 3 additional clinical-TLRs and considered 1 TV-MI as no event. A harmonization process provided a high level of concordance for event adjudication and improved accuracy for final event reporting. These findings suggest it is feasible to pool clinical event outcome data across clinical trials even when different CECs are responsible for event adjudication. Copyright © 2012 Elsevier Inc. All rights reserved.

The birth of a house call practice.

PubMed

De Leon, Fidias E

2009-01-01

Increasingly, physicians of all specialties are frustrated with the complex, unrewarding system of third-party billing in the United States. It has led many physicians to wonder how best to change their practice to ameliorate these challenges or leave their practice altogether. It is possible that family physicians suffer most because they are trained to provide comprehensive care to all comers, regardless of reimbursement status. What they may not know is that leaving the practice might be the best thing for everyone, and it doesn't necessarily mean leaving medicine! As I realized during my experiences working in South Florida, transitioning to a house call practice can be emotionally and financially rewarding.

Reader reaction on estimation of treatment effects in all-comers randomized clinical trials with a predictive marker.

PubMed

Korn, Edward L; Freidlin, Boris

2017-06-01

For a fallback randomized clinical trial design with a marker, Choai and Matsui (2015, Biometrics 71, 25-32) estimate the bias of the estimator of the treatment effect in the marker-positive subgroup conditional on the treatment effect not being statistically significant in the overall population. This is used to construct and examine conditionally bias-corrected estimators of the treatment effect for the marker-positive subgroup. We argue that it may not be appropriate to correct for conditional bias in this setting. Instead, we consider the unconditional bias of estimators of the treatment effect for marker-positive patients. © 2016, The International Biometric Society.

Can sequential parallel comparison design and two-way enriched design be useful in medical device clinical trials?

PubMed

Ivanova, Anastasia; Zhang, Zhiwei; Thompson, Laura; Yang, Ying; Kotz, Richard M; Fang, Xin

2016-01-01

Sequential parallel comparison design (SPCD) was proposed for trials with high placebo response. In the first stage of SPCD subjects are randomized between placebo and active treatment. In the second stage placebo nonresponders are re-randomized between placebo and active treatment. Data from the population of "all comers" and the subpopulations of placebo nonresponders then combined to yield a single p-value for treatment comparison. Two-way enriched design (TED) is an extension of SPCD where active treatment responders are also re-randomized between placebo and active treatment in Stage 2. This article investigates the potential uses of SPCD and TED in medical device trials.

S. S. Chern and I

NASA Astrophysics Data System (ADS)

Yang, Chen Ning

2013-05-01

I do not remember whether I had met Prof. S. S. Chern when he was a graduate student of Tsinghua University in Peking (now Beijing) where my father was a mathematics professor, and I was in elementary school. But I do remember how I had met Mrs. Chern for the first time, in early October, 1929, when I was seven years old and she was in junior high school. Her father, Professor Tsen, had been a professor of Mathematics at Tsinghua University already for a number of years, and the Yangs were new comers that fall. The Tsens invited us to their house for dinner and that was when I first made the acquaintence of "big sister Tsen"...

HIV competition dynamics over sexual networks: first comer advantage conserves founder effects.

PubMed

Ferdinandy, Bence; Mones, Enys; Vicsek, Tamás; Müller, Viktor

2015-02-01

Outside Africa, the global phylogeography of HIV is characterized by compartmentalized local epidemics that are typically dominated by a single subtype, which indicates strong founder effects. We hypothesized that the competition of viral strains at the epidemic level may involve an advantage of the resident strain that was the first to colonize a population. Such an effect would slow down the invasion of new strains, and thus also the diversification of the epidemic. We developed a stochastic modelling framework to simulate HIV epidemics over dynamic contact networks. We simulated epidemics in which the second strain was introduced into a population where the first strain had established a steady-state epidemic, and assessed whether, and on what time scale, the second strain was able to spread in the population. Simulations were parameterized based on empirical data; we tested scenarios with varying levels of overall prevalence. The spread of the second strain occurred on a much slower time scale compared with the initial expansion of the first strain. With strains of equal transmission efficiency, the second strain was unable to invade on a time scale relevant for the history of the HIV pandemic. To become dominant over a time scale of decades, the second strain needed considerable (>25%) advantage in transmission efficiency over the resident strain. The inhibition effect was weaker if the second strain was introduced while the first strain was still in its growth phase. We also tested how possible mechanisms of interference (inhibition of superinfection, depletion of highly connected hubs in the network, one-time acute peak of infectiousness) contribute to the inhibition effect. Our simulations confirmed a strong first comer advantage in the competition dynamics of HIV at the population level, which may explain the global phylogeography of the virus and may influence the future evolution of the pandemic.

Active Chest Tube Clearance After Cardiac Surgery Is Associated With Reduced Reexploration Rates.

PubMed

Grieshaber, Philippe; Heim, Nicolas; Herzberg, Moritz; Niemann, Bernd; Roth, Peter; Boening, Andreas

2018-06-01

Ineffective evacuation of intrathoracic fluid after cardiac surgery (retained blood syndrome [RBS]) might increase postoperative complications, morbidity, and mortality. Active tube clearance (ATC) technology using an intraluminal clearing apparatus aims at increasing chest tube drainage efficiency. This study evaluated whether ATC reduces RBS in an all-comers collective undergoing scheduled cardiac surgery with cardiopulmonary bypass and full or partial median sternotomy. In this nonrandomized prospective trial, 581 consecutive patients undergoing scheduled cardiac surgery with median sternotomy between January 2016 and December 2016 were assigned to receive conventional chest tubes (control group) or a combination of conventional tubes and as many as two ATC devices (ATC group), depending on their operation date. Postoperative occurrence of RBS (one or more of the following: reexploration for bleeding or tamponade, pericardial drainage procedure, pleural drainage procedure) and other endpoints were compared. Propensity score matching was applied. In 222 ATC patients and 222 matched control patients, RBS occurrence did not differ between the groups (ATC 16%, control 22%; p = 0.15). However, reexploration rate for bleeding or tamponade was significantly reduced in the ATC group compared with the control group (4.1% versus 9.1%, respectively; p = 0.015). The mortality of RBS patients (21%) was higher compared with patients without RBS (3.9%, p < 0.001). Among the RBS components, only reexploration (odds ratio 16, 95% confidence interval: 5.8 to 43, p < 0.001) was relevant for inhospital mortality (ATC 6.8%, control 7.7%; p = 0.71). Active tube clearance is associated with reduced reexploration rates in an all-comers collective undergoing cardiac surgery. Reexploration is the only RBS component relevant for mortality. The ATC effect does not translate into improved overall survival. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Evaluation of the 4-French Pulsar-18 Self-expanding Nitinol Stent in Long Femoropopliteal Lesions.

PubMed

Lichtenberg, Michael; Hailer, Birgit; Kaeunicke, Matthias; Stahlhoff, Wilhelm-Friedrich; Boese, Dirk; Breuckmann, Frank

2014-01-01

To evaluate the patency and the freedom of target lesion revascularization of the 4-French Pulsar-18 self-expandable (SE) nitinol stent for the treatment of long femoropopliteal occlusive disease in a two-center, prospective, all-comers registry with a follow-up period of 12 months. This registry enrolled 36 patients with symptomatic femoropopliteal long lesions for recanalization and implantation of the 4-French Pulsar-18 SE nitinol stent. Routine follow-up examination including duplex ultrasound was performed after 6 and 12 months. Primary patency was defined as no binary restenosis on duplex ultrasound (Peak systolic velocitiy ration (PSVR) <2.5) and no target lesion revascularization was performed within 12 months' follow-up. No drug-eluting devices were allowed in this registry. Average lesion length of the femoropopliteal segment was 182.3 ± 51.8 mm. Mean stent implantation length was 181.5 ± 35.4 mm. Total occlusion was present in 46 of the 48 (95.8%) treated lesions. Involvement of popliteal segment I-III was present in 3 (6.3%) lesions. The primary patency after 6 and 12 months was 87.5% and 85.4%, respectively. The clinically driven overall freedom from target lesion revascularization (fTLR) was 89.6% after 6 months and 87.5% after 12 months. ABI, pain-free walking distance and Rutherford category, all improved significantly (P < 0.001) after 6 and 12 months. The primary patency rate in patients with diabetes (P = 0.18) and renal insufficiency (P = 0.3) was not significantly lower as compared to the overall primary patency. In this two-center, all-comers registry, the use of the Pulsar-18 SE nitinol stent for endovascular intervention of femoropopliteal disease with a mean lesion length of 182.3 ± 51.8 mm showed promising primary patency and fTLR rates after 6 and 12 months. Diabetes and renal insufficiency had no negative impact on the patency rate.

Engaging High School Students in Investigative STEM Activities Based on Field Research

NASA Astrophysics Data System (ADS)

Stevens, J.; Sheriff, M. M.; Washington, D. S.; Putnam, A. E.; Strand, P.; Radue, M. J.

2017-12-01

The lead author, an Environmental Science teacher at Gary Comer High School (GCHS), a public charter on the South Side of Chicago, accompanied two students over the course of two summers to conduct field research in remote mountain ranges of interior Asia. The expeditions were funded by the National Science Foundation and orchestrated collaboratively with PI Putnam with the purposes of bringing along high school students and teachers (1) to introduce students from urban areas to practical Earth Science and (2) to bolster the Environmental Science curriculum at GCHS by providing real world events to relate to classroom learning. During the first field trip, a student from GCHS and the lead author traveled to western Mongolia to participate in collecting samples for cosmogenic-nuclide dating of glacial landforms. The student performed all parts of sample collection and used the data to create a poster analyzing the rate of recession of the Potanin Glacier. She went on to present her findings at the AGU Fall Meeting 2016. At GCHS, she assisted the teacher in lessons about climate change. Next year she will be attending the University of Vermont to pursue a major in a STEM field. The second student traveled to the Tibetan Plateau in China and also participated fully in sampling activities. She plans on presenting her project on creating 3D models of sample boulders at the AGU Meeting in 2017. She will present her findings to the rest of the student body at GCHS, assist with pertinent Environmental Science lessons for Freshmen, and explain her experience at the Gary Comer Middle School. The lead author faced several restrictions in the classroom due to standardized testing requirements, leading to more focus on testing skills rather than investigative learning. Next year the focus will switch from ACT to SAT standards, allowing more freedom to pursue investigative lessons. The success of adding information on the field experience will be assessed at the end of the 2017-2018 school year.

9-month results of polymer-free sirolimus eluting stents in young patients compared to a septuagenarian and octogenarian all-comer population.

PubMed

Kherad, Behrouz; Waliszewski, Matthias; Leschke, Matthias; Kader, Muhammad Ali; Bang, Liew Houng; Ruiz-Poveda, Fernando Lozano; Pieske, Burkert; Krackhardt, Florian

2018-06-01

To evaluate the 9-month safety and efficacy of polymer-free sirolimus eluting drug eluting stents in septuagenarians and octogenarians. An all-comer, worldwide single armed trial (ClinicalTrials.gov Identifier NCT02629575) was conducted to demonstrate the safety and efficacy of an ultra-thin strut, polymer-free sirolimus eluting stent (PF-SES). The primary endpoint was the 9-month target revascularization rate (TLR). Secondary endpoints included the rates of major adverse cardiac events (MACE), stent thrombosis (ST) and bleeding (BARC) in septuagenarians (≥70 years, <80 years), and in octogenarians (≥80 years) to be compared to the younger patient group (<70 years). A total of 1607 patients were treated with PF-SES in the sub-70-year-old age group, 694 in septuagenarians, and 371 in the octogenarian patient group. At 9 months, the MACE rates were 7.2% in octogenarians, 5.3% in septuagenarians, and 3.0% in the younger patient group (P = 0.001). These were mostly driven by all-cause mortality (4.4% vs 1.9% vs 0.6%, P < 0.001) while the TLR rates were only numerically lower in the younger age group (P = 0.080). BARC 1-5 bleeding events were more frequent in the older age group (1.9% vs 2.7% vs 4.6%, P = 0.012) whereas the rates for ST were not different (0.7% vs 0.6% vs 0.6%, P = 0.970). In octogenarians treated with PF-SES, the rates for MACE, overall mortality, and bleeding are higher as compared to the younger age groups. However, the rates for TLR and ST were not significantly different across the investigated age groups. PF-SES are safe and effective in octogenarians. © 2017, Wiley Periodicals, Inc.

Mobile economics and pricing of health care services.

PubMed

Huttin, Christine C

2012-01-01

This paper presents tools and concepts to analyze the business environment of the biopharmaceutical industry. It was presented at MEDETEL 2010. Emerging paradigms appear in that industry and new ways to value life science technologies are developed especially using mobile economics analysis. At a time, mobile computing technologies revolutionize the field of health care, this paper contributes to show how the value chain concept can be useful to analyze the value system in a mobile computing environment. It is also a milestone for the designs of future technology platforms and of health care infrastructure, in order to retain enough value between innovators, new and traditionnal players from life science, IT and other new comers, in a fragmented global competitive environment.

Preliminary Inventory of the Retired Records of the 1st United States Army Infantry Division during the Vietnam War, 2 October 1965-14 April 1970. Sanitized Version.

DTIC Science & Technology

1982-05-01

con Oft uh 6 to the appdsb feual Rec"It Comer for RECORDS TRANSMITTAL AND RECEIPT apm pro to shipaat of f Spse arcns aon rese. PAMIf A. TO 4i5 ASd5 * pv... gmo -M IN nm nd 10mi AV No*5 m General Orders; General Correspondence; Daily Staff Journals; Tactical Operatiod Center (TOC) Logs; Cmand Reports...AGENiCYwo m a gewn.uirm DIPSL " 1n 2,I (w l6_t 4,11A 4s. 41) pollo~ 01)S 10~e 1~e (1) (A)A. IndiOs Cap Ill StA SAC(G3O4NID: Th.&. record. were pros edfor

A method of camera calibration with adaptive thresholding

NASA Astrophysics Data System (ADS)

Gao, Lei; Yan, Shu-hua; Wang, Guo-chao; Zhou, Chun-lei

2009-07-01

In order to calculate the parameters of the camera correctly, we must figure out the accurate coordinates of the certain points in the image plane. Corners are the important features in the 2D images. Generally speaking, they are the points that have high curvature and lie in the junction of different brightness regions of images. So corners detection has already widely used in many fields. In this paper we use the pinhole camera model and SUSAN corner detection algorithm to calibrate the camera. When using the SUSAN corner detection algorithm, we propose an approach to retrieve the gray difference threshold, adaptively. That makes it possible to pick up the right chessboard inner comers in all kinds of gray contrast. The experiment result based on this method was proved to be feasible.

Numerical and Experimental Dynamic Characteristics of Thin-Film Membranes

NASA Technical Reports Server (NTRS)

Young, Leyland G.; Ramanathan, Suresh; Hu, Jia-Zhu; Pai, P. Frank

2004-01-01

Presented is a total-Lagrangian displacement-based non-linear finite-element model of thin-film membranes for static and dynamic large-displacement analyses. The membrane theory fully accounts for geometric non-linearities. Fully non-linear static analysis followed by linear modal analysis is performed for an inflated circular cylindrical Kapton membrane tube under different pressures, and for a rectangular membrane under different tension loads at four comers. Finite element results show that shell modes dominate the dynamics of the inflated tube when the inflation pressure is low, and that vibration modes localized along four edges dominate the dynamics of the rectangular membrane. Numerical dynamic characteristics of the two membrane structures were experimentally verified using a Polytec PI PSV-200 scanning laser vibrometer and an EAGLE-500 8-camera motion analysis system.

Error Modeling of Multi-baseline Optical Truss. Part II; Application to SIM Metrology Truss Field Dependent Error

NASA Technical Reports Server (NTRS)

Zhang, Liwei Dennis; Milman, Mark; Korechoff, Robert

2004-01-01

The current design of the Space Interferometry Mission (SIM) employs a 19 laser-metrology-beam system (also called L19 external metrology truss) to monitor changes of distances between the fiducials of the flight system's multiple baselines. The function of the external metrology truss is to aid in the determination of the time-variations of the interferometer baseline. The largest contributor to truss error occurs in SIM wide-angle observations when the articulation of the siderostat mirrors (in order to gather starlight from different sky coordinates) brings to light systematic errors due to offsets at levels of instrument components (which include comer cube retro-reflectors, etc.). This error is labeled external metrology wide-angle field-dependent error. Physics-based model of field-dependent error at single metrology gauge level is developed and linearly propagated to errors in interferometer delay. In this manner delay error sensitivity to various error parameters or their combination can be studied using eigenvalue/eigenvector analysis. Also validation of physics-based field-dependent model on SIM testbed lends support to the present approach. As a first example, dihedral error model is developed for the comer cubes (CC) attached to the siderostat mirrors. Then the delay errors due to this effect can be characterized using the eigenvectors of composite CC dihedral error. The essence of the linear error model is contained in an error-mapping matrix. A corresponding Zernike component matrix approach is developed in parallel, first for convenience of describing the RMS of errors across the field-of-regard (FOR), and second for convenience of combining with additional models. Average and worst case residual errors are computed when various orders of field-dependent terms are removed from the delay error. Results of the residual errors are important in arriving at external metrology system component requirements. Double CCs with ideally co-incident vertices reside with the siderostat. The non-common vertex error (NCVE) is treated as a second example. Finally combination of models, and various other errors are discussed.

Functional requirements document for NASA/MSFC Earth Science and Applications Division: Data and information system (ESAD-DIS). Interoperability, 1992

NASA Technical Reports Server (NTRS)

Stephens, J. Briscoe; Grider, Gary W.

1992-01-01

These Earth Science and Applications Division-Data and Information System (ESAD-DIS) interoperability requirements are designed to quantify the Earth Science and Application Division's hardware and software requirements in terms of communications between personal and visualization workstation, and mainframe computers. The electronic mail requirements and local area network (LAN) requirements are addressed. These interoperability requirements are top-level requirements framed around defining the existing ESAD-DIS interoperability and projecting known near-term requirements for both operational support and for management planning. Detailed requirements will be submitted on a case-by-case basis. This document is also intended as an overview of ESAD-DIs interoperability for new-comers and management not familiar with these activities. It is intended as background documentation to support requests for resources and support requirements.

Solar System Studies in the Infrared with the Spitzer Space Telescope

NASA Technical Reports Server (NTRS)

Cruikshank, D. P.; Stansberry, J. A.; Cleve, J. Van; Burgdorf, M. J.; Fernandez, Y. R.; Meadows, V. S.; Reach, W. T.

2004-01-01

The Spitzer Space Telescope, formerly known as SIRTF, is a cryogenic telescope (85 cm diameter) operating in a heliocentric orbit trailing the Earth. Its three instruments provide capabilities for spectroscopy, wide-field and small-field imaging at many wavelengths in the range 3.5-160 microns. Observations to be executed in the first two years in programs defined by the Guaranteed Time Observer (GTO) group (the authors of this presentation) consist of photometry, spectroscopy, and radiometry of many Solar System objects, including Titan and other satellites of the outer planets, Pluto, Centaurs, trans-Neptunian objects, comers, asteroids, Uranus, and Neptune. At the time of the preparation of this abstract, some preliminary observations have been made, but the final calibration and reduction of the data are still in progress. The latest results of the Solar System investigations will be presented here.

CLL2-BXX Phase II trials: sequential, targeted treatment for eradication of minimal residual disease in chronic lymphocytic leukemia.

PubMed

Cramer, Paula; von Tresckow, Julia; Bahlo, Jasmin; Engelke, Anja; Langerbeins, Petra; Fink, Anna-Maria; Fischer, Kirsten; Wendtner, Clemens-Martin; Kreuzer, Karl-Anton; Stilgenbauer, Stephan; Böttcher, Sebastian; Eichhorst, Barbara; Hallek, Michael

2018-03-01

Four Phase II trials (clinical trials numbers: NCT02345863, NCT02401503, NCT02445131 and NCT02689141) evaluate a different combination of targeted agents in an all-comer population of approximately 60 patients with chronic lymphocytic leukemia irrespective of prior treatment, physical fitness and genetic risk factors. Patients with a higher tumor load start with a debulking treatment with bendamustine. The subsequent induction and maintenance treatment with an anti-CD20 antibody (obinutuzumab or ofatumumab) and a targeted oral agent (ibrutinib, idelalisib or venetoclax) are continued until achievement of a complete response and minimal residual disease negativity. This strategy represents a new era of chronic lymphocytic leukemia therapy where chemotherapy is increasingly replaced by targeted agents and treatment duration is tailored to the patient's individual tumor load and response.

Results of the radiological survey at the ALCOA Research Laboratory, 600 Freeport Road, New Kensington, Pennsylvania (ANK001)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Foley, R.D.; Brown, K.S.

1992-10-01

At the request of the US Department of Energy (DOE), a team from Oak Ridge National Laboratory conducted a radiological survey at the ALCOA Research Laboratory, 600 Freeport Road, New Kensington, Pennsylvania. The survey was performed on November 12, 1991. The purpose of the survey was to determine whether the property was contaminated with radioactive residues, principally [sup 238]U, as a result of work done for the Manhattan Engineer District in 1944. The survey included measurement of direct alpha and beta-gamma levels in the northeast comer of the basement of Building 29, and the collection of a debris sample frommore » a floor drain for radionuclide analysis. The survey area was used for experimental canning of uranium slugs prior to production activities at the former New Kensington Works nearby.« less

Study on Dezincification and De-Lead of Blast Furnace Dust by Fluidized Reduction Experiment

NASA Astrophysics Data System (ADS)

Yang, Shufeng; Liu, Chengsong; Gao, Xiaojie; Li, Jingshe

In the blast furnace process, the dust entrained in the blast furnace gas enters into the down-comer, flows through the gravity dust separator (to eliminate coarse particles) and then is collected in a bag-house. The powder collected by the baghouse is called bag dust, while both fractions are called blast furnace dust whose main components are C and Fe. The dust also contains small amounts of nonferrous metals such as Zn and Pb, which have some value. Also, due to the small particle size and low density the dust is easily suspended in air and so can endanger human health. Therefore it is necessary to develop a process to both treat the dust to recover the metal values and to dispose of the residue — preferably by recycling to the blast furnace itself via the sinter strand. These objectives will result in good economic, environmental and social benefits [1].

Fixing Climate: What Past Climate Changes Reveal About the Current Threat-And How to Counter It

NASA Astrophysics Data System (ADS)

McKinley, Galen A.

2008-10-01

The Earth's climate is changing due to human activities. Recent polls suggest that the U.S. public generally recognizes this fact, and the efforts that led the Intergovernmental Panel on Climate Change (IPCC) and former U.S. vice president Al Gore to win the 2007 Nobel Peace Prize have played no small role in bringing most of the public to realize what scientists have been discussing for years. Yet aside from distorted Hollywood movie accounts such as The Day After Tomorrow, the public knows little about the potential for abrupt change in the climate system. With support from climate science philanthropist Gary Comer, climate scientist Wally Broecker has teamed with science writer Robert Kunzig in this book to bring abrupt climate change into public view. They do this elegantly and convincingly, making the first 12 chapters quite enjoyable.

Retrofit of hollow concrete masonry infilled steel frames using glass fiber reinforced plastic laminates

NASA Astrophysics Data System (ADS)

Hakam, Zeyad Hamed-Ramzy

2000-11-01

This study focuses on the retrofit of hollow concrete masonry infilled steel frames subjected to in-plane lateral loads using glass fiber reinforced plastic (GFRP) laminates that are epoxy-bonded to the exterior faces of the infill walls. An extensive experimental investigation using one-third scale modeling was conducted and consisted of two phases. In the first phase, 64 assemblages, half of which were retrofitted, were tested under various combined in-plane loading conditions similar to those which different regions of a typical infill wall are subjected to. In the second phase, one bare and four masonry-infilled steel frames representative of a typical single-story, single-bay panel were tested under diagonal loading to study the overall behavior and the infill-frame interaction. The relative infill-to-frame stiffness was varied as a test parameter by using two different steel frame sections. The laminates altered the failure modes of the masonry assemblages and reduced the variability and anisotropic nature of the masonry. For the prisms which failed due to shear and/or mortar joint slip, significant strength increases were observed. For those exhibiting compression failure modes, a marginal increase in strength resulted. Retrofitting the infilled frames resulted in an average increase in initial stiffness of two-fold compared to the unretrofitted infilled frames, and seemed independent of the relative infill-to-frame stiffness. However, the increase in the load-carrying capacity of the retrofitted frames compared to the unretrofitted counterparts was higher for those with the larger relative infill-to-frame stiffness parameter. Unlike the unretrofitted infill walls, the retrofitted panels demonstrated almost identical failure modes that were characterized as "strictly comer crushing" in the vicinity of the loaded comers whereas no signs of distress were evident throughout the remainder of the infill. The laminates also maintained the structural integrity of the infill and prevented collapse and debris fallout even at severe loading stages. A finite element macromodel was proposed for the analysis of the GFRP-retrofitted masonry infilled frames. The infill panel was replaced with a nonlinear, compression-only, diagonal strut. This model was verified using the experimental results of the infilled frame testing and is characterized by its ease of application and accuracy.

The promises of big data and small data for travel behavior (aka human mobility) analysis.

PubMed

Chen, Cynthia; Ma, Jingtao; Susilo, Yusak; Liu, Yu; Wang, Menglin

2016-07-01

The last decade has witnessed very active development in two broad, but separate fields, both involving understanding and modeling of how individuals move in time and space (hereafter called "travel behavior analysis" or "human mobility analysis"). One field comprises transportation researchers who have been working in the field for decades and the other involves new comers from a wide range of disciplines, but primarily computer scientists and physicists. Researchers in these two fields work with different datasets, apply different methodologies, and answer different but overlapping questions. It is our view that there is much, hidden synergy between the two fields that needs to be brought out. It is thus the purpose of this paper to introduce datasets, concepts, knowledge and methods used in these two fields, and most importantly raise cross-discipline ideas for conversations and collaborations between the two. It is our hope that this paper will stimulate many future cross-cutting studies that involve researchers from both fields.

CULTURAL INTELLIGENCE ASSISTANCE FOR CROSS-CULTURE UNDERSTANDING AND ACTION RECOMMENDATION

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cui, Xiaohui; Potok, Thomas E; Xu, Songhua

2011-01-01

When traveling or working in a culturally diverse environment, it is demanding for a new comer to quickly notice, understand, and adapt to different culture norms to avoid cultural misunderstanding, and further to establish friendship with the local people. The main challenges include both correctly understanding the intent behind behaviors from people with a different cultural background, and effectively adjusting one s own behaviors to a local cultural setting to express one s intention without ambiguity. Quality cross-cultural assistance can help us accurately recognize the true purpose behind behaviors of a person from a different cultural background, and also advisemore » us to act properly in a new cultural setting. In this project, we aim at providing an advanced cultural intelligence assistance tool, implemented as a mobile application, to facilitate individual users to understand behaviors, norms, and conventions in a new culture, as well as to change their behaviors appropriately in the new cultural environment.« less

The promises of big data and small data for travel behavior (aka human mobility) analysis

PubMed Central

Chen, Cynthia; Ma, Jingtao; Susilo, Yusak; Liu, Yu; Wang, Menglin

2016-01-01

The last decade has witnessed very active development in two broad, but separate fields, both involving understanding and modeling of how individuals move in time and space (hereafter called “travel behavior analysis” or “human mobility analysis”). One field comprises transportation researchers who have been working in the field for decades and the other involves new comers from a wide range of disciplines, but primarily computer scientists and physicists. Researchers in these two fields work with different datasets, apply different methodologies, and answer different but overlapping questions. It is our view that there is much, hidden synergy between the two fields that needs to be brought out. It is thus the purpose of this paper to introduce datasets, concepts, knowledge and methods used in these two fields, and most importantly raise cross-discipline ideas for conversations and collaborations between the two. It is our hope that this paper will stimulate many future cross-cutting studies that involve researchers from both fields. PMID:27182125

Scattering and the Point Spread Function of the New Generation Space Telescope

NASA Technical Reports Server (NTRS)

Schreur, Julian J.

1996-01-01

Preliminary design work on the New Generation Space Telescope (NGST) is currently under way. This telescope is envisioned as a lightweight, deployable Cassegrain reflector with an aperture of 8 meters, and an effective focal length of 80 meters. It is to be folded into a small-diameter package for launch by an Atlas booster, and unfolded in orbit. The primary is to consist of an octagon with a hole at the center, and with eight segments arranged in a flower petal configuration about the octagon. The comers of the petal-shaped segments are to be trimmed so that the package will fit atop the Atlas booster. This mirror, along with its secondary will focus the light from a point source into an image which is spread from a point by diffraction effects, figure errors, and scattering of light from the surface. The distribution of light in the image of a point source is called a point spread function (PSF). The obstruction of the incident light by the secondary mirror and its support structure, the trimmed corners of the petals, and the grooves between the segments all cause the diffraction pattern characterizing an ideal point spread function to be changed, with the trimmed comers causing the rings of the Airy pattern to become broken up, and the linear grooves causing diffraction spikes running radially away from the central spot, or Airy disk. Any figure errors the mirror segments may have, or any errors in aligning the petals with the central octagon will also spread the light out from the ideal point spread function. A point spread function for a mirror the size of the NGST and having an incident wavelength of 900 nm is considered. Most of the light is confined in a circle with a diameter of 0.05 arc seconds. The ring pattern ranges in intensity from 10(exp -2) near the center to 10(exp -6) near the edge of the plotted field, and can be clearly discerned in a log plot of the intensity. The total fraction of the light scattered from this point spread function is called the total integrated scattering (TIS), and the fraction remaining is called the Strehl ratio. The angular distribution of the scattered light is called the angle resolved scattering (ARS), and it shows a strong spike centered on a scattering angle of zero, and a broad , less intense distribution at larger angles. It is this scattered light, and its effect on the point spread function which is the focus of this study.

Resurgence of duckweed research and applications: report from the 3rd International Duckweed Conference.

PubMed

Appenroth, Klaus-J; Sree, K Sowjanya; Fakhoorian, Tamra; Lam, Eric

2015-12-01

Duckweed, flowering plants in the Lemnaceae family, comprises the smallest angiosperms in the plant kingdom. They have some of the fastest biomass accumulation rates reported to date for plants and have the demonstrated ability to thrive on wastewater rich in dissolved organic compounds and thus could help to remediated polluted water resources and prevents eutrophication. With a high quality genome sequence now available and increased commercial interest worldwide to develop duckweed biomass for renewables such as protein and fuel, the 3rd International Duckweed Conference convened at Kyoto, Japan, in July of 2015, to update the community of duckweed researchers and developers on the progress in the field. In addition to sharing results and ideas, the conference also provided ample opportunities for new-comers as well as established workers in the field to network and create new aliances. We hope this meeting summary will also help to disseminate the key advances and observations that have been presented in this conference to the broader plant biology community in order to encourage increased cross-fertilization of ideas and technologies.

Knowledge, attitudes and practices on HIV / AIDS in the south region of Cameroon: case of the town of Kribi.

PubMed

Sanou, Sobze Martin; Fokam, Joseph Martin; Mabvouna, Biguioh Rodriguez; Guetiya, Wadoum Raoul; Sali, Ben Bechir Adogaye; Teikeu, Tessa Vivaldi Vladimir; Nafack, Sonkeng Sonia; Panà, Augusto; Colizzi, Vittorio; Russo, Gianluca

2014-01-01

The aim of our study was to assess knowledge, attitudes, and practices (KAP) regarding HIV/AIDS in the city of Kribi, southern region of Cameroon. In November 2012, a questionnaire composed of 20 items was administered by trained staff from the Biomedical Sciences Department of the University of Dschang to 200 students selected from four population groups: high school students, local traders, tourism personnel (staff of bars, restaurants, hotels, nightclubs), and motorcycle taxi drivers. A cluster sampling method was used to select the first three groups while motorcycle taxi drivers were selected by the method of all comers. KAP regarding HIV/AIDS was found to be fragmentary in the studied population. Only 6.5% systematically uses condoms, 59% believe that AIDS can be cured by traditional medicine and religious faith and 40.9% developed stigmatizing behaviour toward HIV infected people. Among participants there is a wide discrepancy between knowledge and social behaviours toward HIV/AIDS. Strategic and continuous awareness campaigns that are culturally and socially tailored are urgently needed.

Australia: Population.

PubMed

The Australian Bureau of Census and Statistics reported on 27 August 1979 that Australia's total population was 14,376,400 at the end of the first quarter of 1979. Net immigration gain during the same period was 12,700. Natural increase was 32,100--births were 57,100 and deaths were 25,000. In January 1979, Australia introduced a new immigration scheme to improve methods of selecting immigrants. Points are awarded on the basis of personal qualities and employability; an applicant must score 60 out of 100. This scheme supersedes the earlier system under which immigrants were selected on the family reunion criterion and employability. Migrants from Britain and Ireland made up the bulk of the new comers, but their proportion has dropped from 50% in the mid-1960s to 30% in early 1979. In contrast, Asian immigrants have risen from 2% to 22% over the same period. Asian immigration began in the mid-1960s with the relaxation of the "White Australia" policy which barred non-European migrants, and increased when the ban was abolished by Prime Minister Gough Whitlam in 1973.

[Contamination, endocrine disruptors and cancer].

PubMed

Arvelo, Francisco; Sojo, Felipe; Cotte, Carlos

2016-03-01

Since the mid-twentieth century, many species, very different from each other and located in all areas and comers of the planet, began presenting various alterations, many of which suggested to be related to endocrine disorders. Research has shown that such alterations were caused by exposure to various chemical contaminants that could affect the health and cause serious illnesses. Among them stands a diverse and large group of compounds, with very different chemical structures, capable of altering the hormonal balance, act at very low doses and with different mechanisms of action, that are called "endocrine disrupting chemicals". When released into the environment or as part of objects, food or medicines, constitute a major risk to animals and humans, which produces not only endocrine dysfunctions but also different cancers, which include the most common types. Despite the importance and significance of the impact of these compounds, they are not sufficiently known or understood, so the aim of this review is to show their origin and impact in the field of human health, highlighting their role as inducers of cancer, which has led to multiple clinical and biological investigations.

Design Evolution and Performance Characterization of the GTX Air-Breathing Launch Vehicle Inlet

NASA Technical Reports Server (NTRS)

DeBonis, J. R.; Steffen, C. J., Jr.; Rice, T.; Trefny, C. J.

2002-01-01

The design and analysis of a second version of the inlet for the GTX rocket-based combine-cycle launch vehicle is discussed. The previous design did not achieve its predicted performance levels due to excessive turning of low-momentum comer flows and local over-contraction due to asymmetric end-walls. This design attempts to remove these problems by reducing the spike half-angle to 10- from 12-degrees and by implementing true plane of symmetry end-walls. Axisymmetric Reynolds-Averaged Navier-Stokes simulations using both perfect gas and real gas, finite rate chemistry, assumptions were performed to aid in the design process and to create a comprehensive database of inlet performance. The inlet design, which operates over the entire air-breathing Mach number range from 0 to 12, and the performance database are presented. The performance database, for use in cycle analysis, includes predictions of mass capture, pressure recovery, throat Mach number, drag force, and heat load, for the entire Mach range. Results of the computations are compared with experimental data to validate the performance database.

Collaborative science, policy development and program implementation in the transboundary Georgia Basin/Puget Sound ecosystem.

PubMed

Fraser, David A; Gaydos, Joseph K; Karlsen, Erik; Rylko, Michael S

2006-02-01

The transboundary Georgia Basin Puget Sound ecosystem is situated in the southwest corner of British Columbia and northwest comer of Washington State. While bountiful and beautiful, this international region is facing significant threats to its marine and freshwater resources, air quality, habitats and species. These environmental challenges are compounded by rapid population growth and attendant uiban sprawl. As ecosystem stresses amplified and partnerships formed around possible solutions, it became increasingly clear that the shared sustainability challenges in the Georgia Basin and Puget Sound required shared solutions. Federal, state and provincial institutional arrangements were made between jurisdictions, which formalized small scale interest in transboundary management of this ecosystem. Formal agreements, however, can only do so much to further management of an ecosystem that spans international boarders. A transboundary regional research meeting, the 2003 GB/PS Research Conference, opened the doors for large-scale informal cross-boarder cooperation and management. In addition to cooperation, continued efforts to stem toxic pollution, contain urban growth, and protect and restore ecosystems, require a commitment from scientists, educators and policy makers to better integrate research and science with decision-making.

Etching of Silicon in HBr Plasmas for High Aspect Ratio Features

NASA Technical Reports Server (NTRS)

Hwang, Helen H.; Meyyappan, M.; Mathad, G. S.; Ranade, R.

2002-01-01

Etching in semiconductor processing typically involves using halides because of the relatively fast rates. Bromine containing plasmas can generate high aspect ratio trenches, desirable for DRAM and MEMS applications, with relatively straight sidewalk We present scanning electron microscope images for silicon-etched trenches in a HBr plasma. Using a feature profile simulation, we show that the removal yield parameter, or number of neutrals removed per incident ion due to all processes (sputtering, spontaneous desorption, etc.), dictates the profile shape. We find that the profile becomes pinched off when the removal yield is a constant, with a maximum aspect ratio (AR) of about 5 to 1 (depth to height). When the removal yield decreases with increasing ion angle, the etch rate increases at the comers and the trench bottom broadens. The profiles have ARs of over 9:1 for yields that vary with ion angle. To match the experimentally observed etched time of 250 s for an AR of 9:1 with a trench width of 0.135 microns, we find that the neutral flux must be 3.336 x 10(exp 17)sq cm/s.

Description of a Heart Team approach to coronary revascularization and its beneficial long-term effect on clinical events after PCI.

PubMed

Bonzel, Tassilo; Schächinger, Volker; Dörge, Hilmar

2016-05-01

We present a first description of a Heart Team (HT)-guided approach to coronary revascularization and its long-term effect on clinical events after percutaneous coronary intervention (PCI). The HT approach is a structured process to decide for coronary bypass grafting (CABG), PCI or conservative therapy in ad hoc situations as well as in HT conferences. As a hypothesis, during the long-term course after a PCI performed according to HT rules, a low number of late revascularizations, especially CABGs, are expected (F-PCI study). In this monocentric study, the HT approach to an all-comer population was first analyzed and described in general with the help of a database. Next the use of a HT approach was described for a more homogeneous subgroup with newly detected CAD (1.CAD). Those patients in whom the HT decision was PCI (which was a 1.PCI) were then studied with the help of questionnaires for clinical events during a very long-term follow-up. Events were CABG, PCI, diagnostic catheterization (DCath) and death. A significant number of patients were presented to HT conferences: 22 % out of all 11,174 catheterizations, 24 % out of all 7867 CAD cases and 35 % out of 3408 1.CAD cases. Most of these patients had multi-vessel disease (MVD). Conference decisions were isolated CABG in 46-66 %, PCI in 10-14 %, valvular surgery in 9-16 %, HTx in 10-21 % (Endstage heart failure candidates for surgery) and conservative therapy (Medical or no therapy, additional diagnostic procedures or no adherence to recommended therapy) in 2-3 %. However, most PCIs, ad hoc and elective, were performed under Heart Team rules, but without conference. During follow-up of 1.PCI patients (Kaplan-Meier analysis), CABG occurred in only 15 % of patients, PCI in 37 % and DCath in 65 %; mortality of any course was 51 %. Mortalities were similar in one-vessel disease and in a population of the same year, matched for age and sex (p < 0.057), but mortality was higher in 1.PCI patients with MVD (p < 0.001). Beyond 2 years, Kaplan-Meier curves were linear. The structured Heart Team approach is an effective tool for ad hoc and conference-based clinical decision-making with a sustained clinical benefit. This is demonstrated in low late CABG (and PCI) rates after a 1.PCI, without elevated mortality. The all-comer population supports the universal value of these data. Stable annual event rates late after PCI suggest a conversion to stable CAD. Heart Team conferences are also important tools in cases of valvular and end-stage heart disease.

Justification of the Shape of a Non-Circular Cross-Section for Drilling With a Roller Cutter

NASA Astrophysics Data System (ADS)

Buyalich, Gennady; Husnutdinov, Mikhail

2017-11-01

The parameters of the shape of non-circular cross-section affect not only the process of blasting, but also the design of the tool and the process of drilling as well. In the conditions of open-pit mining, it is reasonable to use a roller cutter to produce a non-circular cross-section of blasting holes. With regard to the roller cutter, the impact of the cross-section shape on the oscillations of the axial force arising upon its rotation is determined. It is determined that a polygonal shape with rounded comers of the borehole walls connections and their convex shape, which ensures a smaller range of the total axial force and the torque deflecting the bit from the axis of its rotation is the rational form of the non-circular cross-section of the borehole in terms of bit design. It has been shown that the ratio of the number of cutters to the number of borehole corners must be taken into account when justifying the shape of the cross-section, both from the point of view of the effectiveness of the explosion action and from the point of view of the rational design of the bit.

Waves of novelties in the expansion into the adjacent possible

PubMed Central

Monechi, Bernardo; Ruiz-Serrano, Ãlvaro; Loreto, Vittorio

2017-01-01

The emergence of novelties and their rise and fall in popularity is an ubiquitous phenomenon in human activities. The coexistence of popular evergreens with novel and sometimes ephemeral trends pervades technological, scientific and artistic production. Though this phenomenon is very intuitively captured by our common sense, a comprehensive explanation of how waves of novelties are not hampered by well established old-comers is still lacking. Here we first quantify this phenomenology by empirically looking at different systems that display innovation at very different levels: the creation of hashtags in Twitter, the evolution of online code repositories, the creation of texts and the listening of songs on online platforms. In all these systems surprisingly similar patterns emerge as the non-trivial outcome of two contrasting forces: the tendency of retracing already explored avenues (exploit) and the inclination to explore new possibilities. These findings are naturally explained in the framework of the expansion of the adjacent possible, a recently introduced theoretical framework that postulates the restructuring of the space of possibilities conditional to the occurrence of innovations. The predictions of our theoretical framework are borne out in all the phenomenologies investigated, paving the way to a better understanding and control of innovation processes. PMID:28594909

Naval Waste Package Design Sensitivity

DOE Office of Scientific and Technical Information (OSTI.GOV)

T. Schmitt

2006-12-13

The purpose of this calculation is to determine the sensitivity of the structural response of the Naval waste packages to varying inner cavity dimensions when subjected to a comer drop and tip-over from elevated surface. This calculation will also determine the sensitivity of the structural response of the Naval waste packages to the upper bound of the naval canister masses. The scope of this document is limited to reporting the calculation results in terms of through-wall stress intensities in the outer corrosion barrier. This calculation is intended for use in support of the preliminary design activities for the license applicationmore » design of the Naval waste package. It examines the effects of small changes between the naval canister and the inner vessel, and in these dimensions, the Naval Long waste package and Naval Short waste package are similar. Therefore, only the Naval Long waste package is used in this calculation and is based on the proposed potential designs presented by the drawings and sketches in References 2.1.10 to 2.1.17 and 2.1.20. All conclusions are valid for both the Naval Long and Naval Short waste packages.« less

Identifying factors that predict the choice and success rate of radial artery catheterisation in contemporary real world cardiology practice: a sub-analysis of the PREVAIL study data.

PubMed

Pristipino, Christian; Roncella, Adriana; Trani, Carlo; Nazzaro, Marco S; Berni, Andrea; Di Sciascio, Germano; Sciahbasi, Alessandro; Musarò, Salvatore Donato; Mazzarotto, Pietro; Gioffrè, Gaetano; Speciale, Giulio

2010-06-01

To assess: the reasons behind an operator choosing to perform radial artery catheterisation (RAC) as against femoral arterial catheterisation, and to explore why RAC may fail in the real world. A pre-determined analysis of PREVAIL study database was performed. Relevant data were collected in a prospective, observational survey of 1,052 consecutive patients undergoing invasive cardiovascular procedures at nine Italian hospitals over a one month observation period. By multivariate analysis, the independent predictors of RAC choice were having the procedure performed: (1) at a high procedural volume centre; and (2) by an operator who performs a high volume of radial procedures; clinical variables played no statistically significant role. RAC failure was predicted independently by (1) a lower operator propensity to use RAC; and (2) the presence of obstructive peripheral artery disease. A 10-fold lower rate of RAC failure was observed among operators who perform RAC for > 85% of their personal caseload than among those who use RAC < 25% of the time (3.8% vs. 33.0%, respectively); by receiver operator characteristic (ROC) analysis, no threshold value for operator RAC volume predicted RAC failure. A routine RAC in all-comers is superior to a selective strategy in terms of feasibility and success rate.

NANOTR9: 9th Nanoscience and Nanotechnology Conference

NASA Astrophysics Data System (ADS)

2014-11-01

The conference series NanoTR is the major conference on nanoscience and nanotechnology in Turkey. It brings together leading scientists and engineers in nanotechnology to exchange information on their latest research progress. An exhibition of the companies working in the related field is also organized as a part of the event. With intensive international participation, NanoTR conference series has spread outside the national border and has become an international event in this field. Among international contributions, a wide interest from the countries around Turkey should be emphasized. 9th in the series was organized by Atatürk University in Erzurum-Turkey on June 24-28, 2013 with more than 900 scientists, researchers, private sector representatives from around the world. Conference program included 6 plenary speakers, 35 invited speakers (18 of them were from outside the country), 116 oral presentations, and 340 poster presentations. In addition to 6 plenary sessions, 17 oral and 4 poster sessions created very lively discussion forums covering a vast range of current and emerging sciences from nano-materials, nanoscience, nanofabrication, nano-engineering, nano-electronics, nano-biotechnology, to ethical and social issues of nanoscience and nanotechnology. Also, panel discussions about industrial applications, tutorial sessions have been organized for students, new-comers and company employees.

Drug designs fulfilling the requirements of clinical trials aiming at personalizing medicine

PubMed Central

Mandrekar, Sumithra J.; Sargent, Daniel J.

2014-01-01

In the current era of stratified medicine and biomarker-driven therapies, the focus has shifted from predictions based on the traditional anatomic staging systems to guide the choice of treatment for an individual patient to an integrated approach using the genetic makeup of the tumor and the genotype of the patient. The clinical trial designs utilized in the developmental pathway for biomarkers and biomarker-directed therapies from discovery to clinical practice are rapidly evolving. While several issues need careful consideration, two critical issues that surround the validation of biomarkers are the choice of the clinical trial design (which is based on the strength of the preliminary evidence and marker prevalence), and biomarker assay related issues surrounding the marker assessment methods such as the reliability and reproducibility of the assay. In this review, we focus on trial designs aiming at personalized medicine in the context of early phase trials for initial marker validation, as well as in the context of larger definitive trials. Designs for biomarker validation are broadly classified as retrospective (i.e., using data from previously well-conducted randomized controlled trials (RCTs) versus prospective (enrichment, all-comers, hybrid or adaptive). We believe that the systematic evaluation and implementation of these design strategies are essential to accelerate the clinical validation of biomarker guided therapy. PMID:25414851

Meaning of family reunification as interpreted by young Chinese immigrants.

PubMed

Lam, Amy Mong Chow; Chan, Ting Sam; Tsoi, Kcon Wah

2005-01-01

This paper is a narrative analysis of young Chinese immigrants' subjective interpretation of their family reunification in Hong Kong. The major objectives of the study were to understand what family reunification actually meant to them and how it affected their subsequent adjustment. It also tried to examine the similarities and differences in the experience and interpretation of family reunification among young immigrants who had different levels of adjustment. Participants in this study included 45 immigrants, aged between 12 and 17. Research findings show that family reunification was their long-cherished wish and the main reason for their migration. It was not only their primary concern before coming to Hong Kong but also the stance from which separation with close relatives in their native place and the subsequent hardships as a new comer in the competitive host society were justified. Reunification of the family and harmonious and caring relationship among family members had been the source of comfort and support for those who had successful adjustment. However, for those who did not experience warmth and concern from family members, the disillusionment with a happy family reunification and the experience of distant or even conflictive family relationship had not only created in them a sense of alienation but also resulted in poor adjustment in the new environment.

A prospective, multi-center study of the chocolate balloon in femoropopliteal peripheral artery disease: The Chocolate BAR registry.

PubMed

Mustapha, Jihad A; Lansky, Alexandra; Shishehbor, Mehdi; Miles McClure, John; Johnson, Sarah; Davis, Thomas; Makam, Prakash; Crowder, William; Konstantino, Eitan; Attaran, Robert R

2018-05-01

The Chocolate BAR study is a prospective multicenter post-market registry designed to evaluate the safety and performance of the Chocolate percutaneous transluminal angioplasty balloon catheter in a broad population with symptomatic peripheral arterial disease. The primary endpoint is acute procedural success (defined as ≤30% residual stenosis without flow-limiting dissection); secondary long-term outcomes include freedom from target lesion revascularization (TLR), major unplanned amputation, survival, and patency. A total of 262 patients (290 femoropopliteal lesions) were enrolled at 30 US centers between 2012 and 2014. The primary endpoint of procedure success was achieved in 85.1% of cases, and freedom from stenting occurred in 93.1%. Bail out stenting by independent adjudication occurred in 1.6% of cases and there were no flow limiting dissections. There was mean improvement of 2.1 Rutherford classes (±1.5) at 12-months, with 78.5% freedom from TLR, 97.2% freedom from major amputation, and 93.3% freedom from all-cause mortality. Core Lab adjudicated patency was 64.1% at 12 months. Use of the Chocolate balloon in an "all-comers" population achieved excellent procedural outcomes with low dissection rates and bailout stent use. © 2018 Wiley Periodicals, Inc.

Heat Transfer in a Complex Trailing Edge Passage for a High Pressure Turbine Blade - Part 1: Experimental Measurements. Part 1; Experimental Measurements

NASA Technical Reports Server (NTRS)

Bunker, Ronald S.; Wetzel, Todd G.; Rigby, David L.; Reddy, D. R. (Technical Monitor)

2000-01-01

A combined experimental and computational study has been performed to investigate the detailed heat transfer coefficient distributions within a complex blade trailing edge passage. The experimental measurements are made using a steady liquid crystal thermography technique applied to one major side of the passage. The geometry of the trailing edge passage is that of a two-pass serpentine circuit with a sharp 180-degree turning region at the tip. The upflow channel is split by interrupted ribs into two major subchannels, one of which is turbulated. This channel has an average aspect ratio of roughly 14:1. The spanwise extent of the channel geometry includes both area convergence from root to tip, as well as taper towards the trailing edge apex. The average section Reynolds numbers tested in this upflow channel range from 55,000 to 98,000. The tip section contains a turning vane near the extreme comer. The downflow channel has an aspect ratio of about 5:1, and also includes convergence and taper. Turbulators of varying sizes are included in this channel also. Both detailed heat transfer and pressure distribution measurements are presented. The pressure measurements are incorporated into a flow network model illustrating the major loss contributors.

Corner Wrinkling at a Square Membrane Due to Symmetric Mechanical Loads

NASA Technical Reports Server (NTRS)

Blandino, Joseph R.; Johnston, John D.; Dharamsi, Urmil K.; Brodeur, Stephen J. (Technical Monitor)

2001-01-01

Thin-film membrane structures are under consideration for use in many future gossamer spacecraft systems. Examples include sunshields for large aperture telescopes, solar sails, and membrane optics. The development of capabilities for testing and analyzing pre-tensioned, thin film membrane structures is an important and challenging aspect of gossamer spacecraft technology development. This paper presents results from experimental and computational studies performed to characterize the wrinkling behavior of thin-fi[m membranes under mechanical loading. The test article is a 500 mm square membrane subjected to symmetric comer loads. Data is presented for loads ranging from 0.49 N to 4.91 N. The experimental results show that as the load increases the number of wrinkles increases, while the wrinkle amplitude decreases. The computational model uses a finite element implementation of Stein-Hedgepeth membrane wrinkling theory to predict the behavior of the membrane. Comparisons were made with experimental results for the wrinkle angle and wrinkled region. There was reasonably good agreement between the measured wrinkle angle and the predicted directions of the major principle stresses. The shape of the wrinkle region predicted by the finite element model matches that observed in the experiments; however, the size of the predicted region is smaller than that determined in the experiments.

Severe infestation of blow flies in a raccoon

USGS Publications Warehouse

Kilham, L.; Herman, C.M.

1955-01-01

A raccoon. (Procyon lotor) was observed in a weakened condition for several days at a farm a few miles east of Salisbury, Maryland. It was then caught and held in captivity for a few days. It continued to become weaker and on May 3, 1954, B. Mixon of the Maryland Department of Game and Inland Fish submitted it to us for study. There was no evidence of trauma, either internal or external. The fur was matted over the right hind leg, the inguinal region, and over much of the left hind leg. Inspection revealed the presence of thousands of larvae of the green-bottle fly, Phaenicia sericata, (Meigen}1 actively tunneling in and out of the skin and subcutaneous tissue. Muscle under lying infested skin appeared healthy and untraumatized. A few larvae were in comers of the eyes but none were found in other orifices. Gross and microscopic examination of tissue from the raccoon gave no indication of any acute process which might have led to its moribund condition. James (1947. The flies that cause myiasis in man. U. S. Govt. Print. Off.) and Hall (1948: The blowflies of North America.. Thom. Say Foundation) indicate that P. sericata may vary in virulence, some strains becoming parasitic with an ability to invade healthy tissue. In all probability, the larvae described above hatched from eggs originally laid in a skin wound although no evidence for this was found.

Segmented Mirror Image Degradation Due to Surface Dust, Alignment and Figure

NASA Technical Reports Server (NTRS)

Schreur, Julian J.

1999-01-01

In 1996 an algorithm was developed to include the effects of surface roughness in the calculation of the point spread function of a telescope mirror. This algorithm has been extended to include the effects of alignment errors and figure errors for the individual elements, and an overall contamination by surface dust. The final algorithm builds an array for a guard-banded pupil function of a mirror that may or may not have a central hole, a central reflecting segment, or an outer ring of segments. The central hole, central reflecting segment, and outer ring may be circular or polygonal, and the outer segments may have trimmed comers. The modeled point spread functions show that x-tilt and y-tilt, or the corresponding R-tilt and theta-tilt for a segment in an outer ring, is readily apparent for maximum wavefront errors of 0.1 lambda. A similar sized piston error is also apparent, but integral wavelength piston errors are not. Severe piston error introduces a focus error of the opposite sign, so piston could be adjusted to compensate for segments with varying focal lengths. Dust affects the image principally by decreasing the Strehl ratio, or peak intensity of the image. For an eight-meter telescope a 25% coverage by dust produced a scattered light intensity of 10(exp -9) of the peak intensity, a level well below detectability.

A review of low density porous materials used in laser plasma experiments

NASA Astrophysics Data System (ADS)

Nagai, Keiji; Musgrave, Christopher S. A.; Nazarov, Wigen

2018-03-01

This review describes and categorizes the synthesis and properties of low density porous materials, which are commonly referred to as foams and are utilized for laser plasma experiments. By focusing a high-power laser on a small target composed of these materials, high energy and density states can be produced. In the past decade or so, various new target fabrication techniques have been developed by many laboratories that use high energy lasers and consequently, many publications and reviews followed these developments. However, the emphasis so far has been on targets that did not utilize low density porous materials. This review therefore, attempts to redress this balance and endeavors to review low density materials used in laser plasma experiments in recent years. The emphasis of this review will be on aspects of low density materials that are of relevance to high energy laser plasma experiments. Aspects of low density materials such as densities, elemental compositions, macroscopic structures, nanostructures, and characterization of these materials will be covered. Also, there will be a brief mention of how these aspects affect the results in laser plasma experiments and the constrictions that these requirements put on the fabrication of low density materials relevant to this field. This review is written from the chemists' point of view to aid physicists and the new comers to this field.

Synthesis and time-resolved structural characterization of framework and mineral sulfides

NASA Astrophysics Data System (ADS)

Cahill, Christopher Langley

A new class of open-framework organic/inorganic hybrid materials based on In-S chemistry has been discovered. The compounds therein exhibit unprecedented structural diversity compared to known porous sulfides, primarily due to variation in framework building units. Further, large increases in pore dimensions (vs. zeolites, for example) are observed as these materials consist of comer and edge linked clusters, e.g. In10S20, In9S17, In4S10 and In6S 15. Choice of organic structure directing agents (templates) and careful control of reaction conditions (temperature, pH) both in the In-S and Ge-S systems is shown not only to dictate which building unit will form, but also to direct the resulting framework topology. Several of the compounds described herein crystallize either as powders, or as crystals too small for standard in-house X-ray structural analysis. Diffraction experiments have thus required synchrotron based single crystal techniques for structure determination. Further, certain reaction mixture compositions result in multi-phase end products, the formation pathways of which have been studied with time resolved, in situ synchrotron powder diffraction. An extension of the applicability of the in situ techniques investigated the role of oxygen in hydrothermal systems. Oxidation state is proposed to dictate speciation in the Ni-Ge-S system and to promote phase transformations in the Fe-S mineral system.

Mass-Gathering Medical Care in Electronic Dance Music Festivals.

PubMed

FitzGibbon, Kathleen M; Nable, Jose V; Ayd, Benjamin; Lawner, Benjamin J; Comer, Angela C; Lichenstein, Richard; Levy, Matthew J; Seaman, Kevin G; Bussey, Ian

2017-10-01

Introduction Electronic dance music (EDM) festivals represent a unique subset of mass-gathering events with limited guidance through literature or legislation to guide mass-gathering medical care at these events. Hypothesis/Problem Electronic dance music festivals pose unique challenges with increased patient encounters and heightened patient acuity under-estimated by current validated casualty predication models. This was a retrospective review of three separate EDM festivals with analysis of patient encounters and patient transport rates. Data obtained were inserted into the predictive Arbon and Hartman models to determine estimated patient presentation rate and patient transport rates. The Arbon model under-predicted the number of patient encounters and the number of patient transports for all three festivals, while the Hartman model under-predicted the number of patient encounters at one festival and over-predicted the number of encounters at the other two festivals. The Hartman model over-predicted patient transport rates for two of the three festivals. Electronic dance music festivals often involve distinct challenges and current predictive models are inaccurate for planning these events. The formation of a cohesive incident action plan will assist in addressing these challenges and lead to the collection of more uniform data metrics. FitzGibbon KM , Nable JV , Ayd B , Lawner BJ , Comer AC , Lichenstein R , Levy MJ , Seaman KG , Bussey I . Mass-gathering medical care in electronic dance music festivals. Prehosp Disaster Med. 2017;32(5):563-567.

Improving the Energy Saving Process with High-Resolution Data: A Case Study in a University Building.

PubMed

Han, Jeongyun; Lee, Eunjung; Cho, Hyunghun; Yoon, Yoonjin; Lee, Hyoseop; Rhee, Wonjong

2018-05-17

In this paper, we provide findings from an energy saving experiment in a university building, where an IoT platform with 1 Hz sampling sensors was deployed to collect electric power consumption data. The experiment was a reward setup with daily feedback delivered by an energy delegate for one week, and energy saving of 25.4% was achieved during the experiment. Post-experiment sustainability, defined as 10% or more of energy saving, was also accomplished for 44 days without any further intervention efforts. The saving was possible mainly because of the data-driven intervention designs with high-resolution data in terms of sampling frequency and number of sensors, and the high-resolution data turned out to be pivotal for an effective waste behavior investigation. While the quantitative result was encouraging, we also noticed many uncontrollable factors, such as exams, papers due, office allocation shuffling, graduation, and new-comers, that affected the result in the campus environment. To confirm that the quantitative result was due to behavior changes, rather than uncontrollable factors, we developed several data-driven behavior detection measures. With these measures, it was possible to analyze behavioral changes, as opposed to simply analyzing quantitative fluctuations. Overall, we conclude that the space-time resolution of data can be crucial for energy saving, and potentially for many other data-driven energy applications.

Comparison of the Efficacy and Safety of Orbital and Rotational Atherectomy in Calcified Narrowings in Patients Who Underwent Percutaneous Coronary Intervention.

PubMed

Koifman, Edward; Garcia-Garcia, Hector M; Kuku, Kayode O; Kajita, Alexandre H; Buchanan, Kyle D; Steinvil, Arie; Rogers, Toby; Bernardo, Nelson L; Lager, Robert; Gallino, Robert A; Ben-Dor, Itsik; Pichard, Augusto D; Torguson, Rebecca; Gai, Jiaxiang; Satler, Lowell F; Waksman, Ron

2018-04-15

We aimed to compare the safety and efficacy of rotational atherectomy (RA) and orbital atherectomy (OA) during percutaneous coronary intervention in an all-comer population with severely calcified lesions. We included all patients who underwent percutaneous coronary intervention with OA or RA in our institution from October 2013 until October 2016. Comparison of baseline and procedural characteristics, along with acute complication rates and postprocedural cardiac enzyme elevation, was performed. There were 191 RA and 57 OA patients. Other than creatinine clearance, which was lower in patients with OA (p = 0.01), there were no differences in baseline characteristics. OA was more frequent in left anterior descending artery lesions (p = 0.02), whereas RA was more common in right coronary artery lesions (p = 0.01). Intracoronary imaging rates were above 60% in both groups. There was a higher rate of coronary dissections with OA compared with RA (p = 0.003), but there was no difference in periprocedural events. Maximal troponin levels were similar in both groups. Residual stenosis measured by intravascular ultrasound in 29 patients revealed no significant differences between OA and RA (p = 0.58). In conclusion, RA and OA have similar safety and efficacy profiles in treating patients with calcified coronary lesions, and intracoronary imaging is highly beneficial in identifying coronary injury after atherectomy procedures. Copyright © 2018 Elsevier Inc. All rights reserved.

Technique optimization of orbital atherectomy in calcified peripheral lesions of the lower extremities: the CONFIRM series, a prospective multicenter registry.

PubMed

Das, Tony; Mustapha, Jihad; Indes, Jeffrey; Vorhies, Robert; Beasley, Robert; Doshi, Nilesh; Adams, George L

2014-01-01

The purpose of CONFIRM registry series was to evaluate the use of orbital atherectomy (OA) in peripheral lesions of the lower extremities, as well as optimize the technique of OA. Methods of treating calcified arteries (historically a strong predictor of treatment failure) have improved significantly over the past decade and now include minimally invasive endovascular treatments, such as OA with unique versatility in modifying calcific lesions above and below-the-knee. Patients (3135) undergoing OA by more than 350 physicians at over 200 US institutions were enrolled on an "all-comers" basis, resulting in registries that provided site-reported patient demographics, ABI, Rutherford classification, co-morbidities, lesion characteristics, plaque morphology, device usage parameters, and procedural outcomes. Treatment with OA reduced pre-procedural stenosis from an average of 88-35%. Final residual stenosis after adjunctive treatments, typically low-pressure percutaneous transluminal angioplasty (PTA), averaged 10%. Plaque removal was most effective for severely calcified lesions and least effective for soft plaque. Shorter spin times and smaller crown sizes significantly lowered procedural complications which included slow flow (4.4%), embolism (2.2%), and spasm (6.3%), emphasizing the importance of treatment regimens that focus on plaque modification over maximizing luminal gain. The OA technique optimization, which resulted in a change of device usage across the CONFIRM registry series, corresponded to a lower incidence of adverse events irrespective of calcium burden or co-morbidities. Copyright © 2013 The Authors. Wiley Periodicals, Inc.

Parallel Epidemics of Community-Associated Methicillin-Resistant Staphylococcus aureus USA300 Infection in North and South America.

PubMed

Planet, Paul J; Diaz, Lorena; Kolokotronis, Sergios-Orestis; Narechania, Apurva; Reyes, Jinnethe; Xing, Galen; Rincon, Sandra; Smith, Hannah; Panesso, Diana; Ryan, Chanelle; Smith, Dylan P; Guzman, Manuel; Zurita, Jeannete; Sebra, Robert; Deikus, Gintaras; Nolan, Rathel L; Tenover, Fred C; Weinstock, George M; Robinson, D Ashley; Arias, Cesar A

2015-12-15

The community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) epidemic in the United States is attributed to the spread of the USA300 clone. An epidemic of CA-MRSA closely related to USA300 has occurred in northern South America (USA300 Latin-American variant, USA300-LV). Using phylogenomic analysis, we aimed to understand the relationships between these 2 epidemics. We sequenced the genomes of 51 MRSA clinical isolates collected between 1999 and 2012 from the United States, Colombia, Venezuela, and Ecuador. Phylogenetic analysis was used to infer the relationships and times since the divergence of the major clades. Phylogenetic analyses revealed 2 dominant clades that segregated by geographical region, had a putative common ancestor in 1975, and originated in 1989, in North America, and in 1985, in South America. Emergence of these parallel epidemics coincides with the independent acquisition of the arginine catabolic mobile element (ACME) in North American isolates and a novel copper and mercury resistance (COMER) mobile element in South American isolates. Our results reveal the existence of 2 parallel USA300 epidemics that shared a recent common ancestor. The simultaneous rapid dissemination of these 2 epidemic clades suggests the presence of shared, potentially convergent adaptations that enhance fitness and ability to spread. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Spatial heterogeneity of mitochondrial DNA and allozymes among populations of white-tailed deer and mule deer

USGS Publications Warehouse

Cronin, M.A.; Nelson, M.; Pac, D.

1991-01-01

A raccoon. (Procyon lotor) was observed in a weakened condition for several days at a farm a few miles east of Salisbury, Maryland. It was then caught and held in captivity for a few days. It continued to become weaker and on May 3, 1954, B. Mixon of the Maryland Department of Game and Inland Fish submitted it to us for study. There was no evidence of trauma, either internal or external. The fur was matted over the right hind leg, the inguinal region, and over much of the left hind leg. Inspection revealed the presence of thousands of larvae of the green-bottle fly, Phaenicia sericata, (Meigen}1 actively tunneling in and out of the skin and subcutaneous tissue. Muscle under lying infested skin appeared healthy and untraumatized. A few larvae were in comers of the eyes but none were found in other orifices. Gross and microscopic examination of tissue from the raccoon gave no indication of any acute process which might have led to its moribund condition. James (1947. The flies that cause myiasis in man. U. S. Govt. Print. Off.) and Hall (1948: The blowflies of North America.. Thom. Say Foundation) indicate that P. sericata may vary in virulence, some strains becoming parasitic with an ability to invade healthy tissue. In all probability, the larvae described above hatched from eggs originally laid in a skin wound although no evidence for this was found.

Drug‐coated balloons for de novo lesions in small coronary arteries: rationale and design of BASKET‐SMALL 2

PubMed Central

Gilgen, Nicole; Farah, Ahmed; Scheller, Bruno; Ohlow, Marc‐Alexander; Mangner, Norman; Weilenmann, Daniel; Wöhrle, Jochen; Jamshidi, Peiman; Leibundgut, Gregor; Möbius‐Winkler, Sven; Zweiker, Robert; Krackhardt, Florian; Butter, Christian; Bruch, Leonhard; Kaiser, Christoph; Hoffmann, Andreas; Rickenbacher, Peter; Mueller, Christian; Stephan, Frank‐Peter; Coslovsky, Michael

2018-01-01

The treatment of coronary small vessel disease (SVD) remains an unresolved issue. Drug‐eluting stents (DES) have limited efficacy due to increased rates of instent‐restenosis, mainly caused by late lumen loss. Drug‐coated balloons (DCB) are a promising technique because native vessels remain structurally unchanged. Basel Stent Kosten‐Effektivitäts Trial: Drug‐Coated Balloons vs. Drug‐Eluting Stents in Small Vessel Interventions (BASKET‐SMALL 2) is a multicenter, randomized, controlled, noninferiority trial of DCB vs DES in native SVD for clinical endpoints. Seven hundred fifty‐eight patients with de novo lesions in vessels <3 mm in diameter and an indication for percutaneous coronary intervention such as stable angina pectoris, silent ischemia, or acute coronary syndromes are randomized 1:1 to angioplasty with DCB vs implantation of a DES after successful initial balloon angioplasty. The primary endpoint is the combination of cardiac death, nonfatal myocardial infarction, and target‐vessel revascularization up to 1 year. Secondary endpoints include stent thrombosis, Bleeding Academic Research Consortium (BARC) type 3 to 5 bleeding, and long‐term outcome up to 3 years. Based on clinical endpoints after 1 year, we plan to assess the noninferiority of DCB compared to DES in patients undergoing primary percutaneous coronary intervention for SVD. Results will be available in the second half of 2018. This study will compare DCB and DES regarding long‐term safety and efficacy for the treatment of SVD in a large all‐comer population. PMID:29527709

Blunt splenic injuries: have we watched long enough?

PubMed

Smith, Jason; Armen, Scott; Cook, Charles H; Martin, Larry C

2008-03-01

Nonoperative management (NOM) of blunt splenic injuries (BSIs) has been used with increasing frequency in adult patients. There are currently no definitive guidelines established for how long BSI patients should be monitored for failure of NOM after injury. This study was performed to ascertain the length of inpatient observation needed to capture most failures, and to identify factors associated with failure of NOM. We utilized the National Trauma Data Bank to determine time to failure after BSI. During the 5-year study period, 23,532 patients were identified with BSI, of which 2,366 (10% overall) were taken directly to surgery (within 2 hours of arrival). Of 21,166 patients initially managed nonoperatively, 18,506 were successful (79% of all-comers). Patients with isolated BSI are currently monitored approximately 5 days as inpatients. Of patients failing NOM, 95% failed during the first 72 hours, and monitoring 2 additional days saw only 1.5% more failures. Factors influencing success of NOM included computed tomographic injury grade, severity of patient injury, and American College of Surgeons designation of trauma center. Importantly, patients who failed NOM did not seem to have detrimental outcomes when compared with patients with successful NOM. No statistically significant predictive variables could be identified that would help predict patients who would go on to fail NOM. We conclude that at least 80% of BSI can be managed successfully with NOM, and that patients should be monitored as inpatients for failure after BSI for 3 to 5 days.

'The Real Classroom Is Outside—Get into It!' Teaching through Field Experiences

NASA Astrophysics Data System (ADS)

Passow, M. J.

2015-12-01

Field-based experiences can be powerful influences on students of any age, from pre-college through grad school, as well as on the general public. Every place-based learning experience will be different because the combination of location, participant background, available resources, and other factors will be unique. But certain shared goals, necessities, and similarities can be recognized. Intended outcomes should be identified in advance to inform planning. Preparation for field experiences should involve the students along with other participants. More-experienced students can become role models for new-comers. Field experiences involve active learning, as participants are fully immersed in the sampling site and have all senses stimulated. Constantly-changing variables highlight interconnectedness of Earth processes and fosters Systems Thinking. Decisions about the most effective ways to communicate data and results will differ from what might be based on classroom or laboratory venues. Three examples of field-based learning will be provided. One involves collaboration between educational specialists at a scientific research institution, the Lamont-Doherty Earth Observatory of Columbia University, with high school students enrolled in their school's Authentic Science Research program. The second describes orientation for beginning graduate students to the geology, geography, and history of their new home region through a tourist boat ride, the well-known Circle Ride around Manhattan. The third illustrates use of 'eco-hikes' to enhance environmental understanding for Open House and other visitors. These can serve as models for designing experience-based programs in other situations.

The German Aortic Valve Registry (GARY): in-hospital outcome

PubMed Central

Hamm, Christian W.; Möllmann, Helge; Holzhey, David; Beckmann, Andreas; Veit, Christof; Figulla, Hans-Reiner; Cremer, J.; Kuck, Karl-Heinz; Lange, Rüdiger; Zahn, Ralf; Sack, Stefan; Schuler, Gerhard; Walther, Thomas; Beyersdorf, Friedhelm; Böhm, Michael; Heusch, Gerd; Funkat, Anne-Kathrin; Meinertz, Thomas; Neumann, Till; Papoutsis, Konstantinos; Schneider, Steffen; Welz, Armin; Mohr, Friedrich W.

2014-01-01

Background Aortic stenosis is a frequent valvular disease especially in elderly patients. Catheter-based valve implantation has emerged as a valuable treatment approach for these patients being either at very high risk for conventional surgery or even deemed inoperable. The German Aortic Valve Registry (GARY) provides data on conventional and catheter-based aortic procedures on an all-comers basis. Methods and results A total of 13 860 consecutive patients undergoing repair for aortic valve disease [conventional surgery and transvascular (TV) or transapical (TA) catheter-based techniques] have been enrolled in this registry during 2011 and baseline, procedural, and outcome data have been acquired. The registry summarizes the results of 6523 conventional aortic valve replacements without (AVR) and 3464 with concomitant coronary bypass surgery (AVR + CABG) as well as 2695 TV AVI and 1181 TA interventions (TA AVI). Patients undergoing catheter-based techniques were significantly older and had higher risk profiles. The stroke rate was low in all groups with 1.3% (AVR), 1.9% (AVR + CABG), 1.7% (TV AVI), and 2.3% (TA AVI). The in-hospital mortality was 2.1% (AVR) and 4.5% (AVR + CABG) for patients undergoing conventional surgery, and 5.1% (TV AVI) and AVI 7.7% (TA AVI). Conclusion The in-hospital outcome results of this registry show that conventional surgery yields excellent results in all risk groups and that catheter-based aortic valve replacements is an alternative to conventional surgery in high risk and elderly patients. PMID:24022003

Coverage of Cervical Cancer Screening in Catalonia for the Period 2008–2011 among Immigrants and Spanish-Born Women

PubMed Central

Rodríguez-Salés, Vanesa; Roura, Esther; Ibañez, Raquel; Peris, Mercè; Bosch, F. Xavier; de Sanjosé, Sílvia

2013-01-01

Background: Female immigration in Catalonia, Spain, increased dramatically in the last 10 years. The Public Health system in the Region, provides a free of charge opportunistic cervical cancer screening. Aim: This study examines cervical cancer screening coverage and prevalence of cytology abnormalities in Catalonia by immigration status. Methods: The study analyzes the cytologies registered among women aged 25–65 that have been attended at the Primary Health Centers (PHC) for any reason (n = 1,242,230) during 2008–2011. Coverage was estimated from Governmental data base Information System Primary Care (SISAP) that includes 77% of PHC. The database is anonymous, and includes information on age, country of birth, diagnostic center, and cytology results. Results: During the period 2008–2011, 642,643 smears were performed in a total of 506,189 women over 14 years, of whom 18.3% were immigrants. Cytology coverage was higher among immigrant women compared to Spanish born (51.2 and 39% respectively). Immigrant women also had a higher prevalence of abnormal Paps compared to the Spanish population, 4.5 and 2.9% respectively (p < 0.001). Conclusion: Immigrant women in Catalonia had a high access to the Public Health Services and to cervical cancer screening facilities. The higher prevalence of abnormal cytologies in immigrant women compared to native women indicates the relevance to prioritize cervical cancer screening activities on a regular base in new comers. PMID:24392348

PREFACE: Advanced Materials for Demanding Applications

NASA Astrophysics Data System (ADS)

McMillan, Alison; Schofield, Stephen; Kelly, Michael

2015-02-01

This was a special conference. It was small enough (60+ delegates) but covering a wide range of topics, under a broad end-use focussed heading. Most conferences today either have hundreds or thousands of delegates or are small and very focussed. The topics ranged over composite materials, the testing of durability aspects of materials, and an eclectic set of papers on radar screening using weak ionized plasmas, composites for microvascular applications, composites in space rockets, and materials for spallation neutron sources etc. There were several papers of new characterisation techniques and, very importantly, several papers that started with the end-user requirements leading back into materials selection. In my own area, there were three talks about the technology for the ultra-precise positioning of individual atoms, donors, and complete monolayers to take modern electronics and optoelectronics ideas closer to the market place. The President of the Institute opened with an experience-based talk on translating innovative technology into business. Everyone gave a generous introduction to bring all-comers up to speed with the burning contemporary issues. Indeed, I wish that a larger cohort of first-year engineering PhD students were present to see the full gamut of what takes a physics idea to a success in the market place. I would urge groups to learn from Prof Alison McMillan (a Vice President of the Institute of Physics) and Steven Schofield, to set up conferences of similar scale and breadth. I took in more than I do from mega-meetings, and in greater depth. Professor Michael Kelly Department of Engineering University of Cambridge

Vaccination policies of immigrants in the EU/EEA Member States-the measles immunization example.

PubMed

Bica, Mihai A; Clemens, Ralf

2018-06-01

In 2015-16, the European Union/European Economic Area Member States (EU/EEA MSs) experienced an unprecedented volume and rate of migration, posing serious challenges to existing national immunization systems and strategies and raising the questions of where, when and who to vaccinate. We assessed existing strategies for vaccinating immigrant populations in the EU/EEA using measles as an example of the most important vaccine-preventable diseases. In this cross-sectional study, conducted from March to May 2016, an electronic questionnaire was sent to the Heads of National Immunization Technical Advisory Groups (NITAGs) or equivalent policy-making bodies in each of the 31 EU/EEA Member States. Responses were entered into a structured database and validated by survey responders for final analysis. Validated responses from all 31 EU/EEA NITAGs or equivalents showed that there is no common measles immunization policy for European immigrants. Policies vary widely from no policy at all (9 of 31, 29%) to vaccination of all comers (2 of 31, 6%), or vaccination of selected cohorts based on vaccination history (17 of 31, 55%) or serum antibody analysis (2 of 31, 6%). Further, the operational responsibilities for immigrant vaccination and documentation methods are not unified within the EU/EEA region. With some notable exceptions immunization policies to contain spread of infectious diseases through migration are either non-existent or vary widely between countries in the EU/EEA. With freedom of movement within the EU/EEA there ought to be harmonization and a common EU/EEA vaccination strategy to replace national policies for immigrant populations.

Cross-Cultural Understanding for Global Sustainability: Messages and Meanings from Asian Cultural Landscapes

NASA Astrophysics Data System (ADS)

Singh, R.

2013-11-01

Concept of 'multifunctionality' of cultural landscapes is a reflection of imbued meaning and aesthetics inherent there and also human manifestation of this spirit through existence and aliveness by human creation, love and continuance in various cultures and traditions. This sense helps envisioning landscapes that cross urban-rural divides in sustainable and an integrated way - characterised by wholeness and ecospirituality that developed in the cultural history of landscape sustainability. That is how, the idea of 'wholeness' (cosmality) is transformed into 'holiness' (sacrality) ― evolved and represented with sacred ecology and visualised through the cosmic frames of sacredscapes in Asian region that survived there as part of lifeworld. Understanding, feeling, living with, practicing and passing on these inherent meanings and aesthetics provide peace, solace and deeper feelings to human mind which are the ethereal breathe of sustainability. The rethinking should be based on the foundational value ― the reasoning that underlies the ethical sense of deeper understanding of Man-Nature Interrelatedness, the basic philosophy of coexistence ― referred in different cultures in their own ways, like multicultural co-living ('Old-comer') in Korea, harmonious coexistence (tabunka kyosei) in Japan, harmonious society (xiaokang) in China, wahi tapu (sacred places) in Maori's New Zealand, global family (vasudhaiva kutumbakam) in Indian thought, and also African humanism (ubuntu) in South Africa. Think universally, see globally, behave regionally, act locally but insightfully; this is an appeal for shared wisdom for global sustainability in making our cultural landscapes mosaic of happy, peaceful and sustainable places crossing all the borders and transitions, especially interwoven links among Korea, Japan, China, and India.

Sporadic extra abdominal wall desmoid-type fibromatosis: surgical resection can be safely limited to a minority of patients.

PubMed

Colombo, C; Miceli, R; Le Péchoux, C; Palassini, E; Honoré, C; Stacchiotti, S; Mir, O; Casali, P G; Dômont, J; Fiore, M; Le Cesne, A; Gronchi, A; Bonvalot, S

2015-01-01

To analyse the natural history of extra-abdominal wall desmoid-type fibromatosis (DF) and compare outcome in patients who underwent initial surgery with those who did not. All consecutive patients affected by primary sporadic extra-abdominal wall DF observed between January 1992 and December 2012 were included. Patients were divided into surgical (SG) or non-surgical groups (NSG) according to initial treatment. Relapse free survival was calculated for SG, and crude cumulative incidence (CCI) of switching to surgery or other treatments for NSG. 216 patients were identified, 94 in SG (43%), 122 in NSG (57%). A shift towards a more systematic use of a conservative approach (78% of all comers) was observed in the latter years (2006-2012), although a small proportion of patients (28%) had been offered the conservative strategy even in the early period (1992-2005). Median follow-up (FU) was 49 mo. (interquartile (IQ), 20-89 mo.), 76 months for SG and 39 months for NSG. 5-year relapse-free survival (RFS) for SG was 80% (95% confidence interval (CI), 72-89%). For the NSG, 5-year CCI of switching to surgery was 5% (95% CI: 1.7%, 14%), and 51% to other treatments (95% CI: 41%, 65%). 27 (20%) NSG patients underwent spontaneous regression. A non-surgical approach to extra-abdominal wall DF allowed surgery to be avoided in the majority of patients. This approach can be safely proposed and surgery offered as an option in selected cases. Copyright © 2014 Elsevier Ltd. All rights reserved.

Cultural resource applications for a GIS: Stone conservation at Jefferson and Lincoln Memorials

USGS Publications Warehouse

Joly, Kyle; Donald, Tony; Comer, Douglas

1998-01-01

Geographical information systems are rapidly becoming essential tools for land management. They provide a way to link landscape features to the wide variety of information that managers must consider when formulating plans for a site, designing site improvement and restoration projects, determining maintenance projects and protocols, and even interpreting the site. At the same time, they can be valuable research tools.Standing structures offer a different sort of geography, even though a humanly contrived one. Therefore, the capability of a geographical information system (GIS) to link geographical units to the information pertinent to the site and resource management can be employed in the management of standing structures. This was the idea that inspired the use of a GIS software, ArcView, to link computer aided design CAD) drawings of the Jefferson and Lincoln Memorials with inventories of the stones in the memorials. Both the CAD drawings and the inventory were in existence; what remained to be done was to modify the CAD files and place the inventory in an appropriately designed computerized database, and then to link the two in a GIS project. This work was carried out at the NPS Denver Service Center, Resource Planning Group, Applied Archaeology Center (DSC-RPG-AAC), in Silver Spring, Maryland, with the assistance of US/ICOMOS summer interns Katja Marasovic (Croatia) and Rastislav Gromnica (Slovakia), under the supervision of AAC office manager Douglas Comer. Project guidance was provided by Tony Donald, the Denver Service Center (DSC) project architect for the restoration of the Jefferson and Lincoln Memorials, and GIS consultation services by Kyle Joly.

Clinically relevant characteristics associated with early treatment drug use versus abstinence.

PubMed

Cochran, Gerald; Stitzer, Maxine; Nunes, Edward V; Hu, Mei-Chen; Campbell, Aimee

2014-04-04

This study describes early treatment drug use status and associated clinical characteristics in a diverse sample of patients entering outpatient substance abuse psychosocial counseling treatment. The goal is to more fully characterize those entering treatment with and without active use of their primary drug in order to better understand associated treatment needs and resilience factors. We examined baseline data from a NIDA Clinical Trials Network (CTN) study (Web-delivery of Treatment for Substance Use) with an all-comers sample of patients (N = 494) entering 10 outpatient treatment centers. Patients were categorized according to self-identified primary drug of abuse (alcohol, cocaine/stimulants, opioids, marijuana) and by baseline drug use status (positive/negative) based on urine testing or self-reports of recent use (alcohol). Characteristics were examined by primary drug and early use status. Classified as drug-negative were 84%, 76%, 62%, and 33% of primary opioid, stimulant, alcohol, and marijuana users; respectively. Drug-positive versus -negative patients did not differ on demographics or rates of substance abuse/dependence diagnoses. However, those negative for active use had better physical and mental health profiles, were less likely to be using a secondary drug, and were more likely to be attending 12-step self-help meetings. Early treatment drug abstinence is common among substance users entering outpatient psychosocial counseling programs, regardless of primary abused drug. Abstinence (by negative UA) is associated with better health and mental health profiles, less secondary drug use, and more days of 12-step attendance. These data highlight differential treatment needs and resiliencies associated with early treatment drug use status. NCT01104805.

Safety of Tamsulosin: A Systematic Review of Randomized Trials with a Focus on Women and Children.

PubMed

Kaplan, Steven A; Chughtai, Bilal I

2018-05-08

Although tamsulosin is indicated for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH), it has also been assessed in clinical studies for other conditions/symptoms and in other populations such as women and children. In this systematic review of randomized studies, the overall safety of tamsulosin was assessed, focusing on these understudied populations. Literature searches were conducted using Embase, Medline, and PubMed (inception-December 2015). A study was included if patients were randomized to receive treatment with any dose of tamsulosin capsules, tablets, or an oral controlled absorption system and numerical safety results were reported. Overall, 160 articles involving 46,072 participants met the inclusion criteria. Of these, four studies included women only and three included children. The mean [standard deviation (SD)] age ranged from 7.3 (4.2) to 76.8 (7.1) years. The studies (n; %) evaluated healthy subjects (18; 11%) or patients with lower urinary tract symptoms/BPH (90; 56%), ureteral stones/renal colic (42; 26%), prostatitis (4; 3%), or other conditions (6; 4%). Patients discontinued tamsulosin primarily because of adverse events (AEs) or insufficient response. AEs in women and children were abdominal pain, asthenia, constipation, dizziness, dry mouth, drowsiness, dyspepsia, headache, incontinence, nasal congestion, nausea, orthostatic hypotension, and somnolence. Due to heterogeneity across studies, statistical analysis could not be conducted. No unexpected AEs were observed in an all-comers population treated with tamsulosin for various conditions/symptoms. The overall safety profile in women and children seemed to be generally consistent with the profile in men, the indicated population.

Detecting Periprocedural Myocardial Infarction in Contemporary Percutaneous Coronary Intervention Trials.

PubMed

Spitzer, Ernest; de Vries, Ton; Cavalcante, Rafael; Tuinman, Marieke; Rademaker-Havinga, Tessa; Alkema, Maaike; Morel, Marie-Angele; Soliman, Osama I; Onuma, Yoshinobu; van Es, Gerrit-Anne; Tijssen, Jan G P; McFadden, Eugene; Serruys, Patrick W

2017-04-10

This study sought to investigate the differences in detecting (e.g., triggering) periprocedural myocardial infarction (PMI) among 3 current definitions. PMI is a frequent component of primary endpoints in coronary device trials. Identification of all potential suspected events is critical for accurate event ascertainment. Automatic triggers based on study databases prevent underreporting of events. We generated automated algorithms to trigger PMI based on each definition and compared results using data from the RESOLUTE all comers trial. The operationalization of current PMI definitions was achieved by defining programmable algorithms used to interrogate the study database. From a total of 636 PMI triggers, we identified 234 for the World Health Organization extended definition, 382 for the Third Universal definition, and 216 for the Society for Cardiovascular Angiography and Interventions definition. Differences among the biomarkers used, different cutoff values, and in the hierarchy among biomarkers within definitions, yielded a different number of triggers, and identified unique triggers for each definition. Only 38 triggers were consistently identified by all definitions. Availability of ECG data, eCRF data on clinical presentation, and the reporting of >2 post-procedural values of the same biomarker influenced considerably the number of PMI triggers identified. PMI definitions are not interchangeable. The number of triggers identified and consequently the potential number of events varies significantly, highlighting the importance of rigorous methodology when PMI is a component of a powered endpoint. Emphasis on collection of biomarkers, ECG data, and clinical status at baseline may improve the correct identification of PMI triggers. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Drug-coated balloons for de novo lesions in small coronary arteries: rationale and design of BASKET-SMALL 2.

PubMed

Gilgen, Nicole; Farah, Ahmed; Scheller, Bruno; Ohlow, Marc-Alexander; Mangner, Norman; Weilenmann, Daniel; Wöhrle, Jochen; Jamshidi, Peiman; Leibundgut, Gregor; Möbius-Winkler, Sven; Zweiker, Robert; Krackhardt, Florian; Butter, Christian; Bruch, Leonhard; Kaiser, Christoph; Hoffmann, Andreas; Rickenbacher, Peter; Mueller, Christian; Stephan, Frank-Peter; Coslovsky, Michael; Jeger, Raban

2018-05-01

The treatment of coronary small vessel disease (SVD) remains an unresolved issue. Drug-eluting stents (DES) have limited efficacy due to increased rates of instent-restenosis, mainly caused by late lumen loss. Drug-coated balloons (DCB) are a promising technique because native vessels remain structurally unchanged. Basel Stent Kosten-Effektivitäts Trial: Drug-Coated Balloons vs. Drug-Eluting Stents in Small Vessel Interventions (BASKET-SMALL 2) is a multicenter, randomized, controlled, noninferiority trial of DCB vs DES in native SVD for clinical endpoints. Seven hundred fifty-eight patients with de novo lesions in vessels <3 mm in diameter and an indication for percutaneous coronary intervention such as stable angina pectoris, silent ischemia, or acute coronary syndromes are randomized 1:1 to angioplasty with DCB vs implantation of a DES after successful initial balloon angioplasty. The primary endpoint is the combination of cardiac death, nonfatal myocardial infarction, and target-vessel revascularization up to 1 year. Secondary endpoints include stent thrombosis, Bleeding Academic Research Consortium (BARC) type 3 to 5 bleeding, and long-term outcome up to 3 years. Based on clinical endpoints after 1 year, we plan to assess the noninferiority of DCB compared to DES in patients undergoing primary percutaneous coronary intervention for SVD. Results will be available in the second half of 2018. This study will compare DCB and DES regarding long-term safety and efficacy for the treatment of SVD in a large all-comer population. © 2018 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.

Presence of diabetic microvascular complications does not incrementally increase risk of ischemic stroke in diabetic patients with atrial fibrillation

PubMed Central

Chou, Annie Y.; Liu, Chia-Jen; Chao, Tze-Fan; Wang, Kang-Ling; Tuan, Ta-Chuan; Chen, Tzeng-Ji; Chen, Shih-Ann

2016-01-01

Abstract Conventional stroke risk prediction tools used in atrial fibrillation (AF) incorporate the presence of diabetes mellitus (DM) as a risk factor. However, it is unknown whether this risk is homogenous or dependent on the presence of diabetic microvascular complications, such as diabetic retinopathy, nephropathy, and neuropathy. The present study examined the risk of ischemic stroke in diabetic patients with and without microvascular complications. The present study used the National Health Insurance Research Database in Taiwan with detailed healthcare data on all-comers to the Taiwanese medical system from January 1, 1996 to December 31, 2011. AF and DM were identified when listed as discharge diagnoses or confirmed more than twice in the outpatient department. Patients on antithrombotic agents were excluded. The clinical endpoint was ischemic stroke. Among the 50,180 AF patients with DM, the majority had no microvascular complications (72.7%), while 2.6% had diabetic retinopathy, 8.4% had diabetic nephropathy, and 16.1% had diabetic neuropathy. Ischemic stroke occurred in 6003 patients, with a 4.74% annual risk of ischemic stroke. When compared with DM patients without microvascular complications, those with diabetic retinopathy, nephropathy, or neuropathy had higher incidences of ischemic stroke (4.65 vs 5.07, 4.77, or 5.20 per 100 person-years, respectively). However, after adjusting for confounding factors, the differences were no longer significant. In a large nationwide AF cohort with DM, risk of ischemic stroke was similar between patients with and without microvascular complications, suggesting that risk stratification of these patients does not require inclusion of diabetic retinopathy, nephropathy, and neuropathy. PMID:27399075

Pooled analysis of the CONFIRM registries: impact of gender on procedure and angiographic outcomes in patients undergoing orbital atherectomy for peripheral artery disease.

PubMed

Lee, Michael S; Canan, Timothy; Rha, Seung-Woon; Mustapha, Jihad; Adams, George L

2015-02-01

To compare the acute procedure and angiographic outcomes of peripheral artery disease (PAD) patients treated with orbital atherectomy stratified by gender. The CONFIRM I, II, and III registries are US multicenter, nonrandomized, all-comers registries of PAD patients who were treated with orbital atherectomy. All patients with gender specified in the registry database were included in the current analysis, which compared the final residual stenosis achieved after atherectomy and the rate of acute complications in female and male patients. The 3 registries included 3131 patients with 4761 lesions: 1261 women (mean age 73.2 ± 10.7 years) with 1874 lesions and 1870 men (mean age 70.4 ± 10.2) with 2887 lesions. The women were older (p < 0.001) and had a higher but nonsignificant prevalence of critical limb ischemia (p = 0.075). After treatment, the final residual stenosis in women vs. men was 9% ± 11% vs. 11% ± 11%, respectively (p < 0.001). Women had a higher rate of all types of dissection (13.3% vs. 9.9%, p<0.001). However, both genders had similar rates of flow-limiting dissections (1.6% vs. 1.4%, p = 0.61), perforation, slow flow, vessel closure, spasm, embolism, and thrombus formation. The gender analysis of the CONFIRM registries revealed that there was successful lesion modification with orbital atherectomy in both men and women; however, women had a higher rate of dissection (all types). This difference is likely because of the older age and higher percentage of critical limb ischemia in women in this cohort. These results, however, suggest that additional studies should be completed to further understand the increased risks for women vs. men during endovascular procedures. © The Author(s) 2015.

Observational constraints on earthquake source scaling: Understanding the limits in resolution

USGS Publications Warehouse

Hough, S.E.

1996-01-01

I examine the resolution of the type of stress drop estimates that have been used to place observational constraints on the scaling of earthquake source processes. I first show that apparent stress and Brune stress drop are equivalent to within a constant given any source spectral decay between ??1.5 and ??3 (i.e., any plausible value) and so consistent scaling is expected for the two estimates. I then discuss the resolution and scaling of Brune stress drop estimates, in the context of empirical Green's function results from recent earthquake sequences, including the 1992 Joshua Tree, California, mainshock and its aftershocks. I show that no definitive scaling of stress drop with moment is revealed over the moment range 1019-1025; within this sequence, however, there is a tendency for moderate-sized (M 4-5) events to be characterized by high stress drops. However, well-resolved results for recent M > 6 events are inconsistent with any extrapolated stress increase with moment for the aftershocks. Focusing on comer frequency estimates for smaller (M < 3.5) events, I show that resolution is extremely limited even after empirical Green's function deconvolutions. A fundamental limitation to resolution is the paucity of good signal-to-noise at frequencies above 60 Hz, a limitation that will affect nearly all surficial recordings of ground motion in California and many other regions. Thus, while the best available observational results support a constant stress drop for moderate-to large-sized events, very little robust observational evidence exists to constrain the quantities that bear most critically on our understanding of source processes: stress drop values and stress drop scaling for small events.

Building a Mien-American house: A case study in school-community relations

NASA Astrophysics Data System (ADS)

Hammond, Lorie A.

2000-10-01

Researchers and policymakers agree that schools and parents must work together if they are to provide the sustenance, services, and support which children need to be successful in our increasingly complex society. (Clark, 1983; Comer, 1980, 1996; Clinton, 1995; Epstein, 1995, 1996). Unfortunately, the social and academic success of language minority students is often adversely affected by the alienation of parents from school culture and by the "deficit" view which teachers hold of language minority parents' academic and parenting skills (Boggs, 1985; Delgado-Gaitan, 1990; Heath, 1983; Lareau, 1987, 1989; Philips, 1983). This case study describes the attempts of one school site to build academic and social bridges between immigrant families from a Southeast Asian Hill Tribe, the Iu Mien, and a mainstream elementary school. This effort is facilitated by a constructivist approach to curriculum in which parents, teachers, and children create an intercultural space---a school community garden---as a context in which academic dialogue can occur. Various strategies which enable inter-cultural learning are described, including the use of students as ethnographers, of parents as expert teachers, and of teachers as cultural brokers. The study also considers the cultural conflicts and understandings which occurred when American teachers and Mien parents built a Mien field-house together: a structure which became symbolic of their blended lives. Through both a descriptive narration and interviews with various participants, the study analyzes (a) community-based curriculum development, led by practitioner reformers, as a way to enable language minority students to be academically successful within their own life worlds, as well as (b) the political and bureaucratic forces which make community-based reforms difficult to sustain. This study employs qualitative research strategies within an action-research context in which the author plays the dual role of practitioner reformer and researcher.

The LIBERTY study: Design of a prospective, observational, multicenter trial to evaluate the acute and long-term clinical and economic outcomes of real-world endovascular device interventions in treating peripheral artery disease.

PubMed

Adams, George L; Mustapha, Jihad; Gray, William; Hargus, Nick J; Martinsen, Brad J; Ansel, Gary; Jaff, Michael R

2016-04-01

Most peripheral artery disease (PAD) clinical device trials are supported by commercial manufacturers and designed for regulatory device approval, with extensive inclusion/exclusion criteria to support homogeneous patient populations. High-risk patients with advanced disease, including critical limb ischemia (CLI), are often excluded leading to difficulty in translating trial results into real-world clinical practice. As a result, physicians have no direct guidance regarding the use of endovascular devices. There is a need for objectively assessed studies to evaluate clinical, functional, and economic outcomes in PAD patient populations. LIBERTY is a prospective, observational, multicenter study sponsored by Cardiovascular Systems Inc (St Paul, MN) to evaluate procedural and long-term clinical and economic outcomes of endovascular device interventions in patients with symptomatic lower extremity PAD. Approximately 1,200 patients will be enrolled and followed up to 5 years: 500 patients in the "Claudicant Rutherford 2-3" arm, 600 in the "CLI Rutherford 4-5" arm, and 100 in the "CLI Rutherford 6" arm. The study will use 4 core laboratories for independent analysis and will evaluate the following: procedural and lesion success, rates of major adverse events, duplex ultrasound interpretations, wound status, quality of life, 6-minute walk test, and economic analysis. The LIBERTY Patient Risk Score(s) will be developed as a clinical predictor of outcomes to provide guidance for interventions in this patient population. LIBERTY will investigate real-world PAD patients treated with endovascular revascularization with rigorous study guidelines and independent oversight of outcomes. This study will provide observational, all-comer patient clinical data to guide future endovascular therapy. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Long-term clinical outcomes of biodegradable polymer biolimus-eluting stents versus durable polymer everolimus-eluting stents in patients with coronary artery disease: three-year follow-up of the COMPARE II (Abluminal biodegradable polymer biolimus-eluting stent versus durable polymer everolimus-eluting stent) trial.

PubMed

Vlachojannis, Georgios J; Smits, Pieter C; Hofma, Sjoerd H; Togni, Mario; Vázquez, Nicolás; Valdés, Mariano; Voudris, Vassilis; Puricel, Serban; Slagboom, Ton; Goy, Jean-Jacques; den Heijer, Peter; van der Ent, Martin

2015-07-01

The aim of this analysis was to compare the long-term safety and efficacy of the biodegradable polymer biolimus-eluting stent (BES) with that of the durable polymer everolimus-eluting stent (EES). The COMPARE II study was a prospective, randomised, multicentre, all-comers trial in which 2,707 patients were randomly allocated (2:1) to BES or EES. The pre-specified endpoint at three years was major adverse cardiac events (MACE), a composite of cardiac death, non-fatal myocardial infarction (MI), or target vessel revascularisation (TVR). Moreover, the combined endpoint all-cause death or MI was analysed as a safety, and TVR as an efficacy measure. Three-year follow-up was available in 2,683 patients (99.1%). At three years, MACE occurred in 213 patients (11.9%) in the BES group and in 101 patients (11.1 %) in the EES group (p=0.57). The rate of the combined safety endpoint all-cause death or MI was 9.3% in the BES group vs. 8.4% (p=0.52), while the efficacy measure TVR was 7.6% in BES vs. 6.5% (p=0.27). Interestingly, definite stent thrombosis rates did not differ between groups (1.2% for BES vs. 0.8%, p=0.33). At three-year follow-up, MACE as well as safety and efficacy measures including stent thrombosis were not statistically different between the biodegradable polymer-coated BES and the durable polymer-coated EES. ClinicalTrials.gov Identifier: NCT01233453.

Naltrexone treatment for opioid dependence: does its effectiveness depend on testing the blockade?

PubMed

Sullivan, Maria A; Bisaga, Adam; Mariani, John J; Glass, Andrew; Levin, Frances R; Comer, Sandra D; Nunes, Edward V

2013-11-01

FDA approval of long-acting injectable naltrexone (Vivitrol) for opioid dependence highlights the relevance of understanding mechanisms of antagonist treatment. Principles of learning suggest an antagonist works through extinguishing drug-seeking behavior, as episodes of drug use ("testing the blockade") fail to produce reinforcement. We hypothesized that opiate use would moderate the effect of naltrexone, specifically, that opiate-positive urines precede dropout in the placebo group, but not in the active-medication groups. An 8-week, double-blind, placebo-controlled trial (N=57), compared the efficacy of low (192 mg) and high (384 mg) doses of a long-acting injectable naltrexone (Depotrex) with placebo (Comer et al., 2006). A Cox proportional hazard model was fit, modeling time-to-dropout as a function of treatment assignment and urine toxicology during treatment. Interaction of opiate urines with treatment group was significant. Opiate-positive urines predicted dropout on placebo and low-dose, but less so on high-dose naltrexone, where positive urines were more likely followed by sustained abstinence. Among patients with no opiate-positive urines, retention was higher in both low- and high-dose naltrexone conditions, compared to placebo. Findings confirm that injection naltrexone produces extinction of drug-seeking behavior after episodes of opiate use. Adequate dosage appears important, as low-dose naltrexone resembled the placebo group; opiate positive urines were likely to be followed by dropout from treatment. The observation of high treatment retention among naltrexone-treated patients who do not test the blockade, suggests naltrexone may also exert direct effects on opiate-taking behavior that do not depend on extinction, perhaps by attenuating craving or normalizing dysregulated hedonic or neuroendocrine systems. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Naltrexone treatment for opioid dependence: Does its effectiveness depend on testing the blockade?

PubMed Central

Sullivan, Maria A.; Bisaga, Adam; Mariani, John J.; Glass, Andrew; Levin, Frances R.; Comer, Sandra D.; Nunes, Edward V.

2013-01-01

Background FDA approval of long-acting injectable naltrexone (Vivitrol) for opioid dependence highlights the relevance of understanding mechanisms of antagonist treatment. Principles of learning suggest an antagonist works through extinguishing drug-seeking behavior, as episodes of drug use (“testing the blockade”) fail to produce reinforcement. We hypothesized that opiate use would moderate the effect of naltrexone, specifically, that opiate-positive urines precede dropout in the placebo group, but not in the active-medication groups. Methods An 8-week, double-blind, placebo-controlled trial (N=57), compared the efficacy of low (192-mg) and high (384-mg) doses of a long-acting injectable naltrexone (Depotrex) with placebo (Comer et al., 2006). A Cox proportional hazard model was fit, modeling time-to-dropout as a function of treatment assignment and urine toxicology during treatment. Results Interaction of opiate urines with treatment group was significant. Opiate-positive urines predicted dropout on placebo and low-dose, but less so on high-dose naltrexone, where positive urines were more likely followed by sustained abstinence. Among patients with no opiate-positive urines, retention was higher in both low- and high-dose naltrexone conditions, compared to placebo. Conclusions Findings confirm that injection naltrexone produces extinction of drug-seeking behavior after episodes of opiate use. Adequate dosage appears important, as low-dose naltrexone resembled the placebo group; opiate positive urines were likely to be followed by dropout from treatment. The observation of high treatment retention among naltrexone-treated patients who do not test the blockade, suggests naltrexone may also exert direct effects on opiate-taking behavior that do not depend on extinction, perhaps by attenuating craving or normalizing dysregulated hedonic or neuroendocrine systems. PMID:23827259

Efficacy of the RADPAD Protection Drape in Reducing Operators' Radiation Exposure in the Catheterization Laboratory: A Sham-Controlled Randomized Trial.

PubMed

Vlastra, Wieneke; Delewi, Ronak; Sjauw, Krischan D; Beijk, Marcel A; Claessen, Bimmer E; Streekstra, Geert J; Bekker, Robbert J; van Hattum, Juliette C; Wykrzykowska, Joanna J; Vis, Marije M; Koch, Karel T; de Winter, Robbert J; Piek, Jan J; Henriques, José P S

2017-11-01

Interventional cardiologists are increasingly exposed to radiation-induced diseases like cataract and the stochastic risk of left-sided brain tumors. The RADPAD is a sterile, disposable, lead-free shield placed on the patient with the aim to minimize operator-received scatter radiation. The objective of the trial was to examine the RADPAD's efficacy in a real-world situation. In the current, double-blind, sham-controlled, all-comer trial, patients undergoing diagnostic catheterization or percutaneous coronary interventions were randomized in a 1:1:1 ratio to a radiation absorbing shield (RADPAD), standard treatment (NOPAD), or a sham shield (SHAMPAD). The sham shield allowed testing for shield-induced radiation behavior. The primary outcome was the difference in relative exposure of the primary operator between the RADPAD and NOPAD arms and was defined as the ratio between operator's exposure (E in µSv) and patient exposure (dose area product in mGy·cm 2 ), measured per procedure. A total of 766 consecutive coronary procedures were randomized to the use of RADPAD (N=255), NOPAD (N=255), or SHAMPAD (N=256). The use of RADPAD was associated with a 20% reduction in relative operator exposure compared with that of NOPAD ( P =0.01) and a 44% relative exposure reduction compared with the use of a SHAMPAD ( P <0.001). Use of the SHAMPAD was associated with a 43% higher relative radiation exposure than procedures with NOPAD ( P =0.009). In clinical daily practice, the standard use of the RADPAD radiation shield reduced operator radiation exposure compared with procedures with NOPAD or SHAMPAD. This study supports the routine use of RADPAD in the catheterization laboratory. URL: https://www.clinicaltrials.gov. Unique identifier: NCT03139968. © 2017 American Heart Association, Inc.

Effects of a digital clinical pathway for elective electrocardioversion for atrial fibrillation on quality of care.

PubMed

Valente, Mattia; Zwaan, Esther; Wit, Mirjam; Kimman, Geert P; Umans, Victor

2010-12-01

Clinical pathways attempt to increase efficiency by organizing the care-delivery process into individual analyzable steps. However, full advantage may only be taken if the process is governed by a "process care taker." Currently, new opportunities are emerging for nurses to become involved as health care experts and may become an intermediate between patient and clinical team. We evaluate a digital clinical pathway for electrocardioversion in atrial fibrillation with a nurse-coordinator in the ongoing consecutive experience in clinical practice. The introduction of a digital pathway into the hospital information system allows continuous surveillance of clinical outcome indicators as well as variance indicators. This article describes a service evaluation and the implementation and effects of introducing a clinical pathway. However, when comparing the 2 eras, the primary goals were improved guideline-adherence and reduced walk-through times in the 600 consecutive pathway patients versus 100 consecutive control patients. The pathway was launched in January 2008. Up to January 2009, 600 all-comer, elective patients were treated using this integrated digital clinical pathway, without exception. Treatment and outpatient check-up appointments are made immediately for all patients. The pathway enabled the cardiologist to complete the risk calculator and drug therapy recommendations significantly better when compared with control patients and also reduced walk-through times significantly. Patient satisfaction rose from 8.7 to 9.1 (P < 0.01) using the pathway. A nurse-led clinical pathway for cardioversion patients is safely and efficaciously introduced in a teaching hospital. The pathway improved guideline-adherence. These results emphasize the importance of a nurse-coordinator who is an intermediary between atrial fibrillation patients and the clinical care team.

One year clinical outcomes in patients with insulin-treated diabetes mellitus and non-insulin-treated diabetes mellitus compared to non-diabetics after deployment of the bio-engineered COMBO stent.

PubMed

Kalkman, Deborah N; Woudstra, Pier; den Heijer, Peter; Menown, Ian B A; Erglis, Andrejs; Suryapranata, Harry; Arkenbout, Karin E; Iñiguez, Andrés; van 't Hof, Arnoud W J; Muller, Philippe; Tijssen, Jan G; de Winter, Robbert J

2017-01-01

The COMBO stent is a novel sirolimus-eluting stent with a luminal anti-CD34+ antibody layer to promote vessel healing. No data is currently available on clinical outcomes after treatment with this novel bio-engineered device in diabetic patients. We evaluate clinical outcomes at twelve months after COMBO stent placement in patients without diabetes mellitus (non-DM), patients with non-insulin-treated diabetes mellitus (nITDM) and patients with insulin-treated diabetes mellitus (ITDM). This study is a pre-specified subgroup analysis of the 1000 patient all-comers REMEDEE Registry. The primary endpoint is target lesion failure (TLF), which is a combined endpoint consisting of cardiac death, target vessel-myocardial infarction (tv-MI) and target lesion revascularization (TLR) at twelve months follow-up. Kaplan Meier method is used with log rank to compare outcomes between groups. This subgroup analysis includes 807 non-DM, 117 nITDM and 67 ITDM. Kaplan-Meier estimates for TLF at twelve months are 4.4% in non-DM, 6.8% in nITDM and 20.3% in ITDM, p<0.001 (non-DM vs nITDM p=0.244, non-DM vs ITDM p<0.001). This study gives the first insight into the impact of insulin-treated diabetes mellitus on clinical outcome of patients treated with the novel COMBO stent. At one year after COMBO stent placement significantly higher rates of target lesion failure are seen in patients with ITDM compared to patients with nITDM and patients without DM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Impact of Paclitaxel-Eluting Balloons Compared to Second-Generation Drug-Eluting Stents for of In-Stent Restenosis in a Primarily Acute Coronary Syndrome Population

PubMed Central

Marquis-Gravel, Guillaume; Matteau, Alexis; Potter, Brian J; Gobeil, François; Noiseux, Nicolas; Stevens, Louis-Mathieu; Mansour, Samer

2017-01-01

Background The place of drug-eluting balloons (DEB) in the treatment of in-stent restenosis (ISR) is not well-defined, particularly in a population of all-comers with acute coronary syndromes (ACS). Objective Compare the clinical outcomes of DEB with second-generation drug-eluting stents (DES) for the treatment of ISR in a real-world population with a high proportion of ACS. Methods A retrospective analysis of consecutive patients with ISR treated with a DEB compared to patients treated with a second-generation DES was performed. The primary endpoint was a composite of major adverse cardiovascular events (MACE: all-cause death, non-fatal myocardial infarction, and target lesion revascularization). Comparisons were performed using Cox proportional hazards multivariate adjustment and Kaplan-Meier analysis with log-rank. Results The cohort included 91 patients treated with a DEB and 89 patients treated with a DES (74% ACS). Median follow-up was 26 months. MACE occurred in 33 patients (36%) in the DEB group, compared to 17 patients (19%) in the DES group (p log-rank = 0.02). After multivariate adjustment, there was no significant difference between the groups (HR for DEB = 1.45 [95%CI: 0.75-2.83]; p = 0.27). Mortality rates at 1 year were 11% with DEB, and 3% with DES (p = 0.04; adjusted HR = 2.85 [95%CI: 0.98-8.32]; p = 0.06). Conclusion In a population with a high proportion of ACS, a non-significant numerical signal towards increased rates of MACE with DEB compared to second-generation DES for the treatment of ISR was observed, mainly driven by a higher mortality rate. An adequately-powered randomized controlled trial is necessary to confirm these findings. PMID:28977052

Correlation of body mass index Z-scores with glucose and lipid profiles among overweight and obese children and adolescents.

PubMed

Nogueira-de-Almeida, Carlos Alberto; Mello, Elza Daniel de

To evaluate the prevalence of abnormalities in plasma lipid and glucose profiles among overweight and obese children and adolescents, and to assess the presence of a correlation between body mass index Z-scores and indicators of comorbidities related to both profiles. This was a multicenter cross-sectional study conducted at two outpatient clinics. The study included all 417 comers for the first visit from 2008 to 2012, aged between 7 and 18 years, with BMI above the Z-score +1. Anthropometry and blood sampling were obtained. The prevalence of dyslipidemias, hyperglycemia, and insulin resistance were evaluated, together with the correlations of these variables with the increase of Z-BMI. Dyslipidemia was observed in 43.4% of the boys and 66.1% of the girls, with no difference between genders. High glucose levels were detected in 6.2% of the individuals. Insulin resistance was present in 32.3% and 41.7% of the cases, with no statistical significance between boys and girls. Correlations between the Z-BMI were noted for triglycerides in the entire group and among girls; for HDL-c, only among girls; for glucose, a correlation was observed for the entire group, but not when stratified by gender. The indicators of insulin resistance were all correlated with Z-BMI, even when corrected for age. Overweight and obesity give origin to a high prevalence of dyslipidemia and insulin resistance. BMI Z-scores showed a weak positive correlation with glucose and triglyceride, and negative with HDL-c. In turn, the strongest positive correlation was found with insulin resistance indicators. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

MRI for appendicitis in pregnancy: is seeing believing? clinical outcomes in cases of appendix nonvisualization.

PubMed

Al-Katib, Sayf; Sokhandon, Farnoosh; Farah, Michael

2016-12-01

The primary objective of this study was to determine the clinical outcomes in cases of appendix nonvisualization with MRI in pregnant patients with suspected appendicitis and the implications of appendix nonvisualization for excluding appendicitis. Fifty-eight pregnant patients with suspected appendicitis evaluated with MRI at three centers from a single institution were retrospectively reviewed by three radiologists with varying levels of abdominal imaging experience. All scans were performed on a 1.5-Tesla Siemens unit. Cases were evaluated for diagnostic quality, visualization of the appendix, presence of appendicitis, and alternate diagnoses. Clinical outcomes were gathered from the electronic medical record. Of the 58 patients who underwent MRI for suspected appendicitis, 50 cases were considered adequate diagnostic quality by all three radiologists. The rate of appendix visualization among the three radiologists ranged from 60 to 76% (p = 0.44). The appendix was nonvisualized by at least one of the three radiologists in 25 cases (50%). Of these, none had a final diagnosis of appendicitis including one patient who underwent appendectomy. MRI suggested an alternate diagnosis in 6 (24%) patients with appendix nonvisualization. For the three reviewers, the agreement level on whether or not the appendix was visualized on the MRI had a Light's kappa value of 0.526, indicating a "moderate" level of agreement (p value < 0.01). Despite only moderate level of interobserver agreement for appendix visualization, appendix nonvisualization on MRI in pregnant patients with suspected appendicitis confers a significant reduction in the risk of appendicitis compared to all comers as long as the study is adequate diagnostic quality and there are no secondary signs of appendicitis present.

Esperanzaite, NaCa(2)Al(2)(As(5+)O(4))[As(5+)O(3)(OH)](OH)(2)F(4)(H(2)O), A New Mineral From Mina La Esperanza, Mexico: Descriptive Mineralogy and Atomic Arrangement

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cureton, F.; Falster, A.U.; Foord, E.E.

1998-11-09

Esperanzaite, ideally NaCazA12(As5+0.i)[As5+03 (OH)] (OH)2FJH20), Z =2, is a new mineral from the Mina h Esperarq Durango State, Mexico. The mineral occurs as blue-green botryoidal crystalline masses on rhyolite, with separate spheres up to 1.5 mm Y Deceased in diameter. Mobs hardness is 4.5, specific gravity 3.240h, and 3.36( 3)C.IC. Optical properties were measured in 589 nm light. Esperanzaite is biaxial (-), .Y= Y = Z= colorless, a 1.580(1), ~ 1.588( 1), and y 1.593(1 ); 2V0hs is 74(1 ~ and 2 }'CUIC is 76.3". Dispersion is medium, r < v, and optic axes are oriented as a A Zmore » = +50.5o, b = Y, c P. X = +35". The five strongest X-ray diffraction maxima in the powder pattern are (~ /, hk~: 2.966,100, 13 i, 31 i, 031 ; 3.527,90, 220; 2.700,90,221,002, 040; 5.364>80, 001, 020; 4.796,80,011. Esperanzaite is monoclinic, u 9.687(5), b 10.7379(6), c 5.5523(7)& ~ 105.32( 1 )", space group P21/nz. The atomic arrangement of esperanzaite was solved by Direct Methods and Fourier analysis (R= 0.03 1). The Fundamental Building Block is formed of stacks of heteropolyhedral tetramers; the tetramers are formed of two arsenate tetrahedral and two Al octahedra, comer-linked in 4-member rings. The Fundamental Building Blocks are linked by irregular lda~j and Ca@ polyhedra.« less

Interseismic strain and rotation rates in the northeast Mojave domain, eastern California

USGS Publications Warehouse

Savage, J.C.; Svarc, J.L.; Prescott, II W.

2004-01-01

The northeast Mojave domain, a type locality for bookshelf faulting, is a region of east striking, left-lateral faults in the northeast comer of the Mojave block, a block otherwise dominated by ??N40??W striking, right-lateral faults. Paleomagnetic evidence suggests that blocks within the domain have rotated clockwise about a vertical axis as much as 60?? since 12.8 Ma [Schermer et al., 1996]. In 1994, and again in 2002, the U.S. Geological Survey surveyed an array of 14 geodetic monuments distributed across the northeast Mojave domain. The 2002 survey results were adjusted to remove the coseismic offsets imposed by the nearby Hector Mine earthquake (16 October 1999, Mw = 7.1). The adjusted deformation across the array appears to be uniform and can be approximated by the principal strain rates ??:1 = 28.9 ?? 9.1 N77.2??W ?? 4.8?? and ??2 = -48.2 ?? 8.9 N12.8??E ?? 4.8?? nstrain yr-1; extension reckoned positive, and quoted uncertainties are standard deviations. That strain accumulation could be released by slip . on faults striking N32??W but not by bookshelf faulting on the east striking faults alone. The vertical axis rotation rate of the northeast Mojave domain as a whole relative to fixed North America is 71.0 ?? 6.4 nrad yr-1 (4.07?? ?? 0.37?? Myr-1) clockwise, about twice the maximum tenser shear strain rate. The observed rotation rate acting over 12.8 Myr would produce'a clockwise rotation of 52.1?? ?? 4.7??, exclusive of possible coseismic rotations. That rotation is in rough agreement with the paleomagnetic rotation accumulated in the individual fault blocks within the northeast Mojave domain since 12.8 Ma.

Merkel Cell Carcinoma Therapeutic Update.

PubMed

Cassler, Nicole M; Merrill, Dean; Bichakjian, Christopher K; Brownell, Isaac

2016-07-01

Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine tumor of the skin. Early-stage disease can be cured with surgical resection and radiotherapy (RT). Sentinel lymph node biopsy (SLNB) is an important staging tool, as a microscopic MCC is frequently identified. Adjuvant RT to the primary excision site and regional lymph node bed may improve locoregional control. However, newer studies confirm that patients with biopsy-negative sentinel lymph nodes may not benefit from regional RT. Advanced MCC currently lacks a highly effective treatment as responses to chemotherapy are not durable. Recent work suggests that immunotherapy targeting the programmed cell death receptor 1/programmed cell death ligand 1 (PD-1/PD-L1) checkpoint holds great promise in treating advanced MCC and may provide durable responses in a portion of patients. At the same time, high-throughput sequencing studies have demonstrated significant differences in the mutational profiles of tumors with and without the Merkel cell polyomavirus (MCV). An important secondary endpoint in the ongoing immunotherapy trials for MCC will be determining if there is a response difference between the virus-positive MCC tumors that typically lack a large mutational burden and the virus-negative tumors that have a large number of somatic mutations and predicted tumor neoantigens. Interestingly, sequencing studies have failed to identify a highly recurrent activated driver pathway in the majority of MCC tumors. This may explain why targeted therapies can demonstrate exceptional responses in case reports but fail when treating all comers with MCC. Ultimately, a precision medicine approach may be more appropriate for treating MCC, where identified driver mutations are used to direct targeted therapies. At a minimum, stratifying patients in future clinical trials based on tumor viral status should be considered as virus-negative tumors are more likely to harbor activating driver mutations.

Supersonic Wind Tunnel Tests of a Half-axisymmetric 12 Deg-spike Inlet to a Rocket-based Combined-cycle Propulsion System

NASA Technical Reports Server (NTRS)

DeBonis, J. R.; Trefny, C. J.

2001-01-01

Results of an isolated inlet test for NASA's GTX air-breathing launch vehicle concept are presented. The GTX is a Vertical Take-off/ Horizontal Landing reusable single-stage-to-orbit system powered by a rocket-based combined-cycle propulsion system. Tests were conducted in the NASA Glenn 1- by 1-Foot Supersonic Wind Tunnel during two entries in October 1998 and February 1999. Tests were run from Mach 2.8 to 6. Integrated performance parameters and static pressure distributions are reported. The maximum contraction ratios achieved in the tests were lower than predicted by axisymmetric Reynolds-averaged Navier-Stokes computational fluid dynamics (CFD). At Mach 6, the maximum contraction ratio was roughly one-half of the CFD value of 16. The addition of either boundary-layer trip strips or vortex generators had a negligible effect on the maximum contraction ratio. A shock boundary-layer interaction was also evident on the end-walls that terminate the annular flowpath cross section. Cut-back end-walls, designed to reduce the boundary-layer growth upstream of the shock and minimize the interaction, also had negligible effect on the maximum contraction ratio. Both the excessive turning of low-momentum comer flows and local over-contraction due to asymmetric end-walls were identified as possible reasons for the discrepancy between the CFD predictions and the experiment. It is recommended that the centerbody spike and throat angles be reduced in order to lessen the induced pressure rise. The addition of a step on the cowl surface, and planar end-walls more closely approximating a plane of symmetry are also recommended. Provisions for end-wall boundary-layer bleed should be incorporated.

Samus Counter Lifting Fixture

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stredde, H.; /Fermilab

1998-05-27

A lifting fixture has been designed to handle the Samus counters. These counters are being removed from the D-zero area and will be transported off site for further use at another facility. This fixture is designed specifically for this particular application and will be transferred along with the counters. The future use of these counters may entail installation at a facility without access to a crane and therefore a lift fixture suitable for both crane and/or fork lift usage has been created The counters weigh approximately 3000 lbs. and have threaded rods extended through the counter at the top comersmore » for lifting. When these counters were first handled/installed these rods were used in conjunction with appropriate slings and handled by crane. The rods are secured with nuts tightened against the face of the counter. The rod thread is M16 x 2({approx}.625-inch dia.) and extends 2-inch (on average) from the face of the counter. It is this cantilevered rod that the lift fixture engages with 'C' style plates at the four top comers. The strongback portion of the lift fixture is a steel rectangular tube 8-inch (vertical) x 4-inch x .25-inch wall, 130-inch long. 1.5-inch square bars are welded perpendicular to the long axis of the rectangular tube at the appropriate lift points and the 'C' plates are fastened to these bars with 3/4-10 high strength bolts -grade 8. Two short channel sections are positioned-welded-to the bottom of the rectangular tube on 40 feet centers, which are used as locators for fork lift tines. On the top are lifting eyes for sling/crane usage and are rated at 3500 lbs. safe working load each - vertical lift only.« less

The 2014 interferometric imaging beauty contest

NASA Astrophysics Data System (ADS)

Monnier, John D.; Berger, Jean-Philippe; Le Bouquin, Jean-Baptiste; Tuthill, Peter G.; Wittkowski, Markus; Grellmann, Rebekka; Müller, André; Renganswany, Sridhar; Hummel, Christian; Hofmann, Karl-Heinz; Schertl, Dieter; Weigelt, Gerd; Young, John; Buscher, David; Sanchez-Bermudez, Joel; Alberdi, Antxon; Schoedel, Rainer; Köhler, Rainer; Soulez, Ferréol; Thiébaut, Éric; Kluska, Jacques; Malbet, Fabien; Duvert, Gilles; Kraus, Stefan; Kloppenborg, Brian K.; Baron, Fabien; de Wit, Willem-Jan; Rivinius, Thomas; Merand, Antoine

2014-07-01

Here we present the results of the 6th biennial optical interferometry imaging beauty contest. Taking advantage of a unique opportunity, the red supergiant VY CMa and the Mira variable R Car were observed in the astronomical H-band with three 4-telescope configurations of the VLTI-AT array using the PIONIER instrument. The community was invited to participate in the subsequent image reconstruction and interpretation phases of the project. Ten groups submitted entries to the beauty contest, and we found reasonable consistency between images obtained from independent workers using quite different algorithms. We also found that significant differences existed between the submitted images, much greater than in past beauty contests that were all based on simulated data. A novel crowd-sourcing" method allowed consensus median images to be constructed, filtering likely artifacts and retaining real features." We definitively detect strong spots on the surfaces of both stars as well as distinct circumstellar shells of emission (likely water/CO) around R Car. In a close contest, Joel Sanchez (IAA-CSIC/Spain) was named the winner of the 2014 interferometric imaging beauty contest. This process has shown that new comers" can use publicly-available imaging software to interpret VLTI/PIONIER imaging data, as long as sufficient observations are taken to have complete uv coverage { a luxury that is often missing. We urge proposers to request adequate observing nights to collect sufficient data for imaging and for time allocation committees to recognise the importance of uv coverage for reliable interpretation of interferometric data. We believe that the result of the proposed broad international project will contribute to inspiring trust in the image reconstruction processes in optical interferometry.

Management of concomitant coronary artery disease in patients undergoing transcatheter aortic valve implantation: the United Kingdom TAVI Registry.

PubMed

Snow, Thomas M; Ludman, Peter; Banya, Winston; DeBelder, Mark; MacCarthy, Philip M; Davies, Simon W; Di Mario, Carlo; Moat, Neil E

2015-11-15

The management and impact of concomitant coronary artery disease in patients referred for TAVI remains contentious. We describe the prevalence, clinical impact and management of coronary artery disease (CAD) in patients in the United Kingdom TAVI Registry. All-inclusive study of patients undergoing TAVI in the United Kingdom (excluding Northern Ireland) from January 2007 to December 2011. Coronary artery disease at the time of TAVI was demonstrated on invasive angiography. 2588 consecutive patients were entered in the U.K. TAVI Registry. CAD was reported in 1171 pts with left main stem involvement in 12.4% of this cohort (n=145). Most patients were free of chest pain, but limited by dyspnoea (NYHA Class III & IV 81.9%). Angina was however more prevalent in those patients with CAD (p<0.0001). Hybrid PCI was uncommon, performed in only 14.7% of the CAD cohort (n=172). Survival at 30days, 1year, and 4years was 93.7%, 81.4% and 72.0% respectively. Adjusting for confounders in a multivariate model the presence and extent of CAD was not associated with early (30-days, p=0.36) or late (4years, p=0.10) survival. This contemporary study of coronary artery disease management in an "all-comers" patient population undergoing TAVI demonstrates that whilst often an indicator of significant underlying comorbidity coronary artery disease is not associated with decreased short or long-term survival. The majority of patients with aortic stenosis and concomitant CAD can be managed effectively by TAVI alone. However, the importance of the Heart Team in making decisions on individual patients must not be underestimated. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Use of a Scale Model in the Design of Modifications to the NASA Glenn Icing Research Tunnel

NASA Technical Reports Server (NTRS)

Canacci, Victor A.; Gonsalez, Jose C.; Spera, David A.; Burke, Thomas (Technical Monitor)

2001-01-01

Major modifications were made in 1999 to the 6- by 9-Foot (1.8- by 2.7-m) Icing Research tunnel (IRT) at the NASA Glenn Research Center, including replacement of its heat exchanger and associated ducts and turning vanes, and the addition of fan outlet guide vanes (OGV's). A one-tenth scale model of the IRT (designated as the SMIRT) was constructed with and without these modifications and tested to increase confidence in obtaining expected improvements in flow quality around the tunnel loop. The SMIRT is itself an aerodynamic test facility whose flow patterns without modifications have been shown to be accurate, scaled representations of those measured in the IRT prior to the 1999 upgrade program. In addition, tests in the SMIRT equipped with simulated OGV's indicated that these devices in the IRT might reduce flow distortions immediately downstream of the fan by two thirds. Flow quality parameters measured in the SMIRT were projected to the full-size modified IRT, and quantitative estimates of improvements in flow quality were given prior to construction. In this paper, the results of extensive flow quality studies conducted in the SMIRT are documented. Samples of these are then compared with equivalent measurements made in the full-scale IRT, both before and after its configuration was upgraded. Airspeed, turbulence intensity, and flow angularity distributions are presented for cross sections downstream of the drive fan, both upstream and downstream of the replacement flat heat exchanger, in the stilling chamber, in the test section, and in the wakes of the new comer turning vanes with their unique expanding and contracting designs. Lessons learned from these scale-model studies are discussed.

Web-based treatment for substance use disorders: differential effects by primary substance.

PubMed

Cochran, Gerald; Stitzer, Maxine; Campbell, Aimee N C; Hu, Mei-Chen; Vandrey, Ryan; Nunes, Edward V

2015-06-01

This secondary analysis of data from a large, multi-site effectiveness trial (NCT01104805) sought to determine whether effects of a web-based behavioral treatment (Therapeutic Education System [TES]) differed by participants' self-identified primary drug of abuse. The all-comers sample of individuals entering outpatient psychosocial counseling treatment for substance abuse (N=497) cited cannabis (22.9%; n=114), stimulants (34.4%, n=171), opioids (21.7%, n=108), or alcohol (20.9%, n=104) as their primary substance of abuse. Participants were randomly assigned to receive treatment-as-usual (TAU) with or without TES substituted for approximately 2h of usual counseling. Multivariate analyses of abstinence outcomes examined interactions of treatment effects with primary substance. Adjusted odds ratios (AORs) demonstrated that primary stimulant users receiving TES were more likely to be abstinent in the final four weeks of treatment compared to stimulant users receiving TAU (AOR=3.59, 95% CI=1.25-10.27). Adjusted odds ratios for alcohol (AOR=3.15, 95% CI=0.85-11.65) and cannabis (AOR=2.64, 95% CI=0.73-9.52) also were of similar magnitude to stimulants but did not reach significance. Abstinence among primary opioid users was not improved by the TES intervention (AOR=0.35, 95% CI=0.09-1.47). This study supports the TES web-delivered treatment as a viable intervention for the majority of substance users entering outpatient counseling treatment, with demonstrated effectiveness among stimulant users and promising effects in alcohol and cannabis users but little or no effect in primary opioid users. Web-delivered treatments hold promise for expanding the availability of effective behavioral interventions for the majority of substance use disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

Recognition and Management of Sepsis in Children: Practice Patterns in the Emergency Department.

PubMed

Thompson, Graham C; Macias, Charles G

2015-10-01

Pediatric sepsis remains a leading cause of morbidity and mortality. Understanding current practice patterns and challenges is essential to inform future research and education strategies. Our aim was to describe the practice patterns of pediatric emergency physicians (PEPs) in the recognition and management of sepsis in children and to identify perceived priorities for future research and education. We conducted a cross-sectional, internet-based survey of members of the American Academy of Pediatrics, Section on Emergency Medicine and Pediatric Emergency Research Canada. The survey was internally derived, externally validated, and distributed using a modified Dillman methodology. Rank scores (RS) were calculated for responses using Likert-assigned frequency values. Tachycardia, mental-status changes, and abnormal temperature (RS = 83.7, 80.6, and 79.6) were the highest ranked clinical measures for diagnosing sepsis; white blood cell count, lactate, and band count (RS = 73.5, 70.9, and 69.1) were the highest ranked laboratory investigations. The resuscitation fluid of choice (85.5%) was normal saline. Dopamine was the first-line vasoactive medication (VAM) for cold (57.1%) and warm (42.2%) shock with epinephrine (18.5%) and norepinephrine (25.1%) as second-line VAMs (cold and warm, respectively). Steroid administration increased with complexity of presentation (all-comers 3.8%, VAM-resistant shock 54.5%, chronic steroid users 72.0%). Local ED-specific clinical pathways, national emergency department (ED)-specific guidelines, and identification of clinical biomarkers were described as future priorities. While practice variability exists among clinicians, PEPs continue to rely heavily on clinical metrics for recognizing sepsis. Improved recognition through clinical biomarkers and standardization of care were perceived as priorities. Our results provide a strong framework to guide future research and education strategies in pediatric sepsis. Copyright © 2015 Elsevier Inc. All rights reserved.

Perioperative Results and Complications in 15,964 Transcatheter Aortic Valve Replacements: Prospective Data From the GARY Registry.

PubMed

Walther, Thomas; Hamm, Christian W; Schuler, Gerhard; Berkowitsch, Alexander; Kötting, Joachim; Mangner, Norman; Mudra, Harald; Beckmann, Andreas; Cremer, Jochen; Welz, Armin; Lange, Rüdiger; Kuck, Karl-Heinz; Mohr, Friedrich W; Möllmann, Helge

2015-05-26

Transcatheter aortic valve replacement (TAVR) has evolved into a routine procedure with good outcomes in high-risk patients. TAVR complication rates were evaluated based on prospective data from the German Aortic Valve Registry (GARY). From 2011 to 2013, a total of 15,964 TAVR procedures were registered. We evaluated the total cohort for severe vital complications (SVCs), including the following: death on the day of intervention, conversion to sternotomy, low cardiac output that required mechanical support, aortic dissection, and annular rupture; technical complications of the procedures (TCOs), such as repositioning or retrieval of the valve prosthesis and embolization of the prosthesis; and other complications. Mean patient age was 81 ± 6 years, 54% of the patients were women, the median logistic Euroscore I was 18.3, the German aortic valve score was 5.6, and the Society of Thoracic Surgeons score was 5.0. Overall in-hospital mortality was 5.2%, whereas SVCs occurred in 5.0% of the population. Independent predictors for SVCs were female sex, pre-operative New York Heart Association functional class IV, ejection fraction <30%, pre-operative intravenous inotropes, arterial vascular disease, and higher degree of calcifications. TCOs occurred in 4.7% of patients and decreased significantly from 2011 to 2013. An emergency sternotomy was performed in 1.3% of the patients; however, multivariate analysis did not identify any predictors for conversion to sternotomy. The all-comers GARY registry revealed good outcomes after TAVR and a regression in complications. Survival of approximately 60% of patients who experienced SVCs or who required sternotomy underlines the need for heart team-led indication, intervention, and follow-up care of TAVR patients. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Impact of Remote Monitoring on Long-Term Prognosis in Heart Failure Patients in a Real-World Cohort: Results From All-Comers COMMIT-HF Trial.

PubMed

Kurek, Anna; Tajstra, Mateusz; Gadula-Gacek, Elzbieta; Buchta, Piotr; Skrzypek, Michal; Pyka, Lukasz; Wasiak, Michal; Swietlinska, Malgorzata; Hawranek, Michal; Polonski, Lech; Gasior, Mariusz; Kosiuk, Jedrzej

2017-04-01

Randomized controlled trials demonstrate that remote monitoring (RM) of implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy devices (CRT-Ds) may improve quality of care and prognosis in heart failure (HF) patients. However, the impact of RM on long-term mortality in a real-world cohort is still not well examined. This study was designed as a matched cohort study based on the COMMIT-HF trial--a single-center, ongoing prospective observational registry (NCT02536443). Complete patient demographics, medical history, in-hospital results, hospitalizations, and mortality data were collected based on institutional registries and healthcare providers' records. Patients were divided into 2 groups based on RM presence and matched by means of propensity scores according to clinical characteristics. The primary endpoint of this study was the long-term all-cause mortality. Out of 1,429 consecutive patients, 822 patients with a first implantation of an ICD/CRT-D were included in the analysis. The final matched study population contained 574 patients in RM and in a control group. Although demographic and echocardiographic parameters as well as pharmacological treatments were similar in both groups, a significantly lower 1-year mortality was detected in the RM group (2.1% vs. 11.5%, P < 0.0001). This was also maintained during a 3-year follow-up (4.9% vs. 22.3%, P < 0.0001). Multivariate analysis showed that RM was associated with an improved prognosis (hazard ratio 0.187, 95% confidence interval 0.075-0.467, P = 0.0003). RM of HF patients with ICDs/CRT-Ds significantly reduced long-term mortality in a real-world clinical condition. © 2017 Wiley Periodicals, Inc.

An approach to rule-out an acute cardiovascular event or death in emergency department patients using outcome-based cutoffs for high-sensitivity cardiac troponin assays and glucose.

PubMed

Shortt, Colleen; Phan, Kim; Hill, Stephen A; Worster, Andrew; Kavsak, Peter A

2015-03-01

The application of "undetectable" high-sensitivity cardiac troponin (hs-cTn) concentrations to "rule-out" myocardial infarction is appealing, but there are analytical concerns and a lack of consensus on what concentration should be used to define the lower reportable limit; i.e., limit of detection (LoD) or limit of blank. An alternative approach is to utilize a measurable hs-cTn concentration that identifies patients at low-risk for a future cardiovascular event combined with another prognostic test, such as glucose. We assessed both of these approaches in different emergency department (ED) cohorts to rule-out an event. We used cohort 1 (all-comer ED population, n=4773; derivation cohort) to determine the most appropriate approach at presentation (i.e., Dual Panel test: hs-cTn/glucose vs. LoD vs. LoD/glucose) for an early rule-out of hospital death using the Abbott ARCHITECT hs-cTnI assay. We used cohort 2 (n=144) and cohort 3 (n=127), both early chest pain onset ED populations as the verification datasets (outcome: composite cardiovascular event at 72h) with three hs-cTn assays assessed (Abbott Laboratories, Beckman Coulter, Roche Diagnostics). In cohort 1, the sensitivity was >99% for all three approaches; however the specificity (11%; 95% CI: 10-12%) was significantly higher for the Dual Panel as compared to the LoD approach (specificity=5%; 95% CI: 4-6%). Verification of the Dual Panel in cohort 2 and cohort 3 revealed 100% sensitivity and negative predictive values for all three hs-cTn assays. The combination of a "healthy" hs-cTn concentration with glucose might effectively rule-out patients for an acute cardiovascular event at ED presentation. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Sleeve gastrectomy and the risk of leak: a systematic analysis of 4,888 patients.

PubMed

Aurora, Alexander R; Khaitan, Leena; Saber, Alan A

2012-06-01

Sleeve gastrectomy has become a popular stand-alone bariatric procedure with comparable weight loss and resolution of comorbidities to that of laparoscopic gastric bypass. The simplicity of the procedure and the decreased long-term risk profile make this surgery more appealing. Nonetheless, the ever present risk of a staple-line leak is still of great concern and needs further investigation. An electronic literature search of MEDLINE database plus manual reference checks of articles published on laparoscopic sleeve gastrectomy for morbid obesity and its complications was completed. Keywords used in the search were "sleeve gastrectomy" OR "gastric sleeve" AND "leak." We analyzed 29 publications, including 4,888 patients. We analyzed the frequency of leak after sleeve gastrectomy and its associated risks of causation. The risk of leak after sleeve gastrectomy in all comers was 2.4%. This risk was 2.9% in the super-obese [body mass index (BMI) > 50 kg/m(2)] and 2.2% for BMI < 50 kg/m(2). Staple height and use of buttressing material did not affect leak rate. The use of a size 40-Fr or greater bougie was associated with a leak rate of 0.6% compared with those who used smaller sizes whose leak rate was 2.8%. Leaks were found at the proximal third of the stomach in 89% of cases. Most leaks were diagnosed after discharge. Endoscopic management is a viable option for leaks and was documented in 11% of cases as successful. Sleeve gastrectomy has become an important surgical option for the treatment of the ever growing morbidly obese population. The risk of leak is low at 2.4%. Attention to detail specifically at the esophagogastric junction cannot be stressed enough. Careful patient selection (BMI < 50 kg/m(2)) and adopting the use of a 40-Fr or larger bougie may decrease the risk of leak. Vigilant follow-up during the first 30 days is critical to avoid catastrophe, because most leaks will happen after patient discharge.

5-Year Safety and Efficacy of Resolute Zotarolimus-Eluting Stent: The RESOLUTE Global Clinical Trial Program.

PubMed

Yeh, Robert W; Silber, Sigmund; Chen, Lianglong; Chen, Shaoliang; Hiremath, Shirish; Neumann, Franz-Josef; Qiao, Shubin; Saito, Shigeru; Xu, Bo; Yang, Yuejin; Mauri, Laura

2017-02-13

The authors evaluated the 5-year cumulative incidence of cardiovascular events following Resolute zotarolimus-eluting stent (R-ZES) implantation. Individual trials are often underpowered to show differences for low-frequency adverse events. The R-ZES was studied in 10 prospective clinical trials, designed with identical adverse event definitions, ascertainment, and adjudication. The RESOLUTE Global Clinical Trial Program includes 7,618 patients treated with R-ZES: RESOLUTE first-in-human study (N = 139), RESOLUTE All Comers (N = 1,140), RESOLUTE International (N = 2,349), RESOLUTE US (N = 1,402), RESOLUTE US 38 mm (N = 114), RESOLUTE Japan (N = 100), RESOLUTE Japan Small Vessel Study (N = 65), RESOLUTE Asia (N = 311), RESOLUTE China Randomized Controlled Trial (N = 198), and RESOLUTE China Registry (N = 1,800). The 5-year cumulative incidence of events was calculated. The 5-year cumulative incidence of cardiac events was 13.4% for target lesion failure and included 5.0% cardiac death, 4.4% target vessel myocardial infarction, and 6.3% clinically driven target lesion revascularization. Dual-antiplatelet therapy at 1, 3, and 5 years was 91%, 37%, and 32%, respectively. The 5-year cumulative incidence of definite or probable stent thrombosis was 1.2%, which comprised 0.7% at 1 year and an annualized rate of 0.1% thereafter. Five-year use of dual-antiplatelet therapy varied geographically from 63% in Japan to 11% in Europe. In the largest group of R-ZES patients examined to date, the majority of stent-related events, including target vessel myocardial infarction and stent thrombosis, occurred within the first year of implantation with much lower risks of these events out to 5 years. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes--results from the BASKET PROVE trial.

PubMed

Jensen, Magnus Thorsten; Kaiser, Christoph; Sandsten, Karl Erik; Alber, Hannes; Wanitschek, Maria; Iversen, Allan; Jensen, Jan Skov; Pedersen, Sune; Soerensen, Rikke; Rickli, Hans; Zurek, Marzena; Fahrni, Gregor; Bertel, Osmund; De Servi, Stefano; Erne, Paul; Pfisterer, Matthias; Galatius, Søren

2013-10-09

Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST-segment elevation myocardial infarction (STEMI) revascularized with percutaneous coronary intervention (PCI). Patients from the BASKET-PROVE trial, an 11-center randomized all-comers trial comparing bare-metal and drug-eluting stenting in large coronary vessels, were included. Discharge HR was determined from a resting ECG. Long-term outcomes (7 days to 2 years) were evaluated for all-cause mortality and cardiovascular death and non-fatal myocardial infarction. A total of 2029 patients with sinus rhythm were included, 722 (35.6%) SAP, 647 (31.9%) NSTE-ACS, and 660 (32.5%) STEMI. Elevated discharge HR was associated significantly with all-cause mortality: when compared to a reference of <60 beats per minute (bpm), the adjusted hazard ratios were (95% CI) 4.5 (1.5-13.5, p=0.006) for 60-69 bpm, 3.8 (1.2-11.9, p=0.022) for 70-79 bpm, 4.3 (1.2-15.6, p=0.025) for 80-89 bpm, and 16.9 (5.2-55.0, p<0.001) for >90 bpm. For cardiovascular death/myocardial infarction, a discharge HR >90 bpm was associated with a hazard ratio of 6.2 (2.5-15.5, p<0.001) compared to a HR <60 bpm. No interaction was found for disease presentation, diabetes or betablocker use. In patients revascularized with PCI for stable angina or acute coronary syndromes an elevated discharge HR was independently associated with poor prognosis. Conversely, a HR <60 bpm at discharge was associated with a good long-term prognosis irrespective of indication for PCI. © 2013.

[Factors contributing to endemic cholera in Douala, Cameroon].

PubMed

Guévart, E; Noeske, J; Solle, J; Essomba, J M; Edjenguele, Mbonji; Bita, A; Mouangue, A; Manga, B

2006-06-01

Cholera has been endemic in Douala, Cameroon since 1971. A number of environmental factors favourize the survival of the Vibrio in Douala including location at the mouth of Wouri delta on the Atlantic Ocean, sandy clay soil, shallow dirty polluted foul-smelling groundwater, presence of vast expanses of swamp, streams/drainage ditches infested with algae, and high temperatures with low rainfall and drought during certain periods of the year. Most outbreaks have started in Bepanda, a slum area built on a garbage dump in a swampy zone fed by drainage ditches carrying the faecal pollution from neighbouring upstream districts. It is a densely overcrowded area of uncontrolled urbanization generated by the influx of poor city new-comers who live without adequate access to clean water or basic sanitary facilities. The most affected areas are those resulting from recent unregulated urban sprawl in polluted swamp zones or garbage dumps. Since access to the public water system is inadequate with only 65000 persons connected for 3 million inhabitants, dwellers in most areas must take water from the 70000 urban wells (estimated in 2004) that are often not more than 1.5 m deep. Sewage facilities are insufficient to provide complete evacuation of solid and liquid waste. The network of rivers, streams and man-made ditches waste are poorly maintained and often overflow during the rainy season. The contents of latrines are often discharged directly into the environment. Social factors such as the reformation of urban tribes and persistence of traditional attitudes toward waste disposal and water use have not only led to high-risk behaviour but also created barriers to sanitation and hygiene education. With an inadequate sanitation inspection system, a large but purely accessible public health system and a highly disorganized private health sector exists, effective preventive measures are difficult to implement. The combination of these factors probably account for the endemicity of cholera in Douala.

Flexible and Scalable Data Fusion using Proactive Schemaless Information Services

DOE Office of Scientific and Technical Information (OSTI.GOV)

Widener, Patrick

2014-05-01

Exascale data environments are fast approaching, driven by diverse structured and unstructured data such as system and application telemetry streams, open-source information capture, and on-demand simulation output. Storage costs having plummeted, the question is now one of converting vast stores of data to actionable information. Complicating this problem are the low degrees of awareness across domain boundaries about what potentially useful data may exist, and write-once- read-never issues (data generation/collection rates outpacing data analysis and integration rates). Increasingly, technologists and researchers need to correlate previously unrelated data sources and artifacts to produce fused data views for domain-specific purposes. New toolsmore » and approaches for creating such views from vast amounts of data are vitally important to maintaining research and operational momentum. We propose to research and develop tools and services to assist in the creation, refinement, discovery and reuse of fused data views over large, diverse collections of heterogeneously structured data. We innovate in the following ways. First, we enable and encourage end-users to introduce customized index methods selected for local benefit rather than for global interaction (flexible multi-indexing). We envision rich combinations of such views on application data: views that span backing stores with different semantics, that introduce analytic methods of indexing, and that define multiple views on individual data items. We specifically decline to build a big fused database of everything providing a centralized index over all data, or to export a rigid schema to all comers as in federated query approaches. Second, we proactively advertise these application-specific views so that they may be programmatically reused and extended (data proactivity). Through this mechanism, both changes in state (new data in existing view collected) and changes in structure (new or derived view exists) are made known. Lastly, we embrace found data heterogeneity by coupling multi-indexing to backing stores with appropriate semantics (as opposed to a single store or schema).« less

Flexible and Scalable Data Fusion using Proactive, Schemaless Information Services

DOE Office of Scientific and Technical Information (OSTI.GOV)

Widener, Patrick M.

2014-05-01

Exascale data environments are fast approaching, driven by diverse structured and unstructured data such as system and application telemetry streams, open-source information capture, and on-demand simulation output. Storage costs having plummeted, the question is now one of converting vast stores of data to actionable information. Complicating this problem are the low degrees of awareness across domain boundaries about what potentially useful data may exist, and write-once-read- never issues (data generation/collection rates outpacing data analysis and integration rates). Increasingly, technologists and researchers need to correlate previously unrelated data sources and artifacts to produce fused data views for domain-specific purposes. New toolsmore » and approaches for creating such views from vast amounts of data are vitally important to maintaining research and operational momentum. We propose to research and develop tools and services to assist in the creation, refinement, discovery and reuse of fused data views over large, diverse collections of heterogeneously structured data. We innovate in the following ways. First, we enable and encourage end-users to introduce customized index methods selected for local benefit rather than for global interaction (flexible multi-indexing). We envision rich combinations of such views on application data: views that span backing stores with different semantics, that introduce analytic methods of indexing, and that define multiple views on individual data items. We specifically decline to build a big fused database of everything providing a centralized index over all data, or to export a rigid schema to all comers as in federated query approaches. Second, we proactively advertise these application-specific views so that they may be programmatically reused and extended (data proactivity). Through this mechanism, both changes in state (new data in existing view collected) and changes in structure (new or derived view exists) are made known. Lastly, we embrace found data heterogeneity by coupling multi-indexing to backing stores with appropriate semantics (as opposed to a single store or schema).« less

Exercise Electrocardiogram Neither Predicts Nor Excludes Coronary Artery Disease in Women with Low to Intermediate Risk.

PubMed

Knol, Remco J J; Kan, Huub; Wondergem, Maurits; Cornel, Jan H; Umans, Victor A W M; van der Ploeg, Tjeerd; van der Zant, Friso M

2018-04-01

The value of exercise electrocardiogram (ExECG) in symptomatic female patients with low to intermediate risk for significant coronary artery disease (CAD) has been under debate for many years, and nondiagnostic or even erroneous test results are frequently encountered. Cardiac-CT may be more appropriate to exclude CAD in women. This study compares the results of ExECGs with those of cardiac-CTs, performed within a time frame of 1 month in an all-comers female chest pain population. Five hundred fifty-one consecutive female patients from a patient registry were included. ExECGs were negative in 324 (59%), positive in 14 (3%), and nondiagnostic in 213 (39%) patients. CAD was revealed by cardiac-CT in 57% of the women with negative ExECG. No signs of CAD were present on cardiac-CT in 64% of the women with a positive ExECG. Cardiac-CT showed presence of CAD in 268/551 (49%) patients, of whom 56/268 (21%) was diagnosed with ≥50% stenosis. The ExECG of the latter group was negative in 26 (46%), inconclusive in 29 (52%), and positive in 1 (2%). Considering ≥50% stenosis at cardiac-CT as the reference, sensitivity, specificity, PPV, and NPV of ExECG for the present population were 3.7%, 95.7%, 7.1%, and 91.7%, respectively. Similar diagnostic performance was calculated when considering ≥70% stenosis at cardiac-CT as the reference. ExECG failed to detect CAD in more than half of this cohort and in almost half of women with >50% stenosis at cardiac-CT. Importantly, no CAD was detected by cardiac-CT in 64% of women with a positive ExECG. ExECG is therefore questionable as a diagnostic strategy in women with low-to-intermediate risk of CAD, although prospective studies are warranted to determine whether replacing ExECG by cardiac-CT provides better prognoses.

Patterns and associations between DAPT cessation and 2-year clinical outcomes in left main/proximal LAD versus other PCI: Results from the Patterns of Non-Adherence to Dual Antiplatelet Therapy in Stented Patients (PARIS) registry.

PubMed

Chandrasekhar, Jaya; Baber, Usman; Sartori, Samantha; Aquino, Melissa; Tomey, Matthew; Kruckoff, Mitchell; Moliterno, David; Henry, Timothy D; Weisz, Giora; Gibson, C Michael; Iakovou, Ioannis; Kini, Annapoorna; Faggioni, Michela; Vogel, Birgit; Farhan, Serdar; Colombo, Antonio; Steg, P Gabriel; Witzenbichler, Bernhard; Chieffo, Alaide; Cohen, David; Stuckey, Thomas; Ariti, Cono; Pocock, Stuart; Dangas, George; Mehran, Roxana

2017-09-15

Percutaneous coronary intervention (PCI) of the left main (LM) or proximal left anterior descending artery (pLAD) is considered high-risk as these segments subtend substantial left ventricular myocardial area. We assessed the patterns and associations between dual antiplatelet therapy (DAPT) cessation and 2-year outcomes in LM/pLAD vs. other PCI from the all-comer PARIS registry. Two-year major adverse cardiovascular events (MACE) were a composite of cardiac death, myocardial infarction, definite/probable stent thrombosis or target lesion revascularization. DAPT cessation was predefined as physician-guided permanent discontinuation, temporary interruption, or non-recommended disruption due to non-compliance or bleeding. Of the study population (n=5018), 25.0% (n=1252) underwent LM/pLAD PCI and 75.0% (n=3766) PCI to other segments. Compared to others, LM/pLAD patients presented with fewer comorbidities, less frequent acute coronary syndromes but more multivessel and bifurcation disease treated with greater stent lengths. Two-year adjusted risk of MACE (11.4% vs. 11.6%; HR 1.10, 95% CI 0.90-1.34, p=0.36) was similar between LM/pLAD vs. other patients. DAPT discontinuation was significantly higher (43.3% vs. 39.4%, p=0.01) in LM/pLAD patients with borderline significance for lower disruption (10.0% vs. 14.7%, p=0.059) compared to other patients. DAPT discontinuation was not associated with higher risk of MACE in LM/pLAD (HR 0.65, 95% CI 0.34-1.25) or other PCI groups (HR 0.67, 95% CI 0.47-0.95). LM/pLAD PCI was not an independent predictor of 2-year MACE. Compared to other PCI, patients undergoing LM/pLAD PCI had higher rates of physician recommended DAPT discontinuation, however, discontinuation did not result in greater adverse events. Copyright © 2017 Elsevier B.V. All rights reserved.

Late Eocene impacts: Geologic record, correlation, and paleoenvironmental consequences

USGS Publications Warehouse

Poag, C. Wylie; Mankinen, Edward A.; Norris, Richard D.

2003-01-01

We present new magnetostratigraphic and stable isotopic (18C, 13Ccarb) data to help improve correlations among three late Eocene impact craters and their inferred breccia and ejecta deposits. Our analyses also shed light on potential global environmental consequences attributable to the impacts. The new data come from a continuously cored interval of the subsurface Chickahominy Formation, which lies conformably above the Chesapeake Bay impact crater in southeastern Virginia. The new magnetostratigraphic data indicate that the Chesapeake Bay impact took place in Chron C16n. 2n, the same magnetochron that encompasses the late Eocene ejecta layer at Massignano, Italy. This correlation places both the Chesapeake Bay impact and the Massignano ejecta at ~35.6 Ma, and resolves a previous miscorrelation between these two sites based on planktonic foraminifera and calcareous nannofossils. The new magnetostratigraphic correlations also suggest that the published magnetostratigraphic framework for ejecta-bearing late Eocene strata ar ODP Site 689B (Maud Rise) is incorrect, due to an incomplete section.New 18C data (single species of benthic foraminifera) from the same Chickahominy section ar Chesapeake Bay indicate that successional intervals of warm oceanic bottom-water may be characteristic of the late Eocene. We infer that the warm intervals correlate with successive episodes of greenhouse warming, triggered in part by a comer shower, which produced the Chesapeake Bay, Toms Canyon, Popigai, and presumably additional (as yet undiscovered) late Eocene impact craters. We also demonstrate that a marked negative execution of 13Ccarb persists through the upper half of the Chickahominy Formation. This excursion, also recorded at Massigno, at Bath Cliff, Barbados, and at other widespread localities in the world ocean, may be additional evidence of global-scale, long-term environmental disturbances related to the bolide impacts. As such, this  13C signal may be useful for global subdivision of the late Eocene stratigraphic record.

Clinical outcomes in 995 unselected real-world patients treated with an ultrathin biodegradable polymer-coated sirolimus-eluting stent: 12-month results from the FLEX Registry.

PubMed

Lemos, Pedro A; Chandwani, Prakash; Saxena, Sudheer; Ramachandran, Padma Kumar; Abhyankar, Atul; Campos, Carlos M; Marchini, Julio Flavio; Galon, Micheli Zanotti; Verma, Puneet; Sandhu, Manjinder Singh; Parikh, Nikhil; Bhupali, Ashok; Jain, Sharad; Prajapati, Jayesh

2016-02-17

To evaluate, in the FLEX Registry, clinical outcomes of an ultrathin (60 µm) biodegradable polymer-coated Supraflex sirolimus-eluting stent (SES) for the treatment of coronary artery disease. Additionally, to determine the vascular response to the Supraflex SES through optical coherence tomography (OCT) analysis. Multicentre, single-arm, all-comers, observational registry of patients who were treated with the Supraflex SES, between July 2013 and May 2014, at nine different centres in India. 995 patients (1242 lesions) who were treated with the Supraflex SES, between July 2013 and May 2014, at nine different centres in India. A total of 47 participants underwent OCT analysis at 6 months' follow-up. Percutaneous coronary intervention with Supraflex SES, PRIMARY AND SECONDARY OUTCOME MEASURES: The primary endpoint-the rate of major adverse cardiac events (defined as a composite of cardiac death, myocardial infarction (MI), target lesion revascularisation (TLR))-was analysed during 12 months. At 12 months, the primary endpoint occurred in 36 (3.7%) of 980 patients, consisting of 18 (1.8%) cardiac deaths, 16 (1.6%) MI, 7 (0.7%) TLR and 2 (0.2%) cases of non-target lesion target vessel revascularization. In a subset of 47 patients, 1227 cross-sections (9309 struts) were analysed at 6 months by OCT. Overall, a high percentage of struts was covered (98.1%), with a mean neointimal thickness of 0.13 ± 0.06 µm. The FLEX Registry evaluated clinical outcomes in real-world and more complex cohorts and thus provides evidence that the Supraflex SEX can be used safely and routinely in a broader percutaneous coronary intervention population. Also, the Supraflex SES showed high percentage of stent strut coverage and good stent apposition during OCT follow-up. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Pathogenesis of diverticulosis and diverticular disease.

PubMed

Walker, Marjorie M; Harris, Angela K

2017-06-01

Diverticulosis is defined by the presence of diverticula due to herniation of mucosa and muscularis mucosa through the muscularis propria at sites of vascular penetration in the colon and is asymptomatic in the vast majority affected. There are global differences of distribution, in Western industrialized societies, the most common site is in the left colon, but in Asia right sided diverticulosis predominates. Whilst present in 17.5% of a general population and 42% of all comers at endoscopy it is seen in 71% of those aged ≥80 years. Diverticular disease is defined as clinically significant and symptomatic diverticulosis, which may have an absence of macroscopically overt colitis and in true diverticulitis there is macroscopic inflammation of diverticula with related acute or chronic complications. Whilst overall, diverticulitis affects only 4% of those with diverticulosis, in younger patients (aged 40-49 years) this peaks at 11%. Diverticulosis is one of the most common chronic diseases, yet research in this field on pathogenesis has lagged behind other common conditions such as diabetes mellitus. However, in the last decade there have been major advances in taxonomy that can be used to relate to patients' outcome and treatment in both medicine and surgery. It has been shown there is an association with age, diet, drugs and smoking. Genetic studies have shown a familial association and a specific gene, TNFSF 15 may predict severity of disease. The role of the microbiome has been explored and microbial and metabolomic signatures are also important in predicting disease severity. That diverticulosis is a chronic disease is shown by mucosal pathology with subtle chronic inflammation present in those with asymptomatic diverticulosis and inflammation may lead to muscular hypertrophy, enteric nerve remodeling with disordered motility. The diverticulitis quality of life instrument shows that this condition impacts markedly on patients' well-being and prevention and amelioration of complications should be the aim of treatment and further research to attain this goal is needed.

Newest-generation drug-eluting and bare-metal stents combined with prasugrel-based antiplatelet therapy in large coronary arteries: the BAsel Stent Kosten Effektivitäts Trial PROspective Validation Examination part II (BASKET-PROVE II) trial design.

PubMed

Jeger, Raban; Pfisterer, Matthias; Alber, Hannes; Eberli, Franz; Galatius, Søren; Naber, Christoph; Pedrazzini, Giovanni; Rickli, Hans; Jensen, Jan Skov; Vuilliomenet, André; Gilgen, Nicole; Kaiser, Christoph

2012-02-01

In the BAsel Stent Kosten Effektivitäts Trial PROspective Validation Examination (BASKET-PROVE), drug-eluting stents (DESs) had similar 2-year rates of death and myocardial infarction but lower rates of target vessel revascularization and major adverse cardiac events compared with bare-metal stents (BMSs). However, comparative clinical effects of newest-generation DES with biodegradable polymers vs second-generation DES or newest-generation BMS with biocompatible coatings, all combined with a prasugrel-based antiplatelet therapy, on 2-year outcomes are not known. In BASKET-PROVE II, 2,400 patients with de novo lesions in native vessels ≥3 mm in diameter are randomized 1:1:1 to receive a conventional DES, a DES with a biodegradable polymer, or a BMS with biocompatible coating. In addition to aspirin, stable patients with BMS will receive prasugrel for 1 month, whereas all others will receive prasugrel for 12 months. The primary end point will be combined cardiac death, nonfatal myocardial infarction, and target vessel revascularization up to 2 years. Secondary end points include stent thrombosis and major bleeding. The primary aim is to test (1) the noninferiority of a biodegradable-polymer DES to a conventional DES and (2) the superiority of both DESs to BMS. A secondary aim is to compare the outcomes with those of BASKET-PROVE regarding the effects of prasugrel-based vs clopidogrel-based antiplatelet therapy. By the end of 2010, 878 patients (37% of those planned) were enrolled. This study will test the comparative long-term safety and efficacy of newest-generation stents on the background of contemporary antiplatelet therapy in a large all-comer population undergoing large native coronary artery stenting. Copyright © 2012 Mosby, Inc. All rights reserved.

Defining the Chance of Statistical Cure Among Patients with Extrahepatic Biliary Tract Cancer.

PubMed

Spolverato, Gaya; Bagante, Fabio; Ethun, Cecilia G; Poultsides, George; Tran, Thuy; Idrees, Kamran; Isom, Chelsea A; Fields, Ryan C; Krasnick, Bradley; Winslow, Emily; Cho, Clifford; Martin, Robert C G; Scoggins, Charles R; Shen, Perry; Mogal, Harveshp D; Schmidt, Carl; Beal, Eliza; Hatzaras, Ioannis; Shenoy, Rivfka; Maithel, Shishir K; Pawlik, Timothy M

2017-01-01

While surgery offers the best curative-intent treatment, many patients with biliary tract malignancies have poor long-term outcomes. We sought to apply a non-mixture cure model to calculate the cure fraction and the time to cure after surgery of patients with peri-hilar cholangiocarcinoma (PHCC) or gallbladder cancer (GBC). Using the Extrahepatic Biliary Malignancy Consortium, 576 patients who underwent curative-intent surgery for gallbladder carcinoma or peri-hilar cholangiocarcinoma between 1998 and 2014 at 10 major hepatobiliary institutions were identified and included in the analysis. A non-mixture cure model was adopted to compare mortality after surgery to the mortality expected for the general population matched by sex and age. The median and 5-year overall survival (OS) were 1.9 years (IQR, 0.9-4.9) and 23.9 % (95 % CI, 19.6-28.6). Among all patients with PHCC or GBC, the probability of being cured after surgery was 14.5 % (95 % CI, 8.7-23.2); the time to cure was 9.7 years and the median survival of uncured patients was 1.8 years. Determinants of cure probabilities included lymph node metastasis and CA 19.9 level (p ≤ 0.05). The cure fraction for patients with a CA 19.9 < 50 U/ml and no lymph nodes metastases were 39.0 % versus only 5.1 % among patients with a CA 19.9 ≥ 50 who also had lymph node metastasis. Examining an "all comer" cohort, <15 % of patients with PHCC or GBC could be considered cured after surgery. Factors such CA 19.9 level and lymph node metastasis independently predicted long-term outcome. Estimating the odds of statistical cure following surgery for biliary tract cancer can assist in decision-making as well as inform discussions around survivorship.

The 'Harmonizing Optimal Strategy for Treatment of coronary artery stenosis - sAfety & effectiveneSS of drug-elUting stents & antiplatelet REgimen' (HOST-ASSURE) trial: study protocol for a randomized controlled trial

PubMed Central

2012-01-01

Background Second-generation drug-eluting stents (DES) have raised the bar of clinical performance. These stents are mostly made from cobalt chromium alloy. A newer generation DES has been developed from platinum chromium alloy, but clinical data regarding the efficacy and safety of the platinum chromium-based everolimus-eluting stent (PtCr-EES) is limited, with no comparison data against the cobalt chromium-based zotarolimus-eluting stent (CoCr-ZES). In addition, an antiplatelet regimen is an integral component of medical therapy after percutaneous coronary intervention (PCI). A 1-week duration of doubling the dose of clopidogrel (double-dose antiplatelet therapy (DDAT)) was shown to improve outcome at 1 month compared with conventional dose in acute coronary syndrome (ACS) patients undergoing PCI. However in Asia, including Korea, the addition of cilostazol (triplet antiplatelet therapy (TAT)) is used more commonly than doubling the dose of clopidogrel in high-risk patients. Methods In the 'Harmonizing Optimal Strategy for Treatment of coronary artery stenosis - sAfety & effectiveneSS of drug-elUting stents & antiplatelet REgimen' (HOST-ASSURE) trial, approximately 3,750 patients are being prospectively and randomly assigned in a 2 × 2 factorial design according to the type of stent (PtCr-EES vs CoCr-ZES) and antiplatelet regimen (TAT vs DDAT). The first primary endpoint is target lesion failure at 1 year for the stent comparison, and the second primary endpoint is net clinical outcome at 1 month for comparison of antiplatelet therapy regimen. Discussion The HOST-ASSURE trial is the largest study yet performed to directly compare the efficacy and safety of the PtCr-EES versus CoCr-ZES in an 'all-comers' population. In addition, this study will also compare the clinical outcome of TAT versus DDAT for 1-month post PCI. Trial registration ClincalTrials.gov number NCT01267734. PMID:22463698

Reduced duration of dual antiplatelet therapy using an improved drug-eluting stent for percutaneous coronary intervention of the left main artery in a real-world, all-comer population: Rationale and study design of the prospective randomized multicenter IDEAL-LM trial.

PubMed

Lemmert, Miguel E; Oldroyd, Keith; Barragan, Paul; Lesiak, Maciej; Byrne, Robert A; Merkulov, Evgeny; Daemen, Joost; Onuma, Yoshinobu; Witberg, Karen; van Geuns, Robert-Jan

2017-05-01

Continuous improvements in stent technology make percutaneous coronary intervention (PCI) a potential alternative to surgery in selected patients with unprotected left main coronary artery (uLMCA) disease. The optimal duration of dual antiplatelet therapy (DAPT) in these patients remains undetermined, and in addition, new stent designs using a bioabsorbable polymer might allow shorter duration of DAPT. IDEAL-LM is a prospective, randomized, multicenter study that will enroll 818 patients undergoing uLMCA PCI. Patients will be randomized in a 1:1 fashion to intravascular ultrasound-guided PCI with the novel everolimus-eluting platinum-chromium Synergy stent with a biodegradable polymer (Boston Scientific, Natick, MA) followed by 4 months of DAPT or the everolimus-eluting cobalt-chromium Xience stent (Abbott Vascular, Santa Clara, CA) followed by 12 months of DAPT. The total follow-up period will be 5 years. A subset of 100 patients will undergo optical coherence tomography at 3 months. The primary end point will be major adverse cardiovascular events (composite of all-cause mortality, myocardial infarction, and ischemia-driven target vessel revascularization) at 2 years. Secondary end points will consist of the individual components of the primary end point, procedural success, a device-oriented composite end point, stent thrombosis as per Academic Research Consortium criteria, and bleeding as per Bleeding Academic Research Consortium criteria. IDEAL-LM is designed to assess the safety and efficacy of the novel Synergy stent followed by 4 months of DAPT vs the Xience stent followed by 12 months of DAPT in patients undergoing uLMCA PCI. The study will provide novel insights regarding optimal treatment strategy for patients undergoing PCI of uLMCA disease (www.clinicaltrials.gov, NCT 02303717). Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Community-Based Soil Quality Assessment As a Tool for Designing an Urban Green Infrastructure Network to Manage Runoff.

NASA Astrophysics Data System (ADS)

Klimas, C.; Montgomery, J.

2014-12-01

Green infrastructure (GI) may be the most practical approach for reducing contaminated runoff, providing ecosystem services, mitigating food deserts and creating community open spaces in urban areas. This project was funded by the USEPA's People-Prosperity-Planet (P3) program and was a partnership between a team of DePaul University undergraduates (the P3 team) and high school interns (Green Teens) and staff from the Gary Comer Youth Center (GCYC). GCYC is located in a low-income African-American community on Chicago's south side characterized by high crime, abandoned buildings, lack of green space and a food desert. The overaching project goal was to develop a network of Green Teens qualified to conduct soil quality assessment using USDA-NRCS protocols in order to let them develop GI plans to minimize storm water runoff and contaminant loadings, improve community and environmental health, and provide more equitable access to green space. Working with a USDA-ARS soil scientist from Washington State University, the P3 team conducted soil quality assessment on 116 soil samples collected among four abandoned residential lots owned by GCYC. Analytes included infiltration, bulk density, texture, pH, conductivity, aggregate stability, available nutrients, and total and bioavailable (PBET) lead. Soil pH on all lots is greater than 8.0, are low in organic matter, have little microbial respiration activity, are enriched in available phosphorus, and have average total lead values ranging from 24-2,700 mg/kg. PBET lead was less than 40% on most lots. Regardless, these soils will need to be remediated by adding carbon-rich materials such as biosolids prior to GI installation. Students enrolled in a landscape design course at DePaul developed 3-D models representing potential GI designs for one of the vacant lots that include strategies for immobilizing heavy metals, reducing runoff, and which are tied into an educational module for neighborhood school children.

Hanford tank initiative vehicle/based waste retrieval demonstration report phase II, track 2

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berglin, E.J.

1997-07-31

Using the versatile TracPUMpTm, Environmental Specialties Group, LLC (ES) performed a successful Phase 11 demonstration of a Vehicle- Based Waste Retrieval System (VWRS) for removal of waste material and residual liquid found in the Hanford Underground Storage Tanks (ousts). The purpose of this demonstration was to address issues pertaining to the use of a VWRS in OUSTS. The demonstration also revealed the waste removal capabilities of the TracPumpTm and the most effective techniques and equipment to safely and effectively remove waste simulants. ES successfully addressed the following primary issues: I . Dislodge and convey the waste forms present in themore » Hanford OUSTS; 2. Access the UST through tank openings as small as twenty-four inches in diameter; 3. Traverse a variety of terrains including slopes, sludges, rocks and hard, slippery surfaces without becoming mired; 4. Dislodge and convey waste within the confinement of the Decontamination Containment Capture Vessel (DCCV) and with minimal personnel exposure; 5. Decontaminate equipment to acceptable limits during retrieval from the UST; 6. Perform any required maintenance within the confinement of the DCCV; and 7. Maintain contaminate levels ``as low as reasonably achievable`` (ALARA) within the DCCV due to its crevice and comer-free design. The following materials were used to simulate the physical characteristics of wastes found in Hanford`s OUSTS: (1) Hardpan: a clay-type material that has high shear strength; (2) Saltcake: a fertilizer-based material that has high compressive strength; and (3) Wet Sludge.- a sticky, peanut- butter- like material with low shear strength. Four test beds were constructed of plywood and filled with a different simulant to a depth of eight to ten inches. Three of the test beds were of homogenous simulant material, while the fourth bed consisted of a mixture of all three simulant types.« less

Parameters affecting of Akkuyu's safety assessment for severe core damages

NASA Astrophysics Data System (ADS)

Kavun, Yusuf; Karasulu, Muzaffer

2015-07-01

We have looked at all past core meltdowns (Three Mile Island, Chernobyl and Fukushima incidents) and postulated the fourth one might be taking place in the future most probably in a newly built reactors anywhere of the earth in any type of NPP. The probability of this observation is high considering the nature of the machine and human interaction. Operation experience is a very significant parameter as well as the safety culture of the host nation. The concerns is not just a lack of experience with industry with the new comers, but also the infrastructure and established institutions who will be dealing with the Emergencies. Lack of trained and educated Emergency Response Organizations (ERO) is a major concern. The culture on simple fire drills even makes the difference when a severe condition occurs in the industry. The study assumes the fourth event will be taking place at the Akkuyu NGS and works backwards as required by the "what went wrong " scenarios and comes up with interesting results. The differences studied in depth to determine the impact to the severe accidents. The all four design have now core catchers. We have looked at the operator errors'like in TMI); Operator errors combined with design deficiencies(like in Chernobyl) and natural disasters( like in Fukushima) and found operator errors to be more probable event on the Akkuyu's postulated next incident. With respect to experiences of the operators we do not have any data except for long and successful operating history of the Soviet design reactors up until the Chernobyl incident. Since the Akkuyu will be built, own and operated by the Russians we have found no alarming concerns at the moment. At the moment, there is no body be able to operate those units in Turkey. Turkey is planning to build the required manpower during the transition period. The resolution of the observed parameters lies to work and educate, train of the host nation and exercise together.

Pre-procedural assessment of aortic annulus dimensions for transcatheter aortic valve replacement: comparison of a non-contrast 3D MRA protocol with contrast-enhanced cardiac dual-source CT angiography.

PubMed

Ruile, Philipp; Blanke, Philipp; Krauss, Tobias; Dorfs, Stephan; Jung, Bernd; Jander, Nikolaus; Leipsic, Jonathon; Langer, Mathias; Neumann, Franz-Josef; Pache, Gregor

2016-04-01

To evaluate the feasibility of a non-contrast three-dimensional (3D)-FLASH magnetic resonance angiography (MRA) protocol for pre-procedural aortic annulus assessment for transcatheter aortic valve replacement (TAVR) in comparison with cardiac dual-source computed tomography angiography (CTA). In this prospective study, 69 of 104 consecutive patients (mean age 81.8 ± 5.4 years, 37.7% arrhythmic) with severe aortic stenosis who had undergone pre-TAVR cardiac CTA received a respiratory and ECG-triggered, non-contrast 3D-FLASH MRA at 3 T. Annular area measurements were obtained at mid-diastole for both modalities whereas maximum systolic area was assessed by CTA only. Systolic MRA dimensions were modelled, by adding the relative difference of systolic and diastolic CTA area dimensions as a corrective factor. Hypothetical prosthesis sizing was performed based on systolic CTA, diastolic, and modelled systolic MRA area measurements. MR image quality and degree of annular calcifications were evaluated using 4-point-grading scales. The mean acquisition time was 14 ± 4.2 min. The mean image quality was 3.1 ± 0.9 with only two examinations rated non-diagnostic. The mean degree of calcifications was equal. As assessed by Bland-Altman analysis, there was no relevant systematic difference between area measurements for modelled systolic MRA and systolic CTA [the mean difference -3.1 mm(2) (limits of agreement -44.4 mm(2); 38.2 mm(2))]. Agreement for hypothetical prosthesis sizing was found in 63 of 67 (94%) patients for systolic CTA and modelled systolic MRA. The employed non-contrast 3D-FLASH MRA protocol allows for reliable assessment of aortic annulus dimensions and calcifications even in the presence of arrhythmias in an all-comers pre-TAVR population. Implementation of this technique appears legitimate in patients at an increased risk for contrast-induced nephropathy. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Contamination source review for Building E5032, Edgewood Area, Aberdeen Proving Ground, Maryland

DOE Office of Scientific and Technical Information (OSTI.GOV)

Booher, M.N.; O`Reilly, D.P.; Smits, M.P.

1995-09-01

This report by Argonne National Laboratory (ANL) documents results of a contamination source review of Building E5032 at the Aberdeen Proving Ground (APG) in Maryland. The review included a historical records search, physical inspection, photographic documentation, geophysical investigation, and review of available records regarding underground storage tanks associated with Building E5032. The field investigations were performed by ANL during 1994 and 1995. Building E5032 (APG designation), originally known as Building 99, is located at the northwest comer of the intersection of Hoadley Road and Magnolia Road in the Edgewood Area of APG. It was constructed during World War I asmore » an incendiary bomb filling plant and in 1920s and 1930s maintained as a filling facility. During World War II the building was a pilot plant for the development of a dry white phosphorus filling process. Since then the building has been used for white phosphorus filling pilot studies. Most of the dry filling methods were developed in Building E5032 between 1965 and 1970. Other filling operations in Building E5032 have included mustard during the period shortly after World War II and triethyl aluminum (TEA) during the late 1960s and early 1970s. During the World War II period, the building was connected to the sanitary sewer system with one large and at least one small interior sump. There are also seven sumps adjacent to the exterior of the building: two on the west elevation, four near the four bays on the south elevation, and one at the northeast corner of the building. All of these sumps are connected with the chemical sewer system and received most, if not all, of the production operation wastewater. The discharge from this system was released into the east branch of Canal Creek; the discharge pipe was located southeast of Building E5032. There are no records indicating the use of Building E5032 after 1974, and it is assumed that the building has been out of service since that time.« less

Effects of chronic administration of caffeine and stress on feeding behavior of rats.

PubMed

Pettenuzzo, Leticia Ferreira; Noschang, Cristie; von Pozzer Toigo, Eduardo; Fachin, Andrelisa; Vendite, Deusa; Dalmaz, Carla

2008-10-20

Anorectic effects of caffeine are controversial in the literature, while stress and obesity are growing problems in our society. Since many stressed people are coffee drinkers, the objective of the present study was to evaluate the effect of stress and chronic administration of caffeine on feeding behavior and body weight in male and female rats. Wistar rats (both males and females) were divided into 3 groups: control (receiving water), caffeine 0.3 g/L and caffeine 1.0 g/L (in the drinking water). These groups were subdivided into non-stressed and stressed (repeated-restraint stress for 40 days). During the entire treatment, chow consumption was monitored and rats were weighed monthly. Afterwards, feeding behavior was evaluated during 3-min trials in food-deprived and ad libitum fed animals and also in repeated exposures, using palatable food (Froot Loops and Cheetos). Chronic administration of caffeine did not affect rat chow consumption or body weight gain, but diminished the consumption of both salty (Cheetos) and sweet (Froot Loops) palatable food. In the repeated trial tests, stress diminished savory snack consumption in the later exposures [I.S. Racotta, J. Leblanc, D. Richard The effect of caffeine on food intake in rats: involvement of corticotropin-releasing factor and the sympatho-adrenal system. Pharmacol Biochem Behav. 1994, 48:887-892; S.D. Comer, M. Haney, R.W. Foltin, M.W. Fischman Effects of caffeine withdrawal on humans living in a residential laboratory. Exp Clin Psychopharmacol. 1997, 5:399-403; A. Jessen, B. Buemann, S. Toubro, I.M. Skovgaard, A. Astrup The appetite-suppressant effect of nicotine is enhanced by caffeine. Diab Ob Metab. 2005, 7:327-333; J.M. Carney Effects of caffeine, theophylline and theobromine on scheduled controlled responding in rats. Br J Pharmacol. 1982, 75:451-454] and caffeine diminished consumption of both palatable foods (savory and sweet) during the early and later exposures. Most responses to caffeine were stronger in females, and stress exposure influenced the effect. Neither chronic caffeine nor stress affected adrenal weight and plasma corticosterone levels of the rats. These observations suggest that chronic caffeine consumption may have sex-specific effects on palatable food ingestion.

Preoperative endoscopic versus percutaneous transhepatic biliary drainage in potentially resectable perihilar cholangiocarcinoma (DRAINAGE trial): design and rationale of a randomized controlled trial.

PubMed

Wiggers, Jimme K; Coelen, Robert J S; Rauws, Erik A J; van Delden, Otto M; van Eijck, Casper H J; de Jonge, Jeroen; Porte, Robert J; Buis, Carlijn I; Dejong, Cornelis H C; Molenaar, I Quintus; Besselink, Marc G H; Busch, Olivier R C; Dijkgraaf, Marcel G W; van Gulik, Thomas M

2015-02-14

Liver surgery in perihilar cholangiocarcinoma (PHC) is associated with high postoperative morbidity because the tumor typically causes biliary obstruction. Preoperative biliary drainage is used to create a safer environment prior to liver surgery, but biliary drainage may be harmful when severe drainage-related complications deteriorate the patients' condition or increase the risk of postoperative morbidity. Biliary drainage can cause cholangitis/cholecystitis, pancreatitis, hemorrhage, portal vein thrombosis, bowel wall perforation, or dehydration. Two methods of preoperative biliary drainage are mostly applied: endoscopic biliary drainage, which is currently used in most regional centers before referring patients for surgical treatment, and percutaneous transhepatic biliary drainage. Both methods are associated with severe drainage-related complications, but two small retrospective series found a lower incidence in the number of preoperative complications after percutaneous drainage compared to endoscopic drainage (18-25% versus 38-60%, respectively). The present study randomizes patients with potentially resectable PHC and biliary obstruction between preoperative endoscopic or percutaneous transhepatic biliary drainage. The study is a multi-center trial with an "all-comers" design, randomizing patients between endoscopic or percutaneous transhepatic biliary drainage. All patients selected to potentially undergo a major liver resection for presumed PHC are eligible for inclusion in the study provided that the biliary system in the future liver remnant is obstructed (even if they underwent previous inadequate endoscopic drainage). Primary outcome measure is the total number of severe preoperative complications between randomization and exploratory laparotomy. The study is designed to detect superiority of percutaneous drainage: a provisional sample size of 106 patients is required to detect a relative decrease of 50% in the number of severe preoperative complications (alpha = 0.95; beta = 0.8). Interim analysis after inclusion of 53 patients (50%) will provide the definitive sample size. Secondary outcome measures encompass the success of biliary drainage, quality of life, and postoperative morbidity and mortality. The DRAINAGE trial is designed to identify a difference in the number of severe drainage-related complications after endoscopic and percutaneous transhepatic biliary drainage in patients selected to undergo a major liver resection for perihilar cholangiocarcinoma. Netherlands Trial Register [ NTR4243 , 11 October 2013].

Comparison of corneal endothelial image analysis by Konan SP8000 noncontact and Bio-Optics Bambi systems.

PubMed

Benetz, B A; Diaconu, E; Bowlin, S J; Oak, S S; Laing, R A; Lass, J H

1999-01-01

Compare corneal endothelial image analysis by Konan SP8000 and Bio-Optics Bambi image-analysis systems. Corneal endothelial images from 98 individuals (191 eyes), ranging in age from 4 to 87 years, with a normal slit-lamp examination and no history of ocular trauma, intraocular surgery, or intraocular inflammation were obtained by the Konan SP8000 noncontact specular microscope. One observer analyzed these images by using the Konan system and a second observer by using the Bio-Optics Bambi system. Three methods of analyses were used: a fixed-frame method to obtain cell density (for both Konan and Bio-Optics Bambi) and a "dot" (Konan) or "corners" (Bio-Optics Bambi) method to determine morphometric parameters. The cell density determined by the Konan fixed-frame method was significantly higher (157 cells/mm2) than the Bio-Optics Bambi fixed-frame method determination (p<0.0001). However, the difference in cell density, although still statistically significant, was smaller and reversed comparing the Konan fixed-frame method with both Konan dot and Bio-Optics Bambi comers method (-74 cells/mm2, p<0.0001; -55 cells/mm2, p<0.0001, respectively). Small but statistically significant morphometric analyses differences between Konan and Bio-Optics Bambi were seen: cell density, +19 cells/mm2 (p = 0.03); cell area, -3.0 microm2 (p = 0.008); and coefficient of variation, +1.0 (p = 0.003). There was no statistically significant difference between these two methods in the percentage of six-sided cells detected (p = 0.55). Cell densities measured by the Konan fixed-frame method were comparable with Konan and Bio-Optics Bambi's morphometric analysis, but not with the Bio-Optics Bambi fixed-frame method. The two morphometric analyses were comparable with minimal or no differences for the parameters that were studied. The Konan SP8000 endothelial image-analysis system may be useful for large-scale clinical trials determining cell loss; its noncontact system has many clinical benefits (including patient comfort, safety, ease of use, and short procedure time) and provides reliable cell-density calculations.

Effect of Left Versus Right Radial Artery Approach for Coronary Angiography on Radiation Parameters in Patients with Predictors of Transradial Access Failure

PubMed Central

Shah, Binita; Burdowski, Joseph; Guo, Yu; de Villa, Bryan Velez; Huynh, Andrew; Farid, Meena; Maini, Mansi; Serrano-Gomez, Claudia; Staniloae, Cezar; Feit, Frederick; Attubato, Michael J.; Slater, James; Coppola, John

2016-01-01

Left transradial approach (TRA) for coronary angiography is associated with lower radiation parameters than right TRA in an all-comers population. The aim of this study was to determine the effects of left versus right TRA on radiation parameters in patients with predictors of TRA failure. Patients with predictors of TRA failure (≥3 of 4 following criteria: age ≥70 years, female sex, height ≤64 inches, hypertension) referred to TRA operators were randomized to either right (n=50) or left (n=50) TRA, while those referred to transfemoral approach (TFA) operators were enrolled in a prospective registry (n=50). The primary endpoint was the radiation measure of dose area product (DAP). In an intention-to-treat analysis, DAP (34.1 Gy*cm2 [24.9–45.6] vs 41.9 Gy*cm2 [27.3–58.0], p=0.08), fluoroscopy time (3.7 min [2.4–6.3] vs 5.6 min [3.1–8.7], p=0.07), and operator radiation exposure (516 uR [275–967] vs. 730 uR [503–1165], p=0.06) were not significantly different between left and right TRA, but total dose (411 mGy [310–592] vs 537 mGy [368–780], p=0.03) was significantly lower with left versus right TRA. Radiation parameters were lowest in the TFA cohort (DAP 24.5 Gy*cm2 [15.7–33.2], p<0.001; fluoroscopy time 2.3 min [1.5–3.7], p<0.001; operator radiation exposure 387 uR [264–557]; total dose 345 mGy [250–468], p=0.001). Results were similar after adjustment for differences in baseline characteristics. In conclusion, median measures of radiation were overall not significantly different between left versus right TRA in this select population of patients with predictors of TRA failure. All measures of radiation were lowest in the TFA group. PMID:27328954

Rationale and design of three observational, prospective cohort studies including biobanking to evaluate and improve diagnostics, management strategies and risk stratification in venous thromboembolism: the VTEval Project.

PubMed

Frank, Bernd; Ariza, Liana; Lamparter, Heidrun; Grossmann, Vera; Prochaska, Jürgen H; Ullmann, Alexander; Kindler, Florentina; Weisser, Gerhard; Walter, Ulrich; Lackner, Karl J; Espinola-Klein, Christine; Münzel, Thomas; Konstantinides, Stavros V; Wild, Philipp S

2015-07-01

Venous thromboembolism (VTE) with its two manifestations deep vein thrombosis (DVT) and pulmonary embolism (PE) is a major public health problem. The VTEval Project aims to investigate numerous research questions on diagnosis, clinical management, treatment and prognosis of VTE, which have remained uncertain to date. The VTEval Project consists of three observational, prospective cohort studies on VTE comprising cohorts of individuals with a clinical suspicion of acute PE (with or without DVT), with a clinical suspicion of acute DVT (without symptomatic PE) and with an incidental diagnosis of VTE (PE or DVT). The VTEval Project expects to enrol a total of approximately 2000 individuals with subsequent active and passive follow-up investigations over a time period of 5 years per participant. Time points for active follow-up investigations are at months 3, 6, 12, 24 and 36 after diagnosis (depending on the disease cohort); passive follow-up investigations via registry offices and the cancer registry are performed 48 and 60 months after diagnosis for all participants. Primary short-term outcome is defined by overall mortality (PE-related death and all other causes of death), primary long-term outcome by symptomatic VTE (PE-related death, recurrence of non-fatal PE or DVT). The VTEval Project includes three 'all-comer' studies and involves the standardised acquisition of high-quality data, covering the systematic assessment of VTE including symptoms, risk profile, psychosocial, environmental and lifestyle factors as well as clinical and subclinical disease, and it builds up a large state-of-the-art biorepository containing various materials from serial blood samplings. The VTEval Project has been approved by the local data safety commissioner and the responsible ethics committee (reference no. 837.320.12 (8421-F)). Trial results will be published in peer-reviewed journals and presented at national and international scientific meetings. NCT02156401. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Long-term outcomes in patients with rheumatologic disorders undergoing percutaneous coronary intervention: a BAsel Stent Kosten-Effektivitäts Trial-PROspective Validation Examination (BASKET-PROVE) sub-study.

PubMed

Nochioka, Kotaro; Biering-Sørensen, Tor; Hansen, Kim Wadt; Sørensen, Rikke; Pedersen, Sune; Jørgensen, Peter Godsk; Iversen, Allan; Shimokawa, Hiroaki; Jeger, Raban; Kaiser, Christoph; Pfisterer, Matthias; Galatius, Søren

2017-12-01

Rheumatologic disorders are characterised by inflammation and an increased risk of coronary artery disease (CAD). However, the association between rheumatologic disorders and long-term prognosis in CAD patients undergoing percutaneous coronary intervention (PCI) is unknown. Thus, we aimed to examine the association between rheumatologic disorders and long-term prognosis in CAD patients undergoing PCI. A post-hoc analysis was performed in 4605 patients (age: 63.3 ± 11.0 years; male: 76.6%) with ST-segment elevation myocardial infarction (STEMI; n = 1396), non-STEMI ( n = 1541), and stable CAD ( n = 1668) from the all-comer stent trials, the BAsel Stent Kosten-Effektivitäts Trial-PROspective Validation Examination (BASKET-PROVE) I and II trials. We evaluated the association between rheumatologic disorders and 2-year major adverse cardiac events (MACEs; cardiac death, nonfatal myocardial infarction (MI), and target vessel revascularisation (TVR)) by Cox regression analysis. Patients with rheumatologic disorders ( n = 197) were older, more often female, had a higher prevalence of renal disease, multi-vessel coronary disease, and bifurcation lesions, and had longer total stent lengths. During the 2-year follow-up, the MACE rate was 8.6% in the total cohort. After adjustment for potential confounders, rheumatologic disorders were associated with MACEs in the total cohort (adjusted hazard ratio: 1.55; 95% confidence interval (CI): 1.04-2.31) driven by the STEMI subgroup (adjusted hazard ratio: 2.38; 95% CI: 1.26-4.51). In all patients, rheumatologic disorders were associated with all-cause death (adjusted hazard ratio: 2.05; 95% CI: 1.14-3.70), cardiac death (adjusted hazard ratio: 2.63; 95% CI: 1.27-5.43), and non-fatal MI (adjusted hazard ratio: 2.64; 95% CI: 1.36-5.13), but not with TVR (adjusted hazard ratio: 0.81; 95% CI: 0.41-1.58). The presence of rheumatologic disorders appears to be independently associated with worse outcome in CAD patients undergoing PCI. This calls for further studies and focus on this high-risk group of patients following PCI.

Development of a PD-L1 Complementary Diagnostic Immunohistochemistry Assay (SP142) for Atezolizumab.

PubMed

Vennapusa, Bharathi; Baker, Brian; Kowanetz, Marcin; Boone, Jennifer; Menzl, Ina; Bruey, Jean-Marie; Fine, Gregg; Mariathasan, Sanjeev; McCaffery, Ian; Mocci, Simonetta; Rost, Sandra; Smith, Dustin; Dennis, Eslie; Tang, Szu-Yu; Damadzadeh, Bita; Walker, Espen; Hegde, Priti S; Williams, J Andrew; Koeppen, Hartmut; Boyd, Zachary

2018-01-16

Cancer immunotherapies, such as atezolizumab, are proving to be a valuable therapeutic strategy across indications, including non-small cell lung cancer (NSCLC) and urothelial cancer (UC). Here, we describe a diagnostic assay that measures programmed-death ligand 1 (PD-L1) expression, via immunohistochemistry, to identify patients who will derive the most benefit from treatment with atezolizumab, a humanized monoclonal anti-PD-L1 antibody. We describe the performance of the VENTANA PD-L1 (SP142) Assay in terms of specificity, sensitivity, and the ability to stain both tumor cells (TC) and tumor-infiltrating immune cells (IC), in NSCLC and UC tissues. The reader precision, repeatability and intermediate precision, interlaboratory reproducibility, and the effectiveness of pathologist training on the assessment of PD-L1 staining on both TC and IC were evaluated. We detail the analytical validation of the VENTANA PD-L1 (SP142) Assay for PD-L1 expression in NSCLC and UC tissues and show that the assay reliably evaluated staining on both TC and IC across multiple expression levels/clinical cut-offs. The reader precision showed high overall agreement when compared with consensus scores. In addition, pathologists met the predefined training criteria (≥85.0% overall percent agreement) for the assessment of PD-L1 expression in NSCLC and UC tissues with an average overall percent agreement ≥95.0%. The assay evaluates PD-L1 staining on both cell types and is robust and precise. In addition, it can help to identify those patients who may benefit the most from treatment with atezolizumab, although treatment benefit has been demonstrated in an all-comer NSCLC and UC patient population.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.

Paleomagnetism of the Chinle and Kayenta Formations, New Mexico and Arizona

NASA Astrophysics Data System (ADS)

Bazard, David R.; Butler, Robert F.

1991-06-01

Paleomagnetic data were obtained from 22 sites (6-10 samples/site) in the Upper Shale Member of the Chinle Formation, 43 sites in the Owl Rock Member of the Chinle Formation, and 35 sites in the Kayenta Formation. Thermal demagnetization and data analyses indicate that within-site dispersion is an important criterion for selecting sites which retain a high unblocking temperature characteristic remanent magnetization (ChRM). Site-mean directions define at least four antipodal polarity zones within each member/formation, suggesting the ChRM was acquired soon after deposition. Fifteen site-mean virtual geomagnetic poles (VGPs) from the Upper Shale Member of the Chinle Formation yield an early Norian paleomagnetic pole position of 57.4°N, 87.8°E (K = 60, A95 = 5.0°). Eighteen site-mean VGPs from the Owl Rock Member of the Chinle Formation yield a middle Norian paleomagnetic pole position of 56.5°N, 66.4°E (K = 183, A95 = 2.6°). Twenty-three site-mean VGPs from the Kayenta Formation yield a Pliensbachian pole position of 59.0°N, 66.6°E (K = 155, A95 = 2.4°). Combined with paleomagnetic poles from the Moenave Formation and the Shinarump Member of the Chinle Formation, these data record ˜30 m.y. of North American apparent polar wander (APW) within a regional stratigraphic succession. During the Camian and Norian stages of the Late Triassic, Chinle poles progress westward. During the Hettangian through Pliensbachian stages of the Early Jurassic, the pattern of APW changed to an eastward progression. Even after correction for 4° clockwise rotation of the Colorado Plateau, a sharp comer in the APW path (J1 cusp) is resolved near the pole from the Hettangian/Sinemurian (˜200 Ma) Moenave Formation (59.4°N, 59.2°E). Amongst other implications, the sharp change in the APW path at the J1 cusp implies an abrupt change from counterclockwise rotation of Pangea prior to 200 Ma to clockwise rotation thereafter.

Terrestrial Ecosystems of the Conterminous United States

USGS Publications Warehouse

Sayre, Roger G.; Comer, Patrick; Cress, Jill; Warner, Harumi

2010-01-01

The U.S. Geological Survey (USGS), with support from NatureServe, has modeled the potential distribution of 419 terrestrial ecosystems for the conterminous United States using a comprehensive biophysical stratification approach that identifies distinct biophysical environments and associates them with known vegetation distributions (Sayre and others, 2009). This standardized ecosystem mapping effort used an ecosystems classification developed by NatureServe (Comer and others, 2003). The ecosystem mapping methodology was developed for South America (Sayre and others, 2008) and is now being implemented globally (Sayre and others, 2007). The biophysical stratification approach is based on mapping the major structural components of ecosystems (land surface forms, topographic moisture potential, surficial lithology, isobioclimates and biogeographic regions) and then spatially combining them to produce a set of unique biophysical environments. These physically distinct areas are considered as the fundamental structural units ('building blocks') of ecosystems, and are subsequently aggregated and labeled using the NatureServe classification. The structural footprints were developed from the geospatial union of several base layers including biogeographic regions, isobioclimates (Cress and others, 2009a), land surface forms (Cress and others, 2009b), topographic moisture potential (Cress and others, 2009c), and surficial lithology (Cress and others, in press). Among the 49,168 unique structural footprint classes that resulted from the union, 13,482 classes met a minimum pixel count threshold (20,000 pixels) and were aggregated into 419 NatureServe ecosystems using a semiautomated labeling process based on rule-set formulations for attribution of each ecosystem. The resulting ecosystems are those that are expected to occur based on the combination of the bioclimate, biogeography, and geomorphology. Where land use by humans has not altered land cover, natural vegetation assemblages are expected to occur, and these are described in the ecosystems classification. The map does not show the distribution of urban and agricultural areas - these will be masked out in subsequent analyses to depict the current land cover in addition to the potential distribution of natural ecosystems. This map depicts the smoothed and generalized image of the terrestrial ecosystems dataset. Additional information about this map and any data developed for the ecosystems modeling of the conterminous United States is available online at: http://rmgsc.cr.usgs.gov/ecosystems/.

Gender difference on five-year outcomes of EXCEL biodegradable polymer-coated sirolimus-eluting stents implantation: results from the CREATE study.

PubMed

Zhang, Lei; Qiao, Bing; Han, Ya-Ling; Li, Yi; Xu, Kai; Zhang, Quan-Yu; Yang, Li-Xia; Liu, Hui-Liang; Xu, Bo; Gao, Run-Lin

2013-03-01

The gender difference on long-term outcome in unselected patients after percutaneous coronary intervention (PCI) has not yet been fully investigated. This study aimed to evaluate the gender difference on five-year outcomes following EXCEL biodegradable polymer-coated sirolimus-eluting stenting in patients with coronary disease. A total of 2077 "all comers", consisting of 1528 (73.6%) men and 549 (26.4%) women, who were exclusively treated with EXCEL coronary stents were enrolled in the prospective CREATE study at 59 centers from four countries. After propensity score matching, the baseline characteristics of the two groups were well matched. Recommended antiplatelet regimen was clopidogrel and aspirin for six months followed by chronic aspirin therapy. The primary outcome that was the rate of major adverse cardiac events (MACE), defined as a composite of cardiac mortality, non-fatal myocardial infarction (MI) and target lesion revascularization (TLR), and stent thrombosis (ST) at five years were compared between the two gender groups. In the two groups, women had higher proportions of clinical risk factors, such as being elderly, diabetes mellitus, hypertension and hyperlipidemia, compared to men. Besides, the mean target vessel number per patient was higher and the mean reference vessel diameter smaller for women. Men had higher risks of cardiac death (3.7% vs. 1.6%, P = 0.021) and MACE (8.4% vs. 4.7%, P = 0.004) at five years compared with women. However, the cumulative hazards of non-fatal MI and TLR were similar between men and women. The incidence of Academic Research Consortium (ARC) definite or probable stent thrombosis was similar between the two groups (1.3% vs. 1.0%, P = 0.639). Prolonged clopidogrel therapy (>6 months) did not reduce the cumulative hazards of ST from six months to five years in both men (χ(2) = 0.098, log rank P = 0.754) and women (χ(2) = 2.043, log rank P = 0.153) patients. Women had a lower MACE and cardiac death rate than men after biodegradable polymer-coated sirolimus-eluting stenting in long term follow-up. Effects of prolonged dual antiplatelet therapy (DAPT) in preventing stent thrombosis was similar with six-month DAPT after EXCEL stent implantation in both men and women groups.

Steady-State Pursuit Is Driven by Object Motion Rather Than the Vector Average of Local Motions

NASA Technical Reports Server (NTRS)

Stone, Leland S.; Beutter, B. R.; Lorenceau, J. D.; Ahumada, Al (Technical Monitor)

1997-01-01

We have previously shown that humans can pursue the motion of objects whose trajectories can be recovered only by spatio-temporal integration of local motion signals. We now explore the integration rule used to derive the target-motion signal driving pursuit. We measured the pursuit response of 4 observers (2 naive) to the motion of a line-figure diamond viewed through two vertical bar apertures (0.2 cd/square m). The comers were always occluded so that only four line segments (93 cd/square m) were visible behind the occluding foreground (38 cd/square m). The diamond was flattened (40 & 140 degree vertex angles) such that vector averaging of the local normal motions and vertical integration (e.g. IOC) yield very I or different predictions, analogous to using a Type II plaid. The diamond moved along Lissajous-figure trajectories (Ax = Ay = 2 degrees; TFx = 0.8 Hz; TFy = 0.4 Hz). We presented only 1.25 cycles and used 6 different randomly interleaved initial relative phases to minimize the role of predictive strategies. Observers were instructed to track the diamond and reported that its motion was always coherent (unlike type II plaids). Saccade-free portions of the horizontal and vertical eye-position traces sampled at 240 Hz were fit by separate sinusoids. Pursuit gain with respect to the diamond averaged 0.7 across subjects and directions. The ratio of the mean vertical to horizontal amplitude of the pursuit response was 1.7 +/- 0.7 averaged across subjects (1SD). This is close to the prediction of 1.0 from vertical motion-integration rules, but far from 7.7 predicted by vector averaging and infinity predicted by segment- or terminator-tracking strategies. Because there is no retinal motion which directly corresponds to the diamond's motion, steady-state pursuit of our "virtual" diamond is not closed-loop in the traditional sense. Thus, accurate pursuit is unlikely to result simply from local retinal negative feedback. We conclude that the signal driving steady-state pursuit is not the vector average of local motion signals, but rather a more vertical estimate of object motion, derived in extrastriate cortical areas beyond V1, perhaps NIT or MST.

Dynamic Topography Revisited

NASA Astrophysics Data System (ADS)

Moresi, Louis

2015-04-01

Dynamic Topography Revisited Dynamic topography is usually considered to be one of the trinity of contributing causes to the Earth's non-hydrostatic topography along with the long-term elastic strength of the lithosphere and isostatic responses to density anomalies within the lithosphere. Dynamic topography, thought of this way, is what is left over when other sources of support have been eliminated. An alternate and explicit definition of dynamic topography is that deflection of the surface which is attributable to creeping viscous flow. The problem with the first definition of dynamic topography is 1) that the lithosphere is almost certainly a visco-elastic / brittle layer with no absolute boundary between flowing and static regions, and 2) the lithosphere is, a thermal / compositional boundary layer in which some buoyancy is attributable to immutable, intrinsic density variations and some is due to thermal anomalies which are coupled to the flow. In each case, it is difficult to draw a sharp line between each contribution to the overall topography. The second definition of dynamic topography does seem cleaner / more precise but it suffers from the problem that it is not measurable in practice. On the other hand, this approach has resulted in a rich literature concerning the analysis of large scale geoid and topography and the relation to buoyancy and mechanical properties of the Earth [e.g. refs 1,2,3] In convection models with viscous, elastic, brittle rheology and compositional buoyancy, however, it is possible to examine how the surface topography (and geoid) are supported and how different ways of interpreting the "observable" fields introduce different biases. This is what we will do. References (a.k.a. homework) [1] Hager, B. H., R. W. Clayton, M. A. Richards, R. P. Comer, and A. M. Dziewonski (1985), Lower mantle heterogeneity, dynamic topography and the geoid, Nature, 313(6003), 541-545, doi:10.1038/313541a0. [2] Parsons, B., and S. Daly (1983), The relationship between surface topography, gravity anomalies, and temperature structure of convection, Journal of Geophysical Research: Solid Earth (1978-2012), 88(B2), 1129-1144, doi:10.1029/JB088iB02p01129. [3] Robinson, E. M., B. Parsons, and S. F. Daly (1987), The effect of a shallow low viscosity zone on the apparent compensation of mid-plate swells, Earth and Planetary Science Letters, 82(3-4), 335-348, doi:10.1016/0012-821X(87)90207-X.

The SPIRIT V study: a clinical evaluation of the XIENCE V everolimus-eluting coronary stent system in the treatment of patients with de novo coronary artery lesions.

PubMed

Grube, Eberhard; Chevalier, Bernard; Smits, Peter; Džavík, Vladimir; Patel, Tejas M; Mullasari, Ajit S; Wöhrle, Jochen; Stuteville, Marrianne; Dorange, Cécile; Kaul, Upendra

2011-02-01

The SPIRIT V (A Clinical Evaluation of the XIENCE V Everolimus-Eluting Coronary Stent System in the Treatment of Patients With De Novo Coronary Artery Lesions) study is a post-market surveillance experience of the XIENCE V (Abbott Vascular, Santa Clara, California) everolimus-eluting stent (EES) in patients with higher-risk coronary anatomy. Previous pre-approval studies have shown the safety and efficacy of EES in highly selected groups of patients. The SPIRIT V trial is a prospective, open label, single arm, multicenter study. Two thousand seven hundred patients with multiple de novo coronary artery lesions suitable for treatment with a planned maximum of 4 EES were enrolled at 93 centers in Europe, Asia Pacific, Canada, and South Africa. Lesions had a reference vessel diameter between 2.25 and 4.0 mm and a length of ≤ 28 mm by visual estimation. An independent clinical events committee adjudicated all end point-related events. The primary end point was the composite rate of all death, myocardial infarction (MI), and target vessel revascularization at 30 days. Secondary end points included stent thrombosis and acute success (clinical device and procedure success). At 30 days, the primary composite end point of all death, MI, and target vessel revascularization was 2.7%. At 1 year, rates of cardiac death, overall MI, and target lesion revascularization were 1.1%, 3.5%, and 1.8%, respectively. The cumulative rate of definite and probable stent thrombosis was low at 0.66% at 1 year. Use of EES in patients with multiple, complex de novo lesions yielded 1-year major adverse cardiac events, stent thrombosis, and target lesion revascularization rates that are comparable to those of the more controlled SPIRIT II and SPIRIT III trials-which included patients with restricted inclusion/exclusion criteria-and other all-comer population, physician-initiated studies like the X-SEARCH (Xience Stent Evaluated At Rotterdam Cardiology Hospital) and COMPARE (A Randomized Controlled Trial of Everolimus-eluting Stents and Paclitaxel-eluting Stents for Coronary Revascularization in Daily Practice) trials. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

On the instrumental characterization of a 3-λ scanning lidar to monitor industrial flames and its application for retrieving optical and microphysical properties

NASA Astrophysics Data System (ADS)

Guerrero-Rascado, Juan Luis; da Costa, Renata; Esteban Bedoya, Andrés; Guardani, Roberto; Alados-Arboledas, Lucas; Efrain Bastidas, Álvaro; Landulfo, Eduardo

2015-04-01

The emission of pollutants in megacities and industrial areas can have strong impact, not only from an environmental point of view, but also for human health. Cubatão (23° 53' S, 46° 26' W, 10 m asl) has been one of the most industrialized city in Brazil (located at São Paulo state coast) during the last decades. This work deals with the recent advances made on a 3-λ scanning lidar placed at this industrial region. Special attention has been paid to the characterization of the electronic performance of this lidar system. For this goal, the quality assurance tests, regularly applied in well-established lidar networks such as LALINET [Guerrero-Rascado et al., 2014] and EARLINET [Pappalardo et al. 2014], were applied to the Cubatão scanning lidar in order to improve the knowledge of its performing itself and to design protocols for correcting lidar signal for undesirable instrumental effects. The application of the results derived from these quality assurance tests together with the state-of-the-art methodologies to map the particle optical and microphysical properties inside industrial flares demonstrate the potential of this lidar for the study and measurement of industrial emissions. References: J. L. Guerrero-Rascado, E. Landulfo, J. C. Antuña, H. M. J. Barbosa, B. Barja, A. E. Bastidas, A. E. Bedoya, R. da Costa, R. Estevan, R. N. Forno, D. A. Gouveia, C. Jiménez, E. G. Larroza, F. J. S. Lopes, E. Montilla-Rosero, G. A. Moreira, W. M. Nakaema, D. Nisperuza, L. Otero, J. V. Pallotta, S. Papandrea, E. Pawelko, E. J. Quel, P. Ristori, P. F. Rodrigues, J. Salvador, M. F. Sánchez, and A. Silva, "Towards an instrumental harmonization in the framework of LAINET: dataset of technical specifications", Proceedings of SPIE 2014, vol. 9246, 92460O-1 -- 92460O-14, doi: 10.1117/12.2066873 (2014) G. Pappalardo, A. Amodeo, A. Apituley, A. Comerón, V. Freudenthaler, H. Linné, A. Ansmann, J. Bösenberg, G. D'Amico, I. Mattis, L. Mona, U. Wandinger, V. Amiridis, L. Alados-Arboledas, D. Nicolae, and M. Wiegner, "EARLINET: towards an advanced sustainable European aerosol lidar network," Atmos. Meas. Tech. 7(8), 2389-2409 (2014)

Facilitating the Furrowed Brow: An Unobtrusive Test of the Facial Feedback Hypothesis Applied to Unpleasant Affect.

PubMed

Larsen, Randy J; Kasimatis, Margaret; Frey, Kurt

1992-09-01

We examined the hypothesis that muscle contractions in the face influence subjective emotional experience. Previously, researchers have been critical of experiments designed to test this facial feedback hypothesis, particularly in terms of methodological problems that may lead to demand characteristics. In an effort to surmount these methodological problems Strack, Martin, and Stepper (1988) developed an experimental procedure whereby subjects were induced to contract facial muscles involved in the production of an emotional pattern, without being asked to actually simulate an emotion. Specifically, subjects were required to hold a pen in their teeth, which unobtrusively creates a contraction of the zygomaticus major muscles, the muscles involved in the production of a human smile. This manipulation minimises the likelihood that subjects are able to interpret their zygomaticus contractions as representing a particular emotion, thereby preventing subjects from determining the purpose of the experiment. Strack et al. (1988) found support for the facial feedback hypothesis applied to pleasant affect, in that subjects in the pen-in-teeth condition rated humorous cartoons as being funnier than subjects in the control condition (in which zygomaticus contractions were inhibited). The present study represents an extension of this nonobtrusive methodology to an investigation of the facial feedback of unpleasant affect. Consistent with the Strack et al. procedure, we wanted to have subjects furrow their brow without actually instructing them to do so and without asking them to produce any emotional facial pattern at all. This was achieved by attaching two golf tees to the subject's brow region (just above the inside comer of each eye) and then instructing them to touch the tips of the golf tees together as part of a "divided-attention" experiment. Touching the tips of the golf tees together could only be achieved by a contraction of the corrugator supercilii muscles, the muscles involved in the production of a sad emotional facial pattern. Subjects reported significantly more sadness in response to aversive photographs while touching the tips of the golf tees together than under conditions which inhibited corrugator contractions. These results provide evidence, using a new and unobtrusive manipulation, that facial feedback operates for unpleasant affect to a degree similar to that previously found for pleasant affect.

Structural and Acoustic Numerical Modeling of a Curved Composite Honeycomb Panel

NASA Technical Reports Server (NTRS)

Grosveld, Ferdinand W.; Buehrle, Ralph D.; Robinson, Jay H.

2001-01-01

The finite and boundary element modeling of the curved section of a composite honeycomb aircraft fuselage sidewall was validated for both structural response and acoustic radiation. The curved panel was modeled in the pre-processor MSC/PATRAN. Geometry models of the curved panel were constructed based on the physical dimensions of the test article. Material properties were obtained from the panel manufacturer. Finite element models were developed to predict the modal parameters for free and supported panel boundary conditions up to a frequency of 600 Hz. Free boundary conditions were simulated by providing soft foam support under the four comers of the panel or by suspending the panel from elastic bands. Supported boundary conditions were obtained by clamping the panel between plastic tubing seated in grooves along the perimeter of a stiff and heavy frame. The frame was installed in the transmission loss window of the Structural Acoustic Loads and Transmission (SALT) facility at NASA Langley Research Center. The structural response of the curved panel due to point force excitation was predicted using MSC/NASTRAN and the radiated sound was computed with COMET/Acoustics. The predictions were compared with the results from experimental modal surveys and forced response tests on the fuselage panel. The finite element models were refined and updated to provide optimum comparison with the measured modal data. Excellent agreement was obtained between the numerical and experimental modal data for the free as well as for the supported boundary conditions. Frequency response functions (FRF) were computed relating the input force excitation at one panel location to the surface acceleration response at five panel locations. Frequency response functions were measured at the same locations on the test specimen and were compared with the calculated FRF values. Good agreement was obtained for the real and imaginary parts of the transfer functions when modal participation was allowed up to 3000 Hz. The validated finite element model was used to predict the surface velocities due to the point force excitation. Good agreement was obtained between the spatial characteristics of the predicted and measured surface velocities. The measured velocity data were input into the acoustic boundary element code to compute the sound radiated by the panel. The predicted sound pressure levels in the far-field of the panel agreed well with the sound pressure levels measured at the same location.

Area G Perimeter Surface-Soil and Single-Stage Water Sampling: Environmental Surveillance for Fiscal Years 1996 and 1997, Group ESH-19

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marquis Childs; Ron Conrad

1998-10-01

Area Gin Technical Area 54, has been the principal facility at Los Alamos National Laboratory for the storage and disposal of low-level, solid mixed, and transuranic radioactive waste since 1957. Soil samples were analyzed for tritium, isotopic plutonium, americium-241, and cesium-137. Thirteen metals-silver, arsenic, barium, beryllium, cadmium, chromium, mercury, nickel, lead, antimony, selenium, thallium and zinc-were analyzed on filtered-sediment fractions of the single-stage samples using standard analytical chemistry techniques. During the two years of sampling discussed in this report elevated levels of tritium (as high as 716,000 pCi/L) in soil were found for sampling sites adjacent to the tritium burialmore » shafts located on the south- central perimeter of Area G. Additionally, tritium concentrations in soil as high as 38,300 pCi/L were detected adjacent to the TRU pads in the northeast comer of Area G. Plutonium-238 activities in FY96 soils ranged from 0.001-2.866 pCi/g, with an average concentration of 0.336& 0.734 pCdg. Pu-238 activities in FY97 soils ranged from 0.002-4.890 pCi/g, with an average concentration of 0.437 & 0.928 pCdg. Pu-239 activities in FY96 soils ranged from 0.009 to 1.62 pCdg, with an average of 0.177- 0.297 pCdg. Pu-239 activities in FY97 soils ranged from 0.005 to 1.71 pCi/g, with an average of 0.290- 0.415 pCi/g. The locations of elevated plutonium readings were consistent with the history of plutonium disposal at Area G. The two areas of elevated Am-241 activity reflected the elevated activities found for plutonium, the average values for Am-241 on soils were 0.6-2.07 pCi/g, and 0.10-0.14 pCi/g respectively for samples collected in FY96 and FY97. CS-137 activities in soils had average values of 0.33 pCi/g, and 0.28 pCi/g respectively for samples collected in FY96 and 97. There was no perimeter area where soil concentrations of CS-137 were significantly elevated.« less

Alterations in circulating T-cell lymphocyte populations in children with obstructive sleep apnea.

PubMed

Tan, Hui-Leng; Gozal, David; Wang, Yang; Bandla, Hari P R; Bhattacharjee, Rakesh; Kulkarni, Richa; Kheirandish-Gozal, Leila

2013-06-01

Changes in lymphocyte phenotype and functionality have been described in adult patients with obstructive sleep apnea (OSA). We hypothesized that OSA is associated with T lymphocyte alterations in children, particularly in T regulatory lymphocytes (T regs), and aimed to characterize circulating T lymphocyte subsets in children with OSA. Cross-sectional. Kosair Children's Hospital (Louisville, KY, USA) and Comer Children's Hospital (Chicago, IL, USA). Consecutively recruited children being evaluated for habitual snoring. N/A. Overnight polysomnography (PSG) was performed and a fasting blood sample was obtained from the patients. Flow cytometry was performed on peripheral blood mononuclear cells stained for CD3, CD4, CD8, CD25, FOXP3, interleukin-4 (IL-4), interferon-γ (IFN-γ), and IL-17. Patients were divided into three groups based on their PSG: controls (apnea-hypopnea indices [AHI] < 1/h total sleep time [TST]), mild OSA (1 ≤ AHI < 5/hTST), moderate-severe OSA (AHI ≥ 5/h TST). The percentage of CD4+ and T reg lymphocytes differed across groups. Children with moderate-severe OSA had significantly reduced T reg than control children (median [interquartile range] 4.8 [3.8-5.7% CD4+] versus 7.8 [7.0-9.2% CD4+]; P < 0.001). There were also significant differences in the percentage of T helper 1 (Th1) lymphocytes and in Th1:Th2 ratios between groups. Children with moderate-severe OSA had increased Th1 cells (P = 0.001) and Th1:Th2 ratios (P = 0.0026) compared with children with mild OSA and control children. Associations between AHI and T reg (P = 0.0003; r = -0.46), CD4+ lymphocytes (P = 0.0047; r = -0.37), and Th1:Th2 ratios (P = 0.0009; r = 0.43) emerged. In addition, the percentage of T reg was inversely correlated with Th1:Th2 ratios (P = 0.029; r = -0.29). Pediatric OSA is associated with reduced T reg population and altered Th1:Th2 balance toward Th1 predominance, suggesting a shift to a proinflammatory state. The changes in lymphocytic phenotypes associated with OSA may contribute to the variance in systemic inflammation and downstream morbidities associated with this condition.

Temporal Trends in Transcatheter Aortic Valve Replacement in France: FRANCE 2 to FRANCE TAVI.

PubMed

Auffret, Vincent; Lefevre, Thierry; Van Belle, Eric; Eltchaninoff, Hélène; Iung, Bernard; Koning, René; Motreff, Pascal; Leprince, Pascal; Verhoye, Jean Philippe; Manigold, Thibaut; Souteyrand, Geraud; Boulmier, Dominique; Joly, Patrick; Pinaud, Frédéric; Himbert, Dominique; Collet, Jean Philippe; Rioufol, Gilles; Ghostine, Said; Bar, Olivier; Dibie, Alain; Champagnac, Didier; Leroux, Lionel; Collet, Frédéric; Teiger, Emmanuel; Darremont, Olivier; Folliguet, Thierry; Leclercq, Florence; Lhermusier, Thibault; Olhmann, Patrick; Huret, Bruno; Lorgis, Luc; Drogoul, Laurent; Bertrand, Bernard; Spaulding, Christian; Quilliet, Laurent; Cuisset, Thomas; Delomez, Maxence; Beygui, Farzin; Claudel, Jean-Philippe; Hepp, Alain; Jegou, Arnaud; Gommeaux, Antoine; Mirode, Anfani; Christiaens, Luc; Christophe, Charles; Cassat, Claude; Metz, Damien; Mangin, Lionel; Isaaz, Karl; Jacquemin, Laurent; Guyon, Philippe; Pouillot, Christophe; Makowski, Serge; Bataille, Vincent; Rodés-Cabau, Josep; Gilard, Martine; Le Breton, Hervé

2017-07-04

Transcatheter aortic valve replacement (TAVR) is standard therapy for patients with severe aortic stenosis who are at high surgical risk. However, national data regarding procedural characteristics and clinical outcomes over time are limited. The aim of this study was to assess nationwide performance trends and clinical outcomes of TAVR during a 6-year period. TAVRs performed in 48 centers across France between January 2013 and December 2015 were prospectively included in the FRANCE TAVI (French Transcatheter Aortic Valve Implantation) registry. Findings were further compared with those reported from the FRANCE 2 (French Aortic National CoreValve and Edwards 2) registry, which captured all TAVRs performed from January 2010 to January 2012 across 34 centers. A total of 12,804 patients from FRANCE TAVI and 4,165 patients from FRANCE 2 were included in this analysis. The median age of patients was 84.6 years, and 49.7% were men. FRANCE TAVI participants were older but at lower surgical risk (median logistic European System for Cardiac Operative Risk Evaluation [EuroSCORE]: 15.0% vs. 18.4%; p < 0.001). More than 80% of patients in FRANCE TAVI underwent transfemoral TAVR. Transesophageal echocardiography guidance decreased from 60.7% to 32.3% of cases, whereas more recent procedures were increasingly performed in hybrid operating rooms (15.8% vs. 35.7%). Rates of Valve Academic Research Consortium-defined device success increased from 95.3% in FRANCE 2 to 96.8% in FRANCE TAVI (p < 0.001). In-hospital and 30-day mortality rates were 4.4% and 5.4%, respectively, in FRANCE TAVI compared with 8.2% and 10.1%, respectively, in FRANCE 2 (p < 0.001 for both). Stroke and potentially life-threatening complications, such as annulus rupture or aortic dissection, remained stable over time, whereas rates of cardiac tamponade and pacemaker implantation significantly increased. The FRANCE TAVI registry provided reassuring data regarding trends in TAVR performance in an all-comers population on a national scale. Nonetheless, given that TAVR indications are likely to expand to patients at lower surgical risk, concerns remain regarding potentially life-threatening complications and pacemaker implantation. (Registry of Aortic Valve Bioprostheses Established by Catheter [FRANCE TAVI]; NCT01777828). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Coarse mesh and one-cell block inversion based diffusion synthetic acceleration

NASA Astrophysics Data System (ADS)

Kim, Kang-Seog

DSA (Diffusion Synthetic Acceleration) has been developed to accelerate the SN transport iteration. We have developed solution techniques for the diffusion equations of FLBLD (Fully Lumped Bilinear Discontinuous), SCB (Simple Comer Balance) and UCB (Upstream Corner Balance) modified 4-step DSA in x-y geometry. Our first multi-level method includes a block Gauss-Seidel iteration for the discontinuous diffusion equation, uses the continuous diffusion equation derived from the asymptotic analysis, and avoids void cell calculation. We implemented this multi-level procedure and performed model problem calculations. The results showed that the FLBLD, SCB and UCB modified 4-step DSA schemes with this multi-level technique are unconditionally stable and rapidly convergent. We suggested a simplified multi-level technique for FLBLD, SCB and UCB modified 4-step DSA. This new procedure does not include iterations on the diffusion calculation or the residual calculation. Fourier analysis results showed that this new procedure was as rapidly convergent as conventional modified 4-step DSA. We developed new DSA procedures coupled with 1-CI (Cell Block Inversion) transport which can be easily parallelized. We showed that 1-CI based DSA schemes preceded by SI (Source Iteration) are efficient and rapidly convergent for LD (Linear Discontinuous) and LLD (Lumped Linear Discontinuous) in slab geometry and for BLD (Bilinear Discontinuous) and FLBLD in x-y geometry. For 1-CI based DSA without SI in slab geometry, the results showed that this procedure is very efficient and effective for all cases. We also showed that 1-CI based DSA in x-y geometry was not effective for thin mesh spacings, but is effective and rapidly convergent for intermediate and thick mesh spacings. We demonstrated that the diffusion equation discretized on a coarse mesh could be employed to accelerate the transport equation. Our results showed that coarse mesh DSA is unconditionally stable and is as rapidly convergent as fine mesh DSA in slab geometry. For x-y geometry our coarse mesh DSA is very effective for thin and intermediate mesh spacings independent of the scattering ratio, but is not effective for purely scattering problems and high aspect ratio zoning. However, if the scattering ratio is less than about 0.95, this procedure is very effective for all mesh spacing.

Remedial Investigation Report on Chestnut Ridge Operable Unit 2 (Filled Coal Ash Pond/Upper McCoy Branch) at the Oak Ridge Y-12 Plant, Oak Ridge, Tennessee. Volume 1. Main Text

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1994-08-01

This document is a report on the remedial investigation (RI) of Chestnut Ridge Operable Unit (OU) 2 at the Oak Ridge Y-12 Plant. Chestnut Ridge OU 2 consists of Upper McCoy Branch (UMB), the Filled Coal Ash Pond (FCAP), and the area surrounding the Sluice Channel formerly associated with coal ash disposal in the FCAP. Chestnut Ridge OU 2 is located within the U.S. Department of Energy`s (DOE`s) Oak Ridge Reservation in Anderson County, Tennessee, approximately 24 miles west of Knoxville. The pond is an 8.5-acre area on the southern slope of Chestnut Ridge, 0.5 mile south of the mainmore » Y-12 Plant and geographically separated from the Y-12 Plant by Chestnut Ridge. The elevation of the FCAP is {approximately} 950 ft above mean sea level (msl), and it is relatively flat and largely vegetated. Two small ponds are usually present at the northeast and northwest comers of the FCAP. The Sluice Channel Area extends {approximately}1000 ft from the northern margin of the FCAP to the crest of Chestnut Ridge, which has an elevation of {approximately}1100 ft above msl. The Sluice Channel Area is largely vegetated also. McCoy Branch runs from the top of Chestnut Ridge across the FCAP into Rogers Quarry and out of the quarry where it runs a short distance into Milton Hill Lake at McCoy Embayment, termed UMB. The portion south of Rogers Quarry, within Chestnut Ridge OU 4, is termed Lower McCoy Branch. The DOE Oak Ridge Y-12 Plant disposed of coal ash from its steam plant operations as a slurry that was discharged into an ash retention impoundment; this impoundment is the FCAP. The FCAP was built in 1955 to serve as a settling basin after coal ash slurried over Chestnut Ridge from the Y-12 Plant. The FCAP was constructed by building an earthen dam across the northern tributary of McCoy Branch. The dam was designed to hold 20 years of Y-12 steam plant ash. By July 1967, ash had filled up the impoundment storage behind the dam to within 4 ft of the top.« less

Improved safety and reduction in stent thrombosis associated with biodegradable polymer-based biolimus-eluting stents versus durable polymer-based sirolimus-eluting stents in patients with coronary artery disease: final 5-year report of the LEADERS (Limus Eluted From A Durable Versus ERodable Stent Coating) randomized, noninferiority trial.

PubMed

Serruys, Patrick W; Farooq, Vasim; Kalesan, Bindu; de Vries, Ton; Buszman, Pawel; Linke, Axel; Ischinger, Thomas; Klauss, Volker; Eberli, Franz; Wijns, William; Morice, Marie Claude; Di Mario, Carlo; Corti, Roberto; Antoni, Diethmar; Sohn, Hae Y; Eerdmans, Pedro; Rademaker-Havinga, Tessa; van Es, Gerrit-Anne; Meier, Bernhard; Jüni, Peter; Windecker, Stephan

2013-08-01

This study sought to report the final 5 years follow-up of the landmark LEADERS (Limus Eluted From A Durable Versus ERodable Stent Coating) trial. The LEADERS trial is the first randomized study to evaluate biodegradable polymer-based drug-eluting stents (DES) against durable polymer DES. The LEADERS trial was a 10-center, assessor-blind, noninferiority, "all-comers" trial (N = 1,707). All patients were centrally randomized to treatment with either biodegradable polymer biolimus-eluting stents (BES) (n = 857) or durable polymer sirolimus-eluting stents (SES) (n = 850). The primary endpoint was a composite of cardiac death, myocardial infarction (MI), or clinically indicated target vessel revascularization within 9 months. Secondary endpoints included extending the primary endpoint to 5 years and stent thrombosis (ST) (Academic Research Consortium definition). Analysis was by intention to treat. At 5 years, the BES was noninferior to SES for the primary endpoint (186 [22.3%] vs. 216 [26.1%], rate ratio [RR]: 0.83 [95% confidence interval (CI): 0.68 to 1.02], p for noninferiority <0.0001, p for superiority = 0.069). The BES was associated with a significant reduction in the more comprehensive patient-orientated composite endpoint of all-cause death, any MI, and all-cause revascularization (297 [35.1%] vs. 339 [40.4%], RR: 0.84 [95% CI: 0.71 to 0.98], p for superiority = 0.023). A significant reduction in very late definite ST from 1 to 5 years was evident with the BES (n = 5 [0.7%] vs. n = 19 [2.5%], RR: 0.26 [95% CI: 0.10 to 0.68], p = 0.003), corresponding to a significant reduction in ST-associated clinical events (primary endpoint) over the same time period (n = 3 of 749 vs. n = 14 of 738, RR: 0.20 [95% CI: 0.06 to 0.71], p = 0.005). The safety benefit of the biodegradable polymer BES, compared with the durable polymer SES, was related to a significant reduction in very late ST (>1 year) and associated composite clinical outcomes. (Limus Eluted From A Durable Versus ERodable Stent Coating [LEADERS] trial; NCT00389220). Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Characterization of 618-11 solid waste burial ground, disposed waste, and description of the waste generating facilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hladek, K.L.

1997-10-07

The 618-11 (Wye or 318-11) burial ground received transuranic (TRTJ) and mixed fission solid waste from March 9, 1962, through October 2, 1962. It was then closed for 11 months so additional burial facilities could be added. The burial ground was reopened on September 16, 1963, and continued operating until it was closed permanently on December 31, 1967. The burial ground received wastes from all of the 300 Area radioactive material handling facilities. The purpose of this document is to characterize the 618-11 solid waste burial ground by describing the site, burial practices, the disposed wastes, and the waste generatingmore » facilities. This document provides information showing that kilogram quantities of plutonium were disposed to the drum storage units and caissons, making them transuranic (TRU). Also, kilogram quantities of plutonium and other TRU wastes were disposed to the three trenches, which were previously thought to contain non-TRU wastes. The site burial facilities (trenches, caissons, and drum storage units) should be classified as TRU and the site plutonium inventory maintained at five kilograms. Other fissile wastes were also disposed to the site. Additionally, thousands of curies of mixed fission products were also disposed to the trenches, caissons, and drum storage units. Most of the fission products have decayed over several half-lives, and are at more tolerable levels. Of greater concern, because of their release potential, are TRU radionuclides, Pu-238, Pu-240, and Np-237. TRU radionuclides also included slightly enriched 0.95 and 1.25% U-231 from N-Reactor fuel, which add to the fissile content. The 618-11 burial ground is located approximately 100 meters due west of Washington Nuclear Plant No. 2. The burial ground consists of three trenches, approximately 900 feet long, 25 feet deep, and 50 feet wide, running east-west. The trenches constitute 75% of the site area. There are 50 drum storage units (five 55-gallon steel drums welded together) buried in three rows in the northeast comer. In addition, five eight-foot diameter caissons are located at the west end of the center row of the drum storage units. Initially, wastes disposed to the caissons and drum storage units were from the 325 and 327 building hot cells. Later, a small amount of remote-handled (RH) waste from the 309 building Plutonium Recycle Test Reactor (PRTR) cells, and the newly built 324 building hot cells, was disposed at the site.« less

Modeling Recent Subsidence of Mars' Olympus Mons Using Lava Flows as Paleo-Slope Indicators

NASA Astrophysics Data System (ADS)

Simpson, M.; Reeves, A.; Chadwick, J.; McGovern, P. J.

2013-12-01

Olympus Mons is an enormous volcanic edifice on Mars with a basal diameter over 600 km and a height of 23 km. In spite of this size, no indications of subsidence, such as an obvious topographic moat, have previously been detected around the volcano. In this study, we mapped the orientations of long, thin lava flows on the plains to the south and southeast of Olympus Mons using 100m-resolution imagery from the Thermal Emission Imaging System (THEMIS) on Mars Odyssey, and topography using Mars Orbiter Laser Altimeter (MOLA) data from Mars Global Surveyor. The results show that the flows are no longer oriented in a downhill direction, consistently deviating from modern slope vectors in a counterclockwise direction by 21.4 × 10.8 degrees (n = 65). The configuration of this misalignment between modern and paleo-topography is consistent with subsidence centered on the volcano in the time since the flows were emplaced. Our preliminary geophysical modeling used a range of load volumes, load radii, and lithospheric thicknesses to identify the scenario required to best restore modern topography to match the paleo-topography present when the lava flows were emplaced (i.e. 'uplift' Olympus Mons until the lava flows on the surrounding plains are restored to a downhill direction). The results show that lithospheric subsidence of about 1.2 km due to the magmatic addition of 3.8x10^5 km^3 best fits the observed topographic changes. Load center heights of 1 to 8 km were considered, with best fits generally in the 3-5 km range. Best-fit elastic lithosphere thickness (Te) values were generally 100 km or greater, consistent with estimates for Te from loading models [1,2] and gravity-topography relationships [3,4,5]. Our new crater size-density measurements of the plains in the study area show that the observed subsidence occurred within the past 229 × 26 my. Previous crater counts for Olympus Mons calderas and lower flank flows [6] reveal volcanic activity clustered around 100-200 Myr ago and as young as 2.5 Myr ago, and young faulting of the Olympus Mons edifice suggests recent flank spreading [7]. These young features are consistent with the evidence for recent magmatic loading and subsidence found in this study. REFERENCES: [1] Thurber and Toksoz, 1978; [2] Comer et al., 1985; [3] McGovern et al., 2002, [4] McGovern et al., 2004; [5] Belleguic et al., 2005; [6] Neukum et al 2004; [7] Basilevsky et al., 2006.

Eléments traces dans le sérum des enfants malnutris et bien nourris vivants à Lubumbashi et Kawama dans un contexte d'un environnement de pollution minière

PubMed Central

Musimwa, Aimée Mudekereza; Kanteng, Gray Wakamb; Kitoko, Hermann Tamubango; Luboya, Oscar Numbi

2016-01-01

Introduction La place des éléments traces métalliques essentiels en nutrition humaine ne peut plus être ignorée. Les déficits d'apports, les carences secondaires souvent sous – estimées, et les carences iatrogènes font le lit de pathologies telles que les infections et autres. D'où leurs dosages ont une importance particulière pour en évaluer la gravité et faciliter une prise en charge précoce ou améliorer le régime alimentaire. Cette étude a eu pour objectif de déterminer le profil sanguin en éléments traces (cuivre, sélénium, zinc, fer, chrome, cobalt, etc) chez les enfants malnutris et biens nourris dans un milieu minier à Lubumbashi. Méthodes Trois cents onze cas ont été colligés, 182 malnutris et 129 biens nourris, dans une étude descriptive transversale, effectuée de juillet 2013 à décembre 2014. Pour lequel un échantillonnage exhaustif a été réalisé. Le dosage des métaux dans le sérum s'est fait à l’ ICP-OES (spectrométrie de masse à plasma gon induit) au laboratoire de l'Office Congolais de Contrôle de Lubumbashi. Résultats Les oligoéléments essentiels (cuivre, zinc, sélénium et fer) se retrouvent à des concentrations très basses chez les enfants malnutris comme chez les biens nourris. L'arsenic, le cadmium, le magnésium et le manganèse se présentent à des concentrations normales par rapport aux valeurs de références chez les enfants biens nourris. L'antimoine, le chrome, le plomb et le cobalt se retrouvent élevés chez les malnutris et biens nourris. Le nickel est normal chez les malnutris et les biens nourris. Le magnésium, manganèse se sont présentés à des taux très bas chez les enfants malnutris. Conclusion Les enfants malnutris et biens nourris présentent une malnutrition aux oligo-éléments essentiels associés aux éléments traces métalliques. Ce qui permet de supposer qu'une carence en micronutriments essentiel favorise l'absorption des métaux lourds. PMID:27583075

PubMed

Benítez Brito, Néstor; Oliva García, José Gregorio; Delgado Brito, Irina; Pereyra-García Castro, Francisca; Suárez Llanos, José Pablo; Leyva González, Francisco Gustavo; Palacio Abizanda, José Enrique

2016-11-29

Introducción: la alimentación constituye el pilar fundamental del soporte nutricional de los pacientes hospitalizados. Evaluar el grado de aceptación de la dieta es imprescindible en aras de combatir la desnutrición hospitalaria.Objetivos: a) determinar el grado de satisfacción de los pacientes en relación con las dietas; y b) analizar posibles variables asociadas a un grado de satisfacción mayor (apetito y tipo de dieta).Material y métodos: estudio descriptivo de corte transversal. Se emplea una encuesta de 17 preguntas con datos sociodemográficos, datos cualitativos, así como la valoración general del paciente. Se comparó el grado de satisfacción global en función del apetito y el tipo de dieta (terapéutica vs.basal; con sal vs.sosa) (Test no paramétric o Krustal-Wallis y T-Student para muestras independientes, respectivamente).Resultados: mil cuatrocientos trece pacientes. Edad: 53,9 ± 19 años; 51,3% mujeres. Dieta terapéutica (34,9%). Solo el 39,4% tomó dieta con sal. El 66,8% refirió ingresos previos. La alimentación del hospital para un 43% de pacientes fue ''como esperaba'', mientras que para un 44,1% fue ''mejor de lo que esperaba''. El horario de comidas era adecuado (89,1%) y el tiempo para comer, suficiente (96,4%). En cuanto a las características de la comida servida, consideraron como buenas o muy buenas la misma el porcentaje reflejado: sabor/gusto (56.3%), olor (65,5%), cocinado (69,2%), presentación (80,4%), tamaño de ración (75,9%), calidad (73%), cantidad (77,9%), variedad (67,6%), temperatura (70,4%). La valoración global de la alimentación en una escala de 1 a 10 fue de 6,8 ± 2,3. El apetito se asoció a un aumento significativo de la satisfacción global alimentaria del paciente (p < 0,01). El tipo de dieta o la presencia de sal en la misma no se asociaron a un aumento significativo de la satisfacción con la dieta de los pacientes (p = 0,99 y 0,35, respectivamente).Conclusiones: aunque el grado de satisfacción de la dieta de nuestro hospital es aceptable, es preciso introducir mejoras que aumenten su aceptación. El apetito se asocia a un aumento significativo de la satisfacción global alimentaria. La presencia de sal y el tipo de dieta (basal versusterapéutica) no se relacionan con una mejoría significativa de la valoración global de la dieta.

Investigation of weldable iron-aluminum alloys for corrosion protection in high temperature oxidizing-sulfidizing environments

NASA Astrophysics Data System (ADS)

Banovic, Stephen William

The objective of the present study was to investigate the corrosion behavior of weldable Fe-Al alloys in environments representative of low NOx gas compositions, i.e., high partial pressures of sulfur [p(S2)] and low partial pressures of oxygen [p(O2)]. Through an integrated experimental approach involving thermogravimetric techniques, post-exposure metallographic examination of the corroded samples, and detailed chemical microanalyses of the reaction scales, the effects of aluminum content, temperature, and gas composition on the corrosion behavior were observed. The corrosion behavior of Fe-Al alloys was found to be directly related to the type and morphology of corrosion product that formed during high temperature exposure in the oxidizing/sulfidizing environment. The inhibition stage was characterized by growth of a thin, gamma alumina scale that suppressed excessive degradation of the substrate at all temperatures. Localized mechanical failure of the initial passive scale, in combination with the inability to re-establish itself, was found to result in nodular growth of non-protective sulfide phases across the sample face due to short circuit diffusion through the gamma alumina layer. With the remnants of the initial gamma scale found between the outer and inner scale, it was concluded that these layers grew by iron diffusion outward and sulfur diffusion inward, respectively. The corrosion rate observed during development of these morphologies was directly related to the density of the nodules on the surface and the exposure temperature. The final period observed was the steady-state stage. This behavior was encountered from the onset of exposure for all Fe-5 wt% Al alloys tested, or upon coalescence of the nodular growths. After initially high corrosion rates, the weight gains were found to increase at a steady rate as subsequent growth occurred via diffusion through the continuous scale. Determination of the corrosion product growth mechanism could not be directly obtained from the thermogravimetric data. For samples with relatively high weight gains, enhanced scale growth at the comers and edges of the sample, as well as the morphology of the multi-layered, multi-phase corrosion products, violated the assumptions necessary for data manipulation by this means. The results from this study indicate that weldable compositions of Fe-Al alloys (10 wt% Al) show excellent corrosion resistance to aggressive low NO x gas compositions in the service temperature range (below 600°C). With the potential promise for applications requiring a combination of weldability and corrosion resistance in moderately reducing environments, these alloys are viable candidates for further evaluation for use as sulfidation resistant weld overlay coatings. (Abstract shortened by UMI.)

Incidence, Clinical Presentation, and Predictors of Clinical Restenosis in Coronary Bioresorbable Scaffolds.

PubMed

Polimeni, Alberto; Weissner, Melissa; Schochlow, Katharina; Ullrich, Helen; Indolfi, Ciro; Dijkstra, Jouke; Anadol, Remzi; Münzel, Thomas; Gori, Tommaso

2017-09-25

The aim of this study was to describe the incidence and clinical characteristics, including intracoronary imaging features, of clinical restenosis in bioresorbable coronary scaffolds (BRS). Further, the authors searched for clinical and procedural predictors of scaffold restenosis (ScR) and report on the clinical outcomes after treatment of ScR in a cohort of consecutive all-comer patients. Data from randomized controlled trials demonstrate a higher rate of target lesion failure in patients treated with BRS as compared with those treated with metal drug-eluting stents. Although in-scaffold thrombosis has been thoroughly investigated, there are little data available on the incidence and characteristics of ScR. A total of 657 consecutive patients (age 63 ± 12 years, 79% men, 21% diabetics, 67% acute coronary syndrome) who received a total of 883 BRS for the treatment of coronary artery stenoses between May 2012 and January 2015 were enrolled in a retrospective registry. During the median follow-up of 1,076 days (interquartile range: 762 to 1,206 days), a total of 49 cases of ScR were found in 41 patients (Kaplan-Meier incidence: 2.4%, 6.0%, and 9.0% at 12-, 24-, and 36-month follow-up, respectively). ScR presented as stable angina or as incidental finding in 73% of the cases. The angiographic pattern was complex (type II to IV) in 55% of the ScR lesions. The neointima was homogeneous with high signal intensity in all but 3 cases at optical coherence tomography. Prior revascularization (hazard ratio [HR]: 2.7; 95% confidence interval [CI]: 1.5 to 5.1; p = 0.002), diabetes (HR: 2.9; 95%CI: 1.5 to 5.4; p = 0.001), lesion types B2 or C (HR: 2.8; 95% CI: 1.5 to 5.4; p = 0.002), and implantation technique (HR: 0.3; 95% CI: 0.1 to 0.6; p = 0.001) emerged as independent predictors of ScR. Oversizing (HR: 6.29; 95% CI: 2.4 to 16.4), undersizing (HR: 5.15; 95% CI: 1.99 to 13.30), and a residual stenosis >27% (HR: 8.9; 95% CI: 3.6 to 21.8) were associated with an increased ScR risk. The 3-year incidence of ScR was similar to that observed in similar settings with newer-generation drug-eluting stents. It is often associated with a benign presentation and a complex angiographic pattern. Predictors of ScR match those of metallic stent restenosis, and the implantation technique used at index appears to play an important role. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Confirmation of the binary status of Chamaeleon Hα 2 - a very young low-mass binary in Chamaeleon

NASA Astrophysics Data System (ADS)

Schmidt, T. O. B.; Neuhäuser, R.; Vogt, N.; Seifahrt, A.; Roell, T.; Bedalov, A.

2008-06-01

Context: Neuhäuser & Comerón (1998, Science, 282, 83; 1999, A&A, 350, 612) presented direct imaging evidence, as well as first spectra, of several young stellar and sub-stellar M6- to M8-type objects in the Cha I dark cloud. One of these objects is Cha Hα 2, classified as brown dwarf candidate in several publications and suggested as possible binary in Neuhäuser et al. (2002, A&A, 384, 999). Aims: We have searched around Cha Hα 2 for close and faint companions with adaptive optics imaging. Methods: Two epochs of direct imaging data were taken with the Very Large Telescope (VLT) Adaptive Optics instrument NACO in February 2006 and March 2007 in Ks-band together with a Hipparcos binary for astrometric calibration. Moreover, we took a J-band image in March 2007 to get color information. We retrieved an earlier image from 2005 from the European Southern Observatory (ESO) Science Archive Facility, increasing the available time coverage. After confirmation of common proper motion, we deduce physical parameters of the objects by spectroscopy, like temperature and mass. Results: We find Cha Hα 2 to be a very close binary of 0.16 arcsec separation, having a flux ratio of 0.91, thus having almost equal brightness and indistinguishable spectral types within the errors. We show that the two tentative components of Cha Hα 2 form a common proper motion pair, and that neither component is a non-moving background object. We even find evidence for orbital motion. A combined spectrum of both stars spanning optical and near-infrared parts of the spectral energy distribution yields a temperature of 3000 ± 100 K, corresponding to a spectral type of M6 ± 1 and a surface gravity of log{g} = 4.0+0.75-0.5, both from a comparison with GAIA model atmospheres. Furthermore, we obtained an optical extinction of AV ≃ 4.3 mag from this comparison. Conclusions: We derive masses of 0.110 M⊙ (≥0.070 M⊙) and 0.124 M⊙ (≥0.077 M⊙) for the two components of Cha Hα 2, i.e., probably low-mass stars, but one component could possibly be a brown dwarf. Based on observations made with ESO telescopes at the Paranal Observatory under programme IDs 076.C-0292A, 076.C-0339B, 078.C-0535A, at the La Silla Observatory under programme ID 065.L-0144B, the Hubble Space Telescope under programme ID GO-8716 and on observations made with the European Southern Observatory telescopes obtained from the ESO/ST-ECF Science Archive Facility. Color version of Fig. [see full textsee full text] is only available in electronic form at http://www.aanda.org

Helix Nebula: Enabling federation of existing data infrastructures and data services to an overarching cross-domain e-infrastructure

NASA Astrophysics Data System (ADS)

Lengert, Wolfgang; Farres, Jordi; Lanari, Riccardo; Casu, Francesco; Manunta, Michele; Lassalle-Balier, Gerard

2014-05-01

Helix Nebula has established a growing public private partnership of more than 30 commercial cloud providers, SMEs, and publicly funded research organisations and e-infrastructures. The Helix Nebula strategy is to establish a federated cloud service across Europe. Three high-profile flagships, sponsored by CERN (high energy physics), EMBL (life sciences) and ESA/DLR/CNES/CNR (earth science), have been deployed and extensively tested within this federated environment. The commitments behind these initial flagships have created a critical mass that attracts suppliers and users to the initiative, to work together towards an "Information as a Service" market place. Significant progress in implementing the following 4 programmatic goals (as outlined in the strategic Plan Ref.1) has been achieved: × Goal #1 Establish a Cloud Computing Infrastructure for the European Research Area (ERA) serving as a platform for innovation and evolution of the overall infrastructure. × Goal #2 Identify and adopt suitable policies for trust, security and privacy on a European-level can be provided by the European Cloud Computing framework and infrastructure. × Goal #3 Create a light-weight governance structure for the future European Cloud Computing Infrastructure that involves all the stakeholders and can evolve over time as the infrastructure, services and user-base grows. × Goal #4 Define a funding scheme involving the three stake-holder groups (service suppliers, users, EC and national funding agencies) into a Public-Private-Partnership model to implement a Cloud Computing Infrastructure that delivers a sustainable business environment adhering to European level policies. Now in 2014 a first version of this generic cross-domain e-infrastructure is ready to go into operations building on federation of European industry and contributors (data, tools, knowledge, ...). This presentation describes how Helix Nebula is being used in the domain of earth science focusing on geohazards. The so called "Supersite Exploitation Platform" (SSEP) provides scientists an overarching federated e-infrastructure with a very fast access to (i) large volume of data (EO/non-space data), (ii) computing resources (e.g. hybrid cloud/grid), (iii) processing software (e.g. toolboxes, RTMs, retrieval baselines, visualization routines), and (iv) general platform capabilities (e.g. user management and access control, accounting, information portal, collaborative tools, social networks etc.). In this federation each data provider remains in full control of the implementation of its data policy. This presentation outlines the Architecture (technical and services) supporting very heterogeneous science domains as well as the procedures for new-comers to join the Helix Nebula Market Place. Ref.1 http://cds.cern.ch/record/1374172/files/CERN-OPEN-2011-036.pdf

A Software Designed For STP Data Plot and Analysis Based on Object-oriented Methodology

NASA Astrophysics Data System (ADS)

Lina, L.; Murata, K.

2006-12-01

In the present study, we design a system that is named "STARS (Solar-Terrestrial data Analysis and Reference System)". The STARS provides a research environment that researchers can refer to and analyse a variety of data with single software. This software design is based on the OMT (Object Modeling Technique). The OMT is one of the object-oriented techniques, which has an advantage in maintenance improvement, reuse and long time development of a system. At the Center for Information Technology, Ehime University, after our designing of the STARS, we have already started implementing the STARS. The latest version of the STARS, the STARS5, was released in 2006. Any user can download the system from our WWW site (http:// www.infonet.cite.ehime-u.ac.jp/STARS). The present paper is mainly devoted to the design of a data analysis software system. Through our designing, we paid attention so that the design is flexible and applicable when other developers design software for the similar purpose. If our model is so particular only for our own purpose, it would be useless for other developers. Through our design of the domain object model, we carefully removed the parts, which depend on the system resources, e.g. hardware and software. We put the dependent parts into the application object model. In the present design, therefore, the domain object model and the utility object model are independent of computer resource. This helps anther developer to construct his/her own system based the present design. They simply modify their own application object models according to their system resource. This division of the design between dependent and independent part into three object models is one of the advantages in the OMT. If the design of software is completely done along with the OMT, implementation is rather simple and automatic: developers simply map their designs on our programs. If one creates "ganother STARS" with other programming language such as Java, the programmer simply follows the present system as long as the language is object-oriented language. Researchers would want to add their data into the STARS. In this case, they simply add their own data class in the domain object model. It is because any satellite data has properties such as time or date, which are inherited from the upper class. In this way, their effort is less than in other old methodologies. In the OMT, description format of the system is rather strictly standardized. When new developers take part in STARS project, they have only to understand each model to obtain the overview of the STARS. Then they follow this designs and documents to implement the system. The OMT makes a new comer easy to join into the project already running.

Paleomagnetic data from the Philippine Sea Plate and their tectonic significance

NASA Astrophysics Data System (ADS)

Haston, Roger B.; Fuller, M.

1991-04-01

New paleomagnetic data from Guam and Saipan have been obtained and are used, in conjunction with previously published results from around the Philippine Sea plate, to interpret the origin and history of the Philippine Sea plate. A lower Miocene direction (I=3.5°, D=54.5°, a95=17.4°, k=20.3) and a middle Oligocene direction (I=5.3°, D=68.4°, a95=12.8°, k=52.4) have been obtained from the Palau Islands. Only one reliable result, a middle Oligocene direction (I=15.1°, D=66.1°, a95=11.1°, k=20.1), has been obtained from Guam. Many characteristic remanent magnetic directions have been obtained from the lower Eocene Facpi Formation; however, the results are too scattered (k=4.5) to be considered reliable. Two reliable directions have been obtained from Saipan: a middle Miocene result (I=30.7°, D=28.1°, a95=8.4°, k=64.6), and a lower Eocene result (I=-12.0°, D=43.0°, a95=12.5°, k=16.0). Two lower Eocene results from Chichijima (I=9.5°, D=105.3°, a95=12.6°, k=6.1) and Anijima (I=-0.8°, D=91.7°, a95=16.9°, k=4.9) are the reliable results from the Bonin islands. There are two end-member interpretations for these data: (1) small scale local rotation of blocks along the plate margin, or (2) rotation of the Philippine Sea plate as a whole. To distinguish between these interpretations, we reconstructed the East Philippine Sea province back to its prerifting configuration. The rotation caused by deformation can be estimated by comparing the paleomagnetism of Guam, Saipan, and the Bonin islands to Palau. Prior to reconstruction, the older declination values are scattered. Closing the marginal basins reduces the declination scatter, and all of the islands show increasing clockwise deflection with time. This suggests that the Philippine Sea plate has rotated up to 80° clockwise and moved northward around 20° since the Eocene, and deformational rotation is a second-order feature. The finite pole of rotation of the Philippine Sea plate relative to Eurasia must be somewhere near the southeast comer of the plate, because this is the only location that is compatible with both the change in orientation and paleolatitude for the plate. These data cannot distinguish between a backarc origin or trapped crust origin for the West Philippine Sea province. The existing models require major modification to be consistent with the paleomagnetic data.

Risky Business: Reducing Moral Hazard in Airlift Operations

DTIC Science & Technology

2015-01-01

compared to USAF standards.43 McCarty was con- cerned about airlift transporting unnecessary items like champagne and ice that would normally move by...ice and champagne to Dien Bien Phu.44 Further con- firmation exists in the fact that upon his promotion to brigadier general, de Castries’ new rank...and congratulatory bottle of champagne were airdropped to him but fell instead into Viet Minh hands.45 Certainly not all airlifts into Dien Bien Phu

Implications of river morphology response to Dien Bien Phu fault in NW Vietnam

NASA Astrophysics Data System (ADS)

Lai, K.; Chen, Y.; Lam, D.

2007-12-01

In northern Vietnam, most rivers are flowing southeastward sub- or parallel to the valley of Red River and characterized by long but narrow catchments. The Dien Bien Phu fault is associated with the most seismically active zone in Vietnam and situated in the potential eastern boundary of the rotating southeastern Tibetan block. It cuts the Da River, the largest tributary of Red River in northwest Vietnam and has distorted the drainage basin resulting in complex river patterns. To assess the river morphology response to active Dien Bien Phu fault, we use 1/50,000 topographic data and ASTER images to map the precise river courses and digital elevation model data of SRTM to retrieve and analyze the river profiles. From the mapping results, the N-S striking fault results in three conspicuous north-trending river valleys coincided with the different fault segments to facilitate the measurement and reconstruction of the offsets along the fault. Further combining the longitudinal profile analysis we obtain ca. 10 km offsets by deflected river as the largest left-lateral displacement recorded along the active fault. The restored results show the downstream paleochannel of the Da River had been abandoned and becomes two small tributaries in opposite flow directions at present due to differential crustal uplift. Also the present crisscross valley at the junction of the Da River and the fault is resulted from the capture by another river which has been also deflected by the neotectonics. Based on our observations on river response, the Dien Bien Phu fault is a sinistral dominant fault with an uplift occurring in its eastern block. Furthermore the active Dien Bien Phu fault does not cut through the Red River northward indicating the western block of the fault can not be regarded as a single rigid block. There should be possible to find NW-SE trending faults paralleling to Red River to accommodate the deformation of the western block of the fault.

Implications of river morphology response to Dien Bien Phu fault in NW Vietnam

NASA Astrophysics Data System (ADS)

Lai, K.; Chen, Y.; Lam, D.

2004-12-01

In northern Vietnam, most rivers are flowing southeastward sub- or parallel to the valley of Red River and characterized by long but narrow catchments. The Dien Bien Phu fault is associated with the most seismically active zone in Vietnam and situated in the potential eastern boundary of the rotating southeastern Tibetan block. It cuts the Da River, the largest tributary of Red River in northwest Vietnam and has distorted the drainage basin resulting in complex river patterns. To assess the river morphology response to active Dien Bien Phu fault, we use 1/50,000 topographic data and ASTER images to map the precise river courses and digital elevation model data of SRTM to retrieve and analyze the river profiles. From the mapping results, the N-S striking fault results in three conspicuous north-trending river valleys coincided with the different fault segments to facilitate the measurement and reconstruction of the offsets along the fault. Further combining the longitudinal profile analysis we obtain ca. 10 km offsets by deflected river as the largest left-lateral displacement recorded along the active fault. The restored results show the downstream paleochannel of the Da River had been abandoned and becomes two small tributaries in opposite flow directions at present due to differential crustal uplift. Also the present crisscross valley at the junction of the Da River and the fault is resulted from the capture by another river which has been also deflected by the neotectonics. Based on our observations on river response, the Dien Bien Phu fault is a sinistral dominant fault with an uplift occurring in its eastern block. Furthermore the active Dien Bien Phu fault does not cut through the Red River northward indicating the western block of the fault can not be regarded as a single rigid block. There should be possible to find NW-SE trending faults paralleling to Red River to accommodate the deformation of the western block of the fault.

U. S. Naval Forces, Vietnam Monthly Historical Summary for October 1971

DTIC Science & Technology

1971-12-01

COUNTY (LST-1166) as the Third Coastal Zone LST. t NNIMCB-5 Detail Bronco completed assigned tasks at ACTOVRAD Site Nui Ta Kou and returned to Bien...The last two weeks in Ca Mau were spent building access roads with very wet conditions prevailing. Detail Bronco at Nui Ta Kou, ACTOVRAD Site Nine...completed all work on 20 October and redeployed all material and men to Bien Hoa on the same doty. During October, Detail Bronco had finished road and

Three-year patient-related and stent-related outcomes of second-generation everolimus-eluting Xience V stents versus zotarolimus-eluting resolute stents in real-world practice (from the Multicenter Prospective EXCELLENT and RESOLUTE-Korea Registries).

PubMed

Lee, Joo Myung; Park, Kyung Woo; Han, Jung-Kyu; Yang, Han-Mo; Kang, Hyun-Jae; Koo, Bon-Kwon; Bae, Jang-Whan; Woo, Sung-Il; Park, Jin Sik; Jin, Dong-Kyu; Jeon, Dong Woon; Oh, Seok Kyu; Park, Jong-Seon; Kim, Doo-Il; Hyon, Min Su; Jeon, Hui-Kyung; Lim, Do-Sun; Kim, Myeong-Gon; Rha, Seung-Woon; Her, Sung-Ho; Hwang, Jin-Yong; Kim, Sanghyun; Choi, Young Jin; Kang, Jin Ho; Moon, Keon-Woong; Jang, Yangsoo; Kim, Hyo-Soo

2014-11-01

Long-term outcomes are imperative to confirm safety of drug-eluting stents. There have been 2 randomized controlled trials comparing everolimus-eluting stents (EESs) and Resolute zotarolimus-eluting stents (ZES-Rs). To date, long-term clinical outcomes of these stents were limited to only 1 report, which has recently reported 4-year comparisons of these stents. Therefore, more evidence is needed regarding long-term clinical outcomes of the second-generation stents. This study compared the long-term clinical outcomes of EES with ZES-R in "all-comer" cohorts up to 3-year follow-up. The EXCELLENT and RESOLUTE-Korea registries prospectively enrolled 3,056 patients treated with EES and 1,998 with ZES-R, respectively, without exclusions. Stent-related composite outcomes (target lesion failure) and patient-related composite events up to 3-year follow-up were compared in crude and propensity score-matched analyses. Of 5,054 patients, 3,830 patients (75.8%) had off-label indication (2,217 treated with EES and 1,613 treated with ZES-R). The stent-related outcome (189 [6.2%] vs 127 [6.4%], p = 0.812) and the patient-related outcome (420 [13.7%] vs 250 [12.5%], p = 0.581) did not differ between EES and ZES-R, respectively, at 3 years, which was corroborated by similar results from the propensity score-matched cohort (hazard ratio [HR] 0.92, 95% confidence interval [CI] 0.70 to 1.20, p = 0.523 and 0.85, 95% CI 0.70 to 1.02, p = 0.081, for stent- and patient-related outcomes, respectively). The rate of definite or probable stent thrombosis up to 3 years (22 [0.7%] vs 10 [0.5%], p = 0.370) was also similar. The rate of very late definite or probable stent thrombosis was very low and comparable between the 2 stents (3 [0.1%] vs 1 [0.1%], p = 0.657). In multivariate analysis, chronic renal failure (adjusted HR 3.615, 95% CI 2.440 to 5.354, p <0.001) and off-label indication (adjusted HR 1.782, 95% CI 1.169 to 2.718, p = 0.007) were the strongest predictors of target lesion failure at 3 years. In conclusion, both stents showed comparable safety and efficacy at 3-year follow-up in this robust real-world registry with unrestricted use of EES and ZES-R. Overall incidences of target lesion failure and definite stent thrombosis, including very late stent thrombosis, were low, even in the patients with off-label indications, suggesting excellent long-term safety and sustained efficacy of both types of second-generation drug-eluting stents. Copyright © 2014 Elsevier Inc. All rights reserved.

Ocular Counter-Rolling During Centrifugation and Static Tilt

NASA Technical Reports Server (NTRS)

Cohen, Bernard; Clement, Gilles; Moore, Steven; Curthoys, Ian; Dai, Mingjia; Koizuka, Izumi; Kubo, Takeshi; Raphan, Theodore

2003-01-01

Activation of the gravity sensors in the inner ear-the otoliths-generates reflexes that act to maintain posture and gaze. Ocular counter-rolling (OCR) is an example of such a reflex. When the head is tilted to the side, the eyes rotate around the line of sight in the opposite direction (i.e., counter-rolling). While turning comers, undergoing centrifugation, or making side-to-side tilting head movements, the OCR reflex orients the eyes towards the sum of the accelerations from body movements and gravity. Deconditioning of otolith-mediated reflexes following adaptation to microgravity has been proposed as the basis of many of the postural, locomotor, and gaze control problems experienced by returning astronauts. Evidence suggests that OCR is reduced postflight in about 75% of astronauts tested; but the data are sparse, primarily due to difficulties in recording rotational eye movements. During the Neurolab mission, a short-arm human centrifuge was flown that generated sustained sideways accelerations of 0.5-G and one-G to the head and upper body. This produces OCR; and so for the first time, the responses to sustained centrifugation could be studied without the influence of Earth's gravity on the results. This allowed us to determine the relative importance of sideways and vertical acceleration in the generation of OCR. This also provided the first test of the effects of exposure to artificial gravity in space on postflight otolith-ocular reflexes. There was little difference between the responses to centrifugation in microgravity and on Earth. In both conditions, the induced OCR was roughly proportional to the applied acceleration, with the OCR magnitude during 0.5-G centrifugation approximately 60% of that generated during one-G centrifugation. The overall mean OCR from the four payload crewmembers in response to one-G of sideways acceleration was 5.7 plus or minus 1.1 degree (mean and SD) on Earth. Inflight one-G centrifugation generated 5.7 plus or minus 1.1 degree of OCR, which was a small but significant decrease in OCR magnitude. The postflight OCR was 5.9 plus or minus 1.4 degree, which was not significantly different from preflight values. During both 0.5-G and one-G centrifugation in microgravity, where the head vertical gravitational component was absent, the OCR magnitude was not significantly different from that produced by an equivalent acceleration during static tilt on Earth. This suggests that the larger OCR magnitude observed during centrifugation on Earth was due to the larger body vertical linear acceleration component, which may have activated either the otoliths or the body tilt receptors. In contrast to previous studies, there was no decrease in OCR gain postflight. Our findings raise the possibility that inflight exposure to artificial gravity, in the form of intermittent one-G and 0.5-G centripetal acceleration, may have been a countermeasure to deconditioning of otolith-based orientation reflexes.

Dioxins and Nonortho PCBs in Breast Milk of Vietnamese Mothers Living in the Largest Hot Spot of Dioxin Contamination.

PubMed

Nghi, Tran Ngoc; Nishijo, Muneko; Manh, Ho Dung; Tai, Pham The; Van Luong, Hoang; Anh, Tran Hai; Thao, Pham Ngoc; Trung, Nguyen Viet; Waseda, Tomoo; Nakagawa, Hideaki; Kido, Teruhiko; Nishijo, Hisao

2015-05-05

Bien Hoa Air Base is the largest dioxin contamination hot spot in Vietnam. In 2012, we recruited 216 mothers who were living in 10 communities around Bien Hoa Air Base and had delivered newborns at a prefecture hospital, and we investigated recent exposure levels of dioxins and nonortho PCBs in their breast milk. 2,3,7,8-Tetrachlorodibenzo-p-dioxin (2,3,7,8-tetraCDD) was present at 2.6 pg/g lipid in primiparae and 2.2 pg/g lipid in multiparae. Among multiparae and total subjects, significant high prevalence of 2,3,7,8-tetraCDD≥5 pg/g lipid and 2,3,7,8-tetraCDD contribution≥40% were observed in mothers living in the five communities closest to Bien Hoa Air Base. The TEQ for nonortho PCBs was 1.6 pg-TEQ/g lipid for primiparae, and this was even lower than that in the unsprayed area. The length of residency was a strong factor to increase dioxins, including 2,3,7,8-tetraCDD. Residency in the five communities with the highest exposure was a specific risk factor for increased 2,3,7,8-tetraCDD in breast milk. Food intake might contribute partly to the increased levels of dioxin congeners other than 2,3,7,8-tetraCDD in breast milk. These results suggest that Bien Hoa Air Base has led to elevated 2,3,7,8-tetraCDD levels in breast milk of mothers in nearby areas even in the recent years.

Therapy for pneumococcal infection at the millennium: doubts and certainties.

PubMed

Ball, P

1999-07-26

Rapidly burgeoning worldwide multiple drug-resistant pneumococcal serotypes pose an urgent demand for new management approaches. Perhaps modern intensive care methods may have alternatives to offer. Indeed, standard assessments such as the admission APACHE II score may overestimate individual risk of death in severe CAP, and mortality can be reduced. However, among those at highest risk for mortality in the early phase of invasive disease, the conclusions reached 2-3 decades ago, that it is questionable whether a more effective drug than penicillin can be developed, and that a reduction in the number of deaths consequent to this infection can be accomplished only by widespread immunoprophylactic measures, remain inescapable. Clearly, as discussed elsewhere in this supplement, the continuing validity of these 20-year-old conclusions and the global prevalence of DRSP demand the development and marketing of new conjugate vaccines, although more widespread use of the existing 23-valent polysaccharide vaccine among high-risk populations is essential in the interim. With respect to resistance selection pressures, antibiotic prescription control may provide the answer. However, patient expectations of antibiotic therapy for trivial respiratory infection is high and, in the United Kingdom, 75% of previously healthy adults will receive it; those who do not will usually consult another physician in an effort to secure such therapy. Thus, without the intervention of government or managed care organizations, self-regulation in prescribing is unlikely. The evidence for beta-lactam treatment failure in meningitis has led to alternative approaches, with vancomycin as the primary agent. Penicillins may remain effective for otitis media, but oral cephalosporins are suspect. Data on pediatric pneumococcal pneumonia continue to suggest use of beta-lactams, at least for disease caused by strains with intermediate penicillin sensitivity. Pallares et al concluded that penicillins and cephalosporins remain the drugs of choice for severe pneumococcal pneumonia in adults. Others who share this conclusion often cite that study as evidence. However, in the case of penicillins, the mortality rate was 6% higher in a subgroup selected for monomicrobial infection and reduced risk factors for mortality when penicillin-resistant infection was present, and the overall mortality was 14% higher with penicillin-resistant strains (taking into account "all comers"). Those who depend on the findings of evidence-based medicine may accept the premise that penicillins and cephalosporins remain the drugs of choice, and agree with Goldstein and Garau that it would indeed be a mistake to adopt alternative therapies. Others may consider the deaths of 6 of 100 patients who were not in the highest-risk group too high a price to pay for statistical significance and may be skeptical of the continued use of beta-lactam therapy on higher-risk patients. In addition, the persistent selection pressure applied by continued use of beta-lactams offers a powerful population-based argument for alternatives. As DRSP continues to spread and resistant strains with penicillin MIC >2 mg/L become more prevalent, new agents such as the azabicyclo-methoxyquinolone, moxifloxacin, and perhaps grepafloxacin, but not the more toxic sparfloxacin and trovafloxacin, will undoubtedly flourish as treatments for CAP. By that time, the results of clinical studies on ketolides and oxazolidinones could offer further choices.

Public health assessment of dioxin-contaminated fish at former US airbase, Bien Hoa, Vietnam.

PubMed

Durant, James T; Boivin, Thomas G; Pohl, Hana R; Sinks, Thomas H

2015-01-01

Ponds at the former US airbase at Ben Hoa, Vietnam are contaminated with Agent Orange. The ponds had been used for aquaculture, and in all likelihood, fish from those ponds have been sold to the public. We assessed human exposure to 2,3,7,8-tetrachloro-dibenzo-dioxin (2,3,7,8-TCDD) in fish samples from the ponds. For on-base tilapia, muscle concentrations 2,3,7,8-TCDD ranged from 1.4 to 32.7 pg/g. Fat concentrations ranged from 73.3 to 3990 pg/g. Estimated human exposure doses exceed international guidelines and exceed 2,3,7,8-TCDD's lowest adverse effect levels. The Bien Hoa fishponds are a completed human pathway for TCDD exposure.

Optimization of pharmacotherapy in chronic heart failure: is heart rate adequately addressed?

PubMed

Franke, Jennifer; Wolter, Jan Sebastian; Meme, Lillian; Keppler, Jeannette; Tschierschke, Ramon; Katus, Hugo A; Zugck, Christian

2013-01-01

The aim of the study is to evaluate the use of beta-blockers in chronic heart failure (CHF) and the extent of heart rate reduction achieved in clinical practice and to determine differences in outcome of patients who fulfilled select inclusion criteria of the SHIFT study according to resting heart rate modulated by beta-blocker therapy. We evaluated an all-comer population of our dedicated CHF outpatient clinic between 2006 and 2010. For inclusion, individually optimized doses of guideline-recommended pharmacotherapy including beta-blockers had to be maintained for at least 3 months and routine follow-up performed at our outpatient CHF-clinic thereafter. Treatment dosages of beta-blockers, and demographic and clinical profiles including resting heart rate were assessed. The outcome of patients who fulfilled select inclusion criteria of the SHIFT study (left-ventricular ejection fraction (LVEF) ≤35 %, sinus rhythm, NYHA II-IV) and were followed-up for at least 1 year was stratified according to resting heart rates: ≥75 versus <75 bpm and ≥70 versus <70 bpm. The composite primary endpoint was defined as all-cause death or hospital admission for worsening heart failure during 12-month follow-up. In total, 3,181 patients were assessed in regard to treatment dosages of beta-blockers, and demographic and clinical profiles including resting heart rate. Of the overall studied population, 443 patients fulfilled all inclusion criteria and entered outcome analysis. Median observation time of survivors was 27.5 months with 1,039.7 observation-years in total. Up-titration to at least half the evidence-based target dose of beta-blockers was achieved in 69 % and full up-titration in 29 % of these patients. Patients with increased heart rates were younger, more often male, exhibited a higher NYHA functional class and lower LVEF. The primary endpoint occurred in 21 % of patients in the ≥70 bpm group versus 9 % of patients in the group with heart rates <70 bpm (p <0.01). Likewise, comparing the groups ≥75 and <75 bpm, the primary endpoint was significantly increased in the group of patients with heart rates ≥75 bpm 27 vs. 12.2 %; p < 0.01). 5-year event-free survival was significantly lower among patients with heart rates ≥70 bpm as compared to those with <70 bpm (log-rank test p < 0.05) and among patients in the ≥75 bpm group versus <75 bpm group (log-rank test p < 0.01). In conclusion, in clinical practice, 53 % of CHF patients have inadequate heart rate control (heart rates ≥75 bpm) despite concomitant beta-blocker therapy. In this non-randomized cohort, adequate heart rate control under individually optimized beta-blocker therapy was associated with improved mid- and long-term clinical outcome up to 5 years. As further up titration of beta-blockers is not achievable in many patients, the administration of a selective heart rate lowering agent, such as ivabradine adjuvant to beta-blockers may pose an opportunity to further modulate outcome.

Vegetation classification and distribution mapping report Mesa Verde National Park

USGS Publications Warehouse

Thomas, Kathryn A.; McTeague, Monica L.; Ogden, Lindsay; Floyd, M. Lisa; Schulz, Keith; Friesen, Beverly A.; Fancher, Tammy; Waltermire, Robert G.; Cully, Anne

2009-01-01

The classification and distribution mapping of the vegetation of Mesa Verde National Park (MEVE) and surrounding environment was achieved through a multi-agency effort between 2004 and 2007. The National Park Service’s Southern Colorado Plateau Network facilitated the team that conducted the work, which comprised the U.S. Geological Survey’s Southwest Biological Science Center, Fort Collins Research Center, and Rocky Mountain Geographic Science Center; Northern Arizona University; Prescott College; and NatureServe. The project team described 47 plant communities for MEVE, 34 of which were described from quantitative classification based on f eld-relevé data collected in 1993 and 2004. The team derived 13 additional plant communities from field observations during the photointerpretation phase of the project. The National Vegetation Classification Standard served as a framework for classifying these plant communities to the alliance and association level. Eleven of the 47 plant communities were classified as “park specials;” that is, plant communities with insufficient data to describe them as new alliances or associations. The project team also developed a spatial vegetation map database representing MEVE, with three different map-class schemas: base, group, and management map classes. The base map classes represent the fi nest level of spatial detail. Initial polygons were developed using Definiens Professional (at the time of our use, this software was called eCognition), assisted by interpretation of 1:12,000 true-color digital orthophoto quarter quadrangles (DOQQs). These polygons (base map classes) were labeled using manual photo interpretation of the DOQQs and 1:12,000 true-color aerial photography. Field visits verified interpretation concepts. The vegetation map database includes 46 base map classes, which consist of associations, alliances, and park specials classified with quantitative analysis, additional associations and park specials noted during photointerpretation, and non-vegetated land cover, such as infrastructure, land use, and geological land cover. The base map classes consist of 5,007 polygons in the project area. A field-based accuracy assessment of the base map classes showed overall accuracy to be 43.5%. Seven map classes comprise 89.1% of the park vegetated land cover. The group map classes represent aggregations of the base map classes, approximating the group level of the National Vegetation Classification Standard, version 2 (Federal Geographic Data Committee 2007), and reflecting physiognomy and floristics. Terrestrial ecological systems, as described by NatureServe (Comer et al. 2003), were used as the fi rst approximation of the group level. The project team identified 14 group map classes for this project. The overall accuracy of the group map classes was determined using the same accuracy assessment data as for the base map classes. The overall accuracy of the group representation of vegetation was 80.3%. In consultation with park staff , the team developed management map classes, consisting of park-defined groupings of base map classes intended to represent a balance between maintaining required accuracy and providing a focus on vegetation of particular interest or import to park managers. The 23 management map classes had an overall accuracy of 73.3%. While the main products of this project are the vegetation classification and the vegetation map database, a number of ancillary digital geographic information system and database products were also produced that can be used independently or to augment the main products. These products include shapefiles of the locations of field-collected data and relational databases of field-collected data.

Effectiveness of psychosocial interventions in eating disorders: an overview of Cochrane systematic reviews.

PubMed

Costa, Marcelle Barrueco; Melnik, Tamara

2016-01-01

Eating disorders are psychiatric conditions originated from and perpetuated by individual, family and sociocultural factors. The psychosocial approach to treatment and prevention of relapse is crucial. To present an overview of the scientific evidence on effectiveness of psychosocial interventions in treatment of eating disorders. All systematic reviews published by the Cochrane Database of Systematic Reviews - Cochrane Library on the topic were included. Afterwards, as from the least recent date of these reviews (2001), an additional search was conducted at PubMed with sensitive search strategy and with the same keywords used. A total of 101 primary studies and 30 systematic reviews (5 Cochrane systematic reviews), meta-analysis, guidelines or narrative reviews of literature were included. The main outcomes were: symptomatic remission, body image, cognitive distortion, psychiatric comorbidity, psychosocial functioning and patient satisfaction. The cognitive behavioral approach was the most effective treatment, especially for bulimia nervosa, binge eating disorder and the night eating syndrome. For anorexia nervosa, the family approach showed greater effectiveness. Other effective approaches were interpersonal psychotherapy, dialectic behavioral therapy, support therapy and self-help manuals. Moreover, there was an increasing number of preventive and promotional approaches that addressed individual, family and social risk factors, being promising for the development of positive self-image and self-efficacy. Further studies are required to evaluate the impact of multidisciplinary approaches on all eating disorders, as well as the cost-effectiveness of some effective modalities, such as the cognitive behavioral therapy. RESUMO Transtornos alimentares são doenças psiquiátricas originadas de e perpetuadas por fatores individuais, familiares e socioculturais. A abordagem psicossocial é essencial para o tratamento e a prevenção de recaídas. Apresentar uma visão geral das evidências científicas sobre a efetividade das intervenções psicossociais no tratamento de transtornos alimentares. Foram incluídas todas as revisões sistemáticas publicadas no Banco de Dados de Revisões Sistemáticas da Cochrane Library. Posteriormente, a partir da data menos recente destas revisões (2001), realizou-se uma busca adicional no PubMed, com estratégia de busca sensibilizada e com os mesmos descritores utilizados antes. No total, foram incluídos 101 estudos primários e 30 revisões sistemáticas (5 revisões sistemáticas da Cochrane), metanálises, diretrizes ou revisões narrativas da literatura. Os principais desfechos foram remissão de sintomas, imagem corporal, distorção cognitiva, comorbidade psiquiátrica, funcionamento psicossocial e satisfação do paciente. A abordagem cognitivo-comportamental foi o tratamento mais efetivo, principalmente para bulimia nervosa, transtorno da compulsão alimentar periódica e síndrome do comer noturno. Para anorexia nervosa, a abordagem familiar demonstrou maior efetividade. Outras abordagens efetivas foram psicoterapia interpessoal, terapia comportamental dialética, terapia de apoio e manuais de autoajuda. Além disso, houve um número crescente de abordagens preventivas e promocionais que contemplaram fatores de risco individuais, familiares e sociais, sendo promissoras para o desenvolvimento da autoimagem positiva e autoeficácia. São necessários mais estudos que avaliem o impacto de abordagens multidisciplinares em todos transtornos alimentares, além da relação custo-efetividade de algumas modalidades efetivas, como a terapia cognitivo-comportamental.

Olaparib tablets as maintenance therapy in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a double-blind, randomised, placebo-controlled, phase 3 trial.

PubMed

Pujade-Lauraine, Eric; Ledermann, Jonathan A; Selle, Frédéric; Gebski, Val; Penson, Richard T; Oza, Amit M; Korach, Jacob; Huzarski, Tomasz; Poveda, Andrés; Pignata, Sandro; Friedlander, Michael; Colombo, Nicoletta; Harter, Philipp; Fujiwara, Keiichi; Ray-Coquard, Isabelle; Banerjee, Susana; Liu, Joyce; Lowe, Elizabeth S; Bloomfield, Ralph; Pautier, Patricia

2017-09-01

Olaparib, a poly(ADP-ribose) polymerase (PARP) inhibitor, has previously shown efficacy in a phase 2 study when given in capsule formulation to all-comer patients with platinum-sensitive, relapsed high-grade serous ovarian cancer. We aimed to confirm these findings in patients with a BRCA1 or BRCA2 (BRCA1/2) mutation using a tablet formulation of olaparib. This international, multicentre, double-blind, randomised, placebo-controlled, phase 3 trial evaluated olaparib tablet maintenance treatment in platinum-sensitive, relapsed ovarian cancer patients with a BRCA1/2 mutation who had received at least two lines of previous chemotherapy. Eligible patients were aged 18 years or older with an Eastern Cooperative Oncology Group performance status at baseline of 0-1 and histologically confirmed, relapsed, high-grade serous ovarian cancer or high-grade endometrioid cancer, including primary peritoneal or fallopian tube cancer. Patients were randomly assigned 2:1 to olaparib (300 mg in two 150 mg tablets, twice daily) or matching placebo tablets using an interactive voice and web response system. Randomisation was stratified by response to previous platinum chemotherapy (complete vs partial) and length of platinum-free interval (6-12 months vs ≥12 months) and treatment assignment was masked for patients, those giving the interventions, data collectors, and data analysers. The primary endpoint was investigator-assessed progression-free survival and we report the primary analysis from this ongoing study. The efficacy analyses were done on the intention-to-treat population; safety analyses included patients who received at least one dose of study treatment. This trial is registered with ClinicalTrials.gov, number NCT01874353, and is ongoing and no longer recruiting patients. Between Sept 3, 2013, and Nov 21, 2014, we enrolled 295 eligible patients who were randomly assigned to receive olaparib (n=196) or placebo (n=99). One patient in the olaparib group was randomised in error and did not receive study treatment. Investigator-assessed median progression-free survival was significantly longer with olaparib (19·1 months [95% CI 16·3-25·7]) than with placebo (5·5 months [5·2-5·8]; hazard ratio [HR] 0·30 [95% CI 0·22-0·41], p<0·0001). The most common adverse events of grade 3 or worse severity were anaemia (38 [19%] of 195 patients in the olaparib group vs two [2%] of 99 patients in the placebo group), fatigue or asthenia (eight [4%] vs two [2%]), and neutropenia (ten [5%] vs four [4%]). Serious adverse events were experienced by 35 (18%) patients in the olaparib group and eight (8%) patients in the placebo group. The most common in the olaparib group were anaemia (seven [4%] patients), abdominal pain (three [2%] patients), and intestinal obstruction (three [2%] patients). The most common in the placebo group were constipation (two [2%] patients) and intestinal obstruction (two [2%] patients). One (1%) patient in the olaparib group had a treatment-related adverse event (acute myeloid leukaemia) with an outcome of death. Olaparib tablet maintenance treatment provided a significant progression-free survival improvement with no detrimental effect on quality of life in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation. Apart from anaemia, toxicities with olaparib were low grade and manageable. AstraZeneca. Copyright © 2017 Elsevier Ltd. All rights reserved.

Structure and reactions in some amphiphilic association systems

NASA Astrophysics Data System (ADS)

Guo, Rong

1999-06-01

The partial determinations of phase diagrams for some typical surfactants, such as SDS, CTAB and Triton X-100, give the basic aggregated states of the surfactant systems. In the micellar solutions, the diffusion coefficients of some surfactant association systems are determined by the cyclic voltammetry without any probe and used to describe the phase structure. (1) The first CMC, which represents the formation of spherical micelles, and the second CMC, which represents the transformation from spherical to rod-like micelles, are measured. The first and the second CMC are 8.0 x 10-3 mol. L -1 and 5.6 x 10-3 mol. L-1 for SDS, 8.9 x 10-4 mol. L-1 and 2.1 x 10-2 mol. L-1 for CTAB, and 3.2 x 10 -4 mol. L-1 and 1.3 x 10-3 mol. L-1 for Triton X-100, respectively. (2) The addition of polar additives, such as ethanol and benzyl alcohol (BA) in SDS micelles, or hexanol in Triton X-100 micelles, increases the diffusion coefficients and diffusion activation energy, decreases the micropolarity of the micelles with different shape, and causes the transformation from rod-like micelles to spherical ones or from spherical micelles to bicontinuous structure. (3) The isotropic region, which connects to the water comer in the phase diagram, is probably not an area of a single O/W structure, but an area with three different structures---the rod structure, spherical structure and the bicontinuous one. In the lyotropic liquid crystalline phase, the measurements of the small angle X-ray diffraction indicate that the structure parameters, such as interlayer spacing and water penetration, are related to the compositions of the surfactant association systems. The lamellar liquid crystal has a high water penetration but the hexagonal liquid crystal only has a water penetration about 0.05. Some surfactant association systems have been applied in the hydrotrope action of vitamin C (VC) and preparation of nanoparticles, respectively. Vitamin C (VC) can be used as hydrotrope agent in the cationic surfactant CTAB system with various co-surfactants: n-pentanol, n-octanol, n-valeric acid, and n-caproic acid, but not in SDS or Triton X-100 systems. Presence of VC stabilizes both W/O and O/W microemulsions but destabilizes the lamellar liquid crystalline phase. Hence, the "phase transition" from the lamellar liquid crystalline phase to the isotropic phase of O/W, W/O and bicontinuous structure phase occurs with the addition of VC. The hydrotropic action of VC has been used in sunscreens to increase the solubility of sunscreen E 557. The UV absorption spectra of E557 in various media surprisingly had a dependence on the colloid structure. A new method, the preparation of water-soluble nanoparticles, has been found by employing the effect of the penetration of solvent from water layer to amphiphilic layer in lamellar liquid crystals on the solubility of inorganic salts. Water-insoluble nanoparticles have been synthesized by the reaction of two water-soluble inorganic salts in the lamellar liquid crystal. The particle size is less than 10nm and can be controlled by the thickness of the solvent layer in the lamellar liquid crystal. The lamellar liquid crystalline phase of the Triton X-100/decanol/water system has been chosen as a medium because of its large lamellar liquid crystal region and its stability when inorganic salts are added.

Algunos Resumenes

NASA Astrophysics Data System (ADS)

1980-12-01

EI "Palomar Observatory Sky Survey" es un medio auxiliar bien conocido y ütil para los astronomos. Todo el cielo dei hemisferio Norte esta captado en lotografias, cuyas reproducciones se encuentran archivadas en las bibliotecas de casi todos los observatorios importantes dei mundo.

Transport and bioaccumulation of polychlorinated dibenzo-p-dioxins and dibenzofurans at the Bien Hoa Agent Orange hotspot in Vietnam.

PubMed

Van Thuong, Nguyen; Hung, Nguyen Xuan; Mo, Nguyen Thi; Thang, Nguyen Manh; Huy, Pham Quang; Van Binh, Hoang; Nam, Vu Duc; Van Thuy, Nguyen; Son, Le Ke; Minh, Nguyen Hung

2015-10-01

The Bien Hoa airbase (south of Vietnam) is known as one of the Agent Orange hotspots which have been seriously contaminated by Agent Orange/dioxin during the Vietnam War. Hundreds of samples including soil, sediment and fish were collected at the Bien Hoa Agent Orange hotspot for assessment of the environmental contamination caused by dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs). The toxicity equivalency quotient (TEQ) concentration of PCDD/Fs in soil and sediment varied from 7.6 to 962,000 and 17 to 4860 pg/g dry wt, respectively, implying very high contamination of PCDD/Fs in several areas. PCDD/F levels in fish ranged between 1.8 and 288 pg/g TEQ wet wt and was generally higher than advisory guidelines for food consumption. 2,3,7,8-Tetrachlorinated dibenzo-p-dioxins (2,3,7,8-TCDD) contributed 66-99 % of TEQ for most of the samples, suggesting 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) from Agent Orange as the major source of the contamination. The vertical transport of PCDD/Fs was observed in soil column with high TEQ levels above 1000 pg/g dry wt (Vietnamese limit for necessary remediation activities- TCVN 8183:2009 (2009)) even at a depth of 1.8 m. The vertical transport of PCDD/Fs has probably mainly taken place during the "Ranch Hand" defoliant spray activities due to the leaks and spills of phenoxy herbicides and solvents. The congener patterns suggest that transports of PCDD/Fs by weathering processes have led to their redistribution in the low-land areas. Also, an estimate for the total volume of contaminated soil requiring remediation to meet Vietnamese regulatory limits is provided.

Il faut bien faire avec des bribes, hein! (You Have to Make Do with Scraps, Huh?)

ERIC Educational Resources Information Center

Malandain, Jean-Louis

1983-01-01

Suggestions are made for structuring taped listening exercises to promote careful attention to various elements of spontaneous speech (speaker, speaker characteristics, tone, etc.), and to sensitize students to the usage of "hein" or other specific expressions. (MSE)

"Bien Educado": Measuring the Social Behaviors of Mexican American Children

ERIC Educational Resources Information Center

Bridges, Margaret; Cohen, Shana R.; McGuire, Leah Walker; Yamada, Hiro; Fuller, Bruce; Mireles, Laurie; Scott, Lyn

2012-01-01

Young children's expected social behaviors develop within particular cultural contexts and contribute to their academic experience in large part through their relationships with their teachers. Commonly used measures focus on children's problem behaviors, developed from psychopathology traditions, and rarely situate normative and positive…

"Parlez-Vous Bien Francais?" No Comment!

ERIC Educational Resources Information Center

Dale, Mark; Liss, Mimi

1996-01-01

Describes an experience of introducing a "Records of Achievement" scheme in university extramural language courses. The article discusses the effectiveness of existing teaching/learning styles and examines the way in which records of achievement could foster autonomous learning. Student reaction to recording progress as a means of sustaining…

Fleischmann seminar (fusion)

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2007-10-25

"pictures, television out, no flash and camera, there will be a press section later on in the council room if Prof. Fleischmann will accept"..le DG C.Rubbia insiste pour cette discussion scientifique de ne pas filmer, autrement de bien quitter la salle, ce qui provoque un petit remue-ménage...

Fleischmann seminar (fusion)

ScienceCinema

None

2017-12-09

"pictures, television out, no flash and camera, there will be a press section later on in the council room if Prof. Fleischmann will accept"..le DG C.Rubbia insiste pour cette discussion scientifique de ne pas filmer, autrement de bien quitter la salle, ce qui provoque un petit remue-ménage...

Military Ethics and Professionalism: A Collection of Essays

DTIC Science & Technology

1981-01-01

North America. Other units, such as the Waffen SS, persisted and cohered long after their own host societies had been pounded into dust. On the other...synonymous with victory or defeat. The Waffen SS was highly cohesive, but it was not victorious. The French forces at Dien Bien Phu were highly

75 FR 52544 - Notice of Proposed Information Collection: Comment Request; HUD NEPA ARRA Section 1609(c) Reporting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-26

... other available information. FOR FURTHER INFORMATION CONTACT: Charles Bien, Director, Environmental... Seventh Street, SW., Washington, DC 20410; e-mail: Charles[email protected] ; telephone (202) 402-4462. This... agency, including whether the information will have practical utility; (2) Evaluate the accuracy of the...

PubMed

Diamond, Adele

2009-02-01

Comment aider les enfants à réussir à l'école et, plus généralement, à développer leurs capacités intellectuelles ? Les résultats de travaux fondamentaux en psychologie et en neurosciences permettent de proposer des méthodes pédagogiques efficaces, bien qu'elles semblent parfois aller contre le bon sens.

Icon and Idea: A Symbolic Reading of Pictures in a Peruvian Indian Chronicle.

ERIC Educational Resources Information Center

Adorno, Rolena

1979-01-01

An examination and categorization of over 400 full-page drawings in the 1615 "Nueva coronica y bien gobierno" of Felipe Guaman Poma de Alaya, which details life in the Peruvian Viceroyalty. Explains the function of the illustrations in the text and that of five "signifying attributes" of spatial configuration. (SB)

Des proprietes de l'etat normal du modele de Hubbard bidimensionnel

NASA Astrophysics Data System (ADS)

Lemay, Francois

Depuis leur decouverte, les etudes experimentales ont demontre que les supra-conducteurs a haute temperature ont une phase normale tres etrange. Les proprietes de ces materiaux ne sont pas bien decrites par la theorie du liquide de Fermi. Le modele de Hubbard bidimensionnel, bien qu'il ne soit pas encore resolu, est toujours considere comme un candidat pour expliquer la physique de ces composes. Dans cet ouvrage, nous mettons en evidence plusieurs proprietes electroniques du modele qui sont incompatibles avec l'existence de quasi-particules. Nous montrons notamment que la susceptibilite des electrons libres sur reseau contient des singularites logarithmiques qui influencent de facon determinante les proprietes de la self-energie a basse frequence. Ces singularites sont responsables de la destruction des quasi-particules. En l'absence de fluctuations antiferromagnetiques, elles sont aussi responsables de l'existence d'un petit pseudogap dans le poids spectral au niveau de Fermi. Les proprietes du modele sont egalement etudiees pour une surface de Fermi similaire a celle des supraconducteurs a haute temperature. Un parallele est etabli entre certaines caracteristiques du modele et celles de ces materiaux.

Environmental health risk assessment of dioxin in foods at the two most severe dioxin hot spots in Vietnam.

PubMed

Tuyet-Hanh, Tran Thi; Minh, Nguyen Hung; Vu-Anh, Le; Dunne, Michael; Toms, Leisa-Maree; Tenkate, Thomas; Thi, Minh-Hue Nguyen; Harden, Fiona

2015-07-01

Bien Hoa and Da Nang airbases were bulk storages for Agent Orange during the Vietnam War and currently are the two most severe dioxin hot spots. This study assesses the health risk of exposure to dioxin through foods for local residents living in seven wards surrounding these airbases. This study follows the Australian Environmental Health Risk Assessment Framework to assess the health risk of exposure to dioxin in foods. Forty-six pooled samples of commonly consumed local foods were collected and analyzed for dioxin/furans. A food frequency and Knowledge-Attitude-Practice survey was also undertaken at 1000 local households, various stakeholders were involved and related publications were reviewed. Total dioxin/furan concentrations in samples of local "high-risk" foods (e.g. free range chicken meat and eggs, ducks, freshwater fish, snail and beef) ranged from 3.8 pg TEQ/g to 95 pg TEQ/g, while in "low-risk" foods (e.g. caged chicken meat and eggs, seafoods, pork, leafy vegetables, fruits, and rice) concentrations ranged from 0.03 pg TEQ/g to 6.1 pg TEQ/g. Estimated daily intake of dioxin if people who did not consume local high risk foods ranged from 3.2 pg TEQ/kg bw/day to 6.2 pg TEQ/kg bw/day (Bien Hoa) and from 1.2 pg TEQ/kg bw/day to 4.3 pg TEQ/kg bw/day (Da Nang). Consumption of local high risk foods resulted in extremely high dioxin daily intakes (60.4-102.8 pg TEQ/kg bw/day in Bien Hoa; 27.0-148.0 pg TEQ/kg bw/day in Da Nang). Consumption of local "high-risk" foods increases dioxin daily intakes far above the WHO recommended TDI (1-4 pg TEQ/kg bw/day). Practicing appropriate preventive measures is necessary to significantly reduce exposure and health risk. Copyright © 2015 Elsevier GmbH. All rights reserved.

Geology of Paleozoic Rocks in the Upper Colorado River Basin in Arizona, Colorado, New Mexico, Utah, and Wyoming, Excluding the San Juan Basin

USGS Publications Warehouse

Geldon, Arthur L.

2003-01-01

The geology of the Paleozoic rocks in the Upper Colorado River Basin in Arizona, Colorado, New Mexico, Utah, and Wyoming, was studied as part of the U.S. Geological Survey's Regional Aquifer-System Analysis Program to provide support for hydrogeological interpretations. The study area is segmented by numerous uplifts and basins caused by folding and faulting that have recurred repeatedly from Precambrian to Cenozoic time. Paleozoic rocks in the study area are 0-18,000 feet thick. They are underlain by Precambrian igneous, metamorphic, and sedimentary rocks and are overlain in most of the area by Triassic formations composed mostly of shale. The overlying Mesozoic and Tertiary rocks are 0-27,000 feet thick. All Paleozoic systems except the Silurian are represented in the region. The Paleozoic rocks are divisible into 11 hydrogeologic units. The basal hydrogeologic unit consisting of Paleozoic rocks, the Flathead aquifer, predominantly is composed of Lower to Upper Cambrian sandstone and quartzite. The aquifer is 0-800 feet thick and is overlain gradationally to unconformably by formations of Cambrian to Mississippian age. The Gros Ventre confining unit consists of Middle to Upper Cambrian shale with subordinate carbonate rocks and sandstone. The confining unit is 0-1,100 feet thick and is overlain gradationally to unconformably by formations of Cambrian to Mississippian age. The Bighom aquifer consists of Middle Cambrian to Upper Ordovician limestone and dolomite with subordinate shale and sandstone. The aquifer is 0-3,000 feet thick and is overlain unconformably by Devonian and Mississipplan rocks. The Elbert-Parting confining unit consists of Lower Devonian to Lower Mississippian limestone, dolomite, sandstone, quartzite, shale, and anhydrite. It is 0-700 feet thick and is overlain conformably to unconformably by Upper Devonian and Mississippian rocks. The Madison aquifer consists of two zones of distinctly different lithology. The lower (Redwall-Leadville) zone is 0-2,500 feet thick and is composed almost entirely of Upper Devonian to Upper Mississippian limestone, dolomite, and chert. The overlying (Darwin-Humbug) zone is 0-800 feet thick and consists of Upper Mississippian limestone, dolomite, sandstone, shale, gypsum, and solution breccia. The Madison aquifer is overlain conformably by Upper Mississippian and Pennsylvanian rocks. The Madison aquifer in most areas is overlain by Upper Mississippian to Middle Pennsylvanian rocks of the Four Comers confining unit. The lower part of this confining unit, the Belden-Molas subunit, consists of as much as 4,300 feet of shale with subordinate carbonate rocks, sandstone, and minor gypsum. The upper part of the confining unit, the Paradox-Eagle Valley subunit, in most places consists of as much as 9,700 feet of interbedded limestone, dolomite, shale, sandstone, gypsum, anhydrite, and halite. Locally, the evaporitic rocks are deformed into diapirs as much as 15,000 feet thick. The Four Corners confining unit is overlain gradationally to disconformably by Pennsylvanian rocks. The uppermost Paleozoic rocks comprise the Canyonlands aquifer, which is composed of three zones with distinctly different lithologies. The basal (Cutler-Maroon) zone consists of as much as 16,500 feet of Lower Pennsylvanian to Lower Permian sandstone, conglomerate, shale, limestone, dolomite, and gypsum. The middle (Weber-De Chelly) zone consists of as much as 4,000 feet of Middle Pennsylvanian to Lower Permian quartz sandstone with minor carbonate rocks and shale. The upper (Park City-State Bridge) zone consists of as much as 800 feet of Lower to Upper Permian limestone, dolomite, shale, sandstone, phosphorite, chert, and gypsum. The Canyonlands aquifer is overlain disconformably to unconformably by formations of Triassic and Jurassic age.

"The Struggle for Welcome": Valuing Difference through Refugee Stories in the English Curriculum

ERIC Educational Resources Information Center

Henderson, Deborah; Fitzgerald, Dominique

2014-01-01

This paper is concerned with how refugee stories can be used as the means of exploring values and developing intercultural understanding in the English classroom. To illustrate this possibility, André Dao's (2005) "Vuot Bien--The Search for Freedom: Huong Thi Nguen's Story," about the impact of war and oppression on people's lives,…

Apprendre à apprendre

PubMed Central

Diamond, Adele

2009-01-01

Comment aider les enfants à réussir à l’école et, plus généralement, à développer leurs capacités intellectuelles ? Les résultats de travaux fondamentaux en psychologie et en neurosciences permettent de proposer des méthodes pédagogiques efficaces, bien qu’elles semblent parfois aller contre le bon sens. PMID:20936089

Using Leader-Member Exchange Theory to Examine Principal-School Counselor Relationships, School Counselors' Roles, Job Satisfaction, and Turnover Intentions

ERIC Educational Resources Information Center

Clemens, Elysia V.; Milsom, Amy; Cashwell, Craig S.

2009-01-01

Principals have considerable influence on shaping the role of school counselors with whom they work (Amatea & Clark, 2005; Dollarhide, Smith, & Lemberger, 2007; Ponec & Brock, 2000). Researchers used leader-member exchange theory (Graen & Uhl-Bien, 1995) to examine the relevance of principal-school counselor relationships to school counselors'…

Descartes, René (1596-1650)

NASA Astrophysics Data System (ADS)

Murdin, P.

2000-11-01

Mathematician and philosopher, born in La Haye (now Descartes), Touraine, France, settled in Holland. His work, La Géométrie, formulated geometry in terms of algebra, from which comes the concept of Cartesian coordinates. Studied Aristotelian philosophy and was attracted to mathematics, and the purely logical analysis of practically everything. Wrote Discours de la Méthode pour bien Conduire sa R...

'¡Hable Bien M'Ijo O Gringo O Mx!': Language Ideologies in the Digital Communication Practices of Transnational Mexican Bilinguals

ERIC Educational Resources Information Center

Christiansen, M. Sidury

2018-01-01

This article examines Facebook conversations between members of a transnational social network of US- and Mexico-born English/Spanish bilinguals. Extending Bourdieu's theory of language and symbolic power, the article uses the framework of language ideologies to explore how members establish identity and membership differently depending on whether…

Family Incomes: Will Your Children Be as Well Off as Your? = Les revenue familiaux: vos enfants s'en tireront-ils aussi bien que vous?

ERIC Educational Resources Information Center

Theilheimer, Ish, Ed.

1993-01-01

Against the background of recent radical changes in the Canadian economy, this issue of the Canadian journal "Transition" examines the question of parents' concerns for their children's economic futures. "Changes in Family Incomes and Labour Market Participation in Post-War Canada" (David Ross and Clarence Lochhead) charts…

"Los Ninos y los Libros": Noteworthy Books in Spanish for the Very Young.

ERIC Educational Resources Information Center

Schon, Isabel

2001-01-01

Reviews 15 children's books in Spanish. Titles reviewed include: "Perro y gato [Dog and Cat]" (Ricardo Alcantara); "Baldomero va a la escuela [Baldomero goes to School]" (Alain Broutin); "Duerme bien, pequeno oso [Sleep well, Little Bear]" (Quint Buchholz); "El mas bonito de todos los regales del mundo [The Most Beautiful Gift in the World]…

Mental Health and Well-Being across the Military Spectrum (Bien-etre et sante mentale dans le milieu militaire)

DTIC Science & Technology

2011-04-01

il faut de toute urgence mener des actions complémentaires pour créer un environnement favorable pour l’ensemble des militaires. Dans le domaine du...changement souhaitable de comportement dans un environnement militaire de culture traditionnellement rude (macho) est un vrai défi, et il est recommandé

New provincial records of skinks (Squamata: Scincidae) from northwestern Vietnam

PubMed Central

Pham, Anh Van; Le, Dzung Trung; Nguyen, Son Lan Hung; Ziegler, Thomas

2015-01-01

Abstract We report six new records of skinks from northwestern Vietnam: Eutropis macularius, Scincella devorator, S. monticola, S. ochracea, Sphenomorphus cryptotis and S. indicus. Our new findings increase the species number of skinks (Scincidae) to nine in Dien Bien Province and to 14 in Son La Province. We also provide additional natural history data of aforementioned species. PMID:25698899

Environmental Health Risk Assessment of Dioxin Exposure through Foods in a Dioxin Hot Spot—Bien Hoa City, Vietnam

PubMed Central

Tuyet-Hanh, Tran Thi; Vu-Anh, Le; Ngoc-Bich, Nguyen; Tenkate, Thomas

2010-01-01

This study used the Australian Environmental Health Risk Assessment Framework to assess the human health risk of dioxin exposure through foods for local residents in two wards of Bien Hoa City, Vietnam. These wards are known hot-spots for dioxin and a range of stakeholders from central government to local levels were involved in this process. Publications on dioxin characteristics and toxicity were reviewed and dioxin concentrations in local soil, mud, foods, milk and blood samples were used as data for this risk assessment. A food frequency survey of 400 randomly selected households in these wards was conducted to provide data for exposure assessment. Results showed that local residents who had consumed locally cultivated foods, especially fresh water fish and bottom-feeding fish, free-ranging chicken, duck, and beef were at a very high risk, with their daily dioxin intake far exceeding the tolerable daily intake recommended by the WHO. Based on the results of this assessment, a multifaceted risk management program was developed and has been recognized as the first public health program ever to have been implemented in Vietnam to reduce the risks of dioxin exposure at dioxin hot-spots. PMID:20623031

Katimavik Participant's Manual, Book VIII, Nutrition and Well-Being = Katimavik manuel du participant, cahier VIII, l'alimentation et le bien-etre.

ERIC Educational Resources Information Center

Crelinsten, Michael, Ed.

The bilingual student manual focuses on the nutrition and well-being learning activity portion of Katimavik, a nine-month volunteer community service and experiential learning program for 17 to 21 year old Canadians. Providing participants with basic information and tools to assess and improve nutritional states and tie nutrition concerns into a…

Grassroots Action Research and the Greater Good (La investigación acción de base y el bien mayor)

ERIC Educational Resources Information Center

Rainey, Isobel

2011-01-01

This study examines the action research topics and topic preferences of two groups of grassroots teachers: active researchers, and potential researchers. The analysis of the topics appears to indicate that, over the past decade, action research at the teaching of English at the grassroots level to speakers of other languages has been principally…

Review of Interorganizational Trust Models

DTIC Science & Technology

2010-09-01

rooted in common values, including a common concept of moral obligation. This type of trust typically takes a long time to develop, and is the type of...mais les résultats de la recherche se sont avérés relativement maigres. Bien que nous ayons trouvé de nombreux modèles de confiance...DAVENPORT, 2004, P. 192) ........................................................................................ 16 FIGURE 6. CONCEPT MAP OF LITERATURE

Legio Patria Nostra: The History of the French Foreign Legion Since 1962

DTIC Science & Technology

2005-06-17

burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Department of Defense ... Defense Policy, France, Franco-African Partnership, Dien Bien Phu, Algerian War, Operation Enduring Freedom 16. SECURITY CLASSIFICATION OF: 17... Profondeur (Deep Action Pathfinders) CSLE Compagnie de Service de la Légion Étrangère (Foreign Legion Service Company) CTLE Compagnie de Transit de la

Electronic Messaging for the 90s (Les Messageries Electroniques des Annees 90)

DTIC Science & Technology

1993-05-01

des autres unitds (un programme peut par exemple inclure un algorithme de 2. L CICULAIONDE ’INFRMAION recherche dans des donn~es...dit quc le rdseau, en particulier le r.dseau distant, cette coopdration homme /macbine. aifre des performances bien infirieures A celles des ordinateurs...dans ce sens, entre constructeurs d’ordinateurs, des opdrations traitementltransport. constructeurs didquipements de t~ l ~communications et exploitants de

The Beginnings of Aeromedical Acceleration Research

DTIC Science & Technology

1981-09-30

matiere qui sera la limite des per- formance acrobatique de I’oiseau artificiel , mais bien la resistance physiologique de I’homme qui en est le...3. Bauer, L. H. 1926. Aviation Medizin. Publisher Williams and Wilkins, Baltimore. 4. Bleriot, L, 1922. L’oiseau artificiel . L’Aerophile 19:20, 15...Director, Defense Intelligence Agency, (Code DR), Washington, DC 20301 3 Commander, Naval Air Test Center, Patuxent River, MD 20670 2

Interventional Audiology to Address Hearing Health Care Disparities: Oyendo Bien Pilot Study

PubMed Central

Marrone, Nicole; Ingram, Maia; Somoza, Maria; Jacob, Daisey Sánchez; Sanchez, Adriana; Adamovich, Stephanie; Harris, Frances P.

2017-01-01

Interventional audiology, specifically community-based outreach, can connect people with the hearing health care system. Community-based participatory research methods were applied in two phases of research to: (1) investigate the needs of families affected by hearing loss in a rural Arizona community on the U.S.–Mexico border; and (2) evaluate an outreach program on hearing health. The needs assessment included interviews with persons with hearing loss and focus groups with family members and the greater community. The needs assessment revealed that despite perceived severity of hearing loss, help-seeking for audiologic care was limited due to barriers, stigma, and low self-efficacy. Results informed development of a community-based pilot study conducted as part of an academic-community partnership between audiology, public health, and community health workers of a federally qualified health center. An outreach program, Oyendo Bien (hearing wellness), a 5-week, Spanish-language health education program for older adults (n = 21) incorporated communication strategies and behavioral change techniques. Postprogram focus groups revealed increased self-efficacy and decreased stigma. After 1 year, 7 of 9 participants with hearing loss contacted for follow-up had sought some form of hearing-related health care. Future research should further investigate interventional audiology approaches to address health disparities. PMID:28522894

Decision Theory: Individual Biases and Their Effect on Forecasting in an Organization.

DTIC Science & Technology

1983-12-01

has not bien a great deal written about how these biases effact decisicns in an organizational environment . The purpcse of -:his thesis is tc examine...and prospers while using fallible information to infer the stateb of his uncer- tain environment and to pr.dict future events. Experiments that have...chapters deal with data from two separate crganizati-ons in two different environments . The Judgmental processes of forecasTing future organizational

The Development of a Taxonomy of the Life Skills Required to Become a Balanced Self-Determined Person = Essaie de Classification des Competences Necessaires pour Devenir une Personne Autonome et Bien Equilibree.

ERIC Educational Resources Information Center

Smith, Paul

Intended for use by life skills coaches and students, program evaluators, and individuals developing lesson plans and other training materials, this taxonomy includes all of the terminal performance behaviors and corresponding sub-skills required to become and function as a balanced, self-determined person who manages the problems of everyday life…

Are the Kids Alright? What's Shaping the Attitudes, Values and Behaviour of our Young People? = Les enfants se portent-ils bien? Qu'est-ce qui faconne les attitudes, les valeurs et le comportement de nos jeunes?

ERIC Educational Resources Information Center

Theilheimer, Ish, Ed.

1992-01-01

This theme issue explores the behavior of teenagers. "Are the Kids Alright?" (Ish Theilheimer) develops a perspective on the subject of teen behavior, noting that a growing number of young people demonstrate discontent, alienation, aggression, violence, and antisocial behavior, and that a growing underclass of children is likely to fail.…

Risky Business: Reducing Moral Hazard in Airlift Operations

DTIC Science & Technology

2012-06-01

as to use a weather balloon to mark one of Dien Bien Phu’s drop zones in hopes of making drop operations viable when airland operations were not. In...casualties (killed, wounded, missing) of just over 7,000 and probably over 9,000 taken captive at the end of the battle with the odds stacked against...tethered weather balloon to guide their drops when they could not see the drop zone. Using the Ground-Controlled Approach (GCA) radar, personnel

Patents - An Information Resource.

DTIC Science & Technology

1980-09-01

11 vs sans dire que ces aspects de description at de divulqation interviennent en plus des trois critbrea classiques de nouveautd, de hauteur...la divulgation doit, nous 1’ avons vu, aux termes de Ia loi , permettre b l’homme de l’art de reconstituer 1’invention. Or on sait bien que lea d...je vous en donnerai confirmation au mayen de r~sultats dletudea conduites au cours de ceo dernibres annies dans diff~rents pays et secteurs

U.S.-Vietnam Relations: Background and Issues for Congress

DTIC Science & Technology

2008-10-31

Clips, Produced by U.S. State Department Hanoi and Ho Chi Minh City Public Affairs Sections; Oxford Analytica ( OA ), “Vietnam/Cambodia/Laos: Crisis Could...Spur Reforms,” October 24 2008. 8 For these contrasting views, see EIU, Vietnam Country Report, October 2008, and OA , “Vietnam/Cambodia/Laos: Crisis...military bases in Bien Hoa, Da Nang, Nha Trang, and Phu Cat. In February 2007, the United States announced it would provide $400,000 to support mitigation

Military Review, January 1992. Volume 72, Number 1

DTIC Science & Technology

1992-01-01

tinuing theme for Vietcong propagandists who COMBAT CUISINE The cooks of the French Expeditionary Corps bottles, along with ammunition and medical sup...Vuono’s goal for the 1990s: an French Brigade in Stuttgart, Germany, offers a Army that is deployable, lethal, agile and versa- suitable model of such an...author offers several valid insights into the faulty planning and execution of the French stand at Dien Bien Phu in 1954 in Indochina, T 2400 ON 7 MAY

Ingreso y bienes de la población de edad media y avanzada en México*

PubMed Central

Wong, Rebeca; Espinoza, Mónica

2017-01-01

Resumen El propósito de este artículo es resumir el monto y los tipos de ingreso que percibe y bienes que posee la población de edad media y avanzada en México. Se usan datos de la nueva Encuesta Nacional sobre Salud y Envejecimiento en México (Enasem) 2001, un estudio prospectivo de panel con representación nacional de las personas de 50 años de edad y más. Los resultados confirman las hipótesis formuladas: la distribución del ingreso y la riqueza están sesgadas en favor de ciertos grupos, sobre todo aquéllos con mayor educación; la composición de la riqueza se da principalmente en forma no financiera y el apoyo familiar es una fuente de ingreso importante; la asociación entre riqueza y salud es positiva en general, lo cual es consistente con la literatura internacional. Además se encuentra que la riqueza acumulada está distribuida más equitativamente que el ingreso, y se concluye que el indicador de riqueza ofrece una dimensión de análisis adicional al ingreso, con potencial para contribuir a los estudios del bienestar de la población en edad media y avanzada en México. PMID:29386981

Otite externe maligne à Candida Albicans

PubMed Central

Elayoubi, Fahd; Lachkar, Azeddine; Aabach, Ahmed; Chouai, Mohamed; Ghailan, Mohamed Rachid

2016-01-01

L’otite externe maligne est une ostéomyélite de la base du crane. Le Pseudomonas aeruginosa est le germe le plus incriminé. Cependant l’origine fongique n’est pas rare. Patiente âgée de 80 ans avait présenté une otalgie gauche persistante depuis deux mois malgré un traitement bien conduit. L’examen otologique mettait en évidence des signes inflammatoires au niveau du pavillon, une sténose du conduit avec des granulomes, et otorrhée d’allure purulente. Le scanner montrait un comblement otomastoïdien, un processus inflammatoire extensif des tissus pré et rétro-auriculaire et une lyse du tympanal. Vu l’absence d’amélioration un examen mycologique a été réalisé et qui a révélé la présence de Candida Albicans. Les cas d’otite externe maligne à Candida Albicans sont rarement rapportés. L’origine fongique doit être suspecté devant la négativité des prélèvements bactériologiques et la non amélioration malgré un traitement antibiotique bien conduit, et confirmée par des prélèvements mycologiques parfois multiples. L’otite externe maligne à Candida Albicans est une infection rare potentiellement mortelle. PMID:28154677

Electromagnetic modelling of Ground Penetrating Radar responses to complex targets

NASA Astrophysics Data System (ADS)

Pajewski, Lara; Giannopoulos, Antonis

2014-05-01

This work deals with the electromagnetic modelling of composite structures for Ground Penetrating Radar (GPR) applications. It was developed within the Short-Term Scientific Mission ECOST-STSM-TU1208-211013-035660, funded by COST Action TU1208 "Civil Engineering Applications of Ground Penetrating Radar". The Authors define a set of test concrete structures, hereinafter called cells. The size of each cell is 60 x 100 x 18 cm and the content varies with growing complexity, from a simple cell with few rebars of different diameters embedded in concrete at increasing depths, to a final cell with a quite complicated pattern, including a layer of tendons between two overlying meshes of rebars. Other cells, of intermediate complexity, contain pvc ducts (air filled or hosting rebars), steel objects commonly used in civil engineering (as a pipe, an angle bar, a box section and an u-channel), as well as void and honeycombing defects. One of the cells has a steel mesh embedded in it, overlying two rebars placed diagonally across the comers of the structure. Two cells include a couple of rebars bent into a right angle and placed on top of each other, with a square/round circle lying at the base of the concrete slab. Inspiration for some of these cells is taken from the very interesting experimental work presented in Ref. [1]. For each cell, a subset of models with growing complexity is defined, starting from a simple representation of the cell and ending with a more realistic one. In particular, the model's complexity increases from the geometrical point of view, as well as in terms of how the constitutive parameters of involved media and GPR antennas are described. Some cells can be simulated in both two and three dimensions; the concrete slab can be approximated as a finite-thickness layer having infinite extension on the transverse plane, thus neglecting how edges affect radargrams, or else its finite size can be fully taken into account. The permittivity of concrete can be defined through a constant real value, or else its frequency-dispersion properties can be taken into account by incorporating into the model Debye approximations. The electromagnetic source can be represented as a simple line of current (in the case of two-dimensional models), a Hertzian dipole, a bow tie antenna, or else, the realistic description of a commercial antenna can be included in the model [2]. Preliminary results for some of the proposed cells are presented, obtained by using GprMax [3], a freeware tool which solves Maxwell's equations by using a second order in space and time Finite-Difference Time-Domain algorithm. B-Scans and A-Scans are calculated at 1.5 GHz, for the total electric field and for the field back-scattered by targets embedded in the cells. A detailed description of the structures, together with the relevant numerical results obtained to date, are available for the scientific community on the website of COST Action TU1208, www.GPRadar.eu. Research groups working on the development of electromagnetic forward- and inverse-scattering techniques, as well as on imaging methods, might test and compare the accuracy and applicability of their approaches on the proposed set of scenarios. The aim of this initiative is not that of identifying the best methods, but more properly to indicate the range of reliability of each approach, highlighting its advantages and drawbacks. In the future, the realisation of the proposed concrete cells and the acquisition of GPR experimental data would allow a very effective benchmark for forward and inverse scattering methods. References [1] R. Yelf, A. Ward, "Nine steps to concrete wisdom." Proc. 13th International Conference on Ground Penetrating Radar, Lecce, Italy, 21-25 June 2010, pp. 1-8. [2] C. Warren, A. Giannopoulos, "Creating FDTD models of commercial GPR antennas using Taguchi's optimisation method." Geophysics (2011), 76, article ID G37. [3] A. Giannopoulos, "Modelling ground penetrating radar by GPRMAX." Construction and Building Materials (2005), 19, pp. 755-762.

Discours oraux--discours ecrits: quelles relations? Actes du 4eme colloque d'orthophoine/logopedie (Neuchatel, 3-4 octobre, 1996) (Oral Discourse--Written Discourse: What Is the Relationship? Proceedings of the Colloquium on Speech Therapy (4th, Neuchatel, Switzerland, October 3-4, 1996).

ERIC Educational Resources Information Center

Py, Bernard, Ed.

1996-01-01

Research papers on the relationship between oral and written language include: "Une distinction bien fragile: oral/ecrit" ("A Fragile Distinction: Oral/Written") (Francoise Gadet); "Oral et ecrit dans les representations des enseignants et dans les pratiques quotidiennes de la classe de francais" ("Oral and Written Language in Teachers'…

What Should Users Expect from Information Storage and Retrieval Systems of the 1980’s

DTIC Science & Technology

1981-12-01

cide dcentrer sur ls marchE de l1information secondaire, on doit d~finir Is secteur , rschercher des appuis (coop~rants) pour couvrir cc secteur ...inutiles. Ii appartient bien entendu chaque Gouvernemant dlapprdcier sea prioritds, mais en se plagant dans Is cadre tracE. GOUVERNEMENT ET SECTEUR PRIVE A...directive A76 salon laqualle le Gouvernament f~d~ral slappuiera sur Is secteur priv6 pour publiar at dissminar llinformation scientifique at technique

Human Views: Extensions to the Department of Defense Architecture Framework

DTIC Science & Technology

2008-09-01

évaluent et prédisent les implications. Étant donné la complexité inhérente aux relations dans les S de S, l’absence de VH bien définies et universellement ...n.d.): 1. A Planning, Programming, Budgeting, and Execution process is used to conduct strategic planning and make resource allocation decisions; 2...Responsibilities in the form of functions and tasks have been allocated to each MMEV crew member. In addition, a set of competency requirements (e.g., KSA) has

L'optique spatiale au CES

NASA Astrophysics Data System (ADS)

Courtois, M.; Otrio, G.

2018-04-01

Jai le plaisir d'inaugurer cette troisieme conference ICS0'97 consacree a l'optique patialc Les techniques evoluent tres vite; l'optique et l'optoelectronique n'echappent pas a c:ene regle. Depuis Garmisch. en 1994, bien des evenements concemant ces domaines se som produits le rappellerai !es faits les plus saillants dans la premiere panie de mon expose Je donncrai ensuite un apercu des activites en cours au Cnes et je tenninerai en parlant du futur quelles sont les technologies emergentes et quels projets peuvent en decouler ?

Relationship between Spain and the United States during the 18th and 19th Centuries

DTIC Science & Technology

1990-03-21

buiena correspandencis pars lo sucesivo; y si esta se difiriese a quando hubiese salida dle sus aprielas, ni sot voluntad estaria tan bien dispuesta, ni...ndidndase a voluntad . se podrdn internar hacia nuestres posesiones par [a espalda de Is Luisisna. H-ay que tcner presente quc el rio San Larenzo por el...serd en su mano on poderoso ynstrumento. pars menearlo a so voluntad contra dichas naciones: y que Wse no quedara sin exercicia, por mocha tiempo nadie

The DISAM Journal of International Security Assistance Management. Volume 30, Number 1, March 2008

DTIC Science & Technology

2008-03-01

annexation of a little patch of ground called Sudetenland? Or a French defeat at a place called Dien Bien Phu? Or the return of an obscure cleric to...chats on personal, non-work related subjects – including politics and religion. Family (children), sports, travel, and cuisine are safe...lieu of 2 standard forms can be approved on a case-by- forms or translated versions (Spanish, case basis. The request and forms French , etc.) need

Produccion de plantas grandes usando minicontenedores

Treesearch

R. Kasten Dumroese; Thomas D. Landis

2012-01-01

En América del Norte hay cada vez más interés por la producción híbrida o mixta. La misma consiste en cultivar plantines en contenedores de pequeño volumen y luego trasplantarlos; el trasplante se puede realizar a canteros en el suelo como en la producción a raíz desnuda o bien a contenedores más grandes. Originalmente se llamaban plantines "plug+", "...

Prévalence de l'utilisation des anti-inflammatoires non stéroïdiens chez les femmes enceintes à Lubumbashi (République Démocratique du Congo)

PubMed Central

Kabamba, Arsène Tshikongo; Shamashanga, Laurent Kwete; Mwaba, Jean-Jacques Mulubwa; Kasongo, Christian Busambwa; Longanga, Albert Otshudi; Lukumwena, Zet Kalala

2014-01-01

Malgré l'importance de leurs effets secondaires sur la femme enceinte et le fœtus, les anti-inflammatoires non stéroïdiens (AINS) continuent à être largement utilisés par les femmes enceintes. Leur rapport bénéfice-risque n'est pas toujours bien évalué en pratique courante. L'objectif de ce travail est d’évaluer l'usage des AINS chez la femme enceinte, de discuter les risques potentiels encourus aussi bien par la mère que par le fœtus, et enfin d'en tirer des recommandations éventuelles à la femme enceinte. Du 22 août au 11 septembre 2012, une enquête a été menée auprès de 145 femmes enceintes suivies en consultation prénatale à l'Hôpital Sendwe. Un formulaire reprenant les informations sur les AINS consommés a été remis à chacune d'elle. Les résultats montrent que 75% des femmes interrogées reconnaissent avoir consommé des AINS surtout en automédication et principalement pendant les deux derniers trimestres de la grossesse pour soulager des douleurs d'origines diverses. Cette étude montre que des efforts restent encore à déployer à Lubumbashi afin de combattre l'utilisation des AINS surtout en automédication chez la femme enceinte. PMID:25419270

Critical Energy Infrastructure Protection in Canada

DTIC Science & Technology

2010-12-01

la participation volontaire du secteur privé dans le système intégré proposé et sur des mesures visant à encourager...que le gouvernement attache beaucoup d’importance à la protection des infrastructures énergétiques essentielles. Neuf ans après les attaques du 11...producteurs d’énergie et des services énergétiques qui sont si essentiels à la prospérité et au bien-être du Canada ainsi qu’à la sécurité de l’Amérique du

Technical Evaluation Report on Knowledge Based System Applications for Guidance and Control (Application des Systemes a Base de Connaissances au Guidage-Pilotage),

DTIC Science & Technology

1991-07-01

base de connaissances. Le doniaine de l’intelligence artificieflcs’affirinc en tant que science dont les 6l6mcnts technologiques 6volucnt tr~s...substantiellc de l’cfficacit6 opdrationnellc. Bien que los applications temps riel soient encore relativement rares, un certain nombre de projets de...Sanz-Aranguez SP ProfessorJohn T.Shcpherd UK Dr Elihu Zimet us HOST PAINEL COORDINATOR Mdr Carlos A. Garriga. Lopez SENER Ingenieria y Sistemas SA

Disks Surrounding Massive Stars: When Computational Models are Confronted by Observations

DTIC Science & Technology

2010-01-01

E. Jones,1 C. Tycner,2 J. A. Benson,3 D. J. Hutter,3 H. R. Schmitt,4,5 T. A. A. Sigut,1 and R. T. Zavala3 RESUMEN Las estrellas masivas se...ser detectados directamente, este material puede ser detectado en el espectro de la radiación que observamos de la estrella . A menudo, el material...circunestelar posee una distribución tipo disco, pero el proceso f́ısico que forma y mantiene estos discos no es bien entendido. Las estrellas Be son un

Joint Concept Development and Experimentation: A Force Development Perspective

DTIC Science & Technology

2012-02-01

REFINED SCENARIO SET KLE S E C U R IT Y E N V IR O N M E N T E X IS T IN G Existing Scenarios KLE Figure 7: Hierarchy of force...CORA TM 2012-036 References ..... [1] Palla, G ., Barabasi, A.L., and Vicsek, T . Quantifying Social Group Evolution. Nature, Vol 446, pp...activités interarmées de développement des forces ( planification axée sur les capacités, élaboration et expérimentation de concepts) ne sont pas bien

Inventario mundial de la calidad del carbon mineral (WoCQI) [The world coal quality inventory (WoCQI)

USGS Publications Warehouse

Finkelman, R.B.; Lovern, V.S.

2001-01-01

Los oficiales encargados de la politica comercial de cada pais requieren informacion clara y precisa sobre el recurso del carbon mineral, particularmente sobre sus propiedades y caracteristicas, para tomar decisiones bien fundamentadas con respecto al mejor uso de los recursos naturales, necesidades de importacion y oportunidades de exportacion, objetivos de politica interna y externa, oportunidades de transferencia tecnologica, posibilidades de inversion externa, estudios ambientales y de salud, y asuntos relacionados con el uso de productos secundarios y su disposicion.

Advanced Avionics and the Military Aircraft Man/Machine Interface.

DTIC Science & Technology

1982-07-01

voiture au bas c~t6 de la route, angle d’incidence de l’aile, etc ... Le domaine de variation de chacun de ces param~tres de fonctionnement est en gdn6...ral limit6. Les limites, du domaine autoris6 sont bien souvent floues ; en toute rigueur il faut adniettre qu’au milieu du domaine autoristi, la...rapidement catastrophique 11 est n6anmoihs commode de parler de limite de domaine autoris6 pour chaque para- m~tre de fonctionnement tout en gardant A

Astronomía para ciegos y amblíopes. Proyecto de construcción de un planetario especial en la ciudad de Mar del Plata

NASA Astrophysics Data System (ADS)

Musso, S.

?`Qué es la Astronomía para Ciegos?. El trabajo es una adaptación en base a la escala de magnitudes de Hipparco que cambia el concepto de luz por una adaptación sonora, donde las estrellas de magnitud 6 se escuchan en 10 dB, más o menos lo que consideramos el umbral de la audición humana. Quienes no escuchan muy bien no pueden escuchar las magnitudes 6, de la misma manera que muchos de nosotros, que no poseemos una visión perfecta, no podemos observar esas mismas estrellas en el cielo (más allá de la polución). A los astros de magnitud 5 vamos a relacionarlos a un sonido en 20 dB. Y así sucesivamente. También los colores estarán representados en una convención de graves a agudos y lo mismo algunas características del cielo. Por ejemplo, la Vía Láctea se mostrará como un ``ruido", como bien nos lo hicieron ver nuestros futuros destinatarios. En Mar del Plata nos encontramos ya trabajando en un proyecto que tiene como objetivo final la construcción del Primer Planetario Acústico del Mundo, una herramienta para la enseñanza de la astronomía, un espacio para la lucha contra la discriminación del discapacitado y una posibilidad de ``ver el cielo de un modo diferente".

Schwannome benin primitif retrovesical: une tumeur très rare à propos d'un cas

PubMed Central

Beddouche, Ali; Fahsi, Othemane; Kallat, Adil; El Bote, Hicham; Ziani, Idriss; El Sayegh, Hachem; Iken, Ali; Benslimane, Lounis; Nouini, Yassine

2016-01-01

Le schwannome est une tumeur le plus souvent bénigne, d'origine nerveuse se développant à partir des cellules de la gaine de Schwann. C'est une tumeur très rare tant par sa fréquence que par sa localisation rétrovésicale. L'examen anatomopathologique et immunohistochimique confirme le type histologique ainsi que le caractère bénin ou malin du schwannome. En raison des récidives, et du risque de transformation maligne, l'exérèse doit être complète. Nous rapportons le cas d'un patient âgé de 39 ans, admis pour une douleur pelvienne chronique à type de pesanteur, des signes irritatifs du bas appareil urinaire, et des troubles de transit. L'imagerie (échographie, TDM, IRM) a révélé la présence d'une masse pelvienne rétrovésicale, à paroi fine, latéralisée à gauche, mesurant 68x70x70 mm, exerçant un effet de masse sur la vessie et le sigmoïde. L'intervention chirurgicale menée par une laparotomie médiane a permis l'exérèse d'une masse retrovésicale bien encapsulée. L'examen anatomopathologique et immunohistochimique ont conclu à un schwannome bénin. La récidive et la transformation maligne bien que rare après chirurgie impose une surveillance post opératoire clinique et tomodensitométrique annuelle. PMID:27217902

Application d'une technique de modelisation aerodynamique conceptuelle sur la simulation d'un pilote automatique a commande optimale pour un avion d'affaires

NASA Astrophysics Data System (ADS)

Pollender-Moreau, Olivier

Ce document présente, dans le cadre d'un contexte conceptuel, une méthode d'enchaînement servant à faire le lien entre les différentes étapes qui permettent de réaliser la simulation d'un aéronef à partir de ses données géométriques et de ses propriétés massiques. En utilisant le cas de l'avion d'affaires Hawker 800XP de la compagnie Hawker Beechcraft, on démontre, via des données, un processus de traitement par lots et une plate-forme de simulation, comment (1) modéliser la géométrie d'un aéronef en plusieurs surfaces, (2) calculer les forces aérodynamiques selon une technique connue sous le nom de Vortex Lattice Method, (3) construire un modèle de vol servant à la simulation des aéronefs pour leur enveloppe de vol en ajoutant des fonctions supplémentaires, (4) construire un modèle de turbosoufflante simplifié, (5) développer un algorithme d'équilibre (trim) du mouvement longitudinal, (6) développer des algorithmes de contrôle à commande moderne, (7) développer certaines fonctions d'un système de pilotage automatique, et (8) rassembler le tout sous une même plate-forme de simulation. Afin de supporter ce travail, une application publique Matlab, connue sous le nom de Tornado, est utilisée conjointement avec d'autres fonctions pour la conception du modèle de vol aérodynamique. D'ailleurs, il sera démontré que le modèle de vol, quoiqu'il soit quand même crédible, ne concorde pas tout à fait avec les données de référence. Par contre, puisque le modèle des moteurs fonctionne bien, que l'algorithme d'équilibrage du mouvement longitudinal fonctionne bien et que les pôles des systèmes dynamiques concordent avec la littérature, les tests dynamiques effectués au sein de la plate-forme de simulation permettent d'obtenir des résultats fonctionnels et crédibles. D'ailleurs, deux systèmes d'augmentation de la stabilité basés sur la méthode de contrôle moderne LQR et couvrant l'enveloppe de vol de l'aéronef via un système d'ordonnancement des gains sont implémentés respectivement selon les mouvements longitudinal et latéral. Ces fonctions fonctionnent bien et permettent de rencontrer les qualités de vol requises pour un avion d'affaires. Finalement, certaines fonctions concernant un système de pilotage automatique sont implémentées. Dans le cas du mouvement latéral, ces fonctions sont basées sur les méthodes de contrôle modernes et couvrent la totalité de l'enveloppe de vol; mais en ce qui concerne le mouvement longitudinal, elles sont basées sur des algorithmes d'équilibre difficile à gérer pour implémenter sur toute l'enveloppe de vol, c'est pourquoi les tests présentés sont limités à des scénarios bien précis. Dans les deux cas, les essais effectués donnent d'assez bons résultats.

Extensions of Fundamental Flow Physics to Practical MAV Aerodynamics

DTIC Science & Technology

2016-05-01

performances aérodynamiques. En cas de génération instable de la portance, certaines structures formées par la séparation de l’écoulement, telles...que le vortex du bord d’attaque, peuvent augmenter la portance bien au-delà des espérances à l’état stable. Le présent document étudie les rotations...une accélération dans le sens de l’écoulement à incidence constante (également lissée). Nous examinons de quelle façon la vitesse du mouvement

Project CHECO Southeast Asia Report. Control of Air Strikes in SEA 1961-1966

DTIC Science & Technology

1967-03-01

such use. By the end of December there were 30 F-lOO’s at Da Nang, ten B-57’s at 66/ Bien Hoa, and eighteen F-105’s at Korat .-- One notable...Phanom, Ubon, I Korat , and Phitsanulok with a CRC at Don Muangc There were, in effect, I three control systems operating for airpower in Southeast...much more 21/ efficiently. Strike forces in Thailand were building up. Four squadrons ofF-lOS’s, two each at Takhli and Korat , were in Thailand by

Project CHECO Southeast Asia Report. Search and Rescue Operations in SEA, 1 January 1971 - 31 March 1972

DTIC Science & Technology

1972-10-17

minus four aircraft and approximately 100 personnel) had joined Det 4 of the 3ARRGp and was performing its 3- mission from Korat RTAFB, Thailand.-2 m...RTAFB, Thailand m Det 4 Korat RTAFB, Thailand Det 5 Udorn RTAFB, Thailand 3 Det 12 U-Tapao Royal Thai Naval Base (RTNB), Thailand m Det 14 Tan Son Nhut...1UPOR~ NAKHON PANOJM OL-B RCC 40ARRS Det 5, 3ARRG THAILAND KORAT * umm B NN O RU Det ANRG FOL, -0-AA S OL-A RCC ; SVN U U-APAOCAMBODIA Det RRG BIEN HOA

Propuesta Para La Creacion Del Cuerpo De Ingenieros De Las Fuerzas Armadas De Honduras. Proposal for the Creation of a Corps of Engineers in the Honduran Armed Forces

DTIC Science & Technology

2016-05-26

en cuyo caso, la publicación posterior o venta de este manuscrito con derecho de autor no es permisible. ii REPORT DOCUMENTATION PAGE Form...situación actual en Honduras, vemos que unidades de ingeniería han ejecutado obras públicas que han generado grandes beneficio en algunas regiones...microeconómico, esto es en la habilidad de las firmas para producir bienes y servicios eficientemente y sostener retornos al capital en beneficio de la

Stability in Aerospace Systems (La Stabilite dans Les Systemes Aerospatiaux)

DTIC Science & Technology

1993-02-01

collect&e); lois dc contrt~lc en Vol en atmosphý,es tr~s turbulentes; crit~res. b) Contr6le de 1V6coulement autour des ailes et du fuselage. Cz et Cx...On voit quAh beaucoup d𔄀gards, et bien plus quo rechercho des regles do "chaos de~terministo". d’autres secteurs ; dlactivitA, l’aironautiquc a db et...innovatrices par le risque de converger vers one solution qui nest pas ki rapport a celles basees sur Ia loi dite "en er", bonne do fait de Ia non

Modelisation de la diffusion sur les surfaces metalliques: De l'adatome aux processus de croissance

NASA Astrophysics Data System (ADS)

Boisvert, Ghyslain

Cette these est consacree a l'etude des processus de diffusion en surface dans le but ultime de comprendre, et de modeliser, la croissance d'une couche mince. L'importance de bien mai triser la croissance est primordiale compte tenu de son role dans la miniaturisation des circuits electroniques. Nous etudions ici les surface des metaux nobles et de ceux de la fin de la serie de transition. Dans un premier temps, nous nous interessons a la diffusion d'un simple adatome sur une surface metallique. Nous avons, entre autres, mis en evidence l'apparition d'une correlation entre evenements successifs lorsque la temperature est comparable a la barriere de diffusion, i.e., la diffusion ne peut pas etre associee a une marche aleatoire. Nous proposons un modele phenomenologique simple qui reproduit bien les resultats des simulations. Ces calculs nous ont aussi permis de montrer que la diffusion obeit a la loi de Meyer-Neldel. Cette loi stipule que, pour un processus active, le prefacteur augmente exponentiellement avec la barriere. En plus, ce travail permet de clarifier l'origine physique de cette loi. En comparant les resultats dynamiques aux resultats statiques, on se rend compte que la barriere extraite des calculs dynamiques est essentiellement la meme que celle obtenue par une approche statique, beaucoup plus simple. On peut donc obtenir cette barriere a l'aide de methodes plus precises, i.e., ab initio, comme la theorie de la fonctionnelle de la densite, qui sont aussi malheureusement beaucoup plus lourdes. C'est ce que nous avons fait pour plusieurs systemes metalliques. Nos resultats avec cette derniere approche se comparent tres bien aux resultats experimentaux. Nous nous sommes attardes plus longuement a la surface (111) du platine. Cette surface regorge de particularites interessantes, comme la forme d'equilibre non-hexagonale des i lots et deux sites d'adsorption differents pour l'adatome. De plus, des calculs ab initio precedents n'ont pas reussi a confirmer la forme d'equilibre et surestiment grandement la barriere. Nos calculs, plus complets et dans un formalisme mieux adapte a ce genre de probleme, predisent correctement la forme d'equilibre, qui est en fait due a un relachement different du stress de surface aux deux types de marches qui forment les cotes des i lots. Notre valeur pour la barriere est aussi fortement diminuee lorsqu'on relaxe les forces sur les atomes de la surface, amenant le resultat theorique beaucoup plus pres de la valeur experimentale. Nos calculs pour le cuivre demontre en effet que la diffusion de petits i lots pendant la croissance ne peut pas etre negligee dans ce cas, mettant en doute la valeur des interpretations des mesures experimentales. (Abstract shortened by UMI.)

Etude theorique des fluctuations structurales dans les composes organiques a dimensionnalite reduite

NASA Astrophysics Data System (ADS)

Dumoulin, Benoit

Les systemes a dimensionnalite reduite constituent maintenant une branche entiere de la physique de la matiere condensee. Cette derniere s'est developpee rapidement au cours des dernieres annees, avec la decouverte des materiaux organiques qui presentent, justement, des proprietes physiques fortement anisotropes. Cette these presente une etude en trois parties de plusieurs composes organiques qui, bien que tres differents du point de vue de leurs compositions chimiques et de leurs proprietes physiques a haute temperature, subissent tous une instabilite structurale a tres basse temperature. De plus, dans chacun des cas, l'instabilite structurale est precedee d'un important regime fluctuatif a partir duquel les proprietes physiques changent de maniere significative. Notre etude suit un ordre chronologique inverse puisque nous nous attardons en premier lieu au cas de composes recemment decouverts: les composes de la famille des (BCPTTF)2X (X = PF6 , AsF6). Ces derniers sont des isolants magnetiques a la temperature ambiante et subissent une instabilite structurale de type spin-Peierls a une temperature appelee TSP. En particulier, nous nous interessons a l'etude des proprietes physiques de ces systemes dans le regime fluctuatif, qui precede cette instabilite. Notre etude theorique nous permet de comprendre en detail comment ces systemes s'approchent de l'instabilite struturale. Dans la seconde partie de cette these, nous etudions le regime fluctuatif (pre-transitionnel) observe experimentalement dans le compose de (TMTTF)2PF6. Ce compose organique, dont la structure s'apparente aux sels de Bechgaard, subit une instabilite de type spin-Peierls a une temperature T SP = 19K. Bien que ce compose possede la particularite d'etre un bon conducteur a la temperature ambiante, il subit une transition de type Mott-Hubbard a une temperature Trho ≈ 220K et devient alors un isolant magnetique, analogue aux composes de la famille des (BCPTTF)2X. Le regime fluctuatif precedant l'instabilite spin-Peierls apparait ensuite vers 60K. Notre etude theorique montre qu'un modele d'electrons en interaction de type "g-ologie" avec possibilite de processus umklapp permet de bien rendre compte des proprietes physiques de ce systeme. Finalement, la troisieme partie de cette these porte sur l'etude des premiers composes organiques quasi-unidimensionnels a avoir ete synthetises: les composes de la famille du TTF-TCNQ. Notre etude theorique des instabilites structurales que presentent ces composes n'est evidemment pas la premiere. L'originalite de cette derniere est qu'elle tient compte des fortes interactions entre les electrons, presentent dans ces composes. Pour tenir compte de telles interactions, nous avons choisi la formulation "liquide de Luttinger" qui nous permet de mieux traiter ce regimne dit de couplage fort.

Étude spectrale d'un micro-plasma d'implosion X-pinch

NASA Astrophysics Data System (ADS)

Aranchuk, L. E.

2006-12-01

Le pincement magnétique de type X-pinch permet de réaliser un micro-plasma chaud et dense bien positionné dans l'espace qui présente une applicabilité pour la radiographie X d'objets peu denses de petite taille. Une batterie de diagnostics ayant tous une résolution spectrale a été installée autour d'un X-pinch alimenté par un banc de condensateurs rapide. Les résultats présentés portent sur la taille de la source intégrée en temps, sur la durée d'impulsion et sur le spectre d'émission X. Des exemples de radiographie confortent la détermination de la taille. Des spectres à haute résolution spectrale intégrés en temps (1 à 3 keV) montrent que les ions multichargés présents dans le plasma (Al hydrogénoïde et héliumoïde, Cu et Mo néonoïdes) sont les mêmes que dans les X-pinches alimentés par des générateurs pulsés bien plus puissants. Une spectroscopie large bande à haute résolution temporelle, basée sur des détecteurs innovants, a permis de mettre en évidence une émission dure sub-nanoseconde et de chiffrer la puissance spectrale instantanée et l'énergie X émise entre 20eV et 8keV. La puissance maximale peut dépasser 1GW pendant 0,4-0,7ns. La source émet 10 à 30J pendant 100-150ns en dessous de 400eV.

Les effets bénéfiques de l'accompagnement du patient cancéreux: particularités du Maroc

PubMed Central

Lkhoyaali, Sihame; Aitelhaj, Meryem; Errihani, Hassan

2014-01-01

Au Maroc la majorité des patients âgés cancéreux sont pris en charge par leurs proches l'accompagnement des patients est à l'origine de conséquences émotionnelles psychiques et financières négatives mais en contrepartie il est à l'origine de plusieurs effets bénéfiques à savoir un resserrement des liens familiaux, une surestime du soi et il est la source d'un bien-être affectif et spirituel qui permet de faire face à la maladie. PMID:25722766

Un cosmologiste oublié: Jean Henri Lambert

NASA Astrophysics Data System (ADS)

Débarbat, Suzanne; Lévy, Jacques

Si les travaux de Kepler ont eu une large influence sure les progrès réalisés en astronomie au cours du 17e siècle, le Siècle de lumières a vu apparaître de nouvelles conceptions. La court vie de J.H. lambert s'inscrit dans le 18e siècle. Il s'agit d'un nom bien connu dans différents domaines (photométrie, projections cartographiques, mathématiques appliquées, etc.); mais il n'est guàre mentionné en cosmologie, alors que Lambert y a fourni une contribution originale offrant quelques suprenantes anticipations...

Expeditionary Air Base Defense: Historical Cases and Modern Implications

DTIC Science & Technology

2017-06-01

and redesigning is based on peacetime criteria. Seventh Air Force Base Defense Study Group, 1967 The Dien Bien Phu case study offered many...Freedom in 2004-2012. Analysis of these case studies reveals several themes of expeditionary air base defense in the modern era, including: the...IRAQ AND AFGHANISTAN……………………….48 6 ANALYSIS OF CASE STUDIES ………………………………………………62 7 CONCLUSIONS ……………………………………………………………..…67

La Vie Politique sous la Restauration a Travers ’Le Rouge et le Noir’ de Stendahl (The Political Life during the Restauration as Depicted in Le Rouge et le Noir by Stendahl)

DTIC Science & Technology

1989-01-01

de la classe dirigeante est le clerg6. M. le vicaire de Frilair est le bras droit de l ’&veque dle Besangon et...sympathique effort de recherche ;la documentation contribue bien A 6clairer lanalyse. INTERPRETATION: L 𔄀tude des aspects de la vie politique sous la...References Ouvrages consultes AXccesion For NTIS CRA&I DTIC TA9 El Unanno ’-,’ 1 : By 442.-. - L -- A, _ojes Aof -d/or * A- Dans l’L*tude des

Development of a NURBS-Based Computational Method for the VAST Finite Element Program: Phase 2

DTIC Science & Technology

2008-10-01

de conception assistée par ordinateur (CAO). Cette méthode présente aussi l’avantage de préserver la géométrie exacte des structures analysées et...propres et non linéaires portant sur les réactions plastiques après effondrement de structures à enveloppe mince. Au cours de ces travaux, une vérification...aux structures, a été développée récemment en s’inspirant de la conception assistée par ordinateur (CAO). Bien que cette méthode partage plusieurs

Project CHECO Southeast Asia Report. Rolling Thunder

DTIC Science & Technology

1966-03-28

interdiction pro- grams. In February the USAF bad 18 F-100 ’s and 18 F-105 ’s at ))a Nang, 18 F-105’s at Korat , 18 F-lOO’s at Takhli and eight B-57’s at Bien...force back to its November 1964 strength. In Thailand, the F-105 squadron at Korat was joined in early February by two more squadrons of F-l.05’s, one...135) Ubon 45th Tactical Figbter Squadron Takhli 35th ’l."FS (F-105~ 563rd ’fFS (F-105 Korat 357th ’l."FS (F-105) 12th TJ’S (F-105) Udorn 15th

Health education and agency: a comprehensive program for young women in the Mixteca region of Mexico.

PubMed

Venguer, Tere; Pick, Susan; Fishbein, Martin

2007-08-01

The Si yo estoy bien, mi familia también ("If I am OK then so is my family") is a health and agency education program that was provided over a period of 3 years to 39,000 rural women in Oaxaca, Mexico. The purpose of the article is to describe the development, implementation and evaluation of the program. The theoretical rationale and strategy of this intervention are described, as well as the construction of the program and the implementation. Moreover, an evaluation of the various stages of the program is provided, to enable an assessment of its efficacy, and the scope for dissemination and scaling up.

Traitement chirurgical des métastases osseuses rachidiennes

PubMed Central

Saqui, Abderrazzak El; Aggouri, Mohamed; Benzagmout, Mohamed; Chakour, Khalid; Chaoui, Mohamed El Faiz

2017-01-01

La chirurgie de la métastase est une chirurgie palliative le plus souvent, surtout au niveau du rachis de par sa localisation anatomique. Cette chirurgie doit être bien préparée pour que les suites soient simples et que le traitement adjuvant soit fait dans les meilleurs délais. La stratégie thérapeutique doit être systématiquement prise en réunion de concertation pluridisciplinaire (RCP). Le principal risque de la localisation rachidienne est neurologique, c'est pourquoi cette chirurgie doit être préventive le plus souvent. Elle a pour objectif principal d'améliorer la qualité de vie. PMID:28533876

A Systems Analysis View of the Vietnam War 1965 - 1972. Volume 3. Viet Cong - North Vietnamese Operations

DTIC Science & Technology

1975-02-18

a plot shows, the hardest hit areas for both RP and PF forces are the following: 1. Coastal I CTM - 29% of the enem incidents against BF and PT 0 X.d...32410. 37 10 1 Long hanh 2018 5 17 2 GoCog 201 15 5 1 ThaocT Tz 2789 31 14 1 X"eoa hoo6 50 26 1 Bien Ho 3115 29 3 ienPhong 3235 17 4 1Tay Ninh 3712 16...indicate how nich advantage the enem gains when he can initiate actions at a time and place- of his choosing; only 3-9% of his total KIA resulted from such

Atelier d'astronomie X

NASA Astrophysics Data System (ADS)

Ballet, J.; Barret, D.

2001-01-01

L'astronomie X connait aujourd'hui une de ses périodes les plus actives et les plus fastes, après le lancement de Chandra et XMM-Newton, et alors que Beppo SAX et Rossi XTE sont toujours en orbite. L'extraordinaire complémentarité de ces satellites est telle que leur domaine d'utilisation est extrêmement vaste, couvrant des étoiles jeunes aux toujours énigmatiques sursauts γ, en passant bien entendu par les trous noirs accrétants dans les binaires X ou dans les noyaux actifs de galaxies. L'atelier fut organisé selon quatre thèmes les étoiles, les phénomènes explosifs, les binaires X et les noyaux actifs de galaxies. Les résultats qui y furent présentés, pour chacun de ces thèmes témoignent de la superbe qualité des données obtenues. En particulier l'accès à la haute résolution spectrale (réseaux) en rayons X marque un pas important. Les présentations plus théoriques ont montré que parallèlement des progrès significatifs sont réalisés dans la physique de l'accrétion autour des objets compacts. Les actes de l'atelier donnent un panorama représentatif des progrès réalisés récemment par l'astronomie X, aussi bien du point de vue observationnel que théorique. Ces actes de colloque sont aussi l'occasion de rappeler l'historique et ce que furent les activités scientifiques de notre GdR au moment ou il doit s'intègrer au GdR PCHE et au PNPS. Enfin, pour toutes informations complémentaires concernant l'atelier: http://www.cesr.fr/~barret/adj/vg.html Ce site donne accès en particulier à la plupart des présentations (transparents).

PubMed

Camino Willhuber, Gaston Oscar; Guzman Mentesana, Gustavo; Baez, Alejandra; Lo Presti, Silvina; Bazán, Carolina; Strauss, Mariana; Fretes, Ricardo; Paglini-Oliva, Patricia Adriana; Rivarola, Hector Walter

2017-09-08

 ResumenIntroducción: la actividad mitocondrial es esencial para el músculo cardíaco y esquelético. La relación entre la disfunción mitocondrial y diferentes condiciones cardiovasculares ha sido bien descrita. El tratamiento farmacológico de la insuficiencia cardíaca implica diferentes medicamentos como: inhibidores de la enzima convertidora de la angiotensina, bloqueadores B-adrenérgicos, glucósidos digitálicos y diuréticos. Los beneficios clínicos del tratamiento son claros, sin embargo, el papel de estos fármacos en el metabolismo mitocondrial no esta bien establecido.Objetivo del estudio: El objetivo de nuestro estudio fue analizar las características estructurales y funcionales de las mitocondrias del músculo cardíaco y esquelético en ratones tratados con fármacos habitualmente utilizados para la insuficiencia cardíaca y compararlo con un grupo control.Métodos: Veinticinco ratones albinos divididos en cinco grupos fueron tratados con la medicación para insuficiencia cardíaca durante 30 días (grupo I a IV). 30 días después del tratamiento se sacrificaron, el corazón y el músculo esquelético se analizaron y se compararon con un grupo control (V).Resultados: La actividad enzimática se incrementó ligeramente en los grupos tratados con medicamentos insuficiencia cardiaca en comparación con el grupo control (p> 0,05). morfología mitocondrial se modificó significativamente en los grupos tratados en comparación con el grupo control, además, el área mitocondrial fue significativamente mayor en los grupos tratados, tanto en el músculo cardíaco y estriado.Conclusiones: Concluimos que la medicación insuficiencia cardíaca podría producir modificaciones en la función mitocondrial; creemos que las mitocondrias pueden mantener la actividad enzimática mediante el aumento de tamaño y modificación de la morfología.

Methodes d'amas quantiques a temperature finie appliquees au modele de Hubbard

NASA Astrophysics Data System (ADS)

Plouffe, Dany

Depuis leur decouverte dans les annees 80, les supraconducteurs a haute temperature critique ont suscite beaucoup d'interet en physique du solide. Comprendre l'origine des phases observees dans ces materiaux, telle la supraconductivite, est l'un des grands defis de la physique theorique du solide des 25 dernieres annees. L'un des mecanismes pressentis pour expliquer ces phenomenes est la forte interaction electron-electron. Le modele de Hubbard est l'un des modeles les plus simples pour tenir compte de ces interactions. Malgre la simplicite apparente de ce modele, certaines de ses caracteristiques, dont son diagramme de phase, ne sont toujours pas bien etablies, et ce malgre plusieurs avancements theoriques dans les dernieres annees. Cette etude se consacre a faire une analyse de methodes numeriques permettant de calculer diverses proprietes du modele de Hubbard en fonction de la temperature. Nous decrivons des methodes (la VCA et la CPT) qui permettent de calculer approximativement la fonction de Green a temperature finie sur un systeme infini a partir de la fonction de Green calculee sur un amas de taille finie. Pour calculer ces fonctions de Green, nous allons utiliser des methodes permettant de reduire considerablement les efforts numeriques necessaires pour les calculs des moyennes thermodynamiques, en reduisant considerablement l'espace des etats a considerer dans ces moyennes. Bien que cette etude vise d'abord a developper des methodes d'amas pour resoudre le modele de Hubbard a temperature finie de facon generale ainsi qu'a etudier les proprietes de base de ce modele, nous allons l'appliquer a des conditions qui s'approchent de supraconducteurs a haute temperature critique. Les methodes presentees dans cette etude permettent de tracer un diagramme de phase pour l'antiferromagnetisme et la supraconductivite qui presentent plusieurs similarites avec celui des supraconducteurs a haute temperature. Mots-cles : modele de Hubbard, thermodynamique, antiferromagnetisme, supraconductivite, methodes numeriques, larges matrices

Les masques trompeurs de la bipolarité: étude de 100 cas

PubMed Central

Nabih, Fadoua Oueriagli; Benali, Abdesslam; Adali, Imane; Manoudi, Fatiha; Asri, Fatima

2015-01-01

Le trouble bipolaire (TB) est une pathologie dont la prévalence est estimée à 1-2%. Le diagnostic précoce du trouble constitue un enjeu thérapeutique majeur. L'objectif de ce travail est de déterminer les différents diagnostiques attribués aux patients bipolaires avant de recevoir le diagnostic adéquat et de préciser le délai moyen du retard diagnostique. C'est une étude descriptive transversale portant sur 100 patients atteints de TB, inclus selon les critères du DSM V, qui ont été vus en consultation ou bien hospitalisés dans le service de psychiatrie de l'hôpital Militaire Avicenne de Marrakech, durant une période de deux ans. L’âge moyen des patients était de 29,5 ans avec une prédominance masculine (80%). 40% de nos patients ont reçu au début un autre diagnostic que celui du TB et le premier diagnostic retenu était celui de l’épisode dépressif majeur dans 36% des cas, suivi de l'accès psychotique aigu dans 28% des cas, la schizophrénie dans 16,8% et le trouble de personnalité dans 10,2%. Le délai moyen du retard diagnostic était de 64 mois. 50% des patients ayant reçu un autre diagnostic avaient consulté au moins un psychiatre et 60% des patients avaient été hospitalisés au moins une fois avant le diagnostic du TB. Les errances diagnostiques du TB sont bien établies, conduisant forcément à un retard de prise en charge adéquate. Ces données devraient alerter les psychiatres pour favoriser un meilleur dépistage de la manie et de l'hypomanie qui restent les éléments clé du diagnostic du TB. PMID:26587161

'I do want to ask, but I can't speak': a qualitative study of ethnic minority women's experiences of communicating with primary health care professionals in remote, rural Vietnam.

PubMed

McKinn, Shannon; Duong, Thuy Linh; Foster, Kirsty; McCaffery, Kirsten

2017-10-30

Ethnic minority groups in Vietnam experience economic, social and health inequalities. There are significant disparities in health service utilisation, and cultural, interpersonal and communication barriers impact on quality of care. Eighty per cent of the population of Dien Bien Province belongs to an ethnic minority group, and poor communication between health professionals and ethnic minority women in the maternal health context is a concern for health officials and community leaders. This study explores how ethnic minority women experience communication with primary care health professionals in the maternal and child health setting, with an overall aim to develop strategies to improve health professionals' communication with ethnic minority communities. We used a qualitative focused ethnographic approach and conducted focus group discussions with 37 Thai and Hmong ethnic minority women (currently pregnant or mothers of children under five) in Dien Bien Province. We conducted a thematic analysis. Ethnic minority women generally reported that health professionals delivered health information in a didactic, one-way style, and there was a reliance on written information (Maternal and Child Health handbook) in place of interpersonal communication. The health information they receive (both verbal and written) was often non-specific, and not context-adjusted for their personal circumstances. Women were therefore required to take a more active role in interpersonal interactions in order to meet their own specific information needs, but they are then faced with other challenges including language and gender differences with health professionals, time constraints, and a reluctance to ask questions. These factors resulted in women interpreting health information in diverse ways, which in turn appeared to impact their health behaviours. Fostering two-way communication and patient-centred attitudes among health professionals could help to improve their communication with ethnic minority women. Communication training for health professionals could be included along with the nationwide implementation of written information to improve communication.

Signes cliniques rencontrés chez l'enfant malnutri dans un milieu minier: cas de la ville de Lubumbashi et ses environs

PubMed Central

Musimwa, Aimée Mudekereza; Kanteng, Gray Wakamb; Kitoko, Hermann Tamubango; Luboya, Oscar Numbi

2016-01-01

Introduction La malnutrition reste à ce jour un problème majeur de santé publique, notamment dans les pays en voie de développement. Cette étude a eu pour objectif de déterminer les signes cliniques observés chez l'enfant mal nourri, admis dans une unité de prise en charge. Méthodes Il s'agit d'une étude descriptive transversale, effectuée de juillet 2013 à décembre 2014. 311 cas ont été colligés (182 malnutris et 129 biens nourris), par échantillonnage exhaustif, avec un dépistage actif des enfants malnutris et biens nourris. Le diagnostic est fait cliniquement associé à l'anthropométrie. Résultats Les signes les plus enregistrés chez les enfants malnutris étaient dominés par la toux ou pneumopathie dans 42,50%, la gastroentérite dans 38,55%, les lésions dermatologiques ont présenté 22,91% de cas, la fièvre dans 22,35% de cas, 19,0% des enfants ont présenté les œdèmes, 8,38% d'enfants ont présenté la pâleur, enfin hépatomégalie et splénomégalie sont les signes les moins fréquents avec respectivement 1,68% et 2,89%. Tandis que les enfants en bonne état nutritionnel ont présenté plus la splénomégalie et la fièvre qui seraient liés au paludisme. Conclusion Les enfants malnutris vivant dans un milieu minier présentent une symptomatologie qui ne pas différents de autres enfants mal nourris à l'exception de l'hépatomégalie et splénomégalie qui sont très rare chez nos mal nourris. PMID:27642407

Problématique de la prise en charge des cancers du sein au Sénégal: une approche transversale

PubMed Central

Gueye, Serigne Modou Kane; Gueye, Mamour; Coulbary, Sophie Aminata; Diouf, Alassane; Moreau, Jean Charles

2016-01-01

L’heure où les thérapeutiques innovantes se multiplient dans le cancer du sein, des pays moins nantis comme le Sénégal accusent encore un retard considérable dans la prise en charge globale de ce type de cancer. Au Sénégal, même si la prise en charge des cancers du sein avancés est actuellement bien codifiée, les résultats en terme de survie et de morbidités sont encore médiocres vu les retards diagnostiques et les traitements mutilants, parfois onéreux et mal tolérés, devenus nécessaires. Pour ces cancers avancés, les défis qui restent à relever résident dans l’érection de centres de soins palliatifs et le développement de la pluridisciplinarité pour améliorer la qualité de vie et l’accompagnement des malades. En revanche, pour les cancers infracliniques ou potentiellement guérissables, les défis restent immenses car il s’agira de les dépister, de bien les localiser et les diagnostiquer aussitôt (biopsie écho guidée ou stéréotaxique) mais également de les opérer de façon précise et entière (repérage – exérèse in sano et radiographie de pièce opératoire) tout en limitant les complications comme celles du curage classique (biopsie du ganglion sentinelle). Il s’agit là autant d’objectifs auxquels nos structures de santé ne sont pas toujours préparées. Cette mise au point est une analyse situationnelle sur les écueils contextuels qui grèvent encore la prise en charge globale des cancers du sein au Sénégal. PMID:28154696

Nuevos fenómenos en erupciones cometarias

NASA Astrophysics Data System (ADS)

Silva, A.

Se discuten aquí tres procesos físicos novedosos encontrados en la actividad de cometas: 1) El rol de una distribución de granos de hielo como fuente extendida de H2O en la coma, 2) El efecto de una discontinuidad en el plasma cometario, llamada Cometopausa, sobre la excitación del radical OH , y 3) La actividad por erupciones a grandes distancias heliocéntricas (r > 5 AU). Con respecto a 1) y 2), se presentan modelos que ajustan bien con las observaciones. En cuanto a 3), se presentan explicaciones posibles al fenómeno, y se trata el interesante caso de Chirón 2060, basándose en observaciones propias tomadas desde el CASLEO y datos anteriores.

Brulure par Plaque de Bistouri Electrique: a Propos de Quatre Cas

PubMed Central

Khales, A.; Achbouk, A.; Belmir, R.; Cherkab, L.; Ennouhi, M.A.; Ababou, K.; Ihrai, H.

2010-01-01

Summary La brûlure par plaque de bistouri électrique est un accident rare mais grave par la profondeur de la lésion et par sa localisation, surtout quand qu’elle survient dans un contexte chirurgical dont le vécu reste difficile de la part du malade et du chirurgien. Cette brûlure bien que imprévisible reste grave par la profondeur et la localisation de la brûlure et par sa survenue dans un contexte opératoire, chez des patients malades. La prise en charge de la brûlure doit se faire en milieu spécialisé. La prévention reste le seul moyen d’éviter ce type d’accident. PMID:21991216

Processus ultra-rapides associés à la dynamique d'émission de la protéine GFP

NASA Astrophysics Data System (ADS)

Didier, P.; Guidoni, L.; Schwalbach, G.; Bigot, J.-Y.

2002-06-01

La protéine GFP (Green Fluorescent Protein) est un marqueur très efficace, utilisable en milieu vivant. La spectroscopie femtoseconde est particulièrement bien adaptée pour comprendre les mécanismes d'émission de cette protéine, étant donné la rapidité des processus de transfert mis en jeu. Nous-présentons des résultats sur la dynamique spectro-temporelle d'émission du mutant GFPuv résolue à l'échelle de la centaine de femtosecondes. Une transition Raman à 3300 cm^{-1} ainsi que la dynamique d'etablissement du gain avec un temps caractéristique d'environ 1.5 ps ont été mis en évidence.

Investigación del USGS sobre el ecosistema de arrecifes de coral en el Atlántico

USGS Publications Warehouse

Kuffner, Ilsa B.; Yates, Kimberly K.; Zawada, David G.; Richey, Julie N.; Kellogg, Christina A.; Toth, Lauren T.; Torres-Garcia, Legna M.

2015-10-23

Los arrecifes de coral son estructuras sólidas, biomineralizadas que protegen comunidades costeras actuando como barreras protectoras de peligros tales como los huracanes y los tsunamis. Estos proveen arena a las playas a través de procesos naturales de erosión, fomentan la industria del turismo, las actividades recreacionales y proveen hábitats pesqueros esenciales. La conti-nua degradación mundial de ecosistemas de arrecifes de coral está bien documentada. Existe la necesidad de enfoque y organización de la ciencia para entender los procesos complejos físicos y biológicos e interacciones que están afectando el estado de los arrecifes coralinos y su capacidad para responder a un entorno cambiante.

Impact de la varicocèle sur le volume testiculaire et les paramètres spermatiques

PubMed Central

Benazzouz, Mohamed Hicham; Essatara, Younes; El Sayegh, Hachem; Iken, Ali; Benslimane, Lounis; Nouini, Yassine

2014-01-01

Introduction La varicocèle est une pathologie masculine fréquente dont l'incidence est encore plus importante dans dans la population des hommes infertiles. Si ses mécanismes sont à ce jour incomplètement expliqués il semble acquis que la varicocèle peut être associée a une dysfonction testiculaire avec diminution du volume testiculaire et de la concentration en spermatozoïde de l’éjaculat. Méthodes Dans un premier temps nous exposons les résultats d'une étude rétrospective sur 5 ans (de Mars 2009 à Mars 2014), réalisée au service d'urologie A de l'hôpital Ibn Sina de Rabat et ayant comme objectif d’évaluer l'impact de la varicocèle palpable sur le volume testiculaire et les paramètres spermatiques. Tous les patients inclus dans notre étude avaient une varicocèle palpable. Dans un deuxième temps, et à travers une revue de la littérature nous discutons l'impact du traitement de la varicocèle sur la fertilité. Résultats 39 patients ont été inclus dans notre étude. L’âge moyen était de 29,71 ans et la varicocèle siégeait dans 89,74% des cas du coté gauche. Une atrophie testiculaire homolatérale à la varicocèle était retrouvée dans 7% des cas alors que des anomalies du spermogramme se voyaient dans 69,23% des cas. Conclusion L'impact de la varicocèle sur l'altération des paramètres spermatiques a été clairement établi bien que sa physio pathogénie ne soit pas bien élucidée. Le traitement chirurgical de la varicocèle semble indiqué chez les hommes infertiles présentant une varicocèle clinique et une altération significative du sperme. PMID:25918574

[Not Available].

PubMed

MIján de la Torre, Alberto

2016-06-03

El síndrome de caquexia cancerosa es responsable de la muerte de un número significativo de pacientes con cáncer. Se caracteriza por la presencia de una ingesta reducida, con inflamación sistémica y un metabolismo alterado. Los enfermos presentan característicamente una progresiva pérdida de peso y de masa muscular, junto a deterioro funcional. La pérdida muscular se debe a la combinación de reducción de la síntesis proteica con aumento de su degradación. Ello conduce tanto a un acortamiento como a una reducción en el área de la fibra muscular. Asimismo, existen datos que apoyan que selectivamente algunos de los tipos de fibra muscular se ven más afectados. Es necesario definir bien los valores de corte de sarcopenia para diagnosticar la pérdida muscular y existen diferentes métodos. El sistema de la ubiquitina-proteasoma parece desempeñar un papel predominante en la degradación de la proteína miofibrilar. La tendencia a perder masa muscular en los pacientes con caquexia cancerosa parece estar asociada a la activación de señales catabólicas por citoquinas proinflamatorias, así como por productos tumorales del tipo factor inductor de proteólisis. En referencia a los factores pronósticos, el riesgo de muerte está bien documentado en pacientes con sarcopenia y, especialmente, en aquellos con obesidad asociada a la sarcopenia. Asimismo, se ha establecido una relación directa entre la pérdida intensa de masa muscular y la supervivencia en pacientes con diferentes tipos de tumores del tipo de cáncer de páncreas, pulmón, tracto biliar o cáncer colorrectal. Respecto de la terapia en el síndrome de caquexia cancerosa, es factible que requiera tratamiento con varios grupos combinados que incluyan, junto al soporte nutricional, fármacos orexígenos, con efecto anabólico y antinflamatorio, asociados a intervenciones que estimulen el ejercicio físico.

Resonancias en la región trans-neptuniana

NASA Astrophysics Data System (ADS)

Gallardo, T.; Ferraz-Mello, S.

La expansión de la órbita del planeta Neptuno en la etapa de acreción del Sistema Solar exterior (Fernández e Ip 1984, 1996) parece ser un mecanismo eficiente para la captura de planetesimales en las resonancias exteriores con Neptuno (Malhotra 1995). Por otro lado, los estudios dinámicos realizados por varios autores indican que las resonancias son regiones de evolución estable, en contraste con el comportamiento caótico del resto de la región trans-neptuniana. Por estas razones, y si bien los datos observacionales son todavía muy limitados, se supone que los objetos descubiertos se encuentran en alguna de esas resonancias. En esta comunicación presentamos un estudio analítico y numérico de las principales resonancias exteriores con Neptuno.

Grossesses extra utérines successives et bilharziose tubaire chez une touriste française

PubMed Central

Laroche, Justine; Mottet, Nicolas; Malincenco, Marianna; Gay, Catherine; Royer, Pierre Yves; Riethmuller, Didier

2016-01-01

La bilharziose est la seconde endémie parasitaire mondiale et ses atteintes génito urinaires sont bien décrites. Les grossesses ectopiques (GEU) sur obstruction tubaire par les œufs de bilharziose sont rapportées dans les populations africaines. La bilharziose affecte aussi les voyageurs mais l'atteinte de l'appareil génital féminin est plus rare. Nous rapportons un cas exceptionnel de deux GEU successives sur bilharziose tubaire chez une patiente d'origine Française, sept ans après un voyage touristique au Mali, la première découverte sur pièce de salpingectomie et la seconde ayant nécessité une salpingotomie controlatérale avec une injection de méthotrexate, deux mois plus tard. PMID:27200124

Come bien, camina y no se preocupe--eat right, walk, and do not worry: selective biculturalism during pregnancy in a Mexican American community.

PubMed

Laganá, Kathleen

2003-04-01

Mexican American childbearing women appear to offer a healthy model for pregnancy. However, statistics suggest that they may be at increased risk for poor birth outcome as they acculturate to a U.S. lifestyle. An ethnographic study in Watsonville, California, examined the influence of acculturation on pregnancy beliefs and practices of 29 Mexican American childbearing women. Data from formal semi-structured interviews were submitted to content analysis. During pregnancy, women balanced well-documented, traditional Mexican cultural beliefs with the individualistic beliefs common to Anglo-Americans. Selective biculturalism emerged as a protective approach to stress reduction and health promotion. Stress reduction interventions as part of routine prenatal care have potential benefit for all pregnant women. Future research on cultural barriers to family-based social support during pregnancy is needed.

Tuberculose péritonéale pseudo tumorale mimant un cancer ovarien: un diagnostic différentiel important à considérer

PubMed Central

Moukit, Mounir; Fadel, Fatimazahra Ait El; Kouach, Jaouad; Babahabib, Abdellah; Dehayni, Mohammed; Rahali, Driss Moussaoui

2016-01-01

La tuberculose est une maladie infectieuse curable qui peut simuler dans sa localisation péritonéale un cancer ovarien avancé conduisant ainsi à une chirurgie étendue et inutile souvent chez des femmes en âge de reproduction. Nous rapportons un nouveau cas de tuberculose péritonéale pseudo tumorale chez une patiente âgée de 43 ans chez qui le diagnostic d’un cancer ovarien avec carcinose péritonéale avait été suspecté. La laparotomie exploratrice avec examen histologique extemporané ont permis de confirmer le diagnostic de tuberculose péritonéale. La patiente a bien répondu au traitement antituberculeux selon le protocole 2ERHZ/4RH. PMID:28292155

Influence of dissimilatory metal reduction on fate of organic and metal contaminants in the subsurface

NASA Astrophysics Data System (ADS)

Lovley, Derek R.; Anderson, Robert T.

Dissimilatory Fe(III)-reducing microorganisms have the ability to destroy organic contaminants under anaerobic conditions by oxidizing them to carbon dioxide. Some Fe(III)-reducing microorganisms can also reductively dechlorinate chlorinated contaminants. Fe(III)-reducing microorganisms can reduce a variety of contaminant metals and convert them from soluble forms to forms that are likely to be immobilized in the subsurface. Studies in petroleum-contaminated aquifers have demonstrated that Fe(III)-reducing microorganisms can be effective agents in removing aromatic hydrocarbons from groundwater under anaerobic conditions. Laboratory studies have demonstrated the potential for Fe(III)-reducing microorganisms to remove uranium from contaminated groundwaters. The activity of Fe(III)-reducing microorganisms can be stimulated in several ways to enhance organic contaminant oxidation and metal reduction. Molecular analyses in both field and laboratory studies have demonstrated that microorganisms of the genus Geobacter become dominant members of the microbial community when Fe(III)-reducing conditions develop as the result of organic contamination, or when Fe(III) reduction is artificially stimulated. These results suggest that further understanding of the ecophysiology of Geobacter species would aid in better prediction of the natural attenuation of organic contaminants under anaerobic conditions and in the design of strategies for the bioremediation of subsurface metal contamination. Des micro-organismes simulant la réduction du fer ont la capacité de détruire des polluants organiques dans des conditions anérobies en les oxydant en dioxyde de carbone. Certains micro-organismes réducteurs de fer peuvent aussi dé-chlorer par réduction des polluants chlorés. Des micro-organismes réducteurs de fer peuvent réduire tout un ensemble de métaux polluants et les faire passer de formes solubles à des formes qui sont susceptibles d'être immobilisées dans le milieu souterrain. Des études d'aquifères pollués par du pétrole ont montré que des micro-organismes réducteurs de fer peuvent être des agents efficaces pour éliminer les hydrocarbures aromatiques des eaux souterraines dans des conditions anérobies. Des études en laboratoire ont montré que des micro-organismes réducteurs de fer avaient la capacité d'éliminer l'uranium d'eaux souterraines polluées. L'activité de micro-organismes réducteurs de fer peut être stimulée de différentes manières pour augmenter l'oxydation de polluants organiques et la réduction de métaux. Des analyses moléculaires concernant des études de terrain et de laboratoire ont montré que des micro-organismes du genre Geobacter deviennent les membres dominants de la communauté microbienne quand les conditions de réduction en Fe(III) sont réalisées à la suite d'une pollution organique, ou lorsque la réduction en Fe(III) est stimulée artificiellement. Ces résultats laissent penser que des connaissances supplémentaires sur l'écophysiologie des espèces Geobacter devraient aider à une meilleure prédiction de la diminution naturelle des teneurs en polluants organiques dans des conditions anérobies, ainsi qu'à la définition de stratégies de dépollution biologique de pollutions souterraines par les métaux. Algunos microorganismos Fe(III)-reductores son capaces de destruir selectivamente determinados contaminantes orgánicos en condiciones anaerobias, oxidándolos a dióxido de carbono. Otros de estos microorganismos Fe(III)-reductores pueden reducir, bien compuestos clorados, bien una gran variedad de metales, que dejan de ser solubles y se inmovilizan en el subsuelo. Estudios realizados en acuéferos contaminados por petróleo muestran que los microorganismos Fe(III)-reductores pueden ser unos agentes muy eficientes para eliminar los hidrocarburos aromáticos de las aguas subterráneas en condiciones anaerobias, mientras que estudios de laboratorio muestran el potencial de estos microorganismos para eliminar uranio. La actividad de los microorganismos Fe(III)-reductores se puede estimular para conseguir una mayor eficiencia en la oxidación de contaminantes orgánicos y en la reducción de metales. Diversos análisis moleculares en estudios de campo y de laboratorio muestran que los microorganismos del género Geobacter se convierten en los miembros dominantes de la comunidad microbiana cuando se desarrollan condiciones Fe(III)-reductoras, bien como resultado de la contaminación orgánica, bien por estimulación artificial. En consecuencia, se hace necesario un mayor entendimiento de la ecofisiologéa de los microorganismos del género Geobacter para mejorar las predicciones sobre atenuación natural de los contaminantes orgánicos bajo condiciones anaerobias y para el diseño de estrategias de biorremediación del subsuelo en los casos de contaminación por metales.

Textilome abdominal: à propos d'un cas

PubMed Central

Serghini, Issam; El Fikri, Abdelghani; Salim Lalaoui, Jaafar; Zoubir, Mohamed; Boui, Mohammed; Boughanem, Mohamed

2011-01-01

Le textilome est une complication postopératoire très rare mais bien connue. Il peut s'agir d'un corps étranger composé de compresse(s) ou champ(s) chirurgicaux laissés au niveau d'un foyer opératoire. La découverte du textilome abdominale est généralement tardive. L'anamnèse est donc essentielle pour diagnostic vu que la clinique n'est pas concluante. La clinique associe des troubles chroniques du transit à des syndromes sub-occlusifs, le cliché d'abdomen sans préparation est peu contributif. L’échographie est fiable. La tomodensitométrie permet un diagnostic topographique précis. Certaines équipes proposent des explorations par IRM. Nous rapportons un cas de textilome intra abdominale, chez une patiente opérée 6 mois auparavant d'un fibrome utérin. PMID:22355422

Le mécanisme d'Anticythère, une machine bien mystérieuse (1)

NASA Astrophysics Data System (ADS)

Dupas, Jean-Jacques

2016-09-01

A roman shipwreck was discovered in 1900, near the coast of a small island, Antikythera. Among findings was an object full of gears and axles, with inscriptions. It is called Antikythera Mechanism. The interdisciplinary researches, with modern technics (tomography), proved that it is a mechanical calculating device which displays calendars and related astronomical phenomena : egyptian calendar, metonic calendar, callipic calendar, Saros and Exelgimos dials, Games dials, Sun's motion, Moon's motion realized through a remarkable epicycle gears train. The origin of the Mechanism and his designer are unknown. However, it was probably built during the second half of the 2nd century BCE, as part of the tradition of “sphere making” originated by Archimedes. May be, Poseidonios, from Rhodes, would be the designer. Antikythera Mechanism has not delivered all its mysteries yet. A second paper in a following issue of "l'Astronomie" is devoted to the subject.

Œdème vulvaire massif pendant la grossesse: à propos d'un cas

PubMed Central

El Hassani, Moulay Elmehdi; Kassidi, Farid; Benabdejlil, Youssef; Kouach, Jaouad; Moussaoui, Driss Rahali; Dehayni, Mohammed

2014-01-01

L’œdème vulvaire massif est rare pendant la grossesse, mais requiert une attention particulière car il peut se greffer de complications maternelles et fœtales. Il peut être associé à plusieurs pathologies spécifiques ou non spécifiques à la grossesse dont le diagnostic fait appel obligatoirement à un interrogatoire et un examen clinique minutieux, puis à un bilan biologique standard. Le traitement doit être étiologique chaque fois que possible à coté du traitement symptomatique. Cette situation peut nécessiter un accouchement par césarienne. En dehors du risque potentiel de nécrose tissulaire et du risque exceptionnel de décès maternel associé à l’œdème vulvaire massif du post-partum l’évolution est favorable sous traitement bien conduit. PMID:25922627

La reconstruction du sourcil par greffon composite du cuir chevelu: une astuce pour faciliter la technique

PubMed Central

El Omari, Mounia; El Mazouz, Samir; Gharib, Noureddine; EL Abbassi, Abdallah

2015-01-01

Les sourcils jouent un rôle important dans l’équilibre esthétique du visage. Leur reconstruction ou ophriopoïése, après séquelle de brûlure fait partie intégrante du programme de réhabilitation de la face brûlée. Plusieurs techniques ont été décrites. Nous insistons ici sur l'intérêt d'une technique simple, à la portée de tous les chirurgiens, et dont la méthode et les résultats peuvent être améliorés par un dessin bien planifié des zones donneuse et receveuse: la greffe composite prélevée au niveau du cuir chevelu dessinée à l'aide d'un calque du sourcil controlatéral. PMID:26401195

Le leadership en santé et la philosophie appliquée : une ressource essentielle.

PubMed

Fistein, Elizabeth; Malloy, David Cruise

2017-07-01

En qualité de professionnels de la santé, nous sommes déterminés à assurer l'exploitation efficiente et efficace de nos établissements. Les outils dont nous disposons sont les structures bureaucratiques, les règles, les règlements, les politiques et, bien sûr, les mesures. Il n'y a rien de foncièrement pernicieux à avoir des établissements efficients, efficaces et mesurés, mais nous soutenons que l'humanité et l'authenticité manquent cruellement dans cet environnement, au prix d'un travail significatif. Les solutions que nous proposons appartiennent au milieu de la philosophie, et particulièrement au secteur qui repose sur des principes fondamentaux : qu'est-ce qu'une infirmière, qu'est-ce qu'un patient, qu'est-ce qu'un hôpital?

Como Lo Hago Yo: Anomalías del Tubo Neural en Guatemala — Mielomeningocele Unidad de Espina Bífida e Hidrocefalia

PubMed Central

Manucci, Graciela; von Quednow, Enzo

2014-01-01

En Guatemala nacen por añ 786 niños con defectos de tubo neural. Operamos 65 a 70 niños con mielomenigocele por año. Tenemos equipo multidisciplinario. Recomendamos parto por cesárea. Infección antes de la cirugía es un problema mayor. Derivación tardía es un problema. Disecamos la plaqueta con la técnica clásica. Suturamos la plaqueta para restituir la forma de la médula. Corpectomía en casos de cifósis. Hidrocefalía: Operamos el 80% de los niños. Chiari II: Operamos basados en los síntomas, primero nos aseguramos que la válvula funciona bien. Médula anclada: Operamos basados en los síntomas. PMID:24791216

Evolution des syndromes électrocliniques chez des jumeaux dizygotes: de l'enfance à l'adolescence, à propos d'une observation

PubMed Central

Bugeme, Marcellin; Kadiebwe, David Mulumba; Kakoma, Placide Kambola; Mukuku, Olivier

2015-01-01

Les syndromes électrocliniques ont une prédisposition génétique très variable et leur évolution de l'enfance vers l'adolescence ou l’âge adulte n'est pas bien définie. Nous rapportons ici une observation mettant en jeu deux jumeaux dizygotes âgés de 19 ans ayant présenté un phénotype épileptique différent pendant l'enfance (épilepsie avec absences myocloniques et épilepsie-absence de l'enfant) mais une concordance phénotypique (épilepsie à crises généralisées tonico-cloniques prédominantes) au cours de l'adolescence. Cette observation plaide en faveur d'une implication génétique dans l’évolution de ces syndromes électrocliniques. PMID:26090006

Le stress perçu: validation de la traduction d'une échelle de mesure de stress en dialecte marocain

PubMed Central

Loubir, Dalal Ben; Serhier, Zeineb; Otmani, Nada; Housbane, Samy; Mouddene, Naima Ait; Agoub, Mohamed; Othmani, Mohammed Bennani

2015-01-01

Introduction L'article a pour objectif de valider la traduction en dialecte arabe Marocain, de l’échelle du stress perçu « Perceived Stress Scale » chez un large échantillon de la population marocaine. Méthodes Une méthode de traduction et contre traduction en dialecte Marocain a été réalisée pour l’échelle « Perceived Stress Scale » à 10 items. Une étude de type transversale, a été menée par la suite en suivant un échantillonnage par quotas qui a ciblé les individus âgés de plus de 18 ans et appartenant à différentes catégories sociales. Les participants ont répondus aux versions marocaines de l’échelle « Perceived Stress Scale » et d'une version réduite de l’échelle « The Survey of Recent Life Experience ». La validation des qualités métrologiques a été établie en examinant: la fiabilité interne, la fiabilité test-retest, la validité convergente et la structure factorielle. Résultats Cinq cent trente-cinq participants ont répondu aux questionnaires. La version marocaine de l’échelle « Perceived Stress Scale » a présenté une bonne fiabilité interne (α = 0,80) et fiabilité test-retest (CCI= 0,87). D'autant plus, l'analyse en composante principale de l’échelle « Perceived Stress Scale » a permis d'extraire deux facteurs qui ont permis d'expliquer 53,4% de la variance totale. Les deux échelles utilisées étaient assez bien corrélées (r = 0,467, p < 0,01). Conclusion La présente étude a permis d'obtenir une version marocaine de l’échelle « Perceived Stress Scale » avec des propriétés psychométriques satisfaisantes, dont l'utilisation sera d'une grande aide dans la pratique médicale, aussi bien que dans la réalisation des études de recherche qui s'intéressent au stress psychologique. PMID:26587130

A multi-level intervention in subsidized housing sites to increase fruit and vegetable access and intake: Rationale, design and methods of the 'Live Well, Viva Bien' cluster randomized trial.

PubMed

Gans, Kim M; Gorham, Gemma; Risica, Patricia M; Dulin-Keita, Akilah; Dionne, Laura; Gao, Tina; Peters, Sarah; Principato, Ludovica

2016-06-28

Adequate fruit and vegetable (F&V) intake is important for disease prevention. Yet, most Americans, especially low-income and racial/ethnic minorities, do not eat adequate amounts. These disparities are partly attributable to food environments in low-income neighborhoods where residents often have limited access to affordable, healthful food and easy access to inexpensive, unhealthful foods. Increasing access to affordable healthful food in underserved neighborhoods through mobile markets is a promising, year-round strategy for improving dietary behaviors and reducing F&V intake disparities. However, to date, there have been no randomized controlled trials studying their effectiveness. The objective of the 'Live Well, Viva Bien' (LWVB) cluster randomized controlled trial is to evaluate the efficacy of a multicomponent mobile market intervention at increasing F&V intake among residents of subsidized housing complexes. One housing complex served as a pilot site for the intervention group and the remaining 14 demographically-matched sites were randomized into either the intervention or control group. The intervention group received bimonthly, discount, mobile, fresh F&V markets in conjunction with a nutrition education intervention (two F&V campaigns, newsletters, DVDs and cooking demonstrations) for 12 months. The control group received physical activity and stress reduction interventions. Outcome measures include F&V intake (measured by two validated F&V screeners at baseline, six-month and twelve-months) along with potential psychosocial mediating variables. Extensive quantitative and qualitative process evaluation was also conducted throughout the study. Modifying neighborhood food environments in ways that increase access to affordable, healthful food is a promising strategy for improving dietary behaviors among low-income, racial and ethnic minority groups at increased risk for obesity and other food-related chronic diseases. Discount, mobile F&V markets address all the major barriers to eating more F&V (high cost, poor quality, limited access and limited time to shop and cook) and provide a year-round solution to limited access to healthful food in low-income neighborhoods. LWVB is the first randomized controlled trial evaluating the effectiveness of mobile markets at increasing F&V intake. If proven efficacious at increasing F&V consumption, LWVB could be disseminated widely to neighborhoods that have low access to fresh F&V. Clinicatrials.gov registration number: NCT02669472 First Received: January 19, 2016.

Orthodontic Tooth Movement: A Historic Prospective.

PubMed

Will, Leslie A

2016-01-01

The earliest report on orthodontic tooth movement in the English literature was published in 1911. Oppenheim carried out studies on baboons to determine what histologic changes occurred during tooth movement. Reitan and many others carried out research into the nature of tooth movement. The pressure-tension model of tooth movement developed from these studies, whereby the two sides of the tooth responded to forces as if in isolation. A second theory, proposed by Stuteville in 1938, was the hydraulic theory of tooth movement. In this theory, fluid from the vasculature, lymphatic system and intercellular spaces responds to the forces of tooth movement, damping the force and limiting movement. Bien and Baumrind expanded on this theory with their own studies in the 1960s. It is clear that both the pressure-tension and fluid flow concepts have merit, but considerable work needs to be done to ascertain the details so that tooth movement can be managed and controlled. © 2016 S. Karger AG, Basel.

Regularization Paths for Conditional Logistic Regression: The clogitL1 Package.

PubMed

Reid, Stephen; Tibshirani, Rob

2014-07-01

We apply the cyclic coordinate descent algorithm of Friedman, Hastie, and Tibshirani (2010) to the fitting of a conditional logistic regression model with lasso [Formula: see text] and elastic net penalties. The sequential strong rules of Tibshirani, Bien, Hastie, Friedman, Taylor, Simon, and Tibshirani (2012) are also used in the algorithm and it is shown that these offer a considerable speed up over the standard coordinate descent algorithm with warm starts. Once implemented, the algorithm is used in simulation studies to compare the variable selection and prediction performance of the conditional logistic regression model against that of its unconditional (standard) counterpart. We find that the conditional model performs admirably on datasets drawn from a suitable conditional distribution, outperforming its unconditional counterpart at variable selection. The conditional model is also fit to a small real world dataset, demonstrating how we obtain regularization paths for the parameters of the model and how we apply cross validation for this method where natural unconditional prediction rules are hard to come by.

Regularization Paths for Conditional Logistic Regression: The clogitL1 Package

PubMed Central

Reid, Stephen; Tibshirani, Rob

2014-01-01

We apply the cyclic coordinate descent algorithm of Friedman, Hastie, and Tibshirani (2010) to the fitting of a conditional logistic regression model with lasso (ℓ1) and elastic net penalties. The sequential strong rules of Tibshirani, Bien, Hastie, Friedman, Taylor, Simon, and Tibshirani (2012) are also used in the algorithm and it is shown that these offer a considerable speed up over the standard coordinate descent algorithm with warm starts. Once implemented, the algorithm is used in simulation studies to compare the variable selection and prediction performance of the conditional logistic regression model against that of its unconditional (standard) counterpart. We find that the conditional model performs admirably on datasets drawn from a suitable conditional distribution, outperforming its unconditional counterpart at variable selection. The conditional model is also fit to a small real world dataset, demonstrating how we obtain regularization paths for the parameters of the model and how we apply cross validation for this method where natural unconditional prediction rules are hard to come by. PMID:26257587

Couches minces supraconductrices à haute température critique pour l'électronique

NASA Astrophysics Data System (ADS)

Guilloux-Viry, M.; Perrin, A.

1998-08-01

High critical temperature superconductors (HTCS) are very promising for applications in microelectronics due to the control of high quality epitaxial thin films, in spite of a number of specific constraints. Active and passive devices are already available in various laboratories, prooving that applications are actually expected soon. We report here on the interest of HTCS thin films, on preparation processes including materials and substrates choice, and also on characterization methods which are required in order to chek the quality of the samples. Finally some illustrative examples of applications are presented. Les supraconducteurs à haute température critique ouvrent des perspectives prometteuses dans le domaine de l'électronique en raison de la maîtrise de la croissance de films minces de haute qualité cristalline et physique, malgré des difficultés spécifiques. Des dispositifs, aussi bien actifs que passifs, commencent à être réalisés dans divers laboratoires, montrant que des applications peuvent être effectivement envisagées à relativement court terme.

D'une ouverture de la voyelle /epsilon/ en finale absolue en francais quebecois : analyse acoustique et perceptive

NASA Astrophysics Data System (ADS)

Riverin-Coutlee, Josiane

Cette contribution est consacree a l'ouverture du /epsilon/ en finale absolue, un phenomene phonetique repute etre en declin en francais quebecois et caracteristique de locuteurs âges, peu scolarises, issus de milieux populaires et s'exprimant en situation de communication informelle. Une analyse acoustique de 480 voyelles /epsilon/ issues de la parole formelle de 40 jeunes etudiants universitaires originaires des centres urbains de Saguenay et de Quebec revele toutefois que le phenomene est encore bien vivant en francais quebecois et qu'il est plus frequent chez les locuteurs de Saguenay, une tendance validee auditivement par accord inter-juges. Les resultats d'un test de discrimination et d'identification mene aupres de 26 etudiants universitaires originaires de ces deux memes villes indiquent que les auditeurs naifs de Saguenay semblent moins sensibles a la variation et moins enclins a juger de l'origine geographique d'un locuteur a partir de sa prononciation de la voyelle /epsilon/ en fin de mot.

Démarche pour la mise à niveau d’un secteur de soins pharmaceutiques : le cas de l’hémato-oncologie pédiatrique

PubMed Central

Bussières, Jean-François; Robelet, Antoine; Therrien, Roxane; Touzin, Karine

2010-01-01

Contexte : Bien que le concept de pharmacie clinique ait été développé dans les années soixante, il existe une grande variété de programmes et une grande disparité entre les programmes en clinique externe et en hospitalisation, bénéficiant de la présence d’un pharmacien dans un secteur de soins. Objectif: Éprouver une méthode de mise à niveau des secteurs de soins pharmaceutiques en établissement de santé. Méthode : Il s’agit d’une étude descriptive se déroulant au Centre hospitalier universitaire Sainte-Justine, un établissement mère-enfant de 500 lits. Le secteur de soins pharmaceutiques ciblé pour illustrer la méthode de mise à niveau est l’hématologie-oncologie pédiatrique. La méthode comporte trois étapes, soit une revue de la documentation scientifique, un profil du secteur et une mise à jour du niveau de pratique selon un profil des activités pharmaceutiques dans le secteur avant et après la mise à niveau. Résultats : Au total, 108 articles ont été recensés et 22 ont été retenus à partir d’une recherche dans PubMed. Après une recherche manuelle complémentaire, 36 articles ont finalement été évalués. Parmi les articles retenus, on compte trois lignes directrices, 11 études de développement, une revue de la littérature scientifique, six études pré- et post-interventions et 15 études quasi expérimentales. Bien que les patients de ce secteur ne comptent que pour 5 % des admissions de l’hôpital, la complexité des cas est élevée tant sur le plan de la codification de l’épisode de soins que du potentiel d’intervention pharmaceutique par admission. Conclusion : Il existe peu de données illustrant une démarche de mise à niveau de la pratique dans un secteur de soins pharmaceutiques. Cette étude a éprouvé une méthode de mise à niveau dans un service d’hématologie-oncologie pédiatrique et comporte une revue de la documentation scientifique, un profil du secteur et une description des tâches des pharmaciens de ce secteur avant et après la mise à niveau. PMID:22478967

Les fluctuations supraconductrices dans le compose praseodyme-cerium-oxyde de cuivre

NASA Astrophysics Data System (ADS)

Renaud, Jacques

Ce travail etudie les fluctuations supraconductrices dans le compose supraconducteur a haute temperature critique dope aux electrons Pr2-xCe xCuO4+delta. La technique utilisee pour sonder ces fluctuations est le transport electrique DC dans le plan ab. Il s'agit, a notre connaissance, de la premiere etude de ce type dans la classe generale des supraconducteurs a haute temperature critique dopes aux electrons et, plus particulierement, dans Pr2-xCe xCuO4+delta. De plus, l'etude est effectuee pour trois regimes de dopage, soit sous-dope x = 0.135, dopage optimal x = 0.15 et surdope x = 0.17. Les echantillons etudies sont des couches minces d'epaisseur plus grande que 100 nm crues par ablation laser. Les mesures electriques DC effectuees dans ce travail sont la resistance en reponse lineaire et les courbes IV en reponse non lineaire en fonction de la temperature. La mise en oeuvre experimentale de ces mesures a necessite une grande attention au filtrage et aux effets de chauffage a haut courant. Nous montrons que, sans cette attention, les donnees experimentales sont toujours erronees dans le regime pertinent pour nos echantillons. Les resultats pour le dopage optimal x = 0.15 sont expliques de facon tres convaincante dans le cadre de fluctuations purement 2D. D'abord, le regime des fluctuations gaussiennes est tres bien decrit par le modele d'Aslamazov-Larkin en deux dimensions. Ensuite, le regime de fluctuations critiques, se trouvant a plus basse temperature que le regime gaussien, est tres bien decrit par la physique 2D de Kosterlitz-Thouless. Dans cette analyse, les deux regimes ont des temperatures critiques coherentes entre elles, ce qui semble confirmer ce scenario 2D. Une analyse des donnees dans le cadre de fluctuations 3D est exploree mais donne des conclusions incoherentes. Les resultats pour les autres dopages sont qualitativement equivalents avec le dopage optimal et permettent donc une explication purement 2D. Par contre, contrairement au dopage optimal, les effets du desordre semblent etre tres importants. Une analyse detaillee de tous ces resultats semble indiquer que les signatures 2D in identifiees proviennent vraisemblablement de plans paralleles decouples formes d'environ 4 plans CuO2 couples. On discute de cette mise en ordre partielle comme une possible consequence d'une separation de phase isolante antiferromagnetique/supraconducteur. La largeur de la transition en fonction du dopage est aussi analysee dans le but de mettre en lumiere un possible effet du pseudogap. On montre que nos mesures ne supportent pas une telle interpretation.

Effets des electrons secondaires sur l'ADN

NASA Astrophysics Data System (ADS)

Boudaiffa, Badia

Les interactions des electrons de basse energie (EBE) representent un element important en sciences des radiations, particulierement, les sequences se produisant immediatement apres l'interaction de la radiation ionisante avec le milieu biologique. Il est bien connu que lorsque ces radiations deposent leur energie dans la cellule, elles produisent un grand nombre d'electrons secondaires (4 x 104/MeV), qui sont crees le long de la trace avec des energies cinetiques initiales bien inferieures a 20 eV. Cependant, il n'y a jamais eu de mesures directes demontrant l'interaction de ces electrons de tres basse energie avec l'ADN, du principalement aux difficultes experimentales imposees par la complexite du milieu biologique. Dans notre laboratoire, les dernieres annees ont ete consacrees a l'etude des phenomenes fondamentaux induits par impact des EBE sur differentes molecules simples (e.g., N2, CO, O2, H2O, NO, C2H 4, C6H6, C2H12) et quelques molecules complexes dans leur phase solide. D'autres travaux effectues recemment sur des bases de l'ADN et des oligonucleotides ont montre que les EBE produisent des bris moleculaires sur les biomolecules. Ces travaux nous ont permis d'elaborer des techniques pour mettre en evidence et comprendre les interactions fondamentales des EBE avec des molecules d'interet biologique, afin d'atteindre notre objectif majeur d'etudier l'effet direct de ces particules sur la molecule d'ADN. Les techniques de sciences des surfaces developpees et utilisees dans les etudes precitees peuvent etre etendues et combinees avec des methodes classiques de biologie pour etudier les dommages de l'ADN induits par l'impact des EBE. Nos experiences ont montre l'efficacite des electrons de 3--20 eV a induire des coupures simple et double brins dans l'ADN. Pour des energies inferieures a 15 eV, ces coupures sont induites par la localisation temporaire d'un electron sur une unite moleculaire de l'ADN, ce qui engendre la formation d'un ion negatif transitoire dans un etat electronique dissociatif, cette localisation est suivie d'une fragmentation. A plus haute energie, la dissociation dipolaire (i.e., la formation simultanee d'un ion positif et negatif) et l'ionisation jouent un role important dans le dommage de l'ADN. L'ensemble de nos resultats permet d'expliquer les mecanismes de degradation de l'ADN par les EBE et d'obtenir des sections efficaces effectives des differents types de dommages.

Masculine Knowledge, the Public Good, and the Scientific Household of Réaumur.

PubMed

Terrall, Mary

2015-01-01

In the Royal Academy of Sciences of Paris (founded 1666), expressions of a masculine culture of science echoed contemporary language used to articulate the aristocracy's value to crown and state--even though the academy was not an aristocratic institution as such. In the eighteenth century, the pursuit of science became a new form of manly service to the crown, often described in terms of useful knowledge and benefit to the public good [le bien public]. This article explores the connection of academic scientific knowledge to the domestic spaces where it was made and, in particular, to the household of R.-A. Ferchault de Réaumur, an exemplary academician. Although Réaumur had neither wife nor children, a complex net of affective ties, some of them familial, linked the members of the household, which accommodated women (the artist Hélène Dumoustier and her female relatives) as well as men (a series of assistants, many of whom eventually entered the academy). As head of this dynamic household, Réaumur produced not only scientific results but also future academicians.

Le contrôle des infections au cabinet du pédiatre

PubMed Central

2008-01-01

RÉSUMÉ La transmission des infections au cabinet du pédiatre est de plus en plus préoccupante. Le présent document expose les voies de transmission des infections et les principes sous-jacents aux mesures actuelles pour contrôler les infections. Pour prévenir les infections, il faut bien concevoir le cabinet et adopter des politiques administratives et de triage convenables, de même que des pratiques de base pour les soins de tous les patients (p. ex., hygiène des mains, port de gants, de masques, de lunettes de protection et d’une blouse d’hôpital pour des interventions précises; nettoyage, désinfection et stérilisation convenables des surfaces et du matériel, y compris les jouets, et techniques d’asepsie en cas d’interventions effractives) et des précautions additionnelles en cas d’infections précises. Le personnel doit avoir reçu les vaccins pertinents, et les personnes infectées doivent respecter les politiques de restriction au travail.

Alejarse como proceso social: niños y ancianos «abandonados» en Ayacucho1

PubMed Central

Leinaweaver, Jessaca

2013-01-01

En investigaciones previas sobre el acogimiento familiar y la adopción en Ayacucho, se ha podido descubrir cómo los ayacuchanos adquieren y producen relaciones sociales. Mientras negocian creativamente los discursos y espacios construidos simultáneamente por instituciones, comunidades, y estructuras sociales, van adquiriendo nuevas formas de relacionarse. Este artículo discute el proceso opuesto: el deshacerse de relaciones de parentesco, y el proceso social del abandono o alejamiento. Cuando se aleja a una persona de su familia o su comunidad, los que se quedan en ella llegan a entenderse como ciertos tipos de personas. En los estudios de caso discutidos aquí, recopilados a través de una detallada y cuidadosa observación participante y de entrevistas etnográficas grabadas entre 2001 y 2007, se puede ver cómo, después de un alejamiento social, los individuos que alejan se reinterpretan como sujetos que se encuentran superándose o volviéndose modernos, o bien sacrificándose. PMID:25177044

Lésions concomitantes aux genoux flottants et gravite

PubMed Central

Eone, Daniel Handy; Lamah, Léopold; Bayiha, Jean Emile; Ondoa, Danielle Larissa Essomba; Nonga, Bernadette Ngo; Ibrahima, Farikou; Bahebeck, Jean

2016-01-01

Le genou flottant est issu d’un traumatisme de haute énergie, dont la genèse suggère de vaste dégâts aussi bien sur le plan locorégional que général. Faisant référence au polytaumatisme. Le but de notre étude était de recenser toutes les lésions concomitantes au genou flottant dans notre milieu de pratique et d’évaluer la sévérité. Nous avons mené une étude descriptive et rétrospective couvrant une période de 14 ans et 9 mois. Sur un échantillon de 75 genoux flottants, avec une moyenne d’âge de 35 ans. Soixante six patients avaient obtenu un score d’ISS supérieur ou égal à 16 donc qualifié de polytraumatisé. Les traumatismes crâniens, les lésions thoraciques et abdominales retrouvés en même temps que le genou flottant exigent une réanimation adéquate. PMID:28292046

L'influence d'un stage d'enseignement dans un musee de sciences naturelles sur le sentiment d'autoefficacite en sciences de futurs enseignants

NASA Astrophysics Data System (ADS)

Deblois, Annick

Cette etude qualitative multicas est ancree dans l'approche sociale-cognitive de la theorie de l'autoefficacite de Bandura (1977). Elle s'interesse a quatre stages a l'enseignement qui se sont deroules au Musee canadien de la nature a Ottawa, Canada, en 2009. L'utilisation de donnees secondaires issues du questionnaire STEBI-B traduit et modifie (Dionne et Couture, 2010) ainsi que des entrevues semi-dirigees ont permis une analyse du changement du sentiment d'autoefficacite en sciences chez les stagiaires. Les elements les plus interessants de cette recherche sont l'apprentissage vicariant et la possibilite de repetition qui favorise une meilleure connaissance de soi et une pratique reflexive. Les resultats, dans l'ensemble positifs, illustrent bien le potentiel d'un tel stage afin de rehausser le sentiment d'autoefficacite en sciences chez des stagiaires en enseignement, particulierement chez ceux qui se destinent a enseigner a l'elementaire puisque ceux-ci ont souvent une formation academique dans un domaine autre que les sciences.

Implantation des sites de soins communautaires en République Démocratique du Congo: consécration d'un double standard dans l'accès aux soins

PubMed Central

Dunia, Gisèle Mawazo Binti

2013-01-01

Depuis 2005, la République Démocratique du Congo a amorcé l'implantation des sites de soins communautaires. Cette stratégie a pour objectif de rapprocher les services de santé des populations éloignées. Bien que cela parte d'une bonne intention, elle résulte, à notre sens, en une consécration d'un système de santé à deux vitesses. En effet, les populations vivant en ville ont accès à des soins prestés par des agents de santé formés alors que celles vivant en milieu rural reculé ont pour prestataires de soins des relais communautaires. Cette situation marginalise encore plus des populations dont la situation géographique est déjà préoccupante. Pourtant, la population est prête à parcourir des kilomètres en échange d'un service qu'elle estime de qualité. PMID:23785563

Reconstruction d’une Carbonisation du Pouce par Lambeau Chinois

PubMed Central

Khales, A.; Achbouk, J.A.; Moussaoui, A.; Belmir, R.; Tourabi, K.; Oufkir, A.; Ihrai, H.

2010-01-01

Summary La main en tant qu’organe majeur de la préhension peut être le siège de brûlures graves qui compromettent sa fonction. Bien qu’elle ne représente que 2% de la surface corporelle la brûlure de la main est grave et difficile à traiter, vu la vulnérabilité et la complexité de son appareil locomoteur. Nous rapportons dans ce travail le cas d’un patient victime d’une carbonisation de la main. Huit mois après le parage et la couverture par lambeau inguinal, le patient bénéficie d’une reconstruction du pouce par lambeau chinois associé à une greffe osseuse. Le résultat s’est avéré satisfaisant. Le lambeau chinois prouve par son apport vasculaire et par sa facilité technique qu’il est un moyen très intéressant dans la reconstruction du pouce - ou des doigts en général - surtout dans un contexte de brûlure. PMID:21991226

Editorial. Impact of the Binge Drinking (BD) in Adolescence. Are we doing it right? Editorial. Impacto del consumo episódico excesivo de alcohol en la adolescencia. ¿Lo estamos haciendo bien?

PubMed

Vargas-Martínez, Ana Magdalena; Trapero-Bertran, Marta; Gil-García, Eugenia; Lima-Serrano, Marta

2018-04-15

Nowadays, one of the most prevalent patterns of alcohol consumption is called binge drinking (BD). In 2015, the European School Survey Project on Alcohol and Drugs (ESPAD) Group estimated that about 35% of adolescents of 15-16 years old have had at least one BD occasion in the past 30 days while at national level, the series of surveys on the use of drugs in adolescents of secondary education (ESTUDES, 2014-2015) determined that 32.2% of adolescents stated having performed BD in the last month. The aim of this editorial was to update the context of adolescence drinking and analysing the impact of BD by ages, including health and social costs derived. Once the magnitude of the problem was set, some research and action lines have been established in order to guide future work for the prevention of alcohol misuse and for establishing future preventive policies on alcohol. Finally, the need for evaluating these interventions from the efficiency point of view was discussed and assessed.

Le Laser A Argon Ionise : Applications Therapeutiques

NASA Astrophysics Data System (ADS)

Brunetaud, J. M.; Mosquet, L.; Mordon, S.; Rotteleur, G.

1984-03-01

Le laser a argon ionise est un laser a emission continue, reglee en general en multiraies de 487 a 544 nm. Le rayonnement de ce laser est bien absorbe par les tissus vivants, avec une action preferentielle au niveau des pigments rouges (hemoglobine, myoglobine) et noirs (melanine). Le laser a argon est princi-palement utilise en therapeutique pour ses effets thermiques : en fonction du choix des parametres (puissance optique, surface exposee, temps d'exposition) on peut obtenir une coagulation (temperature optimale au niveau des tissus 60° - 80°) ou une volatisation (temperature superieure a 100°). Si la zone volatilisee est tres etroite (inferieure a 0,5 mm) on obtient un effet de coupe. Par rapport aux deux autres lasers egalement utilises pour leurs effets thermiques (CO2 et Nd. YAG) l'argon a des effets intermediaires : la coagulation sera plus superficielle qu'avec le Nd. YAG et la volatisation plus profonde qu'avec le CO2. Lors de la coupe, la necrose sur les berges sera egalement plus importante qu'avec le CO2.

Grupos españoles de cálculos ab initio de moléculas de interés astrofísico

NASA Astrophysics Data System (ADS)

Yáñez, M.

Pocos campos de la química están tan bien adaptados a la modelización por medio de los métodos teóricos de la Química Cuántica como la Astroquímica y la Química de la Atmósfera, donde las interacciones moleculares son, generalmente, lo suficientemente pequeñas para que el modelo de molécula aislada funcione muy bien. En España son varios los grupos teóricos que dedican su esfuerzo de investigación, o parte de él, al estudio de moléculas o procesos de interés en Astrofísica o en atmósferas planetarias. Presentaremos diferentes ejemplos paradigmáticos de esta actividad en la que se exploran desde aspectos estructurales, hasta aspectos espectroscópicos y dinámicos. Entre los últimos, cabe destacar estudios en los que se demuestra la importancia de procesos a dos estados, prohibidos por espín, en la formación astrofísica de diversos derivados de interés. En el tratamiento espectroscópico se han hecho esfuerzos interesantes, que han aunado teoría y experimento, en el estudio de sistemas relevantes desde el punto de vista atmosférico, como los hidratos de ácido nítrico, o el tratamiento espectroscópico de moléculas no rígidas. No menos interesantes son los estudios de fotoabsorción de radicales o de procesos multifotónicos. Son particularmente abundantes los estudios dedicados a la reactividad específica de sistemas de interés astrofísico o atmosférico, con el objetivo de esclarecer vías de formación de determinados compuestos o de proporcionar mecanismos que permitan identificar las etapas reactivas limitantes de reacciones de interés en esos medios y sobre los que no existía información previa. Así, por ejemplo, se han publicado interesantes estudios sobre la formación o propiedades de compuestos de fósforo, de silico o de azufre o sobre mecanismos de reacción en los que intervienen el ozono, el radical nitrato, el radical OH u otras especies. Finalmente, son también particularmente relevantes los estudios que varios grupos españoles han llevado, y siguen llevando a cabo, sobre sistemas débilmente enlazados, como complejos de Van der Waals o complejos por enlace de hidrógeno, que sin duda juegan un papel importante tanto en medios atmosféricos como interestelares.

Caractérisations structurale et morphologique des couches minces de CuInS2 et d'In-S "airless spray"

NASA Astrophysics Data System (ADS)

Kamoun, N.; Belgacem, S.; Amlouk, M.; Bennaceur, R.; Abdelmoula, K.; Belhadj Amara, A.

1994-03-01

We have prepared CuInS2 thin layers by airless spray "S.P.A." in order to use them as an absorber in a photovoltaic cell. The X-ray diffraction analysis has showed that these layers are well crystallized with a privileged (112) principal orientation for a ratio of the concentrations in the pulverized solution x=frac[Cu^I][In^{III]}=1.1. After heat treatment under vacuum the crystallization have been clearly improved. The structural analysis of the thin CuInS2 layers have revealed that a secondary phases of In2S3 and In6S7 are present. Thus we have realized by the same technique thin In-S layers whose structural and morphological properties have been studied. This analysis has showed that the In-S layers are well crystallized for a ratio y=frac[In^{3+]}[S^{2-]}=0.6 in the spray solution. The In-S layers are essentially formed by a β-In2S3 material. Although the In6S7 phase appears to the detriment of β-In2S3 phase for y= 0.75. Nous avons préparé des couches minces de CuInS2, par pulvérisation chimique réactive sans air "P.S.A.", en vue de leur utilisation en tant qu'absorbeur dans un dispositif photovoltaïque. L'analyse par diffraction X a montré que ces couches sont bien cristallisées et que l'orientation principale (112) est privilégiée pour un rapport de concentrations x=frac[Cu^I]{[In^{III}]}=1,1 dans la solution à pulvériser. Après le traitement thermique sous vide la cristallisation est nettement améliorée. L'analyse structurale des couches minces de CuInS2 a révélé que ces couches renferment des phases secondaires d'In2S3 et d'In6S7. Ainsi nous avons réalisé par la même technique "P.S.A.", des couches minces d'In-S dont nous avons étudié les propriétés structurales et morphologiques, Cette analyse a montré que les couches d'In-S sont bien cristallisées. Pour un rapport de concentrations en solution de pulvérisation y=frac[In^{3+]}[S^{2-]}=0,6 les couches d'In-S sont surtout formées du matériau β-In2S3. Alors que la phase In6S7 apparaît au détriment de la phase β-In2S3 pour y= 0,75.

L’effet du yoga chez les patients atteints de cancer

PubMed Central

Côté, Andréanne; Daneault, Serge

2012-01-01

Résumé Objectif Déterminer si le yoga thérapeutique améliore la qualité de vie de patients atteints de cancer. Sources des données Recherche effectuée avec la base de données MEDLINE (1950–2010) en utilisant les mots-clés yoga, cancer et quality of life. Sélection des études Priorité accordée aux études cliniques randomisées contrôlées évaluant l’effet du yoga sur différents symptômes susceptibles de se présenter chez des patients atteints de cancer en Amérique du Nord. Synthèse Quatre études cliniques randomisées contrôlées ont d’abord été analysées, puis 2 études sans groupe-contrôle. Trois études réalisées en Inde et au Proche-Orient ont également apporté des éléments intéressants au plan méthodologique. Les interventions proposées comprenaient des séances de yoga d’une durée et d’une fréquence variables. Les paramètres mesurés variaient également d’une étude à l’autre. Plusieurs symptômes ont connu des améliorations significatives avec le yoga (meilleure qualité du sommeil, diminution des symptômes anxieux ou dépressifs, amélioration du bien-être spirituel, etc.). Il a aussi semblé que la qualité de vie, dans sa globalité ou dans certaines de ses composantes spécifiques, s’améliorait. Conclusion La variété des effets bénéfiques produits, l’absence d’effet secondaire et le rapport coût-bénéfice avantageux du yoga thérapeutique en fait une intervention intéressante à suggérer par les médecins de famille aux patients atteints de cancer. Certaines lacunes méthodologiques ont pu diminuer la puissance statistique des études présentées, à commencer par la taille restreinte des échantillons et par l’assiduité variable des patients soumis à l’intervention. Il est également possible que les échelles de mesure utilisées ne convenaient pas à ce type de situation et de clientèle pour qu’en soit dégagé un effet significatif. Toutefois, les commentaires favorables des participants recueillis au cours des études et leur degré d’appréciation et de bien-être donnent à penser qu’il faille poursuivre les recherches pour mieux en comprendre les mécanismes.

Acides gras oméga-3 et dyslexie

PubMed Central

Zelcer, Michal; Goldman, Ran D.

2015-01-01

Résumé Question À la lumière de la hausse du nombre d’enfants d’âge scolaire ayant reçu un diagnostic de dyslexie, quel est le rôle des suppléments d’acides gras oméga-3 dans la prise en charge de cette affection? Réponse La dyslexie est le trouble d’apprentissage le plus répandu et elle est connue pour ses causes multifactorielles. De récentes données probantes pointent vers une corrélation entre le métabolisme défectueux des acides gras polyinsaturés et les troubles de neurodéveloppement, tels que la dyslexie. Bien que l’administration de suppléments d’acides gras oméga-3 aux enfants dyslexiques ait fait l’objet d’études, les données probantes sont limitées. Les critères diagnostiques homogènes de dyslexie, les mesures objectives de carence en acides gras et la surveillance étroite de l’apport alimentaire ne sont que quelques-uns des facteurs pouvant améliorer la qualité de la recherche dans ce domaine.

Differents aspects du fer dans l'organisme

PubMed Central

Bessis, Marcel; Breton-Gorius, Janine

1959-01-01

On voit des molécules de ferritine apparaitre dans le cytoplasme des cellules réticulaires au cours de la digestion des érythrocytes, autour des stromas phagocytés. Cette ferritine s'accumule en amas dans lesquels entrent d'autres substances, en particulier des lipides, provenant aussi des stromas globulaires et qui apparaissent sous forme myélinique. Souvent la ferritine se dispose d'une manière cristalline. Parfois la ferritine et l'apoferritine alternent dans ces cristaux. Parfois l'hémosidérine contient des cristaux qui semblent bien être de l'apoferritine pure. L'injection de sels de fer donne lieu à l'apparition de ferritine dans les cellules réticulaires. Dans les conditions de nos expériences, la plus grande partie du fer injecté était sous forme de ferritine dans un délai de 3 jours. Un aspect intermédiaire entre celui du fer injecté et celui de la ferritine a été trouvé. Dans le cas des injections de saccharate de fer ce sont de fines aiguilles; dans le cas des injections de lactate de fer, il s'agit de masses fibreuses. PMID:13800106

Sequential anaerobic-aerobic biodegradation of 2,3,7,8-TCDD contaminated soil in the presence of CMC-coated nZVI and surfactant.

PubMed

Binh, Nguyen Duy; Imsapsangworn, Chaiyaporn; Kim Oanh, Nguyen Thi; Parkpian, Preeda; Karstensen, Kare; Giao, Pham Huy; DeLaune, Ronald D

2016-01-01

Enriched microorganisms in sediment collected from a dioxin-contaminated site in Vietnam (Bien Hoa airbase) were used for examining the effectiveness in biological treatment of 2,3,7,8-Tetrachlorodibenzo-p-dioxin in soil. Four bio-treatments were investigated using a sequential anaerobic (17 weeks) followed by an aerobic (6 weeks) incubation. The maximum removal efficiency was approximately 60% even at an extremely low pH (approx. 3.6) condition. Surfactant Tween-80 was added to enhance the bioavailability of dioxin in two treatments, but it appeared to biostimulate methanogens rather than dechlorinators. As a result, methane production was the highest while the dioxin removal efficiency was the lowest, as compared with the other bio-treatments. Carboxymethylcellulose (CMC) coated on nanoscale zero valent iron (nZVI) surface used in two treatments could prevent the direct contact between bacterial cell surface and nZVI which prevented cell death and lysis, hence enhancing dioxin removal. The presence of CMC--_nZVI in bio-treatments gradually released H2 required for microbiological processes, but the amount used in the experiments were likely too high to maintain optimum H2 levels for biostimulating dechlorinators rather than methanogens.

Traitement intra-artériel des métastases hépatiques de cancer colorectal

PubMed Central

Pellerin, O.; Geschwind, J.-F.

2015-01-01

Le cancer colorectal représente un problème majeur de santé publique. Son incidence annuelle mondiale est d’environ un million de cas et la mortalité annuelle est de plus de 500 000 cas par an. Le foie est l’organe le plus fréquemment touché par les métastases. Leur survenue est observée dans 40 à 60% des cas (contemporaines dans 25% des cas). Bien que la résection chirurgicale soit le seul traitement curatif, nombre de patients ne peuvent en bénéficier en raison de l’importante diffusion des métastases hépatiques. Chimiothérapies et biothérapies systémiques sont les options conventionnelles de la prise en charge des métastases hépatiques multiples. C’est dans ces situations cliniques que les thérapies intra-artérielles peuvent jouer un rôle important. Dans cet article, nous présenterons les différentes thérapies endovasculaires applicables aux métastases hépatiques de cancers colorectaux, avec leurs indications, résultats et complications éventuelles. PMID:21944243

Modélisation macroscopique des milieux stratifiés conducteurs

NASA Astrophysics Data System (ADS)

Matagne, E.; Conard, J. Ph.

1997-11-01

Many laminated structures are recognised in Electrotechnics : magnetic cores, flat conductors windings, slotted surfaces... These structures exhibit macroscopic properties, as magnetic than electric ones. This paper shows how these characteristics can be obtained by homogenisation. It deals with linear materials but taking into account the effect of eddy currents, as well on the macroscopic magnetic permeability as on the macroscopic electric conductivity, which become then complex numbers. An example of use of the macroscopic properties is provided. On peut identifier en électrotechnique de nombreuses structures stratifiées: noyaux magnétiques, bobinages formés de conducteurs plats, surfaces encochées... Ces structures présentent des propriétés macroscopiques tant magnétiques qu'électriques. Cet article montre comment ces caractéristiques peuvent être obtenues par homogénéisation. Il se limite au cas de matériaux linéaires mais en prenant en compte l'effet des courants de Foucault aussi bien sur la perméabilité magnétique macroscopique que sur la conductivité électrique macroscopique, grandeurs qui deviennent alors des nombres complexes. Un exemple d'utilisation des caractéristiques macroscopiques est fourni.

Toward the reconceptualization of the relationship between occupation and health and well-being: Vers la reconceptualisation de la relation entre l'occupation et la santé et le bien-être.

PubMed

Stewart, Katherine E; Fischer, Tess M; Hirji, Rehana; Davis, Jane A

2016-10-01

Foundational to the occupational therapy profession is the belief that engagement in occupation is health promoting; however, this belief fails to account for occupational engagement that may be risky or illness producing. Consensus regarding the nature of the relationship between occupation and health has yet to be achieved. The purpose of this study is to provide a comprehensive description of how the relationship between occupation and health and well-being is discussed within the occupational therapy and occupational science literature. The methodological framework outlined by Arksey and O'Malley served as the basis for this scoping review of the occupational therapy and occupational science literature. One hundred and twelve articles were identified as meeting the criteria for inclusion. The dominant discourse portrays the relationship between occupation and health as positive. The broader literature suggests that occupational engagement can have both positive and negative effects on health and well-being. As such, the reconceptualization of the relationship between occupation and health and well-being is warranted to enable occupational therapists to practise in a more client-centred manner. © CAOT 2015.

Les grands accélérateurs de particules

NASA Astrophysics Data System (ADS)

Patoux, A.; Perot, J.

1991-02-01

The different types of accelerators are recalled with emphasis on the most powerful : the synchrotron particle colliders. The use of superconductors in accelerator magnets as well as in RF cavities is discussed. The characteristics of the large accelerators, existing and planned, are given together with the level of industry involvement in their construction. Details concerning superconducting magnets and cryogenic plants are investigated. Finally, detectors, the most important tool for physics, are mentionned. Après avoir rappelé les différents types d'accélérateurs utilisés, l'accent est mis sur les plus puissants, c'est-à-dire les synchrotrons fonctionnant en anneaux de collision. Le rôle des supraconducteurs est analysé aussi bien pour les aimants que pour les cavités accélératrices. Les caractéristiques des principaux accélérateurs existants ou en projet sont données ainsi que l'implication de l'industrie dans leur fabrication. On insiste plus particulièrement sur les aimants supraconducteurs et les installations cryogéniques. Enfin les détecteurs, éléments indispensables à la physique, sont également évoqués.

L’utilisation du prémélange de monensin chez les vaches laitières : un suivi simple et essentiel pour s’assurer d’une utilisation adéquate

PubMed Central

Dubuc, Jocelyn; Baril, Jean; DesCôteaux, Luc

2009-01-01

Le prémélange de monensin est utilisé fréquemment sur les fermes laitières canadiennes. L’ingrédient actif de ce produit est le monensin sodique. Bien que son utilisation chez les vaches laitières soit sécuritaire, des cas de surdose ont été rapportés à la suite de consommation de niveaux de monensin plus élevés que ceux recommandés. Un suivi hebdomadaire du pourcentage de matières grasses du réservoir de lait de la ferme devrait être fait de routine suite à la livraison d’aliment médicamenteux contenant du monensin pour détecter rapidement les situations de surdose. L’observation d’une baisse soudaine de la consommation volontaire de matière sèche et l’apparition de diarrhée dans un troupeau sont d’autres signes cliniques de surdose de monensin. Une détection rapide de ces cas permettra de corriger la situation. PMID:19721781

Accident D’Electrisation et Hemorragie Cerebro-Meningee : A Propos D’une Observation

PubMed Central

Chaibdraa, A.; Medjellakh, M.S.; Saouli, A.; Bentakouk, M.C.

2008-01-01

Summary L'électrisation est un évènement accidentel qui diffère des autres pathologies occasionnant des brûlures graves, à cause de ses spécificités qui traduisent d'une part la destruction du revêtement cutané, mais également les effets directs ou indirects du courant électrique sur tout tissu de l'organisme rencontré lors de son passage, en particulier le tissu nerveux. Les manifestations neurologiques centrales sont nombreuses, en relation avec les effets de l'électricité sur le parenchyme cérébral ou une lésion associée à l'électrisation. Nous rapportons l'observation d'une hémorragie cérébro-meningée survenant au 3ème jour d'une électrisation grave. Cette complication est bien documentée dans la littérature traitant des accidents d'électrisation post-foudroiement. N'ayant pas rencontré de cas similaire publié lors des accidents dus au courant industriel, nous présentons cette observation, qui soulève le problème du mécanisme physiopathologique de survenue, difficile à trancher. PMID:21991125

Localisation buccale d’un lymphome de Burkitt: à propos d’un cas

PubMed Central

Kissi, Lamia; El Bouihi, Rajaa; Lamchahab, Mouna; Alaoui, Ahmed; Benyahya, Ihsane

2017-01-01

Le lymphome de Burkitt (LB) est une forme de lymphome malin non-Hodgkinien qui provient de l'évolution maligne et de la prolifération de cellules lymphoïdes de type B. Le diagnostic positif repose sur la biopsie d'une masse tumorale ou la ponction de la moelle osseuse révélant la présence de cellules tumorales. Le cas rapporté est celui d'un jeune homme d'une vingtaine d'années qui a été adressé pour des tuméfactions gingivales évoluant depuis 1 mois suite à des extractions dentaires. L'examen anatomopathologique après biopsie complété par l'immunohistochimie conclut à un lymphome de Burkitt. La prise en charge a consisté en une chimiothérapie. Bien que rare, le lymphome de Burkitt est une tumeur agressive qui représente un véritable problème de santé publique d'où la place importante qu'occupe le médecin dentiste dans le diagnostic précoce afin de permettre une prise en charge rapide et appropriée seule garante de la guérison. PMID:28451040

[Not Available].

PubMed

Torres Díaz, Cristina V; Martín Peña, Gonzalo; Ezquiaga, Elena; Navas García, Marta; García de Sola, Rafael

2016-07-19

Gracias a los avances técnicos en técnicas neuroquirúrgicas, y debido a que el diagnóstico y la clasificación de las enfermedades psiquiátricas han evolucionado significativamente a lo largo de las últimas décadas, se están desarrollando tratamientos a nivel experimental para aquellos pacientes resistentes al manejo conservador.La anorexia nerviosa es una enfermedad de prevalencia creciente, con la tasa de mortalidad más elevada dentro de los trastornos psiquiátricos, y con aproximadamente un 20% de pacientes que presentan una evolución tórpida. Para estos pacientes que no responden a manejo conservador, la estimulación cerebral profunda ha surgido como una alternativa terapéutica, si bien la literatura especializada al respecto es escasa.A continuación presentamos una revisión de la fisiopatología de la anorexia nerviosa, así como de los distintos tratamientos neuroquirúrgicos realizados a lo largo de la historia. Se detalla la perspectiva de tratamiento quirúrgico actual, así como los aspectos éticos que se han de considerar en relación con el surgimiento de estas nuevas terapias.

Etude du processus de changement vecu par des familles ayant decide d'adopter volontairement des comportements d'attenuation des changements climatiques

NASA Astrophysics Data System (ADS)

Leger, Michel T.

Les activites humaines energivores telles l'utilisation intensive de l'automobile, la surconsommation de biens et l'usage excessif d'electricite contribuent aux changements climatiques et autres problemes environnementaux. Bien que plusieurs recherches rapportent que l'etre humain est de plus en plus conscient de ses impacts sur le climat de la planete, ces memes recherches indiquent qu'en general, les gens continuent a se comporter de facon non ecologique. Que ce soit a l'ecole ou dans la communaute, plusieurs chercheurs en education relative a l'environnement estiment qu'une personne bien intentionnee est capable d'adopter des comportements plus respectueux de l'environnement. Le but de cette these etait de comprendre le processus d'integration de comportements d'attenuation des changements climatiques dans des familles. A cette fin, nous nous sommes fixe deux objectifs : 1) decrire les competences et les procedes qui favorisent l'adoption de comportements d'attenuation des changements climatiques dans des familles et 2) decrire les facteurs et les dynamiques familiales qui facilitent et limitent l'adoption de comportements d'attenuation des changements climatiques dans des familles. Des familles ont ete invitees a essayer des comportements personnels et collectifs d'attenuation des changements climatiques de sorte a integrer des modes de vie plus ecologiques. Sur une periode de huit mois, nous avons suivi leur experience de changement afin de mieux comprendre comment se produit le processus de changement dans des familles qui decident volontairement d'adopter des comportements d'attenuation des changements climatiques. Apres leur avoir fourni quelques connaissances de base sur les changements climatiques, nous avons observe le vecu de changement des familles durant huit mois d'essais a l'aide de journaux reflexifs, d'entretiens d'explicitation et du journal du chercheur. La these comporte trois articles scientifiques. Dans le premier article, nous presentons une recension des ecrits sur le changement de comportement en environnement. Nous explorons egalement la famille comme systeme fonctionnel de sorte a mieux comprendre ce contexte d'action environnementale qui est, a notre connaissance, peu etudie. Dans le deuxieme article, nous presentons nos resultats de recherche concernant les facteurs d'influence observes ainsi que les competences manifestees au cours du processus d'adoption de nouveaux comportements environnementaux dans trois familles. Enfin, le troisieme article presente les resultats du cas d'une quatrieme famille ou les membres vivent depuis longtemps des modes de vie ecologique. Dans le cadre d'une demarche d'analyse par theorisation ancree, l'etude de ce cas modele nous a permis d'approfondir les categories conceptuelles identifiees dans le deuxieme article de sorte a produire une modelisation de l'integration de comportements environnementaux dans le contexte de la famille. Les conclusions degagees grace a la recension des ecrits nous ont permis d'identifier les elements qui pourraient influencer l'adoption de comportements environnementaux dans des familles. La recension a aussi permis une meilleure comprehension des divers facteurs qui peuvent affecter l'adoption de comportements environnementaux et, enfin, elle a permis de mieux cerner le phenomene de changement de comportement dans le contexte de la famille consideree comme un systeme. En appliquant un processus d'analyse inductif, a partir de nos donnees qualitatives, les resultats de notre etude multi-cas nous ont indique que deux construits conceptuels semblent influencer l'adoption de comportements environnementaux en famille : 1) les valeurs biospheriques communes au sein de la famille et 2) les competences collectivement mises a profit collectivement durant l'essai de nouveaux comportements environnementaux. Notre modelisation du processus de changement dans des familles indique aussi qu'une dynamique familiale collaborative et la presence d'un groupe de soutien exterieur sont deux elements conceptuels qui tendent a influencer les deux principaux construits et, par ce fait, tendent a augmenter les chances d'integrer de nouveaux comportements environnementaux dans des familles. En conclusion, nous presentons les limites de notre recherche ainsi que des pistes pour des recherches futures. Notamment, nous recommandons que l'ecole accueille les familles des eleves dans le cadre d'activites d'education a l'environnement ou les freres, les soeurs et les parents des eleves puissent apprendre ensemble, a l'ecole. Par exemple, nous recommandons la conduite en ERE d'une recherche action portant sur l'apprentissage intergenerationnel de nouveaux comportements dans le contexte de la famille. Mots-cles : education relative a l'environnement, comportement environnemental en famille, changement de comportement en famille, valeurs biospheriques, competences d'action.

Hypocalcémie

PubMed Central

Fong, Jeremy; Khan, Aliya

2012-01-01

Résumé Objectif Présenter aux médecins de famille une approche fondée sur des données probantes pour le diagnostic et la prise en charge de l’hypocalcémie. Qualité des données On a fait une recherche documentaire dans MEDLINE et EMBASE pour cerner des articles parus de 2000 à 2010 portant sur le diagnostic et la prise en charge de l’hypocalcémie. Les niveaux des données (de I à III) sont indiqués, le cas échéant et, dans la plupart des études, les données se situent aux niveaux II et III. On a aussi examiné les références des ouvrages appropriés pour trouver des articles pertinents. Message principal L’hypocalcémie est habituellement attribuable à des taux insuffisants d’hormones parathyroïdes ou de vitamine D ou à une résistance à ces hormones. Le traitement consiste surtout à administrer des suppléments de calcium et de vitamine D par voie orale, ainsi que de magnésium s’il y a carence. On peut intensifier davantage le traitement avec des diurétiques thiazidiques, des chélateurs de phosphore et un régime à faible teneur en sel et en phosphore quand on traite une hypocalcémie secondaire à une hypoparathyroïdie. Une carence en calcium aiguë et dangereuse pour la vie exige un traitement au moyen de calcium intraveineux. Les recommandations thérapeutiques actuelles se fondent largement sur l’opinion d’experts cliniciens et de rapports de cas publiés, car il n’y a pas suffisamment de données probantes disponibles tirées d’études cliniques contrôlées. Au nombre des complications des thérapies actuelles, on peut mentionner l’hypercalciurie, la néphrocalcinose, l’insuffisance rénale et la calcification des tissus mous. La thérapie actuelle est limitée par les fluctuations du calcium sérique. Quoique ces complications soient bien reconnues, les effets sur le bien-être général, l’humeur, la fonction cognitive et la qualité de vie, ainsi que les risques de complications, n’ont pas été adéquatement étudiés. Conclusion Les médecins de famille jouent un rôle central dans l’éducation des patients à propos de la prise en charge à long terme et des complications de l’hypocalcémie. À l’heure actuelle, la prise en charge est sous-optimale et marquée par des fluctuations dans le calcium sérique et l’absence d’une thérapie de remplacement des hormones parathyroïdes homologuée pour l’hypoparathyroïdie.

Fibrillation auriculaire et activité physique

PubMed Central

Bosomworth, N. John

2015-01-01

Résumé Objectif Examiner les données probantes portant sur les effets de divers niveaux d’activité physique sur l’incidence de fibrillation auriculaire (FA) dans la population générale et chez les athlètes d’endurance. Sources des données Une recherche a initialement été menée sur PubMed à l’aide des titres MeSH ou des mots-de-texte anglais (avec descripteur de zone de recherche TIAB [title and abstract]) atrial fibrillation et exercise ou physical activity ou athlet* ou sport*, sans filtre additionnel. Le système GRADE (grading of recommendations, assessment, development, and evaluation) a été utilisé pour tirer les conclusions au sujet de la qualité et du niveau de preuve. Sélection des études Aucune étude d’intervention n’est ressortie de la recherche. Les études d’observation ont alors été jugées acceptables et, bien que des études prospectives de cohortes à long terme de plus grande envergure auraient été préférables, des essais cas-témoins ou transversaux ont aussi été inclus dans cette révision. Synthèse Les données disponibles laissent croire à un lien proportionnel à la dose entre l’exercice plus intense et l’incidence réduite de FA chez les femmes. Il en va de même pour les hommes dont le niveau d’activité physique est de faible à modéré. Chez les hommes seulement, l’activité intense est associée à un risque accru de FA et ce, dans la plupart des études, mais pas la totalité d’entre elles. Ce risque est modéré, le rapport de risque instantané étant de 1,29 dans l’une des études de meilleure qualité. Le risque de FA chez la plupart des personnes régulièrement actives est plus faible que le risque observé dans la population sédentaire appariée. Conclusion La fibrillation auriculaire est probablement moins fréquente à mesure que le niveau d’activité physique augmente, la relation dose-réponse étant démontrable. À toutes les intensités, l’exercice doit être encouragé pour ses effets sur le bien-être physique et la réduction de la mortalité. Chez les hommes qui pratiquent des activités vigoureuses, les effets bénéfiques sur la FA pourraient disparaître et le risque pourrait surpasser celui observé dans la population sédentaire; cependant les données probantes à cet effet ne sont ni robustes ni constantes. Ces hommes devraient être mis au courant de cette hausse modeste du risque s’ils choisissent de poursuivre leurs activités physiques vigoureuses.

Analyse chronometrique intersexes de la resolution de la tache d'horizontalite des liquides

NASA Astrophysics Data System (ADS)

Berthiaume, Francois

D'abondantes recherches ont demontre que la reussite a la tache d'horizontalite des liquides est en moyenne plus elevee chez les individus de sexe masculin que chez ceux de sexe feminin. Deux facteurs principaux ont ete proposes: il s'agit de la connaissance du principe physique de l'invariance de l'orientation des liquides et de certaines habiletes perceptives d'ordre visuel. Le but de la presente recherche est d'etablir la duree detaillee de la resolution de la tache d'horizontalite des liquides chez 185 filles et 180 garcons, ages de 15 a 19 ans et repartis en 8 groupes. Dans une version informatisee, le premier groupe trace la position de la surface de l'eau a l'interieur d'un contenant dans diverses inclinaisons et le deuxieme evalue si l'orientation d'une ligne y represente bien cette position; le troisieme groupe trace une horizontale dans un rectangle et le quatrieme juge si la ligne illustree y est bien horizontale. Quatre autres groupes executent respectivement les memes taches dans la version classique papier-crayon. Le temps accorde a la reflexion avant de commencer le trace, le temps de tracage comme tel et le temps de verification du trace complete sont calcules. Chez les groupes qui evaluent l'orientation d'une ligne sur support informatique, le temps requis pour y parvenir est note. Enfin, un questionnaire estime si les participants connaissent ou non le principe physique d'invariance de l'orientation de la surface d'un liquide. Les resultats revelent que cette connaissance est plus frequente chez les garcons dans l'ensemble des groupes. Dans le cas ou les sujets ont a tracer une ligne, les filles reussissent moins d'essais que les garcons s'il faut, sur support informatique, tracer la surface de l'eau dans un contenant incline ou a l'horizontale. Il en va de meme s'il faut, sur support papier, tracer une horizontale dans un contenant incline. Le trace de la surface de l'eau est plus exact chez les sujets connaissant le principe d'invariance et l'ecart intersexes disparait si l'analyse tient compte de cette connaissance. Sur le plan du temps de reponse, les deux sexes ne se distinguent que lors du trace de la surface de l'eau dans un contenant incline, les garcons reflechissant alors plus longtemps. Le temps mis a produire, puis a verifier un trace, ne differe pas selon le sexe des participants. Dans l'evaluation de l'orientation d'une ligne cependant, les filles ne se distinguent pas des garcons et les participants connaissant le principe d'invariance reussissent mieux que ceux l'ignorant. Par ailleurs, les filles procedent toujours moins rapidement que les garcons. Pour les contenants inclines ou a l'horizontale, si la ligne represente la surface de l'eau, la difference intersexes est annulee quand la connaissance du principe est prise en compte. (Abstract shortened by UMI.)

Facteurs prédictifs de succès des étudiants en première année de médecine à l'université de Parakou

PubMed Central

Adoukonou, Thierry; Tognon-Tchegnonsi, Francis; Mensah, Emile; Allodé, Alexandre; Adovoekpe, Jean-Marie; Gandaho, Prosper; Akpona, Simon

2016-01-01

Introduction Plusieurs facteurs dont les notes obtenues au BAC peuvent influencer les performances académiques des étudiants en première année de médecine. L'objectif de cette étude était d’évaluer la relation entre les résultats des étudiants au BAC et le succès en première année de médecine. Méthodes Nous avons réalisé une étude analytique ayant inclus l'ensemble des étudiants régulièrement inscrits en première année à la Faculté de Médecine de l'université de Parakou durant l'année académique 2010-2011. Les données concernant les notes par discipline et mention obtenue au BAC ont été collectées. Une analyse multivariée utilisant la régression logistique et la régression linéaire multiple a permis d’établir les meilleurs prédicteurs du succès et de la moyenne de l’étudiant en fin d'année. Le logiciel SPSS version 17.0 a été utilisé pour l'analyse des données et un p<0,05 a été considéré comme statistiquement significatif. Résultats Parmi les 414 étudiants régulièrement inscrits les données de 407 ont pu être exploitées. Ils étaient âgés de 15 à 31 ans; 262 (64,4%) étaient de sexe masculin. 98 étaient admis avec un taux de succès de 23,7%. Le sexe masculin, la note obtenue en mathématiques, en sciences physiques, la moyenne au BAC et la mention étaient associés au succès en fin d'année mais en analyse multivariée seule une note en sciences physiques > 15/20 était associée au succès (OR: 2,8 [1,32- 6,00]). Pour la moyenne générale obtenue en fin d'année seule une mention bien obtenue au BAC était associée (coefficient de l'erreur standard: 0,130 Bêta =0,370 et p=0,00001). Conclusion Les meilleurs prédicateurs du succès en première année étaient une bonne moyenne en sciences physiques au BAC et une mention bien. La prise en compte de ces éléments dans le recrutement des étudiants en première année pourrait améliorer les résultats académiques. PMID:27313819

Le niobate de lithium a haute temperature pour les applications ultrasons =

NASA Astrophysics Data System (ADS)

De Castilla, Hector

L'objectif de ce travail de maitrise en sciences appliquees est de trouver puis etudier un materiau piezoelectrique qui est potentiellement utilisable dans les transducteurs ultrasons a haute temperature. En effet, ces derniers sont actuellement limites a des temperatures de fonctionnement en dessous de 300°C a cause de l'element piezoelectrique qui les compose. Palier a cette limitation permettrait des controles non destructifs par ultrasons a haute temperature. Avec de bonnes proprietes electromecaniques et une temperature de Curie elevee (1200°C), le niobate de lithium (LiNbO 3) est un bon candidat. Mais certaines etudes affirment que des processus chimiques tels que l'apparition de conductivite ionique ou l'emergence d'une nouvelle phase ne permettent pas son utilisation dans les transducteurs ultrasons au-dessus de 600°C. Cependant, d'autres etudes plus recentes ont montre qu'il pouvait generer des ultrasons jusqu'a 1000°C et qu'aucune conductivite n'etait visible. Une hypothese a donc emerge : une conductivite ionique est presente dans le niobate de lithium a haute temperature (>500°C) mais elle n'affecte que faiblement ses proprietes a hautes frequences (>100 kHz). Une caracterisation du niobate de lithium a haute temperature est donc necessaire afin de verifier cette hypothese. Pour cela, la methode par resonance a ete employee. Elle permet une caracterisation de la plupart des coefficients electromecaniques avec une simple spectroscopie d'impedance electrochimique et un modele reliant de facon explicite les proprietes au spectre d'impedance. Il s'agit de trouver les coefficients du modele permettant de superposer au mieux le modele avec les mesures experimentales. Un banc experimental a ete realise permettant de controler la temperature des echantillons et de mesurer leur impedance electrochimique. Malheureusement, les modeles actuellement utilises pour la methode par resonance sont imprecis en presence de couplages entre les modes de vibration. Cela implique de posseder plusieurs echantillons de differentes formes afin d'isoler chaque mode principal de vibration. De plus, ces modeles ne prennent pas bien en compte les harmoniques et modes en cisaillement. C'est pourquoi un nouveau modele analytique couvrant tout le spectre frequentiel a ete developpe afin de predire les resonances en cisaillement, les harmoniques et les couplages entre les modes. Neanmoins, certains modes de resonances et certains couplages ne sont toujours pas modelises. La caracterisation d'echantillons carres a pu etre menee jusqu'a 750°C. Les resultats confirment le caractere prometteur du niobate de lithium. Les coefficients piezoelectriques sont stables en fonction de la temperature et l'elasticite et la permittivite ont le comportement attendu. Un effet thermoelectrique ayant un effet similaire a de la conductivite ionique a ete observe ce qui ne permet pas de quantifier l'impact de ce dernier. Bien que des etudes complementaires soient necessaires, l'intensite des resonances a 750°C semble indiquer que le niobate de lithium peut etre utilise pour des applications ultrasons a hautes frequences (>100 kHz).

La Recherche du Quark Top dans le Canal $e$ + Jets a D0 (in French)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lebrat, Jean-Francois

1996-05-01

Le travail de thèse qui est résumé ici a débuté en 1993, alors que l'existence du quark top n'avait pas encore été mise en évidence expérimentalement. Il se concentre sur la recherche du top dans l'un de ses modes de désintégration, le canal e + jets, et utilise l'ensemble des outils d'identication des particules et d'analyse développés par la collaboration DØ. L'analyse présentée ici est la première à utiliser le TRD (le Détecteur à Rayonnement de Transition, qui a été mis au point et fabriqué à Saclay) pour une meilleure identication de l'électron.Nous présenterons tout d'abord le quark top, enmore » décrivant la place qu'il occupe dans le modèle utilisé par les physiciens des particules, le Modèle Standard. Nous montrerons ainsi que l'existence du quark top était prédite par le modèle bien avant sa découverte, et indiquerons ainsi les raisons qui ont motivé notre analyse....« less

QUELS FUTURS TRAITEMENTS POUR LA DEPENDANCE AU TABAC ET AU CANNABIS?

PubMed Central

LE FOLL, Bernard; JUSTINOVA, Zuzana; TANDA, Gianlugi; GOLDBERG, Steven R.

2009-01-01

RESUME Plus de trois millions de morts sont attribués au tabagisme dans le monde par an, et l’usage de tabac est en progression dans les pays en voie de développement. L’usage de tabac est donc une des rares causes de mortalité qui augmente, avec une prévision de plus de 10 millions de morts par an dans 30–40 ans. Le cannabis ou marijuana est la drogue illicite la plus consommée dans le monde et il n’y a actuellement pas de traitement disponible. Bien que les systèmes dopaminergiques jouent un rôle central dans les effets renforçants des drogues, d’autres systèmes sont impliqués. Nous présentons ici des résultats récents obtenus avec des antagonistes des récepteurs cannabinoides CB1, des récepteurs D3 de la dopamine et des récepteurs opioïdes. Ces antagonistes qui modulent de façon directe ou indirecte la transmission dopaminergique cérébrale représentent des approches prometteuses pour le traitement du tabagisme ou de la dépendance au cannabis. Ces approches sont à valider dans des essais cliniques. PMID:18663981

Le syndrome du canal d’Alcock ou névralgie pudendale : un diagnostic à ne pas méconnaître

PubMed Central

Ziouziou, Imad; Bennani, Hassan; Zizi, Mohamed; Karmouni, Tarik; Khader, Khalid El; Koutani, Abdellatif; Andaloussi, Ahmed Iben Attya

2013-01-01

Résumé Le syndrome du canal d’Alcock – ou névralgie pudendale – est lié à la compression chronique du nerf pudendal dans la fossette ischiorectale ou au niveau du ligament sacroépineux. Le diagnostic du syndrome d’Alcock est surtout clinique. Les examens complémentaires sont dominés par les explorations électrophysiologiques et le test de bloc anesthésique. Le diagnostic repose sur des critères bien précis, soit les critères de Nantes. La prise en charge doit être globale, comprenant un traitement médicamenteux, des infiltrations, des techniques de neuromodulation, et dans les cas graves ou résistants, un traitement chirurgical qui consiste à libérer le nerf pudendal. Les névralgies pudendales peuvent être rencontrées après traitement d’une incontinence urinaire d’effort par bande-lettes sous-urétrales (TVT). Ce syndrome motive des consultations en urologie, car la douleur intéresse le territoire du périnée et des organes génitaux. Des signes urinaires peuvent aussi accompagner cette douleur. Il est donc judicieux de connaître cette pathologie. PMID:23914265

Formative research to develop a nutrition education intervention to improve dietary iron intake among women and adolescent girls through community kitchens in Lima, Peru.

PubMed

Creed-Kanashiro, Hilary M; Bartolini, Rosario M; Fukumoto, Mary N; Uribe, Tula G; Robert, Rebecca C; Bentley, Margaret E

2003-11-01

Formative research was conducted with 26 women and 16 adolescent girls to develop an education intervention through community kitchens (CK) in Lima, to increase their dietary iron intake and improve their iron status. A combination of qualitative research methods was used to explore perceptions about foods, nutrition, health, anemia and body image. The women recognized that there was a close association among eating well, "alimentarse bien", their health and prevention and treatment of anemia. They perceived that the nutritive value of a meal is determined primarily by its content of "nutritious" foods and by its being "balanced". Using this information the conceptual model of the education intervention was developed. The vulnerability of women to anemia was presented with the relationship between anemia and diet as the central focus. Feasible ways of achieving a nutritious diet were introduced to the community kitchens through promoting local heme iron sources and the consumption of beans with a vitamin C source. Animal source foods were amongst those considered to be nutritious and were "best buys" for iron content. CK searched for ways of assuring accessibility to these foods. The use of animal source foods in the community kitchen menus increased during the intervention.

Electrochemical behavior of self-assembled monolayers based on functionalized oligothiophenes

NASA Astrophysics Data System (ADS)

Michalitsch, R.; El Kassmi, A.; Lang, P.; Yassar, A.; Garnier, F.

1998-06-01

Self-assembled monolayers (SAMs) of 6-(2,2':5',2”-terthien-5yl)- hexanethiol (α-3T-hex-SH) have been prepared onto platinum substrates. The anodic oxidation of the monolayer effects a polymerisation of the monolayer. The conjugation length of the polymer is significantly higher than that of the terthiophene-derivative, although a major part of the terminal CH-α bonds of the terthiophenes are still available for reactions with other monomers. This suggests a contribution of the aromatic CH-β positions at the formation of the conjugated polymer. Des monocouches auto-assemblées, (SAM), de 6-(2,2':5',2”-terthien-5yl)- hexanethiol (α-3T-hex-SH) ont été préparées sur le platine. L'oxydation anodique effectue une polymérisation de la monocouche. La longueur de conjugaison du polymère est significativement plus élevée qu'au dérivée du terthiophène, bien que la plupart des liaisons CH-α terminal des terthiophènes restent disponibles pour des réaction avec des autres monomères. Ce qui propose la participation des C-H en position β des terthiophène à la formation d'une couche d'un polymère conjugué.

Contemporary horizontal crustal movement estimation for northwestern Vietnam inferred from repeated GPS measurements

NASA Astrophysics Data System (ADS)

Duong, Nguyen Anh; Sagiya, Takeshi; Kimata, Fumiaki; To, Tran Dinh; Hai, Vy Quoc; Cong, Duong Chi; Binh, Nguyen Xuan; Xuyen, Nguyen Dinh

2013-12-01

We present a horizontal velocity field determined from a GPS network with 22 sites surveyed from 2001 to 2012 in northwestern Vietnam. The velocity is accurately estimated at each site by fitting a linear trend to each coordinate time series, after accounting for coseismic displacements caused by the 2004 Sumatra and the 2011 Tohoku earthquakes using static fault models. Considering the coseismic effects of the earthquakes, the motion of northwestern Vietnam is 34.3 ± 0.7 mm/yr at an azimuth of N108° ± 0.7°E in ITRF2008. This motion is close to, but slightly different from, that of the South China block. The area is in a transition zone between this block, the Sundaland block, and the Baoshan sub-block. At the local scale, a detailed estimation of the crustal deformation across major fault zones is geodetically revealed for the first time. We identify a locking depth of 15.3 ± 9.8 km with an accumulating left-lateral slip rate of 1.8 ± 0.3 mm/yr for the Dien Bien Phu fault, and a shallow locking depth with a right-lateral slip rate of 1.0 ± 0.6 mm/yr for the Son La and Da River faults.

Cobertura de los sistemas de pensiones y factores asociados al acceso a una pensión de jubilación en México

PubMed Central

Murillo-López, Sandra; Venegas-Martínez, Francisco

2016-01-01

Resumen Objetivos: obtener estimaciones de indicadores de cobertura de las pensiones por jubilación o retiro para la población mexicana de 65 y más años, y evaluar el impacto que tienen los sistemas de pensiones en las transiciones al retiro de los adultos en edades medias y avanzadas en México. Para ello se utilizan datos microeconómicos provenientes de la Encuesta Nacional de Salud y Envejecimiento. Mediante análisis econométrico se identifican los factores sociodemográficos, económicos, laborales e institucionales que están asociados al acceso a una pensión de jubilación, o bien, a la dependencia de otras fuentes de ingresos. Se encontró que, en México, las transiciones al retiro del mercado de trabajo en las etapas avanzadas del ciclo de vida son limitadas debido a las características eminentemente contributivas de los esquemas de pensiones, los cuales favorecen a la población con trayectorias laborales formales y más estables asociadas a: características de género, oportunidades educativas y posibilidades de inserción en el mercado laboral. PMID:27524936

Consensus formalisé: recommandations de pratiques cliniques pour la prise en charge de la migraine du patient adulte africain

PubMed Central

Ahmed, Mahmoud Ait Kaci; Haddad, Monia; Kouassi, Beugré; Ouhabi, Hamid; Serrie, Alain

2016-01-01

La migraine est une céphalée primaire (selon les derniers critères de l'International Headache Society) qui affecte environ 8% de la population africaine. Les femmes sont plus fréquemment touchées que les hommes et les crises apparaissent le plus souvent avant l’âge de 40 ans. Bien qu'un certain nombre de traitements, de mesure hygiéno-diététiques, et d'autres méthodes non pharmacologiques permettent de limiter l'intensité et la fréquence des crises, la prise en charge médicamenteuse de la crise de migraine est très souvent nécessaire. La disponibilité des traitements et l'accès aux soins diffèrent sur le continent africain et ont conduit à la réalisation du 1er consensus d'experts pour la prise en charge du patient adulte africain. Destiné aux praticiens, ce travail collaboratif multinational a pour objectif de fournir 16 recommandations de pratiques cliniques simples, fondées sur les preuves, et adaptées aux conditions de l'exercice médical en Afrique. PMID:27642420

La santé des Premières nations, des Inuits et des Métis: les facteurs que doivent envisager les leaders en santé canadiens dans la foulée du rapport de la Commission de vérité et réconciliation du Canada.

PubMed

McNally, Mary; Martin, Debbie

2017-03-01

Les peuples des Premières nations, inuits et métis qui habitent au Canada sont aux prises avec de profondes disparités en matière de santé par rapport aux Canadiens non autochtones, et ce, dans presque toutes les mesures liées à la santé et au bien-être. Pour faire progresser les services de santé auprès des peuples autochtones, il faut passer à l'action dans tous les ordres de prestation des soins et des politiques en santé. Il est donc essentiel que les leaders et les prestataires des établissements, des systèmes et des installations de santé du Canada comprennent et prennent en main les déterminants de la santé propres aux peuples autochtones, y compris l'héritage du colonialisme et le racisme ancien et actuel. La Commission de vérité et réconciliation du Canada est le point de départ pour réagir de manière positive aux injustices.

Carcinome neuroendocrine thymique: à propos d’un cas et revue de la littérature

PubMed Central

Ramahandrisoa, Andriatsihoarana Voahary Nasandratriniavo; Hasiniatsy, Nomeharisoa Rodrigue Emile; Refeno, Valéry; Vololonantenaina, Clairette Raharisolo; Rakotoarisoa, Andriamihaja Jean Claude; Rakotovao, Hanitrala Jean Louis; Rafaramino, Florine

2017-01-01

Les tumeurs neuroendocrines thymiques (TNET) sont rares, de pronostic mal connu. L'objectif est de rapporter un cas de TNET et discuter la difficulté diagnostique et thérapeutique en milieu à faibles ressources. Un homme de 60 ans présentait une douleur thoracique, une toux grasse et un amaigrissement récent. Le scanner thoracique révélait une masse tissulaire médiastinale antérieure. L'histologie définitive obtenue quatre mois après la biopsie par médiastinotomie antérieure montrait une TNET bien différenciée, avec marquage intense à la chromogranine et à la synaptophysine. La recherche d'autres tumeurs neuroendocrines et le bilan d'extension étaient négatifs. La tumeur était inextirpable d'emblée et la radiothérapie indisponible. Le patient a reçu deux lignes de chimiothérapie première. Avec un recul de 16 mois, le patient était asymptomatique, mais en progression tumorale. Le diagnostic de TNET peut être retardé quand l'examen immunohistochimique n'est pas réalisé en routine. La chimiothérapie apporte une amélioration des symptômes en situation palliative. PMID:28451004

Etude du champ magnetique dans les nuages moleculaires

NASA Astrophysics Data System (ADS)

Houde, Martin

2001-12-01

Ce travail est une étude du champ magnétique duns l'environnement circumstellaire des étoiles jeunes. Il a pour origine la certitude qu'avait l'auteur qu'il se devait d'être possible de détecter la présence d'un champ magnétique, et de possiblement le caractériser, par le biais d'observations de profils spectraux d'espèces moléculaires ioniques. Il en découle donc qu'un des buts principaux était de prouver que cela est effectivement possible. La thèse comporte alors des éléments théoriques et expérimentaux qui sont à la fois complémentaires et intimement liés. L'aspect théorique est basé sur l'interaction mutuelle que des particules neutres et chargées peuvent avoir l'une sur l'autre daps un plasma faiblement ionisé comme ceux existants daps les nuages moléculaires sites de formation stellaire. Il appert que la présence d'un champ magnétique a un effet direct sur le comportement des ions (via la force de Lorentz) et indirect sur les molécules neutres (via les nombreuses collisions entre les deux types de particules). Une telle interaction est, comme il est maintenant bien connu, présente dans les premières étapes de la formation dune étoile. Il s'agit bien sûr de la diffusion ambipolaire. Nous montrerons qu'il existe cependant un autre type de diffusion, jusqu'ici inconnue, qui se manifeste plus tard au tours de l'évolution des nuages moléculaires. Celle-ci peut avoir un effet dramatique sur l'apparence des profils spectraux (de rotation moléculaire) des espèces ioniques lorsque comparés à ceux qu'exhibent des espèces neutres coexistantes. Mais pour ce faire, il doit y avoir existence de mouvements organisés (des flots ou jets) de matière ou encore la présence de turbulence dans les régions considérées. Une distribution de vélocité du type maxwellienne ne révèlera pas la présence du champ magnétique. Les observations, qui ont pour but de confirmer la théorie, se situent dans le domaine des longueurs d'ondes millimétriques et sous- millimétriques. Plusieurs espèces moléculaires furent détectées dans un échantillon significatif de nuages moléculaires. L'effet prédit fut confirmé et ce peu importe si les raies observées sont opaques ou transparentes. Dans le dernier chapitre, nous considérerons une application intéressante où nous utiliserons la manifestation de cet effet (ou son manque) pour vérifier l'alignement préférentiel des flots bipolaires, qui accompagnent souvent la présence de proto- étoiles, avec le champ magnétique local.

Acceptabilité du test VIH proposé aux nourrissons dans les services pédiatriques, en Côte d'Ivoire, Significations pour la couverture du diagnostic pédiatrique

PubMed Central

Oga, Maxime; Brou, Hermann; Dago-Akribi, Hortense; Coffie, Patrick; Amani-Bossé, Clarisse; Ékouévi, Didier; Yapo, Vincent; Menan, Hervé; Ndondoki, Camille; Timité-Konan, M.; Leroy, Valériane

2014-01-01

Résumé Problème: Le dépistage VIH chez les enfants a rarement été au centre des préoccupations des chercheurs. Quand le dépistage pédiatrique a retenu l'attention, cela a été pour éclairer seulement sur les performances diagnostiques en ignorant même que le test pédiatrique comme bien d'autres peut s'accepter ou se refuser. Cet article met au cœur de son analyse les raisons qui peuvent expliquer qu'on accepte ou qu'on refuse de faire dépister son enfant. Objectif: Etudier chez les parents, les mères, les facteurs explicatifs de l'acceptabilité du test VIH des nourrissons de moins de six mois. Méthodes: Entretien semi-directif à passages répétés avec les parents de nourrissons de moins de six mois dans les formations sanitaires pour la pesée/vaccination et les consultations pédiatriques avec proposition systématique d'un test VIH pour leur nourrisson. Résultats: Nous retenons que la réalisation effective du test pédiatrique du VIH chez le nourrisson repose sur trois éléments. Primo, le personnel de santé par son discours (qui dénote de ses connaissances et perceptions même sur l'infection) orienté vers les mères influence leur acceptation ou non du test. Secundo, la mère qui par ses connaissances et perceptions même sur le VIH, dont le statut particulier, l'impression de bien-être chez elle et son enfant influence toute réalisation du test pédiatrique VIH. Tertio, l'environnement conjugal de la mère, particulièrement caractérisé par les rapports au sein du couple, sur la facilité de parler du test VIH et sa réalisation chez les deux parents ou chez la mère seulement sont autant de facteurs qui influencent la réalisation effective du dépistage du VIH chez l'enfant. Le principe préventif du VIH, et le désir de faire tester l'enfant ne suffisent pas à eux seuls pour aboutir à sa réalisation effective, selon certaines mères confrontées au refus du conjoint. A l'opposé, les autres mères refusant la réalisation du test pédiatrique disent s'y opposer ; bien entendu, même dans le cas où le conjoint l'accepterait. Discussion: Les mères sont les principales mises en cause et craignent les réprimandes et la stigmatisation. Le père, le conjoint peut être un obstacle, quand il s'oppose au test VIH du nourrisson, ou devenir le facilitateur de sa réalisation s'il est convaincu. Le positionnement du père demeure donc essentiel dans la question de l'acceptabilité du VIH pédiatrique. Les mères en ont conscience et présagent des difficultés à faire dépister ou non les enfants sans avis préalable du conjoint à la fois père, et chef de famille. Conclusion: La question du dépistage pédiatrique du VIH, au terme de notre analyse, met en face trois éléments qui exigent une gestion globale pour assurer une couverture effective. Ces trois éléments n'existeraient pas sans s'influencer, donc ils sont constamment en interaction et empêchent ou favorisent la réalisation ou non du test pédiatrique. Aussi, dans une intention d'aboutir à une couverture effective du dépistage VIH des nourrissons, faut-il tenir compte d'une gestion harmonieuse de ces trois éléments: La première, la mère seule (avec ses connaissances, ses perceptions), son environnement conjugal (de proposition du test intégrant 1- l’époux et / ou père de l'enfant avec ses perceptions et connaissances sur l'infection 2- la facilité de parler du test et sa réalisation chez les deux ou un des parents, la mère) et les connaissances, attitudes et pratiques du personnel de l’établissement sanitaire sur l'infection du VIH. Recommandations: Nos recommandations proposent une redéfinition de l'approche du VIH/sida vers des familles exposées au VIH et une intégration plus accentuée du père facilitant leur propre acceptation du test VIH et celle de leur enfant. PMID:25088574

Innovations en vaccinologie: enjeux et perspectives pour l’Afrique

PubMed Central

Diop, Doudou; Sanicas, Melvin

2017-01-01

La vaccination est incontestablement l’une des interventions de santé publique les plus efficaces et les plus rentables qui soient. Les vaccins continuent de révolutionner notre capacité à prévenir les maladies et à améliorer la santé. Avec toutes les avancées technologiques, nous sommes en mesure d’étendre les avantages des vaccins à plus de gens et de fournir une meilleure protection contre les maladies infectieuses mortelles. Toutefois, avec le développement incessant de nouvelles souches microbiennes à travers le monde, la recherche en vaccinologie se doit d’innover continuellement. D’énormes progrès ont été réalisés pour améliorer la couverture vaccinale et introduire de nouveaux vaccins en Afrique. De nouveaux types de vaccins associés à des outils de vectorisation, d’administration et de délivrance spécifiques mais aussi des adjuvants susceptibles de moduler finement la réponse immunitaire sont attendus dans le futur. En Afrique, il est nécessaire de développer une approche régionale afin de répondre efficacement aux nombreux défis. Une meilleure information, la formation des personnels de santé en vaccinologie et des recherches bien ciblées sont les clés des futurs accomplissements dans le domaine. PMID:28690749

Art & Astronomie - impressions celestes

NASA Astrophysics Data System (ADS)

Nazé, Yaël

2015-10-01

Ce livre revisite l'histoire de l'art dans ce qu'elle a de plus universel : son rapport au ciel. De l'Orient à l'Occident, de l'Antiquité à l'époque contemporaine, du classique au plus inattendu, il crée un espace singulier où se mêlent art et science, un musée imaginaire croisant sensibilité intime et compréhension du Cosmos, un jeu sans cesse réinventé...; car il n'y a pas une seule manière de regarder les étoiles. Bien sûr, le ciel possède un énorme pouvoir évocateur, une force inspiratrice à nulle autre pareille, mais l'inspiration n'est pas la seule des relations entre l'art et l'astronomie. En effet, les artistes peuvent apporter leur grain de sel aux révolutions scientifiques, tandis que l'astronomie peut aider à comprendre certaines œuvres. Avec près de 600 illustrations, cet ouvrage n'a pas pour but d'égrener la liste exhaustive des représentations de ciel étoilé, clair de lune, ambiance crépusculaire ou soleil de midi, mais plutôt d'aborder les multiples relations entre l'art et la science. Il s'agit d'une invitation à un voyage aux frontières mouvantes et incertaines des plus belles réalisations de l'esprit humain.

TELEMEDICINA: UN DESAFÍO PARA AMÉRICA LATINA

PubMed Central

Litewka, Sergio

2011-01-01

La telemedicina es una tendencia creciente en la prestación de los servicios médicos. Aunque la eficacia de esta práctica no ha estado bien establecida, es probable que los países en desarrollo compartirán este nuevo paradigma con los desarrollados. Los defensores de la telemedicina en América Latina sostienen que será una herramienta útil para reducir las disparidades y mejorar la accesibilidad de atención de salud. Aunque América Latina quizá se convierta en un lugar para la investigación e investigación de estos procedimientos, no está claro cómo la telemedicina podría contribuir a mejorar la accesibilidad para las poblaciones desfavorecidas, o coexistir con sistemas de atención de salud públicos crónicamente enfermos. Telemedicine is a growing trend in the provision of medical services. Although the effectiveness of this practice has not been well established, it is likely that developing countries will share this new paradigm with developed ones. Supporters of telemedicine in Latin America maintain that it will be a useful tool for reducing disparities and improving health care accessibility. Although Latin America might become a place for research and investigation of these procedures, it is not clear how telemedicine could contribute to improving accessibility for disadvantaged populations, or coexist with chronically ill-funded public healthcare systems. PMID:21625326

Characteristics of Tacca leontopetaloides L. Kuntze collected from An Giang in Vietnam

NASA Astrophysics Data System (ADS)

Vu, Quan Thi Hong; Le, Phung Thi Kim; Vo, Huy Pham Hoang; Nguyen, Triet Thanh; Nguyen, Tam Kim Minh

2017-09-01

Tacca leontopetaloides L. Kuntze has been known as a remedy in folk medicine and also a staple food source in many tropical countries. Nonetheless, there are currently few literature and research on the potential pharmaceutical benefits of this herbal plant. In this study, the constituents of leaves, peels and peeled tubers as well as its antioxidant and antimicrobial activities of Tacca cultivated from mountainous regions in Tinh Bien, An Giang Province, Vietnam were investigated. The results indicated that the highest of total phenolic content (TPC) and total flavonoid content (TFC) were presented in leaves of Tacca which were 16.69 mg GAE (gallic acid equivalent)/g dried weight, 57.24 mg QE (quercetin equivalent)/g dried weight, respectively. Besides, the yield of flour recovery process from Tacca tuber estimated from 18%-20%. The chemical compositions of Tacca flour were 0.66 % total of nitrogen, 0.91% lipid, 0.05% ash and 85.7% starch content on dried weight. Furthermore, the extract of peels possessed potential antimicrobial activity against Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Enterococcus faecalis whilst the extract of others did not show any significant inhibition at the same concentration. As a results, with high starch content (nearly 20% in tuber) is a highly promising new starch for food and pharmaceutical excipient industry, while the usefullness of peel in treatment need further investigation.

Apport des neutrons à l'analyse structurale des composés partiellement désordonnés

NASA Astrophysics Data System (ADS)

Cousson, A.

2003-02-01

La cristallographie est un outil extrêmement puissant qui pourrait être utilisé par de nombreux scientifiques dont les sujets de recherche sont en fait très éloignés. L'évolution des techniques ces dernières années a relégué par exemple la cristallographie des rayons X des petites molécules à un rôle mineur, un rôle de service. Certains ont même le sentiment semble-t-il que toutes les connaissances sont contenues dans de multiples logiciels capables par eux-mêmes de conduire une analyse structurale à un résultat correct unique. Il est souhaitable que chacun soit capable de réaliser l'étude structurale du composé qui l'intéresse et bien entendu nécessaire de comprendre ce que l'on fait, la qualité des résultats et leur analyse en dépend. L'objet de cette présentation est de montrer l'apport spécifique de la diffraction de neutrons sur monocristaux à l'étude du désordre, en particulier des atomes d'hydrogène, et ses conséquences sur la compréhension des propriétés physiques, à partir de développements et d'exemples récents.

TELEMEDICINA: UN DESAFÍO PARA AMÉRICA LATINA.

PubMed

Litewka, Sergio

2005-01-01

La telemedicina es una tendencia creciente en la prestación de los servicios médicos. Aunque la eficacia de esta práctica no ha estado bien establecida, es probable que los países en desarrollo compartirán este nuevo paradigma con los desarrollados. Los defensores de la telemedicina en América Latina sostienen que será una herramienta útil para reducir las disparidades y mejorar la accesibilidad de atención de salud. Aunque América Latina quizá se convierta en un lugar para la investigación e investigación de estos procedimientos, no está claro cómo la telemedicina podría contribuir a mejorar la accesibilidad para las poblaciones desfavorecidas, o coexistir con sistemas de atención de salud públicos crónicamente enfermos.Telemedicine is a growing trend in the provision of medical services. Although the effectiveness of this practice has not been well established, it is likely that developing countries will share this new paradigm with developed ones. Supporters of telemedicine in Latin America maintain that it will be a useful tool for reducing disparities and improving health care accessibility. Although Latin America might become a place for research and investigation of these procedures, it is not clear how telemedicine could contribute to improving accessibility for disadvantaged populations, or coexist with chronically ill-funded public healthcare systems.

Ultrasonic diagnostic in porous media and suspensions

NASA Astrophysics Data System (ADS)

Bacri, J.-C.; Hoyos, M.; Rakotomalala, N.; Salin, D.; Bourlion, M.; Daccord, G.; Lenormand, R.; Soucemarianadin, S.

1991-08-01

An apparatus has been constructed to characterize transient fluid displacements in porous media, and probe sedimenting suspensions. The technique used is to propagate an ultrasonic wave in the sample. Both ultrasonic attenuation and velocity are related to the static and hydrodynamic properties of the medium. The system was built so as to perform array imaging (mapping) and tested with different fluids and suspensions. It is suggested that the ultrasonic technique can be suitable whenever transient, low cost and safe saturation and concentration measurements are to be performed. Nous avons réalisé un appareil pour étudier l'évolution temporelle des écoulements en milieux poreux et au cours de la sédimentation des suspensions. La technique employée utilise la propagation d'une onde ultrasonore dans l'échantillon. L'atténuation et la vitesse ultrasonores sont toutes deux reliées aux propriétés statique et dynamique du mileu. Le système d'imagerie acoustique permet une cartographie à deux dimensions de l'échantillon , ce système a été testé avec différents fluides et suspensions. Notre étude montre que la technique ultrasonore est bien adaptée à la détermination de la dépendance temporelle de la concentration et de la saturation dans des conditions de sécurité et de coût optimales.

Examining neighborhood and interpersonal norms and social support on fruit and vegetable intake in low-income communities.

PubMed

Dulin, Akilah; Risica, Patricia M; Mello, Jennifer; Ahmed, Rashid; Carey, Kate B; Cardel, Michelle; Howe, Chanelle J; Nadimpalli, Sarah; Gans, Kim M

2018-04-05

We examined whether neighborhood-, friend-, and family- norms and social support for consumption and purchase of fruits and vegetables (F&V) were associated with F&V intake among low-income residents in subsidized housing communities. We examined baseline data from a study ancillary to the Live Well/Viva Bien intervention. Participants included 290 residents in four low-income subsidized housing sites who were ≥ 18 years of age, English and/or Spanish speaking, and without medical conditions that prevented consumption of F&V. Linear regression models examined associations of norms and social support with F&V intake after adjustments for sociodemographic characteristics. In the analysis, neighborhood social support for F&V was associated with a 0.31 cup increase in F&V intake (95% CI = 0.05, 0.57). The family norm for eating F&V and family social support for eating F&V were associated with a 0.32 cup (95% CI = 0.13, 0.52) and 0.42 cup (95% CI = 0.19, 0.64) increase in F&V intake, respectively. To our knowledge, no other studies have examined neighborhood, family, and peer norms and social support simultaneously and in relation to F&V intake. These findings may inform neighborhood interventions and community-level policies to reduce neighborhood disparities in F&V consumption.

Office-based endoscopic revision using a microdebrider for failed endoscopic dacryocystorhinostomy.

PubMed

Park, Jongyeop; Kim, Hochang

2016-12-01

This article is to introduce office-based endoscopic revision surgery using a microdebrider for failed endoscopic dacryocystorhinostomy (EN-DCR). The authors conducted retrospective, non-comparative, interventional case series analysis of 27 eyes of 24 patients, treated by office-based revision EN-DCR using a microdebrider. After local anesthesia, anatomical failures (cicatrization, granuloma, synechia) after primary EN-DCR were treated with a microdebrider (Osseoduo 120, Bien-Air Surgery, Le Noirmont, Switzerland) in an office setting, and a bicanalicular silicone tube was placed. Anatomical improvement and functional relief of epiphora were evaluated at 6-months after revision. The causes of failed EN-DCR were rhinostomy site cicatrization (17/27, 63.0 %), granulomatous obstruction (7/27, 25.9 %) and synechial formation (3/27, 11.1 %). The anatomical success rate was 100 %, and 85.2 % cases achieved complete relief of epiphora. The surgery did not exceed 10 min in any case and no complications were observed. Office-based revision EN-DCR using a microdebrider provided prompt management of post-DCR epiphora. The portable nature and all-round ability of the microdebrider allowed office-based surgery, which offered advantage to work with the surgeon's own well-trained office staff. Office-based revision EN-DCR can be both time- and money-saving, and might be regarded the treatment of choice for failed EN-DCR.

Infection respiratoire aigüe et statut nutritionnel chez les enfants de 0-5 ans: cas des cliniques universitaires de Lubumbashi, République Démocratique du Congo

PubMed Central

Ngombe, Léon Kabamba; Mbombo-Ditunga; Kameya, Nduwa; Malingo, Aimé Abasiko; Kayomb, Nathalie Kaj; ea Ngolomba, Jean Ngolomba; Nday, David Kakez; Numbi, Luboya

2014-01-01

Les auteurs rapportent les données d'une étude rétrospective de 153 dossiers d'enfants hospitalisés dans le service de pédiatrie des Cliniques Universitaires de Lubumbashi/RD Congo pour IRA. En ce qui nous concerne, les IRA chez les enfants de moins de 5 ans représentent 26,11% de l'effectif, dont 17,75% âgés de moins d'un an. Le sexe masculin est légèrement prédominant (85 contre 68) et près de 70% des enfants ont un statut nutritionnel précaire. La répartition mensuelle connaît des pics en mars et octobre. Les diagnostiques notifiés sont: rhinite(16,3%),Amygdalite(5,9%),Otite Moyenne Aigue(0,7%),Laryngite (3,3%), Rhinopharyngite (39,2%), Pharyngite (6,5%), Bronchite (7,2%), Bronchopneumonie (5,9%), Pneumonie(2,6%) et Bronchiolite (12,4%).Tous les cas ont bien évolués sous traitement. Le but de ce travail est de déterminer la fréquence des IRA et le statut nutritionnel des enfants ayant été admis dans le service des pédiatries aux C.U.L. PMID:25995789

Multiplicative Process in Turbulent Velocity Statistics: A Simplified Analysis

NASA Astrophysics Data System (ADS)

Chillà, F.; Peinke, J.; Castaing, B.

1996-04-01

A lot of models in turbulence links the energy cascade process and intermittency, the characteristic of which being the shape evolution of the probability density functions (pdf) for longitudinal velocity increments. Using recent models and experimental results, we show that the flatness factor of these pdf gives a simple and direct estimate for what is called the deepness of the cascade. We analyse in this way the published data of a Direct Numerical Simulation and show that the deepness of the cascade presents the same Reynolds number dependence as in laboratory experiments. Plusieurs modèles de turbulence relient la cascade d'énergie et l'intermittence, caractérisée par l'évolution des densités de probabilité (pdf) des incréments longitudinaux de vitesse. Nous appuyant aussi bien sur des modèles récents que sur des résultats expérimentaux, nous montrons que la Curtosis de ces pdf permet une estimation simple et directe de la profondeur de la cascade. Cela nous permet de réanalyser les résultats publiés d'une simulation numérique et de montrer que la profondeur de la cascade y évolue de la même façon que pour les expériences de laboratoire en fonction du nombre de Reynolds.

EDITORIAL: Nanopores—the 'Holey Grail' in nanotechnology research Nanopores—the 'Holey Grail' in nanotechnology research

NASA Astrophysics Data System (ADS)

Demming, Anna

2012-06-01

'Negative space' may be as important in the development of nanomaterials as it is in creating works of art. The term refers to the space around and between objects, an important aspect in artistic composition. In nanotechnology, while nanoposts and nanowires have been assiduously studied and exploited for enhancing the performance of solar cells [1], real-time chemical sensors [2], UV emitters [3] and many other applications, nanopore structures have also yielded important advances in a wide range of fields. In this issue Melnikov, Leburton and Gracheva report on the electrostatic properties of nanopores in a layered semiconductor, and show how they allow a more accurate characterization of DNA than pores in other membranes [4]. Nanoporous materials have been applied to a diverse range of technological challenges. In recognition of its potential in high-efficiency solar cells, Prakasam and colleagues in the US reported the first ever synthesis of self-aligned nanoporous haematite [5]. Haematite is abundant, stable, non-toxic and has a band gap in the visible region and, as their work demonstrates, the photoresponse of nanoporous haematite is very promising for energy harvesting applications. Nanoporous aluminum oxide has also proved to be a particularly valuable material in applications ranging from liquid display panels to biosensor microchips. A collaboration of researchers in Taiwan demonstrated that porous aluminum oxide on an indium tin oxide surface could act as an alignment layer in liquid crystal display panels that have a transmittance of 60-80%, and switch from black to bright with a response time of 62.5 ms [6]. In Korea, Chung, Son and Min investigated the effect of nanostructural parameters of porous aluminum oxide on cell adhesion and proliferation for cell-based microchips [7]. While aluminum oxide without any modifications is not favourable for adherent cell culture, the proliferation of cells dramatically increased in porous aluminum oxide, particularly when the aspect ratio of the nanopore was near unity. In the mid 1990s a collaboration of researchers in the US demonstrated that nanopores could be used to characterize DNA [8]. They showed that as an electric field drove DNA molecules through a pore in a lipid bilayer membrane, the decrease in ionic current due to the partially blocked channel allowed measurement of the polynucleotide length. 'With further improvements, the method could in principle provide direct, high-speed detection of the sequence of bases in single molecules of DNA or RNA', suggested the authors. The idea inspired a catalogue of further research. Gracheva and colleagues in Illinois described a modified approach to detecting DNA using a nanopore in a membrane fabricated from a metal-oxide-semiconductor (MOS) capacitor [9]. The use of semiconductor materials allows the direct integration of high-sensitivity nanoscale MOS amplifiers on the nanopore layer structure to improve the signal. Researchers in the Netherlands have investigated ways of refining geometrical control of nanopores in SiN membranes for more accurate molecular characterization [10]. They reported the fabrication of nanopores using transmission electron microscope beams of different sizes. They found that the stability of small nanopores is related to their geometry, which could be controlled by the size of the beam used in fabrication. One challenge for accurate DNA characterization has been the speed of translocation through the pore. In a collaboration between the University of Illinois and the University of Notre-Dame in Indiana, researchers used a time-varying electric field to slow down the molecule's passage in the pore [11]. In this issue, researchers in Illinois have studied the translocation and stretching of DNA in a pore in a semiconductor membrane consisting of doped p- and n-layers of Si forming a p-n-junction [4]. Control over the stretching of the DNA is important, as is controlling the speed of translocation. Interference between the secondary structure of the probed molecule can interfere with the recorded signal, muddling measurements of the molecule's charge. According to Gracheva and her colleagues, 'the results indicate that the tunable local electric field inside the membrane can effectively control dynamics of a DNA in the channel to either momentarily trap, slow down or allow the biomolecule to translocate at will'. The fertility of research based on nanopores complements well the interest in nanowires and nanoposts. This may largely be a symptom of the comprehensive rigour in scientific enquiry which encourages the investigation of all approaches to a solution. It was once suggested that 'art and science have their meeting point in method' [12]. One might also argue that the creative and inspired ingenuity that is evident in the application of nanopores to such wide-ranging technological challenges demonstrates how the development of scientific methods is in itself a fine art. References [1] Qiu J et al 2010 Solution-derived 40 μm vertically aligned ZnO nanowire arrays as photoelectrodes in dye-sensitized solar cells Nanotechnology 21 195602 [2] Park I, Li Z, Pisano A P and Williams R S 2010 Top-down fabricated silicon nanowire sensors for real-time chemical detection Nanotechnology 21 015501 [3] Gao J et al 2011 UV light emitting transparent conducting tin-doped indium oxide (ITO) nanowires Nanotechnology 22 195706 [4] Melnikov D V, Leburton J-P and Gracheva M E 2012 Slowing down and stretching DNA with an electrically tunable nanopore in a p-n semiconductor membrane Nanotechnology 23 255501 [5] Prakasam H E, Varghese O K, Paulose M, Mor G K and Grimes C A 2006 Synthesis and photoelectrochemical properties of nanoporous iron (III) oxide by potentiostatic anodization Nanotechnology 17 4285-91 [6] Hong C, Tang T-T, Hung C-Y, Pan R-P and Fang W 2010 Liquid crystal alignment in nanoporous anodic aluminum oxide layer for LCD panel applications Nanotechnology 21 285201 [7] Chung S H, Son S J and Min J 2010 The nanostructure effect on the adhesion and growth rates of epithelial cells with well-defined nanoporous alumina s substrates Nanotechnology 21 125104 [8] Kasianowicz J J, Brandin E, Branton D and Deamer D W 1996 Characterization of individual polynucleotide molecules using a membrane channel Proc. Natl Acad. Sci. 93 13770-3 [9] Gracheva M E, Xiong A, Aksimentiev A, Schulten K, Timp G and Leburton J-P 2006 Simulation of the electric response of DNA translocation through a semiconductor nanopore-capacitor Nanotechnology 17 622-33 [10] Van Den Hout M, Hall A R, Wu M Y, Zandbergen H W, Dekker C and Dekker N H 2010 Controlling nanopore size, shape and stability Nanotechnology 21 115304 [11] Mirsaidov U, Comer J, Dimitrov V, Aksimentiev A and Timp G 2010 Slowing the translocation of double-stranded DNA using a nanopore smaller than the double helix Nanotechnology 21 395501 [12] Baron E and Bulwer L L 1864 Caxtoniana vol 2 (Leipzig: Bernard Tauchnits) p 122

[Injecting without getting infected: injectors' strategies to prevent HIV and HCV.

PubMed

Mateu-Gelabert, P; Friedman, S; Sandoval, M

2007-10-01

OBJETIVO: Desde principios de los noventa, en la ciudad de Nueva York se han implementado con éxito programas para reducir la incidencia del virus de la inmunodeficiencia humana (VIH) y, en menor medida, del virus de la hepatitis C (VHC). A pesar de ello, aproximadamente el 70% de los usuario de drogas inyectables (UDI) están infectados por el VHC. Queremos investigar cómo el 30% restante se las ha arreglado para no infectarse. El Staying safe (nombre original del estudio) explora los comportamientos y mecanismos que ayudan a evitar la infección por el VHC y el VIH a largo plazo. MATERIAL Y M#ENTITYSTARTX000E9;TODOS: Hemos utilizado el concepto de «desviación positiva» aplicado en otros campos de salud pública. Estudiamos las estrategias, prácticas y tácticas de prevención de aquellos UDI que, viviendo en contextos de alta prevalencia, se mantienen sin infectar por VIH y el VHC, a pesar de haberse inyectado heroína durante años. Los resultados preliminares presentados en este artículo incluyen el análisis de las entrevistas realizadas a 25 UDI (17 doble negativos, 3 doble positivos y 5 con infección por el VHC y sin infección por el VIH). Se usaron entrevistas semiestructuradas que exploraban con detalle la historia de vida de los sujetos, incluyendo su consumo de drogas, redes sociales, contacto con instituciones, relaciones sexuales y estrategias de protección y vigilancia. RESULTADOS: La intencionalidad es importante para no infectarse, especialmente durante períodos de involución (períodos donde hay un deterioro económico y/o social que llevan al que se inyecta a situaciones de mayor riesgo). Presentamos tres dimensiones independientes de intencionalidad que conllevan comportamientos que pueden ayudar a prevenir la infección: a) evitar «el mono» (síntomas de abstención) asegurando el acceso a la droga; b) «llevarlo bien» para no convertirse en un junkie y así evitar la «muerte social» y la falta de acceso a los recursos, y c) seguir sin infectarse por el VIH (sólo un doble negativo tuvo un amplio conocimiento sobre la hepatitis C). Estas intencionalidades no son mutuamente excluyentes. La presencia de varias refuerza la puesta en práctica a diario de comportamientos que pueden ayudar al que se inyecta a mantenerse libre de infecciones durante años. Algunas prácticas que hemos identificado se implementan en grupo y se comunican de UDI a UDI, de esta manera se extienden entre algunas redes sociales de UDI. CONCLUSIONES: Los UDI que permanecen sin infectarse planean e implementan estrategias de prevención en circunstancias donde otros UDI aplican prácticas de riesgo. El mantenimiento de la no infección no es, por lo tanto, un resultado del azar, sino más bien el resultado del esfuerzo (agencia) de los UDI. Investigar y extender estas estrategias y tácticas a través de programas de prevención podría contribuir a la prevención del VIH y el VHC.

Pincharse sin infectarse: estrategias para prevenir la infección por el VIH y el VHC entre usuarios de drogas inyectables

PubMed Central

MATEU-GELABERT, P.; FRIEDMAN, S.; SANDOVAL, M.

2011-01-01

Resumen Objetivo Desde principios de los noventa, en la ciudad de Nueva York se han implementado con éxito programas para reducir la incidencia del virus de la inmunodeficiencia humana (VIH) y, en menor medida, del virus de la hepatitis C (VHC). A pesar de ello, aproximadamente el 70% de los usuario de drogas inyectables (UDI) están infectados por el VHC. Queremos investigar cómo el 30% restante se las ha arreglado para no infectarse. El Staying safe (nombre original del estudio) explora los comportamientos y mecanismos que ayudan a evitar la infección por el VHC y el VIH a largo plazo. Material y métodos Hemos utilizado el concepto de «desviación positiva» aplicado en otros campos de salud pública. Estudiamos las estrategias, prácticas y tácticas de prevención de aquellos UDI que, viviendo en contextos de alta prevalencia, se mantienen sin infectar por VIH y el VHC, a pesar de haberse inyectado heroína durante años. Los resultados preliminares presentados en este artículo incluyen el análisis de las entrevistas realizadas a 25 UDI (17 doble negativos, 3 doble positivos y 5 con infección por el VHC y sin infección por el VIH). Se usaron entrevistas semiestructuradas que exploraban con detalle la historia de vida de los sujetos, incluyendo su consumo de drogas, redes sociales, contacto con instituciones, relaciones sexuales y estrategias de protección y vigilancia. Resultados La intencionalidad es importante para no infectarse, especialmente durante períodos de involución (períodos donde hay un deterioro económico y/o social que llevan al que se inyecta a situaciones de mayor riesgo). Presentamos tres dimensiones independientes de intencionalidad que conllevan comportamientos que pueden ayudar a prevenir la infección: a) evitar «el mono» (síntomas de abstención) asegurando el acceso a la droga; b) «llevarlo bien» para no convertirse en un junkie y así evitar la «muerte social» y la falta de acceso a los recursos, y c) seguir sin infectarse por el VIH (sólo un doble negativo tuvo un amplio conocimiento sobre la hepatitis C). Estas intencionalidades no son mutuamente excluyentes. La presencia de varias refuerza la puesta en práctica a diario de comportamientos que pueden ayudar al que se inyecta a mantenerse libre de infecciones durante años. Algunas prácticas que hemos identificado se implementan en grupo y se comunican de UDI a UDI, de esta manera se extienden entre algunas redes sociales de UDI. Conclusiones Los UDI que permanecen sin infectarse planean e implementan estrategias de prevención en circunstancias donde otros UDI aplican prácticas de riesgo. El mantenimiento de la no infección no es, por lo tanto, un resultado del azar, sino más bien el resultado del esfuerzo (agencia) de los UDI. Investigar y extender estas estrategias y tácticas a través de programas de prevención podría contribuir a la prevención del VIH y el VHC. PMID:21915175

Ecoulement et mise en structure de suspensions macroscopiques

NASA Astrophysics Data System (ADS)

Petit, L.

In this review, we report the various experimental studies performed on suspensions of solid particules in liquids, and concerning the rheological behaviour of such systems and the ordering of particules under the applied velocity fields. The number of materials which are flowing suspensions (reagents in chemical engineering, paints while spreading, blood flow, muds in oil reservoir) gave rise to a number of experimental studies, especially in the last twenty years. The results show a wide variety of behaviour, even for systems of intermediate concentration. In addition, even for identical systems, the results depend of the type of flow. Then, it is clear that, in addition of the standard parameters which are to be taken into account, it is necessary to consider the type of flow the suspension is submitted to. The flow influences the spatial distribution of the particules, leading to their ordering or migration. These ordering or motions influence the flow, and then, the rheological behaviour of the whole system. So, there is a feedback mechanism from the ordering to the flow, which explains the experimental observations. Nous reportons dans cette revue les différentes études expérimentales réalisées sur les suspensions de particules solides dans un liquide et qui concernent le comportement rhéologique de ces systèmes ainsi que les mouvements des particules sous l'effet des champs de vitesse imposés. Ces mouvements peuvent conduire soit à des mises en structure, ou encore à des migrations des particules. L'importance du nombre de matériaux qui se présentent sous forme de suspension et qui sont mis en écoulement (réactif en génie chimique, peintures lors de leur mise en place, écoulement sanguin, boues dans les forages pétroliers,...) a motivé un grand nombre de travaux expérimentaux plus fondamentaux sur le sujet, particulièrement dans les vingt dernières années. Les résultats correspondants montrent une très grande diversité des comportements même pour les systèmes moyennement concentrés. Bien plus, pour des systèmes identiques, les résultats dépendent du type d'écoulement imposé. Ceci montre clairement, qu'à côté des facteurs standards qui sont à prendre en compte pour caractériser le comportement de tels systèmes (concentration de la phase solide, taille des particules, interactions entre particules, effets de diffusion,...), il est nécessaire de tenir compte de la nature de l'écoulement auquel est soumise la suspension. Cet écoulement modifie la distribution spatiale des particules, soit directement, soit par l'intermédiaire de différents mécanismes tels que écoulements secondaires, diffusion. Ces effets se traduisent par une mise en ordre des particules, ou bien à des mouvements de migration. Les structures ou les mouvements ainsi créés agissent à leur tour sur les propriétés de l'écoulement, et de là, sur le comportement rhéologique de l'ensemble du système. Il existe ainsi un mécanisme de rétroaction de la structure sur l'écoulement qui permet d'expliquer les comportements observés expérimentalement.

Systemes Fermioniques a Basse Dimension D'espace: Supraconductivite, Effet Hall Quantique et Statistique Fractionnaire

NASA Astrophysics Data System (ADS)

Sakhi, Said

Cette these est constituee de trois sujets de recherche distincts. Les deux premiers articles traitent du phenomene de supraconductivite dans un modele bidimensionnel, dans le troisieme article on etudie l'action effective d'un systeme electronique soumis a l'effet d'un champ magnetique (systeme de Hall) et le dernier article examine la quantification d'un systeme de particules identiques en deux dimensions d'espace et la possibilite des anyons. Le modele qu'on analyse dans les deux premiers articles est un systeme fermionique dont les particules chargees et de masse nulle interagissent entre elles avcc un couplage attractif et fort. L'analyse de l'action effective decrivant la physique a basse energie nous permet d'examiner la structure de l'espace de phase. A temperature nulle, le parametre d'ordre du systeme prend une valeur moyenne non nulle. Consequemment, la symetrie continue U(1) du modele est spontanement brisee et il en resulte l'apparition d'un mode de Goldstone. En presence d'un champ electromagnetique externe, ce mode disparait et le champ de jauge acquiert une masse donc l'effet Meissner caracteristique d'un supraconducteur. Bien que le modele ne soit pas renormalisable dans le sens perturbatif, on montre qu'il l'est dans le cadre du developpement en 1/N ou N est le nombre d'especes fermioniques. En outre, on montre que l'inclusion des effets thermiques change radicalement le mecanisme de supraconductivite. En effet, on montre que la brisure spontanee de la symetrie U(1) n'est plus possible a temperature finie a cause de tres severes divergences infrarouges. Par contre, la dynamique des tourbillons (vortex) existant dans le plan devient essentielle. On montre que le phenomene de supraconductivite resulte du confinement de ces objets topologiques et que la temperature critique s'identifie a celle de Kosterlitz -Thouless. Ce mecanisme de supraconductivite presente l'avantage d'aboutir a un rapport gap a la temperature critique plus eleve que celui du modele de BCS et la non violation de la symetrie par renversement du temps et de l'espace contrairement au modele anyonique. Dans le troisieme article, on a developpe une methode systematique pour calculer les determinants fermioniques en presence d'un champ magnetique perpendiculaire au plan de confinement des particules. Aussi bien les effets thermiques que ceux dus aux impuretes sont pris en consideration dans cette methode. La technique est illustree dans le cas du systeme de Hall quantique. Finalement, dans le dernier article, on discute la quantification d'un systeme de particules identiques dans le plan. Apres avoir correctement defini l'espace de phase classique du systeme, l'analyse fait ressortir deux parametres fondamentaux denotes par theta et alpha. Le premier parametre theta est associe a l'intensite du flux magnetique localise au vertex du cone et definit la statistique des particules. Pour des valeurs arbitraires de theta on parle d'anyons. L'autre parametre alpha est associe a l'extension auto-adjointe de l'hamiltonien et ressort de l'unitarite de la theorie. On montre par un exemple explicite que alpha peut etre vu comme le vestige d'une interaction a tres courte distance (haute energie) entre les particules du systeme. Finalement, on montre que le groupe de symetrie du systeme avec extension auto -adjointe n'est plus SO(2,1) car le generateur de dilatation de ce groupe n'est plus compatible avec un parametre alpha arbitraire. (Abstract shortened by UMI.).

Biotransformation of pesticides in saturated-zone materials

NASA Astrophysics Data System (ADS)

Hoyle, Blythe L.; Arthur, Ellen L.

Many studies have been conducted to evaluate pesticide contamination of groundwater in the United States, but investigations of pesticide biotransformation in saturated zones are much less numerous than in surface soils. Because results of studies using soils are not directly applicable to the subsurface, the purpose of this paper is to illustrate examples of pesticide biotransformation in saturated-zone materials. Although it must be considered with caution, the US Environmental Protection Agency's (EPA) "Pesticides in Ground Water Database" was used to focus the discussion on the biotransformation potential of dibromoethane (EDB), atrazine, acetanilide herbicides, and aldicarb, all of which have been detected in groundwater in the United States. Results of more than two dozen studies indicate that a biotransformation potential for these pesticides exists in saturated-zone materials, although for any given pesticide substantial differences in biotransformation occurred. These variations were due both to differences in experimental methods and to heterogeneities in the subsurface materials under investigation. However, because biotransformation mechanisms were not well investigated, it is generally not possible to extrapolate predictions of biotransformation potential beyond the specific sites investigated. These results highlight the need to better understand microbial genetic regulation of biotransformation processes so that genetic information may be effectively incorporated into future investigations of biotransformation potential in the subsurface. Résumé De nombreuses études ont été réalisées pour évaluer le degré de pollution des aquifères par les pesticides aux États-Unis, mais les recherches concernant la biotransformation des pesticides dans les eaux souterraines sont beaucoup moins nombreuses que dans les sols. Du fait que les résultats des études concernant les sols ne sont pas directement applicables au milieu souterrain, le propos de cet article est d'illustrer par des exemples la biotransformation des pesticides dans les nappes. Bien qu'il faille la considérer avec précaution, la base de données sur les pesticides dans les eaux souterraines de l'Agence américaine pour la protection de l'environnement a été utilisée pour centrer la discussion sur le potentiel de biotransformation du dibromoéthane (EDB), de l'atrazine, des désherbants acétanildés et de l'aldicarb, qui tous ont été détectés dans les nappes des États-Unis. Les résultats de plus de deux douzaines d'études indiquent qu'il existe un potentiel de biotransformation de ces pesticides dans les nappes, bien qu'entre chacun de ces pesticides il existe des différences très nettes dans la biotransformation. Ces variations sont en fait dues à la fois à des différences dans les méthodes expérimentales et dans les hétérogénéités dans les matériaux étudiés. Cependant, parce que les mécanismes de la biotransformation ne sont pas bien étudiés, il est en général impossible d'extrapoler les prédictions du potentiel de biotransformation à des sites d'étude spécifiques. Ces résultats soulignent la nécessité de mieux comprendre la régulation génétique microbienne des processus de biotransformation, pour que l'information génétique puisse être efficacement prise en compte dans les futures recherches sur le potentiel de biotransformation dans le sous-sol. Resumen Se han llevado a cabo un gran número de estudios para evaluar la contaminación por pesticidas en los acuíferos de los Estados Unidos de América. Sin embargo, las investigaciones sobre biotransformación de pesticidas en la zona saturada son mucho menos numerosas que en suelos. Como los resultados obtenidos en suelos no son directamente transladables a la zona saturada, el objetivo de este artículo es mostrar ejemplos de biotransformación de pesticidas en la zona saturada. Aunque debe tomarse con cautela, la base de datos "Pesticides in Ground Water Database (Base de Datos de Pesticidas en Aguas Subterráneas)" perteneciente a la US EPA (Agencia de Protección Ambiental de los EEUU) se usó para centrar la discusión en la biotransformación potencial de diversos compuestos orgánicos detectados en diversos acuíferos de los EEUU. Los resultados de más de dos docenas de estudios indican que la biotransformación potencial de estos pesticidas en la zona saturada es posible, aunque para un pesticida dado pueden presentarse grandes diferencias, debidas tanto a diferencias en los métodos experimentales como a la heterogeneidad de los materiales. Sin embargo, no es posible en general extrapolar las predicciones de biotransformación potencial más allá de las zonas específicas estudiadas, al no haberse investigado en detalle sus mecanismos. Los resultados del estudio indican la necesidad de entender mejor la regulación genética de los procesos de biotransformación, para que la información genética pueda incorporarse de manera efectiva en las investigaciones futuras de biotransformación potencial en acuíferos.

Discrete Scaling in Earthquake Precursory Phenomena: Evidence in the Kobe Earthquake, Japan

NASA Astrophysics Data System (ADS)

Johansen, Anders; Sornette, Didier; Wakita, Hiroshi; Tsunogai, Urumu; Newman, William I.; Saleur, Hubert

1996-10-01

We analyze the ion concentration of groundwater issuing from deep wells located near the epicenter of the recent earthquake of magnitude 6.9 near Kobe, Japan, on January 17, 1995. These concentrations are well fitted by log-periodic modulations around a leading power law. The exponent (real and imaginary parts) is very close to those already found for the fits of precursory seismic activity for Loma Prieta and the Aleutian Islands. This brings further support for the general hypothesis that complex critical exponents are a general phenomenon in irreversible self-organizing systems and particularly in rupture and earthquake phenomena. Nous analysons les fluctuations de concentrations ioniques de l'eau issue de puits profonds situés à proximité de l'épicentre du récent tremblement de terre de magnitude 6.9 proche de Kobe au Japon, le 17 janvier 1995. Ces fluctuations sont bien reproduites par des modulations log-périodiques autour d'une loi de puissance. Les parties réelle et imaginaire de l'exposant sont très proches de celles trouvées précédemment pour les tremblements de terre de Loma Prieta et des Iles Aléoutiennes. Ces résultats renforcent l'hypothèse que des exposants critiques complexes sont une propriété générale des phénomènes de croissance irréversible, et en particulier des problèmes de rupture et des tremblements de terre.

Récidive après dix ans de tumeur de granulosa de l’ovaire: à propos de deux cas et revue de la littérature

PubMed Central

Majdoul, Soufya; Tawfiq, Nezha; Bourhaleb, Zouhour; Naqos, Nora; Taleb, Amina; Bouchbika, Zineb; Benchakroun, Nadia; Jouhadi, Hassan; Sahraoui, Souha; Benider, Abdelatif

2016-01-01

Les tumeurs à cellules de la granulosa (TG) de l’ovaire sont des tumeurs rares appartenant au groupe des tumeurs des cordons sexuels et du stroma. Elles représentent 0,6 à 3 % de l’ensemble des tumeurs de l’ovaire et 5 % des tumeurs malignes On distingue deux types: le type juvénile (TGJ) qui se caractérise par son agressivité et le type adulte (TGA) qui est le type le moins agressif et le plus fréquent. Les rechutes de TG de l'ovaire surviennent généralement dans les cinq ans, elles sont rarement sous forme de métastases péritonéales ou locales. Bien que, des options de traitement y compris la chirurgie avec ou sans chimiothérapie et ou radiothérapie ont été rapportés pour le traitement des récidives des TG, il n'y a aucune prise en charge standardisée de récidive de cette maladie. Ici, nous rapportons notre stratégie thérapeutique dans la prise en charge des récidives tardives, après dix ans, de la TG sous forme de carcinose péritonéale pour deux patientes avec une revue de la littérature. PMID:28154722

Programmed home visits by nursing professionals to older adults: prevention or treatment?1

PubMed Central

Dios-Guerra, Caridad; Carmona-Torres, Juan Manuel; Ruíz-Gándara, África; Muñoz-Alonso, Adoración; Rodríguez-Borrego, María-Aurora

2015-01-01

OBJETIVOS: conocer la repercusión de la visita domiciliaria de los profesionales en enfermería a personas de 65 años o más, pluripatológicas, en morbimortalidad. MÉTODO: estudio retrospectivo caso-control por auditoria de historias clínicas. Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. Análisis por medidas de tendencia central, dispersión, posición, tabulación, frecuencias relativas, absolutas; no paramétricas, contrastes χ2; Wilcoxon-Mann-Whitney. RESULTADOS: se estudiaron a 1743 pacientes, de ellos 199 recibieron visita domiciliaria; la edad media de quien recibe visita es de 81,99 años; estos presentan mayor número de patologías de media 3,76; habitan en domicilio particular, si bien en conjunto presentan más institucionalización que los controles; el 50% no tiene identificado el Cuidador Principal; es mayor el número de visitas de las enfermeras a los pacientes que viven en residencias (p < 0,001). El 50% de casos no tiene plan de cuidados, con relación significativa (p < 0,001). No existen diferencias significativas en tiempo de vida entre los casos y los controles. CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención. PMID:26312638

Présentation de l’adaptation française de « l’échelle de coparentage » de McHale pour familles avec jeunes enfants

PubMed Central

Frascarolo, F.; Dimitrova, N.; Zimmermann, G.; Favez, N.; Kuersten-Hogan, R.; Baker, J.; McHale, J.

2009-01-01

Le but de cet article est de présenter l’autoquestionnaire américain de McHale permettant l’évaluation de la qualité du coparentage ainsi qu’un premier pas en direction de sa validation structurelle et de construit en langue française. Quarante et une familles suisses francophones et 84 familles nord-américaines ont rempli ce questionnaire ainsi qu’un autre portant sur leur satisfaction conjugale (Dyadic Adjustment Scale [DAS]). Les résultats des familles suisses correspondent aux résultats américains : d’une part, la distribution des items en quatre facteurs (intégrité familiale, conflit, affection et dénigrement) est retrouvée et, d’autre part, un lien relatif entre la qualité du coparentage et celle des relations conjugales est observé. Ce deuxième résultat confirme la validité de construit du questionnaire, vu le lien reconnu entre ces deux sous-systèmes. Étant donné l’influence de la qualité du coparentage sur le développement socio-affectif de l’enfant, disposer d’un outil permettant son évaluation, dans ses aspects tant positifs (soutien, chaleur, etc.) que négatifs (dénigrement, conflit, etc.), est un atout important aussi bien en recherche qu’en clinique. PMID:19655028

La réparation sphinctérienne directe: points techniques, indications et résultats

PubMed Central

Laalim, Said Ait; Hrora, Abdelmalek; Raiss, Mohammed; Ibnmejdoub, Karim; Toughai, Imane; Ahallat, Mohammed; Mazaz, Khalid

2013-01-01

L'incontinence anale est un handicap physique, psychique et social majeur qui a de nombreuses causes différentes. Les méthodes actuellement disponibles pour améliorer les symptômes de cette incontinence sont les méthodes médicales et de rééducation d'une part et les méthodes chirurgicales d'autre part. Quatre techniques chirurgicales répondent à ces objectifs pour la plupart des malades: la sphinctérorraphie, la neuromodulation des racines sacrées, et les deux techniques de substitution que sont le sphincter artificiel et la graciloplastie dynamisée. La réparation sphinctérienne directe est la technique la plus utilisée dans le traitement chirurgical de l'incontinence anale (IA) par lésion sphinctérienne. Cette technique est envisageable chez les malades ayant une incontinence fécale en rapport avec des lésions limitées du sphincter anal externe. La technique chirurgicale est simple (myorraphie par suture directe ou en paletot) et bien codifiée. Les résultats fonctionnels sont imparfaits et se dégradent avec la durée du suivi. Une continence parfaite après réparation sphinctérienne est rarement acquise de façon durable: le malade candidat à cette approche thérapeutique doit en être averti. PMID:23504542

Appendicite aigue non compliquée: y a-t- il une place pour le traitement conservateur

PubMed Central

El Khader, Ahmed; Lahkim, Mohamed; El Barni, Rachid; Achour, Abdessamad

2015-01-01

Le but de cette étude a été d’évaluer l'efficacité de l'antibiothérapie seule dans le traitement des appendicites aigues non compliquées. C'est une étude prospective, intéressant 68 patients ayant eu une appendicite aigue simple, de confirmation radiologique, traités par l'amoxicilline associée à l'acide clavulanique pendant 10 jours. L'appendicectomie a été réalisée en cas d'aggravation ou en cas de non amélioration au bout de 48heures de traitement. Le traitement conservateur a été efficace dans 82,35% avec une résolution complète des symptômes chez 56 patients. Les 12 cas restants (17,65%) ont subit une appendicectomie. l'appendicite a été gangréneuse dans 8 cas et phlegmoneuse dans 4 cas. Cinq des 56 patients, qui ont bien évolué sous traitement conservateur, ont été réadmis et opérés pour récidive, soit 8,9%. Deux cas ont eu une appendicite compliquée. L'appendicectomie reste le traitement de référence pour l'appendicite aigue, mais le traitement antibiotique peut être proposé en première intension à des patients présentant une appendicite aigue non compliquée. PMID:26327981

Application du concept de maillon faible à un critère d'endurance multiaxial

NASA Astrophysics Data System (ADS)

Flacelière, L.; Morel, F.; Palin-Luc, T.

2002-12-01

En fatigue à grand nombre de cycle, il est aujourd'hui admis que la distribution des contraintes, ainsi que la taille des composants, sont responsables de variations de la limite de fatigue. Sous chargement uniaxial ou multiaxial, on peut montrer qu'une approche statistique dite du maillon le plus faible, combiné à un critère multiaxial d'endurance basé sur une analyse micro plastique, permet de prédire la limite de fatigue de plusieurs matériaux métalliques. Quatre types de chargement sont analysés (traction-compression, torsion, flexion rotative et flexion plane), puis comparées aux résultats expérimentaux, pour une fonte et deux aciers haute résistance. L'approche statistique proposée permet d'intégrer un certain nombre d'aspects: la dispersion des données pour tous types de chargement, l'effet de gradient et l'influence de la présence de défauts matériaux. Enfin, ce modèle rend également compte de la diminution de la limite de fatigue avec l'augmentation du volume contraint. Les prédictions des probabilités de rupture sont raisonnables bien que seules des limites de fatigue relatives à des probabilités de rupture de 50% soient utilisées pour l'identification des paramètres du modèle.

La dysplasie fibreuse: état des lieux

PubMed Central

Akasbi, Nessrine; Abourazzak, Fatima Ezzahra; Talbi, Sofia; Tahiri, Latifa; Harzy, Taoufik

2015-01-01

La dysplasie fibreuse des os est une affection osseuse bénigne congénitale mais non héréditaire, où l'os normal est remplacé par un tissu fibreux renfermant une ostéogenèse immature. Elle est due à une mutation du gène GNAS 1sur le chromosome 20q13, une mutation activatrice de la sous-unité α de la protéine G. C'est une pathologie qui est le plus souvent silencieuse, de découverte fortuite sur une radiographie standard ou révélée par une douleur osseuse ou une fracture pathologique. L'imagerie et l'histologie, quand elle est nécessaire, permettent d’établir le diagnostic. Bien qu'il ne s'agisse pas d'une tumeur, elle est souvent classée dans la catégorie des tumeurs osseuses bénignes pour des raisons de diagnostic différentiel radiographique et anatomopathologique. Elle peut être monostotique ou polyostotique. L'approche thérapeutique est essentiellement symptomatique. Quelques publications récentes ont suggéré l'intérêt majeur d'un bisphosphonate, en particulier le pamidronate, qui diminuerait les douleurs et stimulerait une reminéralisation progressive des zones ostéolytiques chez les patients traités. D'autres traitements tels que la thérapie ciblée sont en cours d’évaluation. PMID:26401215

Cavernomas de la región temporal mesial: Anatomía microquirúrgica y abordajes

PubMed Central

Campero, Alvaro

2015-01-01

Objetivo: Describir la anatomía microquirúrgica y los abordajes a la región temporal mesial (RTM), en relación a cavernomas de dicho sector. Materiales y Método: Cinco cabezas de cadáveres adultos, fijadas en formol e inyectadas con silicona coloreada, fueron estudiadas. Además, desde enero de 2007 a junio de 2014, 7 pacientes con cavernomas localizados en la RTM fueron operados por el autor. Resultados: Anatomia: La RTM fue dividida en 3 sectores: Anterior, medio y posterior. Pacientes: 7 enfermos con cavernomas de la RTM fueron operados por el autor. De acuerdo a la ubicacion en la RTM, 4 cavernomas se ubicaron en el sector anterior, 2 cavernomas se localizaron en el sector medio y 1 cavernoma se ubico en el sector posterior. Para el sector anterior de la RTM se utilizo un abordaje transsilviano-transinsular; para el sector medio de la RTM se utilizo un abordaje transtemporal (lobectomia temporal anterior); y para el sector posterior de la RTM se utilizo un abordaje supracerebeloso-transtentorial. Conclusión: Dividir la RTM en 3 sectores nos permite adecuar el abordaje en función a la localización de la lesión. Así, el sector anterior es bien abordable a través de la fisura silviana; el sector medio a través de una vía transtemporal; y el sector posterior por un abordaje supracerebeloso. PMID:26600986

Regulación del flujo sanguíneo uterino. I. Funciones de estrógeno y receptores estrogénicos α/β en el endotelio vascular uterino durante el embarazo

PubMed Central

Mayra, Pastore R.; Rosalina, Villalón L.; López, Gladys; Iruretagoyena, Jesús; Magness, Ronald

2015-01-01

Resumen El estrógeno y los receptores estrogénicos clásicos (REs), RE-α y RE-β, han demostrado ser parcialmente responsable por las adaptaciones endoteliales uterinas durante el embarazo al corto y largo plazo. Las diferencias moleculares y estructurales, junto con los diferentes efectos causados por estos receptores en las células y los tejidos, sugieren que su función varía dependiendo de la manera en la cual el estrógeno se comunica con sus receptores. En ésta revisión bibliográfica se discuten la función del estrógeno y sus receptores clásicos en las adaptaciones cardiovasculares durante el embarazo y la expresión de los Res in vivo e in vitro en el endotelio de la arteria uterina durante el ciclo ovárico y el embarazo, a la vez comparado con la expresión en endotelio arterial de tejidos reproductivos y no reproductivos. Estos temas integran el conocimiento actual de este amplio campo científico con interpretaciones e hipótesis diversas relacionadas con los efectos estrogénicos mediados bien sea por uno o los dos REs. Esta revisión también incluye la relación con las adaptaciones vasodilatadoras y angiogénicas requeridas para modular el dramático incremento fisiológico en la perfusión útero-placentaria observada durante un embarazo normal. PMID:26113750

PubMed

Escandón-Nagel, Neli

2016-11-29

Introducción: si bien el Trastorno por Atracón es un trastorno de la conducta alimentaria que  no se da exclusivamente en personas obesas, es más común en este grupo que en sujetos con normopeso, sin embargo no todas las personas con malnutrición por exceso presentan Trastorno por Atracón. Objetivo: identificar el conocimiento actual respecto a las diferencias y semejanzas existentes entre personas con malnutrición por exceso con y sin Trastorno por Atracón.Método: para lograr el objetivo anterior, se realizó una revisión de artículos científicos en torno al tema.Resultados: primero se analizó la comorbilidad psicopatológica en obesidad y después se detectaron similitudes y diferencias entre los grupos de interés, tanto en sintomatología general, como así también en sintomatología de la conducta alimentaria. Además, se identificaron algunos aspectos controversiales, en que existe evidencia contradictoria respecto a la comparación intergrupal.Conclusión: de esta revisión se concluye que en el estudio de la obesidad se hace necesario conocer en mayor profundidad las características del subgrupo de pacientes que además presenta Trastorno por Atracón,  ya que estas personas poseen características distintivas cuyo conocimiento permitirá ofrecer tratamientos integrales más adecuados a las necesidades de los pacientes, lo que posibilitará, en consecuencia, diseñar intervenciones más eficaces.

Intérêt de la scintigraphie lymphatique et place de la chirurgie dans les chylothorax congénitaux

PubMed Central

Methlouthi, Jihène; Mahdhaoui, Nabiha; Bellalah, Manel; Selsabil, Nouir; Hedia, Ayache; Sfar, Raja; Essabah, Habib; Abdellatif, Nouri; Sonia, Nouri; Hassen, Seboui

2016-01-01

Le chylothorax est défini par l'accumulation du liquide lymphatique dans la cavité pleurale. Il existe 3 catégories distinctes chez le nouveau-né: les chylothorax congénitaux (CC), les chylothorax malformatifs ou syndromiques (CM) et les chylothorax post-opératoires (CO). Bien que rare, le chylothorax représente la cause la plus fréquente des épanchements pleuraux en période néonatale. Son diagnostic positif est facile par analyse du liquide pleural, mais son mécanisme et surtout l'intégrité du canal thoracique et ses collatérales est parfois difficile à préciser. La lymphoscintigraphie représente l'examen de choix dans le diagnostic etipathogénique. Ce moyen de diagnostic peut être couplé, si possible, au SPECT-CT (single photon emission tomography/computed tomography) permettant de donner des renseignements plus précis, notamment sur le plan anatomique. Sa prise en charge repose sur le drainage du liquide pleural, la suppression des graisses alimentaires et la nutrition parentérale. Le recours à la chirurgie est préconisé devant l'échec du traitement médical. Nous rapportons l'observation d'un nouveau-né porteur d'un chylothorax unilatéral, n'ayant pas répondu au traitement médical. La lymphoscintigraphie avait permis de diagnostiquer le mécanisme étiopathogénique et par conséquent, de guider le traitement chirurgical. PMID:28154676

Anti-arthritic activity of aqueous-methanolic extract and various fractions of Berberis orthobotrys Bien ex Aitch.

PubMed

Alamgeer; Uttra, Ambreen Malik; Hasan, Umme Habiba

2017-07-18

The roots and stem bark of Berberis orthobotrys (Berberidaceae) have long been used traditionally to treat joint pain. Though, it has not been pharmacologically assessed for rheumatoid arthritis. The current study explores anti-arthritic activity and phytochemical analysis of aqueous-methanolic extract (30:70) and fractions (ethyl acetate, n-butanol, and aqueous) of Berberis orthobotrys roots. Anti-arthritic potential was evaluated in vitro using protein denaturation (bovine serum albumin and egg albumin) and membrane stabilization methods at 12.5-800 μg/ml concentration and in vivo via turpentine oil, formaldehyde and Complete Freund Adjuvant (CFA) models at 50, 100 and 150 mg/kg doses. Also, in vitro antioxidant ability was appraised by reducing power assay. Moreover, total flavonoid content, Fourier transform infrared spectroscopy and High performance liquid chromatography of n-butanol fraction were performed. The results revealed concentration dependent inhibition of albumin denaturation and notable RBC membrane stabilization, with maximum results obtained at 800 μg/ml. Similarly, plant exhibited dose dependent anti-arthritic effect in turpentine oil and formaldehyde models, with maximum activity observed at 150 mg/kg. The results of CFA model depicted better protection against arthritic lesions and body weight alterations. Also, B.orthobotrys remarkably ameliorated altered hematological parameters, rheumatoid factor and positively modified radiographic and histopathological changes. Additionally, plant exhibited remarkable anti-oxidant activity. Moreover, phytochemical analysis revealed polyphenols and flavonoids. Taken together, these results support traditional use of B.orthobotrys as potent anti-arthritic agent that may be proposed for rheumatoid arthritis treatment.

The ARGO Project

NASA Astrophysics Data System (ADS)

Kozameh, C. N.

El proyecto µARGO propone el desarrollo, construcción y operación del Observatorio Espacial de Rayos Gamma, que operará en una órbita terrestre. Este observatorio constará de un telescopio con capacidad de medir simultáneamente dirección de incidencia y polarización de rayos Gamma en dos rangos de energía: 50 KeV - 3 MeV y 10 MeV - 1 GeV. Para ello se usarán detectores de silicio de última generación y microelectrónica adaptada a la configuración. La masa total en órbita del observatorio estará en el orden de los 60 - 100 kg. dependiendo de la geometría adoptada lo que permitirá minimizar costos de desarrollo y construcción, sin perder por ello calidad en su misión científica. ? Desde el punto de vista energético μARGO cubrirá el rango cubierto por COMPTEL y EGRET del CGRO, duplicando como mínimo la resolución angular de ambos con una reducción de peso de dos órdenes de magnitud. En adición, μARGO podr´ medir la polarización incidente de los rayos energéticos. Si bien existen otros dos proyectos en marcha (GLAST y AGILE) para reemplazar EGRET que serán lanzados antes que μARGO, estos proyectos no están diseñados para medir polarización ni tampoco cubren el rango mas bajo de energía arriba mencionado.

ALHAMBRA-survey: a new tool for photo-z calibrations in absence of spec-z information

NASA Astrophysics Data System (ADS)

Molino Benito, A.; Benitez Lozano, N.; The Alhambra-Team

2013-05-01

La estimación de los desplazamientos al rojo (redshift) de las galaxias, derivados mediante fotometría multi-banda, se conoce con el nombre de photometric redshifts (photo-z). Es bien sabido que la precisión alcanzable por estas técnicas puede verse incrementada si se dispone de una muestra espectroscópica de galaxias (cuyos redshifts (spec-z) sean conocidos) con la que re-calibrar los puntos cero fotométricos. (Coe et al. 2006, Ilbert et al. 2008, Molino et al. 2012 in prep). ALHAMBRA-survey, que es un cartografiado extragaláctico (de ˜4 grados cuadrados) dedicado a la realización de un estudio de la evolución de las propiedades y contenido del Universo (Moles et al. 2005, 2008), presenta solapamientos parciales con otros cartografiados espectroscópicos ya existentes con el objetivo de validar y mejorar la precisión de sus photo-z. Sin embargo, dada la variabilidad fotométrica entre sus campos, resulta ineficiente extrapolar las correcciones de punto cero, introduciendo sesgos de inhomogeneidad en la precisión de los resultados. En este trabajo se presenta una nueva metodología que permite mejorar la calibración de los puntos cero fotométricos mediante la utilización de la información estadística proporcionada por los propios photo-z. Mediante esta técnica resulta posible no sólo mejorar la precisión de las estimaciones sino, además, soslayar la necesidad de obtener grandes muestras espectroscópicas.

Rethinking the Magnetic Resonance Imaging Findings in Early Rasmussen Encephalitis: A Case Report and Review of the Literature.

PubMed

Holec, Megan; Nagahama, Yasunori; Kovach, Christopher; Joshi, Charuta

2016-06-01

We present a child with Rasmussen encephalitis and highlight the pitfalls of diagnosis when magnetic resonance imaging (MRI) is negative for atrophy. We review the literature regarding this issue, introduce the FreeSurfer software as a potential means of noninvasive diagnosis, and discuss methods for prompt and definitive treatment. In addition to the patient description, we review the English language literature regarding pathologic diagnosis of Rasmussen encephalitis using the key words Rasmussen encephalitis, focal lesions, MRI, atrophy, epilepsia partialis continua and hemiparesis in PubMed. We conducted a retrospective, volumetric analysis of our patient's MRIs using FreeSurfer. Unlike the majority of patients in the literature with Rasmussen encephalitis, our patient's initial MRI was normal and later showed only a small area of T2 and fluid-attenuated inversion recovery high signal despite the presence of epilepsia partialis continua and a rapidly deteriorating clinical course. She did not meet the Rasmussen encephalitis diagnostic criteria until biopsy was obtained but is now seizure-free after functional hemispherotomy performed six months after her initial seizure. FreeSurfer analysis did not show cortical atrophy. The Bien criteria have poor sensitivity for the diagnosis of Rasmussen encephalitis when the MRI is negative for atrophy. Tissue diagnosis is essential in such instances. We suggest a high clinical index of suspicion and multidisciplinary collaboration between radiology, pathology, and neurosurgery to facilitate a greater emphasis on biopsy followed by hemispherotomy as definitive therapy for individuals with early Rasmussen encephalitis. Copyright © 2015 Elsevier Inc. All rights reserved.

Impacts of Austrian Climate Variability on Honey Bee Mortality

NASA Astrophysics Data System (ADS)

Switanek, Matt; Brodschneider, Robert; Crailsheim, Karl; Truhetz, Heimo

2015-04-01

Global food production, as it is today, is not possible without pollinators such as the honey bee. It is therefore alarming that honey bee populations across the world have seen increased mortality rates in the last few decades. The challenges facing the honey bee calls into question the future of our food supply. Beside various infectious diseases, Varroa destructor is one of the main culprits leading to increased rates of honey bee mortality. Varroa destructor is a parasitic mite which strongly depends on honey bee brood for reproduction and can wipe out entire colonies. However, climate variability may also importantly influence honey bee breeding cycles and bee mortality rates. Persistent weather events affects vegetation and hence foraging possibilities for honey bees. This study first defines critical statistical relationships between key climate indicators (e.g., precipitation and temperature) and bee mortality rates across Austria, using 6 consecutive years of data. Next, these leading indicators, as they vary in space and time, are used to build a statistical model to predict bee mortality rates and the respective number of colonies affected. Using leave-one-out cross validation, the model reduces the Root Mean Square Error (RMSE) by 21% with respect to predictions made with the mean mortality rate and the number of colonies. Furthermore, a Monte Carlo test is used to establish that the model's predictions are statistically significant at the 99.9% confidence level. These results highlight the influence of climate variables on honey bee populations, although variability in climate, by itself, cannot fully explain colony losses. This study was funded by the Austrian project 'Zukunft Biene'.

Neogene sequence stratigraphy, Nam Con Son Basin, offshore Vietnam

DOE Office of Scientific and Technical Information (OSTI.GOV)

McMillen, K.J.; Do Van Luu; Lee, E.K.

1996-12-31

An integrated well log, biostratigraphic, and seismic stratigraphic study of Miocene to Recent deltaic sediments deposited in the Nam Con Son Basin offshore from southern Vietnam shows the influence of eustacy and tectonics on sequence development. Sediments consist of Oligocene non-marine rift-basin fill (Cau Formation), early to middle Miocene tide-dominated delta plain to delta front sediments (TB 1.5 to TB 2.5, Due and Thong Formations), and late Miocene to Recent marine shelf sediments (TB. 2.6 to TB 3.1 0, Mang Cau, Nam Con Son, and Bien Dong Formations). Eustacy controlled the timing of key surfaces and sand distribution in themore » tectonically-quiet early Miocene. Tectonic effects on middle to late Miocene sequence development consist of thick transgressive systems tracts due to basin-wide subsidence and transgression, sand distribution in the basin center, and carbonate sedimentation on isolated fault blocks within the basin. Third-order sequence boundaries (SB) are identified by spore peaks, sand stacking patterns, and channel incision. In the basin center, widespread shale beds with coal occur above sequence boundaries followed by transgressive sandstone units. These TST sandstones merge toward the basin margin where they lie on older HST sandstones. Maximum flooding surfaces (MFS) have abundant marine microfossils and mangrove pollen, a change in sand stacking pattern, and often a strong seismic reflection with downlap. Fourth-order genetic-type sequences are also interpreted. The MFS is the easiest marker to identify and correlate on well logs. Fourth-order SB occur within these genetic units but are harder to identify and correlate.« less

Neogene sequence stratigraphy, Nam Con Son Basin, offshore Vietnam

DOE Office of Scientific and Technical Information (OSTI.GOV)

McMillen, K.J.; Do Van Luu; Lee, E.K.

1996-01-01

An integrated well log, biostratigraphic, and seismic stratigraphic study of Miocene to Recent deltaic sediments deposited in the Nam Con Son Basin offshore from southern Vietnam shows the influence of eustacy and tectonics on sequence development. Sediments consist of Oligocene non-marine rift-basin fill (Cau Formation), early to middle Miocene tide-dominated delta plain to delta front sediments (TB 1.5 to TB 2.5, Due and Thong Formations), and late Miocene to Recent marine shelf sediments (TB. 2.6 to TB 3.1 0, Mang Cau, Nam Con Son, and Bien Dong Formations). Eustacy controlled the timing of key surfaces and sand distribution in themore » tectonically-quiet early Miocene. Tectonic effects on middle to late Miocene sequence development consist of thick transgressive systems tracts due to basin-wide subsidence and transgression, sand distribution in the basin center, and carbonate sedimentation on isolated fault blocks within the basin. Third-order sequence boundaries (SB) are identified by spore peaks, sand stacking patterns, and channel incision. In the basin center, widespread shale beds with coal occur above sequence boundaries followed by transgressive sandstone units. These TST sandstones merge toward the basin margin where they lie on older HST sandstones. Maximum flooding surfaces (MFS) have abundant marine microfossils and mangrove pollen, a change in sand stacking pattern, and often a strong seismic reflection with downlap. Fourth-order genetic-type sequences are also interpreted. The MFS is the easiest marker to identify and correlate on well logs. Fourth-order SB occur within these genetic units but are harder to identify and correlate.« less

Le profil clinique et immunologique de 15 patients Marocains atteints de syndrome hyper IgM

PubMed Central

Ouair, Hind; Benhsaien, Ibtihal; Jeddane, Leila; El Bakkouri, Jalila; Elhafidi, Naima; Rada, Noureddine; Najib, Jilali; Ailal, Fatima; Alj, Hanane Salih; Bousfiha, Ahmed Aziz

2017-01-01

Le Syndrome hyper IgM est un déficit immunitaire héréditaire bien connu, décrit pour la première fois en 1961. Il est causé par un défaut au niveau des lymphocytes B, caractérisé par un taux sérique normal ou élevé des IgM et un taux bas ou nul des IgG, IgA, IgE résultant d'une déficience de la commutation isotypique. Ses manifestations cliniques sont dominées par les infections à répétition, surtout du tube digestif, de la sphère ORL et des poumons. Le syndrome est causé par un défaut de commutation de classe d'immunoglobuline dans les cellules B, et une diminution de la capacité des monocytes à induire la prolifération des lymphocytes T. Le résultat net de tous ces défauts est la susceptibilité accrue aux infections opportunistes à Pneumocystis jiroveci, Cryptosporidium spp et d'autres organismes intracellulaires, ainsi qu'une fréquence élevée d'infections bactériennes et virales. L'intérêt de ce projet est d'illustrer l'importance de la compréhension des mécanismes physiopathologiques associés à cette susceptibilité accrue aux infections, ce qui permettra une meilleure prise en charge diagnostique et thérapeutique des patients atteint du Syndrome hyper IgM (SHIM). PMID:28690727

Les brulures electriques chez les voleurs de cuivre

PubMed Central

Belmir, R.; Fejjal, N.; Achbouk, H.; El Mazouz, S.; Gharib, N.; Abassi, A.; Belmahi, A.

2011-01-01

Summary Les vols de biens fabriqués avec le cuivre semblent en hausse depuis un certain temps du fait de son prix élevé de revente, ce qui est à l’origine d’une augmentation du nombre d’accidents électriques par haut voltage (AEHV) qui sont graves du fait des brûlures profondes qu’elles provoquent le long des axes vasculo-nerveux. Les Auteurs rapportent une série de neuf cas d’AEHV traités au service de chirurgie plastique et de brûlés de l’Hôpital Ibn Sina de Rabat, Maroc, à travers laquelle ils étudient les caractéristiques épidémiologiques, cliniques et thérapeutiques. La population intéressée était jeune et active. Les brûlures étaient secondaires à un contact avec des câbles à haute tension lors de tentatives de vol par arrachement de conducteurs en cuivre dans les transformateurs dans 67% des cas, et lors de tentatives de coupure de caténaires alimentant les trains électriques sur le réseau ferroviaire dans 33% des cas. Le traitement des lésions électrothermiques a nécessité des interventions itératives avec amputation et désarticulation des segments de membres nécrosés dans 66% des cas, dont les suites étaient marquées par des séquelles fonctionnelles invalidantes. La prévention de ce type d’AEHV reste fondamentale. PMID:22262961

Utilisation de la mélatonine pour le sommeil chez les enfants en bonne santé

PubMed Central

Janjua, Irvin; Goldman, Ran D.

2016-01-01

Résumé Question Une maman a amené son garçon de 12 ans me consulter à mon bureau. Elle s’inquiète, car il a de la difficulté à s’endormir presque tous les soirs. Elle travaille par quarts et elle prend elle-même de la mélatonine pour l’aider à s’endormir. Elle m’a demandé si son garçon pouvait aussi prendre de la mélatonine. Quels sont les recommandations et les éléments à considérer avant d’utiliser la mélatonine chez les enfants et les adolescents en bonne santé? Réponse L’insomnie est rapportée chez jusqu’à un quart des enfants en bonne santé et chez les trois quarts des enfants atteints d’une affection psychiatrique ou neurodéveloppementale, ce qui entraîne des conséquences négatives. Pour les enfants atteints du syndrome de retard de phase du sommeil, la mélatonine pourrait s’avérer utile lorsque jumelée à une évaluation de l’insomnie et à un suivi régulier. La mélatonine pourrait être envisagée pour des enfants sans diagnostic d’insomnie qui ont une bonne hygiène du sommeil. Bien qu’elle semble sans danger, il n’existe pas de données probantes en faveur de l’emploi systématique de la mélatonine chez les enfants en bonne santé.

La mortalidad en adolescentes con cáncer: características clinicoepidemiológicas de muerte y aspectos éticos emergentes.

PubMed

Cicero-Oneto, Carlo Egysto; Mata-Valderrama, Guadalupe; Valdez-Martínez, Edith

Describir los aspectos epidemiológicos, clínicos y éticos de la mortalidad de los adolescentes con cáncer en -México. Se revisaron 63 expedientes clínicos de adolescentes (de 14 a 18 años de edad) con cáncer, fallecidos entre 2011 y 2014, para obtener información clínica y epidemiológica de su muerte. Los sitios de estudio fueron tres hospitales de concentración en la Ciudad de México. De los 40 adolescentes con criterios de fase terminal, 16 (40%) continuaron recibiendo tratamiento con fines curativos. De los 51 cuyo lugar de muerte era conocido, 45 (88%) murieron en hospital. De los 41 que murieron dentro de los 30 días de su última hospitalización, las muertes fueron principalmente debidas a complicaciones (51%), a progresión de la enfermedad (41%) o bien fueron muertes en tratamiento paliativo (7%, 3/41). La práctica oncológica descansa en lo que es conocido como modelo biomédico. Los resultados del estudio sugieren y apoyan la urgente necesidad de implementar verdaderos servicios de cuidados paliativos, pero más importante que eso, está el ímpetu de poner la ética de la práctica clínica en acción, y de ese modo reforzar la buena práctica de la medicina. Copyright: © 2018 SecretarÍa de Salud

Contribution a la comprehension de la durabilite a l'ecaillage des betons contenant de la cendre volante et du laitier

NASA Astrophysics Data System (ADS)

Houehanou, Ernesto C.

L'incorporation des ajouts cimentaires dans le beton est connue pour ses avantages technologiques et environnementaux. Pour assurer une plus grande utilisation des ajouts cimentaires, il faut accroitre la connaissance dans ce domaine surtout les facteurs relatifs a la durabilite des ouvrages construits avec les betons contenant des ajouts mineraux. Jusqu'a present, la plupart des etudes sur les betons contenant de la cendre volante et du laitier semble s'accorder sur leur moins bonne durabilite a l'ecaillage surtout lorsqu'on les compare au beton ordinaire. Les raisons de cette moins bonne performance ne sont pas toutes connues et cela limite bien des fois l'incorporation de la cendre volante et de laitier dans le beton pour des ouvrages fortement exposes aux cycles de gel-degel en presence de sels fondants. Cette these vise la comprehension des problematiques de la durabilite a l'ecaillage des betons contenant des ajouts cimentaires tels la cendre volante et le laitier. Les objectifs sont de mieux comprendre la representativite et la severite relative des essais normalises ASTM C672 et NQ 2621-900 pour l'evaluation de la durabilite a l'ecaillage de ces betons, d'etudier l'influence de la methode de murissement sur la durabilite a l'ecaillage et d'etudier la relation entre la durabilite a l'ecaillage et la sorptivite des surfaces de beton ainsi que la particularite de la microstructure des betons contenant de la cendre volante. Cinq types de betons a air entraine contenant 25% et 35% de cendre volante et laitier ainsi que 1% et 2% de fumee de silice ont ete produits, muris selon differentes methodes et soumis a des essais acceleres selon les deux procedures normalisees ainsi qu'un essai de sorptivite. Les differentes methodes de murissement sont choisies de facon a mettre en evidence aussi bien l'influence des parametres des essais que celle de la methode de murissement elle-meme. La durabilite en laboratoire des betons testes a ete comparee avec celle de betons similaires apres 4 et 6 annees de service. La microstructure des betons en service a ete analysee au moyen du microscope a balayage electronique (MEB). Les resultats montrent que la qualite du murissement influence grandement la durabilite a l'ecaillage des betons contenant de la cendre volante et de laitier surtout lorsqu'ils sont soumis ' aux essais acceleres en laboratoire. La duree du pretraitement humide est un parametre cle de la durabilite a l'ecaillage des betons testes en laboratoire. Le pretraitement humide correspond a la duree totale du murissement humide (100% HR) et de la periode de presaturation. Pour les deux methodes d'essai, l'allongement du pretraitement humide a 28 jours ameliore la resistance a l'ecaillage de tous les types de betons et en particulier celle des betons avec cendres volantes. Pour les deux methodes d'essai, l'allongement du pretraitement humide a 28 jours ameliore la resistance a l'ecaillage de tous les types de betons et en particulier celle des betons avec cendres volantes. La periode de presaturation de 7 jours de la procedure NQ 2621-900 a un effet similaire a celui d'un murissement humide de meme longueur. Un murissement humide de 28 jours apparait optimal et conduit a une estimation plus realiste de la resistance a l'ecaillage reelle des betons. Pour une meme duree de pretraitement humide, les procedures NQ 2621-900 et ASTM C672 donnent des resultats equivalents. L'utilisation d'un moule a fond drainant n'a pas d'effet sur la resistance a l'ecaillage des betons de cette etude. Bien que le murissement dans l'eau saturee de chaux offre toute l'eau requise pour favoriser le developpement des proprietes du beton et l'amelioration de sa durabilite a l'ecaillage, elle lessive cependant les ions alcalins ce qui diminue defavorablement l'alcalinite et le pH de la solution interstitielle de la pate de ciment pres de la surface exposee. L'utilisation d'un agent de murissement protege mieux les betons contenant de la cendre volante et ameliore significativement leurs resistances a l'ecaillage mais elle a tendance a reduire la durabilite a l'ecaillage des betons contenant de laitier. Pour developper une bonne resistance a l'ecaillage, il est essentiel de produire une surface de beton impermeable qui resiste a la penetration de l'eau externe. La permeabilite et la porosite de la peau du beton sont etroitement liees a la sorptivite. L' allongement de la duree de murissement humide des betons avec ajouts cimentaires diminue systematiquement la sorptivite et ameliore leur durabilite a l'ecaillage, particulierement dans le cas des betons avec cendres volantes. Les resultats montrent qu'il existe une bonne correlation entre les resultats des essais d'ecaillage et les mesures de sorptivite. La correlation etablie entre la sorptivite et la durabilite a l'ecaillage des betons, l'effet • determinant de la carbonatation sur la durabilite a l'ecaillage des betons avec cendres volantes ainsi que l'explication de l'origine de la difference de severite entre les essais ASTM C-672 et NQ 2621-900 sont les contributions scientifiques de cette these. Au plan technique et industriel, elle met en evidence le mode de murissement qui favorise une meilleure durabilite a l'ecaillage des betons et suggere une methode de caracterisation en laboratoire qui ferait une meilleure prediction du comportement en service. Mots cles : Beton, cendre volante, laitier, durabilite, ecaillage, murissement, sorptivite

Le point sur les amas de galaxies

NASA Astrophysics Data System (ADS)

Pierre, M.

Clusters of galaxies: a review After having briefly described the 3 main components of clusters of galaxies (dark matter, gas and galaxies) we shall present clusters from a theoretical viewpoint: they are the largest entities known in the universe. Consequently, clusters of galaxies play a key role in any cosmological study and thus, are essential for our global understanding of the universe. In the general introduction, we shall outline this fundamental aspect, showing how the study of clusters can help to constrain the various cosmological scenarios. Once this cosmological framework is set, the next chapters will present a detailed analysis of cluster properties and of their cosmic evolution as observed in different wavebands mainly in the optical (galaxies), X-ray (gas) and radio (gas and particles) ranges. We shall see that the detailed study of a cluster is conditioned by the study of the interactions between its different components; this is the necessary step to ultimately derive the fundamental quantity which is the cluster mass. This will be the occasion to undertake an excursion into extremely varied physical processes such as the multi-phase nature of the intra-cluster medium, lensing phenomena, starbursts and morphology evolution in cluster galaxies or the interaction between the intra-cluster plasma and relativistic particles which are accelerated during cluster merging. For each waveband, we shall outline simply the dedicated observing and analysis techniques, which are of special interest in the case of space observations. Finally, we present several ambitious projects for the next observatory generation as well as their expected impact on the study of clusters of galaxies. Après avoir brièvement décrit les 3 constituants fondamentaux des amas de galaxies (matière noire, gaz et galaxies) nous présenterons les amas d'un point de vue plus théorique : ce sont les entités les plus massives à l'équilibre connues dans l'univers. Les amas de galaxies jouent donc un rôle de premier plan dans toute étude cosmologique et par conséquent, sont indispensables à notre compréhension globale de l'univers. Dans l'introduction générale, nous détaillons cet aspect fondamental en montrant comment l'étude des amas peut contribuer à contraindre les scénarios cosmologiques. Une fois le contexte scientifique délimité, les chapitres suivants s'attachent à présenter les diverses propriétés des amas et leur évolution cosmique observée dans diverses longueurs d'onde principalement dans les domaines visible (galaxies), X (gaz) et radio (gaz et particules). Nous verrons que l'étude détaillée d'un amas implique celle de l'interaction entre ses différentes composantes et est un passage obligé pour remonter au paramètre ultime (ou premier) qu'est sa masse. Loin d'être un détour ennuyeux, ceci sera l'occasion d'aborder des phénomènes physiques extrêmement variés tel l'aspect multi-phases du milieu intra-amas, les sursauts de formation d'étoiles et l'évolution morphologique des galaxies capturées par les amas, ou bien encore, l'interaction entre le plasma intra-amas et les particules relativistes accélérées lors de la fusion entre deux amas. Bien sûr, pour chaque longueur d'onde, nous ne manquerons pas de décrire simplement les techniques d'observation et d'analyse mises en oeuvre ; celles-ci sont particulièrement intéressantes dans le cas de l'instrumentation spatiale. Nous terminerons en présentant des projets d'observatoires pour l'horizon 2010 et leur impact prévu sur l'étude des amas de galaxies.

Approche morphologique de la fragmentation de l'ADN radio-induite par immunomarquage anti-poly (ADP-ribose) polymérase (PARP) : étude de cultures d'oligodendrogliomes

NASA Astrophysics Data System (ADS)

Varlet, P.; Beuvon, F.; Cervera, P.; Averbeck, D.; Daumas-Duport, C.

1998-04-01

Poly (ADP-ribose) polymerase (PARP) is a nuclear enzyme encompassing two zinc finger motifs which specifically binds to radiation induced DNA strand breaks. We develop a new immuno-labelling of poly ADP-ribose which coupled together with the immunodetection of cells in cycle with MIB1, permits to detect and quantify the DNA fragmentation induced by radiations (Cesium137). This method, applied to organotypical cultures of human oligodendroglioma, submitted to radiation, a dose dependant nuclear signal. This one increased significantly in the presence of a radiosensitizer like iododeoxyuridine (IUDR 5 g/ml). This poly ADP-ribose immunodetection can be useful, to detect furtherly the individual radiosensitivity of human glioma. Les protéases “ICE-like" ou caspases, sont les homologues humaines du produit du gène ced-3 du ver Caenorhabditis elegans et sont activées lors des étapes précoces de l'apoptose. L'objectif de ce travail vise à déterminer dans quelle mesure l'inhibition de l'une d'entre elles, la caspase-3 est susceptible de modifier la sensibilité des cellules vis-à-vis de l'apoptose radioinduite. Des lymphocytes spléniques murins irradiés en présence de Ac-DVED-CHO un inhibiteur spécifique de la caspase-3 présentent un taux de particules hypodiploïdes radioinduites bien inférieur à celui des contrôles et une diminution drastique de la fragmentation internucléosomale de l'ADN. Toutefois, ni l'externalisation des phospholipides anioniques, autre marqueur spécifique de l'apoptose, ni la viabilité ne sont affectées.

Tuberculome de Bouchut dans la tuberculose multi focale: à propos de quatre cas

PubMed Central

Janah, Hicham; Alami, Ahmed; Souhi, Hicham; Zegmout, Adil; Naji-Amrani, Hicham; Raoufi, Mohamed; Elouazzani, Hanane; Rhorfi, Ismail Abderrahmani; Abid, Ahmed

2014-01-01

La tuberculose multifocale a connu un regain de fréquence avec la pandémie du SIDA, elle s'observe encore chez des sujets non infectés par le VIH surtout dans les pays en voie de développement notamment au Maroc. Nous rapportons quatre observations de tuberculose multifocale chez trois patients immunocompétents et un patient immunodéprimé. Quatre patients ont bénéficié d'un bilan phtisiologique, biologique, sérologique(HIV), radiologique et d'angiographie à la fluorescéine pour suspicion de tuberculose multifocale. Il s'agit de trois hommes et une femme, d’âge moyen de 44 ans, trois patients sont immunocompétents et un patient séropositif. La tuberculose intéressait trois localisations chez les quatre patients: pulmonaire dans quatre cas, ophtalmique dans quatre cas, digestive dans un cas, urinaire dans un cas, cérébrale dans un cas et un cas d'atteinte de la moelle osseuse. L'atteinte ophtalmologique est représentée par des nodules choroïdiens de Bouchut dans quatre cas et un nodule papillaire de Bouchut dans un cas; aucun des ces patients ne présentait une uvéite granulomateuse. Nos malades ont reçu un traitement anti-tuberculeux d'une durée de neuf mois avec une bonne évolution clinique, biologique, radiologique et angiographique. Au Maroc, la tuberculose continue à surprendre aussi bien par son extension touchant le sujet débilité et le sujet immunocompétent, que par ses présentations diverses y compris l'atteinte oculaire qu'elle faut rechercher par un examen ophtalmologique soigneux et systématique. PMID:25478047

Ictères pathologiques du nouveau-né à l'hôpital Bonzola de Mbuji-Mayi, République Démocratique du Congo

PubMed Central

Mutombo, André Kabamba; Mukuku, Olivier; Kabulo, Benjamin Kasongo; Mutombo, Augustin Mulangu; Ngeleka, Alain Mutombo; Mutombo, Junior Dibwe; Kabuya, Maguy Sangaji; Kayembe, Celestin Mukoko; Luboya, Oscar Numbi

2014-01-01

L'ictère néonatal, bien qu'il soit souvent très banal, ne doit pas pour autant être négligé car il peut relever des étiologies variées et avoir des significations différentes au point de devenir pathologique. Au cours d'une étude rétro-prospective descriptive, les auteurs analysent les aspects épidemio-cliniques, thérapeutiques et évolutifs des ictères néonataux pathologiques à l'Unité des Urgences Néonatales de Bonzola à Mbuji-Mayi (RD Congo) sur une période de 5 ans. La fréquence est de 4,9% avec une incidence annuelle de 24 cas/an. La prédominance masculine est notée avec un sexe ratio de 1,1. Ces ictères sont précoces (31,1%) et tardif (17,5%). Les principales causes sont dans 81,6% des cas dominées par les infections (42,5%) et, incompatibilité fœto-maternelle (39,1%). La symptomatologie habituelle est notée: ictère franc et pâleur cutanéo-muqueuse (100%), urines jaunes foncées (62,5%), signes neurologiques (42,5%) et généraux (47,5%). Le traitement était à la fois étiologique (60%) et symptomatique ou d'appoint (40%) et a consisté dans l'association antibiotiques avec transfusion et/ou exsanguino-transfusion (24,2%), antibiothérapie seule (35,8%), inducteurs enzymatiques (35%) et photothérapie (5%). L’évolution a été bonne dans 82,3% des cas contre 9,3% des décès. PMID:25883730

New strategy toward dioxin risk reduction for local residents surrounding severe dioxin hotspots in Vietnam

PubMed Central

Thi Tran, Tuyet-Hanh; Nguyen, Ngoc-Bich; Le, Vu-Anh

2013-01-01

Background A public health intervention program with active involvement of local related stakeholders was piloted in the Bien Hoa dioxin hotspot (2007–2009), and then expanded to the Da Nang dioxin hotspot in Vietnam (2009–2011). It aimed to reduce the risk of dioxin exposure of local residents through foods. This article presents the results of the intervention in Da Nang. Methodology To assess the results of this intervention program, pre- and post-intervention knowledge, attitude, and practice (KAP) surveys were implemented in 400 households, randomly selected from four wards surrounding the Da Nang Airbase in 2009 and 2011, respectively. Results After the intervention, the knowledge on the existence of dioxin in food, dioxin exposure pathways, potential high-risk foods, and preventive measures significantly increased (P<0.05). Ninety-eight percent were willing to follow advice on preventing dioxin exposure. Practices to reduce the risk of dioxin exposure also significantly improved (P<0.05). After intervention, 60.4% of households undertook exposure preventive measures, significantly higher than that of the pre-intervention survey (39.6%; χ2=40.15, P<0.001). High-risk foods had quite low rates of daily consumption (from 0 to 2.5%) and were significantly reduced (P<0.05). Conclusions This is seen as an effective intervention strategy toward reducing the risk of human exposure to dioxin at dioxin hotspots. While greater efforts are needed for remediating dioxin-polluted areas inside airbases, there is also evidence to suggest that, during the past four decades, pollution has expanded to the surrounding areas. For this reason, this model should be quickly expanded to the remaining dioxin hotspots in Vietnam to further reduce the exposure risks in other areas. PMID:23791241

Perfiles de luminosidad en galaxias con núcleo tipo Seyfert 1

NASA Astrophysics Data System (ADS)

Boris, N.; Rodriguez-Ardilla, A. A.; Pastoriza, M. G.

Presentamos imágenes CCD en los filtros BVI y Hα de una muestra de 10 galaxias Seyfert 1 y Narrow Line Seyfert 1. Recientes observaciones muestran que hay una diferencia significante en el índice espectral óptico entre NLS1s y Sy1 normales, siendo para las primeras del orden de 2. Otra característica importante es que la mayor parte de las NLS1s muestran tasas de FeII/Hβ mayores que las observadas en otras Sy1s. Desde el punto de vista fotométrico, estas galaxias no tienenningún tipo de estudio previo. Presentamos magnitudes totales, perfiles de luminosidad y mapas de color junto con un detallado análisis de la formación estelar en estos objetos. Encontramos que la descomposición en bulbo + disco representa adecuadamente los perfiles de luminosidad de las galaxias de la muestra. Sin embargo, en todos los casos es necesario que el disco tenga un agujero en su centro. El radio de este agujero va desde los 3 a los 9 kpc. Si bien no tenemos aún una explicación para este hecho, los agujeros parecen estar asociados a anillos circumnucleares de alto oscurecimiento E(B-V) ~1. Los perfiles presentan también un fuerte gradiente de color, siendo notablemente más azules hacia la región nuclear. Los objetos de la muestra cubren todo el rango de tipos morfológicos, no obstante, no encontramos regiones de formación estelar en las regiones exteriores de las galaxias. La formación estelar está confinada a la región nuclear y se data en alrededor de 5 x 107 años.

Utilization of Services Provided by Village-Based Ethnic Minority Midwives in Vietnam: Lessons From Implementation Research.

PubMed

Doan, Duong Thi Thuy; Mirzoev, Tolib; Nguyen, Canh Chuong; Bui, Ha Thi Thu

Global progress in reducing maternal mortality requires improving access to maternal and child health services for the most vulnerable groups. This article reports results of implementation research that aimed to increase the acceptability of village-based ethnic minority midwives (EMMs) by local communities in Vietnam through implementing an integrated interventions package. The study was carried out in 2 provinces in Vietnam, Dien Bien and Kon Tum. A quasi-experimental survey with pretest/posttest design was adopted, which included 6 months of intervention implementation. The interventions package included introductory "launch" meetings, monthly review meetings at community health centers, and 5-day refresher training for EMMs. A mixed-methods approach was used involving both quantitative and qualitative data. A structured questionnaire was used in the pre- and posttest surveys, complemented by in-depth interviews and focus group discussions with EMMs, relatives of pregnant women, community representatives, and health managers. Introductions of EMMs to their local communities by local authorities and supervision of performance of EMMs contributed to significant increases in utilization of services provided by EMMs, from 58.6% to 87.7%. Key facilitators included information on how to contact EMMs, awareness of services provided by EMMs, and trust in services provided by EMMs. The main barriers to utilization of EMM services, which may affect sustainability of the EMM scheme, were low self-esteem of EMMs and small allowances to EMMs, which also affected the recognition of EMMs in the community. Providing continuous support and integration of EMMs within frontline service provision and ensuring adequate local budget for monthly allowances are the key factors that should allow sustainability of the EMM scheme and continued improvement of access to maternal and child health care among poor ethnic minority people living in mountainous areas in Vietnam.

Evolution des quasiparticules nodales du cuprate supraconducteur YBa2Cu3Oy en conductivite thermique

NASA Astrophysics Data System (ADS)

Rene de Cotret, Samuel

Ce memoire presente des mesures de conductivite thermique sur les supraconducteurs YBCO et Tl-2201 afin de statuer sur la presence possible d'un point critique quantique (QCP) dans le diagramme de phase de cuprates. Ce point critique quantique serait a l'origine de la reconstruction de la surface de Fermi, d'un large cylindre de trous en de petites poches de trous et d'electrons. La conductivite thermique dans le regime T → 0 permet d'extraire une quantite purement electronique liee aux vitesses de Fermi et du gap, au noeud. Une discontinuite dans cette quantite pourrait signaler la traversee du dopage critique qui reconstruit la surface de Fermi. Plusieurs sondes experimentales distinguent une transition de phase ou un crossover a T* a temperature finie. D'autres sondes mettent en evidence une transition de phase sous l'effet d'un champ magnetique. La presence ou non de cet ordre, a temperature et champ magnetique nul questionne la communaute depuis plusieurs annees. Dans cette etude, nous detectons une variation brusque de kappa0/T a p = 0.18 dans YBCO et a p = 0.20 dans Tl-2201. Ces sauts sont interpretes comme un signe de la transition a temperature nulle et sont en faveur d'un QCP. Le manque de donnees d'un meme materiau a ces dopages ne permet pas de valider hors de tout doute l'existence d'un point critique quantique. Le modele theorique YRZ decrit aussi bien les donnees de conductivite thermique. Des pistes de travaux experimentaux a poursuivre sont proposees pour determiner la presence ou non du QCP de facon franche. Mots-cles : Supraconducteurs, cuprates, conductivite thermique, point critique quantique.

Microscopie par rayons X dans la fenêtre de l'eau : faisabilité et intérêt pour la biologie d'un instrument de laboratoire

NASA Astrophysics Data System (ADS)

Adam, J. F.; Moy, J. P.

2005-06-01

La biologie étudie des structures ou des phénomènes sub-cellulaires. Pour cela la microscopie est la technique d'observation privilégiée. La résolution spatiale de la microscopie optique s'avère bien souvent insuffisante pour de telles observations. Les techniques plus résolvantes, comme la microscopie électronique par transmission sont souvent destructrices et d'une complexité peu adaptée aux besoins des biologistes. La microscopie par rayons X dans la fenêtre de l'eau permet l'imagerie rapide de cellules dans leur milieu naturel, nécessite peu de préparation et offre des résolutions de quelques dizaines de nanomètres. De plus, il existe un bon contraste naturel entre les structures carbonées (protéines, lipides) et l'eau. Actuellement cette technique est limitée aux centres de rayonnement synchrotron, ce qui impose une planification et des déplacements incompatibles avec les besoins de la biologie. Un tel microscope fonctionnant avec uns source de laboratoire serait d'une grande utilité. Ce document présente un état de l'art de la microscopie par rayons X dans la fenêtre de l'eau. Un cahier des charges détaillé pour un appareil de laboratoire ayant les performances optiques requises par les biologistes est présenté et confronté aux microscopes X de laboratoire déjà existants. Des solutions concernant la source et les optiques sont également discutées.

Mecanismos cinéticos y distribuciones energéticas de iones (H3+, N2H+, CH3+...) en plasmas fríos de H2/N2/CH4

NASA Astrophysics Data System (ADS)

Tanarro, I.; Herrero, V. J.; Islyaikin, A.; Tabarés, F. L.; Tafalla, D.

En este trabajo se presenta el estudio espectrométrico de los plasmas levemente ionizados generados en una descarga continua a baja presión de H2 con trazas de N2 y CH4, orientado principalmente a identificar la naturaleza y distribución energética de los iones que en ella se producen, y a asignar algunos de los mecanismos cinéticos elementales de formación y destrucción de tales especies. Alguno de los iones mayoritarios de estos plasmas, como el H3+, presenta gran interés desde el punto de vista de la Astrofísica por su prevista intervención en la química de las ionosferas planetarias y del medio interestelar, al actuar como sustancia intermedia en la formación de gran variedad de especies moleculares; si bien, dada su pequeña concentración, su observación real en el espacio se demoró hasta la pasada década de los años 90, cuando fue detectado por primera vez en la atmósfera de Júpiter y en otros objetos estelares. Del mismo modo que los trabajos espectroscópicos de laboratorio resultan indispensables para la posterior identificación de las especies observadas en el espacio, es de esperar que la asignación de los procesos cinéticos más importantes que tienen lugar en los plasmas generados en reactores de descarga, como los aquí presentados, permitan extrapolar los resultados así obtenidos al esclarecimiento de los mecanismos fisico-químicos participantes en otros medios observables únicamente a larga distancia.

Dynamique d'étalement

NASA Astrophysics Data System (ADS)

de Gennes, Pierre-Gilles

On analyse la progression d'un coin fiuide sur uo solide (dans le cas ou Tangle de contact thermodynamique θa est nul : regie d'Antonov satisfaite) en tenant compte des interactions Van der Waals a longue portee. On trouve : (a) un angle de contact apparent θa relie a la vitesse d'avancee U par θ^{3}_{a} ˜ U η/γ (η = viscosity, γ tension superficielle du liquide) d'ou une loi rayon/temps d'etalement pour une goutte r(t) 1/10. (b) un film precurseur ζ d'epaisseur ζ(x, f) decroissant asymptotiquement comme x1 ou x est la distance a la ligne triple. L'epaisseur h* d u film au voisinage de la ligne triple est h* a/θa (ou a est une distance atomique). Ceci permet de comprendre le fait (reconnu) que le film precurseur est bien visible seulement si l'angle de contact thermodynamique est nul. We analyse the shape of the liquid-air interface for a droplet spreading on a solid, in a regime where the Antonov rule is satisfied, taking into account the long range Van der Waals interactions between liquid and solid. We find: (a) an apparent contact angle θa related to the velocity U of the triple line by θ^{3}_{a} ˜ U η/γ (η = viscosity, γ surface tension of the liquid). This leads to a law of spreading (radius r/time t) for a droplet r t1/10. (b) a precursor film of thickness ζ, decreasing asymptotically like x-1, where x is the distance from the triple line. The thickness h* of the film at this line is h* a/θa where a is an atomic length: this explains why the precursor films are observed only when the thermodynamic contact angle vanishes.

Elaboration du Ge mesoporeux et etude de ses proprietes physico-chimiques en vue d'applications photovoltaiques

NASA Astrophysics Data System (ADS)

Tutashkonko, Sergii

Le sujet de cette these porte sur l'elaboration du nouveau nanomateriau par la gravure electrochimique bipolaire (BEE) --- le Ge mesoporeux et sur l'analyse de ses proprietes physico-chimiques en vue de son utilisation dans des applications photovoltaiques. La formation du Ge mesoporeux par gravure electrochimique a ete precedemment rapportee dans la litterature. Cependant, le verrou technologique important des procedes de fabrication existants consistait a obtenir des couches epaisses (superieure a 500 nm) du Ge mesoporeux a la morphologie parfaitement controlee. En effet, la caracterisation physico-chimique des couches minces est beaucoup plus compliquee et le nombre de leurs applications possibles est fortement limite. Nous avons developpe un modele electrochimique qui decrit les mecanismes principaux de formation des pores ce qui nous a permis de realiser des structures epaisses du Ge mesoporeux (jusqu'au 10 mum) ayant la porosite ajustable dans une large gamme de 15% a 60%. En plus, la formation des nanostructures poreuses aux morphologies variables et bien controlees est desormais devenue possible. Enfin, la maitrise de tous ces parametres a ouvert la voie extremement prometteuse vers la realisation des structures poreuses a multi-couches a base de Ge pour des nombreuses applications innovantes et multidisciplinaires grace a la flexibilite technologique actuelle atteinte. En particulier, dans le cadre de cette these, les couches du Ge mesoporeux ont ete optimisees dans le but de realiser le procede de transfert de couches minces d'une cellule solaire a triple jonctions via une couche sacrificielle en Ge poreux. Mots-cles : Germanium meso-poreux, Gravure electrochimique bipolaire, Electrochimie des semi-conducteurs, Report des couches minces, Cellule photovoltaique

Fotometria WHBY |o lll|/HB de Regiones H 11 Y la HISTORIA de la Formacion ESTELAR Reciente EN la PEQUENA NUBE de Magallanes

NASA Astrophysics Data System (ADS)

Copetti, M. V. F.; Dottori, H. A.

1987-05-01

El ancho equivalente WHβ de la linea de Hβ en emisión y la razón [0 III]/Hβ del par λλ4959, 50 7 A del [0111], fueron medidos en 23 regiones HII de la Peque˜a Nube de Magallanes, por medio de la fotometría fotoeléctrica a través de un sistema de tres filtros interferenciales: dos Hβ , con bandas pasantes de 100 y 30 A, y un [0111] centrado en 5000 A y con banda pasante de 50 A. Las observaciones fueron realizadas con los telescopios de 1.60-m y 0.60-m del Laboratorio Nacional de Astrofísica, Brasópolis, Brasil. Fueron escogidos diafragmas suficientemente grandes para captar la radiación integrada de cada región HII. Las medidas fueron calibradas por comparación a un conjunto de nebulosas planetarias con flujos absolutos bien definidos. A través de la comparación entre los datos observacionales y modelos evolutivos de WHβ y [0 III] /Hβ (Copetti et al.1986', Astr. and Ap., 156, 111), las edades de las regiones HIl fueron estimadas. Basada en la distribución espacial de las edades de regiones HIl, la historia de la formación estelar reciente en la Pequeña Nube de Magallanes es analizada. La similitud de las medidas de WH&beta y [OIII]/WHβ entre las regiones H II observadas sugiere que hubo una explosión de formación estelar a 4±1 x106 años en la Pequeña Nube de Magallanes. (Parcialmente financiado por CNPq).

PubMed

Black, Amanda; Guilbert, Edith; Costescu, Dustin; Dunn, Sheila; Fisher, William; Kives, Sari; Mirosh, Melissa; Norman, Wendy V; Pymar, Helen; Reid, Robert; Roy, Geneviève; Varto, Hannah; Waddington, Ashley; Wagner, Marie-Soleil; Whelan, Anne Marie

2017-04-01

Mettre à la disposition des fournisseurs de soins des lignes directrices concernant le recours à des méthodes contraceptives pour prévenir la grossesse et la promotion d'une sexualité saine. Efficacité globale des méthodes contraceptives citées : évaluation de l'innocuité, des effets indésirables et de la baisse du taux de grossesse; effet des méthodes contraceptives citées sur la santé sexuelle et le bien-être général; disponibilité des méthodes contraceptives citées au Canada. RéSULTATS: Des recherches ont été effectuées dans MEDLINE et la base de données Cochrane afin d'en tirer les articles en anglais publiés entre janvier 1994 et décembre 2015 traitant de sujets liés à la contraception, à la sexualité et à la santé sexuelle, dans le but de mettre à jour le consensus canadien sur la contraception paru de février à avril 2004. Nous avons également passé en revue les publications pertinentes du gouvernement canadien, ainsi que les déclarations de principes issues d'organisations compétentes vouées à la santé et à la planification familiale. La qualité des résultats a été évaluée au moyen des critères décrits par le Groupe d'étude canadien sur les soins de santé préventifs. Les recommandations quant à la pratique sont classées en fonction de la méthode décrite dans le rapport du Groupe. DéCLARATIONS SOMMAIRES: RECOMMANDATIONS. Copyright © 2017. Published by Elsevier Inc.

Investigation of Natural Circulation Instability and Transients in Passively Safe Small Modular Reactors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ishii, Mamoru

The NEUP funded project, NEUP-3496, aims to experimentally investigate two-phase natural circulation flow instability that could occur in Small Modular Reactors (SMRs), especially for natural circulation SMRs. The objective has been achieved by systematically performing tests to study the general natural circulation instability characteristics and the natural circulation behavior under start-up or design basis accident conditions. Experimental data sets highlighting the effect of void reactivity feedback as well as the effect of power ramp-up rate and system pressure have been used to develop a comprehensive stability map. The safety analysis code, RELAP5, has been used to evaluate experimental results andmore » models. Improvements to the constitutive relations for flashing have been made in order to develop a reliable analysis tool. This research has been focusing on two generic SMR designs, i.e. a small modular Simplified Boiling Water Reactor (SBWR) like design and a small integral Pressurized Water Reactor (PWR) like design. A BWR-type natural circulation test facility was firstly built based on the three-level scaling analysis of the Purdue Novel Modular Reactor (NMR) with an electric output of 50 MWe, namely NMR-50, which represents a BWR-type SMR with a significantly reduced reactor pressure vessel (RPV) height. The experimental facility was installed with various equipment to measure thermalhydraulic parameters such as pressure, temperature, mass flow rate and void fraction. Characterization tests were performed before the startup transient tests and quasi-steady tests to determine the loop flow resistance. The control system and data acquisition system were programmed with LabVIEW to realize the realtime control and data storage. The thermal-hydraulic and nuclear coupled startup transients were performed to investigate the flow instabilities at low pressure and low power conditions for NMR-50. Two different power ramps were chosen to study the effect of startup power density on the flow instability. The experimental startup transient results showed the existence of three different flow instability mechanisms, i.e., flashing instability, condensation induced flow instability, and density wave oscillations. In addition, the void-reactivity feedback did not have significant effects on the flow instability during the startup transients for NMR-50. ii Several initial startup procedures with different power ramp rates were experimentally investigated to eliminate the flow instabilities observed from the startup transients. Particularly, the very slow startup transient and pressurized startup transient tests were performed and compared. It was found that the very slow startup transients by applying very small power density can eliminate the flashing oscillations in the single-phase natural circulation and stabilize the flow oscillations in the phase of net vapor generation. The initially pressurized startup procedure was tested to eliminate the flashing instability during the startup transients as well. The pressurized startup procedure included the initial pressurization, heat-up, and venting process. The startup transient tests showed that the pressurized startup procedure could eliminate the flow instability during the transition from single-phase flow to two-phase flow at low pressure conditions. The experimental results indicated that both startup procedures were applicable to the initial startup of NMR. However, the pressurized startup procedures might be preferred due to short operating hours required. In order to have a deeper understanding of natural circulation flow instability, the quasi-steady tests were performed using the test facility installed with preheater and subcooler. The effect of system pressure, core inlet subcooling, core power density, inlet flow resistance coefficient, and void reactivity feedback were investigated in the quasi-steady state tests. The experimental stability boundaries were determined between unstable and stable flow conditions in the dimensionless stability plane of inlet subcooling number and Zuber number. To predict the stability boundary theoretically, linear stability analysis in the frequency domain was performed at four sections of the natural circulation test loop. The flashing phenomena in the chimney section was considered as an axially uniform heat source. And the dimensionless characteristic equation of the pressure drop perturbation was obtained by considering the void fraction effect and outlet flow resistance in the core section. The theoretical flashing boundary showed some discrepancies with previous experimental data from the quasi-steady state tests. In the future, thermal non-equilibrium was recommended to improve the accuracy of flashing instability boundary. As another part of the funded research, flow instabilities of a PWR-type SMR under low pressure and low power conditions were investigated experimentally as well. The NuScale reactor design was selected as the prototype for the PWR-type SMR. In order to experimentally study the natural circulation behavior of NuScale iii reactor during accidental scenarios, detailed scaling analyses are necessary to ensure that the scaled phenomena could be obtained in a laboratory test facility. The three-level scaling method is used as well to obtain the scaling ratios derived from various non-dimensional numbers. The design of the ideally scaled facility (ISF) was initially accomplished based on these scaling ratios. Then the engineering scaled facility (ESF) was designed and constructed based on the ISF by considering engineering limitations including laboratory space, pipe size, and pipe connections etc. PWR-type SMR experiments were performed in this well-scaled test facility to investigate the potential thermal hydraulic flow instability during the blowdown events, which might occur during the loss of coolant accident (LOCA) and loss of heat sink accident (LOHS) of the prototype PWR-type SMR. Two kinds of experiments, normal blowdown event and cold blowdown event, were experimentally investigated and compared with code predictions. The normal blowdown event was experimentally simulated since an initial condition where the pressure was lower than the designed pressure of the experiment facility, while the code prediction of blowdown started from the normal operation condition. Important thermal hydraulic parameters including reactor pressure vessel (RPV) pressure, containment pressure, local void fraction and temperature, pressure drop and natural circulation flow rate were measured and analyzed during the blowdown event. The pressure and water level transients are similar to the experimental results published by NuScale [51], which proves the capability of current loop in simulating the thermal hydraulic transient of real PWR-type SMR. During the 20000s blowdown experiment, water level in the core was always above the active fuel assemble during the experiment and proved the safety of natural circulation cooling and water recycling design of PWR-type SMR. Besides, pressure, temperature, and water level transient can be accurately predicted by RELAP5 code. However, the oscillations of natural circulation flow rate, water level and pressure drops were observed during the blowdown transients. This kind of flow oscillations are related to the water level and the location upper plenum, which is a path for coolant flow from chimney to steam generator and down comer. In order to investigate the transients start from the opening of ADS valve in both experimental and numerical way, the cold blow-down experiment is conducted. For the cold blowdown event, different from setting both reactor iv pressure vessel (RPV) and containment at high temperature and pressure, only RPV was heated close to the highest designed pressure and then open the ADS valve, same process was predicted using RELAP5 code. By doing cold blowdown experiment, the entire transients from the opening of ADS can be investigated by code and benchmarked with experimental data. Similar flow instability observed in the cold blowdown experiment. The comparison between code prediction and experiment data showed that the RELAP5 code can successfully predict the pressure void fraction and temperature transient during the cold blowdown event with limited error, but numerical instability exists in predicting natural circulation flow rate. Besides, the code is lack of capability in predicting the water level related flow instability observed in experiments.« less

Non-linearite et couplages lumiere-matiere en electrodynamique quantique en circuit

NASA Astrophysics Data System (ADS)

Bourassa, Jerome

L'électrodynamique quantique en circuit est un contexte unique pour l'optique quantique et le calcul quantique. Dans cette architecture où des qubits supraconducteurs, composés de jonctions Josephson, sont fortement couplés au champ électromagnétique de résonateurs coplanaires, la dynamique du système est semblable à celle des atomes dans des cavités optiques. La polyvalence de la conception des circuits supraconducteurs permet d'étudier l'interaction lumière-matière de différents régimes et manières. Ainsi, plusieurs qubits peuvent être couplés à un seul résonateur afin de les enchevêtrer. Une jonction Josephson peut également être intégrée directement au résonateur afin de produire une interaction non linéaire entre les photons. De la même manière, il a été suggéré que le couplage qubitrésonateur pourrait devenir l'échelle d'énergie dominante du système : le régime de couplage ultrafort. Malgré que la dynamique qubit-résonateur soit bien comprise, les modèles actuels ne permettent pas de prédire correctement les effets dispersifs du résonateur sur les qubits tels : le décalage de Lamb, l'interaction d'échange virtuelle et le temps de relaxation. Comme il n'y a pas non plus de modèle général permettant de déterminer les caractéristiques d'un résonateur non linéaire, on comprend mal comment rendre la non-linéarité plus forte, ni même si le régime de couplage ultrafort peut être physiquement réalisé dans ces circuits. Dans le cadre de ma thèse, je me suis intéressé à la modélisation de qubits et de résonateurs afin de mieux comprendre l'interaction lumière-matière en circuits, dans le but de développer des conceptions alternatives d'architectures plus performantes ou qui explorent des régimes d'interactions méconnus. Pour ce faire, j'ai développé une méthode analytique générale permettant de trouver l'hamiltonien exact de circuits distribués non linéaires, une méthode basée sur la mécanique lagrangienne et la représentation des modes propres d'oscillation. La grande qualité de la méthode réside dans la description analytique détaillée des paramètres de l'hamiltonien du système en fonction de la géométrie et des caractéristiques électromagnétiques du circuit. Non seulement le formalisme développé réconcilie le modèle quantique avec l'électromagnétisme classique et la théorie des circuits, mais va bien au-delà en formulant d'importantes prédictions sur la nature des interactions et l'influence des fluctuations du vide du résonateur sur la dynamique des qubits supraconducteurs. À l'aide d'exemples numériques réalistes et compatibles avec les technologies actuelles, je montre comment de simples optimisations de conception permettraient d'augmenter grandement l'efficacité et la rapidité d'exécution de calculs quantiques avec l'architecture, en plus d'atteindre des régimes de non-linéarité et de couplage lumière-matière inédits. En permettant de mieux comprendre l'interaction lumière-matière dans les circuits et d'optimiser l'architecture afin d'atteindre de nouveaux régimes de couplages, la méthode d'analyse de circuit développée dans cette thèse permettra de tester et raffiner nos connaissances sur l'électrodynamique quantique et la physique quantique. Mots-clés: Information quantique, électrodynamique quantique, supraconductivité, électromagnétisme, qubit supraconducteur, résonateur non linéaire, couplage ultrafort, effet Kerr.

Elastoplasticidad anisotropa de metales en grandes deformaciones

NASA Astrophysics Data System (ADS)

Caminero Torija, Miguel Angel

El objetivo de este trabajo es el desarrollo de modelos y algoritmos numericos que simulen el comportamiento del material bajo estas condiciones en el contexto de programas de elementos finitos, dando como resultado predicciones mas precisas de los procesos de conformado y deformacion plastica en general. Para lograr este objetivo se han desarrollado diversas tareas destinadas a mejorar las predicciones en tres aspectos fundamentales. El primer aspecto consiste en la mejora de la descripcion del endurecimiento cinematico anisotropo en pequenas deformaciones, lo cual se ha realizado a traves de modelos y algoritmos implicitos de superficies multiples. Ha sido estudiada la consistencia de este tipo de modelos tanto si estan basados en una regla implicita similar a la de Mroz o en la regla de Prager. Ademas se han simulado los ensayos de Lamba y Sidebottom, obteniendo, en contra de la creencia general, muy buenas predicciones con la regla de Prager. Dichos modelos podrian ser extendidos de forma relativamente facil para considerar grandes deformaciones a traves de procedimientos en deformaciones logaritmicas, similares a los desarrollados en esta tesis y detallados a continuacion. El segundo aspecto consiste en la descripcion de la anisotropia elastoplastica inicial. Esto se ha conseguido mediante el desarrollo de modelos y algoritmos para plasticidad anisotropa en grandes deformaciones, bien ignorando la posible anisotropia elastica, bien considerandola simultaneamente con la anisotropia plastica. Para ello ha sido necesario desarrollar primero un nuevo algoritmo de elastoplasticidad anisotropa en pequenas deformaciones consistentemente linealizado y sin despreciar ningun termino, de tal forma que se conserve la convergencia cuadratica de los metodos de Newton. Este algoritmo en pequenas deformaciones ha servido para realizar la correccion plastica de dos algoritmos en grandes deformaciones. El primero de estos algoritmos es una variacion del clasico algoritmo de Eterovic y Bathe para incluir la posibilidad de plasticidad anisotropa con endurecimiento mixto. Este primer algoritmo esta restringido a casos de isotropia elastica. La isotropia elastica es una hipotesis bastante habitual en plasticidad anisotropa y tiene la ventaja de que permite el uso de formulaciones mixtas u/p. El segundo algoritmo, mas complejo y general, incluye la posibilidad de elasticidad anisotropa, plasticidad anisotropa y endurecimiento mixto. Este algoritmo supone una contribucion importante ya que esta basado en hipotesis comunmente aceptadas y utilizadas en elastoplasticidad isotropa: descomposicion multiplicativa del gradiente de deformaciones en parte elastica y parte plastica, descripcion hiperelastica sencilla en funcion de deformaciones logaritmicas e integracion exponencial que conserva el volumen. Ademas, la estructura final del algoritmo es modular y relativamente sencilla, consistiendo en un pre- y un postprocesador geometrico y una correccion plastica realizada en pequenas deformaciones. El algoritmo esta consistentemente linealizado para conservar la convergencia cuadratica asintotica de los metodos de Newton y la forma final que toma dicha linealizacion es similar al caso de isotropia elastoplastica implementado; consiste en el modulo tangente algoritmico de pequenas deformaciones sobre el que se aplica una transformacion para convertirlo en el de grandes deformaciones. Todos estos modelos han sido implementados en un codigo propio de elementos finitos denominado DULCINEA, el cual tiene formulaciones lagrangianas totales y actualizadas para grandes deformaciones. Una de las tareas necesarias para poder realizar las simulaciones, ha sido el estudio e implementacion de diferentes elementos que no sufran el bloqueo volumetrico severo que se observa en formulaciones estandar basadas en desplazamientos. Este bloqueo se debe a la condicion de quasi-incompresibilidad que imponen los modelos de plasticidad desviadores y consiste en una respuesta exageradamente rigida de la solucion obtenida por el metodo de los elementos finitos estandar. Entre los elementos implementados cabe destacar el basado en la formulacion mixta u/p, que contiene una interpolacion adicional de grados de libertad de presion. Estos grados de libertad adicionales habitualmente son internos al elemento en mecanica de solidos. En este trabajo se ha desarrollado e implementado en DULCINEA una familia de elementos tridimensionales mixtos en grandes deformaciones que incluye el caso particular BMIX 27/27/4, basado en la formulacion u/p, constituido por 27 nudos, con 27 puntos de integracion estandar y 4 grados de libertad de presiones, y que pasa la condicion Inf-Sup o de Babuska-Brezzi. Sin embargo, se ha observado que la formulacion u/p presenta ciertas limitaciones bajo las hipotesis conjuntas de anisotropia elastica y anisotropia plastica. (Abstract shortened by UMI.)

The evolution of groundwater rights and groundwater management in New Mexico and the western United States

NASA Astrophysics Data System (ADS)

DuMars, Charles T.; Minier, Jeffrie D.

Historically, rights in water originated as public property and only later became individualized rights to utilize the public resource, in a manner consistent with the public welfare needs of society, but protected by principles of property law. Five basic regulatory systems for rights in groundwater in the United States have evolved to date. The problems raised by the hydrologic differences between groundwater hydraulically connected to stream systems and groundwater in non-replenished aquifers have been resolved to some extent by a couple of leading court cases. Numerical modeling and other technical methodologies have also evolved to evaluate the scientific issues raised by the different hydrologic conditions, but these are not immune from criticism. The current role of aquifers is evolving into that of storage facilities for recycled water, and their utilization in this manner may be expanded even further in the future. The policy implications of the choices relating to joint management of ground and surface water cannot be overstated. As this paper demonstrates, proactive administration of future groundwater depletions that affect stream systems is essential to the ultimate ability to plan for exploitation, management and utilization of water resources in a rational way that coordinates present and future demand with the reality of scarcity of supply. The examples utilized in this paper demonstrate the need for capacity building, not just to develop good measurement techniques, or to train talented lawyers and judges to write good laws, but also for practical professional water managers to keep the process on a rational course, avoiding limitless exploitation of the resource as well as conservative protectionism that forever precludes its use. Historiquement, les droits d'eau étaient à l'origine un bien public; ils sont devenus plus tard des droits individualisés pour utiliser la ressource publique conformément aux besoins de salut public de la société, mais protégés par des principes de lois de propriété. Cinq systèmes de réglementation de base pour les droits sur les eaux souterraines aux États-Unis ont évolué jusqu'à aujourd'hui. Les problèmes posés par les différences hydrologiques entre les eaux souterraines hydrauliquement connectées aux cours d'eau et celles d'aquifères non réalimentés ont été résolus jusqu'à un certain point par quelques cas de jugement. La modélisation numérique et d'autres méthodologies techniques ont également évolué pour évaluer les résultats scientifiques apportés dans différentes conditions hydrologiques, mais ne sont pas à l'abri de critiques. Le rôle courant des aquifères évolue entre celui des possibilités de stockage pour l'eau recyclée et leur utilisation dans ce but peut être même étendue plus loin dans le futur. Les implications politiques des choix relatifs à la gestion simultanée des eaux souterraines et de surface ne doivent pas être exagérées. Comme le montre cet article, la gestion active de l'épuisement futur des nappes qui affecte les systèmes fluviaux est essentielle pour la capacité finale à planifier l'exploitation, la gestion et l'utilisation des ressources en eau d'une manière rationnelle qui coordonne la demande actuelle et future à la réalité de la rareté de l'alimentation. Les exemples utilisés dans cet article démontrent le besoin d'une capacité d'élaboration, non seulement pour développer de bonnes techniques de mesure, ou pour former d'excellents avocats et juges pour écrire de bonnes lois, mais aussi pour que des praticiens gestionnaires de l'eau maintiennent le processus dans un cours rationnel pour éviter une exploitation sans limite des ressources aussi bien qu'un protectionnisme conservateur qui empêche son usage à jamais. Históricamente, los derechos del agua se originaron como un bien público que se transformaron después en derechos individualizados para usar los recursos públicos, de forma coherente con las necesidades de bienestar social, pero protegidos por los principios de la ley de propiedad. Hasta el momento, cinco sistemas reguladores básicos han evolucionado en los Estados Unidos de América en relación a los derechos en las aguas subterráneas. Los problemas surgidos por las diferencias hidrológicas entre las aguas subterráneas conectadas a corrientes superficiales y las aguas subterráneas en acuíferos sobreexplotados han sido resueltos hasta cierto punto por un par de casos judiciales notables. La modelación numérica y otras metodologías técnicas han evolucionado también para evaluar aspectos científicos asociados a diversas circunstancias hidrológicas, pero no son inmunes a las críticas. El papel actual de los acuíferos está evolucionando hacia el de instalaciones de almacenamiento de agua reciclada y su utilización de esta forma puede expandirse incluso más en el futuro. Las implicaciones políticas de las decisiones relativas a la gestión conjunta de las aguas superficiales y subterráneas no pueden ser exageradas. Como este artículo demuestra, una administración proactiva de las extracciones futuras de aguas subterráneas con efectos en los ecosistemas superficiales es esencial para la capacidad final de planificar la explotación, gestión y utilización de los recursos hídricos de forma racional, coordinando las demandas presentes y futuras con la realidad de la escasez de suministro. Los ejemplos empleados en este artículo demuestran la necesidad de construir capacidad y no únicamente de desarrollar buenas técnicas de medida, o la de educar reguladores y jueces de talento que redacten buenas leyes, pero también de gestores profesionales y aplicados del agua que mantengan el proceso en un compromiso entre evitar la explotación ilimitada del recurso y ejercer un proteccionismo conservador que impida su uso para siempre.

[Not Available].

PubMed

Pérez-Flores, Juan Emmanuel; Chávez-Tostado, Mariana; Larios-Del-Toro, Youné Elizabeth; García-Rentería, Jesús; Rendrón-Félix, Jorge; Salazar-Parra, Marcela; Irusteta-Jiménez, Leire; Michel-Espinoza, Luis Rodrigo; Márquez-Valdez, Aída Rebeca; Cuesta-Márquez, Lisbeth; Álvarez-Villaseñor, Andrea Socorro; Fuentes-Orozco, Clotilde; González Ojeda, Alejandro

2016-07-19

Introducción: la desnutrición intrahospitalaria se ha descrito hace más de 70 años como un problema frecuente. En México se reportan cifras de entre el 20% al 50%; sin embargo no se ha estudiado su prevalencia ni su asociación con la morbilidad y mortalidad hospitalaria.Objetivos: evaluar el estado nutricional y su relación con la morbimortalidad hospitalaria en pacientes mexicanos.Métodos: cohorte prospectiva de pacientes que ingresaron en un hospital de referencia para una estancia hospitalaria mayor de 5 días. Se capturó peso, talla, índice de masa corporal (IMC), estado nutricional de acuerdo con la valoración global subjetiva (VGS) a su ingreso y egreso hospitalario, así como diagnóstico médico, complicaciones y mortalidad. Los datos fueron analizados mediante la prueba T de Student, prueba Chi-cuadrado y prueba Exacta de Fisher.Resultados: se incluyeron 610 pacientes en total, con un promedio de edad de 50,8 ± 17,32 años, 267 mujeres (43,8%) y 343 hombres (56,2%). Del total, 154 fueron catalogados con sospecha de desnutrición o desnutrición (pacientes expuestos, 25,2%) y 456 bien nutridos (pacientes no expuestos, 74,8%), con una relación de 1 a 3. La morbilidad total de la cohorte tuvo un RR = 2,70, IC 95 % (2,06-3,55) y la mortalidad con un RR = 2,64, IC 95% (1,74-4,0), siendo ambas estadísticamente significativas (p = 0,001).Conclusiones: el diagnóstico de desnutrición al ingreso hospitalario constituye un factor de riesgo para el desarrollo de complicaciones y mortalidad. Este padecimiento al ingreso en comparación con el paciente que no presenta desnutrición incrementó el riesgo de mortalidad hasta en 2.64 veces.

Study in a UHF electromagnetic resonant cavity of a bubble field induced by ultrasonic cavitation

NASA Astrophysics Data System (ADS)

Labouret, S.; Frohly, J.

2000-06-01

A method founded on the follow-up of an electromagnetic cavity resonant frequency working round 390 MHz has been carried out in order to measure the void rates of bubble field induced by a 308 kHz ultrasonic cavitation in liquids. This method can detect void rates as low as 2× 10^{-5}. The experimental set up permits to study the influence of some experimental parameters on the void rate, such as the acoustic power, the acoustic irradiation duration, and the dissolved gas concentration in the liquid. Moreover, an estimation of the bubble size distribution is obtained. The extension of the method to open resonators and the possibility to observe the fast evolutions of the void rate are considered. Une méthode basée sur le suivi de la fréquence de résonance d'une cavité électromagnétique fonctionnant autour de 390 MHz a été mise au point et appliquée à la mesure du taux de vide créé dans un liquide par cavitation ultrasonore à 308 kHz. Cette méthode permet de détecter des taux de vide de l'ordre de 2× 10^{-5}. Le dispositif expérimental construit permet d'étudier l'influence de plusieurs paramètres : pression acoustique, durée d'irradiation acoustique, concentration en gaz dans le liquide. De plus, une estimation de la distribution en tailles des bulles est obtenue lorsque le liquide est saturé en gaz. L'adaptation de cette méthode à des résonateurs ouverts est abordée, et les possibilités d'observer des variations très rapides du taux de vide avec une résolution temporelle bien inférieure à la microseconde sont envisagées.

RASTREO DEL CANCER COLORRECTAL CONOCIMIENTO Y ACTITUD DE LA POBLACION

PubMed Central

CASAL, ENRIQUE R.; VELAZQUEZ, ELIZABETH N.; MEJIA, RAUL M.; CUNEO, ALDO; PEREZ-STABLE, ELISEO J.

2014-01-01

Resumen El rastreo de cáncer colorrectal (CCR) cuenta con fuertes evidencias en su favor. Datos preliminares indican que a pesar de ello no se lleva a cabo con la frecuencia adecuada. Se intenta aquí determinar, dentro de un Sistema de Salud que cuenta con los recursos necesarios, los elementos que facilitan o generan barreras para concretar esta práctica preventiva, cuántos individuos lo ponen en práctica y qué predice esta conducta. Se realizó una encuesta telefónica a los afiliados de una Obra Social de empleados de la Universidad de Buenos Aires, de los que 132 completaron el cuestionario (tasa de respuesta 70%). Los elementos considerados facilitadores del rastreo obtuvieron respuestas afirmativas en el 64 a 97%, mientras que los que definían barreras un 11 a 27%. En este último grupo, una categoría diferenciada la constituía el miedo a los efectos adversos: 39%, y el sentimiento de vergüenza relacionado con los procedimientos: 30%. Un 33% de los encuestados tenían hecho un método de rastreo, mayoritariamente de sangre oculta (27), sigmoideoscopía (11) y colonoscopía (20). Una mayoría afirmó que “se haría el procedimiento si el médico se lo recomendara” (95%), o “no se lo haría excepto que su médico se lo aconseje” (87%). Contestar afirmativamente que “los médicos hacen lo mejor para los pacientes” se asoció con haberse hecho un método de rastreo de CCR, OR 1.55 (IC 95%: 1.02-2.37) p: 0.04. El grupo de individuos estudiado parece bien predispuesto para el rastreo del CCR, la recomendación médica sería aquí un determinante prominente para ponerlo en práctica. PMID:19414294

Dynamique des ressources naturelles dans le Parc national de Manda: Cartographie et analyse pour le Développement durable

NASA Astrophysics Data System (ADS)

Ballah Solkam, Rosalie; Médard, Ndoutorlengar

2018-05-01

Au Tchad, le réseau d'aires protégées couvre près de 10,2% de la surface du pays et reste globalement représentatif de toute la diversité des écosystèmes de la région. Cependant, ce réseau n'est pas constitué d'écosystèmes intacts car de nombreuses altérations y ont été apportés (certaines espèces sont déjà au seuil critique d'extinction (Addax, gazelle dama, lamantin), voire ont disparu (Rhinocéros noir et blanc, Oryx)) surtout dans les parcs nationaux. Ce qui nous amène à nous interroger sur la dynamique des ressources naturelles et le degré de conservation du parc national de Manda? Une évaluation de la diversité biologique et des ressources hydrographiques de 1951 à 1999 sur la base de la bibliographie existante, de la carte topographique de 1956, des images satellitaires Landsat 5 et 7 TM et ETM+ de 2 périodes (1986, 1999), complétée par des interviews semi-structurés et des transects sur le terrain, permettra de mieux appréhender la dynamique des ressources et les actions de conservation de la biodiversité réalisées à cet effet. Les résultats montrent une dynamique progressive de la faune de 1951 à 1970, puis une dynamique régressive de 1970 à 1989. Après cette tumultueuse période, un repeuplement du parc s'opère de 1989 à 2002. Par contre, la flore est relativement bien conservée avec quelques cours d'eau, des mares, champs et plantations. Et cela grâce aux multiples projets de conservation de la biodiversité. La promotion de l'écotourisme serait une alternative au développement durable de ce parc.

Prenatal dioxin exposure estimated from dioxins in breast milk and sex hormone levels in umbilical cord blood in Vietnamese newborn infants.

PubMed

Boda, Hitomi; Nghi, Tran Ngoc; Nishijo, Muneko; Thao, Pham Ngoc; Tai, Pham The; Van Luong, Hoang; Anh, Tran Hai; Morikawa, Yuko; Nishino, Yoshikazu; Nishijo, Hisao

2018-02-15

Dioxin concentrations remain elevated in the environment and humans residing near the former US Air Force base in Bien Hoa city, South Vietnam. We recruited 210 mother-infant pairs for whom breast milk dioxin levels were reported in our previous study. Cord blood samples were collected from 162 mother-infant pairs. We selected 16 cord blood samples with a volume over 20mL and fat content of ≥0.03g. Toxic equivalent levels of polychlorinated dibenzodioxins and polychlorinated dibenzofurans (TEQ-PCDD/Fs) and concentrations of 17 congeners, including 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD), in cord blood were measured and compared with levels in breast milk (Study 1). Levels of 2,3,7,8-TCDD and TEQ-PCDD/Fs in cord blood samples were highly and significantly correlated with those in breast milk samples in the same pairs. This suggests dioxins in breast milk reflect prenatal dioxin exposure. Estradiol (E2) and testosterone (TS) were measured in cord blood serum from 162 samples. Associations between dioxins in breast milk and cord blood sex hormones were analyzed by infant sex, after adjusting for confounding factors (Study 2). Increased levels of TEQ-PCDD/Fs in breast milk were associated with decreased cord blood TS in girls. In boys, a significant reduction of cord blood TS was observed in those exposed to 2,3,7,8-TCDD at high levels (≥5.5pg/g lipid). There was no significant association between E2 and dioxins in breast milk in either sex. These results suggest increased prenatal dioxin exposure is associated with decreased cord TS, but in boys, only high level of 2,3,7,8-TCDD influence cord blood TS. Copyright © 2017. Published by Elsevier B.V.

Les nouveaux critères de la Maladie d’Alzheimer – Perspective gériatrique*

PubMed Central

Molin, Pierre; Rockwood, Kenneth

2016-01-01

RÉSUMÉ Deux nouvelles séries de critères pour le diagnostic de la maladie d’Alzheimer sont maintenant en vigueur, incluant une série publiée en 2014. Un « nouveau lexique » conceptualisant la maladie a également été proposé. En 2012, la Conférence consensuelle canadienne affirmait que, pour l’instant, ni les nouveaux critères ni la nouvelle terminologie ne modifiaient la pratique en première ligne. Néanmoins, pour les consultants spécialisés en démence, l’avènement de ces critères ouvre la porte à de nombreux défis et occasions. En général, les nouveaux critères accordent une place grandissante aux biomarqueurs. Toutefois, les évidences qui sous-tendent leur utilisation demeurent incomplètes. L’étude de sujets provenant de la communauté ayant raffiné notre compréhension des critères neuropathologiques des démences, il est probable que notre expérience avec les biomarqueurs en bénéficierait également. Pour l’instant, ces critères sont réservés à la recherche. Cependant, leur adoption à plus large échelle est pressentie, particulièrement aux États-Unis. Les gériatres canadiens doivent être conscients de la terminologie maintenant utilisée et du changement fondamental qui en découle : un diagnostic de maladie d’Alzheimer ne requiert plus un diagnostic de démence. Dans l’attente de nouvelles données – auxquelles les gériatres peuvent contribuer – il y a lieu de faire preuve de prudence dans l’adoption des nouveaux critères, car ils sont susceptibles de moins bien s’appliquer aux personnes âgées. PMID:27403215

Qu’est-ce que l’hidradénite suppurée?

PubMed Central

Lee, Erika Yue; Alhusayen, Raed; Lansang, Perla; Shear, Neil; Yeung, Jensen

2017-01-01

Résumé Objectif Permettre aux médecins de famille de comprendre l’épidémiologie, le tableau clinique, le diagnostic et la prise en charge de l’hidradénite suppurée. Sources d’information Une recherche de la littérature a été effectuée sur PubMed à l’aide des mots-clés MeSH hidradenitis suppurativa. Message principal L’hidradénite suppurée est une affection cutanée chronique, récidivante et incapacitante. C’est un trouble inflammatoire de l’épithélium folliculaire, bien qu’une infection bactérienne secondaire se produise souvent. Le diagnostic, posé en clinique, repose sur les lésions typiques (nodules, abcès, tractus sinusal), le siège (plis cutanés), la nature des rechutes et le caractère chronique. De nombreuses comorbidités sont associées à l’hidradénite suppurée, y compris l’obésité, le syndrome métabolique, la maladie intestinale inflammatoire et la spondylarthropathie. Même si l’absence de traitement curatif et la nature récidivante de l’hidradénite suppurée en compliquent le traitement, il existe des options efficaces pour prendre en charge les symptômes. Conclusion Les médecins de famille doivent soupçonner l’hidradénite suppurée chez les patients qui présentent des abcès cutanés récidivants dans les plis cutanés. Les médecins de famille jouent un rôle important dans le diagnostic précoce, l’instauration du traitement et la recommandation en dermatologie avant que l’hidradénite suppurée ne progresse vers une atteinte terminale incapacitante. PMID:28209697

Effets Seebeck et Nernst dans les cuprates: Etude de la reconstruction de la surface de Fermi sous champ magnetique intense

NASA Astrophysics Data System (ADS)

Laliberte, Francis

2010-06-01

Ce memoire presente des mesures de transport thermoelectrique, les effets Seebeck et Nernst, dans une serie d'echantillons de supraconducteurs a haute temperature critique. Des resultats obtenus recemment au Laboratoire National des Champs Magnetiques Intenses a Grenoble sur La1.7Eu0.2Sr0.1 CuO4, La1.675Eu0.2Sr0.125CuO 4, La1.64Eu0.2Sr0.16CuO4, La1.74Eu0.1Sr0.16CuO4 et La 1.4Nd0.4Sr0.2CuO4 sont analyses. Une attention particuliere est accordee aux equations de la theorie semi-classique du transport et leur validite est verifiee. La procedure experimentale et les materiaux utilises pour concevoir les montages de mesures sont expliques en detail. Enfin, un chapitre est dedie a l'explication et l'interpretation des resultats de transport thermoelectrique sur YBa2Cu3O6+delta publies au cours de l'hiver 2010 dans les revues Nature et Physical Review Letters. Les donnees d'effet Seebeck dans les echantillons de La 1.8-x,Eu0.2SrxCuO 4, ou un changement de signe est observe, permettent de conclure a la presence d'une poche d'electrons dans la surface de Fermi qui domine le transport a basse temperature dans la region sous-dopee du diagramme de phase. Cette conclusion est similaire a celle obtenue par des mesures d'effet Hall dans YBa 2Cu3O6+delta et elle cadre bien dans un scenario de reconstruction de la surface de Fermi. Les donnees d'effet Nernst recueillies indiquent que la contribution des fluctuations supraconductrices est limitee a un modeste intervalle de temperature au-dessus de la temperature critique.

World heritage site - Bien du Patrimoine Mondial - Kluane/Wrangell-St. Elias/Glacier Bay/Tatshenshini-Alsek

USGS Publications Warehouse

Labay, Keith A.; Wilson, Frederic H.

2004-01-01

The four parks depicted on this map make up a single World Heritage Site that covers 24.3 million acres. Together, they comprise the largest internationally protected land-based ecosystem on the planet. The United Nations Educational, Scientific and Cultural Organization (UNESCO) established the World Heritage Program in 1972 for the identification and protection of the world?s irreplaceable natural and cultural resources. World Heritage Sites are important as storehouses of memory and evolution, as anchors for sustainable tourism and community, and as laboratories for the study and understanding of the earth and culture. This World Heritage Site protects the prominent mountain ranges of Kluane, Wrangell, Saint Elias, and Chugach. It includes many of the tallest peaks on the continent, the world's largest non-polar icefield, extensive glaciers, vital watersheds, and expanses of dramatic wilderness. [Les quatre parcs figurant sur cette carte ne constituent qu?un seul site du patrimoine mondial recouvrant plus de 99 millions de km2, ce qui en fait le plus grand ecosysteme terrestre protege par loi internationale. En 1972, L?UNESCO (l?organisation des Nations Unies pour les sciences, l'education et la culture) a etabli le programme du patrimoine mondial afin d?identifier et de proteger les ressources naturelles et culturelles irremplacables de notre plan?te. Si les sites du patrimoine mondial sont si importants c'est parce qu'ils representent a la fois des livres ouverts sur l?histoire de la Terre, le point de depart du tourisme durable et du developpement des collectivites, des laboratoires pour etudier et comprendre la nature et la culture. Ce site du patrimoine mondial assure la protection des chaines de montagnes de Kluane, Wrangell, Saint Elias, et Chugach. On y trouve plusieurs des plus hauts sommets du continent, le plus grand champ de glace non-polaire du monde, d?immenses glaciers, des bassins hydrologiques essentiels, et de la nature sauvage a perte de vue.

Sobrevivendo a un tsunami: lecciones de Chile, Hawai y Japon

USGS Publications Warehouse

Compilado por Atwater, Brian F.; Cisternas V., Marco; Bourgeois, Joanne; Dudley, Walter C.; Hendley, James W.; Stauffer, Peter H.

1999-01-01

Este folleto contiene historias veridicas que ilustran como sobrevivir, y como no sobrevivir, a un tsunami. Esta publicacion esta dirigida a las personas que viven, trabajan o, simplemente, se divierten a lo largo de las costas que pueden ser afectadas por un tsunami. Tales costas rodean la mayor parte del Oceano Pacifico pero tambien incluyen algunas areas costeras de los Oceanos Atlantico e Indico. Aunque mucha gente llama a los tsunamis 'olas de marea', estos no estan relacionados a las mareas, sino son una serie de olas, o 'tren de olas', generalmente causadas por cambios en el nivel del fondo marino durante los terremotos. Los tsunamis tambien pueden ser generados por la erupcion de volcanes costeros, islas volconicas, deslizamientos submarinos e impactos de grandes meteoritos en el mar. Como sucedio en Sumatra en el 2004, los tsunamis pueden alcanzar alturas de 15 metros, no tan solo en la costa sino tambien kilometros tierra adentro. Los relatos presentados en este folleto fueron seleccionados de entrevistas realizadas a personas que sobrevivieron al tsunami del Oceano Pacifico de 1960. Muchas de estas personas, incluyendo a la enfermera de la foto, se enfrento a las olas generadas a poca distancia, en la costa chilena. En cambio, otros debieron hacer frente al tsunami muchas horas despues, en Hawai y Japon. La mayoria de las entrevistas fueron realizadas a fines de los anos ochenta y en los noventa. Las historias ofrecen una mezcla de lecciones de supervivencia a un tsunami. En algunos casos se presentan las acciones que confiablemente salvaron vidas: poner atencion a los avisos de la naturaleza, abandonar los bienes, dirigirse rapidamente a un sector alto y permanecer alli hasta que el tsunami realmente haya terminado. Otras historias describen como se encontro refugio al subir a construcciones y arboles o flotar sobre desechos, tacticas que tuvieron diferentes resultados y que pueden ser recomendadas solo como actos desesperados de personas atrapadas en sectores bajos.

[Not Available].

PubMed

Burgos Peláez, Rosa; Cuerda Compes, María Cristina; García-Luna, Pedro P; Martínez Faedo, Ceferino; Mauri Roca, Sílvia; Moreno Villares, José Manuel; Virgili Casas, M Nuria; Wanden-Berghe, Carmina

2016-07-19

Introducción:la nutrición parenteral (NP) a largo plazo puede asociarse a complicaciones graves, con un deterioro importante de la calidad de vida de los pacientes con síndrome de intestino corto (SIC). Teduglutida, un análogo del péptido-2 similar al glucagón, pertenece a una nueva familia terapéutica y representa el primer abordaje no sintomático del SIC. Objetivos: revisar los datos preclínicos y clínicos en cuanto a eficacia y seguridad de teduglutida. Resultados: la aprobación de teduglutida se basó en los resultados de un estudio en fase III de 24 semanas, doble ciego, controlado con placebo (STEPS). Pacientes con fallo intestinal por SIC dependientes de NP ≥ 3 veces/semana durante ≥ 12 meses recibieron 0,05 mg/kg de teduglutida (n = 43) o placebo (n = 43) 1 vez/día. En la semana 24 hubo significativamente más respondedores en el grupo de teduglutida que en el de placebo (63 vs.30%; p = 0,002). La reducción absoluta media del volumen de NP frente al valor basal en la semana 24 fue significativamente mayor con teduglutida (4,4 vs.2,3 l/semana; p < 0,001). La necesidad de NP se redujo ≥ 1 día en la semana 24 en el 54% de pacientes tratados con teduglutida vs.23% con placebo. Del total de pacientes que recibieron teduglutida en los ensayos en fase III (n = 134), el 12% consiguió una autonomía completa de la NP. Por lo general, la administración subcutánea de teduglutida se toleró bien. Conclusiones: se ha demostrado que teduglutida recupera la absorción intestinal y reduce significativamente la dependencia de la NP, consiguiendo incluso la independencia en algunos pacientes.

Pax narcotica

PubMed Central

Bourgois, Philippe; Hart, Laurie Kain

2016-01-01

RÉSUMÉ/ABSTRACT Fondé sur un travail de terrain mené pendant cinq ans dans le ghetto portoricain de Philadelphie, cet article explore les logiques de violence et de paix à l’œuvre dans ce secteur situé en fin de circuit de l’industrie globale du narcotrafic. Tout en recourant à la violence armée pour éliminer leurs rivaux et défendre leur territoire, les patrons locaux de la drogue doivent simultanément renvoyer l’image de figures généreuses pour éviter que les habitants ne les dénoncent à la police, en se montrant responsables, prêts à redistribuer les ressources, à offrir des emplois bien rémunérés, à discipliner leurs employés et à contenir les excès de violence. Les chefs de la drogue sont donc contraints de transformer leur force brute en un pouvoir vertueux pour prospérer. Ils participent ainsi, avec voisins et employés, à une économie morale de relations patrimoniales et clientélistes au sein de laquelle ils s’imposent comme des leaders charismatiques. À partir d’une relecture du concept d’ « accumulation primitive », cet article revient à la fois : 1) sur la relation coloniale qui pousse la diaspora portoricaine ghettoïsée dans la niche économique que représente la revente de drogue au détail; 2) sur la violence symbolique à l’œuvre à tous les échelons de ce trafic; 3) sur les profits artificiellement élevés générés par cette industrie criminalisée par l’État; 4) et sur la prolifération opportuniste de secteurs spécialisés de l’économie légale et de la bureaucratie publique chargés de gérer les effets collatéraux de la coercition et des violences d’État. PMID:28090135

Des ballons pour demain

NASA Astrophysics Data System (ADS)

Régipa, R.

A partir d'une théorie sur la détermination des formes et des contraintes globales d'un ballon de révolution, ou s'en rapprochant, une nouvelle famille de ballons a été définie. Les ballons actuels, dits de ``forme naturelle'', sont calculés en général pour une tension circonférencielle nulle. Ainsi, pour une mission donnée, la tension longitudinale et la forme de l'enveloppe sont strictement imposées. Les ballons de la nouvelle génération sont globalement cylindriques et leurs pôles sont réunis par un câble axial, chargé de transmettre une partie des efforts depuis le crochet (pôle inférieur), directement au pôle supérieur. De plus, la zone latérale cylindrique est soumise à un faible champ de tensions circonférencielles. Ainsi, deux paramètres permettent de faire évoluer la distribution des tensions et la forme de l'enveloppe: - la tension du câble de liaison entre pôles (ou la longueur de ce câble) - la tension circonférencielle moyenne désirée (ou le rayon du ballon). On peut donc calculer et réaliser: - soit des ballons de forme adaptée, comme les ballons à fond plat pour le bon fonctionnement des montgolfières infrarouge (projet MIR); - soit des ballons optimisés pour une bonne répartition des contraintes et une meilleure utilisation des matériaux d'enveloppe, pour l'ensemble des programmes stratosphériques. Il s'ensuit une économie sensible des coûts de fabrication, une fiabilité accrue du fonctionnement de ces ballons et une rendement opérationnel bien supérieur, permettant entre autres, d'envisager des vols à très haute altitude en matériaux très légers.

PubMed

De Abajo Larriba, Ana Beatriz; Méndez Rodríguez, Enrique; González-Gallego, Javier; Capón Álvarez, Jessica; Díaz Rodríguez, Ángel; Peleteiro Cobo, Beatriz; Mahmoud Atoui, Omar; De Abajo Olea, Serafín; Martínez de Mandojana Hernández, Juan; Lumbreras González, Víctor

2016-11-29

Objetivos: estimar el porcentaje de pacientes con EPOC adiestrados en la consulta para el manejo de inhaladores en la provincia de León.Métodos: estudio epidemiológico, transversal, multicéntrico (30 centros de salud de la provincia de León). Incluyó pacientes mayores de 35 años diagnosticados y tratados de EPOC. Variables a estudio: edad, sexo, hábitat, datos antropométricos, estado nutricional, tabaquismo, espirometría postboroncodilatadora, disnea (mMRC), reagudizaciones, gravedad (Índice Bodex), hospitalizaciones, tratamiento, seguimiento y caracterización del fenotipo (GesEOPC 2014). Los resultados se expresan con sus IC al 95,5%.Resultados: se incluyeron 833 pacientes, el 85,8% varones, con edad media de 64,69 (53,66-75,61) años y 20,65 (4,47-36,8) años evolución de la EPOC. Empleaban 1,88 (1,64-2,16) dispositivos inhaladores de media, p = 0,006, (57% de forma correcta, 23% regular y el 20% incorrecta). El 20,9% no recibieron adiestramiento para usar inhaladores frente al 79,1% adiestrados, p < 0,001, (9,4% por neumólogos, 20,3% enfermeras y 43,5% médicos familia, p = 0,002). Los pacientes bien adiestrados realizan mejor el tratamiento, en el 60,60% (58,91-62,29), p = 0,002. No hubo diferencias significativas en el adiestramiento por tabaquismo, gravedad, ingresos hospitalarios, ni calidad de vida, obteniendo una reducción significativa del número de agudizaciones, siendo de 1,59 (1,12-2,15) reagudizaciones medias en el grupo adiestrado frente a 3,29 (2,50-4,11) en los no adiestrados, p = 0,002.Conclusiones: el nivel de adiestramiento en el uso de inhaladores en los pacientes con EPOC es insuficiente en nuestro medio. La mejor formación de los profesionales y la simplificación de los dispositivos contribuirán a que un mayor número de pacientes realicen el tratamiento de forma adecuada.

Validation de la version française de l’échelle multidimensionnelle des conduites de négligence parentale

PubMed Central

Bérubé, Annie; Chamberland, Claire

2017-01-01

Objectif: La mesure de la négligence parentale pose de nombreux défis et il existe encore peu d’outil capable de la documenter auprès des parents. L’étude vise à documenter les propriétés psychométriques de la traduction française de la version brève de l’Échelle multidimensionnelle des conduites de négligence parentale dans la population générale. Méthode: Cette étude utilise les données d’une enquête téléphonique réalisée auprès d’un échantillon représentatif de 3584 mères et 1202 pères d’enfants âgés entre 6 mois-4 ans, 5-9 ans et 10-15 ans. Des liens sont établis entre la négligence et plusieurs autres facteurs connus pour leurs liens avec la problématique, dont les conduites parentales à caractère violent, le stress lié au tempérament perçu difficile de l’enfant et à la conciliation travail-famille, la consommation d’alcool et de drogues, les symptômes de dépression, la pauvreté, et le soutien social. Résultats: Les analyses factorielles exploratoires montrent la présence de diverses dimensions de la négligence concernant les besoins affectifs/cognitifs, physiques (soins de base) et de supervision des enfants. Bien que les dimensions soient étroitement associées aux facteurs de vulnérabilité psychosociale des enfants et des familles, les coefficients de cohérence interne sont faibles, variant entre 0,20 et 0,64. Conclusion: Des recommandations sont émises pour améliorer la mesure dans la population générale, et notamment la dimension de supervision parentale qui pose des défis particuliers. PMID:28359164

Sequelles de Brulures au Centre Hospitalier Universitaire Ibn Rochd de Casablanca: Aspects Epidemio-Cliniques

PubMed Central

Chafiki, N.; Fassi Fihri, J.; Boukind, E.H.

2007-01-01

Summary Il s'agit d'une étude épidémiologique des séquelles de brûlures à propos de 100 cas colligés au service de chirurgie réparatrice et de brûlés du centre hospitalier universitaire Ibn Rochd (Casablanca). Les adultes représentent 55% de la population étudiée, l'âge moyen global est de 20 ans. Le sexe féminin est le plus touché avec 61% des cas. Les brûlures survenues à domicile sont les plus fréquentes avec 80%. L'agent causal le plus incriminé est la petite bouteille de butane avec 44,4%. Plus de la moitié de la population brûlée (55%) sont accueillis initialement au niveau d'hôpitaux régionaux. Le délai de cicatrisation moyen de 7 mois et 11 jours et par conséquent les séquelles mineures (dyschromie dans 90% des cas et prurit dans 49% des cas) et majeures (rétractions dans 86% et l'hypertrophie dans 51%) sont fréquentes. La répartition globale des séquelles montre une prédominance du segment cervicocéphalique avec 89% des cas et des membres supérieurs dans 82% des cas. Les différents aspects anatomocliniques essentiels ont été décrits au niveau de chaque segment corporel. Nos résultats ont été comparés aux données de la littérature, ce qui nous amène à considérer qu'une large campagne de prévention couplée à une meilleure prise en charge initiale, précoce, bien conduite et multidisciplinaire permet non seulement de réduire le nombre de séquelles mais aussi de diminuer leur sévérité. PMID:21991060

Cirugía transnasal endoscópica para tumores de hipófisis

PubMed Central

Ajler, Pablo; Hem, Santiago; Goldschmidt, Ezequiel; Landriel, Federico; Campero, Alvaro; Yampolsky, Claudio; Carrizo, Antonio

2012-01-01

Introducción: Exponer la técnica utilizada y los resultados obtenidos en los primeros 52 pacientes portadores de tumores hipofisarios tratados por la vía endoscópica transnasal en el Hospital Italiano de Buenos Aires Métodos: Se llevó a cabo un análisis retrospectivo de 52 cirugías endoscópicas transnasales utilizadas en el tratamiento de tumores hipofisários. Las mismas fueron realizadas en el Hospital Italiano de Buenos Aires durante el período junio del 2011 a junio del 2012. Se analizaron las características demográficas de los pacientes, la patología de base y la morbimortalidad asociada a la cirugía. Resultados: La edad media de los pacientes fue de 41,52 años con un rango de 18-79. La distribución fue similar entre hombres y mujeres. Las patologías más frecuentes fueron: adenomas no funcionantes (40.4%), tumores productores de GH/Acromegalia (25%) y tumores productores de ACTH/Enfermedad de Cushing (23.1%). Aproximadamente el 70 % correspondieron a macroadenomas. Sólo un paciente presentó complicaciones. No se registro ningún óbito. Conclusión: Si bien podremos objetivar fehacientemente resultados más concluyentes en futuros trabajos, podemos decir a priori que, en la endoscopía el detalle anatómico es claramente superior al microscópico y que la posibilidad de la introducción del endoscopio en la silla turca permite la visualización directa de remanentes tumorales, de sitios de fístula y como así también de la glándula normal, ventajas que potencialmente podrían permitir obtener mejores resultados quirúrgicos, en términos de control de la enfermedad y tasa de complicaciones. PMID:23596553

mHealth information for migrants: an e-health intervention for internal migrants in Vietnam.

PubMed

Vu, Lan Thi Hoang; Nguyen, Ngan Thi Kim; Tran, Hanh Thi Duc; Muhajarine, Nazeem

2016-05-14

Socio-economic development in Vietnam has resulted in increased internal migration particularly among young women seeking employment opportunities in cities. Vietnamese female migrants who enter new environments often encounter the loss or neglect of their right to access sexual and reproductive health services. To address this, a mobile health (mHealth) intervention model was implemented over 12 months (2013-2014) in a factory in the Long Bien industrial zone of Hanoi, Vietnam. The intervention provided sexual and reproductive health services for female migrants through text messaging, information booklets accompanied maps, and free counseling via a hotline. To evaluate the impact of the intervention, pre- and post-intervention data were collected to measure changes in women's knowledge and practices related to sexual and reproductive health. Qualitative data in the form of personal interviews were also collected. The sample size for the baseline survey was 411 women, and for the post-intervention survey it was 482 women (the intervention involved an open cohort). The majority of women were unmarried and under the age of 25. Results indicate that there was high uptake of the intervention services and that most women found the services important and useful. In addition, there was evidence that the intervention (1) increased women's knowledge of sexual and reproductive health (e.g., proper use of condoms, identification of high-risk behaviors such as having unprotected sex), and (2) fostered improved practices related to sexual and reproductive health (e.g., increased gynecological check-ups and use of condoms). The study demonstrated the feasibility of implementing a multi-faceted intervention for migrant women working in an industrial zone in Hanoi, Vietnam as well as its successful uptake and some early positive effects. This can be used to inform future design and implementation of mHealth/eHealth intervention models for migrant and other vulnerable/hard to reach population.

Soins primaires aux adultes ayant des déficiences intellectuelles et développementales

PubMed Central

Sullivan, William F.; Diepstra, Heidi; Heng, John; Ally, Shara; Bradley, Elspeth; Casson, Ian; Hennen, Brian; Kelly, Maureen; Korossy, Marika; McNeil, Karen; Abells, Dara; Amaria, Khush; Boyd, Kerry; Gemmill, Meg; Grier, Elizabeth; Kennie-Kaulbach, Natalie; Ketchell, Mackenzie; Ladouceur, Jessica; Lepp, Amanda; Lunsky, Yona; McMillan, Shirley; Niel, Ullanda; Sacks, Samantha; Shea, Sarah; Stringer, Katherine; Sue, Kyle; Witherbee, Sandra

2018-01-01

Résumé Objectif Mettre à jour les Lignes directrices consensuelles canadiennes 2011 en matière de soins primaires aux adultes ayant une déficience développementale. Méthodes Des médecins de famille et d’autres professionnels de la santé expérimentés dans les soins aux personnes ayant des DID ont examiné et synthétisé les récentes connaissances empiriques, d’écosystèmes, expertes et expérientielles. Un système a été conçu pour catégoriser la qualité des recommandations. Recommandations Les adultes ayant des DID sont un groupe hétérogène de patients qui présentent des affections médicales et des facteurs qui influent sur leur santé, qui diffèrent de ceux qui touchent les autres membres de la communauté de par leur nature, leurs manifestations, leur gravité ou leur complexité. Ces personnes nécessitent une approche de soins et des interventions adaptées à leurs besoins. Les présentes lignes directrices offrent des conseils en matière de normes de soins. Nous avons incorporé des références à des outils cliniques et à d’autres ressources pratiques. Les approches de soins décrites ici s’appliquent aussi à d’autres groupes de patients ayant un déficit cognitif ou de la communication, ou d’autres déficits des fonctions adaptatives. Conclusion À titre de fournisseurs de soins de première ligne, les médecins de famille jouent un rôle vital de promotion de la santé et de bien-être auprès des adultes ayant des DID. Ces lignes directrices peuvent les aider à prendre des décisions avec les patients et les aidants naturels. PMID:29650617

Sismologie Jovienne

NASA Astrophysics Data System (ADS)

Mosser, Benoît

2000-01-01

Dis-moi comment tu oscilles, je te dirai qui tu es... La Terre, le Soleil ont bien voulu répondre à cette question, et leurs intérieurs sont pour une large part dévoilés. Etoiles et planètes subissent actuellement un interrogatoire serré. Ce mémoire de thèse d'habilitation expose l'état des recherches concernant l'étude sismique de Jupiter, menées essentiellement par la communauté astrophysique française. Il s'attache à montrer tout ce que l'étude sismique de Jupiter, et elle-seule, peut dévoiler. Les principaux résultats sont rappelés, et surtout les conditions dans lesquelles ils ont été obtenus: les fréquences caractéristiques de Jupiter et Procyon ont été mesurées, avec un degré de confiance élevé. Un point observationnel est plus particulièrement développé: la sismométrie jovienne et stellaire avec le spectromètre par transformée de Fourier (FTS) du CFH. Cet instrument unique, que d'aucuns aimeraient reléguer dans un musée, s'est révélé excellent sismomètre et s'avère a court terme comme le seul outil disponible pour l'étude sismique de Jupiter, avec des performances encore améliorées. Il a permis d'acquérir une expertise unique sur laquelle se basent les recherches observationnelles à poursuivre. Les acquis théoriques et observationnels de la sismologie jovienne permettent de dégager les priorités à moyen et long terme: les développements théoriques nécessaires pour répondre aux questions posées par la modélisation de l'intérieur jovien, et surtout les développements intrumentaux sans lesquels le sujet n'a pas d'avenir. On-line Thesis, Benoît Mosser

L'effet de p53 sur la radiosensibilité des cellules humaines normales et cancéreuses

NASA Astrophysics Data System (ADS)

Little, J. B.; Li, C. Y.; Nagasawa, H.; Huang, H.

1998-04-01

The radiosensitivity of normal human fibroblasts in p53 dependent and associated with the loss of cells from the cycling population as the result of an irreversible G1 arrest; cells lacking normal p53 function show no arrest and are more radioresistant. Under conditions in which the repair potentially lethal radiation damage is facilitated, the fraction of cells arrested in G1 is reduced and survival is enhanced. The response of human tumor cells differs significantly. The radiation-induced G1 arrest is minimal or absent in p53+ tumor cells, and loss of normal p53 function has no consistent effect on their radiosensitivity. These results suggest that p53 status may not be a useful predictive marker for the response of human solid tumors to radiation therapy. La radiosensibilité des fibroblastes diploïdes humains est liée à l'expression de p53, et à la perte de cellules en cycle résultant d'un arrêt irréversible en phase G1 ; dans les cellules n'ayant pas une fonction p53 normale, on ne constate aucun arrêt, et elles sont plus radio-résistantes. Dans des conditions favorables à la réparation de lésions potentiellement léthales dues à l'irradiation, la proportion de cellules bloquées en phase G1 baisse, et les chances de survie sont accrues. Bien différente est la réaction des cellules cancéreuses humaines. Le blocage par irradiation en phase G1 est minime ou inexistant dans les cellules cancéreuses p53^+, et la perte de la fonction normale p53 n'a pas d'effet constant sur leur radiosensibilité. Ces résultats laissent penser que l'expression de p53 n'est pas un indice fiable permettant de prévoir la réaction des tumeurs solides à la radiothérapie.

Concepts and measures of patient empowerment: a comprehensive review.

PubMed

Cerezo, Paloma Garcimartín; Juvé-Udina, Maria-Eulália; Delgado-Hito, Pilar

2016-01-01

Analyze the definitions and dimensions of empowerment. Identify the strengths and weaknesses of empowerment measures based on the conceptual model. This was a comprehensive literature review of publications on the MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Twenty-nine articles were selected. Seventeen definitions and seven dimensions of empowerment, and 10 empowerment measures were selected. Empowerment can be seen as an enabling process involving a shift in the balance of power, or as an outcome of this process. The dimensions reflect outcome indicators, such as participation in decision-making and control, and process indicators, such as knowledge acquisition and coping skills. Six of the tools analyzed by this study could be said to provide a robust measure of patient empowerment. we propose a definition of empowerment that helps to deepen understanding of the term and, therefore, its operationalization. Analizar definiciones y dimensiones de empoderamiento. Identificar fortalezas y debilidades de los instrumentos de medida de empoderamiento respecto al modelo conceptual. Revisión integrativa de la literatura en las bases de datos MEDLINE y Cumulative Index to Nursing and Allied Health Literature (CINAHL). Fueram seleccionados 29 artículos . Se identificaron 17 definiciones, 7 propuestas de dimensiones y 10 instrumentos de medida. Empoderamiento puede ser un proceso de capacitación o habilitación en el que se transfiere el poder de un individuo a otro, o bien un resultado producto de ese proceso. Las dimensiones reflejan indicadores de resultados como son la participación en la toma de decisiones y tomar el control, e indicadores relativos al proceso como son la adquisición de conocimientos y las habilidades de afrontamiento. De los instrumentos analizados seis son los instrumentos que presentan mayor robustez. Se propone una definición de empoderamiento que puede ayudar a mejorar la comprensión del término y por lo tanto a operacionalizarlo.

[Not Available].

PubMed

Chafiki, N; Fassi Fihri, J; Boukind, E H

2007-03-31

Il s'agit d'une étude épidémiologique des séquelles de brûlures à propos de 100 cas colligés au service de chirurgie réparatrice et de brûlés du centre hospitalier universitaire Ibn Rochd (Casablanca). Les adultes représentent 55% de la population étudiée, l'âge moyen global est de 20 ans. Le sexe féminin est le plus touché avec 61% des cas. Les brûlures survenues à domicile sont les plus fréquentes avec 80%. L'agent causal le plus incriminé est la petite bouteille de butane avec 44,4%. Plus de la moitié de la population brûlée (55%) sont accueillis initialement au niveau d'hôpitaux régionaux. Le délai de cicatrisation moyen de 7 mois et 11 jours et par conséquent les séquelles mineures (dyschromie dans 90% des cas et prurit dans 49% des cas) et majeures (rétractions dans 86% et l'hypertrophie dans 51%) sont fréquentes. La répartition globale des séquelles montre une prédominance du segment cervicocéphalique avec 89% des cas et des membres supérieurs dans 82% des cas. Les différents aspects anatomocliniques essentiels ont été décrits au niveau de chaque segment corporel. Nos résultats ont été comparés aux données de la littérature, ce qui nous amène à considérer qu'une large campagne de prévention couplée à une meilleure prise en charge initiale, précoce, bien conduite et multidisciplinaire permet non seulement de réduire le nombre de séquelles mais aussi de diminuer leur sévérité.

Pain assessment and management in patients undergoing endovascular procedures in the catheterization laboratory.

PubMed

Hilário, Thamires de Souza; Santos, Simone Marques Dos; Kruger, Juliana; Goes, Martha Georgina; Casco, Márcia Flores; Rabelo-Silva, Eneida Rejane

2017-05-25

To describe how pain is assessed (characteristic, location, and intensity) and managed in clinical practice in patients undergoing endovascular procedures in the catheterization laboratory setting. Cross-sectional study with retrospective data collection. Overall, 345 patients were included; 116 (34%) experienced post-procedural pain; in 107 (92%), pain characteristics were not recorded; the location of pain was reported in 100% of patients, and its intensity in 111 (96%); management was largely pharmacologic; of the patients who received some type of management (n=71), 42 (59%) underwent reassessment of pain. The location and intensity of pain are well reported in clinical practice. Pharmacologic pain management is still prevalent. Additional efforts are needed to ensure recording of the characteristics of pain and its reassessment after interventions. Describir cómo se evalúa el dolor (características, localización e intensidad) y su manejo en la práctica clínica en pacientes sometidos a procedimientos endovasculares en el laboratorio de cateterización. Estudio transversal con recolección retrospectiva de datos. En total, se incluyeron 345 pacientes; 116 (34%) experimentaron dolor post-procedimiento; en 107 (92%), no se registraron las características del dolor; la localización del dolor se informó en el 100% de los pacientes, y su intensidad en 111 (96%); el manejo fue en gran medida farmacológico; de los pacientes que recibieron algún tipo de tratamiento (n=71), 42 (59%) fueron sometidos a reevaluación del dolor. La ubicación y la intensidad del dolor se informan bien en la práctica clínica. El manejo farmacológico del dolor sigue siendo frecuente. Se necesitan esfuerzos adicionales para asegurar el registro de las características del dolor y su reevaluación después de las intervenciones.

Six Common Mistakes in Conservation Priority Setting

PubMed Central

Game, Edward T; Kareiva, Peter; Possingham, Hugh P

2013-01-01

Abstract A vast number of prioritization schemes have been developed to help conservation navigate tough decisions about the allocation of finite resources. However, the application of quantitative approaches to setting priorities in conservation frequently includes mistakes that can undermine their authors’ intention to be more rigorous and scientific in the way priorities are established and resources allocated. Drawing on well-established principles of decision science, we highlight 6 mistakes commonly associated with setting priorities for conservation: not acknowledging conservation plans are prioritizations; trying to solve an ill-defined problem; not prioritizing actions; arbitrariness; hidden value judgments; and not acknowledging risk of failure. We explain these mistakes and offer a path to help conservation planners avoid making the same mistakes in future prioritizations. Seis Errores Comunes en la Definición de Prioridades de Conservación Resumen Se ha desarrollado un vasto número de esquemas de priorización para ayudar a que la conservación navegue entre decisiones difíciles en cuanto a la asignación de recursos finitos. Sin embargo, la aplicación de métodos cuantitativos para la definición de prioridades en la conservación frecuentemente incluye errores que pueden socavar la intención de sus autores de ser más rigurosos y científicos en la manera en que se establecen las prioridades y se asignan los recursos. Con base en los bien establecidos principios de la ciencia de la decisión, resaltamos seis errores comúnmente asociados con la definición de prioridades para la conservación: no reconocer que los planes de conservación son priorizaciones; tratar de resolver un problema mal definido; no priorizar acciones; arbitrariedad; juicios de valor ocultos y no reconocer el riesgo de fracasar. Explicamos estos errores y ofrecemos un camino para que planificadores de la conservación no cometan los mismos errores en priorizaciones futuras. PMID:23565990

Study of the chain conformation of thermotropic nematic main chain polyesters

NASA Astrophysics Data System (ADS)

Li, M. H.; Brûlet, A.; Cotton, J. P.; Davidson, P.; Strazielle, C.; Keller, P.

1994-10-01

The conformation of main chain mesomorphic polyesters is studied by small angle neutron scattering (SANS) in the isotropic and in the nematic phases, by using mixtures of deuterated and undeuterated polymers. Particular attention is given to neglect the transesterification effects occurring mainly at high temperature for these LC polymers. In the isotropic phase, despite the presence of long rigid mesogenic groups, the LC polyester chains have a Gaussian conformation shown by the variation of the radius of gyration as a function of the molecular weight. This result is confirmed from the scattering variation in the intermediate range of the scattering vector. In the nematic phase, the SANS data are well fitted to a model of cylinder, in which the main chain polymer is confined. In the unoriented phase, the measurements in the intermediate range give the values of the radii of cylinders : they lie in between 10 Å and 19 Å depending on the degree of polymerization of chains. In the oriented nematic phase, the scattering patterns are highly anisotropic : they correspond to very long, thin and well-oriented cylinders. We have calculated the fully extended chain lengths using for the monomer length that measured in situ by X-ray diffraction. Then the comparison of this length with the measured height of the cylinders gives the existence of hairpins and their number per chain. For the short chain, the conformation is almost completely elongated in the nematic direction, whereas hairpin defects appear in longer chains. Their number decreases slightly with decreasing temperature. The orientational fluctuations of cylinders relatively to the nematic director are weak as shown from the high values of their order parameter (P_2 > 0.9). These results are discussed for two spacer lengths as a function of the molecular weight and of the temperature. La conformation de polyesters linéaires mésomorphes est étudiée par diffusion de neutrons aux petits angles (DNPA) dans les phases isotrope et nématique sur des mélanges de polymères hydrogénés et deutériés. Les conditions expérimentales ont été choisies afin de pouvoir négliger les effets de la transestérification obtenus à haute température avec cette famille de polymères cristaux liquides. Dans la phase isotrope, en dépit de la présence de longs et rigides groupements mésogènes, les chaînes de polymères ont une conformation gaussienne, comme le montre la variation du rayon de giration en fonction de la masse moléculaire. Ce résultat est confirmé par les mesures faites dans le domaine intermédiaire du vecteur de diffusion. Dans la phase nématique, les données de DNPA sont bien ajustées par un modèle de cylindre dans lequel la chaîne de polymère est confinée. Dans la phase non orientée, les mesures faites dans le domaine intermédiaire donnent les valeurs des rayons des cylindres (compris entre 10 Å et 19 Å selon le degré de polymérisation des chaînes). Dans la phase nématique orientée, les figures de diffusion sont très anisotropes et correspondent à de longs et étroits cylindres bien orientés. La longueur de la chaîne totalement étirée est calculée à partir de la longueur du monomère mesurée par diffraction de rayons X. Par comparaison avec la hauteur du cylindre mesurée en DNPA, nous déduisons l'existence des épingles à cheveux et leur nombre par chaîne. La conformation d'une chaîne courte est complètement étirée dans la direction du champ nématique, alors que des défauts du type épingles à cheveux apparaissent dans les chaînes plus longues. Le nombre de ces défauts décroît légèrement en diminuant la température. Les fluctuations d'orientation des cylindres autour de la direction du champ nématique sont faibles comme le montrent les valeurs élevées des paramètres d'ordre des cylindres (P_2 > 0,9). Les résultats sont discutés, pour deux longueurs d'espaceur, en fonction de la masse moléculaire et de la température.

Le syndrome d’alcoolisme foetal

PubMed Central

2002-01-01

L’alcool est un tératogène physique et comportemental. Le syndrome d’alcoolisme foetal (SAF) est un trouble courant mais encore sous-diagnostiqué découlant de la consommation d’alcool par la mère pendant la grossesse. Bien qu’il puisse être prévenu, le SAF est également invalidant. Même si le SAF est présent dans tous les groupes socioéconomiques du Canada, sa prévalence est élevée dans certaines communautés inuites et des Premières nations du Canada. Le présent énoncé porte sur la prévention, le diagnostic, le dépistage précoce et la prise en charge du SAF par les professionnels de la santé. La prévention du SAF doit s’effectuer à deux échelons. La prévention primaire consiste à éliminer le SAF par une formation en classe ou dans la collectivité et à inciter les femmes à éviter de consommer de l’alcool avant la conception et pendant la grossesse. La prévention secondaire consiste à repérer les femmes qui boivent pendant leur grossesse et à réduire leur consommation. Le présent énoncé décrit plusieurs stratégies de dépistage, dont la stratégie T-ACE (tolérance-agacement, réduction, éveil). Les dispensateurs de soins devraient recommander l’abstinence dès la première visite prénatale. Un envoi rapide en consultation en vue de traiter l’alcoolisme est recommandé pour les femmes enceintes incapables d’arrêter de boire. Le présent énoncé décrit le diagnostic de SAF, de SAF partiel ou atypique, d’anomalies congénitales et de troubles neurodéveloppementaux reliés à l’alcool. En cas d’exposition à l’alcool in utero, un diagnostic de SAF devrait être envisagé en présence d’un retard de croissance courant ou antérieur, de certaines anomalies faciales touchant la lèvre supérieure et les yeux et d’anomalies neurodéveloppementales. Ces caractéristiques sont mieux quantifiées au moyen d’une méthode diagnostique à quatre chiffres. Des stratégies de dépistage précoce des anomalies pouvant être reliées à l’alcool sont soulignées. L’intervention est axée sur l’optimisation du développement, la prise en charge des troubles de comportement et la prestation d’un programme scolaire convenable. Il est capital d’intervenir le plus tôt possible pour prévenir les incapacités secondaires susceptibles de découler d’un délai causé par l’attente d’un diagnostic définitif de SAF. Ce n’est que depuis 1973, lorsque Jones et Smith (1) ont donné des descriptions classiques des malformations reliées à l’exposition du foetus à l’alcool, qu’on a compris toute l’étendue de la dévastation provoquée par la consommation d’alcool pendant la grossesse. Un diagnostic de syndrome d’alcoolisme foetal (SAF) dépend d’un historique de consommation prénatale d’alcool par la mère, combiné à un ensemble de caractéristiques chez le nourrisson : croissance médiocre, traits caractéristiques du visage et anomalies neurodéveloppementales. À l’origine, l’effet de l’alcool sur le foetus (SAF atypique) était décrit comme une exposition à l’alcool accompagnée d’un schéma incomplet de manifestations physiques et psychologiques non spécifiques. Cette nomenclature a largement été remplacée par un système de classification qui précise si les effets sont physiques (anomalies congénitales reliées à l’alcool [ACRA]) ou reliés au développement du système nerveux ou du cerveau (anomalies neurodéveloppementales reliées à l’alcool [ANRA]) (2). Bien que les ACRA et les ANRA n’accompagnent pas nécessairement le SAF complet, leurs effets peuvent être tout aussi graves (3). Récemment, Astley et Clarren (4) ont suggéré de limiter la nomenclature aux termes SAF et SAF atypique.

Groundwater evolution beneath Hat Yai, a rapidly developing city in Thailand

NASA Astrophysics Data System (ADS)

Lawrence, A. R.; Gooddy, D. C.; Kanatharana, P.; Meesilp, W.; Ramnarong, V.

2000-09-01

Many cities and towns in South and Southeast Asia are unsewered, and urban wastewaters are often discharged either directly to the ground or to surface-water canals and channels. This practice can result in widespread contamination of the shallow groundwater. In Hat Yai, southern Thailand, seepage of urban wastewaters has produced substantial deterioration in the quality of the shallow groundwater directly beneath the city. For this reason, the majority of the potable water supply is obtained from groundwater in deeper semi-confined aquifers 30-50 m below the surface. However, downward leakage of shallow groundwater from beneath the city is a significant component of recharge to the deeper aquifer, which has long-term implications for water quality. Results from cored boreholes and shallow nested piezometers are presented. The combination of high organic content of the urban recharge and the shallow depth to the water table has produced strongly reducing conditions in the upper layer and the mobilisation of arsenic. A simple analytical model shows that time scales for downward leakage, from the surface through the upper aquitard to the semi-confined aquifer, are of the order of several decades. Résumé. De nombreuses villes du sud et du sud-est de l'Asie ne possèdent pas de réseaux d'égouts et les eaux usées domestiques s'écoulent souvent directement sur le sol ou dans des canaux et des cours d'eau de surface. Ces pratiques peuvent provoquer une contamination dispersée de la nappe phréatique. A Hat Yai (sud de la Thaïlande), les infiltrations d'eaux usées domestiques sont responsables d'une détérioration notable de la qualité de la nappe phréatique directement sous la ville. Pour cette raison, la majorité de l'eau potable est prélevée dans des aquifères semi-captifs plus profonds, situés entre 30 et 50 m sous la surface. Cependant, une drainance à partir de la nappe phréatique sous la ville constitue une composante significative de la recharge de l'aquifère plus profond, ce qui aura, à long terme, des implications sur la qualité de l'eau. Les résultats fournis par des forages carottés et des piézomètres peu profonds sont présentés. La combinaison entre une concentration élevée en matières organiques, provenant de la recharge par les eaux usées domestiques, et la faible profondeur de la nappe a produit des conditions fortement réductrices dans le niveau supérieur et une mobilisation de l'arsenic. Un modèle analytique simple montre que les échelles de temps pour la drainance vers le bas, à partir de la surface au travers de l'imperméable supérieur vers l'aquifère semi-captif, sont de l'ordre de quelques dizaines d'années. Resumen. Muchas ciudades en el sur y sudeste de Asia carecen de sistemas de saneamiento, por lo que las aguas residuales urbanas son a menudo vertidas bien directamente al suelo o bien a canales de aguas superficiales. Esta práctica puede provocar la contaminación difusa de las aguas subterráneas someras. En Hat Yai, al sur de Tailandia, la percolación de aguas residuales urbanas ha producido un deterioro substancial de la calidad del acuífero somero sobre el que se sitúa la ciudad. Por ello, la mayor parte del suministro de agua potable se obtiene a partir de aguas subterráneas de acuíferos semiconfinados más profundos, localizados entre 30 y 50 m bajo la superficie. No obstante, el goteo desde el acuífero freático constituye una fracción importante de la recarga al acuífero profundo, hecho que tiene implicaciones en lo que respecta a la calidad del agua a largo plazo. Se presentan en este artículo los resultados de testigos de sondeos y de multi-piezómetros someros. El alto contenido en materia orgánica de las aguas urbanas, unido a la cercanía del nivel freático, ha producido la movilización de arsénico al crearse condiciones altamente reductoras. Un modelo matemático sencillo indica que el tiempo de tránsito desde la superficie hasta el acuífero semiconfinado es del orden de varias décadas.

Le groupe de recherches transfusionnelles d’Afrique francophone: bilan des cinq premières années

PubMed Central

Tagny, Claude Tayou; Murphy, Edward L.; Lefrère, Jean-Jacques

2016-01-01

Les travaux de recherches sur la sécurité transfusionnelle en Afrique sub-saharienne sont peu nombreux, souvent limités à des initiatives locales avec des conclusions difficilement représentatives de cette région. Le Groupe de recherches transfusionnelles en Afrique sub-saharienne francophone a été créé en mai 2007 avec pour objectif de développer des stratégies globales d’amélioration de la sécurité transfusionnelle mais adaptables à la situation de chaque pays. Les activités du Groupe à ce jour ont porté essentiellement sur l’obtention de données épidémiologiques et de laboratoire sur la transfusion sanguine et à proposer des stratégies de sécurité transfusionnelle dans le domaine des infections transmissibles par la transfusion. Pour mener à bien ces activités de recherche, le Groupe travaille en étroite collaboration avec les Centres nationaux de transfusion sanguine (CNTS), les Centres régionaux de transfusion sanguine (CRTS), les banques de sang hospitalières (BSH) et les postes de collecte de sang. Pour les 5 premières années, quatre priorités de recherche ont été identifiées: (i) des études descriptives sur les caractéristiques des donneurs de sang et des centres de transfusion; (ii) une estimation du risque résiduel post-transfusionnel des principales infections virales transmissibles par la transfusion; (iii) une analyse des stratégies de sélection médicale des donneurs de sang; et (iv) une description des stratégies de dépistage des ITT et une description du système d’assurance qualité externe existant. Durant cette période, sept projets ont été mis en œuvre au niveau national et publiés et cinq études multicentriques ont été réalisées et publiées. La présente étude rapporte les principales observations et recommandations de ces études. PMID:24360798

Êtes-vous prêt pour un code bleu en cabinet?

PubMed Central

Moore, Simon

2015-01-01

Résumé Problème traité Les urgences médicales sont fréquentes dans le cabinet des médecins de famille, mais nombreux sont ceux qui ne sont pas préparés à répondre aux urgences. Une vidéo éducative en ligne traitant des urgences en cabinet pourrait améliorer la réponse des médecins et de leur personnel aux urgences. Un outil comme celui-là n’a jamais été décrit auparavant. Objectif du programme Utiliser les pratiques fondées sur les données probantes pour produire une vidéo éducative expliquant comment se préparer à parer à une urgence dans un cabinet médical, disséminer la vidéo en ligne et évaluer l’attitude des médecins et de leur personnel à l’égard de la vidéo. Description du programme Une vidéo de 6 minutes a été produite en s’appuyant sur une revue de la littérature récente et des politiques des organismes réglementaires canadiens. La vidéo décrit l’équipement d’urgence recommandé, l’amélioration de la réponse à l’urgence et la formation du personnel en cabinet. Les médecins et leur personnel ont été invités à visualiser la vidéo en ligne à www.OfficeEmergencies.ca. L’opinion de l’auditoire sur le format de la vidéo et son contenu a été évaluée par l’entremise d’un sondage (N = 275). Conclusion Les résultats du sondage indiquent que la vidéo était pertinente et bien présentée, et le format en ligne était pratique et satisfaisant. Les participants s’inscriraient à d’autres formations ayant recours à cette technologie et étaient d’accord pour dire que ce programme améliorerait les soins aux patients.

Facteurs de risque de l'inobservance thérapeutique chez les patients schizophrènes: étude cas- témoins'

PubMed Central

Aarab, Chadya; Elghazouani, Fatima; Aalouane, Rachid; Rammouz, Ismail

2015-01-01

Les progrès réalisés dans le traitement de la schizophrénie n'ont jusqu'ici pas modifié de manière radicale l'importance de l'adhésion des patients à leur médication. L'objectif de ce travail est d'identifier les facteurs de risque de l'abandon du traitement sur un échantillon marocain de malades schizophrènes. C'est une étude transversale menée au centre psychiatrique universitaire de Fès sur une période de 4 mois. Les malades inclus présentaient une schizophrénie ou un trouble schizo-affectif, sélectionnés en deux groupes observant et non observant. L’évaluation de l'observance a été faite par un hétéro-questionnaire comprenant une liste de causes d'abandon du traitement avec des réponses par oui ou non et à l'aide de l’échelle MARS (Medication Adherence Rating Scale). Le traitement statistique des résultats a été réalisé par le logiciel Epi Info version 3.5.1. On a recruté 164 participants, 112 étaient des malades non observants à leur traitement (cas) et 52 patients bien observants (témoins). L’âge moyen est 31 ans, avec une prédominance masculine. Les facteurs de risque d'inobservance thérapeutique sont: l’âge jeune, le sexe masculin, le célibat, les troubles addictifs. Les principales raisons d'abandon du traitement sont le changement fréquent du médecin, le manque d'informations sur la maladie, un mauvais insight et les effets secondaires des antipsychotiques. Le groupe de schizophrènes non adhérents à leur traitement pharmacologique avait un score élevé à l’échelle MARS dans 80% cas. Ces résultats doivent être pris en considération par le personnel soignant pour optimiser l'observance thérapeutique chez les patients souffrant de schizophrénie. PMID:26161196

Contrôler la douleur et réduire l’usage abusif d’opioïdes

PubMed Central

Kotalik, Jaro

2012-01-01

Résumé Objectif Aider les médecins de famille à faire un juste équilibre sur le plan de l’éthique dans leurs pratiques de prescription d’opioïdes. Source des données Une recension des articles en anglais publiés entre 1985 et 2011 a été effectuée dans MEDLINE. La majorité des données probantes étaient de niveau III. Message principal Il est essentiel de suivre les guides de pratique clinique quand on prescrit des opioïdes, sauf s’il est démontré qu’une autre option est justifiée. De plus, quand on réfléchit à la pertinence de prescrire des opioïdes et aux nombreuses implications sur le plan de l’éthique, il est utile de fonder sa décision sur l’application des principes éthiques de la bienfaisance, de la non-malfaisance, du respect de l’autonomie et de la justice. En outre, il est essentiel de se tenir au fait des changements dans les lois et la règlementation, ainsi qu’à propos des registres électroniques provinciaux des ordonnances d’opioïdes. Conclusion Les médecins doivent s’assurer que la douleur de leurs patients est bien évaluée et prise en charge. Le contrôle optimal de la douleur peut exiger la prescription d’opioïdes. Cependant, l’obligation de soulager la douleur doit être exercée en juste équilibre avec l’acquittement de la responsabilité tout aussi importante de ne pas exposer les patients au risque de dépendance et de ne pas créer de possibilités de détournement de drogues, de trafic et de dépendance chez d’autres personnes. Les principes éthiques fondamentaux offrent un cadre de réflexion qui peut aider les médecins à prendre des décisions appropriées sur le plan de l’éthique au sujet de la prescription d’opioïdes.

Prise en charge des corps étrangers enclaves de l’œsophage: à propos de 36 cas

PubMed Central

Togo, Seydou; Ouattara, Moussa Abdoulaye; Li, Xing; Yang, Shang Wen; Koumaré, Sékou

2017-01-01

L'ingestion de corps étranger de l'œsophage est un motif fréquent de consultation aux urgences pédiatriques. Cependant le phénomène peut se retrouver à tous les âges. Les auteurs décrivent les caractéristiques cliniques, paracliniques et thérapeutiques des corps étrangers enclavés dans l'œsophage pris en charge à l'hôpital du Mali. Il s'agit d'une étude prospective, menée entre janvier 2011 et décembre 2014 incluant tous les cas d'ingestion de corps étrangers enclavés dans l'œsophage. Au total 36 patients ont été pris en charge par des moyens endoscopiques ou chirurgicaux. L'âge moyen était de 6 ans (extrêmes: 14 mois- 62 ans). Le sexe masculin était dominant avec un sexe ratio de 1,75. Les corps étrangers étaient bloqués dans le rétrécissement crico-pharyngien dans 69,45% des cas suivi du rétrécissement aortique dans 22,22% des cas. Le délai d'extraction du corps étranger en moyenne était de 7 heures 30. La fibroscopie rigide a permis l'extraction du corps étranger dans 88,89% des cas. Une chirurgie par thoracotomie a permis d'extraire le corps étranger dans 5,55%. Les corps étrangers de l'œsophage peuvent se retrouver à tout âge mais restent plus fréquent chez l'enfant. L'extraction endoscopique est la man'uvre la plus réalisée mais la chirurgie pour extraction d'un corps étranger bloqué dans l'œsophage bien que rare reste le dernier recours à cause souvent de leur nature et de la survenue des complications. Le meilleur moyen pour lutter contre ces accidents reste la prévention. PMID:28904731

Conception de lois de pilotage robustes et sequencement de gains par l'approche de systemes lineaires a parametres variants

NASA Astrophysics Data System (ADS)

Hentabli, Kamel

Cette recherche s'inscrit dans le cadre du projet de recherche Active Control Technology entre l'Ecole de Technologie Superieure et le constructeur Bombardier Aeronautique . Le but est de concevoir des strategies de commandes multivariables et robustes pour des modeles dynamiques d'avions. Ces strategies de commandes devraient assurer a l'avion une haute performance et satisfaire des qualites de vol desirees en l'occurrence, une bonne manoeuvrabilite, de bonnes marges de stabilite et un amortissement des mouvements phugoides et rapides de l'avion. Dans un premier temps, nous nous sommes principalement interesses aux methodes de synthese LTI et plus exactement a l'approche Hinfinity et la mu-synthese. Par la suite, nous avons accorde un interet particulier aux techniques de commande LPV. Pour mener a bien ce travail, nous avons envisage une approche frequentielle, typiquement Hinfinity. Cette approche est particulierement interessante, dans la mesure ou le modele de synthese est construit directement a partir des differentes specifications du cahier des charges. En effet, ces specifications sont traduites sous forme de gabarits frequentiels, correspondant a des ponderations en entree et en sortie que l'on retrouve dans la synthese Hinfinity classique. Par ailleurs, nous avons utilise une representation de type lineaire fractionnelle (LFT), jugee mieux adaptee pour la prise en compte des differents types d'incertitudes, qui peuvent intervenir sur le systeme. De plus, cette representation s'avere tres appropriee pour l'analyse de la robustesse via les outils de la mu-analyse. D'autre part, afin d'optimiser le compromis entre les specifications de robustesse et de performance, nous avons opte pour une structure de commande a 2 degres de liberte avec modele de reference. Enfin, ces techniques sont illustrees sur des applications realistes, demontrant ainsi la pertinence et l'applicabilite de chacune d'elle. Mots cles. Commande de vol, qualites de vol et manoeuvrabilite, commande robuste, approche Hinfinity , mu-synthese, systemes lineaires a parametres variants, sequencement de gains, transformation lineaire fractionnelle, inegalite matricielle lineaire.

Identification des parametres du moteur de l'avion Cessna Citation X pour la phase de croisiere a partir des tests en vol et a base des reseaux de neurones =

NASA Astrophysics Data System (ADS)

Zaag, Mahdi

La disponibilite des modeles precis des avions est parmi les elements cles permettant d'assurer leurs ameliorations. Ces modeles servent a ameliorer les commandes de vol et de concevoir de nouveaux systemes aerodynamiques pour la conception des ailes deformables des avions. Ce projet consiste a concevoir un systeme d'identification de certains parametres du modele du moteur de l'avion d'affaires americain Cessna Citation X pour la phase de croisiere a partir des essais en vol. Ces essais ont ete effectues sur le simulateur de vol concu et fabrique par CAE Inc. qui possede le niveau D de la dynamique de vol. En effet, le niveau D est le plus haut niveau de precision donne par l'autorite federale de reglementation FAA de l'aviation civile aux Etats-Unis. Une methodologie basee sur les reseaux de neurones optimises a l'aide d'un algorithme intitule le "grand deluge etendu" est utilisee dans la conception de ce systeme d'identification. Plusieurs tests de vol pour differentes altitudes et differents nombres de Mach ont ete realises afin de s'en servir comme bases de donnees pour l'apprentissage des reseaux de neurones. La validation de ce modele a ete realisee a l'aide des donnees du simulateur. Malgre la nonlinearite et la complexite du systeme, les parametres du moteur ont ete tres bien predits pour une enveloppe de vol determinee. Ce modele estime pourrait etre utilise pour des analyses de fonctionnement du moteur et pourrait assurer le controle de l'avion pendant cette phase de croisiere. L'identification des parametres du moteur pourrait etre realisee aussi pour les autres phases de montee et de descente afin d'obtenir son modele complet pour toute l'enveloppe du vol de l'avion Cessna Citation X (montee, croisiere, descente). Cette methode employee dans ce travail pourrait aussi etre efficace pour realiser un modele pour l'identification des coefficients aerodynamiques du meme avion a partir toujours des essais en vol. None None None

PubMed

Torrado, Julio; Piazuelo, María Blanca; Ruiz, Irune; Izarzugaza, María Isabel; Camargo, María Constanza; Delgado, Alberto; Abdirad, Afshin; Correa, Pelayo

2010-01-01

ANTECEDENTES: El esófago de Barrett es una reconocida lesión precursora de adenocarcinoma esofágico. Aunque generalmente asociada al reflujo gastroesofágico, los mecanismos patogénicos de la enfermedad no son bien conocidos. El objetivo del presente estudio es explorar la historia natural e identificar marcadores de progreso del proceso precanceroso. MATERIAL Y M#ENTITYSTARTX000E9;TODOS: Se utilizaron cortes histológicos de 67 especímenes de esófago correspondientes a 14 pacientes con esófago de Barrett, a los que se siguió entre 1 - 9 años. Se clasificaron las lesiones en: esófago de Barrett sin displasia, indefinido para displasia o con displasia. Se evaluó la expresión de diferentes mucinas en las células caliciformes y en las columnares usando técnicas de histoquímica e inmunohistoquímica. RESULTADOS: En todos los casos se comprobó la presencia de metaplasia intestinal incompleta. Las células columnares dentro del epitelio metaplásico contenían mucinas neutras. A mayor severidad de la lesión se encontró significativamente menor expresión de sialomucinas en las células columnares (p de tendencia igual a 0,03). En sujetos con lesiones indefinidas para displasia se observó un mayor contenido de sulfomucinas en las células caliciformes (p=0,034) y de MUC2 en las células columnares (p=0,029) que en sujetos con esófago de Barrett sin displasia. Se observó expresión de la mucina intestinal MUC2 y de la mucina gástrica MUC5AC en todas las muestras. MUC6, una mucina de las glándulas profundas gástricas, se presentó ocasionalmente. CONCLUSI#ENTITYSTARTX000F3;N: La evaluación de los perfiles de mucinas en el esófago de Barrett sugiere una transición gradual del fenotipo del epitelio metaplásico a medida que la lesión avanza en el tiempo.

L’expression verbale de la douleur chez l’enfant : Comparaison intermodale entre sensation de douleur et manipulation tactile

PubMed Central

Bienvenu, Margaux; Jacquet, Denis; Michelutti, Marjolaine; Wood, Chantal

2011-01-01

HISTORIQUE: La présente étude se situe dans le contexte de l’expression verbale de la douleur chez l’enfant. Elle porte plus particulièrement sur la dimension qualitative de la sensation de douleur. OBJECTIF: Nous cherchons à repérer les particularités de l’expression verbale relativement à l’aspect qualitatif de la douleur. MÉTHODOLOGIE: La recherche a été menée auprès de 60 patients de quatre à 18 ans ressentant de la douleur, rencontrés dans un hôpital universitaire pédiatrique. Elle confirme en premier lieu l’origine des descripteurs sensoriels de la douleur, qui renvoient aux expériences perceptives passées de l’enfant, non nécessairement liées à la douleur. Ces expériences sont qualifiées de prototypiques, dans la mesure où, bien qu’elles soient liées à des contextes de vie variés, le type de rapport au monde qu’elles provoquent ne varie pas. RÉSULTATS: Dans ce cadre, le pincement, le tiraillement, le tapement, l’écrasement et l’appuiement, le picotement et le serrement constituent chacune des expériences sensorielles et motrices particulières dont la structure de base ne varie pas d’un contexte à l’autre. En second lieu, les résultats obtenus montrent que dès quatre ans, l’enfant est en mesure de comparer, puis de reconnaître une analogie entre une expérience exclusivement tactile et sa sensation de douleur. CONCLUSION: Ces résultats mettent en lumière le rôle primordial du raisonnement analogique dans l’expression verbale de la douleur, ce qui amène à affirmer que le niveau de développement cognitif de l’enfant n’est pas une variable a priori déterminante lorsqu’il s’agit de qualifier sa douleur. PMID:21766069

El fenotipo de las mucinas en el esófago de Barrett

PubMed Central

Torrado, Julio; Piazuelo, María Blanca; Ruiz, Irune; Izarzugaza, María Isabel; Camargo, María Constanza; Delgado, Alberto; Abdirad, Afshin; Correa, Pelayo

2011-01-01

Antecedentes El esófago de Barrett es una reconocida lesión precursora de adenocarcinoma esofágico. Aunque generalmente asociada al reflujo gastroesofágico, los mecanismos patogénicos de la enfermedad no son bien conocidos. El objetivo del presente estudio es explorar la historia natural e identificar marcadores de progreso del proceso precanceroso. Material y métodos Se utilizaron cortes histológicos de 67 especímenes de esófago correspondientes a 14 pacientes con esófago de Barrett, a los que se siguió entre 1 – 9 años. Se clasificaron las lesiones en: esófago de Barrett sin displasia, indefinido para displasia o con displasia. Se evaluó la expresión de diferentes mucinas en las células caliciformes y en las columnares usando técnicas de histoquímica e inmunohistoquímica. Resultados En todos los casos se comprobó la presencia de metaplasia intestinal incompleta. Las células columnares dentro del epitelio metaplásico contenían mucinas neutras. A mayor severidad de la lesión se encontró significativamente menor expresión de sialomucinas en las células columnares (p de tendencia igual a 0,03). En sujetos con lesiones indefinidas para displasia se observó un mayor contenido de sulfomucinas en las células caliciformes (p=0,034) y de MUC2 en las células columnares (p=0,029) que en sujetos con esófago de Barrett sin displasia. Se observó expresión de la mucina intestinal MUC2 y de la mucina gástrica MUC5AC en todas las muestras. MUC6, una mucina de las glándulas profundas gástricas, se presentó ocasionalmente. Conclusión La evaluación de los perfiles de mucinas en el esófago de Barrett sugiere una transición gradual del fenotipo del epitelio metaplásico a medida que la lesión avanza en el tiempo. PMID:21804831

La supraconductivité a 100 ans !

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lebrun, Philippe

2011-04-14

Il y a 100 ans, le 8 avril 1911, une découverte majeure était réalisée : celle de la supraconductivité. La supraconductivité est la caractéristique qu’ont certains métaux et alliages de perdre toute résistance électrique en dessous d’une température donnée. Cette renversante découverte, réalisée de manière presque fortuite par Kammerlingh Onnes de l’Université de Leyde (Pays-Bas) et son étudiant Gilles Holst, a ouvert un nouveau champ de recherche en physique et de fabuleuses perspectives d’applications technologiques. Du point de vue scientifique, la supraconductivité est en effet l’une des rares manifestations de la physique quantique à l’échelle macroscopique.  Du point de vuemore » des retombées techniques, elle est porteuse d’applications majeures dans le domaine de la santé, des communications et de l’énergie. 100 ans après, les physiciens n’ont toujours pas fini d’explorer ce phénomène et ses applications. Le CERN abrite des applications de la supraconductivité à des échelles inédites. L’accélérateur de particules LHC, avec ses milliers d’aimants supraconducteurs répartis sur 27 kilomètres de circonférence, est en effet la plus grande application mondiale de la supraconductivité. Il ne pourrait exister sans elle. Le CERN fête donc la découverte de la supraconductivité avec une conférence exceptionnelle donnée par Philippe Lebrun. Au cours de cette conférence, l’expérience historique de Kammerlingh Onnes sera reproduite. Philippe Lebrun racontera l’histoire de cette étonnante découverte, en la replaçant dans le contexte scientifique de l’époque. Il racontera les développements scientifiques et les applications du premier siècle de la supraconductivité. Conférence en français Merci de bien vouloir vous inscrire au : +41 22 767 76 76 ou cern.reception@cern.ch« less

Tumeurs Stromales Gastro-Intestinales «GIST»: état des lieux et actualités à travers notre expérience portant sur 54 cas et une Revue de littérature

PubMed Central

Taoufiq, Nezha; Naim, Asmaa; Bouchbika, Zineb; Benchekroune, Nadia; Jouhadi, Hassan; Sahraoui, Souha; Benider, Abdelatif

2017-01-01

Les Tumeurs Stromales Gastro-intestinales « GIST » sont une forme très rare de cancers du tube digestif appartenant à la famille des sarcomes. Le but de ce travail est d'établir le profil épidémiologique et évolutif ainsi que les difficultés diagnostique et thérapeutique de cette pathologie maligne prise en charge dans un pays en développement. Une Etude rétrospective étalée sur 8 ans de Janvier 2002 à Mars 2010, a été mené au Service de Radiothérapie et d'Oncologie du CHU de Casablanca (Maroc) ayant colligée 54 cas de tumeurs stromales gastro-intestinales. L'âge moyen de nos patients était de 55 ans. Le délai moyen d'évolution était de 11 mois (0-72 mois). La biopsie a permis de confirmer le diagnostic dans 14 cas et la chirurgie dans 40 cas. La principale forme histologique était fusiforme (92,6%). Les GIST dans notre série avaient une taille tumorale moyenne de 12,5 cm avec un C-Kit positif dans 52 cas. Le risque évolutif a pu être établi dans 47 cas dont 39 avaient un risque élevé. La chirurgie était le principal traitement des patients de notre sérieAprès un recul moyen de 31 mois, la moitié des patients évaluables de notre série (n=19) est en rémission complète maintenue, le tiers (n=13) est décédé alors que le quart (n=8) présente une récidive locale et /ou métastatique. Quoique les recommandations soient éditées pour la prise en charge de ces tumeurs, ces dernières soulèvent encore de nombreux problèmes aussi bien diagnostiques que thérapeutiques dans notre contexte. PMID:28904693

Traumatismo craneoencefálico leve

PubMed Central

Ortega Zufiría, José Manuel; Prieto, Noemí Lomillos; Cuba, Bernardino Choque; Degenhardt, Martin Tamarit; Núñez, Pedro Poveda; López Serrano, María Remedios; López Raigada, Azahara Belén

2018-01-01

Resumen Introducción y objetivo: El TCE leve representa un problema sanitario de enorme interés debido a que un número significativo de enfermos con trauma leve desarrollará complicaciones potencialmente mortales. El objetivo de este estudio ha sido describir una serie amplia de pacientes adultos, mayores de 14 años, que sufren TCE leve, atendidos en el Hospital Universitario de Getafe, entre los años 2010 y 2015 (n = 2480), estudiar el perfil epidemiológico y analizar el diagnóstico y el tratamiento efectuados, así como establecer los principales factores pronósticos que influyen en el resultado final. Método: Se ha realizado un estudio retrospectivo, de revisión de historias clínicas, analizando los resultados con estudio estadístico bivariable y multivariable. Resultados: El TCE leve es más frecuente en varones, y el mecanismo causante más común en nuestro medio es el accidente de tráfico. Se propone un modelo de clasificación de pacientes según grupos de riesgo, que los subdivide en riesgo bajo, intermedio o alto, que se correlaciona bien con la probabilidad de desarrollar complicación intracraneal, y, consecuentemente, con el resultado final. Se discute la indicación de la radiografía simple de cráneo y de la Tomografía Computarizada (TC), así como del ingreso hospitalario para observación neurológica. Conclusiones: En este estudio, la presencia de focalidad neurológica en la exploración clínica, la edad, las alteraciones de la coagulación y la existencia de fractura en la radiografía simple se relacionan con mayor posibilidad de desarrollar lesiones traumáticas intracraneales y con peor pronóstico final. La escala de Glasgow para el Coma es deficitaria en la determinación del resultado final del paciente que sufre TCE, porque no considera variables tales como la amnesia o la pérdida de conocimiento, muy frecuentes en el traumatismo craneoencefálico leve. PMID:29430327

Traduire encore Bertin aujourd'hui : pourquoi faire ? Les nouvelles faces cachées de la Sémiologie Graphique

NASA Astrophysics Data System (ADS)

Dhieb, Mohsen

2018-05-01

La « Sémiologie Graphique » de Bertin est un ouvrage majeur de la cartographie contemporaine. Cependant, dès sa parution en 1967, cet ouvrage a suscité autant d'intérêt que de méfiance : l'ouvrage n'était pas dans le « moule » de la littérature cartographique en vigueur. Pourtant, si plusieurs de ses principes et concepts fondateurs ont été adoptés, plusieurs autres ne sont pas bien passés ou n'ont pas été mis en pratique. Il y a comme un fossé entre certains énoncés théoriques de l'ouvrage et leur mise en pratique. Certaines affirmations de Bertin peuvent paraître obsolètes aujourd'hui à l'heure du numérique, comme la non prise en compte de l'aspect dynamique ou interactif de la carte. L'avènement récent des SIG, de la géomatique et des systèmes de Cartographie Assistée par Ordinateur a relégué les vieilles méthodes de traitement graphique de l'information au second rang. Dès lors pourquoi traduire encore aujourd'hui, à l'heure du numérique, la « Sémiologie Graphique » ? Justement, d'abord, parce que certains principes restent, en substance, peu connus ; plusieurs aspects demeurent encore à explorer ; certaines méthodes et techniques manuelles délaissées peuvent être revisitées et remises en marche grâce à la visualisation ; des innovations n'ont pas été expérimentées ou implémentées par les moyens numériques. Dans le monde arabe, peu de recherches se sont imprégnées de sémiologie graphique. Lors de la traduction de l'ouvrage en arabe, des points restés obscurs ont été décelés. Ce sont ces quelques idées et réflexions qui nous ont poussés à revivre cette formidable aventure.

Conductivite dans le modele de Hubbard bi-dimensionnel a faible couplage

NASA Astrophysics Data System (ADS)

Bergeron, Dominic

Le modele de Hubbard bi-dimensionnel (2D) est souvent considere comme le modele minimal pour les supraconducteurs a haute temperature critique a base d'oxyde de cuivre (SCHT). Sur un reseau carre, ce modele possede les phases qui sont communes a tous les SCHT, la phase antiferromagnetique, la phase supraconductrice et la phase dite du pseudogap. Il n'a pas de solution exacte, toutefois, plusieurs methodes approximatives permettent d'etudier ses proprietes de facon numerique. Les proprietes optiques et de transport sont bien connues dans les SCHT et sont donc de bonne candidates pour valider un modele theorique et aider a comprendre mieux la physique de ces materiaux. La presente these porte sur le calcul de ces proprietes pour le modele de Hubbard 2D a couplage faible ou intermediaire. La methode de calcul utilisee est l'approche auto-coherente a deux particules (ACDP), qui est non-perturbative et inclue l'effet des fluctuations de spin et de charge a toutes les longueurs d'onde. La derivation complete de l'expression de la conductivite dans l'approche ACDP est presentee. Cette expression contient ce qu'on appelle les corrections de vertex, qui tiennent compte des correlations entre quasi-particules. Pour rendre possible le calcul numerique de ces corrections, des algorithmes utilisant, entre autres, des transformees de Fourier rapides et des splines cubiques sont developpes. Les calculs sont faits pour le reseau carre avec sauts aux plus proches voisins autour du point critique antiferromagnetique. Aux dopages plus faibles que le point critique, la conductivite optique presente une bosse dans l'infrarouge moyen a basse temperature, tel qu'observe dans plusieurs SCHT. Dans la resistivite en fonction de la temperature, on trouve un comportement isolant dans le pseudogap lorsque les corrections de vertex sont negligees et metallique lorsqu'elles sont prises en compte. Pres du point critique, la resistivite est lineaire en T a basse temperature et devient progressivement proportionnelle a T 2 a fort dopage. Quelques resultats avec sauts aux voisins plus eloignes sont aussi presentes. Mots-cles: Hubbard, point critique quantique, conductivite, corrections de vertex

Clinical practice guideline: management of acute pancreatitis

PubMed Central

Greenberg, Joshua A.; Hsu, Jonathan; Bawazeer, Mohammad; Marshall, John; Friedrich, Jan O.; Nathens, Avery; Coburn, Natalie; May, Gary R.; Pearsall, Emily; McLeod, Robin S.

2016-01-01

There has been an increase in the incidence of acute pancreatitis reported worldwide. Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. Despite the availability of clinical practice guidelines for the management of acute pancreatitis, recent studies auditing the clinical management of the condition have shown important areas of noncompliance with evidence-based recommendations. This underscores the importance of creating understandable and implementable recommendations for the diagnosis and management of acute pancreatitis. The purpose of the present guideline is to provide evidence-based recommendations for the management of both mild and severe acute pancreatitis as well as the management of complications of acute pancreatitis and of gall stone–induced pancreatitis. Une hausse de l’incidence de pancréatite aiguë a été constatée à l’échelle mondiale. Malgré l’amélioration de l’accès aux soins et aux techniques d’imagerie et d’intervention, la pancréatite aiguë est toujours associée à une morbidité et une mortalité importantes. Bien qu’il existe des guides de pratique clinique pour la prise en charge de la pancréatite aiguë, des études récentes sur la vérification de la prise en charge clinique de cette affection révèlent des lacunes importantes dans la conformité aux recommandations fondées sur des données probantes. Ces résultats mettent en relief l’importance de formuler des recommandations compréhensibles et applicables pour le diagnostic et la prise en charge de la pancréatite aiguë. La présente ligne directrice vise à fournir des recommandations fondées sur des données probantes pour la prise en charge de la pancréatite aiguë, qu’elle soit bénigne ou grave, ainsi que de ses complications et de celles de la pancréatite causée par un calcul biliaire. PMID:27007094

Les expériences de victimisation, la santé mentale et le bien-être de jeunes trans au Québec

PubMed Central

Raymond, Guillaume; Blais, Martin; Bergeron, Félix-Antoine; Hébert, Martine

2016-01-01

Résumé Les normes traditionnelles de genre prescrivent l’adéquation de l’expression de la masculinité et de la féminité au sexe anatomique de naissance. Les personnes qui présentent des variations dans l’expression de genre sont sujettes à diverses formes de réactions sociales suggérant la réprobation (des regards désapprobateurs aux violences physiques) susceptibles d’influencer négativement leur santé mentale. Trente-sept (37) jeunes se décrivant comme trans ou en questionnement sur leur identité de genre ont été recrutés dans le cadre de l’enquête sur les Parcours Amoureux des Jeunes de minorités sexuelles du Québec. Leurs expériences de victimisation parentale et de victimisation basée sur la non-conformité de genre ainsi que des indicateurs de santé mentale (détresse psychologique, estime de soi) ont été mesurés. Afin de comparer les expériences de victimisation et l’état de santé mentale des jeunes trans, ils ont été appariés à 37 garçons et 37 filles cisgenres sur la base de leurs caractéristiques sociodémographiques. Des analyses de prévalence et un modèle acheminatoire ont été réalisés. Les résultats mettent en évidence que les jeunes trans sont plus susceptibles de présenter des scores cliniques de détresse psychologique et de faible estime d’eux-mêmes que leurs pairs cisgenres. La violence verbale parentale et la victimisation basée sur la non-conformité de genre influencent négativement l’estime de soi, ce qui en retour augmente la probabilité de vivre de la détresse psychologique. Les résultats appuient l’importance des interventions de soutien à la diversité sexuelle et de genre. PMID:26966849

Effets du Parecoxib dans la Prévention des Adhérences abdominales postopératoires: étude expérimentale randomisée chez les rats

PubMed Central

Arung, Willy; Tshilombo, François; Odimba, Etienne

2015-01-01

Introduction Bien d’études ont été menées sur les adhérences intrapéritonéales, mais aucune unanimité n'est encore acquise sur leur prévention. Le but de notre étude a été d’évaluer le potentiel effet d'un antiinflammatoire, parecoxib dans la prévention des adhérences ainsi que sur la cicatrisation chez des rats. Méthodes Dans un modèle expérimental d'adhérences postopératoires secondaires à des lésions péritonéales par brûlure, 30 rats furent randomisés en trois groupes suivant le mode d'administration de parecoxib (groupe contrôle; intrapéritonéal; intramusculaire. Résultats Le parecoxib a significativement diminué la quantité (p < .05) et la sévérité (p < .01) des adhérences postopératoires dans les deux modèles expérimentaux. Au total, 21 rats ont développé des adhérences, respectivement 9 (100%) dans le groupe A, 5 (50%) dans le groupe B et 7 (70%) dans le groupe C (p = 0.05). Du point de vue de la formation des adhérences au site du traumatisme, dix-neuf rats en ont développé: 9 (100%) dans le groupe A et 5 (50%) pour chacun de deux autres groupes B et C. Une différence significative a été constatée en comparant ces groupes deux à deux: A vs B (p < 0.05); A vs C (p < 0,05). Parecoxib n'a pas compromis la cicatrisation intestinale, ni cutanée. Conclusion Cette étude a montré que le parecoxib pouvait réduire la formation des adhérences postopératoires. La confirmation de la sécurité du parecoxib sur les anastomoses intestinales doit être investiguée au cours d'autres expérimentations. PMID:26966478

Facteurs de risque de faible poids de naissance en milieu semi-rural de Kamina, République Démocratique du Congo

PubMed Central

Kangulu, Ignace Bwana; Umba, Elie Kilolo Ngoy; Nzaji, Michel Kabamba; Kayamba, Prosper Kalenga Mwenze

2014-01-01

Introduction Le faible poids de naissance constitue un problème majeur de santé publique, aussi bien dans les pays développés que dans les pays en développement, de par son ampleur et sa forte association avec la morbidité et la mortalité infantiles. Méthodes Il s’agit d’une étude cas-témoins rétrospective menée sur les différents facteurs de risque de faible poids de naissance(FPN) en milieu semi-rural de Kamina chez les accouchées et leurs nouveau-nés respectifs enregistrés de la période allant de janvier 2009 à décembre 2010. Résultats Cette étude a répertorié 69 cas des nouveau-nés de FPN sur 483 accouchements enregistrés (14,3%). Les facteurs associés au FPN déterminés dans ce travail sont l’âge maternel inférieur à 18 ans (OR=7,62, IC=3.46-16.8) et supérieur à 35 ans (OR=2,04;IC=0.91-4.46), la primiparité(OR=2,48;IC=1.18-5.21) et le non suivi des consultations prénatales (OR=5,50;IC=2.00-15.03), la prématurité avec grossesse âgée de moins de 37 semaines d’aménorrhée, la grossesse multiple (OR=30,94) et le sexe féminin du nouveau-né. Conclusion Cette étude a démontré que l’âge maternel inférieur à 18 ans et supérieur à 35 ans, le non suivi des consultations prénatales, la primiparité et la prématurité, la grossesse multiple et le sexe féminin du nouveau-né sont les facteurs associés au faible poids de naissance. PMID:25237417

La singularité du patient tuberculeux dans le système de santé: l'expérience du Burkina Faso

PubMed Central

Zerbo, Roger

2013-01-01

La démarche pluridisciplinaire s'impose de plus en plus dans le secteur de la santé dans le contexte africain, où les parcours thérapeutiques sont pluriels et les rapports des usagers des centres de santé sont complexes et peu satisfaisants. La compréhension des représentations de la maladie est nécessaire pour offrir des soins appropriés certes, mais l'expérience individuelle des malades représente également une source de savoir. Les données ont été collectées à travers des entretiens semi-directifs, le recueil des récits de vie et des observations participantes. Cet article rend compte d'une expérience d'implication de socio-anthropologue dans la mise en œuvre d'un programme de santé publique au Burkina Faso en vue d'une amélioration de la prise en charge des malades tuberculeux. L'analyse des données à été conduite dans une visée réflexive. Les perspectives socio-anthropologiques ont révélé que l'expérience des anciens malades tuberculeux peut être mise à profit afin d'apporter des changements dans les relations thérapeutiques et l'intégration sociale des autres malades. Cette idée à été mise en application pour tenir lieu d'une traduction des analyses anthropologiques en actes pour un changement. L'article évoque la manière dont l'approche socio-anthropologique au sein d'un programme de santé, peut mettre en évidence le potentiel des malades à être des acteurs importants dans le fonctionnement des services de soins et leur propre bien-être. Dans cette situation, la démarche théorique implique la réflexivité de l'anthropologue, mais également un regard critique sur les modes d'intervention en santé publique. PMID:24009798

Séroprévalence du virus de l'herpès humain-8 chez des patients VIH positif à l'hôpital général de Yaoundé – Cameroun

PubMed Central

Jacky, Njiki Bikoï; Paul, Ndom; Lilian, Mupang; Sylvie, Agokeng Demanou

2015-01-01

L'épidémiologie de l'infection par le virus herpès humain de type 8 (HHV8) associée à celle à VIH, reste encore méconnue au Cameroun, bien que le pays soit considéré comme une zone endémique pour ces deux virus. L'objectif de ce travail était de ressortir le profil de la séroprévalence du HHV8 au sein de notre population d'étude. 57 personnes ont été recrutées à l'Hôpital Général de Yaoundé et suivies sur une durée 12 mois. Des anticorps IgG anti-HHV8 ont été déterminés par ELISA. Des paramètres autres, tels que l'âge, le sexe, le stade des maladies (SK et VIH/SIDA), le protocole ARV, ainsi que les taux de CD4 ont été utilisés pour déterminer les variables associées à la séropositivité au HHV8. Cette association a été évaluée par le test khi carré. La séroprévalence du HHV8 était de 90% dans notre population en début d'étude et de 74% douze mois plus tard, une séroprévalence qui restait élevée quelque soit le profil clinique, la tranche d'âge, le sexe ou le taux de CD4+ de l'individu. Aucune variable de l'étude n'était significativement associée à la séropositivité du HHV8. Le virus HHV8 semblait circuler au sein de notre population d'étude. Cependant l'on constate, douze mois plus tard, l'absence de manifestations cliniques du SK chez les patients VIH+ positifs, malgré des titres très élevés en IgG anti-HHV8. PMID:26090027

Une recension des écrits concernant la réalité psychoaffective des femmes ayant une vulvodynie : Difficultés rencontrées et stratégies développées

PubMed Central

Cantin-Drouin, Maude; Damant, Dominique; Turcotte, Daniel

2008-01-01

HISTORIQUE : Au cours des trois dernières décennies, une attention grandissante a été portée à l’étude du syndrome de vulvodynie, soit un inconfort vulvaire chronique inexpliqué, éprouvé en l’absence de pathologie précisée. En plus d’avoir des répercussions physiques, l’expérience de la vulvodynie comporte une dimension psychosociale. OBJECTIF : Cet article vise à faire une recension des écrits sur la réalité psychoaffective des femmes qui éprouvent une vulvodynie. MÉTHODE : Une recherche documentaire basée sur une exploration systématique de textes présentant des résultats de recherche et recensés dans les principales banques de données en sciences sociales, dont Dissertation Abstracts, Current Contents et PsycINFO, a été réalisée. RÉSULTATS : Cette recension des écrits révèle, malgré la présence de certains résultats divergents, que les femmes ayant une vulvodynie affrontent souvent des difficultés identitaires et psychologiques, qui sont influencées notamment par les normes sociales de sexualité et de féminité. Pour composer avec ces difficultés, les femmes développent différentes stratégies visant à diminuer le stress occasionné par la douleur et à améliorer leur bien-être psychologique. CONCLUSION : Les difficultés relationnelles et psychologiques vécues par les femmes ayant une vulvodynie ne découlent pas seulement de la douleur physique, mais aussi du sens qu’elles lui accordent, souvent influencé par les discours sociaux sur l’hétérosexualité et la féminité. Il importe donc d’intervenir auprès des femmes en tenant compte de l’influence du contexte social tout en poursuivant le développement des connaissances sur les aspects psychosociaux de cette expérience. PMID:18592063

Approche à la lymphogranulomatose vénérienne

PubMed Central

O’Byrne, Patrick; MacPherson, Paul; DeLaplante, Stephane; Metz, Gila; Bourgault, Andree

2016-01-01

Résumé Objectif Revoir la littérature sur la lymphogranulomatose vénérienne (LGV) donner un aperçu des lignes directrices de pratique clinique et en discuter. Sources d’information Les mots-clés Chlamydia trachomatis et lymphogranuloma venereum (en anglais) ont séparément fait l’objet d’une recherche dans PubMed. Des études empiriques, revues pratiques et lignes directrices de pratique clinique ont été incluses. Toutes les listes de références ont été examinées pour relever d’autres articles. Message principal Depuis 2003, la LGV refait surface dans de nombreux pays occidentaux, y compris au Canada parmi les hommes ayant des relations sexuelles avec des hommes. Bien que la LGV soit un sérotype de Chlamydia trachomatis (sérotype L), elle peut envahir les ganglions lymphatiques régionaux, et donc se manifester par des symptômes qui diffèrent de ceux des autres sous-types de chlamydia (sérotypes A à K). En particulier, la LGV consiste en 3 phases : papule ou ulcère non douloureux au point d’inoculation; envahissement des ganglions lymphatiques régionaux, pouvant se manifester par un syndrome inguinal or rectal; et destruction irréversible du tissu lymphatique. Les sérotypes A à K de chlamydia, quant à eux, produisent exclusivement des infections superficielles de la muqueuse. La lymphogranulomatose vénérienne nécessite aussi un schéma thérapeutique différent de celui pour les autres sérotypes de chlamydia. Conclusion À la lumière de la résurgence actuelle de la LGV, de ses symptômes et de son évolution clinique uniques, et de la nécessité d’un traitement qui diffère de celui des autres sérotypes de chlamydia, il importe que les fournisseurs de soins de première ligne reconnaissent quand il faut inclure la LGV dans le diagnostic différentiel.

Submarine landslides: advances and challenges

USGS Publications Warehouse

Locat, Jacques; Lee, Homa J.

2002-01-01

Due to the recent development of well-integrated surveying techniques of the sea floor, significant improvements were achieved in mapping and describing the morphology and architecture of submarine mass movements. Except for the occurrence of turbidity currents, the aquatic environment (marine and fresh water) experiences the same type of mass failure as that found on land. Submarine mass movements, however, can have run-out distances in excess of 100 km, so their impact on any offshore activity needs to be integrated over a wide area. This great mobility of submarinemass movements is still not very well understood, particularly for cases like the far-reaching debris flows mapped on the Mississippi Fan and the large submarine rock avalanches found around many volcanic islands. A major challenge ahead is the integration of mass movement mechanics in an appropriate evaluation of the hazard so that proper risk assessment methodologies can be developed and implemented for various human activities offshore, including the development of natural resources and the establishment of reliable communication corridors. Key words : submarine slides, hazards, risk assessment, morphology, mobility, tsunami. Le dveloppement rcent de techniques de levs hydrograhiques pour les fonds marins nous a permis d'atteindre une qualit ingale dans la cartographie et la description des glissements sous marins. l'exception des courants de turbidit, on retrouve dans le domaine aquatique les mmes types de mouvements de terrain que sur terre. Par contre, les glissements sous-marins peuvent atteindre des distances excdant 100 km de telle sorte que leur impact sur les activits offshore doit tre pris en compte sur degrandes tendues. La grande mobilit des glissements sous-marins n'est pas encore bien comprise, comme pour le cas des coules dedbris cartographies sur le cne du Mississippi ainsi que pour les grandes avalanches rocheuses sous-marines retrouves au pourtour des les volcaniques. Un dfi majeur auquel nous faisons face est celui de dterminer les alas associs aux divers types demouvements sous-marins ainsi que les risques associs l'activit humaine, telle que l'exploitation des ressources naturelles et l'tablissement de routes de communications fiables. Mots cls : glissements sous-marins, morphologie, ala, risque, mobilit, tsunami.

Descripción del coronógrafo a ser instalado en Argentina (MICA)

NASA Astrophysics Data System (ADS)

Stenborg, G.; Francile, C.; Schwenn, R.; Epple, A.; Rovira, M.

El ``Coronógrafo de espejo para Argentina'' es un telescopio solar terrestre a ser colocado en el Observatorio Astronómico Félix Aguilar (El Leoncito), antes de finalizar 1996, como parte de un programa de ciencia bilateral entre Alemania y Argentina. Eclipses fotográficos de alta resolución han revelado que la corona solar es altamente estructurada y variable. De hecho, está contínuamente deformada y moldeada por los movimientos convectivos de los extremos de los arcos magnéticos en la fotosfera, estando, en muchas oportunidades, afectada por explosivas liberaciones de energía. MICA, en conjunción con otros telescopios solares espaciales y terrestres, tratará de contribuir al entendimiento de cuestiones fundamentales de la física solar. Entre ellas: cómo la corona está siendo calentada, dónde y cómo el viento solar es acelerado, qué causa los transitorios coronales, etc. Para ello investigará la distribución de los parámetros del plasma y su evolución con el tiempo, la estructura espacial de la corona en fina y gran escala, procesos que ocurren en los transitorios coronales y factores que los disparan, etc. Para responder a estas cuestiones MICA observará la atmósfera solar por sobre el limbo entre 1.1 y 2 radios solares aproximadamente, usando un nuevo tipo de sistema coronográfico que permite suprimir el brillo del disco solar suficientemente bien, tomando las imágenes con una cámara CCD de 1024x1024 pixels, codificada en 12 bits, pudiendo el mismo ser operado en forma remota. En la presente exposición describiremos las características del instrumento, cómo será controlado y qué esperamos observar basados en las imágenes obtenidas por los telescopios de similares características LASCO C1 a bordo del SOHO y PICO (ubicado en el Observatorio de Pic du Midi, Francia).

La pelade par plaques

PubMed Central

Spano, Frank; Donovan, Jeff C.

2015-01-01

Résumé Objectif Présenter aux médecins de famille des renseignements de base pour faire comprendre l’épidémiologie, la pathogenèse, l’histologie et l’approche clinique au diagnostic de la pelade par plaques. Sources des données Une recension a été effectuée dans PubMed pour trouver des articles pertinents concernant la pathogenèse, le diagnostic et le pronostic de la pelade par plaques. Message principal La pelade par plaques est une forme de perte pileuse auto-immune dont la prévalence durant une vie est d’environ 2 %. Des antécédents personnels ou familiaux de troubles auto-immuns concomitants, comme le vitiligo ou une maladie de la thyroïde, peuvent être observés dans un petit sous-groupe de patients. Le diagnostic peut souvent être posé de manière clinique en se fondant sur la perte de cheveux non cicatricielle et circulaire caractéristique, accompagnée de cheveux en « point d’exclamation » en périphérie chez ceux dont le problème en est aux premiers stades. Le diagnostic des cas plus complexes ou des présentations inhabituelles peut être facilité par une biopsie et un examen histologique. Le pronostic varie largement et de mauvais résultats sont associés à une apparition à un âge précoce, une perte importante, la variante ophiasis, des changements aux ongles, des antécédents familiaux ou des troubles auto-immuns concomitants. Conclusion La pelade par plaques est une forme auto-immune de perte de cheveux périodiquement observée en soins primaires. Les médecins de famille sont bien placés pour identifier la pelade par plaques, déterminer la gravité de la maladie et poser le diagnostic différentiel approprié. De plus, ils sont en mesure de renseigner leurs patients à propos de l’évolution clinique de la maladie ainsi que du pronostic général selon le sous-type de patients.

Prediction uncertainty of plume characteristics derived from a small number of measuring points

NASA Astrophysics Data System (ADS)

French, H. K.; van der Zee, S. E. A. T. M.; Leijnse, A.

A small number of measuring points may inflict a bias on the characterisation of flow and transport based on field experiments in the unsaturated zone. Simulation of pure advective transport of a Gaussian plume through a setup of 30 regularly placed measuring points revealed regular temporal fluctuations about the real spatial moments. An irregular setup predicted both irregular fluctuations and larger discrepancies from the real value. From these considerations, a regular setup is recommended. Spatial moments were sensitive to the plume size relative to the distance between individual measuring points. To reduce prediction errors of the variance, the distance between the measuring points should be less than twice the standard deviation of the examined plume. The total size of the setup should cover several standard deviations of the plume to avoid mass being lost from the monitored area. Numerical simulations of a dispersing plume (comparing calculations based on 9000 nodes with 30 measuring points) revealed that vertical and horizontal centres of mass were predicted well at all degrees of heterogeneity, and the same was the case for horizontal variances. Vertical variances were more susceptible to prediction errors, but estimates were of the same order of magnitude as the real values. Résumé Lorsque l'on cherche à caractériser l'écoulement et le transport à partir d'expériences de terrain dans la zone saturée, il arrive qu'un petit nombre de points introduisent un biais. La simulation d'un transport purement advectif d'un panache gaussien au travers d'un ensemble de 30 points de mesures espacés régulièrement fait apparaître des variations temporelles régulières autour des moments spatiaux réels. Un ensemble irrégulier conduit à prédire à la fois des variations irrégulières et de plus grandes divergences par rapport à la valeur réelle. A partir de ces constations, un ensemble régulier est recommandé. Les moments spatiaux sont apparus sensibles à la dimension du panache en fonction de la distance entre les différents points de mesure. Afin de réduire les erreurs de prédiction de la variance, la distance entre les points de mesure doit être inférieure au double de l'écart-type du panache examiné. La dimension totale de l'ensemble doit couvrir une étendue de plusieurs écarts-types du panache pour éviter qu'une partie de la matière échappe à la zone surveillée. Des simulations numériques du panache en dispersion (les calculs de comparaison sont basés sur 9000 nœuds avec 30 points de mesure) montrent que le centre vertical et le centre horizontal de la matière dispersée ont été bien prédits à tous les degrés d'hétérogénéité, de même que pour les variances horizontales. Les variances verticales ont été plus sensibles aux erreurs de prédiction, mais les estimations étaient du même ordre de grandeur que les valeurs réelles. Resumen Un número pequeño de puntos de medida puede producir un sesgo en la caracterización en campo del flujo y transporte de solutos en la zona no saturada. La simulación de transporte advectivo (no difusivo) de un penacho Gaussiano a travs de un conjunto de 30 puntos de medida regularmente distribuidos revelan fluctuaciones temporales regulares de los momentos espaciales del penacho. Una distribución irregular de puntos de medida predijo a su vez fluctuaciones irregulares, más alejadas de la realidad, por lo que se recomienda el uso de esquemas de muestreo regulares. Los momentos espaciales fueron sensibles a la relación entre tamaño del penacho y distancia entre puntos de medida. Para reducir los errores en la predicción de la varianza, la distancia entre puntos de observación debe ser menor que dos veces la desviación estándar del penacho. El tamaño del área muestreada debe cubrir varias desviaciones estándar del penacho para evitar perder parte de la masa. Las simulaciones numricas en un penacho dispersivo, comparando los cálculos basados en 9000 nudos con las 30 medidas, mostraron que las posiciones de los centros de masa y las varianzas en dirección horizontal se predijeron bien independientemente del grado de heterogeneidad. Las varianzas verticales, sin embargo, fueron más susceptibles a errores de predicción, pero las estimaciones eran del mismo orden de magnitud que los valores reales.

Dealing with spatial heterogeneity

NASA Astrophysics Data System (ADS)

Marsily, Gh.; Delay, F.; Gonçalvès, J.; Renard, Ph.; Teles, V.; Violette, S.

2005-03-01

Heterogeneity can be dealt with by defining homogeneous equivalent properties, known as averaging, or by trying to describe the spatial variability of the rock properties from geologic observations and local measurements. The techniques available for these descriptions are mostly continuous Geostatistical models, or discontinuous facies models such as the Boolean, Indicator or Gaussian-Threshold models and the Markov chain model. These facies models are better suited to treating issues of rock strata connectivity, e.g. buried high permeability channels or low permeability barriers, which greatly affect flow and, above all, transport in aquifers. Genetic models provide new ways to incorporate more geology into the facies description, an approach that has been well developed in the oil industry, but not enough in hydrogeology. The conclusion is that future work should be focused on improving the facies models, comparing them, and designing new in situ testing procedures (including geophysics) that would help identify the facies geometry and properties. A world-wide catalog of aquifer facies geometry and properties, which could combine site genesis and description with methods used to assess the system, would be of great value for practical applications. On peut aborder le problème de l'hétérogénéité en s'efforçant de définir une perméabilité équivalente homogène, par prise de moyenne, ou au contraire en décrivant la variation dans l'espace des propriétés des roches à partir des observations géologiques et des mesures locales. Les techniques disponibles pour une telle description sont soit continues, comme l'approche Géostatistique, soit discontinues, comme les modèles de faciès, Booléens, ou bien par Indicatrices ou Gaussiennes Seuillées, ou enfin Markoviens. Ces modèles de faciès sont mieux capables de prendre en compte la connectivité des strates géologiques, telles que les chenaux enfouis à forte perméabilité, ou au contraire les faciès fins de barrières de perméabilité, qui ont une influence importante sur les écoulement, et, plus encore, sur le transport. Les modè les génétiques récemment apparus ont la capacité de mieux incorporer dans les modèles de faciès les observations géologiques, chose courante dans l'industrie pétrolière, mais insuffisamment développée en hydrogéologie. On conclut que les travaux de recherche ultérieurs devraient s'attacher à développer les modèles de faciès, à les comparer entre eux, et à mettre au point de nouvelles méthodes d'essais in situ, comprenant les méthodes géophysiques, capables de reconnaître la géométrie et les propriétés des faciès. La constitution d'un catalogue mondial de la géométrie et des propriétés des faciès aquifères, ainsi que des méthodes de reconnaissance utilisées pour arriver à la détermination de ces systèmes, serait d'une grande importance pratique pour les applications. La heterogeneidad se puede manejar por medio de la definición de características homogéneas equivalentes, conocidas como promediar o tratando de describir la variabilidad espacial de las características de las rocas a partir de observaciones geológicas y medidas locales. Las técnicas disponibles para estas descripciones son generalmente modelos geoestadísticos continuos o modelos de facies discontinuos como los modelos Boolean, de Indicador o de umbral de Gaussian y el modelo de cadena de Markow. Estos modelos de facies son mas adecuados para tratar la conectvidad de estratos geológicos (por ejemplo canales de alta permeabilidad enterrados o barreras de baja permeabilidad que tienen efectos importantes sobre el flujo y especialmente sobre el transporte en los acuíferos. Los modelos genéticos ofrecen nuevas formas de incorporar más geología en las descripciones de facies, un enfoque que está bien desarollado en la industria petrolera, pero insuficientemente en la hidrogeología. Se concluye que los trabajos futuros deberían estar más enfocados en mejorar los modelos de facies, en establecer comparaciones y en diseñar nuevos procedimientos para pruebas in-situ (incuyendo la geofísica) que pueden ayudar a identificar la geometría de las facies y sus propiedades. Un catálogo global de la geometría de las facies de los acuíferos y sus características, que podría combinar la génesis de los sitios y descripciones de los métodos utilizados para evaluar el sistema, sería de gran valor para las aplicaciones prácticas.

Prevalence and correlates of intimate partner violence among family planning clients in Conakry, Guinea.

PubMed

Delamou, Alexandre; Samandari, Ghazaleh; Camara, Bienvenu Salim; Traore, Pernamou; Diallo, Fatoumata Guilinty; Millimono, Sita; Wane, Defa; Toliver, Maimouna; Laffe, Kira; Verani, Fabio

2015-12-23

Intimate partner violence (IPV) is a global public health problem that affects women's physical, mental, sexual and reproductive health. Very little data on IPV experience and FP use is available in resource-poor settings, such as in West Africa. The aim of this study was to describe the prevalence, patterns and correlates of IPV among clients of an adult Family Planning clinic in Conakry, Guinea. The study data was collected for four months (March to June 2014) from women's family planning charts and from an IPV screening form at the Adult Family Planning and Reproductive Health Clinic of "Association Guinéenne pour le Bien-Etre Familial", a non-profit organization in Conakry, Guinea. 232 women out of 245 women who attended the clinic for services during the study period were screened for IPV and were included in this study. Of the 232 women screened, 213 (92%) experienced IPV in one form or another at some point in their lifetime. 169 women reported psychological violence (79.3%), 145 reported sexual violence (68.1%) and 103 reported physical violence (48.4%). Nearly a quarter of women reported joint occurrence of the three forms of violence(24%).Half of the IPV positive women were current users of family planning (51.2%) and of these, 77.9% preferred injectable contraceptives. The odds of experiencing IPV was higher in women with secondary or vocational level of education than those with higher level of education (AOR: 8.4; 95% CI 1.2-58.5). Women residing in other communes of Conakry (AOR: 5.6; 95% CI 1.4-22.9) and those preferring injectable FP methods (AOR: 4.5; 95% CI 1.2-16.8) were more likely to experience lifetime IPV. IPV is prevalent among family planning clients in Conakry, Guinea where nine out of ten women screened in the AGBEF adult clinic reported having experienced one or another type of IPV. A holistic approach that includes promotion of women's rights and gender equality, existence of laws and policies is needed to prevent and respond to IPV, effective implementation of policies and laws, and access to quality IPV services in Guinea and countries with higher rates of IPV.

Knowledge, attitude and practices: assessing maternal and child health care handbook intervention in Vietnam.

PubMed

Aiga, Hirotsugu; Nguyen, Vinh Duc; Nguyen, Cuong Dinh; Nguyen, Tho Thi Thi; Nguyen, Lien Thi Phuong

2016-02-09

Maternal and Child Health (MCH) Handbook, an integrated MCH home-based record, was piloted in four provinces of Vietnam (Dien Bien, Hoa Binh, Thanh Hoa and An Giang). The study is aimed at assessing the changes in pregnant women's behavior towards the frequencies of their antenatal care service utilizations and their subsequent breastfeeding practices up to six months of age, through the MCH Handbook intervention. This is because the levels of pregnant women's knowledge, attitude and practices (KAP) towards their antenatal care service utilizations and exclusive breastfeeding practices have been previously neither analyzed nor reported in relation to MCH home-based records in the country. To compare pre-intervention baseline in 2011, post-intervention data were collected in 2013. Structured interviews were conducted with randomly selected 810 mothers of children 6-18 months of age in the four provinces. A focus group discussion among mothers in each of four provinces was conducted. There was no significant difference in pregnant women's knowledge about the need for ≥3 antenatal care visits between pre- and post-interventions. Yet, the proportion of pregnant women who made ≥3 antenatal care visits in post-intervention was significantly higher than in pre-intervention. Thus, MCH Handbook is likely to have contributed to practicing ≥3 antenatal care visits, by changing their attitude. The proportion of mothers who know the need for exclusive breastfeeding necessary during the initial six months significantly increased between pre- and post-interventions. The proportion of those practicing exclusive breastfeeding significantly increased between pre- and post-interventions, too. Thus, MCH Handbook is likely to have contributed to the increase in both knowledge about and practices of exclusive breastfeeding. The results of study imply that MCH Handbook contributed to the increase in pregnant women's practices of ≥3 antenatal care visits and in their knowledge about and practice of exclusive breastfeeding. While there is room for improvement in the level of its data recording, the study confirmed that MCH Handbook plays a catalytic role in ensuring a continuum of maternal, newborn and child care. Note that this study is the first study that attempted to estimate pregnant women's behavioral changes through MCH Handbook intervention in Vietnam.